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Sample records for angioplasty

  1. 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- ...

  2. Angioplasty and stent placement -- peripheral arteries

    Science.gov (United States)

    Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery -angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial ...

  3. Angioplasty and stent - heart - discharge

    Science.gov (United States)

    Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac ...

  4. 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 ...

  5. Angioplasty and stent placement - peripheral arteries - discharge

    Science.gov (United States)

    Percutaneous transluminal angioplasty - peripheral artery - discharge; PTA - peripheral artery - discharge; Angioplasty - peripheral artery - discharge; Balloon angioplasty - peripheral artery- discharge; PAD - PTA ...

  6. Angioplasty and stent placement - carotid artery

    Science.gov (United States)

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery; Carotid artery stenosis - angioplasty; ... Carotid angioplasty and stenting (CAS) is done using a small surgical cut. Your surgeon will make a surgical cut ...

  7. 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 ...

  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. Angioplasty - Multiple Languages: MedlinePlus

    Science.gov (United States)

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

  10. Laser angioplasty for cardiovascular disease

    Science.gov (United States)

    Okada, Masayoshi

    2005-07-01

    Recently, endovascular interventions such as balloon angioplasty, atherectomy and the stenting method, except for conventional surgery have been clinically employed for the patients with atheromatous plaques of the peripheral- and the coronary arteries, because the number of patients with arteriosclerosis is now increasing in the worldwide. Among these procedures, restenoses after endovascular interventions have been remarkably disclosed in 20-40 % of the patients who underwent percutaneous coronary interventions. Thus, there are still some problems in keeping long-term patency by means of endovascular techniques such as balloon angioplasty and atherectomy (1, 2). For reduction of these problems , laser angioplasty using Argon laser was applied experimentally and clinically. Based on excellent experimental studies, laser was employed for 115 patients with stenotic ,or obstructive lesions occluding more thasn 75 % of the peripheral and the coronary arteries angiographycally.

  11. 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

  12. Prediction of Outcome after Femoropopliteal Balloon Angioplasty by Intervascular Ultrasound

    DEFF Research Database (Denmark)

    Schroeder, Torben Veith; Vogt, Katja; Just, S.;

    1997-01-01

    original, intravascular ultrasound, percutaneous transluminal angioplasty, peripheral arteries, plaquemorphology, prediction of outcome......original, intravascular ultrasound, percutaneous transluminal angioplasty, peripheral arteries, plaquemorphology, prediction of outcome...

  13. Cutting Balloon angioplasty for cardiac transplant vasculopathy.

    OpenAIRE

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

    2002-01-01

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

  14. Carotid angioplasty with cerebral protection

    International Nuclear Information System (INIS)

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

  15. Sleep Apnea Tied to Complications After Angioplasty

    Science.gov (United States)

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

  16. Emergency surgical revascularisation for coronary angioplasty complications.

    OpenAIRE

    Carey, J A; Davies, S W; Balcon, R.; Layton, C.; Magee, P; Rothman, M. T.; Timmis, A. D.; Wright, J. E.; Walesby, R K

    1994-01-01

    OBJECTIVES--To evaluate trends in referrals for emergency operations after percutaneous transluminal coronary angioplasty (PTCA) complications; to analyse morbidity and mortality and assess the influence of PTCA backup on elective surgery. DESIGN--A retrospective analysis of patients requiring emergency surgical revascularisation within 24 hours of percutaneous transluminal coronary angioplasty. PATIENTS--Between January 1980 and December 1990, 75 patients requiring emergency surgery within 2...

  17. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    deMuinck, ED; denHeijer, P; vanDijk, RB; Crijns, HJGM; Hillige, HL; Lie, KI

    1996-01-01

    Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty (PTCA)-with an autoperfusion balloon or active system-facilitates prolonged balloon inflation. Prolonged inflations may tack up intimal dissections and improve the primary angioplasty result in complex lesions. Addit

  18. 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

  19. [Subintimal angioplasty and diabetic foot revascularisation].

    Science.gov (United States)

    Pierret, Charles; Tourtier, Jean-Pierre; Bordier, Lise; Blin, Emmanuel; Duverger, Vincent

    2011-01-01

    Diabetic wounds foot are responsible for 5-10% minor or major amputation in France. In fact, amputation risk of lower limbs is 15-30% higher for diabetic patients. University of Texas classification (UT) is the reference for diabetic foot wound. It distinguish non ischemic and ischemic wound with more amputation. If ischaemia is combined, revascularization may be considered for salvage of the limb. Some revascularization techniques are well known: as surgical by-pass, angioplasty with or without stent, or hybrid procedures with the both. Subintimal angioplasty is a more recent endovascular technique, in assessment for old patients who are believed to be unsuitable candidates for conventional by-pass or angioplasty.

  20. Cutting balloon angioplasty for intrastent restenosis treatment

    Directory of Open Access Journals (Sweden)

    João Orávio de Freitas Jr

    1999-05-01

    Full Text Available We describe here two patients with angiographic diagnosis of intrastent restenosis and regional myocardial ischemia. One stent restenosis was located in a native coronary artery and the other in a vein graft. Both were treated with cutting balloon angioplasty (CBA, inflated at low pressures. Angiographic success was obtained and both patients were discharged in the day after the procedure. Cutting balloon angioplasty using low inflation pressures achieved important luminal gains, in these two cases of intrastent restenosis. Further studies are necessary before the effectiveness of this procedure can be precisely defined.

  1. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); A. Soward; M.J.B.M. van den Brand (Marcel); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractCoronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had

  2. 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.

  3. 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...

  4. How does subintimal angioplasty compare to transluminal angioplasty for the treatment of femoral occlusive disease?

    Science.gov (United States)

    Klimach, S G; Gollop, N D; Ellis, J; Cathcart, P

    2014-01-01

    A best evidence topic in surgery was written according to a structured protocol. The question addressed how subintimal angioplasty (SIA) compares to transluminal angioplasty (TA) for the treatment of femoral occlusive disease. One hundred and thirty two papers were found using the reported search; the 5 which represented the best evidence to answer the question are discussed. The evidence on this subject is limited; there are no randomised controlled trials (RCTs) comparing SIA to TA for pathologically equivalent lesions. However SIA remains a safe and effective alternative to surgical bypass grafting when TA cannot be performed.

  5. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    International Nuclear Information System (INIS)

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

  6. Carotid angioplasty and stenting in the elderly

    International Nuclear Information System (INIS)

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

  7. Carotid angioplasty and stenting in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Kadkhodayan, Yasha [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Cross, DeWitte T.; Moran, Christopher J. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Derdeyn, Colin P. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurology, St. Louis, MO (United States)

    2007-11-15

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

  8. Occult, massive hematomas following antegrade femoral angioplasty

    International Nuclear Information System (INIS)

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

  9. Percutaneous transluminal angioplasty of infrarenal arteries in intermittent claudication

    DEFF Research Database (Denmark)

    Henriksen, L O; Jørgensen, B; Holstein, P E;

    1988-01-01

    Percutaneous transluminal angioplasty was performed on 55 iliac and 31 femoropopliteal arteries in 71 patients with intermittent claudication (23 women, 48 men). The two-year patency rate was 80% after iliac and 41% after femoropopliteal angioplasty. In 17 femoropopliteal cases with lesions greater...... than or equal to 5 cm the 2-year patency rate was only 32%, but the corresponding figure for shorter lesions was 53%. Complicating haematoma appeared in 10% of the cases and the arterial state deteriorated in one patient. There was no distal embolization. Percutaneous transluminal angioplasty...

  10. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    International Nuclear Information System (INIS)

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

  11. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

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

    DEFF Research Database (Denmark)

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

    1997-01-01

    OBJECTIVE: To evaluate intravascular ultrasound (IVUS) as a control procedure after femoropopliteal percutaneous transluminal angioplasty (PTA), and compare it with arteriography. DESIGN: Descriptive study. MATERIAL: Arteriographic and intravascular ultrasound data obtained from 18 patients (20...

  13. Subintimal angioplasty for femoro-popliteal occlusive disease.

    Science.gov (United States)

    Markose, George; Miller, Fiona N A C; Bolia, Amman

    2010-11-01

    There has been a longstanding debate about the roles of surgical bypass graft, percutaneous transluminal angioplasty, subintimal angioplasty, and conservative management for femoro-popliteal occlusive disease. Subintimal angioplasty was first described in 1987 as a method of performing an endovascular arterial bypass. The subintimal space at the start of the occlusion is entered with a catheter and a wire loop is used to cross the occlusion and reenter the vessel lumen distally. In patients with critical limb ischemia, there is high quality evidence demonstrating that the limb salvage rate and amputation-free survival rates for surgery and endovascular treatment are similar, but surgery is more expensive than angioplasty in the short term. In patients with intermittent claudication, surgical bypass using an autologous saphenous vein graft is currently believed to be the gold standard, but this is increasingly questioned in the light of recent advances in endovascular techniques. Surgical bypass with vein graft offers a 2-year patency of 81%, compared with 67% for a polytetrafluoroethylene (PTFE) graft and at best 67% for subintimal angioplasty. The better patency offered by surgery must be balanced against a higher morbidity and mortality. To conclude, subintimal angioplasty is an extremely valuable technique in the management of critical limb ischemia. Based on the evidence to date, this technique is likely to have an increasing role in the management of intermittent claudication over the coming years, particularly if the risk of general anaesthesia is high or there is no suitable vein.

  14. [Role of angioplasty in the treatment of renal artery stenosis].

    Science.gov (United States)

    Armero, S; Bonello, L; Paganelli, F; Barragan, P; Roquebert, P-O; Commeau, P

    2011-12-01

    Atherosclerotic renal artery stenosis is frequent and is associated with a high incidence of morbidity and mortality, with a strong correlation with coronary artery disease, (Kalra et al., 2005; Cheung et al., 2002; Guo et al., 2007 [1-3]). The atherosclerotic renal artery stenosis is an independent predictive factor of death (Conlon et al., 1998 [4]). The treatment of this lesion does not have strong evidence. A lot of studies in this area suggest the angioplasty is superior in a big majority between surgery, and angioplasty with stent is superior between balloon angioplasty, but some studies fail to prove the superiority of angioplasty versus medical treatment. These studies have sadly a lot of mistakes and nowadays we don't know what is the treatment for our patients in a lot of cases. The angioplasty is indicated when there is a failure of antihypertensive medications for control of blood pressure, when it is associated with a renal insufficiency quickly progressive or when there is a lesion on each renal artery. Other studies must be organized for prove the superiority of angioplasty when there is a real stenosis, maybe with the use of fractional flow reserve.

  15. AUTOPERFUSION BALLOON CATHETER FOR COMPLICATED CORONARY ANGIOPLASTY - A PROSPECTIVE-STUDY WITH RETROSPECTIVE CONTROLS

    NARCIS (Netherlands)

    DEMUINCK, ED; VANDIJK, RB; DENHEIJER, P; MEEDER, JG; LIE, KI

    1992-01-01

    Prolonged angioplasty balloon inflation with an autoperfusion balloon for failed conventional coronary angioplasty, was compared with emergency surgery for this condition. Restenosis was assessed 6 weeks after successful intervention with the autoperfusion balloon. Forty consecutive patients with pe

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

    NARCIS (Netherlands)

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

    2001-01-01

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

  17. Angioplasty and stent treatment of transplant renal artery stenosis.

    Science.gov (United States)

    Del Pozo, Maitane; Martí, Jordi; Guirado, Lluís; Facundo, Carme; Canal, Cristina; de la Torre, Pablo; Ballarín, José; Díaz, Joan M

    2012-07-17

    Transplant renal artery stenosis is a major complication that requires a therapeutic approach involving surgery or angioplasty. The aim of this study was to analyse the evolution of renal transplant patients with renal allograft artery stenosis treated by angioplasty and stent placement. Thirteen patients were diagnosed with transplant renal artery stenosis. Clinical suspicion was based on deterioration of renal function and/or poorly controlled hypertension with compatible Doppler ultrasound findings. The diagnosis was confirmed by arteriography, performing an angioplasty with stent placement during the same operation. A progressive improvement in renal function was observed during the first 3 months after the angioplasty, and renal function then remained stable over 2 years. In addition, blood pressure improved during the first 2 years, and as a consequence there was no need to increase the average number of anti-hypertensive drugs administered (2.5 drugs per patient). In conclusion, angioplasty with stent placement is a safe and effective procedure for the treatment of transplant renal artery stenosis.

  18. Intravascular ultrasound imaging following balloon angioplasty.

    Science.gov (United States)

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

    1991-01-01

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

  19. Mechanical and acoustic analysis in ultrasonic angioplasty

    Science.gov (United States)

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

    1991-05-01

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

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

    Science.gov (United States)

    McTaggart, Ryan A; Marks, Michael P

    2014-01-01

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

  1. Angioplasty simulation using ChainMail method

    Science.gov (United States)

    Le Fol, Tanguy; Acosta-Tamayo, Oscar; Lucas, Antoine; Haigron, Pascal

    2007-03-01

    Tackling transluminal angioplasty planning, the aim of our work is to bring, in a patient specific way, solutions to clinical problems. This work focuses on realization of simple simulation scenarios taking into account macroscopic behaviors of stenosis. It means simulating geometrical and physical data from the inflation of a balloon while integrating data from tissues analysis and parameters from virtual tool-tissues interactions. In this context, three main behaviors has been identified: soft tissues crush completely under the effect of the balloon, calcified plaques, do not admit any deformation but could move in deformable structures, the blood vessel wall undergoes consequences from compression phenomenon and tries to find its original form. We investigated the use of Chain-Mail which is based on elements linked with the others thanks to geometric constraints. Compared with time consuming methods or low realism ones, Chain-Mail methods provide a good compromise between physical and geometrical approaches. In this study, constraints are defined from pixel density from angio-CT images. The 2D method, proposed in this paper, first initializes the balloon in the blood vessel lumen. Then the balloon inflates and the moving propagation, gives an approximate reaction of tissues. Finally, a minimal energy level is calculated to locally adjust element positions, throughout elastic relaxation stage. Preliminary experimental results obtained on 2D computed tomography (CT) images (100x100 pixels) show that the method is fast enough to handle a great number of linked-element. The simulation is able to verify real-time and realistic interactions, particularly for hard and soft plaques.

  2. Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture

    International Nuclear Information System (INIS)

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

  3. 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.)

  4. 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.

  5. Distal coronary hemoperfusion during percutaneous transluminal coronary angioplasty

    NARCIS (Netherlands)

    Muinck, Ebo Derk de

    1994-01-01

    In this thesis several aspects of passive and active coronary perfusion during coronary angioplasty are investigated. The autoperfusion balloon catheters that were evaluated are the Stack® and the RX-60® catheters (Advanced Cardiovascular Systems, inc., Santa Clara, California, U.S.A). The coronary

  6. A meta-analytic overview of thrombectomy during primary angioplasty

    NARCIS (Netherlands)

    Luca, G. De; Navarese, E.P.; Suryapranata, H.

    2013-01-01

    INTRODUCTION: Even though primary angioplasty restores TIMI 3 flow in more than 90% of STEMI patients, the results in terms of myocardial perfusion are still unsatisfactory in a relatively large proportion of patients. Great interest has been focused in the last years on distal embolization as major

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

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-08-01

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

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

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Nielsen, J D;

    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...

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

    OpenAIRE

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

    2000-01-01

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

  10. 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).

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

    Directory of Open Access Journals (Sweden)

    Ryan A Mctaggart

    2014-04-01

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

  12. A Rare and Serious Unforeseen Complication of Cutting Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Praveen Vemula

    2014-01-01

    Full Text Available Cutting balloon angioplasty (CBA is one of the adept ways of treating “in-stent restenosis.” Various complications related to cutting balloon angioplasty have been reported including arterial rupture, delayed perforation and fracture of microsurgical blades. Here we report a very unusual and inadvertent extraction of a stent previously deployed in the ramus intermedius coronary branch by a cutting balloon catheter. This required repeat stenting of the same site for an underlying dissection. Even though stent extraction is a rare complication it can be serious due to dissection, perforation, and closure of the artery. Physicians performing coronary artery interventions would need to be aware of this rare and serious complication especially if any difficulty is encountered while withdrawing the cutting balloon. Therefore, after removal, cutting balloon should be examined thoroughly for possible stent dislodgment or extraction when used for “in-stent restenosis.”

  13. 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...

  14. Angioplasty alone versus angioplasty and stenting for subclavian artery stenosis--a systematic review and meta-analysis.

    Science.gov (United States)

    Chatterjee, Saurav; Nerella, Nishant; Chakravarty, Saneka; Shani, Jacob

    2013-01-01

    Subclavian artery stenosis has long been treated with great success with bypass surgery. Percutaneous intervention, often used in combination with stent placement, has come into vogue for the past few years as a safe and effective therapeutic modality. This study aimed to compare angioplasty alone with angioplasty followed by stent placement by combining available data. The objective of this study was to perform a review of the available literature to compare the efficacy of percutaneous transluminal angioplasty (PTA) alone with PTA followed by stent placement for proximal subclavian artery stenosis. Successful recanalization was defined as patency at the end of 1 year, and reocclusions and restenoses were noted as events for the purpose of pooling the data. The authors searched the Specialized Register and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, PubMed, EMBASE, and CINAHL databases for relevant trials/studies comparing PTA and PTA with stenting. Review authors independently assessed the methodological quality of studies (focusing on the adequacy of the randomization process, allocation concealment, blinding, completeness of follow-up, and intention-to-treat analysis) and selected studies for inclusion. All retrospective observational studies were also included in the analysis in the absence of double-blinded randomized trials for increasing sample size. All analyses were done using RevMan 5.0. Odds ratio was calculated using Mantel-Haenszel test with a fixed effect model. All included studies were assessed by all authors for potential sources of bias. Eight studies were included in the analysis having 544 participants. Stenting after PTA was significantly superior to angioplasty alone for treatment of subclavian artery stenosis and maintenance of patency at 1 year, as indicated by absence of events (P = 0.004; 95% confidence interval, odds ratio 2.37 [1.32-4.26]) without significant complication rates for either

  15. Emergency endovascular repair of iliac artery rupture caused by post-stenting angioplasty with an endograft

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yu-bin; WU Dan-ming; XU Ke; WANG Cheng-gang; YI Wei; JIA Qi; SUN Yu-xin

    2007-01-01

    @@ Iliac artery rupture is a rare complication of poststenting angioplasty and can lead to massive lifethreatening haemorrhage. Conventional surgery can not repair the damaged vessel easily and may cause substantial blood loss and high operative morbidity and mortality. We report our experience with a selfexpanding covered endoprosthesis for endovascular repair of the rupture of an iliac artery caused by stenting angioplasty.

  16. 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;

    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...

  17. Effect and outcome of balloon angioplasty and stenting of the iliac arteries evaluated by intravascular ultrasound

    DEFF Research Database (Denmark)

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

    1999-01-01

    To document the mechanism of percutaneous transluminal angioplasty (PTA) and stenting of the iliac arteries, and to relate the effect to patency.......To document the mechanism of percutaneous transluminal angioplasty (PTA) and stenting of the iliac arteries, and to relate the effect to patency....

  18. The Dutch experience in percutaneous transluminal angioplasty of narrowed saphenous veins used for aortocoronary arterial bypass

    NARCIS (Netherlands)

    W.H.T. Plokker; H.J. Meester (Hannie); P.W.J.C. Serruys (Patrick)

    1991-01-01

    textabstractOf 19,994 percutaneous transluminal coronary angioplasty procedures performed in The Netherlands between April 1980 and January 1989, the long-term follow-up of 454 patients who underwent angioplasty of greater than or equal to 1 saphenous vein bypass graft was reviewed. In 46% of patien

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  20. MYOCARDIAL PROTECTION DURING CORONARY ANGIOPLASTY WITH AUTOPERFUSION AND FORCED PERFUSION - AN IN-VITRO COMPARISON

    NARCIS (Netherlands)

    DEMUINCK, ED; VERKERKE, BJ; RAKHORST, G; LIE, KI

    1994-01-01

    During coronary angioplasty, perfusion distal to the inflated angioplasty balloon can be maintained with autoperfusion balloon catheters and coronary perfusion pumps. The blood flow rates through the autoperfusion balloon catheters and the flow rates achieved with a perfusion pump were compared in v

  1. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  4. Treatment of benign ureteral stricture by double J stents using high-pressure balloon angioplasty

    Institute of Scientific and Technical Information of China (English)

    YU Hua-liang; YE Lin-yang; LIN Mao-hu; YANG Yu; MIAO Rui; HU Xiao-juan

    2011-01-01

    Background Balloon dilatation angioplasty is a minimally invasive surgery for treating benign ureteral stricture. The aim of this study was to investigate the effect of placing double J (D-J) stents using high-pressure balloon angioplasty in treating benign ureteral stricture.Methods A total of 42 patients (48 cases) with benign ureteral stricture (42 had benign ureteral stricture) were investigated by inserting dual D-J stents using high-pressure balloon angioplasty. The control group contained 50 patients (57 cases) employing the conventional balloon angioplasty with a single D-J stent inserted for comparison.Results The overall effective rate of the treated and control groups was 87.8% (36/41) and 62.7% (32/51), respectively (P <0.05).Conclusion This new approach produces a better curative effect than the conventional balloon angioplasty with a single D-J stent insertion in treating benign ureteral stricture.

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

    Science.gov (United States)

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

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

  6. The patients' perception of recovery after coronary angioplasty.

    Science.gov (United States)

    Higgins, M; Dunn, S; Theobald, K

    2000-08-01

    Coronary angioplasty and stent placement is associated with short hospital stays. Patients are expected to recover at home, alone, following limited care time with nurses. The purpose of the study was to describe participants' perceptions of recovery after angioplasty. Eight men and three women were interviewed 1 month after discharge from hospital. Verbatim transcripts were analysed for major themes using the qualitative techniques of grounded theory. Data analysis revealed three major categories: awareness of the problem, coping response and appraisal of the situation. These were linked via a problem solving process. In step one, the problem was identified. In step two, coping responses were taken to try and solve the problem. In step three, the results of the coping responses were appraised or evaluated. These categories were further defined by four phases identified as: pre-admission, admission, during the angioplasty and recovery. This paper describes the recovery phase. Awareness of the problem in the recovery phase was associated with 'relief from chest pain' for most participants. In contrast, anxiety continued and was associated with 'uncertainty over future health'. Participants described coping responses of "taking control of their life again" by undertaking both physical and psychological strategies. Finally, the situation was appraised to be either a 'good' or a 'bad' recovery. This appraisal was based on such considerations as the absence of chest pain, improvement in well-being and energy levels. The results of this study highlight patients' concerns and support the need for greater emphasis on their psychosocial needs. This care must be provided within the time constraints of short hospital stays. Nurses must also consider providing support to patients in the pre-admission and recovery phases.

  7. Transradial approach for coronary angioplasty in Chinese elderly patients

    Institute of Scientific and Technical Information of China (English)

    CAO Zheng; ZHOU Yu-jie; ZHAO Ying-xin; LIU Yu-yang; SHI Dong-mei; GUO Yong-he; CHENG Wan-jun; NIE Bin; WANG Jian-long

    2008-01-01

    Background The radiaI artery is currently regarded as a useful vascular access site for coronary procedures.This study was conducted to investigate the feasibility and safety of the percutaneous radial artery approach for angioplasty in the elderly.Methods Two thousand and fifty-eight consecutive patients (762 elderly,age≥65 years;and 1296 non-elderly,age <65 years,respectively) who underwent transradial coronary angioplasty were recruited in this study.Study endpoints included procedure success rate,procedure time,vascular complications at access site,and major adverse cardiac and cerebrovascular events during hospitalization.Results Elderly patients were more likely to present with unstable angina and renal dysfunction.The incidence of radial and brachiocephalic trunk anatomical tortuosity was higher in elderly patients than that in non-elderly patients (11.5% vs 3.7%;8.9% vs 2.6%,P<0.01,respectively).However,procedural success rate(94.7% vs 95.6%)and total mean procedure time ((67.9±27.3)minutes vs (58.6±38.5) minutes) for transradial coronary angioplasty were not significantly different between the two groups.Clinical course during the hospitalization was slightly worse in the elderly patients because of more adverse cardiac and cerebrovascular events after the procedure.However,the incidence of vascular complications was not significantly different between the elderly and non-elderly patients.Conclusion Although the incidence of radial and brachiocephalic trunk anatomical tortuosity is higher in elderly patients,transradial coronary intervention can be performed with similar safety and procedural success in these patients as compared with non-elderly patients.

  8. Carotid angioplasty and stent placement for restenosis after endarterectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kadkhodayan, Yasha [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Moran, Christopher J.; Cross, DeWitte T. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Derdeyn, Colin P. [Washington University School of Medicine, Interventional Neuroradiology, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurological Surgery, St. Louis, MO (United States); Washington University School of Medicine, Department of Neurology, St. Louis, MO (United States)

    2007-04-15

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

  9. Who is responsible for the consequences? A case of stent thrombosis subsequent to noncompliance with post angioplasty treatment regimen.

    Science.gov (United States)

    Sajwani, Salma Abdul Aziz; Allana, Saleema

    2014-01-01

    Coronary artery disease (CAD) is a major cause of mortality internationally and in Pakistan. Angioplasty has been proven to be an effective treatment for CAD. Stent thrombosis is a known but preventable complication of angioplasty. Several factors may lead to stent thrombosis with non-compliance with the prescribed drug regimen, being one of the most important factors. We report a case of stent thrombosis after four months of angioplasty. After exploring of patient's post angioplasty routines, it was found that the patient was non-compliant with the prescribed anti- platelets and other prescribed drugs. This time the patient presented with another acute myocardial infarction, and he went through angioplasty again.

  10. 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

  11. Successful angioplasty during pregnancy for renal artery stenosis.

    Science.gov (United States)

    Margueritte, François; Velasco, Stephane; Pourrat, Olivier; Pierre, Fabrice

    2016-03-01

    Renal artery stenosis can be diagnosed during pregnancy and treated at the same time. A 30-year-old woman had a sudden, severe but asymptomatic hypertensive crisis at 21 weeks of gestation. The diagnosis of renal artery stenosis suspected on Doppler ultrasonography was confirmed and treated by renal angioplasty, which reduced her blood pressure. At 27 weeks of gestation, her blood pressure increased again, associated with significant proteinuria, suggesting pre-eclampsia. A cesarean section was performed giving birth to a healthy 940-g child. Renal artery stenosis should be considered when sudden and early-onset hypertension appears during pregnancy.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yeo Chang; Shin, Byung Seok; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook Univ. Hospital, Cheonan (Korea, Republic of); Ohm, Joon Young [The Catholic Univ. of Korea College of Medicine/Bucheon St. Mary' s Hospital, Bucheon (Korea, Republic of); Kim, Ho Jun [Konyang Univ. Hospital, Daejeon (Korea, Republic of)

    2012-06-15

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

  14. Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Kachel, R.; Basche, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Radiologische Klinik); Heerklotz, I.; Grossmann, K. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Innere Medizin); Endler, S. (Medizinische Akademie, Erfurt (Germany, F.R.). Klinik fuer Neurologie und Psychiatrie)

    1991-06-01

    We present our experience with 105 patients in whom percutaneous transluminal angioplasty was performed in 112 stenosed or occluded supra-aortic arteries. Symtoms of cerebrovascular and/or vertebrobasilar insufficiency were present in 104 of the 105 patients. The angioplasty was successful in 35 stenoses of the internal carotid artery, 2 stenoses of the common carotid artery, 1 stenosis of the external carotid artery, 15 stenoses of the vertebral artery, 3 stenoses of the innominate artery and 44 stenoses of the subclavian artery. There were only 4 minor-complications (2 haematomas, 1 transient ischemic attack, 1 small thrombus of the internal carotid artery which was detected by 111-indium platelet scintigraphy and treated by thrombendarterectomy before the appearance of neurological symptoms). All patients were symptom free after angioplasty. During the observations period of 3 to 109 months (average 58 months) there were only two cases with re-stenosis after subclavian angioplasty. The results of more than 700 personal and international published percutaneous transluminal angioplasties of supra-aortic arteries are presented. The results suggest that angioplasty of supra-aortic arteries is an effective method. On strict definition of the indications, the complication rate for angioplasty of the supra-aortic arteries is not likely to be higher than that for operative treatment. (orig.).

  15. Exploring expectations and needs of patients undergoing angioplasty.

    Science.gov (United States)

    Aazami, Sanaz; Jaafarpour, Molouk; Mozafari, Mosayeb

    2016-09-01

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

  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 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...... angioplasty) or persistent greater than or equal to 0.15 rise in arm/ankle blood pressure index (femoropopliteal angioplasty). The respective technical success rates were 82% and 64%. The complication rate was 10.9%, including 5.4% distal embolization. Patency rates were higher in iliac than...... in femoropopliteal lesions, in stenotic than occluded vessels, and also when the lesion was shorter than 5 cm and if there was good run-off. Limb salvage exceeded patency by 10% in the iliac procedures and by 15% in the femoropopliteal. Percutaneous transluminal angioplasty is recommended for selected cases...

  18. Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty

    DEFF Research Database (Denmark)

    Thune, Jens Jakob; Hoefsten, Dan Eik; Lindholm, Matias Greve;

    2005-01-01

    BACKGROUND: Randomized trials comparing fibrinolysis with primary angioplasty for acute ST-elevation myocardial infarction have demonstrated a beneficial effect of primary angioplasty on the combined end point of death, reinfarction, and disabling stroke but not on all-cause death. Identifying......-risk group might have a reduced mortality with an invasive strategy. METHODS AND RESULTS: We classified 1527 patients from the Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI-2) trial with information for all variables...... necessary for calculating the TIMI risk score as low risk (TIMI risk score, 0 to 4) or high risk (TIMI risk score > or =5) and investigated the effect of primary angioplasty versus fibrinolysis on mortality and morbidity in the 2 groups. Follow-up was 3 years. We classified 1134 patients as low risk and 393...

  19. 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)....

  20. Abnormally high failure rate for femoral angioplasty in patients with pseudoxanthoma elasticum

    NARCIS (Netherlands)

    Ammi, Myriam; Kranenburg, Guido; Omarjee, Loukman; Martin, Ludovic; Spiering, Wilko; Lefthériotis, Georges

    2015-01-01

    Pseudoxanthoma elasticum (PXE) is an inherited disease characterized by skin lesions, central blindness, and progressive peripheral occlusive disease. Severe claudication is a frequent symptom for which angioplasty represents a possible therapeutic avenue. We report the outcomes of four patients wit

  1. 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...... 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...

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

    Directory of Open Access Journals (Sweden)

    I. G. Ryadovoy

    2010-01-01

    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. 

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rohan Jayasinghe

    2011-02-01

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

  6. 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).

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-12-21

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

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

    Science.gov (United States)

    Topaz, On

    1993-06-01

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

  10. Early outcomes after carotid angioplasty with stenting performed by neurologists

    Directory of Open Access Journals (Sweden)

    Bathala Lokesh

    2010-01-01

    Full Text Available Aims: To evaluate the results of carotid artery angioplasty and stenting (CAS in treating extracranial carotid artery stenosis performed by neurologists in our center and compare the results with other large published series. Materials and Methods: Data for all patients who underwent CAS from January 2003 through November 2007, was retrieved from the Nanjing Stroke Registry. Perioperative and post-procedural complications within 30 days following stenting were analyzed and compared with that from other series. A total number of 75 patients were enrolled, with a mean age of 65.9 ± 8.8 years, and 64 (85.3% of them were male. Results: Procedural success was achieved in 74 patients (98.7%. Pre-treatment stenosis was 73.8 ± 14.9 and post-treatment residual stenosis was less than 10%. Thirty-four patients (45.3% had bilateral carotid artery disease and seven (9.3% had tandem stenosis. The neurological complication rate was 3.9% (one major and two minor strokes. Bradycardia in four (5.3% and hypotension in 13 (17.3% were observed during procedures. Using the Fischer′s exact t test, the complication rate compared with the large published series did not reveal any statistically significant difference (P > 0.05. Conclusions: We conclude that neurologists, with adequate training, can develop and add this technical skill to the existing cognitive skill of vascular neurology and safely perform stenting.

  11. 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.

  12. 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.

  13. Safety and efficacy of recombinant Hirudin (CGP 39 393) versus Heparin in patients with stable angina undergoing coronary angioplasty

    NARCIS (Netherlands)

    A.A. van den Bos (Arjan); G.R. Heyndrickx (Guy); G-J. Laarman (GertJan); H. Suryapranata (Harry); F. Zijlstra (Felix); P. Close (Philip); J.J.M.M. Rijnierse (Joep); H.R. Büller (Harry); P.W.J.C. Serruys (Patrick); J.W. Deckers (Jaap)

    1993-01-01

    textabstractBACKGROUND. Enhanced thrombin activity has been associated with acute and long-term complications following balloon angioplasty (percutaneous transluminal coronary angioplasty (PTCA). We evaluated, in a 2-to-1 randomized, double-blind trial, the effects of recombinant hirudin, CGP 39 393

  14. Influences on vascular wall smooth muscle cells with novel short-duration thermal angioplasty

    Science.gov (United States)

    Kunio, M.; Shimazaki, N.; Arai, T.; Sakurada, M.

    2012-02-01

    We investigated the influences on smooth muscle cells after our novel short-duration thermal angioplasty, Photo-thermo Dynamic Balloon Angioplasty (PTDBA), to reveal the mechanism that can suppress neo-intimal hyperplasia after PTDBA. We obtained the sufficient arterial dilatations by short-duration heating (angioplasty in vivo. The measured neo-intimal hyperplasia occupancy rate was less than 20% after PTDBA in vivo. We prospect that the inhibition of the growth factor's expression by stretch-fixing may result to suppress the neo-intimal hyperplasia. In addition, the decrease of smooth muscle cells' density in the vessel media by heating might be another reason for the neo-intimal hyperplasia suppression.

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

    DEFF Research Database (Denmark)

    Strøm, M; Konge, L; Lönn, L;

    2016-01-01

    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...... with below the knee percutaneous transluminal angioplasty at the vascular center at Rigshospitalet with the purpose of limb salvage. All patients were deemed unfit for major surgery due to anatomical limitations or severe co-morbidity, and no prior attempts of revascularization were performed. Follow...... 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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-09-01

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

  17. Endovascular angioplasty before resection of a sphenoidal meningioma with vascular encasement.

    Science.gov (United States)

    Chivoret, N; Fontaine, D; Lachaud, S; Chau, Y; Sedat, J

    2011-09-01

    We describe a case of sphenoid wing meningioma presenting with cerebral infarction due to extended vascular encasement in which endovascular angioplasty was performed before surgery to avoid perioperative ischemia. A severe stenosis involved the intracranial internal carotid artery and the proximal segments of the middle and anterior cerebral arteries. Endovascular dilatation was followed by complete surgical resection. Preoperative mild aphasia and hemiparesia resolved completely after surgery. Endovascular angioplasty of arterial trunks and their branches can be proposed before the resection of skull base meningiomas encasing these arteries to decrease the risk of perioperative brain ischemia related to their surgical manipulation or vasospasm.

