Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures: results from VERTOS II

Background and purpose: Pv is increasingly used as treatment for osteoporotic vcfs. However, controversy exists as to whether pv increases the risk for new vcfs during follow-up. The purpose of our research was to assess the incidence of new vcfs in patients with acute vcfs randomized to pv and conservative therapy. Materials and methods: Vertos ii is a prospective multicenter randomized controlled trial comparing pv with conservative therapy in 202 patients. Incidence, distribution, and timing of new vcfs during follow-up were assessed from spine radiographs. In addition, further height loss during follow-up of treated vcfs was measured. Results: After a mean follow-up of 11.4 Months (Median, 12.0; Range, 1-24 months), 18 New vcfs occurred in 15 of 91 patients after pv and 30 new vcfs in 21 of 85 patients after conservative therapy. This difference was not significant (P = .44). There was no higher fracture risk for adjacent-versus-distant vertebrae. Mean time to new vcf was 16.2 Months after pv and 17.8 Months after conservative treatment (Logrank, p = .45). The baseline number of vcfs was the only risk factor for occurrence (Or, 1.43; 95% Ci, 1.05-1.95) And number (P = .01) Of new vcfs. After conservative therapy, further height loss of treated vertebrae occurred more frequently (35 Of 85 versus 11 of 91 patients, p < .001) And was more severe (P < .001) Than after pv. Conclusions: Incidence of new vcfs was not different after pv compared with conservative therapy after a mean of 11.4 Months' follow-up. The only risk factor for new vcfs was the number of vcfs at baseline. Pv contributed to preservation of stature by decreasing both the incidence and severity of further height loss in treated vertebrae

Twee veiligheidsmaten voor diagnostisch ultrageluid : de mechanische en de thermische index

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Prevalence and Clinical Consequences of Carotid Artery Residual Defects Following Endarterectomy: A Prospective CT Angiography Evaluation Study

AbstractObjectivesIt is still unclear whether residual defects seen after carotid endarterectomy (CEA) have clinical consequences. We investigated prevalence of residual defects in the carotid artery and their possible impact on clinical and Duplex ultrasound (DUS) follow-up.Materials and methodsSixty-five patients who had undergone CEA were prospectively examined with 1–3 month postoperative computed tomographic angiography (CTA), clinical and DUS follow-up. Defects in common (CCA), external (ECA) and internal carotid artery (ICA) were scored as clamp marks, intimal step or flap, mural thrombus, kink, microdehiscence suture or residual stenosis.ResultsFifty-eight patients (89.2%) had residual defects in CCA, ECA or ICA (143 defects). Intimal steps (n = 39) and residual stenosis (n = 17) were most noted defects. Only residual defects in ECA were significantly associated with significant higher PSV values both at short-term and long-term follow-up (1990 vs. 1400 mm s−1 at 1 year and 2000 vs. 1230 mm s−1 at 2 years, P-values 0.031 and 0.016).ConclusionCarotid artery residual defects on CTA after CEA are very common, simple fingerprints of the operative procedure, have no clear consequence. When CTA is performed clinically after CEA, knowledge of high prevalence and type of defects detected on CTA may be of importance for radiologists and clinicians