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  1. Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Bonati, Leo H

    2009-10-01

    In the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), early recurrent carotid stenosis was more common in patients assigned to endovascular treatment than it was in patients assigned to endarterectomy (CEA), raising concerns about the long-term effectiveness of endovascular treatment. We aimed to investigate the long-term risks of restenosis in patients included in CAVATAS.

  2. Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial.

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-10-01

    Endovascular treatment (angioplasty with or without stenting) is an alternative to carotid endarterectomy for carotid artery stenosis but there are scarce long-term efficacy data showing that it prevents stroke. We therefore report the long-term results of the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS).

  3. Long-term outcome of endovascular treatment versus medical care for carotid artery stenosis in patients not suitable for surgery and randomised in the Carotid and Vertebral Artery Transluminal Angioplasty study (CAVATAS).

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-01-01

    Optimal treatment of carotid stenosis in patients not suitable for surgery is unclear. The Carotid and Vertebral Artery Transluminal Angioplasty study contained a trial comparing medical and endovascular treatment in patients not suitable for surgery.

  4. Risk assessment after coronary angioplasty with SPECT myocardial perfusion studies

    International Nuclear Information System (INIS)

    The chest pain can be use for stratifying the risk of the patients after coronary angioplasty. Nevertheless this strategy has shown to have a low accuracy in the detection of restenosis and myocardial ischemia. Aims: To establish the usefulness of the SPECT studies in the risk stratification after the coronary angioplasty. Evaluate the incidence of silent ischemia or symptomatic, and its impact on the prognosis. Method: There were included 107 patients (p) submitted to a gated SPECT between the year of the coronary angioplasty. The analysis of the images was performed according to different scores (SSS, SRS, SDS). These data was correlated with the symptoms of the patients. We define group 1 (G1) as the asymptomatic without ischemia (n 59p), group 2 (G2) as silent ischemia (n = 28p) and group 3 (G3) as symptomatic with ischemia (n = 20p). A clinical follow-up was done in search of events (target vessel revascularization, unstable angina, AMI and death). Results: Significant differences were not observed in the clinical variables between the different groups. The SSS was lower in the G1 compare with G2 and G3 (p 0.0001) and was similar between the last two, p = NS (SSS: G1: 2.2 ± 4.9; G2: 7.6 ± 5.9; G3: 9.5 ± 6.8). The SDS was greater in G3 vs. G1 and G2, p = 0.0001, and greater in G2 vs. G1, p = 0.0001 (SDS: G1: 0; G2: 4.8 ± 3.5; G3: 7.2 ± 6.5). No differences where observed in the SRS between the three groups. In the follow-up the total percentage of events was lesser when compare the G1 with the G2 and G3 (G1: 3.3%; G2 and G3: 18.7%; p 0.02). The percentage of annual events of the G3 symptomatic with ischemia (11.03%) and G2 silent ischemia (4.04%) did not present differences (p 0.7). When the events of the G2 (4.04%) were compared with the G1 (1.24%) we observed a trend to major frequency of events in the G2 (p = 0.6). Conclusions: The presence of myocardial ischemia after coronary angioplasty is a determinant of the prognosis. Nevertheless, the extension

  5. Comparative efficacy of eptifibatide and abciximab in primary angioplasty study

    Directory of Open Access Journals (Sweden)

    Rohan Jayasinghe

    2011-02-01

    Full Text Available Rohan Jayasinghe1 Matias Yudi1 Sanjay Jayasinghe21Cardiology Department, Gold Coast Hospital, Griffith University, Queensland, Australia; 2Centre for Immunisation Research, Sydney, AustraliaBackground: Primary percutaneous intervention is the safest and most effective treatment modality for acute ST-segment elevation myocardial infarction (MI in centers where catheterization facilities exist. Intravenous glycoprotein IIb/IIIa inhibitor therapy during the procedures has been proven to provide added benefits. For the two agents, abciximab and eptifibatide, commonly used in this context, there is only limited comparative data available for the clinicians. Hitherto, there is no data published from the Asia–Pacific region on this topic.Method: A retrospective comprehensive analysis was carried out, comparing patients who were treated with abciximab (n = 125 and eptifibatide (n = 125 during primary angioplasty over a 3-year period. The primary outcome measure was in-hospital mortality. The other outcome measures studied include MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complications. A comparative cost analysis was carried out to ascertain the average overall differential cost.Results: In-hospital mortality, MI, stroke, blood transfusion, contrast nephropathy, significant bleeding, and vascular complication were observed at a higher rate in the patients who were treated with abciximab. However, these differences did not reach statistical significance. Due to the higher cost per unit and longer hospital stay, therapy with abciximab costs more than that with eptifibatide.Conclusions: Both abciximab and eptifibatide are safe and effective adjunct therapeutic agents in the setting of primary angioplasty. However, there is a trend toward higher adverse event with the former agent that was not statistically significant. Therapy with abciximab costs more per patient.Keywords: abciximab, eptifibatide, PCI, STEMI

  6. Retrospective Study of Rapid-Exchange Monorail Versus Over-the-Wire Technique for Femoropopliteal Angioplasty

    International Nuclear Information System (INIS)

    PurposeThe purpose of this study was to compare procedural outcome of rapid-exchange (RX) monorail versus conventional over-the-wire (OTW) technique for femoropopliteal angioplasty.Materials and MethodsDemographic data, procedure details, angioplasty success, and complications of 328 consecutive percutaneous transluminal angioplasties (PTAs) were collected from a prospective database and retrospectively analyzed. Procedure details included duration of fluoroscopy, area-dose product, amount of contrast agent, sheath sizes, access route, length of stenosis, presence of total occlusion, technical and anatomical success (residual stenosis <30% in the absence of complications), need for bail-out stenting, and periprocedural complications. The RX technique alone was used in 102 of 328 cases (31%); the OTW technique, in 226 of 328 of cases (68%).ResultsTechnical success was 98% for the RX versus 95.4% for the OTW technique (p = 0.2). A significantly greater number of stents had to be implanted due to angioplasty failure when the OTW technique was used (RX, 5.9%; OTW, 13.7%; p = 0.04). There were no significant differences in fluorocopy time, dose-area product, or amount of contrast medium used. The RX system facilitated the use of smaller sheath sizes (5 Fr = 38% and 6 Fr = 59% for RX versus 5 Fr = 16.8% and ≥6 Fr = 82.5% for OTW) but showed only a tendency toward lower overall complication rates (16.6% [17/102] in the RX group versus 19.9% [45/226] in the OTW group; p = 0.09). There was no effect on length of hospitalization. RX monorail systems were not associated with higher procedural costs when compared to conventional OTW technique.ConclusionWe conclude that RX monorail systems seem to enhance the technical success of femoropopliteal angioplasty. Although smaller sheath sizes can be used due to the lower profile of the RX systems, there is only a tendency toward lower complication rates.

  7. Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study

    Science.gov (United States)

    Roghani-Dehkordi, Farshad; Hadizadeh, Mahmood; Hadizadeh, Fatemeh

    2015-01-01

    BACKGROUND Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet. METHODS We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes. RESULTS In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported. CONCLUSION This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting). PMID:26715936

  8. Coronary Angioplasty

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Is Percutaneous Coronary Intervention? Español Percutaneous (per-ku-TA-ne-us) coronary intervention (PCI), commonly known as coronary angioplasty (AN-jee- ...

  9. Study of Traditional Chinese Medicine in Intervening Vascular Remodeling after Percutaneous Transluminal Coronary Angioplasty

    Institute of Scientific and Technical Information of China (English)

    鹿小燕; 徐浩; 史大卓; 陈可冀

    2004-01-01

    Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS rate can reach 30% to 50%, even with direct stenting into the vessels, it still reaches 20% to 35%. So this affects long-term effect of interventional therapy, which directly relates to prognosis of patients with CHD and has been a hot spot of study in the field of preventing and treating CHD.

  10. Study of Traditional Chinese Medicine in Intervening Vascular Remodeling after Percutaneous Transluminal Coronary Angioplasty

    Institute of Scientific and Technical Information of China (English)

    鹿小燕; 徐浩; 史大卓; 陈可冀

    2004-01-01

    Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS rate can reach 30% to 50%, even with directstenting into the vessels, it still reaches 20% to 35%. So this affects long-term effect of interventional therapy, which directly relates to prognosis of patients with CHD and has been a hot spot of study in the field of preventing and treating CHD.

  11. Angioplasty and stent placement - heart

    Science.gov (United States)

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  12. Deep sea water prevents balloon angioplasty-induced hyperplasia through MMP-2: an in vitro and in vivo study.

    Directory of Open Access Journals (Sweden)

    Pei-Chuan Li

    Full Text Available Major facts about the development of restenosis include vascular smooth muscle cells (VSMCs proliferation and migration. A previous study showed that in vitro treatment with magnesium chloride has the potential to affect the proliferation and migration of VSMCs. Magnesium is the major element in deep sea water (DSW and is a biologically active mineral. It is unclear whether DSW intake can prevent abnormal proliferation and migration of VSMCs as well as balloon angioplasty-induced neointimal hyperplasia. Thus, we attempted to evaluate the anti-restenotic effects of DSW and its possible molecular mechanisms. Several concentrations of DSW, based on the dietary recommendations (RDA for magnesium, were applied to a model of balloon angioplasty in SD rats. The results showed that DSW intake markedly increased magnesium content within the vascular wall and reduced the development of neointimal hyperplasia. The immunohistochemical analysis also showed that the expression of proteins associated with cell proliferation and migration were decreased in the balloon angioplasty groups with DSW supplement. Furthermore, in vitro treatment with DSW has a dose-dependent inhibitory effect on serum-stimulated proliferation and migration of VSMCs, whose effects might be mediated by modulation of mitogen-activated protein kinase (MAPK signaling and of the activity of matrix metalloproteinase-2 (MMP-2. Our study suggested that DSW intake can help prevent neointimal hyperplasia (or restenosis, whose effects may be partially regulated by magnesium and other minerals.

  13. A clinical study on perforator stroke resulting from Wingspan stent angioplasty for symptomatic intracranial artery stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the incidence, potential hazards and effective countermeasure for perforator stroke (PS) resulting from stent angioplasty of symptomatic intracranial artery stenosis. Methods: Peri-operation PS complications of 258 patients receiving Gateway balloon-Wingspan stenting for severe symptomatic intracranial stenosis were analyzed. The incidence, clinical course, and prognosis of PS resulting from stenting were recorded. Special attention was given to the anatomical features, clinical manifestation and video materials of patients with PS. χ2 test was used for statistics. Results: Two hundred and fifty-five patients received stent angioplasty successfully and 7 patients had PS (incidence rate 2.7%). The patients with basilar artery stenosis had a higher incidence of PS resulting from intracranial stenting (6.1%, 4/66) than patients with middle cerebral artery stenosis (2.5%, 3/118) (χ2=2.320, P= 0.025). The potential hazards for PS included preoperative perforator stroke adjacent to the stenotic segment and prominent dissection during operation. Six patients presented symptoms after awake from general anaesthesia and one had symptoms 3 hours after stenting. One deteriorated gradually and the others reached the maximum deficit almost at once. At the follow-up of 3 months, 3 patients were disabled and scored one, two, two by mRS respectively. Conclusion: The incidence of PS resulting from intracranial stenting was low and the prognosis was not disastrous. Stenosis at basilar artery and preoperative perforator stroke adjacent to the stenotic segment were potential risk factors for PS complication. Proper maneuver of angioplasty may decrease the incidence of PS and improve the prognosis. (authors)

  14. Einfluß unterschiedlicher klinischer und anamnestischer Parameter auf die Erfolgsaussichten der perkutanen transluminalen renalen Angioplastie : eine retrospektive Studie

    OpenAIRE

    Bröhr, Marlon Andreas Paul

    2002-01-01

    Between 1993 and 1998 171 patients had a percutaneous transluminal angioplasty of the renal artery. It was examinated in which way different clinal and anamnestic parameters (sex, age, nicotin-abusus, use of stens, pathogenesis of the stenosis) did influence the long-time results of percutaneous transluminal angioplasty of the renal artery.

  15. Evaluation of batroxobin in preventing vascular restenosis in diabetic patients after infrapopliteal arterial angioplasty: a randomized comparative study

    International Nuclear Information System (INIS)

    Objective: To evaluate batroxobin in preventing vascular restenosis in diabetic patients after infrapopliteal arterial angioplasty through comparing the clinical results of the combination use of batroxobin and aspirin with that of simple use of aspirin. Methods: After a successful angioplasty, fifty-two diabetic patients with symptomatic infrapopliteal obstructions were randomly divided into the study group (n=26) and the control group (n=26). Patients in both groups received 100 aspirin everyday, but the patients in study group additionally received 5 IU batroxobin intravenous drip every day for six times. At the end of the follow-up period lasting for 12 months, magnetic resonance angiography (MRA) or Doppler ultrasonic angiography was performed to check the vessels to see if there was any restenosis or reocclusion. The relief degree of clinical symptoms were observed, and both preoperative and postoperative ankle-brachial index (ABI) were regularly determined and compared. Kaplan-Meier curves were constructed to evaluate restenosis/reocclusion-free rate, limb salvage rate and amputation-free rate. Results: During the follow-up period the occurrence of restenosis/reocclusion in study group and control group was 22.0% and 34.5% respectively (P=0.0307). Statistically significant difference in ABI existed between two groups both after the procedure (P<0.05) and at 12 months after the treatment (P=0.0094). Clinical improvement and tissue healing in study group and control group were observed in 23 and 19 patients respectively (P=0.0544). Twelve months after angioplasty, Kaplan-Meier analysis showed that the restenosis/reocclusion-free rate, the limb salvage rate and the amputation-free rate for study group were 74.0%, 96.2% and 84.6% respectively, while they was 54.8%, 92.3% and 84.6% respectively for control group. Conclusion: The results of this study indicate that the use of the clinical therapeutic efficacy and markedly relieve the symptoms, although this

  16. Morphologic alterations after transluminal angioplasty

    International Nuclear Information System (INIS)

    Despite the widespread clinical use of percutaneous transluminal angioplasty, the mechanism by which enlargement of the arterial lumen is achieved by this technique has been poorly understood. In the original description of transluminal angioplasty in 1964, the effectiveness of the procedure was attributed to compression of the atheromatous plaque against a relatively unyielding artery wall. This mechanism was subsequently endorsed in relation to angioplasty using the balloon catheter. The concept of plaque compression or displacement or of herniation of the puttylike athermatous intima into the artery wall was generally accepted by the early pioneers in transluminal angioplasty. This mechanism did not, however, correspond to clinical and morphologic observations that plaques were generally rigid and calcific rather than plastic and could not readily be compressed or deformed. Angiographic observations before and after dilatation have not always been helpful in defining the mechanism since angiography reveals only the lumen contour and does not provide sufficient information concerning the thickness of the arterial wall or the size, configuration, or precise boundaries of plaques. Although direct observation of lesions and associated artery walls immediately after balloon dilatation could provide the necessary information, such data are difficult to obtain since arteries and plaques are rarely directly inspected after dilatation in the living patient. Knowledge of the morphologic consequences of balloon dilatation in human arteries has therefore been obtained mainly from experimental studies of postmortem arteries and corresponding angiographic images and from specimens obtained from amputated limbs or after death

  17. Patient Experience, Pain, and Quality of Life after Lower Limb Angioplasty: A Multisite Prospective Cohort Study

    Energy Technology Data Exchange (ETDEWEB)

    Culverwell, A. D., E-mail: adamculverwell@doctors.net.uk [Leeds General Infirmary (United Kingdom); Tapping, C. R.; Ettles, D. F. [Hull Royal Infirmary (United Kingdom); Kessel, D. [Leeds General Infirmary (United Kingdom)

    2012-08-15

    Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure. Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS). Complications, analgesic requirements, and satisfaction were recorded. Changes to quality of life were assessed by the validated SF36 questionnaire. Results: A total of 88 patients (41%) responded. Overall, disease-related pain decreased over 3 months after the procedure. Smokers had more pain both before and after the procedure (P < 0.05). Explanation was considered better if provided by radiologist (P < 0.05). Sixty-nine percent of patients found the procedures less painful (mean VAS 2.5) than they had anticipated (VAS 5.5). Fifty percent of patients experienced adverse effects related to their puncture site, but this was highest among patients who had undergone the procedure before and smokers. The greatest quality-of-life improvements were in emotional and general health. Higher levels of disease-related pain were associated with worse general, emotional, and physical health (P < 0.05). Conclusion: Lower limb angioplasty provides symptomatic and quality-of-life improvements. Implementation of simple measures could improve patient satisfaction-for example, treatment should be explained by the radiologist in advance. Routine prescription of analgesics with particular attention to smokers and those undergoing repeat interventions is suggested.

  18. Comparative study of conducting iliac angioplasties with digital subtraction and conventional angiography. Incidence on true (consumable) costs

    International Nuclear Information System (INIS)

    Differences in time and cost were evaluated between the performance of iliac angioplasty with conventional (AC) and digital subtraction (AN) angiography, after a total of 27 angioplasties (13 with AC and 14 with AN). Excluding amortization of material and personnel costs, findings confirmed a certain number of advantages for AN: gain in time of about 34%, decrease of about 14% in charges, and notably of 83% in expenditure on films and 50% on contrast media

  19. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available Coronary Angioplasty Stent Placement Shawnee Mission Heart & Vascular Center, Shawnee Mission, Kansas February 19, 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center ...

  20. Three dimensional intravascular ultrasonic assessment of the local mechanism of restenosis after balloon angioplasty

    NARCIS (Netherlands)

    M.A. Costa (Marco); P.J. de Feyter (Pim); K. Kozuma (Ken); A.L. Gaster; M. Sabaté (Manel); I.P. Kay (Ian Patrick); J.M.R. Ligthart (Jürgen); P. Thayssen; M.J.B.M. van den Brand (Marcel); P.W.J.C. Serruys (Patrick); D.P. Foley (David); W.J. van der Giessen (Wim)

    2001-01-01

    textabstractOBJECTIVE: To assess the mechanism of restenosis after balloon angioplasty. DESIGN: Prospective study. PATIENTS: 13 patients treated with balloon angioplasty. INTERVENTIONS: 111 coronary subsegments (2 mm each) were analysed after balloon angioplasty and at a six month follow up using th

  1. Early outcome of high energy Laser (Excimer) facilitated coronary angioplasty ON hARD and complex calcified and balloOn-resistant coronary lesions: LEONARDO Study

    Energy Technology Data Exchange (ETDEWEB)

    Ambrosini, Vittorio; Sorropago, Giovanni; Laurenzano, Eugenio [Montevergine Clinic, Mercogliano (Italy); Golino, Luca, E-mail: lucagolino.jazz@alice.it [Montevergine Clinic, Mercogliano (Italy); Moriggia-Pelascini Hospital, Gravedona, Como (Italy); Casafina, Alfredo; Schiano, Vittorio [Montevergine Clinic, Mercogliano (Italy); Gabrielli, Gabriele [University Hospital Ospedali Riuniti, Ancona (Italy); Ettori, Federica; Chizzola, Giuliano [Spedali Civili University Hospital, Brescia (Italy); Bernardi, Guglielmo; Spedicato, Leonardo [University Hospital S. Maria Misericordia, Udine (Italy); Armigliato, Pietro [Istituto Italiano Ricerche Mediche, Verona (Italy); Spampanato, Carmine [Telethon Institute of Genetics and Medicine (TIGEM), Naples (Italy); Furegato, Martina [Istituto Italiano Ricerche Mediche, Verona (Italy)

    2015-04-15

    Aim: An innovative xenon–chlorine (excimer) pulsed laser catheter (ELCA X80) has been recently used for the treatment of complex coronary lesions, as calcified stenosis, chronic total occlusions and non-compliant plaques. Such complex lesions are difficult to adequately treat with balloon angioplasty and/or intracoronary stenting. The aim of this study was to examine the acute outcome of this approach on a cohort of patients with coronary lesions. Methods and Results: Eighty patients with 100 lesions were enrolled through four centers, and excimer laser coronary angioplasty was performed on 96 lesions (96%). Safety and effectiveness data were compared between patients treated with standard laser therapy and those treated with increased laser therapy. Laser success was obtained in 90 lesions (93.7%), procedural success was reached in 88 lesions (91.7%), and clinical success in was obtained in 87 lesions (90.6%). There was no perforation, major side branch occlusion, spasm, no-reflow phenomenon, dissection nor acute vessel closure. Increased laser parameters were used successfully for 49 resistant lesions without complications. Conclusions: This study suggests that laser-facilitated coronary angioplasty is a simple, safe and effective device for the management of complex coronary lesions. Furthermore, higher laser energy levels delivered by this catheter improved the device performance without increasing complications. - Highlights: • We planned this multicenter study to examine the acute outcome of an innovative xenon–chlorine (excimer) pulsed laser catheter (ELCA X80) for treatment of complex coronary lesions. • We enrolled 80 patients with 100 lesions and performed excimer laser coronary angioplasty in 96 lesions (96%). • Laser success was obtained in 90 lesions (93.7%), procedural success was reached in 88 lesions (91.7%), and clinical success was obtained in 87 lesions (90.6%). • Increased laser parameters were used successfully for 49 resistant

  2. Balloon catheter coronary angioplasty

    International Nuclear Information System (INIS)

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty

  3. Deposition of In-111-labeled platelets after percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Platelet aggregation is presumed to occur at angioplasty sites after intimal disruption. This deposition may lead to acute thromboembolic events and is probably an initial event in recurring arteriosclerotic plaque formation. Thus far the author have studied this process in ten patients undergoing percutaneous transluminal angioplasty (PTA) by labeling the patient's platelets with In-111 on the day prior to PTA. The patient is imaged before the angioplasty procedure and 4 and 24 hours after the procedure. Platelet aggregation at the angioplasty site can be visualized and platelet volume quantified in all patients. The technique is being used in the evaluation of platelet aggregation after PTA. The author attempt to determine the frequency and volume of aggregation, correlate these findings with physical findings, assess the effect of platelet-inhibiting drugs, and assess the anatomic site of angioplasty in terms of predilection for platelet aggregation

  4. Efficiency of ultrasonography and CT angiography in follow-up studies of carotid stent and percutaneous transluminal angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Lee, Byung Hee; Chung, Bong Sub; Ahn, Jung Yong; Heo, Kyung; Kho, Young Sik [Pundang CHA General Hospital, Pochon CHA Univ. College of Medicine, Pochon (Korea, Republic of)

    1999-12-01

    The aim of this study was to determine a more appropriate method for follow-up of carotid stenting by comparing the efficiency of US and CT angiography. Eleven carotid arteries of seven patients(men:5, women:2, mean age:56.4years) who underwent stent placement and percutaneous transluminal angioplasty(PTA) because of carotid stenosis were studied. The follow-up periods ranged from three to eleven (mean, five) months, and US and CT angiography were performed in one day. Color duplex sonography was performed with a 10 MHz linear array transducer. After spiral CT scan were obtained, MPR images were reconstructed on a workstation. Retrospective imaging analysis specifically focused on [1] stent configuration, [2] the accuracy of internal diameter measurement, [3] the detection of blood flow and the measurement of blood flow velocity, [4] the presence of atheroma and intraluminal thrombi, [5] the measurement of stent location, and [6] artifacts. US was more accurate than CT angiography for measuring internal diameter. In all cases, US and CT angiography were able to detect the blood flow at carotid artery, and utilizing the Doppler spectrum, flow velocity was measured. US showed atheromas in all cases but CT angiography demonstrated calcified atheromas in three cases only. In six cases, US failed to determine stent location, though in this respect CT angiography was successful in all cases. Artifacts of US were small reverberation artifact(11/11) of the stent and a defective color Doppler signal caused by acoustic shadowing of atheroma calcification(3/11). Artifacts of CT angiogrpahy were hardbeam artifact of the stent(11/11) and motion artifact(3/11). US was superior to CT angiography in accuracy of measuring stent diameter, hemodynamic assessment, high-resolution views of the luminal state of the stent and minimal artifacts for the non-invasive follow-up studies of carotid stenting.

  5. Efficiency of ultrasonography and CT angiography in follow-up studies of carotid stent and percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    The aim of this study was to determine a more appropriate method for follow-up of carotid stenting by comparing the efficiency of US and CT angiography. Eleven carotid arteries of seven patients(men:5, women:2, mean age:56.4years) who underwent stent placement and percutaneous transluminal angioplasty(PTA) because of carotid stenosis were studied. The follow-up periods ranged from three to eleven (mean, five) months, and US and CT angiography were performed in one day. Color duplex sonography was performed with a 10 MHz linear array transducer. After spiral CT scan were obtained, MPR images were reconstructed on a workstation. Retrospective imaging analysis specifically focused on [1] stent configuration, [2] the accuracy of internal diameter measurement, [3] the detection of blood flow and the measurement of blood flow velocity, [4] the presence of atheroma and intraluminal thrombi, [5] the measurement of stent location, and [6] artifacts. US was more accurate than CT angiography for measuring internal diameter. In all cases, US and CT angiography were able to detect the blood flow at carotid artery, and utilizing the Doppler spectrum, flow velocity was measured. US showed atheromas in all cases but CT angiography demonstrated calcified atheromas in three cases only. In six cases, US failed to determine stent location, though in this respect CT angiography was successful in all cases. Artifacts of US were small reverberation artifact(11/11) of the stent and a defective color Doppler signal caused by acoustic shadowing of atheroma calcification(3/11). Artifacts of CT angiogrpahy were hardbeam artifact of the stent(11/11) and motion artifact(3/11). US was superior to CT angiography in accuracy of measuring stent diameter, hemodynamic assessment, high-resolution views of the luminal state of the stent and minimal artifacts for the non-invasive follow-up studies of carotid stenting

  6. Percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Percutaneous transluminal angioplasty (PTA) is an accepted procedure for the management of arteriosclerotic occlusive disease and other vascular disorders that compromise blood flow through a vessel to various target structures (e.g., heart, kidney, extremities). The Gruentzig-type balloon dilation catheter has made PTA a versatile, relatively low-risk, relatively low-cost procedure. Its cost effectiveness has been well documented, particularly when consideration is given not only to hospital time but also to loss of productivity. In many institutions, PTA now replaces time-honored surgical procedures. This feature of angioplasty mandates that the angiographer participate actively with surgeons and other clinicians in choosing appropriate patients for PTA. This paper attempts to provide angiographers currently performing or intending to perform PTA with proper guidelines for the selection of patients for the procedure, based on anatomic, physiologic, and clinical grounds. Technical factors involved in performing PTA are included, as are common and uncommon problems and potential complications and how to avoid them. The information presented is drawn from experience that the authors acquired in the performance of over 4,000 angioplasty procedures. Adjuncts to PTA, including fibrinolysis and digital imaging, are given considerations as are the potential for laser-aided transluminal angioplasty

  7. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

    Energy Technology Data Exchange (ETDEWEB)

    Chalmers, Nicholas, E-mail: nicholas.chalmers@cmft.nhs.uk [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Walker, Paul T. [James Cook University Hospital, Department of Radiology (United Kingdom); Belli, Anna-Maria [St. George' s Healthcare NHS Trust, Department of Radiology (United Kingdom); Thorpe, Anthony P. [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Sidhu, Paul S. [King' s College Hospital, Department of Radiology (United Kingdom); Robinson, Graham [Hull Royal Infirmary, Department of Radiology (United Kingdom); Ransbeeck, Mariella van [Johnson and Johnson Medical NV/SA, Cordis (Belgium); Fearn, Steven A. [Johnson and Johnson Medical Ltd., Cordis (United Kingdom)

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  8. Assessment of left ventricular performance during percutaneous transluminal coronary angioplasty: a study by intravenous digital subtraction ventriculography.

    OpenAIRE

    Norell, M. S.; Lyons, J. P.; Gershlick, A H; Gardener, J E; Rothman, M. T.; Layton, C A; Balcon, R

    1988-01-01

    Left ventricular performance during percutaneous transluminal coronary angioplasty was assessed in 52 patients by intravenous digital subtraction ventriculography. After injection of contrast into the right atrium ventriculograms were obtained before and during balloon inflation. In 37 patients they were also obtained after the procedure. A 12 lead electrocardiogram was monitored throughout. During balloon inflation the left ventricular ejection fraction fell (from 73% to 57%) in all but one ...

  9. Aorto-iliac angioplasty

    International Nuclear Information System (INIS)

    This paper reports on the results and complications of aortoiliac balloon percutaneous transluminal angioplasty (PTA) and Simpson atherectomy that are compared to determine the role of the latter procedure in the management of aortoiliac disease. In 1984--1988, 92 patients underwent 126 angioplasties of the aortoiliac region. In 1986--1989, 21 patients underwent iliac artery atherectomy. Both groups had similar symptoms, risk factors, and age ranges. The overall technical success rate was 97.6or PTA and 100% for atherectomy. The initial clinical success was 92.8% for PTA and 100% for atherectomy. The 2-year clinical patency rate was 60% for PTA and 64% for artherectomy. Complications requiring surgery occurred in four of 126 (3%) PTA patients and one of 21 (5%) atherectomy patients. Groin hematomas were observed in 16% of PTA patients and 19% of atherectomy patients

  10. Monitoring of gadolinium-BOPTA uptake into the vessel wall during magnetic resonance (MR)-guided angioplasty of the peripheral arteries with a paclitaxel/gadolinium-BOPTA-coated balloon. An experimental study at 3 Tesla

    International Nuclear Information System (INIS)

    Purpose: The success of paclitaxel distribution within the vessel wall during paclitaxel-coated balloon angioplasty to prevent restenosis cannot be monitored under X-ray guidance. The aim of this pilot study was to demonstrate the feasibility of monitoring Gadolinium-BOPTA delivery within the vessel wall during magnetic resonance (MR)-guided paclitaxel/Gadolinium-BOPTA-coated balloon angioplasty of the peripheral arteries. Materials and methods: 6 pigs (47 ± 2 kg) were investigated. All experiments were performed using a 3 Tesla MR scanner. MR-guided bilaterial angioplasty of the iliac arteries was performed using a paclitaxel/MR contrast agent-coated balloon catheter. The feasibility of monitoring the delivery of Gadolinium-BOPTA to the vessel was assessed in 4 animals. In two additional animals, bilateral stenosis was surgically induced in the iliac arteries. Delivery of paclitaxel to the vessel wall was monitored using a 3 D T1-weighted gradient echo (GE) sequence for delineation of the vessel wall. Normalized signal intensity (SI) of the vessel wall was measured before and repeatedly after the intervention for 45 min. in all animals. Results: Paclitaxel/gadolinium-BOPTA-coated balloon angioplasty was successfully accomplished in all iliac arteries (n = 12). In animals with stenosis MR-angiography demonstrated successful dilatation (n = 4). The normalized SI of the vessel wall on T1-weighted GE images significantly increased after the intervention in all animals with and without stenosis for more than 45 min. (p < 0.001). Conclusion: Monitoring of Gadolinium-BOPTA into the vessel wall during MR-guided coated balloon angioplasty is feasible. This is a first step towards providing a tool for the online control of homogenous drug delivery after paclitaxel-coated balloon angioplasty. (orig.)

  11. Monitoring of gadolinium-BOPTA uptake into the vessel wall during magnetic resonance (MR)-guided angioplasty of the peripheral arteries with a paclitaxel/gadolinium-BOPTA-coated balloon. An experimental study at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Neizel, M.; Kelm, M. [University Hospital Duesseldorf (Germany). Dept. of Cardiology, Pneumology and Angiology; Ruebben, A.; Weiss, N. [Aachen Resonance, Aachen (Germany); Guenther, R.W. [University Hospital Aachen (Germany). Dept. of Radiology; Krombach, G.A. [University Hospital Giessen (Germany). Dept. of Radiology

    2014-04-15

    Purpose: The success of paclitaxel distribution within the vessel wall during paclitaxel-coated balloon angioplasty to prevent restenosis cannot be monitored under X-ray guidance. The aim of this pilot study was to demonstrate the feasibility of monitoring Gadolinium-BOPTA delivery within the vessel wall during magnetic resonance (MR)-guided paclitaxel/Gadolinium-BOPTA-coated balloon angioplasty of the peripheral arteries. Materials and methods: 6 pigs (47 ± 2 kg) were investigated. All experiments were performed using a 3 Tesla MR scanner. MR-guided bilaterial angioplasty of the iliac arteries was performed using a paclitaxel/MR contrast agent-coated balloon catheter. The feasibility of monitoring the delivery of Gadolinium-BOPTA to the vessel was assessed in 4 animals. In two additional animals, bilateral stenosis was surgically induced in the iliac arteries. Delivery of paclitaxel to the vessel wall was monitored using a 3 D T1-weighted gradient echo (GE) sequence for delineation of the vessel wall. Normalized signal intensity (SI) of the vessel wall was measured before and repeatedly after the intervention for 45 min. in all animals. Results: Paclitaxel/gadolinium-BOPTA-coated balloon angioplasty was successfully accomplished in all iliac arteries (n = 12). In animals with stenosis MR-angiography demonstrated successful dilatation (n = 4). The normalized SI of the vessel wall on T1-weighted GE images significantly increased after the intervention in all animals with and without stenosis for more than 45 min. (p < 0.001). Conclusion: Monitoring of Gadolinium-BOPTA into the vessel wall during MR-guided coated balloon angioplasty is feasible. This is a first step towards providing a tool for the online control of homogenous drug delivery after paclitaxel-coated balloon angioplasty. (orig.)

  12. Radioisotopic studies in renovascular hypertension before and after surgery or percutaneous transluminal renal angioplasty

    International Nuclear Information System (INIS)

    Over the past few years, radioisotopic studies have emerged as reliable diagnostic procedures in the screening for renovascular hypertension. More specifically, dynamic reno-scintigraphy (DRS) has been proved to be very sensitive in revealing hypoperfusion due to renal artery stenosis, although it cannot compete with the accuracy of arteriography, which only may provide a definitive diagnosis. Moreover, DRS appears to be a convenient test in clinical routine investigation because of its simplicity, low dose of tracer and high margin of safety for the patients

  13. Carotid angioplasty with cerebral protection

    International Nuclear Information System (INIS)

    Background. Carotid endarterectomy (CEA) is widely used in the management of high-grade carotid stenosis. It is a surgical procedure requiring general anaesthesia and is suitable only for lesions located at or close to the carotid bifurcation. It may develop complications, such as stroke, death, cranial nerve palsies, wound haematoma and cardiac complications. The risk of complications is increased in patients with recurrent carotid artery stenosis following CEA, in subjects undergoing radiotherapy to the neck, and in patients with cardiopulmonary disease. The drawbacks of CEA have led physicians to search for alternative treatment options. Carotid angioplasty and stenting (CAS) is less invasive than CEA. The method is particularly suitable for the treatment of recurrent stenosis after previous CEA and distal internal artery stenosis, which is inaccessible for CEA. CAS does not cause cranial nerve palsies. Moreover, it does not require general anaesthesia and causes lower morbidity and mortality in patients with severe cardiopulmonary disease. The complications of CAS include stroke due to distal immobilisation of a plaque or thrombus dislodged during the procedure, abrupt vessel occlusion due to thrombosis, dissection or vasospasm, and restenosis due to intimal hyperplasia. CAS is a relatively new procedure; therefore, it is essential to establish its efficacy and safety before it is introduced widely into clinical practice. Patients and methods. In Slovenia, we have also started with carotid angioplasty by the study: Slovenian Carotid Angioplasty Study (SCAS). We performed CAS in 17 patients (12 males and 5 females) aged from 69 to 82 years. All patients were symptomatic with stenosis greater than 70 %. 10 patients suffered transient ischemic attacks, 4 patients minor strokes and 3 patients amaurosis fugax. Results. Technical success (< 30 % residual stenosis) was achieved in all cases. In 14 patients, no residual stenosis was found, in 2 patients a 15 % residual

  14. Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography

    Directory of Open Access Journals (Sweden)

    Jeon

    2015-12-01

    Full Text Available Background Maturation failure of autogenous arteriovenous fistula (aAVF has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA for immature aAVF has been identified as an effective treatment modality. Objectives The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA. Patients and Methods We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1 patient factors (age; sex; co-morbidities; and aAVF age, side and type; 2 vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease; 3 lesion factors (stenosis number, location and severity; and 4 technical factors (presence of residual stenosis and anatomic success ratio (ASR on follow-up Doppler ultrasonography. Results The technical and clinical success rates were both 94.9% (56/59; the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30% (both P < 0.001 on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation. Conclusion For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended.

  15. Percutaneous transluminal laser angioplasty

    International Nuclear Information System (INIS)

    In this paper the authors report on a new technique-percutaneous transluminal laser angioplasty (PLR) which was performed on 9 patients with iliac and/or femoro-popliteal artery occlusion. All patients were males (mean age: 64.5 years) and had arterial occlusion (mean lenght: cm 12.5). PLR was performed with an argon laser (max power: 16 Watts). In 8 out of 9 patients (88.8%) a complete recanalization was obtained of the occluded arterial tract, without complications. In one case only (12.2%) there was an arterial wall perforation with unsatisfactory results. In our opinion, PLR has proven a simple methodology, which can be performed on any patient due to the very low incidence of severe complications and distal embolism. Moreover PLR has quite low costs, and does not prevent eventual surgical/percutaneous interventions

  16. Angioplasty - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Angioplasty URL of this page: https://medlineplus.gov/languages/angioplasty.html Other topics A-Z A B ...

  17. A COMPARISON OF HIRUDIN WITH HEPARIN IN THE PREVENTION OF RESTENOSIS AFTER CORONARY ANGIOPLASTY

    NARCIS (Netherlands)

    SERRUYS, PW; HERRMAN, JPR; SIMON, R; RUTSCH, W; BODE, C; LAARMAN, GJ; VANDIJK, R; VANDENBOS, AA; UMANS, VAWM; FOX, KAA; CLOSE, P; DECKERS, JW

    1995-01-01

    Background. The likelihood of restenosis is a major limitation of coronary angioplasty. We studied whether hirudin, a highly selective inhibitor of thrombin with irreversible effects, would prevent restenosis after angioplasty. We compared two regimens of recombinant hirudin with heparin. Methods. W

  18. Impact of Diabetes on Long-Term Outcome After Primary Angioplasty

    DEFF Research Database (Denmark)

    De Luca, Giuseppe; Dirksen, Maurits T; Spaulding, Christian;

    2012-01-01

    Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was to evaluate the impact of diabetes on long-term outcome in patients undergoing primary angioplasty treated with bare metal stents...

  19. Impact of diabetes on long-term outcome after primary angioplasty: insights from the DESERT cooperation

    NARCIS (Netherlands)

    Luca, G. De; Dirksen, M.T.; Spaulding, C.; Kelbaek, H.; Schalij, M.; Thuesen, L.; Hoeven, B. van der; Vink, M.A.; Kaiser, C.; Musto, C.; Chechi, T.; Spaziani, G.; Llera, L.S. Diaz de la; Pasceri, V.; Lorenzo, E. Di; Violini, R.; Suryapranata, H.; Stone, G.W.; cooperation, D.

    2013-01-01

    OBJECTIVE: Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was to evaluate the impact of diabetes on long-term outcome in patients undergoing primary angioplasty treated with bare me

  20. Carbon dioxide-guided angioplasty

    International Nuclear Information System (INIS)

    Revascularization procedures are frequently necessary in patients with severe peripheral vascular disease and renal insufficiency (often coexistent with diabetes mellitus). This paper examines the use of carbon dioxide as the contrast agent in percutaneous revascularization procedures (balloon angioplasty). Over the past 10 months, our protocol has used CO2 as the contrast agent for balloon angioplasty in a select group of patients (n = 12) with peripheral vascular disease and renal insufficiency. Some had coexistent diabetes mellitus. With digital subtraction angiography, CO2 was the only contrast agent used during revascularization. Pressure gradients were obtained in appropriate patients

  1. Parallel wire balloon angioplasty for undilatable venous stenosis in hemodialysis fistula

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Beom; You, Jin Jong; Cho, Jae Min [Gyeongsang National University Hospital, Jinju (Korea, Republic of)] (and others)

    2007-05-15

    The purpose of this study was to assess the value of the parallel wire balloon angioplasty technique for treating dysfunctional hemdialysis fistula with rigid stenosis, and this type of lesion was resistant to conventional angioplasty. Between March 2002 and August 2003, we included 6 patients (mean age: 59, males: 2, females: 4) who were treated via parallel the wire balloon angioplasty technique and their hemodialysis fistula has stenoses that were resistant to conventional angioplasty. We performed conventional angioplasty in all patients, but we failed to achieve sufficient dilatation. In the cases of highly resistant stenosis, an additional 0.016 inch wire was inserted into the 7 F vascular sheath. During angioplasty, a 0.016 inch guide wire was inserted between the balloon and the stenosis and then it was pushed to and fro until the balloon indentation disappeared. After the procedure, we performed angiography to identify the residual stenosis and the procedure-related complications. The undilatable stenoses in 5 patients were successfully resolved without complications via the parallel wire angioplasty technique. In one patient, indentation of balloon was not resolved, but the residual stenosis was both minimal and hemodynamically insignificant. The parallel wire angioplasty technique seems to be a feasible and cost-effective method for treating a dysfunctional hemodialysis fistula with undilatable and rigid stenosis.

  2. Evaluation of effect of coronary angioplasty using dipyridamole 99mTc myocardial imaging

    International Nuclear Information System (INIS)

    To evaluate the effect of coronary angioplasty in patients with coronary artery disease, we performed dipyridamole 99mTc myocardial imaging pre-and post-angioplasty. Within one month, 97.8% myocardial segments showing redistribution before angioplasty became normal or improved after angioplasty, but none improved in segments showing 'fixed' defect only. Within one month, effective rate of treatment was 76.7% in 30 patients but 95.8% in 24 patients showing redistribution before angioplasty. Follow-up study within 6 months showed that the effective rate of treatment was 66.7% in 30 patients and 83.3% in 24 patients respectively. The myocardial imagings of three patients kept normal during one year follow-up. In 12.5% cases, the myocardial imaging showed reischemia which was confirmed by angiography

  3. Serial changes in myocardial perfusion and function after successful percutaneous transluminal coronary angioplasty, examined by stress thallium-201 myocardial scintigraphic and stress radionuclide ventriculographic studies

    International Nuclear Information System (INIS)

    In order to study the early and late effects of percutaneous transluminal coronary angioplasty (PTCA), 201Tl myocardial perfusion scintigraphy and exercise 99mTc ventriculography were performed in 25 patients who successfully received PTCA. Before PTCA, reduced myocardial perfusion on stress 201Tl image was observed in all 25 patients, while abnormal regional wall motion during exercise was seen in 22 cases. On stress 201Tl images, reduced myocardial perfusion was demonstrated in 11 cases at 3-7 days after PTCA, but in none at 3 months after the procedure. On the other hand, abnormal exercise regional wall motion was not observed in any case after successful PTCA even in the early phase. When the patients were divided into two groups according to the presence or absence of perfusion abnormalities on stress 201Tl images in the early post-PTCA phase, no difference was seen in clinical and coronary angiographic findings, exercise tolerance, 201Tl uptake score, wall motion score or left ventricular ejection fraction before the procedure. Thus, abnormal myocardial perfusion without impairment of regional left ventricular wall motion is frequently seen in the early post-PTCA phase. But this finding does not necessarily indicate associated myocardial ischemia. (author)

  4. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    International Nuclear Information System (INIS)

    The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic patients (M/F = 41/19; mean age, 69.4 ± 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success, perioperative morbidity and mortality, and clinical success (defined by ulcer healing) were evaluated. Kaplan-Meier life-table analysis was obtained for cumulative clinical success, limb salvage, and survival rates. The procedure was technically successful in 55 of 60 (91.7%) patients; in 5 cases we were not able to achieve a reentry. Periprocedural mortality was 5% (3 patients); three patients (5%) required major amputation periprocedurally. Mean follow-up was 23 months (range, 0-48 months). On an intention-to-treat basis, the limb salvage rate was 93.3% (56/60 patients); ulcer healing was observed in 45 of 60 (75%) patients and it was significantly (p < 0.05) associated with serum creatinine and HbA1c levels, diabetes duration, and infrapopliteal recanalization. One- and three-year cumulative survival rates were 91.5% and 83.1%, respectively; serum creatinine levels, patient age, and clinical success were significant predictors of survival. In conclusion, infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limb-threatening ischemia not suitable for surgical recanalization. This procedure is aimed to create a 'temporary bypass' that facilitates ulcer healing.

  5. Comparison of a nitinol stent versus balloon angioplasty for treatment of a dysfunctional arteriovenous graft

    International Nuclear Information System (INIS)

    This study aimed to 1) evaluate the outcome of placing a nitinol stent for treating dysfunctional arteriovenous grafts (AVG), and 2) compare the results with those of successful balloon angioplasty. Between February 2008 and October 2011, we retrospectively reviewed the interventional data and medical records of 29 patients (21 men, 8 women; mean age, 67.4 years) who underwent interventional procedures for dysfunctional AVG. Stents were placed only in cases with inadequate angioplasty results. Stent patency was evaluated and compared to cases of successful balloon angioplasty using the Kaplan Meier analysis. Eleven stents and 18 angioplasties were performed successfully at the venous anastomotic site of AVG. The primary patency at 3, 6, 12, and 18 months did not differ significantly for stent placement and angioplasty (52%, 29%, 15%, 15% vs. 71%, 50%, 34%, 34%; mean survival, 164 vs. 253 days, p = 0.283). Secondary patency of the stent also did not differ significantly from angioplasty (80%, 80%, 49%, 49% vs. 76%, 57%, 57%, 36%; mean survival, 405 vs. 385 days, p = 0.553). Nitinol stent placement was effective for treating dysfunctional AVG, but did not improve the primary and secondary patency compared to successful angioplasty

  6. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... an abnormal nuclear stress test, which is a study performed with chemical induction of stress rather than ... that was done was a nuclear stress image study. And that study, as I mentioned earlier, suggested ...

  7. ON THE SAFETY OF CONTRAST MEDIA USAGE DURING CORONARY ANGIOPLASTY IN KIDNEY TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    I. G. Ryadovoy

    2010-06-01

    Full Text Available In the present study influence of contrast media on renal transplant function in patients with ischemic heart disease treated by coronary angioplasty and stenting waz estimated. Results are based on clinical and angiographic data, the analysis of amount of contrast media, average speed of it introduction, level of creatinine before and at the first 48 hours after coronary angioplasty in 42 patients with renal transplant. 

  8. Matrix metalloproteinase 9 level as an indicator for restenosis following cervical and intracranial angioplasty and stenting

    OpenAIRE

    Jun-peng Liu; Yin-zhou Wang; Yong-kun Li; Qiong Cheng; Zheng Zheng

    2015-01-01

    Cervical and intracranial angioplasty and stenting is an effective and safe method of reducing the risk of ischemic stroke, but it may be affected by in-stent restenosis. The present study investigated serum level of matrix metalloproteinase 9 as a predictor of restenosis after 40 patients underwent cervical and/or intracranial angioplasty and stenting. Results showed that restenosis occurred in 30% (3/10) of patients when the serum level of matrix metalloproteinase 9 at 3 days after surgery ...

  9. Combination of Rotational Atherothrombectomy and Paclitaxel-Coated Angioplasty for Femoropopliteal Occlusion

    OpenAIRE

    Scheer, F; CW Lüdtke; P Kamusella; Wiggermann, P; Vieweg, H; Schlöricke, E; Lichtenberg, M.; R Andresen; Wissgott, C

    2015-01-01

    OBJECTIVE The rotational atherothrombectomy with Straub Rotarex® is a safe and efficient treatment of acute/subactute vascular occlusions. The purpose of this study was to evaluate the benefit of paclitaxel-coated angioplasty after rotational atherothrombectomy over an observation period of six months. MATERIALS AND METHODS Overall, 29 patients were treated with the Rotarex catheter in combination with paclitaxel-coated angioplasty. All patients had acute/subacute and chronic occlusions of th...

  10. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Pastromas, Georgios, E-mail: geopastromas@gmail.com; Spiliopoulos, Stavros, E-mail: stavspiliop@upatras.gr; Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com; Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr; Siablis, Dimitrios, E-mail: siablis@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece)

    2013-12-15

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) {>=} 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 {+-} 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 {+-} 22.9 months (range 3-95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher's exact test; p < 0.05). According to Kaplan-Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31-0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  11. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    International Nuclear Information System (INIS)

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) ≥ 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 ± 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 ± 22.9 months (range 3–95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher’s exact test; p < 0.05). According to Kaplan–Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31–0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  12. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... the tests that was done was a nuclear stress image study. And that study, as I mentioned ...

  13. Failure of epoprostenol (prostacyclin, PGI2) to inhibit platelet aggregation and to prevent restenosis after coronary angioplasty: results of a randomised placebo controlled trial.

    OpenAIRE

    Gershlick, A H; Spriggins, D.; Davies, S W; Syndercombe Court, Y D; Timmins, J.; Timmis, A D; Rothman, M. T.; Layton, C; Balcon, R

    1994-01-01

    OBJECTIVE--To study the effect of epoprostenol (prostacyclin, PGI2) given before, during, and for 36 h after coronary angioplasty on restenosis at six months and to evaluate the transcardiac gradient of platelet aggregation before and after percutaneous transluminal coronary angioplasty (PTCA) in treated and placebo groups. DESIGN--Double blind placebo controlled randomised study. PATIENTS--135 patients with successful coronary angioplasty. METHODS--Intravenous infusion of PGI2 (4 ng/kg/ml) o...

  14. Psychological and Work Stress Assessment of Patients following Angioplasty or Heart Surgery: Results of 1-year Follow-up Study.

    Science.gov (United States)

    Fiabane, Elena; Giorgi, Ines; Candura, Stefano M; Argentero, Piergiorgio

    2015-12-01

    The aim of this study was to explore changes in subjective psychological health and perceived work stress among patients who returned to work (RTW) after a multidisciplinary cardiac rehabilitation (CR) following cardiac interventions. A total of 108 patients were evaluated at the beginning of their CR, at 6 and 12 months after discharge. Self-report questionnaires were used to assess depression, anxiety, illness perception and work stress at each time stage. Results showed reports of depressive symptoms significantly decreased (p reintegration. PMID:24554616

  15. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... the tests that was done was a nuclear stress image study. And that study, as I mentioned earlier, suggested that there was a defect or decreased blood flow on the lateral wall of ... you have a false positive stress test. So in other words, the test was ...

  16. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... It’s pretty clear just by looking at the films that that’s not necessary. The question about when ... Dr. Mukhari? Well, there was a very telling study, a very important study that came out within ...

  17. Transcutaneous oximetry compared to ankle-brachial-index measurement in the evaluation of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous oximetry values dropped significantly at the end of the procedure and returned close to the baseline levels at 2 and 4 weeks after angioplasty. Ankle-brachial-indices and transcutaneous oximetry were positively correlated before (r = 0.3833, p = 0.009) as well as 4 weeks after angioplasty (r = 0.4596, p = 0.001). Immediately after radiological interventions, ankle-brachial-indices and transcutaneous oximetry are not positively correlated. In patients undergoing angiography only, transcutaneous oximetry levels drop significantly immediately after angiography and remain at decreased levels even at 4 weeks after intervention. Conclusion: Transcutaneous oximetry as parameter of the microcirculation is positively correlated with ankle-brachial-index as parameter of the macrocirculation before and at 4 weeks after angioplasty. Intraarterial angiography leads to a sudden decrease in skin microcirculation without affecting macrocirculation. As indicated by a lack of recovery in transcutaneous oximetry levels after 4 weeks, angiography alone results in a prolonged impaired microcirculation which may

  18. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... symptoms got worse. He had a nuclear stress test, which was abnormal, and he is has now ... of angina. He had an abnormal nuclear stress test, which is a study performed with chemical induction ...

  19. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... a false positive stress test. There are false negative stress tests as well. So you may have ... side we can have false positive and false negative studies. The next step, as Dr. Mukhari says, ...

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... his symptoms got worse. He had a nuclear stress test, which was abnormal, and he is has ... symptoms of angina. He had an abnormal nuclear stress test, which is a study performed with chemical ...

  1. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... stress test, which is a study performed with chemical induction of stress rather than walking on the ... t know yet if there will be any intervention necessary. But I can tell you right now, ...

  2. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... when his symptoms got worse. He had a nuclear stress test, which was abnormal, and he is ... had symptoms of angina. He had an abnormal nuclear stress test, which is a study performed with ...

  3. Cutting Balloon angioplasty for cardiac transplant vasculopathy.

    OpenAIRE

    Takano, Y.; Currier, JW; Yeatman, LA; Kobashigawa, JA; Rogers, AD; Cianfichi, LJ; Fishbein, MC; Tobis, JM

    2002-01-01

    We performed Cutting Balloon angioplasty on 20 lesions in 11 heart transplant recipients 7.5 +/- 3.8 years after transplantation. The mean percentage of diameter stenosis decreased from 88.3% +/- 13.8% to 19.6% +/- 13.7% after Cutting Balloon angioplasty without complication. Seven patients underwent follow-up angiography at 4.9 +/- 1.7 months in a total of 12 lesions, and all lesions showed restenosis with a mean diameter stenosis of 84.4% +/- 19.2%. Cutting Balloon angioplasty can be used t...

