Florian Wolf

• Associate Professor of Radiology
• Managing Director at Medical University of Vienna, Department of Biomedical Imaging and Image-Guided Therapy

Background/Objectives: This study aimed to investigate surgical resections of vascular malformations and haemangiomas of the upper extremity, pre- and postoperative symptoms, complications and recurrences. Methods: A total of 82 patients with vascular malformations and haemangiomas treated by surgical resection from 2010 to 2020 were included in th...

Purpose To describe the outcomes of a survey on the provision of interventional radiology procedures for the treatment of acute pulmonary embolism (PE) in Europe and beyond. Methods An online survey with 14 structured items was designed by the authors and was sent to 7116 CIRSE members via email. The anonymous online survey collected data for eigh...

Purpose To assess the current use of drug-eluting devices for peripheral arterial disease (PAD) among interventional radiologists following the controversy caused by the 2018 meta-analysis suggesting an increased mortality risk for paclitaxel-eluting devices. Methods An anonymous survey was sent to 7035 CIRSE members via email; only complete respo...

Objective This retrospective study evaluates the performance of UK National Institute for Health and Care Excellence (NICE) Guidelines on management of ruptured abdominal aortic aneurysms in a “real world setting” by emulating a hypothetical target trial with data from two European Aortic Centers. Methods Clinical data was retrospectively collecte...

Background: Monitoring of abdominal aortic aneurysms (AAAs) is currently based on serial measurements of maximum aortic diameter. Additional assessment of aneurysm volume has previously been proposed to possibly improve growth prediction and treatment decisions. To evaluate the use of supplementing volume measurements, the authors aimed to charact...

Objective: To assess the early experience with modified version of simplified bare-wire target vessel (SMART) technique, implying delivery of bridging stent graft (BSG) without historically established sheath support, and to compare its outcome to standard endovascular aortic repair procedures with fenestrated/branched devices (F/B-EVAR). Methods...

Purpose To determine the diagnostic accuracy of preinterventional imaging modalities in patients being evaluated for iliocaval venous recanalization and stent placement. Methods Consecutive patients with iliocaval postthrombotic obstructions or nonthrombotic iliac vein lesions (NIVL), who were scheduled for recanalization, underwent duplex ultraso...

Purpose The purpose of this study was to report the closure of iliac arteriovenous fistulas associated with a post-thrombotic iliac vein occlusion by iliac venous stent recanalization. Case Report An 80-year-old woman presented with a worsening painful swelling of her left leg after an iliofemoral deep vein thrombosis 6 months ago. Duplex ultrasou...

Background: The influence of diabetes mellitus (DM) on recurrent in-stent restenosis (ISR) of femoropopliteal arteries remains understudied. We investigated whether DM has an impact on recurrent restenosis after femoropopliteal stenting in patients included in the dRug-coatEd balloon angioPlasty for femoropopliteAl In-stent Restenosis (REPAIR) coop...

Background Patients with cirrhosis often develop portal hypertension-associated splenomegaly and hypersplenism, potentially causing severe cytopenia. AIMS Systematic assessment on the impact of transjugular intrahepatic portosystemic shunt (TIPS) implantation on platelet count (PLT), hemoglobin (Hb), and white blood cell count (WBC). Methods Pati...

Background: Reconstruction of the aorto-iliac segment with femoral vein (FV) as substitute for infected synthetic grafts or mycotic aneurysms constitutes the most sustainably convenient alternative. The aim of this study was to evaluate the long-term outcome of up to 16 years of follow-up, analysing the morphologic adaption of the FV with special...

Transcatheter aortic valve replacement (TAVR) has established itself as a safe and efficient treatment option in patients with severe aortic valve stenosis, regardless of the underlying surgical risk. Widespread adoption of transfemoral procedures led to more patients than ever being eligible for TAVR. This increase in procedural volumes has also s...

Background The most relevant determinant in scheduling monitoring intervals for abdominal aortic aneurysms (AAAs) is maximum diameter. The aim of the study was to develop a statistical model that takes into account specific characteristics of AAA growth distributions such as between-patient variability as well as within-patient variability across t...

Purpose To test a stent-graft specifically designed for the ascending aorta in phantom, cadaver, and clinical application, and to measure deployment accuracy to overcome limitations of existing devices. Methods A stent-graft has been designed with support wires to fixate the apices toward the inner curvature, thereby eliminating the forward moveme...

Introduction: A steerable, guidewireless microcatheter is of interest to interventional radiologists because it can improve effectiveness and reduce procedure timing and cost. Aim: To assess the feasibility and safety of yttrium 90 radioembolization with a new steerable microcatheter without the need to use a guidewire. Material and methods: A...

