WorldWideScience

Sample records for angioplasty transluminal percutaneous coronary

  1. 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...

  2. 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

  3. 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)

  4. [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

  5. 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

  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. [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

  8. 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

  9. 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

  10. 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...

  11. 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.

  12. 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.

  13. 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

  14. 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)

  15. 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

  16. 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...

  17. 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)

  18. 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...

  19. 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 ...

  20. 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.

  1. Aggressive nonsurgical management of acute coronary artery occlusions developing immediately after percutaneous transluminal coronary angioplasty (PTCA)

    International Nuclear Information System (INIS)

    In 368 consecutive percutaneous transluminal coronary angiography (PTCA) procedures, acute occlusion of the dilated artery developed within the first hour after the procedure in 24 cases (6.5%). Four patients underwent emergency bypass surgery. In 17 of the remaining 20 patients, repeat balloon dilation was immediately attempted, and was successful in 11 instances (65%). Five of the six cases in which repeat balloon dilation was not successful responded well to surgical or medical therapy. The author conclude that acute occlusions of dilated coronary arteries shortly after PTCA do not automatically necessitate emergency bypass. Approximately two thirds of such cases can be managed by repeat dilation, converting a potential complication into a successful outcome

  2. 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)

  3. 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.

  4. 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)

  5. 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.).

  6. 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...

  7. 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

  8. 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

  9. High Prevalence of Risk Factors in Patients after PTCA (Percutaneous Transluminal Coronary Angioplasty) with Coronary Stents

    Czech Academy of Sciences Publication Activity Database

    Indráková, V.; Sedlak, Petr; Adášková, Jana; Mazura, Ivan; Tomečková, Marie; Zvárová, Jana

    Prague: Czech Anthropological Society, 2009. ISBN 978-80-254-4746-8. [International Anthropological Congress of Aleš Hrdlička /5./. 02.09.2009-05.09.2009, Prague - Humpolec] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : cardiology * coronary stents * risk factors Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  10. Target vessel revascularization following percutaneous coronary intervention. A 10-year report from the Danish Percutaneous Transluminal Coronary Angioplasty Registry

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Kassis, Eli;

    2005-01-01

    OBJECTIVE: To present the rate of target vessel revascularization (TVR) in a consecutive and unselected national population over 10 years. DESIGN: From 1989 to 1998 all percutaneous coronary interventions (PCIs) performed in Denmark were recorded in the Danish PTCA Registry. RESULTS: From 1989 to...... 1998 the annual rate of PCI rose from 46 to 753 per million inhabitants. From 1995 to 1998 TVR with PCI or coronary artery bypass grafting (CABG) within 9 months from the index PCI decreased significantly (p < 0.001) from 21.2% in 1995 (CABG 8.6% vs PCI 12.6%) to 11.7% in 1998 (CABG 4.3% vs PCI 7.......4%). Independent predictors for TVR were: coronary stenting (OR 0.60; 95% CI 0.52-0.69, p < 0.001), primary success rate (OR 0.69; 95% CI 0.53-0.89, p < 0.005), pre-PCI stenosis severity (OR 1.01; 95% CI 1.00-1.01, p = 0.03), left anterior descending coronary artery (OR 2.35; 95% CI 1.73-3.19, p < 0.001), right...

  11. 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.

  12. Clinical significance of exercise induced ST segment depression after successful percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    To evaluate the clinical significance of ST segment depression during repeated Treadmill exercise after successful PTCA, Thallium-201 SPECT was performed. The Thallium-201 SPECT was performed before, one week after and 3-6 months after PTCA. All thirty-five patients had one vessel disease and positive Thallium-201 exercise test. During follow-up period for 3-6 months, 11 of 35 patients had persistent ST segment depression. Restenosis of dilated coronary lesion was demonstrated in 6 of 11 patients. In another 3 of 35 patients, exercise induced ST segment depression was disappered during follow-up Treadmill exercise. In 14 patients with persistent or transient ST segment depression after PTCA, Thallium-201 SPECT demonstrated transient ischemia in 5 of 6 patients with restenosis. In other 8 patients without restenosis, SPECT images did not demonstrate myocardial ischemia and coronary arteriographic findings could not verify side branch stenosis or intimal dissection which might cause myocardial ischemia. The etiology of ST segment depression after successful PTCA in one vessel disease is not produced by exercise induced myocardial ischemia but still unknown mechanisms may be present. (author)

  13. 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

  14. 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...

  15. 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

  16. 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.)

  17. Assessment of the value of 99Tcm-MIBI stress-rest SPECT imaging for evaluation of the outcomes of percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Objective: To assess the value of stress-rest 99Tcm-MIBI (ST-RE) SPECT imaging for evaluation of perfusion improvement, prediction of restenosis (RS) and cardiac event rate in patients after percutaneous transluminal coronary angioplasty (PTCA). Methods: 99Tcm-MIBI ST-RE SPECT imaging was performed on 100 patients [(52 +- 9) years old] (14 +- 15) months after PTCA. On 30 of the 100 patients, ST-RE SPECT imaging were also performed before PTCA, and 30 patients underwent coronary angiography (CAG). The perfusion findings of myocardial segments were qualitatively classified into four patterns: normal (N), reversible defect (RD), partial reversible defect (PRD) and fixed defect (FD). Restenosis was predicted on the basis of RD or PRD. During the follow-up, cardiac death, myocardial infarction (MI), unstable angina and revascularization were considered as cardiac events. Results: 1) Among 100 patients, RD or PRD was observed in 28 patients, indicating myocardial ischemia (IS); FD was observed in 20 patients, indicating MI. The rate of occurrence of ischemic segments had no significant difference between patients with or without MI(P>0.05). 2) Among 30 patients, perfusion imaging was improved in 23 patients, the improved rate was 76.7%. The number of ischemic segments was decreased from 100 (37%) before PTCA to 10 (3.7%) after PTCA (P99Tcm-MIBI SPECT is a useful noninvasive method for evaluating the effect of PTCA and for predicting RS, and it is of high value for predicting cardiac events

  18. 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)

  19. 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

  20. 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

  1. Twenty-year evolution of Percutaneous coronary intervention and its impact on clinical outcomes a report from the NHLBI-sponsored, multicenter 1985–86 Percutaneous transluminal coronary angioplasty and 1997–2006 Dynamic Registries

    Science.gov (United States)

    Venkitachalam, Lakshmi; Kip, Kevin E; Selzer, Faith; Wilensky, Robert L; Slater, James; Mulukutla, Suresh R; Marroquin, Oscar C; Block, Peter C; Williams, David O; Kelsey, Sheryl F

    2009-01-01

    Background Percutaneous coronary intervention has undergone rapid progress both in technology and adjunct therapy. However, documentation of long-term temporal trends in relation to contemporary practice is lacking. Methods and Results We analyzed PCI use and outcomes in 8976 consecutive patients in the multicenter NHLBI-sponsored 1985–86 Percutaneous coronary transluminal coronary angioplasty (PTCA) and 1997–2006 Dynamic Registries waves [wave 1: 1997–98, bare metal stents; wave 2: 1999, uniform use of stents; wave 3: 2001–02, brachytherapy; waves 4 and 5: 2004–2006, drug-eluting stents]. Patients undergoing PCI in the recent waves were older and more often reported comorbidities than those in the balloon era. PCI was more often performed for acute coronary syndromes and, in spite of the greater disease burden, was more often selective. Procedural success was achieved and maintained more often in the stent era. Significant reductions were observed in in-hospital rates (%) of myocardial infarction (PTCA Registry: 4.9, wave 1: 2.7, wave 2: 2.8, wave 3: 1.9, wave 4: 2.6, wave 5: 2, Ptrend:<0.001) and emergency CABG (PTCA Registry: 3.7, wave 1: 0.4, wave 2: 0.4, wave 3: 0.3, wave 4:0.4, wave 5: 0, Ptrend:<0.001). Compared to the PTCA Registry, risk for repeat revascularization (31–365 days following index PCI) was significantly lower in the Dynamic waves (adjusted hazard ratio, wave 1: 0.72, wave 2: 0.51, wave 3: 0.51, wave 4: 0.30, wave 5: 0.36; P< 0.05 for all). Conclusion Percutaneous interventions, in the last two decades, has evolved to include more urgent, comorbid cases, yet achieving high success rates with significantly reduced need for repeat revascularization. PMID:20031687

  2. 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

  3. 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.)

  4. 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.

  5. 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.

  6. 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 ...

  7. 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.)

  8. 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

  9. 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...

  10. 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...

  11. 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

  12. 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- ...

  13. 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.

  14. 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...

  15. 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

  16. 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...

  17. Development and state of the art of percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    A review is given on the development and the state of the art of percutaneous catheter treatment as a therapeutical principle. Special emphasis is given to the results and indications of catheter treatment in the pelvic region and leg arteries. The progress in the field of coronary arteries and renal arteries is illustrated by the treatment of renovascular hypertony. The limits of indications and doubts about auxiliary drug therpay are pointed out. (orig.)

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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.)

  5. 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.)

  6. 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

    Full Text Available OBJETIVO: Descrever os eventos adversos ocorridos durante e após angioplastia coronária (ATC, possivelmente relacionados ao reuso de produtos médico-hospitalares, além de quantificar e identificar os motivos de descarte em relação ao primeiro uso e ao reuso. MÉTODO: Foram estudados 60 pacientes, sendo que 29 (48,3% apresentavam angina instável, 27 (45% IAM e quatro (6,7% outros diagnósticos. Durante o procedimento e na permanência na Unidade Intensiva Coronariana, atentou-se à possibilidade de ocorrência dos eventos adversos febre, hipertensão, hipotensão, calafrios, sudorese, sangramento, náuseas e vômitos. Foram avaliados sete produtos médico-hospitalares: introdutor, cateter-guia, fio-guia 0.35, fio-guia 0.014, cateter- balão para angioplastia, seringa com manômetro para insuflar balão (indeflator e torneira de três vias (manifold. No total de produtos (76 de primeiro uso e 410 reprocessados, verificou-se se houve descarte e se isto ocorreu antes ou durante o procedimento e quais os motivos para tanto. Utilizou-se o teste Qui Quadrado, admitindo-se erro alfa de 5%. RESULTADOS: Vinte e seis pacientes apresentaram eventos adversos. A hipotensão foi o evento mais prevalente e ocorreu em 11(18,3% casos. Não houve, porém, significância estatística entre o evento adverso hipotensão e reuso ou não dos produtos médico-hospitalares. Por não estarem íntegros, foram descartados três produtos de primeiro uso e 55 produtos dos reutilizados. CONCLUSÃO: Os eventos adversos apresentados pelos pacientes submetidos à angioplastia não estão associados ao reuso dos produtos médico-hospitalares. A integridade e funcionalidade foram os motivos principais de descarte.OBJECTIVE: To describe the adverse effects that occur during and after percutaneous transluminal coronary angioplasty (PTCA possibly related to the reuse of medical equipment. An additional objective is to quantify and identify the reasons of discard in respect to

  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. 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

  9. 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 ...

  10. 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

  11. 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

  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. 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

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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.

  3. Incidence of vascular complications in patients submitted to percutaneous transluminal coronary angioplasty by transradial and transfemoral arterial approach Incidencia de complicaciones vasculares en pacientes sometidos a angioplastía coronaria transluminal percutánea por vía arterial transradial y transfemoral Incidência de complicações vasculares em pacientes submetidos a angioplastia coronariana transluminal percutânea por via arterial transradial e transfemoral

    Directory of Open Access Journals (Sweden)

    Marinez Kellermann Armendaris

    2008-03-01

    Full Text Available OBJECTIVE: To describe the vascular complications of transradial and transfemoral artery punctures in patients submitted to percutaneous transluminal coronary angioplasty (PTCA. METHODS: Prospective cohort study including patients submitted to PTCA. An interview was performed and an instrument applied to collect risk factors/predictors of complications. After the procedure, a physical examination was performed, vital signs were measured and the puncture site was assessed. RESULTS: 199 patients were included, age 64±10 years. Complications found for the radial and femoral approach were respectively: ecchymosis (18.29%, (17.14%; bruising (17.66%, (14.27%; urinary retention (2.43%, (25.71%; loss of vessel permeability (8.53%, (0%. CONCLUSION: The complications found were considered minor or secondary, depending on the classification found in literature. A higher rate of vascular complications related to transradial artery punctures compared to the interventions performed by transfemoral approach.OBJETIVO: Describir complicaciones vasculares relacionadas a punciones arteriales transradial y transfemoral en pacientes sometidos a angioplastía coronaria transluminal percutánea (ACTP. MÉTODOS: Se trata de un estudio de cohorte prospectivo realizado con pacientes sometidos a ACTP. Se llevó a cabo una entrevista y aplicó un instrumento para obtener factores de riesgo/predictores. Fue realizado un examen físico, medición de signos vitales y se evaluó el lugar de punción. RESULTADOS: Fueron incluidos 199 pacientes, edad 64±10 años. Las complicaciones encontradas para vía radial y femoral respectivamente, fueron: esquimosis (18,29%, (17,14%; hematoma (17,66%, (14,27%; retención urinaria (2,43%, (25,71%; pérdida de permeabilidad de vaso (8,53%, (0%. CONCLUSIÓN: Las complicaciones fueron consideradas menores o secundarias conforme clasificación literaria. Existe una mayor incidencia de complicaciones vasculares relacionadas a punciones

  4. 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

  5. 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

  6. Influence on left cardiac remodeling and left ventricular function in coronary heart disease by performing percutaneous transluminal coronary angioplasty and stent implantation and drug re-intervention therapy%冠心病PTCA+支架术及药物再干预对左心重构和左室功能的影响

    Institute of Scientific and Technical Information of China (English)

    赵文强; 王俊; 谢红珍; 吴艳君; 潘啸东

    2008-01-01

    Objective To study influence of percutaneous transluminal coronary angioplasty (PTCA) and stent implantation on left cardiac remodeling and left ventricular function and clinical effect of drug re-inter- vention in coronary heart disease. Methods 98 patients with coronary heart disease were divided into 4 groups one year after performing percutaneous coronary intervention (PCI), clinical and echocardiographic indexes of left cardiac remodeling and left ventricular function were examined by comparison of 4 groups of post-PCI versus pre-PCI, influences of different PCI strategy and different drug re-interventions on left cardiac remodeling and left cardiac function were analysed. Results NYHA cardiac function grade,6 minute's walk test,left atrial volume index( LAVI), left ventricular diastolic-end volume index (LVDEVI), eject fraction (EF), ventricular Wall movement loss fraction(WMLF) in 4 groups of post-PCI were better than those in pre-PCI(all P < 0.001). Those in 6 months group and 12 months group of post-PCI were also better than those in 1 week group of post-PCI(all P<0.01). LAVI, LVEDVI, EF and WMLF were significantly different among different groups of PCI strategy, and better by comparison of Group simvastatin and Group irbesartan versus group of routine drug, but little different by Group tirofiban versus group of routine drug in patients undergoing drug re-intervention of post-PCL Concluslan Left cardiac remodeling and left ventricular function in coronary heart disease have a significant improvement in post-PCIone year, suitable PCI strategy and drug re-intervention have further influence on bettering left cardiac remodeling and left ventricular function.%目的 研究PTCA+支架术对左心重构和左室功能的影响及药物再干预的效果.方法 对98例冠心病患者经皮冠状动脉介入治疗(PCI)术后1年内4组与术前左心重构、左室功能的临床与超声指标对比研究,对不同PCI策略和不同药物干预效应与

  7. [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

  8. 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

  9. 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.)

  10. 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.)

  11. 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

  12. 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 ...

  13. 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.

  14. 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.)

  15. 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.)

  16. 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

  17. 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

  18. 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

  19. Future of Percutaneous Coronary Intervention From an Asian Perspective

    Institute of Scientific and Technical Information of China (English)

    Yean-Leng LIM

    2002-01-01

    @@ We have come a long-way since Andreas Gruentzig performed the first percutaneous transluminal coronary angioplasty (PTCA) in man in 1977. It is timely to assess what we have actually achieved for patients with coronary heart disease with the advent of this treatment modality and where we are heading from now.

  20. 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

  1. 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...

  2. Current status and perspective of percutaneous coronary intervention in China

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ The first percutaneous transluminal coronary angioplasty (PTCA) in China was performed in 1984. Since then the progresses in this field have been achieved gradually. The development process can be divided into 3 phases roughly. According to a national survey organized by Chinese Society of Cardiology,1-3 from 1984 to 1996, as the first phase, percutaneous coronary intervention (PCI) can only be performed in a few centers by a few cardiologists.

  3. 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

  4. 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.

  5. 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.

  6. Clinical utility of self-expanding stents in coronary artery disease

    OpenAIRE

    Kamalesh, Masoor

    2015-01-01

    Aditya R Boddu, Abilash R Balmuri, Masoor Kamalesh Department of Cardiology, Krannert Institute of Cardiology, Richard L Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN, USA Abstract: The field of percutaneous coronary intervention (PCI) has evolved considerably since the era of percutaneous transluminal coronary angioplasty. Percutaneous transluminal coronary angioplasty with stenting has now become one of the cornerstones of treatment for coronary arter...

  7. Percutaneous transluminal angioplasty for Brescia-Cimino hemodialysis fistula dysfunction: technical success rate, patency rate and factors that influence the results

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Kiyosumi [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan)]. E-mail: kiyosumi@belle.shiga-med.ac.jp; Furukawa, Akira [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan); Yamasaki, Michio [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan); Murata, Kiyoshi [Department of Radiology, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu-city, Shiga 520-2192 (Japan)

    2005-06-01

    Objective: To evaluate the initial clinical success and long-term patency rates of percutaneous transluminal angioplasty (PTA) using a venous approach for dysfunctional Brescia-Cimino fistula and to identify factors that may affect initial success and long-term patency. Materials and methods: A total of 99 PTA procedures were performed in retrograde fassion for 60 mature Brescia-Cimino shunts with dysfunction caused by anastomotic or peripheral outflow vein stenosis or occlusion. The initial clinical success rates were compared between stenosis and occlusion using Fisher's exact test. The Kaplan-Meier method was used to calculate the primary and secondary cumulative patency rates, and the log-rank test was used for comparison. Relative risks of patency loss according to clinical characteristics were determined with multivariate Cox models. Results: The initial clinical success rate of all interventions was 92%, and the rates for stenosis and occlusion were 99 and 65%, respectively (P < 0.0001). The primary and secondary cumulative patency rates for fistulas (excluding initial failure) at 12 months were 53 and 84%, respectively. The relative risks were 5.2 (P 0.004) for longer lesions and 4.5 (P = 0.007) for younger fistulas. The primary cumulative patency rate of four patients with a younger fistula and a longer stenosis at 4 months was 0%. Conclusion: Favorable primary and secondary cumulative patency rates are obtained in most patients. Long lesion length and younger age of fistulas were the two factors that reduced the patency rate after PTA.

  8. Value of Doppler Ultrasound Hemodynamics in the Assessment of Renal Artery Stenosis in Transplanted Kidneys: An Assessment of Patients after Percutaneous Transluminal Angioplasty

    Directory of Open Access Journals (Sweden)

    Huraib Sameer

    2001-01-01

    Full Text Available Doppler ultrasound (USS may allow a non-invasive early diagnosis of transplant renal artery stenosis (TRAS. Adequate Doppler sampling of the transplant renal artery is difficult, time consuming and highly operator dependent. As a result, there has been increased attention focused on the intrarenal vessels and downstream changes that occur secondary to TRAS. We evaluated Doppler USS parameters in nine patients with TRAS confirmed on angiography (significant stenosis defined as > 60% diameter narrowing. Doppler USS correctly identified all the nine stenoses. Mean peak systolic velocity (PSV was 3.6 m/s + 1.09. Mean end-diastolic velocity (EDV was 1.75 m/s + 0.25 with an acceleration time (AT of 0.14 + 0.04 sec and resistivity index (RI of 0.42 + 0.12. Early systolic peak (ESP was lost in all cases. Percutaneous transluminal angioplasty (PTA was successfully done in five patients with significant improvement in Doppler parameters. PSV decreased from 4.04 m/s + 1.35 to 0.76 m/s + 0.42 (p = 0.01. Similarly EDV improved from 1.71 m/s + 0.28 to 0.30 m/s + 0.17 (p = 0.001. AT improved from 0.13 + 0.01 to 0.05 + 0.01 sec (p = 0.001. RI normalized from 0.34 + 0.07 to 0.73 + 0.09 (p = 0.008. ESP was restored in all the patients. In conclusion: our results show that the Doppler USS analysis of segmental arteries is an excellent tool for the diagnosis of TRAS and follow-up of patients post PTA.

  9. 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.)

  10. 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

  11. Patient effective doses during intracoronary irradiation with a Rhenium 188 full filled balloon catheter after percutaneous transluminal coronary artery

    International Nuclear Information System (INIS)

    Intracoronary irradiation with a full filled Re188 balloon catheter treatment technique (IRT) after Percutaneous Transluminal Coronary Artery (PTCA) should represent an addition patient exposure dose with respect to common PTCA procedure. Our proposes were determinate the absorbed doses and estimate the risk for fatal cancer in 25 patients (15 males, mean age: 559 years old) treated during an IRT randomized clinical trial carried out in our institution as part of IAEA technical cooperation project. 20 Gy was always the prescribed doses for each patient. The average Re188 concentrated activity used and treatment time were 5256±2371 MBq/ml in 1.5-2 ml and 466±195 seconds, respectively. Two thermoluminescent dosimeters were attached in the chest and pelvis for each patient treated. Calibration for attenuation and scattered radiations was done. The maximal and mean value effective dose obtained for chest patient region were 18 mSv and 15±6 mSv, respectively and for pelvis patient region the results were 10 mSv and 8±3 mSv, respectively. The total risk to develop fatal cancer was 0.084% for patient treated. The patient effective doses is slightly superior to those reported for common procedures as PTCA. The IRT is considered a quite safe procedure, but in order to exposure radiation level optimization the continuous review of procedure should be constantly done. (Author)

  12. Patient effective doses during intracoronary irradiation with a Rhenium 188 full filled balloon catheter after percutaneous transluminal coronary artery

    Energy Technology Data Exchange (ETDEWEB)

    Ponce V, L.; Peix G, A.; Llerena R, L.; Santana V, L. [Instituto de Cardiologia, La Habana (Cuba); Lopez D, A. [Hospital Hermanos Amejeiras, La Habana (Cuba)

    2006-07-01

    Intracoronary irradiation with a full filled Re188 balloon catheter treatment technique (IRT) after Percutaneous Transluminal Coronary Artery (PTCA) should represent an addition patient exposure dose with respect to common PTCA procedure. Our proposes were determinate the absorbed doses and estimate the risk for fatal cancer in 25 patients (15 males, mean age: 559 years old) treated during an IRT randomized clinical trial carried out in our institution as part of IAEA technical cooperation project. 20 Gy was always the prescribed doses for each patient. The average Re188 concentrated activity used and treatment time were 5256{+-}2371 MBq/ml in 1.5-2 ml and 466{+-}195 seconds, respectively. Two thermoluminescent dosimeters were attached in the chest and pelvis for each patient treated. Calibration for attenuation and scattered radiations was done. The maximal and mean value effective dose obtained for chest patient region were 18 mSv and 15{+-}6 mSv, respectively and for pelvis patient region the results were 10 mSv and 8{+-}3 mSv, respectively. The total risk to develop fatal cancer was 0.084% for patient treated. The patient effective doses is slightly superior to those reported for common procedures as PTCA. The IRT is considered a quite safe procedure, but in order to exposure radiation level optimization the continuous review of procedure should be constantly done. (Author)

  13. 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

  14. 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

  15. 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)

  16. 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

  17. 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.

  18. 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 ...

  19. Clinical applications: percutaneous coronary intervention - a review

    International Nuclear Information System (INIS)

    Following a brief review of the early days of coronary angiography, this article traces the development of percutaneous coronary intervention from the pioneering work of Dotter and Gruentzig up to the latest procedures for coronary angioplasty. (orig.)

  20. Clinical applications: percutaneous coronary intervention - a review

    Energy Technology Data Exchange (ETDEWEB)

    Meier, B. [Swiss Cardiovascular Center Bern, Univ. Hospital, Bern (Switzerland)

    2006-07-01

    Following a brief review of the early days of coronary angiography, this article traces the development of percutaneous coronary intervention from the pioneering work of Dotter and Gruentzig up to the latest procedures for coronary angioplasty. (orig.)

  1. 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.)

  2. How Is Coronary Angioplasty Done?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Percutaneous Coronary Intervention Done? Before you have percutaneous coronary intervention (PCI), ... wall, relieving the blockage and improving blood flow. Percutaneous Coronary Intervention Figure A shows the location of the heart ...

  3. 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

  4. 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.)

  5. 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.

  6. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly ... this next slide, we’ve talked about medical therapy, and then under “Percutaneous coronary intervention,” that is ...

  7. 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

  8. Medical operating personnel exposition levels during intracoronary irradiation using a Re188 full filled balloon catheter after percutaneous transluminal coronary artery

    Energy Technology Data Exchange (ETDEWEB)

    Ponce V, F.; Peix G, A.; Llerena R, L.; Santana V, L. [Instituto de Cardiologia, La Habana (Cuba); Lopez D, A. [Hospital Hermanos Amejeiras, La Habana (Cuba)

    2006-07-01

    The intracoronary irradiation using a full filled conventional balloon catheter with Rhenium 188 (Re188) after Percutaneous Transluminal Coronary Artery (PTCA) is a new relative treatment technique to reduce restenosis where the medical operating personnel are exposed to additional radiation ionizing level in the cath lab. In this study a radiation exposure level to medical operating personnel in the cath lab were measured with a Geiger Muller detector in 7 place to different distance from patient (to chest and abdominal region) catheter tabletop during a randomized clinical trial carried out in 25 patients whose were treated. The average concentrated Re188 activity used and treatment time were 5256{+-}2371 MBq/ml in 1.5-2 ml and 466{+-}195 seconds. At 3 cm from right arm patient the average maximum exposition rate were 0,63 mSv/h and 0,51 mSv h, to chest and abdominal patient level, respectively, where also average exposed dose per treated patient was 0,06 mSv and 0,05 mSv, respectively. Our results show that intracoronary irradiation with Re188 in the cath lab do not increase significatively the exposure radiation level to medical operating staff during treatment procedure and it is safe according national and international radiation protection regulations. (Author)

  9. Medical operating personnel exposition levels during intracoronary irradiation using a Re188 full filled balloon catheter after percutaneous transluminal coronary artery

    International Nuclear Information System (INIS)

    The intracoronary irradiation using a full filled conventional balloon catheter with Rhenium 188 (Re188) after Percutaneous Transluminal Coronary Artery (PTCA) is a new relative treatment technique to reduce restenosis where the medical operating personnel are exposed to additional radiation ionizing level in the cath lab. In this study a radiation exposure level to medical operating personnel in the cath lab were measured with a Geiger Muller detector in 7 place to different distance from patient (to chest and abdominal region) catheter tabletop during a randomized clinical trial carried out in 25 patients whose were treated. The average concentrated Re188 activity used and treatment time were 5256±2371 MBq/ml in 1.5-2 ml and 466±195 seconds. At 3 cm from right arm patient the average maximum exposition rate were 0,63 mSv/h and 0,51 mSv h, to chest and abdominal patient level, respectively, where also average exposed dose per treated patient was 0,06 mSv and 0,05 mSv, respectively. Our results show that intracoronary irradiation with Re188 in the cath lab do not increase significatively the exposure radiation level to medical operating staff during treatment procedure and it is safe according national and international radiation protection regulations. (Author)

  10. [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

  11. 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

  12. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  13. Percutaneous transluminal angioscopy: Advanced evaluation of cerebrovascular disease and optimal control of interventional techniques

    International Nuclear Information System (INIS)

    The development of ultrathin fiberscopes has improved the detection of changes in vessel walls by affording direct three-dimensional visualization. The procedure is likely to prove superior to angiography since even simultaneous biplanar angiography can yield only two-dimensional views. Interventional procedures like percutaneous transluminal angioplasty or laser plaque ablation, developed to avoid surgery, may be guided by angioscopy for more informative visualization of preoperative complex plaque structures and postinterventional vessel wall changes. Until now, angioscopy always has been performed intraoperatively. The authors have developed a new 8-French double-lumen balloon catheter system for the percutaneous transluminal approach. The system itself, extended work in a live-animal model (dogs), and preliminary results in humans will be discussed

  14. 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.

  15. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  16. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  17. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... chest pain other than cardiac, but the most serious potentially is coronary artery disease. Coronary artery disease ... of the arteries. Diabetes Mellitus is a very serious cause of particularly premature atherosclerosis particularly in younger ...

  18. Primary percutaneous coronary intervention compared with fibrinolysis for myocardial infarction in diabetes mellitus - Results from the primary coronary angioplasty vs thrombolysis-2 trial

    NARCIS (Netherlands)

    Timmer, Jorik R.; Ottervanger, Jan Paul; de Boer, Menko-Jan; Boersma, Eric; Grines, Cindy L.; Westerhout, Cynthia M.; Simes, John; Granger, Christopher B.; Zijlstra, Felix

    2007-01-01

    Background: There is growing evidence for a clinical benefit of primary percutaneous coronary intervention (PCI) compared with fibrinolysis; however, whether the treatment effect is consistent among patients with diabetes mellitus is unclear. We compared PCI with fibrinolysis for treatment of ST-seg

  19. 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.

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    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

    Medline Plus

    Full Text Available ... chest pain other than cardiac, but the most serious potentially is coronary artery disease. Coronary artery disease is a process that we ... huge risk factor in the development of heart disease, as well as problems ... cause of particularly premature atherosclerosis particularly in younger ...

  2. Coronary artery perforation during percutaneous coronary intervention (PCI), successful management with covered stent

    International Nuclear Information System (INIS)

    Coronary artery perforation, (CP) is a rare and potentially life-threatening complication of percutaneous coronary intervention (PCI). CP has historically been reported to occur in 0.1-3.0% of PCI procedures. Although CP can be caused by coronary wires and balloon angioplasty, they are more frequently reported in PCI using atheroablative devices, stenting and excimer laser coronary angioplasty. We report a case of coronary perforation took place and was managed successfully. (author)

  3. Coronary Angioplasty Stent Placement

    Medline Plus

    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. ...

  4. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  5. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  6. Coronary Angioplasty Stent Placement

    Medline Plus

    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. ...

  7. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  8. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  9. 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. ... heritage. Secondly is smoking. Smoking is a huge risk factor in the development of heart disease, as ...

  10. Coronary Angioplasty Stent Placement

    Medline Plus

    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, ...

  11. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  12. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  13. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  14. 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 ...

  15. 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 ...

  16. 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 ...

  17. 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, ...

  18. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... improve coronary blood flow. You’ll have the opportunity to witness live a cardiac catheterization with possible ... procedure. During this webcast you’ll have the opportunity to ask questions. All you need to do ...

  19. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... seen today is a cardiac catheterization or a diagnostic coronary angiogram. This is performed live from Shawnee, Mission Medical Center’s Heart and Vascular Center in Merriam, Kansas. ...

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  1. 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 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

    Medline Plus

    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 ...

  3. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  4. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... and recognize that women may have what we call “atypical symptoms.” They may have no symptoms at ... certainly a very large vessel. It’s what we call a “dominant right coronary artery,” giving rise to ...

  5. 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...

  6. Experience in percutaneous transluminal angioplasty nursing of 13 hemodialysis patients with central venous stenosis%13例中心静脉狭窄血液透析患者行经皮腔内血管成形术的护理

    Institute of Scientific and Technical Information of China (English)

    吕小林; 葛益飞; 马逊

    2016-01-01

    目的 回顾性分析13例中心静脉狭窄的血液透析患者行经皮腔内血管成形术的护理过程. 方法 术前做好沟通,消除患者的紧张心理;术中密切观察患者的生命体征,关注手术进程;术后观察患侧肢体情况,积极防范并发症,预防中心静脉再狭窄. 结果 本组13例患者经手术扩张后,患者的肢体及面部水肿等症状缓解,1例患者于术后11个月出现内瘘侧肢体肿胀,再次行经皮腔内血管成形术后症状获缓解. 结论 行经皮腔内血管成形术前,应做好患者的心理沟通,消除患者的恐惧和思想顾虑,并充分考虑手术可能发生的风险及采取的应对措施. 术中应密切关注手术进程,严密观察患者的生命体征,维持静脉通路通畅. 术后观察患者病情变化、患侧肢体情况,积极防范术后并发症,并预防中心静脉再狭窄的发生.%Objective To retrospectively analyze the process of percutaneous transluminal angioplasty nursing of 13 hemodialysis patients with central venous stenosis. Methods Preoperative communication should be prepared to eliminate the patient′s anxiety. We closely observed the patient′s vital signs and were concerned about the surgery process during operation. We observed the patient′s affected limb and prevent the complications and central venous re-stenosis after operation. Results Limb and facial edema and other symptoms eased in 13 patients after surgical expansion, and 1 patient swelled in limbs with fistula which was relieved after repeating percutaneous transluminal angioplasty. Conclusions Before percutaneous transluminal angioplasty, we should provide mental communication for patients to eliminate their fears and misgivings, and take full account of operational risks and related countermeasures. We should closely observe the patient′s vital signs, be concerned about the surgery process and keep IVs flowing smoothly in operation. Meanwhile, we should pay attention to

  7. 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).

  8. Evolution of Percutaneous Coronary Intervention in Patients with Diabetes

    Science.gov (United States)

    Rana, Jamal S.; Venkitachalam, Lakshmi; Selzer, Faith; Mulukutla, Suresh R.; Marroquin, Oscar C.; Laskey, Warren K.; Holper, Elizabeth M.; Srinivas, Vankeepuram S.; Kip, Kevin E.; Kelsey, Sheryl F.; Nesto, Richard W.