  4. [Coronary angioplasty in elderly patients].

    Science.gov (United States)

    Liistro, Francesco; Colombo, Antonio

    2002-01-01

    Developed nations are experiencing an unprecedented growth in the number of elderly citizens. Thanks to the modernization of both society and medical care, over the past century, life expectancy in most countries has nearly doubled. The elderly (80 years or over) represent the fastest-growing segment of our population. Owing to their age, the elderly are more afflicted with chronic diseases, including coronary artery disease. Recently, clinicians became more aggressive in the use of invasive cardiovascular diagnostic tests in these patients. With regard to younger patients, we have a wealth of data from large, randomized trials that defined which subsets of patients benefit from revascularization therapies. However, because the very elderly were severely underrepresented in these randomized studies, we have almost no information concerning the choice of treatment in these patients. Initial results of percutaneous revascularization procedures in elderly patients come from retrospective analysis performed during the pre-stent era. In these studies a procedural mortality risk 5-fold higher in patients > 80 years compared with those 80 years). The comparison between the percutaneous approach and the surgical approach to coronary artery disease in the elderly has its major limitation in the lack of data from randomized trials. The available information suggests similar results with the two different strategies (5-year survival rate: 85.7% for the coronary artery bypass grafting group vs 81.4% for the percutaneous revascularization group) with a clear benefit in favor of surgery only in diabetic patients. The only constant difference is the need of a repeat intervention which is significantly higher for the percutaneous approach. Furthermore, the introduction of newer percutaneous devices suitable for the recanalization of totally occluded coronary arteries could increase the completeness of the revascularization achieved with the percutaneous approach with a positive

  5. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... stress test, which is a study performed with chemical induction of stress rather than walking on the ... can’t change and modify, and that’s family history. There’s not much we can do right now ...

  6. The mechanism of angioplasty

    International Nuclear Information System (INIS)

    A model was developed which allows the dilatation of iliac cadaver arteries under normal blood pressure conditions (mean pressure 100 mmHg). Segments of the iliac artery were put under pressure and dilated with balloons under similar conditions as in clinical practice. Purposely oversized balloons were used because most of the arteries did not contain severely stenotic plaques and consequently the commercially available balloons had no effect because of their comparatively small diameter. In spite of the use of oversized balloons, the cadaver arteries could not be significantly dilated. Rupture of the intima and media was almost invariably present. Leakage of distending fluid through the adventitia occurred commonly. The 'therapeutic range' between minimal dilation and partial or total rupture in postmortem studies is small. (orig.)

  7. Sleep Apnea Tied to Complications After Angioplasty

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  8. Protective effect of collateral vessels during coronary angioplasty.

    OpenAIRE

    Norell, M. S.; Lyons, J. P.; Gardener, J E; Layton, C A; Balcon, R

    1989-01-01

    To assess the potential protective role of collateral vessels 27 patients undergoing angioplasty of the left anterior descending coronary artery were studied by intravenous digital subtraction left ventriculography. Fifteen patients had no collateral vessels (group 1) and 12 had some degree of collateral supply (group 2). During balloon inflation ST segment elevation in group 1 (4.9 mm) was significantly greater than that in group 2 (0.9 mm). Similarly the reduction in left ventricular ejecti...

  9. Local Administration of NF-κ B Decoy Oligonucleotides to Prevent Restenosis after Balloon Angioplasty: An Experimental Study in New Zealand White Rabbits

    International Nuclear Information System (INIS)

    Purpose. To evaluate the efficacy of NF-κ B oligonucleotides (ODN) administered by local administration with the channeled balloon catheter to prevent restenosis after balloon angioplasty in restenotic iliac arteries of New Zealand white rabbits. Materials and Methods. In vitro, 8000 rabbit vascular smooth muscle cells (rVSMC) where transfected with a liposomal carrier (TfX50) with 100 ng of decoy and scrambled ODN. Inhibition of proliferation was measured using a MTT assay after 24 hours in comparison to control. In vivo, 22 male New Zealand White rabbits were fed a 1% cholesterol diet and received denudation of both common iliac arteries with a 3 mm balloon catheter to induce an arterial stenosis. Four weeks after stenosis induction, local application of NF-κ B in two different concentrations (1 μg: n = 14; 10 μg: n = 8) was performed randomly on one common iliac artery. Scrambled oligonucleotides without specific binding capacities were injected into the contralateral side. The channeled balloon catheter allows simultaneous balloon dilation (8 atm) of the stenosis and local application of a drug solution (2 atm). Four weeks after local drug delivery the animals were killed and the vessels were excised and computerized morphometric measurements were performed. Results. NF-κ B decoy ODN but not scrambled ODN inhibited proliferation of rVSMC in vitro. Following local ODN application in the animals, no acute vascular complications were seen. NF-κ B ODN resulted in a statistically non significant reduction of neointimal area compared to the control group. The neointimal area was 0.97 mm2 using 1 μg NF-κ B ODN compared to 0.98 mm2 in the control group. The higher dose resulted in a neointimal area of 0.97 mm2 compared to 1.07mm2 at the control side. Conclusions. Local drug delivery of NF-κ B ODN using the 'channeled balloon' catheter could not reduce neointimal hyperplasia in stenostic rabbit iliac arteries. Application modalities have to be improved to

  10. Mechanical and acoustic analysis in ultrasonic angioplasty

    Science.gov (United States)

    Detwiler, Paul W.; Watkins, James F.; Rose, Eric A.; Ratner, A.; Vu, Louis P.; Severinsky, J. Y.; Rosenschein, Uri

    1991-05-01

    The goal of this study was to investigate the relationship between ultrasonic tissue ablation and passive mechanical elasticity. Experience with ultrasonic angioplasty in experimental settings (in-vivo and in-vitro) together with clinical experience in peripheral vascular disease is reported. A model composed exclusively of a hydroxyproline ballistic gelatin matrix showed a negative correlation between material elasticity and the rate of ultrasonic ablation. This model provided a means of studying the effects of collagen content on ablation, exclusive of other biologic components. Ballistic gelatin ablation (mg/sec) was found to increase logarithmically with decreasing protein concentration over the range studied (20.00 to 1.25%). Ablation as a function of gelatin elasticity behaved in a similar manner. Temperature of the material ablated was also demonstrated to affect the rate of ablation. We conclude that the previously reported differences in ablation between thrombi and blood vessel are predictable based on the large difference in their mechanical elasticity, and that this difference provides a wide margin of safety.

  11. Intravascular ultrasound imaging following balloon angioplasty.

    Science.gov (United States)

    Tobis, J M; Mahon, D J; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality. Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation. PMID:1833473

  12. Transluminal angioplasty, fibrinolysis, and newer vascular interventions

    International Nuclear Information System (INIS)

    This refresher course presents an overview of the current status of transluminal angioplasty in the treatment of peripheral vascular disease, renovascular hypertension, and upper extremity vasculature. Indications for therapy, accepted techniques, and the diagnosis and treatment of complications are major topic areas. Newer areas of increasing application are discussed, particularly popliteal and tibial angioplasty. Newer devices and procedures such as lasers, percutaneous atherectomy, and mechanical recanalization devices are reviewed and their role in the current therapeutic armamentarium discussed. The current status of catheter-directed fibrinolytic techniques is presented, particularly as they relate to the concomitant use of transluminal angioplasty. The choice of lytic agents and newer agents is reviewed. Long-term results and complication rates are discussed by anatomic area

  13. Sequential thallium-201 myocardial perfusion studies after successful percutaneous transluminal coronary artery angioplasty: delayed resolution of exercise-induced scintigraphic abnormalities

    International Nuclear Information System (INIS)

    To characterize the sequential changes of myocardial perfusion scintigraphy in patients with coronary artery disease (CAD) after complete revascularization, 43 patients underwent exercise thallium-201 (201Tl) myocardial perfusion scintigraphy before and at 9 +/- 5 days, 3.3 +/- 0.6, and 6.8 +/- 1.2 months after percutaneous transluminal coronary angioplasty (PTCA). Only patients with single-vessel CAD, without previous myocardial infarction, and without evidence of restenosis at 6 to 9 months after PTCA were included. Perfusion scans were analyzed blindly with the use of a new quantitative method to define regional myocardial perfusion in the topographic distribution of each coronary artery, which was shown to be reproducible (r = .94 or higher and SEE of 7% or less, between repeated measures by one and two operators). At 4 to 18 days after PTCA, the mean treadmill walking time increased by 123 +/- 42 sec, mean exercise-induced ST segment depression decreased by 0.6 +/- 0.3 mm, group maximal heart rate increased by 20 +/- 9 beats/min, and group systolic blood pressure at peak exercise increased by 24 +/- 10 mm Hg, compared with pre-PTCA values (p less than .001). However, no group differences were noted in these variables between the three post-PTCA stages. Myocardial perfusion in the distribution of the affected (dilated) coronary artery, on the other hand, improved progressively. In the 45 degree left anterior oblique view for instance, myocardial perfusion increased at 9 days after PTCA (from 68 +/- 24% before PTCA to 91 +/- 9%, p less than .001) and at 3.3 months after PTCA (101 +/- 8%, p less than .05 vs 9 days after PTCA), but no further significant changes were seen at 6.8 months after PTCA (102 +/- 8%). Similar changes were noted in the other two views. No relationship between minor complications during PTCA and delayed improvement on the 201Tl was observed

  14. Primary coronary angioplasty in acute myocardial infarction.

    OpenAIRE

    Grech, E. D.; Ramsdale, D. R.

    1996-01-01

    It is well established that recanalisation of the infarct-related artery is of great benefit in the early hours after acute myocardial infarction. This can be achieved by the use of thrombolytic agents and/or by percutaneous transluminal coronary angioplasty (PTCA). This article reviews data on the role of primary PTCA and summarises current opinion on its use.

  15. [Percutaneous coronary Excimer laser angioplasty in patients with coronary heart disease].

    Science.gov (United States)

    Karsch, K R; Haase, K K; Mauser, M; Ickrath, O; Voelker, W; Baumbach, A; Seipel, L

    1990-07-01

    To verify the efficacy and safety of percutaneous coronary excimer laser angioplasty in patients with coronary artery disease a prospective study was conducted in 60 patients. The application of laser light was possible in 55 of the 60 patients. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter, each arranged concentrically around a central lumen suitable for an 0.014-inch flexible guide wire was used. The light source was a commercial excimer laser emitting energy at a wavelength of 308 nm, with a pulse duration of 60 ns. The laser was operated at 20 Hz; mean energy transmission was 30 +/- 5 mJ/mm2. In 23 of the 55 patients treated with excimer laser energy the qualitative angiographic results were sufficient. In 32 patients additional balloon angioplasty was necessary, either because of an insufficient result or due to vessel closure after laser ablation. In 47 of the 55 patients control angiography was performed within the 6-month follow-up period. Rate of restenosis was higher in patients treated with laser ablation and subsequent balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (6 of 19). Results of the 6-month observation period suggest that 1) coronary excimer laser angioplasty in combination with subsequent balloon angioplasty results in a considerable increase of the restenosis rate; 2) the exclusive use of laser ablation also results in a restenosis rate comparable to balloon angioplasty alone; and 3) the impact of this new method using improved application systems and higher energy transmission has to be determined in further studies. PMID:2399764

  16. Carotid angioplasty and stent placement for restenosis after endarterectomy

    International Nuclear Information System (INIS)

    Recurrent carotid stenosis following endarterectomy is a common complication, and reoperation may be associated with increased morbidity. The goal of this study was to determine the procedural safety and long-term complication rates of carotid angioplasty and stenting for recurrent stenosis. Of 248 consecutive carotid angioplasty and/or stenting procedures performed at our institution between March 1996 and November 2005, 83 procedures for recurrent stenosis following endarterectomy were performed in 75 patients (mean age 68 years; 43 men, 32 women) without cerebral protection devices. The patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and long-term complication rates were calculated. Recurrent stenosis was reduced from a mean of 80.6% to no significant stenosis in 82 of 83 procedures. The procedural stroke rate was 3 out of 83 procedures (3.6%). The procedural transient ischemic attack (TIA) rate was 2 out of 83 procedures (2.4%). Mean follow-up was 22.4 months (range 0.1 to 86.7 months) with at least 6 months follow-up for 54 of 83 procedures (65%). There were five TIAs and no strokes on follow-up (new TIAs at 25.5 and 43.4 months; recurrent TIAs at 1, 11.1, and 12 months, all with normal angiograms). The composite 30-day stroke, myocardial infarction, or death rate was 5 of 83 procedures (6.0%). In this series, angioplasty and stenting were effective in relieving stenosis secondary to recurrent carotid disease after endarterectomy, and have low rates of ischemic complications. (orig.)

  17. Modeling plaque fissuring and dissection during balloon angioplasty intervention.

    Science.gov (United States)

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

    Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage. PMID:17385047

  18. Exploring expectations and needs of patients undergoing angioplasty.

    Science.gov (United States)

    Aazami, Sanaz; Jaafarpour, Molouk; Mozafari, Mosayeb

    2016-09-01

    This study aimed to explore needs and expectations of Iranian patients who undergone angioplasty procedures. Coronary artery disease is the leading cause of morbidity and mortality worldwide. Recently, Percutaneous Coronary Intervention (PCI) has frequently been used as a substitute for coronary artery surgery, representing a less invasive and more cost-effective procedure. However, little information is known about the experiences and needs of patients undergone PCI. This research involved a qualitative study that employed the content analysis method. A semi-structured in-depth interview protocol was carried out using a face-to-face approach. Researchers reached to theoretical saturation by interviewing 18 patients who undergone angioplasty. Constant comparison analysis was used with simultaneous data collection. Three themes emerged from this study including Uncertainty, Procedural knowledge and Social Support. The findings from this study enhance our understanding on expectations and needs of patients who undergone PCI. These findings help nurses and health-care providers to develop and provide pre and post-procedural care according to each individual needs and experiences. This Iranian study not only contributes to other international study but also, emphasizes on the need for pre-procedural awareness and post-procedural support of patients who undergone PCI. PMID:27568316

  19. Assessment of percutaneous transluminal coronary angioplasty by quantitative coronary angiography: diameter versus densitometric area measurements

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); J.H.C. Reiber (Johan); W. Wijns (William); M.J.B.M. van den Brand (Marcel); C.J. Kooijman; H.J. ten Katen (Harald); P.G. Hugenholtz (Paul)

    1984-01-01

    textabstractCineangiograms of 138 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were analyzed with a computer-based coronary angiography analysis system. The results before and after dilatation are presented. In a first study group (120 patients), the severity of the o

  20. Short- and long-term functional effects of percutaneous transluminal angioplasty in hemodialysis vascular access

    NARCIS (Netherlands)

    Van der Linden, J; Smits, JHM; Wolterbeek, DW; Zijlstra, JJ; De Jong, GHT; Van den Dorpel, MA; Blankestijn, PJ

    2002-01-01

    The efficacy of percutaneous transluminal angioplasty (PTA) is usually expressed as the angiographic result. Access flow (Qa) measurements offer a means to quantify the functional effects. This study was performed to evaluate the short-term functional and angiographic effects of PTA and to determine

  1. Wiktor stent implantation in patients with restenosis following balloon angioplasty of a native coronary artery

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); M.E. Bertrand (Michel); V. Wiegand; G. Kober; J.F. Marquis; B. Valeix; R. Uebis; J. Piessen; P.P.T. de Jaegere (Peter)

    1992-01-01

    textabstractIntracoronary stenting has been introduced as an adjunct to balloon angioplasty aimed at overcoming its limitations, namely acute vessel closure and late restenosis. This study reports the first experience with the Wiktor stent implanted in the first 50 consecutive patients. All patients

  2. Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery

    OpenAIRE

    Oliveira Sergio A; Stolf Noedir A; Góis Aécio FT; Soares Paulo R; Lopes Neuza; Borges Jorge; Hueb Whady A.; Ramires Jose AF

    2010-01-01

    Abstract Background Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arteries in patients undergoing surgery, angioplasty, or medical treatment. Methods Patients (611) with stable multivessel coronary artery disease and preserved ventricular function were randoml...

  3. Intracoronary radiation therapy using Re-188 after percutaneous coronary angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Chae, In Ho; Lee, Myoung Mook; Lee, Dong Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    1999-07-01

    Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, intimal hyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of past PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.

  4. Angioplasty - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) ... cardiaque - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Heart Cath and and Heart Angioplasty ...

  5. Percutaneous Transluminal Coronary Angioplasty after Cardiac Transplantation

    OpenAIRE

    Avedissian, Michael G.; Bush, Howard S; Leachman, D. Richard; Fighali, Sayid; Frazier, O. H.

    1989-01-01

    This report describes the 1st use of percutaneous transluminal coronary angioplasty in a posttransplant patient at the Texas Heart Institute. The patient, a 44-year-old man, experienced 3 episodes of moderate allograft rejection, hypercholesterolemia, transient severe hyperglycemia, and transient severe renal insufficiency in the posttransplant period. His cholesterol levels became elevated immediately and remained between 200 and 250 mg/dL, despite treatment with gemfibrozil. He had increasi...

  6. Design Issues for Therapeutic Ultrasound Angioplasty Waveguides

    OpenAIRE

    Noone, Declan, (Thesis); Gavin, Graham; McGuinness, Garrett

    2008-01-01

    Therapeutic ultrasound angioplasty is a new minimally invasive cardiovascular procedure for disrupting atherosclerotic lesions. Mechanical energy is transmitted in the form of ultrasound waves via long, flexible wire waveguides navigated to the lesion site through the vascular system. The underpinning principle of this technology is that plaque may be disrupted through a combination of direct contact ablation, pressure waves, cavitation and acoustic streaming, which all depend on the amplitud...

  7. A New Approach: Regional Nerve Blockade for Angioplasty of the Lower Limb

    International Nuclear Information System (INIS)

    Purpose. An audit study investigated the pilot use of regional nerve block analgesia (as an alternative to sedative/opiate, general or central neuraxial anesthesia) performed by radiologists with the assistance of imaging techniques during complex prolonged angiography. Methods. Radiologists were trained by anesthetic consultants to administer and use lower limb peripheral nerve block for difficult prolonged angioplasty procedures for patients with severe lower limb rest pain who were unable to lie in the supine position. In a pilot study 25 patients with limb-threatening ischemia received sciatic and femoral nerve blockade for angioplasty. The technique was developed and perfected in 12 patients and in a subsequent 13 patients the details of the angiography procedures, peripheral anesthesia, supplementary analgesia, complications, and pain assessment scores were recorded. Pain scores were also recorded in 11 patients prior to epidural/spinal anesthesia for critical ischemic leg angioplasty. Results. All patients with peripheral nerve blockade experienced a reduction in their ischemic rest pain to a level that permitted angioplasty techniques to be performed without spinal, epidural or general analgesia. In patients undergoing complex angioplasty intervention, the mean pain score by visual analogue scale was 3.7, out of a maximum score of 10. Conclusions. The successful use of peripheral nerve blocks was safe and effective as an alternative to sedative/opiate, epidural or general anesthesia in patients undergoing complex angiography and has optimized the use of radiological and anesthetic department resources. This has permitted the frequent radiological treatment of patients with limb-threatening ischemia and reduced delays caused by the difficulty in enlisting the help of anesthetists, often at short notice, from the busy operating lists

  8. The role of the adventitia in the arterial response to angioplasty: the effect of intravascular radiation

    International Nuclear Information System (INIS)

    Purpose: In the current series of experiments we have characterized cell proliferation leading to vascular lesion formation in a porcine model for post-angioplasty restenosis and examined the mechanism of action of intravascular beta irradiation in the prevention of lesion formation in this model. Methods and Materials: Juvenile male pigs were subjected to balloon overstretch injury of the left anterior descending and circumflex coronary arteries using clinical angioplasty catheters. Proliferating cells were labelled by injections of 50 mg/kg of bromo-deoxyuridine (BrDU) 24, 16 and 8 hrs prior to sacrifice and were detected by immunohistochemistry using a specific antibody to BrDU. In some cases, BrDU was given as a pulse 3 days after angioplasty and the animals sacrificed on day 14 to follow the migration of the cells which had proliferated earlier. Characterization of the proliferating cells was performed by immunohistochemistry using antibodies to specific cytoskeletal proteins specific for smooth muscle cells and myofibroblasts. Some vessels were treated at the time of angioplasty with 14 or 28 Gy (to a depth of 2 mm) intravascular irradiation using a flexible catheter with a pure beta emitter 90 SR/Y and the effect on cell proliferation and terminal transferase-mediated UTP nick-end labelling (TUNEL) examined 3 or 7 days later. Results: The first major site of cell proliferation between 2-3 days after angioplasty is the adventitia and not the medial wall. Seven days after angioplasty cell proliferation is predominant in the neointima and is reduced in the media and adventitia. Differential staining with antibodies directed against smooth muscle alpha actin and other cytoskeletal proteins indicates that the proliferating adventitial cells are myofibroblasts. Pulse label studies with BrDU indicates that the proliferating adventitial myofibroblasts migrate into the neointima and contribute to the mass of the restenosis lesion. Fourteen days after angioplasty the

  9. Clinical observation of intraluminal stent angioplasty in the treatment of renal arterial stenoses

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical application of intraluminal stent angioplasty (PTRAS) in the treatment of renal arterial stenoses. Methods: A retrospective study was done in 28 patients with renal arterial stenoses. Primary renal artery stenting was performed in 28 consecutive patients (36 renal arteries). Blood pressure, serum creating, the number of anti-hypertensive medications were recorded at 1, 6, 12 month post stent angioplasty respectively. Arterial angiography was also taken 1 year later to evaluate the incidence of restenosis. Results: Technical success rate was 100% achieving in all patients without serious complications. Primary successful patently rate reached 82% (renal artery 86%), secondary successful rate was 89% (renal artery 90%). Systolic and diastolic blood pressure were reduced significantly (P<0.01) at 1,6,12 month after stent angioplasty comparing with baseline and clinical improvement (cured + improved) of hypertension reached 100%, 92.9%, 89.3% respectively. There were no significant differences between serum creatine level and the number of anti-hypertensive medications before and after stent angioplasty. One year later, 14.3% of all patients showed improvement of renal function, 64.3% remained in stabilization and 21.4% fell into deterioration. Angiographic restenosis was found in 3 cases one year after stent angioplasty. Complications included 1 hematoma at puncture site and 3 transient azotaemia. Conclusions: PTRAS can be performed safely with high technical success and beneficial to the majority of patients with hypertension or renal insufficiency and therefore it should be the first choice in treating renal arterial stenoses

  10. Carotid angioplasty and stenting in the elderly

    International Nuclear Information System (INIS)

    To investigate the technical success rate as well as the procedural and mid-term complication rates of carotid angioplasty and stenting in elderly patients, a group excluded from large randomized endarterectomy trials given their perceived high surgical risk. Of 200 consecutive carotid angioplasty and/or stenting procedures performed between March 1996 and March 2005, 21 procedures were performed without cerebral protection devices in 20 patients over the age of 79 years (mean age: 83 years, 12 men, eight women). These patients' medical records were retrospectively reviewed for vascular imaging reports and available clinical follow-up. Procedural and mid-term complication rates were calculated and compared to a previously published cohort of 133 consecutive patients ≤79 years of age who also underwent endovascular treatment at our institution. Carotid stenosis was reduced from a mean of 82% to no significant stenosis in all procedures. The procedural stroke rate was zero of 21 procedures. The procedural transient ischemic attack rate (TIA) was one of 21 procedures (4.8%). Mean follow-up was 24.6 months (range: 1.0-79.5 months) with at least a 30-day follow-up for 20 of the 21 procedures (95.2%). There were no new strokes. There was one recurrent ipsilateral TIA at 1.9 months. In five cases with follow-up carotid ultrasonography, no hemodynamically significant restenosis had occurred. There were three myocardial infarctions (MI) occurring at 0.5, 2.1, and 15.2 months, of which the last MI was fatal. The composite 30-day stroke and death rate was zero of 21 procedures (95% confidence interval: 0-14%). No significant difference was found in the 30-day rate of stroke, TIA, MI, or death between the elderly and younger patients. Carotid angioplasty and stenting in elderly patients can be performed successfully with acceptable procedural and mid-term complication rates comparable to younger patients. (orig.)

  11. Occult, massive hematomas following antegrade femoral angioplasty

    International Nuclear Information System (INIS)

    Small groin hematomas are not uncommon after percuatenous antegrade femoral angioplasty (PAFA) and are usually apparent clinically. The authors describe three patients of 235 who underwent PAFA, in whom occult, massive hemorrhage was detected after the procedure. All patients underwent fluoroscopically guided antegrade punctures, with adequate hemostasis achieved after the procedure. CT revealed extraperitoneal hematomas in two patients. One patient required surgical intervention with ligation of the inferior epigastric artery. The authors postulate that these hematomas arose due to inadvertent injury to a branch of the common femoral artery during the puncture. The radiologist should be aware of the chance occurrence of this occult, potentially life-threatening complication

  12. Re-stenosis and successful angioplasty

    International Nuclear Information System (INIS)

    Histologic analysis was undertaken on a sample of 20 perfusion-fixed arteries from NZW rabbits 1 month after angioplasty of focal femoral arteriosclerotic lesions. The samples chosen were representative of re-stenosis (>50% stenosis), good result, or aneurysm as defined angiographically. All good results but only half of the restenosis had histologic evidence of a tear into media or adventitia. Tears into adventitia were more likely to have a good result. New myointimal proliferation was more severe with restenosis. An arterial tear was necessary but not sufficient for a good result; outcome was ultimately dependent on the degree of intimal hyperplasia

  13. Percutaneous transluminal angioplasty and stenting of carotid arteries: Early results

    Directory of Open Access Journals (Sweden)

    Čolić Momčilo

    2008-01-01

    Full Text Available INTRODUCTION Treatment of carotid stenosis could be surgical: eversion endarterectomy, conventional endarterectomy and patch-plasty, resection with graft interposition and bypass procedure or, in the past few years, carotid artery angioplasty (PTA with stent implantation. OBJECTIVE The aim of this study is to present early results of carotid artery angioplasty and stenting, as well as to identify indications for this procedure. METHOD Twenty-three patients with stenosis of internal carotid artery were included in the prospective study which was performed in the period from July 2006 to July 2007. For PTA and stenting of the carotid artery we used Balloon dilatation catheter Ultra-softTM SV and Carotid WallstentTM MonorailTM. During the procedure, brain protection by embolic protection system Filter Wire EZ was essentially performed. Descriptive statistical methods were performed to present and describe the patient characteristics, risk factors and results. RESULTS 23 patients were examined. In four (17.39% cases there was asymptomatic, while in 19 (82.61% there was symptomatic homodynamic significant stenosis of the internal carotid artery. Four of these 19 patients (17.39% had late restenosis following carotid endarterectomy, four (17.39% important respiratory failure, and 11 (47.83% important heart disease. Patients were followed up for the first 30 postopertive days. In that period, there were no mortality and no needs for surgical conversions. In one case (4.35%, residual stenosis of 30% remained. Two patients (8.70% had TIA and one (4.35% had CVI. CONCLUSION Main indications for PTA and stenting of carotid arteries are: surgically inaccessible lesions (at or above C2; or subclavial; radiation-induced carotid stenosis; prior ispilateral radical neck dissection; prior carotid endarterectomy (restenosis, severe cardiac and pulmonary conditions. Limitations and contraindications to carotid angioplasty and stentning include: significant

  14. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    International Nuclear Information System (INIS)

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short (≤5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle–brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 ± 0.11 versus 0.82 ± 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery

  15. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail: wponcyl@poczta.onet.pl; Falkowski, Aleksander, E-mail: bakhis@hot.pl [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail: chrissaf@mp.pl; Rac, Monika, E-mail: carmon@pum.edu.pl [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: dariusz13@yahoo.com [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  16. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients

    DEFF Research Database (Denmark)

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik;

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and...... translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if...... patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction...

  17. Determinants of success of coronary angioplasty in patients with a chronic total occlusion: a multiple logistic regression model to improve selection of patients.

    OpenAIRE

    Tan, K H; Sulke, N.; Taub, N A; Watts, E.; Karani, S.; Sowton, E

    1993-01-01

    OBJECTIVE--To study the determinants of success of coronary angioplasty in patients with chronic total occlusions, and to formulate a multiple logistic regression model to improve selection of patients. DESIGN--A retrospective analysis of clinical and angiographic data on a consecutive series of patients. PATIENTS--312 patients (mean age 55, range 31 to 79 years, 86% men) who underwent coronary angioplasty procedure for a chronic total occlusion between 1981 and 1992. RESULTS--Procedural succ...

  18. Angioplasty treatment and stent implant vs. surgical treatment in patients with stenosis of the cervical carotid artery

    International Nuclear Information System (INIS)

    Angioplasty with stent implant is a less invasive procedure than surgical intervention in the treatment of significant stenosis of the common cervical carotid artery (common and internal) (5). Currently the major published studies, in which angioplasty and surgical treatment are compared, show similar results in the major events, as cerebrovascular accidents and mortality, but a greater significant difference in the apparition of acute myocardial infarction, during surgical intervention (5,11). The objective of this study is to compare in both treatment methods the major and minor clinical events, like cerebrovascular accident, acute myocardial infarction, death, bradycardia, hypotension and encephalopathy during the intervention, the hospitalization and the follow-up year, as well as the re-intervention, the time of hospital stay and the complications of the surgical incision. Materials and methods: in this study of historical cohort, 46 patients with significant stenosis of the cervical carotid arteries, who were subjected to intervention from January 1st 2001 to December 31st 2003, were included. 21 patients were treated with angioplasty and stent implant and 25 with surgery (endarterectomy) Results: 1 (4.8%) major cerebrovascular accident occurred during angioplasty, whereas none occurred in the patients treated with surgery. 1 (4%) acute myocardial infarction occurred during intervention in the group of patients treated with surgery, and none in the patients treated with angioplasty. No deaths occurred in any of the groups during intervention, hospitalization and the follow-up year. After 8 months 1 (4%) patient treated with surgery was intervened again with angioplasty and stent implant. There were no statistically significant differences between both groups during hospitalization, and in the apparition of minor complications as bradycardia and hypotension. 2 (8%) complications related to the incision of the neck compromising cranial nerves, occurred in the

  19. Contribution of inhibitory receptor glycoprotein iib / iiia in coronary angioplasty and acute coronary syndrome, about 152 patients

    International Nuclear Information System (INIS)

    The aim of our study was to evaluate the immediate results and long-term intake of anti-GP IIb / IIIa inhibitors for patients with acute coronary syndrome treated with coronary angioplasty. The use of anti-GP IIb / IIIa is a valid therapeutic option in patients with acute coronary syndrome with signs of severity and for patients undergoing complex angioplasty. Adverse effects of anti-GP IIb / IIIa can be seen to encourage vigilance and careful monitoring during the administration of these molecules and perfect knowledge of their pharmacological properties for appropriate use.

  20. Comparative Efficacy of Pulse-Spray Thrombolysis and Angioplasty Versus Surgical Salvage Procedures for Treatment of Recurrent Occlusion of PTFE Dialysis Access Grafts

    International Nuclear Information System (INIS)

    Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone (p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty [0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision

  1. Percutaneous transluminal angioplasty after vascular surgery

    International Nuclear Information System (INIS)

    Percutaneous transluminal angioplasty (PTA) was used to treat 32 patients with 80%-95% stenoses in vascular bypass grafts and anastomotic stenoses. Eight lesions were in femoropopliteal, three in femorotibial, and one in femorofemoral crossover grafts. Twenty patients had stenoses at the prosimal or distal graft anastomoses. PTA was successful and enabled surgical intervention to be avoided in 29 of the 32 patients. Postdilation angiography demonstrated a substantial increase in luminal diameter and Doppler ankle-arm indexes were improved in all 29 successful cases. Long-term follow-up was available in 26 patients. After an average of 15 months, the graft was occluded in nine (35%) of the 26. In the other 17 patients (65%), the graft remained patent. The dilation of graft stenoses may be controversial and is difficult due to the diversity of underlying causes, such as intimal thickening, fibrotic reaction, and suture scar. The author's experience indicates that PTA is an efficient and safe treatment

  2. [Comparison of the results of coronary angioplasty and stenting during one year following surgery].

    Science.gov (United States)

    Simonenko, V B; Seĭdov, V G; Zakharov, S V; Evsiukov, V V; Liubchuk, I V

    2007-01-01

    The purpose of the study was to compare long-term results of angioplasty and coronary arterial stenting (CAS) depending on the initial degree of coronary arterial (CA) lesion according to morphological stenosis classification, as well as to evaluate the influence of re-stenosis on myocardial contractility dynamics, anginal recurrence rate, and exercise tolerance. The subjects, 228 men after angioplasty and 184 men after CAS with wire stents without drug coating, were included in the study between 1989 and 2005. Coronarography was repeated in 358 patients one year after surgery. The patients were divided into two groups. The first group consisted of 161 patients, to who 180 stents were implanted. The second group consisted of 197patients, in who 226 angioplasty procedures were performed. Data were processed using standard variational statistical methods, i.e. the calculation of mean values and standard deviation. Statistical calculations were carried out using Analysis ToolPak- VBA software of Microsoft Excel 2000. The study found that one year after either intervention the number of patients without anginal symptoms fell significantly compared with this number during the in-hospital period. In group 2 the frequency of restenosis was higher and the number of patients with anginal symptoms was significantly bigger than in group 1; the number of asymptomatic patients was significantly bigger in group 1. Initial morphological characteristics of CA lesion had a significant effect on the long-term frequency of restenosis following endovascular treatment. Restenosis was 2 to 2.5 times more frequent in patients with C type CA lesion vs. patients with A type regardless the method of endovascular intervention. The results of the study demonstrate the importance of taking into account initial morphological characteristics of CA lesion; CAS is more preferable than angioplasty, especially in patients with C type CA lesion. PMID:17520881

  3. Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

    OpenAIRE

    Akdemir, Ramazan; Karakurt, Özlem; Orcan, Salih; Karakoyunlu, Nihat; Mucahit Balci, Mustafa; SAĞNAK, Levent; Ersoy, Hamit; Bulent Vatan, Mehmet; Kilic, Harun; Yeter, Ekrem

    2012-01-01

    Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary an...

  4. The use of abciximab associated with primary angioplasty for treating acute myocardial infarction

    OpenAIRE

    Manuel Lisandro Hernández Brito; Newton F. Stadler de Souza Filho; Álvaro Vieira Moura; Luiz Augusto Lavalle; Rubens Zenobio Darwich; Marisa Leal; Eva Cantalejo Munhoz

    2002-01-01

    OBJECTIVE: To assess the benefit resulting from the use of abciximab associated with primary angioplasty. The following parameters were analyzed in-hospital, at 30 days, and 6 months: (a) flow in the culprit artery; (b) ventricular function; (c) combined outcome of death, acute myocardial infarction, and aditional revascularization. METHODS: From November 1997 to June 1999, a longitudinal nonrandomized study with historical data of 137 patients with acute myocardial infarction within the firs...

  5. Significance of Cardiac Troponin T Release in Detecting Minor Myocardial Injury After Percutaneous Transluminal Coronary Angioplasty

    OpenAIRE

    ALPER, Gülinnaz

    1999-01-01

    Cardiac Troponin T (TnT) is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. This study was designed to evaluate the diagnostic efficiency of TnT enzyme immunoassay in detecting myocardial damage in patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA) and to compare this newly developed test with t...

  6. Renal artery stent angioplasty for renovascular hypertension

    International Nuclear Information System (INIS)

    Objective: To evaluate the therapeutic results of expandable stent for treatment of atherosclerotic renovascular obstructive disease. Methods: 15 patients (10 men and 5 women, 41-75 years old; mean age, 52 years) with renal arterial hypertension underwent renal stent angioplasty including renal arterial stenosis 89%(n=13) and fully obstruction without function in 2, of which 2 patients had bilateral involvement. The stenotic range of all arterial segments showed 60% to 90% width of the normal arterial diameter. 16 stents were implanted under the guidance of fluoroscopy. The most of stents implanted were Palmaz (n=12, 75%) with regular clinical and angiographic follow up. Results: Technical success (residual stenosis <30%) was achieved in all patients without serious complication. During the follow-up (6-15 months; mean, 8 ± 4 months), hypertension was improved in 9 patients and cured in 4 patients with a total benefit of 86% and no efficacy in 2(13%). The average systolic blood pressure decreased from 27.12 ± 3.09 kPa to 18.62 ± 3.12 kPa and the average diastolic blood pressure decreased from 17.73 ± 1.92 kPa to 11.12 ± 2.43 kPa after stent treatment (P<0.05). Serum creatinine remained stable in 60% (n=9) patients with improvement in 33% (n=5) and worsened in 6% (n=1) patients. Follow-up angiography was performed in all patients with 1 case of a restenosis. 6 months after expanding through stent by using balloon, the two follow up angiographies showed a stable restenosis about 20%. Conclusions: Percutaneous transluminal stent placement is highly beneficial for patients who had renal arterial obstructive disease. The success of stent angioplasty of complete obstructive renal arteries reveals wide prospects for interventional method. (authors)

  7. Infarct size in primary angioplasty without on-site cardiac surgical backup versus transferal to a tertiary center: a single photon emission computed tomography study

    International Nuclear Information System (INIS)

    Primary percutaneous coronary intervention (PCI) performed in large community hospitals without cardiac surgery back-up facilities (off-site) reduces door-to-balloon time compared with emergency transferal to tertiary interventional centers (on-site). The present study was performed to explore whether off-site PCI for acute myocardial infarction results in reduced infarct size. One hundred twenty-eight patients with acute ST-segment elevation myocardial infarction were randomly assigned to undergo primary PCI at the off-site center (n = 68) or to transferal to an on-site center (n = 60). Three days after PCI, 99mTc-sestamibi SPECT was performed to estimate infarct size. Off-site PCI significantly reduced door-to-balloon time compared with on-site PCI (94 ± 54 versus 125 ± 59 min, respectively, p 12%. Off-site PCI reduces door-to-balloon time compared with transferal to a remote on-site interventional center but does not reduce infarct size. Instead, pre-PCI TIMI 0/1 flow, anterior wall infarct localization, and development of Q-waves are more important predictors of infarct size. (orig.)

  8. Infarct size in primary angioplasty without on-site cardiac surgical backup versus transferal to a tertiary center: a single photon emission computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Knaapen, Paul; Rossum, Albert C. van [VU University Medical Center, Department of Cardiology, Amsterdam (Netherlands); Mulder, Maarten de; Peels, Hans O.; Cornel, Jan H.; Umans, Victor A.W.M. [Medical Center Alkmaar, Department of Cardiology, Alkmaar (Netherlands); Zant, Friso M. van der [Medical Center Alkmaar, Department of Nuclear Medicine, Alkmaar (Netherlands); Twisk, Jos W.R. [VU University Medical Center, Department of Clinical Epidemiology and Biostatistics, Amsterdam (Netherlands)

    2009-02-15

    Primary percutaneous coronary intervention (PCI) performed in large community hospitals without cardiac surgery back-up facilities (off-site) reduces door-to-balloon time compared with emergency transferal to tertiary interventional centers (on-site). The present study was performed to explore whether off-site PCI for acute myocardial infarction results in reduced infarct size. One hundred twenty-eight patients with acute ST-segment elevation myocardial infarction were randomly assigned to undergo primary PCI at the off-site center (n = 68) or to transferal to an on-site center (n = 60). Three days after PCI, {sup 99m}Tc-sestamibi SPECT was performed to estimate infarct size. Off-site PCI significantly reduced door-to-balloon time compared with on-site PCI (94 {+-} 54 versus 125 {+-} 59 min, respectively, p < 0.01), although symptoms-to-treatment time was only insignificantly reduced (257 {+-} 211 versus 286 {+-} 146 min, respectively, p = 0.39). Infarct size was comparable between treatment centers (16 {+-} 15 versus 14 {+-} 12%, respectively p = 0.35). Multivariate analysis revealed that TIMI 0/1 flow grade at initial coronary angiography (OR 3.125, 95% CI 1.17-8.33, p = 0.023), anterior wall localization of the myocardial infarction (OR 3.44, 95% CI 1.38-8.55, p < 0.01), and development of pathological Q-waves (OR 5.07, 95% CI 2.10-12.25, p < 0.01) were independent predictors of an infarct size > 12%. Off-site PCI reduces door-to-balloon time compared with transferal to a remote on-site interventional center but does not reduce infarct size. Instead, pre-PCI TIMI 0/1 flow, anterior wall infarct localization, and development of Q-waves are more important predictors of infarct size. (orig.)

  9. Vibrational angioplasty in recanalization of chronic femoropopliteal arterial occlusions: Single center experience

    International Nuclear Information System (INIS)

    Purpose: This prospective study aims to present the overall success rate, safety and long-term outcome of vibrational angioplasty technique, in the treatment of chronic total femoropopliteal occlusions in our institute. Methods: Between October 2000 and December 2008, patients with chronic total femoropoliteal arterial occlusions, treated with vibrational angioplasty during the same session after a failed attempt with conventional recanalization technique, were included. Patient's follow up included serial ankle-brachial index measurements and arterial duplex ultrasound examinations at 1, 3, 6, 12, 24, 36 and 48 months. Results: Twenty-seven patients (16 males and 11 females) and twenty-eight lesions were included in our study. Twenty-five lesions (89.3%) were successfully recanalized. Pain relief was noticed in twenty-one cases. From ten lesions with tissue loss (ulcer or gangrene) in successfully recanalized occlusions, six healed without major, or minor amputation. One non-healing amputation stump was healed after recanalization, without further complications. Four limbs underwent amputation (one minor and three major) despite successful recanalization, however all had an excellent healing of the amputation stump without further complications. The Kaplan–Meier test demonstrated 90%, 85% and 70% amputation-free survival rate at 12, 24 and 36 months, respectively. No major or minor complications were encountered. Conclusions: Vibrational angioplasty is a safe, effective and durable endovascular technique for the treatment of chronic total occlusions in patients with limb ischemia that would be difficult to recanalize using conventional intraluminal techniques

  10. Vibrational angioplasty in recanalization of chronic femoropopliteal arterial occlusions: Single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Kapralos, Ioannis, E-mail: jkapgr@yahoo.gr [251 Hellenic Air Force General Hospital, Athens (Greece); Kehagias, Elias, E-mail: eliaskmd@yahoo.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Ioannou, Christos, E-mail: ioannou@med.uoc.g [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Bouloukaki, Izolde, E-mail: izolthi@gmail.com [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Kostas, Theodoros, E-mail: kostasth@mailbox.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Katsamouris, Asterios, E-mail: asterios@med.uoc.gr [Faculty of Medicine, University of Crete, Heraklion, Crete (Greece); Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, Faculty of Medicine, University of Crete, Heraklion, Crete (Greece)

    2014-01-15

    Purpose: This prospective study aims to present the overall success rate, safety and long-term outcome of vibrational angioplasty technique, in the treatment of chronic total femoropopliteal occlusions in our institute. Methods: Between October 2000 and December 2008, patients with chronic total femoropoliteal arterial occlusions, treated with vibrational angioplasty during the same session after a failed attempt with conventional recanalization technique, were included. Patient's follow up included serial ankle-brachial index measurements and arterial duplex ultrasound examinations at 1, 3, 6, 12, 24, 36 and 48 months. Results: Twenty-seven patients (16 males and 11 females) and twenty-eight lesions were included in our study. Twenty-five lesions (89.3%) were successfully recanalized. Pain relief was noticed in twenty-one cases. From ten lesions with tissue loss (ulcer or gangrene) in successfully recanalized occlusions, six healed without major, or minor amputation. One non-healing amputation stump was healed after recanalization, without further complications. Four limbs underwent amputation (one minor and three major) despite successful recanalization, however all had an excellent healing of the amputation stump without further complications. The Kaplan–Meier test demonstrated 90%, 85% and 70% amputation-free survival rate at 12, 24 and 36 months, respectively. No major or minor complications were encountered. Conclusions: Vibrational angioplasty is a safe, effective and durable endovascular technique for the treatment of chronic total occlusions in patients with limb ischemia that would be difficult to recanalize using conventional intraluminal techniques.

  11. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris

    DEFF Research Database (Denmark)

    Ravkilde, J; Nissen, H; Mickley, H;

    1994-01-01

    The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) isoenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA). Serial blood samples were drawn for measurement of serum Tn...

  12. The use of abciximab associated with primary angioplasty for treating acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Brito Manuel Lisandro Hernández

    2002-01-01

    Full Text Available OBJECTIVE: To assess the benefit resulting from the use of abciximab associated with primary angioplasty. The following parameters were analyzed in-hospital, at 30 days, and 6 months: (a flow in the culprit artery; (b ventricular function; (c combined outcome of death, acute myocardial infarction, and aditional revascularization. METHODS: From November 1997 to June 1999, a longitudinal nonrandomized study with historical data of 137 patients with acute myocardial infarction within the first 12 hours. Patients undergoing primary angioplasty and were divided into 2 groups: those receiving (A abciximab (26 or (B conventional therapy (111. TIMI flow and regional ventricular function estimated by the standard deviation (SD/chordis index were analyzed. RESULTS: At the end of angioplasty, TIMI 3 flow was observed in 76.9% and 83.8% of the patients in groups A and B, respectively (P=0.58. In the reevaluation, patients with TIMI flow <3 showed a 100% improvement in group A and a 33% in group B (P<0.0001. A significant improvement (P<0.0001 in regional ventricular function, by SD/chordis index, occurred in each group; no significant difference between groups however, was observed (29.9% x 20.2%; P=0.58. A nonsignificant reduction in the combined outcome in the in-hospital phase (3.85% A x 9.0% B; P=0.34 and on the 30th day (4.0% x 12.0%; P=0.22 was observed in group A. CONCLUSION: Abciximab improved blood flow. Primary angioplasty improved regional ventricular function independent of antithrombotic therapy. Abciximab showed a trend toward reducing the combined outcome in the in-hospital phase and on the 30th day.

  13. Transluminal stent-assisted angioplasty for the vertebro-basilar ischemia

    International Nuclear Information System (INIS)

    Objective: To study the safety and efficacy of transluminal stent-assisted angioplasty in the treatment of vertebro-basilar ischemia. Methods: Between June 2002 and April 2002, the transluminal stent-assisted angioplasty was performed in 16 patients with symptomatic vertebro-basilar artery stenosis. Results: The vertebral artery stenosis with contralateral stenosis or occlusion were found in 7 patients, unilateral significant stenosis of the dominant vertebral artery in 7, symptomatic basilar artery stenosis in 1, and the significant unilateral lesion of a non-dominant VA. When symptoms indicated ischemia in the ipsilateral posterior cerebellar artery (PICA) in another. The successful rate of stent implantation was 100% without any serious complications. The degree of stenosis was significantly improved from 73.2% to 5.1%, P < 0.01. Within mean follow-up of 4.4 months (ranged from 1 month to 12 months), there was no neurologic complication. Conclusions: Preliminary results suggest that transluminal stent-assisted angioplasty in the treatment of vertebro-basilar ischemia to be a safe and effective. Long-term angiographic and clinical follow-up for monitoring a larger number of patients is needed

  14. Matrix metalloproteinase 9 level as an indicator for restenosis following cervical and intracranial angioplasty and stenting

    Directory of Open Access Journals (Sweden)

    Jun-peng Liu

    2015-01-01

    Full Text Available Cervical and intracranial angioplasty and stenting is an effective and safe method of reducing the risk of ischemic stroke, but it may be affected by in-stent restenosis. The present study investigated serum level of matrix metalloproteinase 9 as a predictor of restenosis after 40 patients underwent cervical and/or intracranial angioplasty and stenting. Results showed that restenosis occurred in 30% (3/10 of patients when the serum level of matrix metalloproteinase 9 at 3 days after surgery was 2.5 times higher than preoperative level. No restenosis occurred when the serum level of matrix metalloproteinase 9 at 3 days after surgery was not 2.5 times higher than preoperative level. Restenosis occurred in 12% (2/17 of patients when the serum level of matrix metalloproteinase 9 was higher than preoperative level for more than 30 days after surgery, but only occurred in 4% (1/23 of patients when the serum level of matrix metalloproteinase 9 was higher than preoperative level for less than 30 days after surgery. However, the differences observed were not statistically significant (P > 0.05. Experimental findings indicate that when the serum level of matrix metalloproteinase 9 is 2.5 times higher than preoperative level at 3 days after cervical and intracranial angioplasty and stenting, it may serve as a predictor of in-stent restenosis.

  15. Endovascular brachytherapy to prevent restenosis after angioplasty

    International Nuclear Information System (INIS)

    Endovascular radiotherapy is the first effective prophylaxis of restenosis after percutaneous transluminal angioplasty (PTA) and stenting. The FDA recently approved two devices for the delivery of intracoronary radiation following coronary artery stenting. Published multicenter, double-blind, randomized trials of intracoronary radiation therapy report good results for preventing in-stent restenosis, while the data for the peripheral circulation are still inconclusive. Beta-emitters are easier applicable and probably also safer, whereas gamma-emitters have been more extensively evaluated clinically so far. Primary indication for endovascular brachytherapy are patients at high risk for restenosis, such as previous restenoses, in-stent hyperplasia, long stented segment, long PTA lesion, narrow residual vascular lumen and diabetes. Data from coronary circulation suggest a safety margin of at least 4 to 10 mm at both ends of the angioplastic segment to avoid edge restenosis. To prevent late thrombosis of the treated coronary segment, antiplatelet therapy with clopidogrel and aspirin are recommended for at least 6 months after PTA and for 12 months after a newly implanted stent. An established medication regimen after radiotherapy of peripheral arteries is still lacking. (orig.)

  16. New fiber-optic tip for laser angioplasty

    International Nuclear Information System (INIS)

    A class of fiber tip radiating laser light mainly along a cone coaxial to the fiber has been extensively studied in the past few years, and tests have been carried out, for example, in gastroentherology to remove occluding cancers. Their interest in treating obstructions in blood vessels or bronchos is also well known. In practice, however, these fiber tips consisting of cones or truncated cones are not safe in medical applications, in particular, in endoscopy. The cones indeed still radiate a non-negligible part of the light on-axis, particularly in the case of truncated cones. In these cases, the wall of vessels or other cavities can be damaged. Moreover, the conical tips can easily break. Recently more study sapphire tips have become available, but their size frequently does not fit the vessel lumen while the high refractive index results in a different optical behavior with respect to quartz cone tips. For these reasons a new probe has been studied, particularly for laser angioplasty, consisting of a cone fiber tip inserted in a quartz microcapsule. This capsule is sealed on the top by a toroidal-shaped lens structure, which avoids the on-axis radiation and gives rise to a sharp corolla-shaped beam. A typical overall radiation diagram shows a dark central cone with half-aperture of 30-450, depending on the aperture of the cone tip, surrounded by a bright crown with uniform intensity

  17. Infrapopliteal angioplasty in the treatment of ischaemic diabetic lower limbs

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effect of infrapopliteal arterial balloon angioplasty in the treatment of ischaemic diabetic lower limbs. Methods: 53 cases of ischaemic diabetic lower limb containing 64 ischemic limbs were treated with infrapopliteal angioplasty by Amphirion Deep Balloon. Observation of clinical remission including the ulcers was carried out before and after the procedure. Results: 119 ateries of the 53 cases were chosen for PTA and 101 PTA in 50 cases were accomplished, with technical success rate of 84.9%. All the 50 patients got clinical remission including the shrinkage of ulcers and none amputation. Conclusin: Infrapopliteal arterial angioplasty is effective, minimal invasive and safe for the ischaemic diabetic lower limbs. (authors)

  18. [Reperfusion therapy in acute myocardial infarction: primary percutaneous transluminal coronary angioplasty or thrombolysis?].