  18. ST monitoring for myocardial ischemia during and after coronary angioplasty.

    Science.gov (United States)

    Mizutani, M; Ben Freedman, S; Barns, E; Ogasawara, S; Bailey, B P; Bernstein, L

    1990-08-15

    We performed 12-lead electrocardiographic monitoring in 97 patients during coronary angioplasty (PTCA) of a single vessel to correlate ischemic ST changes with clinical, angiographic and coronary hemodynamic variables and to determine the optimum lead or combination of leads for their detection. Ischemia (chest pain or ST change, group A) occurred in 79 patients (80%), but in only 15 of 23 patients (65%) with collaterals (p less than 0.05). Ischemia occurred more often in left anterior descending and left circumflex PTCA than right coronary PTCA, but pain was the only manifestation more often in left circumflex and right coronary PTCA. Ischemic ST change was silent in 16% and this proportion did not differ in clinical or angiographic groups except for diabetes with 3 of 5 (60%) having silent ischemia (p less than 0.05). Patients in group A (ischemia) compared to group B (no ischemia) had less severe lesions (85 +/- 9 vs 91 +/- 7%, p less than 0.01), higher transstenotic gradients (62 +/- 19 vs 53 +/- 9 mm Hg, p less than 0.05) and lower distal occluded pressures (24 +/- 11 vs 33 +/- 10 mm Hg, p less than 0.01), suggesting less collateral flow. Compared with a 12-lead electrocardiogram, the best single lead for detecting ST change during PTCA in each artery had a sensitivity of 80% and this increased to 93% using the best 2 leads. The best 3 leads (V3/III/V5 for left anterior descending and III/V2/V5 for right coronary and left circumflex) increased sensitivity to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Directory of Open Access Journals (Sweden)

    Mohammed F Abdul-Mohsen

    2011-01-01

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

  20. [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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-12-15

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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Jânio Cipriano Rolim

    2016-02-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    NARCIS (Netherlands)

    J. van der Linden (Joke); J.H. Smits (Johannes); J.H. Assink (Jan Hendrik); D.W. Wolterbeek (Derk); J.J. Zijlstra (Jan); G.H.T. de Jong (Gijs); M.A. van den Dorpel; P.J. Blankestijn (Peter)

    2002-01-01

    textabstractThe 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 e

  7. Cephalic arch stenosis in autogenous brachiocephalic hemodialysis fistulas: results of cutting balloon angioplasty

    DEFF Research Database (Denmark)

    Heerwagen, Søren Thorup; Lönn, Lars; Schroeder, Torben V;

    2010-01-01

    Cephalic arch stenosis is a known cause of hemodialysis access failure in patients with brachiocephalic fistulas (BCFs). Outcomes of endovascular treatment are affected by resistance of the stenosis to balloon dilation, a high vein rupture rate and the development of early restenosis. The purpose...... of this retrospective study was to report outcomes after cutting balloon angioplasty (CBA) of cephalic arch stenosis....

  8. 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...

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

    Institute of Scientific and Technical Information of China (English)

    Ramazan Akdemir; Ekrem Yeter; (O)zlem Karakurt; Salih Orcan; Nihat Karakoyunlu; Mustafa Mucahit Balci; Levent Sa(g)nak; Hamit Ersoy; Mehmet Bulent Vatan; Harun Kilic

    2012-01-01

    Acute ST elevation myocarclial infarction has high mortality and morbidity rates.The majority of patients with this condition face erectile dysfunction in addition to other health problems,In this study,we aimed to investigate the effects of two different reperfusion strategies,primary angioplasty and thrombolytic therapy,on the prevalence of erectile dysfunction after acute myocardial infarction.Of the 71 patients matching the selection criteria,45 were treated with primary coronary angioplasty with stenting,and 26 were treated with thrombolytic agents.Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event.The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction.The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008).In conclusion,this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence,and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

  10. The prognostic importance of heart failure and age in patients treated with primary angioplasty

    NARCIS (Netherlands)

    Henriques, JPS; Zijlstra, F; de Boer, MJ; van't Hof, AWJ; Gosselink, ATM; Suryapranata, H; Hoorntje, JCA; Dambrink, Jan Hendrik Everwijn

    2003-01-01

    Background: Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction. Methods: The prognostic value of heart failure

  11. Femoral artery recanalisation with percutaneous angioplasty and segmentally enclosed plasminogen activator

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Bülow, J;

    1989-01-01

    To establish whether re-occlusion of the femoral artery could be prevented, in 6 consecutive patients undergoing percutaneous transluminal angioplasty (PTA) for superficial femoral artery occlusion the recanalised segment was isolated, with a 7-French double-balloon catheter. 5 mg recombined human...

  12. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-01

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

  15. Drug therapy or coronary angioplasty for the treatment of coronary artery disease : New insights

    NARCIS (Netherlands)

    Amoroso, G; Van Boven, AJ; Crijns, HJGM

    2001-01-01

    Background In the last decade percutaneous transluminal coronary angioplasty has become a very popular strategy For the treatment of coronary artery disease, although its efficacy in reducing ischemic events and the subsequent need for revascularization has yet to be proved. Methods We reviewed the

  16. A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); S.G. Ellis (Stephen)

    1997-01-01

    textabstractBACKGROUND: Among physicians who treat patients with acute myocardial infarction, there is controversy about the magnitude of the clinical benefit of primary (i.e., immediate) coronary angioplasty as compared with thrombolytic therapy. METHODS: As part of the Global Use of Strategies to

  17. 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

  18. 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

  19. 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

  20. 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

  1. Restenosis after coronary angioplasty: the paradox of increased lumen diameter and restenosis

    NARCIS (Netherlands)

    K.J. Beatt (Kevin); P.W.J.C. Serruys (Patrick); H.E. Luijten; B.J.W.M. Rensing (Benno); H. Suryapranata (Harry); P.J. de Feyter (Pim); M.J.B.M. van den Brand (Marcel); G-J. Laarman (GertJan); G.A. van Es (Gerrit Anne); J.R.T.C. Roelandt (Jos)

    1992-01-01

    textabstractRestenosis after coronary angioplasty is the single complication that most limits this revascularization procedure in clinical practice. The process is largely unpredictable and the lesion-related factors predisposing to restenosis are poorly understood, with little consensus in publishe

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  3. Long-term outcome of primary angioplasty compared with fibrinolysis across age groups: a Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI-2) substudy

    DEFF Research Database (Denmark)

    Fosbøl, Emil Loldrup; Thune, Jens Jakob; Kelbaek, Henning;

    2008-01-01

    BACKGROUND: Primary angioplasty in patients with acute ST-elevation myocardial infarction has been shown to be superior to fibrinolysis. Whether elderly patients have the same long-term benefit from angioplasty, compared with fibrinolysis, as younger patients is unknown. METHODS: The effect...... of angioplasty versus fibrinolysis was investigated in 1,572 patients from the DANAMI-2 study across age groups. End points were total mortality and a composite end point of death, reinfarction, or disabling stroke. Follow-up was 3 years. RESULTS: Increasing age was associated with mortality (adjusted hazard...... ratio [HR] 2.45 per 10 year increment, 95% confidence interval [CI] 1.78-3.37, P angioplasty over fibrinolysis on the combined outcome was independent of age: patients aged

  4. Endovascular brachytherapy to prevent restenosis after angioplasty; Endovaskulaere Brachytherapie in der Restenoseprophylaxe nach Angioplastie und Stentimplantation: Eine Uebersicht

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A.; Bohndorf, K. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie

    2003-02-01

    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.) [German] Die endovaskulaere Radiotherapie stellt das erste erfolgreiche Therapiekonzept in der Restenoseprophylaxe nach PTA und Stentimplantation dar. Am 3.11.2000 hat die amerikanische Food and Drug Administration erstmalig zwei Brachytherapiegeraete zur Restenoseprophylaxe nach Koronararterien-Stenting zugelassen. Grosse multizentrische, kontrollierte Studien wurden fuer das koronare Stromgebiet mit positiven Ergebnissen publiziert, die Datenlage im peripheren Stromgebiet ist noch ungenuegend. Beta-Strahler bieten Vorteile in der Anwendung, moeglicherweise auch in der Sicherheit, Gamma-Strahler dagegen sind besser klinisch evaluiert. Die primaere Indikation zur endovaskulaeren Brachytherapie

  5. Influence of a history of smoking on short term (six month) clinical and angiographic outcome after successful coronary angioplasty

    NARCIS (Netherlands)

    A.G. Violaris (Andonis); A. Thury (Attila); R. Melkert (Rein); P.W.J.C. Serruys (Patrick); E.S. Regar (Eveline)

    2000-01-01

    textabstractOBJECTIVES: To assess the influence of smoking on restenosis after coronary angioplasty. DESIGN AND PATIENTS: The incidence of smoking on restenosis was investigated in 2948 patients. They were prospectively enrolled in four major restenosis trials in which quantitative

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-11-01

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

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

    International Nuclear Information System (INIS)

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

  8. 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.

  9. Impact of Age on Long-Term Outcome After Primary Angioplasty With Bare-Metal or Drug-Eluting Stent (From the DESERT Cooperation)

    DEFF Research Database (Denmark)

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

    2013-01-01

    stent thrombosis, which may be more pronounced in elderly patients. Therefore, the aim of this study was to evaluate the impact of age on outcome in patients with STEMI who underwent primary angioplasty with bare-metal stents (BMS) or DES. Our population comprised 6,298 patients who underwent primary...... angioplasty and stent implantation included in the Drug-Eluting Stent in Primary Angioplasty (DESERT) Cooperation database. Age was significantly associated with female gender (p...

  10. 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...

  11. Treatment of renovascular hypertension by transluminal angioplasty--13 years experience in a single centre

    DEFF Research Database (Denmark)

    Øvrehus, Kristian A; Andersen, Poul E; Jacobsen, Ib A

    2007-01-01

    OBJECTIVE: The study is a follow-up on treatment of renovascular hypertension (RVH) with percutaneous transluminal renal angioplasty (PTRA). METHODS: Patients were screened on the basis of clinical criteria of increased probability of RVH with renography and in selected cases with renal vein renin......: with improved control of blood pressure; group III: unchanged blood pressure control. Grouping was performed immediately after treatment, at 1 month, 6 months and at the latest follow-up. One hundred-and-twenty-two patients (124 atherosclerotic and 12 fibromuscular lesions) were treated during 13 years...... stable. CONCLUSION: PTRA is an effective treatment of RVH in patients selected by signs of a flow-restricting stenosis. Twelve percent were normotensive after angioplasty and a further 77% had better controlled hypertension. Few complications were seen and renal function was on average unchanged...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Thomas Strecker

    2014-01-01

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

  14. Restenosis after infrapopliteal angioplasty - clinical importance, study update and further directions.

    Science.gov (United States)

    Baumann, Frederic; Diehm, Nicolas

    2013-11-01

    Patients with critical limb ischemia (CLI) represent the most severe form of peripheral arterial disease (PAD) and exhibit high mortality rates. Frequently, PAD in CLI patients involves the infrapopliteal arterial segment challenging endovascular revascularization strategies. Restenosis remains the major drawback of tibial angioplasty encountered in more than two thirds of CLI patients undergoing tibial revascularization. In contrast to earlier observations, tibial patency was recently shown to be essential to attain an optimal clinical outcome in CLI patients subsequent to tibial angioplasty. The exact pathopyhsiological mechanisms of tibial restenosis remains unclear. To date, most of our knowledge on tibial restenosis and its pathophysiology is derived from coronary arteries, based on the similarity of coronary arteries to tibial artery morphology. Nervertheless, multiple antirestenosis concepts are investigated within clinical trials to reduce tibial restenosis.Purpose of the present manuscript is to provide a current update on the pathophysiology of tibial restenosis and potential antirestenosis strategies.

  15. 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

  16. [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

  17. Flow diverter as a rescue therapy for a complicated basilar angioplasty.

    Science.gov (United States)

    Velioglu, Murat; Ozturk, Ersin; Sonmez, Guner; Kendirli, Tansel; Mutlu, Hakan; Basekim, Cinar

    2013-01-01

    Intracranial atherosclerotic disease is a major cause of ischemic stroke. Stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis was terminated prematurely due to a high stroke and death rate in patients randomized for intracranial stent placement. However, for some patients, angioplasty and/or stent placement remains the best approach. Flow diverters (FDs) are designed to produce a hemodynamic flow diversion by constituting a laminar flow pattern in the parent artery and are mainly used in non-ruptured complex wide-neck aneurysms as well as in ruptured aneurysms. Herein, we present a case where an FD was used in a complicated angioplasty for basilar artery atherosclerosis. A 72-year-old female patient was admitted to our hospital with left side weakness and vertigo. Her diffusion magnetic resonance imaging and magnetic resonance angiography showed right-sided pontine and left-sided occipital acute infarcts with left-sided pontine and right-sided occipital chronic infarcted areas and preocclusive mid-basilar stenosis. The patient was under supervised medical treatment. Despite chronic brain stem and occipital infarcts her modified Rankin Scale was 2. Diagnostic angiography showed no posterior communicating arteries and no pial-pial collaterals and a critical mid-basilar artery stenosis. We decided to perform intracranial angioplasty to increase the perfusion of posterior circulation and reduce the risk of additional embolic infarcts. Angioplasty was complicated with dissection and vessel perforation. We used an FD for rescue therapy to avoid rebleeding. The patient was discharged with good clinical and angiographic results.

  18. Rare occurrence of simultaneous coronary artery perforation and intracoronary thrombus formation following angioplasty

    Institute of Scientific and Technical Information of China (English)

    Su-Yan Bian; Liu-Fa Duan

    2013-01-01

    Both coronary artery perforation and intracoronary thrombus formation are life-threatening complications of percutaneous coronary interventions, which rarely occur simultaneously during angioplasty. We herein report a case of stent-related, left circumflex artery perforation, and subsequently acute left main artery thrombosis after the leakage was embolized with 7 microcoils. Intracoronary thromboectomy and systemic anticoagulant therapy were carefully used with good results. This case also represents some of our uncertainties regarding the best management of the patient.

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

    LENUS (Irish Health Repository)

    Forde, J C

    2012-03-01

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

  20. 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...

  1. 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...

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

    Directory of Open Access Journals (Sweden)

    Mohammad Atif Rana

    2015-01-01

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

  3. Primary angioplasty for infarction due to isolated right ventricular artery occlusion

    Institute of Scientific and Technical Information of China (English)

    Anwar; A; Chahal; Min-Young; Kim; Alexander; N; Borg; Yahya; Al-Najjar

    2014-01-01

    We report an unusual case of an isolated right ventricular infarction with haemodynamic compromise caused by spontaneous isolated proximal occlusion of the right ventricular branch of the right coronary artery(RCA), successfully treated by balloon angioplasty. A 58-yearold gentleman presented with epigastric pain radiating into both arms. Electrocardiograph with right ventricular leads confirmed ST elevation in V4 R and a diagnosis of isolated right ventricular infarction was made. Urgent primary percutaneous intervention was performed which revealed occlusion of the right ventricular branch of the RCA. During the procedure, the patient’s blood pressure dropped to 80/40 mm Hg, and echocardiography showed impaired right ventricular systolic function. Despite aggressive fluid resuscitation, the patient remained hypotensive, continued to have chest pain and persistent electrocardiograph changes, and hence balloon angioplasty was performed on the proximal right ventricular branch which restored flow to the vessel and revealed a severe ostial stenosis. This was treated with further balloon angioplasty which restored TIMI 3 flow with resolution of patient’s symptoms. Repeat echocardiography showed complete resolution of theST-elevation in leads V4 R and V5 R and partial resolution in V1. Subsequent dobutamine-stress echocardiography at 4 wk showed good left and right ventricular contractions. The patient was discharged after a 3-d inpatient stay without any complications.

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

    Directory of Open Access Journals (Sweden)

    Jun-peng Liu

    2015-01-01

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

  5. 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.

  6. +Ophitoxaemia and myocardial infarction--the issues during primary angioplasty: a review.

    Science.gov (United States)

    Gupta, Prabha Nini; Thomas, Jinesh; Francis, Preetham Kumar; Shylaja, Sajith Vamadevan

    2014-10-23

    'The Big four' are the most poisonous snakes in India, and especially in Kerala. These include the cobra, the viper, the krait and the sea snake. Most of the poisonous snakebites in India occur in Kerala. We believe there are only a few reports of myocardial infarction after snakebites and most of these are viper bites. We believe this is the second case of primary angioplasty for a snakebite. There are at least a few potential issues in performing a primary angioplasty in a snakebite case, namely (1) Is it a thrombus or a spasm? (2) Are the bleeding parameters deranged? Will the patient tolerate tirofiban and other glycoprotein (GB) 2b3a inhibitors? Will he develop dangerous bleeding due to the high dose of heparin needed? Further, would we save the patient from myocardial infarction only to lose him to renal failure, both due to the nephrotoxicity of the venom, the kidney being further damaged by the contrast media used for the angioplasty? We discuss all these issues as they crossed our mind, and hope it will help further treatment in others. We would like to review the available literature on these points and describe a recent case of ours.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-15

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  9. 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

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-08-15

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

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

    International Nuclear Information System (INIS)

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

  13. Short and long term outcomes of primary angioplasty in patients aged 75 years and over

    Directory of Open Access Journals (Sweden)

    Turgay Işık

    2011-06-01

    Full Text Available The treatment of elderly patients with ST segment elevated myocardial infarction (STEMI remains controversial. This study aimed to investigate the effects of primary angioplasty in elderly patients on in-hospital and long term major adverse cardiac events (MACE.Materials and methods: From October 2003 to March 2008, we retrospectively enrolled 220 patients aged 75 years and over with STEMI who underwent primary angioplasty. Patients’ characteristics, in-hospital and long term events were recorded.Results: Male/Female ratio of patients was 129/91 and mean age was 78.7 ± 3.6 (range, 75-97 years, and 58.6% of male. Of these patients 29.2% were diabetics, 69.8% were hypertensive, 34.4% were smoker and 43.5% were anemic at admission. Anterior myocardial infarction was diagnosed in 52.3% of patients. Mean pain-balloon time was 222 ± 116 minutes. Eighty two (38.2% of these 220 patients had three-vessel disease and 12 (5.7% were diagnosed as cardiogenic shock. Procedural success was observed in 79.6% of patients. Heart failure was observed 27.7% in hospital and intra aortic pump was used in 14.5% of patients. There was no significant difference between age groups in long term major cardiac events and in hospital mortality. Diabetes, leukocyte count at admission and in hospital heart failure were independent predictors of short term MACE and low hemoglobin level at admission and peak CKMB levels were independent predictors of long term MACE.Conclusions: Primary angioplasty in patients aged 75 years and over seems to be associated with low procedural complication, high procedural success, improved short and long term survival.

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

    Science.gov (United States)

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

    1992-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    on the timing of stent thrombosis (ST) with both DES and bare metal stents (BMS) and its prognostic significance in patients undergoing pPCI. The Drug-Eluting Stent in Primary Angioplasty (DESERT) cooperation is based on a pooled database including individual data of randomised trials that evaluate the long...... angioplasty with BMS or DES. At 1201 ± 440 days, ST occurred in 267 patients (4.25%). Most of the events were acute or subacute (within 30 days) and very late (> 1 years), with different distribution between DES vs BMS. Patients with ST were more often diabetic (21.7% vs 15.1%, p=0.005), more frequently had...

  16. 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.

  17. The History of Primary Angioplasty and Stenting for Acute Myocardial Infarction.

    Science.gov (United States)

    Smilowitz, Nathaniel R; Feit, Frederick

    2016-01-01

    The evolution of the management of acute myocardial infarction (MI) has been one of the crowning achievements of modern medicine. At the turn of the twentieth century, MI was an often-fatal condition. Prolonged bed rest served as the principal treatment modality. Over the past century, insights into the pathophysiology of MI revolutionized approaches to management, with the sequential use of surgical coronary artery revascularization, thrombolytic therapy, and percutaneous coronary intervention (PCI) with primary coronary angioplasty, and placement of intracoronary stents. The benefits of prompt revascularization inspired systems of care to provide rapid access to PCI. This review provides a historical context for our current approach to primary PCI for acute MI.

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Aiko eOgawa

    2015-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Oliveira Sergio A

    2010-10-01

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

  3. The Mechanical Study of Vascular Endothelial Growth Factor on the Prevention of Restenosis after Angioplasty

    Institute of Scientific and Technical Information of China (English)

    LIU; Qigong; LU; Zaiying; ZHOU; Honglian; YAN; Jin; ZHANG; Weidong

    2001-01-01

    The mechanism of vascular endothelial growth factor (VEGF) on the prevention of restenosis after angioplasty was investigated. The cultured vascular endothelial cells (VEC) were incubated with the conditioned medium (CM) from vascular smooth muscle cells (VSMC) infected with recombinant adenoviruses containing the hVEGF165 gene. To observe the effects of VEGF on proliferation and NO, ET, 6-keto-PGF1α secretion of VEC, WST-1 method, Griess method and radioimmunoassay were used respectively. The PDGF-B mRNA transcription in VECs was detected by RT-PCR. It was showed that NO, 6-keto-PGF1α and OD value were markedly increased in a dosedependent manner in the VEGF-treated groups as compared with those in the control group, while ET and PDGF-B mRNA were significantly decreased in the VEGF-treated groups (P<0. 05 or P<0. 01). Adenovirus vector mediated hVEGF165 gene could promote the proliferation of VECs and im prove NO, PGI2 secretion, inhibit ET secretionand PDGF-B mRNA transcription in the VECs. Theabove results offered further theoretical evidence for VEGF on the prevention of restenosis after angioplasty.

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

    Directory of Open Access Journals (Sweden)

    Timothy Uschold

    2014-01-01

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

  5. Preliminary experience with drug-coated balloon angioplasty in primary percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Hee; Hwa; Ho; Julian; Tan; Yau; Wei; Ooi; Kwok; Kong; Loh; Than; Htike; Aung; Nwe; Tun; Yin; Dasdo; Antonius; Sinaga; Fahim; Haider; Jafary; Paul; Jau; Lueng; Ong

    2015-01-01

    We evaluated the clinical feasibility of using drugcoated balloon(DCB) angioplasty in patients undergoingprimary percutaneous coronary intervention(PPCI). Between January 2010 to September 2014,89 STelevation myocardial infarction patients(83% male,mean age 59 ± 14 years) with a total of 89 coronary lesions were treated with DCB during PPCI. Clinical outcomes are reported at 30 d follow-up. Left anterior descending artery was the most common target vessel for PCI(37%). Twenty-eight percent of the patients had underlying diabetes mellitus. Mean left ventricular ejection fraction was 44% ± 11%. DCB-only PCI was the predominant approach(96%) with the remaining 4% of patients receiving bail-out stenting. Thrombolysis in Myocardial Infarction(TIMI) 3 flow was successfully restored in 98% of patients. An average of 1.2 ± 0.5 DCB were used per patient,with mean DCB diameter of 2.6 ± 0.5 mm and average length of 23.2 ± 10.2 mm. At 30-d follow-up,there were 4 deaths(4.5%). No patients experienced abrupt closure of the infarctrelated artery and there was no reported target-lesion failure. Our preliminary experience showed that DCB angioplasty in PPCI was feasible and associated with a high rate of TIMI 3 flow and low 30-d ischaemic event.

  6. Interleukin-6 and asymmetric dimethylarginine are associated with platelet activation after percutaneous angioplasty with stent implantation.

    Science.gov (United States)

    Gremmel, Thomas; Perkmann, Thomas; Kopp, Christoph W; Seidinger, Daniela; Eichelberger, Beate; Koppensteiner, Renate; Steiner, Sabine; Panzer, Simon

    2015-01-01

    Data linking in vivo platelet activation with inflammation and cardiovascular risk factors are scarce. Moreover, the interrelation between endothelial dysfunction as early marker of atherosclerosis and platelet activation has not been studied, so far. We therefore sought to investigate the associations of inflammation, endothelial dysfunction and cardiovascular risk factors with platelet activation and monocyte-platelet aggregate (MPA) formation in 330 patients undergoing angioplasty with stent implantation for atherosclerotic cardiovascular disease. P-selectin expression, activation of glycoprotein IIb/IIIa and MPA formation were determined by flow cytometry. Interleukin (IL)-6, high sensitivity C-reactive protein and asymmetric dimethylarginine (ADMA) were measured by commercially available assays. IL-6 was the only parameter which was independently associated with platelet P-selectin expression and activated GPIIb/IIIa as well as with leukocyte-platelet interaction in multivariate regression analysis (all p<0.05). ADMA was independently associated with GPIIb/IIIa activation (p<0.05). Patients with high IL-6 exhibited a significantly higher expression of P-selectin than patients with low IL-6 (p=0.001), whereas patients with high ADMA levels showed a more pronounced activation of GPIIb/IIIa than patients with low ADMA (p=0.003). In conclusion, IL-6 and ADMA are associated with platelet activation after percutaneous angioplasty with stent implantation. It remains to be established whether they act prothrombotic and atherogenic themselves or are just surrogate markers for atherosclerosis with concomitant platelet activation.

  7. Interleukin-6 and asymmetric dimethylarginine are associated with platelet activation after percutaneous angioplasty with stent implantation.

    Directory of Open Access Journals (Sweden)

    Thomas Gremmel

    Full Text Available Data linking in vivo platelet activation with inflammation and cardiovascular risk factors are scarce. Moreover, the interrelation between endothelial dysfunction as early marker of atherosclerosis and platelet activation has not been studied, so far. We therefore sought to investigate the associations of inflammation, endothelial dysfunction and cardiovascular risk factors with platelet activation and monocyte-platelet aggregate (MPA formation in 330 patients undergoing angioplasty with stent implantation for atherosclerotic cardiovascular disease. P-selectin expression, activation of glycoprotein IIb/IIIa and MPA formation were determined by flow cytometry. Interleukin (IL-6, high sensitivity C-reactive protein and asymmetric dimethylarginine (ADMA were measured by commercially available assays. IL-6 was the only parameter which was independently associated with platelet P-selectin expression and activated GPIIb/IIIa as well as with leukocyte-platelet interaction in multivariate regression analysis (all p<0.05. ADMA was independently associated with GPIIb/IIIa activation (p<0.05. Patients with high IL-6 exhibited a significantly higher expression of P-selectin than patients with low IL-6 (p=0.001, whereas patients with high ADMA levels showed a more pronounced activation of GPIIb/IIIa than patients with low ADMA (p=0.003. In conclusion, IL-6 and ADMA are associated with platelet activation after percutaneous angioplasty with stent implantation. It remains to be established whether they act prothrombotic and atherogenic themselves or are just surrogate markers for atherosclerosis with concomitant platelet activation.

  8. 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-T,...

  9. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); P.P.T. de Jaegere (Peter); F. Kiemeneij (Ferdinand); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); G.R. Heyndrickx (Guy); H.U. Emanuelsson (Hakan); J. Marco (Jean); V.M.G. Legrand (Victor); P.H. Materne (Phillipe); J.A. Belardi (Jorge); U. Sigwart (Ulrich); A. Colombo (Antonio); J-J. Goy (Jean-Jacques); P.A. van den Heuvel (Paul); J. Delcan; M-A.M. Morel (Marie-Angèle)

    1994-01-01

    textabstractBalloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as c

  10. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease.

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); P.P.T. de Jaegere (Peter); F. Kiemeneij (Ferdinand); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); G.R. Heyndrickx (Guy); H.U. Emanuelsson (Hakan); J. Marco (Jean); V.M.G. Legrand (Victor); P.H. Materne (Phillipe); J.A. Belardi (Jorge); U. Sigwart (Ulrich); A. Colombo (Antonio); J-J. Goy (Jean-Jacques); P. van den Heuvel; J. Delcan; M-A.M. Morel (Marie-Angèle)

    1994-01-01

    textabstractBACKGROUND. Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical o

  11. Comparison of costs of percutaneous transluminal coronary angioplasty and coronary bypass surgery for patients with angina pectoris

    NARCIS (Netherlands)

    C. van Halem; F. van den Brink; P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); H. Suryapranata (Harry); K.J. Meeter; E. Bos (Egbert); F.J. van Dalen (Frederik); M.J.B.M. van den Brand (Marcel)

    1990-01-01

    textabstractTo determine the costs of a procedure, the total costs of the department that provides the service must be considered and, in addition, the direct cost of the specific procedure. Applying this principle to the cost accounting of angioplasty and bypass surgery results in a direct, i.e. pr

  12. Pharmacological approaches to the prevention of restenosis following angioplasty. The search for the Holy Grail? (part II)

    NARCIS (Netherlands)

    J.P.R. Herrman; W.R.M. Hermans (Walter); J. Vos (Jeroen); P.W.J.C. Serruys (Patrick)

    1993-01-01

    textabstractPart I of this article reviewed the results of studies investigating the effectiveness of antithrombotic, antiplatelet, antiproliferative, anti-inflammatory, calcium channel blocker and lipid-lowering drugs in preventing or reducing restenosis after angioplasty. However, despite 15 years

  13. Prolonged binding of radiolabeled recombinant tissue-type plasminogen activator after angioplasty and enclosed thrombolysis of the femoropopliteal arteries

    DEFF Research Database (Denmark)

    Tønnesen, K H; Vinberg, N; Folkenborg, O

    1992-01-01

    The authors measured the binding of indium-111-labeled recombinant tissue-type plasminogen activator (rt-PA) within the recanalized femoropopliteal segment after percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis. In patients with long occlusions (n = 3), 91 micrograms of rt...

  14. A successful patch angioplasty with auto-pulmonary wall for congenital coronary left main trunk occlusion in a young child.

    Science.gov (United States)

    Terada, Takafumi; Sakurai, Hajime; Nonaka, Toshimichi; Sakurai, Takahisa; Sugiura, Junya; Taneichi, Tetsuyoshi; Ohtsuka, Ryohei

    2015-12-01

    Congenital occlusion of the left main coronary trunk is a life-threatening abnormality, and its optimal management remains controversial. This report describes a case of successful patch angioplasty with auto-pulmonary artery for a 12-year-old boy with congenital left main trunk occlusion. We divided the main pulmonary artery, harvested a pulmonary artery wall strip, and performed patch angioplasty of the occluded left main trunk ostium. We were able to clearly expose the left main trunk behind the pulmonary artery because the obstruction was divided for the patch material. The postoperative course was uneventful, and coronary angiography at 4 months after surgery showed excellent patency of the left main trunk. The auto-pulmonary arterial wall was easy to handle during angioplasty, and its favorable durability has been established both in the Ross procedures and in an arterial switch procedure. Therefore, we conclude that patch angioplasty using a piece of the pulmonary arterial wall represents a good alternative to conventional coronary artery bypass grafting.

  15. Successful percutaneous transluminal angioplasty and stenting for symptomatic intracranial vertebral artery stenosis using intravascular ultrasound virtual histology.

    Science.gov (United States)

    Takayama, Katsutoshi; Taoka, Toshiaki; Nakagawa, Hiroyuki; Myouchin, Kaoru; Wada, Takeshi; Sakamoto, Masahiko; Fukusumi, Akio; Iwasaki, Satoru; Kurokawa, Shinichiro; Kichikawa, Kimihiko

    2007-06-01

    This is the first report of percutaneous transluminal angioplasty (PTA) of an intracranial artery applying intravascular ultrasound virtual histology (IVUS-VH), which has been recently developed for tissue characterization of coronary artery plaque. We report a case of successful PTA and stenting for symptomatic intracranial vertebral artery stenosis using IVUS-VH.

  16. Prolonged high-pressure balloon angioplasty of femoropopliteal lesions:Impact on stent implantation rate and mid-term outcome

    Institute of Scientific and Technical Information of China (English)

    Gianluca Rigatelli; Mariano Palena; Paolo Cardaioli; Fabio dellAvvocata; Massimo Giordan; Dobrin Vassilev; Marco Manzi

    2014-01-01

    Objectives To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions. Methods We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 (75.6 ±12.3 years, 355 males, 76.5%in Rutherford class 5-6), referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Proce-dural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes. Results The preferred approach was ipsilateral femoral antegrade in 433/620 patients (69.7%) and contralateral cross-over in 164/620 (26.4%) and pop-liteal retrograde+femoral antegrade in 23/620 (3.7%). Techniques included subintimal angioplasty in 427/620 patients (68.8%) and endolu-minal angioplasty in 193/620 patients (31.2%). The prolonged high pressure balloon angioplasty procedure was successful in 86.2%(minor intra-procedural complications rate 15.7%), stent implantation was performed in 74 patients (11.9%), with a significant improvement of ankle-brachial index (0.29 ±0.6 vs. 0.88 ±0.3, P<00.1) and Rutherford class (5.3 ±0.8 vs. 0.7 ±1.9, P<0.01), a primary patency rate of 86.7%, restenosis of 18.6%on Doppler ultrasound and a target lesion revascularization of 14.8%at a mean follow-up of 18.1 ±6.4 months (range 1-24 months). Secondary patency rate was 87.7%. Conclusions Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-04-01

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

  18. The usefulness of wire-loop technique for percutaneous angioplasty of insufficient hemodialysis fistula

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Hun; Goo, Dong Erk; Kim, Dae Ho; Choi, Deuk Lin; Moon, Chul [College of Medicine, Soonchunhyang University, Seoul (Korea, Republic of)

    2000-10-01

    To evaluate the usefulness of the wire-loop technique, used to perform percutaneous transluminal angioplasty (PTA) in occluded arteriovenous fistula when standard methods fail to pass the balloon catheter across the stenotic segment. In 30 patients (M:F = 14:16; aged 27-77 (mean, 51.3) years), the Wire-Loop technique was used to perform percutaneous transluminal angioplasty of insufficiently hemodialysed arteriovenous fistula where a balloon catheter had failed to pass through the stenotic lesion after a guide wire had successfully passed. Native and Gore-tex fistula were used in 22 and eight cases, respectively.Sixteen stenoses were located in the central vein, and fourteen in the peripheral. The puncture sites used in order to perform the technique were the femoral vein in all cases of central stenosis; three basilic, four cephalic, and five femoral veins in cases of peripheral stenosis and one femoral and one radial artery in cases of anastomotic stenosis. The guide wire was passed through the stenotic lesion, pulled out using the snare technique, and then stretched in order to tighten it. The balloon catheter was then passed through the lesion and traditional balloon angioplasty was performed. The technical success rate and complications of the technique, and the patency rate of recanalized arteriovenous fistula, were evaluated. In 26 of the thirty patients, (86.7%), the procedure was technically successful. In the remaining four cases, failure was due to venous dissection (n=1), marked residual stenosis (n=2), or cardiac arrest (n=1) during the procedure. The average procedure time was 105 (range, 40-210) minutes, and in three cases rupture of the vein occurred. The patency rate of PTA was 80% (24/30) at four months, 63% (19/30) at six months, and 30% (9/30) at twelve months. The expected technical success rate of traditional PTA, without the Wire-Loop technique, would have been 79.3%, but using the technique, the rate increased to 86.7%. The Wire

  19. Prevalence and prognostic implications of non-sustained ventricular tachycardia in ST-segment elevation myocardial infarction after revascularization with either fibrinolysis or primary angioplasty

    DEFF Research Database (Denmark)

    Høfsten, Dan Eik; Wachtell, Kristian; Lund, Birgit;

    2007-01-01

    AIMS: We compared the prevalence and prognostic implications of non-sustained ventricular tachycardia (nsVT) detected early after ST-segment elevation myocardial infarction (STEMI) in patients randomized to either fibrinolysis or primary angioplasty in the DANAMI-2 trial. METHODS AND RESULTS......: Holter recordings were available in 1017 patients (fibrinolysis: n=501; primary angioplasty: n=516). Primary endpoint was all-cause mortality. The prevalence of nsVT was 8.8% in fibrinolysis-treated, and 8.1% in primary angioplasty-treated patients (P=0.71). During 4519 patient-years of follow-up (median...... 4.3 years), 116 patients died [fibrinolysis vs. angioplasty: HR=1.1 (95% CI, 0.8-1.6), P=0.47]. In univariate analysis, nsVT patients treated with fibrinolysis, had significantly higher mortality when compared with those without nsVT (P

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

    International Nuclear Information System (INIS)

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

  1. Optical coherence tomography layer thickness characterization of a mock artery during angioplasty balloon deployment

    Science.gov (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Boulet, Benoît; Lamouche, Guy

    2011-03-01

    Optical coherence tomography (OCT) is used to study the deformation of a mock artery in an angioplasty simulation setup. An OCT probe integrated in a balloon catheter provides intraluminal real-time images during balloon inflation. Swept-source OCT is used for imaging. A 4 mm semi-compliant polyurethane balloon is used for experiments. The balloon is inflated inside a custom-built multi-layer artery phantom. The phantom has three layers to mock artery layers, namely, intima, media and adventitia. Semi-automatic segmentation of phantom layers is performed to provide a detailed assessment of the phantom deformation at various inflation pressures. Characterization of luminal diameter and thickness of different layers of the mock artery is provided for various inflation pressures.

