Projects & Collaborations 7 foundShow per page10 10 20 50 Clinical Use of Contrast- Enhanced Ultrasound (CEUS) for the Assessment of Vessel Wall Vascularization (Vasa Vasorum) and Inflammation in Carotid Atherosclerosis and Venous Thrombosis Research Project | 1 Project MembersBackground: Injection of ultrasound contrast agents, in conjunction with contrast specific imaging techniques, is increasingly accepted in clinical use for diagnostic ultrasound imaging. As microbubbles contrast agents appear to be ideal pure intravascular tracers to enhance the vascular lumen and more important to assess the dynamic spatial and temporal heterogeneity of the microvasculature, contrast enhanced ultrasound (CEUS) provides a unique opportunity for new application especially in vascular imaging. CEUS of the carotid artery has been introduced as a non-invasive technique to improve detection of carotid atherosclerosis and evaluate the presence of plaque vascularity (vasa vasorum). As the proliferation of intraplaque and adventitial vasa vasorum (neovascularization) are inherently linked with the atherosclerotic plaque development, plaque inflammation and vulnerability, direct visualization of intraplaque neovascularization by CEUS has emerged as a new marker for plaque instability. Furthermore, CEUS provides not only direct in-vivo visualization of the vessel wall vascularization. Late phase CEUS has shown to detect plaque inflammation by visualizing untargeted microbubbles phagozytosed by monocytes. The inflammatory process of the vessel wall is not only involved in the atherosclerotic plaque development but also in the inflammatory process at the time of venous thrombosis and may promote destruction of venous valves, valvular reflux and subsequent development of post-thrombotic syndrome. Aim: It is the aim of this project to perform prospective studies with clinical questions and test the hypothesis that the use of CEUS to detect vessel wall vascularization and inflammation can improve the management of patients with atherosclerotic and thrombotic diseases. Methods: The study project 1 will prospectively evaluate the value of carotid atherosclerosis severity and plaque morphology including intraplaque neovascularization on standard carotid ultrasound and CEUS in 400 high risk patients with suspected coronary artery disease referred for radionuclide myocardial perfusion imaging to predict future vascular events. We hypothesize that patients with instable coronary artery disease and patients with future vascular events during a follow-up of 5 years have more pronounced intraplaque neovascularization on CEUS imaging at baseline. The study project 2 will prospectively evaluate the predictive value of carotid lesion morphology and severity including intraplaque neovascularization on standard carotid ultrasound and CEUS in 240 patients with asymptomatic more than 50% carotid stenosis. We hypothesize that neovascularization within the carotid lesion at baseline will significantly be more pronounced in patients with progressive carotid stenosis determined by repeated yearly carotid ultrasound studies over 5 years and in patients suffering future cerebrovascular and coronary events during follow-up. In patient scheduled for carotid endarterectomy we will investigate the feasibility of ex vivo assessment of vascular inflammation in carotid endarterectomy specimens using targeted microbubbles for molecular ultrasound imaging. In the study project 3, we will test the value of CEUS to detect venous perivascular vascularization and inflammation in 30 patients with acute deep vein thrombosis and 10 patients with superficial vein thrombosis. We hypothesize that venous perivascular vascularization and inflammation assessed by contrast agent enhancement will be significantly more pronounced in the perivascular tissue of the thrombotic popliteal vein than in the non affected contralateral popliteal vein and in 40 control volunteers, and will correlate with level of inflammatory markers, leg volume and the development of the post-thrombotic syndrome. We hypothesize that vascularization and inflammation on CEUS will decrease during the process of thrombus resolution from baseline to 6 months follow-up. Significance: In sum, the results of our study projects would support the concept that intraplaque neovascularization is associated with plaque instability and vulnerability and the use of CEUS imaging may provide an additional non-invasive adjunctive "window" to risk stratify individuals and carotid atherosclerotic lesions, particularly asymptomatic more than 50% stenosis. Furthermore, the results would not only provide new information on vessel wall vascularization and inflammation in atherosclotic disease but also during venous thrombotic disease. This will help to better understand the pathophysiological concept of venous thrombosis, thrombus resolution and subsequent development of post-thrombotic syndrome. e-Stockings - New generation smart compression stockings wih integrated ICT for suprior customized performance Research Project | 1 Project MembersVenous insufficiency is a chronical health problem with a huge impact on the