    Science.gov (United States)

    Bilkis, Valdas; Kibarskis, Aleksandras; Abraitis, Vytautas

    2004-01-01

    Randomized controlled trials that compared primary percutaneous transluminal coronary angioplasty with thrombolysis have shown that primary angioplasty is more effective than intravenous thrombolysis in reducing mortality and morbidity in patients with acute myocardial infarction. Three large myocardial infarction registries - MITI, NRMI-2 and French registry - failed to show an advantage of primary angioplasty compared with thrombolysis. One of the latest trials mentioned in this paper restored the place of primary angioplasty as superior to thrombolysis in acute myocardial infarction. Data of patients treated with primary percutaneous transluminal coronary angioplasty in Clinic of Cardiology of Vilnius University are presented. PMID:15079110

  19. The case for angioplasty in patients with symptomatic intracranial atherosclerosis.

    Science.gov (United States)

    McTaggart, Ryan A; Marks, Michael P

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients. PMID:24782816

  20. Effect of percutaneous transluminal coronary angioplasty on coronary reserve

    International Nuclear Information System (INIS)

    This study was done to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on regional myocardial perfusion (RMP) in the region distal to a stenosis in 48 patients. Quantitative RMP in ml/100g/min was measured from the washout of Xe-133 following selective injection into the involved coronary artery. After successful dilation, determined by a reduction in %stenosis to a ≤ 50% lesion and in pressure gradient across the lesion, the RMP measurement was repeated. In these patients, means %stenosis was 85% pre PTCA and 29% post PTCA with mean pressure gradient of 60 Hg pre PTCA and 21 mm Hg post PTCA. 21 of these 48 patients also had RMP measured after isoproterenol (ISO) both pre and post PTCA to increase myocardial oxygen demand to assess coronary reserve. Heart rate (HR) and systolic blood pressure (SBP) were constant pre and post PTCA which allowed a valid comparison. The results are presented. A group of 13 patients with normal coronary arteries and ventricular function showed a mean control RMP of 78 +- 15 and a mean ISO RMP of 140 +- 26. The data demonstrate that following successful PTCA quantitative RMP improves both at rest and with an ISO challenge and is similar to RMP in normal coronary arteries

  1. Surgarcane biopolymer patch in femoral artery angioplasty on dogs Membrana de biopolímero de cana-de-açúcar como remendo em arterioplastias femorais de cães

    OpenAIRE

    José Lamartine de Andrade Aguiar; Esdras Marques Lins; Silvio Romero de Barros Marques; Antônio Roberto de Barros Coelho; Renata de Oliveira Rossiter; Roberto José Vieira de Melo

    2007-01-01

    PURPOSE: The objective of this study was to evaluate the use of the sugarcane biopolymer membrane in femoral artery patch angioplasty on dogs. METHODS: Eight dogs were submitted to bilateral femoral artery patch angioplasty with a sugarcane biopolymer membrane patch on one side and e-PTFE patch on the contralateral side. This research was performed at Experimental Surgical Research Laboratory of the Centro de Ciências da Saúde at Universidade Federal de Pernambuco. The dogs were submitted to ...

  2. The Timing and Frequency of Complications After Peripheral Percutaneous Transluminal Angioplasty and Iliac Stenting: Is a Change from Inpatient to Outpatient Therapy Feasible?

    International Nuclear Information System (INIS)

    Purpose: A prospective study was performed to assess the frequency and timing of complications after transluminal angioplasty and stent placement with a view to changing our practice and performing these procedures on an outpatient basis.Method: A total of 266 angioplasties and 51 stent deployments were attempted on 240 consecutive patients. Immediate complications were documented by the radiologists. The timing and nature of any complications during and beyond the first 24 hr were reported by the vascular surgeons.Results: There were 14 complications in 240 patients, giving a complication rate of 4.8% per vessel segment dilated. There were five major and nine minor complications. Eighty-six percent of complications were evident before the patient had left the angiography suite. All complications were evident within 4.5 hr of the procedure.Conclusion: The timing of complications suggests it would be reasonable to perform percutaneous transluminal angioplasties and iliac stenting on an outpatient basis in suitable patients

  3. Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture

    International Nuclear Information System (INIS)

    The authors report experience of intravascular angioplasty of atheromatous ostial strictures of the vertebral artery in 24 patients. After reviewing the technique, they authive the indications provided through Doppler velocimetric data. The results seem to be encouraging as symptoms disappeared completely in 21 patients. (orig.)

  4. Percutaneous endoluminal angioplasty of post endarterectomy carotid stenoses

    International Nuclear Information System (INIS)

    Percutaneous transluminal angioplasty of the carotid artery was performed in four patients with recurrent stenosis following endarterectomy. Balloon catheter dilatation was successful in 3 of the 4 lesions. Post dilatation angiography demonstrated an increase in luminal diameter: there were no neurological complications with the procedure. PTA appears to be an effective method of treating recurrent stenosis following carotid endarterectomy. (orig.)

  5. Subintimal angioplasty: predictors of long-term success.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-08-01

    To determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome.

  6. Percutaneous coronary angioplasty in a cardiac transplant recipient.

    OpenAIRE

    Gammage, M D; Shiu, M F; English, T A

    1988-01-01

    Two years after an orthotopic cardiac transplant a 28 year old man was found to have clinically significant stenosis of the right coronary artery at routine coronary angiography. This lesion was accompanied by a perfusion defect on exercise thallium scintigraphy. Percutaneous transluminal coronary angioplasty of the lesion improved the angiographic appearance of the stenosis and reduced the exercise thallium perfusion defect.

  7. Transluminal angioplasty in the management of mesenteric angina

    International Nuclear Information System (INIS)

    The efficacy of transluminal angioplasty for the treatment of peripheral atherosclerotic disease has been well documented. The successful treatment of abdominal angina has been reported, although the follow-up is too short to accurately evaluate the long term results of this procedure. (orig.)

  8. Design of a randomized controlled trial of comprehensive rehabilitation in patients with myocardial infarction, stabilized acute coronary syndrome, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting: Akershus Comprehensive Cardiac Rehabilitation Trial (the CORE Study

    Directory of Open Access Journals (Sweden)

    Karin Kogstad Else

    2000-11-01

    Full Text Available Abstract Objectives 1. To assess the long-term effectiveness of a comprehensive cardiac rehabilitation programme on quality of life and survival in patients with a large spectrum of cardiovascular diseases (myocardial infarction, acute coronary syndrome, percutaneous transluminal coronary angioplasty and coronary artery bypass grafting. 2. To establish the degree of correlation between expected improvement of health-related quality of life and improvement in physical function attributable to rehabilitation in the intervention group, in comparison with similar changes in the conventional care group. Design Randomized, controlled, parallel-group design (intervention/conventional care. Setting Akershus County, southeast of Oslo City, Norway. Participants 500 patients, men and women, aged 40-85 years, who have sustained at least one of the above-mentioned cardiovascular diseases. Interventions 8 weeks of supervised, structured physical training of three periods of 20 min per week, targeting a heart rate of 60-70% of the individual's maximum; home-based physical exercise training with the same basic schedule as in the supervised period; quantification of patients' compliance with the exercise programme by the use of wristwatches, information stored in the watch memory being retrieved once a month during the 3-year follow-up period; and life-style modification with an emphasis on the cessation of smoking and on healthy nutrition and weight control.

  9. Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia

    International Nuclear Information System (INIS)

    Objective: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. Design: Retrospective study of angiographic and clinical files in selected group. Materials and methods: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. Results: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). Conclusions: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group

  10. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    Science.gov (United States)

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort.

  11. Factors influencing acute high-grade restenosis in emergency percutaneous transluminal coronary angioplasty for acute myocardial infarction.

    OpenAIRE

    Kusachi, Shozo; Iwasaki,Kohichirou; Nishiyama, Osamu; Ueda, Minoru; Kita, Toshimasa; Hata,Takato; Taniguchi, Gyou; Watanabe, Hirofumi; Hina, Kazuyoshi; Saito, Daiji; Tsuji, Takao; Haraoka,Shoichi

    1989-01-01

    We studied the factors which may induce acute high grade restenosis in emergency percutaneous transluminal coronary angioplasty (PTCA). PTCA was attempted in 50 patients with acute myocardial infarction, and the balloon catheter passed successfully across the occlusion site in 47 (94%) of the patients. These 47 patients were analyzed. "Acute restenosis" was defined as a lesion which was revascularized to less than 50% luminal reduction narrowed again to more than 75% luminal reduction...

  12. The exposure of radiologists and patients to radiation during coronary angiography and percutaneous transluminal coronary angioplasty (PTCA)

    International Nuclear Information System (INIS)

    The exposure of radiologists and patients to radiation during coronary angiography and percutaneous transluminal coronary angioplasty (PTCA) in Finland was studied using phantom measurements. Additional tests were made concerning the performance of TV fluoroscopy systems, cine fluorographic units and film processing. These tests include sensitometric quality control of film processing, automatic exposure control in fluoroscopy and cinefluorography, and contrast and resolution in a cine frame and TV image

  13. Angioplasty and stent placement in chronic occlusion of the superficial femoral artery: technique and results.

    OpenAIRE

    Conroy, RM; Gordon, IL; Tobis, JM; Hiro, T; Kasaoka, S; Stemmer, EA; Wilson, SE

    2000-01-01

    PURPOSE: To improve the patency rate for angioplasty in chronic occlusion of the superficial femoral artery by deploying stents after angioplasty. MATERIALS AND METHODS: Angioplasty and stent placement were performed in 61 arteries in 48 male patients. The mean occlusion length was 13.5 cm and the mean stent length was 30 cm. Patency rates were analyzed at 6 months and at 1, 2, 3, and 4 years. The predictors of restenosis were analyzed by univariate and multiple logistic regression. RESULTS: ...

  14. Below knee angioplasty in elderly patients: Predictors of major adverse clinical outcomes.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2011-03-01

    To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI).

  15. Five-year Irish trial of CLI patients with TASC II type C/D lesions undergoing subintimal angioplasty or bypass surgery based on plaque echolucency.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2009-06-01

    To report a 5-year observational parallel group study comparing the effectiveness of subintimal angioplasty (SIA) to bypass grafting (BG) for treatment of TASC II type C\\/D lesions in the lower limb arteries of patients with critical limb ischemia (CLI).

  16. Changing Health Behaviors to Improve Health Outcomes after Angioplasty: A Randomized Trial of Net Present Value versus Future Value Risk Communication

    Science.gov (United States)

    Charlson, M. E.; Peterson, J. C.; Boutin-Foster, C.; Briggs, W. M.; Ogedegbe, G. G.; McCulloch, C. E.; Hollenberg, J.; Wong, C.; Allegrante, J. P.

    2008-01-01

    Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on "net present value" economic theory, would be more effective in behavioral intervention than the standard "future value approach"…

  17. The Case for Angioplasty in Patients with Symptomatic Intracranial Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Ryan A Mctaggart

    2014-04-01

    Full Text Available Intracranial atherosclerotic disease (ICAD is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of intracranial atherosclerotic disease (ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients.

  18. Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery

    Directory of Open Access Journals (Sweden)

    Oliveira Sergio A

    2010-10-01

    Full Text Available Abstract Background Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arteries in patients undergoing surgery, angioplasty, or medical treatment. Methods Patients (611 with stable multivessel coronary artery disease and preserved ventricular function were randomly assigned to CABG, PCI, or medical treatment alone (MT. After 5-year follow-up, 392 patients (64% underwent new angiography. Progression was considered a new stenosis of ≥ 50% in an arterial segment previously considered normal or an increased grade of previous stenosis > 20% in nontreated vessels. Results Of the 392 patients, 136 underwent CABG, 146 PCI, and 110 MT. Baseline characteristics were similar among treatment groups, except for more smokers and statin users in the MT group, more hypertensives and lower LDL-cholesterol levels in the CABG group, and more angina in the PCI group at study entry. Analysis showed greater progression in at least one native vessel in PCI patients (84% compared with CABG (57% and MT (74% patients (p Conclusion The angioplasty treatment conferred greater progression in native coronary arteries, especially in the left anterior descending territories and treated vessels. The progression was independently associated with hypertension, male sex, and previous myocardial infarction.

  19. Clinical effects of intracoronary brachytherapy on diffuse in-stent restenosis after coronary angioplasty

    International Nuclear Information System (INIS)

    Objective: To investigate the effect of intracoronary brachytherapy using 90Sr/90Yon in-stent restenosis in patients with coronary disease. Methods: Thirty-nine patients (male 29, female 10) with in-stent restenosis after percutaneous coronary intervention (PCI) were studied. The patients were divided randomly into two groups: single-balloon group (21 cases, control group) and brachytherapy group (18 cases, treatment group). All the lesions were treated with balloon angioplasty satisfactorily. After that the patients in treatment group took a brachytherapy using the Beta-Cath system (Novoste). After the operation, there was a 9-months follow-up. Results: Within the follow-up, one case (5.6%) in treatment group was found to be with in-stent restenosis and 8 cases(38.1%) in control group. There was significant difference between the two groups (P= 0.006). Conclusion: The brachytherapy using 90Sr/90Y after balloon angioplasty is safe, effective and feasible for containing diffuse in-stent restenosis in patients. (authors)

  20. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III.

    Science.gov (United States)

    Uberoi, Raman; Milburn, Simon; Moss, Jon; Gaines, Peter

    2009-09-01

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online. PMID:19644643

  1. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    International Nuclear Information System (INIS)

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  2. Radiation dose and risk from fluoroscopically guided percutaneous transluminal angioplasty and stenting in the abdominal region

    International Nuclear Information System (INIS)

    The objective of this study was to estimate the radiation dose and associated risks resulting from fluoroscopically guided percutaneous transluminal angioplasty with or without stent placement in the abdominal region. Average examination parameters for renal and aortoiliac procedures were derived using data from 80 consecutive procedures performed in our institute. Organ and effective doses were estimated for endovascular procedures with the use of a Monte Carlo (MC) transport code and an adult mathematical phantom. Thermoluminescent dosimeters were used in an anthropomorphic phantom to verify MC calculations. Radiation-induced risks were estimated. Results are presented as doses normalized to dose area product, so that the patient dose from any technique and X-ray unit can be easily calculated for iliac and renal PTA/stenting sessions. The average effective dose varied from 75 to 371 μSv per Gycm2 depending on the beam quality, procedure scheme and sex of the patient. Differences up to 17% were observed between MC-calculated data and data derived from thermoluminescent dosimetry. The radiation-induced cancer risk may be considerable for younger individuals undergoing transluminal angioplasty with stent placement. (orig.)

  3. Endovascular gamma irradiation for the prevention restenosis after angioplasty of femoropopliteal de novo stenoses

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the effectiveness and detect side effects of centered, overlapped endovascular gamma irradiation after angioplasty of de novo femoropopliteal stenoses. Thirty patients (age 65.3±9.2 years) with arterial occlusive disease were prospectively enrolled to receive endovascular gamma irradiation (192-iridium, 14 Gy centered at 2 mm vessel wall) immediately after percutaneous transluminal angioplasty (PTA) of femoropopliteal stenoses. Irradiation overlapped dilatation by 1-2 cm at each end. Follow-up involved angiography after 12 months; duplex sonography; and interviews before and after PTA and at 1, 6, and 12 months follow-up. PTA and centered endovascular irradiation were performed successfully in all patients. Three thromboembolic complications occurred during irradiation. Angiographic and clinical follow-up was possible in 28 patients. The angiographic degree of stenosis was 73.8%±16.3% before and 3.6%±23.5% after PTA and was 3.5%±43.7% at the 1-year follow-up. Restenosis (>50%) of the target lesion developed in three patients (10.7%) and edge stenoses (>30%) in nine patients (32.1%). An aneurysm of the irradiated segment in one patient was treated by stenting. The rate of retreatment was 17.9%. The vessel diameter after endovascular gamma irradiation and PTA of femoropopliteal stenoses remained stable. Restenosis, induction of edge stenoses, and aneurysm were reasons for reinterventions. (orig.)

  4. Radiation dose and risk from fluoroscopically guided percutaneous transluminal angioplasty and stenting in the abdominal region

    Energy Technology Data Exchange (ETDEWEB)

    Stratakis, John; Damilakis, John [University of Crete, Department of Medical Physics, P.O. Box 2208, Iraklion, Crete (Greece); Tsetis, Dimitrios; Gourtsoyiannis, Nicholas [University of Crete, Department of Radiology, P.O. Box 2208, Iraklion, Crete (Greece)

    2007-09-15

    The objective of this study was to estimate the radiation dose and associated risks resulting from fluoroscopically guided percutaneous transluminal angioplasty with or without stent placement in the abdominal region. Average examination parameters for renal and aortoiliac procedures were derived using data from 80 consecutive procedures performed in our institute. Organ and effective doses were estimated for endovascular procedures with the use of a Monte Carlo (MC) transport code and an adult mathematical phantom. Thermoluminescent dosimeters were used in an anthropomorphic phantom to verify MC calculations. Radiation-induced risks were estimated. Results are presented as doses normalized to dose area product, so that the patient dose from any technique and X-ray unit can be easily calculated for iliac and renal PTA/stenting sessions. The average effective dose varied from 75 to 371 {mu}Sv per Gycm{sup 2} depending on the beam quality, procedure scheme and sex of the patient. Differences up to 17% were observed between MC-calculated data and data derived from thermoluminescent dosimetry. The radiation-induced cancer risk may be considerable for younger individuals undergoing transluminal angioplasty with stent placement. (orig.)

  5. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay

    Science.gov (United States)

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25–125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  6. Application of percutaneous angioplasty in the cases of vertebroclavicular steal syndrome

    International Nuclear Information System (INIS)

    The case of the percutaneous angioplasty method application for a patient with nonspecific aortoarteritis, subtotal stenosis of the left sybclavian artery with tendency to vertebro-clavicular steal syndrome is presented. Good results of treatment are shown and advantages of percutaneous angioplasty in the case of vertebro-clavicular steal syndrome are marked

  7. Percutaneous transluminal angioplasty of the superficial femoral artery by retrograde catheterization via the popliteal artery

    DEFF Research Database (Denmark)

    Tønnesen, K H; Sager, P; Karle, A; Henriksen, L; Jørgensen, B

    1988-01-01

    We report the results of 50 angioplasty procedures via the popliteal artery. A 3-year follow-up including control of blood pressures at ankle and toe levels show results comparable to reports in the literature. This new approach for angioplasty of the superficial femoral artery and eventually of ...

  8. Cost-effectiveness analysis of orbital atherectomy plus balloon angioplasty vs balloon angioplasty alone in subjects with calcified femoropopliteal lesions

    Directory of Open Access Journals (Sweden)

    Weinstock B

    2014-03-01

    Full Text Available Barry Weinstock,1 Raymond Dattilo,2 Tiffini Diage3 1Orlando Health Heart Institute, Mid-Florida Cardiology Specialists, Orlando, FL, USA; 2Department of Cardiology, St Francis Health Center, Topeka, KS, USA; 3North American Science Association (NAMSA, Sunnyvale, CA, USA Introduction: As cost considerations become increasingly critical when selecting optimal endovascular treatment strategies, a cost-benefit analysis was conducted comparing the Diamondback 360°® Orbital Atherectomy System (OAS (Cardiovascular Systems, Inc., St Paul, MN, USA and balloon angioplasty (BA vs BA alone for treatment of calcified femoropopliteal lesions. Patients and methods: The clinical outcomes from COMPLIANCE 360°, a prospective, multicenter, randomized study comparing OAS+BA vs BA alone for treatment of calcified femoropopliteal lesions, were correlated with cost data and previously published quality of life data. Site of service, hospital charges, and associated medical resource utilization were obtained from Uniform Billing statements for index treatments and associated revascularizations out to 1 year. Hospital costs were estimated using hospital-specific, procedure-specific cost-to-charge ratios. Length of stay and procedural data were collected from participating study sites. Results: Twenty-five subjects with 38 lesions and 25 subjects with 27 lesions were randomized to the OAS+BA and BA-alone groups, respectively. Mean hospital charges (US$51,755 vs US$39,922 and estimated hospital costs (US$15,100 vs US$11,016 were higher for OAS+BA compared with BA alone (not statistically significant. Stent utilization was statistically significantly higher with BA-alone treatment for all subjects (1.1 vs 0.1, P=0.001 and in the subset of subjects with one lesion (1.0 vs 0.1, P<0.00001. There was a significant difference in cost for single-lesion versus multiple-lesion treatment. Using costs and quality-adjusted life years (QALYs for the single-lesion cohort, the 1-year

  9. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    Science.gov (United States)

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  10. Segmentally enclosed thrombolysis in percutaneous transluminal angioplasty for femoropopliteal occlusions

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Nielsen, J D; Holstein, P; Bülow, J; Jørgensen, M; Andersen, E

    1991-01-01

    Segmentally enclosed thrombolysis (SET) was performed immediately following 34 percutaneous transluminal angioplasties (PTAs) for femoropopliteal occlusions. The dilated segment was sealed off with a double balloon catheter, and recombinant tissue plasminogen activator (rt-PA) 1 mg/ml and heparin...... clinically relevant changes in plasma fibrinogen occurred. Two puncture site hemorrhages did not coincide with the coagulopathy induced by SET. One-year patency was 80%. Early rethrombosis occurred in 9% versus 41% in our previous series on standard PTA for femoropopliteal occlusions (p less than 0...

  11. Long-term results of brachiocephalic artery percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    This paper establishes the ling-term and angiographic sequelae of percutaneous transluminal angioplasty (PTA) of stenoses of the origins of the brachycephalic arteries. From November of the proximal segments of the brachycephalic arteries. Clinical follow-up after PTA was 45 months. Two patients had recurrence of vertigo, after 16 and 75 months. There was no evidence of restenosis in the patient whose recurrence was after 16 months, but considerable restenosis was noted in the patient whose symptoms recurred after 75 months. That patient underwent successful repeated PTA

  12. Transluminar catheter angioplasty of abdominal aorta in Takayasu's arteritis

    International Nuclear Information System (INIS)

    Nine patients with Takayasu's arteritis and a long stenotic segment of the abdominal aorta were treated by percutaneous transluminal angioplasty (PTA). Intermittent claudication dissappeared in six of seven cases, the femoral pulse reappeared in all five; ankle/arm indices increased in seven cases; elevated blood pressure normalized in seven of eight cases. Seven patients were followed for 3 to 28 months. They were all free of symptoms from the lower extremities. In three patients with or without renal artery stenosis and with hypertension, the blood pressure decreased after PTA of the abdominal aorta only. PTA may be a valuable treatment in Takayasu's arteritis and stenosis of the abdominal aorta. (orig.)

  13. Percutaneous transluminal angioplasty after bypass operations on the lower extremities

    International Nuclear Information System (INIS)

    To prevent bypass thrombosis, percutaneous transluminal angioplasty (PTA) was performed on 32 stenoses in 25 patients following vascular surgery. Seventeen patients showed 23 stenoses at the level of the anastomoses or in the bypass itself; 8 patients exhibited 9 stenoses proximal or distal to the bypass. Twenty-two patients underwent successful PTA and showed an increase in the ankle/arm Doppler index from 0.38±0.13 to 0.76±0.11 after PTA. The long-term patency rates at 6, 12 and 24 months were 75%, 57% and 39%, respectively. The reason for three unsuccessful PTAs are discussed. (orig.)

  14. Angiography for renal artery stenosis: no additional impairment of renal function by angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Lufft, Volkmar; Fels, Lueder M.; Egbeyong-Baiyee, Daniel; Olbricht, Christoph J. [Abteilung Nephrologie, Medizinische Hochschule Hannover (Germany); Hoogestraat-Lufft, Linda; Galanski, Michael [Abteilung Diagnostische Radiologie, Medizinische Hochschule Hannover (Germany)

    2002-04-01

    The aim of this study was to compare renal function between patients with renal angiography and patients with renal angiography and angioplasty (AP) for renal artery stenosis (RAS). Forty-seven patients with suspected RAS were prospectively investigated by digital subtraction angiography (DSA) using non-ionic low osmolar contrast media (CM). In 22 patients RAS was detected and in 16 cases an angioplasty was performed in the same session. The following parameters were determined 1 day prior to and after the DSA, respectively: serum creatinine (S-Crea, {mu}mol/l) and single-shot inulin clearance (In-Cl, ml/min) for the evaluation of renal function; and urine alpha 1-microglobuline (AMG, {mu}g/g Crea) and beta-N-acetyl-glucoseaminidase (beta-NAG, U/g Crea) as markers of tubular toxicity. Serum creatinine was measured additionally 2 days after CM had been injected. In both groups with and without AP 174{+-}65 and 104{+-}56 ml of CM (p<0.0005) were used, respectively. There were no differences with regard to renal function or risk factors for CM nephrotoxicity between both groups. In the group with AP S-Crea and In-Cl (each: mean{+-}SD) did not change significantly (before DSA: 171{+-}158 and 61{+-}24, after DSA: 189{+-}177 and 61{+-}25, respectively), beta-NAG (median) rose from 4 to 14 (p<0.05) and AMG from 8 to 55 (n.s., because of high SD). In the group without AP S-Crea increased from 134{+-}109 to 141{+-}113 (p<0.01), In-Cl dropped from 65{+-}26 to 62{+-}26 (p<0,01), beta NAG (median) rose from 4 to 8 (p=0.01), and AMG from 7 to 10 (n.s.). A rise in baseline S-Crea by more than 25% or 44 {mu}mol/l occurred in 4 and 2 patients in the group with and without AP, respectively. Creatinine increase was reversible in all cases within 7 days. In this study using sensitive methods to detect changes of renal function and tubular toxicity no additional renal function impairment in DSA with angioplasty for RAS compared with DSA alone could be demonstrated. Our data suggest

  15. Monitoring the effect of heparin by measurement of activated clotting time during and after percutaneous transluminal coronary angioplasty.

    OpenAIRE

    Rath, B.; Bennett, D. H.

    1990-01-01

    The anticoagulant effect of heparin during percutaneous transluminal coronary angioplasty was monitored by measurements of the activated clotting time in two studies that compared the effects of a single bolus of heparin with those of a bolus of heparin combined with a continuous infusion of the drug. In a preliminary study 40 patients received a single heparin bolus of 10,000 units (protocol I) and a further 40 patients received both a heparin bolus of 10,000 and a continuous infusion of hep...

  16. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    Science.gov (United States)

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long

  17. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    Science.gov (United States)

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  18. MR-Guided Percutaneous Angioplasty: Assessment of Tracking Safety, Catheter Handling and Functionality

    International Nuclear Information System (INIS)

    Purpose: Magnetic resonance (MR)-guided percutaneous vascular interventions have evolved to a practical possibility with the advent of open-configuration MR systems and real-time tracking techniques. The purpose of this study was to assess an MR-tracking percutaneous transluminal angioplasty (PTA) catheter with regard to its safety profile and functionality. Methods: Real-time, biplanar tracking of the PTA catheter was made possible by incorporating a small radiofrequency (RF) coil in the catheter tip and connecting it to a coaxial cable embedded in the catheter wall. To evaluate potentially hazardous thermal effects due to the incorporation of the coil, temperature measurements were performed within and around the coil under various scanning and tracking conditions at 1.5 Tesla (T). Catheter force transmission and balloon-burst pressure of the MR-tracking PTA catheter were compared with those of a standard PTA catheter. The dilatative capability of the angioplasty balloon was assessed in vitro as well as in vivo, in an isolated femoral artery segment in a swine. Results: The degree of heating at the RF coil was directly proportional to the power of the RF pulses. Heating was negligible with MR tracking, conventional spin-echo and low-flip gradient-echo sequences. Sequences with higher duty cycles, such as fast spin echo, produced harmful heating effects. Force transmission of the MR-tracking PTA catheter was slightly inferior to that of the standard PTA catheter, while balloon-burst pressures were similar to those of conventional catheters. The MR-tracking PTA catheter functioned well both in vitro and in vivo. Conclusion: The in vivo use of an MR-tracking PTA catheter is safe under most scanning conditions

  19. Characterization of Pebax angioplasty balloon surfaces with AFM, SEM, TEM, and SAXS.

    Science.gov (United States)

    Warner, Jacob A; Forsyth, Bruce; Zhou, Fang; Myers, Jason; Frethem, Chris; Haugstad, Greg

    2016-04-01

    In the medical device industry, angioplasty balloons have been widely used in the less invasive treatment of heart disease by expanding and relieving clogged structures in various arterial segments. However, new applications using thin coatings on the balloon surface have been explored to enhance therapeutic value in the delivery of pharmaceuticals (drug-elution) or control thermal energy output (RF ablation). In this study, angioplasty balloon materials comprised of poly(ether-block-amide) (Pebax) were investigated via atomic force microscopy (AFM), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and small-angle X-ray scattering (SAXS) to characterize physical properties at the balloon surface that may affect coating adhesion. The soft segment of this Pebax 1074 material is polyethylene oxide (PEO) and the hard segment is nylon-12. The morphology of the hard segments of this block co-polymer are found via AFM stiffness measurements to be (40 ± 20) nm by (300 ± 150) nm and are oriented parallel to the surface of the balloon. SAXS measurements found the lamellar spacing to be (18.5 ± 0.5) nm, and demonstrate a preferential orientation in agreement with TEM and AFM measurements. Fixation of this balloon in resin, followed by cryo-sectioning is shown to provide a novel manner in which to investigate surface characteristics on the balloon such as material or coating thickness as well as uniformity in comparison to the bulk structure. These outputs were deemed critical to improve overall balloon processing such as molding and surface treatment options for robust designs toward better procedural outcomes targeting new therapeutic areas. PMID:25891789

  20. Hyperperfusion syndrome after carotid stent angioplasty

    International Nuclear Information System (INIS)

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  1. Hyperperfusion syndrome after carotid stent angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Grunwald, I.Q.; Politi, M.; Reith, W.; Krick, C.; Karp, K.; Zimmer, A.; Struffert, T.; Kuehn, A.L.; Papanagiotou, P. [University of the Saarland, Department for Interventional and Diagnostic Neuroradiology, Homburg (Germany); Roth, C.; Haass, A. [University of the Saarland, Clinic for Neurology, Homburg (Germany)

    2009-03-15

    This study assesses the incidence and causes of hyperperfusion syndrome occurring after carotid artery stenting (CAS). We retrospectively reviewed the clinical database of 417 consecutive patients who were treated with CAS in our department to identify patients who developed hyperperfusion syndrome and/or intracranial hemorrhage. Magnetic resonance imaging (MRI) including fluid-attenuated inversion recovery and diffusion-weighted imaging was performed before and after CAS in 269 cases. A Spearman's rho nonparametric correlation was performed to determine whether there was a correlation between the occurrence/development of hyperperfusion syndrome and the patient's age, degree of stenosis on the stented and contralateral side, risk factors such as diabetes, smoking, hypertension, adiposity, gender and fluoroscopy time, and mean area of postprocedural lesions as well as preexisting lesions. Significance was established at p < 0.05. Of the 417 carotid arteries stented and where MRI was also completed, we found hyperperfusion syndrome in 2.4% (ten cases). Patients who had preexisting brain lesions (previous or acute stroke) were at a higher risk of developing hyperperfusion syndrome (p = 0.022; Spearman's rho test). We could not validate any correlation with the other patient characteristics. Extensive microvascular disease may be a predictor of hyperperfusion syndrome after carotid stent placement. We believe that further studies are warranted to predict more accurately which patients are at greater risk of developing this often fatal complication. (orig.)

  2. Effects of a behavioural intervention on quality of life and related variables in angioplasty patients

    DEFF Research Database (Denmark)

    Appels, Ad; van Elderen, Therese; Bär, Frits;

    2006-01-01

    The EXhaustion Intervention Trial investigated the effect of a behavioural intervention programme on exhaustion, health-related quality of life (HRQL), depression, anxiety, hostility, and anginal complaints in angioplasty patients who felt exhausted after percutaneous coronary intervention (PCI)....

  3. More accurate assessment of stenotic lesions in percutaneous transluminal angioplasty.

    Science.gov (United States)

    Janevski, B K; Breslau, P J; Jorning, P J

    1986-01-01

    Eighty patients underwent percutaneous transluminal dilatation and recanalisation of atheromatous lesions of the arteries of the lower extremities in the University Hospital of Maastricht in the period of 1980 to 1984. Out of 80 attempted procedures of the iliac and femoro-popliteal tract 71 (89%) were technically possible and were considered initially successful. In all cases of iliac artery lesions a retrograde arteriogram was performed prior to PTA. Intra-arterial pressure measurements at rest and after hyperemia were used for exact assessment of the hemodynamic significance of the stenosis before and after PTA. A follow-up of all patients successfully treated by angioplasty was performed. The early hemodynamic success rate of PTA for iliac lesions was 90 per cent and for femoral-popliteal segment 83 per cent. There was no morbidity or mortality. The cumulative 3-year patency rate for both segments was 74 per cent. PMID:2943842

  4. Radiation risk to patients from percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    This paper reports that percutaneous transluminal coronary angioplasty (PTCA) is commonly used to control coronary atherosclerosis, and in many patients repeated applications occur. We investigated the current level of radiation dose and the corresponding risk for PTCA patients. The frequency of PTCA and patient demographics were also examined. Data for 1,503 Ottawa Heart Institute patients undergoing PTCA between January 1, 1987, and December 31, 1989, were analyzed retrospectively. Entrance exposures were estimated from records of the fluoroscopy time per case, the number of cine frames used, and exposure rate measurements. These were converted to average organ doses by using the Monte Carlo results of the Rosenstein group. Risks of including fatal cancers were estimated according to ICRP Report 60 (draft)

  5. Percutaneous transluminal angioplasty (PTA) of the infrarenal abdominal aorta

    International Nuclear Information System (INIS)

    The results of percutaneous transluminal angioplasty (PTA) (n=13) of the lower abdominal aorta are reported in 12 patients. The mean patient age was relatively low (46 years). In 7 cases there were isolated aortic obstructions (6 stenoses, 1 occlusion). In the remaining 6 aortic stenoses, there were also major atherosclerotic lesions distally. The mean diameter of the aortic section in which PTA was performed, measured 8.2 mm. The total diameter of the PTA balloon(s) averaged 19.1 mm. The arterial gradient dropped significantly from 41.4 mm Hg (mean) to 2 mm Hg after PTA. The arm-ankle index increases significantly from 0.64 to 0.97. The follow-up included 9 patients; 1 showed restenosis 38 month after PTA. There were no clinically relevant complications. The data published on abdominal PTA in atherosclerotic lesions are summarized. (orig.)

  6. Angioplasty of symptomatic high-grade internal carotid artery stenosis with intraluminal thrombus: therapeutic approach

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, A.; Mayol, A. [Seccion de Neurorradiologia Intervencionista, Servicio de Radiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Gil-Peralta, A.; Gonzalez-Marcos, J.R. [Servicio de Neurologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Boza, F. [Servicio de Neurofisiologia, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain); Ruano, J. [Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocio, Avenida Manuel Siurot s/n, 41013, Sevilla (Spain)

    2004-04-01

    Intraluminal thrombus in the internal carotid artery (ICA) is usually found in patients with severe atheromatous stenosis. Having reviewed 300 carotid angioplasties for symptomatic >70% ICA stenosis, we found three patients (1%) with intraluminal thrombus. Conservative treatment with anticoagulants and double antiplatelet coverage can result in lysis of the thrombus without severe risks. Percutaneous transluminal angioplasty and stenting, preferably with distal protection, can be an excellent alternative to carotid endarterectomy. (orig.)

  7. Intracoronary irradiation with rhenium 188 to reduce restenosis following a coronary angioplasty. Preliminary results

    International Nuclear Information System (INIS)

    This paper shows the preliminary results from our contribution to a coordinated project with the International Atomic Energy Agency, which corroborates that the intracoronary irradiation allows to reduce the restenosis following a percutaneous transluminal coronary angioplasty (PTCA) in patients with ischemic cardiopathy as a result of neointima hyperplasia reduction. In the treatment, both beta and gamma emitters can be used, but with the latter (specifically with rhenium 188), its is possible to use an angioplasty balloon catheter for therapy purposes

  8. Cerebral angioplasty practice at major medical centers in the United States

    International Nuclear Information System (INIS)

    Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

  9. Observation and nursing of complications due to high re-perfusion injury occurring after balloon angioplasty for diabetic vascular diseases of lower extremity

    International Nuclear Information System (INIS)

    Objective: To evaluate the symptomatic nursing in treating the complications caused by high re-perfusion which develops after balloon angioplasty for the treatment of diabetic vascular diseases of lower extremity. Methods: Eighteen patients with lower limb ischemia caused by diabetes mellitus developed high re-perfusion injury complications after receiving balloon angioplasty. The patients were randomly and equally divided into study group and control group. The special nursing measures designed by the author's department, including raising the diseased lower limb, enforcing the flexion and extension movement of the leg, cold compress, wound exposure, etc. were carried out for patients of study group, while no special nursing measures were adopted for patients of control group. The clinical results, such as limb pain, swelling and subcutaneous petechia after re-perfusion injury, were evaluated and compared between two groups. Results: After the treatment, the limb pain, swelling and subcutaneous petechia due to high re-perfusion injury in study group were relieved more markedly than that in control group, the difference in evaluation score between two groups was statistically significant (P<0.01). Conclusion: The special symptomatic nursing measures are very effective in relieving the high re-perfusion injury after balloon angioplasty for the treatment of diabetic lower limb ischemia. (authors)

  10. Assessment of myocardial perfusion abnormality and hibernating myocardium by gated blood pool and exercise-stress thallium tomographies after successful coronary angioplasty

    International Nuclear Information System (INIS)

    Cardiac function and myocardial perfusion were assessed by exercise-stress thallium SPECT and resting gated blood pool SPECT techniques before and after 47 successful coronary angioplasties. Thallium perfusion was analyzed visually and quantitatively in stress and resting studies. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) were calculated and regional wall motion was scored by amplitude and phase images in radionuclide planar and tomographic imagings. The thallium redistribution in delayed or resting SPECTs was more sensitive (87%) for detecting myocardial ischemia compared to symptoms (36%) and ECG changes (60%). An exercise capacity, LVEF, PFR, and the scores of perfusion and regional wall motion were improved significantly after coronary angioplasty. Stress thallium and gated blood pool SPECTs showed the improvements of myocardial perfusion in 159 (79%) of 201 segments and regional wall motion in 47 (51%) of 92 segments, respectively. These results suggest that the combined use of stress thallium SPECT, gated blood pool planar and SPECT techniques can contribute not only to the assessment of the efficacy of coronary angioplasty but also to detecting the mismatching of myocardial perfusion and contraction ('myocardial hibernation') in infarct-related myocardial lesions. (author)

  11. Reconstructive treatment of dural arteriovenous fistulas of the transverse and sigmoid sinus: transvenous angioplasty and stent deployment

    Energy Technology Data Exchange (ETDEWEB)

    Liebig, T.; Henkes, H.; Brew, S.; Miloslavski, E.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Kirsch, M. [Universitaetsklinikum Greifswald der Ernst-Moritz-Arndt-Universitaet, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany)

    2005-07-01

    Various techniques for the endovascular treatment of dural arteriovenous fistulas (dAVFs) of the transverse and sigmoid sinus have recently evolved. Transvenous coil occlusion of the involved segment and transarterial embolization of the feeding arteries with liquid agents are the commonest treatments utilized. However, with respect to venous hypertension as the probable pathogenic cause of this disorder, a nonocclusive or remodeling technique might be preferable. We will present a series involving four patients, treated with transvenous angioplasty and stent deployment as a definitive treatment of dAVFs of the transverse and sigmoid sinus. This method was used as a primary treatment or as an adjunct to previous noncurative transarterial n-butyl cyanoacrylate and particle embolization. In three of the four cases, complete occlusion of the fistula was achieved with confirmation of occlusion seen on follow-up angiographical studies. In one case a negligible and nonsymptomatic remnant of the fistula fed by the tentorial artery was left untreated. From our experience, we conclude that transvenous stent deployment is an alternative to traditional concepts. Additionally, the pathological theory of dAVFs in this region located in venous pouches of the sinus wall is supported by the fact that they can be occluded by mechanical compression during angioplasty and subsequently maintained by a stent. (orig.)

  12. Evidence of a cellular protective effect by antecedent angina independent of collateral flow recruitment during coronary angioplasty in humans

    International Nuclear Information System (INIS)

    The main aim of this study was to elucidate whether the beneficial effect of antecedent angina is a cellular protective effect or the result of an increase of collateral flow. Of 42 patients with angina who underwent percutaneous transluminal coronary angioplasty (PTCA) for proximal left anterior descending artery (LAD) stenosis, 22 had experienced antecedent anginal pain (AP) within 7 days prior to PTCA. 99mTc-sestamibi was injected during balloon inflation, and quantitative analysis of ischemic severity during coronary occlusion was calculated (SS). An electrocardiogram was recorded during ballooning to calculate the sum of ST elevation (ΣST). ΣST was significantly reduced in patients with AP compared with patients without AP (1.88±0.89 mV vs 1.18±0.74 mV, p=0.0088); however, no difference was observed in defect severity. A close correlation was observed between SS and ΣST in both groups. The multivariate regression model demonstrated that both a large SS (p<0.0001) and the absence of preceding AP (p=0.001) were significantly related to the elevation of ΣST. Recent angina can render the myocardium more resistant to subsequent ischemia during angioplasty and is true preconditioning rather than simply an increase of flow. (author)

  13. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    International Nuclear Information System (INIS)

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  14. [Ultrasound coronary angioplasty: state of the art and new clinical aspects].

    Science.gov (United States)

    Rosenschein, U; Budde-Schwartzman, B

    1997-12-01

    Therapeutic ultrasound was shown to ablate thrombi and to disrupt atherosclerotic plaques in vitro and recently to recanalize occluded coronary arteries in acute myocardial infarction (AMI). The goal of this article is to update collective experience and to weigh the promising and unresolved aspects of this newly developed technology and its clinical results. As therapeutic ultrasound was for long known a synonym for lithotripsy of calculi diseases, it lastly received high attention as a catheter-based ultrasound method to ablate thrombi and disrupt atherosclerotic plaques in interventional cardiology (Figure 1). The effect of therapeutic ultrasound to ablate selectively pathological tissue depends on its bioselectivity for elastic fibers: After ultrasound sonication, healthy tissue-rich in elastin and collagen-including arterial wall remains intact whereas thrombus and plaque with their minimal elastic support are found to be highly susceptible to ablation. Our catheter for coronary ultrasound thrombolysis (Figure 2) consists of a solid metal probe and is connected to a piezo-electric transducer at its proximal end. The distal part ends in a three-wire flexible segment with a 1.6 mm tip ball to guarantee maximal wire flexibility and optimal transmission of ultrasound energy. The initial in vitro studies resulted in a fundamental understanding of the destructive effect of ultrasound on tissue based on 4 factors: mechanical vibration, thermal effects, microcurrents, and cavitation. The first studies on human peripheral vessels were published in 1991 being performed during femoral bypass surgery on occluded and partially obstructed arteries. The procedure was performed without perforation, no adverse side effects emerged, restenosis rate was 20%. The clinical application of coronary ultrasound angioplasty was initiated in 1991; Siegel published his data on 44 patients. In his study, 30 patients with chronic atherosclerotic occlusive lesions and 14 with unstable or

  15. Use of Reactor-Produced Radioisotopes for Prevention Restenosis After Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, F.F.; Pipes, D.W.

    1999-12-21

    Coronary heart disease leads to myocardial infarction and is a major cause of death in the US. Myocardial infarctions result from atherosclerotic plaque deposits in the coronary arteries, reducing blood flow through these arteries which supply oxygen and nutrients to the heart muscle. The two major approaches for restoring adequate blood flow are coronary bypass graft surgery and coronary angioplasty. Angioplasty is a routinely used clinical procedure, where a deflated balloon attached to the end of a long catheter is inserted into an artery in the leg and then advanced through the aorta into the blocked regions of the coronary arteries. After positioning in the occluded region of the artery, the balloon is inflated with a pressurized saline solution which opens the artery restoring blood flow by pressing the atherosclerotic plaque into the vessel wall. Angioplasty is a widely performed procedure with the coronary arteries and is a much less expensive alternative to coronary bypass surgery. The best patients for angioplasty are those with single occlusions and this method is preferred over bypass grafting because of the significantly reduced expense. The reformation of plaque deposits in arteries (restenosis) following angioplasty, however, is a major clinical problem encountered in as high as 40 percent of patients. Because reduction of health care costs is a major national priority, development of effective new preventative methods for restenoses is an important national priority.

  16. Adjuvant revascularization of intracranial artery occlusion with angioplasty and/or stenting

    International Nuclear Information System (INIS)

    In conjunction with intravenous and/or intra-arterial thrombolysis, adjuvant revascularization of intracranial artery occlusion by angioplasty vs. stenting remains controversial. We evaluated outcome in patients with intracranial occlusion after angioplasty and/or stenting. Thirty-three patients who underwent angioplasty or stenting (17 stenting and 16 angioplasty) for intracranial arterial occlusion during the past 5 years were enrolled from prospective neurointerventional database. We compared recanalization rate [defined as thrombolysis in myocardial infarction (TIMI) grade II/III flow], adverse events, and clinical outcome [modified Rankin scale (mRS) at 1 and 6 months]. We also tried to determine independent variables associated with clinical outcome. Median initial National Institutes of Health Stroke Scale (NIHSS) was 13 and median time to treatment was 12 h from symptom onset. The successful recanalization rate was mean 79%. Symptomatic hemorrhage occurred in 15% (5/33). Events (27%, 9/33) at 1 month included four deaths, four major, and one minor stroke. Good outcome (mRS ≤ 2) was achieved in 17 patients (52%) at 6 months and was significantly related to age, initial NIHSS, TIMI flow, and stenting on bivariate analysis. On multivariable analysis, stenting was the only variable significantly associated with a 6-month, good clinical outcome (OR, 14.48; 95% CI, 1.76 to 118.93; p = 0.013) Intracranial revascularization with angioplasty and/or stenting may improve the clinical outcome in selected patients with intracranial occlusion. Multiple factors are related to favorable clinical outcome. (orig.)

  17. Short-term outcome of stent-assisted angioplasty for extracranial carotid stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and short-term outcome of stent-assisted angioplasty for extracranial carotid stenosis. Methods: From October 2000 to September 2002, 93 cases of extracranial carotid stenosis, including 86 cases of carotid bifurcation stenosis, 4 of extracranial internal carotid stenosis, 2 of common carotid stenosis and 1 of functional external carotid stenosis, were treated by self-expandable stent placement and angioplasty. Results: Stent placement and angioplasty were successfully administered in all the 93 patients. The average stenosis rate was reduced from (79.5 ± 14.6)% before treatment to (11.2 ± 7.8)% after stent-assisted angioplasty. There were only 1 case of TIA (1.1%) and 1 case of minor stroke (1.1%) during the operation, without mortality or major stroke. No cerebral ischemic attach occurred in the 91 patients during clinical follow up for a period of 3-25 months with an average of 7.9 months. twenty-nine patients were angiographically followed up 6 months after treatment with only one asymptomatic restenosis (3.4%). Conclusions: Endovascular stent-assisted angioplasty for extracranial stenosis is safe and effective with considerable good short-term outcome

  18. Use of Reactor-Produced Radioisotopes for Prevention Restenosis After Angioplasty

    International Nuclear Information System (INIS)

    Coronary heart disease leads to myocardial infarction and is a major cause of death in the US. Myocardial infarctions result from atherosclerotic plaque deposits in the coronary arteries, reducing blood flow through these arteries which supply oxygen and nutrients to the heart muscle. The two major approaches for restoring adequate blood flow are coronary bypass graft surgery and coronary angioplasty. Angioplasty is a routinely used clinical procedure, where a deflated balloon attached to the end of a long catheter is inserted into an artery in the leg and then advanced through the aorta into the blocked regions of the coronary arteries. After positioning in the occluded region of the artery, the balloon is inflated with a pressurized saline solution which opens the artery restoring blood flow by pressing the atherosclerotic plaque into the vessel wall. Angioplasty is a widely performed procedure with the coronary arteries and is a much less expensive alternative to coronary bypass surgery. The best patients for angioplasty are those with single occlusions and this method is preferred over bypass grafting because of the significantly reduced expense. The reformation of plaque deposits in arteries (restenosis) following angioplasty, however, is a major clinical problem encountered in as high as 40 percent of patients. Because reduction of health care costs is a major national priority, development of effective new preventative methods for restenoses is an important national priority

  19. Infrapopliteal Percutaneous Transluminal Balloon Angioplasty: Clinical Results and Influence Factors

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jang Hyeon; Lee, Seung Jin; Jung, Hye Doo; Lim, Jae Hoon; Chang, Nam Kyu; Yim, Nam Yeol; Kim, Jae Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Lee, Keun Bae [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2011-09-15

    To assess the efficacy of percutaneous transluminal angioplasty (PTA) in patients with infrapopliteal arterial disease, and to determine the influencing factor for prognosis. A total of 55 patients (60 limbs) with infrapopliteal arterial stenosis or occlusion underwent PTA. Atherosclerotic risk factors, clinical symptoms, TransAtlantic Inter-Society Consensus (TASC) classification, and vascular wall calcification were evaluated before PTA. The number of patent infrapopliteal arteries was estimated, and the outcome was evaluated by symptom relief and limb salvage. Technical success was achieved in 53/60 limbs (88.3%) and 81/93 arteries (87.1%), TASC classification (p = 0.038) and vascular calcification (p = 0.002) influenced on technical failure. During follow-up, 26 of 55 limbs (47%) achieved symptom relief and 42/55 limbs (76%) underwent limb salvage. Non-diabetic patients (9/12, 75%) were superior to diabetic patients (17/43, 40%) in terms of symptom relief (p = 0.024). TASC classification and vascular wall calcification influenced on symptom relief and limb salvage. The number of patent infrapopliteal arteries after PTA influenced symptom relief (p < 0.001) and limb amputation (p = 0.003). PTA in patients with chronic critical limb ischemia is worthwhile as a primary treatment. The influence factors should be considered before PTA, and PTA should be performed in as many involved arteries as possible.

  20. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    Science.gov (United States)

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  1. Inferior knee arterial endoluminal angioplasty in treating severe lower limb ischemia though the DEEP balloon catheter

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of inferior knee arterial endoluminal angioplasty for treating severe lower limb ischemia with the use of the DEEP balloon catheter. Methods: Eleven patients (17 limbs) with severe ischemia of lower extremities from August 2007 to April 2008 were retrospectively studied. All involved limbs suffered from rest pain including 6 limbs (6/17)complicated with ulcer, 2 (2/17) with toe gangrene or 3 (3/17)with both of the complaints. ABI (Ankle bxancial index) were 0.2-0.5 and 0.51-0.7 in 12 limbs and 5 limbs respectively, with average value 0.47. Results: The success rate of operation was 100% (17/17). Pain relieved obviously in 13 limbs (13/17) and reduced in 2 limbs (2/17). 2 limbs (2/17) still suffered from pain and underwent upper-knee amputation and other 2 with ulcerations(2/ 17)were healed. 3 (3/17) with toe gangrene underwent partial foot amputation, 1 with dried gangrene remained unchanged and the other was lost. Another one showed ulcer healed and toe was lost. Increase of ABI was more than 0.5 in 10 limbs(10/17) and 0.3-0.5 in 5 limbs(5/17) with average value of 0.83. 10 patients with sixteen limbs were followed up in an average period of 4.3 months (1-9 months). Of the 15 immediate pain-relieved limbs, 12(12/15) limbs remained free of pain and pain recurred in 3 other limbs; and 2 of them with pain-reduced after PTA again; the other 1 underwent amputation, Average value of ABI was 0.70. Conclusions: Inferior arterial endoluminal angioplasty for the treatment of severe limb ischemia with application of the DEEP balloon catheter show high successful rate and short-term encouraging clinical results but mid-term and long-terms follow up should be undertaken for further investigation. (authors)

  2. Gene Therapy for the Prevention of in- Stent Restenosis Post Coronary Angioplasty

    Directory of Open Access Journals (Sweden)

    P Ranjzad

    2005-10-01

    Full Text Available Around the world, Coronary Artery Disease (CAD is quickly becoming the most common cause of morbidity and mortality. Percutaneous coronary interventions- angioplasty and stent insertion- have proved effective and reliable treatments for CAD but their long-term efficacy is limited by the high rate of restenosis. This occurs in 30 – 50% of patients undergoing angioplasty and results in symptoms requiring repeat intervention in up to 75% of them. Stent insertion has been shown to reduce this rate but in-stent restenosis still occurs in 20-40% of cases. The high incidence of restenosis represents a large economic burden on health resources. As a consequence of the resistance of restenosis to traditional therapeutic approaches, gene therapy has emerged an attractive potential therapy for this problem. Excessive extracellular matrix (ECM deposition in the neointima is the main mechanism leading to luminal loss after coronary stenting. Transforming growth factor-β (TGF-β is a major regulator of ECM deposition and there is substantial evidence to suggest its role in restenosis. TGF-β1 is the predominant isoform in vascular tissues and its production is observed to be upregulated in human restenotic lesions and in the intima of injured animal vessels. The aim of this study is to develop, investigate and compare the effects of two potentially therapeutic recombinant, replication-deficient adenoviruses, which will give rise to the expression of transgenic proteins which antagonise the fibrogenic effects of TGF-β1 in coronary arteries post stent insertion. The cDNA for these proteins have each been inserted into replication deficient adenovirus vectors under the control of the Major Immediate/Early Murine Cytomegalovirus (MIEmCMV promoter. Virus identity and the presence of transgenes have been confirmed by restriction analysis and Southern blotting respectively. Efficient transgene expression has been confirmed in cultured porcine coronary vascular

  3. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    Science.gov (United States)

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  4. Transluminal Angioplasty of Peroneal Artery Branches in Diabetics: Initial Technical Experience

    International Nuclear Information System (INIS)

    The present study aimed to report the technical feasibility of percutaneous transluminal angioplasty (PTA) of obstructed or insufficient collateral branches (anterior and posterior perforating branches) from distal peroneal to foot arteries in diabetic patients with chronic critical limb ischemia (CLI) and chronic noncrossable occlusion of the anterior and posterior tibial arteries. Twenty-four diabetic CLI patients (age, 67 ± 8 years; 87% males) undergoing collateral PTA were included. Baseline clinical angiographic and follow-up data were retrospectively reviewed. Collateral PTA was associated with a concomitant PTA of other sites in 21 (83%) cases. In 15 cases the treated collateral linked the peroneal with the plantaris communis; in 9 cases, the peroneal with the dorsalis pedis. Angiographic results of collateral PTA were good in 13 cases (<30% residual stenosis), whereas the result was considered moderate (30%-49% residual stenosis) in the remaining cases. Neither perforation nor acute occlusion of the treated collaterals or other relevant complications were observed. Mean follow-up was 32 ± 17 months. Major amputation was necessary for two (8.3%) patients. Cumulative limb salvage rates at 2 and 4 years were 96% and 87%, respectively. In conclusion, this initial experience shows that PTA of the collateral branches from distal peroneal to foot arteries is a feasible technique. Future studies are required to define the clinical role of this novel approach

  5. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    International Nuclear Information System (INIS)

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity

  6. Optimization and audit of radiation dose during percutaneous transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Livingstone Roshan

    2007-01-01

    Full Text Available The percutaneous transluminal coronary angioplasty (PTCA is one of the interventional procedures which impart high radiation doses to patients compared to the other cardiologic procedures. This study intends to audit and optimize radiation dose imparted to patients undergoing PTCA. Forty-four patients who underwent PTCA involving single or multiple stent placement guided under cardiovascular X-ray machine were included in the study. Radiation doses were measured using dose area product (DAP meter for patients undergoing single and multiple stent placements during PTCA. A dose reduction of 27-47% was achieved using copper filters and optimal exposure parameters. The mean DAP values before optimization were 66.16 and 122.68 Gy cm 2 for single and multiple stent placement respectively. These values were 48.67 and 65.44 Gy cm 2 respectively after optimization. In the present scenario, due to the increase in the number of PTCAs performed and the associated risk from radiation, periodical audit of radiation doses for interventional procedures are recommended.