    2010-01-01

    OBJECTIVE To evaluate the association of successive percutaneous coronary intervention (PCI) modalities with balloon angioplasty (BA), bare-metal stent (BMS), drug-eluting stents (DES), and pharmacotherapy over the last 3 decades with outcomes among patients with diabetes in routine clinical practice. RESEARCH DESIGN AND METHODS We examined outcomes in 1,846 patients with diabetes undergoing de novo PCI in the multicenter, National Heart, Lung, and Blood Institute–sponsored 1985–1986 Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry and 1997–2006 Dynamic Registry. Multivariable Cox regression models were used to estimate the adjusted risk of events (death/myocardial infarction [MI], repeat revascularization) over 1 year. RESULTS Cumulative event rates for postdischarge (31–365 days) death/MI were 8% by BA, 7% by BMS, and 7% by DES use (P = 0.76) and for repeat revascularization were 19, 13, and 9% (P < 0.001), respectively. Multivariable analysis showed a significantly lower risk of repeat revascularization with DES use when compared with the use of BA (hazard ratio [HR] 0.41 [95% CI 0.29–0.58]) and BMS (HR 0.55 [95% CI 0.39–0.76]). After further adjustment for discharge medications, the lower risk for death/MI was not statistically significant for DES when compared with BA. CONCLUSIONS In patients with diabetes undergoing PCI, the use of DES is associated with a reduced need for repeat revascularization when compared with BA or BMS use. The associated death/MI benefit observed with the DES versus the BA group may well be due to greater use of pharmacotherapy. PMID:20519661

  9. 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

  10. 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

  11. Percutaneous Transluminal Angioplasty Combine with Salvia Injection Cura the Below Knee Vascular Lesion of Diabetic By Pressurize Injection%长球囊联合丹参注射液加压注射治疗糖尿病膝下血管病变

    Institute of Scientific and Technical Information of China (English)

    路延平; 张健; 张孟增; 王瑞锋

    2012-01-01

    目的 观察长球囊血管腔内成形术(percutaneous transluminal angioplasty,PTA)联合丹参注射液,腔内加压注射治疗糖尿病膝下血管病变的疗效.方法 19例糖尿病患者共23条膝下动脉硬化闭塞肢体,首先采用长球囊开通狭窄、闭塞的血管,再联合丹参注射液腔内加压注射治疗.术后观察踝/肱指数、通畅率、溃疡愈合时间及临床症状的改善.结果 21条患肢得到成功治疗,技术成功率91.3%(21/23).踝/肱指数(ankle brachial index,ABI)由术前的0.31±0.14上升为术后的0.71±0.18,与术前比较差异有统计学意义(P<0.05).术后随访3~10个月,13条患肢(61.9%)间歇性跛行、患肢静息痛等临床症状基本消失,足背或胫后动脉搏动恢复;8条(38.1%)患肢明显缓解.6条肢体术前伴足趾溃疡者,术后创面均愈合;1条足趾坏疽肢体清创换药23天后行截趾术,术后切口愈合良好.术后1、3、6个月通畅率分别为95.2%、85.7%、61.9%.结论 腔内加压注射丹参注射液作为长球囊PTA微创治疗糖尿病合并膝下血管病变的补充,可促进动脉侧支血管生成,改善血供,改善微循环,促进糖尿病足溃疡面愈合,近期疗效好、通畅率高,值得推广.%Objective Review the curative effect of percutaneous transluminal angioplasty ( PTA) combined with salvia injection to the below knee vascular lesion of diabetic. Methods Collect 19 diabetics with together 23 inferior genicular artery blunting. First, remove obstacles from angusty or obliterative blood vessel by percutaneous transluminal angioplasty (PTA) , then begin intracavitary pressurize injection used the salvia miltiorrhiza, and observe the ankle brachial index (ABI) ,patency rate, the time of anabrosis healing and the amelioration of clinical symptom. Results The 21 affected limb of them were Curat successfully,the achievement ratio of technique was 91.3% (21/23). ABI ascensus from 0. 31 ± 0. 14 of preoperative to 0. 71

  12. Antiplatelet and anticoagulant therapy in elective percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Verheugt Freek WA

    2001-05-01

    Full Text Available Abstract Thrombosis plays a major role in acute vessel closure both after coronary balloon angioplasty and after stenting. This review will address the role of antiplatelet and anticoagulant therapy in preventing early thrombotic complications after percutaneous coronary intervention. The focus will be on agents that are routinely available and commonly used.

  13. 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.

  14. 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)

  15. 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

  16. 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; Inzidenzen von Major-Amputationen, Bypass-Operationen und perkutanen transluminalen Angioplastien (PTA) zur Behandlung der peripheren arteriellen Verschlusskrankheit in einer deutschen Klinik der Maximalversorgung 1996-2003

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A. [Klinik fuer Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg (Germany); Inst. fuer Medizinmanagement und Gesundheitswissenschaften, Univ. Bayreuth (Germany); Freitag, M.H. [Inst. fuer Medizinmanagement und Gesundheitswissenschaften, Univ. Bayreuth (Germany); Woelfle, K.D. [Chirurgisches Zentrum, Klinik fuer Gefaesschirurgie, Zentralklinikum Augsburg (Germany); Bohndorf, K.; Kirchhof, K. [Klinik fuer Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg (Germany)

    2006-09-15

    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.)

  17. ASSOCIATION OF HIGH LIPOPROTEIN(a LEVELS WITH CORONARY ARTERY PATENCY DURING THE FIRST YEAR AFTER PERCUTANEOUS CORONARY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    M. V. Ezhov

    2014-07-01

    Full Text Available Objective: to study an association of high lipoprotein(a [Lp(a] levels with the development of restenosis and the progression of coronaryatherosclerosis after percutaneous coronary interventions (PCI in patients with chronic coronary heart disease (CHD.Subjects and methods. From 502 enrolled patients (mean age 54.7 ± 8.9 years, 92 underwent routine percutaneous transluminal coronary angioplasty (PTCA, 270 had PTCA with the bare metal stent (BMS being implantation, 140 had PTCA using drug-eluting stents (DES. Functionalclasses III and IV angina have been registered in 337 (67 % patients; history of one myocardial infarction (MI was noted in 234 (47 % cases, 171 (34 % had experienced 2 or more MIs. Blood samples for lipid and Lp(a measurements were taken in all the patients. Restenosis was defined as at least 50 % lumen narrowing of the coronary artery segment after angioplasty. Coronary atherosclerosis progression was established in cases of the new occlusion occurring, as well as identifying a 10 % decrease in lumen diameter in comparison with baseline angiograms.Results. Repeated coronary angiography revealed the signs of restenosis in 103 of 243 patients. Dividing patients into 3 groups according to the type of intervention demonstrated that the level of Lp(a (median 25–75 % quartiles was significantly higher in the restenosis group after implantation of BMS (33; 11–62 and 16; 6–39 mg/dl, respectively; p = 0.014 versus those who had undergone DES implantation (23; 10–30 and 20; 6–60 mg/dl; p = 0.7 or balloon angioplasty (17; 4–48 and 9; 4–36 mg/dl; p = 0.3. Patients with progression of coronary atherosclerosis had difference only in Lp(a levels compared to the group without progression (36; 13–62 versus 12; 4–26 mg/dl, p < 0,001.Conclusion. During the first year after elective PCI Lp(a concentration determined the severity of coronary atherosclerosis in non-culprit lesionsand associated with the risk of in

  18. ASSOCIATION OF HIGH LIPOPROTEIN(a LEVELS WITH CORONARY ARTERY PATENCY DURING THE FIRST YEAR AFTER PERCUTANEOUS CORONARY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    M. V. Ezhov

    2011-01-01

    Full Text Available Objective: to study an association of high lipoprotein(a [Lp(a] levels with the development of restenosis and the progression of coronaryatherosclerosis after percutaneous coronary interventions (PCI in patients with chronic coronary heart disease (CHD.Subjects and methods. From 502 enrolled patients (mean age 54.7 ± 8.9 years, 92 underwent routine percutaneous transluminal coronary angioplasty (PTCA, 270 had PTCA with the bare metal stent (BMS being implantation, 140 had PTCA using drug-eluting stents (DES. Functionalclasses III and IV angina have been registered in 337 (67 % patients; history of one myocardial infarction (MI was noted in 234 (47 % cases, 171 (34 % had experienced 2 or more MIs. Blood samples for lipid and Lp(a measurements were taken in all the patients. Restenosis was defined as at least 50 % lumen narrowing of the coronary artery segment after angioplasty. Coronary atherosclerosis progression was established in cases of the new occlusion occurring, as well as identifying a 10 % decrease in lumen diameter in comparison with baseline angiograms.Results. Repeated coronary angiography revealed the signs of restenosis in 103 of 243 patients. Dividing patients into 3 groups according to the type of intervention demonstrated that the level of Lp(a (median 25–75 % quartiles was significantly higher in the restenosis group after implantation of BMS (33; 11–62 and 16; 6–39 mg/dl, respectively; p = 0.014 versus those who had undergone DES implantation (23; 10–30 and 20; 6–60 mg/dl; p = 0.7 or balloon angioplasty (17; 4–48 and 9; 4–36 mg/dl; p = 0.3. Patients with progression of coronary atherosclerosis had difference only in Lp(a levels compared to the group without progression (36; 13–62 versus 12; 4–26 mg/dl, p < 0,001.Conclusion. During the first year after elective PCI Lp(a concentration determined the severity of coronary atherosclerosis in non-culprit lesionsand associated with the risk of in

  19. Study of Percutaneous Coronary Intervention in Patient with Coronary Artery Disease at Tertiary Care Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Virendra C. Patil

    2015-10-01

    Full Text Available Background: The interventional treatment option for the coronary artery disease has recently gained popularity. This study was intended to elaborate Percutaneous Coronary Intervention (PCI and coronary angiographic profile in patients with coronary artery disease. Material & Methods: This was a retrospective study conducted over one year period. The patients with significant Coronary Artery Disease (CAD by angiogram were included in this study. The p value < 0.05 was considered as statistically significant. Results: Total 135 patients with CAD were enrolled with mean age of 59.65±10.32. Total 59.24% of males and 40.74% of females underwent Percutaneous Transluminal Coronary Angioplasty (PTCA (p=0.00234. Total 67.40% of patients had hypertension, 48.75% of male patients had history of tobacco consumption, 27.5% of males and 21.81% of females had Type 2 Diabetes Mellitus (T2DM, 58.75% of males and 43.63% of females had dyslipidemia, 33.75% of males and 23.63% of females had obesity, 33.75% of males and 30.90% of females had metabolic syndrome. Total 41.25% of males and 45.45% of females had affection of Left Anterior Descending (LAD (p=0.0207, 18.75% of males and 20% of females had Left Circumflex (LCx lesion or Right Coronary Artery (RCA. Total 10% of males and 9.09% of females had LAD and LCX lesion. Total 7.5% of males and 9% of females had affection of LAD+ RCA. Among 22.5% of males and 16.36% of females received bare metal stents and 77.5% of males and 83.62% of females received drug eluting stents. The case fatality rate was 1.41%. Conclusions: Study highlights the burden of modifiable coronary artery disease risk factors like, hypertension, obesity and metabolic syndrome undergoing PTCA. Male patients outnumbered with most common coronary artery lesion being LAD. Our findings suggest that favorable outcomes, matching the international data can be achieved in a rural hospital setting.

  20. 心肌灌注显像在PCI术前后的应用价值%Role of myocardial perfusion imaging in the evaluation of patients undergoing percutaneous transluminal coronary intervention.

    Institute of Scientific and Technical Information of China (English)

    宋长祥; 刘永; 陆武; 孙承波

    2011-01-01

    目的 探讨心肌灌注显像(MPI)在经皮冠状动脉介入治疗(PCI)术前后的应用价值.方法 32例行PCI患者,分别于术前2个月及术后6个月内行心肌灌注断层显像,术后6个月内均再次行冠脉造影检查.应用配对t检验对比分析两次MPI与CAG结果.结果 PCI术后MPI显示28例患者心肌灌注可逆性缺损或固定性缺损节段数减少.与CAG对比分析,PCI术前后两次MPI敏感性/特异性分别为83.8/73.0%,86.5/81.1%.结论 对于心肌血运状况的评价,心肌灌注显像无论在PCI术前还是术后均为必要而有效的诊断手段.%Objective To study the value of myocardial perfusion imaging (MPI) for the evaluation of improvement in myocardial perfusion in patients with percutaneous transluminal coronary intervention(PCI).Methods 32 patients (13 women, 19 men) were analyzed. MPI was performed before and after PCI respectively. In all patients coronary angiography was done at 1east once after PCI. Statistical analysis of the numbers of segments before and after PCI was performed, using paired T tests. Results Improvement, defined as a decrease in thc number of ischemic or fixed segments, was observed in 28 of 32 patients after PCI. The sensitivity and specificity of MPI calculated before and after PCI, using angiography as the gold standard, were 83.8%, 73.0%; 86.5%, 81.1%,respectively. Conclusion It is necessary to assess the perfusion both before and shortly after PCI with MPI, since it provides the best documentation of the changes in myocardial perfusion.

  1. 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.

  2. Coronary Artery Bypass Grafting

    Science.gov (United States)

    ... Rehabilitation Coronary Heart Disease Heart Attack Heart Surgery Percutaneous Coronary Intervention Send a link to NHLBI to someone by ... include lifestyle changes, medicines, and a procedure called percutaneous coronary intervention (PCI), also known as coronary angioplasty. PCI is ...

  3. Myocardial Perfusion SPECT Imaging in Patients after Percutaneous Coronary Intervention

    OpenAIRE

    Georgoulias, Panagiotis; Valotassiou, Varvara; Tsougos, Ioannis; Demakopoulos, Nikolaos

    2010-01-01

    Coronary artery disease (CAD) is the most prevalent form of cardiovascular disease affecting about 13 million Americans, while more than one million percutaneous transluminal intervention (PCI) procedures are performed annually in the USA. The relative high occurrence of restenosis, despite stent implementation, seems to be the primary limitation of PCI. Over the last decades, single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), has proven an invaluable tool ...

  4. Who Needs Coronary Artery Bypass Grafting?

    Science.gov (United States)

    ... Rehabilitation Coronary Heart Disease Heart Attack Heart Surgery Percutaneous Coronary Intervention Send a link to NHLBI to someone by ... coronary arteries that can't be treated with percutaneous coronary intervention (PCI), also known as coronary angioplasty. Your doctor ...

  5. 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)

  6. 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.

  7. Trends in Percutaneous Coronary Interventions in New South Wales, Australia

    OpenAIRE

    Farhat Yusuf; Nicholas J. Parr; Weerasinghe, Daminda P.

    2009-01-01

    This is the first detailed study on percutaneous coronary intervention (PCI) in New South Wales (NSW), Australia. Hospital data for PCIs carried out between 1 July 1990 and 30 June 2002 are analysed. The study explores trends in PCI rates by selected socio-demographic factors, the utilisation of angioplasties vis-a-vis stents, emergency admissions, and selected coexisting conditions which determine the disease status of PCI patients. Logistic regression models are used to study the medical co...

  8. 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....

  9. 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).

  10. Percutaneous coronary intervention in nonagenarians: pros and cons

    Institute of Scientific and Technical Information of China (English)

    Giuseppe Biondi Zoccai; Antonio Abbate; Fabrizio D'Ascenzo; Davide Presutti; Mariangela Peruzzi; Elena Cavarretta; Antonino G.M. Marullo; Marzia Lotrionte; Giacomo Frati

    2013-01-01

    Percutaneous coronary intervention is a mainstay in the management of symptomatic or high-risk coronary artery disease. The bulk of clinical evidence and experience underlying this fact relies, however, on relatively young patients. Indeed, few data of very limited quality are available which adequately define the risk-benefit and cost-benefit profile of coronary angioplasty and stenting in very old subjects, such as those of 90 years of age or older (i.e., nonagenarians). The aim of this review is to provide a concise, yet practical, synthesis of the available evidence on percutaneous coronary revascularization in the very elderly. The main arguments elaborated upon are to what extent we can extrapolate findings from studies including younger patients to nonagenarians, whether we should provide higher priority to prognosis or quality of life in such patients, and whether we can afford to allocate vast resources to care for such subjects in an era of financial constraints. Our review of 18 studies and 1082 patients suggest that percutaneous coronary intervention is feasible and associated with acceptable short- and long-term results in this population, which is nonetheless fraught with a high mortality risk irrespective of the revascularization procedure. Accordingly, the pros and cons of percutaneous coronary intervention should be carefully weighed when considering this treatment in nonagenarians.

  11. 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

  12. 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

  13. Coronary computed tomography angiography indicates complexity of percutaneous coronary interventions

    OpenAIRE

    Stähli, B E; Bonassin, F; Goetti, R; Küest, S M; Frank, M.; Altwegg, L A; Gebhard, C; Levis, A; Wischnewsky, M. B.; Lüscher, T F; Alkadhi, H.; Kaufmann, P A; Maier, W.

    2012-01-01

    BACKGROUND: Coronary computed tomography angiography (CCTA) provides information regarding lesion morphology and three-dimensional coronary anatomy incremental to coronary angiography. We addressed the question whether preprocedural CCTA bears potential for guiding percutaneous coronary interventions (PCI). METHODS AND RESULTS: Sixty-six coronary lesions attempted with PCI within 6 months of preprocedural CCTA were retrospectively assessed. Lesion parameters from unenhanced computed tomogr...

  14. Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis.

    Science.gov (United States)

    Choi, Jin-Ho; Min, James K; Labounty, Troy M; Lin, Fay Y; Mendoza, Dorinna D; Shin, Dae Hee; Ariaratnam, Nikki S; Koduru, Sunaina; Granada, Juan F; Gerber, Thomas C; Oh, Jae K; Gwon, Hyeon-Cheol; Choe, Yeon Hyeon

    2011-11-01

    Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 ± 4.25 Hounsfield units/10 mm for diameter stenosis of 0% to 49% to -13.37 ± 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions. PMID:22093264

  15. Twenty-four-hour Tl-201 delayed scan underestimates myocardial viability in patients with acute myocardial infarction after percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Myocardial viability in area at risk of acute myocardial infarction (AMI) after reperfusion therapy may be underestimated by the 24-hour images due to reverse redistribution (r-RD). Subjects were 37 AMI patients in whom Tc-99m pyrophosphate (PYP)/Tl-201 dual-isotope SPECT was positive. The 24-hour delayed scan was performed with only a Tl window. One month later, follow up rest Tl SPECT was performed to evaluate myocardial viability. In early (at PYP/Tl-201 dual-isotope SPECT), 24-hour, and one month follow up Tl studies, Tl uptake in the area of AMI was scored into four grades: 3 as normal to 0 as severely reduced. The scores were evaluated. Among the 37 AMI lesions, there were 16 r-RD, 3 RD, 16 fixed defect (FD) and 2 normal (positive PYP and normal Tl). Mean Tl scores were early; 1.4±1.1, 24-hr; 0.9±0.9 and one month; 1.3±1.1. The 24-hour Tl score was lower than the early and one month Tl scores (p<0.01). Reverse redistribution is frequently observed in an area at risk where PYP SPECT was positive. Nuclear medicine physicians should be aware of the existence of frequent r-RD in Tl scan to avoid the underestimation of myocardial viability in the acute phase after PTCA. (author)

  16. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Bahn, Young Eun; Kim, Young Hwan; An, Eun Jung; Kim, See Hyung [Keimyung Univ. College of Medicine, Daegu (Korea, Republic of)

    2012-07-15

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions.

  17. Percutaneous transluminal biopsy using 7F forceps for diagnosing malignant biliary obstruction

    International Nuclear Information System (INIS)

    To evaluate the usefulness of the percutaneous transluminal biopsy using 7-F forceps for diagnosing malignant biliary obstruction. One hundred and seven consecutive patients with obstructive jaundice underwent transluminal forceps biopsy. The lesions involved the common bile duct (n = 33), common hepatic duct (n = 13), hilum (n = 17), right or left intrahepatic bile duct (n = 32), multiple sites (extra and intrahepatic ducts, n = 7), or anastomotic sites (n = 5). In each patient, an average of three specimens was taken with 7F biopsy forceps through a transhepatic biliary drainage tract. The final diagnosis was confirmed with pathologic findings, or a clinical and radiologic follow up. The final diagnoses showed malignancies in 75 patients and benign biliary obstructions in 32 patients. Pathologic classifications of malignancies established by forceps biopsy included 67 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 hepatocelluar carcinoma. There were 6 false-negative diagnoses. The diagnostic performance of transluminal forceps biopsy in malignant biliary obstruction had a sensitivity of 92%, specificity of 100%, positive predictive value of 100%, a negative predictive value of 84.2%, and an accuracy of 94.2%. Percutaneous transluminal forceps biopsy is a safe procedure that is easy to perform through a transhepatic biliary drainage tract. It is a highly accurate technique for diagnosing malignant biliary obstructions

  18. Percutaneous coronary Intervention for ostial occlusion lesion of an anomalous right coronary artery

    Institute of Scientific and Technical Information of China (English)

    Shi-Wei Yang; Yu-Jie Zhou

    2009-01-01

    Ostial lesions present many challenges for percutaneous coronary intervention (PCI). Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including "buddy wire" technique and "focused-force" angioplasty.

  19. Patient radiation exposure during coronary angiography and intervention

    Energy Technology Data Exchange (ETDEWEB)

    Fransson, S.G.; Persliden, J. [Univ. Hospital, Linkoeping (Sweden). Dept. of Thoracic Radiology

    2000-03-01

    Purpose: To prospectively register fluoroscopic and cine times in a random fashion, and to measure patient radiation exposure from routine coronary angiography and coronary balloon angioplasty. We also evaluated an optional dose reduction system used during interventions. Material and methods: The incident radiation to the patient was measured as kerma area product (KAP) in Gycm{sup 2}, obtained from an ionisation chamber mounted on the undercouch tube during 65 coronary angiography procedures and another 53 percutaneous transluminal coronary angioplasties, mostly directly following complete coronary angiography. Results and conclusion: The values from coronary angiography were comparable to other reports with a mean fluoroscopic time of 4.4 min and a mean KAP value of 62.6 Gy/cm{sup 2}. The corresponding figures from coronary balloon angioplasty without stenting were lower than otherwise reported, with 8.2 min and 47.9 Gycm{sup 2}, respectively. The use of coronary stents did prolong the mean fluoroscopic time (10.5 min) but did not significantlyenhance the patient mean radiation dose (51.4 Gycm{sup 2}). The dose reduction technique resulted in a significant KAP value reduction of 57%. In conclusion, with regard to radiation exposure, coronary angiography and balloon angioplasty are considered safe procedures.

  20. Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment

    OpenAIRE

    Tan, M; Pua, U; Wong, DES; Punamiya, SJ; Chua, GC; Teo, N

    2010-01-01

    Purpose: Lower extremity amputation prevention (LEAP) is an ongoing program in our institution aimed at salvaging limbs in patients with critical limb ischemia (CLI). Patients in the LEAP program with reconstructible anatomy on initial Doppler imaging received either bypass surgery or percutaneous transluminal balloon angioplasty (PTA). We present the 3 year limb salvage rate and angiographic disease patterns in 42 consecutive diabetic patients with CLI who received PTA in 2005. Methods and M...

  1. Bivalirudin in percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Sam J Lehman

    2006-12-01

    Full Text Available Sam J Lehman, Derek P ChewDepartment of Medicine, Flinders University, South Australia, AustraliaAbstract: Bivalirudin is a member of the direct thrombin inhibitor group of anticoagulants. It has been evaluated as an alternative to unfractionated and low-molecular-weight heparins in the settings of percutaneous coronary intervention (PCI and acute coronary syndrome (ACS. Results of clinical trials to date suggest bivalirudin is a viable alternative to the use of a heparin combined with a glycoprotein (GP IIb/IIIa inhibitor in these settings. Thrombin has a central role in coagulation and platelet activation in ACS and during PCI. Its direct inhibition is an attractive target for therapy in these settings. Bivalirudin is a 20 amino acid polypeptide hirudin analog. It displays bivalent and reversible binding to the thrombin molecule, inhibiting its action. Direct inhibition of thrombin with bivalirudin has theoretical pharmacokinetic and pharmacodynamic advantages over the indirect anticoagulants. A reduction in rates of bleeding without loss of anti-thrombotic efficacy has been a consistent finding across multiple clinical trials. There may be economic benefits to the use of bivalirudin if it permits a lower rate of use of the GP IIb/IIIa inhibitors. This article reviews the pharmacology of bivalirudin and clinical trial evidence to date. There are now data from multiple clinical trials and meta-analyses in the setting of ACS and PCI. Early results from the acute catheterization and urgent intervention strategy (ACUITY trial are discussed. Keywords: bivalirudin, direct thrombin inhibitor, acute coronary syndrome, percutaneous coronary intervention

  2. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    Science.gov (United States)

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054

  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. 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...

  5. Spontaneous coronary artery dissection causing acute coronary syndrome in a young patient without risk factors

    Directory of Open Access Journals (Sweden)

    Parag Chevli

    2014-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction that is more common in younger patients (under age 50 and in women. Although the etiology is not known, some predisposing conditions to SCAD are well known and include Marfan syndrome, pregnancy and peripartum state, drug abuse, and some anatomical abnormalities of the coronary arteries such as aneurysms and severe kinking. We describe a case of SCAD in a young woman who presented with sudden onset of chest pain and was admitted for the treatment of acute coronary syndrome. The coronary angiography showed dissection of the left anterior descending artery. The patient underwent successful percutaneous transluminal coronary angioplasty and stent placement.

  6. 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)

  7. 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...

  8. Revascularization Strategies in Patients with Diabetes Mellitus and Acute Coronary Syndrome.

    Science.gov (United States)

    Buntaine, Adam J; Shah, Binita; Lorin, Jeffrey D; Sedlis, Steven P

    2016-08-01

    Patients with diabetes mellitus (DM) have more severe CAD and higher mortality in acute coronary syndrome (ACS) than patients without DM. The optimal mode of revascularization-coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)-remains controversial in this setting. For patients with DM and ST-segment elevation myocardial infarction, prompt revascularization of the culprit artery via PCI is generally preferable. In non-ST-elevation ACS, the decision on mode of revascularization is more challenging. Trials comparing CABG with percutaneous transluminal coronary angioplasty, bare metal stents, and first-generation drug-eluting stents in DM patients with multivessel have demonstrated decreased mortality in those receiving CABG. On the other hand, trials and retrospective analyses comparing CABG to PCI with second-generation drug-eluting stents have not shown a statistically significant mortality benefit favoring CABG. This potentially narrowed that gap between CABG and PCI requires further investigation. PMID:27339854

  9. Medline Plus

    Full Text Available ... breast Macular degeneration Nerve conduction Osteoarthritis Osteoporosis Ovulation Parkinson's disease Percutaneous transluminal coronary angioplasty (PTCA) Peristalsis Phagocytosis ...

  10. 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)

  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. 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

  13. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  14. Radiotherapy of renal arterial stenosis using percutaneous transluminal angioplasy (PTA) as compared with surgical measures

    International Nuclear Information System (INIS)

    The techniques and findings of percutaneous transluminal angioplasy (PTA) are described. The method was technically applicable in 24 (86%) of 28 cases of renal arterial stenosis. Two clinically quiescent complications are reported. After a mean observation period of 16.7 months, normal blood pressure was recorded in 8 patients, improved blood pressure in 7 patients, and unchanged values in 5 patients. The disturbed renal function observed in 8 patients was found to have returned to normal in 4 cases and improved in 4 cases. PTA is an alternative to surgical revascularisation in the treatment of renovascular hypertension. Owing to its low traumatic effect on the patient, it is recommended as the method of choice. (orig./MG)

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

    Science.gov (United States)

    Rosenschein, U; Budde-Schwartzman, B

    1997-12-01

    stable angina or AMI were treated by ultrasound angioplasty. Residual stenosis after ultrasound treatment was 71%, after balloon dilation reduced to 34%. In the 6-month follow-up angiograms showed no major adverse effect or restenosis. Our experience with coronary ultrasound thrombolysis (CUT) is based on the analysis of 33 patients' data in the feasibility (Table 1) plus multicenter phase of the ACUTE trial (Analysis of Coronary Ultrasound Thrombolysis Endpoints) (Figure 3). Our patients were exclusively treated for AMI by ultrasound angioplasty and afterwards by PTCA if required (Figure 4). The average final percent stenosis was 20% (Figure 5). The main efficacy parameters, device success and angiographic success rates were 100%, clinical success rate was 91.7% (Figure 6 and Table 2). The adverse clinical events of CUT are limited--at least in our studies--to reocclusion of infarct-related artery and ischemia and could be reversed by additional PTCA. No adverse clinical side effects were observed during sonication of the coronary tree. Final angiography revealed residual stenosis of 20% without morphological signs. These excellent results suggest that bioselectivity of ultrasound together with the developed skills of the catheter system induces rapid and selective thrombolysis with no need to cross the target lesion before sonication. But what is the better solution for thrombosis and which for plaque disruption? The development of transluminal balloon catheter really modified therapeutic approach to obstructive coronary and peripheral arterial disease but it is still accompanied by a high rate of abrupt closure, AMI and death. Although the use of intravenous thrombolytic agents is well established in the treatment of AMI and these agents are widely used, a large patient collective remains (up to 33% and more) in whom their use is inadvisable due to recent stroke, surgery, trauma or other contraindications. (ABSTRACT TRUNCATED) PMID:9483436

  16. Percutaneous Intervention of Sequential Coronary Venous Graft

    OpenAIRE

    Zeki DOGAN; Karabulut, Ahmet; Uzunlar, Bulent

    2014-01-01

    We present a case with coronary bypass grafts in which venous graft was anastomosed to obtuse marginal (OM) 1 and OM2 branches sequentially. We performed percutaneous intervention to the proximal circumflex (CX), OM1, and bridging segment of the venous graft. Finally, bridging segment of the venous graft began to function as a CX body extending between the OM1 and OM2.

  17. Comparison of the Postprocedural Quality of Life between Coronary Artery Bypass Graft Surgery and Percutaneous Coronary Intervention: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Kaneez Fatima

    2016-01-01

    Full Text Available The treatment of choice between coronary artery bypass graft surgery (CABG and percutaneous coronary intervention (PCI has remained unclear. Considering quality of life (QOL increases life expectancy, we believe QOL should be important in determining the optimum treatment. Thus the objective of this review was to illustrate the comparative effects of CABG and PCI on postprocedural QOL. Methods. We searched PubMed (Medline and Embase from inception of the databases to May 2014 using “PCI versus CABG quality of life”, “Percutaneous Coronary intervention versus Coronary artery bypass graft surgery Quality of life”, “PCI versus CABG health status”, “Angioplasty versus CABG”, “Percutaneous coronary intervention versus coronary artery bypass surgery health status”, and different combinations of the above terms. 447 articles were found. After applying strict exclusion criteria, we included 13 studies in this review. Results. From the 9 studies that compared QOL scores at 6 months after procedure, 5 studies reported CABG to be superior. From the 10 studies that compared QOL among patients at 1 year after procedure, 9 reported CABG to be superior. Conclusion. It can be established that CABG is superior to PCI in improving patient’s QOL with respect to all scales used to determine quality of life.

  18. Additional value of transluminal attenuation gradient in CT angiography to predict hemodynamic significance of coronary artery stenosis

    NARCIS (Netherlands)

    W.J. Stuijfzand (Wynand); I. Danad (Ibrahim); P.G. Raijmakers (Pieter); C.B. Marcu (Constantin B.); M.W. Heymans (Martijn); C. van Kuijk (Cornelis); A.C. van Rossum (Albert); K. Nieman (Koen); J.K. Min (James); J. Leipsic (Jonathon); N. van Royen (Niels); P. Knaapen (Paul)

    2014-01-01

    textabstractObjectives The current study evaluates the incremental value of transluminal attenuation gradient (TAG), TAG with corrected contrast opacification (CCO), and TAG with exclusion of calcified coronary segments (ExC) over coronary computed tomography angiogram (CTA) alone using fractional f

  19. 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.

  20. 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

  1. 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

  2. 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

  3. Diagnostic Performance of Transluminal Attenuation Gradient and Noninvasive Fractional Flow Reserve Derived from 320-Detector Row CT Angiography to Diagnose Hemodynamically Significant Coronary Stenosis

    DEFF Research Database (Denmark)

    Ko, Brian S; Wong, Dennis T L; Nørgaard, Bjarne L; Leong, Darryl P; Cameron, James D; Gaur, Sara; Marwan, Mohamed; Achenbach, Stephan; Kuribayashi, Sachio; Kimura, Takeshi; Meredith, Ian T; Seneviratne, Sujith K

    2015-01-01

    Purpose To compare the diagnostic performance of 320-detector row computed tomography (CT) coronary angiography-derived computed fractional flow reserve (FFR; FFRCT), transluminal attenuation gradient (TAG; TAG320), and CT coronary angiography alone to diagnose hemodynamically significant stenosis...

  4. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease

    OpenAIRE

    Serruys, Patrick; Morice, Marie-Claude; Kappetein, Arie Pieter; Colombo, Antonio; Holmes, David; Mack, Michael; Stahle, E.; Feldman, Ted; Brand, Marcel, van den; Bass, Eric; Dyck, Nic; Leadly, Katrin; Dawkins, Keith; Mohr, Friedrich

    2009-01-01

    textabstractBACKGROUND Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary-artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating patients with previously untreated three-vessel or left main coronary artery disease (or both). METHODS We randomly assigned 1800 patients with three-vessel or left main coronary artery disease to und...

  5. 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

  6. 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. 