quality of life of older persons, since it induces pain and pressure to the legs, affecting general physical condition and daily routines, greatly hindering their mobility both indoor and outdoor. It is characterized by poor back flow of blood to the heart which can ultimately originate ulcers. Specifically, venous leg ulceration affects approximately 1% of the general population in Europe, with a reported higher incidence in population above 65 years old, and a total indicative annual cost of ?6.5 billion. The most practical non-invasive treatment to improve blood circulation is compression therapy. But even the use of current compression therapy methods (such as obtrusive and unstylish bandages and stockings) greatly limits the older persons in their mobility and hinders their autonomy and self-confidence to perform daily routine tasks and physical activity. It is difficult to put medical compression stockings on and take them off, bringing unnecessary pain in the process for the elderly users and restricting their freedom and mobility. In fact, most elderly need assistance for the application of compression stockings, and must wait for the care services twice a day being unable to move indoor or outdoor before being helped. The overall objective of the e-Stockings project is to develop novel ?smart? compression stocking solutions that enable customised compression levels according to each patient needs, relying on ICT to support real-time pressure adjustments and patient data monitoring. The key features of the novel stockings are: user-friendliness; compliance with individual clinical needs of the patient; and appealing design. The innovative concept will rely on electronic sensors, actuators and the necessary supporting computational elements embedded in e-textiles, connected through wireless technologies to an ICT platform running supporting applications and optionally providing associated e-health services. Such a ?smart? ICT-enabled solution is expected to have a strong impact on the quality of life of older persons with leg venous disorders ? delivering high quality compression treatment; enabling users to monitor their health condition, and providing warning to assisting services in the case of emergency ? enhancing their independence and their mobility capacity both indoor and outdoor beyond the perimeter of their home. The solutions developed will be tested by primary end-users with leg venous disorders; clinical tests will be conducted by a specialized medical unit in Switzerland and user testing will be performed in nursing homes/leg clinics in Denmark, Switzerland and UK. After testing, the consortium will mobilize resources and key stakeholders, possibly a large player with market access, to bring the developed solutions and products to market, which we estimate for the initial versions to take 2 years. Evaluation of perivascular venous vascularization and inflammation by contrast-enhanced ultrasound (CEUS) in patients with acute deep vein thrombosis and superficial thrombophlebitis. Research Project | 1 Project MembersBackground: Contrast-enhanced ultrasound (CEUS) provides direct in-vivo visualization of the adventitial vasa vasorum using the fact that contrast agents microspheres are ideal intravascular tracers, thus, permitting a non-invasive assessment of the dynamic spatial and temporal heterogeneity of the microvasculature. Moreover, late phase CEUS has shown to detect inflammation by visualizing untargeted microbubbles phagozytosed by monocytes. The inflammatory process of the vessel wall and surrounding tissue associated with perivascular angiogenesis at the time of deep venous thrombosis (DVT) and superficial vein thrombophlebitis (SVT) may promote destruction of venous valves, valvular reflux and subsequent development of post-thrombotic syndrome (PTS). Therefore, we will test the value of CEUS to detect venous perivascular vascularization and inflammation in patients with acute DVT or SVT. Aims: To determine the presence and degree of venous perivascular vascularization and inflammation assessed with CEUS in patients with acute DVT or SVT, and compare this to controls without thrombosis. Patients and Methods: 20 patients with first unilateral proximal DVT and 10 patients with SVT of the lower-extremity will be included in this study. Diagnosis of DVT and SVT will be performed using standard compression and duplex ultrasound using a ultrasound scanner equipped with a linear array L9-4 MHz probe. For CEUS imaging 2.5ml of SonoVueTM will be injected as an intravenous bolus into an antecubital vein. The thrombotic popliteal vein and the normal popliteal vein at the contralateral side or the thrombotic superficial vein and the normal superficial vein at the contralateral side will be evaluated using a standardized cross-sectional view. Similarly the normal popliteal vein and the superficial vein in a control group will be evaluated. Perivascular contrast-enhancement will be determined with visual interpretation (absent, moderate, abundant) and with quantitative analysis using a dedicated QLAB software to quantify video intensity within the first minute after bolus contrast