  7. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schleder, Stephan, E-mail: stephan.schleder@ukr.de [University Hospital Regensburg, Department of Radiology (Germany); Diekmann, Matthias [Radiology Center Rahlstedt (Germany); Manke, Christoph [General Hospital Fulda, Department of Radiology (Germany); Heiss, Peter [University Hospital Regensburg, Department of Radiology (Germany)

    2015-02-15

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  8. Gadopentetate dimeglumine as a contrast agent in peripheral angioplasty. A case report

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, J.M.; Smiddy, P.; Molloy, M.P. [St. Jame`s Hospital, Dublin (Ireland). Dept. of Diagnostic Imaging; O`Hare, N.J. [St. Jame`s Hospital, Dublin (Ireland). Dept. of Medical Physics

    1998-09-01

    Gadopentetate dimeglumine (Gd-DTPA) is widely used as a contrast agent in MR imaging. We report on a case in which Gd-DTPA was used as the contrast agent during angioplasty in a patient who had recently had an adverse reaction to a non-ionic iodinated contrast medium. Gd-DTPA allowed a diagnostic angiogram to be performed with no side effects, and may thus be a useful contrast agent at angioplasty in patients with contra-indications to iodinated contrast media. (orig.)

  9. Prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty plus stent

    International Nuclear Information System (INIS)

    Objective: To study the prognostic value of myocardial perfusion tomographic imaging in patients after percutaneous transluminal coronary angioplasty (PTCA) plus stent. Methods: Seventy-five patients underwent 99Tcm-methoxyisobutylisonitrile (MIBI) stress-rest myocardial perfusion tomographic imaging (6.91 ± 2.99) months after PTCA. They were then followed-up for (41.71 ± 20.00) months, and unstable angina pectoris, acute myocardial infarction, cardiac death and revascularization for cardiac events were recorded during follow-up. Results: Twenty-five patients had cardiac events during follow-up. And the cardiac event rate in patients with normal and fixed defects(5.9%, 16.7%) was significantly lower than that in those with reversible defects (52.5%, χ2=10.94, P2=6.57, P2=7.37, P=0.0066; χ2=6.28, P=0.012), and the mean time free of cardiac event after PTCA was (33.8 ± 5.0) months. Conclusion: The presence of reversible defects on post-PTCA cardiac imaging predicts a higher cardiac event rate, the myocardial perfusion tomography imaging after PTCA is valuable for predicting the prognosis of patients after PTCA plus stent. (authors)

  10. Stent-assisted angioplasty for atherosclerotic stenosis of the carotid artery. An overview

    International Nuclear Information System (INIS)

    For symptomatic stenosis of the carotid artery the invasive options for treatment (by means of stent or operation) are superior to conservative medical treatment. Recent multi-center randomized controlled trials, which will be presented here, indicate that stenting in the treatment of symptomatic carotid stenosis is neither safer nor more effective than carotid endarterectomy. When carried out by an experienced interventionalist stent-assisted angioplasty (CAS) is an alternative to carotid endarterectomy. Subgroup-analysis indicates that for patients older than 70 years of age invasive techniques should be the method of choice. In the case of contralateral high-grade stenosis or occlusion, CAS is the method of choice. For patients treated by stenting, the periprocedural complication rate is not influenced by the use of protection systems. The present results on symptomatic carotid stenosis should not be transferred to the therapy of asymptomatic carotid stenosis. A 3-armed study (SPACE2) on the comparison of the best medical treatment with the invasive treatment modalities (CAS or CEA) is in preparation and will be started in 2 months. (orig.)

  11. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    International Nuclear Information System (INIS)

    The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques

  12. Treatment of an Immature Autogenous Arteriovenous Fistula with Percutaneous Transluminal Angioplasty

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in facilitating maturation of autogenous arteriovenous fistulae. There were 12 immature autogenous arteriovenous fistulae. We performed 15 PTAs transvenously. Post-intervention anatomic and clinical successes were estimated, and the 6-month and 1-year primary and secondary patency rates were calculated using Kaplan-Meier analysis. All immature fistulae had underlying stenosis (n=20): arteriovenous anastomosis (n=1) and venous outflow (n=19): 1) within 5 cm from the anastomosis (n=10); 2) more than 5 cm but less than 10 cm from the anastomosis (n=5); 3) more than 10 cm from the anastomosis, including central veins (n=4). Six fistulae had two or more stenoses. Repeat intervention was necessary in two patients. The anatomical success rate was 94.3%, and the clinical success rate was 86.7%. The 6-month and 1-year primary patency rates were 72.7% and 54.5%, and the secondary patency rates were 100% and 81.8%, respectively. All immature hemodialysis fistulae have underlying stenosis, most of which are located near the arteriovenous anastomosis. Early interventional procedures are helpful in the salvage and maintenance of immature arteriovenous fistulae, with a high degree of success

  13. Treatment of an Immature Autogenous Arteriovenous Fistula with Percutaneous Transluminal Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyoung Rae [Kangwon National University, Chuncheon (Korea, Republic of)

    2008-11-15

    The purpose of this study was to evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in facilitating maturation of autogenous arteriovenous fistulae. There were 12 immature autogenous arteriovenous fistulae. We performed 15 PTAs transvenously. Post-intervention anatomic and clinical successes were estimated, and the 6-month and 1-year primary and secondary patency rates were calculated using Kaplan-Meier analysis. All immature fistulae had underlying stenosis (n=20): arteriovenous anastomosis (n=1) and venous outflow (n=19): 1) within 5 cm from the anastomosis (n=10); 2) more than 5 cm but less than 10 cm from the anastomosis (n=5); 3) more than 10 cm from the anastomosis, including central veins (n=4). Six fistulae had two or more stenoses. Repeat intervention was necessary in two patients. The anatomical success rate was 94.3%, and the clinical success rate was 86.7%. The 6-month and 1-year primary patency rates were 72.7% and 54.5%, and the secondary patency rates were 100% and 81.8%, respectively. All immature hemodialysis fistulae have underlying stenosis, most of which are located near the arteriovenous anastomosis. Early interventional procedures are helpful in the salvage and maintenance of immature arteriovenous fistulae, with a high degree of success

  14. Changes of the serum level of C-reactive protein after coronary angioplasty

    International Nuclear Information System (INIS)

    Objective: To study the changes of C-reactive protein level (CRP) after percutaneous transluminal coronary angioplasty (PTCA) and its relation with clinical outcome after the operation. Methods: Serum levels of CRP in 47 patients with unstable angina pectoris were measured via immunoradiometric assay (IRMA), before and 48 h, 1 week after operation. Incidence of restenosis was observed within a 9 months follow-up and the CRP levels of the patients with restenosis were compared with those of the patients without restenosis, CRP levels before and 48 h after coronary angiography in 25 cases were used as the controls. Results: The mean CRP level at 48 h after PTCA operation was significantly higher than that before operation (P < 0.01), while no differences between those at 1 week before and after PTCA operation and no significant difference between those of before and after coronary angiography operation were observed. Clinical restenosis was confirmed in 13 patients in the followup period and their CRP levels at 48 h after operation were significantly higher than that in the patients without restenosis (P < 0.01). Conclusion: Serum CRP levels at 48 h after PTCA operation were significantly higher than that before operation and it correlated closely with the clinical outcome

  15. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    Directory of Open Access Journals (Sweden)

    Pedro Beraldo de Andrade

    2014-07-01

    Full Text Available Background: The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Objective: To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. Methods: From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. Results: The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. Conclusions: The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.

  16. Femoral versus Radial Access in Primary Angioplasty. Analysis of the ACCEPT Registry

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, Pedro Beraldo de, E-mail: pedroberaldo@cardiol.br; Andrade, Mônica Vieira Athanazio de; Barbosa, Robson Alves; Labrunie, André [Santa Casa de Misericórdia de Marília, São Paulo -SP (Brazil); Hernandes, Mauro Esteves [Santa Casa de Votuporanga, São Paulo -SP (Brazil); Marino, Roberto Luiz [Hospital Madre Teresa, Belo Horizonte -MG (Brazil); Precoma, Dalton Bertolim [Sociedade Hospital Angelina Caron, Campina Grande do Sul -PR (Brazil); Sá, Francisco Carleial Feijó de [Hospital do Coração do Cariri, Barbalha -CE (Brazil); Berwanger, Otávio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo -SP (Brazil); Mattos, Luiz Alberto Piva e [Sociedade Brasileira de Cardiologia, São Paulo -SP (Brazil); Instituto Dante Pazzanese de Cardiologia, São Paulo -SP (Brazil); Unidades de Hemodinâmica e Intervenção Cardiovascular Rede D' Or / São Luiz, São Paulo, SP (Brazil)

    2014-06-15

    The radial access provides a lower risk of bleeding and vascular complications related to the puncture site in comparison to the femoral access. Recent studies have suggested a reduction in mortality associated with the radial access in patients with acute myocardial infarction undergoing percutaneous coronary intervention. To compare the occurrence of adverse cardiovascular ischemic and hemorrhagic events in patients undergoing primary angioplasty according to the type of arterial access route. From August 2010 to December 2011, 588 patients undergoing primary percutaneous coronary intervention during acute ST-segment elevation myocardial infarction were assessed; they were recruited from 47 centers participating in the ACCEPT registry. Patients were grouped and compared according to the arterial access used for the procedure. The mean age was 61.8 years; 75% were males and 24% had diabetes mellitus. There was no difference between groups as regards the procedure success rate, as well as regards the occurrence of death, reinfarction, or stroke at six months of follow-up. Severe bleeding was reported in 1.1% of the sample analyzed, with no statistical difference related to the access used. The femoral and radial accesses are equally safe and effective for the performance of primary percutaneous coronary intervention. The low rate of cardiovascular events and of hemorrhagic complications reflects the quality of the participating centers and the operators expertise with the use of both techniques.

  17. Patients' feelings and experiences during and after peripheral percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Background: Peripheral Arterial Disease (PAD) often caused by atherosclerosis is a major health care issue worldwide. Percutaneous Transluminal Angioplasty (PTA) on the lower limb is a common procedure used to enhance peripheral circulation. With an increasing number of individuals acquiring peripheral PTA treatment and with an increased focus on patient centred care, there is a need to find out more about patients' feelings and thoughts of undergoing PTA. Aim: The aim was to identify patients who are predominantly anxious or calm during and after peripheral PTA and to explore reasons for these feelings. Method: The study includes 51 patients who received PTA treatment in western Sweden. Findings: Seventy-eight percent of the patients rated themselves as calm after the PTA. The analysed interviews resulted in two themes: reasons for feelings of calmness and reasons for feelings of anxiety. Conclusion: In order to feel calm during and after the PTA, information given prior to the PTA needs to be comprehensive and consistent with the actual situation at the angiography suite. The dialogue with the physician and the radiographers was considered valuable, as was the ability to follow the procedure on the image screen. It is concluded that a thorough dialogue with the physician in a calm setting after the PTA is important for the patients' ability to foresee and plan for the future. Moreover, there is a need to find ways to improve analgesic routines regarding assessment and evaluation in connection with PTA treatment as pain is shown to increase anxiety

  18. Medical angioplasty - Hope and expectations: An optimistic overview

    Directory of Open Access Journals (Sweden)

    Mohammed F Abdul-Mohsen

    2011-01-01

    Full Text Available Primary and secondary prevention of cardiovascular diseases (CVD are markedly overlooked worldwide. The use of these kinds of preventive methods will greatly improve outcome of or even reverse major CVD, especially coronary atherosclerosis. Comprehensive lifestyle changes combined with aggressive medical therapy [lipid lowering agents "statins", antiplatelet agents, beta-blockers and angiotensin-converting enzyme inhibitors] for patients suffering from coronary heart disease significantly reduce all major adverse cardiovascular events (MACE, especially in those with stable coronary artery disease (CAD, even if their coronary lesions are significant. The main mechanistic pathways for the significant reduction of MACE are: Stabilization of atheromatous plaques through endothelial function reparation, strengthening of the fibrous cap of the atheromatous plaque and reduction of atheroma burden, i.e., reversal of the process of coronary artery stenosis, the great dream of "medical angioplasty". Despite the compelling data indicating the great beneficial effects of both primary and secondary prevention of coronary atherosclerosis, the US national survey data reveals that only a minority of patients eligible by guidelines for these therapies in fact receive them. Hence, we strongly believe that our main duties as cardiologists is to improve the up-to-date knowledge of the practicing physicians about utility of aggressive medical therapy for both prevention and reversal of CVD, and also to promote useful primary and secondary prevention programs among physicians and patients. Meanwhile, further improvement and refinement of the current therapeutic modalities and introduction of new modalities for the management of lipid parameters other than LDL-C, such as HDL-C, triglyceride, lipoprotein (a, LDL particle size and susceptibility to oxidation may add further favourable effects in prevention and reversal of atherosclerotic process. Cardiologists should be

  19. [Exercise tolerance in patients after successful percutaneous transluminal coronary angioplasty].

    Science.gov (United States)

    Tsumoto, S; Nakagawa, Y; Asakuma, S; Naruse, H; Komasa, N; Ohyanagi, M; Tateishi, J; Yasutomi, N; Fujitani, K; Iwasaki, T

    1991-01-01

    In 32 patients with successful percutaneous transluminal coronary angioplasty (PTCA), we performed treadmill exercise tests (TMET) before and about one month after PTCA to assess the correlation between the improvement in coronary artery lesions and exercise tolerance. Either the Bruce protocol (B: n = 12) or the modified Bruce protocol (MB: n = 20) was used; with the latter being applied to patients whose cardiac function seemed depressed. In 15 patients, oxygen consumption (VO2) was measured by analyzing the expired gases, 13 patients underwent exercise thallium-201 myocardial perfusion scintigraphy before and after PTCA, whose results were compared with those of TMET. In both B and MB protocols, the treadmill walking time was significantly prolonged after PTCA, compared to that before PTCA (B: 7.4 +/- 1.3 vs 9.5 +/- 1.9, MB: 11.4 +/- 3.5 vs 12.7 +/- 3.5 min). Heart rates (HR) and rate pressure products (RPP) were significantly increased after PTCA in both protocols (HR B: 139 +/- 18 vs 154 +/- 17, MB: 121 +/- 20 vs 137 +/- 19 bpm, RPP B: 26,500 +/- 5,600 vs 30,300 +/- 6,700, MB: 19,400 +/- 6,200 vs 22,700 +/- 6,600 mmHg.bpm), however, systolic blood pressure did not change significantly after PTCA in either protocol. While there was a significant improvement in VO2 after PTCA (21.6 +/- 6.3 vs 25.7 +/- 4.2 ml/kg/min), the O2-pulse remained unchanged. Thallium-201 myocardial scintigraphy revealed improvement of myocardial perfusion in 8 of the 13 cases examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1841916

  20. Time course, predictors and clinical implications of stent thrombosis following primary angioplasty. Insights from the DESERT cooperation

    DEFF Research Database (Denmark)

    De Luca, Giuseppe; Dirksen, Maurits T; Spaulding, Christian;

    2013-01-01

    -term safety and effectiveness of DES as compared to BMS in patients undergoing pPCI for STEMI. Follow-up data were collected for 3-6 years after the procedure. ST was defined as definite or probable, based on the ARC definition. The study population consists of 6,274 STEMI patients undergoing primary...... timing of stent thrombosis (ST) with both DES and bare metal stents (BMS) and its prognostic significance in patients undergoing pPCI. The Drug-Eluting Stent in Primary Angioplasty (DESERT) cooperation is based on a pooled database including individual data of randomised trials that evaluate the long......Primary percutaneous coronary intervention (pPCI) has improved survival as compared to thrombolysis. Concerns still remain regarding the risk of stent thrombosis in the setting of STEMI, especially after drug-eluting stent (DES) implantation. Therefore, the aim of this study was to report on the...

  1. Subintimal angioplasty for the treatment of long segment occlusion of superficial femoral artery: the midterm results

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical value of subintimal angioplasty in treating long segment occlusion of superficial femoral artery and to observe its midterm results. Methods: Subintimal angioplasty was performed in 45 patients with long segment occlusion of superficial femoral artery, whose clinical presentation was intermittent claudication or critical limb ischemia. The primary patency, limb salvage and factors influencing long-term patency were observed, and the clinical data were analyzed. Results: Of the total 45 cases, the subintimal angioplasty was successfully accomplished in 43. The success rate of antegrade approach technique via the superficial femoral artery was 80% (n=36), the occlusion was recanalized by using retrograde approach technique via ipsilateral popliteal artery in 7 case. The total technical success rate was 95.6%. The primary patency in 43 successful cases at 6, 12, 24 and 36 months was 85.7%, 69.0% 57.3% and 50.9%, respectively. No statistically significant difference in primary patency existed between the group of intermittent claudication and the group of critical limb ischemia (P>0.05). Statistically significant prediction factors for primary patency included the number of the run off vessels below the knee and the length of the occlusion (P<0.05). Conclusion: Subintimal angioplasty is an effective procedure for the treatment of long segment occlusions of superficial femoral artery with satisfactory mid-term results. (authors)

  2. HEMOPERFUSION DURING CORONARY ANGIOPLASTY - 1ST EUROPEAN EXPERIENCE WITH A NEW HEMOPERFUSION PUMP

    NARCIS (Netherlands)

    DEMUINCK, ED; MEEDER, J; MAGIELSE, C; BOM, VJJ; VANDIJK, RB; VERKERKE, GJ; LIE, KI

    1994-01-01

    Hemolysis tests with fresh human blood were performed in vitro with a new 5 ml, piston-type hemoperfusion pump, designed to prevent myocardial ischemia during coronary angioplasty. Despite driving pressures greater than 3 atmospheres, shear stress greater than 200 Pa, turbulent pump flow, and the pr

  3. Implication of Laser Technology Than That of Shape Memory Alloy [NiTinol] in Angioplasty

    Directory of Open Access Journals (Sweden)

    C. Anil Kumar

    2009-11-01

    Full Text Available Modern Angioplasty is an alternative to bypass heart surgery because of safety and validity. As we know that the Heart diseases has risen to become that number of deaths in most of the developing or developed countries due to the high increase rates of obesity, drug dependence, and diabetes. Stents are used throughout the body but the most critical area being coronary arteries. Convention Material like Stainless Steel 316LN is used before, now a day’s Smart Materials like Nitinol is having wider application in Angioplasty. This paper presents the comparison and limitations of the Shape memory alloy [Nitinol] technology with that of Laser technology. The several materials used in angioplasty for stenting are Stainless steel 316LN, Titanium and Nitinol. Laser technology finds more beneficial due to its rapid growth in technology and also more advantageous because of the alloys used are resistant to corrosion, yet the corrosion occurs when two dissimilar surfaces are in contact and this happens in almost all alloys These devices have been used for only a few years and, although initial results look promising, long-term effects have not been fully investigated. It's important to note that, if restenosis recur there is no good method to simply remove the blockage, and follow-up treatments may require laser surgery or localized drug delivery using other angioplasty devices.

  4. Postpartum cerebral angiopathy: atypical features and treatment with intracranial balloon angioplasty

    International Nuclear Information System (INIS)

    Postpartum cerebral angiopathy (PCA) is an uncommon cause of ischemic and hemorrhagic stroke in young women. It is usually clinically benign and not relapsing. We describe a patient with non-hemorrhagic PCA who had an atypical progressive neurological deficit from bilateral hemisphere watershed ischemia despite treatment with aggressive medical therapy and intracranial balloon angioplasty. (orig.)

  5. Quantitative evaluation of cerebral blood flow by XeCT in stenting angioplasty for carotid artery

    International Nuclear Information System (INIS)

    Objective: To evaluate the hemodynamic characteristics of severe carotid artery stenosis and curative effect of stent angioplasty through XeCT. Methods: From April 2006 to November 2006, 13 patients with severe carotid artery stenoses underwent stent angioplasty in our hospital, including 11 male and 2 females, in an average age of 57.31 ± 6.12. All patients underwent XeCT examination to evaluate the quantitative cerebral blood flow (CBF). The ischemic cortex is categorized into 4 kinds, the normal region, oligemia area, reversible ischemic site and ischemic core center. Measurement and comparison of the changes were taken before and after the therapy. Results: Preoperative XeCT revealed different decrease of CBF in the ipsilateral cortex, especially in MCA distributing territory. Ischemic areas reduced significantly after the stenting angioplasty. Oligemia area reduced from 32.63% to 14.22%. Reversible ischemic area reduced from 13.54% to 8.38%. Normal area increased from 47.51% to 71.13%. But ischemic core center showed no significant changes. Conclusions: XeCT is beneficial for evaluation of the hemodynamic characteristics of carotid artery stenoses and also for accurately demonstrating the curative effects of the stent angioplasty. (authors)

  6. Postpartum cerebral angiopathy: atypical features and treatment with intracranial balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Song, J.K. [Center for Endovascular Surgery, Hyman-Newman Inst. for Neurology and Neurosurgery, New York, NY (United States); Cacayorin, E.D. [Interventional Neuroradiology, Dept. of Radiology, Univ. of Texas Medical School, Houston, TX (United States); Fisher, S.; Seifert, T.D.; Alexandrov, A.V.; Malkoff, M.D.; Grotta, J.C.; Campbell, M.S. [Div. of Stroke Neurology, Dept. of Neurology, Univ. of Texas Medical School, Houston, TX (United States)

    2004-12-01

    Postpartum cerebral angiopathy (PCA) is an uncommon cause of ischemic and hemorrhagic stroke in young women. It is usually clinically benign and not relapsing. We describe a patient with non-hemorrhagic PCA who had an atypical progressive neurological deficit from bilateral hemisphere watershed ischemia despite treatment with aggressive medical therapy and intracranial balloon angioplasty. (orig.)

  7. Iliac artery myointimal hyperplasia in rabbits submitted to angioplasty and treated with Moringa oleifera

    Directory of Open Access Journals (Sweden)

    Jânio Cipriano Rolim

    2016-02-01

    Full Text Available Objective: to assess post-angioplasty myointimal hyperplasia in iliac artery of rabbits treated with extract of Moringa oleifera leaves. Methods : we conducted a randomized trial in laboratory animals for five weeks of follow-up, developed in the Vivarium of Pharmaceutical Technology Laboratory of the Universidade Federal da Paraíba. We used rabbits from the New Zealand breed, subjected to a hypercholesterolemic diet and angioplasty of the external iliac artery, randomized into two groups: M200 Group (n=10 - rabbits treated with 200mg/kg/day of Moringa oleifera leaves extract orally; SF group (n=10 - rabbits treated with 0.9% saline orally. After five weeks, the animals were euthanized and the iliac arteries prepared for histology. Histological sections were analyzed by digital morphometry. Statistical analysis was performed using the Student's t test. The significance level was 0.05. Results : there was no significant difference in myointimal hyperplasia between M200 and SF groups when comparing the iliac arteries submitted to angioplasty. Conclusion : there was no difference of myointimal hyperplasia between groups treated with saline and Moringa oleifera after angioplasty.

  8. High-fidelity translesional pressure gradients during percutaneous transluminal coroanry angioplasty: correlation with quantitative coronary angiography

    NARCIS (Netherlands)

    C. Lamm; M. Dohnal; P.W.J.C. Serruys (Patrick); H.U. Emanuelsson (Hakan)

    1993-01-01

    textabstractA fiberoptic pressure sensor mounted on an 0.018-inch guidewire (Pressure Guide) was used to measure the transstenotic pressure gradient in 30 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with lesions considered suitable for quantitative coronary angiographic

  9. Intradural vertebral endarterectomy with nonautologous patch angioplasty for refractory vertebrobasilar ischemia: Case report and literature review

    OpenAIRE

    Timothy Uschold; Adib A Abla; Wilson, David A.; McDougall, Cameron G.; Peter Nakaji

    2014-01-01

    Background: The natural history of patients with symptomatic vertebrobasilar ischemic symptoms due to chronic bilateral vertebral artery occlusive disease is progressive, and poses significant challenges when refractory to medical therapy. Surgical treatment options depend largely on location and characteristics of the atheroma (s), and generally include percutaneous transluminal angioplasty (PTA) with or without stent placement, posterior circulation revascularization (bypass), extracranial ...

  10. Experimental and numerical investigation of wire waveguides for therapeutic ultrasound angioplasty

    OpenAIRE

    Noone, Declan, (Thesis)

    2008-01-01

    Therapeutic ultrasound angioplasty is an emerging minimally invasive cardiovascular procedure for disrupting atherosclerotic lesions using small diameter wire waveguides. The lesions are damaged through a combination of direct ablation, pressure waves, cavitation and acoustic streaming caused by distal-tip displacements at ultrasonic frequencies. Numerical and experimental methods are used to investigate the outputs of the wire waveguides during ultrasonic activation. A commercially avail...

  11. Immediate versus deferred coronary angioplasty in non-ST-segment elevation acute coronary syndromes

    NARCIS (Netherlands)

    R.K. Riezebos; E. Ronner; E. ter Bals; T. Slagboom; P.C. Smits; J.M. ten Berg; F. Kiemeneij; G. Amoroso; M.S. Patterson; M.J. Suttorp; J.G.P. Tijssen; G.J. Laarman

    2009-01-01

    BACKGROUND: The field of acute coronary syndromes is characterised by an increasing tendency towards early invasive catheter-based diagnostics and therapeutics-a practice based on observational and retrospective data. OBJECTIVE: To compare immediate versus deferred angioplasty in patients with non-S

  12. Percutaneous transluminal angioplasty of iliac and femoral arteries in severe lower-limb ischaemia

    DEFF Research Database (Denmark)

    Jørgensen, B; Henriksen, L O; Karle, A;

    1988-01-01

    Percutaneous transluminal angioplasty was performed 92 times in 86 patients with severe lower-limb ischaemia (40% occlusion), giving rise to rest pain and/or gangrene. The patients were thereafter observed for periods up to 5 years. Criteria for success were appearance of normal groin pulse (iliac...

  13. Late hemodynamic failure following percutaneous transluminal angioplasty for long and multifocal femoropopliteal stenoses

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Holstein, P

    1991-01-01

    The outcome of percutaneous transluminal angioplasty (PTA) was evaluated for treatment of 87 limbs with femoropopliteal stenoses, including 55 short stenoses (2.4 +/- 1.6 cm, mean +/- SD), seven single long stenoses (10.4 +/- 2.0 cm), and 25 multifocal stenoses (2.1 +/- 1.6 cm), where two to four...

  14. A cutting balloon for coronary angioplasty: new trend in the prevention of restenoses

    International Nuclear Information System (INIS)

    Results on application of angioplasty with a cutting balloon in 8 men with ischemia heart disease are presented all patients had injury of one coronary vessel. The first experience makes it possible to consider that application of a cutting balloon is not dangerous, the arteria wall traumatization is small and restonoses frequency should be consequently smaller. 7 refs.; 3 figs

  15. Ultrasonography-guided Balloon Angioplasty in an Autogenous Arteriovenous Fistula: Preliminary Results

    International Nuclear Information System (INIS)

    Percutaneous trasnluminal angioplasty (PTA) of a malfunctioning arteriovenous fistula (AVF) in hemodialysis patients requires the use of contrast angiography and fluoroscopy guidance. We attempted to perform this procedure under duplex ultrasound guidance to reduce the amount of contrast agent administered and to reduce the radiation dose during the interventional procedures. From September 2006 to February 2007, 45 patients received interventional treatment due to malfunctioning hemodialysis access in our hospital. Among the patients, we selected 10 patients diagnosed with stenosis of an autogenous arteriovenous fistula based on a physical examination. There were six males and four females aged 51-78 years (mean age, 59 years). Seven of these patients had a Brescia-Cinimo type fistula and three patients had a basilic vein transposition. All procedures were performed in the angiography suite. All procedures that required angioplasty were performed under duplex ultrasound guidance and then contrast angiography was performed to confirm the final patency of the vessels. Conventional angioplasty was also performed under fluoroscopy guidance for any lesions that required an additional angioplasty. The volume flow before and after the PTA and procedure time were recorded. Clinical success was defined as the performance of one or more successful hemodialysis sessions after treatment. Eight of ten patients did not require an additional angioplasty by conventional angiography after the duplex- guided angioplasty. One case showed recoiling of stenosis after the duplex-guided PTA and another case was missed at duplex scanning due to the extremely short nature of the recoiling of stenosis. The mean volume flow before and after PTA was 167 ml/min (range, 80-259 ml/min) and 394.2 ml/min (range, 120-586 ml/min), respectively. No complications associated with the duplex-guide procedure occurred. In nine cases, PTA enabled hemodialysis to be conducted more than one time. In one

  16. Ultrasonography-guided Balloon Angioplasty in an Autogenous Arteriovenous Fistula: Preliminary Results

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Chang [Daejeon St Mary' s Hospital, Daejeon (Korea, Republic of); Cho, June Sik [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    2007-09-15

    Percutaneous trasnluminal angioplasty (PTA) of a malfunctioning arteriovenous fistula (AVF) in hemodialysis patients requires the use of contrast angiography and fluoroscopy guidance. We attempted to perform this procedure under duplex ultrasound guidance to reduce the amount of contrast agent administered and to reduce the radiation dose during the interventional procedures. From September 2006 to February 2007, 45 patients received interventional treatment due to malfunctioning hemodialysis access in our hospital. Among the patients, we selected 10 patients diagnosed with stenosis of an autogenous arteriovenous fistula based on a physical examination. There were six males and four females aged 51-78 years (mean age, 59 years). Seven of these patients had a Brescia-Cinimo type fistula and three patients had a basilic vein transposition. All procedures were performed in the angiography suite. All procedures that required angioplasty were performed under duplex ultrasound guidance and then contrast angiography was performed to confirm the final patency of the vessels. Conventional angioplasty was also performed under fluoroscopy guidance for any lesions that required an additional angioplasty. The volume flow before and after the PTA and procedure time were recorded. Clinical success was defined as the performance of one or more successful hemodialysis sessions after treatment. Eight of ten patients did not require an additional angioplasty by conventional angiography after the duplex- guided angioplasty. One case showed recoiling of stenosis after the duplex-guided PTA and another case was missed at duplex scanning due to the extremely short nature of the recoiling of stenosis. The mean volume flow before and after PTA was 167 ml/min (range, 80-259 ml/min) and 394.2 ml/min (range, 120-586 ml/min), respectively. No complications associated with the duplex-guide procedure occurred. In nine cases, PTA enabled hemodialysis to be conducted more than one time. In one

  17. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Nogueira, Raul G. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States); Schwamm, Lee H.; Buonanno, Ferdinando S.; Koroshetz, Walter J. [Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Neurocritical Care and Vascular Neurology Section, Boston, MA (United States); Yoo, Albert J.; Rabinov, James D.; Pryor, Johnny C.; Hirsch, Joshua A. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States); Massachusetts General Hospital, Harvard Medical School, Department of Neurosurgery, Endovascular Neurosurgery/Interventional Neuroradiology Section, Boston, MA (United States)

    2008-04-15

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score {<=}2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66{+-}17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17{+-}3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9{+-}3.9 h (anterior circulation) and 11.0{+-}7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and

  18. Renal Angioplasty in Non-atheromatous Renal Artery Stenosis: Technical Results and Clinical Outcome in 43 Patients

    International Nuclear Information System (INIS)

    This study retrospectively reviewed the technical and clinical results of percutaneous transluminal renal artery angioplasty (PTRA) for non-atheromatous renal artery stenosis (RAS) in a Tertiary Renal Referral Centre. Forty-three patients (including 9 children) underwent 49 PTRA procedures for stenoses of 63 arteries over the period 1984-2001 (14 patients had bilateral stenosis treated during one procedure. There were 29 females and 14 males (age range 1-72 years, median 37 years). The etiology of the RAS was classical beaded FMD (medial fibroplasia) in 24, atypical or 'variant FMD' with a more focal stenosis (intimal fibroplasia) in 11, neurofibromatosis type 1 (NF) in 7 and Takayasu's Arteritis in 1. Five of the NF patients had angioplasty for stenoses following vascular repair procedures. A technically good result was obtained in 34/34 arteries with 'classical' RAS, 9/13 atypical arteries, 11/15 arteries of NF patients and in the one Takayasu's case. Clinical follow-up for a mean of 16 months revealed a cure rate of hypertension in classical FMD of 35% with improvement in a further 55%. In the atypical FMD cases, follow-up was obtained on 6 patients with 2 cures and the other 4 demonstrating benefit. There was a better chance of cure in younger patients. In native artery PTRA in children with NF, only 1 out of 3 patients was 'cured' post-PTRA, and 2 out of 3 failed. However, in postsurgical stenoses in NF patients 1 out of 4 patients was 'cured' and 3 out of 4 improved. In conclusion, classical FMD responds well to PTRA with better results in younger patients. Atypical FMD, especially in children and when associated with NF, is less predictable. Stenoses consequent to revascularization surgery respond well to PTRA

  19. Left main coronary stenosis as a late complication of percutaneous angioplasty:an old problem,but still a problem

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Faggian; Gianluca Rigatelli; Francesco Santini; Giuseppe Petrilli; Paolo Cardaioli; Loris Roncon; Alessandro Mazzucco

    2009-01-01

    Objective Accelerated left main coronary stenosis (LMCS) is a known potential late complication of coronary artery catheter procedures. The aim of this study was to assess the current occurrence of LMCS as a delayed complication of percutaneous angioplasty (PTCA) of the left coronary branches in our institution. Methods The medical records of patients referred for coronary artery by-pass surgery from the same Cardiology Unit in the January 2003 to December 2006 period and presenting a significant (> 50%) LMCS as a new finding following a PTCA of the left coronary artery branches, were reviewed. Patients with retrospective evidence of any LMCS at previous coronary angiographies preceding the percutaneous procedure were excluded. Results Thirty-seven patients (5 females, mean age 71.1±8.6 years) out of 944 (4%) having undergone a PTCA, fulfilled the inclusion criteria, 19 (51%) after a procedure also involving the LAD coronary artery. Extraback-up guiding catheters were used in most cases. Use of multiple wires or balloons was observed in 3 cases (8%). Rotablator and proximal occlusion device were used in one case respectively (3%). Twenty patients (54%) have had more than one percutaneous coronary intervention on the left coronary branches. The mean time elapsed from the first angioplasty and surgical intervention was 18.1±7.8 months. Conclusions The potential occurrence of LMCS following a percutaneous intervention procedure, especially when complicated and repeated, should not be underestimated in the current era. This evidence may offer the rationale to schedule non-invasive imaging tests to monitor left main coronary patency after the procedure as well as to fuel further research to develop less traumatic materials.

  20. Angioplasty in patients with vertebrobasilarintracranial atherosclerotic stenosis and stenting of the vertebral artery ostium: results from a single center experience

    International Nuclear Information System (INIS)

    Full text: Medical therapy in patients with TIA or stroke in the vertebrobasilar system (VBS) is not always optimal to change the natural history of the disease. Alternative treatment includes endovascular angioplasty with and without stenting. The purpose of the study was to report the results from angiography and clinical outcome in a small cohort of patients with VBS pathology who underwent angioplasty and/or stenting. Fourteen patients (mean age of 60.5 ±8.4 years) were treated. All patients underwent digital subtractive cerebral angiography to find a stenosis that met criteria for endovascular therapy. Neuroimaging before procedure included angio-CT/MRI. extra and transcranial colour duplex scanning was used for hemodynamic evaluation of the stenosis and recanalization before, and 1 year after the treatment. Clinical outcome according to modified Rankin Scale (mRS) and mortality were assessed on day 90 and one year after the treatment. Standard medical treatment was given to all patients. Results: TIA had 9 patients, and previous stroke had 8 patients.Left vertebral artery (VA) was affected in 6 patients, right in 8 patients. Tandem VS stenoses had 1 patient (ostium and VA4-segment). Contralateral VA thrombosis was found in 4 patients and a hypoplastic VA in 1. Mean degree of VBS stenosis in all patients was 87.5 ±7.2%. Successful balloon angioplasty of the intracranial AV4 stenosis was achieved in 3 patients, however not in one other with a severe basilar artery stenosis. Eight patients with extracranial atherosclerotic stenosis of the ostium (VAO) and 1 with right VA1 dissection received stents with excellent angiogpahic results. Balloon predialtation was achieved with mean pressure of 10.8 ±2.8 mm Hg.The mean length of the stents was 18.3 ±11.2 mm, with mean diameter 4.2 mm. Types of stents used were: 1 Pulsar, 1 Integrity, 2 orsiro, 1 CristalloIdeale, 1 energy, and 3 drug eluding stents endeavor Resolute. Mean scopia time was 8.5 ±8 minutes, and mean

  1. Deep arterial injury during experimental angioplasty: relation to a positive indium-111-labeled platelet scintigram, quantitative platelet deposition and mural thrombosis

    International Nuclear Information System (INIS)

    Although it is not clear why coronary occlusion and restenosis occur after successful coronary angioplasty, factors related to the procedure may influence early and late results. The possible adverse effects of a medial tear documented histologically and produced during balloon angioplasty of the common carotid arteries were studied in 30 fully heparinized (100 U/kg body weight) normal pigs. Scanning electron microscopy showed endothelial denudation and extensive platelet deposition in all dilated arterial segments. Visible macroscopic mural thrombus was present within an hour of the procedure in 29 (91%) of the 32 arteries that had a medial tear documented by histologic study; the tear produced an indium-111-labeled platelet deposition of 116.4 +/- 26.5 X 10(6)/cm2 (mean +/- SE) and total thrombotic occlusion in 2 arteries (4%). None of the 24 arteries without a medial tear had a thrombus, and the mean platelet deposition in that group was 7.0 +/- 0.5 X 10(6)/cm2 (p less than 0.0008). In 12 pigs scanned with a gamma camera, visible thrombus was associated with platelet deposition in excess of 20 X 10(6)/cm2 in 12 arteries, 9 of which had a positive indium-111-labeled platelet scintigram. Thus, arterial angioplasty causes deep arterial injury, which appears to be a major cause of mural thrombosis, heavy platelet deposition, a positive indium-111-labeled platelet scintigram and acute arterial occlusion. A positive indium-111-labeled platelet scintigram was always associated with macroscopic thrombus of at least 20 > 10(6) platelets/cm2 and underlying deep arterial injury

  2. The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

    International Nuclear Information System (INIS)

    Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis (≥70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http://www

  3. Detection of restenosis after successful coronary angioplasty: Improved clinical decision making with use of a logistic model combining procedural and follow-up variables

    International Nuclear Information System (INIS)

    A prospective study of 111 patients who underwent repeat coronary angiography and exercise thallium-201 scintigraphy 6 +/- 2 months after complete revascularization by percutaneous transluminal coronary angioplasty was performed to assess whether clinical, procedure-related and postangioplasty exercise variables yield independent information for the prediction of angiographic restenosis after angioplasty. Complete revascularization was defined as successful angioplasty of one or more vessels that resulted in no residual coronary lesion with greater than 50% diameter stenosis. Restenosis was defined as a residual stenosis at the time of repeat angiography of greater than 50% of luminal diameter. Restenosis occurred in 40% of the patients. The 111 patients were randomly subdivided into a learning group (n = 84) and a testing group (n = 27). A logistic discriminant analysis was performed in the learning group and the logistic model was used to estimate a logistic probability of restenosis. This probability of restenosis was validated in the testing group. In the learning group of 84 patients univariate analysis of 39 factors revealed 8 factors related to restenosis: recurrence of angina (p less than 0.0001), postangioplasty abnormal finding on exercise thallium-201 scintigram (p less than 0.0001), exercise thallium-201 scintigram score (p less than 0.0001), difference between exercise and rest ST segment depression (p less than 0.001), postangioplasty exercise ST segment depression (p less than 0.001), absolute postangioplasty stenosis diameter (p less than 0.003), postangioplasty exercise work load (p less than 0.03) and postangioplasty exercise heart rate (p less than 0.05)

  4. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

    Directory of Open Access Journals (Sweden)

    Humberto Andres Vaz

    2016-04-01

    Full Text Available Abstract Background: The kinetics of high-sensitivity troponin T (hscTnT release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective: To evaluate the release of hscTnT by serial measurements after exercise testing (ET, and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods: Patients with acute ST-segment elevation myocardial infarction (STEMI undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h, 2 (TnT2h, 5 (TnT5h, and 8 hours (TnT8h after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance. Results: This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h. After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002, 59% (p = 0.003 and 45% (p = 0.003 higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion: Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.

  5. Captopril for prevention of Contrast Induced Nephropathy in patients undergoing Coronary Angioplasty: A double blind placebo controlled clinical trial

    OpenAIRE

    Hashemi, M.; Kharazi, A; Shahidi, S.

    2005-01-01

    Background: Contrast induced nephropathy is a potential cause of mortality and morbidity in patients undergoing angiography–angioplasty. Except for hydrating and probably low – isoosmolar contrast agents in high risk groups, other modalities have not provided benefit. We investigated preventive effects of captopril for contrast induced nephropathy during angiography–angioplasty. Methods: In a double blind placebo controlled clinical trial, 88 patients were randomized to two groups: 42 pa...

  6. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk, E-mail: hongsukpark@gmail.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Do, Young Soo, E-mail: ysdo@skku.edu [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Park, Kwang Bo, E-mail: kbjh.park@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Kim, Duk-Kyung, E-mail: dukkyung.kim@samsung.com [Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, Sung Wook, E-mail: sw.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Shin, Sung Wook, E-mail: sw88.shin@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Cho, Sung Ki, E-mail: sungkismc@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Hyun, Dongho, E-mail: mesentery.hyun@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of); Choo, In Wook, E-mail: inwook.choo@samsung.com [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul (Korea, Republic of)

    2013-11-01

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.

  7. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: Angioplasty versus stent placement

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up. Materials and methods: We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n = 13) and stent placement (n = 9) for 22 stenotic renal arteries. Results: Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48–183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery. Conclusion: Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure

  8. Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty

    International Nuclear Information System (INIS)

    Vertebrobasilar artery occlusion (VBO) produces high mortality and morbidity due to low recanalization rate utilization in endovascular therapy. The use of percutaneous transluminal angioplasty (PTA) to improve recanalization rate additional to local intra-arterial fibrinolysis (LIF) was investigated in this study. Results obtained following recanalization therapy in acute intracranial VBO are reported. Eighteen consecutive patients with acute VBO underwent LIF with or without PTA, from August 2000 to May 2006. Eight patients were treated using LIF alone, and ten required additional PTA. Rate of recanalization, neurological status before treatment, and clinical outcomes were evaluated. Of 18 patients, 17 achieved recanalization. One procedure-related complication of subarachnoid hemorrhage occurred. Overall survival rate was 94.4% at discharge. Seven patients achieved good outcomes [modified Rankin scale (mRS) 0-2], and the other 11 had poor outcomes (mRS 3-6). Five of six patients who scored 9-14 on the Glasgow Coma Scale (GCS) before treatment displayed good outcomes, whereas ten of 12 patients who scored 3-8 on the GCS showed poor outcomes. GCS prior to treatment showed a statistically significant correlation to outcomes (p < 0.05). Moreover, the National Institutes of Health Stroke Scale (NIHSS) before treatment correlated well with mRS (correlation coefficient 0.487). No statistical difference between the good and poor outcome groups was observed for the duration of symptoms, age, etiology, and occlusion site. Endovascular recanalization can reduce mortality and morbidity of acute VBO. Good GCS and NIHSS scores prior to treatment can predict the efficacy of endovascular recanalization. (orig.)

  9. Endovascular recanalization of acute intracranial vertebrobasilar artery occlusion using local fibrinolysis and additional balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Kashiwagi, Junji; Okahara, Mika [Shinbeppu Hospital, Department of Radiology, Beppu, Oita (Japan); Kiyosue, Hiro; Tanoue, Shuichi; Sagara, Yoshiko; Mori, Hiromu [Oita University Faculty of Medicine, Department of Radiology, Yufu, Oita (Japan); Hori, Yuzo [Nagatomi Neurosurgical Hospital, Department of Radiology, Oita, Oita (Japan); Abe, Toshi [Kurume University School of Medicine, Department of Radiology, Kurume, Fukuoka (Japan)

    2010-05-15

    Vertebrobasilar artery occlusion (VBO) produces high mortality and morbidity due to low recanalization rate utilization in endovascular therapy. The use of percutaneous transluminal angioplasty (PTA) to improve recanalization rate additional to local intra-arterial fibrinolysis (LIF) was investigated in this study. Results obtained following recanalization therapy in acute intracranial VBO are reported. Eighteen consecutive patients with acute VBO underwent LIF with or without PTA, from August 2000 to May 2006. Eight patients were treated using LIF alone, and ten required additional PTA. Rate of recanalization, neurological status before treatment, and clinical outcomes were evaluated. Of 18 patients, 17 achieved recanalization. One procedure-related complication of subarachnoid hemorrhage occurred. Overall survival rate was 94.4% at discharge. Seven patients achieved good outcomes [modified Rankin scale (mRS) 0-2], and the other 11 had poor outcomes (mRS 3-6). Five of six patients who scored 9-14 on the Glasgow Coma Scale (GCS) before treatment displayed good outcomes, whereas ten of 12 patients who scored 3-8 on the GCS showed poor outcomes. GCS prior to treatment showed a statistically significant correlation to outcomes (p < 0.05). Moreover, the National Institutes of Health Stroke Scale (NIHSS) before treatment correlated well with mRS (correlation coefficient 0.487). No statistical difference between the good and poor outcome groups was observed for the duration of symptoms, age, etiology, and occlusion site. Endovascular recanalization can reduce mortality and morbidity of acute VBO. Good GCS and NIHSS scores prior to treatment can predict the efficacy of endovascular recanalization. (orig.)

  10. Percutaneous transluminal angioplasty of chronic arterial occlusive disease below the knee joint

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the safety and efficacy of the percutaneous transluminal angioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged 57-75 years(mean, 62 years). Indications were disabling claudication (SVS/ISCVS grade 1, category 3) in five cases, rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade3, category 5) in eight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheter in tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combined thrombolytic therapy with Urokinase was performed in 14 patients. Involved infrapopliteal vessels were four distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibial arteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than 30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearance of claudication or rest pain, and healing of ulcereation. Technical success was achieved in 30 of 36 arteries(83%). Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46 months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and 63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vessel thrombosis, and one occluding intimal flap. PTA was an effective method for treatment of chronic arterial occlusive disease below the knee joint and considered as the procedure of first choice. Severe claudicant(grade1) should be included in the indication of the tibioperoneal PTA

  11. BMI and Health Status in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D)

    Science.gov (United States)

    Chung, Sheng-Chia; Hlatky, Mark A.; Stone, Roslyn A.; Rana, Jamal S.; Escobedo, Jorge; Rogers, William J.; Bromberger, Joyce T.; Kelsey, Sheryl F.; Brooks, Maria Mori

    2011-01-01

    BACKGROUND The longitudinal association between obesity, weight variability and health status outcomes is important for patients with coronary disease and diabetes. METHODS The Bypass Angioplasty Revascularization Investigation 2 Diabetes trial (BARI 2D) was a multi-center randomized clinical trial to evaluate the best treatment strategy for patients with both documented stable ischemic heart disease and type 2 diabetes. We examined BARI 2D participants for four years to study how BMI was associated with health status outcomes. Health status was evaluated by the Duke Activity Status Index (DASI), RAND Energy/fatigue, Health Distress, and Self-rated health. BMI was measured quarterly throughout follow-up years, and health status was assessed at each annual follow-up visit. Variation in BMI measures was separated into between-person and within-person change in longitudinal analysis. RESULTS Higher mean BMI over follow-up years (the between-person BMI) was associated with poorer health status outcomes. Decreasing BMI (the within-person BMI change) was associated with better Self-rated health. The relationships between BMI variability and DASI or Energy appeared to be curvilinear, and differed by baseline obesity status. Decreasing BMI was associated with better outcomes if patients were obese at baseline, but was associated with poorer DASI and Energy outcomes if patients were non-obese at baseline. CONCLUSIONS For patients with stable ischemic heart disease and diabetes, weight gain was associated with poorer health status outcomes, independent of obesity-related comobidities. Weight reduction is associated with better functional capacity and perceived energy for obese patients but not for non-obese patients at baseline. PMID:21742107

  12. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    International Nuclear Information System (INIS)

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I2 test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I2 = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I2 = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I2 = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I2 = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes

  13. Detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise thallium scintigraphy

    International Nuclear Information System (INIS)

    The usefulness of serial exercise thallium scintigraphy (ETS) in the detection of restenosis after successful percutaneous transluminal coronary angioplasty (PTCA) was evaluated. The study was undertaken on 73 patients (45 without significant residual coronary stenosis; 28 with partial anatomic correction) who received coronary angiography (CAG) after over 6 month period following successful PTCA or after a recurrence of angina pectoris. ETS was performed serially before, soon after, at 3 months, and at 6 months after PTCA in order to determine the presence of chest pain (CP) and significant ST-segment depression (ST) during exercise, and of reversible defect (RD) in thallium images. Redistribution of 10 % or above on delayed images were considered as positive reversible defects. Restenosis was defined as an increase of the diameter stenosis of the dilated lesion above the 75 % level. Rate of restenosis was 29 % for patients followed for over 6 months with recurrences of angina early at 2.4 ± 1.9 months (mean ± SD). As to the positive ETS cases, 77 % were detected within the first 3 months, and 92 % whithin the 6 months. In the detection of restenosis, figures for RD sensitivity and specificity were 96 % and 88 % respectively, which were superior to those figures for CP (59 %, 85 %) and ST (74 %, 82 %). ETS was particularly useful in the identification of the restenotic vessel as well as in the detection of restenosis in patients with multi-vessel disease or partial anatomic correction, and thus has proven to be of extreme value in follow-up after PTCA. (author)

  14. Angioplasty Guided by Intravascular Ultrasound: Meta-Analysis of Randomized Clinical Trials

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, José Albuquerque Neto de, E-mail: jafneto@cardiol.br; Nogueira, Iara Antonia Lustosa [Universidade Federal do Maranhão, São Luiz, MA (Brazil); Figueiro, Mabel Fernandes; Buehler, Anna Maria; Berwanger, Otavio [Instituto de Ensino e Pesquisa do Hospital do Coração, São Paulo, SP (Brazil)

    2013-08-15

    The impact of intravascular ultrasound (IVUS) use on stenting has shown inconclusive results. Systematic review and meta-analysis of the impact of IVUS on stenting regarding the clinical and angiographic evolution. A search was performed in Medline/Pubmed, CENTRAL, Embase, Lilacs, Scopus and Web of Science databases. It included randomized clinical trials (RCTs) that evaluated the implantation of stents guided by IVUS, compared with those using angiography alone (ANGIO). The minimum follow-up duration was six months and the following outcomes were assessed: thrombosis, mortality, myocardial infarction, percutaneous and surgical revascularization, major adverse cardiovascular events (MACE) and restenosis. The binary outcomes were presented considering the number of events in each group; the estimates were generated by a random effects model, considering Mantel-Haenszel statistics as weighting agent and magnitude of effect for the relative risk (RR) with its respective 95% confidence interval (95%CI). Higgins I{sup 2} test was used to quantify the consistency between the results of each study. A total of 2,689 articles were evaluated, including 8 RCTs. There was a 27% reduction in angiographic restenosis (RR: 0.73, 95% CI: 0.54-0.97, I{sup 2} = 51%) and statistically significant reduction in the rates of percutaneous revascularization and overall (RR: 0.88; 95% CI: 0.51 to 1.53, I{sup 2} = 61%, RR: 0.73, 95% CI: 0.54 to 0.99, I{sup 2} = 55%), with no statistical difference in surgical revascularization (RR: 0.95, 95% CI: 0.52-1.74, I{sup 2} = 0%) in favor of IVUS vs. ANGIO. There were no differences regarding the other outcomes in the comparison between the two strategies. Angioplasty with stenting guided by IVUS decreases the rates of restenosis and revascularization, with no impact on MACE, acute myocardial infarction, mortality or thrombosis outcomes.