  7. 急性心肌梗塞经桡动脉冠状动脉介入治疗远期疗效%Long-term effect of delayed percutaneous coronary intervention via radial artery in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    万镇; 范修才

    2011-01-01

    目的:探讨急性心肌梗塞(AMI)后延迟经桡动脉冠状动脉腔内成形术及支架术治疗的远期疗效.方法:133例AMI患者被分为经皮冠状动脉介入治疗组(PCI组)和非PCI组,PCI组于发病后平均13 d行PCI术.随访两组患者的心脏事件发生率.结果:随访期间,与非PCI组相比,PCI组患者主要不良心血管事件发生率明显降低(80%比27.3%,P<0.05),左室射血分数明显提高[(42±6.9)%比(57.4±3.5)%,P<0.05].结论:急性心肌梗塞后延迟冠状动脉介入治疗可减少患者的心脏事件发生.%Objective: To study the long-term effect of delayed percutaneous coronary intervention (PCI) and percutaneous transluminal coronary angioplasty (PTCA) via radial artery in patients with acute myocardial infarction (AMI). Methods: A total of 133 AMI patients were divided into PCI group and non-PCI group, patients in PCI group were given PCI on a mean 13 days after the onset. Major adverse cardiovascular events (MACE) of the two groups were followed up. Results: During follow up period, compared with non - PCI group, incidence rate of MACE (80% vs. 27. 3% , P<0. 05) significantly decreased, left ventricular ejection fraction [ (42±6. 9) % vs. (57. 4±3. 5) % , P< 0. 05] significantly increased in PCI group. Conclusion: Delayed percutaneous coronary intervention can significantly decrease cardiac events in patients with acute myocardial infarction.

  8. The early percutaneous coronary intervention in elderly patients with acute coronary syndrome

    Institute of Scientific and Technical Information of China (English)

    Xiong HUANG; Xuebin CAO; Gang ZHANG

    2008-01-01

    It is challenging to undo early percutaneous intervention (PCI) in the elderly with acute coronary syndrome (ACS). Fifteen patients older than 65 years with ACS within 24 hours of the event were admitted from April 4, 2004 to December 12, 2005. All the patients had early percutaneous coronary intervention and were followed up for 6-12 months by telephone or in the out-patient department. Nine of the 15 patients exhibited acute myocardial infarction (AMI). Six exhib-ited unstable angina (UA). All the patients had early PCI. The average door-to-balloon time was 78 minutes (40-110 minutes). The average PCI time was 99 minutes (68-120 minutes). Nineteen of 36 lesions in the fifteen angioplasty patients were treated and 20 stents were implanted in total. All the procedures were considered successful. Neither deaths nor recurrent angina occurred in the 6-12 months of follow-up. It was shown that early PCI might be an effective and safe method to treat eld-erly patients with ACS.

  9. 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

  10. 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

  11. Trends in Percutaneous Coronary Interventions in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Farhat Yusuf

    2009-01-01

    Full Text Available This is the first detailed study on percutaneous coronary intervention (PCI in New South Wales (NSW, Australia. Hospital data for PCIs carried out between 1 July 1990 and 30 June 2002 are analysed. The study explores trends in PCI rates by selected socio-demographic factors, the utilisation of angioplasties vis-a-vis stents, emergency admissions, and selected coexisting conditions which determine the disease status of PCI patients. Logistic regression models are used to study the medical conditions that require both PCI and coronary artery bypass graft (CABG. The PCI rate has grown rapidly at 12.1% per annum, with a particularly rapid increase for persons aged 75+. The rate of multiple stent utilisation increased at 4.6% per annum. Pacific-born and Middle-Eastern-born patients are more than twice as likely as the Australian-born to have diabetes. Factors affecting failure of PCI requiring CABG include perforation and multi-vessel disease. PCI services in public hospitals need to be increased to facilitate the availability of these procedures to all segments of the population, as do targeted community-level programmes to educate high-risk groups in the control of heart diseases.

  12. Prognosis after percutaneous coronary intervention in patients with psoriasis

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Lindhardsen, Jesper; Gislason, Gunnar;

    2012-01-01

    ABSTRACT: BACKGROUND: Psoriasis is an inflammatory disease associated with increased risk of coronary artery disease. However, the potential impact of psoriasis on the prognosis following percutaneous coronary revascularization (PCI) is unknown. METHODS: The study comprised the entire Danish...

  13. Nicorandil in patients with acute coronary syndrome and stable angina undergoing Percutaneous Coronary Intervention: literature review

    OpenAIRE

    Neda Partovi; Homa Falsoleiman

    2014-01-01

    Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary...

  14. 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.)

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Barriers to Implementation of Primary Percutaneous Coronary Intervention in Europe

    DEFF Research Database (Denmark)

    Laut, Kristina Grønborg; Pedersen, Alma Becic; Lash, Timothy;

    2011-01-01

    Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). Despite substantial evidence of its effectiveness, only 40–45% of European STEMI patients are currently treated with PPCI and there are large...... is needed. Keywords Primary percutaneous coronary intervention, acute ST-elevation myocardial infarction, implementation, practice variation, registry data...

  20. Assessment of Coronary Artery Aneurysms Cased By Kawasaki Diesease Using Transluminal Attenuation Gradient Analysis of CT Angiograms

    OpenAIRE

    Gutierrez, Noelia Grande

    2015-01-01

    Patients with coronary artery aneurysms (CAA) resulting from Kawasaki Disease (KD) are at risk for thrombosis and myocardial infarction. Current guidelines recommend using CAA diameter >8 mm as the criterion for initiating systemic anticoagulation, but there is little outcome data to support this choice. Transluminal Attenuation Gradient (TAG) has been proposed as a non-invasive method for evaluating the functional significance of coronary stenoses using CT Angiography (CTA). However TAG has ...

  1. Assessment Of Coronary Artery Aneurysms Using Transluminal Attenuation Gradient And Computational Modeling In Kawasaki Disease Patients

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Shirinsky, Olga; Gagarina, Nina; Lyskina, Galina; Fukazawa, Ryuji; Owaga, Shunichi; Burns, Jane; Marsden, Alison

    2015-11-01

    Kawasaki Disease (KD) can result in coronary artery aneurysms (CAA) in up to 25% of patients, putting them at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines recommend CAA diameter >8 mm as the arbitrary criterion for initiating systemic anticoagulation. KD patient specific modeling and flow simulations suggest that hemodynamic data can predict regions at increased risk of thrombosis. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length and has been proposed as a non-invasive method for characterizing coronary stenosis from CT Angiography. We hypothesized that CAA abnormal flow could be quantified using TAG. We computed hemodynamics for patient specific coronary models using a stabilized finite element method, coupled numerically to a lumped parameter network to model the heart and vascular boundary conditions. TAG was quantified in the major coronary arteries. We compared TAG for aneurysmal and normal arteries and we analyzed TAG correlation with hemodynamic and geometrical parameters. Our results suggest that TAG may provide hemodynamic data not available from anatomy alone. TAG represents a possible extension to standard CTA that could help to better evaluate the risk of thrombus formation in KD.

  2. 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.)

  3. 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 ...

  4. 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

  5. An attempt of thallium-201 myocardial perfusion imaging during transient coronary arterial occlusion by PTCA

    International Nuclear Information System (INIS)

    To evaluate the myocardial perfusion during transient coronary occlusion, we attempted to obtain the myocardial scintigraphy during percutaneous transluminal coronary angioplasty (PTCA). Tl-201 was injected at the last inflation of angioplastic balloon and occlusion was kept on for 60 sec. Planar images or SPECT were obtained immediately after PTCA. With this protocol, myocardial perfusion defects were observed during PTCA and fully redistributed 3 hours after Tl injection. Extent of ischemic lesions were almost same as that observed during exercise in two cases without collateral vessels. In a case with well visualized collateral vessels, perfusion defect was smaller in PTCA images than that in exercise stressed images. We conclude that intravenous injection of Tl-201 during PTCA is useful to assess the alteration of myocardial perfusion due to transient coronary occlusion without increasing the risk of angioplastic procedure. (author)

  6. 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

  7. Percutaneous brachial artery catheterization for coronary angiography and percutaneous coronary interventions (pci): an encouraging experience of 100 cases

    International Nuclear Information System (INIS)

    Objective: To evaluate the practicability and safety of the percutaneous transbrachial approach (TBA) for diagnostic coronary angiography and therapeutic percutaneous coronary interventions. Study Design: Quasi experimental study. Place and Duration of Study: The study was carried out in Armed Forces Institute of Cardiology- National Institute of Heart Diseases (AFIC-NIHD) from March 2009 to May 2011. Patients and Methods: We collected data of 100 consecutive patients who underwent coronary catheterization by the percutaneous transbrachial approach. Transbrachial catheterization was performed only if the radial access failed or radial pulse was feeble. Study endpoints included successful brachial artery catheterization, vascular and neurological complications at access site and procedure success rate. Results: Mean age of the patients was 54 years (range 33-79 yrs) and 65(65%) were males and 35 (35%) were females. The right brachial artery was used in all of the cases. Procedural success was achieved in 100% of the patients. Coronary angiography was performed in 70 patients and percutaneous coronary interventions were done in 30 cases. Out of these 30 cases, PCI to left coronary arteries (LAD and LCX) were performed in 19 patients while 11 patients had PCI to right coronary artery (RCA). No case of vascular complications such as major access site bleeding, vascular perforation, brachial artery occlusion causing forearm ischemia, compartment syndrome, vascular spasm or failure to catheterize coronary arteries requiring alternate vascular access were observed. Conclusion: Brachial artery is a safe and easily accessible approach for coronary angiography and percutaneous coronary interventions. (author)

  8. 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

  9. Cardiovascular Glossary

    Science.gov (United States)

    ... not close naturally, as it should, after birth. Percutaneous coronary intervention (PCI) - Any of the noninvasive procedures usually performed ... catheterization laboratory. Angioplasty is an example of a percutaneous coronary ... a transcatheter intervention. Percutaneous transluminal coronary ...

  10. Transluminal Attenuation Gradient for Thrombotic Risk Assessment in Kawasaki Disease Patients with Coronary Artery Aneurysms

    Science.gov (United States)

    Grande Gutierrez, Noelia; Kahn, Andrew; Burns, Jane; Marsden, Alison

    2014-11-01

    Kawasaki Disease (KD) can result in coronary aneurysms in up to 25% of patients if not treated early putting patients at risk of thrombus formation, myocardial infarction and sudden death. Clinical guidelines for administering anti-coagulation therapy currently rely on anatomy alone. Previous studies including patient specific modeling and computer simulations in KD patients have suggested that hemodynamic data can predict regions susceptible to thrombus formation. In particular, high Particle Residence Time gradient (PRTg) regions have shown to correlate with regions of thrombus formation. Transluminal Attenuation Gradient (TAG) is determined from the change in radiological attenuation per vessel length. TAG has been used for characterizing coronary artery stenoses, however this approach has not yet been used in aneurysmal vessels. The aim of this study is to analyze the correlation between TAG and PRTg in KD patients with aneurysms and evaluate the use of TAG as an index to quantify thrombotic risk. Patient specific anatomic models for fluids simulations were constructed from CT angiographic image data from 3 KD aneurysm patients and one normal control. TAG values for the aneurysm patients were markedly lower than for the non-aneurysmal patient (mean -18.38 vs. -2). In addition, TAG values were compared to PRTg obtained for each patient. Thrombotic risk stratification for KD aneurysms may be improved by incorporating TAG and should be evaluated in future prospective studies.

  11. 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)....

  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. 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

  14. Mean platelet volume and the risk of periprocedural myocardial infarction in patients undergoing coronary angioplasty

    NARCIS (Netherlands)

    Verdoia, M.; Camaro, C.; Barbieri, L.; Schaffer, A.; Marino, P.; Bellomo, G.; Suryapranata, H.; Luca, G. De

    2013-01-01

    BACKGROUND: Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI). Mean platelet volume (MPV) has been proposed as a marker for platelet activation, as larger sized platelets have been associated with higher pro-thrombotic

  15. 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

  16. 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

  17. Primary Percutaneous Coronary Intervention in a Patient with Haemophilia A

    Directory of Open Access Journals (Sweden)

    S. Ashwin Reddy

    2013-01-01

    Full Text Available Haemophilia A is a rare genetic condition leading to coagulation factor VIII deficiency and thus predisposing to bleeding diathesis. Due to advances in treatment, life expectancy of haemophilia A sufferers is increasing, and the incidence and prevalence of coronary artery disease are rising. There have been many reported cases of acute myocardial infarction in such patients, who subsequently undergo elective percutaneous coronary intervention. We present the case of a 55-year-old gentleman presenting with an acute anterior full-thickness myocardial infarction who required emergency primary percutaneous coronary intervention.

  18. Percutaneous coronary intervention for acute coronary syndrome in dextrocardia and situs

    International Nuclear Information System (INIS)

    A 55 years old male presented with Non-ST Elevated Myocardial Infarction (NSTEMI). He was a known case of dextrocardia. Standard ECG showed finding consistent with dextrocardia. Coronary angiogram was performed after due manipulation and then successful Percutaneous Coronary Intervention (PCI) of right coronary artery was done. (author)

  19. Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    P.N. Ruygrok (Peter); M.W.I. Webster (Mark); V. de Valk (Vincent); G.A. van Es (Gerrit Anne); J.A. Ormiston (John); M-A.M. Morel (Marie-Angèle); P.W.J.C. Serruys (Patrick)

    2001-01-01

    textabstractBACKGROUND: Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. METHODS AND

  20. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device.......To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device....

  1. Risk of thrombosis during coronary angloplasty with low-osmolality contrast media

    International Nuclear Information System (INIS)

    This paper investigates the incidence of coronary thrombus during percutaneous transluminal coronary angioplasty (PTCA), comparing two types of low-osmolality contrast media (ioxaglate vs iohexol). One hundred patients undergoing PTCA were randomized to ioxaglate (n = 50) or iohexol (n = 50). Thrombus was noted on the angiogram and on the guide wire. The authors analyzed 40 variables (four clinical, 21 angiographic, and 15 procedural) without any statistically significant difference. Angiographic evidence of thrombus was seen in one patient (2%) with ioxaglate and in 11 patients (22%) with iohexol ( P < .0056). One patient (2%) with ioxaglate and six (12%) with iohexol showed thrombotic residues on the guide wire (not significant [NS]). There were three acute myocardial infarctions (one with ioxaglate and two with iohexol, P = [NS]) and no deaths

  2. 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

  3. Relationship between plasminogen activator inhibitor-1 gene polymorphism and early local hemostatic activation in patients with percutaneous coronary intervention procedure

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between plasminogen activatorinhibitor-1 (PAI-1) 4 G/5 G gene polymorphism and local homeostatic activation of PAI-1, D-dimers (DD), activated factor VII (F VII Ia) and P-Selectin (CD62P), on patients under percutaneous coronary intervention (PCI)procedures, and to evaluate its prognostic value on acute stent thrombosis by gene polymorphism analysis. Methods: 20 stable angina patients with a 70% diameter stenosis by visual estimation during angiography and a clinical indication for revascularization were selected. Lesions were treated with the use of standard interventional techniques, both stents implantation underwent with adjunctive balloon angioplasty. Simultaneous blood samples were drawn in sequence from the ostium of the coronary artery before balloon angioplasty through guiding catheter, from the distal coronary artery just beyond the dilated segment after balloon angioplasty and after stent implantation, through aspiration catheter. Markers of PAI-1 and CD62P were measured by ELISA. Markers of F VII and DD were measured by technique chronometrique and ELISA VIDAS respectively. Prevalence of the 4 G/5 G polymorphism was investigated using DNA analysis. Results: The distribution of PAI-1 genotypes in French people was as follows: 4 G/4 G in 30.0%, 4 G/5 G in 60.0% and 5 G/5 G in 10.0%. Among the patients, the frequency of the 4 G and 5 G allele were 0.60 and 0.40 respectively. In patients with the 4 G/5 G polymorphism of PAI-1 gene, the activities of the PAI-1, DD and F VIIa in the coronary circulation were significantly increased after balloon angioplasty in comparing with those before balloon angioplasty (P=0.01, respectively). However, there were no significant differences between the levels of hemostatic activation at ostium before balloon angioplasty and distal to lesion after stent implantation in patients with the 4 G/5 G genotype. Conclusions: Balloon angioplasty more easily induces vessel shrinkage and

  4. Early Coronary Artery Bypass Grafting Following Life-Saving Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Kerem Yay

    2013-10-01

    Full Text Available Aim: Percutaneous coronary intervention is usually the initial treatment option for treatment of emergent and severe coronary atherosclerosis with suitable coronary arteries. We aimed to investigate the clinical features, morbidity and mortality rates of coronary artery bypass grafting performed following life-saving stent procedures and patency rates of these stents. Material and Method: Between January 2005 and December 2008, we performed coronary artery bypass grafting on 23 patients who had previous percutaneous coronary intervention to the culprit artery for acute myocardial infarction. Early postoperative coronary angiography was obtained for evaluation of stent patency. Results: In-hospital mortality occurred in five patients (21.7%. Coronary angiographic examination of the remaining patients revealed severe stenosis or occlusion at 16 out 20 stents (80%. The mean time interval between percutaneous coronary intervention and coronary artery bypass grafting was found to be statistically significant regarding stent patency (p=0.007. Discussion: Bypass grafting to a previously stented coronary artery may be the relevant approach even if the angiographic findings are normal, because intraoperative manipulation and systemic effects of cardiopulmonary bypass if used will result in deformity or occlusion of the stent.

  5. On the use of abciximab in percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Iversen, Allan

    2011-01-01

    Introduction: The present thesis ´On the use of abciximab in percutaneous coronary intervention´ is based on 6 papers concerning the glycoprotein IIb/IIIa inhibitor, abciximab. The thesis is divided into 2 sections. One section concerning a randomized trial comparing intracoronary (IC......) with intravenous (IV) abciximab in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), and one section concerning results from 3 registry studies on the effect of abciximab in distinct subgroups of patients with acute coronary syndrome...... might benefit more than others, and that abciximab might even be harmful in yet others. Although data are not consistent, suggestions have been made, that risk factors, such as diabetes, age and complexity of the coronary lesions might influence the efficacy of abciximab. Objectives and methods...

  6. Abciximab and percutaneous coronary intervention: new indications. Medium-term benefit.

    Science.gov (United States)

    2000-04-01

    (1) Abciximab is now indicated for the prevention of ischaemic complications in patients undergoing percutaneous coronary intervention, and for the prevention of myocardial infarction in patients with unstable angina undergoing percutaneous coronary intervention. (2) The clinical file on abciximab now includes three placebo-controlled trials. (3) The EPIC trial involved patients at high risk of thrombosis, while the EPILOG trial included patients regardless of their risk of thrombosis. In neither trial did abciximab reduce overall mortality. In high-risk patients abciximab reduced the risk of a new myocardial infarction at one year, but not for longer. In patients at lower risk, the reduction in the risk of reinfarction persisted for at least six months. (4) The CAPTURE trial showed that abciximab, started 24 hours before angioplasty for unstable angina, reduced the risk of myocardial infarction at one month. (5) The bleeding risk was controlled by the use of heparin at doses adjusted to body weight, and by applying strict precautions to protect the injection site. PMID:11503782

  7. Medline Plus

    Full Text Available ... breast Macular degeneration Nerve conduction Osteoarthritis Osteoporosis Ovulation Parkinson's disease Percutaneous transluminal coronary angioplasty (PTCA) Peristalsis Phagocytosis Pituitary ...

  8. Cardioprotective Effects of Atorvastatin plus Trimetazidine in Percutaneous Coronary Intervention

    OpenAIRE

    Lin, Xuefeng; Ma, Aiqun; Zhang, Wei; Lu, Qun; Sun, Chaofeng; Tian, Hongyan; Lei, Xinjun; Bai, Xiaojun

    2013-01-01

    Objective: To explore the effects of preoperative administration of conventional doses of atorvastatin plus trimetazidine on the myocardial injury of patients during the perioperative period of percutaneous coronary intervention (PCI). Methodology: 475 cases of acute coronary syndrome patients before PCI were randomly divided into the control group (238 cases) and experimental group (237 cases).The control group was treated with conventional doses of atorvastatin calcium (20 mg each time, onc...

  9. Developments in the percutaneous treatment of obstructive coronary artery disease

    OpenAIRE

    Agostoni, P.

    2009-01-01

    Percutaneous coronary interventions are recognized techniques to treat coronary artery disease. However, despite the progress in the development of materials and techniques, several limitations affect the acute and long-term performance of these procedures. In particular, there are three mayor drawbacks: restenosis, thrombosis and technical feasibility of the procedure. The recent introduction of drug-eluting stents has been a major step forward in reducing restenosis. The pivotal randomized ...

  10. Reduced Oxidative Stress in STEMI Patients Treated by Primary Percutaneous Coronary Intervention and with Antioxidant Therapy

    DEFF Research Database (Denmark)

    Ekeløf, Sarah; Jensen, Svend Eggert; Rosenberg, Jacob;

    2014-01-01

    PURPOSE: Coronary reperfusion by primary percutaneous coronary intervention (PCI) has been established as an essential therapy of ST-elevation myocardial infarction (STEMI). Although the coronary intervention is undoubtedly beneficial, reperfusion itself can induce processes resulting in additional...

  11. Platelet PIA1/PIA2 polymorphism and the risk of periprocedural myocardial infarction in patients with acute coronary syndromes undergoing coronary angioplasty

    NARCIS (Netherlands)

    Verdoia, M.; Secco, G.G.; Cassetti, E.; Schaffer, A.; Barbieri, L.; Perrone-Filardi, P.; Marino, P.; Suryapranata, H.; Sinigaglia, F.; Luca, G. De

    2014-01-01

    Acute coronary syndromes (ACSs) represent a high-risk condition, as enhanced platelet reactivity importantly influences myocardial perfusion and procedural results after percutaneous coronary intervention (PCI). In fact, higher rate of periprocedural myocardial infarction (PMI) and reduced event-fre

  12. Prognostic value of serum total bilirubin in patients with acute coronary syndrome after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    孙同文

    2013-01-01

    Objective To investigate the predictive value of serum total bilirubin (STB) level in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) .Methods A total of 1273 consecutive patients treated with PCI in cardiology department,First Affiliated Hospital of Zhengzhou University from June

  13. Patient’s Radiation Exposure in Coronary Angiography and Angioplasty: The Impact of Different Projections

    OpenAIRE

    Farajollahi Alireza; Rahimi Atena; Khayati Shal Ebrahim; Ghaffari Samad; Ghojazadeh Morteza; Tajlil Arezou; Aslanabadi Nasser

    2014-01-01

    Introduction: We aimed to determine angiography projections with lower Dose Area Product (DAP) rate by measuring the mean DAP and fluoroscopy times in coronary angiography (CAG) and percutaneous coronary intervention (PCI) and calculating DAP rate in different projections. Methods: DAP and fluoroscopy times were measured in all employed projections in real-time in 75 patients who underwent CAG or PCI by a single cardiologist in Madani Cardiovascular University Hospital (45 in CAG group and 30...

  14. Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction Treated by Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Marcelo A. Nakazone

    2010-01-01

    Full Text Available Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections which although not frequent, are still causes of morbidity and mortality. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 46-year-old male admitted due to acute anterior ST elevation myocardial infarction submitted to primary percutaneous coronary intervention successfully. Coronary angiography showed a suboccluded ostial lesion of left main coronary artery. VDRL was titrated to 1/512. The patient was discharged with treatment including benzathine penicillin. Previous case reports of acute myocardial infarction in association with syphilitic coronary artery ostial stenosis have been reported, but the fact that the patient was treated by percutaneous coronary intervention is unique in this case.

  15. Reperfusion delay in patients treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schoos, Mikkel M; Sejersten, Maria; Hvelplund, Anders;

    2012-01-01

    -hospital organization with tele-transmitted electrocardiograms, field triage and direct transfer to a 24/7 primary percutaneous coronary intervention (PPCI) center. METHODS AND RESULTS: This was a single center cohort study with long-term follow-up in 472 patients. The PPCI center registry was linked by person...

  16. QT Dispersion: Does It Change after Percutaneous Coronary Intervention?

    Directory of Open Access Journals (Sweden)

    Mahsa Asadi Moghaddam

    2011-02-01

    Full Text Available Background: Myocardial ischemia is one of several causes of prolonged QT dispersion. The aim of this study was to evaluate the effect that percutaneous coronary intervention has on the depolarization and repolarization parameters of surface electrocardiography in patients with chronic stable angina.Methods: We assessed the effects of full revascularization in patients with chronic stable angina and single-vessel disease who underwent percutaneous coronary intervention. Twelve-lead electrocardiograms were recorded before intervention and 24 hours subsequently. We measured parameters including QRS duration, QT and corrected QT durations, and JT and corrected JT duration in both electrocardiograms and compared the values.Results: There were significant differences between the mean QRS interval (0.086 ± 0.01sec vs. 0.082 ± 0.01 second; p value = 0.01, mean corrected QT dispersion (0.080 ± 0.04 sec vs. 0.068 ± 0.04 sec; p value = 0.001, and mean corrected JT dispersion (0.074 ± 0.04 sec vs. 0.063 ± 0.04 sec; p value = 0.001 before and after percutaneous coronary intervention. No significant differences were found between the other ECG parameters.Conclusion: Our data indicate that the shortening of corrected QT dispersion and corrected JT dispersion in patients undergoing percutaneous coronary intervention is prominent.

  17. Successful management of dislodged stents during percutaneous coronary intervention.

    Science.gov (United States)

    Farman, Muhammad Tariq; Sial, Jawaid Akbar; Saghir, Tahir; Rizvi, Syed Nadeem Hasan; Rasool, Syed Ishtiaq; Jamal, Syed Zahid

    2010-02-01

    Stent dislodgement is a very rare but recognized and potentially serious complication of percutaneous coronary intervention (PCI). This case series describe the incidence and etiology of such cases at National Institute of Cardiovascular Diseases, Karachi during the year 2008 and the method of treatment of this complication. PMID:20209706

  18. Operator dependence of outcome after primary percutaneous coronary intervention

    NARCIS (Netherlands)

    Vlaar, Pieter J.; de Smet, Bart J.; van den Heuvel, Ad F.; Anthonio, Rutger L.; Jessurun, Gillian A.; Tan, Eng-Shiong; Hillege, Hans L.; Zijlstra, Felix

    2011-01-01

    Aims: Primary percutaneous coronary intervention (PCI) is a widely practised therapeutic procedure to treat ST-elevation myocardial infarction (STEM l). However, a significant proportion of patients undergoing primary PCI suffers from adverse events, such as incomplete myocardial reperfusion. It is

  19. Genetic inflammatory factors predict restenosis after percutaneous coronary interventions

    NARCIS (Netherlands)

    Monraats, PS; Pires, NMM; Agema, WRP; Zwinderman, AH; Schepers, A; de Maat, MPM; Doevendans, PA; de Winter, RJ; Tio, RA; Waltenberger, J; Frants, RR; Quax, PHA; van Vlijmen, BJM; Atsma, DE; van der Laarse, A; van der Wall, EE; Jukema, JW

    2005-01-01

    Background - Restenosis is a negative effect of percutaneous coronary intervention (PCI). No clinical factors are available that allow good risk stratification. However, evidence exists that genetic factors are important in the restenotic process as well as in the process of inflammation, a pivotal

  20. 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

  1. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Tonino, Pim A L; De Bruyne, Bernard; Pijls, Nico H J;

    2009-01-01

    BACKGROUND: In patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio...... of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes. METHODS: In 20 medical centers in the United States and Europe, we randomly assigned 1005 patients with multivessel coronary artery disease to undergo PCI with implantation of drug...... in the angiography group were free from angina at 1 year, as compared with 81% of patients in the FFR group (P=0.20). CONCLUSIONS: Routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point...

  2. Radiation exposure in coronary intervention

    Energy Technology Data Exchange (ETDEWEB)

    Furuta, Motomu [Kokura Memorial Hospital, Kitakyushu, Fukuoka (Japan)

    1999-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) based on plain old balloon angioplasty is the representative surgery in cardiac interventional radiography, which, with accompanying the increase of patients, causing the serious exposure problem to patients and staff. Recent progress in PTCA practice owes to the development of new devices like the stent with which reduction of exposure dose has been somewhat attained due to the short operation time. Further, standardization of the operation procedure helps to shorten the time. In author`s facility, the pulse fluoroscopy stands from four modes: low-dose, normal, high-quality and slow ones. In these modes, the exposure dose, not the irradiation dose, is taken into consideration according to the FDA concept. The respective modes resulted in the reduction to 33, 70, 70 and 50% of the ordinary fluoroscopy skin dose (12.96 mGy/min: 1.49 R/min). As for exposure to operating staff, the scattering radiation was measured with the DIGITEX 2400 CX apparatus, WAC water phantom and VICTOREEN 450 ionization chamber survey meters and with shielding curtains and lead-acryl board. Shielding was found important for reduction of exposure to the staff. (K.H.)

  3. Immediate Results of Percutaneous Trans-Luminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis

    OpenAIRE

    Seyfollah Abdi; Negar Salehi; Babak Ghodsi; Hossein Ali Basiri; Mahmoud Momtahen; Ata Firouzi; Hamid Reza Sanati; Farshad Shakerian; Mohsen Maadani; Homan Bakhshandeh; Soheila Chamanian; Mitra Chitsazan; Anoushiravan Vakili-Zarch

    2012-01-01

    Background Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The stud...

  4. [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

  5. [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

  6. A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    傅向华

    2003-01-01

    A randomized trail comparing primary percutaneous coronary intervention with a strategy of short-acting thrombolysis and immediate planned primary percutaneous coronary intervention in acute myocardial infarction!050000$河北医科大学第二医院河北医科大学心脏介入中心@傅向华

  7. Comparison of Coronary Artery Bypass Grafting with Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease

    OpenAIRE

    Kawecki, Damian; Morawiec, Beata; Fudal, Marcin; Milejski, Wojciech; Jacheć, Wojciech; Nowalany-Kozielska, Ewa

    2011-01-01

    Purpose Coronary artery bypass grafting (CABG) is the optimal treatment option for left main coronary artery disease (LMCAD). However, LMCAD remains a constant topic of discussion between cardiac surgeons and interventional cardiologists. The aim of this study was to assess the efficacy of LMCAD treatments by comparing the mid-term outcomes of CABG and percutaneous coronary intervention (PCI) using bare metal stents or drug-eluting stents (DESs). Materials and Methods The study population was...

  8. 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

  9. Transluminal attenuation gradient in coronary computed tomography angiography for determining stenosis severity of calcified coronary artery: a primary study with dual-source CT

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Minwen; Wei, Mengqi; Wen, Didi; Zhao, Hongliang; Liu, Ying; Li, Jian [Fourth Military Medical University, Department of Radiology, Xijing Hospital, Xi' an, Shaanxi Province (China); Li, Jiayi [Fourth Military Medical University, Department of Cardiology, Xijing Hospital, Xi' an, Shaanxi Province (China)

    2015-05-01

    To evaluate the diagnostic accuracy of transluminal attenuation gradient (TAG) for stenosis severity of calcified lesions assessed by coronary computed tomography angiography (CCTA). One hundred seven patients who underwent CCTA and coronary angiography (CAG) were enrolled. TAGs of 309 major epicardial coronary arteries were measured. The impact of plaque composition, Agatston scores, and lesion length ratio on TAG were analyzed. Diagnostic performance vs. CAG of TAG, CCTA, and combined TAG/CCTA were evaluated, and incremental value of TAG for reclassification of CCTA stenosis severity in calcified lesions was also analyzed. TAG decreased consistently with stenosis severity. TAG was significantly lower in coronary arteries with calcification scores >300 and lesion length ratios >2/3. TAG improved diagnostic accuracy of CCTA (c-statistic =0.982 vs. 0.942, P = 0.0001) in calcified lesions, and the sensitivity, specificity, positive, and negative predictive values of TAG cutoff ≤ -11.33 were 72 %, 91 %, 88 %, and 78 %, respectively. The addition of TAG to CCTA resulted in significant reclassification (NRI =0.093, P = 0.022) in calcified vessels. Measurement of TAG may improve diagnostic performance and reclassification of CCTA in coronary stenosis caused by calcified lesions. (orig.)

  10. Current status of percutaneous coronary intervention of chronic total occlusion

    Institute of Scientific and Technical Information of China (English)

    Jun-bo GE

    2012-01-01

    This paper describes the current status of percutaneous coronary intervention (PCI) for totally occluded coronary arteries.Chronic total occlusion is associated with 10%-20% of all PCI procedures.Results show that opening an occluded vessel,especially one supplying a considerable area of myocardium,may be beneficial for a patient's angina relief and heart function.We describe the devices used currently in re-canalization such as new wires,microcatheters (including Tonus and Cosair) and intravascular ultrasound guidance.Different techniques to improve the success rate and reduce complications are discussed in detail.

  11. Acute Stent Thrombosis After Primary Percutaneous Coronary Intervention

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Wiberg, Sebastian; Van't Hof, Arnoud;

    2015-01-01

    OBJECTIVES: This study sought to determine clinical, procedural, and treatment factors associated with acute stent thrombosis (AST) in the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial. BACKGROUND: Bivalirudin started during transport for primary percutaneous coronary...... intervention (PCI) for ST-segment elevation myocardial infarction significantly reduced major bleeding compared with heparin with or without glycoprotein IIb/IIIa inhibitors (GPI), but it was associated with an increase in AST. METHODS: We compared patients with (n = 12) or without AST (n = 2,184) regarding...

  12. Device entrapment: a rare complication of percutaneous coronary intervention.

    Science.gov (United States)

    Rehman, Abdul; Rehman, Abdur; Khan, Javaid Arif; Sial, Javaid A; Baloch, Zafar Haleem

    2011-10-01

    Device entrapment is a rare complication of percutaneous coronary intervention. It has hazardous potentials for the patient. Emergent cardiac surgery is the only option after failure of retrieval devices. We have described here a case of a 55 years old male. During percutaneous coronary intervention, the balloon inflated only partially at its ends and entrapped in the lesion along with the stent. Multiple attempts at inflation failed and the patient developed severe chest pain for few minutes. Surgery was contemplated but final attempt at inflation was successful and the patient stabilized. It was an emergent situation and could have led to fatal outcome, although this patient escaped narrowly from any fatal outcome. PMID:22015124

  13. Functional Status and Search for Meaning After Percutaneous Coronary Intervention.

    Science.gov (United States)

    Skaggs, Brenda G; Yates, Bernice C

    2016-02-01

    The purpose of this study was to determine the differences in the search for meaning and functional status (psychological and physical) between persons who undergo percutaneous coronary intervention and have recurrent angina symptoms and those who do not have recurrent symptoms. Participants (224; 147 male, 77 female) who underwent PCI completed the following study materials: Meaning in Heart Disease instrument, Hospital Anxiety and Depression Scale, and SF36v2™. Persons with recurrent angina symptoms (40% of the sample) were more likely to have higher disrupted meaning, greater anxiety, greater depression, lower physical functioning, and greater use of meaning-based coping (searching for answers and refocusing global meaning) compared with individuals without recurrent symptoms. Interventions are needed to identify the risk of recurrent symptoms after percutaneous coronary intervention and provide coping and cognitive behavioral interventions focused on managing the psychological and physical disruptions. PMID:25512267

  14. Predictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention

    OpenAIRE

    Muntner, Paul; Mann, Devin M.; Woodward, Mark; Choi, James W.; Stoler, Robert C; Shimbo, Daichi; Farkouh, Michael E.; Kim, Michael C.

