Georg Mühlenbruch

University Hospital RWTH Aachen, Aachen, North Rhine-Westphalia, Germany

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Publications (145)381.32 Total impact

  • 10/2015; DOI:10.1259/bjrcr.20150278
  • Casper Mihl · Madeleine Kok · Joachim E Wildberger · Jakub Turek · Georg Muehlenbruch · Marco Das ·
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    ABSTRACT: The aims of this study were to test high-flow application of contrast media (CM) using novel high-flow needles and to assess injection- and flow-related parameters in a circulation phantom and in an in vivo population. A circulation phantom simulating physiological parameters was used. Preheated CM (300 mg/mL) was injected at flow rates varying between 5 and 15 mL/s through a novel 18-gauge high-flow intravenous injection needle. In addition, feasibility of these high-flow needles was tested with administration of flow rates of 9 mL/s in 20 patients referred for pre-transcatheter aortic valve implantation assessment. Injection parameters (eg, peak pressures, peak flow rates) in both phantom and in vivo setup were continuously monitored by a data acquisition program. Attenuation at predefined levels of the aorta (eg, aortic root to common femoral arteries) was measured in all patients to determine clinical applicability. In the phantom setup, injection rates up to 15 mL/s were feasible. An enhancement plateau was reached at 11 mL/s (464 [20] HU). In patients, no pressure- or flow-related complications (eg, extravasation) were recorded (mean [SD] peak pressure, 154 [8] psi; mean [SD] peak flow rate, 9.2 [0.1 mL/s; range, 9.1-9.6]). Diagnostic attenuation values were reached at all predefined levels of the aorta (330.8 [113.1] HU to 622.9 [81.5] HU). These results indicate that injections with 9 mL/s using high-flow injection needles are safe. The pressure limit of 325 psi was not reached, and the injections resulted in diagnostic attenuation values. Using this dedicated needle, high flow rates should not be considered a drawback for CM application in routine CT angiography examinations.
    Investigative radiology 03/2015; 50(7). DOI:10.1097/RLI.0000000000000153 · 4.44 Impact Factor
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    ABSTRACT: C-peptide has pro-atherogenic effects in animal models, and elevated C-peptide levels are associated with cardiovascular and all-cause mortality in patients undergoing coronary angiography. This cross-sectional study investigated the association between C-peptide serum levels and coronary artery calcification (CAC) in patients with rheumatoid arthritis (RA), a high-risk group for cardiovascular events. Fifty-four patients with RA were recruited from an arthritis outpatient department at the University Hospital in Aachen, Germany. CAC was measured by multi-slice CT scan, and blood samples were drawn from all patients for the analysis of C-peptide and other cardiovascular biomarkers. Mean serum levels of C-peptide (1.187 ± 0.771 vs 0.745 ± 0.481 nmol/L, p = 0.02), YKL-40, LDL cholesterol, and triglycerides were significantly higher in patients with CAC (n = 32, 59 %) compared to those without CAC (n = 22, 41 %). Univariate analysis revealed a significant association of C-peptide [OR 4.7, 95 % CI (1.1, 20.2)], YKL-40, triglycerides, hypertension, smoking, age, and male sex with the presence of CAC. After adjustment for body mass index, cholesterol, diabetes, adiponectin, calcium, and phosphate, C-peptide was still significantly associated with CAC in a multivariate logistic regression model. In conclusion, C-peptide serum levels are independently associated with the presence of CAC in patients with RA. These data suggest a potential role of C-peptide in cardiovascular disease in patients with RA.
