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Benjamin Claus

Publications and source records attributed to Benjamin Claus.

4 recordsLinked to original sources

Increased cell opening and prolapse of struts of a neuroform stent in curved vasculature: value of angiographic computed tomography: technical case report.

OBJECTIVE AND IMPORTANCE: To describe the use of a new imaging tool, angiographic computed tomography, for visualization of cell opening and strut prolapse of a Neuroform 2 stent (Boston Scientific/Target, Fremont, CA) placed in curved vasculature for treatment of a basilar tip aneurysm. CLINICAL PRESENTATION: A 46-year-old woman presented with an unruptured 8-mm basilar tip aneurysm with a wide patulous neck. INTERVENTION: A 4 x 20-mm Neuroform 2 stent was placed across the aneurysm neck. Angiographic computed tomographic scanning was performed using a flat detector biplane angiographic system with new commercially available software (Dyna-CT; Siemens Medical Solution, Forchheim, Germany) and the following parameters: 20-second acquisition, 0.4-degree increment, 512 matrix in projections, 220-degree total angle, 20 degree/s, and approximately 15 to 30 frames/s, for a total of 538 projections. Image postprocessing was performed to correct scattered radiation, beam hardening, and ring artifacts on a commercially available workstation (Leonardo, Siemens Medical Solutions, Erlangen, Germany). The aneurysm was coiled in a second session, using bare platinum coils without clinical sequelae. CONCLUSION: Increased opening of cells and prolapsing of struts of an open cell design stent can occur after placement in a curved vessel across an aneurysm orifice. Angiographic computed tomography is a new imaging tool that provides visualization of intracranial stents that is superior to digital subtraction angiogram or nonsubtracted images. It will enhance our understanding of stent behavior in clinical practice and improve the efficacy and safety of intracranial stent placement. Further in vitro and in vivo imaging studies of intracranial stents are necessary to assess the value of this promising new technique.

Angiography, Digital Subtraction↗

Operative technique and early hemodynamic results with the Freedom Solo valve.

BACKGROUND AND AIM OF THE STUDY: Stentless aortic valve prostheses usually require two separate suture lines. The Freedom Solo valve (Sorin Group, Saluggia, Italy), by using a minimized implantation technique, requires only a single running suture line of 4-0 polypropylene. Herein are reported the surgical experience and early hemodynamic results obtained with this new valve. METHODS: Following annular decalcification, the Freedom Solo prosthesis was implanted in the supraannular aortic position in the sinuses of Valsalva of 82 patients (52 females, 30 males; mean age 76.6 +/- 7.0 years). Echocardiography was performed to monitor gradients and regurgitation. RESULTS: The logistic EuroSCORE was 12.8 +/- 9.9. Isolated aortic valve replacement was performed in 48 patients; concomitant procedures included coronary artery bypass grafting, mitral procedures, subvalvular myectomy, and atrial ablation. The mean valve size implanted was 26.4 +/- 2.1 mm, and cross-clamp time was 39.0 +/- 7.0 min in primary isolated valve replacement. Non-valve-related 30-day mortality was 3.6%. At discharge, hemodynamic parameters were favorable, with low peak (16.2 +/- 8.0 mmHg) and mean (8.3 +/- 4.5 mmHg) gradients, and without paravalvular leakage and only minimal regurgitation (grade < I degrees) in 10 patients. CONCLUSION: Supraannular implantation of the Freedom Solo stentless valve is safe and reliable, using a single suture line. The valve provides excellent hemodynamics at hospital discharge, without paravalvular leakage. The reduced cross-clamp time represents an attractive surgical alternative in elderly patients.

Aged↗

Angiographic CT in cerebrovascular stenting.

We evaluated the feasibility of angiographic CT (ACT) for visualizing metallic stents in three patients who underwent intracranial (n = 2) or extracranial (n = 1) stent placement to treat atherosclerotic lesions. ACT is a new technique that provides cross-sectional CT-like images based on rotational radiography performed with a rotating C-arm-mounted flat-panel detector. ACT allowed for the clear visualization of stents in both intracranial and extracranial arteries and was superior to conventional digital subtraction angiography and digital radiography in visualizing both the stent struts and their relationships to the arterial walls and aneurysmal lumen.

Aged↗

Three-dimensional rotational myelography.

Three-dimensional (3D) rotational radiography, initially developed to visualize intracranial aneurysms, is applied to the cervical spine after conventional myelography. We call this process 3D rotational myelography. 3D reconstruction and then postprocessing allows imaging in multiple planes. Spinal or nerve root sheath alterations caused by bony or soft tissue can be visualized and differentiated by using this technique.

Brachial Plexus Neuritis↗