  2. Limb-salvage angioplasty in poor surgical chronic liver disease and diabetic patients.

    Science.gov (United States)

    Hamdy, Hussam; El-Kolly, M; Ezzat, H; Abbas, M; Farouk, Y; Naser, M; Magdy, M; Elraouf, A

    2013-08-01

    Critical limb ischemia (CLI) in high surgical risk patients with chronic liver diseases has a grave prognosis with a one-year mortality rate of 20% and a one-year amputation rate of 25% after the initial diagnosis. According to Trans-Atlantic Inter-Society Consensus (TASC)-II Guidelines, revascularization (surgical & endovascular) is the treatment of choice for patients with critical limb ischemia (CLI). The primary goal of revascularization is to relieve ischemic rest pain, heal ulcers, prevent amputation, improve patient's quality of life (limb salvage) and secondary goal was the periprocedural complications. Endovascular techniques include balloon angioplasty, stents, stent-grafts, and plaque debulking procedures. Surgical options, identification of patients at risk of postoperative complications could have an impact on the indications for a procedure as well as permitting modifications of treatment to reduce the surgical risk This study evaluated the treatment out comas after limb salvage angioplasty for patients who otherwise would be candidates for primary amputation due to poor co-morbid conditions as chronic liver disease and diabetes. The clinical evaluation, laboratory investigations and abdominal ultrasonography were performed to all patients to evaluate their liver status. Patients were classified according to Child-pugh classification into child A, B & C. All patients were subjected to either detailed arterial duplex or C.T. angiography to assess their arterial lesions from January 2008- January 2010. 95 patients with critical limb ischemia (Rutherford categories 4, 5, 6) were treated by primary percutaneous transluminal angioplasty (PTA). No patient was excluded on the basis of the extent of arterial occlusive disease. The primary end points were immediate technical success, clinical improvement and limb salvages rates. Secondary end points were periprocedural complications and mortality. Most of the patients were male (54.7%) with mean age 62 (48

  3. [The role of ionized radiation in prevention of restenosis after coronary angioplasty].

    Science.gov (United States)

    Przewłocki, T; Pieniazek, P; Tracz, W; Kostkiewicz, M; Olszowska, M; Podolec, P

    1997-01-01

    Restenosis occurs to be an Achilles heel of coronary interventions. Three overlapping processes: elastic recoil, neointimal proliferation and arterial remodelling are responsible for development of arterial renarrowing. The only method which proved efficient in reducing the restenosis rate is coronary stenting. Stents deployed using high pressure technique diminish restenosis rate by about one third. Stents eliminate elastic recoil and arterial remodelling but aggravate neointimal proliferation. A concept of radiation therapy was introduced to solve the problem of neointimal hyperplasia. Experiments on animal models of restenosis proved that both gamma as well as beta irradiation inhibited neointimal proliferation after arterial injury. Results of experimental investigations concerning both intraarterial irradiation during angioplasty as well as radioactive stent implantation are reviewed. Authors discuss also results of first clinical trials, the design and preliminary results of some larger studies like PARIS, SCRIPPS, GENEVA, BERT, IRIS, WRIST. Further investigational directions in intravascular radiation therapy are also presented. PMID:9591455

  4. Budd-Chiari and inferior caval vein syndromes due to membranous obstruction of the liver veins. Successful treatment with angioplasty and transcaval TIPS

    DEFF Research Database (Denmark)

    Holland-Fischer, Peter

    2004-01-01

    -up the stents remain open and the patient is symptom free. This successful combination of stent placement and TIPS has not been described before. The case report is followed by a review of the literature on the use of angioplasty in short hepatic vein stenosis and TIPS in Budd-Chiari syndrome. It is concluded...... that angioplasty and TIPS are safe and efficient procedures to reduce liver engorgement and complications of portal hypertension in selected patients with Budd-Chiari syndrome....

  5. MYOCARDIAL PERFUSION ASSESSMENT IN FORECASTING EFFECT OF CORONARY ANGIOPLASTY IN PATIENTS WITH ISCHEMIC CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    A. B. Mironkov

    2015-01-01

    Full Text Available Aim. To define influence of the left ventricle (LV perfusion defects on the clinical status dynamics after coronary angioplasty in patients with the expressed myocardium dysfunction of ischemic etiology. Materials and methods. Examined 86 patients (81 men and 5 women aged from 46 to 73 years before and in 2–3 days after percutaneous coronary intervention with diagnosis: CAD, CHF with NYHA class III–IV, echocardiography parameters of LV: ejection fraction less than 40%, end-diastolic volume is more than 200 ml. Perfusion defects of myocardium estimated with use of ECG-gated single photon emission computed tomography. Predictors were defined: perfusion defects on LV apex (in score, perfusion defects in the area of LAD, LCx and RCA (%, the LV global perfusion defects (in score and %. Results. In 42% of cases 6-minute walk test increased to 3 times; The NYHA class decreased by 2 classes (group 1. In 28 cases 6-minute walk test increased to 2 times and the NYHA class decreased on 1 class. In 22 patients 6-minute walk test increased less than 50% of reference values and there was no dynamics NYHA class (50 patients of the group 2. Initial extent of LV global perfusion defects in group 1 – 41,2 ± 4,0%, in group 2 – 58,3 ± 2,4% (р = 0,0004. Similar values are received for perfusion indicators in the area of LAD and the LV apex. Prevalence of myocardial perfusion defects at rest reflects prevalence of a cardiosclerosis in a cardiac muscle. Conclusion. Degree of LV myocardial perfusion defects in patients with the expressed heart failure of ischemic etiology is the key indicator influencing clinical efficiency of coronary angioplasty. Critical size for definition of the favorable forecast of revascularization are 60% and more perfusion defects testifying that in a cardiac muscle the focal cardiosclerosis prevails over the functioning myocardium. 

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-08-15

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

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

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Heme oxygenase-1 alleviates cigarette smoke-induced restenosis after vascular angioplasty by attenuating inflammation in rat model.

    Science.gov (United States)

    Ni, Leng; Wang, Zhanqi; Yang, Genhuan; Li, Tianjia; Liu, Xinnong; Liu, Changwei

    2016-03-14

    Cigarette smoke is not only a profound independent risk factor of atherosclerosis, but also aggravates restenosis after vascular angioplasty. Heme oxygenase-1 (HO-1) is an endogenous antioxidant and cytoprotective enzyme. In this study, we investigated whether HO-1 upregulating by hemin, a potent HO-1 inducer, can protect against cigarette smoke-induced restenosis in rat's carotid arteries after balloon injury. Results showed that cigarette smoke exposure aggravated stenosis of the lumen, promoted infiltration of inflammatory cells, and induced expression of inflammatory cytokines and adhesion molecules after balloon-induced carotid artery injury. HO-1 upregulating by hemin treatment reduced these effects of cigarette smoke, whereas the beneficial effects were abolished in the presence of Zincprotoporphyrin IX, an HO-1 inhibitor. To conclude, hemin has potential therapeutic applications in the restenosis prevention after the smokers' vascular angioplasty.

  11. 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

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

    OpenAIRE

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

    1980-01-01

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

  13. 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 ...

  14. [Dextrocardia in situs inversus totalis with obstructive coronary disease. Its treatment by coronary angioplasty by the brachial approach].

    Science.gov (United States)

    da Silva, M J; Arie, S; Garcia, D P; Bellotti, G; Pileggi, F

    1992-10-01

    Dextrocardia in "situs inversus totalis" with obstructive coronary disease is a rare clinical situation, with few cases treated by coronary angioplasty using the femoral approach being reported. In this report we describe the case of a 61-year-old male patient who underwent successful dilatation of two arteries by the brachial approach. We discuss technical aspects related to the procedure, which may be easily performed when proper equipment is available.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-04-15

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

  17. 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...

  18. 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 ...

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

    Directory of Open Access Journals (Sweden)

    Pei-Chuan Li

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

  20. 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.

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

    Institute of Scientific and Technical Information of China (English)

    向定成; 杨传红; 候友贤; 龚志华; 易绍东; 邱建

    2003-01-01

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

  2. Same-day discharge after angioplasty for peripheral vascular disease: is it a safe and feasible option?

    Science.gov (United States)

    Maher, Paula

    2014-09-01

    Peripheral vascular disease affects 20% of the population >55 years of age. Patients who become symptomatic are managed by a number of technique's including medical management, percutaneous angioplasty, bypass surgery, and in nonreconstructable situations, limb amputation. Clinicians treating patients by means of angioplasty have traditionally carried out these procedures on an inpatient basis. Limited resources and pressure on the availability of inpatient beds has necessitated clinicians to reevaluate how many of these patients are managed. Treating suitable patients as day cases is an attractive option that frees up resources and is financially advantageous. This paper examines the feasibility of same-day discharge after angioplasty, with a particular emphasis on achieving safe patient outcomes. It explores how advances in endovascular technologies and techniques have contributed to making same-day discharge an ever more feasible option. Nurse led pre-admission clinics run by specialist nurses facilitate safe and appropriate patient selection, where patients at risk for postprocedural problems can be identified effectively based on predefined clinical criteria.

  3. Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

    Science.gov (United States)

    Shimazaki, N.; Tokunaga, H.; Katou, Y.; Hayashi, T.; Arai, T.

    2009-02-01

    We have studied to develop the new thermal angioplasty methodology, photo-thermo dynamic balloon angioplasty (PTDBA), which provides artery dilatation with short-term (<15s) and uniform heating through the balloon by the combination of the efficient laser driven heat generation and fluid perfusion. Thermal denaturation degree of the collagen in artery media may be the important factor to attain sufficient artery dilatation for the PTDBA. In order to predict the optimum heating condition i.e. the balloon temperature and heating duration, we investigated the thermal denaturation dynamics of artery collagen in ex vivo. The extracted fresh porcine carotid artery was used. The temperature-dependent light scattering property and mechanical property of the artery specimen were simultaneously measured during artery temperature rising by specially made setup to assess the denaturation of arterial collagen. The change rate of the backscattered light intensity from the artery specimen; I(T)/I0 with 633nm was measured to evaluate the artery scattering property change with the thermal denaturation. The artery specimen was heated from 25°C to 80°C with constant temperature rising rate of 3°C/min. The measured I(T)/I0 was suddenly increased over 48°C. This boundary temperature might be the initiation temperature of the arterial collagen denaturation. We defined the variation of the I(T)/I0 as the collagen denaturation ratio, and calculated the reactive enthalpy by the chemical equilibrium theory. Since the calculated enthalpy was similar to the enthalpy in literature report, the variety of I(T)/I0 during the temperature rising might be attributed to the collagen conformational change due to the denaturation. In terms of the artery internal force measurement, the artery force was decreased with increasing of the artery temperature up to 65°C (i.e. softening), and increased over 65°C (i.e. shrinkage). We confirmed that the changes of the backscattered light (at 633nm in

  4. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-03-15

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

  6. Changes in Right Ventricular Dysfunction After Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension.

    Science.gov (United States)

    Tsugu, Toshimitsu; Murata, Mitsushige; Kawakami, Takashi; Minakata, Yugo; Kanazawa, Hideaki; Kataoka, Masaharu; Endoh, Jin; Tsuruta, Hikaru; Itabashi, Yuji; Maekawa, Yuichiro; Abe, Takayuki; Fukuda, Keiichi

    2016-10-01

    The aim was to investigate the effect of balloon pulmonary angioplasty (BPA) on right ventricular (RV) function in chronic thromboembolic pulmonary hypertension. Twenty-six patients with chronic thromboembolic pulmonary hypertension were enrolled and were divided into 2 groups, group H with high (>30 mm Hg) mean pulmonary arterial pressure and group L with low (25 to 30 mm Hg) mean pulmonary arterial pressure. RV function was assessed using 2-dimensional speckle-tracking echocardiography as well as 3-dimensional echocardiography, and RV dyssynchrony was assessed by the RV strain curves. Exercise capacity was evaluated by the 6-minute walk distance. RV dilatation was significantly reduced after BPA. In group H, RV ejection fraction, RV free wall longitudinal strain and RV dyssynchrony were all impaired before BPA and were ameliorated after BPA. In group L, RV ejection fraction as well as RV dyssynchrony were impaired without the reduction of RV free wall longitudinal strain and were improved after BPA, indicating that RV dysfunction may be attributable to the RV dyssynchrony in group L. Furthermore, RV dyssynchrony at baseline was the only parameter that was correlated with improvement in the 6-minute walk distance after BPA. RV dyssynchrony may affect RV function and could be the useful parameter for clinical outcome after BPA. PMID:27530827

  7. Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

    Science.gov (United States)

    Fukui, Shigefumi; Ogo, Takeshi; Takaki, Hiroshi; Ueda, Jin; Tsuji, Akihiro; Morita, Yoshiaki; Kumasaka, Reon; Arakawa, Tetsuo; Nakanishi, Michio; Fukuda, Tetsuya; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi; Goto, Yoichi

    2016-01-01

    Objective To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. Methods Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. Results No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, pBPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile. PMID:27220694

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-15

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Nozomu; Tanasawa, Toshihiko; Okada, Takeshi; Endo, Otone; Yamamoto, Naohito [Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Department of Neurosurgery, Aichi (Japan); Miyachi, Shigeru; Hattori, Kenichi [Nagoya University Graduate School of Medicine, Department of Neurosurgery, Nagoya (Japan)

    2006-11-15

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

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

    Directory of Open Access Journals (Sweden)

    Pedro Beraldo de Andrade

    2014-07-01

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

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

    Science.gov (United States)

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

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

  14. Effect of percutaneous transluminal angioplasty on the stenosis of autogenous radiocephalic ateriovenous fistula for hemodialysis

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Min; Kim, Jeong Ho; Byun, Sung Su; Kang, Jin MMo; Choi, Sang Tae; Kim, Jong Woo; Kim, Hyung Sik; Choi, Hye Young [Gachon University Gil Medical Center, Incheon (Korea, Republic of); Park, Jae Hyung [Dept. of Radiology, Seonam University College of Medicine, Myongji Hospital, Goyang (Korea, Republic of)

    2016-02-15

    The purpose of this study was to evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) on stenosis of autogenous radiocephalic arteriovenous fistula (RCF) for hemodialysis and to determine the factors influencing patency. This retrospective study included 136 patients referred for PTA of RCF stenosis between March 2005 and July 2014. The technical success rate, complications, and patency rate were evaluated. The following factors were analyzed as they might influence patency: age, gender, site and duration of arteriovenous fistula, underlying disease, body mass index, hypercholesterolemia, smoking, peripheral artery or coronary artery occlusive disease, stenosis length/grade, cutting balloon, and balloon size. The initial technical success rate was 91.9% (125/136). Complications included vessel rupture (n = 2) and vessel dissection (n = 2). The patency rates at 6, 12, 24, and 48 months after PTA were 81.9, 67.1, 52.7, and 42.3%, respectively. The patency rate was higher in cases with longer (> 3 cm) stenosis (p = 0.04). Use of cutting balloon and larger size of balloon catheter made the patency longer, but this difference was not statistically significant (p = 0.637, 0.258). PTA is a safe and effective way to manage stenosis in RCF. The length of stenosis was the only factor which affected the patency rate in this study.

  15. Intravascular optical coherence tomography to characterize tissue deformation during angioplasty: preliminary experiments with artery phantoms

    Science.gov (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Pazos, Valérie; Bisaillon, Charles-Étienne; Boulet, Benoit; Lamouche, Guy

    2012-09-01

    We explored the potential of intravascular optical coherence tomography (IVOCT) to assess deformation during angioplasty balloon inflation. Using a semi-compliant balloon and artery phantoms, we considered two experimental scenarios. The goal for the first scenario was to investigate if variation in the elasticity of the structure surrounding the balloon could be sensed by IVOCT monitoring. In this scenario, we used three single-layer phantoms with various mechanical properties. Image analysis was performed to extract the inner and outer diameters of the phantoms at various pressures. The goal for the second scenario was twofold. First, we investigated the IVOCT capability to monitor a more complex balloon inflation process. The balloon was in a folded state prior to inflation. This allowed studying two stages of deformation: during balloon unfolding and during balloon expansion. Second, we investigated IVOCT capability to monitor the deformation in a three-layer phantom used to better mimic a true artery. So, not only were the IVOCT images processed to provide the inner and outer diameters of the phantom, but the layer thicknesses were also determined. In both scenarios, IVOCT monitoring revealed to be very efficient in providing relevant information about the phantom deformation during balloon inflation.

  16. Effect of Carvedilol on the Coronary Vascular Endothelial Function after Percutaneous Transluminal Coronary Angioplasty

    Institute of Scientific and Technical Information of China (English)

    苏显明; 马奕; 崔长琮

    2003-01-01

    Objectives To understand the effect of carvedilol on the coronary vascular endothelial function of the patients with coronary heart disease after percutaneous transluminal coronary angioplasty (PTCA). Methods 51cases, having one or more than two branches narrow ( ≥ 70% ) , were diagnosed by coronary angiography. These patients were divided randomly into carvedilol group (n = 28 ) and control group (n = 23) who did not take carvedilol.Endothelin (ET) and nitro dioxide (NO) levels of peripheral blood were measured before and after PTCA,before and after two weeks by taking carvedilol. Results Compared with the ET and NO levels before PTCA, ET were markedly increased and NO were decreased after PTCA (p < 0.05); compared with the ET and NO levels before taking carvedilol, ET were decreased and NO were increased after two week (p <0.05) , but the ET and NO levels of the control group did not change in the period of two weeks observation (p > 0.05). Conclusions Carvedilol may improve the coronary vascular endothelial function after PTCA.

  17. 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.

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

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2012-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  1. 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.

  2. 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

  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. Gender-related differences in outcome after BMS or DES implantation in patients with ST-segment elevation myocardial infarction treated by primary angioplasty

    DEFF Research Database (Denmark)

    De Luca, Giuseppe; Verdoia, Monica; Dirksen, Maurits T;

    2013-01-01

    Several studies have found that among patients with ST-segment elevation myocardial infarction (STEMI) treated by thrombolysis, female sex is associated with a worse outcome. However, still controversial is the prognostic impact of gender in primary angioplasty, especially in the era of drug-elut......-eluting stents (DES). Therefore, the aim of this study was to investigate sex-related differences in clinical outcome in patients with STEMI treated with primary angioplasty with Bare-Metal Stent (BMS) or DES.......Several studies have found that among patients with ST-segment elevation myocardial infarction (STEMI) treated by thrombolysis, female sex is associated with a worse outcome. However, still controversial is the prognostic impact of gender in primary angioplasty, especially in the era of drug...

  5. [The practical clinical guidelines of the Sociedad Española de Cardiología on interventional cardiology: coronary angioplasty and other technics].

    Science.gov (United States)

    Esplugas, E; Alfonso, F; Alonso, J J; Asín, E; Elizaga, J; Iñiguez, A; Revuelta, J M

    2000-02-01

    Interventional cardiology has had an extraordinary expansion in last years. This clinical guideline is a review of the scientific evidence of the techniques in relation to clinical and anatomic findings. The review includes: 1. Coronary arteriography. 2. Coronary balloon angioplasty. 3. Coronary stents. 4. Other techniques: directional atherectomy, rotational atherectomy, transluminal extraction atherectomy, cutting balloon, laser angioplasty and transmyocardial laser and endovascular radiotherapy. 5. Platelet glycoprotein IIb/IIIa inhibitors. 6. New diagnostic techniques: intravascular ultrasound, coronary angioscopy, Doppler and pressure wire. For the recommendations we have used the classification system: class I, IIa, IIb, III like in the guidelines of the American College of Cardiology and the American Heart Association.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-08-15

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

  7. [Changes in left ventricular dP/dt during transluminal coronary angioplasty].

    Science.gov (United States)

    Crochet, D; Petitier, H; Grossetête, R

    1985-03-01

    The authors studied changes of LV dP/dt during transcutaneous coronary angioplasty (TCA). The aim of the study was to detect the alterations of LV function during coronary occlusion and to evaluate the immediate effects of PCA on myocardial function. Six patients with incapacitating angina and isolated left anterior descending disease were successfully treated by TCA using Gruntzig's technique. The study protocol included several recording sequences per patient during the phases of balloon inflation at progressively increasing pressures from 2 to 10 hours. Each sequence comprised a recording under basal conditions and every 5 seconds during inflation (20 seconds) and deflation (45 seconds) of the following parameters: heart rate, aortic and LV pressures, positive and negative peaks of LV dP/dt, and the intracoronary pressure gradient at the beginning and the end of each sequence. The first part of the results based on 27 recorded sequences analysed the bad effects of myocardial ischaemia; coronary occlusion induced a significant fall (p less than 0.01) in the positive and negative peak dP/dt values and on elevation (p less than 0.01) in LV end diastolic pressure, without affecting LV systolic pressure or heart rate. These changes have the following characteristics: they are early, occurring within seconds of coronary occlusion; they affect LV contraction and relaxation simultaneously, but the effects are more marked on LV relaxation; the severity is proportional to the duration of occlusion; they are totally reversible; the disturbances of relaxation return to normal more quickly than those of contraction.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Directory of Open Access Journals (Sweden)

    Humberto Andres Vaz

    2016-04-01

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

  9. Medikamentenbeschichtete Angioplastie-Ballons für peripher-arterielle Eingriffe

    Directory of Open Access Journals (Sweden)

    Diehm N

    2010-01-01

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

  10. 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

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

    Science.gov (United States)

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

    1988-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-15

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2011-01-01

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

  16. Morphological changes of ulcerative plaque in patients received carotid angioplasty and stenting (CAS)

    Energy Technology Data Exchange (ETDEWEB)

    Sadikin, Cindy [Department of Radiology, Dokter Soetomo Hospital, Surabaya (Indonesia); Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: cindysadikin@walla.com; Teng, Michael Mu Huo [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China); School of Medicine, National Yang Ming University, Taipei, Taiwan (China)], E-mail: mhteng@mail2000.com.tw; Yeh, C.-C. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: ccyeh@vghtpe.gov.tw; Chang, F.-C. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China)], E-mail: fcchang@vghtpe.gov.tw; Luo, C.-B. [Department of Radiology, Taipei Veteran General Hospital, Taipei, Taiwan (China); School of Medicine, National Yang Ming University, Taipei, Taiwan (China)], E-mail: cbluo@vghtpe.gov.tw

    2008-03-15

    Background: Carotid ulceration plaque is a strong risk factor for stroke and systemic vascular events. The purpose of this study was to assess immediate and follow-up ulcer morphology after carotid angioplasty and stenting (CAS). Methods and results: A total of 124 patients were included in the study. Ulcerative plaques were identified in 92 arteries from 81 patients (21% were asymptomatic and 79% symptomatic). The ulcer disappeared immediately after stenting in 36 (39%) of 92 arteries in 50 patients. Patients with initial mild degree of stenosis (50-69% stenosis) prior to stent, Type-3 and Type-4 ulcers were more prone to have residual ulcers immediate after stenting procedure. Ulcers located distal and proximal to the site of maximal stenosis, and ulcers extending outside of the imaginary line connecting the distal and proximal normal borders of the carotid artery were also more likely to have residual ulcers (P < 0.001). Follow-up angiograms (mean time after CAS = 10.1 months, range = 3-28 months) performed in 32 arteries (29 patients) revealed that residual ulceration disappeared in 17 lesions (53%) and became smaller in 15 lesions (47%). During follow-up, ipsilateral neurological symptoms were not evident in any of the 29 patients (mean time after CAS = 20.1 months, range = 9-41 months). Conclusions: Ulceration morphology, and stenosis severity prior to stent procedure had an impact on ulcer coverage after CAS. Our findings suggest that residual ulcers disappear or improve over time and that with appropriate medication, will not lead to embolic strokes.

  17. Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.

    Science.gov (United States)

    Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

    2014-04-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases.

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

    Science.gov (United States)

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

    2016-01-01

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

  19. 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.

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

    International Nuclear Information System (INIS)

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

  1. 颈动脉狭窄支架成形术%Stent-supported angioplasty for carotid stenosis

    Institute of Scientific and Technical Information of China (English)

    苑超; 王克勤

    2005-01-01

    1994年Marks和Mathias将支架技术应用于高位颈动脉夹层,Theron和Mathias以及Roubin和他的同事首先使用了这些方法治疗颈动脉狭窄,颈动脉狭窄支架成形术(CAS)应用于临床已经有10余年了。到目前颈动脉狭窄支架治疗的有效性还没有得到最后的证实,目前比较内膜剥脱术与支架治疗的试验正在进行当中,主要有:北美的CREST(Carotid Revascularization Endarterectomy versus Stent Trial)。欧洲的CAVATAS(Carotid and Vemebral Artery Transluminal Angioplasty Study)和SPACE(Stent Protected Angioplasty versus Carotid Endarterectomy)。大概1~3年后会有一定的结果。以指导CAS和CEA的应用。

  2. Primary coronary angioplasty compared with intravenous thrombolytic therapy for acute myocardial infarction : Six-month follow up and analysis of individual patient data from randomized trials

    NARCIS (Netherlands)

    Grines, C; Patel, A; Zijlstra, F; Weaver, WD; Granger, C; Simes, RJ; Ellis, S; Betriu, A; Grines, C; Garcia, E; Grinfeld, L; Gibbons, R; Ribeiro, E; Ribichini, F; Akhras, F; Jones, M; Topol, E; Califf, R; Van der Werf, F; Ardissino, D; Armstrong, PW; Aylward, P; Bates, E; Beatt, K; Cheseboro, J; Col, J; Emanuelsson, H; Fuster, [No Value; Gibler, WB; Gore, J; Guerci, A; Hochman, J; Holmes, D; Kleiman, N; Morris, D; Neuhaus, K; Ohman, M; Pfisterer, M; Phillips, H; Rutsch, W; Vahanian, A; White, H; Stone, G; Browne, K; Marco, J; Rothbaum, D; O'Keefe, DRJ; Overlie, P; Donohue, B; O'Neill, W; de Boer, MJ; van 'T Hof, AWJ; Hoorntje, JCA; Ottervanger, JP; Suryapranata, H; Moreno, R; Abeytua, M; de Sa, EL; Lopez-Sendon, JL; Delcan, JL; Berrocal, D; Bellardi, J; Steffenino, G; Dellavalle, A; Holmes, DR; Gersh, BJ; Hopfenspirger, MR; Silva, LA; Carneiro, R; Akhras, F; Abu Ousa, A

    2003-01-01

    Background Overviews of trials suggest that percutaneous transluminal coronary angioplasty (PTCA) may be more effective than thrombolysis. However, whether these effects are sustained beyond hospital discharge, and the extent to which the results are applicable to a broad cross section of patients a

  3. Lumen narrowing after percutaneous transluminal coronary balloon angioplasty follows a near gaussian distribution: a quantitative angiographic study in 1,445 successfully dilated lesions

    NARCIS (Netherlands)

    B.J.W.M. Rensing (Benno); W.R.M. Hermans (Walter); P.J. de Feyter (Pim); J.G.P. Tijssen (Jan); P.W.J.C. Serruys (Patrick); J.W. Deckers (Jaap)

    1992-01-01

    textabstractTo determine whether significant angiographic narrowing and restenosis after successful coronary balloon angioplasty is a specific disease entity occurring in a subset of dilated lesions or whether it is the tail end of a gaussian distributed phenomenon, 1,445 successfully dilated lesion

  4. Effect of coronary occlusion during percutaneous transluminal angioplasty in humans on left ventricular chamber stiffness and regional diastolic pressure-radius relations

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); C.J. Slager (Cornelis); J. Grimm; H.P. Krayenbuehl; P.G. Hugenholtz (Paul); O.M. Hess (Otto)

    1986-01-01

    textabstractThe effect of repeated (3 to 10 second) and transient (15 to 75 second) abrupt coronary occlusion on the global and regional chamber stiffness was studied in nine patients undergoing angioplasty of a single proximal left anterior descending coronary artery stenosis. The left ventricular

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

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2009-06-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  7. Perioperative Nursing of Carotid Angioplasty%颈动脉支架成形术围手术期的护理策略

    Institute of Scientific and Technical Information of China (English)

    常红; 梁建姝; 王金茹; 胡秀兰

    2010-01-01

    @@ 颈动脉支架术(carotid angioplasty and stenting,CAS)是近20年来发展起来的新技术,远端保护伞的应用使得CAS术后并发症明显下降[1],但CAS围手术期并发症不容忽视.

  8. Off-pump coronary artery bypass grafting or percutaneous transluminal coronary angioplasty with stenting for proximal left anterior descending coronary artery disease?

    NARCIS (Netherlands)

    Drenth, Derk Jan

    2005-01-01

    This thesis describes and discusses the results of a prospective randomized controlled clinical trial comparing percutaneous coronary angioplasty with stenting (stenting) and off-pump coronary artery bypass grafting with a left internal mammary artery (surgery) in patients with a high-grade stenosis

  9. Impact of previous percutaneous transluminal coronary angioplasty and/or stenting revascularization on outcomes after surgical revascularization : insights from the imagine study

    NARCIS (Netherlands)

    Chocron, Sidney; Baillot, Richard; Rouleau, Jean Lucien; Warnica, Wayne J.; Block, Pierre; Johnstone, David; Myers, Martin G.; Calciu, Cristina Dana; Nozza, Anna; Martineau, Pierre; van Gilst, Wiek H.

    2008-01-01

    Aim To determine the impact of previous coronary artery revascularization by percutaneous transluminal coronary angioplasty and/or stenting (PCI) on outcome after subsequent coronary artery bypass grafting (CABG). Methods and results The ischaemia management with Accupril post-bypass Graft via Inhib

  10. 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

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

    Science.gov (United States)

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

    1997-09-01

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

  12. Percutaneous transluminal renal angioplasty with stent is effective for blood pressure control and renal function improvement in atherosclerotic renal artery stenosis patients

    Institute of Scientific and Technical Information of China (English)

    LIAO Chuan-jun; YANG Bao-zhong; WANG Zhong-gao

    2012-01-01

    Background Percutaneous transluminal renal angioplasty with stent is an effective procedure for atherosclerotic renal artery stenosis.However,the decision to perform this procedure has recently raised considerable debate.The aim of this study was to assess the effects of percutaneous transluminal renal angioplasty with stent in atherosclerotic renal artery stenosis patients,especially as it relates to blood pressure control and renal function improvement.Methods A retrospective analysis was made of the clinical data from 125 atherosclerotic renal artery stenosis patients who underwent percutaneous transluminal renal angioplasty from July 2004 to June 2008 in the Department of Vascular Surgery of Beijing Chaoyang Hospital.We compared blood pressure,number of oral antihypertensive medications,and renal function changes pre and post-procedure at 24 months follow-up.Results A total of 125 atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 143 stents were placed.At 24 months follow-up,both systolic and diastolic blood pressure and the number of oral antihypertensive medications were significantly reduced (P <0.05).Overall,the estimated glomerular filtration rate did not change significantly (P >0.05); however,a significant increase in estimated glomerular filtration rate was observed in the subgroup of patients with a lower baseline estimated glomerular filtration rate and in the subgroup of patients with bilateral renal artery stenosis (P <0.05).Conclusion Percutaneous transluminal renal angioplasty is a safe procedure for atherosclerotic renal artery stenosis patients,providing a significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications.

  13. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Johannes Salamon

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

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

    International Nuclear Information System (INIS)

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

  17. 65. Impact of focused echocardiography in clinical decision of patients presented with STMI, underwent primary percutenouse angioplasty

    Directory of Open Access Journals (Sweden)

    M. Qasem

    2016-07-01

    Full Text Available Echocardiography in coronary artery diseases is an essential, routine echocardiography prior to primary percutaneous angioplasty is not clear. In our clinical practice in primary angioplasty we faced lots of complications either before or during or after the procedure. Moreover, lots of incidental findings that discovered after the procedure which if known will affect the plan of management. One-hundred-nineteen consecutive underwent primary angioplasty. All patients underwent FE prior to the procedure in catheterization lab while the patient was preparing for the procedure. FE with 2DE of LV at base, mid and apex, and apical stander views. Diastology grading, E/E′ and color doppler of mitral and aortic valve were performed. (N = 119 case of STMI were enrolled, mean age 51 ± 12 year. Eleven cases (9.2% had normal coronary and normal LV function. Twenty cases (17% of MI complication detected before the procedures: RV infarction 8.4% (5.1% asymptomatic and 3.3% symptomatic, ischemic MR (8.4%, LV apical aneurysm (0.8%, significant pericardial effusion (0.80%. Acute pulmonary edema in 17 cases (14.3%: six cases (5.1% developed acute pulmonary edema on the cath lab with grade 3 diastolic dysfunction and E/E ′  >20, 9 cases (7.6% develop acute pulmonary edema in CCU with grade 2–3 diastolic dysfunction and E/E′ 15–20. 2 cases (2.7% develop acute pulmonary in CCU with grade 1–2 diastolic dysfunction and E/E′ 9–14. One case (0.8% presented cardiac tamponade 2 h post PCI. Incidental finding not related to STMI were as follow: 2 cases (1.7% with severe fibro degenerative MR, 2 cases (1.7% with mild to moderate AR and 2 cases (1.7% with mild to moderate AS. Isoled CABG 5/4.2% and CABG and MVR 2/1.7%. FE play an important role in guiding the management, early detection the incidental findings and complication post PCI.

  18. 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.

  19. Primary angioplasty and later elective multivessel stenting in a patient with dextrocardia: a case report and literature review.

    Science.gov (United States)

    Elbasheer, Elbagir; Habib, Abdelhakim; Salam, Adil

    2010-07-01

    Dextrocardia is a rare congenital anomaly with a prevalence of 1 in 10,000 births. The incidence of coronary artery disease in such patients is thought to be similar to that of the general public, however, patients are seldom seen during routine clinical practice and at the cardiac catheterization laboratory. Patients with this condition and acute myocardial ischemia may pose challenges at presentation, clinical and diagnostic findings and at cardiac catheterization. In this report, a male patient presenting with acute inferior myocardial infarction and three-vessel coronary artery disease was managed successfully with emergency primary angioplasty and later elective multivessel stenting. This is the first combined primary and later multivessel stenting to be reported in a single patient with dextrocardia and situs inversus. The clinical findings, details of the procedures and literature review will be discussed.

  20. 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.

  1. Experimental Study of Adenovirus Vector Mediated-hVEGF165 Gene on Prevention of Restenosis after Angioplasty

    Institute of Scientific and Technical Information of China (English)

    刘启功; 陆再英; 岳远坤; 林立; 张卫东; 颜进

    2004-01-01

    This study evaluated the effects of adenovirus vector mediated human vascular endothelial growth factor-165 (hVEGF165) gene on prevention of restenosis after angioplasty. Rabbit models of bilateral carotid artery injury were established by balloon denudation. The recombinant adenoviruses containing hVEGF165 cDNA was directly injected into left side of the injured carotid arteries.On day 3 and week 3 after transfection the expression of VEGF was observed by RT-PCR and immunohistochemistry. The thrombokinesis, reendothelialization (rET) and intimal hyperplasia in carotid arteries were evaluated by computerized image analysis system 3 weeks after gene transfer.The changes in the VEGF gene-treated side were compared with the control side. Our results showed that 3 days and 3 weeks after hVEGF165 gene transfer the VEGF mRNA and antigen expression were detected in vivo. 3 weeks after the transfer, the carotid artery rET was markedly better in the VEGF gene-treated group compared with the control. The thrombokinesis, intima area/media area (I/M), maximal intimal and medial thicknesses (ITmax and MTmax) demonstrated a statistically significant decrease in arteries treated with VEGF gene as compared with the control group. It is concluded that VEGF gene transfer could be achieved by intra-arterial injection of recombinant adenoviruses. It might accelerate the restoration of endothelial integrity, inhibit thrombokinesis and attenuate intimal hyperplasia in the injured arteries after VEGF gene transfer. This procedure could be useful in preventing restenosis after angioplasty.