    Rheumatology International 03/2015; 35(9). DOI:10.1007/s00296-015-3244-y · 1.52 Impact Factor
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    ABSTRACT: Iodinated contrast media (CM) in computed tomographic angiography is characterized by its concentration and, consecutively, by its viscosity. Viscosity itself is directly influenced by temperature, which will furthermore affect injection pressure. Therefore, the purposes of this study were to systematically evaluate the viscosity of different CM at different temperatures and to assess their impact on injection pressure in a circulation phantom. Initially, viscosity of different contrast media concentrations (240, 300, 370, and 400 mgI/mL) was measured at different temperatures (20°C-40°C) with a commercially available viscosimeter. In the next step, a circulation phantom with physical conditions was used. Contrast media were prepared at different temperatures (20°C, 30°C, 37°C) and injected through a standard 18-gauge needle. All other relevant parameters were kept constant (iodine delivery rate, 1.9 g I/s; total amount of iodine, 15 g I). Peak flow rate (in milliliter per second) and injection pressure (psi) were monitored. Differences in significance were tested using the Kruskal-Wallis test (Statistical Package for the Social Sciences). Viscosities for iodinated CM of 240, 300, 370, and 400 mg I/mL at 20°C were 5.1, 9.1, 21.2, and 28.8 mPa.s, respectively, whereas, at 40°C, these were substantially lower (2.8, 4.4, 8.7, and 11.2 mPa.s). In the circulation phantom, mean (SD) peak pressures for CM of 240 mg I/mL at 20°C, 30°C, and 37°C were 107 (1.5), 95 (0.6), and 92 (2.1) psi; for CM of 300 mg I/mL, 119 (1.5), 104 (0.6), and 100 (3.6) psi; for CM of 370 mg I/mL, 150 (0.6), 133 (4.4), and 120 (3.5) psi; and for CM of 400 mg I/mL, 169 (1.0), 140 (2.1), and 135 (2.9) psi, respectively, with all P values less than 0.05. Low concentration, low viscosity, and high temperatures of CM are beneficial in terms of injection pressure. This should also be considered for individually tailored contrast protocols in daily routine scanning.
    Investigative radiology 01/2014; 49(4). DOI:10.1097/RLI.0000000000000019 · 4.44 Impact Factor
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    ABSTRACT: Sclerostin is a Wnt pathway antagonist regulating osteoblast activity and bone turnover. Here, we assessed the potential association of sclerostin with the development of coronary artery (CAC) and aortic valve calcifications (AVC) in haemodialysis (HD) patients. We conducted a cross-sectional multi-slice computed tomography (MS-CT) scanning study in 67 chronic HD patients (59.4 +/- 14.8 yrs) for measurement of CAC and AVC. We tested established biomarkers as well as serum sclerostin (ELISA) regarding their association to the presence of calcification. Fifty-four adults without relevant renal disease served as controls for serum sclerostin levels. Additionally, sclerostin expression in explanted aortic valves from 15 dialysis patients was analysed ex vivo by immunohistochemistry and mRNA quantification (Qt-RT-PCR). CAC (Agatston score > 100) and any AVC were present in 65% and in 40% of the MS-CT patient group, respectively. Serum sclerostin levels (1.53 +/- 0.81 vs 0.76 +/- 0.31 ng/mL, p < 0.001) were significantly elevated in HD compared to controls and more so in HD patients with AVC versus those without AVC (1.78 +/- 0.84 vs 1.35 +/- 0.73 ng/mL, p = 0.02). Multivariable regression analysis for AVC revealed significant associations with higher serum sclerostin. Ex vivo analysis of uraemic calcified aortic valves (n = 10) revealed a strong sclerostin expression very close to calcified regions (no sclerostin staining in non-calcified valves). Correspondingly, we observed a highly significant upregulation of sclerostin mRNA in calcified valves compared to non-calcified control valves. We found a strong association of sclerostin with calcifying aortic heart valve disease in haemodialysis patients. Sclerostin is locally produced in aortic valve tissue adjacent to areas of calcification.
    BMC Nephrology 10/2013; 14(1):219. DOI:10.1186/1471-2369-14-219 · 1.69 Impact Factor
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    ABSTRACT: Both iodine delivery rate (IDR) and iodine concentration are decisive factors for vascular enhancement in computed tomographic angiography. It is unclear, however, whether the use of high-iodine concentration contrast media is beneficial to lower iodine concentrations when IDR is kept identical. This study evaluates the effect of using different iodine concentrations on intravascular attenuation in a circulation phantom while maintaining a constant IDR. A circulation phantom with a low-pressure venous compartment and a high-pressure arterial compartment simulating physiological circulation parameters was used (heart rate, 60 beats per minute; stroke volume, 60 mL; blood pressure, 120/80 mm Hg). Maintaining a constant IDR (2.0 g/s) and a constant total iodine load (20 g), prewarmed (37°C) contrast media with differing iodine concentrations (240-400 mg/mL) were injected into the phantom using a double-headed power injector. Serial computed tomographic scans at the level of the ascending aorta (AA), the descending aorta (DA), and the left main coronary artery (LM) were obtained. Total amount of contrast volume (milliliters), iodine delivery (grams of iodine), peak flow rate (milliliter per second), and intravascular pressure (pounds per square inch) were monitored using a dedicated data acquisition program. Attenuation values in the AA, the DA, and the LM were constantly measured (Hounsfield unit [HU]). In addition, time-enhancement curves, aortic peak enhancement, and time to peak were determined. All contrast injection protocols resulted in similar attenuation values: the AA (516 [11] to 531 [37] HU), the DA (514 [17] to 531 [32] HU), and the LM (490 [10] to 507 [17] HU). No significant differences were found between the AA, the DA, and the LM for either peak enhancement (all P > 0.05) or mean time to peak (AA, 19.4 [0.58] to 20.1 [1.05] seconds; DA, 21.1 [1.0] to 21.4 [1.15] seconds; LM, 19.8 [0.58] to 20.1 [1.05] seconds). This phantom study demonstrates that constant injection parameters (IDR, overall iodine load) lead to robust enhancement patterns, regardless of the contrast material used. Higher iodine concentration itself does not lead to higher attenuation levels. These results may stimulate a shift in paradigm toward clinical usage of contrast media with lower iodine concentrations (eg, 240 mg iodine/mL) in individual tailored contrast protocols. The use of low-iodine concentration contrast media is desirable because of the lower viscosity and the resulting lower injection pressure.
