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Sample records for artery transluminal angioplasty

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

    International Nuclear Information System (INIS)

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

  2. 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

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

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    Čolić Momčilo

    2008-01-01

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

  4. 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

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

    International Nuclear Information System (INIS)

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

  6. Percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    1988-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    LENUS (Irish Health Repository)

    Ederle, Jörg

    2009-10-01

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

  10. Percutaneous 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 ...

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    1988-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  15. 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.

  16. 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.

  17. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  20. The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

    International Nuclear Information System (INIS)

    Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions

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

    Science.gov (United States)

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

    1991-01-01

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

  2. Effects of percutaneous transluminal angioplasty on muscle BOLD-MRI in patients with peripheral arterial occlusive disease: preliminary results

    International Nuclear Information System (INIS)

    The purpose was to evaluate the effect of percutaneous transluminal angioplasty (PTA) of the superficial femoral artery (SFA) on the blood oxygenation level-dependent (BOLD) signal change in the calf musculature of patients with intermittent claudication. Ten patients (mean age, 63.4 ± 11.6 years) with symptomatic peripheral arterial occlusive disease (PAOD) caused by SFA stenoses were investigated before and after PTA. Patients underwent BOLD-MRI 1 day before and 6 weeks after PTA. A T2*-weighted single-shot multi-echo echo-planar MR-imaging technique was applied. The BOLD measurements were acquired at mid-calf level during reactive hyperaemia at 1.5 T. This transient hyperperfusion of the muscle tissue was provoked by suprasystolic cuff compression. Key parameters describing the BOLD signal curve included maximum T2*(T2*max), time-to-peak to reach T2*max (TTP) and T2* end value (EV) after 600 s of hyperemia. Paired t-tests were applied for statistic comparison. Between baseline and post-PTA, T2*max increased from 11.1±3.6% to 12.3±3.8% (p=0.51), TTP decreased from 48.5±20.8 s to 35.3±11.6 s (p=0.11) and EV decreased from 6.1±6.4% to 5.0±4.2% (p=0.69). In conclusion, BOLD-MRI reveals changes of the key parameters T2*max, TTP, and EV after successful PTA of the calf muscles during reactive hyperaemia. (orig.)

  3. 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.)

  4. 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

  5. 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

  6. Angioplasty and stent placement - heart

    Science.gov (United States)

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

  7. 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.

  8. 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...

  9. The application of subintimal recanalization in percutaneous transluminal angioplasty for chronic long-segment occlusion of femoropopliteal artery

    International Nuclear Information System (INIS)

    Objective: To discuss the technical points and clinical efficacy of subintimal recanalization technique in treating chronic long-segment total occlusion of femoropoliteal artery. Methods: Forty-two patients with chronic long-segment total occlusion of femoropoliteal artery underwent subintimal recanalization treatment. The basic procedure of subintimal recanalization was as follows. First, a subintimal path in the wall of the occluded artery was created by inserting a super-slip guide wire and the guide wire was then pushed into the true lumen of the outflow tract, which was followed by balloon angioplasty and stent placement to insure the patency of the re-canalized path. The technical points were discussed and the clinical results were evaluated. Results: The subintimal recanalization of occluded arterial segment was successfully achieved in 39 patients. The clinical symptoms were promptly and remarkably relieved after the procedure. The technical success rate was 92.9% (39/42). Technical failure occurred in three patients because the guide wire could not be managed into the true lumen of the outflow tract. Conclusion: The subintimal recanalization is an effective and safe technique for the treatment of chronic long-segment total occlusion of femoropoliteal artery. (authors)

  10. Percutaneous transluminal angioplasty after vascular surgery

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    1986-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Huraib Sameer

    2001-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  16. 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.

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

    International Nuclear Information System (INIS)

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

  18. Transluminal angioplasty in the management of mesenteric angina

    International Nuclear Information System (INIS)

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

  19. Effect of percutaneous transluminal coronary angioplasty on coronary reserve

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  2. 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...

  3. 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.

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

    International Nuclear Information System (INIS)

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

  5. [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

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

    DEFF Research Database (Denmark)

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

    1991-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Bilkis, Valdas; Kibarskis, Aleksandras; Abraitis, Vytautas

    2004-01-01

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

  9. 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.

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

    Science.gov (United States)

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

    1999-10-01

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

  11. Radiation risk to patients from percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

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

  12. 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.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Marinez Kellermann Armendaris

    2008-03-01

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

  15. Renal artery stent angioplasty for renovascular hypertension

    International Nuclear Information System (INIS)

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

  16. 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

  17. 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

  18. 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

  19. 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...

  20. 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.)

  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. 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.

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    ALPER, Gülinnaz

    1999-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    鹿小燕; 徐浩; 史大卓; 陈可冀

    2004-01-01

    Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS rate can reach 30% to 50%, even with 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.

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

    Institute of Scientific and Technical Information of China (English)

    鹿小燕; 徐浩; 史大卓; 陈可冀

    2004-01-01

    Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS rate can reach 30% to 50%, even with 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  15. 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...

  16. Incidence of major amputations, bypass procedures and percutaneous transluminal angioplasties (PTA) in the treatment of peripheral arterial occlusive disease in a German referral center 1996-2003; Inzidenzen von Major-Amputationen, Bypass-Operationen und perkutanen transluminalen Angioplastien (PTA) zur Behandlung der peripheren arteriellen Verschlusskrankheit in einer deutschen Klinik der Maximalversorgung 1996-2003

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-09-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-02-01

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

  18. Hemodynamic evaluation of transluminal iliac artery balloon dilatation.

    Science.gov (United States)

    Breslau, P J; van Soest, M; Janevski, B; Jörning, P J

    1985-10-01

    In order to document the hemodynamic results of transluminal iliac artery balloon dilatation, 23 aortoiliac segments were evaluated before and after treatment. Hemodynamic parameters were: intra-arterial common femoral pressure measurements, indirect ankle pressure measurements and femoral velocity waveform analysis. The segments were divided into group (a) aortoiliac segments with an open superficial femoral artery (n = 8), and group (b) aortoiliac segments with an occluded superficial femoral artery (n = 15). In group (a) all patients were free of symptoms and ankle pressure improved significantly six months after dilatation. Velocity waveform analysis of the common femoral artery did not correlate with this improvement. In group (b) intra-arterial pressure measurements showed improvement in 60% (9/15) after six months. Ankle pressure measurements and velocity waveform analysis did not correlate with the intra-arterial pressure changes. Transluminal iliac artery balloon dilatation of iliac stenosis in patients with an open superficial femoral artery can be evaluated by indirect ankle pressure measurements. In patients with iliac stenosis in combination with occluded superficial femoral arteries intra-arterial pressure measurements are needed to demonstrate hemodynamic improvement. PMID:2932658

  19. The effects of delayed percutaneous transluminal coronary angioplasty plus intracoronary stents on myocardial perfusion in patients with acute myocardial infarction

    International Nuclear Information System (INIS)

    Objective: To assess the myocardial perfusion in patients with acute myocardial infarction (AMI) after delayed percutaneous transluminal coronary angioplasty (PTCA) and intracoronary stent implanting. Methods: Fifty-six patients with AMI were divided into delayed PTCA + stent group (treatment group, n=30) and control group (n=26). The treatment group were received delayed PTCA and coronary artery stents 15-30 d after AMI. The first 99Tcm-MIBI was performed 1-3 d before PTCA + stent (treatment group) and 15-30 d after AMI (control group), and followed by the second (1 month later), and the third (6 months later) 99Tcm-MIBI. Results: One month and six months after the treatment procedure (PTCA + stent), the blood flow deficit degree of myocardial infarction area in treatment group was much improved comparing with that before the procedure (treatment group, P0.05). Conclusions: There is residual myocardial viability in the AMI regions and PTCA + stent implantation keeps more jeopardize myocardium viable. Active therapy after AMI can significantly improve myocardial perfusion

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

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

    International Nuclear Information System (INIS)

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

  2. 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...

  3. 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

  4. 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 ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-12-01

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

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

    International Nuclear Information System (INIS)

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

  7. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  11. 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

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

    International Nuclear Information System (INIS)

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

  13. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Rath, B.; Bennett, D. H.

    1990-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

  19. 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

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

    Czech Academy of Sciences Publication Activity Database

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

  2. 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.

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

    International Nuclear Information System (INIS)

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

  4. 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.

  5. 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.)

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  8. 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

  9. 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.

  10. 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.

  11. 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: ...

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

    International Nuclear Information System (INIS)

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

  13. 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

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

    International Nuclear Information System (INIS)

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

  15. Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Mohammad Arabi

    2014-01-01

    Full Text Available Although endovascular management of lower extremity peripheral arterial disease (PAD is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

  18. 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.)

  19. 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.

  20. Collagen turnover in arterial disease

    OpenAIRE

    Sluijter, J.P.G.

    2004-01-01

    Increased atherosclerotic plaque formation can lead to lumen reduction and finally to lumen obstruction. Percutaneous transluminal angioplasty (PTA) or balloon angioplasty (dilation) are approaches generally used to treat coronary, but also peripheral atherosclerotic disease. Their goal is to restore the blood supply. The repair process or restructuring of the artery after balloon angioplasty comprises two major features, neointimal formation and geometrical remodeling, and results in a decre...

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

    International Nuclear Information System (INIS)

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

  2. Aorto-iliac angioplasty

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.

    2003-01-01

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

  5. 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

  6. 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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2015-11-01

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

  9. Renal dynamic imaging for the treatment assessment of renal artery angioplasty and stenting in patients with atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To investigate the value of renal dynamic imaging with 99Tcm-DTPA on the evaluation and prediction of the outcome after percutaneous transluminal renal artery angioplasty and stenting (PTRAS) in patients with atherosclerotic renal artery stenosis (ARAS). Methods: Seventy-six patients with unilateral ARAS underwent PTRAS successfully. All the patients received baseline renal dynamic imaging within 2 weeks before the surgery and follow-up imaging 6 months after PTRAS. GFR (per 1.73 m2 of body surface area) of kidney with ARAS was measured with the Gates method. ARAS was classified as mild (50%-69%),moderate (70%-89%), and severe (≥90%) stenosis according to the results of renoarteriography before the surgery. GFR was graded as Ⅰ (GFR≥30 ml · min-1), Ⅱ (15 ml · min-1 ≤GFR <30 ml · min-1) and Ⅲ (GFR < 15 ml · min-1), on the baseline dynamic imaging.Blood pressure was also measured before and after the surgery. The t test, χ2 test, Fisher exact test and multiple logistic regression analysis were used for statistical analysis with SPSS 13.0. Results: The baseline GFR of kidney with mild and moderate ARAS was significant higher than that with severe stenosis ((26.79 ± 15.34) vs (19.48 ±11.56) ml · min-1, t=2.262, P=0.027). The blood pressure was improved in 32% (24/75), and not changed in 68% (51/75) of patients.Improvement of blood pressure was observed in 39.62% (21/53) of patients with a baseline GFR≥ 15 ml · min-1, and in 13.64% (3/22) of patients with a baseline GFR <15 ml · min-1 (χ2=4.825, P=0.028). Using multivariate analysis, baseline GFR ≥ 15 ml · min-1 was the only predictor of blood pressure improvement (OR=0.465, P=0.032). GFR in kidney with ARAS was improved in 22.37% (17/76), stable in 68.42% (52/76), and worse in 9.21% (7/76) of patients. The 33.33% (8/24) and 17.65% (9/51) of patients with and without blood pressure improvement, respectively, achieved GFR improvement. However, the difference was not statistically

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2011-11-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Gutierrez, Noelia Grande

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  16. 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.

  17. 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.

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

    Science.gov (United States)

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

    2014-11-01

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

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

    International Nuclear Information System (INIS)

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

  20. 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.

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    De Pasquale C

    2014-06-01

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

  4. 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

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

    International Nuclear Information System (INIS)

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

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

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

    International Nuclear Information System (INIS)

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

  9. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  13. Local Intra-Arterial Fibrinolysis in Acute Basilar Artery Occlusion

    OpenAIRE

    Enomoto, Y.; Yoshimura, S.; Kitajima, H.; Tamakawa, N.; Iwama, T

    2007-01-01

    Acute basilar artery (BA) occlusion is typically associated with poor outcome; however newer diagnostic and treatment modalities have the potential to improve prognosis. In this study, six patients with acute BA occlusion were followed and the effectiveness of local intra-arterial fibrinolysis (LIF) and subsequent percutaneous transluminal angioplasty (PTA) with a balloon catheter were assessed. Of the six patients with BA occlusion observed in this study, two had extended brain stem infarcti...