    2011-01-01

    Few data are available on factors associated with low adherence or early clopidogrel discontinuation following percutaneous coronary intervention (PCI). Patients (n=284) were evaluated prior to hospital discharge following PCI to identify factors associated with low adherence to clopidogrel 30 days later. Pre-PCI adherence to daily medications was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low, medium, or high (scores

  15. Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

    OpenAIRE

    Seyed Ahmad Hassantash; Hossein Vakili; Mohammad Hassan Namazi; Habibollah Saadat; Roxana Sadeghi; Hassan Rajabi Moghadam; Morteza Safi; Mohammad Reza Motamedi

    2009-01-01

    Background: Primary percutaneous coronary intervention (primary PCI) is the method of choice in establishing reperfusion in acute myocardial infarction (AMI) patients. The aim of this study was to determine the success rate of primary PCI in a university medical center in Iran with a view to promoting it as a first-line therapy in patients with AMI, especially in centers with established catheterization labs across the country. Methods: All cases of AMI admitted between September 2001 and Sep...

  16. Percutaneous Coronary Intervention Utilization and Appropriateness across the United States

    OpenAIRE

    Michael P Thomas; Parzynski, Craig S.; Curtis, Jeptha P.; Milan Seth; Nallamothu, Brahmajee K.; Chan, Paul S.; Spertus, John A.; Patel, Manesh R.; Bradley, Steven M.; Gurm, Hitinder S.

    2015-01-01

    Background Substantial geographic variation exists in percutaneous coronary intervention (PCI) use across the United States. It is unclear the extent to which high PCI utilization can be explained by PCI for inappropriate indications. The objective of this study was to examine the relationship between PCI rates across regional healthcare markets utilizing hospital referral regions (HRRs) and PCI appropriateness. Methods The number of PCI procedures in each HRR was obtained from the 2010 100% ...

  17. Factors Associated with Early Adverse Events after Coronary Artery Bypass Grafting Subsequent to Percutaneous Coronary Intervention

    OpenAIRE

    Kamal, Yasser Ali; Mubarak, Yasser Shaban; Alshorbagy, Ashraf Ali

    2016-01-01

    Background A previous percutaneous coronary intervention (PCI) may affect the outcomes of patients who undergo coronary artery bypass grafting (CABG). The objective of this study was to compare the early in-hospital postoperative outcomes between patients who underwent CABG with or without previous PCI. Methods The present study included 160 patients who underwent isolated elective on-pump CABG at the department of cardiothoracic surgery, Minia University Hospital from January 2010 to Decembe...

  18. Effect of Percutaneous Coronary Intervention on Left Ventricular Diastolic Function in Patients With Coronary Artery Disease

    OpenAIRE

    Salehi, Nahid; Saidi, Mohammadreza; Rai, Alireza; Najafi, Farid; Javeedannejad, Seedmokhtar; Babanejad, Mehran; Tadbiri, Hooman

    2015-01-01

    Background: There is considerable disagreement over the effects of percutaneous coronary intervention (PCI) on left ventricular diastolic function that has necessitated the investigation of diastolic indices. The present study was conducted to evaluate left ventricular diastolic function and its indices, three months after performing the PCI procedure in patients with coronary artery disease (CAD). Methods: In a quasi-experimental clinical trial study (before and after), 51 patients with CAD ...

  19. Comparison of primary coronary percutaneous coronary intervention between Diabetic Men and Women with acute myocardial infarction

    OpenAIRE

    Liu, Heng-Liang; Liu, Yang; Hao, Zhen-Xuan; Geng, Guo-Ying; Zhang, Zhi-Fang; Jing, Song-Bin; Ba, Ning; Guo, Wei

    2015-01-01

    Objective: This study aimed to explore the short-term efficacy and safety of primary percutaneous coronary intervention (PCI) in female diabetic patients complicated with acute myocardial infarction (AMI). Methods: A total of 169 diabetic patients with AMI who underwent primary PCI were selected and divided into group A (52 females) and group B (117 males). The clinical data, characteristics of coronary artery lesions, lengths of hospital stay, and incidences of complications were then compar...

  20. Percutaneous Coronary Intervention in Single Coronary Artery from Right Sinus: Radial Route is Right

    OpenAIRE

    Rakesh Mahla; Himanshu Mahla; Dinesh Choudhary; Pintu Nahata

    2015-01-01

    We present percutaneous coronary intervention (PCI) using radial approach in a rare case of single coronary artery originating from the right sinus. Although these anomalies and stenosis of anomalous vessels have been described previously, treatment of atherosclerotic lesions by PCI has rarely been reported. There is a definite procedural risk during PCI in patients with a single ostium because dissection with the guiding catheter would result in a catastrophic event. Additionally, technical ...

  1. The Effect of Elective Percutaneous Coronary Intervention of the Right Coronary Artery on Right Ventricular Function

    OpenAIRE

    Farahnaz Nikdoust; Seyed Abdolhosein Tabatabaei 1; Akbar Shafiee; Atoosa Mostafavi; Maryam Mohamadi; Sareh Mohammadi

    2014-01-01

    Background: Right Ventricular (RV) dysfunction has been introduced as a predictor of mortality in acute myocardial infarction. Objectives: This study aimed to investigate the effect of right coronary revascularization on systolic and diastolic RV dysfunction. Patients and Methods: This study was conducted on unstable angina patients who were candidate for elective Percutaneous Revascularization Intervention (PCI) on the right coronary artery. The participants were initially evaluated ...

  2. Sheathless transradial coronary angioplasty in an achondroplasic patient with ST elevation myocardial infarction.

    Science.gov (United States)

    Rahman, Nasir; Nabi, Amjad; Gul, Ibrahim

    2015-01-01

    We present a case of a 50-year-old man with achondroplasia, who presented with anterior ST segment myocardial infarction (STEMI). He was taken urgently to the catheterisation laboratory. Owing to his short stature, it was not possible to insert a radial artery sheath so he underwent a sheathless primary percutaneous coronary intervention (PCI) through the right radial artery, with no complication. He was shifted to the coronary care unit and had an uneventful hospital course. He was discharged in stable condition and follows up regularly as an outpatient. PMID:26508119

  3. Co-registration of optical coherence tomography and X-ray angiography in percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hebsgaard, Lasse; Nielsen, Troels Munck; Tu, Shengxian;

    2014-01-01

    Background Intracoronary imaging provides accurate lesion delineation and precise measurements for sizing and positioning of coronary stents. During percutaneous coronary intervention (PCI), it may be challenging to identify corresponding segments between intracoronary imaging and angiography...

  4. Gender differences following percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Holmvang, L.; Mickley, H.

    2008-01-01

    . In acute coronary syndromes there is no evidence of gender differences regarding the benefit of primary PCI for ST-segment elevation myocardial infarction. However, several trials of unstable angina and non-ST-segment elevation myocardial infarction indicate that women do not have the similar benefit...

  5. Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jakobsen, Lars; Niemann, Troels; Thorsgaard, Niels;

    2012-01-01

    The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood.......The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood....

  6. A study on preparation of 166Ho-DTPA as liquid radiation source for brachytherapy of restenosis of coronary artery

    International Nuclear Information System (INIS)

    DTPA(Diethylene Triamine Pentaacetic Acid) was labelled with 166Ho to minimize the radiation damage of other organs in the worst case of balloon rupture. The labelling yield of 166Ho-DTPA, which was determined by instant thin layer chromatography at varying mole ratio, was 100 % when ratio of DTPA to 166Ho was 4 to 1 and stable at room temperature for 24 hours. Gamma camera imaging data of male rabbit suggested that 166Ho-DTPA was fast excreted via urinary system within 30 min after intravenous administration. Large scale production of high specific activity 166Ho is possible by research reactor HANARO, so it is easy to put to practical use. It is judged that the process of restenosis may be inhibited effectively if 166Ho-DTPA with excellent property of 166Ho radionuclide is filled within the balloon during the PTCA (Percutaneous Transluminal Coronary Angioplasty)

  7. Rate of Urgent Coronary Artery Bypass Grafting in Elective Percutaneous Coronary Intervention (PCI)

    OpenAIRE

    Yonos Nozari; Seyed Amir Kassaei

    2008-01-01

    Background: Latest research shows that about 0.5% of percutaneous coronary intervention (PCI) patients will need urgent coronary artery bypass grafting (CABG) because of coronary accidents. The ACC/AHA guidelines regard on-site cardiac surgery back-up obligatory for PCI centers. It seems the need for urgent CABG in some Iranian PCI centers is less than 0.5%, which may affect decision-making for performing PCI without on-site surgical back-up in the same condition in Iran.Methods: This retrosp...

  8. Thrombus Aspiration during Percutaneous coronary intervention in Acute non-ST-elevation myocardial infarction Study (TAPAS II)-Study design

    NARCIS (Netherlands)

    Kampinga, M. A.; Vlaar, P. J.; Fokkema, M. L.; Gu, Y. L.; Zijlstra, F.

    2009-01-01

    Background and Objective. The Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS) has shown that thrombus aspiration improves myocardial perfusion and clinical outcome compared with conventional primary percutaneous coronary intervention (PCI) i

  9. Rapid Progression of Coronary Atherosclerosis: A Review

    Directory of Open Access Journals (Sweden)

    Priyank Shah

    2015-01-01

    Full Text Available Atherosclerosis is chronic disease, the prevalence of which has increased steadily as the population ages. Vascular injury is believed to be critical initiating event in pathogenesis of spontaneous atherosclerosis. Syndrome of accelerated atherosclerosis has been classically described in patients undergoing heart transplantation, coronary artery bypass graft, and percutaneous transluminal coronary angioplasty. In contrast to spontaneous atherosclerosis, denuding endothelial injury followed by thrombus formation and initial predominant smooth muscle cell proliferation is believed to be playing a significant role in accelerated atherosclerosis. There is no universal definition of rapid progression of atherosclerosis. However most studies describing the phenomenon have used the following definition: (i > or = 10% diameter reduction of at least one preexisting stenosis > or = 50%, (ii > or = 30% diameter reduction of a preexisting stenosis <50%, and (iii progression of a lesion to total occlusion within few months. Recent studies have described the role of coronary vasospasm, human immunodeficiency virus, various inflammatory markers, and some genetic mutations as predictors of rapid progression of atherosclerosis. As research in the field of vascular biology continues, more factors are likely to be implicated in the pathogenesis of rapid progression of atherosclerosis.

  10. Elective Percutaneous Coronary Intervention: The Relationship between Preprocedural Blood Glucose Levels and Periprocedural Myocardial Injury

    OpenAIRE

    Madani, Mohsen; Alizadeh, Keivan; Ghazaee, Sepideh Parchami; Zavarehee, Abbas; Abdi, Seifollah; Shakerian, Farshad; salehi, Negar; Firouzi, Ata

    2013-01-01

    Regardless of the diabetic status of patients with coronary artery disease, hyperglycemia and hypoglycemia are adversely associated with cardiovascular events. The relationship between glucose levels and increased mortality risk in acute myocardial infarction has been shown through various glucose metrics; however, there is a dearth of multivariate analysis of the relationship between elective coronary angioplasty and preprocedural blood glucose levels.

  11. ANALYSIS OF OUTPATIENT PHYSICIANS, PRESCRIPTION OF DISAGGREGANT THERAPY FOR PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION AND/OR CORONARY ANGIOPLASTY WITH STENT IMPLANTATION WITHIN THE RECVAD REGISTRY

    Directory of Open Access Journals (Sweden)

    A. V. Zagrebelnyi

    2015-01-01

    Full Text Available Objective: to estimate the quality of antiaggregants therapy in patients with coronary heart disease in outpatient settings. Materials and methods. The data of the retrospective outpatient RECVAD registry (3690 patients who lived in Ryazan and its Region and had evidence in their outpatient medical records for one of the diagnoses, such as coronary heart disease, hypertension, chronic heart failure, atrial fibrillation, or their concurrence, were used. Forty­nine patients after acute myocardial infarction (AMI and/or percutaneous coro­ nary interventions (PCI with stenting ≤ 1 year before their inclusion in the registry, who were to undergo dual antiaggregant therapy (DAT according to current clinical guidelines (CG, were identified among 427 patients after AMI and/or PCI with coronary angioplasty. Contra­ indications to DAT were simultaneously revealed and a relationship of the use of therapy to their presence was compared. Results. Among the 49 patients who had indications for DAT that was used in 15 (30.6 % cases and that was not in 3 (6.1 % patients in the presence of contraindications, 25 (51.0 % did not receive DAT in the absence of contraindications and 6 (12.3 % patients received the therapy in the presence of contraindications. Conclusion. DAT prescribed by outpatient physicians does not always meet the current CG. There are cases of not using DAT in the presence of obvious indications for DAT and, on the contrary, those of its use in the presence of contraindications. 

  12. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan;

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  13. Health-related quality of life in the elderly three years after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Panasewicz, Anna; Pedersen, Susanne S.; Veenhuis, Stefanie J G;

    2013-01-01

    Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (......Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (...

  14. Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access

    International Nuclear Information System (INIS)

    The aim of this study was to compare the radiation dose to patients during coronary angiography (CA) and coronary intervention (percutaneous transluminal coronary angioplasty, PTCA) by the femoral or radial artery access routes. A plane-parallel ionisation chamber, mounted on an under-couch X-ray tube (Siemens Coroskop TOP with an optional dose reduction system), recorded the dose-area product (DAP) to the patient from 40 coronary angiographies and 42 coronary interventions by the femoral route. The corresponding numbers for radial access were 36 and 24, respectively. Using a human-shaped phantom, conversion factors between maximum entrance surface dose and DAP were derived for CA and CA plus PTCA, respectively. The dose to the staff was measured with TL dosimeters for 22 examinations. Fluoroscopy time and DAP were significantly (p=0.003) larger using the radial access route for coronary angiography (7.5 min, 51 Gy cm2) than the corresponding values obtained from femoral access route (4.6 min, 38 Gy cm2). For CA plus PTCA the fluoroscopy time and DAP were larger for radial access (18.4 min, 75 Gy cm2) than for femoral access (12.5 min, 47 Gy cm2; p=0.013). In our experience, radial access did significantly prolong the fluoroscopy time and increase the patient doses. (orig.)

  15. Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access

    Energy Technology Data Exchange (ETDEWEB)

    Sandborg, Michael; Pettersson, Haakan [Department of Radiation Physics, Faculty of Health Sciences and University Hospital, 58185, Linkoeping (Sweden); Fransson, Sven-Goeran [Department of Thoracic Radiology, University Hospital, 58185, Linkoeping (Sweden)

    2004-04-01

    The aim of this study was to compare the radiation dose to patients during coronary angiography (CA) and coronary intervention (percutaneous transluminal coronary angioplasty, PTCA) by the femoral or radial artery access routes. A plane-parallel ionisation chamber, mounted on an under-couch X-ray tube (Siemens Coroskop TOP with an optional dose reduction system), recorded the dose-area product (DAP) to the patient from 40 coronary angiographies and 42 coronary interventions by the femoral route. The corresponding numbers for radial access were 36 and 24, respectively. Using a human-shaped phantom, conversion factors between maximum entrance surface dose and DAP were derived for CA and CA plus PTCA, respectively. The dose to the staff was measured with TL dosimeters for 22 examinations. Fluoroscopy time and DAP were significantly (p=0.003) larger using the radial access route for coronary angiography (7.5 min, 51 Gy cm{sup 2}) than the corresponding values obtained from femoral access route (4.6 min, 38 Gy cm{sup 2}). For CA plus PTCA the fluoroscopy time and DAP were larger for radial access (18.4 min, 75 Gy cm{sup 2}) than for femoral access (12.5 min, 47 Gy cm{sup 2}; p=0.013). In our experience, radial access did significantly prolong the fluoroscopy time and increase the patient doses. (orig.)

  16. Meta-analysis of time-related benefits of statin therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention

    NARCIS (Netherlands)

    Navarese, E.P.; Kowalewski, M.; Andreotti, F.; Wely, M. van; Camaro, C.; Kolodziejczak, M.; Gorny, B.; Wirianta, J.; Kubica, J.; Kelm, M.; Boer, M.J. de; Suryapranata, H.

    2014-01-01

    Patients with acute coronary syndromes (ACSs) still experience high rates of recurrent coronary events, particularly, early in their presentation. Statins yield substantial cardiovascular benefits, but the optimal timing of their administration, before or after percutaneous coronary intervention (PC

  17. 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

  18. 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...

  19. Diagnosis and management of coronary dissection and perforation in percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    TAN Ning; HE Peng-cheng

    2010-01-01

    @@ With 20 years of instrumental progress and technical creativity,percutaneous coronary intervention(PCI)has become one of the most important treatments for coronary artery disease.As PCI depends either on the mechanical dilatation of the artery or on the ablation of atherosclerotic plaque,and because most procedures are carried out in impaired coronary arteries,including the passage of the guidewire,balloon inflation,and stent implantation,PCI may result in life-threatening complications,such as dissection and perforation.These complications should be treated correctively and promptly.The purpose of this paper was to review the incidence,pathogenesis and management of coronary artery dissection and perforation arising from the use of PCI.

  20. Percutaneous Coronary Intervention in Single Coronary Artery from Right Sinus: Radial Route is Right

    Directory of Open Access Journals (Sweden)

    Rakesh Mahla

    2015-01-01

    Full Text Available We present percutaneous coronary intervention (PCI using radial approach in a rare case of single coronary artery originating from the right sinus. Although these anomalies and stenosis of anomalous vessels have been described previously, treatment of atherosclerotic lesions by PCI has rarely been reported. There is a definite procedural risk during PCI in patients with a single ostium because dissection with the guiding catheter would result in a catastrophic event. Additionally, technical difficulties may occur due to the ostial configuration and course of the branch to be stented. The patient suffered an acute coronary syndrome-inferior wall STEMI, and was thrombolysed elsewhere within a window period of 4 h. He had post myocardial infarction (MI angina and was referred to our center after 3 days of thrombolysis. We present this technically challenging and rare case in which PCI of right coronary artery was performed through the radial route.

  1. Percutaneous coronary intervention for acute myocardial infarction with mitral regurgitation.

    Science.gov (United States)

    Tu, Yan; Zeng, Qing-Chun; Huang, Ying; Li, Jian-Yong

    2016-09-01

    Ischemic mitral regurgitation (IMR) is a common complication of acute myocardial infarction (AMI). Current evidences suggest that revascularization of the culprit vessels with percutaneous coronary artery intervention (PCI) or coronary artery bypass grafting can be beneficial for relieving IMR. A 2.5-year follow-up data of a 61-year-old male patient with ST-segment elevation AMI complicated with IMR showed that mitral regurgitation area increased five days after PCI, and decreased to lower steady level three months after PCI. This finding suggest that three months after PCI might be a suitable time point for evaluating the possibility of IMR recovery and the necessity of surgical intervention of the mitral valve for AMI patient. PMID:27582769

  2. 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.)

  3. The Prognosis of Primary Percutaneous Coronary Intervention after One Year Clinical Follow Up

    Directory of Open Access Journals (Sweden)

    Yahya Dadjoo

    2013-03-01

    Full Text Available Objectives: The aim of this study was to evaluate the clinical outcomes, one year after primary percutaneous coronary intervention(PCI. Patients and Methods: From September 2009 to March 2012, primary PCI was performed on 70 cases, and the data relating to their catheterization were recorded. Peri-interventional treatment data included PCI with drug-eluting or bare-metal stent or balloon angioplasty alone. Results: The mean age of the patients was 61.34+11.31 years, and 72.9% of them were males. The ratios of patients with diabetes, hypertension and, hyperlipidemia were 61.4%, 71.4%, and 52.9% respectively. In clinical follow-up, total incidence of death was 4.3%, with no death occurring during 30 days. However, 3 patients died after one-year, of which one patient (1.4% had cardiac problem and the other 2 (2.9% died because of non-cardiac reasons. Target vessel revascularization, reinfarction within 30 days, and mechanical complication or stroke were not found in any of the patients. Patients with hypertension (6% and those with LAD ST-elevation myocardial infarction (5% died after one year (P= 0.263 and P= 0.319 respectively. However, no mortality was reported in patients with RCA and LCX ST-elevation myocardial infarction. Of subjects with multivessel disease, 7% died after one-year (P= 0.161, but there was no reported mortality in those with single vessel disease.

  4. Usefulness of myocardial perfusion SPECT after percutaneous coronary intervention (PCI)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Jin; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-02-15

    As the indication of percutaneous coronary intervention (PCI) has expanded to the more difficult and complicated cases, frequent restenosis is still expected after PCI. According to AHA/ACC guideline of the present time, routine use of myocardial perfusion single photon emission tomography (SPECT) is not recommended after coronary intervention, but symptom itself or exercise EKG is not enough for the detection of restensis or for the prediction of event-free survival. In high risk and/or symptomatic subjects, direct coronary angiography is required. Myocardial perfusion SPECT could detect restenosis in 79% of the patients if performed 2 to 9 months after PCI. Reversible perfusion decrease in the myocardial perfusion SPECT is known to be the major prognostic indicator of major adverse cardiac event in PCI patients and also the prognosis is benign in the patients without reversible perfusion decrease. Though the cumulated specificity is 79% in the literature and optimal timing of myocardial perfusion SPECT is in controversy, SPECT is recommended even in asymptomatic patients at 3 to 9 months after PCI. Considering the evidences recently reported in the literature, myocardial perfusion SPECT is useful for risk stratification and detection of coronary artery restenosis requiring re-intervention in the asymptomatic patients after PCI.

  5. Improvement in coronary haemodynamics after percutaneous coronary intervention: assessment using instantaneous wave-free ratio

    OpenAIRE

    Nijjer, S. S.; Sen, S.; Petraco, R.; R. Sachdeva; Cuculi, F.; Escaned, J; Broyd, C; Foin, N.; Hadjiloizou, N.; Foale, R A; Malik, I; Mikhail, G W; Sethi, A. S.; Al-Bustami, M.; Kaprielian, R. R.

    2013-01-01

    Objective: To determine whether the instantaneous wave-free ratio (iFR) can detect improvement in stenosis significance after percutaneous coronary intervention (PCI) and compare this with fractional flow reserve (FFR) and whole cycle Pd/Pa. Design: A prospective observational study was undertaken in elective patients scheduled for PCI with FFR ≤0.80. Intracoronary pressures were measured at rest and during adenosine-mediated vasodilatation, before and after PCI. iFR, Pd/Pa and FFR values...

  6. Direct thrombin inhibitors in acute coronary syndromes: effect in patients undergoing early percutaneous coronary intervention

    OpenAIRE

    Sinnaeve, Peter; Simes, John; Yusuf, Salim; Garg, Jyotsna; Mehta, Shamir; Eikelboom, John; Bittl, John A; Serruys, Patrick; Topol, Eric J.; Granger, Christopher B

    2005-01-01

    AIMS: We evaluated the effect of direct thrombin inhibitors (DTIs) in patients undergoing early percutaneous coronary intervention (PCI), using the DTI Trialists' Collaboration database of 35,970 patients from 11 randomized trials of DTIs vs. heparin. METHODS AND RESULTS: We performed a Cox proportional hazards regression analysis with PCI as a time-dependent covariate to assess the independent impact of DTIs according to the performance of early PCI. PCI was performed in 7049 patients in the...

  7. Percutaneous transluminal angioplasty (PTA) and venous stenting in hemodialysis patients with vascular access-related venous stenosis or occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Christidou, Fotini P. [Renal Unit, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Kalpakidis, Vasilios I. [Department of Radiology, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Iatrou, Kostas D. [Department of Radiology, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Zervidis, Ioannis A. [Department of Radiology, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Bamichas, Gerasimos I. [Renal Unit, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Gionanlis, Lazaros C. [Renal Unit, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Natse, Taisir A. [Renal Unit, G.H. ' G. Papanikolaou' , Thessaloniki (Greece); Sombolos, Kostas J. [Renal Unit, G.H. ' G. Papanikolaou' , Thessaloniki (Greece)]. E-mail: sobolos@spark.net.gr

    2006-05-15

    Aim of the study: To present our experience with PTA and venous stenting in hemodialysis patients with vascular access (VA) related venous stenosis or occlusion. Patients - methods: We studied retrospectively 22 hemodialysis patients with VA-related venous stenosis or occlusions that were treated with PTA and subsequent stenting. The following lesions were detected by digital subtraction venography: occlusion of the brachiocephalic and/or subclavian veins in four patients, stenosis (80-90%) of the same veins in 10 patients, stenosis (80-95%) of the axillary vein in four patients, brachial vein stenosis in two patients, and cephalic vein stenosis in two patients. The follow-up period ranged from 3 to 29 months (mean 15.4 {+-} 9.8 months). Primary and cumulative stent patency was recorded. Results: Twenty-two primary venous PTA-stent implantation procedures were performed using 25 stents. The initial deployment of these 25 stents was technically successful, with complete opening (>80%) of the vein's lumen in all but one patient (95.4%). The patency of the vein immediately after the stenting procedure was greater than 90% in 13 patients, 80-90% in eight patients, and less than 40% in the case involving failure. Seventeen episodes of re-obstruction occurred in 13 patients (59%), and all were treated with the same PTA-stent procedures. At the end of the study period 47 stents had been placed in patients. The 3, 6, 12 and 24-month primary patency rates were 88.3%, 65.3%, 45.6% and 25.5%, respectively. Overall cumulative stent patency was 95.4% after 3 months, 79% after 6 months, 74% after 12 months, and 62.8% after 24 months. Conclusion: PTA with primary venous stenting is an effective method for the treatment of VA-related stenosis or occlusion. However, repeat and sometimes multiple interventions are usually needed for the treatment of re-stenosis or re-occlusion episodes.

  8. Coronary artery bypass grafting versus percutaneous intervention in coronary revascularization: a historical perspective and review

    Directory of Open Access Journals (Sweden)

    Burgess SN

    2015-06-01

    Full Text Available Sonya N Burgess,1 John J Edmond,2 Craig P Juergens,1 John K French11Department of Cardiology, Liverpool Hospital and South Western Sydney Clinical School, The University of New South Wales, Sydney, NSW, Australia; 2Department of Cardiology, Dunedin Public Hospital, Dunedin, New Zealand Background: Coronary artery bypass graft surgery is arguably the most intensively studied surgical procedure, and percutaneous coronary intervention (PCI has been subjected to more randomized clinical trials than any other interventional procedure. Changes seen in revascularization techniques have been numerous. The rapid evolution of evidence-based revascularization procedures has occurred as a result of many pivotal large randomized clinical trials. Objective: This review compares and contrasts outcomes from two coronary revascularization techniques, coronary artery bypass grafting (CABG and PCI, with particular reference to the landmark trials that inform practice guidelines. Methods: We undertook a comprehensive review of published literature addressing trials in this field performed to address current knowledge both in the predrug-eluting stent and postdrug-eluting stent era. Results and discussion: Surgical and percutaneous revascularization strategies have different strengths and weaknesses, and neither strategy is superior in all patients, clinical presentations, or anatomical subgroups. Current data support the use of percutaneous intervention in ST elevation myocardial infarction and in single-vessel disease. In noncomplex multivessel disease and isolated left main stem PCI, the data support non-inferiority of PCI compared to CABG as reflected in the 2014 European Society of Cardiology guidelines. Landmark revascularization trials of multivessel disease comparing CABG to PCI found no survival benefit to CABG over PCI, except in patients with complex disease. In these trials, revascularization drove differences in primary endpoints and in all but the

  9. 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

  10. Comparison of prasugrel and clopidogrel in patients with acute coronary syndrome undergoing percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Nicholas B Norgard

    2009-10-01

    Full Text Available Nicholas B Norgard,1 Mazen Abu-Fadel21University at Buffalo, School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA; 2University of Oklahoma Health Sciences Center, Cardiovascular Section, Oklahoma City, OK, USAAbstract: Antiplatelet agents are the cornerstone of treatment for patients with acute coronary syndrome (ACS undergoing percutaneous coronary intervention (PCI. Clopidogrel, when added to aspirin, has demonstrated considerable success at reducing thrombotic complications of ACS and/or PCI compared to aspirin alone and is standard of care for the management of patients with ACS and in patients undergoing PCI. Prasugrel is a novel thienopyridine antiplatelet agent recently approved for the treatment of patients with ACS undergoing PCI. Prasugrel provides greater and more consistent platelet inhibition than clopidogrel due to earlier and more extensive formation of its active metabolite. The enhanced platelet inhibition with prasugrel led to a reduction in major adverse cardiovascular events in patients with moderate to high risk ACS scheduled for PCI in the phase 3 TRITON-TIMI 38 trial. This benefit was seen more in patients suffering a STEMI and those with diabetes. However, this reduction in events was met with a significant increase in the risk of bleeding which overcame prasugrel’s benefit in certain groups. Future studies with prasugrel are needed to determine its optimal utilization to minimize bleeding risks and evaluate its outcomes in ACS and safety profile in special patient populations.Keywords: clopidogrel, prasugrel, percutaneous coronary intervention, acute coronary syndrome

  11. Percutaneous transvenous mitral commissurotomy (PTMC) and percutaneous coronary intervention (PCI) successfully applied in one patient in same sitting.

    Science.gov (United States)

    Sial, Jawaid Akbar; Farman, Muhammad Tariq; Saghir, Tahir; Zaman, Khan Shah

    2011-01-01

    Sixty years old male with severe rheumatic mitral stenosis (MS), presented with dyspnoea New York Heart Association (NHYA) class III to IV. Coronary angiogram revealed severe occlusive coronary artery disease in left anterior coronary artery (LAD). Percutaneous Transvenous Mitral Commissurotomy (PTMC) and Percutaneous Coronary Intervention (PCI) of Left Anterior Descurery (LAD) were done in same sitting. Both procedures were successful and ended without complication. After, half an hour while shifting to coronary care unit (CCU) patient developed cardiac tamponade, which was managed successfully. Patient was followed up for three month, he is doing well and recent echocardiogram showed mild mitral stenosis with normal left ventricular function. This case demonstrates the feasibility of the combined appliance on interventional techniques in selected patients as an alternative to cardiac surgery. PMID:22368914

  12. Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Lassen, Jens Flensted;

    2007-01-01

    AIMS: Collateral flow may influence long-term results after percutaneous coronary intervention (PCI) because of haemodynamic forces compete with the antegrade flow through the dilated lesion. The aim of the study was to assess the influence of recruitable collateral blood flow on restenosis......-derived collateral flow index (CFI) was determined as (P(w)-P(cvp))/(P(a)-P(cvp)), where P(w) represents coronary wedge pressure, P(cvp) central venous pressure, and P(a) mean aortic blood pressure. Both were measured during transient coronary occlusion by a balloon inflation of 30 s. Pre-interventional FFR (0.......25) had a lower pre-interventional FFR (0.50 +/- 0.14 vs. 0.72 +/- 0.18, P

  13. Coronary plaque morphology on multi-modality imagining and periprocedural myocardial infarction after percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Akira Sato

    2016-06-01

    Full Text Available Percutaneous coronary intervention (PCI may be complicated by periprocedural myocardial infarction (PMI as manifested by elevated cardiac biomarkers such as creatine kinase (CK-MB or troponin T. The occurrence of PMI has been shown to be associated with worse short- and long-term clinical outcome. However, recent studies suggest that PMI defined by biomarker levels alone is a marker of atherosclerosis burden and procedural complexity but in most cases does not have independent prognostic significance. Diagnostic multi-modality imaging such as intravascular ultrasound, optical coherence tomography, coronary angioscopy, near-infrared spectroscopy, multidetector computed tomography, and magnetic resonance imaging can be used to closely investigate the atherosclerotic lesion in order to detect morphological markers of unstable and vulnerable plaques in the patients undergoing PCI. With the improvement of technical aspects of multimodality coronary imaging, clinical practice and research are increasingly shifting toward defining the clinical implication of plaque morphology and patients outcomes. There were numerous published data regarding the relationship between pre-PCI lesion subsets on multi-modality imaging and post-PCI biomarker levels. In this review, we discuss the relationship between coronary plaque morphology estimated by invasive or noninvasive coronary imaging and the occurrence of PMI. Furthermore, this review underlies that the value of the multimodality coronary imaging approach will become the gold standard for invasive or noninvasive prediction of PMI in clinical practice.

  14. Diagnostic Performance of Transluminal Attenuation Gradient and Noninvasive Fractional Flow Reserve Derived from 320-Detector Row CT Angiography to Diagnose Hemodynamically Significant Coronary Stenosis: An NXT Substudy.