    Investigative radiology 07/2013; 48(11). DOI:10.1097/RLI.0b013e31829979e8 · 4.44 Impact Factor
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    ABSTRACT: Objectives: To investigate simultaneous dual-isotope SPECT/CT with two differently radioisotope-labelled albumin-microsphere fractions for treatment planning of hepatic radioembolisation. Methods: In addition to 99mTechnetium-labelled albumin microspheres (commercially available), we performed labelling with 111Indium. Binding stability of 111Indium-labelled microspheres was tested in vitro and in vivo in mice. Simultaneous dual-isotope SPECT/CT imaging was validated in an anthropomorphic torso phantom; subsequently, dual-isotope SPECT/CT was performed under in-vivo conditions in pigs (n = 3) that underwent transarterial injection of 99mTechnetium- and 111Indium-labelled microspheres in the liver (right and left hepatic artery, respectively), in both kidneys and in the gluteal musculature. In total, n = 18 transarterial injections were performed. Results: In-vitro testing and in-vivo studies in mice documented high binding stability for both 99mTechnetium-labelled and 111Indium-labelled microsphere fractions. In phantom studies, simultaneous dual-isotope SPECT/CT enabled reliable separation of both isotopes. In pigs, the identified deposition of both isotopes could be accurately matched with intended injection targets (100 %, 18/18 intended injection sites). Furthermore, an incidental deposition of 99mTechnetium-labelled microspheres in the stomach could be correlated to the test injection into a right hepatic artery. Conclusion: Simultaneous dual-isotope SPECT/CT after transarterial injection with 99mTechnetium- and 111Indium- labelled microspheres is feasible. Thus, it may offer additional, valuable information compared to single 99mTechnetium-labelled albumin examinations.
    European Radiology 06/2013; 23(11). DOI:10.1007/s00330-013-2916-9 · 4.01 Impact Factor
  • S Prinz · M Dafotakis · R K Schneider · G Mühlenbruch · B E Stopschinski ·
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    ABSTRACT: We report on the case of a 63-year-old patient with a meningoencephalitis, presenting itself with headache and a general neuropsychological retardation. Additionally, a reddening and swelling of both auricles could be seen. Magnetic resonance imaging showed confluent, contrast-uptaking lesions. In the cerebrospinal fluid an aseptic lymphocytic pleocytosis was found. A biopsy of the ear revealed a chronic lymphoplasmacellular inflammatory reaction. We diagnosed a relapsing polychrondritis, an inflammatory disease of the cartilage, which can in rare cases affect the central nervous system. Typically, the patients complain about red swollen ears, the "red puffy ear sign". After initiation of steroid and azathioprin therapy the patient recovered fully.