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2009-09-01

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

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

    International Nuclear Information System (INIS)

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

  17. 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

  18. Transluminal placement of a prosthetic graft-stent device for treatment of subclavian artery aneurysm.

    Science.gov (United States)

    May, J; White, G; Waugh, R; Yu, W; Harris, J

    1993-12-01

    A 78-year-old man was seen with an expanding 5 cm false aneurysm of the right subclavian artery. This was treated by an intraluminal graft-stent device introduced through the brachial artery via a 16 F sheath. The graft was constructed from two polytetrafluoroethylene patches of 0.4 mm thickness and anchored in the subclavian artery by an 8 mm stainless steel stent. The procedure was monitored by an image intensifier. Completion arteriography and postoperative duplex scanning confirmed normal flow through the subclavian artery with no communication between the lumen and the aneurysmal sac. The patient recovered without complication. PMID:8264035

  19. 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.)

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  2. 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).

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

    International Nuclear Information System (INIS)

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

  4. 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

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

    International Nuclear Information System (INIS)

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

  6. 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

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

    International Nuclear Information System (INIS)

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

  8. 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

  9. 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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2009-01-01

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

  12. 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

  13. 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

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

    International Nuclear Information System (INIS)

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

  15. 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

  16. Reperfusion hemorrhage following superior mesenteric artery stenting.

    LENUS (Irish Health Repository)

    Moore, Michael

    2012-02-03

    Percutaneous transluminal angioplasty and stent placement is now an established treatment option for chronic mesenteric ischemia and is associated with low mortality and morbidity rates. We present a case of reperfusion hemorrhage complicating endovascular repair of superior mesenteric artery stenosis. Although a recognized complication following repair of carotid stenosis, hemorrhage has not previously been reported following mesenteric endovascular reperfusion. We describe both spontaneous cessation of bleeding and treatment with coil embolization.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

  19. Transluminal color-coded three-dimensional magnetic resonance angiography for visualization of signal Intensity distribution pattern within an unruptured cerebral aneurysm: preliminarily assessment with anterior communicating artery aneurysms

    International Nuclear Information System (INIS)

    The natural history of unruptured cerebral aneurysm is not known; also unknown is the potential growth and rupture in any individual aneurysm. The authors have developed transluminal color-coded three-dimensional magnetic resonance angiography (MRA) obtained by a time-of-flight sequence to investigate the interaction between the intra-aneurysmal signal intensity distribution patterns and configuration of unruptured cerebral aneurysms. Transluminal color-coded images were reconstructed from volume data of source magnetic resonance angiography by using a parallel volume-rendering algorithm with transluminal imaging technique. By selecting a numerical threshold range from a signal intensity opacity chart of the three-dimensional volume-rendering dataset several areas of signal intensity were depicted, assigned different colors, and visualized transparently through the walls of parent arteries and an aneurysm. Patterns of signal intensity distribution were analyzed with three operated cases of an unruptured anterior communicating artery aneurysm and compared with the actual configurations observed at microneurosurgery. A little difference in marginal features of an aneurysm was observed; however, transluminal color-coded images visualized the complex signal intensity distribution within an aneurysm in conjunction with aneurysmal geometry. Transluminal color-coded three-dimensional magnetic resonance angiography can thus provide numerical analysis of the interaction between spatial signal intensity distribution patterns and aneurysmal configurations and may offer an alternative and practical method to investigate the patient-specific natural history of individual unruptured cerebral aneurysms. (orig.)

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

    International Nuclear Information System (INIS)

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

  1. Arterio-oesophageal fistula caused by aberrant right subclavian artery aneurysm

    OpenAIRE

    Takahashi, Shinya; Okada, Kenji; Orihashi, Kazumasa; Sueda, Taijiro

    2013-01-01

    A 63-year old man had dysphagia for 4 months and was admitted to our hospital with sudden haematemesis. Computed tomography revealed an aberrant right subclavian artery (ARSA) aneurysm and free air inside the aneurysm. Arterio-oesophageal fistula was diagnosed, and an emergency operation was performed. Before thoracotomy, a percutaneous transluminal angioplasty (PTA) balloon was inserted from the right brachial artery and placed at the orifice of the ARSA to control bleeding. Through a left t...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-04-15

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

  4. Interventional therapy of renal artery stenosis in kidney transplants

    International Nuclear Information System (INIS)

    Objective: To evaluate efficacy of percutaneous transluminal angioplasty (PTA) and stenting for treatment of transplanted renal artery stenosis (TRAS). Method: Seven patients with TRAS were included in this study. By femoral or axillary approach, balloon angioplasty and/or metallic stents placement at stenotic renal artery were performed. Results: Of the seven patients, balloon angioplasty was carried out in 3 (2 cases via femoral artery, 1 via axillary artery), both balloon angioplasty and metallic stents placement were performed in 4 (2 via femoral artery, 2 via axillary artery). After the procedure, blood pressure recovered to normal in 5 cases, controlled with administration of antihypertensive in the other 2 cases. By 9 to 36 month's follow-up, restenosis of renal artery occurred in only 1 case at 9 months after stent implantation. The second balloon angioplasty were taken and better renal artery blood flow was obtained in this case. Other 6 cases showed no restenosis. Conclusion: PTA and stents placement were effective and safe approach in treatment of TRAS. Further investigation was needed to prevent and manage restenosis after these procedures

  5. 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

  6. 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

  7. 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.

  8. Cryoplasty for the Prevention of Arterial Restenosis

    International Nuclear Information System (INIS)

    Restenosis after percutaneous transluminal angioplasty remains the limiting factor for the long-term benefit of endovascular therapies of peripheral arterial occlusive disease. Despite a variety of modifications and adjuncts to angioplasty such as bare metal stents, covered stents, and drug-eluting stents as well as a number of new technologies like laser angioplasty and cutting balloon angioplasty, restenosis rates have not been significantly affected and remain inferior to those for surgery for long lesions in the femoropopliteal segment. Cryoplasty, which combines balloon angioplasty with the application of cryothermal energy to the vessel wall, was suggested as a promising approach to prevent the formation of neointimal hyperplasia after angioplasty procedures. This review discusses the basic principles of cryoplasty, summarizes the current data on restenosis rates after cryoplasty treatment, and evaluates cryoplasty as a new treatment method to solve the problems associated with restenosis development. The results of the clinical studies suggest that cryoplasty is a feasible and safe technique in the treatment of femoropopliteal disease, however, they have failed to prove any superiority of cryoplasty over conventional angioplasty.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

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

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

    International Nuclear Information System (INIS)

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

  11. 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

  12. Peripheral artery atherectomy

    International Nuclear Information System (INIS)

    Twenty-one femoropopliteal percutaneous transluminal atherectomies were performed with the Simpson catheter. Evaluation included clinical examination, Doppler ultrasonography (ankle-arm index, before and immediately and 1,3 and 6 months after atherectomy), and angiography (6 months after or for clinical worsening). Twenty of 21 procedures achieved satisfactory vessel patency, with the addition of complementary angioplasty for residual stenosis over 30% (one of three cases). Early thrombosis occurred in only one of 21 cases (absence of platelet inhibitor pretherapy), and no distal embolization occurred. Six-month follow-up showed stable improvements in 11 of 12 patients and restenosis in only one (absence of platelet inhibitor pretherapy). Preliminary results indicate that atherectomy is the method of choice for restoring large lumens, with minimal arterial wall injury and fewer cases of restenosis than with angioplasty

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

    OpenAIRE

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

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  16. Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans

    International Nuclear Information System (INIS)

    To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2014-01-01

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

  20. 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

  1. Endovascular brachytherapy to prevent restenosis after angioplasty

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  3. Balloon Angioplasty and Drug Eluting Stenting for Treatment of Peripheral Arterial Occlusive Disease

    Directory of Open Access Journals (Sweden)

    Akın İzgi

    2010-08-01

    Full Text Available Peripheral arterial disease is one of the manifestations of systemic atherosclerosis. In the last decade, remarkable technological advances, especially in the stent area, have shifted revascularization strategies from traditional open surgical approaches toward less morbide percutaneous endovascular treatments. However, even with new designed nitinol bare stents, restenosis remains as the major obstacle of this procedures. More recently, drug eluting stent platforms have been used to treat atherosclerotic peripheral arterial disease. In this article, we reviewed new studies relevant to drug eluting stents for lower extremity peripheral arterial occlusive disease.

  4. Surgical removal of entrapped guidewire fragment following direct circumflex artery angioplasty and stenting

    Science.gov (United States)

    Domaradzki, Wojciech; Skwarna, Bartosz; Król, Marek; Kuczera, Małgorzata; Cisowski, Marek

    2015-01-01

    We present a case of a 64-year-old man with coronary artery disease, who underwent a percutaneous coronary intervention of the circumflex artery. As the guidewire was being withdrawn from the target vessel, it became entrapped by the structure of the previously implanted stent. Attempts to retrieve the foreign body were unsuccessful. Changes in electrocardiogram were observed during the procedure, and the level of cardiac biomarkers increased within the next 24-hours. The patient was admitted to the Cardiac Surgery Department. Remnants of the foreign body were removed under visual control using extracorporeal circulation, and coronary artery bypass grafting was performed. Treatment options and outcomes are discussed. PMID:26702281

  5. Flow Quantification from 2D Phase Contrast MRI in Renal Arteries Using Clustering

    Science.gov (United States)

    Zöllner, Frank G.; Monnsen, Jan Ankar; Lundervold, Arvid; Rørvik, Jarle

    We present an approach based on clustering to segment renal arteries from 2D PC Cine MR images to measure blood velocity and flow. Such information are important in grading renal artery stenosis and support the decision on surgical interventions like percutan transluminal angioplasty. Results show that the renal arteries could be extracted automatically and the corresponding velocity profiles could be calculated. Furthermore, the clustering could detect possible phase wrap effects automatically as well as differences in the blood flow patterns within the vessel.

  6. Acute Vertebral Artery Origin Occlusion Leading to Basilar Artery Thrombosis Successfully Treated by Angioplasty with Stenting and Thrombectomy

    OpenAIRE

    Abe, Arata; Okubo, Seiji; Onozawa, Shiro; Nakajima, Masataka; Suzuki, Kentaro; Harada-Abe, Mina; Ueda, Masayuki; Katsura, Ken-ichiro; Katayama, Yasuo

    2014-01-01

    Few reports have described the successful treatment of stroke caused by acute vertebral artery (VA) origin occlusion by endovascular surgery. We describe the case of a 68-year-old man who experienced stroke due to left acute VA origin occlusion. Cerebral angiography showed that the left VA was occluded at its origin, the right VA had hypoplastic and origin stenosis, and the basilar artery was occluded by a thrombus. The VA origin occlusion was initially passed through with a 0.035-inch guide ...

  7. 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

  8. Balloon angioplasty of infrapopliteal artery in chronic lower limb ischemia with diabetes

    International Nuclear Information System (INIS)

    Objective: To evaluate the technique, successful rate and perioperative complications together with the therapy and prevention of using PTA in treating diabetic patients with infrapopliteal arterial diseases. Methods: Angiographic and clinical data of 27 patients with diabetic lower limb ischemia treated by PTA from January 2006 to May 2007 were retrospectively reviewed. Rutherf0rd-Becker categories and ankle- brachial index(ABI)were evaluated before and after the treatment. The effects were compared between different lesion types (stenosis or occlusion)and between different ways of balloon technique. The complications were also analyzed, together with the primary, discussion of the therapy and prevention. Results: 24 patients showed improvement of ischemic symptoms, and 3 cases fell in failure. The intra-procedural main complications included acute thrombosis, vascular wall perforation, distal emboli resulting from plaque falling off and dissection. There were statistically significant differences between the effects of two type lesions and between different balloon methods. Conclusions: 1. The condition of lower limb arteries should be assessed carefully before operation. 2. PTA shows safe and good clinical result and ought to be recommended in treating diabetic patients with peripheral arterial diseases, especially the lower extremity ischemia. (authors)

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

    International Nuclear Information System (INIS)

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

  11. 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.

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

    International Nuclear Information System (INIS)

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

  13. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-03-01

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

  15. 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- ...

  16. 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.

  17. 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.

  18. 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.