  15. Reducing Radiation Dose in Coronary Angiography and Angioplasty Using Image Noise Reduction Technology.

    Science.gov (United States)

    Kastrati, Mirlind; Langenbrink, Lukas; Piatkowski, Michal; Michaelsen, Jochen; Reimann, Doris; Hoffmann, Rainer

    2016-08-01

    This study sought to quantitatively evaluate the reduction of radiation dose in coronary angiography and angioplasty with the use of image noise reduction technology in a routine clinical setting. Radiation dose data from consecutive 605 coronary procedures (397 consecutive coronary angiograms and 208 consecutive coronary interventions) performed from October 2014 to April 2015 on a coronary angiography system with noise reduction technology (Allura Clarity IQ) were collected. For comparison, radiation dose data from consecutive 695 coronary procedures (435 coronary angiograms and 260 coronary interventions) performed on a conventional coronary angiography system from October 2013 to April 2014 were evaluated. Patient radiation dosage was evaluated based on the cumulative dose area product. Operators and operator practice did not change between the 2 evaluated periods. Patient characteristics were collected to evaluate similarity of patient groups. Image quality was evaluated on a 5-grade scale in 30 patients of each group. There were no significant differences between the 2 evaluated groups in gender, age, weight, and fluoroscopy time (6.8 ± 6.1 vs 6.9 ± 6.3 minutes, not significant). The dose area product was reduced from 3195 ± 2359 to 983 ± 972 cGycm(2) (65%, p noise reduction technology. Image quality was graded as similar between the evaluated systems (4.0 ± 0.7 vs 4.2 ± 0.6, not significant). In conclusion, a new x-ray technology with image noise reduction algorithm provides a substantial reduction in radiation exposure without the need to prolong the procedure or fluoroscopy time. PMID:27344273

  16. Endovascular brachytherapy (EVBT) with rhenium-188 for restenosis prophylaxis after angioplasty of infrainguinal lesions. Early experience

    International Nuclear Information System (INIS)

    Purpose: Restenosis remains a major problem in percutaneous transluminal angioplasty (PTA) of peripheral arteries. The aim of this feasibility study was to evaluate the technical feasibility and safety of a new endovascular brachytherapy (EVBT) device with Rhenium-188 in restenosis prophylaxis of infrainguinal arteries. Materials and Methods: From March 2006 to April 2009, 52 patients with 71 infrainguinal arterial lesions were treated with Re-188 to prevent restenosis after PTA. 40 patients with 53 lesions (24 de-novo lesions and 29 restenoses) were reexamined (clinic, color-coded duplex ultrasound) after a mean follow-up period of 12.7 months (2.6 to 25.1 months). The liquid beta-emitter Re-188 was introduced to the target lesion via an EVBT certified PTA balloon and a tungsten applicator. After the calculated irradiation time, Re-188 was aspirated back into the tungsten applicator. A dose of 13 Gy was applied at a depth of 2 mm into the vessel wall. Results: After a mean follow-up of 12.7 months, the overall restenosis rate after Re-PTA was 15.1 % (8/53 lesions). The restenosis rate for de-novo lesions was 20.8 % (5/24) and 10.3 % for restenoses (3/29). In 4 patients reintervention was necessary (3 PTAs and 2 major amputations). No periprocedural complications were observed. No elevated radiation dose for the patient or the interventionalist was measured. Conclusion: EVBT with a Re-188 filled balloon catheter was technically feasible and safe after PTA of infrainguinal arterial lesions with restenosis rates lower than expected compared to published results. Treatment of restenoses seems to be more effective than de-novo lesions. (orig.)

  17. Myocardial perfusion assessed by dynamic computed tomography before and after percutaneous transluminal coronary angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Mori, Takao; Takeuchi, Motoshi; Igarashi, Yuichiro and others

    1987-12-01

    A method for quantitatively and visually assessing myocardial perfusion using a new transmission computed tomography scanner and contrast media injection was devised. Myocardial perfusion was assessed before and after percutaneous transluminal coronary angioplasty (PTCA). Six patients with left anterior descending coronary artery stenosis undergoing PTCA were successfully studied. Cardiac outputs calculated from the ventricular curves of the ROIs in the left ventricular cavity correlated well with the thermodilution measurements using Swan-Ganz catheters (r = 0.90, p < 0.01). The ratios of myocardial blood flow (F) to the tissue element volume (V) were calculated (F/V) from the myocardial curves of the ROIs in the myocardium as parameters of myocardial perfusion, according to the Zierler's principle. The F/Vs in the myocardium perfused by the left anterior descending coronary artery before PTCA were significantly less than those of the control subjects (4.4 x 10/sup -2/ +- 1.2 x 10/sup -2/ vs 8.1 x 10/sup -2/ +- 2.9 x 10/sup -2/: p < 0.05). After PTCA, the F/Vs improved significantly (7.7 x 10/sup -2/ +- 2.0 x 10/sup -2/), but even after PTCA, the F/Vs in three patients with old myocardial infarction were lower than those of three without myocardial infarction (9.1 x 10/sup -2/ +- 1.3 x 10/sup -2/ vs 6.4 x 10/sup -2/ +- 1.6 x 10/sup -2/), suggesting that myocardial infarction may have a decreased vascular bed. For visual assessment, functional images were synthesized by deriving a functional parameter for blood flow (PH/M1E) from the gammavariate fitted time density curves for each pixel. In all patients, before PTCA, decreased myocardial perfusion was imaged as dark pixels. After PTCA, myocardial perfusion improved in all patients, but decreased perfusion was still observed in some. (J.P.N.).

  18. Salvage living donor liver transplantation after percutaneous transluminal angioplasty for recurrent Budd-Chiari syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Mitoro Akira

    2011-03-01

    Full Text Available Abstract Introduction Budd-Chiari syndrome is a very rare pathological entity that ultimately leads to liver failure. Several therapeutic modalities, including percutaneous transluminal angioplasty, have been attempted to save the life of patients with Budd-Chiari syndrome. Few reports have described a salvage living donor liver transplantation performed after percutaneous transluminal angioplasty in a patient with acute Budd-Chiari syndrome. Case presentation A 26-year-old Japanese man developed severe progressive manifestations, such as massive ascites and hematemesis due to rupture of esophageal varices. After making several investigations, we diagnosed the case as Budd-Chiari syndrome. We first performed percutaneous transluminal angioplasty to dilate a short-segment stenosis of his inferior vena cava. The first percutaneous transluminal angioplasty greatly improved the clinical manifestations. However, after a year, re-stenosis was detected, and a second percutaneous transluminal angioplasty failed to open the severe stricture of his inferior vena cava. Since our patient had manifestations of acute liver failure, we decided to perform salvage living donor liver transplantation from his brother. The transplantation was successfully performed and all clinical manifestations were remarkably alleviated. Conclusion In cases of recurrent Budd-Chiari syndrome, the blocked hepatic venous outflow is not always relieved, even with invasive therapies. We have to take into account the possibility of adopting alternative salvage therapies if the first therapeutic modalities fail. When invasive therapy such as percutaneous transluminal angioplasty fails, liver transplantation should be considered as an alternative option.

  19. Effect of endovascular primary stent-assisted angioplasty on atherosclerotic intracranial stenosis

    International Nuclear Information System (INIS)

    Objective: To analyse the preliminary outcome and its relevant factors of endovascular stent-assisted angioplasty for intracranial stenosis. Methods: Sixty-one atherosclerotic intracranial stenosis in 57 patients (23 stenosis in posterior and 38 in anterior circulation) were treated with endovascular angioplasty using balloon-expandable coronary stents. Results: Technical success was achieved in all patients, with no procedural and associated complications except one of intracranial hemorrhage. Angiographic results immediately after stenting suggested that the residual postprocedure stenosis was 0%-32% (mean 8.7% ± 4.4%), with significant reduction from preprocedure stenosis (74.5% ± 6.7%). The patients were clinically asymptomatic and had no recurrent TIA and stroke. Follow-up angiogram in 43 patients revealed no restenosis (<50%), though 3 patients revealed mild endothelial hyperplasia. Conclusions: Endovascular stenting for intracranial stenosis is safe and feasible, and would be favorable for decreasing incidence of stroke during short-term follow up

  20. Amputation-Free Survival after Crural Percutaneous Transluminal Angioplasty for Critical Limb Ischemia

    DEFF Research Database (Denmark)

    Strøm, M; Konge, L; Lönn, L; Schroeder, T V; Rørdam, P

    2015-01-01

    BACKGROUND AND AIM: To evaluate the amputation-free survival after below the knee percutaneous transluminal angioplasty in a consecutive group of patients with critical ischemia of the lower extremity. MATERIALS AND METHODS: A total of 70 consecutive patients with critical ischemia were treated......-up clinical examinations were performed within 6 weeks and after 1 year. All medical records were crosschecked with the national vascular registry ensuring a valid 1-year status in 97% of the patients. RESULTS: A total of 15 major amputations were performed during follow-up, with 11 amputations performed...... within the first year. Complications after percutaneous transluminal angioplasty were rare. Cumulative mortality after 1 and 2 years was 22% and 34%, respectively. Amputation-free survival at 1 and 2 years of follow-up was 68% and 58%, respectively. There were no association between known risk factors...

  1. Evaluation of interventional angioplasty by using thrombolysis and balloon dilatation in treating pulmonary embolism

    International Nuclear Information System (INIS)

    Objective: To evaluate the interventional angioplasty by using thrombolysis and balloon dilatation in the treatment of pulmonary embolism. Methods: Eight patients with pulmonary embolism were treated with interventional management including fragmentation of the thrombus, thrombolysis with urokinase flush infusion, balloon dilatation and continuing low-dose infusion for 24 hours. Anticoagulation with heparin was given simultaneously. Results: The pulmonary artery was completely recanalized in three patients, and partially recanalized in five patients. The blood oxygen saturation reached 100% in 3 cases and was over 93% in 5 cases. Conclusion: Interventional angioplasty by means of thrombolysis or balloon dilatation is an effective therapy for pulmonary embolism in reopening the embolized pulmonary artery, bringing the pulmonary hemodynamics to normal condition and correcting the hypoxemia. (authors)

  2. Successful Venous Angioplasty of Superior Vena Cava Syndrome after Heart Transplantation

    Directory of Open Access Journals (Sweden)

    Thomas Strecker

    2014-01-01

    Full Text Available Introduction. For patients with terminal heart failure, heart transplantation (HTX has become an established therapy. Before transplantation there are many repeated measurements with a pulmonary artery catheter (PAC via the superior vena cava (SVC necessary. After transplantation, endomyocardial biopsy (EMB is recommended for routine surveillance of heart transplant rejection again through the SVC. Case Presentation. In this report, we present a HTX patient who developed a SVC syndrome as a possible complication of all these procedures via the SVC. This 35-year-old Caucasian male could be successfully treated by balloon dilatation/angioplasty. Conclusion. The SVC syndrome can lead to pressure increase in the venous system such as edema in the head and the upper part of the body and further serious complications like cerebral bleeding and ischemia, or respiratory problems. Balloon angioplasty and stent implantation are valid methods to treat stenoses of the SVC successfully.

  3. Spontaneous Coronary Dissection: “Live Flash” Optical Coherence Tomography Guided Angioplasty

    Science.gov (United States)

    Bento, Angela Pimenta; Fernandes, Renato Gil dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  4. Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

    Science.gov (United States)

    Kaneko, Kenji; Shimazaki, Natsumi; Gotoh, Maya; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    Our photo thermal reaction heating architecture balloon realizes less than 10 s short term heating that can soften vessel wall collagen without damaging surrounding tissue thermally. New thermal balloon angioplasty, photo-thermo dynamic balloon angioplasty (PTDBA) has experimentally shown sufficient opening with 2 atm low pressure dilation and prevention of chronic phase restenosis and acute phase thrombus in vivo. Even though PTDBA has high therapeutic potential, the most efficient heating condition is still under study, because relationship of treatment and thermal dose to vessel wall is not clarified yet. To study and set the most efficient heating condition, we have been working on establishment of temperature history estimation method from our previous experimental results. Heating target of PTDBA, collagen, thermally denatures following rate process. Denaturation is able to be quantified with measured collagen birefringence value. To express the denaturation with equation of rate process, the following ex vivo experiments were performed. Porcine extracted carotid artery was soaked in two different temperature saline baths to enforce constant temperature heating. Higher temperature bath was set to 40 to 80 degree Celsius and soaking duration was 5 to 40 s. Samples were observed by a polarizing microscope and a scanning electron microscope. The birefringence was measured by polarizing microscopic system using Brace-Koehler compensator 1/30 wavelength. The measured birefringence showed temperature dependency and quite fit with the rate process equation. We think vessel wall temperature is able to be estimated using the birefringence changes due to thermal denaturation.

  5. Popliteal artery thrombosis in a patient with Cogan syndrome: Treatment with thrombolysis and percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    A 31-year-old woman with Cogan syndrome (a rare form of systemic vasculitis) was evaluated for a cold, painful left foot with diminished pulses. Arteriography demonstrated thrombosis of the left popliteal artery with evidence of vasculitis. Thrombolytic therapy was begun with initial success but eventual rethrombosis. After reinitiating thrombolytic therapy combined with intraarterial vasodilator therapy, successful angioplasty was performed with sustained results, at 6-month follow-up

  6. Treatment of blue digit syndrome with percutaneous transluminal angioplasty-angiographic features

    International Nuclear Information System (INIS)

    Since 1978, the authors have treated nine patients with blue toe syndrome and one patient with blue finger syndrome using percutaneous transluminal angioplasty rather than surgery. None of the patients had distal embolization as a consequence of the balloon dilation. Nine patients have had no evidence of recurrent embolization on follow-up. One patient had a questionable single episode of recurrent embolization. The angiographic, hemodynamic, and clinical features of these ten patients which have been associated with a successful result are outlined

  7. Acute occlusion of the coronary artery after transluminal balloon coronary angioplasty

    International Nuclear Information System (INIS)

    The research was aimed at elucidation of the relationship of the clinical and angiographic factors, on the one hand, and development of acute occlusion following transluminal balloon coronary angioplasty TBCA, on the other. TBCA was carried out in 162 patients. Eight (4.9 %) patients developed acute occlusion of the coronary artery, which was complicated by acute myocardial infarction in 50 % cases. 35 refs.; 4 tabs

  8. Results of Primary Angioplasty in a Reference Center: in-Hospital Outcomes

    OpenAIRE

    Ramos, R.; Patrício, L; Bernardes, L; Cacela, D; Sousa, L.; Fiarresga, A; Gonçalves, JM; Toste, A; Lousinha, A; Oliveira, JA; Ferreira, ML; Andreozzi, V; Cruz Ferreira, R

    2009-01-01

    INTRODUCTION: Primary angioplasty is accepted as the preferred treatment for acute myocardial infarction in the first 12 hours. However, outcomes depend to a large extent on the volume of activity and experience of the center. Continuous monitoring of methods and results obtained is therefore crucial to quality control. OBJECTIVE: To describe the demographic, clinical and angiographic characteristics as well as in-hospital outcomes of patients undergoing primary PCI in a high-volume Portu...

  9. Immediate versus deferred coronary angioplasty in non-ST-segment elevation acute coronary syndromes

    OpenAIRE

    Riezebos, R.K.; Ronner, E.; Bals, ter, E.; Slagboom, T.; Smits, P.C.; Berg, ten, A.J.W.M.; Kiemeneij, F.; Amoroso, G.; Patterson, M S; Suttorp, M J; Tijssen, J.G.P.; Laarman, G.J.

    2009-01-01

    BACKGROUND: The field of acute coronary syndromes is characterised by an increasing tendency towards early invasive catheter-based diagnostics and therapeutics-a practice based on observational and retrospective data. OBJECTIVE: To compare immediate versus deferred angioplasty in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). METHODS: A randomised, prospective multicentre trial was performed in patients admitted with NSTE-ACS, eligible for percutaneous coronary in...

  10. Unusual Response of Subclavian In-Stent Restenosis to Balloon Angioplasty in a Patient with HIV

    Directory of Open Access Journals (Sweden)

    Mohammad Atif Rana

    2015-01-01

    Full Text Available Human Immunodeficiency Virus (HIV infection and use of protease inhibitors have been associated with accelerated atherosclerosis. Increased rates of coronary in-stent restenosis are reported in these patients. There is limited data available on peripheral vascular disease interventions on these patients. Herein we report an aggressive subclavian in-stent restenosis with an unexpected response to balloon angioplasty treatment with a large, mobile tissue flap formation and its treatment with another stent.

  11. Ureteric angioplasty balloon placement to increase localised dosage of BCG for renal pelvis TCC.

    LENUS (Irish Health Repository)

    Forde, J C

    2012-03-01

    Endoscopic percutaneous resection of a renal pelvis transitional cell carcinoma (TCC) is a viable treatment option in those who would be rendered dialysis dependent following a nephroureterectomy. We report endoscopic percutaneous resection of an upper tract TCC recurrence in a single functioning kidney followed by antegrade renal pelvis BCG instillation with novel placement of inflated angioplasty balloon in the ureter to help localise its effect.

  12. Noninvasive Positive Pressure Ventilation against Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

    OpenAIRE

    Kiyoshi Moriyama; Sayuri Sugiyama; Koji Uzawa; Mariko Kotani; Toru Satoh; Tomoko Yorozu

    2011-01-01

    A 69-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) was on amblatory oxygen inhalation therapy (3 L/min) and scheduled for percutaneous transluminal pulmonary angioplasty (PTPA). The patient's New York Heart Association functional status was class III with recent worsening of dyspnea and apparent leg edema. Transthoracic echocardiography revealed right ventricular enlargement with mean pulmonary artery pressure of 42 mmHg. After PTPA, he was complicated with postopera...

  13. Percutaneous peripheral laser angioplasty with a pulsed Nd:YAG laser and sapphire tips

    Science.gov (United States)

    Kvasnicka, Jan; Stanek, Frantisek; Boudik, Frantisek; Kubecek, Vaclav; Krivanek, Jiri; Keclik, Richard; Prochazkova, Helena; Hamal, Karel

    1990-07-01

    Percutaneous transluminal laser angioplasty with a pulsed Nd:YAG laser (1,064 nm wavelength, 100 jig pulse duration, up to 0.4 J per pulse, 10 Hz repetition rate) coupled to optical fibers with sapphire tips of 1.8, 2.2 and 2.9 mm diameter was performed in 17 chronic occlusions of iliac, femoral, popliteal and fibular arteries in 15 patients. Clinically the procedure was successful in 14 cases. The probe formed a primary channel of at least 2.0 mm width which was further dilated by conventional balloon catheter. Ankle/brachial systolic pressure index (ABPI) increased from 0.46 0.13 to 0.84 0.21 after the procedure. Two failures were due to an extensive dissection which occurred after balloon angioplasty and resulted in an early reocclusion. In the remaining case a balloon catheter could not be introduced through the 30 cm long primary channel which reoccluded shortly after the recanalization. The initial patency rate was 82 % and in 5 patients followed for more then 6 months the ABPI showed only a minor decrease. These first results are encouraging and it is likely that this method could become an important alternative to conventional balloon angioplasty.

  14. Recanalization by means of laser and angioplasty in atherosclerotic lesions of the lower limbs

    International Nuclear Information System (INIS)

    From January to November 1989, 31 iliac and femoro-popliteal atherosclerotic lesions were treated in 29 patients (age range: 33-80 years) by means of percutaneous laser-assisted angioplasty. The lesions were 6 iliac tubolar stenoses, 6 iliac occlusions and 19 femoro-popliteal occlusions, 2-20 cm long. The laser equipment employed was in 10 cases a Cardiolase 4000 Nd: YAG 'hot tip' unit, and in 21 cases a Nd: YAG 'sapphire contact probe' unit. Initial success was achieved in 23/31 lesions (74%); the follow-up, by clinical examination, Doppler US, and ankle-arm pressure index performed every 4ty month, showed 1-year actuarial patency of 80% for femoro-popliteal occlusion and 100% for iliac lesion, with 87% cumulative patency. Overall complication rate was 22.5%. There were 6 local complications, 4 of which were hematomas at the arterial puncture site, and 2 were perforation of the superficial femoral artery, all without any clinical sequelae; one patient developed rethrotrombosis within 72 hours from treatment,which needed amputation after an emergency bypass. Preliminary results show no significant improvement when compared with conventional balloon angioplasty results both in immediate success rate and in short-to-midterm patency; furthermore, laser therapy was burdened by a higher complication rate. We believe that laser angioplasty should be employed only in arterial occlusion uncrossable with angiographic guidance alone

  15. Stent angioplasty of iliac artery stenoses under MR-control: initial clinical results

    International Nuclear Information System (INIS)

    Purpose: To investigate the feasibility of MR-guided stent angioplasty of iliac artery stenozls under passive visualization. Material and methods: Three patients with short, concentric stenoses of the iliac arteries were enrolled. The vascular interventions were performed on a 1.5 T MR scanner (Magnetom Symphony, Siemens, Erlangen, Germany). Stents, guidewires, and balloon catheters were visualized on the basis of susceptibility artifacts. Contrast-enhanced MR angiography (ceMRA) was used to localized the stenosis prior to stent deployment. Nitinol stents were placed under MR-guidance using a fast 2D gradient echo technique. Balloon dilatiation was performed with an angioplasty catheter inflated with diluted gadolinium-DTPA. Postinterventional results were evaluated by ceMRA, DSA, and Doppler indices. Results: Position of the stent, stent deployment, and balloon dilatation were depicted by MR. All stents were correctly placed within the stenosis. Stent positions as monitored by MRI were identical to those seen on DSA images. All patients were treated successfully by the MR-guided intervention. Conclusion: An MR-guided stent angioplasty of simple iliac artery stenoses is feasible under passive visualization. (orig.)

  16. Percutaneous Angioplasty and Stenting of left Subclavian Artery Lesions for the Treatment of Patients with Concomitant Vertebral and Coronary Subclavian Steal Syndrome

    International Nuclear Information System (INIS)

    Objective. To evaluate the efficacy of subclavian stenosis percutaneous transfemoral angioplasty (PTA)-treatment in patients with intermittent or complete subclavian steal syndrome (SSS), and coronary-subclavian steal syndrome (C-SSS) after left internal mammary artery-interventricular anterior artery (LIMA-IVA) by pass graft. Methods. We studied 42 patients with coronary subclavian steal syndrome subdivided in two groups; the first group consisted of 15 patients who presented an intermittent vertebral-subclavian steal, while the second group consisted of 27 patients with a complete vertebral-subclavian steal. All patients were treated with angioplasty and stent application and were followed up for a period of 5 years by echocolordoppler examination to evaluate any subclavian restenosis. Results. Subclavian restenosis was significantly increased in patients with a complete subclavian steal syndrome. The restenosis rate was 6.67% in the first group and 40.75% in the second group, These patients had 9.1 fold-increase risk (CI confidence interval 0.95-86.48) in restenosis. Conclusion. Patients with a complete subclavian and coronary steal syndrome present a higher risk of subclavian restenosis

  17. Assessment of "silent" restenosis and long-term follow-up after successful angioplasty in single vessel coronary artery disease: the value of quantitative exercise electrocardiography and quantitative coronary angiography

    NARCIS (Netherlands)

    G-J. Laarman (GertJan); H.E. Luijten; L.G.P.M. van Zeyl; K.J. Beatt (Kevin); J.G.P. Tijssen (Jan); P.W.J.C. Serruys (Patrick); P.J. de Feyter (Pim)

    1990-01-01

    textabstractExercise electrocardiographic (ECG) testing during follow-up after coronary angioplasty is widely applied to evaluate the efficacy of angioplasty, even in asymptomatic patients. One hundred forty-one asymptomatic patients without previous myocardial infarction underwent quantitative exer

  18. Long-term results after primary infrapopliteal angioplasty for limb ischemia; Langzeitergebnisse nach Ballonangioplastie kruraler Arterien

    Energy Technology Data Exchange (ETDEWEB)

    Alfke, H. [Klinikum Luedenscheid (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vannucchi, A. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Froelich, J.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Klinikum Bad Hersfeld (Germany). Klinik fuer Radiologie und Nuklearmedizin; El-Sheik, M.; Wagner, H.J. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Vivantes-Klinikum im Friedrichshain (Germany). Inst. fuer Radiologie und Interventionelle Therapie

    2007-08-15

    Purpose: To evaluate the technical success rate, procedure-related complications, and clinical long-term results for patients who underwent infrapopliteal angioplasty. Materials and Methods: We retrospectively evaluated all patients who underwent infrapopliteal angioplasty to treat critical chronic limb ischemia or severe claudication from 1/1997 to 12/1999. We excluded patients with acute (< 2 weeks) limb ischemia. Procedure-related data were prospectively documented in a database and analyzed with a focus on the technical success rate and procedure-related complications. In addition all clinical documents were analyzed, and a follow-up examination was performed or telephone interviews were conducted with patients, relatives and referring doctors for follow-up. The primary end points were the limb salvage rate and patient survival rate. The secondary end points included the complication rate, technical success rate, and walking distance. Results: 112 patients with a mean age of 72 years (41 women, 71 men) underwent crural angioplasty on 121 limbs. Four patients suffered from severe claudication (Rutherford category 3) and all others had critical chronic limb ischemia (category 4 to 6). The complication rate was 2.7 %. The technical success rate was 92 %. The ankle brachial index increased from 0.59 to 0.88. The mean walking distance increased significantly from 52 {+-} 66 to 284 {+-} 346 meters at the time of follow-up. The limb salvage rate was 83.6 % after one year and 81.1 % after three years. The mean survival rate according to Kaplan-Meier was 79.4 %, 69.2 %, and 54.2 % at 1, 2, and 3 years, respectively. Patients with at least one patent run-off vessel after angioplasty had a significantly better limb salvage rate. Diabetes was not a risk factor for limb salvage. Conclusion: Infrapopliteal angioplasty shows a high technical success rate with an acceptable complication rate. The clinical long-term success seems favorable if a least one open run-off vessel was

  19. 微创Sky手术与球囊成形术治疗脊柱骨质疏松压缩性骨折的效果比较%Comparative study on the effect of Sky minimally invasive surgery and balloon angioplasty in the treatment of spinal osteoporotic compression fractures

    Institute of Scientific and Technical Information of China (English)

    吕海文

    2016-01-01

    Objective To compare the effect of Sky minimally invasive surgery and balloon angioplasty in the treatment of spinal osteoporotic compression fractures.Methods 61 cases of spinal osteoporotic compression fractures in our hospital from April 2012 to August 2013 were selected and divided into two groups according to the random number table,of whom 30 cases were treated with Sky bone expander surgery (Sky group),31 cases were treated with percutaneous balloon vertebroplasty (balloon group).Compared the effect of two groups combined with postoperative follow-up.Results There was no statistically significant difference in treatment efficiency between Sky group and balloon group (93.3% vs.93.5%,P>0.05).There were no statistically significant differences in operation time,intraoperative blood loss and self-rating pain score between Sky group and balloon group [(41.4±5.3)min vs.(39.5±5.5)min,(17.6±4.1)ml vs.(19.0±4.3)ml,(2.9± 1.1) vs.(3.1 ± 1.0);P>0.05].There were no postoperative complications in both two groups.Conclusion Sky minimally invasive surgery and balloon angioplasty are both effective methods for the treatment of spinal osteoporotic compression fractures,which can significantly improve spinal function and relief spinal pain.%目的 比较微创Sky手术与球囊成形术治疗脊柱骨质疏松压缩性骨折的效果.方法 选取我院2012年4月至2013年8月61例脊柱骨质疏松压缩性骨折患者,根据随机数表分为两组,其中30例采用Sky骨扩张器手术治疗(记为Sky组),31例采用经皮球囊扩张椎体成形术治疗(记为球囊组).结合术后随访观察两组治疗效果.结果 Sky组治疗有效率相较球囊组差异无统计学意义(93.3%vs.93.5%,P>0.05);Sky组手术时长[(41.4±5.3) min]、术中出血量[(17.6±4.1)ml]、患者自我疼痛评分(2.9±1.1)与球囊组[(39.5±5.5) min、(19.0±4.3) ml、(3.1±1.0)]相比,差异无统计学意义(P>0.05);两组术后均未出现并发症.结论 微

  20. Can MR Measurement of Renal Artery Flow and Renal Volume Predict the Outcome of Percutaneous Transluminal Renal Angioplasty?

    International Nuclear Information System (INIS)

    Purpose: Predicting therapeutic benefit from percutaneous transluminal renal angioplasty (PTRA) in patients with renal artery stenosis (RAS) remains difficult. This study investigates whether magnetic resonance (MR)-based renal artery flow measurements relative to renal parenchymal volume can predict clinical outcome following PTRA.Methods: The data on 23 patients (13 men, 10 women; age range 47-82 years, mean age 64 years) were analyzed. The indication for treatment was hypertension (n = 18) or renal insufficiency (n = 5). Thirty-four cases of RAS were identified: bilateral disease was manifest in 11 and unilateral disease in 12 patients. The MR imaging protocol included a breath-hold, cardiac-gated cine phase-contrast sequence for renal flow measurement and a fast multiplanar spoiled gradient-echo sequence for renal volume measurement. MR measurements were performed on the day prior to and the day following PTRA. Clinical success was defined as (a) a reduction in diastolic blood pressure > 15% or (b) a reduction in serum creatinine > 20%. Kidneys were categorized as normal volume or low volume. A renal flow index (RFI) was calculated by dividing the renal flow (ml/min) by the renal volume (cm3).Results: Clinical success was observed in 11 patients. Twelve patients did not benefit from angioplasty. Normal kidney volume was seen in 10 of 11 responders and in 8 of 12 nonresponders, resulting in a sensitivity of 91%, specificity of 33%, a positive predictive value (PPV) of 56% and a negative predictive value (NPV) of 80%. A RFI below a threshold of 1.5 ml/min/cm3 predicted successful outcome with 100% sensitivity, 33% specificity, 58% PPV, and 100% NPV. The combination of normal renal volume and a RFI below 1.5 ml/min/cm3 identified PTRA responders with a sensitivity of 91%, a specificity of 67%, a PPV of 71%, and a NPV of 89%. PTRA resulted in a greater increase in renal flow in responders compared with nonresponders (p < 0.001).Conclusion: A combination of cine

  1. Low-pressure balloon angioplasty with adjuvant pharmacological therapy in patients with acute ischemic stroke caused by intracranial arterial occlusions

    International Nuclear Information System (INIS)

    The use of coronary balloons in the cerebral vasculature is limited due to their poor trackability and increased risk of vessel injury. We report our experience using more compliant elastomer balloons for thrombus resistant to intraarterial (IA) pharmacological and mechanical thrombolysis in acute stroke. We retrospectively analyzed 12 consecutive patients with an occluded intracranial artery treated with angioplasty using a low-pressure elastomer balloon. Angiograms were graded according to the Thrombolysis in Cerebral Infarction (TICI) and Qureshi grading systems. Outcomes were categorized as independent (modified Rankin scale, mRS, score ≤2), dependent (mRS score 3-5), or dead (mRS score 6). Included in the study were 12 patients (mean age 66±17 years, range 31-88 years; mean baseline National Institutes of Health stroke scale score 17±3, range 12-23). The occlusion sites were: internal carotid artery (ICA) terminus (five patients, including two concomitant cervical ICA occlusions), M1 segment (two patients), and basilar artery (two patients). Pharmacological treatment included intravenous (IV) t-PA only (two patients), IA urokinase only (nine patients), both IV t-PA and IA urokinase (one patient), and IV and/or IA eptifibatide (eight patients). Mean time to treatment was 5.9±3.9 h (anterior circulation) and 11.0±7.2 h (posterior circulation). Overall recanalization rate (TICI grade 2/3) was 91.6%. Procedure-related morbidity occurred in one patient (distal posterior inferior cerebellar artery embolus). There were no symptomatic hemorrhages. Outcomes at 90 days were independent (five patients), dependent (three patients) and dead (four patients, all due to progression of stroke with withdrawal of care). Angioplasty of acutely occluded intracranial arteries with low-pressure elastomer balloons results in high recanalization rates with an acceptable degree of safety. Prior use of thrombolytics may increase the chances of recanalization, and glycoprotein IIb

  2. Clinical usefulness of doppler ultrasonography before percutaneous transluminal angioplasty immature native arteriovenous fistula

    International Nuclear Information System (INIS)

    To report the clinical efficacy of preprocedural doppler ultrasound examination for the treatment of immature arteriovenous fistula by means of percutaneous transluminal angioplasty (PTA) and the efficacy of PTA about its treatment. From November 2008 to May 2013, 28 patients who were diagnosed with immature arteriovenous fistula using doppler ultrasound examination and obtained successful maturation of it after PTA were included in this study. A retrospective comparative analysis was performed according to the findings between doppler ultrasound examination and fistulography during the procedure. The success rate of PTA and patency of fistula were evaluated in each patient Doppler ultrasound examination revealed stenosis in twenty three patients and thrombotic total occlusion in five patients. Stenosis was located in the proximal cephalic vein 2 cm from the anastomosis in 67.8% (19/28). In the five cases of thrombotic total occlusion, the lesions were long lesions from the anastomosis to the entire proximal cephalic vein at the elbow joint level. Fistulography revealed 5 patients with thrombotic total occlusion and 24 stenosis sites in 23 patients, respectively. The location and characteristics of all lesions were consistent on doppler ultrasound examination. Only four cases were observed as non-thrombotic total occlusion on fistulography, which had more than 90% stenosis on doppler ultrasound examination. The initial success rate of PTA for immature arteriovenous fistula was 96.4% (27/28). In three patients, clinical success was obtained after four times of additional PTA. Six additional PTAs were performed during follow-up, no complications related to the procedures were found. The primary patency rate was 92.9% at 3 months, 60.7% at 6 months and 39.3% at 12 months. The estimated mean survival of arteriovenous fistula was 347.9 days and the estimated median survival was 232 days. Also, the 12 months primary patency rates between the stenosis group and occlusion

  3. Clinical usefulness of doppler ultrasonography before percutaneous transluminal angioplasty immature native arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Eun [Dept. of Radiology, Inje University Seoul Paik Hospital, College of Medicine, Inje University, Seoul (Korea, Republic of); Cho, Young Kwon; Sim, Jae Chan; Lee, So Young; Sung, Su Ah; Hwang, Young Hwan [Eulji General Hospital, College of Medicine, Eulji University, Seoul (Korea, Republic of)

    2013-11-15

    To report the clinical efficacy of preprocedural doppler ultrasound examination for the treatment of immature arteriovenous fistula by means of percutaneous transluminal angioplasty (PTA) and the efficacy of PTA about its treatment. From November 2008 to May 2013, 28 patients who were diagnosed with immature arteriovenous fistula using doppler ultrasound examination and obtained successful maturation of it after PTA were included in this study. A retrospective comparative analysis was performed according to the findings between doppler ultrasound examination and fistulography during the procedure. The success rate of PTA and patency of fistula were evaluated in each patient Doppler ultrasound examination revealed stenosis in twenty three patients and thrombotic total occlusion in five patients. Stenosis was located in the proximal cephalic vein 2 cm from the anastomosis in 67.8% (19/28). In the five cases of thrombotic total occlusion, the lesions were long lesions from the anastomosis to the entire proximal cephalic vein at the elbow joint level. Fistulography revealed 5 patients with thrombotic total occlusion and 24 stenosis sites in 23 patients, respectively. The location and characteristics of all lesions were consistent on doppler ultrasound examination. Only four cases were observed as non-thrombotic total occlusion on fistulography, which had more than 90% stenosis on doppler ultrasound examination. The initial success rate of PTA for immature arteriovenous fistula was 96.4% (27/28). In three patients, clinical success was obtained after four times of additional PTA. Six additional PTAs were performed during follow-up, no complications related to the procedures were found. The primary patency rate was 92.9% at 3 months, 60.7% at 6 months and 39.3% at 12 months. The estimated mean survival of arteriovenous fistula was 347.9 days and the estimated median survival was 232 days. Also, the 12 months primary patency rates between the stenosis group and occlusion

  4. Percutaneous transluminal angioplasty of malfunctioning Brescia-Cimino arteriovenous fistula: analysis of factors adversely affecting long-term patency

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, Koji; Hirota, Shozo; Sugimura, Kazuro [Department of Radiology, Kobe University School of Medicine, 7-5-2 Kusunoki-cho, Chuo-Ku, 650-0017, Kobe (Japan); Higashino, Takanori; Kuwata, Yoichiro; Imanaka, Kazufumi [Department of Radiology, Nishi-Kobe Medical Center, 5-7-1 Koji-dai, Nishi-ku, 651-2273, Kobe (Japan)

    2003-07-01

    Our objective was to identify the factors adversely affecting long-term patency after percutaneous transluminal angioplasty (PTA) for hemodialysis Brescia-Cimino arteriovenous fistulas. Between November 1995 and March 2000, 91 PTA procedures were performed on 50 patients with 57 Brescia-Cimino fistulas. A retrospective study based on the chart review was performed. The initial technical success rate for all procedures and the primary and secondary patency rates for all fistulas were calculated. Regarding fistulas successfully maintained by the primary PTA, the primary and secondary patency rates were compared using the Kaplan-Meier method between two patient groups. They were classified on the basis of several factors, including age (older, over 70 years, and younger group), age of the fistulas (older, over 6 months, and younger group), with or without diabetes mellitus (DM), solitary or multiple lesions, long or short segment lesion, stenosis or occlusion, and with or without arterial and/or anastomotic lesions. Initial technical success rates for all procedures and fistulas were 91.2 and 89.5%, respectively. Cumulative primary and secondary patency rates at 1 year were 47.3 and 67.3%, respectively. In the comparative study, the secondary patency rate for the older group was lower than that of the younger group with statistical significance (p =0.029). The higher age is the only factor that reduces the long-term patency rate after PTA. (orig.)

  5. Percutaneous transluminal angioplasty of malfunctioning Brescia-Cimino arteriovenous fistula: analysis of factors adversely affecting long-term patency

    International Nuclear Information System (INIS)

    Our objective was to identify the factors adversely affecting long-term patency after percutaneous transluminal angioplasty (PTA) for hemodialysis Brescia-Cimino arteriovenous fistulas. Between November 1995 and March 2000, 91 PTA procedures were performed on 50 patients with 57 Brescia-Cimino fistulas. A retrospective study based on the chart review was performed. The initial technical success rate for all procedures and the primary and secondary patency rates for all fistulas were calculated. Regarding fistulas successfully maintained by the primary PTA, the primary and secondary patency rates were compared using the Kaplan-Meier method between two patient groups. They were classified on the basis of several factors, including age (older, over 70 years, and younger group), age of the fistulas (older, over 6 months, and younger group), with or without diabetes mellitus (DM), solitary or multiple lesions, long or short segment lesion, stenosis or occlusion, and with or without arterial and/or anastomotic lesions. Initial technical success rates for all procedures and fistulas were 91.2 and 89.5%, respectively. Cumulative primary and secondary patency rates at 1 year were 47.3 and 67.3%, respectively. In the comparative study, the secondary patency rate for the older group was lower than that of the younger group with statistical significance (p =0.029). The higher age is the only factor that reduces the long-term patency rate after PTA. (orig.)

  6. [Correction of dyslipidemia in patients with arteriosclerosis obliterans as a method for improving the results of endovascular angioplasty].

    Science.gov (United States)

    Petukhov, V A; Seitmykhamedov, M D; Dibirov, A D; Dubovik, S G; Sergeeva, N A; Prokubovskiĭ, V I

    1992-01-01

    The authors analyse the results of endovascular angioplasty of the pelvic and lower limb arteries in 147 patients of various age suffering from arteriosclerosis obliterans. It was found that the results of endovascular angioplasty depended on the state of the lipid balance. The necessity for correcting the shifts in the lipid metabolism is shown. The article evaluates the results of dyslipidemia correction by dietotherapy, pharmacotherapy, and operation for partial ilio-shunting in patients with arteriosclerosis obliterans of the pelvic and lower limb arteries. The efficacy of the listed methods of treatment are analysed according to the severity of dyslipidemia. PMID:1457133

  7. Balloon pulmonary angioplasty: a treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Aiko eOgawa

    2015-02-01

    Full Text Available In chronic thromboembolic pulmonary hypertension, stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension. Chronic thromboembolic pulmonary hypertension can be cured surgically by pulmonary endarterectomy; however, patients deemed unsuitable for pulmonary endarterectomy due to lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, advances have been made in balloon pulmonary angioplasty for these patients, and this review highlights this recent progress.

  8. Impotence due to external Iliac steal syndrome: Treatment with percutaneous transluminal angioplasty and stent placement

    Energy Technology Data Exchange (ETDEWEB)

    Gur, Serkan [Sifa University, Dept. of Radiology, Izmir (Turkmenistan); Oguzkurt, Levent; Kaya, Bilal; Tekbas, Guven; Ozkan, Ugur [Baskent University, Faculty of Medicine, Dept. of Radiology, Adana (Turkmenistan)

    2013-01-15

    We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.

  9. Impotence due to external Iliac steal syndrome: Treatment with percutaneous transluminal angioplasty and stent placement

    International Nuclear Information System (INIS)

    We report a case of erectile dysfunction caused by external iliac artery occlusion, associated with pelvic steal syndrome; bilateral internal iliac arteries were patent. The patient stated that he had experienced erectile dysfunction at similar times along with claudication, but he did not mention it before angiography. He expressed that the erectile dysfunction did not last long and that he felt completely okay after the interventional procedure, in addition to his claudication. Successful treatment of the occlusion, by percutaneous transluminal angioplasty and stent implantation, helped resolve erectile dysfunction completely and treat the steal syndrome.

  10. Two cases of radiation-induced skin injury following percutaneous transluminal coronary angioplasty (PTCA)

    International Nuclear Information System (INIS)

    Two cases of radiation-induced skin injury following percutaneous transluminal coronary angioplasty (PTCA) are reported. Case 1 is a 52-year-old man who underwent PTCA for 7 times. Case 2 is a 67-year-old man who underwent PTCA for 5 times. In both cases, a cutaneous lesion developed into an ulcer over the right infrascapular region. The ulcer was treated surgically. The histopathological features were compatible with chronic radiation dermatitis. To avoid such injury in interventional procedures with long fluoroscopic time, it is very important for medical staffs to recognize the radiation-induced skin injury and to reduce the patient's absorbed dose as much as possible. (author)

  11. Self-Expandable Stent Placement in Infrapopliteal Arteries After Unsuccessful Angioplasty Failure: One-Year Follow-up

    International Nuclear Information System (INIS)

    The purpose of this prospective study was to evaluate whether stent placement in infrapopliteal arteries is helpful in failed percutaneous transluminal angioplasty (PTA). Infrapopliteal PTA was performed in 70 arteries of 66 patients with chronic critical lower limb ischemia. The group comprised 55 males and 11 females, with an average age of 63.4 (range, 42-82) years. Diabetes mellitus was present in 92.4% of patients. Only the palpable anterior tibial and posterior tibial arteries were evaluated. Stents (Xpert stent; Abbot Vascular, Redwood City, CA, USA) were placed in 16 arteries where PTA was not successful (the failure was defined as residual stenosis >30% after PTA). In 54 arteries simple PTA was performed and was technically successful. Twenty-four nondilated arteries with no significant stenosis served as a comparison group. The 12-month patency rate was evaluated according to a combination of palpation and Doppler ultrasound. In all cases stent placement restored the flow in the artery immediately after unsuccessful PTA. Twelve-month follow-up showed a patency rate of 82% in the PTA group, 78% in the stent group, and 69% in the comparison group. We conclude that stent placement in the case of unsuccessful infrapopliteal PTA changed technical failure to success and restored flow in the dilated artery. At 12-month follow-up the patency rate of infrapopliteal arteries stented for PTA failure did not differ significantly either from nonstented arteries with an optimal PTA result or from a comparison group of nonintervened arteries.

  12. Chronic critical lower-limb ischemia: prospective trial of angioplasty with 1-36 months follow-up.

    Science.gov (United States)

    Matsi, P J; Manninen, H I; Suhonen, M T; Pirinen, A E; Soimakallio, S

    1993-08-01

    To determine the utility of percutaneous transluminal angioplasty (PTA) in the treatment of chronic critical lower-limb ischemia, a prospective study of 103 consecutive patients (117 limbs) was performed. Patients underwent PTA for a total of 209 lesions in the iliac (n = 4), femoropopliteal (n = 121), and infrapopliteal (n = 84) arteries and were followed up for 1-36 months (mean, 12 months). The primary technical success rate was 92% for stenosis and 80% for occlusion. Survival analysis with the Kaplan-Meier method revealed 1-, 2-, and 3-year limb salvage rates of 56%, 49%, and 49%, respectively. The following factors correlated favorably with limb salvage in Cox multiple regression analyses: a small number of diseased lower-limb vessels (one to five vs six to eight) and treated lesions per limb (one or two vs three to five), achieved peripheral runoff (one to three patent calf vessels vs none), and an occlusion as the successfully treated target lesion (instead of stenosis). PMID:8327682

  13. Transthoracic coronary flow reserve and dobutamine derived myocardial function: a 6-month evaluation after successful coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Pardo Moira

    2004-12-01

    Full Text Available Abstract After percutaneous transluminal coronary angioplasty (PTCA, stress-echocardiography and gated single photon emission computerized tomography (g-SPECT are usually performed but both tools have technical limitations. The present study evaluated results of PTCA of left anterior descending artery (LAD six months after PTCA, by combining transthoracic Doppler coronary flow reserve (CFR and color Tissue Doppler (C-TD dobutamine stress. Six months after PTCA of LAD, 24 men, free of angiographic evidence of restenosis, underwent standard Doppler-echocardiography, transthoracic CFR of distal LAD (hyperemic to basal diastolic coronary flow ratio and C-TD at rest and during dobutamine stress to quantify myocardial systolic (Sm and diastolic (Em and Am, Em/Am ratio peak velocities in middle posterior septum. Patients with myocardial infarction, coronary stenosis of non-LAD territory and heart failure were excluded. According to dipyridamole g-SPECT, 13 patients had normal perfusion and 11 with perfusion defects. The 2 groups were comparable for age, wall motion score index (WMSI and C-TD at rest. However, patients with perfusion defects had lower CFR (2.11 ± 0.4 versus 2.87 ± 0.6, p m at high-dose dobutamine (p m of middle septum (r = 0.55, p In conclusion, even in absence of epicardial coronary restenosis, stress perfusion imaging reflects a physiologic impairment in coronary microcirculation function whose magnitude is associated with the degree of regional functional impairment detectable by C-TD.

  14. Superior caval venous syndrome after atrial switch procedure: relief of complete venous obstruction by gradual angioplasty and placement of stents.

    Science.gov (United States)

    Michel-Behnke, I; Hagel, K J; Bauer, J; Schranz, D

    1998-10-01

    Superior caval venous syndrome is one of the late problems known to occur after Mustard repair of complete transposition. Reoperation may leave residual stenosis, and carries substantial risk for the patient. It is now feasible to use intravascular stents to overcome systemic venous baffle obstructions, and such an approach is probably more effective. The purpose of our study therefore, was to assess immediate and medium term results of inserting stents subsequent to gradual balloon enlargement of acquired atresia of the intraatrial baffle in patients who had undergone an atrial switch operation. We investigated five patients with complete obstruction of the superior caval venous pathway at perforation of the atretic segment was achieved using a guide wire technique. The procedure was successful in all patients. Gradual angioplasty was performed and intravascular stents were implanted. The pressure in the superior caval vein dropped to normal values, symptoms improved, and the patency of the newly created venoatrial communication was proven at mid-term follow-up. Thus critical obstructions at the superior caval venous pathway after the Mustard procedure can be reopened by interventional catheterization. Implantation of balloon-expandable intravascular stents is safe and effective in the acute relief of the obstructions, but careful long-term follow-up is mandatory. PMID:9855097

  15. Intradural vertebral endarterectomy with nonautologous patch angioplasty for refractory vertebrobasilar ischemia: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Timothy Uschold

    2014-01-01

    Full Text Available Background: The natural history of patients with symptomatic vertebrobasilar ischemic symptoms due to chronic bilateral vertebral artery occlusive disease is progressive, and poses significant challenges when refractory to medical therapy. Surgical treatment options depend largely on location and characteristics of the atheroma (s, and generally include percutaneous transluminal angioplasty (PTA with or without stent placement, posterior circulation revascularization (bypass, extracranial vertebral artery reconstruction, or vertebral artery endarterectomy. Case Description: We present the case of a 56-year-old male with progressive vertebrobasilar ischemia due to tandem lesions in the right vertebral artery at the origin and intracranially in the V4 segment. The contralateral vertebral artery was occluded to the level of posterior inferior cerebellar artery (PICA and posterior communicating arteries were absent. Following PTA and stent placement at the right vertebral artery origin, the patient was successfully treated with intradural vertebral artery endarterectomy (V4EA and patch angioplasty via the far lateral approach. Distal endovascular intervention at the V4 segment proved not technically feasible after multiple attempts. Conclusions: V4EA is an uncommonly performed procedure, but may be considered for carefully selected patients. The authors′ techniques and indications are discussed. Historical outcomes, relevant anatomic considerations, and lessons learned are reviewed from the literature.

  16. Cutting Balloon-Assisted Angioplasty of an Anastomotic Carotid-Brachial Bypass Graft Stenosis: A Case Report

    International Nuclear Information System (INIS)

    Neointimal hyperplasia leads to anastomotic stenosis in bypass grafts. These stenoses are often resistant to conventional balloon dilatation. We present a case of a carotid-brachial bypass graft stenosis, which was treated by a 5-mm cutting balloon angioplasty with a good angiographic and clinical result

  17. Captopril for prevention of Contrast Induced Nephropathy in patients undergoing Coronary Angioplasty: A double blind placebo controlled clinical trial

    Directory of Open Access Journals (Sweden)

    M Hashemi

    2005-09-01

    Full Text Available Background: Contrast induced nephropathy is a potential cause of mortality and morbidity in patients undergoing angiography–angioplasty. Except for hydrating and probably low – isoosmolar contrast agents in high risk groups, other modalities have not provided benefit. We investigated preventive effects of captopril for contrast induced nephropathy during angiography–angioplasty. Methods: In a double blind placebo controlled clinical trial, 88 patients were randomized to two groups: 42 patients received captopril (12.5 mg every 8 hours from 2 hours before the procedure until 48 hours thereafter, and 46 patients received placebo in the same manner. Serum creatinine was measured before and 48 hours after angioplasty. The data were analyzed by SPSS software, using unpaired student t-test for comparing mean creatinine rise in both groups and paired student t-test for the changes in serum creatinine in each group. Results: The mean creatinine rise in captopril group (0.214 mg/dl and placebo group (0.226 mg/dl were not significantly different. The incidence of acute renal failure (creatinine rise more than 0.5 mg/dl in the captopril (11.9 % and placebo group (10.8 % were not significantly different. Conclusion: Captopril does not effectively prevent contrast nephropathy, but it is not harmful for renal function and can be administered safely during angiography – angioplasty in patients with normal renal function. However, the effect of captopril in patients with high- risk characteristics remains to be clarified. Of note, we found a trend for less creatinine rise in diabetics who received captopril during the procedure in comparison to diabetics who received placebo. Keywords: Angiography, Angioplasty, Contrast induced Nephropathy, Captopril, Angiotension Converting Enzyme Inhibitor, Creatinine

  18. Prediction of outcome after femoropopliteal balloon angioplasty by intravascular ultrasound

    DEFF Research Database (Denmark)

    Vogt, K C; Just, S; Rasmussen, John Bøje Grønvall;

    1997-01-01

    arteries remained patent. Two occlusions and two stenoses developed during the first 3 months after the intervention and one occlusion occurred after 1 year. The following IVUS parameters were related to a favourable patency: presence of calcification; dissection or plaque rupture and residual stenosis of...... less than 70%. The arteriographically determined diameter reduction did not show predictive value. CONCLUSION: This study shows that in contrast to arteriography, IVUS revealed parameters predictive for patency following PTA....