    Fortschritte der Neurologie · Psychiatrie 07/2012; 80(8):463-7. DOI:10.1055/s-0031-1299439 · 0.63 Impact Factor
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    ABSTRACT: Purpose: Ruptured cerebral arterial aneurysms require prompt treatment by either surgical clipping or endovascular coiling. Training for these sophisticated endovascular procedures is essential and ideally performed in animals before their use in humans. Simulators and established animal models have shown drawbacks with respect to degree of reality, size of the animal model and aneurysm, or time and effort needed for aneurysm creation. We therefore aimed to establish a realistic and readily available aneurysm model. Materials and methods: Five anticoagulated domestic pigs underwent endovascular intervention through right femoral access. A total of 12 broad-neck aneurysms were created in the carotid, subclavian, and renal arteries using the Amplatzer vascular plug. Results: With dedicated vessel selection, cubic, tubular, and side-branch aneurysms could be created. Three of the 12 implanted occluders, two of them implanted over a side branch of the main vessel, did not induce complete vessel occlusion. However, all aneurysms remained free of intraluminal thrombus formation and were available for embolization training during a surveillance period of 6 h. Two aneurysms underwent successful exemplary treatment: one was stent-assisted, and one was performed with conventional endovascular coil embolization. Conclusion: The new porcine aneurysm model proved to be a straightforward approach that offers a wide range of training and scientific applications that might help further improve endovascular coil embolization therapy in patients with cerebral aneurysms.
    CardioVascular and Interventional Radiology 06/2012; 36(1). DOI:10.1007/s00270-012-0431-z · 2.07 Impact Factor
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    ABSTRACT: To implement a retrospective intrinsic landmark-based (ILB) gating protocol for contrast-enhanced ultrasound (CEUS) and to compare its efficiency to non-gated, manually gated and extrinsically gated CEUS. CEUS of the liver was performed in healthy mice (n = 5) and in NEMO knockout mice with dysplastic livers (n = 5). In healthy animals, first-pass kinetics of non-specific microbubbles was recorded. Knockout mice were analysed regarding retention of VEGFR2-specific microbubbles. For retrospective gating, a landmark which showed respiratory movement was encircled as a region of interest (ROI). During inspiration, the signal intensity within the ROI altered, which served as gating signal. To evaluate the accuracy, non-gated, extrinsically gated and ILB-gated time-intensity curves were created. For each curve, descriptive parameters were calculated and compared to the gold standard (manual frame-by-frame gating). No significant differences in the variation of ILB- and extrinsically gated time-intensity curves from the gold standard were observed. Non-gated data showed significantly higher variations. Also the variation of molecular ultrasound data was significantly lower for ILB-gated compared to non-gated data. ILB gating is a robust and easy method to improve data accuracy in functional and molecular ultrasound liver imaging. This technique can presumably be translated to contrast-enhanced ultrasound examinations in humans. • Quantitative analysis of the uptake of contrast agents during ultrasound is complex. • Intrinsic landmark-based gating (ILB) offers a simple implementable method for motion correction. • Results using ILB-gating are comparable to extrinsic gating using external biomonitoring devices. • Functional and molecular imaging of mobile organs will benefit from ILB gating.
    European Radiology 03/2012; 22(8):1789-96. DOI:10.1007/s00330-012-2429-y · 4.01 Impact Factor
  • S Leykamm · B Wessling · G Mühlenbruch ·

    12/2011; 23(1). DOI:10.1007/s00062-011-0067-4
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    ABSTRACT: To develop and evaluate a user-friendly tool to enable efficient, accurate, and reproducible quantification of blood vessel stenosis in computed tomographic (CT) and magnetic resonance (MR) angiographic data sets. All clinical experiments were approved by the institutional review board, and informed patient consent was acquired. Animal experiments were approved by the governmental review committee on animal care. A virtual elastic sphere passes through a blood vessel specified by user-provided start and end points, and the adapting diameter over the course of the vessel is recorded. The program was tested in phantoms to determine the accuracy of diameter estimation, and it was applied in micro-CT data sets of mice with induced vessel stenosis. Dual-energy CT angiography and MR angiography were performed in 16 patients with carotid artery stenosis, and reproducibility and required reader time of this automated technique were compared with manual measurements. Additionally, the effect of dual-energy CT-based discrimination between iodine- and calcium-based enhancement was investigated. Differences between carotid artery diameters of mice and between automated and manual measurement durations were assessed with a paired t test. Reproducibility of stenosis scores was evaluated with the Fisher z test. Phantom diameters were determined with an average error of 0.094 mm. Diameters of normal and injured carotid arteries of mice were significantly different (P < .01). For patient data, automated interreader variability was significantly (P < .01) lower than manual intra- and interreader variability, while time efficiency was improved (P < .01). The virtual elastic sphere tool is applicable to CT, dual-energy CT, and MR angiography, and it improves reproducibility and efficiency over that achieved with manual stenosis measurements.