injection (perivascular vascularization) and at 6 minutes following the bolus contrast injection (inflammation). Visual based and quantitative analysis of perivascular contrast-enhancement in DVT or SVT will be compared to the contrast-enhancement at the non affected contralateral side and to results of the control group. CEUS imaging with quantification of perivascular contrast-enhancement will be performed at baseline, 2 weeks, and 3 months after acute thrombosis or initial investigation in controls. Additionally, at each visit, measurement of inflammatory markers as well as quantitative measurement of leg volume using an automated 3D image system will be performed. Expected results: We hypothesize that venous perivascular vascularization and inflammation assessed by contrast agent enhancement can be quantified and will be significantly more pronounced in the perivascular tissue of the thrombotic vein than in the non affected vein and in controls, and will correlate with level of inflammatory markers and leg volume. Vascularization and inflammation will decrease during the process of thrombus resolution from baseline to 3 months follow-up. Significance: These results would provide new information on the pathophysiological concept of thrombosis and thrombus resolution. It might help to better understand the pathophysiologic mechanisms that promote the development of chronic venous insufficiency and post-thrombotic syndrome. As inflammation with pronounced perivascular vascularization might play an important role in incomplete thrombus clearance, venous outflow obstruction and the development of post-thrombotic syndrome after acute DVT, in the future, our results could lead to novel approaches to interrupt the natural history and prevent post-thrombotic syndrome. New applications of contrast-enhanced ultrasound (CEUS) in vascular medicine Research Project | 1 Project MembersNo Description available Perfusions-Kontrastultraschall an der Unterschenkelmuskulatur bei Sklerodermie-Patienten Research Project | 1 Project MembersNo Description available Assessment of the atherosclerotic burden with contrast enhanced 3D/4D ultrasound Research Project | 1 Project MembersNo Description available Contrast enhanced ultrasound imaging of neovascularization in vulnerable carotid plaques Research Project | 1 Project MembersNo Description available 1 1
Clinical Use of Contrast- Enhanced Ultrasound (CEUS) for the Assessment of Vessel Wall Vascularization (Vasa Vasorum) and Inflammation in Carotid Atherosclerosis and Venous Thrombosis Research Project | 1 Project MembersBackground: Injection of ultrasound contrast agents, in conjunction with contrast specific imaging techniques, is increasingly accepted in clinical use for diagnostic ultrasound imaging. As microbubbles contrast agents appear to be ideal pure intravascular tracers to enhance the vascular lumen and more important to assess the dynamic spatial and temporal heterogeneity of the microvasculature, contrast enhanced ultrasound (CEUS) provides a unique opportunity for new application especially in vascular imaging. CEUS of the carotid artery has been introduced as a non-invasive technique to improve detection of carotid atherosclerosis and evaluate the presence of plaque vascularity (vasa vasorum). As the proliferation of intraplaque and adventitial vasa vasorum (neovascularization) are inherently linked with the atherosclerotic plaque development, plaque inflammation and vulnerability, direct visualization of intraplaque neovascularization by CEUS has emerged as a new marker for plaque instability. Furthermore, CEUS provides not only direct in-vivo visualization of the vessel wall vascularization. Late phase CEUS has shown to detect plaque inflammation by visualizing untargeted microbubbles phagozytosed by monocytes. The inflammatory process of the vessel wall is not only involved in the atherosclerotic plaque development but also in the inflammatory process at the time of venous thrombosis and may promote destruction of venous valves, valvular reflux and subsequent development of post-thrombotic syndrome. Aim: It is the aim of this project to perform prospective studies with clinical questions and test the hypothesis that the use of CEUS to detect vessel wall vascularization and inflammation can improve the management of patients with atherosclerotic and thrombotic diseases. Methods: The study project 1 will prospectively evaluate the value of carotid atherosclerosis severity and plaque morphology including intraplaque neovascularization on standard carotid ultrasound and CEUS in 400 high risk patients with suspected coronary artery disease referred for radionuclide myocardial perfusion imaging to predict future vascular events. We hypothesize that patients with instable coronary artery disease and patients with future vascular events during a follow-up of 5 years have more pronounced intraplaque neovascularization on CEUS imaging at baseline. The study project 2 will prospectively evaluate the predictive value of carotid lesion morphology and severity including intraplaque neovascularization on standard carotid ultrasound and CEUS in 240 patients with