The original version of this article, published on 05 September 2019, unfortunately contained a mistake. The image of "Jena Valve" in Table 3 was incorrect.

Transcatheter aortic valve replacement (TAVR) is a minimally invasive alternative to conventional aortic valve replacement in symptomatic patients with severe aortic stenosis and contraindications to surgery. The procedure has shown to improve patient’s quality of life and prolong short- and mid-term survival in high-risk individuals, becoming a wi...

Objectives To evaluate the influence of baseline parameters on the occurrence of stent-graft surface movement after endovascular aneurysm repair (EVAR) and to investigate its association with migration and stent-graft-related endoleaks (srEL). Methods In this retrospective, cross-sectional study, three-dimensional surface models of the stent-graft...

Objective This study retrospectively assessed in-hospital mortality and long-term results of emergency thoracic endovascular aortic repair (TEVAR) for patients with life-threatening acute complicated type B aortic dissection (acTBD). Methods Between March 2001 and December 2016, there were 55 patients (40 male; median age, 52 ± 13 years) with an a...

Upon publication of this article (Kok et al., 2018), the authors noticed that author ‘Miguel Casares Santiago’ was spelt incorrectly. This has been corrected by means of this correction article.

Background: The optimal revascularization therapy for in-stent restenosis (ISR) of femoropopliteal arteries represents a matter of debate. We investigated the outcomes of patients treated with drug-coated balloon (DCB) angioplasty for ISR of femoropopliteal arteries. Methods and results: Patient-level data from 3 randomized trials of DCB angiopl...

Objective DISRUPT PAD II was designed to evaluate the safety and performance of intravascular lithotripsy (IVL), a novel approach using pulsatile sonic pressure waves, to modify intimal and medial calcium in stenotic peripheral arteries. Background Vascular calcification restricts vessel expansion, increases the risk of vascular complications, and...

Background The purpose of this survey was to determine the current trends in endovascular practice by Interventional Radiologists (IR’s) across Europe and to understand the engagement by Interventional Radiology (IR) with clinical practice. CIRSE European members were invited to participate in an online survey between July 11th, 2016 and August 8th...

Introduction: Multi-slice computed tomography (MSCT) is an accurate tool for the assessment of left ventricular ejection fraction (LVEF). However, in order to reduce radiation dose, prospective acquisition protocols are currently used, in which the end-systole and end-diastole are not scanned. Our aim was to study the accuracy of the assessment of...

According to the technical and scientific progress in the field of endovascular recanalization of iliocaval and iliofemoral venous obstructions this position paper was created by the AustrianUnion of Vascular Medicine and by the "Task Force Postthrombotic Syndrome Austria". The position paper comprises current scientific knowledge and expert opinio...

Despite the progress in endovascular treatment of patients with peripheral arterial disease, restenosis remains the major drawback, especially in patients with femoropopliteal lesions. To reduce neointimal proliferation and subsequent restenosis the use of antiproliferative drug eluting devices was implemented in the endovascular treatment of femor...

Background Manifest postthrombotic syndrome as well as major residual thrombosis after catheter-directed thrombolysis (CDT) are potential indications for iliac venous stenting. Dedicated venous stents provide satisfying patency rates and freedom of recurrent thrombosis. The present case emphasizes the value of dedicated venous stents in comparison...

The objective of the study was to evaluate the accuracy of cardiac computed tomography angiography (CTA) for the diagnosis of prosthetic valve dysfunction (PVD) compared with surgery. Patients after heart valve repair who were referred for clinically indicated CTA (coronary artery or bypass graft

Objectives: The hypothesis that paclitaxel-eluting balloon angioplasty provides higher 1-year patency rates in femoropopliteal artery in-stent restenosis compared with standard percutaneous transluminal angioplasty (PTA) was tested. Background: Several trials have demonstrated that paclitaxel-eluting balloon angioplasty reduces late luminal loss...

Objectives: To compare electrocardiographic (ECG)-triggered high-pitch (HP) dual-source computed tomography angiography (CTA) with non- ECG-triggered HP CTA of the aorta, particularly the ascending aorta, with regard to image quality, motion artifacts, contrast-to-noise-ratio (CNR), signal-to-noise-ratio (SNR), and radiation dose. Methods: Fifty...

Objectives: This is the first-in-human study of a drug-eluting bioresorbable vascular scaffold (BVS) for treatment of peripheral artery disease (PAD) involving the external iliac artery (EIA) and superficial femoral artery (SFA). Background: Drug-eluting BVS has shown promise in coronary arteries. Methods: The ESPRIT BVS system is a device-dru...