  2. Percutaneous transluminal angioplasty and stenting of the vertebral artery ostium with balloon-mounted bare coronary stents

    Directory of Open Access Journals (Sweden)

    Javad Kojuri

    2011-01-01

    Full Text Available Background : Vertebral artery ostial stenosis (VAOS is one of the most frequent causes of posterior circulation stroke. Percutaneous angioplasty and stenting (PTAS is one of the treatment modalities. Patients and Methods : This is a longitudinal observational study from September 2006 to February 2009, conducted at hospitals affiliated with the Shiraz University of Medical Sciences, Shiraz, southern Iran. The patient cohort included patients with posterior circulation stroke or transient ischemic attack (TIA and more than 70% VAOS, and patients with asymptomatic VAOS of more than 70% and aplasia or total occlusion of the contralateral VA or subclavian artery. All the patients underwent PTAS with balloon-mounted bare coronary stents. Technical success, procedural complications, composite outcomes of death, stroke or TIA in the vertebrobasilar territory during the first 30 days, stroke or TIA in the vertebrobasilar territory, and restenosis during follow-up, were assessed. Results : During the study period, 81 patients (mean age 68 + 8.9 years, 63 (78% males, 71 symptomatic and 18 asymptomatic underwent the procedure. Technical success was achieved in 88 (99% patients. Procedure-related complications, other than puncture site complications, were seen in two patients (2.2%. The composite outcome of death, stroke or TIA in the vertebrobasilar territory during the first 30 days was 1%. None of the patients had clinical recurrence or restenosis during the follow-up (mean follow-up 14 months. Conclusion : Percutaneous transluminal angioplasty and stenting of the proximal VA was feasible and safe. The risk of restenosis should be analyzed in long-term studies with angiographic follow-up.

  3. 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.

  4. Percutaneous transluminal coronary angioplasty for culprit lesions in patients with post myocardial infarction angina based on dextrocardia and anomalous coronary arteries. Case reports and methods.

    Science.gov (United States)

    Yabe, Y; Tsukahara, R

    1995-05-01

    Four cases of successful coronary angioplasty for anomalous coronary arteries, including dextrocardia associated with three-vessel disease, single left coronary artery with proximal left anterior descending lesion, anomalous right coronary artery (RCA) from adjacent left coronary sinus of Valsalva associated with proximal RCA lesion, and anomalous left circumflex angulated lesion bifurcated from the RCA, were encountered. Four cases with 8 target lesions who had a mean age of 63.5 +/- 11.5 years old are presented. All the targets lesions were completely dilated through balloon angioplasty, including use of a newly developed support device for cases with large jeopardized myocardium. The factors for complete revascularization were appropriate selection of catheters and originality and ingenuity of procedural technique based on the anatomic characteristics.

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

  8. Serum iron concentration, but not hemoglobin, correlates with TIMI risk score and 6-month left ventricular performance after primary angioplasty for acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Ching-Hui Huang

    Full Text Available Anemia is associated with high mortality and poor prognosis after acute coronary syndrome (ACS. Increased red cell distribution width (RDW is a strong independent predictor for adverse outcomes in ACS. The common underlying mechanism for anemia and increased RDW value is iron deficiency. It is not clear whether serum iron deficiency without anemia affects left ventricular (LV performance after primary angioplasty for acute myocardial infarction (AMI. We investigated the prognostic value of serum iron concentration on LV ejection fraction (EF at 6 months and its relationship to thrombolysis in myocardial infarction (TIMI risk score in post MI patients.We recruited 55 patients who were scheduled to undergo primary coronary balloon angioplasty after AMI and 54 age- and sex-matched volunteers. Serum iron concentration and interleukin-6 levels were measured before primary angioplasty. LVEF was measured by echocardiography at baseline and after 6 months. TIMI risk score was calculated for risk stratification.Serum iron concentration was significantly lower in those in whom LVEF had not improved ≥ 10% from baseline (52.7 ± 24.1 versus 80.8 ± 50.8 µg/dl, P = 0.016 regardless of hemoglobin level, and was significantly lower in the AMI group than in the control group (62.5 ± 37.7 versus 103.0 ± 38.1 µg/dl, P<0.001. Trend analysis revealed that serum iron concentration decreased as TIMI risk score increased (P = 0.002. In addition, lower serum iron concentrations were associated with higher levels of inflammatory markers. Multiple linear regression showed that baseline serum iron concentration can predict LV systolic function 6 months after primary angioplasty for AMI even after adjusting for traditional prognostic factors.Hypoferremia is not only a marker of inflammation but also a potential prognostic factor for LV systolic function after revascularization therapy for AMI, and may be a novel biomarker for therapeutic intervention.

  9. [The performance of coronary angioplasties at centers without cardiac surgery. The recommendations of the Sociedad Española de Cardiología].

    Science.gov (United States)

    Esplugas Oliveras, E; Hernández Antolín, R A; López Bescós, L; Moreu Burgos, J; Pomar Moya-Prats, J L

    1999-01-01

    During the early years of coronary interventions a rigorous on-site surgical stand-by was mandatory. The increased experience in coronary angioplasty both on total number of procedures and the experience gained by each operator, together with the technical improvements, namely since the introduction of stents has induced an evolution in the stand-by strategy, with new concepts such as "next available operating room" or coronary interventions "without on site" surgical facilities, are gaining widespread acceptance. With the aim of defining the requirements to perform coronary interventions at hospitals without coronary surgery, the following aspects are reviewed: a) complications following coronary angioplasty that require coronary surgery; b) the current status of coronary angioplasty without surgical stand-by in different countries. All this information allows us to advance some recommendations concerning the performance of coronary interventions at hospitals without on-site cardiac surgery. Different issues including hospital characteristics, operator and cardiac catheterization laboratory requirements, as well as lesion characteristics and the type of informed consent, should be taken into account.

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

    International Nuclear Information System (INIS)

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

  11. Local hemodynamic changes caused by main branch stent implantation and subsequent virtual side branch balloon angioplasty in a representative coronary bifurcation.

    Science.gov (United States)

    Williams, Andrew R; Koo, Bon-Kwon; Gundert, Timothy J; Fitzgerald, Peter J; LaDisa, John F

    2010-08-01

    Abnormal blood flow patterns promoting inflammation, cellular proliferation, and thrombosis may be established by local changes in vessel geometry after stent implantation in bifurcation lesions. Our objective was to quantify altered hemodynamics due to main vessel (MV) stenting and subsequent virtual side branch (SB) angioplasty in a coronary bifurcation by using computational fluid dynamics (CFD) analysis. CFD models were generated from representative vascular dimensions and intravascular ultrasound images. Time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and fractional flow reserve (FFR) were quantified. None of the luminal surface was exposed to low TAWSS (stenting introduced eccentric areas of low TAWSS along the lateral wall of the MV. Virtual SB angioplasty resulted in a more concentric region of low TAWSS in the MV distal to the carina and along the lateral wall of the SB. The luminal surface exposed to low TAWSS was similar before and after virtual SB angioplasty (rest: 43% vs. 41%; hyperemia: 18% vs. 21%) and primarily due to stent-induced flow alterations. Sites of elevated OSI (>0.1) were minimal but more impacted by general vessel geometry established after MV stenting. FFR measured at a jailed SB was within the normal range despite angiographic stenosis of 54%. These findings indicate that the most commonly used percutaneous interventional strategy for a bifurcation lesion causes abnormal local hemodynamic conditions. These results may partially explain the high clinical event rates in bifurcation lesions.

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

    International Nuclear Information System (INIS)

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

  13. 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

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

    International Nuclear Information System (INIS)

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

  15. 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

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

    Science.gov (United States)

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

    1993-08-01

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

  17. Interventional recanalization of artificial arteriovenous fistula and graft for hemodialysis: angioplasty and pulsed-spray thrombolysis with Urokinase

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) and pul-sed-spray pharmaco-mechanical thrombolysis (PSPMT) using urokinase for the management of insufficient hemodialysis access. Between September 1996 and May 1998, 21 insufficient hemodialysis accesses were treated in 16 patients(3 artificial arteriovenous fistulae, AVF; and 13 arteriovenous graft, AVG). PTA and PSPMT were performed in 6 and 15 cases, respectively, and success and long-term patency rates were evaluated. The overall success rate of PTA and PSPMT for insufficient hemodialysis access was 76. 2%(16/21). The success rates of PTA and PSPMT were 83.3%(5/6) and 73.3%(11/15), respectively. The primary patency rates of PSPMT were 69±12.8% at 6 months and 38±18.6% at 12 months. One of the two initially successful PTAs had been patent for 7 months, and the second PTA was performed at that time due to venous stenosis. The other was patent for 15 months throughout the follow-up period. PTA and PSPMT are effective primary methods for the treatment of insufficient hemodialysis access;success and patency rates were high, and the procedures can be performed repeatedly.=20

  18. Ball-Tip Fibres For Laser Angioplasty: Comparison Of Wavelengths From A Pulsed Neodymium-Yag Laser.

    Science.gov (United States)

    Michaels, Jonathan A.; Cross, Frank W.; Bowker, Timothy J.; Bown, Stephen G.

    1989-06-01

    A new ball-tip fibre optic device has been assessed for the purpose of laser angioplasty. A pulsed Neodymium-YAG laser producing 100 p.s pulses at a repetition rate of 10 Hz was used to ablate human cadaver arterial tissue using approximately 500 mJ per pulse at a wavelength of 1064 nm or 300 mJ at a wavelength of 1.3 μm. Both wavelengths are capable of ablating atheroma with little histological evidence of surrounding thermal damage. Crater depths of about 5 μm per Joule were produced using 1064 nm with normal tissue exposed under saline. Crater depth increases by about 50% when exposures are carried out under blood and when diseased arterial tissue is exposed the crater depth is almost doubled. Depth of ablation with a wavelength of 1.3 μm is 3 to 4 times greater than with 1064 nm for the same exposure and a similar increased response is seen for diseased tissue or in the presence of blood. Further experiments at 1064 nm have shown that the ball-tip device has advantages over bare fibre or sapphire tipped devices in the recanalisation of occluded femoral vessels in an artificial circulation.

  19. The usefulness of percutaneous transluminal angioplasty of the middle cerebral artery stenosis in patients with transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Chul; Lim, Hyo Soon; Kim, Jae Kyu; Seo, Jeong Jin; Jeong, Gwang Woo; Kang, Heoung Keun [Chonnam National Univ. Medical School, Kwangju (Korea, Republic of)

    2001-06-01

    To determine the effectiveness of percutaneous transluminal angioplasty(PTA) of atherosclerotic middle cerebral artery(MCA) stenosis in patients with transient ischemic attack (TIA). Ten patients with TIA who had undergone PTA were retrospectively investigated. In all ten, angiography revealed stenosis of the MCA. Mechanical dilatation was performed at the stenotic portion, and the angiographic findings after PTA, as well as peri/post-angioplastic complications, were evaluated. Four to 64 (mean, 23.5) months later, neurologic symptoms and the nature and timing of recurrent attacks were also assessed. The degree of stenosis before PTA was 50-75% in six patients and greater than 75% in four. Complete or partial angiographic recanalization of the stenotic segment occurred in nine patients (90%). During follow-up, seven patients recovered without recurrent TIA or cerebral stroke; one reported a tingling sensation and one experienced vertebrobasilar insufficiency. Motor aphasia developed in one patient after PTA, but after systemic heparinization, improved within 24 hours. One patient who suffered intracranial hemorrhage due to vascular rupture during PTA did three days later. PTA for atherosclerotic MCA stenosis in patients with TIA is an effective therapeutic method.

  20. 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.

  1. Finite Element Modeling of Balloon Angioplasty by Considering Overstretch of Remnant Non-diseased Tissues in Lesions

    Science.gov (United States)

    Gasser, T. Christian; Holzapfel, Gerhard A.

    2007-06-01

    The paper deals with the modeling of balloon angioplasty by considering the balloon-induced overstretch of remnant non-diseased tissues in atherosclerotic arteries. A stenotic artery is modeled as a heterogenous structure composed of adventitia, media and a model plaque, and residual stresses are considered. The constitutive models are able to capture the anisotropic elastic tissue response in addition to the inelastic phenomena associated with tissue stretches beyond the physiological domain. The inelastic model describes the experimentally-observed changes of the wall during balloon inflation, i.e. non-recoverable deformation, and tissue weakening. The contact of the artery with a balloon catheter is simulated by a point-to-surface strategy. The states of deformations and stresses within the artery before, during and after balloon inflation are computed, compared and discussed. The 3D stress states at physiological loading conditions before and after balloon inflation differ significantly, and even compressive normal stresses may occur in the media after dilation.

  2. 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.

  3. Development of novel short-term heating angioplasty: diameter and elasticity change of vascular wall ex vivo

    Science.gov (United States)

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

    2007-02-01

    In order to investigate the optimum operation parameters on novel short-term heating (angioplasty in which we demonstrated sufficient vascular dilatation with lower pressure by heat- induced denaturation of arterial collagen. And we have also demonstrated the suppression of intimal hyperplasia in animal experiments. We need to understand the PTDB dilatation mechanism to determine the optimum operation parameters. The prototype PTDB with diameter of 3mm was used in our experiments. The internal diameters of extracted fresh porcine carotid arteries at pre- and post- PTDB dilatation were measured. Balloon parameters were follows; pressure P=2atm, peak temperature in balloon T=60-80 °C, and heating duration t=4-30s. Morphological change in the media of dilated artery with PTDB were microscopically examined with Weigert staining. Elastic properties were carried out by stress-strain measurements with calculation of young's modulus. We found that PTDB dilatation provided the effect to prevent elastic recoil. We explained that the reason of this effect might be arrangement of micro- structure in the media, i.e., heat-denatured collagen fibers sustained the elastic recoil due to rubbery elastin fibers. The arterial elasticity was not significant different after PTDB dilatation. It was suggested that there could be no compliance mismatch after PTDB dilatation in physiological range. We found that a part of PTDB dilatation mechanism, in which the vascular wall structure played an important role. The optimum operation parameters for PTDB might be determined in consideration of collagen denaturation progress and arterial composition.

  4. Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

    Energy Technology Data Exchange (ETDEWEB)

    Brodmann, Marianne, E-mail: marianne.brodmann@medunigraz.at; Rief, Peter; Froehlich, Harald; Dorr, Andreas; Gary, Thomas; Eller, Philipp; Hafner, Franz [Medical University of Graz, Division of Angiology (Austria); Deutschmann, Hannes [Medical University Graz, Division of Interventional Radiology (Austria); Seinost, Gerald; Pilger, Ernst [Medical University of Graz, Division of Angiology (Austria)

    2013-02-15

    Due to intimal hyperplasia instent reobstruction in the femoropopliteal arterial segment is still an unsolved problem. Different techniques have been discussed in case of reintervention to guarantee longlasting patency rate. We conducted a randomized, controlled, pilot trial comparing Silverhawk atherectomy with percutaneous transluminal angioplasty (PTA) in patients with a first instent reobstruction in the femoropopliteal arterial segment, to evaluate intima media thickness (IMT) within the treated segment, as a parameter of recurrence of intimal hyperplasia. In a total 19 patients were included: 9 patients in the atherectomy device and 10 patients in the PTA arm. IMT within the treated segment was statistically significantly elevated in all patients treated with the Silverhawk device versus the patients treated with PTA. The obvious differentiation in elevation of IMT in nonfavor for patients treated with the Silverhawk device started at month 2 (max IMT SH 0.178 mm vs. IMT PTA 0.1 mm, p = 0.001) with a spike at month 5 (max IMT SH 0.206 mm vs. IMT PTA 0.145 mm, p = 0.003) and a decline once again at month 6 (max IMT SH 0.177 mm vs. IMT PTA 0.121 mm, p = 0.02). The values for mean IMT performed the same way. Although Silverhawk atherectomy provides good results at first sight, in the midterm follow-up of treatment of first instent restenosis it did not perform better than PTA as it showed elevated reoccurrence of intimal media hyperplasia.

  5. Laser-driven short-duration heating angioplasty: chronic artery lumen patency and histology in porcine iliac artery

    Science.gov (United States)

    Shimazaki, Natsumi; Kunio, Mie; Naruse, Sho; Arai, Tsunenori; Sakurada, Masami

    2012-02-01

    We proposed a short-duration heating balloon angioplasty. We designed a prototype short-duration heating balloon catheter that can heat artery media to 60-70°C within 15-25 s with a combination of laser-driven heat generation and continuous fluid irrigation in the balloon. The purpose of this study was to investigate chronic artery lumen patency as well as histological alteration of artery wall after the short-duration heating balloon dilatation with porcine healthy iliac artery. The short-term heating balloon dilated sites were angiographically patent in acute (1 hour) and in chronic phases (1 and 4 weeks). One week after the dilatation, smooth muscle cells (SMCs) density in the artery media measured from H&E-stained specimens was approx. 20% lower than that in the reference artery. One and four weeks after the dilatations, normal structure of artery adventitia was maintained without any incidence of thermal injury. Normal lamellar structure of the artery media was also maintained. We found that the localized heating restricted to artery media by the short-duration heating could maintain adventitial function and artery normal structure in chronic phase.

  6. 血管成形术后I型胶原的动态演变及其调控机制%Dynamic changes in type Ⅰ collagen, MMP-1 and TIMP-1 after angioplasty

    Institute of Scientific and Technical Information of China (English)

    向定成; 何建新; 杨传红; 龚志华; 赖晃文; 王锐斌; 易绍东; 邱建

    2002-01-01

    目的 探讨血管成形术后Ⅰ型胶原的动态演变规律及其与MMP-1和TIMP-1的关系.方法 采用小型猪髂动脉再狭窄动物模型,分别在血管成形术后1、2、3和6个月取材,用免疫组化、透射电镜加图象分析技术观察血管内膜增生、平滑肌细胞(VSMC)表型特征、Ⅰ型胶原、MMP-1和TIMP-1的表达情况.结果 血管内膜增生在成形术后3个月达高峰,Ⅰ型胶原的表达水平在成形术后逐渐增高,MMP-1的表达水平在血管成形术后早期较低,至6个月时达正常血管水平,而TIMP-1在血管成形术后早期即明显增高,在3个月内达高峰,6个月时仍稳定在较高水平;VSMC表型在早期主要是增生型,而后期以收缩型为主;TIMP-1/MMP-1的比值与新生内膜面积及Ⅰ型胶原的表达水平均呈显著正相关(r=0.65, P<0.01).结论 血管成形术后细胞外Ⅰ型胶原随着时间的推移而逐渐增加,Ⅰ型胶原的动态演变主要取决于TIMP-1/MMP-1的活性比值并与VSMC表型特征有一定的联系.%Objective To investigate the dynamic changes of type Ⅰ collagen, and the activity of metalloproteinases-1 (MMP-1) and tissue inhibitor of metalloproteinases-1 (TIMP-1) after angioplasty. Methods The restenotic model of iliac arteries of domestic microswine was established with hypercholesterol feed plus two angioplasties. Angioplastied vessels were harvested at the end of 1, 2, 3 and 6 months after the second angioplasty. Immunohistochemistry, transmission electronic microscopy and image quantitative analysis techniques were employed to study neointimal proliferation, the phenotype of vascular smooth muscle cells (VSMC) and the expression of type Ⅰ collagen, MMP-1 and TIMP-1. Results The peak of vascular neointimal proliferation was at 3 months after angioplasty. The expression of type Ⅰ collagen gradually increased from 1 to 6 months after angioplasty. For MMP-1, expression was lower in the early stage after angioplasty but

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-04-15

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

  8. Effects of a Lifestyle Modification Program on Knowledge, Attitude and Practice of Hypertensive Patients with Angioplasty: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Fahimeh Jafari

    2016-10-01

    Full Text Available Background: Lack of knowledge, attitude and practice are some of the barriers of having a healthy lifestyle and controlling high blood pressure. This study aimed to determine the effectiveness of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty. Methods: This study was a randomizedcontrolledclinical trial conducted from November to April 2014 on 60 hypertensive patients with angioplasty in ShahidChamran hospital of Isfahan, Iran. The samples were randomly assigned to two equal groups. Data collection was performed in three stages by a researcher-made questionnaire. The intervention plan was 6 education sessions and then follow up were done by phone call. The gathered data were analyzed via SPSS (V.20, using t-test, Chi-square, repeated measurement, and post hoc LSD test andANOVA statistics. Results: The mean score of knowledge, attitude and practice in the experimental group immediately after the intervention was 77.8±7.2, 88.3±6.4 and 86.2±6.5, respectively and one month after the intervention was 80.8±7.4, 91.1±3.5 and 92.5±2.2, respectively. But in the control group, the mean score of knowledge, attitude and practice immediately after the intervention (34.90±11.23, 61.11±6.28, and 38.64±7.15 and one month after the intervention was (38.64±7.15, 59.56±6.31 and 37.27±7.26. Conclusion: Lifestyle modification program can be effective in promoting the knowledge, attitude and practice of hypertensive patients with angioplasty. Nurses can use this program in their care provision programs for these patients.

  9. Roles of thrombin and platelet membrane glycoprotein IIb/IIIa in platelet-subendothelial deposition after angioplasty in an ex vivo whole artery model

    International Nuclear Information System (INIS)

    Platelet deposition at the site of injury caused by balloon angioplasty is associated with acute closure and restenosis. In a new ex vivo whole artery angioplasty model, the authors examined the roles of thrombin inhibition with D-Phe-Pro-ArgCH2Cl (PPACK) and inhibition of the platelet membrane fibrinogen receptor glycoprotein IIb/IIIa (GPIIb/IIIa) with monoclonal antibody 7E3 on platelet deposition at the site of balloon injury. Fresh rabbit aortas were mounted in a perfusion chamber. One half of the mounted arterial segment was dilated with a standard angioplasty balloon catheter and the uninjured half served as the control segment. The vessels were perfused with human blood at physiological pressure and shear rates of 180-250 second-1 for 30 minutes. Platelet deposition was measured using 111In-labeled platelets and scanning electron microscopy. With heparin (2 units/ml) anticoagulation, 8.2 ± 2.2 x 10(6) platelets/cm2 were deposited at the site of balloon injury compared with 0.7 ± 0.2 x 10(6) platelets/cm2 on uninjured segments (p less than 0.02, n = 7). PPACK was tested at a concentration (10 microM) that totally inhibited platelet aggregation in response to thrombin. 7E3 was tested at a concentration (10 micrograms/ml) that totally inhibited platelet aggregation. Platelet deposition at the site of balloon injury was reduced 47% by PPACK and 70% by 7E3 compared with heparin. At shear rates seen in nonstenotic coronary arteries, PPACK and 7E3 are more effective than heparin in reducing platelet deposition at the site of balloon injury. The significant inhibition of platelet deposition by PPACK demonstrates the importance of heparin-resistant thrombin in platelet thrombus formation

  10. Effects of a Lifestyle Modification Program on Knowledge, Attitude and Practice of Hypertensive Patients with Angioplasty: A Randomized Controlled Clinical Trial

    Science.gov (United States)

    Jafari, Fahimeh; Shahriari, Mohsen; Sabouhi, Fakhri; Khosravi Farsani, Alireza; Eghbali Babadi, Maryam

    2016-01-01

    ABSTRACT Background: Lack of knowledge, attitude and practice are some of the barriers of having a healthy lifestyle and controlling high blood pressure. This study aimed to determine the effectiveness of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty. Methods: This study was a randomized controlled clinical trial conducted from November to April 2014 on 60 hypertensive patients with angioplasty in Shahid Chamran hospital of Isfahan, Iran. The samples were randomly assigned to two equal groups. Data collection was performed in three stages by a researcher-made questionnaire. The intervention plan was 6 education sessions and then follow up were done by phone call. The gathered data were analyzed via SPSS (V.20), using t-test, Chi-square, repeated measurement, and post hoc LSD test and ANOVA statistics. Results: The mean score of knowledge, attitude and practice in the experimental group immediately after the intervention was 77.8±7.2, 88.3±6.4 and 86.2±6.5, respectively and one month after the intervention was 80.8±7.4, 91.1±3.5 and 92.5±2.2, respectively. But in the control group, the mean score of knowledge, attitude and practice immediately after the intervention (34.90±11.23, 61.11±6.28, and 38.64±7.15) and one month after the intervention was (38.64±7.15, 59.56±6.31 and 37.27±7.26. Conclusion: Lifestyle modification program can be effective in promoting the knowledge, attitude and practice of hypertensive patients with angioplasty. Nurses can use this program in their care provision programs for these patients. Trial Registration Number:IRCT2015062420912N3 PMID:27713892

  11. Impact of time from symptom onset to drug administration on outcome in patients undergoing glycoprotein IIb-IIIa facilitated primary angioplasty (from the EGYPT cooperation).

    Science.gov (United States)

    De Luca, Giuseppe; Van't Hof, Arnoud W J; Gibson, C Michael; Cutlip, Donald; Zeymer, Uwe; Noc, Marko; Maioli, Mauro; Zorman, Simona; Gabriel, H Mesquita; Emre, Ayse; Rakowski, Tomasz; Gyongyosi, Maryann; Huber, Kurt; Bellandi, Francesco; Dudek, Dariusz

    2015-03-15

    Contrasting data have been so far reported on facilitation with glycoprotein IIb-IIIa inhibitors (GpIIbIIIa) in patients who underwent primary percutaneous coronary intervention. However, it has been demonstrated a time-dependent composition of coronary thrombus in ST-segment elevation myocardial infarction, with more platelets in the first hours. Subsequently, the benefits of early administration of GpIIbIIIa may be affected by the time from symptoms onset to GpIIbIIIa, that therefore is the aim of this study. Our population is represented by 814 patients who underwent GpIIbIIIa facilitated primary angioplasty included in the Early glycoprotein IIb-IIIa inhibitors in primary angioplasty database. Patients were divided according to quartiles of time from symptom onset to GpIIbIIIa administration (≤65 minutes; 65 to 100 minutes; 101 to 178 minutes; and >178 minutes). Myocardial perfusion was evaluated by myocardial blush grade and ST-segment resolution. Time from symptoms onset to GpIIbIIIa was linearly associated with hypertension, diabetes, hypercholesterolemia, and previous myocardial infarction but inversely associated with smoking. Abciximab was more often administrated later from symptoms onset. Time from symptoms onset to GpIIbIIIa was significantly associated with the rate of preprocedural recanalization (thrombolysis in myocardial infarction [TIMI] 2 to 3; p Time to GpIIbIIIa had a significant impact on mortality (hazard ratio [95% confidence interval] 1.46 [1.11 to 1.92], p = 0.007) that was confirmed after correction for baseline confounding factors (adjusted hazard ratio [95% confidence interval] 1.41 [1.02 to 2.21], p = 0.042). In conclusion, this study showed that in patients who underwent primary angioplasty with upstream GpIIbIIIa, time from symptoms onset to GpIIbIIIa strongly impacts on preprocedural recanalization, distal embolization, myocardial perfusion, and long-term survival.

  12. Application of GlycoProtein IIb/IIIa antagonist( Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in Chinese

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇

    2002-01-01

    Objective: to report the application of GPIIb/IIIa antagonist (Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in Chinese. Method: Twenty-one patients who underwent percutaneous transluminal catheter angioplasty(PTCA) and stent implantation were included. After arterial puncture, integrilin was injected at dose of 180ug/kg, and then maintained at 2μg/kgmin for 18 hours. Asprine, plavix(clopidogrel) and heparin were used at the same time. ACT, PT, KPTT and blood routine were routinely monitored. Results: All sheaths were drawn out 2 to 4 hours after the procedure.. There was no severe complication such as hematoma, acute and subacute thrombosis in coronary artery, or thrombocytopenia. ACT returned to less than 150 seconds in 2 hours in 15 patients; in 4 hours in 6 patients. There was no significant difference between the pre- and post-procedure value of PT and platelet count. KPTT was significantly higher than pre-procedure value at 2 hours after the procedure .No recurrence of angina pectoris was observed in the first nine patients within one year follow-up, and no restenosis occurred in stents in the five patients who had coronary angiography one year later. Conclusion: Application of GPIIb/IIIa receptor antagonist (Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in combination with aspirin and plavix could significantly reduce the dosage and duration of heparin with benefit of shortening the indwelling time of sheaths, but did not increase risk of bleeding or lead to thrombosis in stent.

  13. Application of GlycoProtein lib/Ⅲa antagonist(Integrilin) in peri-percutaneous transluminal catheter angioplasty and stent implantation in Chinese

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇

    2002-01-01

    Objective: to report the application of GPⅡb/Ⅲa antagonist (Integrilin) in peri-opercuta-neous transluminal catheter angioplasty and stent implantation in Chinese. Method: Twenty-one patients who underwent percutaneous transluminal catheter angioplasty(PTCA) and stent implantation were included. After arterial puncture, integrilin was injected at dose of 180ug/kg, and then main-tained at 2μg/kg·min for 18 hours. Asprine, plavix(clopidogrel) and heparin were used at the same time. ACT, PT, KPTT and blood routine were routinely monitored. Results: All sheaths were drawn out 2 to 4 hours after the procedure.. There was no severe complication such as hematoma, acute and subacute thrombosis in coronary artery, or thrombocytopenia. ACT returned to less than 150 aeconds in 2 hours in 15 patients; in 4 hours in 6 patients. There was no significant difference between the preand post-procedure value of PT and platelet count. KPTT was significantly higher than pre-procedure value at 2 hours after the procedure . No recurrence of angina pectoris was observed in the first nine patients within one year follow-up, and no restenosis occurred in stents in the five patients who had coronary angiography one year later. Conclusion: Application of GPⅡb/Ⅲa receptor antagonist (Integrilin)in peri-parcutaneous transluminal catheter angioplasty and stent implantation in combination with aspirin and plavix could significantly reduce the dosage and duration of heparin with benefit of shortening the indwelling time of sheaths, but did not increase risk of bleeding or lead to thrombosis in stent.

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

    International Nuclear Information System (INIS)

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

  15. Successful treatment of post-exertion acute myocardial infarction by primary angioplasty and stenting in a patient with antiphospholipid antibody syndrome.

    Science.gov (United States)

    Musuraca, Gerardo; Imperadore, Ferdinando; Terraneo, Clotilde; De Girolamo, Piergiuseppe; Cemin, Claudio; Bonmassari, Roberto; Vergara, Giuseppe

    2004-01-01

    Antiphospholipid syndrome is a disorder characterized by arterial and venous thromboses, thrombocytopaenia and stroke. Acute myocardial infarction is rarely associated with this syndrome. The treatment of these patients is a clinical challenge. This report is about a patient with antiphospholipid syndrome presenting with an acute myocardial infarction after an exercise test. The infarct-related coronary artery was successfully revascularized by primary angioplasty and stenting without any major bleeding complications. We think that the physical exertion could have favoured acute coronary thrombosis in this particular setting.

  16. Cell adhesion molecules and the coronary restenosis after percutaneous transluminal corcnary angioplasty%粘附分子与冠脉成形术后再狭窄

    Institute of Scientific and Technical Information of China (English)

    刘云海; 徐标; 张丽容

    2003-01-01

    @@ 冠心病的介入治疗,尤其是经皮腔内冠脉成形术(percutaneous transluminal coronary angioplasty, PTCA)及冠脉内支架术(intracoronary stenting, ICS)已成为冠心病治疗的主要手段之一,但30%~50%的PTCA术后及10%~15%的ICS术后的再狭窄(restenosis, RS)率已成为影响冠脉成形术远期疗效的重要因素.

  17. Preventive effects of anisodamine against contrast-induced nephropathy in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty

    Institute of Scientific and Technical Information of China (English)

    GENG Wei; XUE Ling; FU Xiang-hua; GU Xin-shun; WANG Yan-bo; WANG Xue-chao; LI Wei; JIANG Yun-fa; HAO Guo-zhen; FAN Wei-ze

    2012-01-01

    Background Anisodamine is widely used in therapy for treating acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation.We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.Methods A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate (eGFR) of 60 ml-1 ·min-1.1.73 m-2 or less,who were undergoing coronary angiography or angioplasty,were randomly assigned to receive an infusion of either sodium chloride (control group,n=128) or anisodamine (treatment group,n=132).Patients in the treatment group received an infusion of anisodamine at a rate of 0.2 μg · kg-1.min-1 from 12 hours before to 12 hours after coronary angiography or angioplasty,while patients in the control group received an infusion of sodium chloride with the same volume as the treatment group.All patients received intravenous sodium chloride hydration.CIN was defined as a 25% increase in serum creatinine from baseline or an absolute increase of >0.5 mg/dl within three days after contrast exposure.The primary end point was the incidence of CIN.The secondary end point was a 25% or greater reduction in eGFR.Results There were no significant differences between the two groups with regard to age,gender,risk factors,laboratory results,medications and interventions.The incidence of CIN was 9.8% (13/132) in the treatment group and 20.3% (26/128) in the control group (P <0.05).The secondary end point was 6.0% (8/132) in the treatment group and 16.4% (21/128) in the control group (P<0.05).Conclusion These results indicate the preventive effects of anisodamine against CIN in type 2 diabetics with renal insufficiency who are undergoing coronary angiography or angioplasty.

  18. Free radicals in a conglomerate of peripheral blood with a spin trap investigated by the EPR method before and after angioplasty treatment

    Science.gov (United States)

    Krzyminiewski, Ryszard; Kruczynski, Zdzislaw; Stepien, Aleksander; Dobosz, Bernadeta

    2008-01-01

    The Electron Paramagnetic Resonance (EPR) was used to investigate free radicals in the peripheral blood of patients subjected to angioplasty treatment. To detect these free radicals, a nitrosobenzene spin trap was used in this experiment. The EPR spectra of the blood with a spin trap conglomerate was measured at room temperature and at 170 K. To confirm the kind of free radicals in the conglomerate blood-spin trap, simulation and quantum-chemical calculations were made, and the conglomerate spin trap with ascorbic acid was measured. Two different types of radicals, one at room temperature and the other in a frozen sample of blood, were found.

  19. Small dense low density lipoprotein particles are associated with poor outcome after angioplasty in peripheral artery disease.

    Directory of Open Access Journals (Sweden)

    Vincenzo Jacomella

    Full Text Available PURPOSE: In patients suffering from symptomatic peripheral artery disease (PAD, percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis. METHODS: Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI were measured. Three months after the intervention duplex sonography was performed to detect restenosis. RESULTS: Sixty-four patients (53% male with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV was significantly lower (33.1±11.0% vs. 39.4±12.1%, p = 0.038 in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p = 0.046 and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p = 0.044 than patients without improvement. CONCLUSIONS: Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD.

  20. 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.)

  1. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-15

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

  3. 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

  4. 切割球囊扩张在股浅动脉长段闭塞治疗中的作用%Angioplasty with cutting balloon in patient with long segmental obstruction of superficial femoral artery

    Institute of Scientific and Technical Information of China (English)

    王爱林; 徐恒; 刘军; 韩圣辉

    2012-01-01

    Objective To compare the technical success rate and midterm results of cutting balloon angioplasty (CBA) to conventional balloon angioplasty (BA) for treatment of long segmental obstruction of the superficial femoral artery. Methods Between March 2009 and May 2010, 33 patients with long segmental obstruction of the superficial femoral artery treated with conventional angioplasty underwent cutting angioplasty. Follow-up consisted clinical examination and computed tomographic angiography at interval of one year. Results After conventional angioplasty there were still severe stenoses in the treated segments of the superficial femoral artery among the 33 selected patients. The stenosis rate decreased from 60% -95% (average 78%) post-conventional angioplasty to 15% -45% (average 36%) after cutting balloon angioplasty. Three patients complicated minor vessel dissection without other major complication. The one year patency of the cutting balloon angioplasty was 66% , which is better than the patency of the conventional balloon angioplasty ( 37% ) . Conclusion Cutting balloon angioplasty provides better vessel patency additional to balloon angioplasty in the treatment of the long segmental obstruction of the superficial femoral artery.%目的 分析评价在常规球囊扩张基础上加用切割球囊治疗股浅动脉长段闭塞的治疗效果和中期通畅率.方法 应用了切割球囊扩张治疗33例股浅动脉长段闭塞患者,导丝通过闭塞段后,首先应用常规球囊进行扩张后,进行动脉造影,对常规球囊扩张后仍有明显狭窄部位进行切割球囊扩张,再次动脉造影评价切割球囊扩张效果.术后对经过治疗的24例患者进行1年的中期随访,并与前期完成的24例单纯常规球囊扩张的1年通畅率进行比较,总结分析两者的中期通畅率、再狭窄的病变特点.结果 在股浅动脉长段闭塞部位进行常规球囊扩张后,均存在不同部位的短段重度狭窄,狭窄部位位于

  5. Basic study of effects on the smooth muscle cells' proliferation with novel short-term thermal angioplasty in vitro and in vivo

    Science.gov (United States)

    Kunio, M.; Shimazaki, N.; Ito, A.; Hayashi, T.; Arai, T.; Sakurada, M.