    Science.gov (United States)

    Ko, Brian S; Wong, Dennis T L; Nørgaard, Bjarne L; Leong, Darryl P; Cameron, James D; Gaur, Sara; Marwan, Mohamed; Achenbach, Stephan; Kuribayashi, Sachio; Kimura, Takeshi; Meredith, Ian T; Seneviratne, Sujith K

    2016-04-01

    Purpose To compare the diagnostic performance of 320-detector row computed tomography (CT) coronary angiography-derived computed fractional flow reserve (FFR; FFRCT), transluminal attenuation gradient (TAG; TAG320), and CT coronary angiography alone to diagnose hemodynamically significant stenosis as determined by invasive FFR. Materials and Methods This substudy of the prospective NXT study (no. NCT01757678) was approved by each participating institution's review board, and informed consent was obtained from all participants. Fifty-one consecutive patients who underwent 320-detector row CT coronary angiographic examination and invasive coronary angiography with FFR measurement were included. Independent core laboratories determined coronary artery disease severity by using CT coronary angiography, TAG320, FFRCT, and FFR. TAG320 is defined as the linear regression coefficient between luminal attenuation and axial distance from the coronary ostium. FFRCT was computed from CT coronary angiography data by using computational fluid dynamics technology. Diagnostic performance was evaluated and compared on a per-vessel basis by the area under the receiver operating characteristic (ROC) curve (AUC). Results Among 82 vessels, 24 lesions (29%) had ischemia by FFR (FFR ≤ 0.80). FFRCT exhibited a stronger correlation with invasive FFR compared with TAG320 (Spearman ρ, 0.78 vs 0.47, respectively). Overall per-vessel accuracy, sensitivity, specificity, and positive and negative predictive values for TAG320 (<15.37) were 78%, 58%, 86%, 64%, and 83%, respectively; and those of FFRCT were 83%, 92%, 79%, 65%, and 96%, respectively. ROC curve analysis showed a significantly larger AUC for FFRCT (0.93) compared with that for TAG320 (0.72; P = .003) and CT coronary angiography alone (0.68; P = .008). Conclusion FFRCT computed from 320-detector row CT coronary angiography provides better diagnostic performance for the diagnosis of hemodynamically significant coronary stenoses

  15. The Angio-Seal™ femoral closure device allows immediate ambulation after coronary angiography and percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Hvelplund, Anders; Jeger, Raban; Osterwalder, Remo;

    2011-01-01

    Aims: To test the safety of immediate mobilisation of patients undergoing coronary angiography and percutaneous coronary intervention (PCI) closed with Angio-Seal™ -a femoral vascular closure device. Methods and results: First, a randomised controlled trial of immediate mobilisation vs. delayed...

  16. Spontaneous coronary artery dissection in men presenting with acute coronary syndrome, successfully managed by intravascular ultrasound-guided percutaneous coronary intervention

    OpenAIRE

    Thomas, Bethan Nia; Aslam, Sajid; Cullen, James; Anantharaman, Rajaram

    2014-01-01

    Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. It is most commonly seen in young women, without atherosclerosis, in the peripartum period. Management options include conservative medical treatment, percutaneous coronary intervention or a surgical approach depending on the presentation, extent of dissection and luminal stenosis. We describe three unusual cases of spontaneous coronary artery dissection occurring in young/middle-aged men—the first in associati...

  17. Slow-flow phenomenon after elective percutaneous coronary intervention of computed tomography-detected vulnerable coronary lesion

    Science.gov (United States)

    Wolny, Rafał; Dębski, Artur; Kruk, Mariusz

    2014-01-01

    No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality. We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon. PMID:25489304

  18. Targeting reperfusion injury in the era of primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen

    2015-01-01

    Introduction of reperfusion therapy by primary percutaneous coronary intervention (PCI) has resulted in improved outcomes for patients presenting with ST-segment elevation myocardial infarction. Despite the obvious advantages of primary PCI, acute restoration of blood flow paradoxically also...

  19. Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    许晓晗

    2013-01-01

    Objective To explore the effects of trimetazidine therapy on left ventricular(LV)function after percutaneous coronary intervention(PCI).Methods A total of 106 patients with unstable angina pectoris undergoing successful

  20. Safety of Early Discharge After Primary Percutaneous Coronary Intervention.

    Science.gov (United States)

    Satılmısoglu, M Hulusi; Gorgulu, Sevket; Aksu, Hale Unal; Aksu, Huseyin; Ertaş, Gokhan; Tasbulak, Omer; Buturak, Ali; Kalkan, Ali Kemal; Degirmencioglu, Aleks; Koroglu, Bayram; Tusun, Eyyup; Murat, Ahmet; Oz, Ahmet

    2016-06-15

    In contrast to ST-elevation myocardial infarction treatment, there is no clear definition for when and which patient to discharge. Our study's main goal was to test the hypothesis that an early discharge strategy (within 48 to 56 hours) in patients with successful primary percutaneous coronary intervention (PPCI) is as safe as in patients who stay longer. The Early Discharge after Primary Percutaneous Coronary Intervention trial was designed in a prospective, randomized, multicenter fashion and registered with http://clinicaltrials.gov (NCT01860079). Of 900 patients with ST-elevation myocardial infarction, the study randomized 769 eligible patients to the early or the standard discharge group. The study's primary outcomes were all-cause mortality and readmission at 30 days. We considered assessment of functional status and health-related quality of life to be secondary outcomes. The early discharge group had significantly shorter length of hospital stay compared with the standard discharge group (45.99 ± 9.12 vs 114.87 ± 63.53 hours; p <0.0001). Neither all-cause mortality nor readmissions were different between the 2 study groups (p = 0.684 and p = 0.061, respectively). Quality-of-life measures were not statistically different between the 2 study groups. Our study reveals that discharge within 48 to 56 hours after successful PPCI is feasible, safe, and does not increase the 30-day readmission rate. Moreover, the patients perceived health status at 30 days did not differ with early discharge. PMID:27156829

  1. Significant reduction of left atrial volume concomitant with clinical improvement after percutaneous transluminal septal myocardial ablation for drug-refractory hypertrophic obstructive cardiomyopathy, and its precise detection with multidetector CT

    OpenAIRE

    Maekawa, Yuichiro; Akita, Keitaro; Tsuruta, Hikaru; Yamada, Yoshitake; Hayashida, Kentaro; Yuasa, Shinsuke; Murata, Mitsushige; Jinzaki, Masahiro; Fukuda, Keiichi

    2016-01-01

    Objective In patients with hypertrophic obstructive cardiomyopathy (HOCM), left atrial (LA) volume measurement is very important to provide prognostic information. Recent studies demonstrated that multidetector CT (MDCT) is useful to assess the changes in LA volume. Our aim was to examine the utility of a follow-up cardiac MDCT for long-term evaluation of the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on LA volume. Methods We studied a consecutive cohort of 20 pati...

  2. Stress echocardiography for risk stratification of patients following percutaneous coronary intervention

    OpenAIRE

    Cortigiani, Lauro; Sicari, Rosa; Bigi, Riccardo; Bovenzi, Francesco; Picano, Eugenio

    2007-01-01

    Objectives: To assess the prognostic value of stress echocardiography following percutaneous coronary intervention. Materials and methods: The study group was made by 904 patients (682 men; age 64?10 years) who underwent stress echocardiography with exercise (n=66), dipyridamole (n=677) or dobutamine (n=161) after a median of 7 months from percutaneous coronary intervention. Patients were followed-up for the occurence of hard (death, infarction) and major events [death, infarction, late (>3 m...

  3. Primary coronary angioplasty in 9,434 patients during acute myocardial infarction: predictors of major in- hospital adverse events from 1996 to 2000 in Brazil

    Directory of Open Access Journals (Sweden)

    Mattos Luiz Alberto

    2002-01-01

    Full Text Available OBJECTIVE: To verify the results after the performance of primary coronary angioplasty in Brazil in the last 4 years. METHODS: During the first 24 hours of acute myocardial infarction onset, 9,434 (12.2% patients underwent primary PTCA. We analyzed the success and occurrence of major in-hospital events, comparing them over the 4-year period. RESULTS: Primary PTCA use increased compared with that of all percutaneous interventions (1996=10.6% vs. 2000=13.1%; p<0.001. Coronary stent implantation increased (1996=20% vs. 2000=71.9%; p<0.001. Success was greater (1998=89.5% vs. 1999=92.5%; p<0.001. Reinfarction decreased (1998=3.9% vs. 99=2.4% vs. 2000=1.5%; p<0.001 as did emergency bypass surgery (1996=0.5% vs. 2000=0.2%; p=0.01. In-hospital deaths remained unchanged (1996=5.7% vs. 2000=5.1%, p=0.53. Balloon PTCA was one of the independent predictors of a higher rate of unsuccessful procedures (odds ratio 12.01 [CI=95%] 1.58-22.94, and stent implantation of lower mortality rates (odds ratio 4.62 [CI=95%] 3.19-6.08. CONCLUSION: The success rate has become progressively higher with a significant reduction in reinfarction and urgent bypass surgery, but in-hospital death remains nearly unchanged. Coronary stenting was a predictor of a lower death rate, and balloon PTCA was associated with greater procedural failure.

  4. Improved clinical outcomes with intracoronary compared to intravenous abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Hansen, Peter Riis; Iversen, Allan; Abdulla, Jawdat

    2010-01-01

    Intracoronary (IC) administration of abciximab may increase local drug levels by several orders of magnitude compared to intravenous (IV) treatment and may improve clinical outcomes in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). In the absence...

  5. Analysis of digital subtraction coronary angiography for estimation of flow reserve in critical coronary stenosis

    International Nuclear Information System (INIS)

    To examine the accuracy of digital subtraction angiographic assessment of coronary flow reserve in critical coronary stenosis, time-density curve was obtained from digital subtraction coronary angiograms for myocardial region of interest. Time to peak contrast(TPC) and time constant of the washout exponential curve(T) were measured in 14 patients with stable effort angina pectoris and critical one vessel lesion before and after percutaneous transluminal coronary angioplasty(PTCA). All patients had normal left ventricular ejection fraction (59 ± 7 %) and Tl201 myocardial image at rest. The values of TPC and T were significantly shortened from 5.4 ± 1.3 to 4.5 ± 1.0 sec (p < 0.02) and from 10.9 ± 3.8 to 5.3 ± 1.3 sec(p < 0.001) after PTCA, respectively. However, in 9 of all patients TPC after PTCA showed approximately the same valued as those before PTCA. In 5 experimental dogs with critical circumflex stenosis, coronary flow(CF;Doppler flow meter) and systolic thickning of the posterior wall(by sonomicrometry) at rest were not different from control, however, contrast media-induced reactive hyperemia was markedly attenuated, accompanied with a significant of T (7.7 ± 4.5 vs 15.8 ± 10.9 sec, p < 0.01) and completely unchanged TPC (both 6.8 sec). With simultaneous tracing of CF and time-density curve, TPC and washout phase corresponded with contrast-induced transient CF reduction and hyperemic phase, respectively. We conclude that T might be more sensitive for estimation of CF is maintained almost normal, such as patients with stable effort angina pectoris having normal left ventricular wall motion at rest. (author)

  6. Medline Plus

    Full Text Available Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure begins with ...

  7. 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

  8. Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Damen, Nikki L; Versteeg, Henneke; Boersma, Eric;

    2013-01-01

    Depression has been associated with poor prognosis in patients with coronary artery disease (CAD), but little is known about the impact of depression on long-term mortality. We examined whether depression was associated with 7-year mortality in patients treated with percutaneous coronary...... intervention (PCI), after adjusting for socio-demographic and clinical characteristics, anxiety, and the distressed (Type D) personality....

  9. Acute pontine infarction after percutaneous coronary intervention : a very rare but devastating complication

    NARCIS (Netherlands)

    Arslan, F; Mair, J; Franz, W-M; Otten, M; van Lelyveld, L

    2015-01-01

    A 64-year-old man suffering from an acute posterior wall myocardial infarction underwent primary percutaneous coronary intervention. After several aspiration attempts, tirofiban infusion and pre- and post-dilatation, a bare-metal stent was successfully implanted in the culprit right coronary artery.

  10. Successful retrieval of an unexpanded coronary stent from the left main coronary artery during primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Šalinger-Martinović Sonja

    2011-01-01

    Full Text Available Introduction. Dislodgement and embolization of the new generation of coronary stents before their deployment are rare but could constitute a very serious complication. Case Outline. We report a case of a stent dislodgement into the left main coronary artery during the primary coronary intervention of infarct related left circumflex artery in a patient with acute myocardial infarction. The dislodged and unexpanded bare-metal stent FlexMaster 3.0x19 mm (Abbot Vascular was stranded and bended in the left main coronary artery (LMCA, probably by the tip of the guiding catheter, but stayed over the guidewire. It was successfully retrieved using a low-profile Ryujin 1.25x15 balloon catheter (Terumo that was passed through the stent, inflated and then pulled back into the guiding catheter. After that, the whole system was withdrawn through the 6 F arterial sheath via the transfemoral approach. After repeated cannulation via the 6F arterial sheath, additional BMW and ATW guidewires were introduced into the posterolateral and obtuse marginal branches and a bare-metal stent Driver (Medtronic Cardiovascular Inc 3.0x18 mm was implanted in the target lesion. Conclusion. Stent dislodgement is a rare but potentially life-threatening complication of the percutaneous coronary intervention. This incident occurring in the LMCA in particular during an acute myocardial infarction requires to be urgently resolved. The avoidance of rough manipulation with the guiding catheter and delivery system may help in preventing this kind of complications.

  11. Analysis of selected utility properties of biomaterials used in coronary stents

    Directory of Open Access Journals (Sweden)

    W. Walke

    2013-01-01

    Full Text Available Purpose: The study analysed influence of the selected functional properties of metallic biomaterials on selected functional properties of coronary stents used in invasive cardiology.Design/methodology/approach: Pitting corrosion resistance tests were performed by means of potentiodynamic method. Corrosion resistance tests were performed on the ground of registered anodic polarisation curves and Stern method. The research also comprised galvanic corrosion resistance tests with application of Evans method. Measurements were made with VoltaLab® PGP 201 system. Tests were performed in artificial blood plasma at the temperature T = 37.0±1°C and pH = 7.0±0.2. Measurements of fluoroscopic visibility with application of cardiovascular imaging system Integris 5000 by Philips were also performed.Findings: Application of Ta layer in composite stents made of Cr-Ni-Mo steel is an effective method used for improvement of their functional properties, and in particular of their fluoroscopic visibility, at the same time decreasing their corrosion resistance. It is of crucial meaning for increasing effectiveness and safety of lowinvasive percutaneous transluminal coronary angioplasty.Practical implications: Improvement of fluoroscopic visibility of coronary stents is possible through application of materials with increased X-ray absorptivity for their production. Within this scope you can consider certain form of implant created as a whole from one biomaterial or mixture of two biomaterials (layer implants, on the assumption that one of them features greater X-ray absorptivity.Originality/value: Application of middle layer made of tantalum in composite stent does not influence initiation of galvanic corrosion process but it produces better fluoroscopic visibility that brings forth improved safety of coronary angioplasty

  12. Impact of coronary dominance on in-hospital outcomes after percutaneous coronary intervention in patients with acute coronary syndrome.

    Directory of Open Access Journals (Sweden)

    Toshiki Kuno

    Full Text Available OBJECTIVE: This study evaluated the manner in which coronary dominance affects in-hospital outcomes of acute coronary syndrome (ACS patients undergoing percutaneous coronary intervention (PCI. BACKGROUND: Previous studies have shown that left dominant coronary anatomies are associated with worse prognoses in patients with coronary artery disease. METHODS: Data were analyzed from 4873 ACS patients undergoing PCI between September 2008 and April 2013 at 14 hospitals participating in the Japanese Cardiovascular Database Registry. The patients were grouped based on diagnostic coronary angiograms performed prior to PCI; those with right- or co-dominant anatomy (RD group and those with left-dominant anatomy (LD group. RESULTS: The average patient age was 67.6±11.8 years and both patient groups had similar ages, coronary risk factors, comorbidities, and prior histories. The numbers of patients presenting with symptoms of heart failure, cardiogenic shock, or cardiopulmonary arrest were significantly higher in the LD group than in the RD group (heart failure: 650 RD patients [14.7%] vs. 87 LD patients [18.8%], P = 0.025; cardiogenic shock: 322 RD patients [7.3%] vs. 48 LD patients [10.3%], P = 0.021; and cardiopulmonary arrest: 197 RD patients [4.5%] vs. 36 LD patients [7.8%], P = 0.003. In-hospital mortality was significantly higher among LD patients than among RD patients (182 RD patients [4.1%] vs. 36 LD patients [7.8%], P = 0.001. Multivariate logistic regression analysis revealed that LD anatomy was an independent predictor for in-hospital mortality (odds ratio, 1.75; 95% confidence interval, 1.06-2.89; P = 0.030. CONCLUSION: Among ACS patients who underwent PCI, LD patients had significantly worse in-hospital outcomes compared with RD patients, and LD anatomy was an independent predictor of in-hospital mortality.

  13. Measurement of fractional flow reserve to guide decisions for percutaneous coronary intervention

    OpenAIRE

    Wasem, Jürgen; Klauss, Volker; Pijls, Nico; Rieber, Johannes; Schnell-Inderst, Petra; Bornschein, Bernhard; Siebert, Uwe

    2008-01-01

    Background: Coronary artery disease (CAD) is one of the leading causes of premature death in Germany. Percutaneous coronary interventions (PCI) are frequently performed in patients with angiographically intermediate stenoses. However, the necessity of PCI has not been proven for all patients. Pressure-based fractional flow reserve (FFR) is an invasive test that can be used to assess the functional significance of intermediate coronary stenoses in order to guide decisions on PCI. Objectives: T...

  14. Mechanical post-conditioning in STEMI patients undergoing primary percutaneous coronary intervention

    OpenAIRE

    Boukhris, Marouane; Bousselmi, Radhouane; Tomasello, Salvatore Davide; Elhadj, Zied Ibn; Azzarelli, Salvatore; Marzà, Francesco; Galassi, Alfredo R.

    2014-01-01

    Although early myocardial reperfusion via primary percutaneous coronary intervention (PCI) allows the preservation of left ventricular function and improves outcome, the acute restoration of blood flow may contribute to the pathophysiology of infarction, a complex phenomenon called reperfusion injury. First described in animal models of coronary obstruction, mechanical post-conditioning, a sequence of repetitive interruption of coronary blood flow applied immediately after reopening of the oc...

  15. Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting for Diabetics with Multivessel Coronary Artery Disease: The Korean Multicenter Revascularization Registry (KORR)

    OpenAIRE

    Gwon, Hyeon-Cheol; Choi, Seung Hee; Choi, Byung-Il William; Cho, Seung Yun; Ro, Young Moo; Lee, Won Ro; ,

    2005-01-01

    This study was designed to assess the relative merits of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in multivessel coronary artery disease (MVCAD), particularly for Korean diabetics. Among 3,279 patients with MVCAD who were recommended for revascularization were enrolled from nine centers in Korea, 2,154 were selected after statistical adjustments for the disparities between two groups. Survival rates were not significantly different for three years be...

  16. Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease and Diabetic Nephropathy: A Single Center Experience

    OpenAIRE

    Bae, Ki Sun; Park, Hyeong Cheon; Kang, Byung Seung; Park, Jong Won; Chon, Nu Ri; Oh, Kyung Jin; Yoon, Young Won; Hong, You Sun; Ha, Sung Kyu

    2007-01-01

    Background Patients with diabetic nephropathy (DN) and coronary artery disease (CAD) represent a subset of patients with high cardiovascular morbidity and mortality. The optimal revascularization strategy using either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The purpose of this study was to compare the clinical outcomes of PCI to CABG in DN patients with CAD. Methods The clinical and angiographic records of DN patients with CAD ...

  17. Rehospitalization following percutaneous coronary intervention for commercially insured patients with acute coronary syndrome: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Meadows Eric S

    2012-07-01

    Full Text Available Abstract Background While prior research has provided important information about readmission rates following percutaneous coronary intervention, reports regarding charges and length of stay for readmission beyond 30 days post-discharge for patients in a large cohort are limited. The objective of this study was to characterize the rehospitalization of patients with acute coronary syndrome receiving percutaneous coronary intervention in a U.S. health benefit plan. Methods This study retrospectively analyzed administrative claims data from a large US managed care plan at index hospitalization, 30-days, and 31-days to 15-months rehospitalization. A valid Diagnosis Related Group code (version 24 associated with a PCI claim (codes 00.66, 36.0X, 929.73, 929.75, 929.78–929.82, 929.84, 929.95/6, and G0290/1 was required to be included in the study. Patients were also required to have an ACS diagnosis on the day of admission or within 30 days prior to the index PCI. ACS diagnoses were classified by the International Statistical Classification of Disease 9 (ICD-9-CM codes 410.xx or 411.11. Patients with a history of transient ischemic attack or stroke were excluded from the study because of the focus only on ACS-PCI patients. A clopidogrel prescription claim was required within 60 days after hospitalization. Results Of the 6,687 ACS-PCI patients included in the study, 5,174 (77.4% were male, 5,587 (83.6% were Conclusions For ACS patients who underwent PCI, revascularization procedures represented a large portion of rehospitalizations. Revascularization procedures appear to be the most frequent, most costly, and earliest cause for rehospitalization after ACS-PCI.

  18. [Patients facing with the decision to undergo percutaneous coronary intervention].

    Science.gov (United States)

    Bobbio, Marco

    2015-03-01

    Percutaneous coronary intervention (PCI) is a common procedure to treat coronary artery stenoses. Several studies had demonstrated that PCI does not reduce the risk of death or myocardial infarction when performed to patients with stable angina. However it has been observed that most patients believe that PCI will reduce their risk for death and myocardial infarction. On the other hand, cardiologists generally acknowledge the limitation of PCI according to the current literature.Cardiologists' decision to refer a patient to PCI is based on factors other then perceived benefits such as fear of missing a needed procedure, defensive medicine, desire of demonstrating their professional competence, vested professional and economic interests, accomplish patient expectation, the so called oculo-stenotic reflex, when a lesion is dilated regardless the clinical indication. Patients' misleading perception of harm and benefits of a procedure is mainly related to the cognitive dissonance, when individuals tend to reduce the conflict of an uncomfortable decision adopting information, which are likely to reduce their discomfort. Furthermore, patients believe that doing more means doing better, that technologic intervention are better than pharmacological treatment that in turn are better than doing nothing. Finally, they assume that a procedure is really effective since their physician suggested it.It should be emphasized that physicians and patients do not communicate successfully about key decision and how little we know about patient understanding of the factors that influence important medical care decisions. Although considerable attention is given to facilitating informed consent, patients' perceived benefits of elective PCI do not match existing evidence, as they overestimated both the benefits and urgency of their procedures. These findings suggest that an even greater effort at patient education is needed prior to elective PCI to facilitate fully informed decision

  19. Periprocedural Myocardial Injury and Long-term Clinical Outcome in Patients Undergoing Percutaneous Coronary Interventions of Coronary Chronic Total Occlusion

    OpenAIRE

    Di Serafino, Luigi; Borgia, Franscesco; Maeremans, Joren; Pyraxas, Stylianos A.; De Bruyne, Bernard; Wijns, William; Heyndrickx, Guy R; Dens, Jo; di Mario, Carlo; Barbato, Emanuele

    2016-01-01

    BACKGROUND: Periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) might occur more frequently during challenging procedures such as PCI of chronic coronary total occlusion (CTO). The prognostic implication of PMI in CTO-PCI remains unclear. METHODS: From January 2006 to September 2012, a total of 715 consecutive patients undergoing CTO-PCI were screened at three centers. Only patients with available pre-PCI and post-PCI troponin (cTn) were included (n ...

  20. Impact of repeated percutaneous coronary intervention on long-term survival after subsequent coronary artery bypass surgery

    OpenAIRE

    Komiya Tatsuhiko; Shimamoto Takeshi; Sakaguchi Genichi

    2011-01-01

    Abstract (Background) In the current stent era, aggressive repeated percutaneous coronary intervention (PCI) has become more common. The aim of this study was to investigate the impact of previous repeated PCI on the subsequent coronary artery bypass grafting (CABG). (Methods) Between January 1990 and January 2008, a total of 894 patients underwent first-time isolated elective CABG. Among the 894 patients, 515 patients had had no PCI (group A), 179 patients had had single PCI (Group B), and 2...

  1. Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT Investigators

    OpenAIRE

    Kleiman, Neal; Cokkinos, Dennis; Simoons, Maarten; Harrington, Robert Alex; Califf, Robert; Topol, Eric; Lincoff, Michael; Flaker, G.C.; Pieper, Karen; Wilcox, Robert; Berdan, Lisa; Lorenz, T.J.; Boersma, Eric

    2000-01-01

    textabstractBACKGROUND: Platelet glycoprotein (GP) IIb/IIIa antagonists prevent the composite end point of death or myocardial infarction (MI) in patients with acute coronary syndromes. There is uncertainty about whether this effect is confined to patients who have percutaneous coronary interventions (PCIs) and whether PCIs further prevent death or MI in patients already treated with GP IIb/IIIa antagonists. METHODS AND RESULTS: PURSUIT patients were treated with the GP IIb/IIIa antagonist ep...

  2. Peri-procedural Glycemic Control in Patients with Diabetes Mellitus Undergoing Coronary Angiography with Possible Percutaneous Coronary Intervention

    OpenAIRE

    Shah, Binita; Berger, Jeffrey S.; Amoroso, Nicholas S.; Mai, Xingchen; Lorin, Jeffrey D.; Danoff, Ann; Schwartzbard, Arthur Z.; Lobach, Iryna; Guo, Yu; Feit, Frederick; Slater, James; Attubato, Michael J.; Sedlis, Steven P.

    2014-01-01

    Peri-procedural hyperglycemia is an independent predictor of mortality in patients undergoing percutaneous coronary intervention (PCI). However, peri-procedural management of blood glucose is not standardized. The effects of routinely continuing long-acting glucose-lowering medications prior to coronary angiography with possible PCI on peri-procedural glycemic control have not been investigated. Patients with diabetes mellitus (DM) (n=172) were randomized to continue (Continue group; n=86) or...

  3. Effect of Cardiac Rehabilitation Program on Heart Rate Recovery after Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting

    OpenAIRE

    Ali Abbasi; Mostafa Nejatian; Seyed Hesameddin Abbasi; Mehrab Marzban; Saeed Davoodi; Abbasali Karimi; Seyed Ebrahim Kassaian; Mojtaba Salarifar; Mohammad Alidoosti; Abbas Soleimani

    2008-01-01

    Background: The objective of this study was to evaluate the effect of a hospital-based cardiac rehabilitation program on heart rate recovery (HRR) in patients who received percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Methods: Two hundred forty patients, who completed 24 sessions of a cardiac rehabilitation program (phase 2) after PCI (n=62) or CABG (n=178) at the rehabilitation department of Tehran Heart Center were included in the present study. Demogra...

  4. Risk score for contrast induced nephropathy following percutaneous coronary intervention

    International Nuclear Information System (INIS)

    Contrast-induced nephropathy (CIN) is an important cause of acute renal failure. Identification of risk factors of CIN and creating a simple risk scoring for CIN after percutaneous coronary intervention (PCI) is important. A prospective single center study was conducted in Kuwait chest disease hospital. All patients admitted to chest disease hospital for PCI from March to May 2005 were included in the study. Total of 247 patients were randomly assigned for the development dataset and 100 for the validation set using the simple random method. The overall occurrence of CIN in the development set was 5.52%. Using multivariate analysis; basal Serum creatinine, shock, female gender, multivessel PCI, and diabetes mellitus were identified as risk factors. Scores assigned to different variables yielded basal creatinine > 115 micron mol/L with the highest score(7), followed by shock (3), female gender, multivessel PCI and diabetes mellitus had the same score (2). Patients were further risk stratified into low risk score (12). The developed CIN model demonstrated good discriminative power in the validation population. In conclusion, use of a simple risk score for CIN can predict the probability of CIN after PCI; this however needs further validation in larger multicenter trials. (author)

  5. Plasma calprotectin predicts mortality in patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Louise J N; Haahr-Pedersen, Sune Ammentorp; Bjerre, Mette;

    2010-01-01

    We investigated the predictive value of plasma calprotectin levels for mortality in patients with ST segment elevation myocardial infarction (STEMI) successfully treated with primary percutaneous coronary intervention (pPCI).......We investigated the predictive value of plasma calprotectin levels for mortality in patients with ST segment elevation myocardial infarction (STEMI) successfully treated with primary percutaneous coronary intervention (pPCI)....

  6. Negative and positive affect are independently associated with patient-reported health status following percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Pedersen, Susanne S.; Erdman, Ruud A M;

    2009-01-01

    We examined the association between negative and positive affect and 12-month health status in patients treated with percutaneous coronary intervention (PCI) with drug-eluting stents.......We examined the association between negative and positive affect and 12-month health status in patients treated with percutaneous coronary intervention (PCI) with drug-eluting stents....

  7. The Effect of Elective Percutaneous Coronary Intervention of the Right Coronary Artery on Right Ventricular Function

    Directory of Open Access Journals (Sweden)

    Farahnaz Nikdoust

    2014-12-01

    Full Text Available Background: Right Ventricular (RV dysfunction has been introduced as a predictor of mortality in acute myocardial infarction. Objectives: This study aimed to investigate the effect of right coronary revascularization on systolic and diastolic RV dysfunction. Patients and Methods: This study was conducted on unstable angina patients who were candidate for elective Percutaneous Revascularization Intervention (PCI on the right coronary artery. The participants were initially evaluated by transthoracic echocardiography and tissue Doppler imaging prior to PCI and the RV function parameters were assessed. Echocardiography was repeated two months after PCI and the results were compared with baseline. Paired t-test was used to compare the pre- and post-procedural measurements. Besides, Pearson’s correlation was used to find out the linear association between the RV function parameters and Left Ventricular Ejection Fraction (LVEF. P value < 0.05 was considered as statistically significant. Results: This study was conducted on 30 patients (mean age = 60.00 ± 8.44 years; 24 [80%] males. In the pre-procedural echocardiography, 15 patients (50% had normal RV function, 14 patients (46.7% had grade-1 RV dysfunction, and only 1 patient (3.3% had grade-2 RV dysfunction. Following PCI, however, all the patients had normal systolic and diastolic RV functions. Comparison of echocardiographic RV function parameters showed an improvement in both systolic and diastolic functional parameters of the RV. Nonetheless, no significant correlation was observed between these parameters and Left Ventricular (LV function. Conclusions:: A significant improvement was found in RV function, but not LV function, after right coronary PCI. Revascularization of the right coronary artery may be beneficial for the patients who suffer from RV failure due to ischemia

  8. Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT Investigators

    NARCIS (Netherlands)

    N.S. Kleiman (Neal); D.V. Cokkinos (Dennis); M.L. Simoons (Maarten); R.A. Harrington (Robert Alex); R.M. Califf (Robert); E.J. Topol (Eric); A.M. Lincoff (Michael); G.C. Flaker; K.S. Pieper (Karen); R.G. Wilcox (Robert); L.G. Berdan (Lisa); T.J. Lorenz; H. Boersma (Eric)

    2000-01-01

    textabstractBACKGROUND: Platelet glycoprotein (GP) IIb/IIIa antagonists prevent the composite end point of death or myocardial infarction (MI) in patients with acute coronary syndromes. There is uncertainty about whether this effect is confined to patients who have percutaneous cor

  9. Prevention of contrast-induced nephropathy in STEMI patients undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Busch, Sarah Victoria Ekeløf; Jensen, Svend Eggert; Rosenberg, Jacob;

    2013-01-01

    Objective: To evaluate the current prophylactic strategies against CIN in patients with STEMI treated by primary percutaneous coronary intervention. Background: Contrast-induced nephropathy (CIN) is the third leading course of acute renal failure and a recognized complication to cardiac...... catheterization. CIN is associated with increased risk of cardiac adverse events and mortality, and recent studies point at the risk of developing a transient or persistent renal dysfunction. Patients with ST-elevation myocardial infarction treated by primary percutaneous coronary intervention have a markedly...... increased risk of developing CIN. At present no strategy is universally accepted in the prevention of CIN in the acute setting of primary percutaneous coronary intervention. Method: We performed a systematic search in Pubmed and EMBASE and ended up including nine randomised clinical trials; six studies of N...

  10. Decision-making in percutaneous coronary intervention: a survey

    Directory of Open Access Journals (Sweden)

    Rahilly-Tierney Catherine R

    2008-06-01

    Full Text Available Abstract Background Few researchers have examined the perceptions of physicians referring cases for angiography regarding the degree to which collaboration occurs during percutaneous coronary intervention (PCI decision-making. We sought to determine perceptions of physicians concerning their involvement in PCI decisions in cases they had referred to the cardiac catheterization laboratory at a major academic medical center. Methods An anonymous survey was mailed to internal medicine faculty members at a major academic medical center. The survey elicited whether responders perceived that they were included in decision-making regarding PCI, and whether they considered such collaboration to be the best process of decision-making. Results Of the 378 surveys mailed, 35% (133 were returned. Among responding non-cardiologists, 89% indicated that in most cases, PCI decisions were made solely by the interventionalist at the time of the angiogram. Among cardiologists, 92% indicated that they discussed the findings with the interventionalist prior to any PCI decisions. When asked what they considered the best process by which PCI decisions are made, 66% of non-cardiologists answered that they would prefer collaboration between either themselves or a non-interventional cardiologist and the interventionalist. Among cardiologists, 95% agreed that a collaborative approach is best. Conclusion Both non-cardiologists and cardiologists felt that involving another decision-maker, either the referring physician or a non-interventional cardiologist, would be the best way to make PCI decisions. Among cardiologists, there was more concordance between what they believed was the best process for making decisions regarding PCI and what they perceived to be the actual process.

  11. Cardiac resynchronisation therapy after percutaneous trans-coronary-venous mitral annuloplasty.

    Science.gov (United States)

    Siminiak, Tomasz; Jerzykowska, Olga; Kalmucki, Piotr; Link, Rafał; Baszko, Artur

    2013-01-01

    We present a case of a 45-year-old man with symptomatic heart failure and ischaemic functional mitral regurgitation (FMR), who underwent a successful percutaneous trans-coronary venous mitral annuloplasty with the Carillon system. The procedure resulted in clinical improvement as well as in a decrease in the degree of MR as assessed by echocardiography. Fifteen months later, the patient underwent cardiac resynchronisation (CRT) device implantation, resulting in a further improvement in echocardiographic measures of FMR. This case not only confirms the feasibility of CRT after percutaneous trans-coronary-venous mitral annuloplasty, but also suggests a possible synergistic effect of both therapies, warranting future clinical trials. PMID:24399586

  12. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI). II. Clinical evaluation

    International Nuclear Information System (INIS)

    In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm2/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm2 before and 69.1 Gy cm2 after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff. (orig.)