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

    International Nuclear Information System (INIS)

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

  20. Clinical-pathological-angiographic correlations following transluminal atherectomy

    International Nuclear Information System (INIS)

    Following percutaneous atherectomy, arterial and catheter diameter relationships were correlated with angiographic and ankle-arm index results. There was a greater amount of tissue removed, improved luminal reconstitution, and ankle-arm index in lesions where the catheter and arterial diameters were equal or within 0.5 mm. Excluding lesions requiring angioplasty, 77% of our lesions had less than 30% residual stenosis; including lesions requiring concomitant angioplasty, the initial overall patency was 93%, with a 1-year patency rate of 92.5%. This study indicates that adequate matching of the atherectomy catheter diameter to the arterial diameter is necessary to optimize tissue removal and clinical results

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

    International Nuclear Information System (INIS)

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

  2. Intra-arterial infusion of prostaglandin EI in Buerger's disease

    International Nuclear Information System (INIS)

    In Buerger's disease, arterial occlusion is so peripheral that reopening procedure such as reconstructive vascular surgery, percutaneous transluminal angioplasty and local fibrinolysis are not feasible, and major amputation is the only alternative. Prostaglandin E1, a potent vasodilator and inhibitor of platelet aggregation, has been used to treat the patients with severe arterial occlusive disease. In three cases of Buerger's disease, who are manifested by resting pain, non-healing ischemic ulcer, or impending gangrene and who were not candidates for direct arterial reconstructive procedure, we infused Prostaglandin El intraarterially at a fixed dosage to evaluate its effectiveness. We report our experience with the use of this drug in relieving the ischemic symptoms, healing the intractable ulcer, or avoiding the major amputation

  3. Drug-Coated Balloons for Infrainguinal Peripheral Artery Disease.

    Science.gov (United States)

    Sethi, Sanjum S; Lee, Michael S

    2016-07-01

    Revascularization of infrainguinal peripheral artery disease has traditionally been accomplished via percutaneous transluminal angioplasty. However, long-term results have been hampered by high rates of restenosis. Along with the advent of stents, paclitaxel-coated balloons are an emerging therapeutic option for the invasive management of infrainguinal peripheral artery disease. Paclitaxel has been successful in inhibiting neointimal hyperplasia, the main mechanism for in-stent restenosis. Technological advances have facilitated the development of paclitaxel-coated balloons, which show promise in early trials for femoropopliteal stenosis relative to uncoated balloons. For infrapopliteal stenoses, the data remain scant and conflicted. Therefore, large-scale randomized clinical trials with long-term follow-up evaluating safety and effectiveness between various strategies need to be performed to determine the optimal invasive management strategy for infrainguinal peripheral artery disease. PMID:27342205

  4. 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...

  5. The Outback Catheter: A New Device for True Lumen Re-entry After Dissection During Recanalization of Arterial Occlusions

    International Nuclear Information System (INIS)

    To report the initial experience with a new catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions. The catheter was used in 10 patients with intermittent claudication caused by chronic segmental occlusions of the superficial femoral or popliteal arteries. In all patients, conventional guidewire recanalization had failed. In 8 patients, successful true lumen re-entry was achieved with the Outback catheter. Percutaneous transluminal angioplasty was successfully performed in these patients without complications. Two technical failures occurred in heavily calcified arteries. The Outback catheter was safe and effective when used in complicated recanalization procedures in the superficial femoral and popliteal artery and the tibial trunk

  6. Excimer laser-assisted recanalisation of femoral arterial stenosis or occlusion caused by the use of Angio-Seal

    International Nuclear Information System (INIS)

    The aim of this study was to demonstrate the effect of excimer laser and balloon angioplasty of femoral artery stenosis and occlusion after use of a haemostatic puncture closure device. A haemostatic puncture closure device (Angio-Seal) was used in 6000 patients after diagnostic or therapeutic artery catheterisation. In 34 of those patients symptoms of peripheral artery disease occurred. Sixteen of those 34 cases were transferred to our clinic for excimer laser angioplasty. All 16 patients presented with symptoms of acute peripheral artery disease within 1-14 days: superficial femoral artery (SFA) occlusions (4 cases); superficial femoral artery stenosis (3 cases); high-grade stenosis of the common femoral artery (CFA; 3 cases); high-grade stenosis of CFA; SFA and profund femoral artery (PFA; 3 cases); and occlusions of CFA, SFA and PFA (3 cases). Before any procedure was performed, informed consent was given by the patient, which included the use of the Angio-Seal closure device. Every patient who had to undergo recanalisation procedures gave additional informed consent which especially included the usage of the excimer laser for recanalisation. A measurement of the walking distance, ankle-brachial systolic pressure index (ABI) and diagnostic angiography was performed in 13 cases before and immediate after as well as 3 and 6 months after therapeutic percutaneous transluminal laser angioplasty followed by balloon angioplasty (PTLA/PTA). In 3 patients the risks of PTLA/PTA was considered too high; those patients underwent surgical repair. Angiographic and clinical improvement was achieved in 13 of 13 patients. The mean walking distance increased from 81 to >400 m. The average ankle-brachial systolic pressure index (ABI) increased from 0.47 to 0.84. One patient developed a dissection of the SFA, and in 1 case a peripheral embolisation was seen. The PTLA/PTA technique is a successful therapeutic option for patients with femoral artery occlusion or high-grade stenosis

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

    DEFF Research Database (Denmark)

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

    1990-01-01

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

  8. 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

  9. Recanalization of superficial femoral artery by retrograde approach via popliteal artery

    International Nuclear Information System (INIS)

    To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all men and range of age were from 53 years to 66 years (mean age: 63 years). Range of lesion length were from 15 cm to 30 cm (mean length: 22.4 cm). Localization of popliteal artery was done with Doppler stethoscope or 'road-map' DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). Retrograde puncture of popliteal artery was done in 15 patients successfully. TEC and PTA was performed in 9 patients, TEC only in 2 patients, and TLA and PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occur in 10 patients except for 1 patient with poor cardiac output in whom it occurred 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. Retrograde approach of superficial femoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method

  10. Recanalization of superficial femoral artery by retrograde approach via popliteal artery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Kyu; Kim, Hyung Kil; Yun, Ung; Seo, Jeong Jin; Kang, Heoung Keun [Chonnam University Medical School, Kwangju (Korea, Republic of)

    1995-09-15

    To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all men and range of age were from 53 years to 66 years (mean age: 63 years). Range of lesion length were from 15 cm to 30 cm (mean length: 22.4 cm). Localization of popliteal artery was done with Doppler stethoscope or 'road-map' DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). Retrograde puncture of popliteal artery was done in 15 patients successfully. TEC and PTA was performed in 9 patients, TEC only in 2 patients, and TLA and PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occur in 10 patients except for 1 patient with poor cardiac output in whom it occurred 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. Retrograde approach of superficial femoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.

  11. A blunt chest trauma causing left anterior descending artery dissection and acute myocardial infarction treated by deferred angioplasty

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

    Full Text Available Traumatic coronary artery dissection is an uncommon cause of acute myocardial infarction (AMI. We report a case of blunt chest trauma resulting from a motorcycle collision causing ostial dissection of the left anterior descending (LAD artery in a 31-year-old previously healthy male. The patient also suffered from compound comminuted fractures of the humerus and ulna and severe liver laceration, which hampered both percutaneous and surgical acute revasularization. After a stormy hospital course, a bare metal stent was implanted to seal the LAD artery dissection. The patient was discharged in a stable condition and was followed-up for rehabilitation. This case report underscores the multidisciplinary approach in facing challenges encountered after rare sequelae of chest trauma.

  12. The Erasme Study: A Multicenter Study on the Safety and Technical Results of the Palmaz Stent Used for the Treatment of Atherosclerotic Ostial Renal Artery Stenosis

    International Nuclear Information System (INIS)

    Purpose: To assess, in a multicenter setting, safety, technical results, and restenosis rate of the Palmaz stent for treatment of atherosclerotic ostial renal artery stenosis. Methods: Ten centers enrolled 106 patients (120 treated renal artery stenoses) in the study. Patient selection was based on unsuccessful percutaneous transluminal renal angioplasty (residual stenosis ≥ 20%) performed for treatment of ostial stenosis ≥ 50%, in patients with hypertension and/or impaired renal function. Safety was assessed by means of the complication rate, and technical results by the number of successful stent placements and occurrence of restenosis (>50%) at intraarterial angiographic follow-up. Results: Stent placement was successful (n = 112) or partially successful (n = 5) in 117 (98%) arteries. Complications occurred in 19 procedures; seven were of serious clinical significance. Angiographic follow-up was performed in 89 of 117 (76%) cases, at a mean of 8 months (range 2.5-18 months). Fifteen stents (16.9%) showed restenosis (at a mean of 8.5 months), of which 10 were successfully redilated. Conclusion: Renal artery stenting has a high technical success rate, a complication rate comparable to percutaneous transluminal renal angioplasty, and a low rate of restenosis at 8 months angiographic follow-up

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Parag Chevli

    2014-09-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Kamalesh, Masoor

    2015-01-01

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

  17. Percutaneous treatment of critical lower limb ischemia in patients with obstruction of the crural arteries

    International Nuclear Information System (INIS)

    This article describes the application of percutaneous transluminal angioplasty (PTA) in the treatment of crural artery obstruction in patients with critical lower limb ischemia. In 17 patients, 24 PTAs of crural artery obstructions were performed. The clinical material consisted of 9 men and 8 women, whose mean age was 72 years (range 54-85 years). 11 patients were classified in clinical stage Fontaine IV, and 6 in stage III. The obstructions were from 3 to 21 cm (mean 6 cm). In 8 cases, PTA of the femoropopliteal segment was also carried out. The risk factors and comorbidities included diabetes 10 cases (58.8%), hypertension 9 cases (56%), ischemic heart disease 8 cases (50%), hyperlipidaemia 7 cases (43.8%), cerebrovascular diseases 3 cases (18.8%), and cigarette smoking 6 cases (37.5%). Technical success was defined as restoration of the artery along its whole length to the foot. Pain relief at rest and healing of trophic lesions at 30-day follow-up were recognized as a good outcome. Technical success was achieved in 12 patients (70.6%). In 2 cases the patency was only restored in the proximal part of the artery (12.5%). In 3 cases (17.6%) the procedure failed. In one case acute occlusion of the artery occurred. In 2 cases the obstruction was not successfully passed with a guidewire. In 4 cases hematoma was found at the puncture site, without clinical consequences. In 13 patients (76.4%) clinical success was achieved. Percutaneous transluminal angioplasty is an effective and relatively safe method of treatment of patients with critical limb ischemia caused by obstruction of the crural arteries. (author)

  18. Endovascular Therapy for Femoropopliteal Artery Disease and Association of Risk Factors With Primary Patency: The Implication of Critical Limb Ischemia and TASC II C/D Disease.

    Science.gov (United States)

    Nishibe, Toshiya; Yamamoto, Kiyohito; Seike, Yoshimasa; Ogino, Hitoshi; Nishibe, Masayasu; Koizumi, Jun; Dardik, Alan

    2015-11-01

    The treatment of femoropopliteal artery disease remains controversial, without clear guidelines specifying the indications for endovascular therapy (EVT). Accordingly, we retrospectively examined our experience of using EVT to treat femoropopliteal artery disease. A total of 91 limbs in 82 patients underwent EVT for the treatment of femoropopliteal artery disease. Percutaneous transluminal angioplasty alone was performed in 20 limbs, and additional stenting was performed in 71 limbs. The 1-year primary patency, primary-assisted patency, limb salvage, and survival rates were 76%, 88%, 96%, and 92%, respectively. Multivariate Cox analysis of primary patency showed that critical limb ischemia (CLI; hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.08-5.33; P EVT for femoropopliteal artery disease. PMID:26574486

  19. Brakial Arter Oklüzyonunda Rekonalizasyon Ve Perkütan Translüminal Anjiyoplasti

    OpenAIRE

    Yazici, B; Akan, H.; SARAÇ, A.

    2010-01-01

    Recanalization and Percutaneous Transluminal Angioplasty in Brachial Artery Occlusion: Case Report Percutaneous transluminal angioplasty is a widely-accepted method for patients with arterial stenosis and occlusion. Technical succes rate of percutaneous transluminal angioplasty is higher than 90 % in atherosclerotic lesions. In this study, the results of percutaneous transluminal angioplasty were evaluated in a 49-year-old women with coldness, numbness and pain in her right hand due to bra...

  20. Angiographic diagnosis and therapy for radiological interventions in obliterative atherosclerosis of the pelvic and lower limb arteries

    International Nuclear Information System (INIS)

    Angiographic diagnosis and therapy are discussed in relationship to the indications and follow-up of radiological interventions in patients with obliterative atherosclerosis located in the arteries of the pelvis and lower limbs. Various noninvasive diagnostic procedures permit reliable clinical information to be obtained on the localization, extent and geometry of arterial lesions, and the velocity of blood in the vascular system. Determination of symptom-limited ergometry and oscillographic, plethysmographic, Doppler sonographic, light microscopic and magnetic resonance techniques are all described in more detail. The therapeutic interventions are mentioned with regard to angiography and percutaneous transluminal angioplasty (PTA), with particular emphasis on the treatment of risk factors, training, and medication. The long-term results are given after PTA for the Freiburg patient series. Thus, the cooperation of angiologists, radiologists and vascular surgeons considerably optimizes the treatment of patients suffering from occlusive arterial disease. (orig.)