Objective To identify the most accurate quantitative coronary stenosis parameter by CTA for prediction of functional significant coronary stenosis resulting in coronary revascularization. Methods160 consecutive patients were prospectively examined with CTA. Proximal coronary stenosis was quantified by minimal lumen area (MLA) and minimal lumen diam...

Background and purpose: Based on a tight network of stroke units (SUs) and interventional centres, endovascular treatment of acute major intracranial vessel occlusion has been widely implemented in Austria. Documentation of all patients in the nationwide SU registry has thereby become mandatory. Methods: Demographic, clinical and interventional...

The Hedgehog pathway is an important regulator of early tissue patterning and stem cell propagation. It was found to be aberrantly activated in numerous types of human cancer and might be relevant in cancer stem cells. The identification of adult stem cells in the pituitary raised the question if tumor-initiating cells and Hedgehog signaling are in...

To prospectively evaluate image quality (IQ) and radiation dose of dual-source cardiac computed tomography (CCTA) using different imaging protocols. CCTA was performed in 150 patients using the retrospective ECG-gated spiral technique (rECG) the prospective ECG-gated technique (pECG), or the prospective ECG-gated technique with systolic imaging and...

To quantify the detectability of peripheral artery stenosis on hybrid CT angiography (CTA) reformations. Hybrid reformations were developed by combining multipath curved planar reformations (mpCPR) and maximum intensity projections (MIP). Fifty peripheral CTAs were evaluated twice: either with MIP, mpCPR and axial images or with hybrid reformations...

The hypothesis that covered stents are superior to bare-metal stents (BMS) in long femoropopliteal artery disease was tested. The one-year results of the VIASTAR trial revealed a patency benefit of covered stents in the treatment-per-protocol (TPP) analysis only. A prospective, randomized, single-blind, multicenter study evaluated 141 patients with...

Aim: The aim of this paper was to report our preliminary experience in outcome, safety and mid-term results in the treatment of thoracoabdominal aortic aneurysms (TAAA) with a novel multibranchstentgraft (E-xtra DESIGN ENGINEERING, JOTEC, Germany). Methods: Eight patients (mean age 66 years, 2 female) with TAAA (Crawford type I: 2 cases, type II...

Objective To prospectively evaluate image quality and radiation dose using a low-dose computed tomography angiography protocol and iterative image reconstruction for high-pitch dual-source CT-angiography (DSCTA) of the supraaortic arteries. Material and Methods DSCTA was performed in 42 patients, using either 120 kVp tube voltage, 120 mAS tube cur...

The aim was to investigate the image quality of dual-energy computed-tomography (DECT) compared to single-energy images at 80kV and 140kV in oral tumors. Forty patients underwent a contrast-enhanced DECT scan on a definition flash-CT. Four reconstructions (80kV, 140kV, mixed (M), and optimum-contrast (OC)) were assessed by four blinded readers for...

To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m(2)] were investiga...

PURPOSE Cardiac allograft vasculopathy represents a major cause of mortality in the later course of cardiac transplant. CCTA represents a valuable non-invasive imaging tool in the diagnosis of cardiac allograft vasculopathy with the disadvantage of radiation burden. Radiation dose reduction in CCTA of cardiac transplant is challenging as patients o...

The hypothesis that endovascular treatment with covered stents has equal risks but higher efficacy than BMS in long femoro-popliteal artery disease was tested. While endovascular treatment of short SFA lesions revealed excellent results, efficacy in long lesions remains unsatisfactory. In a prospective, randomized, single-blind, multicenter study 1...

During the last years the indications of Cardiac Magnetic Resonance Imaging (CMRI) have been continuously expanded. However, the acceptance of the method by cardiologists and radiologists does not correlate with respect to the diagnostic potential. Several factors, such as expensive equipment, relatively long examination times, high technical know...

Objective: To compare tumour-to-liver contrast (TLC) of C-arm CT during hepatic arteriography (CACTHA) acquired using three protocols in patients with HCC. Methods: This prospective study was IRB approved and informed consent was obtained from each patient. Twenty-nine patients (mean age, 68 ± 7 years; 27 men) with 55 HCCs (mean diameter, 2.6 ±...

To evaluate the reliability of attenuation values in virtual non-contrast images (VNC) reconstructed from contrast-enhanced, dual-energy scans performed on a second-generation dual-energy CT scanner, compared to single-energy, non-contrast images (TNC). Sixteen phantoms containing a mixture of contrast agent and water at different attenuations (0-1...