    2011-03-01

    We investigated the effect on smooth muscle cells' proliferation with stretch-fixing in both in vitro and in vivo porcine study to determine the optimum heat condition of novel short-term thermal angioplasty, Photo-thermo Dynamic Balloon Angioplasty (PTDBA). With PTDBA, we have obtained the sufficient arterial dilatation by short-term heating (< 15 s, < 70 °C) and low dilatation pressure (< 0.4 MPa) without excessive neo-intimal hyperplasia on chronic phase. The smooth muscle cells were found to be fixed with stretched shape in vascular wall after PTDBA in vivo. The deformation rate of smooth muscle cells' nuclei was 1.6 +/- 0.1 after PTDBA (15 s, 65 °C, 0.35 MPa). The smooth muscle cells, which were extracted from porcine arteries, were cultured on the specially designed equipment to give stretch-fixing stimulus in vitro. The cell proliferation was inhibited at 20 % stretching compared to 15 % stretching significantly (p < 0.05). The immunostaining specimens of basic Fibroblast Growth Factor (bFGF) and its receptor FGFR-1 were made from the porcine arteries in vivo. We found that the expressions of bFGF and FGFR-1 in the media were not observed after PTDBA. We think that these results suggested the possibility for the inhibition of the excessive cell proliferation after PTDBA.

  6. Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kuhan, Ganesh, E-mail: gkuhan@nhs.net; Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R. [Nottingham University Hospitals, Vascular and Endovascular Unit, Queens Medical Centre (United Kingdom); Whitaker, Simon C.; Habib, Said B. [Nottingham University Hospitals, Department of Radiology, Queen' s Medical Centre (United Kingdom)

    2012-10-15

    Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

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

    Science.gov (United States)

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

    2007-02-01

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

  8. Selective treatment of atherosclerotic plaques using nanosecond pulsed laser with a wavelength of 5.75 μm for less-invasive laser angioplasty

    Science.gov (United States)

    Ishii, K.; Tsukimoto, H.; Hazama, H.; Awazu, K.

    2009-07-01

    XeCl excimer laser coronary angioplasty (ELCA), has gained more attention for the treatment of serious stenosis blocked by plaque. Low degrees of thermal damage after ablation of atherosclerotic plaques have been achieved by ELCA. However, the large number of risks associated with the procedure, for example, dissections or perforations of the coronary arteries limits its application. The laser treatment technique with high ablation efficiency but low arterial wall injury is desirable. Mid-infrared laser with a wavelength of 5.75 μm is selectively well absorbed in C=O stretching vibration mode of ester bonds in cholesteryl ester. We studied the effectiveness of nanosecond pulsed laser at 5.75 μm for novel less-invasive laser angioplasty. In this study, we used a mid-infrared tunable solid-state laser which is operated by difference-frequency generation, at 5.75 μm, a pulse width of 5 ns and a pulse repetition rate of 10 Hz as a treatment light source, and a thoracic aorta of WHHLMI rabbit as an atherosclerosis model. As a result, less-invasive treatment parameters for removing atherosclerotic plaques in a wet condition were confirmed. This study shows that the nanosecond pulsed laser irradiation at 5.75 μm is a powerful tool for selective and less-invasive treatment of atherosclerotic plaques.

  9. Selective removal of cholesteryl ester in atherosclerotic plaque by nanosecond pulsed laser at 5.75 μm for less-invasive laser angioplasty

    Science.gov (United States)

    Ishii, Katsunori; Tsukimoto, Hideki; Hazama, Hisanao; Awazu, Kunio

    2009-02-01

    Laser angioplasty, for example XeCl excimer laser coronary angioplasty (ELCA), has gained more attention for the treatment of serious stenosis blocked by plaque. Low degrees of thermal damage after ablation of atherosclerotic plaques have been achieved by ELCA. However, the large number of risks associated with the procedure, for example, dissections or perforations of the coronary arteries limits its application. A laser treatment technique with high ablation efficiency but low arterial wall injury is desirable. Mid-infrared laser with a wavelength of 5.75 µm is selectively well absorbed in C=O stretching vibration mode of ester bonds in cholesteryl ester. The purpose of this study is to determine the effectiveness of nanosecond pulsed laser at 5.75 µm irradiation for atherosclerotic plaques. We made a study on the irradiation effect to atherosclerotic plaques in tunica intima in a wet condition. In this study, we used a mid-infrared tunable solid-state laser which is operated by difference-frequency generation, with a wavelength of 5.75 µm, a pulse width of 5 ns and a pulse duration of 10 Hz as a treatment light source, and a thoracic aorta of WHHLMI rabbit as an atherosclerosis model. As a result, less-invasive interaction parameters for removing atherosclerotic plaques were confirmed. This study shows that the nanosecond pulsed laser irradiation at 5.75 µm is a powerful tool for selective and less-invasive treatment of atherosclerotic plaques.

  10. In vivo and protease-activated receptor-1-mediated platelet activation but not response to antiplatelet therapy predict two-year outcomes after peripheral angioplasty with stent implantation.

    Science.gov (United States)

    Gremmel, T; Steiner, S; Seidinger, D; Koppensteiner, R; Panzer, S; Kopp, C W

    2014-03-01

    Data linking the response to antiplatelet therapy with clinical outcomes after angioplasty and stenting for lower extremity artery disease (LEAD) are scarce. Moreover, associations of in vivo and thrombin-inducible platelet activation with the occurrence of adverse events have not been investigated in these patients, so far. We therefore assessed clinical outcomes and on-treatment platelet reactivity by four test systems in 108 patients receiving dual antiplatelet therapy after infrainguinal angioplasty and stenting for LEAD. Further, in vivo and thrombin receptor-activating peptide (TRAP)-6-inducible glycoprotein (GP) IIb/IIIa activation and P-selectin expression were measured as sensitive parameters of platelet activation. The primary endpoint was defined as the composite of atherothrombotic events and target vessel restenosis or reocclusion. Residual platelet reactivity to adenosine diphosphate and arachidonic acid was similar between patients without and with adverse outcomes within two-year follow-up (all p>0.05). Further, the occurrence of clinical endpoints did not differ significantly between patients without and with high on-treatment residual platelet reactivity by all test systems (all p>0.05). In contrast, in vivo and TRAP-6-inducible platelet activation were significantly more pronounced in patients with subsequent adverse events (all pangioplasty and stenting for LEAD.

  11. 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.

  12. Randomized trial of Legflow® paclitaxel eluting balloon and stenting versus standard percutaneous transluminal angioplasty and stenting for the treatment of intermediate and long lesions of the superficial femoral artery (RAPID trial): Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    A. Karimi; S.W. de Boer (Sanne W.); D.A.F. Van Den Heuvel; B. Fioole (Bram); D. Vroegindeweij (Dammis); J.M.M. Heyligers (Jan); P.N.M. Lohle (Paul N.M.); O.E. Elgersma (Otto E.); R.P.T. Nolthenius (Rudolf ); J.A. Vos (Jan Albert); J.-P.P.M. de Vries (Jean-Paul)

    2013-01-01

    textabstractBackground: Restenosis after percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) may occur in 45% of patients at 2 years follow-up. Paclitaxel-coated balloons have been found to reduce neointimal hyperplasia, and thus reduce restenosis. Recently, the Legfl

  13. APPLICATION OF OPEN ANGIOPLASTY IN BUDD-CHIARI SYNDROME PATIENTS%布-加氏综合征血管内直视成型术的应用

    Institute of Scientific and Technical Information of China (English)

    刘健; 杨晓涵; 徐宏耀; 贾奎; 纪宗正

    2001-01-01

    Objective To summarize the technique and indication of total corrective operation of Budd-Chiari syndrome by open angioplasty. Methods Twelve patients of Budd-Chiari syndrome from November 1997 to September 1999 treated by total open angioplasty were studied. Results About 1 500-2 580ml self-blood was recycled and transfused during the operation. Bank-blood was not required to patients, except one who experienced second thoracectomy for hemostasis after the operation. The pressure of inferior vena cava declined obviously and no complication occurred after operation. All patients were cured. Ultrasonic examination was performed six months after operation and no reocclusion of inferior vena cava was found in these patients. Conclusion Total corrective operation by open angioplasty is efficacy to treat Budd-Chiari syndrome. Controlling hemorrhage of inferior vena cava to maintain a clear operation field is the key to success of operation.%目的总结下腔静脉(inferior vena cava, IVC)型及肝静脉(hepatic veins, HV)开口阻塞型布-加氏综合征(Budd-Chiari syndrome, BCS)根治术的方法及适应证。方法 1997年11月至1999年9月对12例BCS患者用自体血回收、球囊阻断IVC的方法施行根治性血管内直视成形术。结果术中回收并回输自体血1 500~2 580ml不等,除1例第二次开胸止血外,其余患者未输库血。术后随访3~36个月,IVC保持通畅。结论直视下对BCS施行根治性手术,疗效确切,控制出血及延长术野明视时间是手术成功的关键。

  14. 冠状动脉球囊成形术及支架术后再狭窄%Restenosis after percutaneous transluminal coronary angioplasty and stent implantation

    Institute of Scientific and Technical Information of China (English)

    沈珠军

    2001-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) has become one of the most important treatment method in coronary artery disease along with coronary bypass operation and medicine in recent years.Restenosis after intervention becomes the Achili's heel in our daily treatment.In some degree stenting can reduce restenosis,but the restenosis after stenting is still over 20%.The focus of the treatment of restenosis over the last 2 decades has been through the application of pharmacologically active agents and mechanical approaches using a host of different devices.But this frequent and costly complication of percutaneous revascularization techniques has proved refractory to all such therapies.This review will focus on the studies that have been done during recent years,it will cover the mechanism of restenosis after PTCA and stenting,the risk factors involved in the restenosis,and the prevention and treatment of restenosis.

  15. 经皮冠状动脉成形术并发症及其护理%Complications and nursing after percutaneous transluminal coronary angioplasty

    Institute of Scientific and Technical Information of China (English)

    钟莉萍

    2006-01-01

    经皮冠状动脉成形术(percutaneous transluminal coronary angioplasty,PTCA)具有创伤小、安全、成功率高、患者易接受等优点,在临床上得到越来越广泛的应用,成为治疗冠心病的主要方法之一.随着技术水平的提高和设备条件的改善,PTCA的手术安全性已大为提高,但术后的并发症却显得愈加突出.因此,术前预防与术后护理对减少PTCA术后并发症显得愈加重要.

  16. Thrombus aspiration plus intra-infarct-related artery administration of tirofiban improves myocardial perfusion during primary angioplasty for acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; ZHANG Xiao-jiang; LI Wen-zheng; LI Shi-ying; SONG Li; WANG Jian; WU Zheng; CHI Yun-peng; ZHENG Bin; ZHAO Han-jun; LI Qing-xiang

    2010-01-01

    Background We developed a new combined strategy of thrombus aspiration plus intra-infarct-related artery (IRA) bolus administration of tirofiban via the aspiration catheter in patients with ST-segment elevation myocardial infarction (STEMI). This strategy can reduce the distal embolism and achieve highly localized concentrations of tirofiban, which can improve myocardial reperfusion without increasing the risk of bleeding. The aim of this study was to investigate whether this combined strategy is superior to thrombus aspiration alone in improving myocardial perfusion in patients with STEMI undergoing primary angioplasty.Results Baseline characteristics of the two groups were well-balanced. The TIMI 3 flow showed a better tendency in the intra-IRA group than in the aspiration alone group (97.22% vs. 87.04%, X~2=7.863, P=0.049). The peak of CK-MB (83.9 (68.9-310.5) U/L vs. 126.1 (74.7-356.7) U/L, P=0.034) and Tnl (42.7 (14.7-113.9) ng/ml vs. 72.5 (59.8-135.3) ng/ml, FMD.029) were lower in the intra-IRA group than in the aspiration alone group. LVEF in the hospital favored the intra-IRA group, (45.7±8.3)% to (42.9±12.1)%, t=1.98, P=0.049. There was a tendency towards a lower MACE at 9-month follow-up in the intra-IRA group although it did not reach statistical difference (Log-rank X~2=2.865, P=0.09). There was no statistical difference in any bleeding events between the two groups.Conclusions Thrombus aspiration plus intra-IRA bolus administration of tirofiban combined with angioplasty may be related with improved myocardium perfusion, saved more myocardium, and resulted in a better clinical prognosis.

  17. 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.

  18. Coronary Angioplasty Stent Placement

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  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... to open up blockages and improve coronary blood flow. You’ll have the opportunity to witness live ... or blockages that are formed that reduce blood flow. Coronary artery disease by-and-large is defined ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... Month, and we’re particularly focusing on women’s heart disease. And I think it’s very, very important that ... that women not be ignored, because women have heart disease to the same extent as men, and it’s ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... Thank you for watching this “OR-Live” webcast presentation from Shawnee Mission Medical Center in Merriam, Kansas. “ ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... care of the intravenous medications and any other medicines that need to be administered in monitoring his ... put in, versus medicated or what’s known as drug-eluding stents. And there has been a lot ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... Shawnee Mission, Kansas February 19, 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee ... live a cardiac catheterization with possible intervention during this procedure. During this webcast you’ll have the ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... side is my colleague and friend of many years, Dr. Jhalan Mukhari. Dr. Mukhari is also a ... brief clinical pieces of information. He’s an 80-year-old gentleman who has been having ongoing chest ...

  2. Angioplasty and Vascular Stenting

    Science.gov (United States)

    ... throughout the body, including: narrowing of large arteries (aorta and its branches) due to atherosclerosis , or hardening ... saturated fat, exercising and not smoking. Individuals with diabetes, high blood pressure and/or high cholesterol need ...

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    Full Text Available ... individuals and how we treat them, keeping in mind not only the results in the Cardiac Catheterization ... positive one, and we’ll keep that in mind. But we’ll certainly keep an eye on ...

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

  5. Coronary Angioplasty Stent Placement

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    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 ...

  6. Coronary Angioplasty Stent Placement

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    Full Text Available ... we can’t change and modify, and that’s family history. There’s not much we can do right ... the range, and you can talk with your family physician or your cardiologist, when this needs to ...

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    Full Text Available ... to make referrals, make appointments, or request more information. Just click on the buttons on your screen ... give you a few brief clinical pieces of information. He’s an 80-year-old gentleman who has ...

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    Full Text Available ... to the audience, we did not find any evidence of any flow-limiting blockages in the blood ... the heart catheterization procedure, and it showed no evidence of any blood clot in the blood vessels ...

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    Full Text Available ... they present to the hospital. So their first knowledge that they have heart disease is in the ... a stress test in a year, with the knowledge that this last stress test was a false ...

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    Full Text Available ... have accessed the femoral artery, which is the big blood vessel in the leg, through which we ... getting to the point where if it’s a big artery, a bare metal stent will work, a ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... to be go ahead and take patients into surgery and operate on them with blood thinning medicines ...

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    Full Text Available ... door to informed medical care. “OR-Live,” the vision of improving health. Hello and welcome. We’re ... door to informed medical care. “OR-Live,” the vision of improving health. 10

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

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... the most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. ... heritage. Secondly is smoking. Smoking is a huge risk factor in the development of heart disease, as ...

  15. Coronary Angioplasty Stent Placement

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    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 ...

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    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 ...

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

  18. Coronary Angioplasty Stent Placement

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

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing ... medical care. “OR-Live,” the vision of improving health. 10

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    Full Text Available ... right now about our genetic heritage. Secondly is smoking. Smoking is a huge risk factor in the development ... little blood seeping around that area. So your doctor may have some specific recommendations regarding not squatting, ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... screen and open the door to informed medical care. “OR-Live,” the vision of improving health. Hello ... she will be monitoring the patient and taking care of the intravenous medications and any other medicines ...

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    Full Text Available ... a false positive stress test. So in other words, the test was abnormal but there is no ... cardiac catheterization with coronary angiography. So in other words, we took a look. He implanted a catheter ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... disease. First and foremost is medical therapy. Med management is extremely important, it maybe the simplest thing we can do, but often the most overlooked. 4 So there are certain risk factors that we have for coronary artery disease. ...

  4. Coronary Angioplasty Stent Placement

    Science.gov (United States)

    ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... putting in a bare metal stent. The whole theory behind that is you have a lesser chance ...

  5. Coronary Angioplasty Stent Placement

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    Full Text Available ... 2009 Welcome to this OR-Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, ... putting in a bare metal stent. The whole theory behind that is you have a lesser chance ...

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    Full Text Available ... we call a “dominant right coronary artery,” giving rise to multiple branches downstream, and there is an ... diet. Often statin therapy, particularly if their cholesterol levels or triglyceride levels are high, we’ll talk ...

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    Full Text Available ... And let me give you a few brief clinical pieces of information. He’s an 80-year-old ... going to be quite as urgent in their clinical ramifications. What would probably the next step that ...

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... Live westbound cast presentation, live from Shawnee Mission Medical Center in Merriam, Kansas. During the program it’s ... your screen and open the door to informed medical care. “OR-Live,” the vision of improving health. ...

  9. Coronary Angioplasty Stent Placement

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    Full Text Available ... Jackson. I’m a board certified cardiologist and staff member at the Shawnee Mission Medical Center. I ... be performing today’s procedure. He too is a staff member of Shawnee Mission’s Medical Center’s Heart and ...

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    Full Text Available ... what they think is indigestion, they think it’s GI, and unfortunately it can turn out to be ... terms of probability is to look at the GI tract and then see if there is any ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... the opening of the blood vessel. It’s a collagen plug, and that will help seal the opening. ... stent should be on Plavix or a similar type of anti-platelet drug lifelong. One of the ...

  12. Coronary Angioplasty Stent Placement

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    Full Text Available ... featuring cardiovascular procedures and cardiovascular disease, in honor of American Heart Month. I’m Dr. Jay Jackson. I’ ... and sometimes these people come in the throes of a heart attack. The American heart association suggests that probably half of all ...

  13. Coronary Angioplasty Stent Placement

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    Full Text Available ... cardiovascular disease, in honor of American Heart Month. I’m Dr. Jay Jackson. I’m a board certified cardiologist and staff member at the Shawnee Mission Medical Center. I will be your host for today’s program. Joining ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... care of the intravenous medications and any other medicines that need to be administered in monitoring his ... surgery and operate on them with blood thinning medicines onboard. And one has to deal with the ...

  15. Coronary Angioplasty Stent Placement

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    Full Text Available ... put in, versus medicated or what’s known as drug-eluding stents. And there has been a lot ... Both bare metal stents and medicated stents, or drug-eluting stents, have their role, and we often ...

  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... right now, looking at these images, the left side looks perfect, so that’s good news. This gentlemen presented with chest pain, which ... musculoskeletal pain in the chest, and all those things should be investigated in due course. Very good. I think the other point to make is ...

  17. Coronary Angioplasty Stent Placement

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    Full Text Available ... reduce blood flow. Coronary artery disease by-and-large is defined as a greater than 70 percent ... the back wall, and this is a very large vessel in this gentleman. It goes way along ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... a big artery, a bare metal stent will work, a smaller artery or in some of the ... the equipment that we use from the early days has undergone a sea change. The catheters that ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart. This could involve any one of the three major arteries. What you will be seeing here ... here, Jay, and now we’ll doing a -- 3 Take another angle to look at that. Take ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... have accessed the femoral artery, which is the big blood vessel in the leg, through which we ... But there is clearly a huge body of data that shows that tobacco use is associated with ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... such as non-cue wave heart attacks and myocardial infarctions, I think they need to be intervened upon. There is no question about that. People who have having an acute heart attack there is absolutely no question they ...

  2. Coronary Angioplasty Stent Placement

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    Full Text Available ... the vision of improving health. Hello and welcome. We’re coming to you live from the state- ... coronary artery disease, how blockage is performed, how we treat them, hopefully prevent them, and the different ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... On occasion, if somebody comes in with an acute heart attack, they have clot in the vessel, we’ll ... question about that. People who have having an acute heart attack there is absolutely no question they need to ...

  4. Coronary Angioplasty Stent Placement

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

  5. Coronary Angioplasty Stent Placement

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    Full Text Available ... Jay, and welcome. We have our patient, who has very graciously and kindly consented to participate in ... information. He’s an 80-year-old gentleman who has been having ongoing chest discomfort for the past ...

  6. Coronary Angioplasty Stent Placement

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    Full Text Available ... the patient wanting to do? Is it a matter of keeping the patient comfortable walking from the ... Plavix, 75 milligrams daily?“ It probably doesn’t matter. It can be taken any time, very important. ...

  7. Coronary Angioplasty Stent Placement

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

  8. Coronary Angioplasty Stent Placement

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    Full Text Available ... I’m Dr. Jay Jackson. I’m a board certified cardiologist and staff member at the Shawnee ... Dr. Jhalan Mukhari. Dr. Mukhari is also a board certified cardiologist, as well as a certified interventional ...

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    Full Text Available ... to you live from the state-of-the-art Cardiac Catheterization Laboratory at Shawnee Mission Medical Center ... and he will go to the right coronary art which, which goes along the back wall of ...

  10. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart, and then there are other issues as well. It 5 could be a pinched nerve. It could be musculoskeletal pain ... we decide that a heart artery needs to be fixed?” Well, again, it’s when we deem that significant. So ...

  11. Coronary Angioplasty Stent Placement

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    Full Text Available ... and years to develop. It’s a buildup of cholesterol plaque within the arterial wall that occludes the ... we call “hyperlipidemia” or “dislipidemia,” or commonly, high cholesterol, and we look at the fractions with the ...

  12. Coronary Angioplasty Stent Placement

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    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 ...

  13. Coronary Angioplasty Stent Placement

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    Full Text Available ... area. So your doctor may have some specific recommendations regarding not squatting, lifting, certainly walking and those ... do is everybody everything we can medically with diet. Often statin therapy, particularly if their cholesterol levels ...

  14. Coronary Angioplasty Stent Placement

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    Full Text Available ... the past year, at a somewhat who lower level of frequency. He came into the hospital when his symptoms got worse. He had a nuclear stress test, which was abnormal, and he is has ...

  15. Coronary Angioplasty Stent Placement

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    Full Text Available ... the past year, at a somewhat who lower level of frequency. He came into the hospital when ... diet. Often statin therapy, particularly if their cholesterol levels or triglyceride levels are high, we’ll talk ...

  16. Coronary Angioplasty Stent Placement

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    Full Text Available ... then he will exchange catheters and he will go to the right coronary art which, which goes ... may get. And you can see -- let me go to the next slide. Symptoms of coronary artery ...

  17. Coronary Angioplasty Stent Placement

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    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 ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... like to show you a slide here about treatment for what we call “significant coronary artery disease,” ... out that we also want to focus on treatment of non-flow limiting disease. First and foremost ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... target lesion. Now with the stents being as flexible as they are, we can pretty much get to anywhere we want. The issue of the bare metal stent versus the drug-coated stents is an ongoing debate. ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... heart disease, as well as problems with the lungs. But there is clearly a huge body of ... clot in the blood vessels that supplied the lungs, which can sometimes cause chest pain and shortness ...

  1. Coronary Angioplasty Stent Placement

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    Full Text Available ... often a difficult area to see on stress testing and such, and so we’ll be able ... much we can do right now about our genetic heritage. Secondly is smoking. Smoking is a huge ...

  2. Coronary Angioplasty Stent Placement

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    Full Text Available ... Medical Center in Merriam, Kansas. During the program it’s easy for you to make referrals, make appointments, ... mail your questions then. Now let me turn it over to Dr. Mukhari to introduce the staff ...

  3. Coronary Angioplasty Stent Placement

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    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly ... screen and open the door to informed medical care. “OR-Live,” the vision of improving health. 10

  4. Coronary Angioplasty Stent Placement

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    Full Text Available ... of the bare metal stent versus the drug-coated stents is an ongoing debate. And I think ... that with putting in a bunch of drug-coated stents, and it looks very pretty when we’ ...

  5. Coronary Angioplasty Stent Placement

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    Full Text Available ... at the patient’s side is my colleague and friend of many years, Dr. Jhalan Mukhari. Dr. Mukhari ... be done. 9 I had one patient, a friend of mine, who is actually a physician, who ...

  6. Drug-eluting versus plain balloon angioplasty for the treatment of failing dialysis access: Final results and cost-effectiveness analysis from a prospective randomized controlled trial (NCT01174472)

    Energy Technology Data Exchange (ETDEWEB)

    Kitrou, Panagiotis M., E-mail: panoskitrou@gmail.com [Department of Interventional Radiology, Patras University Hospital, School of Medicine, Rion 26504 (Greece); Katsanos, Konstantinos [Department of Interventional Radiology, Guy' s and St. Thomas’ Hospitals, NHS Foundation Trust, King' s Health Partners, London SE1 7EH (United Kingdom); Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris [Department of Interventional Radiology, Patras University Hospital, School of Medicine, Rion 26504 (Greece)

    2015-03-15

    Highlights: •1-Year target lesion primary patency significantly higher after PCB application compared to plain balloon angioplasty in the failing dialysis access. •Significant difference in favor of PCB in cumulative primary patency of AVGs at 1 year. •No significant difference in cumulative primary patency of AVFs treated with PCB at 1 year. •Cost effectiveness analysis performed. •Paclitaxel-coated balloon angioplasty proves to be a cost-effective option for treating dialysis access. -- Abstract: Objective: To report the final results and cost-effectiveness analysis of a prospective randomized controlled trial investigating drug-eluting balloon (DEB) versus plain balloon angioplasty (BA) for the treatment of failing dialysis access ( (NCT01174472)). Methods: 40 patients were randomized to angioplasty with either DEB (n = 20) or BA (n = 20) for treatment of significant venous stenosis causing a failing dialysis access. Both arteriovenous fistulas (AVF) and synthetic arteriovenous grafts (AVG) were included. Angiographic follow up was scheduled every two months. Primary endpoints were technical success and target lesion primary patency at 1 year. Cumulative and survival analysis was performed. Incremental net benefit (INB) and incremental cost effectiveness ratio (ICER) were calculated and the cost-effectiveness acceptability curve (CEAC) was drawn. Results: Baseline variables were equally distributed between the two groups. At 1 year, cumulative target lesion primary patency was significantly higher after DEB application (35% vs. 5% after BA, p < 0.001). Overall, median primary patency was 0.64 years in case of DEB vs. 0.36 years in case of BA (p = 0.0007; unadjusted HR = 0.27 [95%CI: 0.13–0.58]; Cox adjusted HR = 0.23 [95%CI: 0.10–0.50]). ICER was 2198 Euros (€) per primary patency year of dialysis access gained. INB was 1068€ (95%CI: 31–2105€) for a willingness-to-pay (WTP) threshold of 5000€ (corresponding acceptability probability >97

  7. Drug-eluting versus plain balloon angioplasty for the treatment of failing dialysis access: Final results and cost-effectiveness analysis from a prospective randomized controlled trial (NCT01174472)

    International Nuclear Information System (INIS)

    Highlights: •1-Year target lesion primary patency significantly higher after PCB application compared to plain balloon angioplasty in the failing dialysis access. •Significant difference in favor of PCB in cumulative primary patency of AVGs at 1 year. •No significant difference in cumulative primary patency of AVFs treated with PCB at 1 year. •Cost effectiveness analysis performed. •Paclitaxel-coated balloon angioplasty proves to be a cost-effective option for treating dialysis access. -- Abstract: Objective: To report the final results and cost-effectiveness analysis of a prospective randomized controlled trial investigating drug-eluting balloon (DEB) versus plain balloon angioplasty (BA) for the treatment of failing dialysis access ( (NCT01174472)). Methods: 40 patients were randomized to angioplasty with either DEB (n = 20) or BA (n = 20) for treatment of significant venous stenosis causing a failing dialysis access. Both arteriovenous fistulas (AVF) and synthetic arteriovenous grafts (AVG) were included. Angiographic follow up was scheduled every two months. Primary endpoints were technical success and target lesion primary patency at 1 year. Cumulative and survival analysis was performed. Incremental net benefit (INB) and incremental cost effectiveness ratio (ICER) were calculated and the cost-effectiveness acceptability curve (CEAC) was drawn. Results: Baseline variables were equally distributed between the two groups. At 1 year, cumulative target lesion primary patency was significantly higher after DEB application (35% vs. 5% after BA, p < 0.001). Overall, median primary patency was 0.64 years in case of DEB vs. 0.36 years in case of BA (p = 0.0007; unadjusted HR = 0.27 [95%CI: 0.13–0.58]; Cox adjusted HR = 0.23 [95%CI: 0.10–0.50]). ICER was 2198 Euros (€) per primary patency year of dialysis access gained. INB was 1068€ (95%CI: 31–2105€) for a willingness-to-pay (WTP) threshold of 5000€ (corresponding acceptability probability >97

  8. ANGIOPLASTIA DE RESCATE EN MUJER DE 33 AÑOS CON ANTICONCEPCIÓN ORAL Y CORONARIOPATÍA DILATADA / Rescue angioplasty in a 33-year old woman with oral contraception and dilated coronariopathy

    Directory of Open Access Journals (Sweden)

    Francisco L Moreno-Martínez

    2009-09-01

    Full Text Available Coronary angioplasty is recognized nowadays as the first-choice therapeutic strategy for acute coronary syndrome with ST-segment elevation. Atherosclerotic disease is still the main cause ofthis sickness; however, other disturbances, such is dilated coronariopathy, may favor this coronary event. Although some authors raise that atherosclerosis is the main cause of coronary dilation, it is uncommon that this lipid disorder promotes consequences early in life. We present the case of a 33-year-old female (oral contraceptive user - etinor who had not any apparent coronary risk factor but suffered from inferior acute myocardial infarction. The thrombolysis failed, and fortunately we could perform the angioplasty. Intracoronary thrombosis with distal embolism occurred, that waswhy we administered streptokinase. Possible mechanisms that involve oral contraceptives and dilated coronariopathy are discussed, and angiographic images are shown.

  9. Ballon angioplasty and stenting for acute ischemic stroke%急性缺血性卒中患者的球囊血管成形和支架置入术治疗

    Institute of Scientific and Technical Information of China (English)

    石明超; 王守春

    2009-01-01

    药物溶栓治疗急性缺血性卒中存在一定的局限性,球囊血管成形和支架置入术已成为急性缺血性卒中治疗的研究热点.文章综述了球囊血管成形和支架置入术治疗急性缺血性卒中的有效性和安全性.%Thrombolytic agents for the treatment of acute ischemic stroke have some limitations. Balloon angioplasty and stenting have become the research hotspot in the treatment of acute ischemic stroke. 1his article reviews the effectiveness and safety of balloon angioplasty and stenting in the treatment of acute ischemic stroke.

  10. [Percutaneous angioplasty of the left renal artery in a patient with acute infarction of the left kidney with persistent occlusion of the right renal artery treated with angiotensin converting enzyme inhibitor].

    Science.gov (United States)

    Latacz, Paweł; Rudnik, Andrzej; Gutowska, Aleksandra; Zając, Mariola; Kondys, Marek; Ludyga, Tomasz; Kazibudzki, Marek; Cierpka, Lech

    2011-01-01

    A case of a 67 year-old woman with acute renal syndrome during treatment of angiotensin converting enzyme is presented. In angiography was affirmed acute occlusion left renal artery (LRA) with chronic occlusion right renal artery. Percutaneous angioplasty with implantation stent of the LRA were performed with optimal effect. In this article, the clinical management of patients with angiographically documented acute occlusion renal artery is discussed.

  11. 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...

  12. Endovascular gamma-irradiation for prevention of restenosis after angioplasty of femoropopliteal de-novo-stenoses. Long-term results of a feasibility study; Die endovaskulaere {gamma}-Bestrahlung zur Praevention der Restenose nach Perkutaner Transluminaler Angioplastie von de-novo-Stenosen femoropoplitealer Arterien. Langzeitergebnisse einer Pilotstudie

    Energy Technology Data Exchange (ETDEWEB)

    Krueger, K.; Zaehringer, M.; Schulte, O.; Lackner, K. [Inst. und Poliklinik fuer Radiologische Diagnostik, Univ. zu Koeln (Germany); Bendel, M.; Bongartz, R.; Nolte, M. [Klinik und Poliklinik fuer Strahlentherapie, Univ. zu Koeln (Germany)

    2002-03-01

    Objectives: To evaluate the performance and efficacy of endovascular irradiation after percutaneous transluminal angioplasty (PTA) of de-novo femoropopliteal stenoses in a pilot study. Methods: 6 patients received non-centered endovascular irradiation (12 Gray at surface of the vessel wall) immediately after angioplasty of de-novo femoropopliteal stenosis, 1 patient was given centered endovascular irradiation using 192-iridium (12 Gray at surface of the vessel wall) Centered irradiation was considered for two other patients. Duplex sonographies and interviews were performed the day before and after PTA and after 1, 3, 6, 9, 12, 18, 24 months up to 4 years. Intraarterial angiography was performed in symptomatic patients. Results: Non-centered endovascular irradiation was possible in all patiens without problems or complications. Centered irradiation was not possible in two patients with the cross-over approach. One thromboembolic complication occurred during centered irradiation. Both restenosis and new stenosis at the edge of irradiated distance occurred in 1/7 patiens. No other side effects were observed during follow-up. Conclusions: In our pilot study endovascular irradiation after angioplasty of de-novo femoropopliteal stenosis was possible with low rates of complications and restenosis and taking vessel anatomy into account. (orig.) [German] Zielsetzung: Mit einer Pilotstudie sollten Probleme bei der Durchfuehrung sowie die Effektivitaet der endovaskulaeren Bestrahlung nach PTA von de-novo-Stenosen der Oberschenkelarterien untersucht werden. Methode: Bei 6 Patienten wurde unmittelbar nach PTA einer de-novo-Stenose der A. femoralis superficialis eine nicht-zentrierte, bei 1 Patienten eine zentrierte endovaskulaere gamma-Bestrahlung mit 192 Iridium durchgefuehrt. Die Strahlendosis betrug 12 Gray an der Intima. 2 weitere Patienten waren fuer eine zentrierte Bestrahlung vorgesehen. Im Follow-up erfolgten eine standardisierte Anamnese und eine farbkodierte

  13. 根面成形术在牙冠延长手术中的应用%Application of root angioplasty in crown lengthening surgery

    Institute of Scientific and Technical Information of China (English)

    刘丽静; 张雷; 龚连喜

    2016-01-01

    Objective To analyze the application of root angioplasty in the crown lengthening surgery. Methods A total of 80 patients that corresponding to criteria from January 2013 to December 2015 in repair outpatients of our hospital were selected and received retrospec-tive study,and they were randomly divided into the observation group and the control group according to different surgical methods with 40 ca-ses in each group. The observation group was given root angioplasty and crown lengthening surgery,while the control group was only given crown lengthening surgery. Check-up was performed at 6 weeks postoperatively and 3 weeks after restoration,the condition of root surface cov-ered by the gum,the condition of gingival recession of the restoration and the subjective satisfaction of the patients were observed. Results The average coverage of the observation group was 91. 3%,which was significantly more than 55. 3% of the control group (P<0. 05). The a-mount of the gum covering of the observation group was (3.1 ±1.3)mm,which was significantly larger than (1.9 ±1.0)mm of the control group(P<0. 05). Conclusion Root angioplasty can guarantee blood supply,reduce the damage,but the indication range is small,and it is influenced by many factors,and needs to incorporate the ideas of all sides when used in clinic.%目的:探讨根面成形术在牙冠延长手术中的应用效果。方法选择2013年1月至2015年12月在我院修复科就诊的符合要求的患者80例,根据手术方法的不同分成观察组和对照组,每组40例。观察组采用根面成形术和常规牙冠延长术,对照组仅行常规牙冠延长术。分别在术后第6周和修复后第3周进行复查,观察牙龈覆盖根面的情况,修复体边缘有无牙龈退缩和患者主观满意度。结果观察组平均覆盖率为91.3%,对照组平均覆盖率为55.3%,2组比较差异有统计学意义(P<0.05);观察组牙龈覆盖量为(3.1±1.3)mm,对照组牙龈覆盖量为(1.9±1.0)mm,2

  14. Eating behavior and nutritional status in patients who underwent coronary angioplasty La conducta alimentaria y estado nutricional en pacientes sometidos a angioplastia coronaria

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    L. Proença Vieira

    2012-02-01

    Full Text Available Introduction: The identification of stages of dietary change and the factors affecting food choices can direct more effective nutritional intervention against coronary heart disease progression. Objective: Identify the stages of change of eating behavior and its relation with nutritional status, food consumption and previous cardiovascular events in patients who underwent coronary angioplasty. Methods: A cross-sectional study with 200 hospitalized patients from a specialized cardiology hospital, after elective coronary angioplasty. They were applied an algorithm that identifies the provision of change of eating habits for a healthier pattern. Variables measured were stages of change of eating behavior, nutritional status, food consumption and cardiovascular events (previous myocardial infarction or angioplasty. It was realized comparison of averages by analysis of variance or Student´s test and Chi-square test for qualitative variables. Value of significance was taken at 5%. Results: The patients were classified in the following stages: 36% maintenance, 26% preparation, 17% precontemplation, 12% action and 9% contemplation. It was observed higher cardiovascular events in maintenance/action group (p = 0.04, higher consumption of calories (p = 0.04, meat/eggs (p = 0.01 and sweets (p = 0.03 in preparation stage, comparing to maintenance group, and no association between nutritional status and stages of change (p = 0.13, although 62% of the individuals in maintenance stage were overweight. Conclusions: This work contributed to identifying the stages of change and conditions that favor changes in eating pattern. Even patients that classified themselves into the maintenance stage need to adjust their eating habits in order to reach a healthy weight.Introducción: La identificación de las etapas de cambio en la dieta y los factores que afectan la elección de alimentos puede dirigir una intervención nutricional más eficaz contra la progresión de

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

    International Nuclear Information System (INIS)

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

  16. Influence of inflation pressure and balloon size on the development of intimal hyperplasia after balloon angioplasty. A study in the atherosclerotic rabbit.

