View clinical trials related to Stenoses.
Filter by:This is a prospective, observational study designed to evaluate the role of dynamic computed tomographic perfusion (CTP) and Computed Tomography-Derived Fractional Flow Reserve (CT-FFR) in patients presenting with chest discomfort.Patients with lesions greater than 50% and who meet all other inclusion/exclusion criteria will qualify to be a subject in the CTP study /CT-FFR 49. Those who agree to participate will be scheduled to have the CT-FFR and CTP performed within sixty days of the initial Coronary CTA procedure. A CTA will be performed at rest for FFR. The patient will then take approximately a 30 min break. Regadenoson will then be administered and the dynamic CT procedure will be done for perfusion. If patients are deemed to be appropriate for invasive angiography by the referring physician, coronary lesions between 40% and 80% will get a fractional flow measurement performed if indicated on a clinical basis. Stenosis in vessels less than 1.5 mm will be excluded from the study. The CT-FFR and CTP will be performed in these patients within 60 days of index coronary angiography.
Evaluation of current and newly developed endoluminal therapies in the management of Upper and Lower GI conditions.
The identification of abnormal narrowing of a blood vessel from non-invasive coronary angiography remains an exciting goal. While Computed Tomography (CT) has established a clear role in patients it retains some limitations. Primarily, alterations in blood flow leading to a restriction in blood supply to tissues cannot be accurately predicted from the anatomical assessment of an abnormal narrowing in a blood vessel - a limitation of both invasive, and computed tomographic, angiography. This is important, as there is now a raft of evidence demonstrating that revascularisation should only be considered in the presence of a restriction in blood supply to tissues. The gold standard method of identifying a restriction in blood supply to tissues is measurement of the fractional flow reserve (FFR), a dimensionless value generated as a ratio between the circulatory pressure before and after a narrowing of a blood vessel. At present, patients with indeterminately significant abnormal narrowing in a blood vessel identified using CT must go on to have a further test for a restriction in blood supply to tissues, prior to any decision about revascularisation being made. As part of our governance commitment to maintaining our reporting standards, we undertake ongoing audit of our cardiac CT practice. The investigators recently identified a group of patients who have undergone FFR measurement as part of routine clinical care, and compared these to our clinical reports, to ensure that appropriate recommendations were being made. It appeared that the ability to predict important abnormal narrowing in a blood vessel was reasonable (~70%) and hence we propose the formulation of a research question to explore this further. The primary objective of this study is to determine the accuracy of a visual assessment of the likely significance on blood flow of a narrowing of a blood vessel identified on cardiac CT, in comparison to invasive, fractional flow reserve. The secondary objective is to evaluate features of an abnormal narrowing in a blood vessel that is likely to have a significant impact on blood flow. The investigators' working hypothesis is that cardiac CT FFR is a useful predictor of abnormal narrowing in a blood vessel.
This study compared the FLAIR™ Endovascular Stent Graft to balloon angioplasty in patients with stenoses at the venous anastomosis of a synthetic AV access graft.