  13. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI). II. Clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Haakan; Andersson, Torbjoern [Department of Radiology, Oerebro University Hospital, 701 85 Oerebro (Sweden); Beckman, Karl-Wilhelm; Persliden, Jan [Department of Medical Physics, Oerebro University Hospital, 701 85 Oerebro (Sweden)

    2002-11-01

    In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm{sup 2}/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm{sup 2} before and 69.1 Gy cm{sup 2} after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff. (orig.)

  14. Analysis of digital subtraction angiography for estimating flow reserve in critical coronary artery stenosis

    International Nuclear Information System (INIS)

    To assess the accuracy of digital subtraction angiography in evaluating coronary flow reserve in cases with critical coronary artery stenosis, time-density curves were obtained from digital subtraction coronary angiograms in the myocardial region of interest. Time to peak contrast (TPC) and time constant of the washout exponential curve (T) were measured in 14 patients with stable effort angina pectoris and critical one vessel lesion before and after percutaneous transluminal coronary angioplasty (PTCA). All patients had normal left ventricular ejection fraction (59±7%) and 201Tl myocardial images at rest. The values of TPC and T were significantly shortened from 5.4±1.3 to 4.5±1.0 sec (p<0.02) and from 10.9±3.8 to 5.3±1.3 sec (p<0.001) after PTCA, respectively. However, in 9 patients TPC values were approximately the same before and after PTCA. In five experimental dogs with critical circumflex coronary artery stenosis, coronary flow (CF; Doppler flowmeter) and systolic thickening of the posterior wall (by sonomicrometry) at rest did not differ from those of the controls. However, contrast media-induced reactive hyperemia was markedly attenuated, accompanied by a significant increase in T (7.7±4.5 vs 15.8±10.9 sec, p<0.01) and totally unchanged TPC (both 6.8 sec). With simultaneous tracings of CF and time-density curves, TPC and washout phases corresponded with contrast-induced transient CF reduction and hyperemic phases, respectively. We concluded that T may be more sensitive for estimating CF maintained nearly normal, e.g., in patients with stable effort angina pectoris having normal left ventricular wall motion at rest. (author)

  15. Comparison of outcomes of percutaneous coronary intervention on proximal versus non-proximal left anterior descending coronary artery, proximal left circumflex, and proximal right coronary artery: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kassaian Seyed

    2007-03-01

    Full Text Available Abstract Background Previous studies have shown that lesions in proximal left anterior descending coronary artery (LAD may develop more restenosis after balloon angioplasty than lesions in other coronary segments. However, stenting seems to have reduced this gap. In this study, we compared outcomes of percutaneous coronary intervention (PCI on proximal LAD versus proximal left circumflex (LCX or right coronary artery (RCA and proximal versus non-proximal LAD. Methods From 1737 patients undergoing PCI between March 2004 and 2005, those with cardiogenic shock, primary PCI, total occlusions, and multivessel or multi-lesion PCI were excluded. Baseline characteristics and in-hospital outcomes were compared in 408 patients with PCI on proximal LAD versus 133 patients with PCI on proximal LCX/RCA (study I and 244 patients with PCI on non-proximal LAD (study II. From our study populations, 449 patients in study I and 549 patients in study II participated in complete follow-up programs, and long-term PCI outcomes were compared within these groups. The statistical methods included Chi-square or Fisher's exact test, student's t-test, stratification methods, multivariate logistic regression and Cox proportional hazards model. Results In the proximal LAD vs. proximal LCX/RCA groups, smoking and multivessel disease were less frequent and drug-eluting stents were used more often (p = 0.01, p Conclusion Despite the known worse prognosis of proximal LAD lesions, in the era of stenting, our long-term outcomes were similar in patients with PCI on proximal LAD versus proximal LCX/RCA and non-proximal LAD. Furthermore, we had better angiographic success rates in patients with PCI on proximal LAD.

  16. A Cross-sectional study of stand-alone Percutaneous Coronary Intervention in a Nigerian Cardiac Catheterization Laboratory

    OpenAIRE

    Johnson, Adeyemi; Falase, Bode; Ajose, Ifeoluwa; Onabowale, Yemi

    2014-01-01

    Background There is a paucity of diagnostic and therapeutic facilities in Nigeria to confirm coronary artery disease and offer appropriate interventional therapy. There is now a private cardiac catheterization laboratory in Lagos but as there are no sustained Open Heart Surgery programmes, percutaneous coronary interventions are currently being performed without surgical backup. This study was designed to assess results of stand-alone percutaneous coronary intervention (PCI) as currently prac...

  17. Percutaneous coronary intervention and adjunctive pharmacotherapy in women: a statement for healthcare professionals from the American Heart Association.

    Science.gov (United States)

    Lansky, Alexandra J; Hochman, Judith S; Ward, Patricia A; Mintz, Gary S; Fabunmi, Rosalind; Berger, Peter B; New, Gishel; Grines, Cindy L; Pietras, Cody G; Kern, Morton J; Ferrell, Margaret; Leon, Martin B; Mehran, Roxana; White, Christopher; Mieres, Jennifer H; Moses, Jeffrey W; Stone, Gregg W; Jacobs, Alice K

    2005-02-22

    More than 1.2 million percutaneous coronary interventions are performed annually in the United States, with only an estimated 33% performed in women, despite the established benefits of percutaneous coronary intervention and adjunctive pharmacotherapy in reducing fatal and nonfatal ischemic complications in acute myocardial infarction and high-risk acute coronary syndromes. This statement reviews sex-specific data on the safety and efficacy of contemporary interventional therapies in women. PMID:15687113

  18. The short-term out-come of primary percutaneous coronary intervention for patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of primary percutaneous coronary intervention (PCI) for acute myocardial infarction. Methods: 63 patients with acute myocardial infarction were treated by primary PCI within 12 hour from onset and were followed up for one to fourteen months. Results: Procedure was successed in 61 patients (96.8%). Three patients received only primary angioplasty and 58 patients received stent implantation. All of them gained TIMI III grade perfusion flow. Non-perfusion flow occurred in five patients but their flows were improved by intracoronary urokinase infusion. Ventricular tachycardia and fibrillation happened in five patients, and were converted to sinus rhythm by defibrillation in four and one died. Two of the five patients complicated with cardiogenic shock, with one died on 1st day and the other on 4th day after successful PCI, respectively. Main cardiac events occurred in five patients (17%) during follow-up with two sudden death, one reinfarction and repeated PCI, one received selective CABG and on PCI due to intrastent restenosis. Conclusions: Primary PCI could provide higher successful rate of reperfusion with low hospital mortality and good short-term prognosis. (authors)

  19. A Preliminary Real-Time and Realistic Simulation Environment for Percutaneous Coronary Intervention

    OpenAIRE

    Jianhuang Wu; Haoyu Wang; Peng Zhang; Xin Ma; Qingmao Hu

    2015-01-01

    Percutaneous coronary intervention (PCI) is a minimally invasive surgery procedure that is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period in order to ensure successful surgical outcome. In this paper, a realistic and real-time interactive simulator for training PCI procedure is presented. A set of new approaches for core simulation components is devised an...

  20. Impact of frailty on outcomes after percutaneous coronary intervention: a prospective cohort study

    OpenAIRE

    Murali-Krishnan, Rachel; Iqbal, Javaid; Rowe, Rebecca; Hatem, Emer; Parviz, Yasir; Richardson, James; Sultan, Ayyaz; Gunn, Julian

    2015-01-01

    Background Average life expectancy is rising, resulting in increasing numbers of elderly, frail individuals presenting with coronary artery disease and requiring percutaneous coronary intervention (PCI). PCI can be of value for this population, but little is known about the balance of benefit versus risk, particularly in the frail. Objective To determine the relationship between frailty and clinical outcomes in patients undergoing PCI. Methods Patients undergoing PCI, for either stable angina...

  1. Risks of Death and Graft Failure After Surgical Versus Percutaneous Coronary Revascularization in Renal Transplant Patients

    OpenAIRE

    Charytan, David M.; Li, Shuling; Liu, Jiannong; Qiu, Yang; Herzog, Charles A.

    2013-01-01

    Background Reliable data regarding absolute and relative risks of death and graft failure after coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in renal transplant patients are unavailable. Methods and Results Renal transplant patients undergoing inpatient CABG (n=1400) or PCI (n=4097) were identified from United States Renal Data System data. Cumulative incidence of nonfatal graft failure and death was reported for observed events. A Cox model with th...

  2. The first year of the Venlo percutaneous coronary intervention program: procedural and 6-month clinical outcomes

    OpenAIRE

    Mol, K.A.; Rahel, B.M.; Eerens, F.; Aydin, S; Troquay, R. P. Th.; Meeder, J.G.

    2013-01-01

    Objectives Analysis of the first results of off-site percutaneous coronary interventions (PCI) and fractional flow reserve (FFR) measurements at VieCuri Medical Centre for Northern Limburg in Venlo. Background Off-site PCI is accepted in the European and American Cardiac Guidelines as the need for PCI increases and it has been proven to be a safe treatment option for acute coronary syndrome. Methods Retrospective cohort study reporting characteristics, PCI and FFR specifications, complication...

  3. Effect of High Dose Rosuvastatin Loading before Percutaneous Coronary Intervention on Contrast-Induced Nephropathy

    OpenAIRE

    Yun, Kyeong Ho; Lim, Jae Hong; Hwang, Kyo Bum; Woo, Sun Ho; Jeong, Jin Woo; Kim, Yong Cheol; Joe, Dai-Yeol; Ko, Jum Suk; Rhee, Sang Jae; Lee, Eun Mi; Oh, Seok Kyu

    2014-01-01

    Background and Objectives Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality. This observational, non-randomized study evaluated the effect of rosuvastatin loading before percutaneous coronary intervention (PCI) on the incidence of CIN in patients with acute coronary syndrome (ACS). Subjects and Methods A total of 824 patients who underwent PCI for ACS were studied (408 patients in the statin group=40 mg rosuvastatin loading before PCI; 416 patients of con...

  4. Combined elective percutaneous coronary intervention and transapical transcatheter aortic valve implantation

    OpenAIRE

    Pasic, Miralem; Dreysse, Stephan; Unbehaun, Axel; Buz, Semih; Drews, Thorsten; Klein, Christoph; D'Ancona, Giuseppe; Hetzer, Roland

    2012-01-01

    There is no established strategy of how and when to treat coronary artery disease (CAD) in patients referred for transcatheter aortic valve implantation (TAVI). Simultaneous, single-stage treatment of both pathologies is a possible solution. We report our initial results of simultaneously performed transapical TAVI and elective percutaneous coronary interventions (PCI) in high-risk patients with severe aortic valve stenosis. Between April 2008 and July 2011, a total of 419 patients underwent ...

  5. 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.

  6. 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

  7. Intravascular Ultrasound in Percutaneous Coronary Intervention for Chronic Total Occlusion

    Directory of Open Access Journals (Sweden)

    M Mohandes

    2010-09-01

    Full Text Available Background: Percutaneous coronary intervention (PCI of chronic total occlusion (CTO is one of the most challenging procedures in interventional cardiology. New techniques and devices have made possible to face these complex procedures. Intravascular ultrasound (IVUS reveals special features and contributes greatly to procedural success.Method: We analysed retrospectively IVUS contribution and findings in 23 cases of a total 46 CTOs PCI from February 2009 to August 2010 in our cath lab. Both true and functional CTO were included in this study. The procedure was considered successful when a TIMI III flow was reached in the occluded vessel after stent implantation with a residual stenosis less than 30%. IVUS features and contribution in CTO-PCI were analysed. All data were introduced in SPSS version 15 (SPSS Inc. Chicago, Illinois, USA. Continuous variables were described by mean ± SD and categorical variables were expressed as percentage. A P<0.05 was considered statistically significant.Results: 46 PCIs in 34 patients were performed during 19 months in our centre. The procedure was successful in 28 cases (60.9%.. IVUS was performed in 23 (82.1% of successful procedures. IVUS revealed calcium somewhere in 17 (73.9%. Despite wire angiographic verification in true lumen distally IVUS showed subintimal wire position in part of CTO segment in 6(26.1%. In 22(95.7% of cases IVUS allowed both the wire position verification in true lumen and the vessel measurement before stent implantation. In 1(4.3% case a second wire was introduced into true lumen guided by IVUS after realising that the first wire was in false lumen. We could not find significant relation between calcium presence and subintimal wire penetration in CTO segment (p: 0.14 Conclusions: IVUS showed calcium in CTO segment in a high percentage of cases. It is not unusual to find wire penetration in subintimal space in part of CTO segment. IVUS has a key contribution in the step by step

  8. Short- and long-term outcomes in octogenarians undergoing percutaneous coronary intervention with stenting

    NARCIS (Netherlands)

    M.S. Marcolino; C. Simsek (Cihan); S.P.M. de Boer (Sanneke); R.T. van Domburg (Ron); R.J.M. van Geuns (Robert Jan); P.P.T. de Jaegere (Peter); K.M. Akkerhuis (Martijn); J. Daemen (Joost); P.W.J.C. Serruys (Patrick); H. Boersma (Eric)

    2012-01-01

    textabstractAims: To investigate the incidence of cardiac events in octogenarians who underwent percutaneous coronary intervention (PCI) with stenting, as well as to evaluate the efficacy and safety of drug-eluting stents (DES) in this population. Methods and results: The study included 6,129 consec

  9. Health-related quality of life in the elderly three years after percutaneous coronary intervention

    NARCIS (Netherlands)

    A. Panasewicz (Anna); S.S. Pedersen (Susanne); S.J.G. Veenhuis (Stefanie); R.M. Oemrawsingh (Rohit); W.J. van der Giessen (Wim); R.J.M. van Geuns (Robert Jan); E.S. Regar (Eveline); P.P.T. de Jaegere (Peter); P.W.J.C. Serruys (Patrick); R.T. van Domburg (Ron)

    2013-01-01

    textabstractAims: Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (=70 years) with younger patients (<70 years) at 6, 12, 36 months post-PCI, and 2) examined whether predictors of impaired HRQO

  10. Clinical impact of intracoronary abciximab in patients undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Gu, Youlan L; Iversen, Allan Zeeberg;

    2012-01-01

    The aim of this study was to perform an individual patient-level pooled analysis of randomised trials, comparing intracoronary versus intravenous abciximab bolus use in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI)....

  11. Clinical effects of intracoronary tirofiban on preventing no-reflow during emergency percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    林杰

    2012-01-01

    Objective To assess the effects of intracoronary tirofiban on preventing no-reflow during emergency percutaneous coronary intervention(PCI) . Methods All 99 cases with acute myocardial infarction who underwent emergency PCI between March 2009 and March 2012 were randomized into test group

  12. Primary percutaneous coronary intervention as a national Danish reperfusion strategy of ST-elevation myocardial infarction

    DEFF Research Database (Denmark)

    Sørensen, Jacob Thorsted; Steengaard, Carsten; Holmvang, Lene;

    2013-01-01

    The use of primary percutaneous coronary intervention (PCI) as the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI) requires optimal systems-of-care and logistics in order to enable rapid treatment of all patients. In Denmark, this has been achieved through prehospital...

  13. High osteopontin levels predict long-term outcome after STEMI and primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Bjerre, Mette; Pedersen, Sune Folke; Møgelvang, Rasmus;

    2013-01-01

    between plasma OPN at admission and the long-term outcome in patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). METHODS: We included a total of 730 consecutive STEMI patients admitted to a single high-volume invasive heart...

  14. Beta blocker therapy is associated with reduced depressive symptoms 12 months post percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Battes, Linda C; Pedersen, Susanne S.; Oemrawsingh, Rohit M;

    2012-01-01

    Beta blocker therapy may induce depressive symptoms, although current evidence is conflicting. We examined the association between beta blocker therapy and depressive symptoms in percutaneous coronary intervention (PCI) patients and the extent to which there is a dose-response relationship between...

  15. Relation of body mass index to risk of stent thrombosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schmiegelow, Michelle; Torp-Pedersen, Christian; Gislason, Gunnar H;

    2012-01-01

    Stent thrombosis is a devastating complication after percutaneous coronary intervention (PCI), but the influence of obesity on risk of stent thrombosis is unclear, and it is unknown if this relation is dependent on stent type. The objective of this study was to examine the relation between body...

  16. Co-occurrence of diabetes and hopelessness predicts adverse prognosis following percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Denollet, Johan; Erdman, Ruud A M;

    2009-01-01

    We examined the impact of co-occurring diabetes and hopelessness on 3-year prognosis in percutaneous coronary intervention patients. Consecutive patients (n = 534) treated with the paclitaxel-eluting stent completed a set of questionnaires at baseline and were followed up for 3-year adverse...

  17. Sex- and age-related differences in clinical outcome after primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jakobsen, Lars; Niemann, Troels; Thorsgaard, Niels;

    2012-01-01

    AIMS: To compare the outcome after primary percutaneous coronary intervention (PPCI) according to sex and age, including comparison of sex- and age-specific mortality of PPCI patients with that of the general population. METHODS AND RESULTS: This population-based follow-up study included 7...

  18. Three-year clinical event rates in different age groups after contemporary percutaneous coronary intervention

    NARCIS (Netherlands)

    N. Kukreja (Neville); Y. Onuma (Yosinobu); H.M. Garcia-Garcia (Hector); J.W.I. van Nierop; J. Daemen (Joost); R.T. van Domburg (Ron); P.W.J.C. Serruys (Patrick)

    2011-01-01

    textabstractAims: As the global population ages, elderly patients will form an increasing proportion of those undergoing percutaneous coronary intervention (PCI). We investigated the safety and efficacy of bare metal stents (BMS) and DES in all patients undergoing PCI at our institution, stratified

  19. Platelet receptor P2RY12 haplotypes predict restenosis after percutaneous coronary interventions

    NARCIS (Netherlands)

    Rudez, Goran; Pons, Douwe; Leebeek, Frank; Monraats, Pascalle; Schrevel, Marlies; Zwindermanp, Aeilko; de Winter, Robbert; Tio, Rene; Doevendans, Pieter; Jukema, Wouter; de Maat, Moniek

    2008-01-01

    The platelet receptor P2Y12 (gene symbol P2RY12) is involved in several processes that contribute to restenosis after percutaneous coronary interventions (PCI). Therefore, common variation in the P2Y12 gene may serve as a useful marker for risk stratification. We studied whether common variation in

  20. Statins in prevention of repeat revascularization after percutaneous coronary intervention--a meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Zhang, Zhi-Jiang; Cheng, Qi; Jiang, Guo-Xin; Marroquin, Oscar C

    2010-04-01

    Recent prospective cohort studies have shown that patients discharged on statins after percutaneous coronary intervention (PCI) are at lower risks of repeat revascularization and mortality when compared to those not on statins after discharge. However, few randomized clinical trials among post-PCI patients confirmed these beneficial effects. It is needed to evaluate the effects of post-procedural statin therapy on individual clinical outcomes to facilitate the further investigation on identifying the underlying mechanism(s). A meta-analysis of randomized clinical trials was conducted to examine the effects of statin therapy initiated after coronary angioplasty on repeat revascularization, all-cause mortality and myocardial infarction (MI). From relevant reports on Medline (from inception to October 2009), six randomized clinical trials comprising 2979 patients were included. Relative risks were evaluated for pooled data via random effect models. Compared with controls, post-PCI statin therapy was associated with a significantly decreased risk of repeat revascularization (risk ratio (RR)=0.73, 95% confidence interval (CI), 0.55-0.98, p=0.04), nonsignificantly decreased risks of all-cause mortality (RR=0.88, 95% CI, 0.35-2.21, p=0.79), MI (RR=0.76, 95% CI, 0.49-1.18, p=0.23), and target lesion or target vessel revascularization (RR=0.58, 95% CI, 0.24-1.39, p=0.22). In conclusion, statin therapy after PCI can reduce the risk of repeat revascularization. Further investigation is needed to identify the underlying mechanism(s). PMID:19922797

  1. Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club.

    Science.gov (United States)

    Lassen, Jens Flensted; Holm, Niels Ramsing; Banning, Adrian; Burzotta, Francesco; Lefèvre, Thierry; Chieffo, Alaide; Hildick-Smith, David; Louvard, Yves; Stankovic, Goran

    2016-05-17

    Coronary bifurcations are involved in 15-20% of all percutaneous coronary interventions (PCI) and remain one of the most challenging lesions in interventional cardiology in terms of procedural success rate as well as long-term cardiac events. The optimal management of bifurcation lesions is, despite a fast growing body of scientific literature, the subject of considerable debate. The European Bifurcation Club (EBC) was initiated in 2004 to support a continuous overview of the field, and aims to facilitate a scientific discussion and an exchange of ideas on the management of bifurcation disease. The EBC hosts an annual, compact meeting, dedicated to bifurcations, which brings together physicians, engineers, biologists, physicists, epidemiologists and statisticians for detailed discussions. Every meeting is finalised with a consensus statement which reflects the unique opportunity of combining the opinions of interventional cardiologists with the opinions of a large variety of other scientists on bifurcation management. The present 11th EBC consensus document represents the summary of the up-to-date EBC consensus and recommendations. It points to the fact that there is a multitude of strategies and approaches to bifurcation stenting within the provisional strategy and in the different two-stent strategies. The main EBC recommendation for PCI of bifurcation lesions remains to use main vessel (MV) stenting with a proximal optimisation technique (POT) and provisional side branch (SB) stenting as a preferred approach. The consensus document covers a moving target. Much more scientific work is needed in non-left main (LM) and LM bifurcation lesions for continuous improvement of the outcome of our patients. PMID:27173860

  2. Creatine kinase-MB elevation after percutaneous coronary intervention predicts adverse outcomes in patients with acute coronary syndromes.

    OpenAIRE

    Roe, Matthew; Mahaffey, Kenneth; Kilaru, Rakhi; Akkerhuis, Martijn; Simoons, Maarten; Harrington, Robert Alex; Tardiff, Barbara; Granger, Christopher; Ohman, Magnus; Moliterno, David; Lincoff, Michael; Califf, Robert; Topol, Eric; Werf, Frans; Alexander, John

    2004-01-01

    textabstractAIM: To study the relationship between outcomes and peak creatine kinase (CK)-MB levels after percutaneous coronary intervention (PCI) in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS). METHODS AND RESULTS: Peak CK-MB ratios (peak CK-MB level/upper limit of normal [ULN]) after PCI were analysed in 6164 patients with NSTE ACS from four randomized trials who underwent in-hospital PCI. We excluded 696 patients with elevated CK or CK-MB levels

  3. 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

  4. 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

  5. The effects of cardiac rehabilitation on physiologic and psycologic condition of patients after percutaof patients after percutaneous transluminal coronary angioplasty (PCTA)%冠心病经皮冠状动脉腔内成形术后心脏康复治疗的疗效

    Institute of Scientific and Technical Information of China (English)

    郭兰; 孙家珍

    2000-01-01

    目的:探讨冠心病经皮冠状动脉腔内血管成形术(PTCA)后康复治疗的效果.方法:60例PTCA患者随机分组为康复治疗组(30例)、常规治疗组(30例),康复治疗组接受12周的Ⅱ期康复运动训练和教育程序,3个月后进行平板运动试验,心理焦虑表测试,生活质量调查.结果:康复治疗组在运动时间、运动负荷数、心理焦虑表得分、性生活改善、危险因素控制等方面优于对照组,有显著差异(P<0.05).结论:康复治疗对PTCA术后患者的心理、生理状况有促进改善的作用.

  6. Peri-procedural use of rivaroxaban in elective percutaneous coronary intervention to treat stable coronary artery disease. The X-PLORER trial

    NARCIS (Netherlands)

    Vranckx, P.; Leebeek, F.W.; Tijssen, J.G.; Koolen, J.; Stammen, F.; Herman, J.P.; Winter, R.J. de; van, T.H.A.W.; Backx, B.; Lindeboom, W.; Kim, S.Y.; Kirsch, B.; Eickels, M. van; Misselwitz, F.; Verheugt, F.W.A.

    2015-01-01

    Patients on rivaroxaban requiring percutaneous coronary intervention (PCI) represent a clinical conundrum. We aimed to investigate whether rivaroxaban, with or without an additional bolus of unfractionated heparin (UFH), effectively inhibits coagulation activation during PCI. Stable patients (n=108)

  7. Transradial percutaneous coronary intervention for chronic total occlusion of coronary artery disease using sheathless standard guiding catheters

    OpenAIRE

    Huang-Chung Chen; Wei-Chieh Lee; Shu-Kai Hsueh; Cheng-I Cheng; Chien-Jen Chen; Cheng-Hsu Yang; Chih-Yuan Fang; Chi-Ling Hang; Hon-Kan Yip; Chiung-Jen Wu; Hsiu-Yu Fang

    2015-01-01

    Objectives: Our aim was to evaluate the feasibility and safety of routine transradial approach (TRA) percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions using the sheathless technique with standard guiding catheters. Background: Transradial approach PCI was applied for CTO lesions. A major limitation of TRA CTO PCI is the inability to use large guiding catheters because of the relatively small size of the radial artery. Therefore, the sheathless technique for...

  8. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI). I. Experimental studies

    International Nuclear Information System (INIS)

    The objectives of this study were to evaluate the influence on image quality and dose to the patient and operator of various equipment settings for percutaneous coronary intervention (PCI), and to optimize the set-up. With an Alderson phantom, different settings, such as projection, protective screens, filtration, image intensifier size and collimation, were evaluated. Kerma-area product (KAP) was recorded as a measure of patient dose and scattered radiation was measured with an ionization chamber. Effective dose for a standardized PCI procedure was measured with thermoluminescent dosimeters inside the phantom. Image quality was evaluated with a contrast-detail phantom. Based on these findings, the equipment set-up was optimized to a low fluoroscopy dose rate with a sufficient image quality. Several operating parameters affected dose, particularly scattered radiation. The optimization reduced the fluoroscopy KAP rate from 44 to 16 mGy cm2/s using 15 cm of acrylic. The effective dose was reduced from 13 to 4.6 mSv for a standardized PCI procedure. Radiation dose to patient and operator in PCI is heavily dependent on both equipment set-up and operating parameters which can be influenced by the operator. With a careful optimization, a large reduction of radiation dose is possible. (orig.)

  9. Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI). I. Experimental studies

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Haakan; Andersson, Torbjoern [Department of Radiology, Oerebro University Hospital, 701 85 Oerebro (Sweden); Beckman, Karl-Wilhelm; Persliden, Jan [Department of Medical Physics, Oerebro University Hospital, 701 85 Oerebro (Sweden)

    2002-10-01

    The objectives of this study were to evaluate the influence on image quality and dose to the patient and operator of various equipment settings for percutaneous coronary intervention (PCI), and to optimize the set-up. With an Alderson phantom, different settings, such as projection, protective screens, filtration, image intensifier size and collimation, were evaluated. Kerma-area product (KAP) was recorded as a measure of patient dose and scattered radiation was measured with an ionization chamber. Effective dose for a standardized PCI procedure was measured with thermoluminescent dosimeters inside the phantom. Image quality was evaluated with a contrast-detail phantom. Based on these findings, the equipment set-up was optimized to a low fluoroscopy dose rate with a sufficient image quality. Several operating parameters affected dose, particularly scattered radiation. The optimization reduced the fluoroscopy KAP rate from 44 to 16 mGy cm{sup 2}/s using 15 cm of acrylic. The effective dose was reduced from 13 to 4.6 mSv for a standardized PCI procedure. Radiation dose to patient and operator in PCI is heavily dependent on both equipment set-up and operating parameters which can be influenced by the operator. With a careful optimization, a large reduction of radiation dose is possible. (orig.)

  10. Changes of plasma IMD/ADM-2 contents after intervention therapy in patients with coronary heart disease

    International Nuclear Information System (INIS)

    Objective: To study the possible role played by intermedin (IMD) adrenomedullin-2 (ADM-2) in the development of coronary heart disease (CHD) through measurement of the changes of its plasma content after intervention therapy. Methods: Plasma IMD/ADM-2 and adrenomedullin (ADM) contents were measured with RIA in 36 controls (only once) and repeatedly in 30 patients with CHD before, 24h, and 72h after percutaneous transluminal coronary angioplasty (PTCA) with placement of stent. Results: (1) Before intervention therapy, the plasma contents of IMD/ADM-2 in the patients were significantly lower while the plasma ADM contents were significantly higher than those in controls (both P<0.01). (2) The plasma contents of IMD/ADM-2 were higher in the patients with more vessels blocked and the ADM contents were lower, but both changes were not significantly. (3) The plasma contents of IDM/ADM-2 and ADM changes somewhat but not significantly 24h after PTCA. However, at 72h, the plasma IMD/ADM -2 contents were significantly increased (P<0.05), but plasma ADM contents were significantly decreased (P<0.05). (4) No correlationship existed between the plasma contents of ADM and IMD/AMD-2 (r=-0.358, P=0.174). Conclusion: IMD/AMD- 2 might play some role in the development of CHD, but the exact mechanism was not fully understood. (authors)

  11. Intervention with rotational atherectomy, sharp balloon and implant of conventional Stent in ostium lesion of right coronary artery, calcified

    International Nuclear Information System (INIS)

    Atherosclerotic lesions from the right coronary artery ostium have a low incidence in the manifestation of coronary disease. The high content of smooth muscle cells in the coronary ostium is related to a low success probability of a percutaneous intervention. We present a clinical complex case of a 61 years old female with right coronary artery ostium disease to whom we performed an angioplasty with cutting balloon and rotational arterectomy with successful results

  12. Maximizing benefit of drug-eluting stent by direct coronary stenting because of further reduction of inflammatory response

    Institute of Scientific and Technical Information of China (English)

    LI Jian-jun; GAO Run-lin

    2009-01-01

    @@ Coronary stents have been used as standard mechanical devices for percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD).1-3 They provide vessel wall scaffolding and prevent early elastic recoil and restenosis, which are major limitations of balloon angioplasty.4,5 Consequently, coronary stenting has a higher successful rate of PCI and improves the clinical outcome of the patients with CAD.6

  13. Culprit only or multivessel percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction and multivessel disease

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Farkas, Dóra Körmendiné;

    2012-01-01

    Aims: In patients with ST-segment elevation myocardial infarction (STEMI), timely reperfusion with primary percutaneous coronary intervention (PPCI) is the preferred treatment. However, it remains unclear whether the optimal strategy is complete revascularisation or culprit vessel PPCI only...

  14. Outcomes after primary percutaneous coronary intervention in octogenarians and nonagenarians with ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Terkelsen, Christian Juhl;

    2013-01-01

    BACKGROUND: Elderly patients with ST-segment elevation myocardial infarction (STEMI) constitute a particular risk group in relation to primary percutaneous coronary intervention (PPCI). OBJECTIVE: We examined the proportion of octogenarians and nonagenarians undergoing PPCI in Western Denmark...

  15. High prevalence of ulcer bleeding risk factors in dual antiplatelet-treated patients after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Berit Elin S; Hansen, Jane M; Junker, Anders B;

    2015-01-01

    INTRODUCTION: Dual antiplatelet therapy is standard treatment following percutaneous coronary intervention (PCI) and stenting. However, such therapy increases the risk of upper gastrointestinal bleeding (UGIB). The risk factors of UGIB are well-documented and proton pump inhibitor (PPI) treatment...

  16. Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    王荣英

    2003-01-01

    Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction@王荣英$河北医科大学第二医院!石家庄050000 0311-70469016011

  17. Intracoronary abciximab in diabetic patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Piccolo, Raffaele; Eitel, Ingo; Galasso, Gennaro;

    2015-01-01

    of intracoronary abciximab administration in diabetic patients with STEMI undergoing primary percutaneous coronary intervention (PCI). METHODS: Reperfusional and clinical outcomes of intracoronary abciximab compared with intravenous bolus abciximab according to diabetic status were evaluated in a pooled analysis...

  18. Cardioprotective effects of ischemic postconditioning in patients treated with primary percutaneous coronary intervention, evaluated by magnetic resonance

    DEFF Research Database (Denmark)

    Lønborg, Jacob; Kelbaek, Henning; Vejlstrup, Niels;

    2010-01-01

    Postconditioning has been suggested to reduce myocardial damage during primary percutaneous coronary intervention (PPCI) in patients with ST-segment-elevation myocardial infarction. However, because clinical experience is limited, we examined the cardioprotective effects of postconditioning, usin...

  19. Use of clopidogrel in the reduction of myocardial damage during percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Arijit Dasgupta

    2009-03-01

    Full Text Available Arijit Dasgupta, Debabrata MukherjeeGill Heart Institute, University of Kentucky, Lexington, KY, USAAbstract: It is estimated that approximately a quarter of patients undergoing coronary intervention may have significant post-procedural creatinine (CK/creatinine kinase myocardial band (CK-MB elevations and approximately half may have post-procedural troponin elevations. Current data suggest that periprocedural infarction is associated with short-, intermediate-, and long-term adverse outcomes, most notably mortality. This review examines the role of clopidogrel in decreasing periprocedural myonecrosis following percutaneous coronary intervention (PCI. Clopidogrel is an important pharmacologic agent used to reduce myocardial infarction post-coronary intervention as assessed directly by the evaluation of cardiac biomarkers and indirectly by the evaluation of short-term ischemic events. The optimal dose of clopidogrel is considered to be at least 300 mg given 6 to 15 hours prior to PCI but there is considerable evidence to suggest that a loading dose of 600 mg given 2 to 6 hours prior to PCI may be more efficacious in limiting post-coronary intervention events. The benefit obtained from clopidogrel appears independent of and incremental to that of other antiplatelet and antithrombotic agents used during and after coronary intervention.Keywords: percutaneous coronary intervention, myonecrosis, clopidogrel, antiplatelet agents, myocardial infarction 

  20. Understanding the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) Trial Implications for current and future clinical practice

    OpenAIRE

    Farooq, Vasim

    2014-01-01

    markdownabstract__Abstract__ The landmark Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) Trial1-4 has aided in reducing the area of uncertainty in decision making between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in patients with complex coronary artery disease.5-8 As part of the SYNTAX Trial, quantification of the coronary artery disease burden was undertaken with the anatomical SYNTAX Score (www.synta...