    Science.gov (United States)

    Sarembock, I J; LaVeau, P J; Sigal, S L; Timms, I; Sussman, J; Haudenschild, C; Ezekowitz, M D

    1989-10-01

    To evaluate the effect of balloon size and inflation pressure on acute and subsequent outcome following balloon angioplasty (BA), 70 New Zealand White rabbits with bilateral femoral atherosclerosis were assigned to four groups: group 1, oversized balloon, low inflation pressure (n = 35 vessels; balloon size, 3.0 mm/inflation pressure, 5 atm); group 2, oversized balloon, high inflation pressure (n = 36; 3.0 mm/10 atm); group 3, appropriate size, low inflation pressure (n = 17; 2.5 mm/5 atm); and group 4, appropriate size balloon, high inflation pressure (n = 19; 2.5 mm/10 atm). Angiograms were obtained before, 10 minutes after, and 28 days after BA and read by two blinded observers using electronic calipers. The in vivo balloon-to-vessel ratio was measured for each group. There were eight non-BA controls. Rabbits were sacrificed either immediately (n = 34) or at 28 days after BA (n = 36), with the femoral vessels pressure perfused for histologic and morphometric analysis. The latter was performed at 28 days only. Absolute angiographic diameters increased in all groups immediately after BA (p less than 0.01). Acute angiographic success, defined as greater than 20% increase in luminal diameter, was higher using high inflation pressure (group 2, 32/36 [89%] and group 4, 16/19 [84%] vs. group 1, 23/35 [66%] and group 3, 9/17 [53%]; p less than 0.05). A 3.0-mm balloon resulted in significant oversizing irrespective of inflation pressure (balloon-to-vessel ratio, 1.5 +/- 0.1 vs. 1.1 +/- 0.1 to 1, for the 2.5-mm balloon). Vessels exposed to high inflation pressure had a significantly higher incidence of mural thrombus, dissection (p less than 0.01), and medial necrosis versus low pressure (p less than 0.05). At 28 days, the rates of restenosis (defined as greater than 50% loss of initial gain) were 14/20 (70%), 11/16 (69%), 5/10 (50%), and 5/10 (50%) for groups 1 through 4 (p = NS; a trend in favor of the groups using an oversized balloon). There was an increase in the

  17. Application of bidirectional subintimal angioplasty in atherosclerotic occlusion of lower extremities%双向内膜下血管成形术在治疗下肢动脉闭塞症中的应用

    Institute of Scientific and Technical Information of China (English)

    路军良; 李京雨; 张强; 徐力扬; 刘涛

    2009-01-01

    Objective To discuss the therapeutic efficacy of bidirectional subintimal angioplasty in the treatment of atherosclerotic occlusive of lower limbs. Methods Five patients with long segment of obstructed artery in lower limb were enrolled in the study. Of five patients, occlusion of the lower segment of abdominal aorta and bilateral iliac artery was seen in one, occlusion of iliac artery in 2 and occlusion of superficial femoral artery in the remaining two. Antegrade subintimal angioplasty procedure was unsuccessful in all five patients as the wire could not be placed into the true lumen, so retrograde subintimal angioplasty by puncturing the distal segment of the occlusive artery was employed. Through the newly created channel the retrograde guide wire was manipulated to be pulled out of vessel through the antegrade catheter. The subintimal tract was dilated with angioplasty balloon and the stent implantation was performed. Results Bidirectional subintimal angioplasty was successfully accomplished in all five patients, with a total of nine stents being implanted. Conclusion Bidirectional subintimal angioplasty is a safe and effective procedure for bringing the subintimal recanalization to success, this technique can be regarded as a remedial measure when unidirectional subintimal angioplasty ends up in failure.%目的 探讨双向内膜下血管成形术在治疗周围动脉完全闭塞性病变中的意义.方法 采用双向内膜下血管成形术治疗5例长段动脉闭塞患者,其中腹主动脉下端合并两侧髂总动脉及髂外动脉闭塞1例,髂外动脉闭塞2例,股浅动脉闭塞2例.在单向内膜下再通时,进人真腔失败后而在患肢闭塞动脉远端血管穿刺,使用导丝从病变对侧进入闭塞段内膜下,在病变内膜下腔,采用导丝贯穿至对侧导管技术,成功后,将导丝从对侧导管引出体外,然后用球囊扩张成型并植入支架.结果 本组5例患者均成功完成双向

  18. Comparison of Immediate and 2-Year Outcomes between Excimer Laser-Assisted Angioplasty with Spot Stent and Primary Stenting in Intermediate to Long Femoropopliteal Disease

    Directory of Open Access Journals (Sweden)

    Tien-Yu Wu

    2013-01-01

    Full Text Available Background. To compare the clinical outcomes between excimer laser-assisted angioplasty (ELA with spot stent (group A and primary stenting (group B in intermediate to long femoropopliteal disease. Methods. Outcomes of 105 patients totaling 119 legs treated with two different strategies were analyzed retrospectively in a prospectively maintained database. Results. Baseline characteristics were similar in both groups. Better angiographic results and lesser increase of serum C-reactive protein levels (0.60 ± 0.72 versus 2.98 ± 0.97 mg/dL, P<0.001 after the intervention were obtained in Group B. Group A had inferior 1-year outcomes due to higher rate of binary restenosis (67% versus 32%, P=0.001 and lower rate of primary patency (40% versus 58%, P=0.039. Rates of amputation-free survival, target vessel revascularization, assisted primary patency, and stent fracture at 24 months were similar in both groups (80% versus 82%, P=0.979, 65% versus 45%, P=0.11, 78% versus 80%, P=0.75 and 6.3% versus 6.8%, P=0.71, resp.. Conclusion. Greater vascular inflammation after ELA with spot stent resulted in earlier restenosis and inferior 1-year clinical outcomes than primary stenting. This benefit was lost in the primary stenting group at 2 years due to late catch-up restenosis. Active surveillance with prompt intervention was required to maintain the vessel patency.

  19. 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

  20. 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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    Bo Liu; Zhiwei Li; Peng Xie

    2014-01-01

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

  3. 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. 

  4. Selective ablation of WHHLMI rabbit atherosclerotic plaque by quantum cascade laser in the 5.7 μm wavelength range for less-invasive laser angioplasty

    Science.gov (United States)

    Hashimura, Keisuke; Ishii, Katsunori; Akikusa, Naota; Edamura, Tadataka; Yoshida, Harumasa; Awazu, Kunio

    2013-06-01

    We investigated the potential of a compact and high-power quantum cascade laser (QCL) in the 5.7 μm wavelength range for less-invasive laser angioplasty. Atherosclerotic plaques consist mainly of cholesteryl esters. Radiation at a wavelength of 5.75 μm is strongly absorbed in C=O stretching vibration mode of cholesteryl esters. Our previous study achieved to make cutting differences between a normal artery and an atherosclerotic lesions using nanosecond pulsed laser by difference-frequency generation (DFG laser) at the wavelength of 5.75 μm. For applying this technique to clinical treatment, a compact laser device is required. In this study, QCL irradiation effects to a porcine normal aorta were compared with DFG laser. Subsequently, QCL irradiation effects on an atherosclerotic aorta of myocardial infarction-prone Watanabe heritable hyperlipidemic rabbit (WHHLMI rabbit) and a normal rabbit aorta were observed. As a result, the QCL could make cutting differences between the rabbit atherosclerotic and normal aortas. On the other hand, the QCL induced more thermal damage to porcine normal aorta than the DFG laser at the irradiation condition of comparable ablation depths. In conclusion, the possibility of less-invasive and selective treatment of atherosclerotic plaques using the QCL in the 5.7 μm wavelength range was revealed, although improvement of QCL was required to prevent the thermal damage of a normal artery.

  5. Elevated Neutrophil-to-Lymphocyte Ratio Predicts Intermediate-Term Outcomes in Patients Who Have Advanced Chronic Kidney Disease with Peripheral Artery Disease Receiving Percutaneous Transluminal Angioplasty

    Science.gov (United States)

    Chen, I-Chih; Yu, Chao-Chin; Wu, Yi-Hsuan; Chao, Ting-Hsing

    2016-01-01

    Background Inflammation plays an important role in the pathogenesis of cardiovascular disease in patients with advanced chronic kidney disease (CKD). Neutrophil-to-lymphocyte ratio (NLR), an inflammatory biomarker, has not been evaluated in patients who have advanced CKD with peripheral artery disease (PAD) undergoing percutaneous transluminal angioplasty (PTA), especially in Taiwan. Methods We retrospectively evaluated 148 advanced CKD (creatinine clearance rate ≤ 30 mL/min/1.73 m2) identified from a prospective registry in our hospital (303 PTA cases in total). Kaplan-Meier analysis with log-rank test was used to study event-free survival, and all univariables (p value Rutherford grade 6, either NLR or NLR ≥ 3.76, and a history of hypertension had a positively prognostic impact on the occurrence of primary composite endpoint, whereas higher albumin level (≥ 3.0 mg/dL) and technical success had a significantly protective effect. History of hypertension, either NLR or NLR ≥ 3.76, and age were associated with all-cause mortality. In addition, Rutherford 6, higher albumin level (≥ 3.0 mg/dL), technical success, NLR, and age could predict the occurrence of major amputation. Conclusions NLR, but not C-reactive protein or platelet-lymphocyte ratio, is an important prognostic predictor of all major clinical outcomes in patients with advanced CKD and PAD receiving PTA. Further studies are warranted to establish a better strategy and healthcare program in this clinical setting. PMID:27713601

  6. Differential effects of Nd-YAG laser on collagen and elastin production by chick embryo aortae in vitro. Relevance to laser angioplasty for removal of atherosclerotic plaques

    Energy Technology Data Exchange (ETDEWEB)

    Abergel, R.P.; Zaragoza, E.J.; Dwyer, R.M.; Uitto, J.

    1985-08-30

    Aortae from 17-day old chick embryos were subjected to irradiation with a Nd:YAG laser at energy densities varying from 1.2 - 4.7 X 10(3) J/cm2. The aortae were pulse-labeled in vitro with (/sup 3/H)proline or (/sup 14/C)valine, and the synthesis of collagenous polypeptides and soluble elastin was examined by SDS-polyacrylamide gel electrophoresis, followed by fluorography and quantitative scanning densitometry. Irradiation of the aortae with Nd:YAG laser resulted in inhibition of the synthesis of the extracellular matrix proteins. The production of collagen was inhibited to a considerably larger degree than the production of elastin. Thus, the biosynthetic pathway for collagen production appears to be more susceptible to laser inhibition than the corresponding pathway for elastin production. These observations may have relevance to laser angioplasty which has been proposed to be applicable for removal of atherosclerotic plaques in human vessels. Specifically, the results suggest that inhibition of the extracellular matrix production may result in weakening of the vessel wall with subsequent aneurysm formation and rupture.

  7. QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFUL TRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED LESCOL XL (FLUVASTATIN ADDED TO STANDARD THERAPY. RESULTS OF THE LESQOL OPEN-LABEL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2010-01-01

    Full Text Available Aim. The main aim of the present study was to evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who were prescribed fluvastatin extended release in addition to standard treatment.Material and methods. This was a national prospective multicenter observational study. Patients with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatin extended release (Lescol Forte, Novartis 80 mg QD were included in the present observation. The following efficacy and safety parameters were evaluated: quality of life evaluated with SF-36 scale before and during treatment; hypolipidemic efficacy, compliance to therapy; adverse events and serious adverse events. Observation period was 6 months in all patients and 12 months in some patients at the discretion of the investigator.Results. 524 patients (79% men and 21% women completed the 6 months observation period and 116 patients were followed up for 12 months. Significant increase of all measures of SF-36 scales, physical and mental health was observed in 6 and 12 months of fluvastatin extended release treatment. Total and low density lipoprotein cholesterol reduction was 30.5% and 54.9% respectively, p<0.01, in 6 months and 34.2% and 34.3% respectively in 12 months of treatment, p<0.01. High density lipoprotein cholesterol was significantly increased by 22.5% in 12 months of treatment, p<0.01. There were very few adverse events and laboratory changes during the course of treatment.Conclusion. LESQOL study showed significant increase in quality of life and good hypolipidemic efficacy as well as good tolerability of fluvastatin extended release in patients after coronary angioplasty.

  8. 冠状动脉内放射治疗防止血管成形术后再狭窄的研究进展%Endocoronary radiation for the prevention of restenosis after angioplasty

    Institute of Scientific and Technical Information of China (English)

    曾勇; 朱文玲

    2001-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) is a very effective approach to treat coronary artery disease.However,restenosis after PTCA affects 40% to 60% of patients in the months after an initially successful intervention.Although a number of new techniques and pharmacological approaches have been tried to reduce the rate of restenosis,only a few have shown even preliminary efficacy.Radiation therapy seems to provide an interesting,nonpharmacological approach to prevent the restenosis after PTCA during recent years.The experiments and clinical data of this new approach are reviewed in this paper.

  9. Endothelin Receptor Antagonist and the Prevention of Percutaneous Transluminal Coronary Angioplasty Restenosis%内皮素受体抗体与PTCA术后再狭窄的防治

    Institute of Scientific and Technical Information of China (English)

    陆平; 盛净

    2004-01-01

    经皮腔内冠状动脉成形术(percutaneous transluminal coronary angioplasty,PTCA)已广泛应用于冠心病的治疗.但是术后再狭窄限制其发展.再狭窄的发生常伴随内皮素(endothelin,ET)和其受体表达增多,抑制ET受体可以减轻再狭窄的发生.本文阐述内皮素受体抗体与PTCA术后再狭窄的关系.

  10. 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.

  11. The Effect of Short-term Intra-arterial Delivery of Paclitaxel on Neointimal Hyperplasia and the Local Thrombotic Environment after Angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Yajun, E, E-mail: eyj7681@yahoo.com.cn [Affiliated Hospital of Hebei University, Department of Interventional Radiology (China); He Nengshu, E-mail: eyajun@hotmail.com; Fan Hailun, E-mail: mydream510@yahoo.com.cn [Tianjin Institute of Radiology, General Hospital of Tianjin Medical University, Department of Radiology (China)

    2013-08-01

    PurposeTo evaluate the effects of short-term intra-arterial delivery of paclitaxel on neointimal hyperplasia and the local thrombotic environment after angioplasty.MethodsAn experimental common carotid artery injury model was established in 60 rats, which were divided into experimental groups (40 rats) and controls (20 rats). Local intra-arterial administration of paclitaxel was applied at 2 doses (90 and 180 {mu}g/30 {mu}l), and the effects of short-term delivery of paclitaxel on neointimal hyperplasia and the expression of tissue factor (TF), plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) were evaluated at days 15 and 30 by hematoxylin and eosin staining and immunohistochemistry.ResultsAt 15 and 30 days after injury, neointimal thickness and area, the ratio of intimal area to medial area and the stenotic rate were all significantly decreased in the group provided the high concentrations (180 {mu}g/30 {mu}l) of paclitaxel for 2 min or 10 min and in the group provided the low concentration (90 {mu}g/30 {mu}l) of paclitaxel for 10 min (p < 0.05). At 30 days after injury, there were no significant changes in TF expression among all experimental groups. PAI-1 expression increased in the neointima of the high concentration 10 min group (p < 0.05), while t-PA expression decreased in the neointima of the high concentration 2 min group (p < 0.05).ConclusionIn the rat common carotid artery injury model, the short-term delivery of paclitaxel could effectively inhibit neointimal hyperplasia in the long term, with very little influence on the local expression of TF and PAI-1.

  12. 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.

  13. Percutaneous transluminal angioplasty and stenting for severe stenosis of the intracranial extradural internal carotid artery causing transient ischemic attack or minor stroke.

    Science.gov (United States)

    Ko, Jun Kyeung; Choi, Chang Hwa; Cha, Seung Heon; Choi, Byung Kwan; Cho, Won Ho; Kang, Tae Ho; Sung, Sang Min; Cho, Han Jin; Lee, Tae Hong

    2015-08-01

    The purpose of this study is to assess the technical feasibility and clinical efficacy of percutaneous transluminal angioplasty and stenting (PTAS) for symptomatic stenosis of the intracranial extradural (petrous and cavernous) internal carotid artery (ICA).Review of medical records identified 26 consecutive patients who underwent PTAS using a balloon-expandable coronary stent (n = 15, 57.7%) or a Wingspan self-expandable stent (n = 11, 42.3%) for treatment of severe stenosis (>70%) involving the intracranial extradural ICA. The inclusion criteria were transient ischemic attack with an ABCD(2) score of ≥3 (n = 12, 46.2%) or minor stroke with an NIHSS score of ≤4 (n = 14, 53.8%). Technical success rates, complications, and angiographic and clinical outcomes were analyzed retrospectively.PTAS was technically successful in all patients. The mean stenosis ratio decreased from 77.1% to 10.0% immediately after PTAS. The overall incidence of procedural complications was 23.1%, and the postoperative permanent morbidity/mortality rate was 7.7%. A total of 22 patients were tracked over an average period of 29.9 months. During the observation period, 20 patients (90.9%) had no further cerebrovascular events and stroke recurrence occurred in two patients (9.1%), resulting in an annual stroke risk of 3.7%. Two cases (11.1%) of significant in-stent restenosis (>50%) were found on follow-up angiography (n = 18).PTAS for severe stenosis (>70%) involving the intracranial extradural ICA showed a good technical feasibility and favorable clinical outcome in patients with transient ischemic attack or minor stroke.

  14. 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.

  15. 聚丙烯网片在鼻中隔成形术中的应用%Application of Polypropylene Mesh to Septoplasty Angioplasty

    Institute of Scientific and Technical Information of China (English)

    周卫; 肖才文; 李慧

    2012-01-01

    Objective: To Study effects of applying polypropylene mesh to septoplasty angioplasty.Methods: To choose 632 surgical patients with deviation of nasal septum,among which,448 patients were selected to use polypropylene mesh of proper size into the mucosa flap,61 patients were treated without any filling material,and 123 patients were backfilled with nasal septum cartilages.Results: Less patients using polypropylene mesh suffer from postoperative complications.They recover in a short period,and their nasal physiological function is properly protected.Conclusion: Polypropylene mesh is one of the reliable artificial substitute materials in mucosa flap of septoplasty.It can reduce the postoperative complications as nasal septum perforation,etc.And at the same time it can protect the physiological of nasal septum and nasal cavity.%目的:探讨聚丙烯网片在鼻中隔成形术中的应用效果。方法:选择632例鼻中隔偏曲的手术患者,其中448例术中选用大小适宜的聚丙烯网片置入鼻中隔术腔黏膜瓣中,61例未填放任何材料,123例行鼻中隔软骨回填。结果:填放聚丙烯网片的患者术后并发症少,恢复快,鼻腔生理功能得以保护。结论:聚丙烯网片可作为鼻中隔成形术中一种可靠的替代材料,可减少鼻中隔穿孔等术后并发症的发生和保护鼻中隔及鼻腔的生理功能。

  16. 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.

  17. Traços psicológicos dos pacientes submetidos a angioplastia transluminal coronária Psychological profile of patients that underwent coronary angioplasty

    Directory of Open Access Journals (Sweden)

    Lourdes Helena de Campos

    1990-12-01

    Full Text Available Este trabalho teve por objetivo a identificação de traços psicológicos e características emocionais comuns aos pacientes que foram, pela primeira vez, submetidos a angioplastia transluminal coronária (ATC, no Instituto Dante Pazzanese de Cardiologia. Foram analisados 84 pacientes, de ambros os sexos, com idade média de 55 anos. Foram realizadas, pela equipe de psicólogos, duas entrevistas semidirigidas, durante cada uma das quais foram aplicados o Inventário de Ansiedade Traço - Estado (IDATE e a Escala de Hamilton. Essas entrevistas foram realizadas imediatamente anterior à ATC e um dia após o procedimento, na alta dos pacientes. Os resultados permitiram-nos concluir que a grande maioria apresentou padrão comportamental tipo A, próprio do coronariano, alto estresse constitucional e ambiental e ansiedade - traço acima da média. Obtiveram alta porcentagem, também, as variáveis tensão, depressão, grau de competitividade e labilidade de humor.This paper presents psychological and emotional characteristics that were found common to patients that underwent a first coronary angioplasty at Instituto Dante Pazzanese de Cardiologia. We studied 84 patients of both sexes, with mean age of 55 years. Two semi-directed interviews were conducted by the psychology team, and during each of them the State-Trait - Anxiety Inventory STAI and the Hamilton Scale were applied. Such interviews were conducted immediately before PTCA and repeated one day after it, at patient's discharge. We concluded that most patients had a type A personality, typical of patients with coronary artey disease, high constitutional stress and anxiety-trace higher than the average population. There was also a high incidence of tension, depression, competitivity and humor lability.

  18. A new era of therapeutic strategies for chronic thromboembolic pulmonary hypertension by two different interventional therapies; pulmonary endarterectomy and percutaneous transluminal pulmonary angioplasty.

    Directory of Open Access Journals (Sweden)

    Takumi Inami

    Full Text Available BACKGROUND: Pulmonary endarterectomy (PEA is established for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH. Recently, percutaneous transluminal pulmonary angioplasty (PTPA has been added for peripheral-type CTEPH, whose lesions exist in segmental, subsegmental, and more distal pulmonary arteries. A shift in clinical practice of interventional therapies occurred in 2009 (first mainly PEA, later PTPA. We examined the latest clinical outcomes of patients with CTEPH. METHODS AND RESULTS: This study retrospectively included 136 patients with CTEPH. Twenty-nine were treated only with drug (Drug-group, and the other 107 underwent interventional therapies (Interventions-group (39 underwent PEA [PEA-group] and 68 underwent PTPA [PTPA-group]. Total 213 PTPA sessions (failures, 0%; mortality rate, 1.47% was performed in the PTPA-group (complications: reperfusion pulmonary edema, 7.0%; hemosputum or hemoptysis, 5.6%; vessel dissection, 2.3%; wiring perforation, 0.9%. Although baseline hemodynamic parameters were significantly more severe in the Interventions-group, the outcome after the diagnosis was much better in the Interventions-group than in the Drug-group (98% vs. 64% 5-year survival, p<0.0001. Hemodynamic improvement in the PEA-group was a 46% decrease in mean pulmonary arterial pressure (PAP and a 49% decrease in total pulmonary resistance (TPR (follow-up period; 74.7 ± 32.3 months, while those in the PTPA-group were a 40% decrease in mean PAP and a 49% decrease in TPR (follow-up period; 17.4 ± 9.3 months. The 2-year survival rate in the Drug-group was 82.0%, and the 2-year survival rate, occurrence of right heart failure, and re-vascularization rate in the PEA-group were 97.4%, 2.6%, and 2.8%, and those in the PTPA-group were 98.5%, 2.9%, and 2.9%, respectively. CONCLUSION: The patients who underwent interventional therapies had better results than those treated only with drugs. The availability of both of these operative

  19. Does endovascular treatment of infra-inguinal arterial disease with drug-eluting stents offer better results than angioplasty with or without bare metal stents?

    Science.gov (United States)

    Antoniou, George A; Georgakarakos, Efstratios I; Antoniou, Stavros A; Georgiadis, George S

    2014-08-01

    A best evidence topic in vascular and endovascular surgery was developed according to a structured protocol. The question addressed was whether treatment of infra-inguinal arterial occlusive disease with drug-eluting stents (DESs) provides improved outcomes compared with bare metal stents (BMSs) or percutaneous balloon angioplasty (PTA) alone. Altogether, 136 papers were found using the reported searches, of which 5 provided the best evidence to answer the question. All papers represent either level 1 or 2 evidence. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Main outcome measures varied among the studies, and included patency, in-stent restenosis, target lesion revascularization, major adverse events, clinical improvement and limb salvage. Evidence on the comparative efficacy of DESs in femoro-popliteal arterial disease is mainly based on two randomized, controlled trials. Paclitaxel-eluting stents were evaluated in the Zilver PTX trial and demonstrated superior 2-year results to either BMSs or PTA, as indicated/shown by patency (DES vs PTA, 74.8 vs 26.5%, P < 0.01), clinical benefit (DES vs PTA, P < 0.01) and event-free survival (DES vs PTA, 86.6 vs 77.9%, P = 0.02). However, the SIROCCO trial found that the sirolimus-eluting stent did not exhibit statistically significant differences in 2-year in-stent restenosis (22.9 vs 21.1%) and target lesion revascularization (6 vs 13%) compared with the BMS. Treatment of infra-politeal arterial disease with DESs was related with superior outcomes to those of BMSs, as indicated/shown by patency, freedom from target lesion revascularization and freedom from major adverse events. Furthermore, the ACHILLES trial, the only published trial comparing the infra-popliteal DES with PTA, revealed lower angiographic restenosis (22.4 vs 41.9%, P = 0.019) and greater vessel patency (75 vs 57.1%, P = 0.025) in the DES group at 1 year

  20. Collagen thermal denaturation study for thermal angioplasty based on modified kinetic model: relation between the artery mechanical properties and collagen denaturation rate

    Science.gov (United States)

    Shimazaki, N.; Hayashi, T.; Kunio, M.; Arai, T.

    2010-02-01

    We have been developing the novel short-term heating angioplasty in which sufficient artery lumen-dilatation was attained with thermal softening of collagen fiber in artery wall. In the present study, we investigated on the relation between the mechanical properties of heated artery and thermal denaturation fractures of arterial collagen in ex vivo. We employed Lumry-Eyring model to estimate temperature- and time-dependent thermal denaturation fractures of arterial collagen fiber during heating. We made a kinetic model of arterial collagen thermal denaturation by adjustment of K and k in this model, those were the equilibrium constant of reversible denaturation and the rate constant of irreversible denaturation. Meanwhile we demonstrated that the change of reduced scattering coefficient of whole artery wall during heating reflected the reversible denaturation of the collagen in artery wall. Based on this phenomenon, the K was determined experimentally by backscattered light intensity measurement (at 633nm) of extracted porcine carotid artery during temperature elevation and descending (25°C-->80°C-->25°C). We employed the value of according to our earlier report in which the time-and temperature- dependent irreversible denaturation amount of the artery collagen fiber that was assessed by the artery birefringence. Then, the time- and temperature- dependent reversible (irreversible) denaturation fraction defined as the reversible ((irreversible) denatured collagen amount) / (total collagen amount) was calculated by the model. Thermo-mechanical analysis of artery wall was performed to compare the arterial mechanical behaviors (softening, shrinkage) during heating with the calculated denaturation fraction with the model. In any artery temperature condition in 70-80°, the irreversible denaturation fraction at which the artery thermal shrinkage started was estimated to be around 20%. On the other hand, the calculated irreversible denaturation fraction remained below

  1. 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

  2. PTCA后再狭窄的中医药防治研究进展%Progression on prevention & treatment of coronary artery restenosis following percutaneous transluminal coronary angioplasty by using traditional Chinese medicine

    Institute of Scientific and Technical Information of China (English)

    方平; 王发渭

    2004-01-01

    经皮腔内冠状动脉成形术(Percutaneous transluminal coronary angioplasty,PTCA)由Gmentzing等人于1977年发明至今,已作为有效治疗冠心病的一种方法广泛应用于临床。随着临床经验的不断积累及手术装置的不断改善,成为心血管疾病介入治疗的主要手段之一。但此后20余年间,术后再狭窄的高发病率(据报道达30%-50%)一直是困扰西

  3. 腔内血管成形术治疗髂动脉长段慢性完全闭塞性病变%Endovascular angioplasty for the treatment of long iliac artery chronic total occlusions

    Institute of Scientific and Technical Information of China (English)

    叶开创; 施慧华; 刘光; 蒋米尔; 殷敏毅; 陆信武; 李维敏; 黄英; 黄新天; 陆民; 刘晓兵; 赵海光

    2011-01-01

    目的 评价腔内血管成形术治疗髂动脉长段慢性完全闭塞性病变(CTO)的可行性、有效性及安全性.方法 回顾性分析2006年1月至2010年12月经腔内血管成形术治疗的病变长度>5 cm的髂动脉CTO患者139例(157条患肢)的临床资料.其中男性93例(105条患肢),女性46例(52条患肢);年龄50 ~96岁,平均年龄(77±10)岁.TASCⅡ分型:B型18例,C型89例,D型32例.采用左肱动脉和(或)股动脉穿刺经内膜下或血管内行髂动脉闭塞的球囊血管成形联合支架植入术治疗.结果 技术成功率96.2% (151/157).踝肱指数由术前的0.42±0.19上升到术后的0.81±0.26.随访6~53个月,平均随访(30±7)个月,髂动脉支架畅通率94.1% (111/118),7例发生支架内再狭窄或闭塞,无髂动脉破裂、支架移位、穿刺动脉假性动脉瘤及动静脉瘘的发生.结论 腔内血管成形术治疗髂动脉长段CTO安全、有效,术后支架通畅率高,联合肱动脉和股动脉双向穿刺技术能够显著提高技术成功率.%Objective To evaluate the effectiveness,safety and feasibility of endovascular angioplasty in treating long iliac artery chronic total occlusions (CTO).Methods The clinical data from a consecutive series of patients with long ( > 5 cm) iliac artery CTO who treated by endovascular angioplasty from January 2006 to December 2010 was retrospectively analyzed.There were 139 patients ( 157 limbs) with long iliac artery CTO treated by endovascular angioplasty in this study [ male 93 and female 46,mean age (77 ± 10) years].According to TASC Ⅱ classification,there were 18 patients in type B,89 patients in type C and 32 patients in type D.Recanalization of the occluded lesions was attempted with the left brachial and/or femoral access.Results The ankle brachial index increased from 0.42 ± O.19 before treatment to 0.81 ±0.26 after treatment.The rate of technical success was 96.2% (151/157) and the patency rate of iliac artery was 94.1% (111

  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. Percutaneous angioplasty used to manage native and recurrent coarctation of the aorta in infants younger than 1 year: immediate and midterm results.

    Science.gov (United States)

    Adjagba, Philippe Mahouna; Hanna, Baher; Miró, Joaquim; Dancea, Adrian; Poirier, Nancy; Vobecky, Suzanne; Déry, Julie; Lapierre, Chantale; Dahdah, Nagib

    2014-10-01

    Balloon angioplasty (BAP) used to manage native coarctation of the aorta (CoAo) in infants remains controversial. This study aimed to compare short- and midterm results of BAP between native CoAo (NaCo) and postsurgical recoarctations (ReCo) in infants younger than 1 year. This retrospective study compared the clinical, echocardiographic, hemodynamic, and angiographic data for infants who underwent BAP between July 2003 and September 2012. The 12 NaCo and 13 ReCo patients in this study underwent BAP at 4.61 ± 3.69 and 4.88 ± 3.07 months (p = 0.84) and weighed 5.49 ± 2.57 and 6.10 ± 2.11 kg (p = 0.52), respectively. Their respective heights were 60.58 ± 10.58 and 61.15 ± 6.74 cm (p = 0.87). All the ReCo patients had their initial surgery before the age of 3 months. The minimal CoAo diameter was 2.81 ± 0.96 mm in the NaCo group and 2.86 ± 1.0 mm in the ReCo group (p = 0.90). The relative gradient reduction was 62.79 ± 32.43 % in the NaCo group and 73.37 ± 20.78 % in the ReCo group (p = 0.33). The in situ complication rate (pseudoaneurysm) was 8.33 % in the NaCo group and 7.69 % in the ReCo group (p = 0.74). During the early follow-up evaluation, five NaCo patients (41.66 %) presented with recoarctation requiring BAP reintervention within 1.75 ± 1.41 months (all had their initial BAP before 3 months of age) compared with 1 ReCo patient (7.69 %) (p = 0.165). The mean follow-up period was 3.09 ± 2.69 years for the NaCo patients and 3.6 ± 3.18 years for the ReCo patients (p = 0.69), during which the blood pressure gradient was 12.33 ± 9.67 for the NaCo patients and 7.80 ± 8.78 for the ReCo patients (p = 0.17), with corresponding Doppler peak instantaneous gradients of 21.29 ± 11.19 and 16.20 ± 10.23 (p = 0.24). The resultant diameter ratio between the minimal isthmus diameter and the aortic diameter at the diaphragmatic level was 0.81 ± 0.15 in the NaCo group and 0.85 ± 0.12 in the ReCo group (p = 0.53). The immediate and midterm results of BAP for the

  6. Routine Early Angioplasty after Fibrinolysis

    DEFF Research Database (Denmark)

    Wang, Zhipeng; Liang, Bo; Mei, Qibing

    2009-01-01

    ,2 and clopidogrel has become part of the standard management of ST-segment elevation myocardial infarction. The benefit of beta-blockade — a reduction in ischemic complications — is also significant among patients with myocardial infarction, even when the possibility of an excess rate of cardiogenic shock...

  7. 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 ...

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

    Directory of Open Access Journals (Sweden)

    João Luiz de Lara Elesbão

    2010-06-01

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

  9. Reporting standards for angioplnsty and stent-assisted angioplasty for intracraniai atherosclerosis%血管成形术和支架辅助血管成形术治疗颅内动脉粥样硬化的报告标准(下)

    Institute of Scientific and Technical Information of China (English)

    Schumacher HC; 曹亦斌; Meyers PM; Higashida RT; Derdeyn CP; Lavine SD; Nesbit GM; Sacks D; Rasmussen P; Wechsler LR

    2010-01-01

    @@ 编者按:本刊经Philip M. Meyers博士代表写作组授权,将"Reporting standards for angioplasty and stent-assisted angioplasty for intracranial atherosclerosis"译为中文在本刊刊登.标准中对患者的选择、颅内动脉狭窄程度的判断、最佳内科治疗、围手术期处理、血管内治疗、术后并发症等,进行了规范化总结,拟为今后的临床试验和研究的规范化确定标准,以保证结果的可比性,对神经介入医师具有重要的指导意义.

  10. 激光泪道成形术联合抗代谢药物治疗复发性泪道阻塞疗效分析%Clinical observation of lacrimal laser angioplasty combined with anti-metabolism drug treatment for recurrent lacrimal duct obstruction

    Institute of Scientific and Technical Information of China (English)

    李强; 曹东; 杨兴旺; 李博; 高雪辉

    2010-01-01

    目的 观察分析激光泪道成形术联合抗代谢药物治疗复发性泪道阻塞的疗效.方法 对101 例激光泪道成形术后复发病例实施激光泪道成形术联合抗代谢药物治疗.结果 术后随访观察3月,治愈85只眼,占84.2%;好转11只眼,占10.9%,总有效率95%.失败5只眼,占4.9%.结论 激光泪道成形术联合抗代谢药物治疗复发性泪道阻塞效果肯定,并发症少,值得推广.%Objective To observe and analyze the results of lacrimal laser angioplasty combined with antimetabolites in the treatment of recurrgnt lacrimal duct obstruction.Methods One hundred and one recurrent lacrimal laser angioplasty cases were implemented lacrimal laser angioplasty combined with anti-metabolism drug treatment.Results Postoperative follow-up time were three months,of which 85 cured,accounted for 84.2%;11 improvement;accounted for 10.9%,the total effective rate was 95%:5 failed,accounted for 4.9%.Conclusions Lacrimal laser angioplasty combined with anti-metabolism drug treatment is effective for treatment of recurrent lacrimal duct obstruction and has few complications,it is worth promoting.

