TY  - THES
A1  - Welsch, Stefan
T1  - Die Rolle des iFlow-Algortithmus im Rahmen der endovaskulären Therapie von symptomatischen Nierenarterienstenosen
T1  - The role of the iFlow-algorithm within the endovascular treatment of symptomatic renal artery stenosis
N2  - Das Ziel dieser Arbeit war herauszufinden, ob der iFlow-Algorithmus als zusätzlicher Parameter zu Evaluierung des technischen Erfolgs einer Revaskularisation einer Nierenarterienstenose eingesetzt werden kann. Hierfür haben wir die „mean time to peak“ in Sekunden in den farbcodierten Bildern gemessen, um den Effekt einer Stentimplantation auf den Blutfluss zu eruieren. Im Verlauf haben wir dann getestet, ob unsere Ergebnisse den klinischen Verlauf unserer Patienten wiederspiegeln, um feststellen zu können, ob die syngo iFlow-Software den Erfolg der endovaskulären Therapie voraussagen kann.
N2  - The goal of this Dissertation was to evaluate the application of the iFlow-Algorithm as a supplementary tool to predict the technical success of renal artery revascularization. To accomplish this, we measured the mean time to peak in color coded DSA images in seconds to evaluate the effect of the endovascular stent implantation on the arterial blood flow. We then tested, if our findings also represent the clinical progress of our patients to see if the syngo iFlow-Software can predict a successful endovascular treatment.
KW  - endovascular
KW  - Nierenarterie
KW  - renal artery
KW  - Bluthochdruck
KW  - high blood pressure
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-223324
ER  - 
TY  - JOUR
A1  - Augustin, Anne Marie
A1  - Welsch, Stefan
A1  - Bley, Thorsten Alexander
A1  - Lopau, Kai
A1  - Kickuth, Ralph
T1  - Color-coded summation images in the evaluation of renal artery stenosis before and after percutaneous transluminal angioplasty
JF  - BMC Medical Imaging
N2  - Background: Endovascular therapy is the gold standard in patients with hemodynamic relevant renal artery stenosis (RAS) resistant to medical therapy. The severity grading of the stenosis as well as the result assessment after endovascular approach is predominantly based on visible estimations of the anatomic appearance. We aim to investigate the application of color-coded DSA parameters to gain hemodynamic information during endovascular renal artery interventions and for the assessment of the procedures technical success. 
Methods: We retrospectively evaluated 32 patients who underwent endovascular renal artery revascularization and applied color-coded summation imaging on selected monochromatic DSA images. The differences in time to peak (dTTP) of contrast enhancement in predefined anatomical measuring points were analyzed. Furthermore, differences in systolic blood pressure values (SBP) and serum creatinine were obtained. The value of underlying diabetes mellitus as a predictor for clinical outcome was assessed. Correlation analysis between the patients gender as well as the presence of diabetes mellitus and dTTP was performed. 
Results: Endovascular revascularization resulted in statistically significant improvement in 4/7 regions of interest. Highly significant improvement of perfusion in terms of shortened TTP values could be found at the segmental artery level and in the intrastenotical segment (p<0.001), significant improvement prestenotical and in the apical renal parenchyma (p<0.05). In the other anatomic regions, differences revealed not to be significant. Differences between SBP and serum creatinine levels before and after the procedure were significant (p=0.004 and 0.0004). Patients ' gender as well as the presence of diabetes mellitus did not reveal to be predictors for the clinical success of the procedure. Furthermore, diabetes and gender did not show relevant correlation with dTTP in the parenchymal measuring points.
Conclusions: The supplementary use of color-coding DSA and the data gained from parametric images may provide helpful information in the evaluation of the procedures ' technical success. The segmental artery might be a particularly suitable vascular territory for analyzing differences in blood flow characteristics. Further studies with larger cohorts are needed to further confirm the diagnostic value of this technique.
KW  - digital subtraction angiography
KW  - color-coded
KW  - endovascular
KW  - renal artery
KW  - PTA
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259086
VL  - 21
IS  - 1
ER  -