    Radiology 09/2011; 260(3):709-17. DOI:10.1148/radiol.11110069 · 6.87 Impact Factor
  • M Dafotakis · J Schiefer · M Wiesmann · G Mühlenbruch ·
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    ABSTRACT: The wrist drop, also called carpoptosis or drop hand, is a common clinical presentation in case of peripheral damage to the radial nerve. But what about the picture of a bilateral finger/wrist drop?! We report the case of a 61-year-old female patient who was admitted to the hospital for myocardial infarction. Subsequently she developed a right dominant bilateral wrist drop. Further neurological examination revealed a positive Wartenberg sign pointing towards a central motoric dysfunction. The following native cerebral CT scan demonstrated bilateral hypodense lesions in both hand knobs in the precentral gyri. Subsequent MRI confirmed acute cerebral infarction in these two but also several other, clinically silent, locations. Further diagnostic work-up revealed a hypokinetic cardiac apex suggesting cardiac embolism to be the cause for cerebral thrombembolism and the clinically leading symptom of right-dominant bilateral finger/wrist drop. Besides the case presentation also the differential diagnosis and clinical test for diagnostic work-up of wrist drops are presented and discussed.
    Fortschritte der Neurologie · Psychiatrie 05/2011; 79(5):304-6. DOI:10.1055/s-0031-1273331 · 0.63 Impact Factor
  • M Palmowski · G Mühlenbruch · C Grouls · R W Günther ·
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    ABSTRACT: In Conn's syndrome, adrenal vein sampling (AVS) is used to secure the site of hormonal overproduction. The left adrenal vein is usually easy to explore, the right is difficult. Examination requires several differently configured catheters. Here, we introduce a new technique for AVS using a single cobra catheter, which was tested in n = 13 patients. In an inverted configuration, the cobra catheter can be used to explore the left side, while the regular configuration can be used for the right side. The technical details are described in the manuscript. In all patients, left AVS could be performed successfully using the inverted catheter configuration. In n = 11 patients, right AVS was carried out successfully with a cobra catheter in regular configuration. In two cases, a Sidewinder-I catheter was required due to a steep angle of the adrenal vein.
    RöFo - Fortschritte auf dem Gebiet der R 02/2011; 183(2):167-70. · 1.40 Impact Factor
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    M Schaaf · G Mommertz · A Ludolph · S Geibprasert · G Mühlenbruch · M Das · T Krings ·
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    ABSTRACT: Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics. Nineteen consecutive patients with symptomatic (n = 13) and asymptomatic (n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA. Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of <80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, -0.01 ± 0.39; P = .429; >70 years: MSC, 0.29 ± 0.48; P ≤ .0001). BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.
    American Journal of Neuroradiology 11/2010; 31(10):1791-8. DOI:10.3174/ajnr.A2219 · 3.59 Impact Factor
  • Georg Mühlenbruch · Timo Krings ·

    European Radiology 04/2010; 20(9). DOI:10.1007/s00330-010-1789-4 · 4.01 Impact Factor
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    ABSTRACT: Cardiac resynchronization therapy (CRT) provides a therapeutic option for patients with congestive heart failure (CHF). There is evidence that the optimal pacing site (OIS) is vicinal to the region of the latest contraction (RLC). However, the RLC is not identified routinely to guide lead implantation to the coronary venous system (CVS). The aim of this study was: (i) to develop a software over-imposing CVS-anatomy on parametric images of left ventricular dyssynchrony in a 3D-format obtained from computed tomography (CT) and cardiac magnetic resonance imaging (MRI); and (ii) to apply this 3D-software for analysing the possible correlation between functional/ clinical improvement and the distance between final implantation site (FIS) and RLC. In 20 CHF-patients (11 men, 65.6 +/- 6.8 y, ejection fraction (EF): 27.5 +/- 6.1%) CRT-leads were implanted; follow-up included echocardiographic and exercise evaluation. The OIS and the FIS were noted on 3D-registrations and the distances OIS-RLC and FIS-RLC measured.The target vessel was reached in 14 cases. NYHA class and EF improved significantly with a low rate of non-responders of 3 (15%) (EF) and 4 (20%) (NYHA). Image registration was possible in all patients. Post-process 3D-analysis revealed no correlation between the distance FIS-RLC and functional or echocardiographic improvements.There was a trend towards a shorter distance FIS-RLC in patients classified as responders (EF). NYHA class improved significantly better in patients with target vessel implantation. Registration of CT/MRI-images enables efforts to reach the RLC by preoperative identification of corresponding veins. Larger randomized trials must define the definite therapeutic benefit.