  11. Subintimal angioplasty true lumen re-entry technology in the treatment of lower limb atherosclerosis obliterans%下肢动脉硬化闭塞症内膜下成形术中再入真腔技术的进展

    Institute of Scientific and Technical Information of China (English)

    周承校; 胡何节

    2012-01-01

    内膜下成形术近年来广泛应用于下肢动脉硬化闭塞症的介入治疗中,再入真腔技术是内膜下成形术的关键.本文综述了超声、同期双向内膜下血管成形术、导管系统等新兴技术在内膜下成形术中再入真腔技术的应用及各类技术的优缺点.%Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

  12. 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

  13. The effect of postoperative analgesia of flurbiprofen for percutaneous vertebral angioplasty in preemptive analgesia%氟比洛酚酯超前镇痛用于经皮椎体成形术术后镇痛的效果

    Institute of Scientific and Technical Information of China (English)

    崔鸿飞

    2011-01-01

    目的 观察氟比洛酚酯超前镇痛对经皮椎体成形术术后镇痛效果的影响.方法 选择ASAⅠ-Ⅱ级择期行经皮椎体成形术切除术患者40例,随机均分为氟比洛酚酯超前镇痛组和氟比洛酚酯术后镇痛组.超前镇痛组于手术前静注氟比洛酚酯50 mg;术后镇痛组于手术结束时静注氟比洛酚酯50 mg.用视觉模拟评分(VAS)评定术后0、1、4、8和12 h的疼痛程度及术后24 h总体镇痛评价.记录患者追加镇痛药和出现不良反应的情况.结果 术后24 h总体VAS评分B组为(1.8±0.6)分,与超前镇痛组的(3.2±0.8)差异有统计学意义(P<0.05).两组均未见明显不良反应.结论 氟比洛酚酯超前镇痛应用于经皮椎体成形术术后镇痛效果确切、使用方便、不良反应小.%Objective To observe the effect of postoperative analgesia of flurbiprofen for percutaneous vertebral angioplasty in preemptive analgesia. Methods 40 paifients with ASA Ⅰ - Ⅱ level elective through skin vertebral angioplasty resection patients were seleted and randomly divided into 40 cases, flurbiprofen preemptive analgesia group(group A), and flurbiprofen postoperative analgesia group (group B). Group A was administrated with 50mg flurbiprofen before operation through intravenous, and Group B was administrated with it in the end of operation. By visual analog scale(VAS) ,the score of postoperative 0,1,4,8 and 12h level of pain and postoperative analgesia 24h overall evaluation was assessed. And the additional analgesics and deelop aderse reactions of patients were recorded.Results After operation 24h overall VAS score of group B (1.8 + 0.6) points was above that of group A (3.2 +0. 8) points (P < 0.05). Both groups had no obvious adverse reactions. Conclusion Postoperative analgesia of flurbiprofen for pereutaneous vertebral angioplasty in preemptive analgesia had exact effect,convenience and less adverse reactions.

  14. Angioplastia carotídea com reversão do fluxo em octogenários: relato de caso Carotid angioplasty with flow reversion in octogenarians: a case report

    Directory of Open Access Journals (Sweden)

    Bernardo Massière

    2010-09-01

    Full Text Available Pacientes octogenários submetidos à angioplastia carotídea apresentam maior incidência de eventos neurológicos quando comparados a grupos de pacientes mais jovens e a grupos da mesma faixa etária submetidos à endarterectomia carotídea. A maior taxa de complicações pode ser explicada por fatores anatômicos e anatomopatológicos que aumentam a dificuldade técnica e o risco de ateroembolismo do procedimento endovascular. O procedimento foi realizado no centro cirúrgico, com o paciente em decúbito dorsal e sob anestesia geral. Realizamos acesso cirúrgico transverso limitado, na base do pescoço à direita, com dissecção, identificação e reparo da artéria carótida comum e veia jugular interna. Foram administradas 10.000 U de heparina e puncionada a carótida comum pela técnica de Seldinger com introdução de bainha 8F em sentido cranial. Na sequência, foi puncionada a veia jugular interna com instalação de bainha 8F em sentido caudal. Em seguida, ambas as bainhas foram conectadas, utilizando-se um segmento de equipo de soro. A carótida comum foi fechada por cadarço duplo de silicone e o fluxo retrógrado pela carótida interna foi estabelecido. Subsequentemente, foi introduzido fio guia 0.014 x 190 cm com cruzamento da lesão, realizando-se angioplastia com balão 5 x 20 mm e em seguida stent (Wallstent® 7 x 50 - Boston Scientific foi introduzido, posicionado e liberado. A angioplastia carotídea com reversão de fluxo, por via transcervical, constitui estratégia de proteção cerebral custo-eficiente e com menor potencial emboligênico em pacientes octogenários com anatomia desfavorável.Octogenarian patients submitted to carotid angioplasty present higher incidence of neurological events when compared to younger patients and to patients in this same age submitted to carotid endarterectomy. The higher complication rate could be related to anatomic and anatomopathological factors that increase technical difficulties and

  15. 腘动脉的解剖学特点与腘动脉硬化闭塞的腔内治疗%The significance of anatomical features of popliteal artery in popliteal angioplasty

    Institute of Scientific and Technical Information of China (English)

    蒋俊豪; 陈斌; 董智慧; 石贇

    2014-01-01

    目的 明确腘动脉分区的解剖学意义,探讨腘动脉的解剖学特征对腘动脉硬化闭塞性病变腔内治疗的指导意义.方法 选择自2011年8月至2013年7月我院血管外科收治的部分股腘动脉硬化闭塞症113例共118条肢体.在行腔内治疗时于病变开通前对腘动脉行屈膝位造影,观察腘动脉的弯曲形态,弯曲拐点的部位,分析其与腘动脉分区的关系;对行腘动脉支架治疗的病例于治疗后再行屈膝位造影观察弯曲形态和血流动力学的变化.结果 腘动脉存在多种弯曲形态,75.4%的弯曲拐点位于P2区,18.6%位于P1区,6.0%位于P3区.73例行腘动脉支架治疗的病例中,10例在治疗后发生腘动脉弯曲程度变化,6例发生远端血管扭曲.血管扭曲现象均出现于跨弯曲部支架治疗的病例中,其中5例在屈膝位出现血流动力学变化.结论 通过屈膝位造影能够更好地理解腘动脉分区的解剖学意义并了解腘动脉的弯曲形态,有助于提高位于不同分区内的腘动脉硬化闭塞性病变腔内治疗的合理性.%Objective To define the significance of the anatomical division and features of popliteal artery in popliteal angioplasty.Methods This study involved 118 lower limbs in 113 cases of femoropoliteal occlusive disease undergoing angioplasty in our center between August 2011 and July 2013.A bent-knee angiogram was taken before recanalization of the lesion.The flexion pattern and the location of flexion points of popliteal artery were collected to study their relationship with the division of popliteal artery.A post-procedural bent-knee angiogram was taken in case of popliteal stenting to assess any change in flexion angulation and distal flow.Results There are diverse flexion patterns in popliteal artery,75.4% of the flexion points locate in P2 segment,18.6% in P1,and 6.0% in P3.On post-procedural bent-knee angiogram in 73 cases of popliteal stenting,10 had a more acute distal

  16. 胫腓动脉血管成形术治疗下肢严重缺血35例%Percutaneous transluminal angioplasty of tibioperoneal arteries for severe limb ischemia

    Institute of Scientific and Technical Information of China (English)

    陆信武; 李维敏; 陆民; 黄新天; 刘晓兵; 殷敏毅; 赵海光; 蒋米尔

    2008-01-01

    Objective The purpose of this study was to assess the technical feasibility, safety and effectiveness of percutaneous transluminal angioplasty (PTA)for the treatment of severe limb ischemia caused by tibioperoneal arteries occlusion. Methods From June 2004 to May 2007,35 patients with critical limb ischemia (CLI)were treated on an intention-to-treat basis with tibioperoneal arterial PTA. Main outcome measures were technical success rate, primary patency rate, limb salvage rate and complications. Results The technical success rate of tibioperoneal arterial PTA Was 83%.Mean follow-up time was 11.5 months, primary patency rate and limb salvage rate were 57%and 82%,respectively.Mean length of tibioperoneal arterial PTA was 9.5 cm(4.5~14 cm),concurrent treatment of iliac artery or femoral-popliteal artery was carried out in 19 patients via either angioplasty or combined with stenting.There were three complications including arterial spasm and thrombosis in one, which Was relieved by thrombolysis and antispasmodics, and artery perforation in 2 cases, which was treated conservatively. Conclusion In tibioperoneal arterial occlusions in CLI patients, PTA is feasible with a high initial technical success rate and high limb salrage rate,tibioperoneal arterial PTA carries a lower morbidity and less severe complications. PTA is a safe, effective and good treatment alternative for CLI patients of tibioperoneal arterial occlusions.%目的 评价胫腓动脉经皮血管腔内成形术(percutaneous transluminal angioplasty,PTA)治疗下肢严重缺血的可行性、安全性和有效性.方法 对2004年6月至2007年5月收治的35例胫腓动脉闭塞的下肢严重缺血(critical limb ischemia,CLI)患者应用PTA治疗.评价的主要参数为:胫腓动脉PTA技术成功率、通畅率、救肢率和并发症.结果 胫腓动脉PTA的技术成功率为83%,平均随访11.5个月,通畅率为57%,救肢率82%.胫腓动脉平均扩张长度9.5 cm(4.5~14 cm),19例患者同时行

  17. 微创小切口等离子射频成形术治疗顽固性肱骨外上髁炎%Application of minimally invasive radiofrequency angioplasty for the treatment of humeral epicondylitis

    Institute of Scientific and Technical Information of China (English)

    孙海宁; 于秀淳; 付志厚; 惠文鹏

    2011-01-01

    Objective To evaluate the clinical efficacy of minimally invasive radiofrequency angioplasty in treating the humeral epicondylitis.Methods From July 2005 to October 2010, 39 patients (12 males and 27 females) with refractory humeral epicondylitis were admitted in the hospital.Of the 39 patients, 18 were with epicondylitis on the left side and 21 were on the right side.A 2-3cm incision was obtained under the minimally invasive surgery.RF formed after punching the tendon with special tendon RF segment.Results All patients were followed up for 26 months on average (range; 10 to 48 months).35 cases were cured, 2 cases demonstrated excellent efficacy and 2 cases good efficacy.No surgery-related complication happened.Conclusions Minimal invasive radiofrequency angioplasty has characteristics of small lesion and easy operation in treating the refractory humeral epicondylitis with confirmed efficacy and no impact on the integrity and physical strength of the tendon.It can also promote the physical recovery of the tendon.It is an effective, reliable and new method in treating this disease at present.%目的评价微创手术等离子射频成形术治疗顽固性肱骨外上髁炎的临床效果.方法自2005年7月至2010年10月收治39例顽固性肱骨外上髁炎,男12例,女27例,左侧18例,右侧21例,行微创小切口手术治疗,切口长约2~3cm,肌腱专用射频刀头行肌腱打孔,射频成形.结果所有病例均得到随访,时间10-48个月,平均26个月,治愈35例,显效2例,有效2例,无手术相关并发症发生.结论小切口等离子射频成形术治疗顽固性肱骨外上髁炎创伤小,操作简单,不影响肌腱的完整性和生理强度,并且可促进肌腱的生理性恢复,疗效确切,是目前治疗该疾病的一种微创、疗效可靠的新方法.

  18. Evaluation of percutaneous transluminal angioplasty for treatment of infrapopliteal arteriosclerosis obliterans%经皮腔内血管成形术治疗膝下动脉粥样硬化闭塞症的评价

    Institute of Scientific and Technical Information of China (English)

    张玉超; 黄英; 李维敏; 陆信武; 黄新天; 陆民; 蒋米尔

    2012-01-01

    Objective To assess the therapeutic effect of percutaneous transluminal angioplasty ( PTA )on the treatment of infrapopliteal arteriosclerosis obliterans( ASOs ). Methods From Jan. 2007 to Jun. 2011, clinical data of patients with infrapopliteal ASO undergoing PTA at our department were retrospectively reviewed. Results Infrapopliteal PTA was performed on 138 lower limbs for 138 patients( mean age,77. 31 ±7. 52 year - old ). The mean diameter of balloon catheters used for infrapopliteal arteries was 2. 8 mm( 2 mm ~4 mm ), with the mean length of 110. 6 mm( 40 mm ~ 170 mm ). There were no severe complications occurring intraoperatively or postoperatively. Early results showed that all patients had significant improvement in ischemic symptoms( 100% ), and no patients had limb loss. During a mean follow -up of 24. 1 months( 4 ~ 58 months ), the rate of improvement in ischemic symptoms for treated limbs was 78. 4% and the limb salvage rate was 93. 9% at 2 years. Conclusion Minimal invasive PTA for the treatment of infrapopliteal ASO is safe and effective for improving ischemic symptoms of lower limbs and limb salvage.%目的 评价经皮腔内血管成形术(percutaneous transluminal angioplasty,PTA)治疗膝下动脉粥样硬化闭塞症(arteriosclerosis obliterans,ASO)的疗效.方法 回顾性研究2007年1月至2011年6月我科收治的累及膝下动脉ASO并行PTA治疗的患者的临床资料.结果 138例患者,平均年龄(77.31±7.52)岁,治疗膝下动脉所用球囊平均直径 2.8mm(2~4mm),平均长度110.6mm(40~170mm),术中及术后无严重并发症.术后早期治疗肢体临床症状明显改善率为100%,无截肢患者.平均随访24.1个月(4~58个月),治疗肢体术后2年临床症状明显改善率78.4%,救肢率93.9%.结论 PTA治疗膝下动脉ASO可有效改善临床缺血症状并提高救肢率.

  19. 观察舌骨甲状软骨悬吊术联合改良咽侧成形术应用于阻塞性睡眠呼吸暂停低通气综合征的治疗效果%Contrast Observe the Therapeutic Effect of the Lateral Pharyngeal Angioplasty Joint Hyoid Thyroid Cartilage Suspension Surgery and the Lateral Pharyngeal Angioplasty are Applied to the Obstructive Sleep Apnea Hypopnea Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘三印

    2014-01-01

    目的:观察改良咽侧成形术联合舌骨甲状软骨悬吊术手术治疗阻塞性睡眠呼吸暂停低通气综合征的治疗效果。方法本课题以2010年2月至2012年5月期间于我院诊断为OSAHS并且行手术治疗的患者为观测对象,采用回顾分析的研究方法,将临床资料完整的病例分为两组,一组采用改良咽侧成形术,一组采用改良咽侧成形术联合舌骨甲状软骨悬吊术,分别统计二者治疗前及治疗后6个月的PSG监测结果,并对其治疗效果及安全性进行评价。结果共计纳入有效病例47例,其中第一组26例,第二组21例。第一组治愈5例,显效11例,有效7例,无效3例,总有效率为88%;第二组治愈5例,显效12例,有效4例,无效0例,总有效率为100%。二者总有效率之间的差异有统计学意义(P<0.05)。结论改良咽侧成形术联合舌骨甲状软骨悬吊术治疗阻塞性睡眠呼吸暂停低通气综合征疗效安全可靠、操作简单方便、治愈率高,值得临床推广应用。%Objective Observe the therapeutic effect of the uppp joint hyoid thyroid cartilage suspension surgery in for the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS). Methods The object observation of the subject is the patient who diagnosed with OSAHS, and treatmented buy surgical methods in our hospital during February 2010 to May 2012. Divid the complete clinical data into two groups by retrospective analysis. One set using the Lateral pharyngeal angioplasty, anther Lateral pharyngeal angioplasty joint hyoid thyroid cartilage suspension surgery. Then statistics its PSG monitoring results that before treatment and 6 months after treatment, and evaluate its therapeutic effect and safety. Results A total of effective cases is 47 cases, including 26 cases of the first group, the second group of 21 patients. Five cases were cured, 11 cases were markedly effective effective in 7 cases, and 3 ineffective in

  20. 球囊血管成形术对血浆TNF-α、ET水平及局部血管组织ET-IR的影响%Effect of balloon angioplasty on plasma ET and TNF-α levels and tissue endothe lin immunoreactivity in experimental atherosclerotic rabbits

    Institute of Scientific and Technical Information of China (English)

    杜荣增; 吴宗贵; 黄佐; 黄高忠; 张国元

    2001-01-01

    目的 :通过建立兔髂动脉粥样硬化(AS)模型,观察球囊 血管成形术(BA)对血浆肿瘤坏死因子α(TNF-α)、内皮素(ET)水平及局部血管组织E T免疫反应性(ET-IR)的影响。方法:20只新西兰雄性大白兔经高脂饲 料喂养至少8周造成AS,然后进行髂动脉BA,18只兔获得成功。检测了BA前、即刻及24 h后 血浆ET和TNF-α水平,ET采用放射免疫法测定,TNF-α采用生物活性法测定。同时,应用 免疫组织化学技术评价血管组织ET-IR。结果:BA前后即刻:血浆ET水 平(pg/ml)分别为76.4±13.58和92.67±11.38(P0.05);而血浆TNF-α水平(U/ml)分别为31.35±6.23和56.26±7.37(P 0.05)。 BA后局部髂动脉血管壁ET-IR较未经BA的髂动脉明显增加。结论:BA 后血浆ET、TNF-α水平升高及局部血管壁ET-IR增加可能与局部血管内膜损伤有关,提示E T、TNF-α可能参与了PTCA后急性冠脉收缩及再狭窄过程。%Objective: To assess the effect of balloon angiopl asty on circulating endothelin (ET) and TNF-α levels and tissue endothelin in experimental atherosclerosis in rabbits. Methods: After 20 New Z ealand rabbits had a high cholesterol diet for at least 8 weeks, successful ball oon angioplasty was performed in rihgt iliac arteries in 18 rabbits. Circulatin g levels of ET and TNF-α were measured before as well as immediately and 24 h after balloon angioplasty. Tissue endothelin immunoreactivity in atherosclerotic iliac artery wall after balloon angioplasty was assessed by immunohistochemica l technique. Results: Plasma levels of ET and TNF-α were signi ficantly increased immediately after ballon angioplasty (76.40±13.58)pg/ml vs (92.67±11.38) pg/ml and (31.35±6.23) U/ml vs (56.26±7.37) U/ml, resp ectively (P0.05). T issue endothelin immunoreactiuvity was markedly increased in right iliac artery wall after balloon angioplasty than that in opposite iliac artery wall. Conclusion: The increase of plasma

  1. 可注射珊瑚人工骨与经皮球囊成型修复股骨头坏死%Percutaneous balloon angioplasty combined with injectable coral artificial bone repairs femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    朱康华; 孟志斌; 黄涛; 谭海涛; 孙博; 庞学毅

    2016-01-01

    BACKGROUND: There are many methods for the treatment of femoral head necrosis, such as core decompression, bone graft, arthroplasty and joint replacement, and each of which has its own shortcomings. So, percutaneous bal oon angioplasty combined with coral artificial bone provides a new attempt for the treatment of femoral head necrosis. OBJECTIVE: To observe the effect of percutaneous bal oon angioplasty combined with coral artificial bone on femoral head necrosis repair. METHODS: Twenty-four Duroc piglets were enrol ed to establish bilateral femoral head necrosis models by liquid nitrogen freezing method. Then, model piglets were randomly treated with percutaneous bal oon angioplasty combined with injectable coral artificial bone (experimental group) or bone cement (control group) on one affected side, and meanwhile, given no treatment on the contralateral side (blank control group). At 2, 4, 8 and 16 weeks after surgery, X-ray examination, biomechanical test and histological detection were conducted. RESULTS AND CONCLUSION: X-ray showed that at 16 weeks after surgery, numerous new bones could be found in the experimental group and there was a fuzzy boundary between the artificial bone and surrounding tissues; no new bone formed in the control group, and the boundary was clear; in the blank control group, the surface of the femoral head col apsed, and bone trabeculae arranged disorderly, which were seriously destroyed. And in the histological detection at 16 weeks after surgery, there were numerous bone trabecula and osteoblasts around the coral bone in the experimental group, and the coral artificial bone almost dissolved; in the control group, bone cement was in an irregular shape and no bone trabecula formed; in the blank control group, bone trabecula were damaged in the col apsed area, whose structure was in disorder. Additional y, biomechanical changes in the experimental group were significantly better than those in the other two groups at different time

  2. 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.

  3. Acute cell death rate of vascular smooth muscle cells during or after short heating up to 20s ranging 50 to 60°C as a basic study of thermal angioplasty

    Science.gov (United States)

    Shinozuka, Machiko; Shimazaki, Natsumi; Ogawa, Emiyu; Machida, Naoki; Arai, Tsunenori

    2014-02-01

    We studied the relations between the time history of smooth muscle cells (SMCs) death rate and heating condition in vitro to clarify cell death mechanism in heating angioplasty, in particular under the condition in which intimal hyperplasia growth had been prevented in vivo swine experiment. A flow heating system on the microscope stage was used for the SMCs death rate measurement during or after the heating. The cells were loaded step-heating by heated flow using a heater equipped in a Photo-thermo dynamic balloon. The heating temperature was set to 37, 50-60°C. The SMCs death rate was calculated by a division of PI stained cell number by Hoechst33342 stained cell number. The SMCs death rate increased 5-10% linearly during 20 s with the heating. The SMCs death rate increased with duration up to 15 min after 5 s heating. Because fragmented nuclei were observed from approximately 5 min after the heating, we defined that acute necrosis and late necrosis were corresponded to within 5 min after the heating and over 5 min after the heating, respectively. This late necrosis is probably corresponding to apoptosis. The ratio of necrotic interaction divided the acute necrosis rate by the late necrosis was calculated based on this consideration as 1.3 under the particular condition in which intimal hyperplasia growth was prevented in vivo previous porcine experiment. We think that necrotic interaction rate is larger than expected rate to obtain intimal hyperplasia suppression.

  4. Too much coronary angioplasty in the USA?: less may be better - the conflicting roles of inexactness of medicine as a science, asymmetric information, technologic imperative, unnecessary care and ethicomedicinomics in US healthcare.

    Science.gov (United States)

    Onuigbo, M A C; Agbasi, N

    2014-09-01

    US healthcare expenditure per capita far exceeds that of any other nation in the world. Indeed, over the last 15 years, the USA has distantly surpassed most countries in the developed world in total healthcare expenditures per capita with the USA now spending 17.4% of its gross domestic product (GDP) on healthcare ($7960 per capita), compared with only 8.5% of GDP in Japan ($2878 per capita), a distant second. Consequently, by current projections, the US healthcare bill will have ballooned from $2.5 trillion in 2009 to over $4.6 trillion by 2020. Such spending growth rates are unsustainable and the system would soon go broke if not corrected. The drivers of these spending growth rates in US healthcare are several and varied. Indeed, in September 2012, the Institute of Medicine reported that US healthcare squandered $750 billion in 2009 through unneeded care, Byzantine paperwork, fraud and other wasteful activities. Recently, the question was raised as to whether we have too much coronary angioplasty in the USA. In this analysis, we examine these and other various related aspects of US healthcare, make comparisons with other national healthcare delivery systems, and suggest several reengineering modalities to help fix these compellingly glaring glitches and maladies of US healthcare.

  5. Percutaneous transluminal angioplasty for treatment of below-the-knee arterial lesion%经皮腔内血管成形术治疗下肢缺血膝下病变

    Institute of Scientific and Technical Information of China (English)

    谭正力; 缪鹏; 田然; 宋希涛; 李树国; 刘昌伟; 郁正亚

    2015-01-01

    目的:探讨经皮腔内血管成形术治疗下肢缺血膝下病变在Rutherford Ⅱ~Ⅵ不同分级的临床治疗效果。方法回顾分析首都医科大学附属北京同仁医院及北京协和医院血管外科2011年至2013年收治的189例下肢缺血膝下病变(blow the knee,BTK)行腔内血管成形术患者(207条肢体)。术前按Rutherford分级分组,术后随访并计算其临床症状缓解率、一期通畅率、生存率和保肢率。结果共入选患者189例,207条患肢。患者平均年龄(71.33±6.90)岁。其中,糖尿病148例、吸烟60例、高血压病124例、高脂血症90例、冠状动脉粥样硬化性心脏病(以下简称冠心病)58例、肾功能不全21例、脑血管病30例。患肢Rutherford分级Ⅱ~Ⅲ级45条、Ⅳ级71条、Ⅴ~Ⅵ级91条。平均随访时间(21.8±5.2)个月,总体病死率7.41%。Rutherford Ⅱ~Ⅲ级术后第1年、第2年保肢率分别为97.56%和93.81%,Ⅳ级术后第1年、第2年的保肢率分别为92.55%和87.86%,Ⅴ~Ⅵ级术后第1年、第2年的保肢率分别86.50%和77.58%。术后1年一期通畅率分别为86.85%、67.12%、50.54%,2年的一期通畅率分别为65.14%、54.67%、37.68%。结论经皮腔内血管成形术治疗严重下肢缺血合并膝下病变安全、有效,虽然中期随访通畅率较低,但保肢率较高,可以作为首选治疗方法。%Objective To report our experience in treating patients with below-the-knee (BTK)arterial lesions,Rutherford classⅡ-Ⅵ,with percutaneous transluminal angioplasty (PTA).Methods A retrospective analysis of BTK arterial angioplasty procedures was performed.Patients were classified according to different Rutherford stages.SVS runoff scores were determined after the completion of the intervention and tansluminal angioplasty (PTA)of infrapopliteal artery for the treatment of patients with lower extremity ischemia at Rutherford Ⅱ-Ⅵ stages

  6. The study of inhibit the Slit/Robo pathway on vascular restenosis after angioplasty in rabbits%下调Slit/Robo通路抑制兔血管成形术后血管再狭窄

    Institute of Scientific and Technical Information of China (English)

    曾智桓; 张仁丹; 赵艳群; 郑坚奕; 周万兴; 张卫; 朱桂平; 李博维

    2016-01-01

    目的:探讨下调Slit/Robo 通路对兔血管成形术后血管再狭窄的影响及机制。方法:将30只雄性新西兰大白兔分成3组,即空白组、对照组及实验组,每组10只。高脂饲养,除空白组外均制作髂动脉内皮剥脱血管狭窄模型。普通喂养4周后在血管狭窄部位行经皮球囊扩张成形术制作再狭窄模型。随后予R5抗体进行腹腔注射。继续喂养4周后再次血管造影检查,用图像工作站对血管造影结果行血管狭窄分析,并测定血清中Slit2、Robo1浓度,取髂动脉行HE 染色。结果:成功建立兔髂动脉成形术后血管再狭窄动物模型。对照组及实验组与空白组相比,Slit2、Robo1血清浓度均显著升高(P <0.01),但实验组经R5抗体干预后,Slit2、Robo1血清浓度较对照组明显降低(P <0.05),经血管造影证实髂动脉血管面积狭窄率及直径狭窄率均降低(P <0.05)。结论:兔血管再狭窄模型 Slit2/Robo1的表达显著增高,R5抗体可有效抑制 Slit2/Robo1的表达,下调Slit2/Robo1信号通路可治疗兔血管成形术后再狭窄。%Objective To study the effect and mechanism of down-regulating Silt2/Robo 1 signaling pathway on rabbit iliac artery after angioplasty restenosis. Methods The 30 male New Zealand white rabbits were divided randomly into 3 groups , namely the blank group , the control group , and the experimental group , 10 rabbits in each group. Hign-fat feeding , the rabbits were produced endothelial denudation of iliac artery stenosis model. Another 4 weeks of feeding , percutaneous balloon angioplasty was performed. Then R5 antibody was injected into the abdominal cavity. After 4 weeks of feeding ,angiography again. The results of angiography was analysied by image workstation. The concentrations of Slit2 and Robo1 was detected by ELISA. The iliac artery tissue examined by HE staining. Results The rabbit iliac artery after

  7. Analysis of the curative effect of lacrimal laser angioplasty combined with lacrimal stent implantation in the treatment of patients with lacrimal duct obstruction diseases%泪道激光成形术联合泪道支架置入术治疗泪道阻塞性疾病的疗效分析

    Institute of Scientific and Technical Information of China (English)

    林波

    2016-01-01

    Objective:To analyze the curative effect of lacrimal laser angioplasty combined with lacrimal stent implantation in the treatment of patients with lacrimal duct obstruction diseases(LDOD).Methods:500 patients with lacrimal duct obstruction diseases were selected.240 patients in the control group were treated by lacrimal laser angioplasty,while 260 patients in the observation group were treated by lacrimal laser angioplasty combined with lacrimal stent implantation.We compared the efficiency of two groups after treatment.Results:The total effective rate of the observation group was 93.8%,higher than that of the control group of 83.3%(P<0.05),and the difference was statistically significant.Conclusion:The effect of lacrimal laser angioplasty combined with lacrimal stent implantation in the treatment of patients with lacrimal duct obstruction diseases is significant and the safety is high.%目的:分析、探讨泪道激光成形术联合泪道支架置入术治疗泪道阻塞性疾病(LDOD)的临床疗效。方法:收治泪道阻塞性疾病患者500例,对照组240例采用泪道激光成形术治疗,观察组260例采用泪道激光成形术联合泪道支架置入术治疗,比较两组治疗有效率。结果:观察组总有效93.8%,明显高于对照组的83.3%,差异具有统计学意义(P<0.05)。结论:泪道激光成形术联合泪道支架置入术治疗泪道阻塞性疾病效果显著,安全性高。

  8. Qualidade de vida após revascularização cirúrgica do miocárdio, angioplastia ou tratamento clínico Quality of life after surgical myocardial revascularization, angioplasty or medical treatment

    Directory of Open Access Journals (Sweden)

    Myrthes Emy Takiuti

    2007-05-01

    Full Text Available FUNDAMENTO: Ainda que os benefícios clínicos das intervenções coronarianas parecem confirmados, seus efeitos na qualidade de vida (QV permanecem pouco estudados. OBJETIVO: Avaliar a qualidade de vida (QV na doença multiarterial coronariana em pacientes submetidos randomicamente a cirurgia, angioplastia ou tratamento clínico. MÉTODOS: Foi utilizando Short-Form Health Survey (SF36 questionnaire em 483 pacientes. Desses, 161 foram revascularizados; 166 receberam angioplastia e 153 tiveram tratamento clínico. RESULTADOS: Na internação, 86% referiam angina; 34%, infarto; e 32% fumavam. Tratamento clínico: 12 pacientes (7,7% tiveram infarto agudo do miocárdio (IAM; 24 (15,3% receberam cirurgia; e 19 (12,1% morreram. Além disso, cinco (3,2% sofreram AVC e 40 (25,6% tinham angina. No componente mental, 64,1% melhoram e 30,8% pioram a condição. No componente físico, 70,5% melhoram e 27,6% pioram a condição. Cirurgia: 13 pacientes (8,1% tiveram IAM, dois (1,2% receberam cirurgia; 12 (7,4% morreram. Em adição, nove (5,6% sofreram AVC e 30 (18,6% sofriam angina. No componente mental, 72,7% melhoram e 25,5% pioram a condição. No componente físico, 82,6% melhoram e 16,1% pioram a condição. Angioplastia: 18 pacientes (10,9% tiveram IAM, 51 (30,7% receberam intervenções e 18 (19,9% morreram. Além disso, seis (3,6% sofreram AVC e 35 (21% relatavam angina. No componente mental, 66,9% melhoram e 26,5% pioram a condição No componente físico, 77,1% melhoram e 20,5% pioram a condição. CONCLUSÃO: Observou-se melhora em todos os domínios e nas três opções terapêuticas. Comparativamente, a cirurgia ofereceu melhor qualidade de vida após quatro anos de seguimento.BACKGROUND: Although the clinical benefits of coronary interventions seem to be confirmed, their effects on quality of life (QoL are still scarcely studied. OBJECTIVE: To assess the QoL in multivessel coronary disease in patients randomly undergoing surgery, angioplasty or

  9. Improved penis degloving fixed angioplasty treating childrens completely buried penis%改良阴茎脱套固定成形术治疗小儿完全型隐匿阴茎

    Institute of Scientific and Technical Information of China (English)

    李刚; 杨春雷; 郭祥; 李爽; 王军; 廖嫚; 李莎; 雷伟; 郭晖; 马慧; 程银涛

    2014-01-01

    目的:探讨改良阴茎脱套固定成形术治疗小儿完全型隐匿阴茎的临床效果。方法对50例小儿完全型隐匿阴茎患儿采用改良阴茎脱套固定成形术,患者平均年龄(6.5±1.0)岁(3岁~12岁)。结果术后48例阴茎体暴露充分,2例轻度回缩,包皮早期水肿轻微,外形美观,术后恢复快,疗效满意,随访6个月至1年无手术并发症,远期疗效肯定。结论改良阴茎脱套固定成形术治疗小儿完全型隐匿阴茎是一种操作简单、术后外观满意、并发症少的理想术式。%Objective To evaluate the effects of modified degloving penis plasty in the treatment of children with fixed complete concealed penis. Methods Fifity children with complete type of concealed penis were treated by modified penile degloving fixed angioplasty. Average age of patients was 6.5±1 years old (aged 3~12 years old). Results Forty-nine cases had fully exposed of postoperative penile body, 1 cases had mildretraction, wrapping early edema slightly, beautiful appearance, faster postoperative recovery. The curative effect was satisfied. No operation complication was found 6 months/1 years following up and long-term efficacy was satisfied. Conclusion Modified penis avulsion fixed plasty is a simple operation method with postoperative apperance satisfaction, less complication for treatment of complete type of concealed penis.

  10. Peer learning pharyngeal application of diet care in children after angioplasty in palate%同伴学习在儿童腭咽成形术后饮食护理中的应用

    Institute of Scientific and Technical Information of China (English)

    王亚波; 王桂兰

    2015-01-01

    Objective To explore the application of peer learning pharyngeal diet nursing of angioplasty in children after palatal.Methods 132 patients with uvulopalatopharyngoplasty were randomly divided into experimental group and control group,experimental group of 66 pa-tients in the routine care,while two two pairs for the same ward,obtain cooperation from parents,let the children peer learning.66 cases in the control group were only given routine nursing care,not too much contact with other children.Results in the experimental group after opera-tion,compliance is good,in strict accordance with the diet feeding,postoperative recovery was significantly higher than that of control group (P<0.05).Conclusion Peer learning for children after palatopharyngoplasty diet nursing,can effectively improve the smooth degree of the children to eat,thus effectively promotepostoperative recovery.%目的 探讨同伴学习在儿童腭咽成形术术后饮食护理中的应用.方法 将132例腭咽成形术患儿随机分为实验组和对照组,各66例,实验组患儿在常规护理的基础上,同时两两配对、安置同一病房,取得家长配合,让患儿进行同伴学习.对照组患儿仅给予常规护理,不与其他患儿过多接触.比较2组患儿术后进食的顺利程度.结果 实验组患儿术后行为顺应性良好,严格按照饮食原则进食,明显优于对照组,比较差异具有统计学意义(P<0.05).结论 同伴学习用于儿童腭咽成形术后饮食护理,能有效提高患儿进食的顺利程度,从而有效促进术后恢复.