  1. Evaluation of high dose atorvastatin therapy 24 hours before elective percutaneous coronary intervention on peri-PCI myocardial infarction

    OpenAIRE

    Rahmani R; Nafasi L; Salary A; Meisami A; Abdollahi A

    2013-01-01

    Background: Percutaneous coronary intervention (PCI) may been associated with high-er risk of cardiac events during this procedure. The goal of this study was to compare high dose atorvastatin therapy with low dose atorvastatin therapy 24 hours before PCI to a reduction in Peri- percutaneous coronary intervention myocardial infarction.Methods: One hundred ninety patients with stable angina were enrolled in a randomiz-ed controlled clinical trial study. All patients received low dose atorvasta...

  2. Platelet inhibitors in non-ST-segment elevation acute coronary syndromes and percutaneous coronary intervention: glycoprotein IIb/IIIa inhibitors, clopidogrel, or both?

    Science.gov (United States)

    Silva, Matthew A; Donovan, Jennifer L; Gandhi, Pritesh J; Volturo, Gregory A

    2006-01-01

    The role of glycoprotein (Gp) IIb/IIIa receptor antagonists remains controversial and these agents are infrequently utilized during non-ST-segment elevation acute coronary syndromes (NSTE-ACS) despite American Heart Association/American College of Cardiology guidelines. Despite recommendations, the NRMI-4 (National Registry of Myocardial Infarction 4) and CRUSADE (Can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines?) registries observed that only 25%-32% of eligible patients received early Gp IIb/IIIa therapy, despite a 6.3% absolute mortality reduction in NRMI-4 and a 2% absolute mortality reduction in CRUSADE. A pooled analysis of Gp IIb/IIIa data from these registries suggest a major reduction in mortality (Odds Ratio = 0.43, 95% Confidence Index 0.25-0.74, p = 0.002) with early Gp IIb/IIIa therapy, yet clinicians fail to utilize this option in NSTE-ACS. The evidence-based approach to NSTE-ACS involves aspirin, clopidogrel, low-molecular weight heparins, or unfractionated heparin in concert with Gp IIb/Ila receptor antagonists, however, newer percutaneous coronary intervention (PCI)-based trials challenge current recommendations. Novel strategies emerging in NSTE-ACS include omitting Gp IIb/Ila inhibitors altogether or using Gp IIb/IIIa inhibitors with higher doses of clopidogrel in selected patients. The ISAR-REACT (Intracoronary stenting and antithrombotic regimen-Rapid early action for coronary treatment) and ISAR-SWEET (ISAR-Is abciximab a superior way to eliminate elevated thrombotic risk in diabetics) trials question the value of abciximab when 600 mg of clopidogrel concurrently administered during PCI. The CLEAR-PLATELETS (Clopidogrel loading with eptifibatide to arrest the reactivity of platelets) and PEACE (Platelet activity extinction in non-Q-wave MI with ASA, clopidogrel, and eptifibatide) trials suggest more durable platelet inhibition when Gp IIb/IIIa inhibitors are

  3. Peripheral artery disease in korean patients undergoing percutaneous coronary intervention: prevalence and association with coronary artery disease severity.

    Science.gov (United States)

    Kim, Eun Kyoung; Song, Pil Sang; Yang, Jeong Hoon; Song, Young Bin; Hahn, Joo-Yong; Choi, Jin-Ho; Gwon, Hyeon-Cheol; Lee, Sang Hoon; Hong, Kyung Pyo; Park, Jeong Euy; Kim, Duk-kyung; Choi, Seung-Hyuk

    2013-01-01

    Peripheral artery disease (PAD) is an important marker for the risk stratification of patients with coronary artery disease (CAD). We investigated the prevalence of PAD in patients undergoing percutaneous coronary intervention (PCI) with CAD and the relationship between ankle-brachial pressure index (ABPI) and CAD severity. A total of 711 patients undergoing PCI for CAD from August 2009 to August 2011 were enrolled. PAD diagnosis was made using the ABPI. The prevalence of PAD was 12.8%. In PAD patients, mean values of right and left ABPI were 0.71 ± 0.15 and 0.73 ± 0.15. Patients with PAD had a higher prevalence of left main coronary disease (14.3% vs 5.8%, P = 0.003), more frequently had multivessel lesions (74.9% vs 52.1%, P ABPI-based PAD screening should be implemented in all patients undergoing PCI with CAD, especially in severe cases. PMID:23341717

  4. Torsades de pointes related to transient marked QT prolongation following successful emergent percutaneous coronary intervention for acute coronary syndrome.

    Science.gov (United States)

    Kawabata, Mihoko; Hirao, Kenzo; Takeshi, Sasaki; Sakurai, Kaoru; Inagaki, Hiroshi; Hachiya, Hitoshi; Isobe, Mitsuaki

    2008-01-01

    We report 2 patients in whom transient marked QT prolongation occurred after successful emergent percutaneous coronary intervention (PCI) for acute coronary syndrome. One patient developed torsades de pointes. In both cases, the QT interval became markedly prolonged within 24 hours after PCI, and this prolongation persisted for 4 days. The T waves had a giant and bizarre negative shape with a prolonged T-wave peak to T-wave end interval. No new-onset ischemia or congenital long QT syndrome was related to the episodes. The patients had not taken any drugs that could have prolonged the QT interval, and their serum potassium levels were within normal limits. Torsades de pointes following successful PCI for acute coronary syndrome is uncommon, but acquired long QT syndrome should be considered and treated in patients in whom giant and bizarre negative T waves and QT prolongation develop after PCI. PMID:18328336

  5. Primary coronary angioplasty for ST-Elevation Myocardial Infarction in Qatar: First nationwide program

    Science.gov (United States)

    Gehani, Abdurrazzak; Al Suwaidi, Jassim; Arafa, Salah; Tamimi, Omer; Alqahtani, Awad; Al-Nabti, Abdulrahman; Arabi, Abdulrahman; Aboughazala, Tarek; Bonow, Robert O; Yacoub, Magdi

    2012-01-01

    Abstract: In this article, we outline the plans, protocols and strategies to set up the first nationwide primary Percutaneous Coronary Intervention (PCI) program for ST-elevation myocardial Infarction (STEMI) in Qatar, as well as the difficulties and the multi-disciplinary solutions that we adopted in preparation. We will also report some of the landmark literature that guided our plans. The guidelines underscore the need for adequate number of procedures to justify establishing a primary-PCI service and maintain competency. The number of both diagnostic and interventional procedures in our centre has increased substantially over the years. The number of diagnostic procedures has increased from 1470 in 2007, to 2200 in 2009 and is projected to exceed 3000 by the end of 2012. The total number of PCIs has also increased from 443 in 2007, to 646 in 2009 and 1176 in 2011 and is expected to exceed 1400 by the end of 2012. These figures qualify our centre to be classified as ‘high volume’, both for the institution and for the individual interventional operators. The initial number of expected primary PCI procedures will be in excess of 600 procedures per year. Guidelines also emphasize the door to balloon time (DBT), which should not exceed 90 minutes. This interval mainly represents in-hospital delay and reflects the efficiency of the hospital system in the rapid recognition and transfer of the STEMI patient to the catheterization laboratory for primary-PCI. Although DBT is clearly important and is in the forefront of planning for the wide primary PCI program, it is not the only important time interval. Myocardial necrosis begins before the patient arrives to the hospital and even before first medical contact, so time is of the essence. Therefore, our primary PCI program includes a nationwide awareness program for both the population and health care professionals to reduce the pre-hospital delay. We have also taken steps to improve the pre-hospital diagnosis of

  6. 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)

  7. Meta-Analysis of Usefulness of Percutaneous Left Ventricular Assist Devices for High-Risk Percutaneous Coronary Interventions.

    Science.gov (United States)

    Briasoulis, Alexandros; Telila, Tesfaye; Palla, Mohan; Mercado, Nestor; Kondur, Ashok; Grines, Cindy; Schreiber, Theodore

    2016-08-01

    High-risk percutaneous coronary intervention (PCI) is often offered to patients with extensive coronary artery disease, decreased left ventricular function, and co-morbid conditions that increase surgical risk. In these settings, percutaneous left ventricular assist devices (PVADs) can be used for hemodynamic support. To assess the effects of PVAD use on mortality, myocardial infarction, and complication rates in patients undergoing high-risk PCI, we systematically searched the electronic databases, MEDLINE, PUBMED, EMBASE, and Cochrane for prospective controlled trials and cohort studies of patients that received hemodynamic support with PVADs for high-risk PCI. The primary outcome measures were 30-day all-cause mortality, 30-day myocardial infarction rates, periprocedural major bleeding, and vascular complications. We included 12 studies with 1,346 participants who underwent Impella 2.5 L device placement and 8 cohort studies with 205 patients that received TandemHeart device for high-risk PCI. Short-term mortality rates were 3.5% and 8% and major bleeding rates were 7.1% and 3.6% with Impella and TandemHeart, respectively. Both devices are associated with comparable periprocedural outcomes in patients undergoing high-risk PCI. PMID:27265673

  8. Saphenous Vein Graft Perforation During Percutaneous Coronary Intervention - A Nightmare to be Avoided

    Directory of Open Access Journals (Sweden)

    Surender Deora

    2015-01-01

    Full Text Available Percutaneous coronary interventions (PCIs of saphenous vein grafts (SVGs is challenging and is associated with adverse short- and long-term clinical outcome as compared to native coronary arteries. SVG perforation is rare but catastrophic and needs immediate attention. Various factors predisposing for SVG perforation are old degenerated graft, ulcerated plaque, severe fibrotic, or calcified lesion necessitating high pressure balloon or stent inflation, use of intravascular ultrasound (IVUS or other atheroablative devices. Management includes prolonged balloon occlusion, reversal of anticoagulation, use of covered stent, and emergency pericadiocentesis if required.

  9. Obesity, health status, and 7-year mortality in percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Younge, John O; Damen, Nikki L; van Domburg, Ron T;

    2013-01-01

    understanding of the phenomenon, we examined the association between body mass index (BMI) and all-cause mortality in patients treated with percutaneous coronary intervention (PCI) at 7-year follow-up, and the potential role of health status in explaining the obesity paradox.......Obesity is a growing health problem and is associated with adverse outcomes in coronary artery disease (CAD). However, recent studies have shown better survival in cardiovascular patients with overweight or obesity, which has been referred to as the "obesity paradox". As there is no clear...

  10. Abdominal Wall Hematoma as a Rare Complication following Percutaneous Coronary Intervention

    Science.gov (United States)

    Moon, In Tae; Sohn, Young Seok; Lee, Ji Young; Park, Hwan Cheol; Choi, Sung Il; Kim, Soon Gil; Oh, Ji Young

    2016-01-01

    Abdominal wall hematoma is a rare but potentially serious vascular complication that may develop after coronary angiographic procedures. In particular, an oblique muscle hematoma caused by an injury of the circumflex iliac artery is very rare, yet can be managed by conservative treatment including hydration and transfusion. However, when active bleeding continues, angiographic embolization or surgery might be needed. In this study, we report an uncommon case of injury to the circumflex iliac artery by an inappropriate introduction of the hydrophilic guidewire during the performance of a percutaneous coronary intervention.

  11. Percutaneous coronary interventions in a rural hospital without surgical backup: report of one year of experience.

    Science.gov (United States)

    Brown, Daniel C; Mogelson, Stanley; Harris, Reed; Kemp, David; Massey, Marlys

    2006-08-01

    This paper demonstrates that percutaneous coronary intervention (PCI) can be provided in a rural setting with results that are at least as good as the national average without untoward risk to the patient. Percutaneous coronary intervention is the initial treatment of choice for acute myocardial infarction (AMI). Historically, PCI has been available in metropolitan areas, yet 20% of the population lives in rural areas. Rural patients with AMI may not be receiving optimal care, especially if PCI is not readily available. In a rural setting, door-to-balloon time for patients with acute ST-elevation MI was 67.66 +/- 30.80 min. This is significantly better than the 186 min reported in the National Registry Myocardial Infarction (NRMI). These results were achieved with a complication rate that was not significantly different from national averages. This study demonstrates that PCI can be provided safely and with good results in a rural setting. PMID:16933573

  12. Total leukocyte count but not C-reactive protein predicts one-year mortality in patients with acute coronary syndromes treated with percutaneous coronary intervention

    OpenAIRE

    Ndrepepa, Gjin; Braun, Siegmund; Iijima, Raisuke; Keta, Dritan; Byrne, Robert A.; Schulz, Stefanie; Mehilli, Julinda; Schömig, Albert; Kastrati, Adnan

    2009-01-01

    Abstract Although an association between elevated white blood cells (WBC) count and mortality in patients with acute coronary syndromes (ACS) has been established, the independence of this association from coronary risk factors and C-reactive protein has been inadequately studied. This prospective registry included 4329 patients with ACS treated with percutaneous coronary intervention (PCI): 1059 patients with ST-segment elevation acute myocardial infarction, 1753 patients with non...

  13. Intimal Hyperplasia in Balloon Dilated Coronary Arteries is Reduced by Local Delivery of the NO Donor, SIN-1 Via a cGMP-Dependent Pathway

    Directory of Open Access Journals (Sweden)

    Arner Anders

    2011-06-01

    Full Text Available Abstract Background To elucidate the mechanism by which local delivery of 3-morpholino-sydnonimine (SIN-1 affects intimal hyperplasia after percutaneous transluminal coronary angioplasty (PTCA. Methods Porcine coronary arteries were treated with PTCA and immediately afterwards locally treated for 5 minutes, with a selective cytosolic guanylate cyclase inhibitor, 1 H-(1,2,4oxadiazole(4,3-alphaquinoxaline-1-one (ODQ + SIN-1 or only SIN-1 using a drug delivery-balloon. Arteries were angiographically depicted, morphologically evaluated and analyzed after one and eight weeks for actin, myosin and intermediate filaments (IF and nitric oxide synthase (NOS contents. Results Luminal diameter after PCI in arteries treated with SIN-1 alone and corrected for age-growth was significantly larger as compared to ODQ + SIN-1 or to controls (p Conclusions After PTCA local delivery of high concentrations of the NO donor SIN-1 for 5 minutes inhibited injury induced neointimal hyperplasia. This favorable effect was abolished by inhibition of guanylyl cyclase indicating mediation of a cyclic guanosine 3',5'-monophosphate (cGMP-dependent pathway. The momentary events at the time of injury play crucial role in the ensuring development of intimal hyperplasia.

  14. Antithrombotic therapy in anticoagulated patients with atrial fibrillation presenting with acute coronary syndromes and/or undergoing percutaneous coronary intervention/stenting

    Directory of Open Access Journals (Sweden)

    Benjamin J. Wrigley

    2010-07-01

    Full Text Available The management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary inter vention/stenting cannot be done according to a regimented common protocol, and stroke and bleeding risk stratification schema should be employed to individualize treatment options. A delicate balance is needed between the prevention of thromboembolism, against recurrent cardiac ischemia or stent thrombosis, and bleeding risk. New guidance from a consensus document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association and the European Association ofPercutaneous Cardiovascular Interventions on the management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting with Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention/Stenting has sought to clarify some of the major issues and problems surrounding this practice, and will allow clinicians to make much more informed decisions when faced with treating such patients.

  15. Thrombotic Occlusion during Intravascular Ultrasonography-Guided Percutaneous Coronary Intervention of Stumpless Chronic Total Occlusion

    OpenAIRE

    Lee, Un Joo; Kim, Hyun Soo; Lee, Cheolhyun; Kim, Kwang-yeol; Kim, Weon

    2014-01-01

    Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO proced...

  16. Feasibility of virtual 3-Fr percutaneous coronary intervention using standard guiding catheters

    OpenAIRE

    Honda, Tsuyoshi; Fujimoto, Kazuteru; Miyao, Yuji

    2014-01-01

    Introduction Recent studies have reported the efficacy of sheathless percutaneous coronary intervention (PCI) using hydrophilic-coated 5-Fr guiding catheters that are one to two Fr sizes smaller in diameter than the corresponding introducer sheath (virtual 3-Fr PCI). However, the limited number of shapes of hydrophilic-coated guiding catheters occasionally makes them difficult to engage and control. Aim To evaluate the efficacy and feasibility of virtual 3-Fr PCI using standard guiding cathet...

  17. Usefulness of Intracoronary Epinephrine in Severe Hypotension during Percutaneous Coronary Interventions

    OpenAIRE

    Choi, Jin Hee; Chun, Kook-Jin; Lee, Sang Hyun; Chon, Min Ku; Lee, Sang-Gwon; Kim, Jeong Su; Kim, Jun; Park, Yong-Hyun; Kim, June Hong

    2013-01-01

    Background and Objectives Life-threatening hypotension during percutaneous coronary interventions (PCI) is devastating for the patient and is associated with fatal adverse outcomes. The aim of our study was to assess the usefulness of intracoronary epinephrine in severe hypotension unresponsive to other measures during PCI. Subjects and Methods We analyzed the Pusan National University Yangsan hospital cardiac catheterization laboratory database to identify patients who underwent PCI from Dec...

  18. Predictors and prognosis of early ischemic mitral regurgitation in the era of primary percutaneous coronary revascularisation

    OpenAIRE

    MacHaalany, Jimmy; Bertrand, Olivier F; O’Connor, Kim; Abdelaal, Eltigani; Voisine, Pierre; Larose, Éric; Charbonneau, Éric; Costerousse, Olivier; Déry, Jean-Pierre; Sénéchal, Mario

    2014-01-01

    Background Studies assessing ischemic mitral regurgitation (IMR) comprised of heterogeneous population and evaluated IMR in the subacute setting. The incidence of early IMR in the setting of primary PCI, its progression and clinical impact over time is still undetermined. We sought to determine the predictors and prognosis of early IMR after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Methods Using our primary PCI database, we screened for ...

  19. Sex differences in long-term outcomes of patients with percutaneous coronary intervention: the Armenian experience

    OpenAIRE

    Yeva Sahakyan; Thompson, Michael E; Lusine Abrahamyan

    2013-01-01

    The present study aimed at assessing sex differences in perioperative characteristics and 3-year event-free survival from major adverse cardiac and cerebrovascular events (MACCE) in patients with percutaneous coronary intervention (PCI) in Armenia. The study utilized an observational, retrospective cohort design enrolling patients who underwent PCI from 2006 to 2008 at a single center in Yerevan, Armenia. Major adverse cardiac and cerebrovascular events included all-cause mortality, myocardia...

  20. Percutaneous coronary intervention in the Occluded Artery Trial: Procedural success, hazard, and outcomes over 5 years

    OpenAIRE

    Buller, C; Rankin, J.; Carere, R; P. Buszman; Pfisterer, M.; Dzavik, V; Thomas, B.; Forman, S.; Ruzyllo, W; Mancini, G.; Michalis, L; de Abreu, G.; Lamas, G.; Hochman, J

    2009-01-01

    BACKGROUND: The Occluded Artery Trial (OAT) was a 2,201-patient randomized clinical trial comparing routine stent-based percutaneous coronary intervention (PCI) versus optimal medical therapy alone in stable myocardial infarction (MI) survivors with persistent infarct-related artery occlusion identified day 3 to 28 post MI. Intent-to-treat analysis showed no difference between strategies with respect to the incidence of new class IV congestive heart failure, MI, or death. The influence of PCI...

  1. Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study

    OpenAIRE

    Wijns, William; Shite, Junya; Jones, Michael R; Lee, Stephen W.-L.; Price, Matthew J.; Fabbiocchi, Franco; Barbato, Emanuele; Akasaka, Takashi; Bezerra, Hiram; Holmes, David

    2015-01-01

    Aims ILUMIEN I is the largest prospective, non-randomized, observational study of percutaneous coronary intervention (PCI) procedural practice in patients undergoing intra-procedural pre- and post-PCI fractional flow reserve (FFR) and optical coherence tomography (OCT). We report on the impact of OCT on physician decision-making and the association with post-PCI FFR values and early clinical events. Methods and results Optical coherence tomography and documentary FFR were performed pre- and p...

  2. Mean Platelet Volume and Long-Term Mortality in Patients Undergoing Percutaneous Coronary Intervention

    OpenAIRE

    Shah, Binita; Oberweis, Brandon; Tummala, Lakshmi; Amoroso, Nicholas S.; Lobach, Iryna; Sedlis, Steven P.; Grossi, Eugene; Berger, Jeffrey S.

    2012-01-01

    Increased platelet activity is associated with adverse cardiovascular events. Mean platelet volume (MPV) correlates with platelet activity but the relationship between MPV and long-term mortalityin patients undergoing percutaneous coronary intervention(PCI) is not well established. Furthermore, the role of change in MPV over time has not been previously evaluated. We evaluatedMPV at baseline, 30 days, 60 days, 90 days, 1 year, 2 years, and 3 years post-procedure in 1,512 patients who underwen...

  3. Influences of percutaneous coronary intervention on myocardial activity in myocardial infarction patients with different viable myocardium

    Institute of Scientific and Technical Information of China (English)

    李丽琪

    2013-01-01

    Objective To evaluate the effect of percutaneous coronary intervention (PCI) on left ventricular function in patients with different types of myocardial infarction and to explore the correlation factors for the left ventricular function.Methods A total of 43 patients diagnosed as acute myocardial infarction were enrolled in this study.The perfusion and delayed enhancement magnetic resonance imaging (DE-MRI) was applied to observe the fol-

  4. Appraisal of the Prognosis in Patients with Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

    Institute of Scientific and Technical Information of China (English)

    马晓娟; 殷惠军; 陈可冀

    2009-01-01

    Acute myocardial infarction(AMI) is still the leading factor causing crippling and death in cardiovascular disease.Percutaneous coronary intervention(PCI) can significantly reduce inpatient mortality and incidence of complication.But owing to the existence of restenosis,in-stent thrombosis,etc.,recurrent post-PCI cardiovascular events and high repeatability of hospitalization,as well as its crippling rate and mortality, remain a serious threat to the society and the patients' family.Therefore,the apprais...

  5. A Cost-Minimization Analysis of the Angioseal Vascular Closure Device following Percutaneous Coronary Intervention

    OpenAIRE

    Resnic, Frederic S.; Arora, Nipun; Matheny, Michael; Reynolds, Matthew R.

    2007-01-01

    The Angioseal vascular closure device has been shown to be safe and effective in reducing the time to hemostasis following percutaneous coronary intervention (PCI). The health economic implications of routinely using Angioseal after PCI have not been explored. We performed a cost-minimization analysis comparing routine Angioseal use after PCI to mechanical compression using a decision analytic model. The relative probabilities of 7 vascular access complications were derived from pooled analys...

  6. Thrombus aspiration during primary percutaneous coronary intervention associated with reduced platelet activation

    OpenAIRE

    Sahin, Muslum; Acar, Goksel; Kalkan, Mehmet E.; Acar, Rezzan D; Kilicgedik, Alev; Teymen, Burak; Arslantas, Ugur; Kirma, Cevat

    2015-01-01

    Objectives: To determine the effect of thrombectomy on platelet function in patients undergoing primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI). Methods: This retrospective study included 413 consecutive STEMI patients who underwent PPCI between March 2012 and September 2013 at Kartal Kosuyolu High Specialty Education and Research Hospital, Istanbul, Turkey that were assigned to the thrombus aspiration (TA) group or the non-TA group. Pl...

  7. On-treatment platelet reactivity in patients with chronic obstructive pulmonary disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Campo, Gianluca; Pavasini, Rita; Pollina, Alberto; Tebaldi, Matteo; Ferrari, Roberto

    2014-01-01

    Patients with chronic obstructive pulmonary disease (COPD) show a poor prognosis after myocardial infarction (MI) and percutaneous coronary intervention (PCI). We evaluated on-treatment platelet reactivity (PR) and several gene polymorphisms related to PR in 130 patients undergoing PCI with and without COPD. Those with concomitant COPD showed higher on-treatment PR values both at the time of PCI and 1 month after. This finding may contribute to explain the poor prognosis of COPD patients after MI and PCI. PMID:23878160

  8. Supported high-risk percutaneous coronary intervention with the impella 2.5 device the europella registry

    NARCIS (Netherlands)

    K.D. Sjauw; T. Konorza; R. Erbel; P.L. Danna; M. Viecca; H.H. Minden; C. Butter; T. Engstrøm; C. Hassager; F.P. Machado; G. Pedrazzini; D.R. Wagner; R. Schamberger; S. Kerber; D.G. Mathey; J. Schofer; A.E. Engström; J.P.S. Henriques

    2009-01-01

    OBJECTIVES: This retrospective multicenter registry evaluated the safety and feasibility of left ventricular (LV) support with the Impella 2.5 (Abiomed Europe GmbH, Aachen, Germany) during high-risk percutaneous coronary intervention (PCI). BACKGROUND: Patients with complex or high-risk coronary les

  9. Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schenkeveld, Lisanne; Pedersen, Susanne S.; van Nierop, Josephine W I;

    2010-01-01

    Health status has become increasingly important as an outcome measure in patients with cardiovascular disease. Poor patient-rated health status has been shown to predict mortality in patients with coronary artery disease and heart failure. In patients treated with percutaneous coronary intervention...

  10. Reduced positive affect (anhedonia) is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Damen, Nikki L; Pelle, Aline J; Boersma, Eric;

    2013-01-01

    Negative mood states (e.g., anxiety and depression) have been associated with increased cardiovascular morbidity and mortality in coronary artery disease (CAD), but little is known about the impact of positive emotions on these health outcomes. We examined whether anhedonia (i.e., reduced positive...... affect) was associated with 7-year mortality in patients treated with percutaneous coronary intervention (PCI)....

  11. 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)

  12. Coronary artery bypass surgery without cardiopulmonary bypass: short- and mid-term results.

    Science.gov (United States)

    Mishra, Y; Mehta, Y; Kohli, V M; Kohli, V; Mairal, M; Mishra, A; Bapna, R K; Trehan, N

    1997-01-01

    From March 1994 to April 1997, 433 patients had undergone coronary artery bypass grafting without cardiopulmonary bypass in our institute. Sixty-eight patients had various organ dysfunctions and/or aortic atheroma or calcification and were regarded as high risk for cardiopulmonary bypass. In 277 patients surgery was performed through midline sternotomy, while in 156 minithoracotomy approach was used. In 361 patients single coronary artery bypass grafting was done, and in 72 two-coronary arteries were bypassed. In 63 patients who had graftable vessels in anterior wall and diffusely diseased ungraftable vessels in posterolateral and/or inferior wall, transmyocardial laser revascularisation was also done along with coronary artery bypass grafting to achieve complete myocardial revascularisation. Nine patients in this series were also subjected to simultaneous carotid endarterectomy along with myocardial revascularisation. In two patients complementary percutaneous transluminal coronary angioplasty of left circumflex coronary artery was done five days after minithoracotomy and left internal mammary artery to left anterior descending coronary artery bypass grafting. Forty-two cases were extubated in operating room. Average blood loss was 260 ml. Six patients were reexplored for postoperative bleeding. Seven patients had perioperative myocardial infarction. One developed neurological complication. Hospital mortality was 2.3 percent (10/433 cases) and four deaths were due to malignant ventricular arrhythmias. Nine patients developed chest wound complications. Average hospital stay after operation was six days, 423 patients were discharged from hospital and all of them were asymptomatic. During three years follow-up (range 3 to 38 months) there were three known cardiac deaths. Ninety percent (391) patients reported to the follow-up clinic and 91 percent of them were angina-free. In patients who were subjected to transmyocardial laser revascularisation along with coronary

  13. Acute and subacute stent thrombosis after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction : incidence, predictors and clinical outcome

    NARCIS (Netherlands)

    Hesstermans, A. A. C. M.; van Werkum, J. W.; Zwart, B.; van der Heyden, J. A.; Kelder, J. C.; Breet, N. J.; van't Hof, A. W. J.; Koolen, J. J.; Brueren, B. R. G.; Zijlstra, F.; ten Berg, J. M.; Dambrink, Jan Hendrik Everwijn

    2010-01-01

    Background: Early coronary stent thrombosis occurs most frequent after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Objectives: To identify the specific predictors of, respectively, acute and subacute stent thrombosis in patients after prim

  14. Monitoring Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    N.J. Breet

    2011-01-01

    textabstractDual antiplatelet therapy with aspirin and thienopyridines is the cornerstone in the treatment of patients with acute coronary syndrome (ACS) and in those undergoing PCI with stent-implantation.However, the magnitude of on-treatment platelet reactivity is not uniform among individuals, d

  15. Percutaneous Coronary Intervention using a Full Metal Jacket with Drug-eluting Stents: Major Adverse Cardiac Events at One Year

    OpenAIRE

    Calé, Rita; Teles, Rui Campante; Almeida, Manuel; do Rosário, Ingrid; Sousa, Pedro Jerónimo; Brito, João; Raposo, Luís; Gonçalves, Pedro Araújo; Gabriel, Henrique Mesquita; Mendes, Miguel

    2013-01-01

    Background The clinical benefit of percutaneous coronary intervention (PCI) for long coronary lesions is unclear; furthermore, concerns have been raised about its safety. Objectives To evaluate the predictors of major adverse cardiac events (MACE) associated with PCI using a full metal jacket (FMJ), defined as overlapping drug-eluting stents (DES) measuring > 60 mm in length, for very long lesions. Methods We enrolled 136 consecutive patients with long coronary lesions requiring FMJ in our si...

  16. Comparison of Long-Term Outcome After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Unprotected Left Main Coronary Artery Disease (from the CREDO-Kyoto PCI/CABG Registry Cohort-2).

    OpenAIRE

    Shiomi, Hiroki; MORIMOTO, TAKESHI; Hayano, Mamoru; Furukawa, Yutaka; Nakagawa, Yoshihisa; Tazaki, Junichi; Imai, Masao; Yamaji, Kyohei; Tada, Tomohisa; Natsuaki, Masahiro; Saijo, Sayaka; Funakoshi, Shunsuke; Nagao, Kazuya; Hanazawa, Koji; Ehara, Natsuhiko

    2012-01-01

    The long-term outcome of percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) for unprotected left main coronary artery disease (ULMCAD) remains to be investigated. We identified 1,005 patients with ULMCAD of 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG Registry Cohort-2. Cumulative 3-year incidence of a composite of death/myocardial infarction (MI)/stroke was significantly higher in the PCI group than in the...

  17. Percutaneous coronary intervention following repair of type B aortic dissection: a report of 8 cases

    Institute of Scientific and Technical Information of China (English)

    Quanmin Jing; Xiaozeng Wang; Yaling Han; Bo Luan; Geng Wang; Xiaojiang Liu; Hongxu Jin

    2008-01-01

    Objective Patients with aortic dissection have a significant incidence of coronary artery disease.The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent,and to assess the effect of anti-coagulant and anti-platelet treatment on patients' thrombosis process.Methods From January 2005 to July 2007,8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair,underwent percutaneous coronary intervention (PCI) because of coexisting coronary artery disease.Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol.Patients were followed up for a mean period of 23 months.Clinical and false lumen status data were collected during the follow-up.Results PCI were technically successful in all 8 patients and no severe complications such as death,paraplegia,renal failure occurred during hospitalization.Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up.There were no major complications such as death,dissection rupture or aneurysm development occurred during the follow-up period.Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft,without interrupting the thrombosis process.

  18. Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Richard; A; Brogan; Christopher; J; Malkin; Philip; D; Batin; Alexander; D; Simms; James; M; McLenachan; Christopher; P; Gale

    2014-01-01

    Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction(NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention(PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed.

  19. Immediate mobilization after coronary angiography or percutaneous coronary intervention following hemostasis with the AngioSeal vascular closure device (the MOBS study)

    DEFF Research Database (Denmark)

    Larsen, Ellen Nyholm; Hansen, Charlotte Bak; Thayssen, Per;

    2014-01-01

    BACKGROUND: In patients undergoing coronary angiography or percutaneous coronary intervention (PCI), the standard post procedure regime includes immobilization and bed rest despite the use of vascular closure devices. AIM: In the Mobilization after Coronary Angiography or Percutaneous Coronary...... Intervention (MOBS) study we compared bleeding complications after cardiac catheterization with femoral artery access after mobilization immediately off the angiographic table or standard care with1 hour (MOBS I after a diagnostic angiogram) or 2 hours of bed rest before mobilization (MOBS II after PCI...... group 20.5%, p=0.62. CONCLUSIONS: Immediate mobilization after a coronary angiogram or PCI with the femoral access site closed by the closure device AngioSeal was not associated with increased bleeding risk compared to standard care with bed rest....

  20. The effects of percutaneous coronary interventional therapy on platelet activation and the systems fibrinolysis in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Objective: To investigate the effects of percutaneous coronary interventional therapy on platelet activation and the systemic fibrinolysis in patients with coronary artery disease (CAD). Methods: The plasma concentration of platelet alpha-granule membrane glycoprotein-140 (GMP-140), plasminogen activator inhibitor-1 (PAI-1), tissue-type plasminogen activator (t-PA), von Willebrand factor (vWF) and D-dimer (D-D) of the blood sampled from vein according to the schedule were measured by ELISA. Results: In the sixty-five patients with CAD, at 10 minutes after the procedure, plasma levels of GMP-140, t-PA and D-D were significantly higher than the previous ones; and at 24 h, plasma levels of PAI-1 and vWF were also increased significantly. Conclusions: The activation of platelet and impaired fibrinolytic activity were occurred after PCI in the patients with CAD

  1. 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

  2. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study

    DEFF Research Database (Denmark)

    Pijls, Nico H J; Fearon, William F; Tonino, Pim A L;

    2010-01-01

    The purpose of this study was to investigate the 2-year outcome of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD)....

  3. Succesful treatment of spontaneous dissection of the coronary artery by primary percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Yüksel Çavuşoğlu

    2011-09-01

    Full Text Available Spontaneous coronary artery dissection (SCAD is a rare cause of acute myocardial infarction. The disease is usually seen in young-middle aged women and leads to sudden death in the majority of cases. In survived patients, diagnosis of SCAD has been made with coronary anjiography. Involvement of left main coronary artery (LMCA is very unusual. We describe on a case of SCAD involving the LMCA in a young woman presenting with an acute myocardial infarction and cardiogenic shock status. There were no risk factors for coronary artery disease and no evidence of atherosclerosis on angiography. Coronary angiography revealed dissection of the LMCA that extended into the anterior descending and circumflex coronary arteries. The dissection was successfully treated with primary coronary artery stenting. The patient was discharged without complication. There was no problem in the first evaluation at the end of the first of the month. J Clin Exp Invest 2011; 2 (3: 299-303.