  19. Early rethrombosis in femoropopliteal occlusions treated with percutaneous transluminal angioplasty

    DEFF Research Database (Denmark)

    Jørgensen, B; Meisner, S; Holstein, P;

    1990-01-01

    was explained by a high incidence (41%) of rethrombosis within hours of dilatation. Early rethrombosis was seen with all lengths of occlusion (1-27 cm) with no statistically significant difference from other subsets. This study concludes that conventional PTA in femoropopliteal occlusions should be...... reserved for cases of limb salvage, preferably in patients who are technically inoperable. We suggest a new technique of segmentally enclosed thrombolysis to prevent early rethrombosis after PTA in femoropopliteal occlusions....

  20. Consideration for primary angioplasty: impact on the door-to-drug time in AMI patients ultimately treated with thrombolytic agent.

    Science.gov (United States)

    Brady, W J; Esterowitz, D; Syverud, S A

    2001-01-01

    The objective of this study was to determine if consideration for percutaneous transluminal coronary angioplasty (PTCA) delays administration of thrombolytic therapy in acute myocardial infarction (AMI) patients. Retrospective medical record review of patients ultimately diagnosed with AMI who presented to the ED with chest pain and ST segment elevation on the electrocardiogram; these patients also received acute reperfusion therapy (PTCA or thrombolytic agent). AMI was diagnosed by abnormal elevations in the creatinine phosphokinase MB fraction. The study period covered 2 years (July 1, 1994 to June 30, 1996) in a university hospital ED with an annual volume of 60,000 patient-visits. The use of reperfusion therapies, time intervals, and times of presentation were recorded. Patients were divided into two groups based on cardiac catheterization laboratory (CATH) availability: (group I, CATH currently in operation, Monday to Friday, 7 am to 7 pm and group II, CATH currently not in-operation, all other times). Fifty-two patients with AMI met entry criteria. Patients were treated with thrombolytic therapy in 25 cases; PTCA in 27 cases. Patients received thrombolytic agents within statistically equivalent time intervals regardless of the period of presentation; time to thrombolytic therapy for group I patients was 38 +/- 16 minutes compared with 36 +/- 26 minutes for group II patients (P =. 891). A trend toward significance was noted in the use of PTCA compared with thrombolytic agent; Group I patients were more often treated with PTCA (19) compared with group II patients (11, P =.067). Patients were more rapidly treated with PTCA during CATH operation; the mean time to PTCA for group I patients was 73.5 minutes compared with PTCA for group II patients with 107.8 minutes (P =.033). The consideration for PTCA did not significantly delay the administration of thrombolytic therapy at the study site institution. PTCA was initiated more rapidly in patients presenting with

  1. Endovascular brachytherapy (EVBT) with rhenium-188 for restenosis prophylaxis after angioplasty of infrainguinal lesions. Early experience; Endovaskulaere Brachytherapie (EVBT) mit Rhenium-188 zur Restenoseprophylaxe nach Angioplastie infrainguinaler Laesionen. Erste Erfahrungen

    Energy Technology Data Exchange (ETDEWEB)

    Leissner, G.G.; Winterstein, A.; Bohndorf, K.; Wohlgemuth, W.A. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie; Wengenmair, H. [Klinikum Augsburg (Germany). Medizinische Physik und Strahlenschutz; Sciuk, J. [Klinikum Augsburg (Germany). Klinik fuer Nuklearmedizin; Woelfle, K.D. [Klinikum Augsburg (Germany). Klinik fuer Gefaesschirurgie; Weinrich, K. [Klinikum Augsburg (Germany). II. Medizinische Klinik, Angiologie

    2011-08-15

    Purpose: Restenosis remains a major problem in percutaneous transluminal angioplasty (PTA) of peripheral arteries. The aim of this feasibility study was to evaluate the technical feasibility and safety of a new endovascular brachytherapy (EVBT) device with Rhenium-188 in restenosis prophylaxis of infrainguinal arteries. Materials and Methods: From March 2006 to April 2009, 52 patients with 71 infrainguinal arterial lesions were treated with Re-188 to prevent restenosis after PTA. 40 patients with 53 lesions (24 de-novo lesions and 29 restenoses) were reexamined (clinic, color-coded duplex ultrasound) after a mean follow-up period of 12.7 months (2.6 to 25.1 months). The liquid beta-emitter Re-188 was introduced to the target lesion via an EVBT certified PTA balloon and a tungsten applicator. After the calculated irradiation time, Re-188 was aspirated back into the tungsten applicator. A dose of 13 Gy was applied at a depth of 2 mm into the vessel wall. Results: After a mean follow-up of 12.7 months, the overall restenosis rate after Re-PTA was 15.1 % (8/53 lesions). The restenosis rate for de-novo lesions was 20.8 % (5/24) and 10.3 % for restenoses (3/29). In 4 patients reintervention was necessary (3 PTAs and 2 major amputations). No periprocedural complications were observed. No elevated radiation dose for the patient or the interventionalist was measured. Conclusion: EVBT with a Re-188 filled balloon catheter was technically feasible and safe after PTA of infrainguinal arterial lesions with restenosis rates lower than expected compared to published results. Treatment of restenoses seems to be more effective than de-novo lesions. (orig.)

  2. Safety and efficacy of limus-eluting stents and balloon angioplasty for sirolimus-eluting in-stent restenosis

    Energy Technology Data Exchange (ETDEWEB)

    Ota, Hideaki [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Mahmoudi, Michael [University of Surrey, Guildford Road, Surrey, GU2-7XH (United Kingdom); Kitabata, Hironori; Torguson, Rebecca; Chen, Fang; Satler, Lowell F.; Suddath, William O.; Pichard, Augusto D. [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States); Waksman, Ron, E-mail: ron.waksman@medstar.net [Division of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010 (United States)

    2015-03-15

    Objectives: The aim of this study was to compare the safety and efficacy of everolimus-eluting stent (EES), sirolimus-eluting stent (SES), and plain old balloon angioplasty (POBA) for the treatment of SES in-stent restenosis (S-ISR). Background: The optimal treatment for drug-eluting in-stent restenosis remains controversial. Methods: The study cohort comprised 310 consecutive patients (444 lesions) who presented with S-ISR to our institution and underwent treatment with EES (43 patients), SES (102), or POBA (165). The analyzed clinical parameters were the 1-year rates of death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), definite stent thrombosis (ST) and major adverse cardiac event (MACE) defined as the composite of death, MI, or TLR at 1-year. Results: The three groups were well matched for the conventional risk factors for coronary artery disease except for smoking. The 1-year analyzed clinical parameters were similar in the three groups: MACE (EES = 14%, SES = 18%, POBA = 20%; p = 0.65), death (EES = 2.3%, SES = 6.2%, POBA = 6.1%; p = 0.61), MI (EES = 4.8%, SES = 2.1%, POBA = 2.5%; p = 0.69), TLR (EES = 11.9%, SES = 12.1%, POBA = 24%; p = 0.78), and TVR (EES = 11.9%, SES = 24.8%, POBA = 22.2%; p = 0.23). There were no cases of definite ST. MACE-free rate was significantly lower in patients with recurrent in-stent restenosis (log-rank p = 0.006). Presentation with acute MI, number of treated lesions and a previous history of MI were found to be independent predictors of MACE. Conclusions: In patients presenting with S-ISR, treatment with implantation of an EES, SES, or POBA is associated with similar clinical outcomes. Patients presenting with recurrent ISR may have a poorer clinical outcome.

  3. Two cases of radiation-induced skin injury following percutaneous transluminal coronary angioplasty (PTCA)

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Chiho; Ichino, Naoki; Araki, Yoshiko; Mouri, Yuki; Yamatodani, Yoshiko [Minoo City Hospital, Osaka (Japan); Morikawa, Kaoru

    1999-02-01

    Two cases of radiation-induced skin injury following percutaneous transluminal coronary angioplasty (PTCA) are reported. Case 1 is a 52-year-old man who underwent PTCA for 7 times. Case 2 is a 67-year-old man who underwent PTCA for 5 times. In both cases, a cutaneous lesion developed into an ulcer over the right infrascapular region. The ulcer was treated surgically. The histopathological features were compatible with chronic radiation dermatitis. To avoid such injury in interventional procedures with long fluoroscopic time, it is very important for medical staffs to recognize the radiation-induced skin injury and to reduce the patient`s absorbed dose as much as possible. (author)

  4. Value of P-31 MR spectroscopy for percutaneous transluminal angioplasty of the iliofemoral arteries

    International Nuclear Information System (INIS)

    Phosphorus metabolism of the calf muscles has been determined by P-31 MR spectroscopy for evaluation of percutaneous transluminal angioplasty (PTA) of the lower extremities. Seventeen patients with atherosclerotic stenosis or occlusion of the iliac and femoral arteries underwent P-31 MR spectroscopy before and after PTA. Seven normal controls also underwent P-31 MRS of the lower extremities. The average ratio of β-adenosine triphosphate β-ATP), phosphocreatine (PCr), and inorganic phosphate (Pi) to the total signal per minute was compared. A 1.5-T superconductive MR unit was used. In patients with atherosclerotic disease, the ratio of β-ATP was lower before PTA at all measurement points before, during, and after exercise. A minimal drop in the values was observed with exercise, and the recovery was very slow after exercise

  5. Peripheral macroembolism complicating laser angioplasty of arteries of extremities - therapy with radiologic interventional methods

    International Nuclear Information System (INIS)

    From 1987 to 1989 in the Barmherzige Brueder Hospital in Linz/Austria 160 arteries of extremities were treated with laser-assisted balloon dilatation. During these interventions peripheral macroembolism occurred 8 times. The mean length of the recanalised segment was 8.7 cm and thus longer than average (6.5 cm). All 8 cases were successfully treated by aspiration or aspiration combined with local lysis. No adverse effects on long-term results were noted. In 4 cases an early occlusion of the recanalised segment was diagnosed within 48 hours after laser-assisted angioplasty, three times accompanied by embolism. These emboli, too, were removed by aspriation and lysis. To reduce the risk of embolisation strict rules of indication concerning the age of an occlusion have to be observed and mechanical trauma has to be minimised. (orig.)

  6. Rupture of the Renal Artery After Cutting Balloon Angioplasty in a Young Woman With Fibromuscular Dysplasia

    International Nuclear Information System (INIS)

    A 24-year-old woman with uncontrollable high blood pressure for 3 months had significant stenosis of the left renal artery caused by fibromuscular dysplasia (FMD). The lesion was resistant to percutaneous transluminal angioplasty at 18 atm with a semicompliant balloon. Angioplasy with a 6 x 10 mm cutting balloon (CB) caused rupture of the artery. Low-pressure balloon inflation decreased but did not stop the leak. An attempt to place a stent-graft (Jostent; Jomed, Rangendingen, Germany) failed, and a bare, 6-mm balloon-expandable stent (Express SD; Boston Scientific, MN) was deployed to seal the leak, which had decreased considerably after long-duration balloon inflation. The bleeding continued, and the patient underwent emergent surgical revascularization of the renal artery with successful placement of a 6-mm polytetrafluoroethylene bypass graft. CBs should be used very carefully in the treatment of renal artery stenosis, particularly in patients with FMD

  7. The effects of 103Pd radioactive stent on restenosis after balloon angioplasty in rabbits

    International Nuclear Information System (INIS)

    Objective: To investigate the preventive effects of 103Pd radioactive stent on restenosis after balloon angioplasty in rabbits. Methods: 50 New Zealand white rabbits were balloon injured on abdominal aorta and followed by intravascular stent with ordinary or 103Pd radioactive stent, respectively. At the end of 3 days, 1, 2, 4 and 8 weeks after injury, the animals were killed in time-subgroups. Abdominal aortas were examined immuno-histochemically and pathologically. Before sacrifice, the two 8-week subgroups of rabbits received angiography. Result: Compared with the rabbits received ordinary stent, the rate of neo-intimal proliferation and vascular stenosis in rabbits received 103Pd radioactive stent were suppressed. Conclusion: It is showed that 103Pd radioactive stent could prevent arterial restenosis and the 103Pd being used as a radioactive agent in the procedure is safe and effective

  8. Radionuclide examination of ischemic heart disease patients after percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Twenty five patients were examined prior to percutaneous transluminal coronary angioplasty (PTCA) and one week following it by exercise thallium scintigraphy, 6 of them were also examined summation radionuclide ventriculography. The results of the tests allowed to conclude that myocardial perfusion definitely improved in 18 patients, no change was found in 3 patients and a trend towards deterioration was recorded in 4 patients. The deteriorated or unchanged results of the radionuclide examinations could presumably be attributed to incomplete dilation of significant arterial stenosis, rapidly produced restenosis or extensive anatomical alteration in the coronary circulation. Best results were obtained when complete dilation could be achieved of the left anterior descending coronary artery in patients without any additional coronary artery lesions and myocardial infarction in their history. It was also found that growing experience of the PTCA team greatly improved the success rate of the procedure. (author). 4 figs., 2 tabs., 20 refs

  9. Stent-Graft for the Management of Hepatic Artery Rupture Subsequent to Transcatheter Thrombolysis and Angioplasty in a Liver Transplant Recipient

    International Nuclear Information System (INIS)

    Arterial rupture subsequent to angioplasty occurs in about 5% of cases. Thrombolysis with re-establishment of flow without resolving underlying anatomic defects such as hepatic arterial stenosis leads to re-thrombosis. We present a case of arterial anastomotic rupture after thrombolysis and angioplasty of an underlying anastomotic hepatic arterial stenosis. Both the underlying anatomic defect and the rupture were resolved successfully with placement of a stent-graft, with a resultant patent artery for 1 year after the procedure.

  10. The comparison a 16-year follow-up results of balloon angioplasty for aortic coarctation in children of different age groups: a single-center experience

    OpenAIRE

    Yakup Ergül; Kemal Nişli; Aygün Dindar; Rukiye Eker Ömeroğlu; Ümrah Aydoğan

    2011-01-01

    Objective: Pediatric patients with different age groups who underwent balloon angioplasty for aortic coarctation were evaluated for recoarctation, aneurysm, peripheral arterial injuries and concomitant diseases. Methods: From January 1994 to 2010, 80 patients with aortic coarctation (native/recoarctation) were evaluated, retrospectively. According to age at angioplasty, patients were divided into three groups: Group A (0-3 months, n=29, 25 male/4 female, average weight 4±1.2 kg), Group B (3-1...

  11. Frequency and predictors for angiographically improved inflow of contrast medium after carotid angioplasty and stenting

    International Nuclear Information System (INIS)

    Percutaneous transluminal carotid angioplasty and stenting (PTAS) can result in immediate improvement in cerebral blood flow (CBF) evident through faster transit of contrast medium on angiography. To evaluate frequency and predictors of changes in inflow of contrast medium before and after PTAS, we reviewed 86 patients (mean age 68.6 ± 9.1 years) treated for symptomatic or asymptomatic carotid stenosis. Clinical data and lesion characteristics were extracted from charts and digital angiograms, respectively. Perfusion change was assessed qualitatively by comparing pre- and poststenting images matched for projection and time from injection. Improved inflow was defined on the basis of spatial or temporal distribution of contrast medium: grade -1: fewer vessels visible after stenting; 0: no change; 1: more distal small arteries visible; 2: time-matched poststenting image showing a capillary blush; 3: time-matched poststenting image showing small veins, 4 time-matched poststenting image showing large veins and sinuses. Faster inflow of contrast medium was observed in 74 % of patients (grades 1: 34 %,and 4: 4.7 %). In linear regression analysis, higher degrees of ipsilateral stenosis were associated with greater changes in inflow of contrast medium (P < 0.05). Right internal carotid lesions were associated with greater change in inflow than left-sided lesions (P < 0.01). In 31 patients (36 %) we initially showed contralateral anterior cerebral artery (ACA) filling, and in 39 % of these, normal filling was restored after stenting. Lesser contralateral carotid stenosis was associated with crossed ACA filling and with restoration of normal filling pattern after stenting. Faster appearance of a contrast-medium blush is seen in most cases of carotid angioplasty and stenting and depends on the degree of hemodynamic inflow obstruction relieved by stenting. (orig.)

  12. The influence of admission glucose on epicardial and microvascular flow after primary angioplasty

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background Patients with elevated admission glucose levels may be at increased risk of death after myocardial infarction, independent of other baseline risk factors and more severe coronary artery disease. However, data regarding admission glucose and epicardial and microvascular flow after primary angioplasty is limited.Methods Angioplasty was performed in 308 ST-segment elevated myocardial infarction patients. Patients were divided into 3 groups on the basis of admission glucose level: group 1, <7.8 mmol/L; group 2, (7.8 - 11.0) mmol/L; and group 3, ≥11.0 mmol/L. Results Compared with group 1, patients in group 2 and group 3 were more often female and older. Triglycerides (TG) in group 3 were significantly higher than group 1. At angiography, they more frequently had 2-vessel or 3-vessel disease. In the infarct-related artery, there was no relationship between hyperglycemia and thrombolysis in myocardial infarction (TIMI) 3 flow after percutaneous coronary intervention (PCI) (89.7%, 86.0% and 86.3%, P=NS). However, corrected TIMI frame count (CTFC) in group 2 and group 3 were more than group 1. TIMI myocardial perfusion grade (TMPG) 0-1 grade among patients with hyperglycemia after PCI were more frequent (30.9% and 29.0% vs 17.3%, P<0.05). There was less frequent complete ST-segment resolution (STR) and early T wave inversion among patients with hyperglycemia after PCI. Conclusion Elevated admission glucose levels in ST-segment elevation myocardial infarction patients treated with primary PCI are independently associated with impaired microvascular flow. Abnormal microvascular flow may contribute at least in part to the poor outcomes observed in patients with elevated admission glucose.

  13. Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices

    International Nuclear Information System (INIS)

    Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device. Materials and methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture. Patients were kept flat for 15 min and allowed to fully mobilize at 60 min. Puncture sites were scored for visible bruising, haematoma and pain at discharge and on outpatient follow-up. Patient preference for future outpatient treatment was assessed. Results: Fifty-seven outpatients underwent 81 punctures. Forty-eight (84%) patients underwent iliac angioplasty; of those 42% underwent stent placement. Six patients (10%) required inpatient admission, five secondary to failed suture deployment. One patient had a non-closer-related puncture site intimal flap occlusion successfully repaired at surgery. Fifty-one (90%) patients discharged with a mean time of 157 min (60-280 min). Forty-six (92%) patients had no visible bruising or palpable haematoma on discharge. No patient had a haematoma greater than 2.5 cm. No discharged patient required readmission. Thirty percent reported a moderate to severe groin pain score (2-5/5) at discharge, increasing to 40% at follow-up. Forty-seven (98%) of the 48 patients, who expressed a preference, would be happy to undergo outpatient treatment again. Conclusion: Outpatient treatment is feasible, well tolerated and preferable to patients, but 10% will require inpatient admission. A planned post-procedure analgesia regimen or advice should be considered

  14. Fatty acid metabolic disorder detected by 123I-BMIPP SPECT shortly after elective percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    To evaluate clinical significance of decreased or unchanged BMIPP uptake in repeated SPECT, 23 patients underwent BMIPP SPECT before elective PTCA (BM-1), soon after PTCA (72 hours, BM-2), and 3 months later (BM-3). SPECT imagings were divided into 7 segments and were semi-quantitatively evaluated by 2 cardiologists in the blinded fashion. Decreased uptake at BM-2 compared with BM-1 was evaluated by comparing with stress Thallium-201 SPECT performed in the same schedule but on the different date (Tl-1,2,3), ischemic manifestation at PTCA, and wall motion change of LVG. Patients with restenosis were excluded from this study. BM-2 showed decreased uptake in 14 (61%), unchanged in 2 (9%), and increased in 7 (30%) patients, while stress Tl showed increased perfusion in all patients. Among 91 myocardial segments correspondent to PTCA vessels, 30 (33%) showed overt uptake reduction, and only 13 (14%) segments showed increased uptake. BM-2 uptake reduction was significantly associated with the absence of collateral artery (odds ratio, OR=3.1, p<0.01), multi vessel disease (OR=2.0, p=0.01), total balloon inflating time (p<0.05), ST elevation on ECG (OR=3.6, p=0.01), chest pain during PTCA (OR=3.1, p<0.1), while pre-dilatation by using small size balloon catheter prevented BM-2 uptake reduction (OR=6.0, p=0.01). Multiple logistic regression analysis showed that chest pain, balloon inflating time and pre-dilatation were independently associated with BM-2 uptake reduction. Three months after PTCA, the segments with BM-2 reduction hail stress Tl uptake similar to the segments without BM-2 reduction, however, they showed poorer recovery of BM-3 uptake and LV wall motion. BMIPP uptake reduction shortly after angioplasty was associated with ischemic manifestation and poor LV motion recovery, thus, it may be a sensitive representation of the stunned myocardium. (J.P.N.)

  15. The Role of Postintervention Pullback Pressure Gradient in Percutaneous Transluminal Angioplasty for Central Vein Stenosis in Dialysis Patients

    International Nuclear Information System (INIS)

    Purpose: The severity of residual stenosis (RS) sometimes cannot be accurately measured by angiography during central vein intervention. This study evaluated the role of pullback pressure measurement during central vein stenosis (CVS) intervention. Methods: A retrospective review enrolled 94 consecutive dialysis patients who underwent CVS interventions but not stenting procedures. Patients were classified into 2 groups by either angiography or pressure gradient (PG) criteria, respectively. Groups divided by angiographic result were successful group (RS ≤30 %) and acceptable group (50 % ≥ RS > 30 %), while groups divided by PG were low PG group (PG ≤5 mmHg) and high PG group (PG >5 mmHg). Baseline characteristics and 12-month patency rates between the groups were analyzed. Results: The angiography results placed 63 patients in the successful group and 31 patients in the acceptable group. The patency rate at 12 month was not statistically different (P = 0.167). When the patients were reclassified by the postintervention pullback PG, the patency rate at 12 months was significant (P = 0.048). Further analysis in groups redivided by different combinations of RS and PG criteria identified significant differences in the group with both RS ≤30 % and PG ≤5 mmHg compared with those with either RS >30 % (P = 0.047) or PG >5 mmHg (P = 0.027). In addition, there was a significant difference between those with both RS ≤30 % and PG ≤5 mmHg compared with those with both RS >30 % and PG >5 mmHg (P = 0.027). Conclusion: Postintervention PG can better predict long-term outcomes after angioplasty for CVS in nonstented dialysis patients than angiography

  16. The Role of Postintervention Pullback Pressure Gradient in Percutaneous Transluminal Angioplasty for Central Vein Stenosis in Dialysis Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yu-Sheng, E-mail: dissertlin@yahoo.com.tw [Chang Gung Memorial Hospital, Chiayi, Chang Gung Institute of Technology, Division of Cardiology (China); Yang, Cheng-Hsu, E-mail: yangch@adm.cgmh.org.tw [Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Division of Cardiology and Department of Internal Medicine (China); Chu, Chi-Ming, E-mail: chuchiming@ndmctsgh.edu.tw [National Defense Medical Center and University, Section of Health Informatics, Institute of Public Health (China); Fang, Chi-Yung, E-mail: cyfang@seed.net.tw; Chen, Chien-Jen, E-mail: cjchen@adm.cgmh.org.tw [Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Division of Cardiology and Department of Internal Medicine (China); Hsu, Jen-Te, E-mail: hsujente@gmail.com; Yang, Teng-Yao, E-mail: 2859@adm.cgmh.org.tw [Chang Gung Memorial Hospital, Chiayi, Chang Gung Institute of Technology, Division of Cardiology (China); Hang, Chi-Ling, E-mail: samuelhang@hotmail.com; Wu, Chiung-Jen, E-mail: cvcjwu@adm.cgmh.org.tw [Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Division of Cardiology and Department of Internal Medicine (China)

    2013-10-15

    Purpose: The severity of residual stenosis (RS) sometimes cannot be accurately measured by angiography during central vein intervention. This study evaluated the role of pullback pressure measurement during central vein stenosis (CVS) intervention. Methods: A retrospective review enrolled 94 consecutive dialysis patients who underwent CVS interventions but not stenting procedures. Patients were classified into 2 groups by either angiography or pressure gradient (PG) criteria, respectively. Groups divided by angiographic result were successful group (RS {<=}30 %) and acceptable group (50 % {>=} RS > 30 %), while groups divided by PG were low PG group (PG {<=}5 mmHg) and high PG group (PG >5 mmHg). Baseline characteristics and 12-month patency rates between the groups were analyzed. Results: The angiography results placed 63 patients in the successful group and 31 patients in the acceptable group. The patency rate at 12 month was not statistically different (P = 0.167). When the patients were reclassified by the postintervention pullback PG, the patency rate at 12 months was significant (P = 0.048). Further analysis in groups redivided by different combinations of RS and PG criteria identified significant differences in the group with both RS {<=}30 % and PG {<=}5 mmHg compared with those with either RS >30 % (P = 0.047) or PG >5 mmHg (P = 0.027). In addition, there was a significant difference between those with both RS {<=}30 % and PG {<=}5 mmHg compared with those with both RS >30 % and PG >5 mmHg (P = 0.027). Conclusion: Postintervention PG can better predict long-term outcomes after angioplasty for CVS in nonstented dialysis patients than angiography.

  17. Análise morfométrica da carótida de suínos submetidos a angioplastia com ou sem implante de stent de cromo-cobalto Morphometric analysis of swine carotid artery angioplasty with or without cobalt-chromium stent implantation

    Directory of Open Access Journals (Sweden)

    João Luiz de Lara Elesbão

    2010-06-01

    Full Text Available Contexto: A hiperplasia intimal é a reação tardia mais comum decorrente da angioplastia. O uso de stents de cromo-cobalto é bem estudado na circulação coronariana, porém não há muitos estudos que abordem o uso desses stents nas circulações carotídea e periférica. Objetivo: Analisar mediante morfometria a reação intimal presente na artéria carótida de suínos submetidos a angioplastia isoladamente e a angioplastia seguida de implante de stent de cromo-cobalto. Materiais e métodos: Em oito suínos, foi realizada angioplastia da artéria carótida comum direita e angioplastia seguida de implante de um stent de cromo-cobalto na artéria carótida comum esquerda. Após 4 semanas, os animais foram submetidos a eutanásia para a retirada de amostras de tecido arterial e preparo de lâminas histológicas. As imagens das lâminas foram digitalizadas e analisadas por programa de morfometria digital. A análise estatística foi realizada através da média e desvio padrão das áreas em cada grupo, utilizando-se o Teste t de Student. O valor de p Background: Intimal hyperplasia is the most common delayed response to angioplasty. The use of cobalt-chromium stents is well studied in the coronary circulation; however, there are few studies on their use in the carotid and peripheral circulation. Objective: To analyze the intimal reaction in a swine carotid artery undergoing simple angioplasty and angioplasty followed by implantation of cobalt-chromium stent. Materials and methods: We carried out angioplasty in the right common carotid artery and angioplasty with cobalt-chromium stent in the left common carotid artery in eight swine. Four weeks later, all animals were sacrificed for arterial tissue sampling and preparation of histological slides. Slide images were scanned and analyzed using a digital morphometry program. Statistical analysis was performed by mean values and standard deviations of the areas in each group, using the Student's t

  18. Percutaneous transluminal angioplasty of brachiocephalic arteries: Indications and long-term success in a series of 25 patients

    International Nuclear Information System (INIS)

    The clinical records and procedural details of 28 angioplasty procedures performed on 25 patients were reviewed. Long-term follow-up was conducted by examining the referring physicians' records and by direct telephone contact with the patient. Nine patients had neurologic symptoms only, eight patients had arm claudication symptoms only, seven patients had both neurologic and arm symptoms, and two patients underwent dilation procedures to provide graft inflow. Procedural complications were a stroke in the contralateral carotid distribution during follow-up thoracic aortography, and an embolus to the fifth digit (of no clinical significance). Long-term success of the angioplasty procedure did not correlate with initial symptoms, degree of stenosis, lesion length, or postangioplasty appearance. All patients with arm and neurologic symptoms and who were followed up for 3 years, with the exception of the patient who suffered a periprocedural stroke

  19. Gore-Tex small-vessel angioplasty: A suitable substitute for the use of autogenous saphenous vein grafts

    OpenAIRE

    Garcia-Rinaldi, Raul; Rea, John E.; Gallagher, Michael W.; Laevsky, Marlene J.; Ogburn, Michael; Porter, Robert H.

    1980-01-01

    Autogenous saphenous vein has been the material of choice for small-vessel angioplasty and for circulatory access graft reconstruction. In an effort to conserve autogenous saphenous vein, we used expanded polytetrafluoroethylene (PTFE) grafts in 45 patients over a 12-month period. We used Gore-Tex* to reconstruct 17 circulatory access grafts, 16 carotid arteries, two brachial arteries, seven femoral arteries, and three popliteal anterior or posterior tibial arteries. The indications for recon...

  20. Percutaneous transluminal angioplasty in a patient with internal carotid artery stenosis following gamma knife radiosurgery for recurrent pituitary adenoma

    OpenAIRE

    Hidemichi Ito; Hidetaka Onodera; Taigen Sase; Masashi Uchida; Hiroyuki Morishima; Kotaro Oshio; Takashi Shuto; Yuichiro Tanaka

    2015-01-01

    Background: Intracranial vascular complications following radiosurgery are extremely rare. Case Description: We report a case of stenosis in the internal carotid artery 5 years after gamma knife radiosurgery for a recurrent pituitary adenoma. Percutaneous transluminal angioplasty was performed successfully with anatomical and functional improvement. Conclusion: These results suggested the importance of monitoring for arterial stenosis in the long-term follow-up. Moreover, this is the ...

  1. Below-the-ankle Angioplasty and Stenting for Limb Salvage: Anatomical Considerations and Long-term Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris [School of Medicine, Patras University Hospital, Department of Interventional Radiology (Greece)

    2013-08-01

    PurposeTo report the long-term angiographic and clinical results in a series of below-the-ankle (BTA) angioplasty procedures and to present some biomechanical issues related to the unique anatomical geometry of the ankle.MethodsWe performed a retrospective analysis of BTA angioplasty procedures. Clinical end points included technical success, patient mortality, salvage of the treated foot, and repeat target lesion revascularization. Imaging end points included primary patency, binary restenosis of the target lesion at the 50 % threshold, and stent integrity (stent fracture, deformation, or collapse). Univariate subgroup analysis was performed.ResultsIn total, 40 limbs in 37 patients (age 73.5 {+-} 8.2 years) with critical limb ischemia were included and 42 inframalleolar lesions (4.2 {+-} 1.4 cm) were analyzed. Technical success was achieved in 95.2 % (40 of 42). Provisional stent placement was performed in 45.2 % (19 of 42). Two patients died, and two major amputations occurred up to 3 years. At 1 year, overall primary vessel patency was 50.4 {+-} 9.1 %, lesion binary restenosis rate was 64.1 {+-} 8.3 %, and repeat intervention-free survival was 93.6 {+-} 4.3 % according to life table analysis of all treated lesions. Pairwise subgroup analysis showed that BTA self-expanding stents were associated with significantly higher restenosis and poorer primary patency compared to plain balloon angioplasty or sirolimus-eluting balloon-expandable stents. Significant deformation and/or fracture of balloon-expandable stents placed BTA were identified in five of 11. Dynamic imaging showed that the dorsalis pedis artery is kinked during foot dorsiflexion, whereas the distal posterior tibial artery is kinked during plantar flexion of the foot.ConclusionBTA angioplasty for critical limb ischemia treatment is safe and feasible with satisfactory long-term results. BTA stent placement must be reserved for bailout indications.

  2. Early intervention in acute myocardial infarction: significance for myocardial salvage of immediate intravenous streptokinase therapy followed by coronary angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, H.I.; Almagor, Y.; Keren, G.; Chernilas, J.; Roth, A.; Eschar, Y.; Shapira, I.; Shargorodsky, B.; Berenfeld, D.; Laniado, S.

    1987-03-01

    Sixteen patients with acute myocardial infarction underwent treatment with streptokinase up to 3 hours after the onset of chest pain. Nine patients (group I) received streptokinase within 1 hour of the onset of pain, and seven patients (group II) received it within 2 to 3 hours. All underwent multigated radionuclide ventriculography after streptokinase therapy and 1 week later. Percutaneous transluminal coronary angioplasty of the infarct artery was performed within 24 hours in all patients. An effort-limited treadmill stress test was performed before discharge. There was no mortality or serious complication. Mean peak total creatine kinase was 521 +/- 289 mU/ml in group I, and 1,614 +/- 709 mU/ml in group II (p less than 0.05). The mean initial left ventricular ejection fraction was 47 +/- 11% in group I and 37 +/- 10% in group II. After early angioplasty (within 24 hours) and at 1 week recovery, left ventricular ejection fraction increased to 53 +/- 9% in group I (p less than 0.05) and to 40 +/- 7% in group II (p = NS). Seven of the nine patients in group I had normal radionuclide ventriculograms at discharge compared with none of the seven patients in group II. Thrombolytic therapy administered less than 1 hour after the onset of symptoms of acute myocardial infarction followed by angioplasty of the infarct artery results in preservation of left ventricular function, whereas therapy given after 2 hours has only a limited effect.

  3. Safety and efficacy of angioplasty with intracoronary stenting in patients with unstable coronary syndromes. Comparison with stable coronary syndromes

    Directory of Open Access Journals (Sweden)

    Luís C. L. Correia

    2000-06-01

    Full Text Available OBJECTIVE: To assess safety and efficacy of coronary angioplasty with stent implantation in unstable coronary syndromes. METHODS: Retrospective analysis of in-hospital and late evolution of 74 patients with unstable coronary syndromes (unstable angina or infarction without elevation of the ST segment undergoing coronary angioplasty with stent placement. These 74 patients were compared with 31 patients with stable coronary syndromes (stable angina or stable silent ischemia undergoing the same procedure. RESULTS: No death and no need for revascularization of the culprit artery occurred in the in-hospital phase. The incidences of acute non-Q-wave myocardial infarction were 1.4% and 3.2% (p=0.6 in the unstable and stable coronary syndrome groups, respectively. In the late follow-up (11.2±7.5 months, the incidences of these events combined were 5.7% in the unstable coronary syndrome group and 6.9% (p=0.8 in the stable coronary syndrome group. In the multivariate analysis, the only variable with a tendency to significance as an event predictor was diabetes mellitus (p=0.07; OR=5.2; 95% CI=0.9-29.9. CONCLUSION: The in-hospital and late evolutions of patients with unstable coronary syndrome undergoing angioplasty with intracoronary stent implantation are similar to those of the stable coronary syndrome group, suggesting that this procedure is safe and efficacious when performed in unstable coronary syndrome patients.

  4. Initial clinical experience with a new pulsed dye laser device in angioplasty of limb ischemia and shunt fistula obstructions

    International Nuclear Information System (INIS)

    Selective plaque ablation with laser radiation at 405-530 nm in vitro has been reported. The possibilities are investigated of a new pulsed dye laser device for in vivo recanalization of arteries in ischemic lower limbs and stenoses/occlusions of arterio-venous hemo-dialysis shunt fistulae. A specially designed 9F or 7F multifiber catheter was used for treatment of 10 patients with lower limb artery obliterations and 11 patients with malfunctioning hemodialysis access fistulae (HAF). The recanalization technical success was 5/5 in the iliac arteries (IA), 4/5 in the superficial femoral arteries (SFA), and 11/11 in the HAF. Early re-occlusions occurred in one SFA and IA, respectively, caused by very bad run-off. There was one clinically insignificant SFA perforation. Additional balloon angioplasty was considered necessary in 10/16 lesions. Mean ankle-arm index increased from 0.68 to 0.97. With two exceptions all HAF patients were re-integrated in the dialysis program. Pulsed dye laser angioplasty promises to be an effective and fast method for plaque ablation debulking. The first clinical experience confirms previous in vitro results. In particular laser recanalization may become the method of choice for treatment of rigid HAF obstructions and it seems to be superior to vascular surgery or balloon angioplasty alone. (author). 15 refs.; 2 figs

  5. Laser angioplasty using a lensed-fiber delivery system and a pulsed Nd:YAG laser: early clinical results

    Science.gov (United States)

    White, Christopher J.; Ramee, Stephen R.; Mesa, Juan E.; Hollier, Larry H.; Murgo, Joseph P.; Aita, Michael; Samson, Gene; Godfrey, Maureen A.

    1990-07-01

    We performed a clinical trial to evaluate the safety and efficacy of a unique lensed-fiber delivery system with a pulsed Neodymium-yttrium aluminum garnet (Nd-YAG) laser in patients with atherosclerotic peripheral vascular disease. The lensed-fiber consists of a spherical silica lens, 1 .5 mm in diameter, mounted at the distal tip of a 300 im silica optical fiber. The Nd-YAG laser is pulsed at 10 Hz, and we delivered 0.5 J/pulse with a pulse duration of 100 msecs in 2- to 5-second bursts. Successful recanalization of stenoses or occlusions was obtained in 9 of 10 patients and was manifested by improvement in blood flow as measured angiographically and with ankle-brachial blood pressure index improvement (> 0. 15). There were no arterial perforations or dissections associated with the laser angioplasty. All successfully recanalized patients required adjunctive balloon angioplasty to obtain a satisfactory reduction in luminal diameter stenosis of the treated artery. We conclude that this unique delivery system and the pulsed Nd-YAG laser are a safe and effect method of recanalizing arterial stenoses not amenable to conventional balloon angioplasty alone.

  6. Effects of Endovascular Brachytherapy with 192Ir Afterloading System on Expression of Type Ⅰ Collagen after Angioplasty

    Institute of Scientific and Technical Information of China (English)

    向定成; 杨传红; 候友贤; 龚志华; 易绍东; 邱建

    2003-01-01

    Objectives To investi-gate the effect and mechanism of endovascularbrachytherapy with 192Ir on expression of type Ⅰ collagen, metalloproteinases - 1 (MMP - 1) and the tissueinhibitor (TIMP- 1 ) after angioplasty. MethodsRestenotic model of domestic microswine was em-ployed and the iliac arteries were randomized to radi-ation group ( n = 12), which were treated with 20 ~ 25Gy of 192Ir, and non - radiation group ( n = 36) afterangioplasty. The target vessels were harvested in theend of 3 months and 6 months after angioplasty. Im-munohistochemistry and in situ hybridization were usedto detect proteins of type Ⅰ collagen, MMP-1 andTIMP- 1, and mRNA expression of type Ⅰ collagen.Results The protein and mRNA of type Ⅰ collagen,the ratios of TIMP-1/MMP-1 were significantlylower iu radiation group than in non- radiation group( P < 0.05 or 0.01 ). The peak of transcription of typeⅠ collagen mRNA was at 6 months and 3 months in non-radiation group and radiation group respectively.Conclusions Endovascular brachytherapy with192Ir might modify the metabolism of extracellular ma-trix after angioplasty by inhibiting the synthesis of typeⅠ collagen and the activities of MMP - 1 and TIMP - 1.

  7. The impact of stent implantation on the patency rate of femoropopliteal artery after subintimal angioplasty for occlusive arteriosclerosis

    International Nuclear Information System (INIS)

    Objective: To assess the impact of stent implantation on the patency rate of femoropopliteal artery after subintimal angioplasty for occlusive arteriosclerosis. Methods: During the period from January 2007 to May 2009, a total of 43 patients with occlusive femoropopliteal arteriosclerosis (43 diseased legs) were treated in authors' hospital. Of the 43 patients, simple percutaneous subintimal angioplasty was performed in 24 (non-stent group), while percutaneous subintimal angioplasty with subsequent stent implantation was carried out in the remaining 19 (stent group). After the treatment, CTA or Doppler ultrasonic examination was performed to check the results. Interventional therapy was respected in some cases who developed restenosis. Results: The 12-month limb salvage rate was 98%. Perioperative minor complications occurred in 7% of patients (3/43). Two-year mortality rate was 7% (3/43). During the follow-up period, arterial restenosis or occlusion occurred in 22 cases. Three cases in non-stent group developed arterial occlusion within one month after the treatment. Repeated interventional procedure was carried out for 12 diseased legs. The primary patency rates of non-stent group at 6, 12 and 24 months were (83.3±7.6)%, (74.0±9.2)% and (56.1±13.5)%, respectively, while those of stent group were (89.5±7.0)%, (77.5±9.9)% and (32.2±16.6)%, respectively. The primary assisted patency rates at 12 and 24 months in non-stent group were (90.9±6.1)% and (64.2±14.7)%, respectively, while those in stent group were (94.4±5.4)% and (39.0±15.90%, respectively. The difference in both the primary patency rate and primary assisted patency rate between the two groups were of no significance (P>0.05). Cox-regression analysis indicated that the number of patent distal vessels, the type of femoropopliteal occlusive diseases and the history of smoking bore a close relationship to the two-year primary patency rate after subintimal angioplasty (r=-4.417, 2.502, 3.115; SX=1

  8. Percutaneous transluminal angioplasty and stent insertion in central venous steno-occlusion

    International Nuclear Information System (INIS)

    To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion in central venous steno-occlusion. Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion (six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence (six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residual stenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. The overall success rate was 89.5%;those of primary and revision intervention were 90. 9% and 87.5%, respectively. Primary and revision patency rates were 72.7% and 50%, respectively, at 6months, and 40% and 25% at 12 months. In five patients who underwent revision, primary and secondary patency rates were 80% and 100% at 6months, 40% and 80% at 12 months, and 0% and 60% at 18 months. Only reduction of the pressure gradient after PTA correlated significantly with patency rates. No significant complications observed during the procedures follow-up period. PTA and stent insertion is effective for the treatment of central venous steno-occlusion.=20

  9. Effect of percutaneous transluminal angioplasty in insufficiency of arteriovenous fistula for hemodialysis

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of percutaneous transluminal angioplasty(PTA) and to determine the factors affecting the long-term patency rate in the management of insufficient hemodialytic arteriovenous fistula(AVF). Forty-nine cases of insufficient hemodialytic AVF were treated in 44 patients(native AVF:20, graft AVF:29, M:17, F:27, Age:22-70 years). In 28 thrombus patients, thrombolysis was performed with urokinase, and was followed by PTA. The initial success rate and complications of PTA were evaluated. According to the site and length of the stenosis, type and age of the AVF, the presence or abscence of thrombus, a history of diabetic mellitus, the patient's age, and the duration of renal failure, patency rates were compared within each subgroup using the Kaplan-Meier logrank test. The initial success rate of PTA for insufficient hemodialytic AVF was 88%(43/49), the patency rate of PTA was 67% at 6 months, and 50% at 12 months. The initial success rate of thrombolysis was 89%(25/28). The complication rate of PTA was 12%(6/49), of which five cases were vein rupture, and one was subcutaneous hematoma. Statistically, the patency rates in the above mentioned subgroups were not significantly different. PTA with or without thrombolysis offers safe and effective management of insufficient hemodialytic AVF

  10. Neuroendocrine Responses to Transvascular Autonomic Modulation: A Modified Balloon Angioplasty in Multiple Sclerosis Patients.

    Science.gov (United States)

    Arata, M; Sternberg, Z

    2016-02-01

    Balloon angioplasty (BA) is a treatment modality to correct vascular lesions in multiple sclerosis (MS) patients, who present with chronic cerebrospinal venous insufficiency (CCSVI). We hypothesized that BA clinical benefits stems in part from improvement in cardiovascular autonomic nervous system (ANS) function. We adopted the Transvascular Autonomic Modulation (TVAM), as a modified BA technique, with the objective of further enhancing ANS functional activities. TVAM involved dilation of multiple vascular beds, including IJVs, azygos and renal veins, and application of manual compression. Since the ANS regulates the function of the hypothalamus pituitary (HPA) axis, we examined TVAM effects on HPA axis in MS patients, and determined the relationship between ANS function and HPA activity. The adrenocorticotropic hormone (ACTH) and cortisol serum levels, systolic and diastolic blood pressure (BP), and heart rate variability (HRV) parameters were measured before and 24 h after TVAM procedure in 72 MS patients. Baseline ACTH and cortisol serum levels were lower than normal ranges in 18% and 25% MS patients respectively. The intervention resulted in significant reductions in both ACTH and cortisol (pcounter to the stress-mediated increases in serum levels of these hormones, which are expected following an invasive procedure. The clinical implications of this unexpected response warrant further investigations. PMID:25789986

  11. Below knee angioplasty in elderly patients: predictors of major adverse clinical outcomes.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

    AIM: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). MATERIALS AND METHODS: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. RESULTS: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). CONCLUSION: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  12. Below knee angioplasty in elderly patients: Predictors of major adverse clinical outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Keeling, Aoife N.; Khalidi, Karim; Leong, Sum [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland); Wang, Tim T. [Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary' s Hospital, London W2 1NY (United Kingdom); Ayyoub, Alaa S.; McGrath, Frank P. [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland); Athanasiou, Thanos [Department of Biosurgery and Surgical Technology, Imperial College London, St. Mary' s Hospital, London W2 1NY (United Kingdom); Lee, Michael J., E-mail: mlee@rcsi.ie [Department of Academic Radiology, Beaumont Hospital, Beaumont Road, Dublin 9 (Ireland)

    2011-03-15

    Aim: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). Materials and methods: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. Results: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). Conclusion: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  13. Primary percutaneous transluminal coronary angioplasty in the acute infarction of the right ventricle

    Directory of Open Access Journals (Sweden)

    Gligić Branko

    2003-01-01

    Full Text Available Background. Predilection site for the acute myocardial infarction of the right ventricle, (AMI-RV is the upper third of the right coronary artery and for this reason such an infarction is followed by numerous complications, primarily by conduction disorders and very often by sudden and rapid cardiogenic shock development. Methods. Primary percutaneous transluminal coronary angioplasty (PPTCA was performed on three patients in whom the acute infarction of the right ventricular was diagnosed and who had been hospitalized six hours after the beginning of chest pain. In all three patients intracoronary stent was implanted. On the admission patients had been in the threatening cardiogenic shock, with the prominent chest pain and with the elevation of ST-segment in V4R>2 mV. In the course of intervention patients were administered low-molecular intracoronary heparin with direct platelet glycoprotein IIb/IIIa inhibitors (abciximab, according to the established procedure applied in such cases. Results. The complete dilatation of the infarcted artery was established with the signs of reperfusion and the further clinical course was completely normal, there was no heart failure and patients had no subjective difficulties. Conclusion. Invasive approach in the treatment of AMI-RV is justifiable, and possibly the therapy of choice of these patients, providing well trained and equipped team is available.

  14. Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery

    International Nuclear Information System (INIS)

    Background: To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Methods: Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. Results: The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Conclusions: Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found

  15. Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Weber, W. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany); Mayer, T.E. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Henkes, H. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany); Kis, B. [Department of Neurology, Alfried Krupp Hospital, Essen (Germany) and Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, Virchow Street 174, D-45147 Essen (Germany)]. E-mail: bernhard.kis@uni-duisburg-essen.de; Hamann, G.F. [Department of Neurology, Klinikum Grosshadern, University of Munich (Germany); Holtmannspoetter, M. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Brueckmann, H. [Department of Neuroradiology, Klinikum Grosshadern, University of Munich (Germany); Kuehne, D. [Department of Radiology and Neuroradiology, Alfried Krupp Hospital, Essen (Germany)

    2005-11-01

    Background: To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Methods: Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. Results: The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Conclusions: Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found.

  16. Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

    International Nuclear Information System (INIS)

    Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

  17. Below knee angioplasty in elderly patients: Predictors of major adverse clinical outcomes

    International Nuclear Information System (INIS)

    Aim: To determine predictors of clinical outcome following percutaneous transluminal angioplasty (PTA) in elderly patients with below knee atherosclerotic lesions causing intermittent claudication (IC) or critical limb ischaemia (CLI). Materials and methods: Over 7.5 years, 76 patients (CLI 72%, n = 55) underwent below knee PTA. The composite end-point of interest was major adverse clinical outcome (MACO) of the treated limb at follow-up which was defined as clinical failure, need for subsequent endovascular or surgical revascularization or amputation. Actuarial freedom from MACO was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards regression. Results: IC was improved in 95% at mean 3.4 years (range 0.5-108 months). Successful limb salvage and ulcer healing were seen in 73% with CLI. Most failures were in the CLI group (27% CLI vs. 5% IC), with an amputation rate of 16% for CLI vs. 5% for IC and persistent ulceration in 24% of CLI. Significant independent predictors of MACO were ulceration (hazard ratio 4.02, 95% CI = 1.55-10.38) and family history of atherosclerosis (hazard ratio 2.53, 95% CI = 1.1-5.92). Conclusion: Primary below knee PTA is a feasible therapeutic option in this elderly population. Limb ulceration and family history of atherosclerosis may be independent predictors of adverse outcome.

  18. Percutaneous transluminal ultrasonic angioplasty: preliminary clinical report of ultrasound plaque ablation in totally occluded peripheral arteries.

    Science.gov (United States)

    Monteverde-Grether, C; Valez y Tello de Meneses, M; Nava-López, G; Jauregui, R; Borges, J; Abundes, A; López-Cuéllar, M; Armilla, M

    1991-01-01

    Peripheral arterial obstructive disease has been treated with ultrasound ablation. Thirty two patients (pts), mean age 67 +/- 10 years underwent angiosonoplasty, with a prototype ultrasonic system, due to severe claudication (31%), rest pain (44%), rest pain and ulceration (25%). Angiosonoplasty was successful in 26/32 (81%) stenoses, (1/2 iliac, 9/2 femorals, 11/12 popliteal, 5/6 tibial). Angiography before and after angiosonoplasty confirmed that the lesions were successfully opened, (81%, p less than 0.05). A mean of 3 +/- 2 passes were required to adequately remove sufficient plaque. Balloon angioplasty was used in combination with angiosonoplasty in 11/32 (34%) occluded vessels. Complications included groin hematoma in 4 pts (12%) and vascular spasm in two patients (6%). Within 24 hours, 27/32 (94%) pts were discharged clinically improved. Reocclusion occurred in 4 pts (12%) immediately after the procedure. Ankle brachial indices significantly increased from 0.52 +/- 0.10 before to 0.70 +/- 0.12 after (p less than 0.05). In conclusion, the use of ultrasound energy to ablate atherosclerotic plaque would appear safe, and has shown no restenosis and a low incidence of complications over a six month period. PMID:1840288

  19. Is provisional stenting the effective option? The WIDEST study (Wiktor stent in de novo stenosis)

    OpenAIRE

    Fluck, D.; Chenu, P; Mills, P; Davies, A; Street, J.; Paul, E; Balcon, R; Layton, C; Investigators', G

    2000-01-01

    AIM—To compare the immediate and late outcomes of patients treated by a policy of routine stent implantation with routine balloon angioplasty and the use of stents only when an ideal result has not been obtained.
METHODS—A nine centre, multinational, randomised study of 300 patients with coronary artery disease thought suitable for treatment of a single lesion by balloon angioplasty or stent implantation. Only new lesions in patients who had not undergone previous bypass surgery were included...

  20. Angioplasty and stenting for severe vertebral artery oriifce stenosis:effects on cerebellar function remodeling veriifed by blood oxygen level-dependent functional magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Bo Liu; Zhiwei Li; Peng Xie

    2014-01-01

    Vertebral artery oriifce stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood lfow and perfusion in the posterior circulation after inter-ventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso-nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery oriifce stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat-ment only. The intervention group received vertebral artery oriifce angioplasty and stenting+identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent function-al magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery oriifce stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.

  1. Idiopathic infantile arterial calcification in a 12-year-old girl presenting as chronic mesenteric ischemia: imaging findings and angioplasty results

    International Nuclear Information System (INIS)

    We report an unusual case of chronic mesenteric ischemia presenting in a 12-year-old girl with idiopathic infantile arterial calcinosis (IIAC). This is the first reported case in the literature of chronic mesenteric ischemia in the setting of IIAC. The girl presented with a classical history of postprandial abdominal pain. Imaging demonstrated significant stenoses of the celiac axis, superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Angioplasty of the celiac axis and SMA was attempted, with successful dilation of the SMA only. At 3-, 6- and 12-month follow-ups, the child's symptoms had almost resolved. This case report has three important ramifications: chronic mesenteric ischemia is a possible clinical presentation in children with IACC, pre-angioplasty imaging is important in guiding treatment approach, and angioplasty was effective in this case of chronic mesenteric ischemia and offers hope for other similarly affected children. (orig.)

  2. Fate of side branches after intracoronary implantation of the Gianturco-Roubin flex-stent for acute or threatened closure after percutaneous transluminal coronary angioplasty.