asymptomatic more than 50% carotid stenosis. We hypothesize that neovascularization within the carotid lesion at baseline will significantly be more pronounced in patients with progressive carotid stenosis determined by repeated yearly carotid ultrasound studies over 5 years and in patients suffering future cerebrovascular and coronary events during follow-up. In patient scheduled for carotid endarterectomy we will investigate the feasibility of ex vivo assessment of vascular inflammation in carotid endarterectomy specimens using targeted microbubbles for molecular ultrasound imaging. In the study project 3, we will test the value of CEUS to detect venous perivascular vascularization and inflammation in 30 patients with acute deep vein thrombosis and 10 patients with superficial vein thrombosis. We hypothesize that venous perivascular vascularization and inflammation assessed by contrast agent enhancement will be significantly more pronounced in the perivascular tissue of the thrombotic popliteal vein than in the non affected contralateral popliteal vein and in 40 control volunteers, and will correlate with level of inflammatory markers, leg volume and the development of the post-thrombotic syndrome. We hypothesize that vascularization and inflammation on CEUS will decrease during the process of thrombus resolution from baseline to 6 months follow-up. Significance: In sum, the results of our study projects would support the concept that intraplaque neovascularization is associated with plaque instability and vulnerability and the use of CEUS imaging may provide an additional non-invasive adjunctive "window" to risk stratify individuals and carotid atherosclerotic lesions, particularly asymptomatic more than 50% stenosis. Furthermore, the results would not only provide new information on vessel wall vascularization and inflammation in atherosclotic disease but also during venous thrombotic disease. This will help to better understand the pathophysiological concept of venous thrombosis, thrombus resolution and subsequent development of post-thrombotic syndrome.
e-Stockings - New generation smart compression stockings wih integrated ICT for suprior customized performance Research Project | 1 Project MembersVenous insufficiency is a chronical health problem with a huge impact on the quality of life of older persons, since it induces pain and pressure to the legs, affecting general physical condition and daily routines, greatly hindering their mobility both indoor and outdoor. It is characterized by poor back flow of blood to the heart which can ultimately originate ulcers. Specifically, venous leg ulceration affects approximately 1% of the general population in Europe, with a reported higher incidence in population above 65 years old, and a total indicative annual cost of ?6.5 billion. The most practical non-invasive treatment to improve blood circulation is compression therapy. But even the use of current compression therapy methods (such as obtrusive and unstylish bandages and stockings) greatly limits the older persons in their mobility and hinders their autonomy and self-confidence to perform daily routine tasks and physical activity. It is difficult to put medical compression stockings on and take them off, bringing unnecessary pain in the process for the elderly users and restricting their freedom and mobility. In fact, most elderly need assistance for the application of compression stockings, and must wait for the care services twice a day being unable to move indoor or outdoor before being helped. The overall objective of the e-Stockings project is to develop novel ?smart? compression stocking solutions that enable customised compression levels according to each patient needs, relying on ICT to support real-time pressure adjustments and patient data monitoring. The key features of the novel stockings are: user-friendliness; compliance with individual clinical needs of the patient; and appealing design. The innovative concept will rely on electronic sensors, actuators and the necessary supporting computational elements embedded in e-textiles, connected through wireless technologies to an ICT platform running supporting applications and optionally providing associated e-health services. Such a ?smart? ICT-enabled solution is expected to have a strong impact on the quality of life of older persons with leg venous disorders ? delivering high quality compression treatment; enabling users to monitor their health condition, and providing warning to assisting services in the case of emergency ? enhancing their independence and their mobility capacity both indoor and outdoor beyond the perimeter of their home. The solutions developed will be tested by primary end-users with leg venous disorders; clinical tests will be conducted by a specialized medical unit in Switzerland and user testing will be performed in nursing homes/leg clinics in Denmark, Switzerland and UK. After testing, the consortium will mobilize resources and key stakeholders, possibly a large player with market access, to bring the developed solutions and products to market, which we estimate for the initial versions to take 2 years.
