Hungarian Radiology

[Use of covered stents in the endovascular treatment of extracranial stenosis of the internal carotid artery]


MARCH 22, 2008

Hungarian Radiology - 2008;82(01-02)

[INTRODUCTION - Significant stenosis of the internal carotid artery is frequently treated with stent placement. With growing clinical experience and usage of finer instrumentation, the incidence of periprocedural complications have reduced in larger centers. Two-thirds of the complications are postprocedural, due to the embolisation through the stent structure. Covered stents seem to be a good option against such embolisation. Our study demonstrates the efficiency, safety and feasibility of covered stent grafts, and the long term outcome of patients who underwent endovascular treatment of extracranial internal carotid artery stenoses, caused by highly embologenic plaques. MATERIALS AND METHODS - Between 2002 and 2003, 30 patients (22 male, 8 female, aged 50-89yrs, mean: 66 yrs) with 30 internal carotid artery stenoses having ipsilateral symptoms and/or stenotic lesions caused by irregular or ulcerated soft plaques or restenosis were treated with self-expanding covered stents (Symbiot, Boston Scientific). Predilatation and protecting devices were not used. Postdilatation was applied in every patient. Mean followup was 60 months (range 57-66 months), by Doppler ultrasonography as well as clinical examination. RESULTS - The degree of stenosis was found to range from 70% to subtotal occlusion. The plaque surfaces were irregular or ulcerated in 70%. The stenotic lesions were up to 30 mm in length. The narrowing of the internal carotid artery never extended to the common carotid artery. The technical success rate of stenting was 100%. The stents could be positioned with an accuracy of 2-3 mm. Periprocedurally, there were no neurological complications or deaths. During follow-up no strokes or stroke-related deaths occurred. Restenosis was found in two patients (6,6%) who underwent successful balloon dilatation. CONCLUSION - Our experience indicates that the covered stent is an efficient periprocedural and postprocedural “protecting device” to prevent neurological complications due to embolizations caused by high-risk plaques in stenotic lesions of extracranial internal carotid artery.]



Further articles in this publication

Hungarian Radiology

[Gynecological malignancies: review of the radiological diagnostics and image-guided therapy - Onco Update 2008]


[The recent results of diagnostical imaging of gynecological tumours and the actual place of interventional radiological methods are discussed. Systematical reviews of articles published during the last year (2007) have been availed to discuss: cervical cancer, endometrial cancer, ovarian cancer, general and special imaging of the female pelvis, different uterine fibroid ablation methods (embolisation and high-intensity focused ultrasound [HIFU]). Experience of gynecological tumour imaging is growing rapidly, therefore, even the current examination algorithm is changing continuously. New diagnostic and therapeutic modalities are making their way into the daily routine. Some examinations become obsolete during the course of time and thus their further application should be avoided. In the meanwhile, some modalities prove their worth and become indespensable during the investigation of a given pathology.]

Hungarian Radiology

[Intracranial malignant tumour in a child resolving after radiotherapy]


Hungarian Radiology

[Nothing is the same]


Hungarian Radiology

[Sessions, 2007 year performance and 2008 year plans of the Hungarian College of Radiologists]

PALKÓ András

Hungarian Radiology

[Nobel prize scientists- Pioneers in imaging diagnostics]

KISS-TÓTH Emőke, KUN Gáborné, LOMBAY Béla

All articles in the issue

Related contents

Clinical Neuroscience

[One year follow-up after stroke. A preliminary feasibility study in Josephtown of Budapest]

SZŐCS Ildikó, SZATMÁRI Szabolcs, FEKETE Klára, ORBÁN-KIS Károly, VASTAGH Ildikó, FOLYOVICH András, AJTAY András, BERECZKI Dániel

[Stroke is a major public health issue in Hungary with considerable regional differences in mortality. We have limited information to explain such regional differences. To assess these differences, we would need comparative followup studies optimally carried out by personal contact with the patient or the carer. According to several epidemiological studies, follow-up can be carried out with significantly lower cost and similar efficiency by telephone contact or regular mail. In this pilot study we intend to assess: 1. the efficacy of telephone follow-up one year after stroke in this geographical region 2. whether the efficacy of follow-up can be further increased with questionnaires sent out by regular mail 3. whether telephone and mail-based assessment is sufficient to perform a larger population based study. We included 135 patients hospitalized consecutively for acute cerebrovascular disease (stroke or TIA) by the Department of Neurology, Semmelweis University in January and February of 2008. Based on residence, patients were divided into three groups: those living in the least wealthy district of Budapest (i.e. District-8); those living in other districts of the city; and those living in suburban areas. One year after the hospital treatment follow-up was possible by telephone in 76%. Further 12 patients could be contacted by questionnaire sent out by regular mail. Efficacy of follow-up was altogether 84%. Even in this small group of patients, we have found a tendency for more severe strokes (p=0.06) and higher acute case fatality (32% vs. 5%, p=0.029) in residents of District-8 of Budapest compared to those residing in more wealthy districts of the city and in suburban areas. Survival rate one year after stroke or TIA was only 39% in those living in District-8, 66% in those living in other districts and 75% in suburban dwellers (p=0.006). Telephone and mail-based questionnaires are insufficient for follow-up in these regions even when applied in combination. These preliminary data raise the possibility that the socio-economical conditions might influence stroke severity and outcome in the population. A larger study to address this issue would require more accurate definition of patient-groups and more efficient follow-up methods.]