The purpose of our study was to compare high-resolution gadofosveset-enhanced MR angiography (MRA) with the reference standard CT angiography (CTA) in planning endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms. Thirty consecutive patients were included in this prospective study. CTA was performed routinely before EVAR for stent-graf...

Radiofrequency ablation of atrial fibrillation (AF) creates left atrial (LA) tissue damage with a subsequent healing process. We sought to prospectively assess the time course of biomarkers of tissue repair after ablation and to evaluate their association with clinical variables. 30 consecutive patients (57.9 ± 1.7 yrs, 63% males) with paroxysmal A...

To assess radiation dose and diagnostic image quality of a low-dose (80 kV) versus a standard-dose (120 kV) protocol for computed tomography angiography (CTA) of the supra-aortic arteries. 64-slice CTA of the supra-aortic arteries was performed in 42 consecutive patients using randomly either 80 or 120 kV at 300 absolute mAs. Intravascular attenuat...

Primary hyperaldosteronism due to aldosterone secreting adrenal adenomas is an important and potentially curable cause for hypertension. The differentiation between unilateral or bilateral adrenal adenomas is crucial, as unilateral adenomas can easily be cured by surgery whereas bilateral adenomas have to be treated conservatively. Exact diagnosis...

Objectives To evaluate the accuracy of high-pitch delayed enhancement (DE) CT for the assessment of myocardial viability with MRI as the reference standard. Methods Twenty-four patients (mean age 66.9 ± 9.2 years) with coronary artery disease underwent DE imaging with 128-slice dual-source CT (prospective electrocardiography (ECG)-triggering) and...

The aim of this study was to assess whether visualisation of in-stent changes can be improved with high-resolution, steady-state, blood pool contrast-enhanced MR angiography compared with first-pass MR angiography. Intra-arterial digital subtraction angiography (DSA) served as the reference standard. Twenty patients after stent placement in the sup...

Evaluate quantification of the aortic regurgitant fraction and volume with computed tomography (CT). Fifty-three patients with aortic regurgitation (AR) and 29 controls were examined with 64-multi-detector CT coronary angiography and transthoracic echocardiography (TTE). A dedicated software algorithm employing three-dimensional segmentation of lef...

Imaging morphology and function of the right heart is of paramount importance in patients with adult congenital heart disease, since right ventricular dysfunction is associated with adverse cardiac events. Cardiac MRI has been shown to be a powerful tool for the non-invasive precise assessment of right ventricular and valvular dysfunction. Differen...

PURPOSE The purpose of the present study was to assess the accuracy of the detection of peripheral in-stent lesions by means of Multidetector Computed Tomography (MDCT) angiography in comparison to intraarterial Digital Subtraction Angiography (ia-DSA) METHOD AND MATERIALS 31 consecutive patients (11 female, 20 male) with a mean age of 66 years (r...

To evaluate coronary stents in vitro using 128-slice-dual-source computed tomography (CT). Twelve different coronary stents placed in a non-moving cardiac/chest phantom were examined by 128-slice dual-source CT using three CT protocols [high-pitch spiral (HPS), sequential (SEQ) and conventional spiral (SPIR)]. Artificial in-stent lumen narrowing (A...

The purpose of this study was to compare a manual and automated 3D volume segmentation tool for evaluation of left atrial (LA) function by 64-slice multidetector-CT (MDCT). In 33 patients with paroxysmal atrial fibrillation a MDCT scan was performed before radiofrequency-catheter ablation. Atrial function (minimal volume (LAmin), maximal volume (LA...

The purpose of this study was to evaluate and compare the perceptibility of 75% and 95% in-stent stenoses with CT angiography and MR angiography using six stent types in a phantom model. Six different stent types were placed into tubes filled with contrast agent (ioversol or gadoteric acid), and nylon cylinders (8 mm diameter) bored in the central...

Infectious myocarditis is a life-threatening condition because it can lead to arrhythmia, dilated cardiomyopathy and congestive heart failure. A large number of different infectious causes have been identified as leading to myocarditis, with enteroviral infections being the most common reasons. We present a rare Austrian case of bacterial-induced m...

Helical prospective ECG-gating (pECG) may reduce radiation dose while maintaining the advantages of helical image acquisition for coronary computed tomography angiography (CCTA). Aim of this study was to evaluate helical pECG-gating in CCTA in regards to radiation dose and image quality. 86 patients undergoing 64-multislice CCTA were enrolled. pECG...

The purpose of this study was to compare 64-MDCT scanners from four vendors in the in vitro evaluation of coronary artery stents. Twelve coronary artery stents (nominal outer diameter, 2.5-5.0 mm) oriented in the z-axis were placed in a combined cardiac-chest phantom and imaged with 64-MDCT scanners from four vendors. Quantitative image quality par...