    Science.gov (United States)

    Mazur, W; Grinstead, W C; Hakim, A H; Dabaghi, S F; Abukhalil, J M; Ali, N M; Joseph, J; French, B A; Raizner, A E

    1994-12-15

    Side branch occlusion may occur in the course of percutaneous transluminal coronary angioplasty (PTCA), particularly if complicated by site dissection. Concern that the additional placement of a stent may further jeopardize side branches is logical. Consequently, this study analyzed pre-PTCA, post-PTCA, poststent, and 6-month follow-up angiograms of 100 consecutive patients in whom 103 Gianturco-Roubin stents were implanted for acute or threatened closure after PTCA. Side branches were defined as major (> 50% of the stented vessel diameter) and minor ( 50% stenosis), and 129 minor branches were analyzed. Seven major branches (6%), all of which were diseased before PTCA, and 23 minor branches (18%) were lost after PTCA. Immediately after stent insertion, only 1 additional major and 1 minor branch were lost, whereas 2 of 7 major (29%) and 9 of 23 minor (39%) branches reappeared. At follow-up angiography, 7 major branches (6%) were more stenosed and 6 (6%) were improved compared with the angiogram before PTCA. Only 2 major (2%) and 5 minor (4%) branches remained occluded. Additionally, 2 major and 1 minor branch, which were patent after PTCA and stenting, were occluded at follow-up as a result of total occlusion of the stented segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7977091

  3. High Residual Collagen-Induced Platelet Reactivity Predicts Development of Restenosis in the Superficial Femoral Artery After Percutaneous Transluminal Angioplasty in Claudicant Patients

    Energy Technology Data Exchange (ETDEWEB)

    Gary, Thomas, E-mail: thomas.gary@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria); Prüller, Florian, E-mail: florian.prueller@klinikum-graz.at; Raggam, Reinhard, E-mail: reinhard.raggam@klinikum-graz.at [Medical University of Graz, Clinical Institute of Medical and Chemical Laboratory Diagnostics (Austria); Mahla, Elisabeth, E-mail: elisabeth.mahla@medunigraz.at [Medical University of Graz, Department of Anesthesiology and Intensive Care Medicine (Austria); Eller, Philipp, E-mail: philipp.eller@medunigraz.at; Hafner, Franz, E-mail: franz.hafner@klinikum-graz.at; Brodmann, Marianne, E-mail: marianne.brodmann@medunigraz.at [Medical University of Graz, Division of Angiology, Department of Internal Medicine (Austria)

    2016-02-15

    PurposeAlthough platelet reactivity is routinely inhibited with aspirin after percutaneous angioplasty (PTA) in peripheral arteries, the restenosis rate in the superficial femoral artery (SFA) is high. Interaction of activated platelets and the endothelium in the region of intervention could be one reason for this as collagen in the subendothelium activates platelets.Materials and MethodsA prospective study evaluating on-site platelet reactivity during PTA and its influence on the development of restenosis with a total of 30 patients scheduled for PTA of the SFA. Arterial blood was taken from the PTA site after SFA; platelet function was evaluated with light transmission aggregometry. After 3, 6, 12, and 24 months, duplex sonography was performed and the restenosis rate evaluated.ResultsEight out of 30 patients developed a hemodynamically relevant restenosis (>50 % lumen narrowing) in the PTA region during the 24-month follow-up period. High residual collagen-induced platelet reactivity defined as AUC >30 was a significant predictor for the development of restenosis [adjusted odds ratio 11.8 (9.4, 14.2); P = .04].ConclusionsHigh residual collagen-induced platelet reactivity at the interventional site predicts development of restenosis after PTA of the SFA. Platelet function testing may be useful for identifying patients at risk.

  4. Early Clinical Results Of Pulsed ND-YAG Laser Angioplasty In Patients

    Science.gov (United States)

    Cross, F. W.; Bowker, T. J.

    1988-06-01

    This paper describes the use of a 100u second pulsed Nd-YAG laser at 1.064 um wavelength in the treatment of critical ischemia of the lower limb in five human subjects. Laser energy was delivered percutaneously to superficial femoral artery occlusions using standard angiography access techniques. The fiber tip was modified by the use of a 2.2mm hemispherical sapphire tip in contact with the tissue and laser energy was delivered at 0.5 Joules per pulse at a repetition rate of 10Hz. Patients were selected because of their unsuitability for standard treatment, either through technical inoperability of poor general health. Their mean age (±SD) was 74 ± 11 years and the mean occlusion length (+SD) in the five patients was 16.3 ± 11.9 cm. Passage of a guidewire across the occlusion was attempted, but failed, in every case. The laser crossed all these occlusions with a mean energy delivery of 129 + 76 Joules. Mean ankle-brachial pressure index (ABPI) in the successful cases doubled from 0.25 to 0.5. Two of the recanalised segments closed within 24 hours due to poor runoff but remained open in the remaining three patients for a followup period of up to one year, averting amputation in one of them. These are poor risk patients with deteriorating critical ischemia and little hope of alternative treatment. Laser angioplasty using a pulsed Nd-YAG laser has been shown to be feasible in femoropopliteal disease and should now be applied in patients with less severe symptoms.

  5. Astro research fellowship: low dose radiation to prevent restenosis after angioplasty

    International Nuclear Information System (INIS)

    Purpose: To determine the optimal time to deliver a single dose of external radiation therapy (12 Gy) postoperatively following balloon angioplasty (on same day, day 2 or day 4) to prevent restenosis in a non-stented swine model. To model an endovascular radioactive source for prevention of restenosis in the same animal model. Materials and Methods: Both external iliac arteries in eleven red duroc swine were injured using balloon overdilation (3 inflations, 60 secs. each, 16 psi), and the first five were additionally injured using denudation. One artery in each animal was then irradiated using anteroposterior and posterioranterior fields using Co-60 with 12 Gy prescribed to the midplane, with the other artery serving as a control. Irradiation was delivered on the same day, day 2 or day 4. Animals were sacrificed 3 months following injury, and histomorphometric analysis was performed. Additionally, a prototype endovascular beta source was designed and manufactured for clinical testing, based on Monte Carlo estimations. Results: Neointima formation was noted in both radiated and control arteries. The mean neointimal thickness in the radiated and control arteries was 116 ± 39 μm and 131 ± 47 μm respectively. Time of radiation delivery did not have a significant effect in preventing restenosis. Physical measurements of the endovascular source are in progress using a water based phantom. Animal testing will commence on ten red duroc swine. Conclusion: External radiation at this low dose does not appear to prevent restenosis in an unstented animal model. We hope to begin animal experiments using an endovascular source to prevent restenosis

  6. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    International Nuclear Information System (INIS)

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology

  7. Medikamentenbeschichtete Angioplastie-Ballons für peripher-arterielle Eingriffe

    Directory of Open Access Journals (Sweden)

    Diehm N

    2010-01-01

    Full Text Available Seit der ersten perkutanen transluminalen Angioplastie (PTA, welche 1977 in Zürich durchgeführt wurde, bleibt die Restenose- Problematik ein relevanter Nachteil dieser eleganten minimal-invasiven Behandlungsoption. Verschiedene Versuche, die Restenoserate nach PTA zu senken, wie zum Beispiel die endovaskuläre Bestrahlung (Brachytherapie, und verschiedene medikamentöse Ansätze konnten unsere Erwartungen bislang nicht erfüllen. In den vergangenen Jahren wurden zunehmend moderne Nitinolstents eingesetzt mit dem Ziel, die Restenosewahrscheinlichkeit und die hieraus entstehende Notwendigkeit für wiederholt notwendige endovaskuläre Eingriffe an der initial behandelten Zielläsion zu senken. Im Gegensatz zur koronaren Intervention konnten sich medikamentenbeschichtete Stents in der endovaskulären Behandlung von Patienten mit peripher- arterieller Verschlusskrankheit (PAVK nicht durchsetzen, weil die komplexen biomechanischen Anforderungen des femoro-poplitealen Segments durch die aktuellen Stentdesigns nur unzureichend erfüllt zu sein scheinen. Im Bereich der Unterschenkelarterien ist die Restenoserate nach Ballonangioplastie noch höher als im femoro-poplitealen Segment. Auch hier ist die klinische Effizienz von Stents fraglich, zumal es sich bei Patienten, bei denen eine Indikation zu PTA der Unterschenkelarterien besteht, oftmals um sehr langstreckige Obstruktionen handelt. Medikamentenfreisetzende PTABallons sind eine neue erfolgversprechende Technologie, welche darauf abzielt, die Restenosewahrscheinlichkeit durch Applikation von proliferationshemmenden Substanzen wie Paclitaxel in die Gefäßwand zu senken. Erste Studien aus der koronaren und femoro-poplitealen Strombahn haben deren klinische Effizienz bereits belegt. Dieses Manuskript soll eine Übersicht über den klinischen Nutzen von medikamentenfreisetzenden Ballons in der peripherarteriellen Intervention vermitteln.

  8. Analysis of periinterventional complications of intracranial angioplasty and stenting: A single center experience

    Energy Technology Data Exchange (ETDEWEB)

    Silber, Toni; Ziemann, Ulf [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany); Ernemann, Ulrike [Department of Diagnostic and Interventional Neuroradiology, University of Tübingen (Germany); Bischof, Felix, E-mail: felix.bischof@uni-tuebingen.de [Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen (Germany)

    2014-12-15

    Highlights: • Periinterventional complications in 7.5% of patients with intracranial artery stenting. • 2.5% of periinterventional complications were perforator strokes. • 3.8% of patients developed a hemorrhagic stroke due to reperfusion injury. • Complications could be reduced by individualized measures to prevent perforator stroke or reperfusion injury. - Abstract: Background and purpose: Treatment of symptomatic intracranial atherosclerotic disease by angioplasty and stenting (PTAS) is limited by a high rate of periinterventional strokes. We performed a detailed analysis of these strokes at our center in order to identify strategies to reduce the risk of periinterventional complications. Methods: Case records and imaging data of 80 patients with a symptomatic 70–99% stenosis of a major intracranial artery treated with PTAS between July 2007 and December 2013 were reviewed. All patients had a sufficient response to aspirin and clopidogrel. Periinterventional strokes were categorized as either ischemic (perforator territory, distal embolic or delayed stent thrombosis) or hemorrhagic (intraparenchymal, subarachnoid). Results: Periinterventional complications occurred in 6/80 (7.5%) patients, consisting of 2 ischemic strokes (2.5%, both perforator territory), 3 hemorrhagic strokes (3.8%, 2 intraparenchymal due to reperfusion injury, 1 subarachnoid due to vessel rupture) and one death (1.3%) unrelated to stroke. All strokes occurred within 24 h after PTAS. Conclusion: Our retrospective data analysis suggests that the risk of periinterventional stroke after PTAS of symptomatic intracranial atherosclerotic disease might be reduced by sufficient antiplatelet therapy and optimized management of patients with high risk for reperfusion injury or perforator strokes, including selection of a stenting device adapted to individual vessel morphology.

  9. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure.

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud's disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  10. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure

    Science.gov (United States)

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud’s disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  11. Primary infragenicular angioplasty for diabetic neuroischemic foot ulcers following the angiosome distribution: a new paradigm for the vascular interventionist?

    Directory of Open Access Journals (Sweden)

    Alexandrescu V

    2011-08-01

    Full Text Available Vlad Alexandrescu1, Gerard Hubermont21Department of Vascular Surgery, Princess Paola Hospital, Marche- en-Famenne, Belgium; 2Department of Diabetology, Princess Paola Hospital, Marche-en-Famenne and Sainte-Thérèse Hospital, Bastogne, BelgiumAbstract: The angiosome principle was first described by Jan Taylor in 1987 in the plastic reconstructive surgery field, providing useful information on the vascular anatomy of the human body. Specifically concerning foot and ankle pathology, it may help the clinician to select better vascular access and specific strategies for revascularization. This knowledge may be particularly beneficial when treating diabetic neuroischemic foot wounds associated with particularly aggressive atherosclerotic disease and a poor collateral circulation. The implementation of angiosome-based strategies in diabetic infragenicular vascular reconstruction may afford encouraging wound healing and limb preservation rates using both bypass and endovascular techniques. The minimal invasiveness of these novel strategies enables us to perform more specific and more distal tibial and/or foot arterial reconstructions, in one or multiple targeted vessels. This paper reviews the available literature on this revascularization strategy and focuses on the potential benefit of angiosome-guided primary angioplasty for diabetic ischemic foot ulcers.Keywords: critical limb ischemia, diabetic foot, limb salvage, angiosomes, angioplasty

  12. Stent assisted angioplasty in intracranial atherosclerotic severe stenoses. Efficacy of CT angiography in evaluation of the stented vessels

    International Nuclear Information System (INIS)

    Our aim was to determine whether CT angiography (CTA) is suitable for the evaluation of patency and in-stent restenoses in small vessel stents for intracranial angioplasty. From June, 2000 to February, 2006, 26 patients received stent-assisted angioplasty for intracranial atherosclerotic lesions. The procedure was successfully performed in all patients. Multi plannar reconstruction (MPR) was evaluated for image quality on three groups with I-E (Internal-External diameter) ratios, as follows: Group A=I-E ratio>0.5 (Possible to evaluate stent lumen, high certainty), Group B=0.31≤I-E ratio≤0.5 (Possible to evaluate stent lumen, low certainty), Group C=I-E ratio≤0.31 (Uninterpretable). We examined the possibility of evaluating the stent lumen, maching the identity with the angiographical findings, and finding a predictor of favorable CTA findings. CTA was performed in 19 patients. It was possible to evaluate the visible stent lumen in 14 patients (73.7%); 10 patients comprised group A, 4 patients group B, 5 patients group C. Nine patients were evaluated with both CTA and angiography after the stenting. CTA findings were identical with angiographical findings in 8 of 9 patients. Stent diameter was associated with CTA findings, all of the patients who received 4.0 mm stents were in group A. The stent lumen may be visualized and evaluated in most stents using CTA, but tend to only be interpretable in the small vessels. (author)

  13. Comparison of the effect of stem cell therapy and percutaneous transluminal angioplasty on diabetic foot disease in patients with critical limb ischemia

    Czech Academy of Sciences Publication Activity Database

    Dubský, M.; Jirkovská, A.; Bém, R.; Fejfarová, V.; Pagacová, L.; Němcová, A.; Sixta, B.; Chlupáč, J.; Peregrin, J. H.; Syková, Eva; Jude, E. B.

    2014-01-01

    Roč. 16, č. 12 (2014), s. 1733-1738. ISSN 1465-3249 Grant ostatní: GA MZd(CZ) 00023001IKEM Institutional support: RVO:68378041 Keywords : critical limb ischemia * stem cell therapy * percutaneous transluminal angioplasty Subject RIV: FH - Neurology Impact factor: 3.293, year: 2014

  14. Study on the dynamic change of endothelin in the development of stenosis of aorta after balloon injury in rabbits

    International Nuclear Information System (INIS)

    Objective: To study the dynamic change of endothelin (ET) in the blood with pathological and immunohistochemical changes of ET(ET-immunoreaction, ET-IR) in the development of stenosis of rabbit aorta after transluminal angioplasty. Methods: According to the different periods of being killed after micro-balloon angioplasty, 30 rabbits were divided randomly into 6 groups including 6-hour group, 1-day group, 3-day group, 7-day group, 15-day group and 22-day group. 3 out of 5 rabbits in each group were created as models of aortic endothelium injury by micro-balloon angioplasty, the rest 2 rabbits were taken as control. ET levels in the plasma were measured by ELISA before, as well as after micro-balloon angioplasty. Pathomorphological examination of the local traumatic aorta was carried out to observe the intimal thickness and the extent of lumen stenosis, and ET-IR was assessed by immunohistochemical technique performed on aortic wall after micro-balloon angioplasty. Results: (1) The major change of vascular stenosis was proliferation of vascular smooth muscle cell (VSMC) and endothelium. (2) ET levels in the plasma and ET-IR on the local aortic wall were significantly increased after micro-balloon angioplasty. Conclusions: The experimental results show that the major pathologic change of vascular stenosis is the obvionus proliferation of VSMC and endothelium. Further more, ET is a key factor in the development of vascular stenosis. (authors)

  15. Surgarcane biopolymer patch in femoral artery angioplasty on dogs Membrana de biopolímero de cana-de-açúcar como remendo em arterioplastias femorais de cães

    Directory of Open Access Journals (Sweden)

    José Lamartine de Andrade Aguiar

    2007-01-01

    Full Text Available PURPOSE: The objective of this study was to evaluate the use of the sugarcane biopolymer membrane in femoral artery patch angioplasty on dogs. METHODS: Eight dogs were submitted to bilateral femoral artery patch angioplasty with a sugarcane biopolymer membrane patch on one side and e-PTFE patch on the contralateral side. This research was performed at Experimental Surgical Research Laboratory of the Centro de Ciências da Saúde at Universidade Federal de Pernambuco. The dogs were submitted to a new surgery at 180 days after the patch angioplasty in order to harvest the femoral artery. All the animals were evaluated by: clinical examination, measure of femoral artery diameter, arteriogram and Doppler fluxometry. Yet the material harvested was sent to histological study. Each animal served as its own control. RESULTS: In all vessels of both groups there were no cases of infection, aneurysm formation, rupture or pseudoaneurysm formation and thrombosis. In both groups it was observed a chronic inflammatory reaction with lymphocytes, neutrophils and fibrosis in the outer surface of the patches. It was observed fibrosis in the inner surfaces of all the patches. In e-PTFE patches occurred invasion by fibroblasts. CONCLUSION: The sugarcane biopolymer membrane can be used as a patch in femoral artery angioplasty on dogs.OBJETIVO: Avaliar a utilização da membrana do biopolímero de cana-de-açúcar quando utilizada como remendo em arterioplastias femorais de cães. MÉTODOS: Oito cães foram submetidos a arterioplastia femoral bilateral com enxertos em remendo com a membrana do biopolímero de cana-de-açúcar em um lado e com a prótese de e-PTFE no lado contra-lateral. Os experimentos foram realizados no Núcleo de Cirurgia Experimental do Centro de Ciências da Saúde da Universidade Federal de Pernambuco. A avaliação dos animais foi realizada através do exame clínico, da medida do diâmetro das artérias femorais, da fluxometria Doppler, da

  16. Is echocardiography or magnetic resonance imaging superior for precoarctation angioplasty evaluation?

    Science.gov (United States)

    Mendelsohn, A M; Banerjee, A; Donnelly, L F; Schwartz, D C

    1997-09-01

    We compared the dimensions of the aorta obtained by two-dimensional transthoracic echocardiography (echo) (median, 2.5 mo preangioplasty) and magnetic resonance imaging (MRI) (median, 4.2 mo preangioplasty) to those obtained by angiography (cath) in 13 patients (age, 7.7 +/- 1.6 yr; mean +/- SEM) who underwent evaluation for coarctation balloon angioplasty between April 1993-January 1996. Echo measurements were obtained from the suprasternal and subcostal sagittal planes, MRI measurements from axial and sagittal oblique views, and cath measurements from the straight lateral or oblique views. Measurements of the diameters of the aortic isthmus, coarctation, descending aorta at the diaphragm, and isthmus length were made by all three modalities. Presence of aorto-aortic collaterals was determined, and the coarctation length was delineated. Investigators were blinded to other measurement data prior to statistical analysis. Data analysis by repeated analysis of variance (ANOVA) and Student-Newman-Keuls testing revealed no statistically significant difference between systolic pressure gradient by clinical examination (32.2 +/- 5.9 mm Hg), peak instantaneous Doppler evaluation (37.5 +/- 2.9 mm Hg), or preangioplasty systolic pressure gradient (32.1 +/- 3.3 mm Hg). With the exception of measurements of the descending aorta (echo, 11.7 +/- 0.9 mm vs. MRI, 13.3 +/- 0.8 mm vs. cath, 14.0 +/- 1.3 mm; P = 0.04), there was no statistically significant difference in dimensions of the aortic isthmus (9.2 +/- 0.6 mm vs. 10.5 +/- 0.9 mm vs. 10.8 +/- 0.9 mm), coarctation site diameter (4.8 +/- 0.6 mm vs. 5.6 +/- 0.9 mm vs. 5.3 +/- 0.8 mm), or isthmus length (12.4 +/- 2.1 mm vs. 12.1 +/- 2.2 mm vs. 10.9 +/- 1.7 mm). The correlation coefficients derived from comparisons of MRI vs. cath to echo vs. cath were similar for all dimensions except for isthmus length (P cardiac function and intracardiac anomalies. Both modalities detected the single patient with a long segment coarctation. We

  17. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach.

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

    Full Text Available In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI / magnetic resonance imaging (MRI road map approach and an MPI-guided approach using a blood pool tracer.A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4 was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography.Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide.4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions.

  18. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    Science.gov (United States)

    Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Results Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. Conclusions 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions. PMID:27249022

  19. EVOLUCIÓN CLÍNICA DE PACIENTES CON INFARTO AGUDO DE MIOCARDIO TRATADOS CON ANGIOPLASTIA PRIMARIA / Clinical evolution of patients with acute myocardial infarction treated with primary angioplasty

    Directory of Open Access Journals (Sweden)

    Ernesto del Pino Sánchez

    2012-07-01

    objective was to describe patients' clinical evolution with acute myocardial infarction treated by primary coronary angioplasty. Method: A descriptive, longitudinal and prospective study was performed in 69 patients, who were admitted to the Cardiology and Cardiovascular Surgery Institute, from July 1, 2007 to December 31, 2008, between 8 a.m. and 4 p.m. All patients underwent primary coronary angioplasty. A clinical evolution was made during 180 days, where frequency of major clinic events were evaluated: death, re-AMI, angina post-AMI, unstable angina, need of new re-vascularization and major hemorrhage. Results: The tobacco addiction and hypertension had an elevated prevalence. The inferior infarction location and single vessel disease were the most frequent. The immediate successful result prevailed. The failed cases was related with the right coronary artery, TIMI 0-1 flow and evolution time bigger six hours. The major clinic events were limited and it was more frequent during the first 30 days follow-up. Conclusions: Primary coronary angioplasty underwent during the first six hours after symptoms onset is an efficacious procedure, due to the predominance of the successful result and fewer frequency of major clinic events during six months follow-up.

  20. Incidence of major amputations, bypass procedures and percutaneous transluminal angioplasties (PTA) in the treatment of peripheral arterial occlusive disease in a German referral center 1996-2003

    International Nuclear Information System (INIS)

    Purpose: To determine the current incidence of major amputations, bypass procedures and percutaneous transluminal angioplasties (PTA) in a study population of patients with peripheral arterial occlusive disease in a German referral center. Materials and Methods: In a retrospective study, we recruited patients with peripheral arterial occlusive disease who underwent an amputation, bypass procedure, or PTA in the region of the pelvis or lower limbs between 1996 and 2003 at the Augsburg Medical Center. Patients were identified via the hospital database. This was performed with the help of the International Classification of Diseases (ICD 9 and 10), the operation code (OPS), and appropriate invoices. The incidence of PTAs was further estimated with 200 charts. Results: Of 5379 patients, 627 underwent amputation, 1832 a bypass procedure, and 2920 a PTA. The incidence of PTAs increased during the study period from 51.3/100 000/year to 64.4/100 000/year (p<0.01), while the number of amputations and bypass procedures remained stable. The incidence of PTAs was exceeded by that of bypass procedures only in patients older than 85 years. The age of the amputees decreased during the study period from 72.2 to 70.5 years (p<0.01). The age of patients who underwent a bypass procedure increased from 67.2 to 69.4 years, and the age of patients who underwent PTA increased form 66.3 to 69.8 years (p<0.01). Bypass procedures and PTAs were performed in men 6.3 years earlier than in women (p<0.01). Conclusion: The result is a population-corrected need of 8.4/100 000/year major amputations, 23/100 000/year bypass procedures and 64.4/100 000/year PTAs for patients with peripheral arterial occlusive disease within the referral area of our hospital. The performance of major amputations and bypass procedures stagnates, while the incidence of PTAs is increasing. (orig.)

  1. ANGIOPLASTIA PERCUTÁNEA CON STENT EN EL TRONCO PRINCIPAL DE LA ARTERIA CORONARIA IZQUIERDA / Percutaneous angioplasty with stent in the left main coronary artery

    Directory of Open Access Journals (Sweden)

    Javier Almeida Gómez

    2012-10-01

    is coronary artery bypass surgery. In several multicenter studies, the possibility of treating coronary artery disease by percutaneous coronary intervention with implantation of endoluminal prosthesis or stent is suggested. The objective of this research was to characterize percutaneous angioplasty with stent in the left main coronary artery. Method: An observational, descriptive and transversal study was carried out in 21 patients with percutaneous angioplasty with stent in the left main coronary artery, performed in the laboratory of Hemodynamics and Interventional Cardiology of Hermanos Ameijeiras Hospital, between January 2010 and July 2011. Results: There was no significant difference in sex. The age group 50-64 years (47.6% and white skin color (76.19% were predominant. The most commonly found cardiovascular risk factor was hypertension (85.71%, followed by dyslipidemia (47.61%. Effort angina was the most observed diagnosis with 14 cases (66.66%. The lesion in the body of the trunk (12 patients, 57.1% was the most prevalent, followed by ostial lesion (8 cases. Drug-eluting (61.9% was the most used type of stent and only 4 patients had surgically protected trunks. Conclusions: Most cases were elective, with a predominance of unprotected trunks. Hypertension was the coronary risk factor most commonly found. A significant association between diabetes mellitus and ostial location of the lesion was found.

  2. Letter regarding article "Primary coronary angioplasty for ST-°©‐Elevation Myocardial Infarction in Qatar: First nationwide program"

    Directory of Open Access Journals (Sweden)

    Mohamed Badreldin Elshazly

    2012-03-01

    Full Text Available Dear Editor: In their article “Primary Coronary Angioplasty for ST-Elevation Myocardial Infarction (STEMI in Qatar: First Nationwide Program”, Gehani et al. developed an impressive plan to implement primary percutaneous coronary intervention (PCI for the first time in Qatar [1]. As a graduate of Weill Cornell Medical College in Qatar, I have witnessed immense improvement in the Qatari healthcare system over the past few years. From building the new state of the art Heart Hospital to developing the first unified nationwide primary PCI program in the world, there is no doubt that Qatar has made an immense leap towards implementing world-class cardiovascular healthcare in the Middle East.

  3. Effects of ilexonin a on IL-6 and M-CSF following ballon angioplasty in rabbit common carotid artery

    International Nuclear Information System (INIS)

    Objective: To observe the effects of ilexonin A(IA) on IL-6 and M-CSF following ballon angioplasty in rabbit common carotide artery to provide experimental basis for percutaneous coronary interventions. Mehtods: 30 Japanese rabbits were fed with high cholesterol food for 4 weeks. Then they were divided into three groups randomly. Each group had ten rabbits. 1) Control group: the incision was sew directly after right carotide artery of the rabbit was seeked. 2) Balloon dilation group: the proximal of the carotide artery was cuted, the ballon was delivered and distended, after it was drawn repeatly, the incision was closed. 3) IA therapy group: operation was the same to the balloon dilation group, then IA was administered in vein. All of them were fed with high cholesterol diet for 4 weeks and the blood samples were collected 1 d before the operation and 1 d, 1,2,4 weeks after the operation. The serum IL-6 and M-CSF levels were determined with radioimmunoassay. The pathological changes of injuried artery were observed. Results: 1) The IL-6 level in balloon dilation group was higher than that in IA therapy group after the operation (P<0.05), and came back later to preoperation level. 2) Though the M-CSF level in IA therapy group was increased, but it was lower than that in dilation group (P<0.05). 3) The pathological results demonstrated that the artery endothelial in control group was smooth and no foam cell in sight. In bolloon dilation group, the endangium was thickened, the vascular smooth muscle cells proliferated, there were many foam cells and the lumen was constrictive. In IA therapy group, the number of foam cells reduced, the constrictive degree of lumen was alleviated. Conclusion: IA can redece the levels of serum IL-6 and M-CSF and inhibit the proliferation of vascular smooth muscle cells following ballon angioplasty. (authors)

  4. The effect of local sustained delivery of sirolimus on the vascular PAI-1 and t-PA expression after angioplasty

    International Nuclear Information System (INIS)

    Objective: To investigate the effect of local sustained delivery of sirolimus on the vascular inhibitor of plasminogen activator-1 (PAI-1) and tissue type plasminogen activator (t-PA) expression after angioplasty. Methods: Experimental common carotid artery injury model was established in the rats. A total of 30 male Wistar rats were divided into experimental group (n=20) and control group (n=10). Adventitial administration of drug was applied. Pluronic F-127 gel containing sirolimus was administered to the exposed adventitial surface of injured carotid artery. The experimental group was divided into high concentration (600 μg/100 μl) sub-group and low concentration (300 μg/100μl) sub-group according to the concentration of sirolimus delivered. The effect of local sustained delivery sirolimus on vascular PAI-1 and t-PA expression after percutaneous angioplasty was evaluated by immunohistochemistry. Results: Compared to control group, 15 and 30 days after injury local sustained delivery of sirolimus in both high concentration and low concentration sub-groups the expression of the PAI-1 in neointima was significantly enhanced (P0.05). At 15 and 30 days after injury, the expression of t-PA in neointima was decreased in both high and low concentration sub-groups (P<0.05), and the expression of t-PA in media was significantly decreased in high concentration sub-group (P<0.05) while on significant difference could be detected in low concentration sub-group. Conclusion: Local sustained delivery of sirolimus can induce the high expression of PAI-1 and low expression of t-PA in neointima although it inhibits the proliferation of neointima in the same time, and the imbalanced expression of t-PA and PAI-1 may probably play an important role in the late formation of thrombosis after the placement of drug-eluting stent. (authors)

  5. Early detection and percutaneous transluminal angioplasty of hemodialysis fistula stenoses: correlation with venous dialysis pressure and urea recirculation rate=20

    International Nuclear Information System (INIS)

    To evaluate the usefulness of venous dialysis pressure (VDP) and urea recirculation rate (URR) for the early detection of venous stenoses, the most common cause of hemodialysis fistular failure. To correlate the outcome of early percutaneous transluminal angioplasty (PTA) with VDP and URR after PTA. Eighty one chronic hemodialysis patients were monitored for VDP and URR during each session of hemodialysis treatment. Twenty-eight patients with elevated VDP and URR underwent fistulography, and the results were prospectively analysed. PTA was performed in twelve discrete stenoses (>70% reduction of the lumen) in six patients. Following PTA, VDP and URR were reevaluated. Fistulogramas showed that 15 of 28 patients had 22 stenoses. All of these lesions occurred in the proximal vein of an arteriovenous fistula, showing less than 50% reduction of the lumen in six stenoses, 50-70% in four, more than 70% in twelve, and no complete occlusion. Stenosis length was less than 1cm in twelve lesions, 1-3cm in seven, and 3-6cm in three. In 11 of 12 stenoses, angioplasty was successful with no significant residual stenosis remaining. After PTA, mean VDP and URR fell significantly: 117.8±20.6mmHg to 99.8±8.2mmHg(p=3D0.025), and 22.9±16.1 to 7.6±7.2(p=3D0.014), respectively. Early detection and early PTA of venous stenoses led to a high initial patency rate when used in conjuction with elective measurement of VDP and URR. After PTA, VDP and URR fell significantly, and there was close correlation with the outcome of PTA

  6. Infrapopliteal angioplasty with a long over-the-wire balloon for the treatment of severe limb ischemia in diabetic patients: a retrospective analysis

    International Nuclear Information System (INIS)

    Objective: To retrospectively evaluate the safety and efficacy of percutaneous transluminal angioplasty (PTA) by using a long over-the-wire (OTW) balloon for the treatment of severe limb ischemia in diabetic patients. Methods: During the period from April 2007 to March 2008, infrapopliteal PTA by using a long OTW balloon was performed in 34 patients. The patients, with a mean age of (71.8±7.4) years, had 53 affected limbs with a total of 119 vascular lesions. All patients presented with a chief complaint of limb ischemic symptoms. Angiographic findings were retrospectively analysed and the lesions were categorized according to the length and severity. The mean follow-up period was (7.4±2.6) months. Magnetic resonance angiography (MRA) of the lower limb was conducted every three months during the follow-up period, and the clinical data were collected and analysed. Results: Infrapopliteal PTA by using a long OTW balloon was successfully carried out in 92.4% of vascular lesions (110/119). Ankel-brachial index (ABI) and transcutaneous oxygen tension (TcPO2) were improved from preoperative (0.50±0.18) and (18.85±12.08) mmHg to postoperative (0.81±0.12) and (39.85±12.67) mmHg, respectively. At the end of follow-up, 29 patients maintained a stable outcome. Recurrence of symptoms were seen in five patients, and three of them had to receive a second PTA. Although two major amputations and four minor amputations had to be done, 94% limb salvage rate and 59% patency rate were obtained. Conclusion: Infrapopliteal PTA by using a long OTW balloon for the treatment of severe limb ischemia in diabetic patients, is clinically feasible and safe. Its midterm outcome is satisfactory and encouraging although its long-term effect needs to be evaluated with further study. (authors)

  7. Identification of the occluded artery in patients with myocardial ischemia induced by prolonged percutaneous transluminal coronary angioplasty using traditional vs transformed ECG-based indexes.

    Science.gov (United States)

    García, J; Wagner, G; Sömmo, L; Lander, P; Laguna, P

    1999-10-01

    We have studied the spatial properties of ischemic changes as induced by prolonged angioplasty and how the changes are related to different ECG indexes. Indexes based on measurements at specific points in time (ST level at J + 60 ms point, maximal T wave amplitude and position, QT interval, and QRS duration) and global indexes (based on the Karhunen-Loève transform and applied to the QRS complex, ST-T complex, ST segment, and T wave), considering both repolarization and depolarization information, were analyzed. The changes during the occlusion period of the different indexes were used as variables in a multivariate discriminant analysis to determine which indexes showed the best discrimination of the three major occlusion sites (corresponding to LAD, RCA, and LCX coronary arteries). Occlusions in LCX artery were the most difficult to classify. With three local indexes (ST60 level measured in lead V3, T wave amplitude in I, and ST60 in III) it was possible to correctly classify 76% of patients by the occlusion site, and with three KLT-derived indexes (first-order KLT index for ST-T complex in I and for QRS in leads V3 and I) 83% of correct classification was obtained. Using six indexes for local and KLT-derived indexes the correct classification was increased to 85 and 90% of patients, respectively. The use of different ECG indexes (from different intervals) on quasiorthogonal leads permitted the identification of the occluded artery in patients undergoing PTCA and may be extended to more general use. PMID:10529303

  8. The human HDL proteome displays high inter-individual variability and is altered dynamically in response to angioplasty-induced atheroma plaque rupture.

    Science.gov (United States)

    Jorge, Inmaculada; Burillo, Elena; Mesa, Raquel; Baila-Rueda, Lucía; Moreno, Margoth; Trevisan-Herraz, Marco; Silla-Castro, Juan Carlos; Camafeita, Emilio; Ortega-Muñoz, Mariano; Bonzon-Kulichenko, Elena; Calvo, Isabel; Cenarro, Ana; Civeira, Fernando; Vázquez, Jesús

    2014-06-25

    Recent findings support potential roles for HDL in cardiovascular pathophysiology not related to lipid metabolism. We address whether HDL proteome is dynamically altered in atheroma plaque rupture. We used immunoaffinity purification of HDL samples from coronary artery disease patients before and after percutaneous transluminal coronary angioplasty (PTCA), a model of atheroma plaque disruption. Samples were analyzed by quantitative proteomics using stable isotope labeling and results were subjected to statistical analysis of protein variance using a novel algorithm. We observed high protein variability in HDL composition between individuals, indicating that HDL protein composition is highly patient-specific. However, intra-individual protein variances remained at low levels, confirming the reproducibility of the method used for HDL isolation and protein quantification. A systems biology analysis of HDL protein alterations induced by PTCA revealed an increase in two protein clusters that included several apolipoproteins, fibrinogen-like protein 1 and other intracellular proteins, and a decrease in antithrombin-III, annexin A1 and several immunoglobulins. Our results support the concept of HDL as dynamic platforms that donate and receive a variety of molecules and provide an improved methodology to use HDL proteome for the systematic analysis of differences among individuals and the search for cardiovascular biomarkers. Biological significance The HDL proteome is an interesting model of clinical relevance and has been previously described to be dynamically altered in response to pathophysiological conditions and cardiovascular diseases. Our study suggests that interindividual variability of HDL proteome is higher than previously thought and provided the detection of a set of proteins that changed their abundance in response to plaque rupture, supporting the concept of HDL as dynamic platforms that donate and receive a variety of molecules. PMID:24747125

  9. Microvascular Coronary Flow Comparison in Acute Myocardial Infarction Angioplasty treated with a mesh covered stent (MGUARD Stent) versus Bare Metal Stent

    Energy Technology Data Exchange (ETDEWEB)

    Lindefjeld, Dante S., E-mail: dslindef@puc.cl [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Guarda, Eduardo [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Méndez, Manuel [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Martínez, Alejandro [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Pérez, Osvaldo [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Fajuri, Alejandro; Marchant, Eugenio [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Aninat, Mauricio; Torres, Humberto [Hospital Dr. Gustavo Fricke, Viña del Mar-Chile (Chile); Dussaillant, Gastón [Hospital Clínico Universidad de Chile, Santiago-Chile (Chile)

    2013-01-15

    Background: Distal embolization of thrombus/platelet aggregates decreases myocardial reperfusion during primary percutaneous coronary intervention (PCI), and is associated with worse immediate and long-term prognosis of patients with ST-elevation myocardial infarction (STEMI). Objective: Assess the efficacy of a mesh covered stent (MGuard™ stent, MGS) in preventing distal embolization and microvascular reperfusion impairment during primary PCI, compared with a bare metal stent (BMS). Methods: Forty patients with STEMI referred for primary PCI were randomized for stenting the culprit lesion with the MGS (n = 20) or a BMS (n = 20). Blinded experts performed off-line measurements of angiographic epicardial and microvascular reperfusion criteria: TIMI flow grade, myocardial blush, corrected TIMI frame count (cTFC). Results: At baseline clinical, angiographic and procedural variables were not different between groups. Post PCI TIMI flow grade was similar in both groups. We observed better myocardial Blush grade in group MGS compared to BMS (median value 3.0 vs 2.5, 2p = 0.006) and cTFC (mean cTFC: MGS 19.65 ± 4.07 vs BMS 27.35 ± 7.15, 2p < 0.001, cTFC mean difference MGS-BMS: 7.7, CI 95%: 3.94 to 11.46). MGS stent group had a higher percentage of successful angioplasty (cTFC ≤ 23: MGS 85% vs BMS 30%, 2p < 0.001). We had two cases of acute stent thrombosis (one for each group) at 30 days follow up, but no clinical events at 6 months follow up. Conclusions: In this exploratory study, MGS significantly improved microvascular reperfusion criteria compared with a BMS in primary PCI. However its safety and impact on clinical outcomes should be verified in larger randomized clinical trials.

  10. Serum Iron Concentration, but Not Hemoglobin, Correlates with TIMI Risk Score and 6-Month Left Ventricular Performance after Primary Angioplasty for Acute Myocardial Infarction

    OpenAIRE

    Ching-Hui Huang; Chia-Chu Chang; Chen-Ling Kuo; Ching-Shan Huang; Tzai-Wen Chiu; Chih-Sheng Lin; Chin-San Liu

    2014-01-01

    Objective Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS). Increased red cell distribution width (RDW) is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV) performance after primary angioplasty for acute myocardial infarction (AMI). We investigated the prognost...

  11. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    OpenAIRE

    Johannes Salamon; Martin Hofmann; Caroline Jung; Michael Gerhard Kaul; Franziska Werner; Kolja Them; Rudolph Reimer; Peter Nielsen; Annika Vom Scheidt; Gerhard Adam; Tobias Knopp; Harald Ittrich

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superp...

  12. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction

    Science.gov (United States)

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-01-01

    Abstract Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia–reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI). We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers. Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline. Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  13. Risk Factors for Incident Peripheral Arterial Disease in Type 2 Diabetes: Results From the Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) Trial

    OpenAIRE

    Althouse, Andrew D.; Abbott, J . Dawn; Forker, Alan D.; Bertolet, Marnie; Barinas-Mitchell, Emma; Thurston, Rebecca C.; Mulukutla, Suresh; Aboyans, Victor; Brooks, Maria Mori; ,

    2014-01-01

    OBJECTIVE The aim of this article was to define risk factors for incidence of peripheral arterial disease (PAD) in a large cohort of patients with type 2 diabetes mellitus (T2DM), overall and within the context of differing glycemic control strategies. RESEARCH DESIGN AND METHODS The Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) randomized controlled trial assigned participants to insulin-sensitizing (IS) therapy versus insulin-providing (IP) therapy. A total...

  14. Angioplasty of a persistent sciatic artery: case report Angioplastia de artéria isquiática persistente: relato de caso

    OpenAIRE

    Denis Szejnfeld; Sergio Quilici Belczak; Igor Rafael Sincos; Ricardo Aun

    2011-01-01

    Transluminal balloon angioplasty is a good choice for the treatment of lower limb arterial occlusion. Although there are some guidelines addressing its indications, some situations are so unusual that there is no consensus on their management. The presence of a persistent sciatic artery is a rare congenital anomaly of the circulatory system and may be associated with early atheromatous degeneration and occlusion. The authors describe the case of an 81-year-old woman that presented with a hist...

  15. Cognitive functioning and subjective quality of life in relapsing-remitting multiple sclerosis patients before and after percutaneous transluminal angioplasty: a preliminary report

    Directory of Open Access Journals (Sweden)

    De Pasquale C

    2014-06-01

    Full Text Available Concetta De Pasquale,1,2 Maria Luisa Pistorio,1 Massimiliano Veroux,2 Alessia Giaquinta,2 Pierfrancesco Veroux,2 Michele Fornaro11Department of Education Science, University of Catania, Catania, Italy; 2Vascular Surgery and Organ Transplant Unit, Department of Surgery Transplantation and Advanced Technologies, University Hospital of Catania, Catania, ItalyBackground: Multiple sclerosis (MS is a disease of the nervous system that has profound effects on everyday functioning and quality of life of not only the person who is diagnosed, but also her/his family and acquaintances. Despite this, the uncertainties of the actual etiological basis of MS make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness. This has led to an interest in potential novel therapeutic avenues, including percutaneous transluminal angioplasty (PTA. Yet, evidence in support of PTA in the management of MS is scarce and contradictory. The aim of the present study was to provide a preliminary assessment as to whether PTA may impact subjective quality of life and cognitive functioning in severe MS. Method: Ninety-five MS outpatients were followed-up for 24 months on a scheduled basis using the Milan Overall Dementia Assessment and the short-form 36-item scales, and were clinically evaluated by an appointed neurologist and psychiatrist. Results: At end point (month 24, only a minority of patients were still active in the study (n=33 or 34.74%. Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion. Limitations were: a lack of any active control group; small sample size; Berkson’s bias; and selection by indication biases.Conclusion: Given

  16. Preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty for the treatment of chronic occlusive arterial disorders of lower extremities

    International Nuclear Information System (INIS)

    Objective: To evaluate the safety and efficacy of preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty in treating chronic occlusive arterial disorders of lower extremities. Methods: From January 2008 to December 2009, preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty was performed in 12 patients with chronic occlusive arterial disorders of lower extremities, including 8 males and 4 females with an average age of 56.3 years (within a range of 38-71 years). All 12 patients had a history of chronic ischemia of lower limb,the mean ill duration was 19.3 months (3-48 months). All patients complained of intermittent claudication with a mean distance of 125 m (50-200 m). Rest pain occurred in 5 patients (42%), toe necrosis was seen in 3 patients (25%) and critically ischemic limb in 4 patients (33%). Ankle-brachial index (ABI) was 0.00 0.65 with a mean of 0.33. In all 12 patients catheter-directed thrombolysis with rt-PA or urokinase was initially carried out, which was followed by endovascular angioplasty (balloon dilatation or stent placement) in two days. The clinical data and the therapeutic results were analyzed. Results: Technical success was achieved in all 12 patients. The mean time of thrombolysis was 48 hours. Of 12 patients, rt-PA was employed in 4 and urokinase in 8. The occluded length of the diseased arteries before the treatment was 60-150 mm, with a mean of 80 mm. After catheter-directed thrombolysis,the occluded length decreased to 10-50 mm (mean of 30 mm). Endovascular angioplasty was successfully completed in all patients after thrombolysis therapy. Postoperative ABI was 0.64-1.0 (mean of 0.86), which was increased by 0.53 when compared to the preoperative figure. During the perioperative period neither complications needed to be surgically treated nor death occurred. All patients were followed up, and the arteries remained open after one year in all cases. Conclusion

  17. Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry treatment following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion

    International Nuclear Information System (INIS)

    Objective: To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry procedure following unsuccessful subintimal angioplasty for the treatment of arterial occlusion below the ankle. Methods: TDP or TPD retrograde intraluminal re-entry angioplasty was carried out in 8 diseased limbs of 8 diabetic patients (5 males and 3 females, aged 62∼81 years with a mean age of 75±8 years), who were accompanied with chronic below-the-ankle arterial occlusive disease, after the standard transtibial subintimal angioplasty had failed. Both before and after the procedure the clinical symptoms, dorsal or plantar arterial pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the degree of pain relief, the healing of the wound, the salvage of the diseased limb and the restenosis occurrence of the target vessels were evaluated. Results: Of the total 8 patients, TDP or TPD retrograde intraluminal re-entry angioplasty was successfully performed in 5(62.5%). After the treatment the foot pain was markedly relieved, the median pulse volume scores and ankle-brachial indexes were increased from 0.60±0.55 and 0.32±0.20 before the procedure to 2.40±0.55 and 0.75±0.12 after the procedure, respectively (P<0.01 for both). At the end of the follow-up lasting for twelve months, the visual analogue scale was apparently improved, the scores decreased from preoperative 7.40±1.14 to 2.20±1.48 (P=0.002). Of two cases with intractable skin ulcer, the skin lesion was completely healed in one and was significantly decreased in size in another. No amputation surgery was needed in all successfully treated patients. Magnetic resonance angiography revealed that one target vessel developed re-stenosis. Conclusion: TDP and TDP retrograde intraluminal re-entry techniques are clinically feasible and effective for the

  18. Subintimal angioplasty for below-the-ankle arterial occlusion in diabetic patients with chronic critical limb ischemia

    International Nuclear Information System (INIS)

    Objective: To assess the feasibility and efficacy of subintimal angioplasty (SA) for the treatment of below-the-arterial occlusion in diabetic patients with chronic critical limb ischemia (CLI). Methods: SA was adopted for 57 diseased lower limbs in 37 diabetic patients with chronic CLI and occlusive disease of the dorsalis pedis artery (DPA) and/or planter artery (PA), who were not suitable candidates for intraluminal angioplasty or bypass surgery. Of the total 57 diseased lower limbs, tissue loss was seen in 31 (54.4%) and pain was reported in 51 (89.5%). SA was carried out to create continuous arterial flow to the foot for limb salvage. Both before and after the procedure the clinical symptoms, DPA or PA pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the healing of the wound, the salvage of the diseased limb and the re-stenosis occurrence of the target vessels were evaluated. Kaplan-Meier curves were constructed to evaluate limb salvage, survival rate and freedom from amputation. Results: A total of 66 below-the-ankle arterial lesions were detected in 57 affected limbs. Of the 66 lesions, SA was successfully performed in 55 (83.3%). Before SA the median pulse volume scores and ABIs were 0.33±0.54 and 0.31±0.19 respectively, which became 2.04±1.05 and 0.80±0.14 respectively after SA, the differences in both median pulse volume scores and ABI were statistically significant (P<0.01 for both). One patient (2.7%) died within 30 days after the procedure. Mild complications, such as bleeding, thrombosis or angiospasm etc. occurred in five patents (13.5%). Twelve months after SA. Kaplan-Meier analysis showed that the limb salvage rate was 94.6%, the freedom from amputation was 89.2% and the survival rate was 97.3%. Conclusion: SA of the dorsalis pedis artery and/or planter artery is an effective technique for lower limb salvage in diabetic

  19. Eventos adversos e motivos de descarte relacionados ao reuso de produtos médicos hospitalares em angioplastia coronária Adverse events and reasons for discard related to the reuse of cardiac catheters in percutaneous transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Margarete Ártico Batista

    2006-09-01

    the brand-new and reuse of medical equipment. METHOD: Sixty patients were studied (48.3% with unstable angina, 45% with acute myocardial infarction and 6.7% with other diagnoses. During the procedure and stay in the Intensive Coronary Unit, the occurrence of fever, hypotension or hypertension, chills, sudoresis, bleeding, nausea and vomits were observed. Seven products were evaluated: catheter introducer, catheter guides (0.35 and 0.014, catheter balloons for angioplasty, indeflators and manifolds. In total, 76 brand-new and 410 reused apparatuses were studied to verify the occurrence of discard, whether this happened before or during the procedure and for what reasons. P-values < 0.05 were considered signicant. RESULTS: Twenty-six patients presented adverse effects. Hypotension was the most common seen in 11(18.3% cases. There was no significant association between this adverse effect and reuse or not of the equipment. Three brand-new products and 55 of the reused products were discarded as they were incomplete. CONCLUSION: The adverse effects presented by patients submitted to coronary vessel angioplasty were not associated to the reuse of the medical equipment. The integrity and functionality were the main reasons of discard.

  20. An empirical comparison of several clustered data approaches under confounding due to cluster effects in the analysis of complications of coronary angioplasty.

    Science.gov (United States)

    Berlin, J A; Kimmel, S E; Ten Have, T R; Sammel, M D

    1999-06-01

    In the analysis of binary response data from many types of large studies, the data are likely to have arisen from multiple centers, resulting in a within-center correlation for the response. Such correlation, or clustering, occurs when outcomes within centers tend to be more similar to each other than to outcomes in other centers. In studies where there is also variability among centers with respect to the exposure of interest, analysis of the exposure-outcome association may be confounded, even after accounting for within-center correlations. We apply several analytic methods to compare the risk of major complications associated with two strategies, staged and combined procedures, for performing percutaneous transluminal coronary angioplasty (PTCA), a mechanical means of relieving blockage of blood vessels due to atherosclerosis. Combined procedures are used in some centers as a cost-cutting strategy. We performed a number of population-averaged and cluster-specific (conditional) analyses, which (a) make no adjustments for center effects of any kind; (b) make adjustments for the effect of center on only the response; or (c) make adjustments for both the effect of center on the response and the relationship between center and exposure. The method used for this third approach decomposes the procedure type variable into within-center and among-center components, resulting in two odds ratio estimates. The naive analysis, ignoring clusters, gave a highly significant effect of procedure type (OR = 1.6). Population average models gave marginally to very nonsignificant estimates of the OR for treatment type ranging from 1.6 to 1.2 with adjustment only for the effect of centers on response. These results depended on the assumed correlation structure. Conditional (cluster-specific) models and other methods that decomposed the treatment type variable into among- and within-center components all found no within-center effect of procedure type (OR = 1.02, consistently) and a

  1. Factors influencing technical success and outcome of percutaneous balloon angioplasty in de novo native hemodialysis arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Heye, Sam, E-mail: sam.heye@uzleuven.be [University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven (Belgium); Maleux, Geert, E-mail: geert.maleux@uzleuven.be [University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven (Belgium); Vaninbroukx, Johan, E-mail: johan.vaninbroukx@uzleuven.be [University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven (Belgium); Claes, Kathleen, E-mail: Kathleen.claes@uzleuven.be [University Hospitals Leuven, Department of Nephrology, Herestraat 49, 3000 Leuven (Belgium); Kuypers, Dirk, E-mail: dirk.kuypers@uzleuven.be [University Hospitals Leuven, Department of Nephrology, Herestraat 49, 3000 Leuven (Belgium); Oyen, Raymond, E-mail: raymond.oyen@uzleuven.be [University Hospitals Leuven, Department of Radiology, Herestraat 49, 3000 Leuven (Belgium)

    2012-09-15

    Objective: To determine predictors of technical success, dysfunction recurrence and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVFs). Methods: Retrospective analysis of first time PTA of 167 AVF in 162 patients (100 men, 66 ± 13 years). Anatomical (location, length, grade and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus and AVF age, side and location) were reviewed. Results: 217 stenoses or segmental occlusions were treated. Technical success rate (84.4%) was higher in radiocephalic AVF compared to brachial artery–median vein AVF (p = 0.030) and was negatively correlated with initial stenosis (p = 0.049). Dysfunction recurrence was seen in 52.7% and correlated negatively with technical success (p = 0.013) and AVF age (p = 0.008). Early dysfunction (within 6 months) was negatively correlated with AVF age (p = 0.016) and positively with diabetes (p = 0.003). Higher AVF age resulted in higher primary (p = 0.005) and secondary patency rates (p = 0.037–0.005). Conclusions: Technical success of PTA in hemodialysis AVF is affected by AVF type and initial stenosis and has significant effect on dysfunction recurrence, but not on AVF longevity. Younger AVF has increased risk for (early) recurrent dysfunction and lower patency rates. Patients with diabetes mellitus have higher risk for early dysfunction.