  4. Solid Right Ventricular Compression by Intraventricular Septum-Hematoma Induced after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Ibrahim El-Battrawy

    2016-01-01

    Full Text Available Intraventricular septum-hematoma is a rare complication following percutaneous coronary intervention (PCI. This complication may represent a challenge for accurate diagnosis and treatment. This case report is about a 60-year-old male patient being admitted with an acute coronary syndrome. Despite successful PCI with drug eluting stent implantation into the right coronary artery (RCA the patient complained about recurrent angina pectoris according to Canadian Cardiovascular Society (CCS class IV. Cardiac magnetic resonance imaging and transthoracic echocardiography revealed a massive 4.9×9.2 cm sized end-diastolic septum-hematoma, which compromised right ventricular cavity. Emergent recoronary angiography ruled out further contrast extravasation from the RCA. Conservative treatment was intended after discussion in the “heart-team.” The patient completely recovered with nearly complete resolution of the hematoma after 6 months.

  5. 冠脉支架置入术与冠脉搭桥术治疗严重冠心病的对比研究——SYNTAX研究%Percutaneous Coronary Intervention Versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease: SYNTAX Study

    Institute of Scientific and Technical Information of China (English)

    柴仁杰; 张斌

    2009-01-01

    @@ 1 文献来源 Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease [J]. N Engl J Med, 2009,360(10):961- 972.

  6. The Incidence and the Risk Factors of Silent Embolic Cerebral Infarction After Coronary Angiography and Percutaneous Coronary Interventions.

    Science.gov (United States)

    Deveci, Onur Sinan; Celik, Aziz Inan; Ikikardes, Firat; Ozmen, Caglar; Caglıyan, Caglar Emre; Deniz, Ali; Bicakci, Kenan; Bicakci, Sebnem; Evlice, Ahmet; Demir, Turgay; Kanadasi, Mehmet; Demir, Mesut; Demirtas, Mustafa

    2016-05-01

    Silent embolic cerebral infarction (SECI) is a major complication of coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients with stable coronary artery disease (CAD) who underwent CAG with or without PCI were recruited. Cerebral diffusion-weighted magnetic resonance imaging was performed for SECI within 24 hours. Clinical and angiographic characteristics were compared between patients with and without SECI. Silent embolic cerebral infarction occurred in 12 (12%) of the 101 patients. Age, total cholesterol, SYNTAX score (SS), and coronary artery bypass history were greater in the SECI(+) group (65 ± 10 vs 58 ± 11 years,P= .037; 223 ± 85 vs 173 ± 80 mg/dL,P= .048; 30.1 ± 2 vs 15 ± 3,P< .001; 4 [33.3%] vs 3 [3.3%],P= .005). The SECI was more common in the PCI group (8/24 vs 4/77,P= .01). On subanalysis, the SS was significantly higher in the SECI(+) patients in both the CAG and the PCI groups (29.3 ± 1.9 vs 15 ± 3,P< .01; 30.5 ± 1.9 vs 15.1 ± 3.2,P< .001, respectively). The risk of SECI after CAG and PCI increases with the complexity of CAD (represented by the SS). The SS is a predictor of the risk of SECI, a complication that should be considered more often after CAG. PMID:26253467

  7. XS0601 reduces the incidence of restenosis: a prospective study of 335 patients undergoing percutaneous coronary intervention in China

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Background XS0601, consisting of active ingredients (Chuangxiongol and paeoniflorin), has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention (PCI). Methods A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery.Results A total of 308 patients (91.9%) completed the study and 145 cases (47.1%) received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group (26.0% vs. 47.2%, P < 0.05), and the minimum lumen diameter (MLD) was greater [(2.08 ± 0.89) mm for XS0601 vs. (1.73 ± 0.94) mm for placebo, P < 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event (10.4% in the XS0601 group vs. 22.7% in the placebo group, P < 0.05). The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group (7.1% and 11.0%) as compared with those in placebo group (19.5% and 42.9%) (P < 0.05). No significant side effects occurred within the 6-month follow-up period in the XS0601 group.Conclusion Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.

  8. Succesful treatment of spontaneous dissection of the coronary artery by primary percutaneous coronary intervention

    OpenAIRE

    Yüksel Çavuşoğlu; Ömer Göktekin; Kadir Uğur Mert; Muharrem Nasifov; Hüseyin Uğur Yazıcı

    2011-01-01

    Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction. The disease is usually seen in young-middle aged women and leads to sudden death in the majority of cases. In survived patients, diagnosis of SCAD has been made with coronary anjiography. Involvement of left main coronary artery (LMCA) is very unusual. We describe on a case of SCAD involving the LMCA in a young woman presenting with an acute myocardial infarction and cardiogenic shock status. There w...

  9. 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

  10. Prognosis and high-risk complication identification in unselected patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Andersson, Hedvig; Ripa, Maria Sejersten; Clemmensen, Peter;

    2010-01-01

    The aim of this study was to evaluate treatment with primary percutaneous coronary intervention (PCI) in unselected patients with ST-segment elevation myocardial infarction (STEMI).......The aim of this study was to evaluate treatment with primary percutaneous coronary intervention (PCI) in unselected patients with ST-segment elevation myocardial infarction (STEMI)....

  11. Increased mortality associated with low use of clopidogrel in patients with heart failure and acute myocardial infarction not undergoing percutaneous coronary intervention: a nationwide study

    DEFF Research Database (Denmark)

    Bonde, Lisbeth; Sorensen, Rikke; Fosbøl, Emil Loldrup;

    2010-01-01

    We studied the association of clopidogrel with mortality in acute myocardial infarction (AMI) patients with heart failure (HF) not receiving percutaneous coronary intervention (PCI).......We studied the association of clopidogrel with mortality in acute myocardial infarction (AMI) patients with heart failure (HF) not receiving percutaneous coronary intervention (PCI)....

  12. Patterns of ST segment resolution after guidewire passage and thrombus aspiration in primary percutaneous coronary intervention (PPCI) for acute myocardial infarction

    Science.gov (United States)

    Russhard, Paul; Al Janabi, Firas; Parker, Michael; Clesham, Gerald J

    2016-01-01

    Background ST segment elevation allows the rapid identification of patients with acute myocardial infarction who benefit from emergency reperfusion. Primary percutaneous coronary intervention (PPCI) has emerged as the preferred perfusion strategy for patients presenting with ST segment elevation myocardial infarction (STEMI). Methods and results We studied the effects of the simple passage of an angioplasty guidewire followed by mechanical thrombus aspiration on the ST segment displacement in 289 patients presenting with acute STEMI. Simple guidewire passage led to a statistically significant fall in the mean ST elevation from 5.9 to 4.9 mm (p<0.001), but the mean ST displacement after subsequent mechanical thrombus aspiration was 4.8 mm, not statistically significantly different from guidewire passage. When compared with simple guidewire passage, thrombus aspiration resulted in more patients achieving more than 50% ST resolution (21.8% vs 15.2%, p=0.009), but a higher proportion had a worsening of ST elevation compared to baseline (19.7% vs 13.5%, p=0.041). Conclusions Mechanical thrombus aspiration in acute STEMI did not improve the mean ST resolution compared with simple guidewire passage. Thrombus aspiration increased the proportion achieving 50% resolution but also increased the proportion who had a worsening of ST elevation. These data may help explain some of the uncertainties surrounding the routine use of thrombus aspiration in STEMI and potentially supports the use of ‘time to angioplasty guidewire passage’ as one of the ways to judge the promptness of PPCI services. PMID:27335657

  13. Relationship between interleukin-18 levels and characterization of atherosclerotic plaque and percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Weihua Li; Kaimin Lin; Lei Gao; Rong Wu; Qiang Xie; Yongjun Guo; Shuhui Dai

    2008-01-01

    Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P<0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)

  14. Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report

    Directory of Open Access Journals (Sweden)

    Yakup Alsancak

    2015-01-01

    Full Text Available Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication.

  15. Percutaneous coronary intervention therapy improved prognosis of high-risk patients with acute coronary syndromes

    Institute of Scientific and Technical Information of China (English)

    JI Qiu-shang; ZHANG Yun; LI Gui-shuang; CHEN Yu-guo; MA Dong-dong; YANG Xiao-jing; ZHU Yuan-yuan

    2003-01-01

    @@ Objective In this study, we evaluated the effects of pereutaneous coronary intervention (PCI) therapy on prognosis of high-risk patients with acute coronary syndromes(ACS). Methods From September, 2001 to July, 2002 we continuously observed 110 eases of ACS patients, including 70 cases of acute myocardial infarction (AMI)and 40 cases of anstable angin apeetoris(UAP).

  16. Minimizing bleeding complications of percutaneous coronary intervention and glycoprotein IIb-IIIa antiplatelet therapy.

    Science.gov (United States)

    Juran, N B

    1999-10-01

    Percutaneous coronary intervention in patients with coronary artery disease can lead to thrombotic occlusion of the artery and to subsequent ischemic complications. Patients undergoing these procedures have been treated with aspirin, heparin, or both as a means of preventing thrombosis. The arsenal of antithrombotic agents has recently been augmented by the addition of a new class of drugs the platelet receptor glycoprotein (GP) IIb-IIIa inhibitors, which include abciximab, eptifibatide, and tirofiban. Unlike aspirin or heparin, which inhibit some but not all pathways leading to thrombosis, GP IIb-IIIa inhibitors block the final common pathway of platelet aggregation. When used in conjunction with aspirin and heparin, GP IIb-IIIa inhibitors have yielded favorable clinical outcomes, reducing the incidence of death, myocardial infarction, and urgent intervention. However, GP IIb-IIIa inhibitors also have been associated with an increased risk of bleeding complications, especially at the femoral access site. This presents new challenges for nurses charged with the care of patients treated with these agents. The goal of nursing care for this population is to ensure the optimal benefits of GP IIb-IIIa inhibitor therapy while simultaneously preventing or minimizing groin bleeding in patients undergoing percutaneous coronary procedures. PMID:10502235

  17. Bioactive coronary stent coating based on layer-by-layer technology for siRNA release.

    Science.gov (United States)

    Hossfeld, S; Nolte, A; Hartmann, H; Recke, M; Schaller, M; Walker, T; Kjems, J; Schlosshauer, B; Stoll, D; Wendel, H-P; Krastev, R

    2013-05-01

    One procedure to treat stenotic coronary arteries is the percutaneous transluminal coronary angioplasty (PTCA). In recent years, drug-eluting stents (DESs) have demonstrated elaborate ways to improve outcomes of intravascular interventions. To enhance DESs, the idea has evolved to design stents that elute specific small interfering RNA (siRNA) for better vascular wall regeneration. Layer-by-layer (LbL) technology offers the possibility of incorporating siRNA nanoplexes (NPs) to achieve bioactive medical implant coatings. The LbL technique was used to achieve hyaluronic acid/chitosan (HA/Chi) films with incorporated Chi-siRNA NPs. The multilayer growth was monitored by quartz crystal microbalance. The coating on the stents and its thickness were analyzed using fluorescence and scanning electron microscopy. All stents showed a homogeneous coating, and the polyelectrolyte multilayers (PEMs) were not disrupted after ethylene oxide sterilization or expansion. The in vitro uptake of fluorescent-labeled NPs from PEMs in primary human endothelial cells (ECs) was analyzed by flow cytometry for 2, 6 and 9 days. Furthermore, stents coated with HA/Chi and Chi-siRNA NPs were expanded into porcine arteries and showed ex vivo delivery of NPs. The films showed no critical results in terms of hemocompatibility. This study demonstrates that Chi-siRNA NPs can be incorporated into PEMs consisting of HA and Chi. We conclude that the NPs were delivered to ECs under in vitro conditions. Furthermore, under ex vivo conditions, NPs were transferred into porcine artery walls. Due to their good hemocompatibility, they might make an innovative tool for achieving bioactive coatings for coronary stents. PMID:23333865

  18. Changes in myocardial perfusion due to physical exercise in patients with stable coronary artery disease

    International Nuclear Information System (INIS)

    Percutaneous transluminal coronary angioplasty (PTCA) is one of the main therapy options for patients with coronary artery disease (CAD), resulting in an improvement in myocardial perfusion and exercise capacity. Nevertheless, studies have also demonstrated a positive effect of regular exercise training on myocardial perfusion and maximum exercise capacity. The aim of this study was to evaluate changes in myocardial stress perfusion after 1 year of exercise training in comparison with the effects of PTCA in patients with CAD. In 66 male patients with angiographically confirmed significant coronary artery stenosis in one target vessel, myocardial perfusion scintigraphy was performed at baseline and 12 months after randomisation into either a physical exercise group or a PTCA group. Circumferential count rate profiles in 16 wall segments were classified according to their relative count rate and localisation within or outside the area supplied by the stenosed vessel. Ischaemic segments showed a significant improvement in myocardial count rate within the target area after 12 months in both the PTCA and the training group (PTCA group: from 76.8±4.9% to 86.6±10.9%, p=0.03; training group: from 74.0±7.3% to 83.7±10.8%, p<0.01). Outside the target area only the training group showed a significant improvement (from 77.7±4.4% to 91.7±4.8%, p<0.01). Our data indicate a significant improvement in stress myocardial perfusion in the training group after 12 months. The ischaemia is reduced not only in the target region of the leading stenosis but also in other ischaemic myocardial areas. In contrast, after PTCA stress perfusion improves only in the initially ischaemic parts of the target area. (orig.)

  19. Evaluation and percutaneous management of atherosclerotic peripheral vascular disease

    International Nuclear Information System (INIS)

    Atherosclerotic peripheral vascular disease (PVD) of the lower extremities deprives a person of the ability to exercise to their satisfaction, later of the ability to perform the activities of their daily life, and finally of their legs themselves. Peripheral vascular disease has long been managed by the vascular surgeon utilizing endarterectomy and peripheral arterial bypass. Patient acceptance of nonsurgical, percutaneous procedures such as percutaneous transluminal balloon angioplasty (PTA) is high. Increased utilization of these procedures has led to improved techniques and adjuncts to therapy, as well as more critical review of long-term results. This article will review the evaluation and nonoperative management of PVD, with an emphasis on the newer modalities of management presently being investigated

  20. Low-density lipoprotein cholesterol target goal attainment rate and related factors in patients with acute coronary syndrome after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    张波

    2014-01-01

    Objective To observe the low-density lipoprotein cholesterol(LDL-C)target goal attainment rate and related factors in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods From March 2011 to March 2012,a total of832 ACS patients were retrospectively evaluated in the Cardiology Department of the First Affiliated Hospital of Dalian Medical University.The target goal attainment

  1. Diabetes Mellitus and Glucose as Predictors of Mortality in Primary Coronary Percutaneous Intervention

    Directory of Open Access Journals (Sweden)

    Renato Budzyn David

    2014-10-01

    Full Text Available Background: Diabetes mellitus and admission blood glucose are important risk factors for mortality in ST segment elevation myocardial infarction patients, but their relative and individual role remains on debate. Objective: To analyze the influence of diabetes mellitus and admission blood glucose on the mortality of ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention. Methods: Prospective cohort study including every ST segment elevation myocardial infarction patient submitted to primary coronary percutaneous intervention in a tertiary cardiology center from December 2010 to May 2012. We collected clinical, angiographic and laboratory data during hospital stay, and performed a clinical follow-up 30 days after the ST segment elevation myocardial infarction. We adjusted the multivariate analysis of the studied risk factors using the variables from the GRACE score. Results: Among the 740 patients included, reported diabetes mellitus prevalence was 18%. On the univariate analysis, both diabetes mellitus and admission blood glucose were predictors of death in 30 days. However, after adjusting for potential confounders in the multivariate analysis, the diabetes mellitus relative risk was no longer significant (relative risk: 2.41, 95% confidence interval: 0.76 - 7.59; p-value: 0.13, whereas admission blood glucose remained and independent predictor of death in 30 days (relative risk: 1.05, 95% confidence interval: 1.02 - 1.09; p-value ≤ 0.01. Conclusion: In ST segment elevation myocardial infarction patients submitted to primary coronary percutaneous intervention, the admission blood glucose was a more accurate and robust independent predictor of death than the previous diagnosis of diabetes. This reinforces the important role of inflammation on the outcomes of this group of patients.

  2. Effect of n-3 Polyunsaturated Fatty Acids on Regression of Coronary Atherosclerosis in Statin Treated Patients Undergoing Percutaneous Coronary Intervention

    Science.gov (United States)

    Ahn, Jinhee; Park, Seo Kwang; Park, Tae Sik; Kim, Jin Hee; Yun, Eunyoung; Kim, Sang-Pil; Lee, Hye Won; Oh, Jun-Hyok; Choi, Jung Hyun; Cha, Kwang Soo; Hong, Taek Jong; Lee, Sang Yeoup

    2016-01-01

    Background and Objectives Statins remain the mainstay of secondary coronary artery disease (CAD) prevention, but n-3 polyunsaturated fatty acids (ω-3 PUFA) display biological effects that may also reduce the risk of atherosclerosis and CAD. However, data on the possible antiatherosclerotic benefits of adding ω-3 PUFA to statin therapy are limited. This study aimed to investigate the potential additive effects of ω-3 PUFA on regression of atherosclerosis in CAD patients receiving statin therapy and stent implantation. Subjects and Methods Seventy-four CAD patients undergoing percutaneous coronary intervention (PCI) with stent implantation were enrolled, prescribed statins, and randomly assigned to two groups: n-3 group (ω-3 PUFA 3 g/day, n=38) or placebo group (placebo, n=36). All patients completed the study follow-up consisting of an intravascular ultrasound at baseline and at 12 months. Results There was no difference in the baseline characteristics and distribution of other medications. No significant differences were observed in primary endpoints, including changes in atheroma volume index (−12.65% vs. −8.51%, p=0.768) and percent atheroma volume (−4.36% vs. −9.98%, p=0.526), and in secondary endpoints including a change in neointimal volume index (7.84 vs. 4.94 mm3/mm, p=0.087). Conclusion ω-3 PUFA had no definite additional effect on the regression of coronary atherosclerosis when added to statin in CAD patients undergoing PCI. PMID:27482256

  3. Optical coherence tomography following percutaneous coronary intervention with Excimer laser coronary atherectomy

    Energy Technology Data Exchange (ETDEWEB)

    Rawlins, John, E-mail: john.rawlins@doctors.net.uk; Talwar, Suneel; Green, Mark; O’Kane, Peter

    2014-01-15

    The indications for Excimer laser coronary atherectomy (ELCA) have been refined in modern interventional practice. With the expanding role for optical coherence tomography (OCT) providing high-resolution intra-coronary imaging, this article examines the appearance of the coronary lumen after ELCA. Each indication for ELCA is discussed and illustrated with a clinical case, followed by detailed analysis of the OCT imaging pre and post ELCA. The aim of the article is to provide information to interventional cardiologists to facilitate decision making during PCI, when ELCA has been used as part of the interventional strategy.

  4. Thrombotic Occlusion during Intravascular Ultrasonography-Guided Percutaneous Coronary Intervention of Stumpless Chronic Total Occlusion.

    Science.gov (United States)

    Lee, Un Joo; Kim, Hyun Soo; Lee, Cheolhyun; Kim, Kwang-Yeol; Kim, Weon

    2014-12-01

    Percutaneous coronary intervention (PCI) of stumpless chronic total occlusion (CTO) lesions with a side branch stemming from the occlusion have a significantly lower treatment success rate because physicians cannot identify an accurate entry point with only conventional angiographic images. An intravascular ultrasonography (IVUS)-guided wiring technique might be useful for the penetration of stumpless CTO. We recently experienced thrombotic occlusion during an IVUS-guided stumpless CTO procedure. The cause of the thrombosis is not completely understood; the thrombosis may have been associated with the long use of the IVUS catheter. Special precautions should be taken to prevent thrombus in such cases. PMID:25568847

  5. Intraluminal Thrombus in Facilitated Versus Primary Percutaneous Coronary Intervention An Angiographic Substudy of the ASSENT-4 PCI (Assessment of the Safety and Efficacy of a New Treatment Strategy With Percutaneous Coronary Intervention) Trial

    OpenAIRE

    Zalewski, Jaroslaw; Bogaerts, Kris; Desmet, Walter; Sinnaeve, Peter; Berger, Peter; Grines, Cindy; Danays, Thierry; Armstrong, Paul; Werf, Frans

    2011-01-01

    Objectives This study investigated the occurrence of intraluminal thrombus and its potential implications with facilitated percutaneous coronary interventions (fPCIs). Background The effect of fPCI on the presence and consequences of intraluminal thrombus is unknown. Methods Thrombolysis In Myocardial Infarction (TIMI) flow grade, frame count, and thrombus grade; distal embolization; and slow flow in the infarct-related artery were assessed in a blinded fashion on coronary angiograms in 1,342...

  6. Prognostic factors of male patients with acute coronary syndrome after percutaneous coronary intervention therapy

    International Nuclear Information System (INIS)

    Objective: To study the prognostic risk factors of male patients with coronary heart disease in stent placement era. Methods: One hundred and four patients were enrolled in this study (aged 64.9 ± 9.6 years) including 61 diagnosed as acute myocardial infarction, and 43 as unstable angina with followed up 11.9 ± 8.7 months. All factors including demographic factors, non-interventional work-up, associated clinical complications and results of coronary artery angiography reached a model of Logistic regression analysis. Results: Based on MACE (major adverse cardiac events), as quantitative factors, diseased proximal middle left anterior descending artery was a significant independent variable (P<0.05), and its coefficient was 22.00. Conclusions: Diseased proximal middle left anterior descending coronary artery is the prognostic factor of MACE in male patients with acute coronary syndrome. (authors)

  7. A Preliminary Real-Time and Realistic Simulation Environment for Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Jianhuang Wu

    2015-01-01

    Full Text Available Percutaneous coronary intervention (PCI is a minimally invasive surgery procedure that is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period in order to ensure successful surgical outcome. In this paper, a realistic and real-time interactive simulator for training PCI procedure is presented. A set of new approaches for core simulation components is devised and integrated into the simulator. Trainees can interact with the virtual simulation environment with real instruments and essential maneuvers encountered in real PCI procedure. Although presently targeted at PCI, our simulator could be easily extended to mimic the necessities of any vascular interventional radiology procedures by updating vascular anatomy. Preliminary validation of the proposed physical model of instruments is conducted on vascular phantom to demonstrate its performance and effectiveness.

  8. A preliminary real-time and realistic simulation environment for percutaneous coronary intervention.

    Science.gov (United States)

    Wu, Jianhuang; Wang, Haoyu; Zhang, Peng; Ma, Xin; Hu, Qingmao

    2015-01-01

    Percutaneous coronary intervention (PCI) is a minimally invasive surgery procedure that is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period in order to ensure successful surgical outcome. In this paper, a realistic and real-time interactive simulator for training PCI procedure is presented. A set of new approaches for core simulation components is devised and integrated into the simulator. Trainees can interact with the virtual simulation environment with real instruments and essential maneuvers encountered in real PCI procedure. Although presently targeted at PCI, our simulator could be easily extended to mimic the necessities of any vascular interventional radiology procedures by updating vascular anatomy. Preliminary validation of the proposed physical model of instruments is conducted on vascular phantom to demonstrate its performance and effectiveness. PMID:25879018

  9. Percutaneous Retrograde Recanalization of a Chronic Total Coronary Artery Occlusion in a 7 Year Old

    Energy Technology Data Exchange (ETDEWEB)

    Natal-Hernandez, Luz; Meadows, Jeffery; Shunk, Kendrick A.; Boyle, Andrew J., E-mail: aboyle@medicine.ucsf.edu

    2013-03-15

    The arterial switch operation for correction of transposition of the great arteries can be complicated by late stenosis or occlusion of the coronary arteries that are re-implanted to the new aorta. We report the case of a young boy who underwent this operation as a neonate and was found to have an occluded anomalous left anterior descending artery (LAD) before age 3. Subsequent bypass surgery was complicated by anastomotic stricture and kinking of the left internal mammary artery graft to the LAD. At age 7, the LAD territory showed reversible ischemia on nuclear perfusion testing and he was referred for percutaneous coronary intervention. A combined approach with pediatric and adult interventional cardiologists resulted in successful retrograde PCI to recanalize the chronic total occlusion of the LAD. Important features of this technique in pediatric patients are discussed.

  10. 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)

  11. Combined Value of Red Blood Cell Distribution Width and Global Registry of Acute Coronary Events Risk Score for Predicting Cardiovascular Events in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

    OpenAIRE

    Zhao, Na; Mi, Lan; Liu, Xiaojun; Pan, Shuo; Xu, Jiaojiao; Xia, Dongyu; Liu, Zhongwei; Zhang, Yong; Xiang, Yu; Yuan, Zuyi; Guan, Gongchang; Wang, Junkui

    2015-01-01

    Global Registry of Acute Coronary Events (GRACE) risk score and red blood cell distribution width (RDW) content can both independently predict major adverse cardiac events (MACEs) in patients with acute coronary syndrome (ACS). We investigated the combined predictive value of RDW and GRACE risk score for cardiovascular events in patients with ACS undergoing percutaneous coronary intervention (PCI) for the first time. We enrolled 480 ACS patients. During a median follow-up time of 37.2 months,...

  12. Supported high-risk percutaneous coronary intervention with the Impella 2.5 device the Europella registry

    DEFF Research Database (Denmark)

    Sjauw, Krischan D; Konorza, Thomas; Erbel, Raimund;

    2009-01-01

    OBJECTIVES: This retrospective multicenter registry evaluated the safety and feasibility of left ventricular (LV) support with the Impella 2.5 (Abiomed Europe GmbH, Aachen, Germany) during high-risk percutaneous coronary intervention (PCI). BACKGROUND: Patients with complex or high-risk coronary...... with poor LV function. The Impella 2.5, a percutaneous implantable LV assist device, might be a superior alternative to the traditionally used intra-aortic balloon pump. METHODS: The Europella registry included 144 consecutive patients who underwent a high-risk PCI. Safety and feasibility end points.......4), and 43% of the patients were refused for coronary artery bypass grafting. A PCI was considered high-risk due to left main disease, last remaining vessel disease, multivessel coronary artery disease, and low LV function in 53%, 17%, 81%, and 35% of the cases, respectively. Mortality at 30 days was 5...

  13. Effect of prolonging interval time between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes

    Institute of Scientific and Technical Information of China (English)

    Zhang Guoru; Li Yongjun; Wang Mei; Guo Bingyan; Lyu Xinhu; Liu Jin-bo; Liu Dongchao

    2014-01-01

    Background It is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention.The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.Methods Blood samples of eight patients were taken before the first exposure to ionizing radiation,10 minutes,20 minutes,30 minutes,1 hour,and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics.Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group.Blood samples were taken before coronary angiography and 15 minutes after the last exposure.By enumerating γ-H2AX foci,the impact of prolonging the interval on DNA double-strand breaks was investigated.Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.Results An increase in foci was found in all patients received percutaneous coronary intervention.The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure.There was no statistically significant difference between the two groups in γ-H2AX foci at baseline.On average there were (0.79±0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66±0.21) in the intermittent radiation exposure group after exposure (P<0.05).Conclusions A significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures.The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.

  14. Impact of obstructive sleep apnea on the occurrence of restenosis after elective percutaneous coronary intervention in ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Behrendt Dominik

    2008-06-01

    Full Text Available Abstract Rationale There is growing evidence that obstructive sleep apnea is associated with coronary artery disease. However, there are no data on the course of coronary stenosis after percutaneous coronary intervention in patients with obstructive sleep apnea. Objectives To determine whether sleep apnea is associated with increased late lumen loss and restenosis after percutaneous coronary intervention. Methods 78 patients with coronary artery disease who underwent elective percutaneous coronary intervention were divided in 2 groups: 43 patients with an apnea hypopnea – Index 10/h (group II. Late lumen loss, a marker of restenosis, was determined using quantitative coronary angiography after 6.9 ± 3.1 months. Main results Angiographic restenosis (>50% luminal diameter, was present in 6 (14% of group I and in 9 (25% of group II (p = 0.11. Late lumen loss was significant higher in pt. with an AHI > 10/h (0.7 ± 0.69 mm vs. 0.38 ± 0.37 mm, p = 0.01. Among these 35 patients, 21(60% used their CPAP devices regularly. There was a marginally lower late lumen loss in treated patients, nevertheless, this difference did not reach statistical significance (0.57 ± 0.47 mm vs. 0.99 ± 0.86 mm, p = 0.08. There was no difference in late lumen loss between treated patients and the group I (p = 0.206. Conclusion In summary, patients with OSA and coronary artery disease have a higher degree of late lumen loss, which is a marker of restenosis and vessel remodeling after elective percutaneous intervention.

  15. Outcomes of after-hours versus regular working hours primary percutaneous coronary intervention for acute myocardial infarction

    OpenAIRE

    Graham, Michelle M; Ghali, William A.; Southern, Danielle A.; Traboulsi, Mouhieddin; Knudtson, Merril L.; ,

    2011-01-01

    Background Primary percutaneous coronary intervention (PCI) is a proven therapy for acute ST-segment elevation myocardial infarction. However, outcomes associated with primary PCI may differ depending on time of day. Methods and results Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease, a clinical data-collection initiative capturing all cardiac catheterisation patients in Alberta, Canada, the authors described and compared crude and risk-adjusted survival...

  16. ST-Segment Resolution Prior to Primary Percutaneous Coronary Intervention Is a Poor Indicator of Coronary Artery Patency in Patients with Acute Myocardial Infarction

    NARCIS (Netherlands)

    N.J. Verouden; J.D. Haeck; K.T. Koch; J.P. Henriques; J. Baan; R.J. van der Schaaf; M.M. Vis; R.J. Peters; A.A. Wilde; J.J. Piek; J.G. Tijssen; R.J. de Winter

    2010-01-01

    Background: The prognostic value of ST-segment resolution (STR) after initiation of reperfusion therapy has been established by various studies conducted in both the thrombolytic and mechanic reperfusion era. However, data regarding the value of STR immediately prior to primary percutaneous coronary

  17. Immediate Small Side Branch Occlusion after Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ostovan

    2007-09-01

    Full Text Available Background: Small side branches, albeit less important than their larger counterparts, have not yet received due attention in the literature. Nor has there ever been a comparison between drug-eluting stents and bare metal stents apropos side branch occlusion. The aim of this study was to compare the patency of small (≥0.5 and ≤1.5 mm in diameter side branches with respect to bare metal vs. drug-eluting stents immediately after their deployment.Methods: This prospective bi-center study, conducted between June 2005 and January 2007, enrolled 82 patients treated with ≥1 of two stents (TAXUSTM LiberteTM or LiberteTM. Side branches ≥0.5 and <1.5 mm in diameter arising from the main vessel at the lesion site were evaluated. Results: Thirty-eight patients were treated with 42 LiberteTM stents (58 side branches and forty-four patients with 50 TAXUSTM LiberteTM (102 side branches. The rate of small side branch occlusion was 35.3% (36 in the TAXUSTM LiberteTM group compared to 29.31% (15 in the LiberteTM group (P-value= 0.7. The presence of type 1 side branch morphology (Lefevre classification was the most powerful predictor of small side branch occlusion (P-value=0.03. Conclusion: This study shows that drug-eluting stents are not inferior to bare metal stents as regards small side branch occlusion during coronary stenting

  18. Three-dimensional virtual surgery models for percutaneous coronary intervention (PCI) optimization strategies

    Science.gov (United States)

    Wang, Hujun; Liu, Jinghua; Zheng, Xu; Rong, Xiaohui; Zheng, Xuwei; Peng, Hongyu; Silber-Li, Zhanghua; Li, Mujun; Liu, Liyu

    2015-06-01

    Percutaneous coronary intervention (PCI), especially coronary stent implantation, has been shown to be an effective treatment for coronary artery disease. However, in-stent restenosis is one of the longstanding unsolvable problems following PCI. Although stents implanted inside narrowed vessels recover normal flux of blood flows, they instantaneously change the wall shear stress (WSS) distribution on the vessel surface. Improper stent implantation positions bring high possibilities of restenosis as it enlarges the low WSS regions and subsequently stimulates more epithelial cell outgrowth on vessel walls. To optimize the stent position for lowering the risk of restenosis, we successfully established a digital three-dimensional (3-D) model based on a real clinical coronary artery and analysed the optimal stenting strategies by computational simulation. Via microfabrication and 3-D printing technology, the digital model was also converted into in vitro microfluidic models with 3-D micro channels. Simultaneously, physicians placed real stents inside them; i.e., they performed “virtual surgeries”. The hydrodynamic experimental results showed that the microfluidic models highly inosculated the simulations. Therefore, our study not only demonstrated that the half-cross stenting strategy could maximally reduce restenosis risks but also indicated that 3-D printing combined with clinical image reconstruction is a promising method for future angiocardiopathy research.

  19. 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...

  20. Computed tomography of coronary artery anomaly - case report

    International Nuclear Information System (INIS)

    Background: Anomalies of coronary vessels can be described as varies group of congenital heart disease, which can have different level of clinical manifestation and changeable pathophysiological mechanisms. Diagnosis and imaging of vessel course is essential before percutaneous angioplasty intervention and coronary artery bypass grafting as well as before implantation of artificial valve. Case Report: Patient with cardiologic history, previously percutaneous intervention were performed and left circumflex coronary artery were assessed as occluded. Computed tomography revealed anomalous origin of patent circumflex branch arising from right Valsava sinus. Conclusions: Selective percutaneus coronary angiography is challenging in case of coronary anomalies, there are only few indirect symptoms of anomalies. The advantage of computed tomography over classic coronarography is visibility of all patent coronary vessels after single administration of contrast medium. It is possible to describe its anatomic relations, evaluation of walls and its changes