    Acta cardiologica 04/2010; 65(2):161-70. DOI:10.2143/AC.65.2.2047049 · 0.65 Impact Factor
  • M. Palmowski · G. Mühlenbruch · C. Grouls · R. Günther ·

    RöFo - Fortschritte auf dem Gebiet der R 02/2010; 182(08). DOI:10.1055/s-0029-1245588 · 1.40 Impact Factor
  • AH Mahnken · RT Hoffmann · G Mühlenbruch · K Brehmer · G Dohmen · RW Günther · R Koos ·

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    ABSTRACT: Der mit Symptomen verbundene Kollaps des wahren thorakalen Lumens durch einen komprimierenden thrombosierten Falschkanal ist Der mit Symptomen verbundene Kollaps des wahren thorakalen Lumens durch einen komprimierenden thrombosierten Falschkanal ist eine seltene Morphologie der Typ-B-Dissektion. Der Kollaps kann mit einer vital bedrohenden Organmalperfusion oder peripheren eine seltene Morphologie der Typ-B-Dissektion. Der Kollaps kann mit einer vital bedrohenden Organmalperfusion oder peripheren Extremitätenischämie assoziiert sein. Wir berichten über eine erfolgreiche endovaskuläre Behandlung eines „true lumen collapse“ Extremitätenischämie assoziiert sein. Wir berichten über eine erfolgreiche endovaskuläre Behandlung eines „true lumen collapse“ bei einer 65-jährigen Patientin, die mit akuter Paraparese beider Beine und einem akuten Nierenversagen 5Wochen nach dem bei einer 65-jährigen Patientin, die mit akuter Paraparese beider Beine und einem akuten Nierenversagen 5Wochen nach dem Initialereignis zur Aufnahme kam. Der Kollaps des wahren Lumens wurde durch eine extensive Thrombosierung des Falschkanals Initialereignis zur Aufnahme kam. Der Kollaps des wahren Lumens wurde durch eine extensive Thrombosierung des Falschkanals bei fehlendem „reentry“ verursacht. bei fehlendem „reentry“ verursacht. A symptomatic true lumen collapse within the descending aorta due to extensive false lumen thrombosis is a rare morphology A symptomatic true lumen collapse within the descending aorta due to extensive false lumen thrombosis is a rare morphology in type B dissection. Because of organ malperfusion, it represents a life-threatening situation. Here we present successful in type B dissection. Because of organ malperfusion, it represents a life-threatening situation. Here we present successful management of a symptomatic true lumen collapse in a 65-year-old patient. She suffered from sudden paraparesis in both legs management of a symptomatic true lumen collapse in a 65-year-old patient. She suffered from sudden paraparesis in both legs combined with acute renal failure 5 weeks after acute type B dissection and underwent thoracic stent grafting in an emergency combined with acute renal failure 5 weeks after acute type B dissection and underwent thoracic stent grafting in an emergency setting. The true lumen collapse was caused by extensive thrombosis of the false lumen in combination with the absence of setting. The true lumen collapse was caused by extensive thrombosis of the false lumen in combination with the absence of a distal reentry point. a distal reentry point. SchlüsselwörterTyp-B-Aortendissektion-Kollaps wahres Lumen-Organmalperfusion-Akutes Nierenversagen-Thorakaler Stentgraft SchlüsselwörterTyp-B-Aortendissektion-Kollaps wahres Lumen-Organmalperfusion-Akutes Nierenversagen-Thorakaler Stentgraft KeywordsType B dissection-True lumen collapse-Organ malperfusion-Renal failure-TEVAR KeywordsType B dissection-True lumen collapse-Organ malperfusion-Renal failure-TEVAR
    Gefässchirurgie 01/2010; 15(1):38-42. DOI:10.1007/s00772-009-0700-6 · 0.24 Impact Factor

Publication Stats

2k Citations
381.32 Total Impact Points


  • 2006-2014
    • University Hospital RWTH Aachen
      • Department of Neurology
      Aachen, North Rhine-Westphalia, Germany
    • University of Tuebingen
      Tübingen, Baden-Württemberg, Germany
  • 2004-2013
    • RWTH Aachen University
      • • Department of Nuclear Medicine
      • • Department of Diagnostic and Interventional Radiology
      • • Department of Neurology
      Aachen, North Rhine-Westphalia, Germany