  2. The effects of delayed percutaneous transluminal coronary angioplasty plus intracoronary stents on myocardial perfusion in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Objective: To assess the myocardial perfusion in patients with acute myocardial infarction (AMI) after delayed percutaneous transluminal coronary angioplasty (PTCA) and intracoronary stent implanting. Methods: Fifty-six patients with AMI were divided into delayed PTCA + stent group (treatment group, n=30) and control group (n=26). The treatment group were received delayed PTCA and coronary artery stents 15-30 d after AMI. The first 99Tcm-MIBI was performed 1-3 d before PTCA + stent (treatment group) and 15-30 d after AMI (control group), and followed by the second (1 month later), and the third (6 months later) 99Tcm-MIBI. Results: One month and six months after the treatment procedure (PTCA + stent), the blood flow deficit degree of myocardial infarction area in treatment group was much improved comparing with that before the procedure (treatment group, P0.05). Conclusions: There is residual myocardial viability in the AMI regions and PTCA + stent implantation keeps more jeopardize myocardium viable. Active therapy after AMI can significantly improve myocardial perfusion

  3. The application of subintimal recanalization in percutaneous transluminal angioplasty for chronic long-segment occlusion of femoropopliteal artery

    International Nuclear Information System (INIS)

    Objective: To discuss the technical points and clinical efficacy of subintimal recanalization technique in treating chronic long-segment total occlusion of femoropoliteal artery. Methods: Forty-two patients with chronic long-segment total occlusion of femoropoliteal artery underwent subintimal recanalization treatment. The basic procedure of subintimal recanalization was as follows. First, a subintimal path in the wall of the occluded artery was created by inserting a super-slip guide wire and the guide wire was then pushed into the true lumen of the outflow tract, which was followed by balloon angioplasty and stent placement to insure the patency of the re-canalized path. The technical points were discussed and the clinical results were evaluated. Results: The subintimal recanalization of occluded arterial segment was successfully achieved in 39 patients. The clinical symptoms were promptly and remarkably relieved after the procedure. The technical success rate was 92.9% (39/42). Technical failure occurred in three patients because the guide wire could not be managed into the true lumen of the outflow tract. Conclusion: The subintimal recanalization is an effective and safe technique for the treatment of chronic long-segment total occlusion of femoropoliteal artery. (authors)

  4. Interventional recanalization of artificial arteriovenous fistula and graft for hemodialysis: angioplasty and pulsed-spray thrombolysis with Urokinase

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pul-sed-spray pharmaco-mechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodialysis access. Between September 1996 and May 1998, 21 insufficient hemodialysis accesses were treated in 16 patients(3 artificial arteriovenous fistulae, AVF; and 13 arteriovenous graft, AVG). PTA and PSPMT were performed in 6 and 15 cases, respectively, and success and long-term patency rates were evaluated. The overall success rate of PTA and PSPMT for insufficient hemodialysis access was 76. 2%(16/21). The success rates of PTA and PSPMT were 83.3%(5/6) and 73.3%(11/15), respectively. The primary patency rates of PSPMT were 69±12.8% at 6 months and 38±18.6% at 12 months. One of the two initially successful PTAs had been patent for 7 months, and the second PTA was performed at that time due to venous stenosis. The other was patent for 15 months throughout the follow-up period. PTA and PSPMT are effective primary methods for the treatment of insufficient hemodialysis access;success and patency rates were high, and the procedures can be performed repeatedly.=20

  5. Ball-Tip Fibres For Laser Angioplasty: Comparison Of Wavelengths From A Pulsed Neodymium-Yag Laser.

    Science.gov (United States)

    Michaels, Jonathan A.; Cross, Frank W.; Bowker, Timothy J.; Bown, Stephen G.

    1989-06-01

    A new ball-tip fibre optic device has been assessed for the purpose of laser angioplasty. A pulsed Neodymium-YAG laser producing 100 p.s pulses at a repetition rate of 10 Hz was used to ablate human cadaver arterial tissue using approximately 500 mJ per pulse at a wavelength of 1064 nm or 300 mJ at a wavelength of 1.3 μm. Both wavelengths are capable of ablating atheroma with little histological evidence of surrounding thermal damage. Crater depths of about 5 μm per Joule were produced using 1064 nm with normal tissue exposed under saline. Crater depth increases by about 50% when exposures are carried out under blood and when diseased arterial tissue is exposed the crater depth is almost doubled. Depth of ablation with a wavelength of 1.3 μm is 3 to 4 times greater than with 1064 nm for the same exposure and a similar increased response is seen for diseased tissue or in the presence of blood. Further experiments at 1064 nm have shown that the ball-tip device has advantages over bare fibre or sapphire tipped devices in the recanalisation of occluded femoral vessels in an artificial circulation.

  6. Diagnostic and therapeutic imaging of the renal circulation: Film-screen arteriography, digital subtraction angiography, and percutaneous angioplasty and embolization

    International Nuclear Information System (INIS)

    Renal dysfunction is often engendered by disorders of the major renal arteries or their arborizations. Alternatively, primary renal parenchymal disease may manifest vascular alterations, which are indicative of the pathogenetic condition. Thus for these groups of diseases, imaging of the renal circulation frequently provides information that will lead to a generic or specific diagnosis. Traditionally, renal vascular imaging has been accomplished by conventional film-screen angiography. More recently, however, digital subtraction angiography has become established as an advantageous method of diagnosing renal vascular diseases. In addition the role of angiography is becoming increasingly extended to include therapeutic applications, such as percutaneous transluminal angioplasty for renal artery stenosis and transcatheter embolization of parenchymal abnormalities. The contents of this chapter are twofold: In the first section (The Procedures and Their Attributes) the authors describe the techniques, their applications, and their virtues and disadvantages. The second section (Vascular Imaging and Renal Disease) places these vascular imaging methods within the context of evaluating and treating renal disease

  7. The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions

  8. Factors influencing technical success and outcome of percutaneous balloon angioplasty in de novo native hemodialysis arteriovenous fistulas

    International Nuclear Information System (INIS)

    Objective: To determine predictors of technical success, dysfunction recurrence and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVFs). Methods: Retrospective analysis of first time PTA of 167 AVF in 162 patients (100 men, 66 ± 13 years). Anatomical (location, length, grade and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus and AVF age, side and location) were reviewed. Results: 217 stenoses or segmental occlusions were treated. Technical success rate (84.4%) was higher in radiocephalic AVF compared to brachial artery–median vein AVF (p = 0.030) and was negatively correlated with initial stenosis (p = 0.049). Dysfunction recurrence was seen in 52.7% and correlated negatively with technical success (p = 0.013) and AVF age (p = 0.008). Early dysfunction (within 6 months) was negatively correlated with AVF age (p = 0.016) and positively with diabetes (p = 0.003). Higher AVF age resulted in higher primary (p = 0.005) and secondary patency rates (p = 0.037–0.005). Conclusions: Technical success of PTA in hemodialysis AVF is affected by AVF type and initial stenosis and has significant effect on dysfunction recurrence, but not on AVF longevity. Younger AVF has increased risk for (early) recurrent dysfunction and lower patency rates. Patients with diabetes mellitus have higher risk for early dysfunction

  9. Roles of thrombin and platelet membrane glycoprotein IIb/IIIa in platelet-subendothelial deposition after angioplasty in an ex vivo whole artery model

    International Nuclear Information System (INIS)

    Platelet deposition at the site of injury caused by balloon angioplasty is associated with acute closure and restenosis. In a new ex vivo whole artery angioplasty model, the authors examined the roles of thrombin inhibition with D-Phe-Pro-ArgCH2Cl (PPACK) and inhibition of the platelet membrane fibrinogen receptor glycoprotein IIb/IIIa (GPIIb/IIIa) with monoclonal antibody 7E3 on platelet deposition at the site of balloon injury. Fresh rabbit aortas were mounted in a perfusion chamber. One half of the mounted arterial segment was dilated with a standard angioplasty balloon catheter and the uninjured half served as the control segment. The vessels were perfused with human blood at physiological pressure and shear rates of 180-250 second-1 for 30 minutes. Platelet deposition was measured using 111In-labeled platelets and scanning electron microscopy. With heparin (2 units/ml) anticoagulation, 8.2 ± 2.2 x 10(6) platelets/cm2 were deposited at the site of balloon injury compared with 0.7 ± 0.2 x 10(6) platelets/cm2 on uninjured segments (p less than 0.02, n = 7). PPACK was tested at a concentration (10 microM) that totally inhibited platelet aggregation in response to thrombin. 7E3 was tested at a concentration (10 micrograms/ml) that totally inhibited platelet aggregation. Platelet deposition at the site of balloon injury was reduced 47% by PPACK and 70% by 7E3 compared with heparin. At shear rates seen in nonstenotic coronary arteries, PPACK and 7E3 are more effective than heparin in reducing platelet deposition at the site of balloon injury. The significant inhibition of platelet deposition by PPACK demonstrates the importance of heparin-resistant thrombin in platelet thrombus formation

  10. Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results

    International Nuclear Information System (INIS)

    The purpose was to evaluate the effect of percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) on the blood oxygenation level-dependent (BOLD) signal change in the calf musculature of patients with intermittent claudication. Ten patients (mean age, 63.4 ± 11.6 years) with symptomatic peripheral arterial occlusive disease (PAOD) caused by SFA stenoses were investigated before and after PTA. Patients underwent BOLD-MRI 1 day before and 6 weeks after PTA. A T2*-weighted single-shot multi-echo echo-planar MR-imaging technique was applied. The BOLD measurements were acquired at mid-calf level during reactive hyperaemia at 1.5 T. This transient hyperperfusion of the muscle tissue was provoked by suprasystolic cuff compression. Key parameters describing the BOLD signal curve included maximum T2*(T2*max), time-to-peak to reach T2*max (TTP) and T2* end value (EV) after 600 s of hyperemia. Paired t-tests were applied for statistic comparison. Between baseline and post-PTA, T2*max increased from 11.1±3.6% to 12.3±3.8% (p=0.51), TTP decreased from 48.5±20.8 s to 35.3±11.6 s (p=0.11) and EV decreased from 6.1±6.4% to 5.0±4.2% (p=0.69). In conclusion, BOLD-MRI reveals changes of the key parameters T2*max, TTP, and EV after successful PTA of the calf muscles during reactive hyperaemia. (orig.)

  11. Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, Rolf W. [University Hospital Basel, Department of Radiology, Division of Interventional Radiology, Basel (Switzerland)]|[Kantonsspital Bruderholz, Department of Radiology, Bruderholz (Switzerland); Schulte, Anja-Carina [University of Basel, Biocenter, Basel (Switzerland); Aschwanden, Markus; Thalhammer, Christoph [University Hospital Basel, Department of Angiology, Basel (Switzerland); Kos, Sebastian; Jacob, Augustinus L.; Bilecen, Deniz [University Hospital Basel, Department of Radiology, Division of Interventional Radiology, Basel (Switzerland)

    2009-02-15

    The purpose was to evaluate the effect of percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) on the blood oxygenation level-dependent (BOLD) signal change in the calf musculature of patients with intermittent claudication. Ten patients (mean age, 63.4 {+-} 11.6 years) with symptomatic peripheral arterial occlusive disease (PAOD) caused by SFA stenoses were investigated before and after PTA. Patients underwent BOLD-MRI 1 day before and 6 weeks after PTA. A T2*-weighted single-shot multi-echo echo-planar MR-imaging technique was applied. The BOLD measurements were acquired at mid-calf level during reactive hyperaemia at 1.5 T. This transient hyperperfusion of the muscle tissue was provoked by suprasystolic cuff compression. Key parameters describing the BOLD signal curve included maximum T2*(T2*{sub max}), time-to-peak to reach T2*{sub max} (TTP) and T2* end value (EV) after 600 s of hyperemia. Paired t-tests were applied for statistic comparison. Between baseline and post-PTA, T2*{sub max} increased from 11.1{+-}3.6% to 12.3{+-}3.8% (p=0.51), TTP decreased from 48.5{+-}20.8 s to 35.3{+-}11.6 s (p=0.11) and EV decreased from 6.1{+-}6.4% to 5.0{+-}4.2% (p=0.69). In conclusion, BOLD-MRI reveals changes of the key parameters T2*{sub max}, TTP, and EV after successful PTA of the calf muscles during reactive hyperaemia. (orig.)

  12. Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kuhan, Ganesh, E-mail: gkuhan@nhs.net; Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R. [Nottingham University Hospitals, Vascular and Endovascular Unit, Queens Medical Centre (United Kingdom); Whitaker, Simon C.; Habib, Said B. [Nottingham University Hospitals, Department of Radiology, Queen' s Medical Centre (United Kingdom)

    2012-10-15

    Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

  13. Renal dynamic imaging for the treatment assessment of renal artery angioplasty and stenting in patients with atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To investigate the value of renal dynamic imaging with 99Tcm-DTPA on the evaluation and prediction of the outcome after percutaneous transluminal renal artery angioplasty and stenting (PTRAS) in patients with atherosclerotic renal artery stenosis (ARAS). Methods: Seventy-six patients with unilateral ARAS underwent PTRAS successfully. All the patients received baseline renal dynamic imaging within 2 weeks before the surgery and follow-up imaging 6 months after PTRAS. GFR (per 1.73 m2 of body surface area) of kidney with ARAS was measured with the Gates method. ARAS was classified as mild (50%-69%),moderate (70%-89%), and severe (≥90%) stenosis according to the results of renoarteriography before the surgery. GFR was graded as Ⅰ (GFR≥30 ml · min-1), Ⅱ (15 ml · min-1 ≤GFR <30 ml · min-1) and Ⅲ (GFR < 15 ml · min-1), on the baseline dynamic imaging.Blood pressure was also measured before and after the surgery. The t test, χ2 test, Fisher exact test and multiple logistic regression analysis were used for statistical analysis with SPSS 13.0. Results: The baseline GFR of kidney with mild and moderate ARAS was significant higher than that with severe stenosis ((26.79 ± 15.34) vs (19.48 ±11.56) ml · min-1, t=2.262, P=0.027). The blood pressure was improved in 32% (24/75), and not changed in 68% (51/75) of patients.Improvement of blood pressure was observed in 39.62% (21/53) of patients with a baseline GFR≥ 15 ml · min-1, and in 13.64% (3/22) of patients with a baseline GFR <15 ml · min-1 (χ2=4.825, P=0.028). Using multivariate analysis, baseline GFR ≥ 15 ml · min-1 was the only predictor of blood pressure improvement (OR=0.465, P=0.032). GFR in kidney with ARAS was improved in 22.37% (17/76), stable in 68.42% (52/76), and worse in 9.21% (7/76) of patients. The 33.33% (8/24) and 17.65% (9/51) of patients with and without blood pressure improvement, respectively, achieved GFR improvement. However, the difference was not statistically

  14. Early and long-term outcome of elective stenting of the infarct-related artery in patients with viability in the infarct-area: Rationale and design of the Viability-guided Angioplasty after acute Myocardial Infarction-trial (The VIAMI-trial

    Directory of Open Access Journals (Sweden)

    Visser Cees A

    2004-11-01

    Full Text Available Abstract Background Although percutaneous coronary intervention (PCI is becoming the standard therapy in ST-segment elevation myocardial infarction (STEMI, to date most patients, even in developed countries, are reperfused with intravenous thrombolysis or do not receive a reperfusion therapy at all. In the post-lysis period these patients are at high risk for recurrent ischemic events. Early identification of these patients is mandatory as this subgroup could possibly benefit from an angioplasty of the infarct-related artery. Since viability seems to be related to ischemic adverse events, we initiated a clinical trial to investigate the benefits of PCI with stenting of the infarct-related artery in patients with viability detected early after acute myocardial infarction. Methods The VIAMI-study is designed as a prospective, multicenter, randomized, controlled clinical trial. Patients who are hospitalized with an acute myocardial infarction and who did not have primary or rescue PCI, undergo viability testing by low-dose dobutamine echocardiography (LDDE within 3 days of admission. Consequently, patients with demonstrated viability are randomized to an invasive or conservative strategy. In the invasive strategy patients undergo coronary angiography with the intention to perform PCI with stenting of the infarct-related coronary artery and concomitant use of abciximab. In the conservative group an ischemia-guided approach is adopted (standard optimal care. The primary end point is the composite of death from any cause, reinfarction and unstable angina during a follow-up period of three years. Conclusion The primary objective of the VIAMI-trial is to demonstrate that angioplasty of the infarct-related coronary artery with stenting and concomitant use of abciximab results in a clinically important risk reduction of future cardiac events in patients with viability in the infarct-area, detected early after myocardial infarction.

  15. Comparison of healing of ischaemic diabetic foot ulcers after stem cell therapy or percutaneous transluminal angioplasty

    Czech Academy of Sciences Publication Activity Database

    Dubský, M.; Jirkovská, A.; Bém, R.; Pagacová, L.; Fejfarová, V.; Skibová, J.; Varga, M.; Syková, Eva

    2010-01-01

    Roč. 53, Suppl.1 (2010), S57-S57. ISSN 0012-186X. [Annual Meeting of the European Association for the Study of Diabetes (EASD) /46./. 22.09.2010-24.09.2010, Stockholm] Institutional research plan: CEZ:AV0Z50390703 Keywords : diabetes * EASD Subject RIV: FH - Neurology

  16. Vascular responses to endovascular irradiation of 188Re in the rabbit model after angioplasty

    International Nuclear Information System (INIS)

    The effects on vascular restenosis of intravascular radiation delivery from 188Rhenium (Re)-perrhenate liquid-filled balloon through beta-particle radiation are controversial. To determine the effect of beta-radiation on vascular injury in hypercholesterolemic rabbits, thirty rabbits fed with a high cholesterol diet were enrolled into this study. All the rabbits underwent percutaneous transluminal balloon overstretch over left iliac artery. After balloon overstretch, the catheter was withdrawn and immediately followed by irradiation using low dose 188Re solution (10 Gray) in the vascular wall 0.5 mm distal to intimal surface. After 2 and 6 weeks, arteries were harvested for histological and immunological analysis. This rabbit study suggest that endovascular 188Re low dose irradiation at the non-injury segment of iliac artery may enhance intima hyperplasia and smooth muscle cell proliferation. (author)

  17. Time-to-treatment and infarct size in STEMI patients undergoing primary angioplasty.

    OpenAIRE

    De Luca, G.; Parodi, G.; R. Sciagrà; F. Venditti; B. Bellandi; Vergara, R.; A. Migliorini; Valenti, R.; ANTONIUCCI D

    2012-01-01

    Several reports have shown that in patient with ST-segment elevation acute myocardial infarction (STEMI) longer ischemia time is associated with impaired reperfusion and higher mortality. However, there is still some doubts with regards time to reperfusion role in patients treated with primary percutaneous coronary intervention (PCI). Therefore, the aim of the current study was to evaluate the impact of time-to-treatment on infarct size as evaluated by myocardial scintigraphy in a large cohor...

  18. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium- to Long-term Follow-up

    Science.gov (United States)

    He, Lan; Liu, Fang; Wu, Lin; Qi, Chun-Hua; Zhang, Li-Feng; Huang, Guo-Ying

    2015-01-01

    Background: Although balloon angioplasty (BA) has been performed for more than 20 years, its use as a treatment for native coarctation of the aorta (CoA) during childhood, especially in young infants, remains controversial. This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants. Methods: The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA. Patient's weight ranged from 2.4 to 6.1 kg. All 37 patients were experiencing cardiac dysfunction, and eight patients were in cardiac shock with severe metabolic acidosis. Eleven patients had an isolated CoA, whereas the others had a CoA associated with other cardiac malformations. Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation. Transfemoral arterial approaches were used for the BA. The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm, and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter. Results: The femoral artery was successfully punctured in all but one patient, with that patient undergoing a carotid artery puncture. The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13–76 mmHg). The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5–2.8 mm). All patients had successful dilation; the PG significantly decreased to 13.0 ± 11.0 mmHg (range 0–40 mmHg), and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5–5.3 mm). No intraoperative complications occurred for any patients. However, in one case that underwent a carotid artery puncture, a giant aneurysm formed at the puncture site and required surgical repair. The following observations were made during the follow-up period from 6-month to 7-year: (1) The PG across the

  19. Percutaneous Balloon Angioplasty for Severe Native Aortic Coarctation in Young Infants Less Than 6 Months: Medium-to Long-term Follow-up

    Institute of Scientific and Technical Information of China (English)

    Lan He; Fang Liu; Lin Wu; Chun-Hua Qi; Li-Feng Zhang; Guo-Ying Huang

    2015-01-01

    Background:Although balloon angioplasty (BA) has been performed for more than 20 years,its use as a treatment for native coarctation of the aorta (CoA) during childhood,especially in young infants,remains controversial.This study aimed to assess the effects and potential role of percutaneous transcatheter BA for native CoA as an alternative therapy to surgical repair in young infants.Methods:The 37 patients aged from 6 days to 6 months with severe CoA in congestive heart failure or circulatory shock were admitted for BA.Patient's weight ranged from 2.4 to 6.1 kg.All 37 patients were experiencing cardiac dysfunction,and eight patients were in cardiac shock with severe metabolic acidosis.Eleven patients had an isolated CoA,whereas the others had a CoA associated with other cardiac malformations.Cardiac catheterization and aortic angiography were performed under general anesthesia with intubation.Transfemoral arterial approaches were used for the BA.The size of the balloon ranged from 3 mm × 20 mm to 8 mm × 20 mm,and a coronary artery balloon catheter was preferred over a regular peripheral vascular balloon catheter.Results:The femoral artery was successfully punctured in all but one patient,with that patient undergoing a carotid artery puncture.The systolic peak pressure gradient (PG) across the coarctation was 41.0 ± 16.0 mmHg (range 13-76 mmHg).The mean diameter of the narrowest coarctation site was 1.7 ± 0.6 mm (range 0.5-2.8 mm).All patients had successful dilation;the PG significantly decreased to 13.0 ± 1 1.0 mmHg (range 0-40 mmHg),and the diameter of coarctation significantly improved to 3.8 ± 0.9 mm (range 2.5-5.3 mm).No intraoperative complications occurred for any patients.However,in one case that underwent a carotid artery puncture,a giant aneurysm formed at the puncture site and required surgical repair.The following observations were made during the follow-up period from 6-month to 7-year:(1) The PG across the coarctation measured by

  20. Balloon Angioplasty and Drug Eluting Stenting for Treatment of Peripheral Arterial Occlusive Disease

    Directory of Open Access Journals (Sweden)

    Akın İzgi

    2010-08-01

    Full Text Available Peripheral arterial disease is one of the manifestations of systemic atherosclerosis. In the last decade, remarkable technological advances, especially in the stent area, have shifted revascularization strategies from traditional open surgical approaches toward less morbide percutaneous endovascular treatments. However, even with new designed nitinol bare stents, restenosis remains as the major obstacle of this procedures. More recently, drug eluting stent platforms have been used to treat atherosclerotic peripheral arterial disease. In this article, we reviewed new studies relevant to drug eluting stents for lower extremity peripheral arterial occlusive disease.

  1. Preparation and characterisation of polyamide 11/montmorillonite (MMT) nanocomposites for use in angioplasty balloon applications

    Energy Technology Data Exchange (ETDEWEB)

    Halim, Khairul Anwar A. [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland); School of Materials Engineering, Universiti Malaysia Perlis, Perlis (Malaysia); Farrell, Joseph B. [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland); Kennedy, James E., E-mail: jkennedy@ait.ie [Department of Polymer Engineering, Athlone Institute of Technology, Athlone (Ireland)

    2013-12-16

    With increased demands on catheter balloon functionality, there is an emphasis to blend new materials which can improve mechanical performance. Polymer nanocomposites were prepared by melt blending polyamide 11 (PA 11) with organically modified montmorillonite nanoclay. The effects of incorporating the nanoclay on the short-term mechanical properties of PA 11 were assessed using a design of experiments (DoEs) approach. X-ray diffraction (XRD), transmission electron microscopy (TEM), differential scanning calorimetry (DSC) and dynamic mechanical thermal analysis techniques (DMA) were used to characterise the morphology of the nanocomposites. Design of experiments studies revealed that the optimum nanocomposites properties can be achieved by carefully controlling the melt compounding parameters. XRD and TEM data proved that exfoliated clay morphologies existed within the matrix at low clay loading (2%). Whereas the interaction between the polymer matrix and nanoclay was quantified in the DMA spectra, showed a significant increase in storage modulus (up to 80%). The reinforcing effect of nanoclay within the PA 11 was further investigated using mechanical testing, where significant increases in the ultimate tensile strength and strain at break of reinforced tri-layer balloon tubing were observed. - Highlights: • TEM reveals the coexistence of exfoliated and intercalated nanostructures. • Isothermal crystallisation studies found that the nano-clays reduced the crystallisation time. • Significant increase in the storage modulus was due to the reinforcing effect of the nano-clay platelets. • It was observed that the activation energy values decreased due to the presence of nanoclay.

  2. Risk Factors of Reperfusion Failure following Primary Angioplasty for ST-Segment Elevation Myocardial Infarction (STEMI

    Directory of Open Access Journals (Sweden)

    HamidReza Sanati

    2015-10-01

    Full Text Available Background: Although  percutaneous  coronary  intervention  (PCI  improves  outcomes  compared  to  thrombolysis,  a substantial number of ST-elevation myocardial infarction (STEMI patients do not achieve optimal myocardial reperfusion. This study was designed to evaluate factors related to suboptimal myocardial reperfusion after primary PCI in patients with STEMI.Methods: Totally, 155 patients (124 men; mean age = 56.6 ± 11.03 years, range = 31- 85 years with STEMI undergoing primary PCI were retrospectively studied. Additionally, the relationships between the occurrence of reperfusion failure and variables such as age, sex, cardiac risk factors, family history, Body Mass Index, time of symptom onset, ejection fraction, previous PCI, coronary artery bypass graft surgery or previous myocardial infarction, and angiographic data were analyzed. Results: Procedural success was 97.1% and complete ST resolution occurred in 43.2%. Age; cardiac risk factors; family history; body mass index; previous MI, coronary artery bypass graft surgery, or PCI; and use of thrombectomy device and GPIIb/IIIa inhibitor were not the determining factors (p value > 0.05. According to our multivariate analysis, time of symptom onset (OR [95% CI]: 045 [0.2 to 0.98]; p value = 0.044 and ejection fraction (OR [95% CI]:0.37 [0.26 to .091]; p value = 0.050 had reverse and male gender had direct significant associations with failed reperfusion (OR [95%CI]:0.34 [0.11 to 1.08]; p value = 0.068. More degrees of ST resolution occurred when the right coronary artery was the culpritvessel (p value = 0.001. The presence of more than three cardiac risk factors was associated with failed reperfusion (p value= 0.050.Conclusion: Considering the initial risk profile of patients with acute STEMI, including time of symptom onset and ejection fraction, as well as the accumulation of cardiac risk factors in a given patient, we could predict failed myocardial reperfusion to design a

  3. Radiation dosimetry in patients and physicians during percutaneous coronary angioplasty in Recife, Pernambuco, Brazil

    International Nuclear Information System (INIS)

    Objective: The present study was aimed at estimating the values of radiation doses received by physicians and patients during interventional cardiology procedures performed at a public hospital in the city of Recife, Pernambuco, Brazil. Materials and Methods: Measurements were made in two cardiologists with more than ten years of experience and in 31 adult patients, with 22 of them being clinically followed-up after the procedure. The individual irradiation parameters were documented. Results: The values for maximum patients skin dose ranged between 612 and 8,642 mGy, achieving more than 2,000 mGy in 53% of the patients; such dose values may cause deterministic effects. As regards the physicians, the mean effective dose per procedure was 11 μSv, and the highest mean equivalent doses in the limbs were 923 μSv in the left foot, 514 μSv in the right foot, 382 μSv in the left hand, and 150 μSv in the left eye. Depending on the number of procedures, the doses received by the physician may exceed the dose limits established by the Brazilian and international standards. Conclusion: The obtained results indicate the necessity of adopting strategies for optimizing the radiological protection for both patients and physicians. (author)

  4. Dosimetric fundamentals of endovascular brachytherapy using Re-188 to prevent restenosis after angioplasty

    International Nuclear Information System (INIS)

    Various radionuclides can be used for endovascular brachytherapy. A new concept is to inflate the balloon of a dilitation catheter with a radioactive solution. Re-188 can be eluated from a generator system and is available daily. The aim of this study was to obtain dosimetric data for this radionuclide. The dose decrease of Re-188 was calculated and measured with a TLD-system radial to a balloon catheter typically used in cardiology (diameter: 3 mm, length: 20 mm). Using a specific acitivity of 370 MBq/ml a dose of 0,3 Gy could be achieved within 1 min in a TLD in contact with the balloon. Paired TLDs differed about 3%. A fast dose reduction of 50% and 10% were stated within 0.5 mm and 2.5 mm, respectively. Calculated and measured values were in good agreement. The data are comparable to those known for Y-90. Calculations of dose distribution are consistent with TLD measurements of Re-188. Using a specific activity of 1.85 GBq/ml, a dose of 10-15 Gy at the coronary artery wall can be achieved within 2-3 min. (orig./MG)

  5. When is rotational angiography superior to conventional single‐plane angiography for planning coronary angioplasty?

    Science.gov (United States)

    Taylor, Jane; Boutong, Sara; Brett, Sarah; Louis, Amal; Heppenstall, James; Morton, Allison C.; Gunn, Julian P.

    2015-01-01

    Objectives To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning. Background As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three‐dimensional anatomy. However, its value in PCI remains unknown. Methods We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre‐PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters. Results Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed‐over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P RoCA improved confidence assessing lesion length (P = 0.01), percentage stenosis (P = 0.02), tortuosity (P RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X‐ray dose, contrast agent volume, or procedure duration. © 2015 Wiley Periodicals, Inc. PMID:26012725

  6. [Clopidogrel versus prasugrel in acute coronary syndrome treated with coronary angioplasty].

    Science.gov (United States)

    Lalor, Nicolas; Rodríguez, Leandro; Elissamburu, Pablo; Filipini, Eduardo; Conde, Diego; Nau, Gerardo; Cura, Fernando; Trivi, Marcelo

    2015-01-01

    Greater antithrombotic potency new antiplatelet agents have been added such as prasugrel (PR) and ticagrelor to the traditional use of clopidogrel (CL) in the treatment of acute coronary syndrome (ACS). This study was aimed at comparing the incidence of long term ischemic and hemorrhagic events in patients treated with CL or PR during hospitalization. Retrospective ACS data base analysis performed by our cardiology service was completed prospectively. There were consecutively included all patients with percutaneous coronary intervention (PCI) during hospitalization due to ACS from December 2011 thru December 2012. A total of 398 ACS patients who underwent PCI with stent implantation were recruited. No differences in cardiovascular related deaths were observed in both groups (PR 2.9% vs. CL 2.5%, p=0.48). PR group showed less re-infraction (1.9% vs. 6.8%, p=0.01) with more total bleedings (18.5% vs. 8.5%, p=0.001) and minor bleedings (12.4% vs. 3.4%, p<0.001) with no differences in major and life threatening bleedings (p=ns). Multivariate analysis showed that independent predictors of cardiovascular mortality were age (OR 1.08, CI 95% 1.02-1.16) and renal failure (OR 6.98, CI 95% 1.23-39.71). Independent predictors for total bleeding were age (OR 1.06, CI 95% 1.02-1.09),ST segment elevation myocardial infarction (OR 1.99, CI 95% 1.05-3.79), renal failure (OR 3.32, CI 95% 1.62-6.78) and prasugrel use (OR 3.97, CI 95% 1.87-8.41). Use of prasugrel, in the ACS that requires PCI with stent, is associated with a lower myocardial infarction a year after follow-up, and it also leads to an increase of milder hemorrhage. No significant differences were observed in the cardiovascular mortality of both groups. PMID:26339874

  7. Study on the dynamic change of endothelin and the effect of treatment by captopril in the development of stenosis of aorta after balloon injury in rabbits

    International Nuclear Information System (INIS)

    Objective: To study the dynamic change of endothelin (ET) in the blood, the pathological change, and the ET-IR (ET-immunoreaction, ET-IR) in the development of stenosis after balloon injury of rabbit aorta, and to investigate the effect of captopril on the prevention of restenosis after transluminal angioplasty. Methods: According to the different time of being killed after micro-balloon angioplasty, 48 rabbits were divided randomly into 6 groups such as 6-hour group, 1-day group, 3-day group, 7-day group, 15-day group, and 22-day group. 6 out of 8 rabbits of each group were created models of aortic endothelium injury by micro-balloon angioplasty, and 3 of them were given captopril (2 mg·kg-1·d-1 p. o.) from 1 day before balloon injury to the day being killed. The rest 2 rabbits in each group were controls. ET level in the plasma was measured by ELISA before, as well as after micro-balloon angioplasty, and pathomorphological examination of local aorta was carried out to observe the intimal thickness and the extent of lumen stenosis, and ET-IR was assessed by immunohistochemical technique in the aortic wall. Results: (1) The major change of vascular stenosis was the proliferation of vascular smooth muscle cell (VSMC) and endothelium. (2) ET levels in the plasma and ET-IR in the local aortic wall were significantly increased after micro-balloon angioplasty. (3) The intimal thickness and extent of lumen stenosis in the group of medical treatment by captopril were significantly lower than those in injury group. Conclusions: The experimental results show that the major pathologic change of vascular stenosis is the significant proliferation of VSMC and endothelium. Further more, ET is a key factor in the development of vascular stenosis, and captopril can prevent restenosis after angioplasty. (author)

  8. Budd-Chiari and inferior caval vein syndromes due to membranous obstruction of the liver veins. Successful treatment with angioplasty and transcaval TIPS

    DEFF Research Database (Denmark)

    Holland-Fischer, Peter

    2004-01-01

    The case is presented of a 25-year-old Caucasian patient with Budd-Chiari syndrome due to membranous obstruction of the liver veins and inferior caval vein syndrome as a result of secondary hyperplasia of the caudate lobe of the liver, obstructing the caval vein. Diagnosis was established by...... intravascular pressure measurements, ultrasound examinations and caval and liver vein angiograms. Treatment consisting of stent placement in the outlet of a hepatic vein and subsequent transjugular intrahepatic porto-systemic shunt (TIPS) insertion via the caval vein was successful. After 34 months of follow......-up the stents remain open and the patient is symptom free. This successful combination of stent placement and TIPS has not been described before. The case report is followed by a review of the literature on the use of angioplasty in short hepatic vein stenosis and TIPS in Budd-Chiari syndrome. It is...

  9. Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans

    International Nuclear Information System (INIS)

    To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001)

  10. Coronary Angioplasty Stent Placement

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    Full Text Available ... symptoms one may get. And you can see -- let me go to the next slide. Symptoms of coronary artery ... take a suction catheter, very tiny catheter, and go out and suction out the clot, ... handed some more questions. Let’s see here. Dr. Mukhari, there’s a question that ...

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    Full Text Available ... But there is clearly a huge body of data that shows that tobacco use is associated with ... medicated stents. I hear they’re bad.” The data that has come out since then has showed ...

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    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly premature atherosclerosis particularly in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ...

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    Full Text Available ... Smoking is a huge risk factor in the development of heart disease, as well as problems with ... very large diameter artery and a very short local lesion, you can often get by with putting ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... and very difficult to get to the target lesion. Now with the stents being as flexible as they are, we can pretty much get to anywhere we want. The issue of the bare metal stent versus the drug-coated stents is an ongoing debate. And I ...

  15. Coronary Angioplasty Stent Placement

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    Full Text Available ... the equipment that we use from the early days has undergone a sea change. The catheters that ... the stent design has improved from the early days when they were very difficult to deploy and ...

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    Full Text Available ... control rooming doing she is doing in the dark. And with that, I’ll turn it back ... the patient wanting to do? Is it a matter of keeping the patient comfortable walking from the ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... times we use other techniques such as intravascular ultrasound, where we take the same guide wire and pass a little tiny ultrasound catheter down where we can actually look at ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... rebroadcast of 6:30 p.m. Central Standard time today, and you’ll have an opportunity to ... because we have a saying in cardiology where time is muscle, and the quicker you can get ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... that need to be administered in monitoring his vital signs. And 1 Stephanie, in the back, in the ... in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ...

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    Full Text Available ... that this last stress test was a false positive one, and we’ll keep that in mind. But we’ll certainly keep an eye on this gentleman long-term to make certain that he does well. Oh, I think we’ll about out of time, and we’ ...

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    Full Text Available ... so. I think the main vascular and the life threatening, immediate life threatening causes of chest pain I think have ... done. And once we commit people to a life-long therapy with very potent blood thinners, that ...

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    Full Text Available ... hopefully prevent them, and the different techniques we use to open up blockages and improve coronary blood ... huge body of data that shows that tobacco use is associated with accelerated hardening of the arteries. ...

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    Full Text Available ... in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ... medical care. “OR-Live,” the vision of improving health. 10

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    Full Text Available ... OR-Live” makes it easy for you to learn more, just click on the “Request information” button on your webcast screen and open the door to informed medical care. “OR-Live,” ...

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    Full Text Available ... area. So your doctor may have some specific recommendations regarding not squatting, lifting, certainly walking and those ... do is everybody everything we can medically with diet. Often statin therapy, particularly if their cholesterol levels ...

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    Full Text Available ... tests that we can do to evaluate the source of his chest pain. There is certainly a ... cause a clot to form, which is a source of heart attacks. So while a significant number ...

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    Full Text Available ... of his chest pain. There is certainly a number of causes of chest pain other than cardiac, ... source of heart attacks. So while a significant number of heart attacks occur with hemodynamically, or flow- ...

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    Full Text Available ... lower level of frequency. He came into the hospital when his symptoms got worse. He had a ... all patients die before they present to the hospital. So their first knowledge that they have heart ...

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    Full Text Available ... Mukhari will take a variety of different angled shots to look at all the vessels. We have ... you now just having looked at the initial shots, the left main is clean and I see ...

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    Full Text Available ... such as non-cue wave heart attacks and myocardial infarctions, I think they need to be intervened upon. There is no question about that. People who have having an acute heart attack there is absolutely no question they ...

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    Full Text Available ... have accessed the femoral artery, which is the big blood vessel in the leg, through which we ... But there is clearly a huge body of data that shows that tobacco use is associated with ...

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    Full Text Available ... the vision of improving health. Hello and welcome. We’re coming to you live from the state- ... coronary artery disease, how blockage is performed, how we treat them, hopefully prevent them, and the different ...

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    Full Text Available ... host for today’s program. Joining me at the patient’s side is my colleague and friend of many ... Thank you, Jay, and welcome. We have our patient, who has very graciously and kindly consented to ...

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    Full Text Available ... you can see it on the monitor at your end, but what we see here is that the main pumping ... turn your head over this way. Look to your right. During the course of this procedure, what you’ll see is the camera moves, and ...

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    Full Text Available ... and suction out the clot, and that helps open up the vessel. I think we’ve been ... The balloons and wires that we use to open the blockages up, they have become much more ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... procedure. We use a diamond encrusted burr, you drill out the calcium, and then you may go ... another surgical procedures, then we’re in a bit of a dilemma, and we have to take ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... to open up blockages and improve coronary blood flow. You’ll have the opportunity to witness live ... or blockages that are formed that reduce blood flow. Coronary artery disease by-and-large is defined ...

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    Full Text Available ... LDL cholesterol, in excess certainly of 100, 130, should be treated. Depending on the range, and you ... pain in the chest, and all those things should be investigated in due course. Very good. I ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... of the next hour you will learn about coronary artery disease, how blockage is performed, how we treat them, ... chest pain. Obviously, as cardiologists our concern is coronary artery disease or blockages that are formed that reduce blood ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing we can do, but often the most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. ...

  2. Coronary Angioplasty Stent Placement

    Science.gov (United States)

    ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... putting in a bare metal stent. The whole theory behind that is you have a lesser chance ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... putting in a bare metal stent. The whole theory behind that is you have a lesser chance ...

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    Full Text Available ... we call a “dominant right coronary artery,” giving rise to multiple branches downstream, and there is an ... diet. Often statin therapy, particularly if their cholesterol levels or triglyceride levels are high, we’ll talk ...

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    Full Text Available ... most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. Probably ... Secondly is smoking. Smoking is a huge risk factor in the development of heart disease, as well ...

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    Full Text Available ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... Thank you for watching this “OR-Live” webcast presentation from Shawnee Mission Medical Center in Merriam, Kansas. “ ...

  7. Coronary Angioplasty Stent Placement

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    Full Text Available ... to witness live a cardiac catheterization with possible intervention during this procedure. During this webcast you’ll ... t know yet if there will be any intervention necessary. But I can tell you right now, ...

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... Month, and we’re particularly focusing on women’s heart disease. And I think it’s very, very important that ... that women not be ignored, because women have heart disease to the same extent as men, and it’s ...

  9. Coronary Angioplasty Stent Placement

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    Full Text Available ... Shawnee Mission, Kansas February 19, 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee ... live a cardiac catheterization with possible intervention during this procedure. During this webcast you’ll have the ...

  10. Coronary Angioplasty Stent Placement

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    Full Text Available ... side is my colleague and friend of many years, Dr. Jhalan Mukhari. Dr. Mukhari is also a ... brief clinical pieces of information. He’s an 80-year-old gentleman who has been having ongoing chest ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... coronary artery. Take in a breath, sir, and hold your breath. And the first picture seems to ... patient. Take in a deep breath, sir, and hold it. Jay, it’s certainly a very large vessel. ...

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    Full Text Available ... Jay, and welcome. We have our patient, who has very graciously and kindly consented to participate in ... information. He’s an 80-year-old gentleman who has been having ongoing chest discomfort for the past ...

  13. Coronary Angioplasty Stent Placement

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    Full Text Available ... the patient wanting to do? Is it a matter of keeping the patient comfortable walking from the ... Plavix, 75 milligrams daily?“ It probably doesn’t matter. It can be taken any time, very important. ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... pain is cardiac. There’s a variety of different causes of chest pain. Obviously, as cardiologists our concern ... chest pain. There is certainly a number of causes of chest pain other than cardiac, but the ...

  15. Coronary Angioplasty Stent Placement

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    Full Text Available ... from the heart, and then there are other issues as well. It 5 could be a pinched ... prevents these stents from clotting off. The real issue between a bare metal stent and a drug- ...

  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... range, and you can talk with your family physician or your cardiologist, when this needs to be ... little blood seeping around that area. So your doctor may have some specific recommendations regarding not squatting, ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... Jackson. I’m a board certified cardiologist and staff member at the Shawnee Mission Medical Center. I ... be performing today’s procedure. He too is a staff member of Shawnee Mission’s Medical Center’s Heart and ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... putting in a bare metal stent. The whole theory behind that is you have a lesser chance ... a stress test in a year, with the knowledge that this last stress test was a false ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... a big artery, a bare metal stent will work, a smaller artery or in some of the ... the equipment that we use from the early days has undergone a sea change. The catheters that ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... of any flow-limiting blockages in the blood vessels that emanate from the left coronary system. And now we have threaded a catheter over to the blood vessel on the right side and engaged the right ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... reduce blood flow. Coronary artery disease by-and-large is defined as a greater than 70 percent ... the back wall, and this is a very large vessel in this gentleman. It goes way along ...

  2. Coronary Angioplasty Stent Placement

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    Full Text Available ... have accessed the femoral artery, which is the big blood vessel in the leg, through which we ... getting to the point where if it’s a big artery, a bare metal stent will work, a ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... they present to the hospital. So their first knowledge that they have heart disease is in the ... a stress test in a year, with the knowledge that this last stress test was a false ...

  4. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart. This could involve any one of the three major arteries. What you will be seeing here ... here, Jay, and now we’ll doing a -- 3 Take another angle to look at that. Take ...

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    Full Text Available ... flow limiting and doesn’t seem to be something that would be causing this gentleman’s symptoms, which ... to make certain that we’re not missing something else, so the heart function is normal, good ...

  6. Coronary Angioplasty Stent Placement

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    Full Text Available ... looking at the left system, then he will exchange catheters and he will go to the right ... anymore, because there has been a fairly highly rate of re-narrowing of these vessels. 7 Same ...

  7. Coronary Angioplasty Stent Placement

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    Full Text Available ... not to just ignore any kind of symptoms. Diabetics, in particular, are a subclass of patients who ... vessel disease or multiple vessel blockages, or a diabetic, we think that the drug-eluting stents are ...

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... at the initial shots, the left main is clean and I see no elements of any blockages ... contractility of the pump, arteries really look pretty clean with the exception of that downstream area in ...

  9. Coronary Angioplasty Stent Placement

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    Full Text Available ... against the wall, but what happens is scar tissue forms, so it’s literally scarring in there. That ... secreted from the metal stent and prevents scar tissue from forming. So at one time it was ...

  10. Coronary Angioplasty Stent Placement

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    Full Text Available ... the arteries. Diabetes Mellitus is a very serious cause of particularly premature atherosclerosis particularly in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ...

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    Full Text Available ... cardiovascular disease, in honor of American Heart Month. I’m Dr. Jay Jackson. I’m a board certified cardiologist and staff member at the Shawnee Mission Medical Center. I will be your host for today’s program. Joining ...

  12. Coronary Angioplasty Stent Placement

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    Full Text Available ... I think one can safely say that the equipment that we use from the early days has ... ve gone through a fairly comprehensive list of equipment that we have used historically in dealing with ...

  13. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... to be go ahead and take patients into surgery and operate on them with blood thinning medicines ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Hello and welcome. We’re ... door to informed medical care. “OR-Live,” the vision of improving health. 10

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    Full Text Available ... people in, because we have a saying in cardiology where time is muscle, and the quicker you ... us who have practiced the medicine or practiced cardiology from the standpoint of patient-centric view is ...

  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... the most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. ... heritage. Secondly is smoking. Smoking is a huge risk factor in the development of heart disease, as ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... a stress test in a year, with the knowledge that this last stress test was a false ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... discomfort in this gentlemen, which might take some time but are not going to be quite as ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... lower drug level, but it actually reduces the risk of cardiac events. So we’ll want to do everything with this gentleman to prevent that from happening. In absence of symptoms, we may want to repeat some kind of a stress test in a year, with the knowledge that this last stress test was a false ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... long-term,” that has changed as a moving target. But at one point it was a year. ... deploy and very difficult to get to the target lesion. Now with the stents being as flexible ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... there is a role in this day and age area for coronary bypass surgery. 8 So what ... patient. We need to come back to how old the patient is, what the other comorbidities are, ...

  2. Coronary Angioplasty Stent Placement

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    Full Text Available ... care of the intravenous medications and any other medicines that need to be administered in monitoring his ... surgery and operate on them with blood thinning medicines onboard. And one has to deal with the ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... put in, versus medicated or what’s known as drug-eluding stents. And there has been a lot ... Both bare metal stents and medicated stents, or drug-eluting stents, have their role, and we often ...

  4. Coronary Angioplasty Stent Placement

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    Full Text Available ... right now, looking at these images, the left side looks perfect, so that’s good news. This gentlemen presented with chest pain, which ... musculoskeletal pain in the chest, and all those things should be investigated in due course. Very good. I think the other point to make is ...

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    Full Text Available ... be more difficult to open up, and that leads to more techniques that we’ll discuss. 6 ... ahead with stenting?” And I think that may lead to some of the questions. We don’t ...

  6. Coronary Angioplasty Stent Placement

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    Full Text Available ... On occasion, if somebody comes in with an acute heart attack, they have clot in the vessel, we’ll ... question about that. People who have having an acute heart attack there is absolutely no question they need to ...

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    Full Text Available ... metal stent, which is generally stainless steel in compound, and it opens it up, and we take ... wire and pass a little tiny ultrasound catheter down where we can actually look at the plaque ...

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... I can tell you right now, looking at these images, the left side looks perfect, so that’s ... can turn out to be cardiac, and sometimes these people come in the throes of a heart ...

  9. Coronary Angioplasty Stent Placement

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    Full Text Available ... a false positive stress test. So in other words, the test was abnormal but there is no ... cardiac catheterization with coronary angiography. So in other words, we took a look. He implanted a catheter ...

  10. Coronary Angioplasty Stent Placement

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    Full Text Available ... screen and open the door to informed medical care. “OR-Live,” the vision of improving health. Hello ... she will be monitoring the patient and taking care of the intravenous medications and any other medicines ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... medical care. “OR-Live,” the vision of improving health. 10

  12. Coronary Angioplasty Stent Placement

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    Full Text Available ... right now about our genetic heritage. Secondly is smoking. Smoking is a huge risk factor in the development ... little blood seeping around that area. So your doctor may have some specific recommendations regarding not squatting, ...

  13. Coronary Angioplasty Stent Placement

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    Full Text Available ... the course of the next hour you will learn about coronary artery disease, how blockage is performed, ... OR-Live” makes it easy for you to learn more, just click on the “Request information” button ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... I’m Dr. Jay Jackson. I’m a board certified cardiologist and staff member at the Shawnee ... Dr. Jhalan Mukhari. Dr. Mukhari is also a board certified cardiologist, as well as a certified interventional ...

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    Full Text Available ... to you live from the state-of-the-art Cardiac Catheterization Laboratory at Shawnee Mission Medical Center ... and he will go to the right coronary art which, which goes along the back wall of ...

  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... right coronary ostium, and we are in the process of taking our first images of the right ... coronary artery disease. Coronary artery disease is a process that we used to think took years and ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... the past year, at a somewhat who lower level of frequency. He came into the hospital when ... diet. Often statin therapy, particularly if their cholesterol levels or triglyceride levels are high, we’ll talk ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... then he will exchange catheters and he will go to the right coronary art which, which goes ... may get. And you can see -- let me go to the next slide. Symptoms of coronary artery ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... the past year, at a somewhat who lower level of frequency. He came into the hospital when his symptoms got worse. He had a nuclear stress test, which was abnormal, and he is has ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... Heart Month, and we’re particularly focusing on women’s heart disease. And I think it’s very, very important that the audience understand and recognize that women may have what we call “atypical symptoms.” They ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart, and then there are other issues as well. It 5 could be a pinched nerve. It could be musculoskeletal pain ... we decide that a heart artery needs to be fixed?” Well, again, it’s when we deem that significant. So ...

  2. Coronary Angioplasty Stent Placement

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    Full Text Available ... and years to develop. It’s a buildup of cholesterol plaque within the arterial wall that occludes the ... we call “hyperlipidemia” or “dislipidemia,” or commonly, high cholesterol, and we look at the fractions with the ...

  3. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... initial injections. So this is the first view. Sir, turn your head over this way. Look to ... the right coronary artery. Take in a breath, sir, and hold your breath. And the first picture ...

  4. Coronary Angioplasty Stent Placement

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    Full Text Available ... of the bare metal stent versus the drug-coated stents is an ongoing debate. And I think ... that with putting in a bunch of drug-coated stents, and it looks very pretty when we’ ...

  5. Coronary Angioplasty Stent Placement

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    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly ... screen and open the door to informed medical care. “OR-Live,” the vision of improving health. 10

  6. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... directly. Once he’s completed looking at the left system, then he will exchange catheters and he will ... blood vessels that emanate from the left coronary system. And now we have threaded a catheter over ...

  7. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... the most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. Probably ... heritage. Secondly is smoking. Smoking is a huge risk factor in the development of heart disease, as well ...

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it ... thing we can’t change and modify, and that’s family history. There’s not ...

  9. Coronary Angioplasty Stent Placement

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    Full Text Available ... like to show you a slide here about treatment for what we call “significant coronary artery disease,” ... out that we also want to focus on treatment of non-flow limiting disease. First and foremost ...

  10. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... target lesion. Now with the stents being as flexible as they are, we can pretty much get to anywhere we want. The issue of the bare metal stent versus the drug-coated stents is an ongoing debate. ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart disease, as well as problems with the lungs. But there is clearly a huge body of ... clot in the blood vessels that supplied the lungs, which can sometimes cause chest pain and shortness ...

  12. Coronary Angioplasty Stent Placement

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    Full Text Available ... at the patient’s side is my colleague and friend of many years, Dr. Jhalan Mukhari. Dr. Mukhari ... be done. 9 I had one patient, a friend of mine, who is actually a physician, who ...

  13. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... And let me give you a few brief clinical pieces of information. He’s an 80-year-old ... going to be quite as urgent in their clinical ramifications. What would probably the next step that ...

  14. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, Kansas. During the program it’s ... your screen and open the door to informed medical care. “OR-Live,” the vision of improving health. ...

  15. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... change. The catheters that we use to gain access into the vessels are smaller. They’re more user- friendly. The balloons and wires that we use to open the blockages up, they have become much more ...

  16. Angioplasty and Vascular Stenting

    Science.gov (United States)

    ... throughout the body, including: narrowing of large arteries (aorta and its branches) due to atherosclerosis , or hardening ... saturated fat, exercising and not smoking. Individuals with diabetes, high blood pressure and/or high cholesterol need ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... live from the state-of-the-art Cardiac Catheterization Laboratory at Shawnee Mission Medical Center in Merriam, ... have the opportunity to witness live a cardiac catheterization with possible intervention during this procedure. During this ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... care of the intravenous medications and any other medicines that need to be administered in monitoring his ... put in, versus medicated or what’s known as drug-eluding stents. And there has been a lot ...

  19. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... two-part series featuring cardiovascular procedures and cardiovascular disease, in honor of American Heart Month. I’m ... next hour you will learn about coronary artery disease, how blockage is performed, how we treat them, ...

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... individuals and how we treat them, keeping in mind not only the results in the Cardiac Catheterization ... positive one, and we’ll keep that in mind. But we’ll certainly keep an eye on ...