Rafael Rehwald's research while affiliated with University of Innsbruck and other places

Publications (26)

Article
Full-text available
Dual-energy computed tomography (DECT) allows distinguishing between tissues with similar X-ray attenuation but different atomic numbers. Recent studies demonstrated that this technique has several areas of application in patients with ischemic stroke and a potential impact on patient management. After endovascular stroke therapy (EST), hyperdense...
Preprint
Full-text available
Whilst grading neurovascular abnormalities is critical for prompt surgical repair, no statistical markers are currently available for predicting the risk of adverse events, such as stroke, and the overall resilience of a network to vascular complications. The lack of compact, fast, and scalable simulations with network perturbations impedes the ana...
Article
Full-text available
Background: A supernumerary kidney (SK) is an additional kidney with its own capsule and blood supply that is not fused with the ipsilateral kidney (IK). Because individual case reports indicate a high morbidity rate, the aim of this retrospective study was a detailed analysis of this rare anatomical variant. Methods: Our systematic imaging-base...
Chapter
Full-text available
Whilst grading neurovascular abnormalities is critical for prompt surgical repair, no statistical markers are currently available for predicting the risk of adverse events, such as stroke, and the overall resilience of a network to vascular complications. The lack of compact, fast, and scalable simulations with network perturbations impedes the ana...
Article
Full-text available
Whilst grading neurovascular abnormalities is critical for prompt surgical repair, no statistical markers are currently available for predicting the risk of adverse events, such as stroke, and the overall resilience of a network to vascular complications. The lack of compact, fast, and scalable simulations with network perturbations impedes the ana...
Article
Full-text available
Objective: The aim was to investigate whether dual-energy computed tomography (DECT) reconstructions optimised for oedema visualisation (oedema map; EM) facilitate an improved detection of early infarctions after endovascular stroke therapy (EST). Methods: Forty-six patients (21 women; 25 men; mean age: 63 years; range 24-89 years) were included...
Article
Full-text available
Background Angioembolization is the method of choice for treating haemorrhage after blunt pelvic trauma. The aim of this study was to determine technical factors related to endovascular procedures which might be related to patient outcome. Methods This retrospective study included 112 consecutive patients (40 women and 72 men; mean age 57.2 ± 20.0...
Article
Study design: A retrospective cohort study. Objective: The aim of the study was to assess the impact of time to surgery in patients with MDs on their functional outcome. The current single-center study presents results of emergency surgery for LDH in a group of patients with acute paresis in a "real-world" setting. Summary of backround data: M...
Article
Full-text available
Objective: Systemic air embolism (AE) is a rare but feared complication of transthoracic biopsy with potentially fatal consequences. The aim of the study was to assess the effect of patient positioning during transthoracic biopsy on preventing systemic AE. Materials and methods: We compared a historical control group of 610 patients (group 1) wh...
Article
Full-text available
The air embolism in this case was likely to have been caused by positioning the patient in a prone position, which was associated with the lesion to be biopsied being at a maximum height over the left atrium. Due to the resulting negative pressure, air entered through a fistula that formed between the airspace and the pulmonary vein. The air could...
Article
Background: Aneurysms of the distal anterior cerebral artery (DACA) are rare, representing between 1% and 9% of all intracranial aneurysms. The best treatment strategy for these aneurysms continues to be debated. Objective: We conducted a systematic review of the literature to evaluate the safety and efficacy of treatment strategies of DACA aneu...
Article
Background: The aim of the present study was to determine the prevalence of hepatic artery stenosis (HAS) and the prognostic implications of hepatic arterial collaterals in liver transplant (LT) recipients with biliary strictures. Methods: 105 LT recipients transplanted between 2004 and 2015 at our center had documented biliary strictures. HAS a...
Article
Full-text available
The authors report a case of left ventricular perforation and cardiac tamponade in a patient undergoing endovascular aortic and mesenteric stent grafting. During the procedure, the anesthetist noticed a sudden increase in central venous pressure and a decrease in blood pressure. Cardiac tamponade was suspected and confirmed by transesophageal echoc...
Article
Introduction In the last 25 years neuromodulation by deep brain stimulation gained widely acceptance starting in the field of movement disorders and getting further indications in pain syndroms and mood disorders. Surgical interventions should only be considered being a treatment option after proving ineffectiveness of conservative therapy forms. T...
Article
Full-text available
Objectives After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. MethodsDECT scans of 20 patients showing 45 BBB disrupt...
Article
The aim was to identify the factors influencing intracranial vessel density (VD). The Hounsfield units of the dense vessel and the contralateral side was measured in 34 patients with arterial clots, 20 with venous clots, and 196 without clots and correlated with skull thickness, density and dimensions, gender, age, red blood cell count (RBC), hemog...
Article
Full-text available
Objective Experimental coarctation of the aorta prevents the development of downstream atherosclerosis. The aim of this study was to find out whether or not atherosclerotic stenoses protect distal vascular territories from developing atherosclerosis in humans. Design and setting A total of 2125 vascular segments from angiographies of 101 patients w...
Article
Full-text available
Background: Spondylosis leads to an overestimation of bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA) but not with quantitative computed tomography (QCT). The correlation between degenerative changes of the spine and QCT-BMD was therefore investigated for the first time. Methods: One hundred thirty-four patients (66 female an...
Article
Full-text available
Background Spondylosis leads to an overestimation of bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA) but not with quantitative computed tomography (QCT). The correlation between degenerative changes of the spine and QCT-BMD was therefore investigated for the first time. Methods One hundred thirty-four patients (66 female and...
Article
Full-text available
Objective The aim of this study was to describe the renal arteries of humans in vivo, as precisely as possible, and to formulate an expected value for the exclusion of renal denervation due to the anatomical situation based on the criteria of the Symplicity HTN trials. Design and setting In a retrospective cohort study, the renal arteries of 126 pa...
Article
Full-text available
Dual-energy CT features the opportunity to differentiate among up to 3 different materials because the absorption of x-rays depends on the applied tube voltage and the atomic number of the material. For example, it is possible to distinguish between blood-brain barrier disruption and an intracerebral hemorrhage following treatment for a stroke. The...