Hungarian Immunology

[Undifferentiated connective tissue disease]


[Undifferentiated connective tissue disease (UCTD) is a term used by many authors to define a group a diffuse connective tissue disorders that lack definitive characteristics of any particular well-defined disorder. UCTD was diagnosed if the patients had at least two clinical symptoms and their sera contained one type of the anti nuclear antibody. Six hundred and sixty five patients with UCTD were followed between 1994 and 1999. The presence of the fever and anti-DNS antibodies correlated with SLE, arthritis/arthralgia and anti-RNP antibodies with MCTD, Raynaud phenomenon and ANA positivity with scleroderma, xerostomia/xerophtalmia and anti-SSA/SSB antibodies with Sjögren' syndromes, rheumatoid factor positivity and polyarthritis with rheumatoid arthritis. In conclusion, the UCTD represents a dynamic phase, one part of the patients show progression to definite connective tissue diseases, one part show regression, and on part of the patients stay in UCTD phase.]

Hungarian Radiology

[Surgical treatment of scoliosis: pre- and postoperative follow-up with whole-body EOS radiography]


[Currently, Cotrel-Dubousset spondylodesis is the treatment of choice in orthopaedics. It allows for correction of deformity in three-dimensions allowing for stable fixation. EOS (Extended Orthopedic System) is an ultra low dose X-ray imaging system, simultaneously acquiring images of the whole body in two planes. Examinations with the EOS system is not only indicated in cases related to orthopaedics but in multiple other conditions owing to its low level of emitted radiation with rapid and cost-effective imaging. The importance of EOS examination is emphasized in systemic skeletal disorders, thus allowing itt o be used in various other clinical fields.]

Lege Artis Medicinae



[INTRODUCTION - Rare asymptomatic pleuropulmonary neoplasms can represent serious differencial diagnostic difficulties both for clinicans and pathologists. Immunohistochemical tests are essential tools for the diagnosis of soliter fibrotic tumor of the pleura. These tests are also of diagnostic and prognostic importance. CASE REPORT - The report summarizes the case of an asymptomatic 63 years old man. The patient was admitted to hospital with a parahilar infiltrate of the right lung. Based on this chest X-ray abnormality pulmonary malignancy was suspected. The patient was referred to surgical intervention and the diagnosis of was based on post-surgical histology. These fibrotic tumors have typical immunohistochemical features. Although the histomorphology of the tumor suggested the presence of a benign tumor the p53 positivity and focal CD34 positivity indicated the possibility of malignant transformation as well. The patient is alive 17 months after surgery and there is no relapse of the disease. CONCLUSION - Although histologically benign, soliter fibrotic tumors of the pleura may occasionally transform into malignant variants. Therefore complete surgical resection and longterm clinical and close radiological follow-up is recommended for these patients. Clinician can plan well ahead the frequency and time of the follow-up with the help of the prognostic factors of hystology.]

Hungarian Immunology

[Importance of Raynaud’s phenomenon in the connective tissue diseases]

CZIRJÁK László, NAGY Zoltán

[In the presence of Raynaud’s phenomenon compression syndromes, vibration, disorders causing hyperviscosity or arterial lesion and drog induced vasospasm should be excluded. In the background of unilateral Raynaud’s phenomenon organic, morphological abnormalities are present. Raynaud's phenomenon may also be the first symptom of connective tissue diseases, therefore the follow up of these cases is required. In case of patients with primary Raynaud’s phenomenon, the probability of developing a connective tissue diseases is very low. In the presence of antinuclear antibody positivity and/or scleroderma capillary pattern by capillarmicroscopy, the follow up is important, because these cases may develop a connective tissue disease, which predominantly belong to the scleroderma family. Simultaneous presence of Raynaud’s phenomenon and inflammation also strongly indicates that a connective tissue disease may later develop.]