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    José Lamartine de Andrade Aguiar

    2007-01-01

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

  5. Management of Renal Artery Stenosis - an Update

    Directory of Open Access Journals (Sweden)

    Alhadad A

    2008-01-01

    Full Text Available The role of the renal vasculature in eliciting renovascular hypertension (RVH was established in 1934, when Goldblatt et al. [1] in a classical experimental study demonstrated that partial obstruction of the renal artery increased mean arterial blood pressure (BP. The pathophysiology of renal artery stenosis (RAS is incompletely understood but has been postulated to be related to increased afterload from neurohormonal activation and cytokine release [2].Atherosclerotic RAS (ARAS is increasingly diagnosed in the expanding elderly population, which also has a high prevalence of arterial hypertension. There is still considerable uncertainty concerning the optimal management of patients with RAS. Many hypertensive patients with RAS have co-existing essential hypertension and furthermore, it is often difficult to determine to what degree the RAS is responsible for the impairment of renal function. There are three possible treatment strategies: medical management, surgery, or percutaneous transluminal renal angioplasty (PTRA with or without stent implantation. The use of stents has improved the technical success rate of PTRA and also led to lower risk of restenosis, in particular for ostial RAS. PTRA with stenting has therefore replaced surgical revascularisation for most patients with RAS and has led to a lower threshold for intervention. The treatment of choice to control hypertension in fibromuscular dysplasia (FMD is generally accepted to be PTRA [3]. In ARAS, on the other hand, the benefits with PTRA are less clear [4] and the challenge to identify which patients are likely to benefit from revascularisation remains unknown.

  6. Drug-eluting balloon catheters for lower limb peripheral arterial disease: the evidence to date

    Directory of Open Access Journals (Sweden)

    Barkat M

    2016-05-01

    Full Text Available Mohamed Barkat,1 Francesco Torella,1 George A Antoniou2 1Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Liverpool, 2Department of Vascular and Endovascular Surgery, The Royal Oldham Hospital, Pennine Acute Hospitals NHS Trust, Manchester, UK Abstract: A significant proportion of patients with severe lower limb peripheral arterial disease require revascularization. Over the past decade, an endovascular-first approach even for complex disease has gained widespread use among vascular specialists. An important limitation of percutaneous transluminal balloon angioplasty or stenting remains the occurrence of restenosis. Drug-coated balloons have emerged as an exciting technology developed to overcome the limitations of standard balloon angioplasty and stenting. Drug-eluting devices inhibit neointimal growth of vascular smooth muscle cells with the potential of preventing restenosis. This review provides a synopsis of the up-to-date evidence on the role of drug-coated balloons in the treatment of lower limb peripheral arterial disease. Bibliographic searches were conducted using MEDLINE, EMBASE, and the Cochrane Library electronic database. Eleven randomized clinical trials, two systematic reviews, and a published registry providing the best available evidence were identified. Current evidence suggests that angioplasty with drug-coated balloon is reliable, safe, and efficient in increasing patency rates and reducing target lesion revascularization and restenosis. However, it remains unknown whether these improved results can translate into beneficial clinical outcomes, as current randomized clinical trials have failed to demonstrate a significant benefit in limb salvage and mortality. Further randomized trials focusing on clinical and functional outcomes of drug-eluting balloons and on cost versus clinical benefit are required. Keywords: drug-eluting balloon, drug-coated balloon, angioplasty, peripheral arterial

  7. 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

  8. Diagnostic and therapeutic imaging of the renal circulation: Film-screen arteriography, digital subtraction angiography, and percutaneous angioplasty and embolization

    International Nuclear Information System (INIS)

    Renal dysfunction is often engendered by disorders of the major renal arteries or their arborizations. Alternatively, primary renal parenchymal disease may manifest vascular alterations, which are indicative of the pathogenetic condition. Thus for these groups of diseases, imaging of the renal circulation frequently provides information that will lead to a generic or specific diagnosis. Traditionally, renal vascular imaging has been accomplished by conventional film-screen angiography. More recently, however, digital subtraction angiography has become established as an advantageous method of diagnosing renal vascular diseases. In addition the role of angiography is becoming increasingly extended to include therapeutic applications, such as percutaneous transluminal angioplasty for renal artery stenosis and transcatheter embolization of parenchymal abnormalities. The contents of this chapter are twofold: In the first section (The Procedures and Their Attributes) the authors describe the techniques, their applications, and their virtues and disadvantages. The second section (Vascular Imaging and Renal Disease) places these vascular imaging methods within the context of evaluating and treating renal disease

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

    International Nuclear Information System (INIS)

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

  10. Exploration of the interventional diagnosis and treatment for atherosclerotic renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To determine the prevalence of renal artery stenosis (RAS) and the efficacy of percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with documented coronary artery disease. Methods: Selective renal artery angiography or abdominal digital subtraction angiography was performed immediately after coronary angiography to detect and quantify RAS in 200 consecutive patients with known or suspected coronary artery disease. Eight severe stenotic renal arteries in 7 patients were treated with PTRA and stenting. All the lesions are considered to be atherosclerotic. Results: RAS (defined as ≥50% diameter stenosis) was detected in 21 of 200 patients (10.5%) and 19 of 99 patients with coronary artery disease (19.2 % ) who had at least one coronary artery of ≥50 % diameter stenosis. Procedure success rate was 100% in the 7 patients received PTRA and stenting. Blood pressure control improved in 74.1% patients with hypertension. Angiographic follow-up was done in 3 patients in 3 to 9 months and no restenosis was found in the vessels. Conclusions: It is necessary to routinely perform RAS for the patients with coronary artery disease undergoing coronary angiography to identify RAS, especially in those associated with hypertension, so as to diagnose and treat RAS in early stage. PTRA and stenting carries high success rate and appears to be an effective and safe treatment for RAS

  11. The interventional management for early hepatic arterial thrombosis after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To summarize the interventional management for early hepatic arterial thrombosis (HAT)after liver transplantation. Methods: 32 patients suspected of HAT or HAS after liver transplantation in 502 cases from April 2001 to September 2006 were done hepatic arterial angiography. Among them, 20 patients were confirmed as HAT immediately through hepatic arterial angiography, and were further treated by transarterial thrombolysis, percutaneous transluminal angioplasty (PTA)and stent-graft placement. Results: HAT was identified in 20 patients (3.98%), occurring in the median 4.5 days (2-19 days)after liver transplantation. The sites of all the thrombosis were found at the anastomotic point of the hepatic artery. 5 cases were treated by PTA and 3 cases by stent placement during the transarterial thrombolysis. Coil and stent-graft were used in 2 cases with hepatic arterial anastomotic hemorrhage. Hepatic arterial recanalization was obtained in 20 cases. The period of thrombolysis was 2.5 days (2-11 days). Conclusions: Continuous infusion of urokinase through hepatic artery with catheter, PTA and stent placement are effective modalities for hepatic arterial thrombosis after liver transplantation. (authors)

  12. 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 ...

  13. Radiologic management of hepatic arterial stenosis or thrombosis following liver transplantation

    International Nuclear Information System (INIS)

    To assess the results and usefulness of interventional procedures for hepatic arterial stenosis or thrombosis following liver transplantation. During the past five years, eight patients aged 1-59 (mean, 39) years among 187 liver transplant recipients showed elevated of liver enzyme levels (AST/ALT) and decreased arterial flow at Doppler ultrasound. Hepatic arteriography revealed luminal stenosis or occlusion at the proper hepatic artery, and six patients, one of whom required thrombolysis before the procedure, underwent percutaneous transluminal angioplasty (PTA) using a balloon. In two with thrombosis, thrombolysis without PTA was performed. In order to increase hepatic arterial flow, four patients underwent additional coil embolization of the gastroduodenal or splenic artery. Hepatic arterial flow recovered in all six patients after PTA. Three required repeat PTA for restenosis and one of these needed stent placement after repeated PTA. At follow-up, 6-17 months later, the three had good hepatic function. Within four days, the other three expired due to graft failure, hepatorenal syndrome and sepsis. One of the patients who underwent thrombolysis without PTA expired and the other required retransplantation. In this case there were no procedure - related complications. Radiologic interventions are useful for treatment of hepatic arterial stensis or thrombosis in patients with liver transplantations

  14. Radiologic management of hepatic arterial stenosis or thrombosis following liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Byung Suck; Sung, Kyu Bo; Lim, Soo Mee; Yoon, Hyun Ki; Song, Ho Young [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-06-01

    To assess the results and usefulness of interventional procedures for hepatic arterial stenosis or thrombosis following liver transplantation. During the past five years, eight patients aged 1-59 (mean, 39) years among 187 liver transplant recipients showed elevated of liver enzyme levels (AST/ALT) and decreased arterial flow at Doppler ultrasound. Hepatic arteriography revealed luminal stenosis or occlusion at the proper hepatic artery, and six patients, one of whom required thrombolysis before the procedure, underwent percutaneous transluminal angioplasty (PTA) using a balloon. In two with thrombosis, thrombolysis without PTA was performed. In order to increase hepatic arterial flow, four patients underwent additional coil embolization of the gastroduodenal or splenic artery. Hepatic arterial flow recovered in all six patients after PTA. Three required repeat PTA for restenosis and one of these needed stent placement after repeated PTA. At follow-up, 6-17 months later, the three had good hepatic function. Within four days, the other three expired due to graft failure, hepatorenal syndrome and sepsis. One of the patients who underwent thrombolysis without PTA expired and the other required retransplantation. In this case there were no procedure - related complications. Radiologic interventions are useful for treatment of hepatic arterial stensis or thrombosis in patients with liver transplantations.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-15

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

  16. 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...

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

    International Nuclear Information System (INIS)

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

  18. Renal Artery Stenting Using CO2 Gas Angiography in Combination with Iodinated Contrast Angiography.

    Science.gov (United States)

    Adachi, Yuya; Endo, Akihiro; Nakashima, Ryuma; Sugamori, Takashi; Takahashi, Nobuyuki; Kinoshita, Yoshihisa; Tanabe, Kazuaki

    2016-01-01

    A 76-year-old woman was hospitalized repeatedly due to unexplained heart failure. On admission, she had hypertensive acute heart failure. Her symptoms disappeared promptly after the initial treatment; however, her systolic blood pressure remained at over 160 mmHg despite her taking three antihypertensive drugs. Closer examination revealed hemodynamically significant right renal artery stenosis and a lack of left kidney function. We performed percutaneous transluminal renal angioplasty using CO2 angiography in combination with iodinated contrast agents. The patient's renal function and blood pressure improved, however, CO2 gas-induced mild ischemic colitis occurred. We discuss the possibility of the use of combined iodinated contrast angiography and CO2 angiography to avoid contrast-induced nephropathy and the complications peculiar to CO2 angiography. PMID:27580543

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

    Science.gov (United States)

    Rosenschein, U; Budde-Schwartzman, B

    1997-12-01

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

  20. 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

  1. 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.

  2. 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

  3. Re-stenosis and successful angioplasty

    International Nuclear Information System (INIS)

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

  4. 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

  5. Renal Artery Stenting in Patients with a Solitary Functioning Kidney

    International Nuclear Information System (INIS)

    Purpose: To retrospectively evaluate the results of renal artery stenting in patients with renovascular disease and a solitary functioning kidney.Methods: Palmazstents were placed in 16 patients with a solitary functioning kidney,renal artery stenosis, hypertension and renal failure. Stenoses were evaluated with color Doppler ultrasound, MR angiography and digital subtraction angiography (DSA). Indications for stenting were: recoil after percutaneous transluminal renal angioplasty (PTRA) (63%),arterial dissection after PTRA (13%) and primary stenting (25%).Immediate results were evaluated by DSA. On follow-up (6-36 months),patients underwent periodical evaluation of clinical conditions (blood pressure and serum creatinine level) and stent patency, by means of color Doppler ultrasound.Results: Stent placement was successful in all patients (100%). Cumulative primary patency rate was: 100% at 1 day, 93.75% at 6 months, 81.25% at 12 months and 75% at 24 months. A significant reduction in diastolic blood pressure occurred (mean ± SD 104 ± 6 vs 92 ± 3;p 0.05).Conclusion: Renal artery stenting, both after PTRA and as primary stenting, represents a safe procedure, able to preserve renal function in patients with a solitary functioning kidney

  6. 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

  7. Balloon catheter coronary angioplasty

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  9. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kufner, Sebastian, E-mail: kufners@dhm.mhn.de [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Cassese, Salvatore; Groha, Philipp; Byrne, Robert A. [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Schunkert, Heribert; Kastrati, Adnan [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Ott, Ilka; Fusaro, Massimiliano [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany)