Citations

... Recently, dual-energy imaging methods have become increasingly popular in research and clinical practice because of their capability to discriminate between tissues of similar X-ray attenuation but different atomic numbers (15)(16)(17)(18)(19). Dual-energy CT technology is based upon the light-matter interaction and different absorption characteristics of specific substances. ...
... Our validations show that techniques accepting pre-mapped vascular structures, when compared to those dealing with raw inputs, can provide enhanced anatomical models. Raw-input-based techniques are still advantageous in avoiding extra pre-processing steps associated with vascular delineation, and can be applied to some types of studies, e.g., that focus on investigating topology-based biomarkers [23], [48], [49]. Among all validated methods, the proposed work superiorly approaches the anticipated vascular models that hold comprehensive anatomical details. ...
... Supernumerary kidneys are rare congenital renal anomalies, most of which are detected incidentally and are associated with other congenital anomalies and complications like urinary stasis, hydronephrosis, calculus and pyonephrosis [1]. A few cases were also associated with renal cancers in the native as well as supernumerary kidneys [2]. ...
... Note that in (d), on DECTA-VNC there is early ischemia-related low attenuation in the gray matter of the superior left temporal lobe that is not seen on the NCCT, but is visible as infarcted brain days later parenchymal attenuation resulting from increased water content, related to both ionic (extracellular) edema as well as intracellular edema [24]. This principle has recently been used to create "brain edema maps" [21,22,25] in the acute stroke setting. Since CTA uses different scan parameters than NCCT (CTA optimized for vasculature, NCCT optimized for gray matter (GM) and white matter (WM)), CTA imaging suffers from inherent lack of gray-white matter contrast and therefore may be inferior in early brain edema/infarct detection. ...
... ICU-free days to day 28 and hospital-free days to day 90 did not differ significantly between the TAE and non-TAE groups [24 [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] days vs. 23 [14][15][16][17][18][19][20][21][22][23][24][25][26][27] days; p = 0.473 and 59 (22-67) days vs. 55 (30-70) days; p = 0.990, respectively; Table 2]. ...
... Our results are consistent with other published literature reporting on prognostic indicators such as preoperative duration and grade of weakness on the outcome [1,10,13,21,24,25,27,29,49]. Macki et al. 2016 [13], reviewed 71 patients undergoing lumbar decompression for foot drop and reported an improvement of 73.2% in muscle weakness post-operatively whilst demonstrating preoperative muscle strength and palsy duration as significant prognostic factors. ...
... [2] Outside air can invade into the cardiovascular system via the pulmonary vein; therefore, the biopsy needle entering the intrapulmonary vessels can be a risk for this complication. [3] Well-known risk factors for this complication are coughing during the procedure, positive pressure ventilation, cystic or cavitary lesion, ground-glass nodules, and the coexistence of vasculitis, prone position, and usage of a thick needle. [2] Even a small air embolism could be fatal, if the air induces coronary ischemia and arrhythmia. ...
... 4,8 Therefore, a stenosis at a proximal arterial position will precipitate ischemia of the bile duct epithelium and can lead to biliary stricture (BS) formation, graft dysfunction, bilomas, and bile leaks. 4,9,10 Duplex ultrasound (US) findings can be suggestive of HAS; however, a definitive map of the arterial tree requires computed tomography (CT) or digital subtraction angiography (DSA) which identify the stenosis location and severity. 10 Several hypotheses exist regarding the cause of HAS. ...
... Regarding the treatment of distal ACA aneurysm, endovascular treatment was once reported to be difficult due to distal lesion, many bending points in which catheter control was difficult, relatively small aneurysm, and small diameter of parent artery [6][7][8]. However, recently, due to improvements in devices and techniques, the success rate of endovascular treatment has increased, and there are some reports that good results have been obtained [9][10][11][12]. A systematic review of endovascular treatment for distal anterior cerebral aneurysms, including ruptured cases, by Sturiale et al. reported a complete or near-complete embolization rate of 86% and a treatment failure rate of 8% [11]. ...
... Many studies have focused on the correlation between osteoporosis and vertebral disc degeneration. [27][28][29][30][31] Surprisingly, opposing results have been reported by different studies. Salo et al and Wang et al reported that lower lumbar spine BMD was associated with less severe disc degeneration. ...