Evaluation of perivascular venous vascularization and inflammation by contrast-enhanced ultrasound (CEUS) in patients with acute deep vein thrombosis and superficial thrombophlebitis. Research Project | 1 Project MembersBackground: Contrast-enhanced ultrasound (CEUS) provides direct in-vivo visualization of the adventitial vasa vasorum using the fact that contrast agents microspheres are ideal intravascular tracers, thus, permitting a non-invasive assessment of the dynamic spatial and temporal heterogeneity of the microvasculature. Moreover, late phase CEUS has shown to detect inflammation by visualizing untargeted microbubbles phagozytosed by monocytes. The inflammatory process of the vessel wall and surrounding tissue associated with perivascular angiogenesis at the time of deep venous thrombosis (DVT) and superficial vein thrombophlebitis (SVT) may promote destruction of venous valves, valvular reflux and subsequent development of post-thrombotic syndrome (PTS). Therefore, we will test the value of CEUS to detect venous perivascular vascularization and inflammation in patients with acute DVT or SVT. Aims: To determine the presence and degree of venous perivascular vascularization and inflammation assessed with CEUS in patients with acute DVT or SVT, and compare this to controls without thrombosis. Patients and Methods: 20 patients with first unilateral proximal DVT and 10 patients with SVT of the lower-extremity will be included in this study. Diagnosis of DVT and SVT will be performed using standard compression and duplex ultrasound using a ultrasound scanner equipped with a linear array L9-4 MHz probe. For CEUS imaging 2.5ml of SonoVueTM will be injected as an intravenous bolus into an antecubital vein. The thrombotic popliteal vein and the normal popliteal vein at the contralateral side or the thrombotic superficial vein and the normal superficial vein at the contralateral side will be evaluated using a standardized cross-sectional view. Similarly the normal popliteal vein and the superficial vein in a control group will be evaluated. Perivascular contrast-enhancement will be determined with visual interpretation (absent, moderate, abundant) and with quantitative analysis using a dedicated QLAB software to quantify video intensity within the first minute after bolus contrast injection (perivascular vascularization) and at 6 minutes following the bolus contrast injection (inflammation). Visual based and quantitative analysis of perivascular contrast-enhancement in DVT or SVT will be compared to the contrast-enhancement at the non affected contralateral side and to results of the control group. CEUS imaging with quantification of perivascular contrast-enhancement will be performed at baseline, 2 weeks, and 3 months after acute thrombosis or initial investigation in controls. Additionally, at each visit, measurement of inflammatory markers as well as quantitative measurement of leg volume using an automated 3D image system will be performed. Expected results: We hypothesize that venous perivascular vascularization and inflammation assessed by contrast agent enhancement can be quantified and will be significantly more pronounced in the perivascular tissue of the thrombotic vein than in the non affected vein and in controls, and will correlate with level of inflammatory markers and leg volume. Vascularization and inflammation will decrease during the process of thrombus resolution from baseline to 3 months follow-up. Significance: These results would provide new information on the pathophysiological concept of thrombosis and thrombus resolution. It might help to better understand the pathophysiologic mechanisms that promote the development of chronic venous insufficiency and post-thrombotic syndrome. As inflammation with pronounced perivascular vascularization might play an important role in incomplete thrombus clearance, venous outflow obstruction and the development of post-thrombotic syndrome after acute DVT, in the future, our results could lead to novel approaches to interrupt the natural history and prevent post-thrombotic syndrome.
New applications of contrast-enhanced ultrasound (CEUS) in vascular medicine Research Project | 1 Project MembersNo Description available
Perfusions-Kontrastultraschall an der Unterschenkelmuskulatur bei Sklerodermie-Patienten Research Project | 1 Project MembersNo Description available
Assessment of the atherosclerotic burden with contrast enhanced 3D/4D ultrasound Research Project | 1 Project MembersNo Description available
Contrast enhanced ultrasound imaging of neovascularization in vulnerable carotid plaques Research Project | 1 Project MembersNo Description available