    2015-04-15

    Background: The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. A strategy of percutaneous transluminal angioplasty (PTA) with covered stent (CS) may represent a valuable alternative to open surgery. However, systematic evaluations of CS in this setting represent a scientific gap. In the present study, we investigate the procedural and clinical outcomes associated with PTA and CS implantation to repair iatrogenic injuries of peripheral arteries. Methods: All patients undergoing PTA with CS for endovascular repair of iatrogenic injuries of peripheral arteries between August 2010 and July 2013 at our Institution were retrospectively analyzed. The primary endpoint was the technical success. Secondary endpoints were in-hospital mortality and cumulative death, target lesion revascularization (TLR), amputation and major stroke at 12-month follow-up. Results: During the period of observation, a total of 30 patients underwent PTA with either self-expandable (43.3%) or balloon-expandable CS (56.7%) for iatrogenic injuries of peripheral arteries. Injuries consisted of perforation/rupture (76.7%), arteriovenous fistula (16.7%) and pseudoaneurysm (6.7%) of iliac–femoral arteries. Technical success was achieved in all cases. Median follow-up was 409 days [210–907]. The incidence of in-hospital mortality was 10.0%. At 12-month follow-up, the incidence of death, TLR, amputation and major stroke was 20.0%, 17.0%, 3.3% and 6.7%, respectively. Conclusion: The use of covered stents for endovascular repair of iatrogenic injuries of peripheral arteries shows a high technical success and may be alternative to surgery. Further studies with larger populations are needed to confirm these preliminary findings. - Highlights: • The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. • Percutaneous transluminal angioplasty with

  10. Hepatic artery complications after orthotopic liver transplantation: interventional treatment or retransplantation?

    Institute of Scientific and Technical Information of China (English)

    YANG Yang; YI Shu-hong; ZHANG Jian; ZHANG Jun-feng; YI Hui-min; JIANG Nan; JIANG Hua; ZHU Kang-shun; JIANG Zai-bo; SHAN Hong; CHEN Gui-hua; LI Hua; FU Bin-sheng; ZHANG Qi; ZHANG Ying-cai; LU Ming-qiang; CAI Chang-jie; XU Chi; WANG Gen-shu

    2008-01-01

    Background The main therapeutic treatments for hepatic artery complications after orthotopic liver transplantation (OLT) include thrombolysis, percutaneous transluminal angioplasty, stent placement, and liver retransplantation. The prognosis of hepatic artery complications after OLT is not only related to the type, extent, and timing but also closely associated with the selection and timing of the therapeutic methods. However, there is no consensus of opinion regarding the treatment of these complications. The aim of this study was to determine optimal treatment for hepatic artery complications after OLT.Methods The clinical data of 25 patients diagnosed with hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) between October 2003 and March 2007 were retrospectively reviewed. Treatments included liver retransplantation and interventions which contain thrombolysis, percutaneous transluminal angioplasty and stent placement. Results Among five patients with HAT, 3 were treated with thrombolysis. One recovered, one died after thrombolysis and another one died of multi-organ failure after retransplantation because of recurrent HAT. The remaining 2 patients underwent successful retransplantation and have survived after that. Among 12 patients presented with HAS within 1 month postoperatively, 2 patients underwent retransplantation due to irreversible liver failure and another 10 patients were treated with interventions. The liver function failed to improve in 3 patients and retransplantations were performed in 4 patients after stent placement because of ischemic cholangitis. Among 6 patients undergoing liver retransplantations, two died of intracranial hemorrhage and infection respectively. Eight patients presented with HAS after 1 month postoperatively, 5 patients were treated with interventional management and recovered after stent placement. Among another 3 patients presented with HAS, 2 patients' liver function was stable and one patient received late

  11. ALimb-Saving Procedure forTreatment ofArterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    SeyedHashem Sezavar-Seyedi-Jandaghi

    2015-10-01

    Full Text Available As the major hazard of percutaneous vertebroplasty (PV, cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate post- intervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV.

  12. Endovascular Repair of a Type III Thoracoabdominal Aortic Aneurysm in a Patient with Occlusion of Visceral Arteries

    International Nuclear Information System (INIS)

    The successful endovascular repair of a type III thoracoabdominal aortic aneurysm (TAAA) with the use of a tube endograft is reported. A 56-year-old male with a 6.4-cm type III TAAA, a 4.2-cm infrarenal abdominal aortic aneurysm, and chronic renal insufficiency presented with flank pain, nausea, acute anuria, and serum creatinine of 6.1 mg/dl. Acute occlusion of the left solitary renal artery was diagnosed and emergent recanalization with percutaneus transluminal angioplasty and stenting was performed successfully, with reversal of the serum creatinine level at 1.6 mg/dl. Further imaging studies for TAAA management revealed ostial occlusion of both the celiac artery (CA) and the superior mesenteric artery (SMA) but a hypertrophic inferior mesenteric artery (IMA) providing retrograde flow to the aforementioned vessels. This rare anatomic serendipity allowed us to repair the TAAA simply by using a two-component tube endograft without fenestrations (Zenith; William Cook, Bjaeverskov, Denmark) that covered the entire length of the aneurysm, including the CA and SMA origins, since a natural arterial bypass from the IMA to the CA and SMA already existed, affording protection from gastrointestinal ischemic complications. The patient had a fast and uneventful recovery and is currently doing well 6 months after the procedure. To our knowledge, this is the first report in the English literature of successful endovascular repair of a TAAA involving visceral arteries with the simple use of a tube endograft

  13. 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.

  14. 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

  15. Day-case peripheral angioplasty using nurse-led admission, discharge, and follow-up procedures: arterial closure devices are not necessary

    International Nuclear Information System (INIS)

    Aim: To audit the safety of day-case peripheral arterial intervention without the use of arterial-closure devices using nurse-led admission, discharge, and follow-up procedures. Materials and methods: Patients referred for elective, peripheral vascular intervention were selected for day-case care according to pre-determined criteria using telephone triage. Post-procedure haemostasis was achieved using manual compression. After 3 h bed-rest, patients were mobilized and discharged at 5 h. Patients were contacted by telephone next working day to audit complications. Results: One hundred and eighty-three elective day-case peripheral interventions were performed over 2 years, predominantly using 6 F sheaths. No closure devices were used. Five patients (2%) returned to the department because of persistent groin symptoms the next day. One of these had a false aneurysm. Four required no further treatment. A single patient returned at day 6 with a delayed false aneurysm. Conclusion: Day-case peripheral vascular intervention can be safely performed in appropriately selected patients without the use of arterial closure devices. Specialist radiology nurses have a major role in the counselling, care, and follow-up of these patients

  16. Coronary Angioplasty Stent Placement

    Medline Plus

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

  17. Feasibility of MR-guided angioplasty of femoral artery stenoses using real-time imaging and intraarterial contrast-enhanced MR angiography

    Energy Technology Data Exchange (ETDEWEB)

    Paetzel, C.; Zorger, N.; Bachthaler, M.; Voelk, M.; Seitz, J.; Herold, T.; Feuerbach, S.; Lenhart, M.; Nitz, W.R. [University Hospital of Regensburg (Germany). Dept. of Diagnostic Radiology

    2004-09-01

    Purpose: To show the feasibility of magnetic resonance (MR) for guided interventional therapy of femoral and popliteal artery stenoses with commercially available materials supported by MR real-time imaging and intraarterial MR angiography. Materials and Methods: Three patients (1 female, 2 male), suffering from symptomatic arterial occlusive disease with stenoses of the femoral (n=2) or popliteal (n=1) arteries were included. Intraarterial digital subtraction angiography was performed in each patient pre- and post-interventionally as standard of reference to quantify stenoses. The degree of the stenoses reached from 71-88%. The MR images were acquired on a 1.5 T MR scanner (Magnetom Sonata; Siemens, Erlangen, Germany). For MR-angiography, a Flash 3D sequence was utilized following injection of 5 mL diluted gadodiamide (Omniscan; Amersham Buchler, Braunschweig, Germany) via the arterial access. Two maximum intensity projections (MIP) were used as road maps and localizer for the interactive positioning of a continuously running 2D-FLASH sequence with a temporal solution of 2 images per second. During the intervention, an MR compatible monitor provided the image display inside the scanner room. Safety guidelines were followed during imaging in the presence of a conductive guidewire. The lesion was crossed by a commercially available balloon catheter (Wanda, Boston Scientific; Ratingen, Germany), which was mounted on a 0.035'' guidewire (Terumo; Leuven, Belgium). The visibility was provided by radiopaque markers embedded in the balloon and was improved by injection of 1 mL gadodiamide into the balloon. After dilation, the result was checked by intraarterial MR angiography and catheter angiography. Results: The stenoses could be correctly localized by intraarterial MR angiography. There was complete correlation between intraarterial MR angiography and digital subtraction angiography. The combination of guidewire and balloon was visible and the balloon was

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

    International Nuclear Information System (INIS)

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

  19. Transluminally Placed Endovascular Grafts for Venous Lesions in Patients on Hemodialysis

    International Nuclear Information System (INIS)

    This report summarizes a feasibility study of transluminally placed endovascular grafts (TPEG) using pre-expanded polytetrafluoroethylene (PTFE) to treat venous abnormalities inpatients on hemodialysis. Seventeen patients with peripheral(n = 11) or central (n = 6) venous lesions were treated with TPEG devices. Covered Gianturco stents were used for the peripheral lesions and covered Palmaz stents were used for central lesions. Venous abnormalities included vascular rupture after balloon angioplasty or surgical thrombectomy (n = 4),stenosis associated with an aneurysm (n = 2) and occlusive disease and central stenoses not responsive to balloon angioplasty (n = 11). The mean primary patency period was 37 days. The mean secondary patency period was 215 days. At 60,180, and 360 days the primary and secondary patency rates were 40%,32%, and 32%, and 70%, 55%, and 39%, respectively. Follow-up studies have shown various outcomes of the implanted TPEG devices,which have included stenoses within the TPEG (n = 2),stenoses central to the TPEG (n = 1), stenoses peripheral to the TPEG (n = 3), acute thrombosis extending to the TPEG without a stenosis (n = 1), graft abandoned with patent TPEG (n = 6), and TPEG patent within primary patency period at last follow-up (n =4). The TPEG devices, made with pre-expanded PTFE, appear safe in the short term, do not prevent progressive dialysis access site failure, and need to be compared to PTA and endovascular stenting in a randomized prospective trial

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  1. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  2. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... right coronary ostium, and we are in the process of taking our first images of the right ... coronary artery disease. Coronary artery disease is a process that we used to think took years and ...

  3. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... catheter at the opening of the arteries, injected dye, so we could outline the arteries and look ... requires a diagnostic portion where you inject the dye, but at that point, once you see a ...

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

    Directory of Open Access Journals (Sweden)

    Visser Cees A

    2004-11-01

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

  5. 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...

  6. 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

    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....... Immediately after PTRA the patients were grouped as follows - I: 31%, II: 59%, III: 10%. At 1 month, I: 13%, II: 72%, III: 15%; at 6 months, I: 11%, II: 74%, III: 15%, and at the latest follow-up, I: 11%, II: 78%, III: 11%. There were few significant complications, and renal function remained on average...

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

    International Nuclear Information System (INIS)

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

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

    Czech Academy of Sciences Publication Activity Database

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

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

  9. Comparison of healing of ischaemic diabetic foot ulcers after stem cell therapy or percutaneous transluminal angioplasty

    Czech Academy of Sciences Publication Activity Database

    Dubský, M.; Jirkovská, A.; Bém, R.; Pagacová, L.; Fejfarová, V.; Skibová, J.; Varga, M.; Syková, Eva

    2010-01-01

    Roč. 53, Suppl.1 (2010), S57-S57. ISSN 0012-186X. [Annual Meeting of the European Association for the Study of Diabetes (EASD) /46./. 22.09.2010-24.09.2010, Stockholm] Institutional research plan: CEZ:AV0Z50390703 Keywords : diabetes * EASD Subject RIV: FH - Neurology

  10. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... of the next hour you will learn about coronary artery disease, how blockage is performed, how we treat them, ... chest pain. Obviously, as cardiologists our concern is coronary artery disease or blockages that are formed that reduce blood ...

  11. Coronary Angioplasty Stent Placement

    Medline Plus

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

  12. Angioplasty and stent placement - carotid artery - discharge

    Science.gov (United States)

    ... Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society ...

  13. Natural orifice transluminal endoscopy surgery: A review

    Institute of Scientific and Technical Information of China (English)

    Jo(a)o Moreira-Pinto; Estev(a)o Lima; Jorge Correia-Pinto; Carla Rolanda

    2011-01-01

    Minimally invasive surgery started spreading worldwide in 1987, when the first laparoscopic cholecystectomy was performed. Meanwhile, improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions, even beyond the wall barrier. The first transgastric peritoneoscopy, in 2004, brought to light the concept of natural orifice transluminal endoscopic surgery (NOTES). The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation. The authors present a review of all developments concerning NOTES, including animal studies and human experience.