  11. Letalidade hospitalar nas angioplastias coronárias no Estado do Rio de Janeiro, Brasil, 1999-2003 Hospital case fatality associated with coronary angioplasty in Rio de Janeiro State, Brazil, 1999-2003

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Godoy

    2007-04-01

    Full Text Available O estudo analisa a letalidade hospitalar nas angioplastias coronárias, pagas pelo Sistema Único de Saúde (SUS, realizadas nos hospitais do Estado do Rio de Janeiro, Brasil, de 1999 até 2003. As informações sobre as angioplastias coronárias provieram do banco de Autorizações de Internações Hospitalares da Secretaria de Estado de Saúde do Estado do Rio de Janeiro. As taxas de letalidade foram estimadas segundo faixas etárias, sexo, diagnósticos e hospitais. A letalidade geral foi de 1,9% em 8.735 angioplastias coronárias. A taxa mais baixa ocorreu nas anginas (0,8%, as mais elevadas nos infartos agudos do miocárdio (6% e em outros diagnósticos (7%. A letalidade foi menor nas mulheres na faixa etária entre 50 e 69 anos, e a partir dos setenta anos foi quase três vezes maior que a dos mais jovens (de 1,4 a 4%, em ambos os sexos. Ocorreu grande variabilidade entre as taxas de letalidade nas angioplastias coronárias nos diferentes hospitais (entre 0 e 6,5%. Portanto, é necessário acompanhar de modo contínuo a adequação da utilização da angioplastia coronária. Em conclusão, a performance deste procedimento no âmbito da modalidade de atenção pelo SUS nos hospitais, dentro do período estudado, não foi satisfatória.This study analyzes hospital case fatality associated with percutaneous transluminal coronary angioplasties (PTCA covered by the Brazilian Unified National Health System (SUS and performed in hospitals in the State of Rio de Janeiro from 1999 to 2003. PTCA data were obtained from the State Health Department's database on Authorizations for Hospital Admissions. Case fatality rates were estimated according to age, gender, diagnosis, and hospital. Overall case fatality was 1.9% in 8,735 PTCAs. The lowest rate was associated with angina (0.8% and the highest rates with acute myocardial infarction (6% and other diagnoses (7%. In the 50-69-year bracket, case fatality was higher in women. In the over-70 group, it was

  12. Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Experiência inicial com dispositivo de reversão de fluxo para proteção cerebral na angioplastia carotídea

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    Sidnei José Galego

    2013-03-01

    Full Text Available PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction and minor (hematoma adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with OBJETIVO: Relatar os achados iniciais da utilização do GORE Flow Reversal System® (Sistema de Fluxo de Reversão, com foco em eventos adversos maiores/menores nos primeiros 30 dias do pós-operatório. MÉTODOS: Os primeiros 24 pacientes submetidos a angioplastia carotídea com a utilização do sistema GORE, de junho de 2010 a maio de 2012, foram avaliados retrospectivamente com relação a indicações, detalhes anatômicos, dificuldades técnicas e desfechos clínicos imediatos, incluindo eventos adversos maiores (acidente vascular cerebral, morte, infarto agudo do miocárdio e menores (hematoma. RESULTADOS: Hipertensão sistêmica estava presente em 100% dos pacientes, diabete melito em 58,3% e doença coronariana em 37,5%. Arco aórtico tipo II foi encontrado em 62,5% dos pacientes e lesão de aterosclerose predominantemente na bifurcação carotídea que afeta as artérias carótidas internas e comuns em 79,2%. Dados angiográficos revelaram artérias carótidas contralaterais com estenose <50% em 95,8% de casos e preservação de fluxo sanguíneo cerebral em 95,8%. Todos os

  13. Early and long-term outcome of elective stenting of the infarct-related artery in patients with viability in the infarct-area: Rationale and design of the Viability-guided Angioplasty after acute Myocardial Infarction-trial (The VIAMI-trial

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    Visser Cees A

    2004-11-01

    Full Text Available Abstract Background Although percutaneous coronary intervention (PCI is becoming the standard therapy in ST-segment elevation myocardial infarction (STEMI, to date most patients, even in developed countries, are reperfused with intravenous thrombolysis or do not receive a reperfusion therapy at all. In the post-lysis period these patients are at high risk for recurrent ischemic events. Early identification of these patients is mandatory as this subgroup could possibly benefit from an angioplasty of the infarct-related artery. Since viability seems to be related to ischemic adverse events, we initiated a clinical trial to investigate the benefits of PCI with stenting of the infarct-related artery in patients with viability detected early after acute myocardial infarction. Methods The VIAMI-study is designed as a prospective, multicenter, randomized, controlled clinical trial. Patients who are hospitalized with an acute myocardial infarction and who did not have primary or rescue PCI, undergo viability testing by low-dose dobutamine echocardiography (LDDE within 3 days of admission. Consequently, patients with demonstrated viability are randomized to an invasive or conservative strategy. In the invasive strategy patients undergo coronary angiography with the intention to perform PCI with stenting of the infarct-related coronary artery and concomitant use of abciximab. In the conservative group an ischemia-guided approach is adopted (standard optimal care. The primary end point is the composite of death from any cause, reinfarction and unstable angina during a follow-up period of three years. Conclusion The primary objective of the VIAMI-trial is to demonstrate that angioplasty of the infarct-related coronary artery with stenting and concomitant use of abciximab results in a clinically important risk reduction of future cardiac events in patients with viability in the infarct-area, detected early after myocardial infarction.

  14. Intravascular ultrasound imaging following balloon angioplasty.

    OpenAIRE

    Tobis, JM; Mahon, DJ; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directl...

  15. Hyperperfusion syndrome after carotid stent angioplasty

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-03-15

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

  16. 原位肝移植术后门静脉狭窄内支架植入治疗的随访观察%Follow-up study of percutaneous transhepatic portal vein angioplasty and stent placement after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    王欣; 王剑锋; 黄强; 高堃; 翟仁友; 杨伟利

    2013-01-01

    Objective To evaluate the efifcacy of the stent implantation in treatment of portal vein stenosis or thrombosis after liver transplantation. Methods From November 2004 to August 2012, 31 patients with portal vein stenosis after liver transplantation were referred for angiographic analysis and stent placement treatment successfully. After percutaneous transheptic balloon angioplasty, stents were deployed. Thrombolytic therapy for patients with portal vein thrombosis. Embolization was performed in patients with varices or portal vein lfow changes. The therapeutic results were monitored by the follow-up on clinical symptoms and imaging examinationsin inorder to know about the stent and complications. Results Thirty-nine stents were deployed subsequently. Four patients were given thrombolytic therapy, and 5 patients were given collateral embolization included. All the portal vein recanalized and the symptoms were relieved. Besides, 2 patients with portal vein stenosis and cavernous transformation were given stent placement successfully. Portal vein patency was all maintained in 29 patients for 6-99 months. The cumulative patency rate was 100%. In the follow-up study , the splenic vein thrombosis raised again in one case of portal vein thrombosis (PVT) after 17 months therapy. The short-time severe complication related to interventional therapy is thoracic cavity hemorrhage in 1 cases (3.2%);and the long-term complication is the blood lfown down in the other branch of portal vein in 1 cases (3.2%). Conclusions Interventional therapy is an effective method for the treatment of portal vein stenosis after liver transplantation and has low stent restenosis rate. For the patient with PVT, it still has the risk of thrombosis again in the long-term study. And we should be vigilant for possible complications.%目的:评价肝移植术后门静脉狭窄或伴血栓形成者内支架植入治疗的疗效。方法回顾性分析2004年11月至2012年8月,北

  17. 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

  18. Changes of nitric oxide and endothelin serum level after carotid balloon denudation or stent assisted angioplasty: an experimental and clinical observation%颈动脉球囊扩张与支架置入术后血清一氧化氮和内皮素变化的实验与临床观察

    Institute of Scientific and Technical Information of China (English)

    刘加春; 王大明; 钱江南; 李雅国; 王利军; 姜学丽; 翟乐乐; 陆军; 祁鹏

    2009-01-01

    Objective To observe the changes of nitric oxide (NO) and endothelin (ET) serum level in the Guangxi BA-MA minipigs whose carotid arteries were injured by balloon denudation and in the patients with catotid stent assisted angioplasty. Methods Twelve Guangxi BA-MA minipigs were choosen. High fat/cholesterol feeding and endovascular balloon denudation were used to create a carotid artery atherosclerotic stenosis animal model. Blood samples were collected from peripheral veins before starting the procedure, and again, at 2 and 3 weeks after the procedure, respectively. Serum NO and ET concentrations of blood samples were tested. Nineteen patients with carotid artery stenosis who underwent stent assisted angioplasty were randomly selected, and their serum NO and ET were tested using the same methods as above. Results In the animal group, there was a significant decrease of mean NO concentration at 2 weeks after carotid injury (t-test, P<0.05 ), however, no significant change of ET was observed. A very significant increase of ET was observed at 3 weeks after the procedure (t-test, P <0.01 ). In the patient group, there were no significant differences among serum NO or ET concentration of peripheral vein blood before, immediately after, and 6 h after the endovascular treatment. Conclusions In this study, a decrease of NO concentration and an increase of ET concentration of peripheral vein blood are found in BA-MA minipigs after carotid arteries are injured by balloon denudation, which might be a cue for the formation of atherosclerosis. However, no significant changes are observed in this group of patients who underwet carotid angioplasty treatment. Therefore, further studies are needed.%目的:观察小型猪颈动脉球囊扩张前后和颈动脉狭窄患者狭窄扩张、支架置入术前后血清一氧化氮(NO)和内皮素(ET)的变化.方法:选取12头广西巴马小型猪,分别于颈动脉球囊损伤前、损伤后2周和3周检测静脉血血清中NO

  19. 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

  20. Tratamento coadjuvante da arterite de Takayasu através de angioplastia transluminal percutânea com stents: relato de caso e revisão de literatura Coadjuvant treatment of Takayasu Arteritis by percutaneous transluminal angioplasty with stents: case report and literature review

    Directory of Open Access Journals (Sweden)

    Glauber Tercio de Almeida

    2008-04-01

    Full Text Available Os autores fazem uma breve revisão de literatura sobre o uso coad-juvante de stents na arterite de Takayasu e apresentam um relato de caso de uma mulher jovem, 27 anos de idade, com quadro de cefaléia holocraniana acompanhada de náuseas, síncopes e tonturas. Concomitantemente apresentou turvação visual e claudicação de membros superiores. Entre as várias possibilidades, aventou-se a hipótese diagnóstica de arterite de Takayasu, confirmada posteriormente, sendo então realizado tratamento coadjuvante através de angioplastia transluminal percutânea com stents.The authors present a brief literature review about coadjuvant treatment with stents in Takayasu Arteritis and report a case of a 27 year old woman showing a holocranial cephalalgia, associated with nausea, fainting and dizziness. Simultaneously she suffered blurred sight and claudication of the upper limbs. Among the different diagnostic possibilities, the hypothesis of Takayasu Arteritis was first considered and later confirmed. Coadjuvant treatment by a percutaneous transluminal angioplasty with stents was performed.

  1. Um novo substituto vascular: arterioplastia femoral em cães com remendo de membrana de biopolímero de cana-de-açúcar - avaliação hemodinâmica e histopatológica A new vascular substitute: femoral artery angioplasty in dogs using sugarcane biopolymer membrane patch - hemodynamic and histopathologic evaluation

    Directory of Open Access Journals (Sweden)

    Silvio Romero de Barros Marques

    2007-12-01

    érias femorais com os remendos foram retirados para estudo histopatológico e os animais foram mortos com dose tóxica de anestésico. RESULTADOS: No período de avaliação de 180 dias, nos dois grupos, não foram observados casos de infecção da ferida operatória, dilatação, ruptura, falso-aneurisma ou trombose. Nos dois grupos foi encontrada, na superfície externa dos remendos, uma resposta inflamatória crônica com neutrófilos e linfócitos além de fibrose. Na superfície interna dos remendos, em ambos os grupos, foi encontrada fibrose. No grupo controle ocorreu invasão dos remendos de e-PTFE por fibroblastos. CONCLUSÕES: Com base nos resultados obtidos com o modelo experimental utilizado, durante o período de observação de 180 dias, conclui-se que a membrana do biopolímero de cana-de-açúcar constitui-se em um substituto arterial adequado quando utilizado sob forma de remendos em artérias femorais de cães.BACKGROUND: Achievement of an ideal arterial substitute to be used in the reconstruction of small- and medium-caliber arteries is still the main objective of most scientific research studies developed in the area of vascular substitutes. Sugarcane biopolymer membrane could be extremely useful to perform vascular reconstruction in arteries with diameter smaller than 4 mm, allowing treatment of diseases that affect millions of people in Brazil and worldwide. OBJECTIVE: To evaluate the hemodynamic and histopathologic behavior of sugarcane biopolymer membrane when used as a patch in femoral artery angioplasty in dogs. METHOD: Eight adult mongrel dogs, under general anesthesia, underwent percutaneous Doppler velocimetry of the left and right femoral arteries for preoperative control at the Health Sciences Center Experimental Research Laboratory of Universidade Federal de Pernambuco. After being disinfected, the dogs underwent femoral artery patch angioplasty using a sugarcane membrane biopolymer patch on the left side and an expanded PTFE (e-PTFE patch on the

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

    Institute of Scientific and Technical Information of China (English)

    吕海文

    2016-01-01

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

  3. 中西医结合治疗糖尿病下肢动脉病变介入术后再狭窄的临床研究%Effect of Integrative Medical Therapy on Post-angioplasty Arterial Restenosis in Lower Limbs of Diabetic Patients

    Institute of Scientific and Technical Information of China (English)

    姜涛; 文祯; 姜敏; 卢桂阳

    2011-01-01

    Objective To evaluate the effect of integrative medical therapy on lower limb post-angioplasty arterial restenosis in diabetes patients. Methods Thirty-six patients with lower limb diabetic arterial disease of Fontaine Ⅲ/Ⅳ stage after successful baloon angioplasty were assigned randomly and equally to two groups, the control group and the treatment group, both were treated with basic therapy for 3 months, but Chinese drugs were given to the treatment group additionally. Level of acroesthesia was determined before and after treatment with simplified McGill pain questionnaire (SF-MPQ) scoring, ankle brachial index (ABI), toe brachiai index (TBI), mean flow velocity of dorsal artery (MDA) and tibial artery (MTA) were measured by ultrasound Doppler meter, and blood preparation was determined. Moreover, the ulcer remission rate, ulcer cure rate, restenosis rate, and amputation rate were determined in the 6-month and 12-month follow-up studies. Results Significant improvements of ABI, TBI,MDA and MTA, es well as on blood levels of high-sensitivity C-reactive protein (hs-CRP) and fibrinogen (FIB)were shown in the treatment group after treatment, showing significant difference in comparing with those before treatment (P<0.05 or P <0.01 ), also in comparing with the control group (P <0. 05 or P <0. 01 ) respectively,while in the control group, although a trend of improvement was seen, these indices were insignificantly changed statistically (P >0. 05). Comparisons between groups after 3-month treatment showed significant difference in is chemia remission rate and pain relief rate ( P <0.05). Outcomes of 6-month follow-up displayed that the differences between groups were insignificant in terms of the ulcer cure rate the and amputation rate ( P>0. 05), but did show significance in the ulcer remission rate and the restenosis rate (P < 0. 05), while all the 4 parameters were insignificantly different between groups after 12-month follow-up ( P>0. 05

  4. Peri-procedural levels of multiple serum biomarkers and prognosis in ST-segment elevation myocardial infarction patients undergoing primary angioplasty%急性心肌梗死患者直接经皮冠状动脉介入治疗围手术期多血清标志物与预后

    Institute of Scientific and Technical Information of China (English)

    赵博; 颜红兵; 赵汉军; 宋莉; 周鹏; 刘臣

    2012-01-01

    predicting the outcome of patients. This study is to evaluate the role of peri-procedural multiple serum biomarkers approach in the assessment of the prognosis in acute ST-segment elevation myocardial infarction (STEMI) patients undergoing primary angioplasty. Methods This study is a sub-study of the SUIT-AMI trial (Impacts of superselective IRA infusion of glucoprotein Ⅱ b/Ⅲa inhibitor on myocardial reperfusion and bleeding complications in AMI patients, NCT01181388) including 203 consecutive patients with STEMI who underwent primary angioplasty. The complete data of biomarkers was available for analysis in 145 of 203 patients. According to the pre-procedure cardiac troponin Ⅰ (20 ng/ml) and high sensitive CRP ( 10 mg/ L) and instantly post-procedure N-terminal probrain natriuretic peptide (2000 fmol/ml) , these patients were divided into four groups (low value, n =50; single high value, n =62; double high values, n =26; and triple high values, n =7). In-hospital ultrasound based cardiac function,30-day and 180-day major adverse cardiac events [MACE, including cardiac death, recurrent myocardial infarction (MI) and target vascular revascularization (TVR)] and bleeding were recorded for analysis. Results In-hospital MACE were recorded in four patients. Of them, three in the low value group (6% ) and one in the triple high values group (14% ) with a tendency of higher than other three groups (χ2 =7.922, P = 0. 048). At 30-day follow-up, there were 7 MACEs including two deaths (all from double high values group) , three recurrent Mis and two TVRs without significant differences between groups (χ2 = 5. 381 , P > 0. 05 ) . However, the 30 day mortality of the double high value group was greatly higher than other groups (8% us. 0% ,χ2 = 9. 282, P = 0. 026). At 180-day follow-up, there were 10 MACEs including five deaths, three recurrent Mis and two TVRs without great difference between groups. Conclusions Abnormal multiple serum biomarkers may indicates a poor prognosis

  5. Diferença de letalidade hospitalar do infarto agudo do miocárdio entre homens e mulheres submetidos a angioplastia primária Difference in the case-fatality rate of acute myocardial infarction between men and women submitted to primary angioplasty

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Santana Passos

    1998-10-01

    Full Text Available OBJETIVO: Comparar a letalidade hospitalar (LH de homens e mulheres submetidos a angioplastia transluminal coronária primária (ATCP como estratégia de reperfusão no infarto agudo do miocárdio (IAM. MÉTODOS: Estudo de coorte retrospectivo baseado em informações de prontuários médicos de pacientes hospitalizados devido a IAM em hospital de referência para doença coronária, utilizando preferencialmente a ATCP como técnica de reperfusão miocárdica precoce. Foram incluídos 83 pacientes, 35 (42% mulheres e 48 (58% homens, que preencheram critérios para reperfusão miocárdica precoce. RESULTADOS: A média de idade das mulheres foi superior a dos homens (66±10 vs 58±11 anos; pPURPOSE: To compare the in-hospital case-fatality rate of men and women submitted to percutaneous transluminal coronary angioplasty (PTCA as a strategy of reperfusion in acute myocardial infarction (MI. METHODS: A retrospective cohort study based on information abstracted from medical records of MI patients admitted to a hospital where PTCA is used as the prefered method for early myocardial reperfusion. A total of 83 patients, 35 (42% women and 48 (58% men, who met the criteria for early myocardial reperfusion was included in the analysis. RESULTS: The mean age of women was higher than that of men (66±10 vs 58±11 years; p<0.001. The women also had a higher frequency of diabetes mellitus (37.1% vs 6.4%; p<0.001. Despite these differences in age and in the frequency of diabetes mellitus, the percentage of patients in whom the PTCA was considered successful was similar between men (83.3% and women (82.3%. The case-fatality rate was also similar between men and women; 14.6% and 14.3%, respectively. CONCLUSION: The possibility that the excess risk of death in women with MI may be reduced and even eliminated with the use of PTCA, supports to the need for the development of a clinical trial to assess this question.

  6. 脉冲电场介导AT2R基因在血管局部表达及其对血管新生内膜的影响%Electroporation-mediated angiotensin Ⅱ type 2 receptor expression improves neo intimal hyperplasia of carotid arteries in rats after balloon angioplasty

    Institute of Scientific and Technical Information of China (English)

    刘德峰; 屈小玲; 刘建平

    2011-01-01

    Objective To determine the effects of electroporation on the transfection of angiotensin Ⅱ type 2 receptor (AT2R) gene into rat carotid arteries and predict its role in neointimal hyperplasia of carotid arteries after balloon angioplasty. Methods After the establishment of rat carotid balloon injury restenosis model, 18 SD rats were divided into AT2R transfection group, empty plasmid transfection group (GFP), and non-transfection group (n = 6 ). AT2R gene plasmid or empty plasmid was transfected by electroporation into rat carotid arteries. Their arteries were harvested at 3, 14 and 21 d after gene transfer, with 2 rats at each time points. The expression of AT2B and morphology of the arteries were evaluated by immunohistochemistry and HE staining respoctively. Results Electroporation-mediated transfection of AT2R gene into injured rat carotid arteries significantly up-regulated the levels of AT2R mRNA in the neointima in a time dependent manner from day 3 to day 14 ( strong to moderate to mild expression). But no expression of AT2B was found in the other 2 groups at these 3 time points. At day 21, AT2R transfection significantly reduced intimal/medial area ratio as compared with non-transfection group and GFP transfection group (0.76 ± 0.08 vs 1.39 ± 0.08 and 1.32 ± 0. 10, P < 0.01 ). No significant difference was found between non-transfection group and GFP transfection group. Conclusion Our results indicate that electroporation is an effective means to introduce naked AT2R DNA into the blood vessel wall, and gene transfer of AT2R in vessel wall may effectively inhibit VSMC proliferation and neointimal hyperplasia in the rat carotid arteries after balloon angioplasty.%目的 研究脉冲电场对血管紧张素2型受体(AT2R)基因在血管局部表达的作用,探讨AT2R基因在体转染对大鼠颈动脉球囊损伤后新生内膜增生的作用.方法 大鼠颈动脉球囊损伤后,用脉冲电穿孔法介导AT2R cDNA真核表达质粒或空质粒载

  7. 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

  8. The clinical application of percutaneous transluminal balloon angioplasty for hemodialysis patients with stenosis of arteriovenous ifstula%经皮腔内血管成形术在血透患者动静脉内瘘血管狭窄中的应用

    Institute of Scientific and Technical Information of China (English)

    郑尘非; 孙文学; 贾秀芬; 缪克凯; 潘慧君; 刘毅; 黄朝兴

    2015-01-01

    Objective: To report the technical success and long-term clinical outcomes of arteriovenous ifstula (AVF) stenosis after percutaneous transluminal balloon angioplasty (PTA).Methods: A total of 30 patients with stenosis of AVF were enrolled. There were 16 men and 14 women, and the median age was 64.8±13.2 years. Mean time between ifstula creation and intervention was 16.5±13.8 months. The mean duration of hemodialysis time was 31.5±30.2 months. They were examined by digital subtraction angiography (DSA) when they under-went PTA. After the treatment of PTA, all of the patients were examined by 64-multislice spiral computed tomog-raphy angiography every 3 months.Results: The technical success rate was 90.0% in the hemodialysis patients (17 native AVFs and 10 arteriovenous grafts). Primary patency at ifrst, second, third, fourth and iffth three months was 100%, 91.3%, 79.5%, 72.6% and 62.2% respectively. Univariate analysis indicated that there was no signiif-cant correlation between the clinical factors (including age, diabetes mellitus, location, length, grade, and number of stenosis) and primary patency (P>0.05).Conclusion: PTA is an effective treatment method for arteriovenous stenosis, which has high rates of technical success and less complication.%目的:探讨经皮腔内血管成形术(PTA)治疗动静脉内瘘(AVF)狭窄的疗效。方法:回顾性分析30例上肢AVF狭窄患者的临床资料,其中男16例,女14例,平均年龄(64.8±13.2)岁;瘘管平均使用时间(16.5±13.8)月,患者平均透析时间(31.5±30.2)月。所有患者在数字减影血管造影(DSA)下行PTA,术后每3个月经64层螺旋CT血管造影对AVF功能进行评估。结果:本组手术成功率90.0%,其中17例自体AVF和10例人工血管动静脉内瘘(AVG)。术后27例患者首次开通率3个月为100%,6个月为91.3%,9个月为79.5%,12个月为72.6%,15个月为62.2%;术后AVF首次通畅率的单因素Cox风

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

    OpenAIRE

    Ryan A McTaggart; Marks, Michael P.

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these result...

  10. Holmium:YAG laser coronary angioplasty in acute myocardial infarction

    Science.gov (United States)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Patients who sustain complicated acute myocardial infarction in whom thrombolytic agents either fail or are contraindicated often need mechanical revascularization other than PTCA. In 24 patients with acute infarction complicated by continuous chest pain and ischemia who either received lytics or with contraindication to lytics, a holmium:YAG laser (Eclipse Surgical Technologies, Palo Alto, CA) was utilized for thrombolysis and plaque ablation. Clinical success was achieved in 23/24 patients, with 23 patients (94%) surviving the acute infarction. Holmium:YAG laser is very effective and safe in thrombolysis and revascularization in this complicated clinical setting.

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

    DEFF Research Database (Denmark)

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

    1990-01-01

    success as well as vascular patency were evaluated. The results were grouped into the following subsets: the indication for PTA, the severity of the vascular lesion, the crural run-off and the length of lesion. The results were in every respect poor with total occlusions when compared with stenoses....... This 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....

  12. 机器人单孔腹腔镜下行猪肾部分切除术及肾盂输尿管成形术的初步尝试%Robotic single-site surgery: laparoscopic partial nephrectomy and ureteropelvic angioplasty in pigs

    Institute of Scientific and Technical Information of China (English)

    杨波; 王辉清; 肖亮; 牟燕清; 王林辉; 许传亮; Riccardo Autorino; Jihad H. Kaouk; 孙颖浩

    2011-01-01

    目的 初步尝试机器人单孔腹腔镜下行猪肾部分切除术及肾盂输尿管成形术,评估机器人单孔腹腔镜下行泌尿外科重建手术的可行性和不同通道技术的人机工程学效果,总结操作经验.方法 猪肾部分切除术:完全侧卧位,平脐水平,沿腹直肌外缘切开4 cm长皮肤切口,钝性分离皮下脂肪,以气腹针建立气腹.按菱形将4个套管置入腹腔,其中左右为8 mm的达芬奇机器人金属套管,上下为Surgiquest 10 mm无阀套管.安装机器人臂后,按常规完成肾部分切除术,肾脏缺损采用"滑夹"的无结技术进行全层水平褥式缝合关闭.肾盂输尿管成形术(UPJ):改用Surgiquest新型无阀单孔通道,切口两侧置入8 mm的机器人金属套管.观察镜接12 mm普通腹腔镜套管后,置入单孔通道内,按常规完成UPJ成形术.结果 完成肾部分切除术2例,通道建立时间分别为5、8 min,机器人系统安装时间为11、9 min,手术操作时间为55、42 min,温缺血时间23、18 min,出血50、20 ml.完成肾盂输尿管成形术2例,通道建立时间为17、12 min,机器人安装时间为5、4 min,手术操作时间为32、25 min,出血均为0 ml.结论 机器人单孔腹腔镜手术在合理安置通道后,能顺利完成泌尿外科高难度重建手术;专用机器人单孔通道可获得更理想的人机工程学效果.%Objective To make an initial attempt to use robotic single-site surgery for laparoscopic partial nephrectomy and ureteropelvic angioplasty in pigs, so as to assess the feasibility and ergonomics of the robotic single-site surgery in iaparoscopic urological reconstruction surgery and to summarize the manipulation experience. Methods Partial nephrectomy: at a lateral position, a 4 cm incision was made at the level of hilum on the lateral border of the rectus muscle, and the subcutaneous tissue layer was dissected bluntly with the Kelly clamp. After pneumoperitoneum was established by the veress needle, four

  13. Angiotensin Ⅱ type 2 receptor gene mediated by the tetracycline-regulatable system inhibits neointimal hyperplasia in rat carotid arteries after balloon angioplasty%血管紧张素Ⅱ2型受体在体可调控表达对大鼠颈动脉新生内膜增生的影响

    Institute of Scientific and Technical Information of China (English)

    苗莉; 罗先润; 景涛; 张辉; 刘安丰; 娄云霄; 何国祥

    2011-01-01

    Objective Transducing the angiotensin Ⅱ type 2 receptor (AT2R) gene into rat balloon injury carotid arteries can attenuate neointimal hyperplasia, but how to regulate the expression of the AT2.R gene according to our need is very important in utilizing transgenie technology. The purpose of the current study is to investigate the effects of the AT2R gene medicated by the tetracy-cline regulatable system on neointimal hyperplasia in rat carotid arteries after balloon angioplasty. Methods After establishment of the rat model of carotid balloon injury restenosis, we locally perfused into the rat carotid arteries PBS (the control group), mesenchy-mal stem cells (the MSC group) or MSC/AT2R (the MSC/AT2R group) with AT2R medicated by the tetracycline regulatable system, the latter again subdivided into a doxycycline administration (Dox) and non-doxycycline Dox administration (non-Dox) group. At 14 and 28 days after the operation, we evaluated the expression of AT2R by immunohistochemistry and RT-PCR and measured the neointi-ma/media (I/M) area ratio was by morphometric analysis. Results In the MSC/AT2R + Dox group, the expressions of AT2R mRNA and protein in the neointima were significantly up-regulated from day 14 to 28 after injury (P <0.01), and the I/M ratio significantly reduced (P<0.01). The transplanted MSC showed no obvious effect on the neointimal hyperplasia. Conclusion The expression of the AT2R gene can be regulated efficiently in vivo by local delivery of MSC with dual-stable expression of the AT2R gene, and thus inhibit neointimal hyperplasia.%目的 血管紧张素Ⅱ2型受体(angiotensinⅡtype 2 receptor,AT2R)基因转染可减轻血管损伤后新生内膜的过度增生,但如何主动调控转入体内基因的表达有着重要的临床意义.文中以四环素可调控系统下的AT2R基因转染的骨髓间充质干细胞(mesenchymal stem cell,MSC)为载体,探讨AT2R在体可调控表达及对大鼠颈动脉新生内膜的影响.方法 大鼠

  14. 冠状动脉造影和血管成形术诊治老年冠心病:经桡动脉与经股动脉途径对比%Comparison on transradial versus transfemoral approach for coronary angiography and angioplasty in the elderlys with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    李兴升; 陈庆伟; 王志刚; 柯大智; 吴庆

    2011-01-01

    Objective To compare the advantages and disadvantages of transradial and transfemoral approaches in coronary angiography and angioplasty, and to evaluate the curative efficacy and safety of transradial approach for the elderlys with coronary heart disease (CHD). Methods Totally 1637 patients over or equal to 60 years old with diagnosed CHD or suspected CHD were selected and randomly divided into transradial group (n= 909) and transfemoral group (n= 728). The time and success rate of puncture, time of angiography, X-ray exposure time of angiography, success rate of PCI, complications in puncture site, incidence of vagal reflex, average length of stay and major adverse cardiac events (MACE) 3 months after PCI were compared between the two groups. Results The puncture time of transradial group was longer than that of transfemoral group (P<0.05). There were 897 cases (897/909, 98. 68%) with success puncture of radial artery in transradial group and 722 (722/728, 99. 18%) with success puncture of femoral artery in transfemoral group. There was no difference in success rate of puncture, success rate of PCI and MACE 3 months after PCI between the two group (P> 0. 05), while the time of angiography, X-ray exposure time of angiography, complications in puncture site, incidence of vagal reflex and average length of stay in transradial group were all lower than those in transfemoral group (P<0.01). Conclusion Percutaneous radial artery approach is safe and feasible for PCI in the elderlys with CHD, without lying in bed, lower incidence of local complications and trauma, therefore can be used as the routine approach for PCI, especially for the elderlys.%目的 比较经桡动脉和经股动脉途径在冠状动脉造影和血管成形术中的优缺点,评价经桡动脉途径介入治疗老年冠心病的有效性与安全性.方法 60岁及以上冠心病或可疑冠心病患者1637例,按穿刺途径随机分为桡动脉组(n=909)和股动脉组(n=728),比较两

  15. 核因子κB对血管成形术后平滑肌细胞增殖和新生内膜形成的影响%Effect of nuclear factor-kappa B on vascular smooth muscle cell proliferation and neointima formation after angioplasty

    Institute of Scientific and Technical Information of China (English)

    周俊; 陆国平; 戚文航; 吴春芳

    2007-01-01

    point in antisense group, decoy group, antisense plus decoy group (P<0.05). ⑥Western blot analysis showed that NF-κB p65 was weakly expressed at 6 hours after vascular balloon-injury, increased significantly at 1 day, reached the peak at 7 days and weakened at 14 days, while ERK2 protein was weakly expressed, a little increased at 1 day, reached the peak at 7 days and weakened at 14 days. Treatment of antisense group, decoy group and antisense plus decoy group inhibited protein synthesis more significantly than those of model group, sense group and scramble group (P<0.05).CONCLUSTON: NF-κB expression increases in proliferating smooth muscle cells. NF-κB modulates genes expression and protein synthesis of MCP-1 and ERK2. Cellular proliferation in vessel wall dynamically changes after balloon angioplasty injury. Antisense and decoy oligonucleotide of NF-κB by local lipofectamine transfer inhibit the expression of regulated target gene.

  16. Clinical efficacy of coronary angioplasty of chronic occlusion in patients with previous Q-myocardial infarction

    Directory of Open Access Journals (Sweden)

    Glukhov Е.А.

    2013-12-01

    classes of heart failure has not reached the statistical significance. According to the ultrasound investigation of hypo-and akinesia areas of infarction there was a statistically significant increase in the incidence of myocardial hypokinesis prevalence of 152 (76% versus baseline 103 (51.5%, p <0.0001. Conclusions. The late recanalization of chronic occlusion (after 8 weeks post-MI with the restoration of optimum antegrade blood flow improves left ventricular function and long-term prognosis reducing the risk of cardiovascular disorders during the period of the 12-month follow-up.

  17. Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

    Science.gov (United States)

    Jang, Woo Sung; Cho, Joon Yong; Lee, Jong Uk; Lee, Youngok

    2016-01-01

    Background Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. Methods Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. Results At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were 2.1±1.0 m/sec and 0.9±0.9 m/sec, respectively (p=0.001). Although the incidence of grade 3–4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: 6.5±3.4 years; group II: 3.8±2.2 years; p=0.037). Conclusion Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3–4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction. PMID:27733993

  18. Percutaneous transluminal coronary angioplasty for angina pectoris after a non-Q-wave acute myocardial infarction

    NARCIS (Netherlands)

    H. Suryapranata (Harry); K.J. Beatt (Kevin); P.J. de Feyter (Pim); J. Verrostte; M.J.B.M. van den Brand (Marcel); F. Zijlstra (Felix); P.W.J.C. Serruys (Patrick)

    1988-01-01

    textabstractDespite initially favorable prognosis in patients with non-Q-wave acute myocardial infarction (AMI), long-term mortality in this subset of patients appears to be similar to or even greater than that in patients with Q-wave AMI. The relatively poor late prognosis is primarily due to a hig

  19. Effects of reprocessing on chemical and morphological properties of guide wires used in angioplasty

    Directory of Open Access Journals (Sweden)

    Rogério Valentim Gelamo

    2013-09-01

    Full Text Available OBJECTIVE: To investigate the influence of the reprocessing technique of enzymatic bath with ultrasonic cleaning and ethylene oxide sterilization on the chemical properties and morphological structure of polymeric coatings of guide wire for regular guiding catheter. METHODS: These techniques simulated the routine of guide wire reprocessing in many hemodynamic services in Brazil and other countries. Samples from three different manufacturers were verified by scanning electron microscopy and X-ray photoelectron spectroscopy. RESULTS: A single or double sterilization of the catheters with ethylene oxide was not associated with morphological or chemical changes. However, scanning electron microscopy images showed that the washing method was associated with rough morphological changes, including superficial holes and bubbles, in addition to chemical changes of external atomic layers of polymeric coating surfaces, as detected by the X-ray photoelectron spectroscopy method, which is compatible with extended chemical changes on catheter surfaces. CONCLUSION: The reprocessing of the catheters with ethylene oxide was not associated with morphological or chemical changes, and it seemed appropriate to maintain guide wire coating integrity. However, the method combining chemical cleaning with mechanical vibration resulted in rough anatomical and chemical surface deterioration, suggesting that this reprocessing method should be discouraged.

  20. Subintimal angioplasty for long (TASC C and D superficial femoral artery occlusions

    Directory of Open Access Journals (Sweden)

    Hassan Abdelsalam

    2015-12-01

    Conclusion: Although we observed a low primary patency rate there were encouraging limb salvage rates in patients with TASC C and D lesions treated with SIA. It provides an alternative to surgery in high risk patients, with acceptable technical success and complication rates but re-intervention is likely to be required.