Popliteal vascular entrapment syndrome is caused by aberrations or hypertrophy of the gastrocnemius muscles, which compress the neurovascular structures of the popliteal fossa, leading to symptoms of vascular and degeneration as well as aneurysm formation. Imaging of popliteal vascular entrapment may be performed with ultrasound, magnetic resonance...

Purpose To evaluate the role of 4 different reformation techniques and axial images from multidetector computed tomographic angiography (MDCTA) versus selective carotid arteriography (SCA) in patients with internal carotid artery (ICA) stenosis. Methods Imaging studies from 50 patients (43 men; mean age 70.3±8.0 years, range 51– 85) with known cer...

The purpose of this study was to assess the diagnostic value of PET/CT as a one step examination in patients with colorectal cancer. Therefore we proved whether diagnostic PET/CT adds information over PET or contrast-enhanced CT alone for staging or restaging of patients with colorectal cancer. Seventy-three patients (46 males and 27 females; age r...

The aim of this study was to assess the value of multislice computed tomography (CT) for the assessment of valvular abnormalities in patients with infective endocarditis (IE) in comparison with transesophageal echocardiography (TEE) and intraoperative findings. Multislice CT has recently shown promising data regarding valvular imaging in a 4-dimens...

Only few information exist about the diagnostic accuracy of PET/CT for restaging patients with metastatic recurrence of breast carcinoma. Therefore, our study hypothesis was to perform diagnostic contrast enhanced CT (ce-CT) and FDG-PET in a one-step investigation, to prove sensitivity of each modality and to determine whether diagnostic PET/CT add...

Identification of plasma markers indicative for atrial fibrillation-associated silent brain lesions. 1. Comparative determination of the plasma concentrations of secretagogin, S100B, neuropeptide Y, brain fatty acid binding protein, matrix metalloprotease 9, brain natriuretic peptide, and of D-Dimer in 222 patients with atrial fibrillation and 28 c...

To prove the sensitivity of dual-time-point imaging with 18F-flourodeoxyglucose-positron emission tomography (18F-FDG-PET) of the liver to evaluate possible changes in the tumor-to-background ratio considering an improved detection rate of liver lesions. Image acquisition for the first whole-body scan started at a mean time point of 69 min (55-110...

This paper reports our experience with endovascular techniques for the retrieval of lost or misplaced intravascular objects. Over 12 years, 78 patients were referred for interventional retrieval of intravascular foreign objects. In this retrospective study, radiological procedure records and patients' medical records were reviewed to determine the...

To compare iomeprol 400 and iodixanol 320 in pulmonary artery MDCTA in subjects with suspected pulmonary embolism. Eighty randomized subjects received equi-iodine intravenous doses (48 g) of iomeprol 400 (n=40) or iodixanol 320 (n=40), via power injector at 4 mL/s. Four-row (35 subjects) and 64-row (45 subjects) scanners were used. Lumen attenuatio...

To report about the endovascular treatment of isolated iliac artery aneurysms (IIAA) with stentgraft placement and transluminal or CT-guided embolization of the internal iliac artery or the combination of these methods. Over a period of 5.6 years, 36 interventions were performed in 20 patients with 23 IIAAs. In a retrospective analysis patient reco...

Post-transplant follow-up of heart transplant patients consists of repeated coronary angiography, which is associated with high costs, discomfort and risk. We sought to determine whether multislice computed tomography (MSCT) permits the exclusion or progression of coronary artery disease in heart transplant patients. MSCT scanning (Philips CT MX 80...

Surgical ablation procedures are an established surgical procedure for restoration of sinus rhythm and reestablishment of atrial function in patients with chronic atrial fibrillation. The purpose of this study was to evaluate the feasibility and reproducibility of steady-state free precession magnetic resonance imaging (SSFP MRI) for examination of...

To compare the performance of 64-slice with 16-slice CT scanners for the in vitro evaluation of coronary artery stents. Twelve different coronary artery stents were placed in the drillings of a combined heart and chest phantom, which was scanned with a 16- and 64-slice CT scanner. Coronal reformations were evaluated for artificial lumen narrowing,...

PURPOSE To use 16 row multidetector spiral-CT (MDSCT) in the preoperative evaluation of patients undergoing totally endoscopic coronary artery bypass grafting (TECAB) and to show postoperative results. METHOD AND MATERIALS 12 patients underwent MDSCT pre- and post-operatively (Siemens MDSCT, 16x0,75mm collimation, SD 1,0mm, 2,8mm feed/rotation, ro...