  14. Interventional treatment of transplant renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stents. Methods: The average time from transplantation to the symptom of TRAS was 6.6 month (3-15 month) in 21 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed with ordinary balloon (5 F, length 20-30 mm) and/or small balloon (2.6 F, length 36 mm) in all patients, and stents were embedded in 5 of them. Results: A total of 32 PTA were successfully performed (1 time, 13 cases; 2 times, 5 cases, and 3 times, 3 cases) by femoral approach (22) and brachial approach (10). Stenosis were significantly decreased from 79%-97% pre-PTA to 10%-30% post-PTA. Systolic pressure decreased from 170 mmHg (150-210 mmHg) pre-PTA to 135 mmHg (100-190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90-145 mmHg) to 85 mmHg (80-125 mmHg). Restenosis rates was 38% after first PTA and 14% after second time. 4 self-expandable stents (Wallstent) and 1 balloon-dilatation stent (Palmaz) were released in 5 cases. There were healing (n=6), melioration (n=8), improvement (n=5), and inefficiency (n=2) after follow-up of 23 months (3-60 month). No complication was found except puncture hematoma by the brachial artery approach in 1 case. Conclusion: PTA is safe and effective in the treatment of TRAS and high rates of procedure success may be achieved with the help of brachial approach and small balloon catheter. Reasonable use of stents is beneficial in decreasing the restenosis rates. (authors)

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

    International Nuclear Information System (INIS)

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

  16. Angioplasty - Multiple Languages: MedlinePlus

    Science.gov (United States)

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

  17. [Coronary angioplasty in elderly patients].

    Science.gov (United States)

    Liistro, Francesco; Colombo, Antonio

    2002-01-01

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

  18. Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery

    International Nuclear Information System (INIS)

    Acute symptomatic occlusion of the cervical internal carotid artery (ICA) can be treated by intravenous administration of tissue plasminogen activator, percutaneous transluminal angioplasty, and carotid endarterectomy. Carotid artery stenting (CAS) is now indicated for cervical ICA stenosis, but the safety and the efficacy of urgent CAS have not been established. We retrospectively reviewed 10 patients treated by urgent CAS for atherosclerotic occlusive lesions of cervical ICA with acute stroke. Five patients had complete occlusions and five had near total occlusions. Five of the 10 patients had intracranial tandem occlusions. Indication for urgent CAS was determined by mismatch of diffusion-weighted and perfusion-weighted magnetic resonance imaging findings. Stents were successfully deployed in all lesions. Three of five patients with concomitant intracranial tandem occlusions were treated by additional intraarterial fibrinolysis after the CAS. Intracranial artery occlusions were completely recanalized in one patient, and partially recanalized in two by fibrinolysis. Hyperperfusion syndrome did not occur in any of the patients. A favorable outcome (modified Rankin Scale ≤1) was obtained in all of the five patients with isolated cervical ICA occlusion and one of the five patients with intracranial tandem occlusions. Urgent CAS is a safe and effective treatment in patients with isolated cervical ICA occlusion. Treatment of intracranial tandem occlusions is an issue that must be resolved. (author)

  19. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... Smoking is a huge risk factor in the development of heart disease, as well as problems with ... very large diameter artery and a very short local lesion, you can often get by with putting ...

  20. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... hopefully prevent them, and the different techniques we use to open up blockages and improve coronary blood ... huge body of data that shows that tobacco use is associated with accelerated hardening of the arteries. ...

  1. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  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 ... 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 ...

  4. Coronary Angioplasty Stent Placement

    Medline Plus

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

  5. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... coronary artery. Take in a breath, sir, and hold your breath. And the first picture seems to ... patient. Take in a deep breath, sir, and hold it. Jay, it’s certainly a very large vessel. ...

  6. Coronary Angioplasty Stent Placement

    Medline Plus

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

  7. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  8. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... at the initial shots, the left main is clean and I see no elements of any blockages ... contractility of the pump, arteries really look pretty clean with the exception of that downstream area in ...

  9. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... the arteries. Diabetes Mellitus is a very serious cause of particularly premature atherosclerosis particularly in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ...

  10. Coronary Angioplasty Stent Placement

    Medline Plus

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

  11. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... the course of the next hour you will learn about coronary artery disease, how blockage is performed, ... OR-Live” makes it easy for you to learn more, just click on the “Request information” button ...

  12. 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 ...

  13. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... initial injections. So this is the first view. Sir, turn your head over this way. Look to ... the right coronary artery. Take in a breath, sir, and hold your breath. And the first picture ...

  14. 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

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

  16. Angioplasty and Vascular Stenting

    Science.gov (United States)

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

  17. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... two-part series featuring cardiovascular procedures and cardiovascular disease, in honor of American Heart Month. I’m ... next hour you will learn about coronary artery disease, how blockage is performed, how we treat them, ...

  18. Coronary Angioplasty Stent Placement

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    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly ... one that came in from Art. He said, “Two weeks ago I had a drug-eluting stent ...

  19. Coronary Angioplasty Stent Placement

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    Full Text Available ... can see on the screen now, some initial injections. So this is the first view. Sir, turn ... have a saying in cardiology where time is muscle, and the quicker you can get ant artery ...

  20. Coronary Angioplasty Stent Placement

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    Full Text Available ... have a saying in cardiology where time is muscle, and the quicker you can get ant artery ... up and these blockages improved, the more heart muscle is saved. Dr. Mukhari, what are we doing ...

  1. The mechanism of angioplasty

    International Nuclear Information System (INIS)

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

  2. 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...

  3. Paclitaxel-Coated Balloons: Review of a Promising Interventional Approach to Preventing Restenosis in Femoropopliteal Arteries.

    Science.gov (United States)

    Teleb, Mohamed; Wardi, Miraie; Gosavi, Sucheta; Said, Sarmad; Mukherjee, Debabrata

    2016-06-01

    Peripheral arterial disease (PAD), a major cause of morbidity and mortality worldwide, is characterized by intermittent claudication and is associated with chronic diseases such as diabetes and hypertension. The goal of treatment is to address the underlying cause and to modify risk factors. Although medical management is the first-line treatment of PAD, some individuals may have severe symptoms and require revascularization with percutaneous transluminal angioplasty with or without stent placement or surgery. Interventional approaches may, however, be associated with high prevalence of restenosis and subsequent complications such as critical limb ischemia and amputation. Drug-eluting balloons (DEBs) are a new interventional technology with the primary goal of preventing restenosis. We review the clinical trials and studies that assessed the efficacy and safety profile of DEB and will focus on the restenosis rate in femoropopliteal arteries including target lesion revascularization (TLR) and late lumen lesion (LLL) using different modalities of intervention such as stents and DEB. Average data collected from the trials reported included restenosis rate of 25%, 0.3 mm LLL, and 14% reduction in TLR with DEB versus uncoated balloons. Below the knee (BTK) only intervention studies were excluded from this review as endovascular approach is usually reserved for critical limb ischemia for BTK disease. Interventional approach to treat PAD with DEB appears to be a promising technology. Additional larger studies are needed to further define safety, efficacy, and longer term outcome with this novel technology. PMID:27231422

  4. Feasibility and efficacy of stent placement in the treatment of hepatic artery stenosis after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To evaluate the feasibility and efficacy of stent placement for the treatment of hepatic artery stenosis (HAS) after liver transplantation. Methods: Thirteen patients were proved to be HAS by angiography after liver transplantation. Twelve of them were treated with stent placement, 1 patient only received pereutaneous transluminal angioplasty (PTA). Stent placement techniques and the clinical data of 13 eases were retrospectively analyzed. Results: Among 13 patients with HAS, 11 patients were successfully treated with stent placement. During 9-227 days of follow-up (mean, 97 days), no intrastent restenosis was found by Doppler sonography. In 7 patients with less than 2 weeks diagnosis-therapy intervals, the elevated liver enzyme and/or bilirubin became normal after stent placement in 6 patients except 1 patient died of multiple organ failure at 9 days after the procedure; while in 4 patients with more than 2 weeks diagnosis-therapy intervals, 1 patient died of septicemia due to repeated bile duct infection and liver function failure, the other 3 patients still had repeated bile duct infection, which was improved after endoscopic retrograde cholangiopancreatography (ERCP) and drainage. Conclusion: Stent placement for HAS after liver transplantation is feasible. Catheter-sheath and coronary artery stents can be used to improve stent placement success. Early diagnosis and therapy are the critical factors for the efficacy of stent placement. (authors)

  5. 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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  7. Carbon dioxide-guided angioplasty

    International Nuclear Information System (INIS)

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

  8. 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...

  9. Who Needs Coronary Artery Bypass Grafting?

    Science.gov (United States)

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

  10. Improvement of renal function after opening occluded atherosclerotic renal arteries.

    Science.gov (United States)

    Kanamori, Hiroshi; Toma, Masanao; Fukatsu, Atsushi

    2009-09-01

    Percutaneous transluminal renal angioplasty (PTRA) with stenting has been effective in the control of hypertension, renal function and pulmonary edema caused by atherosclerotic renal artery stenosis (ARAS). However, concerning the viability of renal function, this procedure has not been fully established, especially in the presence of renal atrophy or severe renal parenchymal disease. We report a dramatically improved case of acute renal failure caused by acute worsening ARAS treated by stenting. A 72-year-old female was admitted for accelerated renal dysfunction (serum ceatinine; 1.2-2.3 mg/dl) and hypertension (190/100 mmHg). At 10 days after admission, the patient's serum ceatinine increased to 6.7 mg/dl, her pulmonary edema was exaggerated and hemodialysis was required. Ultrasonography showed bilateral high-echoic kidneys, but no apparent finding of renal artery stenosis (RAS). At day 15, computed tomographic angiography indicated bilateral ostial RAS. Renal angiography demonstrated total occlusion of the right and severe (90%) disease in the left. ARAS was diagnosed by intravascular ultrasonography. The guidewire was inserted in both renal arteries, PTRA with stenting was performed in the right and a stent was directly implanted in the left. Immediately, each kidney enlarged to almost normal size, leading to satisfactory urination. She was released from hemodialysis the next day since her serum creatinine was normal and the pulmonary edema was improved. Although there is still no reliable prognostic factor including resistive index or kidney size, it is important that PTRA with stenting in ARAS should be considered in a case of accelerated renal dysfunction because of the possible improvement. PMID:19726830

  11. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... symptoms one may get. And you can see -- let me go to the next slide. Symptoms of coronary artery ... take a suction catheter, very tiny catheter, and go out and suction out the clot, ... handed some more questions. Let’s see here. Dr. Mukhari, there’s a question that ...

  12. Coronary Angioplasty Stent Placement

    Medline Plus

    Full Text Available ... is associated with accelerated hardening of the arteries. Diabetes Mellitus is a very serious cause of particularly premature atherosclerosis particularly in younger patients. Then things such as hypertension, obesity, and certainly what we call “hyperlipidemia” or “dislipidemia,” ...

  13. Coronary Angioplasty Stent Placement

    Medline Plus

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

  14. Coronary Angioplasty Stent Placement

    Medline Plus

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

  15. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  16. Coronary Angioplasty Stent Placement

    Medline Plus

    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 ...

  17. Coronary Angioplasty Stent Placement

    Medline Plus

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

  18. Coronary Angioplasty Stent Placement

    Medline Plus

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

  19. Coronary Angioplasty Stent Placement

    Medline Plus

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Arner Anders

    2011-06-01

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

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

    Science.gov (United States)

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

    2014-06-25

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

  4. 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

  5. Interventional treatment of transplanted renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment of transplanted renal artery stenosis (TRAS) by pereutaneous transluminal angioplasty (PTA)and stentplacement. Methods: The averange time from trans- plantation to the symptom occurrence of TRAS was 5.5 months (4-15 months)in 12 TRAS patients. All of them received the interventional therapy through femoral approach. Average BP, creatinine level and stenosis before and after the procedure were taken as the judgement standards. Results: PTA was performed with balloon (length 20-40 mm, diameter 5-7 mm)in 4 patients, stenting after PTA in 5, including 3 of direct stenting. Two cases (17%)occurred restenosis after PTA and restenting was undertaken. Three ases (25%)with restenosis after stentplacement were undergone PTA. One self-expandable stent and 9 balloon- dilatation stent were released in 10 eases. Stenosis significantly decreased from 65%-95% preoperatively to 15%-25% postoperatively, together with average BP decreased from 175/105 mmHg to 140/80 mmHg and creatinine level decreased from 475.5 μmol/L to 118.5 μmol/L. Among 12 cases included 4 healed, melioration (5), improvement (2), and inefficiency (1) during follow-up of 9 months (3-24 months). No complication occurred. Conclusion: The interventional therapy is effective and safe for TRAS with high rates of procedure success and efficacy. The proper selection of the adapted approach combined with PTA and stenting may effectively raise the long term efficacy for TRAS and success rate of the procedure. (authors)

  6. Endovascular procedures in the treatment of obstructive lesions of brachiocephalic arteries

    Directory of Open Access Journals (Sweden)

    Sagić Dragan

    2002-01-01

    Full Text Available Background. To assess the early effects, possible risks, and long term results of percutaneous transluminal angioplasty (PTA of brachiocephalic trunk (BT and subclavian arteries (SA. Methods. During the period of 11 years, in 92 patients (57 males - 62%, mean age 53,5 ± 7,8 years 93 PTA of SA/BT were performed; 70 (75% lesions were stenosis, while 23 (25% lesions were occlusions with mean diameter stenosis percent of 83,1 ± 6,2%. Clinical indications were: vertebrobasilar insufficiency (n=57, upper limb ischemia (n=40, coronary steal syndrome (n=4 and scheduled aorto-coronary bypass, using internal thoracic artery (ITA (n=4 asymptomatic patients. Mean lesion length was 22 ± 8 mm. Results. Eighty one (87% out of 93 lesions were successfully dilated; all of 12 (13% failures were due to unsuccessful recanalisation of occluded arteries. In 10 patients 10 stents were implanted (2 in BT and 8 in left SA. There were 6 (6.5% procedural complications: 1 dissection, 1 thrombosis of the left SA, transient ischemic attack in 2 patients, and 2 cases of dislocation of atheromatous plaque from the right SA into the right common carotid artery. During the follow-up of 48 ± 3 months, 16 (20% restenoses were treated by PTA (n=7 or operatively (n=9. Primary and secondary patency for all lesions treated during 11 years was 87% and 80%, respectively (stenosis: 97% and 89%; occlusions: 58% and 58%. Conclusion. PTA with or without stenting was relatively simple, efficient and safe procedure. It required short hospitalization with low treatment costs. If any of suboptimal results or chronic occlusions were present, the implantation of endovascular stents should have been considered.

