Quantification and Significance of Pulmonary Vascular Volume in Predicting Response to Ultrasound-Facilitated, Catheter-Directed Fibrinolysis in Acute Pulmonary Embolism (SEATTLE-3D)

Farbod N Rahaghi, Raúl San José Estépar, Samuel Z Goldhaber, Jasleen K Minhas, Pietro Nardelli, Gonzalo Vegas Sanchez-Ferrero, Isaac De La Bruere, Syed M Hassan, Stefanie Mason, Samuel Y Ash, Carolyn E Come, George R Washko, Gregory Piazza, Farbod N Rahaghi, Raúl San José Estépar, Samuel Z Goldhaber, Jasleen K Minhas, Pietro Nardelli, Gonzalo Vegas Sanchez-Ferrero, Isaac De La Bruere, Syed M Hassan, Stefanie Mason, Samuel Y Ash, Carolyn E Come, George R Washko, Gregory Piazza

No abstract available

Keywords: computed tomography angiography; fibrinolysis; pulmonary embolism; ventricular dysfunction, right.

Figures

Figure.. Sample Images and reconstructions prior to,…
Figure.. Sample Images and reconstructions prior to, and after treatment with Ultrasound-facilitated catheter directed fibrinolysis as well as the relationship between vascular reconstruction parameters with baseline and change in right ventricular size.
A, Three-dimensional heart surface model generated from the computed tomography (CT) scan is used to compute the right ventricular volume (VRV) and left ventricular volume (VLV) and the corresponding ratio (VRV/VLV), pre (A) and post (B) treatment with ultrasound-facilitated,catheter-directed fibrinolysis. Axial slices from pre and post-treatment show increased distal vessel visibility (C and D). CT vascular reconstruction before (E) and after treatment (F) show increased distal vasculature, labeled as arterial (blue) and venous (red) by an automated convolutional neural network trained on previously manually labeled data sets. Decreased distal venous vascular volume density at baseline is associated with increased VRV/VLV ratio at baseline (G) without similar finding on the arterial phase (H). The density of distal arterial volume adjusted by the venous volume is associated with increased baseline VRV/VLV ratio (I) and with VRV/VLV response to treatment (J).

References

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Source: PubMed

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