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

    Science.gov (United States)

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

    1997-01-01

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

  8. [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

  9. Percutaneous renal artery stenting reduces arterial blood pressure, but what about renal function? A single-center experience

    Directory of Open Access Journals (Sweden)

    Erkan Dervişoğlu

    2010-02-01

    Full Text Available Objective: To assess the effects of percutaneous transluminal angioplasty and stenting (PTRA/S on arterial blood pressure and renal function.Methods: A retrospective chart review of patients undergoing PTRA/S at our institution between December 2003 and September 2006 was done. Follow-up data were derived from hospital records. Estimated glomerular filtration rate (EGFR was used as the marker of renal function. To evaluate the pre- and post-procedure values in individual patients the paired t test and Wilcoxon signed-rank tests were used.Results: Thirty-six patients (16 women, 30 men; mean age 59±15 years, range: 25-83 years underwent 43 PTRA/S interventions at our institution. The mean duration of follow-up was 9.3±8.6 (range 2-28 months. We observed no significant change in EGFR from pre-procedure to that obtained at follow-up (71.4±40.2 mL/min vs.73.3±39.0 mL/min; p=0.483. Mean arterial blood pressure (MABP, however, was reduced significantly: pre-procedure MABP-123±22 mmHg; post-procedure follow-up value of 101±14 mmHg (p <0.001. The mean number of antihypertensive medications used at the time of intervention was 2.1±1.0 (range: 0-4, whereas at follow-up, this number had decreased to 1.3±1.0 (range: 0-4; p<0.001. In patients with renal impairment (EGFR ≤59 mL/min, 41% showed improvement, 29% showed no change and 29% demonstrated deterioration in EGFR. Conclusion: PTRA/S may preserve renal function, especially in patients with pre-procedural impaired renal function.

  10. Implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths in antegrade and crossover procedures: midterm results

    Energy Technology Data Exchange (ETDEWEB)

    Dorffner, Roland; Neumann, Christian; Gergely, Istvan [Department of Radiology, Hospital of the Brothers of St. John, Esterhazystrasse 26, 7000, Eisenstadt (Austria); Renner, Reinhold; Resinger, Mathias [Department of Surgery, Hospital of the Brothers of St. John, Esterhazystrasse 26, 7000, Eisenstadt (Austria); Juhasz, Max [Department of Internal Medicine, Hospital of the Brothers of St. John, Esterhazystrasse 26, 7000, Eisenstadt (Austria); Dorffner, Georg [Department of Medical Cybernetics and Artificial Intelligence, University of Vienna, Freyung 6/2, 1010, Vienna (Austria)

    2003-11-01

    The aim of this study was to evaluate the technical performance of the implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths. Thirty-three lesions (24 stenoses, 9 occlusions) in 32 patients (mean age 67 years) were stented. Selective stent implantation was performed after unsatisfactory percutaneous transluminal angioplasty result with an antegrade access in 21 patients and through a crossover sheath in 11 patients. A total of 36 stents were implanted. Stent delivery was successful in all cases (stent diameter 5 or 6 mm, stent length 11-38 mm). In none of the cases was stent dislodgement from the balloon observed. Stent placement was optimal without residual stenosis in 30 cases. In 1 case the stent was chosen too short requiring implantation of a second stent. In 1 patient distal embolization was observed which was treated with catheter embolectomy. Nine-month primary and secondary patency rates were 79{+-}8.7 and 86{+-}7.7%, respectively. Implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths is safe in antegrade and crossover procedures. (orig.)

  11. Implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths in antegrade and crossover procedures: midterm results

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the technical performance of the implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths. Thirty-three lesions (24 stenoses, 9 occlusions) in 32 patients (mean age 67 years) were stented. Selective stent implantation was performed after unsatisfactory percutaneous transluminal angioplasty result with an antegrade access in 21 patients and through a crossover sheath in 11 patients. A total of 36 stents were implanted. Stent delivery was successful in all cases (stent diameter 5 or 6 mm, stent length 11-38 mm). In none of the cases was stent dislodgement from the balloon observed. Stent placement was optimal without residual stenosis in 30 cases. In 1 case the stent was chosen too short requiring implantation of a second stent. In 1 patient distal embolization was observed which was treated with catheter embolectomy. Nine-month primary and secondary patency rates were 79±8.7 and 86±7.7%, respectively. Implantation of the Corinthian IQ stent into the femoropopliteal arteries using 6-F introducer sheaths is safe in antegrade and crossover procedures. (orig.)

  12. 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.

  13. 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

  14. Quantificação volumétrica da hiperplasia neointimal em artérias ilíacas após implante de suporte intravascular metálico Volumetric assessment of neointimal hyperplasia in iliac arteries after metal stent implantation

    Directory of Open Access Journals (Sweden)

    Samuel Martins Moreira

    2009-08-01

    Full Text Available OBJETIVO: Quantificar a hiperplasia neointimal em artérias ilíacas após stent, correlacionando fatores clínicos, arteriais e materiais dos stents. MATERIAIS E MÉTODOS: De junho de 2003 a agosto de 2005, 60 pacientes realizaram angioplastia transluminal percutânea e stent. Desses, 30 foram reestudados com ultrassonografia intravascular. Os dados foram analisados no laboratório de análise quantitativa. RESULTA-DOS: Dezesseis pacientes eram do sexo masculino (53,3% e 14 (46,7%, do sexo feminino. A média de idade foi de 60,3 anos. Apresentaram hipertensão arterial 22 pacientes (73,3%, tabagismo, 18 (62,1%, hiperlipidemia, 20 (66,7%, e diabetes, 9 (30%. Foram implantados 20 stents de nitinol (66,7% e 10 de aço inoxidável (33,3%. Quatro pacientes eram TASC A (13,3%, 15 eram TASC B (50% e 11, TASC C (36,7%. O volume da hiperplasia variou de 49,02 mm³ a 112,87 mm³ (média de 80,33 mm³. O percentual de obstrução intra-stent variou de 18% a 47% (média de 27,4%. Os resultados clínicos obtidos com stent se mantiveram até o reestudo. CONCLUSÃO: A hiperplasia neointimal sempre ocorre após a angioplastia transluminal percutânea e stent, porém os percentuais de obstrução não foram superiores a 50% em nenhum caso. Não houve diferença estatisticamente significante dos percentuais de obstrução intra-stent quanto aos materiais dos stents, aos fatores clínicos e aos fatores arteriais.OBJECTIVE: To quantify neointimal hyperplasia in iliac arteries after stent implantation, correlating clinical, arterial factors and stent material. MATERIALS AND METHODS: In the period from June/2003 to August/ 2005, 60 patients were submitted to percutaneous transluminal angioplasty and stenting. Among these patients, 30 were followed-up with intravascular ultrasonography. Data were analyzed in a laboratory of quantitative analysis by means of a specific software. RESULTS: Sixteen (53.3% patients were men, and 14 (46.7%, women, and the mean age was 60

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

    OpenAIRE

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

    2011-01-01

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

  16. Percutaneous Endovascular Treatment of Hepatic Artery Stenosis in Adult and Pediatric Patients After Liver Transplantation

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the efficacy of percutaneous endovascular techniques for the treatment of hepatic artery stenosis (HAS) occurring after liver transplantation (LT) in adult and pediatrics patients. From February 2003 to March 2009, 25 patients (15 adults and 10 children) whose developed HAS after LT were referred to our interventional radiology unit. Technical success was achieved in 96% (24 of 25) of patients. Percutaneous transluminal angioplasty (PTA) was performed in 13 patients (7 children), and stenting was performed in 11 patients (2 children). After the procedure, all patients were followed-up with liver function tests, Doppler ultrasound, and/or computed tomography. Mean follow-up was 15.8 months (range 5 days to 58 months). Acute hepatic artery thrombosis occurred immediately after stent deployment in 2 patients and was successfully treated with local thrombolysis. One patient developed severe HA spasm, which reverted after 24 h. After the procedure, mean trans-stenotic pressure gradient decreased from 30.5 to 6.2 mmHg. Kaplan-Meyer curve of HA primary patency was 77% at 1 and 2 years. During the follow-up period, 5 patients (20%) had recurrent stenosis, and 2 patients (8.3%) had late thrombosis. Two of 7 patients with stenosis/thrombosis underwent surgical revascularization (n = 1) and liver retransplantation (n = 1). Six (25%) patients died during follow-up, but overall mortality was not significantly different when comparing patients having patent hepatic arteries with those having recurrent stenosis/thrombosis. There were no significant differences in recurrent stenosis/thrombosis and mortality comparing patients treated by PTA versus stenting and comparing adult versus pediatric status. Percutaneous interventional treatment of HAS in LT recipients is safe and effective and decreases the need for surgical revascularization and liver retransplantation. However, the beneficial effects for survival are not clear, probably because

  17. Patient and physician perception of natural orifice transluminal endoscopic appendectomy

    Czech Academy of Sciences Publication Activity Database

    Hucl, T.; Saglová, A.; Beneš, M.; Kocík, M.; Oliverius, M.; Valenta, Zdeněk; Špičák, J.

    2012-01-01

    Roč. 18, č. 15 (2012), s. 1800-1805. ISSN 1007-9327 Institutional research plan: CEZ:AV0Z10300504 Keywords : natural orifice transluminal endoscopic surgery * patient perception * physician perception * appendectomy * laparoscopy Subject RIV: FJ - Surgery incl. Transplants Impact factor: 2.547, year: 2012

  18. 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...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-04-01

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

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

    Science.gov (United States)

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

    1990-07-01

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

  2. 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)

  3. Interventional treatment of transplanted renal artery stenosis

    International Nuclear Information System (INIS)

    Objective: To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods: The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3-18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20-30 mm) and/or small balloon catheters (2.6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results: A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75%-98% pre-PTA to 10%-30% post-pTA.Systolic pressure decreased from 170 mmHg (150-210 mmHg) pre-pTA to 135 mmHg (100-190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90-145 mmHg) to 85 mmHg (80-125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n=11), melioration (n=15), improvement (n=7), and inefficiency (n=2) after follow-up of 23 months (3-60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions: PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter. Reasonable use of stents is beneficial in decreasing the restenosis. (authors)

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

    OpenAIRE

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

    2002-01-01

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

  5. 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 ...

  6. Medline Plus

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

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

    International Nuclear Information System (INIS)

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

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    C. Anil Kumar

    2009-11-01

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

  10. Flexible platforms for natural orifice transluminal and endoluminal surgery

    OpenAIRE

    Patel, Nisha; Seneci, Carlo; Yang, Guang-Zhong; Darzi, Ara; Teare, Julian

    2014-01-01

    The flexible endoscope is playing an increasingly pivotal role in minimally invasive transluminal and endoluminal surgery. Whilst the flexible nature of the platform is desirable in order to navigate through the abdominal cavity or through a lumen, there are a number of issues with using the platform for this purpose. The challenges associated with using flexible endoscopes such as a lack of triangulation of instruments and force transmission, which is often inadequate for endoscopic surgery ...

  11. Natural orifice transluminal endoscopic surgery (NOTES): implications for anesthesia.

    Science.gov (United States)

    Schaefer, Michael

    2009-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) has recently evolved as a novel approach for abdominal surgery with great potential to further improve the advantages of laparoscopy over laparotomy. The first patients undergoing NOTES cholecystectomy or appendectomy reported no or only minimal pain, required no narcotic analgesics, and were discharged early from the hospital and immediately resumed daily activities. If this is confirmed by randomized controlled clinical trials, what are the potential implications for anesthesia? PMID:20948698

  12. Natural orifice transluminal endoscopic surgery (NOTES): implications for anesthesia

    OpenAIRE

    Schaefer, Michael

    2009-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) has recently evolved as a novel approach for abdominal surgery with great potential to further improve the advantages of laparoscopy over laparotomy. The first patients undergoing NOTES cholecystectomy or appendectomy reported no or only minimal pain, required no narcotic analgesics, and were discharged early from the hospital and immediately resumed daily activities. If this is confirmed by randomized controlled clinical trials, what ar...

  13. Natural orifice transluminal endoscopic surgery in pancreatic diseases

    OpenAIRE

    Gillen, Sonja; Kleeff, Jörg; Kranzfelder, Michael; Shrikhande, Shailesh V; Friess, Helmut; Feussner, Hubertus

    2010-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique that has received considerable interest in recent years. Although minimal access surgery has increasingly replaced traditional open abdominal surgical approaches for a wide spectrum of indications, in pancreatic diseases its widespread use is limited to few indications because of the challenging and demanding nature of major pancreatic operations. Nonetheless, there have been attempts in animal models as well as i...

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  16. Vascular responses to endovascular irradiation of 188Re in the rabbit model after angioplasty

    International Nuclear Information System (INIS)

    The effects on vascular restenosis of intravascular radiation delivery from 188Rhenium (Re)-perrhenate liquid-filled balloon through beta-particle radiation are controversial. To determine the effect of beta-radiation on vascular injury in hypercholesterolemic rabbits, thirty rabbits fed with a high cholesterol diet were enrolled into this study. All the rabbits underwent percutaneous transluminal balloon overstretch over left iliac artery. After balloon overstretch, the catheter was withdrawn and immediately followed by irradiation using low dose 188Re solution (10 Gray) in the vascular wall 0.5 mm distal to intimal surface. After 2 and 6 weeks, arteries were harvested for histological and immunological analysis. This rabbit study suggest that endovascular 188Re low dose irradiation at the non-injury segment of iliac artery may enhance intima hyperplasia and smooth muscle cell proliferation. (author)

  17. 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.

  18. Ankle-Arm Index, Angiography, and Duplex Ultrasonography After Recanalization of Occlusions in Femoropopliteal Arteries: Comparison of Long-Term Results

    International Nuclear Information System (INIS)

    Purpose: Comparison of the relative values of the ankle-arm index (AAI) at rest and after exercise, angiography, and duplex ultrasonography for the follow-up of percutaneous transluminal angioplasty (PTA) in patients with peripheral vascular disease. Methods: Thirty-two patients were prospectively followed after technically and clinically successful PTA of a femoropopliteal occlusion. The patency of the femoropopliteal artery was assessed for 1 year using AAI measurements at rest and after exercise; duplex ultrasonography at 4, 12, 24, 36, and 52 weeks; and angiography at 3 and 12 months after PTA. Results: Patency was highly dependent on the measurement technique. The cumulative patency after 1 year determined with the AAI at rest and during exercise, by angiography, and by duplex ultrasonography was 74%, 19%, 31%, and 32%, respectively. Seventy-five percent of the restenoses occurred at the site of the treated occlusion. Conclusion: Duplex ultrasonography is most suitable for this assessment, as it causes no patient discomfort and the specificity is better than AAI after exercise because vascular disease in other, proximal segments does not interfere with the results

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

    Directory of Open Access Journals (Sweden)

    Virendra C. Patil

    2015-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-15

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

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

    Directory of Open Access Journals (Sweden)

    M. V. Ezhov

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    M. V. Ezhov

    2011-01-01

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

  3. 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.

  4. 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

  5. Renal sympathetic denervation: MDCT evaluation of the renal arteries.

    LENUS (Irish Health Repository)

    Hutchinson, Barry D

    2013-08-01

    Percutaneous transluminal renal sympathetic denervation is a new treatment of refractory systemic hypertension. The purpose of this study was to assess the clinical utility of MDCT to evaluate the anatomic configuration of the renal arteries in the context of renal sympathetic denervation.

  6. [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

  7. Natural orifice transluminal endoscopic surgery:Where are we going?

    Institute of Scientific and Technical Information of China (English)

    Susan; H; Whang; Klaus; Thaler

    2010-01-01

    The foundation for natural orifice transluminal endoscopic surgery(NOTES) is to access the peritoneal and other body cavities through the wall of the alimentary tract via natural orifices,with the goal of performing procedures within the peritoneum and other cavities,without the need to make incisions in the abdominal wall.We have made great progress in the field of NOTES since the publication of the White Paper in 2006.There are still major fundamental goals as outlined by the Society of American Gastroint...

  8. Initial experiences of a multicenter transluminal revascularization registry

    International Nuclear Information System (INIS)

    This paper establishes a multicenter registry for collection and analysis of data from a large series of patients undergoing percutaneous transluminal revascularization of peripheral vascular lesions. The registry began as a joint collaboration between the radiology departments of Thomas Jefferson University Hospital and the University of Pennsylvania, through the Philadelphia Society of Angiography/Interventional Radiology. The American College of Radiology research office in Philadelphia is used as the data collection center. A detailed data form has been developed. It includes information about patient history, procedure indications, lesion location and morphology, techniques used, immediate angiographic and clinical outcome, and clinical follow-up at intervals up to 5 years

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

    International Nuclear Information System (INIS)

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

  10. Flash pulmonary edema in patients with renal artery stenosis--the Pickering Syndrome

    DEFF Research Database (Denmark)

    Pelta, Anna; Andersen, Ulrik B; Just, Sven;

    2010-01-01

    We report the prevalence of flash pulmonary edema in patients consecutively referred for balloon angioplasty of uni- or bilateral renal artery stenosis (PTRA), and describe the characteristics of this special fraction of the patients. We further report two unusual cases.......We report the prevalence of flash pulmonary edema in patients consecutively referred for balloon angioplasty of uni- or bilateral renal artery stenosis (PTRA), and describe the characteristics of this special fraction of the patients. We further report two unusual cases....

  11. Aorta-LITA Bypass Grafting with Saphenous Vein in a Patient Undergoing Coronary Artery Surgery with Subclavian Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Kerim Çağlı

    2011-12-01

    Full Text Available The internal thoracic artery (ITA is the primary graft for coronary artery bypass grafting and can not be used if there is subclavian artery stenosis (SAS. Aorto-axillary, carotid-subclavian bypass and also angioplasty with stenting or other interventional treatments are acceptable procedures for SAS treatment. Aorta-ITA bypass with saphenous vein can be alternative and simple technique for SAS to save Winslow pathway for patients with peripheral artery disease.

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

    Science.gov (United States)

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

    2015-01-01

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

  13. 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).

  14. 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.

  15. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  18. Persistent trigeminal artery: in situ thrombosis and associated perforating vessel infarction.

    Science.gov (United States)

    Gaughen, John R; Starke, Robert M; Durst, Christopher R; Evans, Avery J; Jensen, Mary E

    2014-06-01

    We report a patient with progressive brainstem infarction despite medical therapy. The patient was transferred to our institution for potential angioplasty of basilar stenosis. Imaging review demonstrated persistent trigeminal artery in situ thrombosis and associated perforating vessel infarction. Persistent trigeminal arteries are commonly associated with an atretic basilar artery and interventional treatment can result in significant morbidity and mortality. PMID:24351576

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

    Science.gov (United States)

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

    1990-07-01

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

  20. Re-implant of the right coronary artery: a surgical technique for the treatment of ostial lesions

    Directory of Open Access Journals (Sweden)

    Bongiovani Hércules Lisboa

    2002-01-01

    Full Text Available Previously described surgical treatment for ostial coronary artery stenosis relied on either venous or arterial bypasses or ostial patch angioplasty. These surgical procedures are performed with bovine pericardium, saphenous vein or internal thoracic artery. We describe a technique of right coronary artery re-implantation into the aorta. The procedure was performed in four patients with right coronary artery ostial stenosis along with other left coronary artery lesions.

  1. Can catheter-directed thrombolysis be applied to acute lower extremity artery embolism after recent cerebral embolism from atrial fibrillation?

    Energy Technology Data Exchange (ETDEWEB)

    Si, T.-G. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China); Guo, Z. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China)], E-mail: dr.guozhi@yahoo.com.cn; Hao, X.-S. [Department of interventional treatment, Tianjin medical university cancer Hospital and Institution, Tianjin (China)

    2008-10-15

    Purpose: To assess the feasibility and efficacy of catheter-directed thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute limb embolism in patients with recent cerebral embolism due to atrial fibrillation. Materials and methods: Eight patients (six men, two women; mean age 63.5 years) with acute embolic occlusion of two left common iliac arteries, four femoral arteries (three left; one right), and two right popliteal arteries were treated. All patients had a history of recent cerebral embolism (mean 6 days, range 5-15 days) and all had a history of atrial fibrillation (duration 5-10 years). Catheter-directed thrombolysis started a few hours (mean 6.2 h; range 3-10 h) after the onset of arterial embolism. Two 5 mg boluses of rt-PA were injected into the proximal clot through a 5 F end-hole catheter and, subsequently, two additional boluses of 5 mg rt-PA were injected into the emboli. In patients with residual emboli, infusion with rt-PA (1 mg/h) was continued. Percutaneous transluminal angioplasty was performed in three patients, and a stent was deployed in one patient. Results: Technical success was achieved in all patients. Clinical success rate was 87.5% (7/8). The one clinical failure was secondary to chronic occlusion of outflow runoff vessels. The mean duration of continuous rt-PA infusion was 3.6 h, the mean total dose of rt-PA administered was 23.6 mg (range 20-28 mg). There was no significant change in stroke scale scores during thrombolysis and no intracerebral haemorrhage was found at computed tomography (CT) after thrombolysis. Minor complications included haematomata at puncture sites (6/8), bleeding around the vascular sheath (2/8), and haematuria (1/8). During the follow-up period of 3-6 months, one patient suffered from recurrent cerebral embolism and died. Conclusions: Catheter-directed thrombolysis with rt-PA is an option for acute lower extremity arterial embolism in patients with recent cerebral embolism and a history of

  2. Can catheter-directed thrombolysis be applied to acute lower extremity artery embolism after recent cerebral embolism from atrial fibrillation?

    International Nuclear Information System (INIS)

    Purpose: To assess the feasibility and efficacy of catheter-directed thrombolysis with recombinant tissue plasminogen activator (rt-PA) for acute limb embolism in patients with recent cerebral embolism due to atrial fibrillation. Materials and methods: Eight patients (six men, two women; mean age 63.5 years) with acute embolic occlusion of two left common iliac arteries, four femoral arteries (three left; one right), and two right popliteal arteries were treated. All patients had a history of recent cerebral embolism (mean 6 days, range 5-15 days) and all had a history of atrial fibrillation (duration 5-10 years). Catheter-directed thrombolysis started a few hours (mean 6.2 h; range 3-10 h) after the onset of arterial embolism. Two 5 mg boluses of rt-PA were injected into the proximal clot through a 5 F end-hole catheter and, subsequently, two additional boluses of 5 mg rt-PA were injected into the emboli. In patients with residual emboli, infusion with rt-PA (1 mg/h) was continued. Percutaneous transluminal angioplasty was performed in three patients, and a stent was deployed in one patient. Results: Technical success was achieved in all patients. Clinical success rate was 87.5% (7/8). The one clinical failure was secondary to chronic occlusion of outflow runoff vessels. The mean duration of continuous rt-PA infusion was 3.6 h, the mean total dose of rt-PA administered was 23.6 mg (range 20-28 mg). There was no significant change in stroke scale scores during thrombolysis and no intracerebral haemorrhage was found at computed tomography (CT) after thrombolysis. Minor complications included haematomata at puncture sites (6/8), bleeding around the vascular sheath (2/8), and haematuria (1/8). During the follow-up period of 3-6 months, one patient suffered from recurrent cerebral embolism and died. Conclusions: Catheter-directed thrombolysis with rt-PA is an option for acute lower extremity arterial embolism in patients with recent cerebral embolism and a history of

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

    Directory of Open Access Journals (Sweden)

    Brito Manuel Lisandro Hernández

    2002-01-01

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

  4. Recent advances in natural orifice transluminal endoscopic surgery†.

    Science.gov (United States)

    Yip, Hon-chi; Chiu, Philip Wai-yan

    2016-01-01

    Natural orifice transluminal endoscopic surgery (NOTES) has emerged as one of the most exciting areas in the field of minimally invasive surgery during the last decade. NOTES comprises a wide spectrum of procedures from various natural accesses such as transgastric or transvaginal routes, and different direct-target or distant-target organs. Since polypectomy was first performed in 1955, major advances in technology and refinement of endoscopic technique have allowed endoscopic surgeons to perform complex endoscopic interventions such as endoscopic submucosal dissection. Recognizing the safety and feasibility of submucosal tunnelling and mucosal closure, endoscopic resection beyond the level of mucosa has been increasingly reported. One of these procedures, peroral endoscopic myotomy for achalasia, has gained much popularity and excellent results have been published comparable with that of traditional Heller's cardiomyotomy. Submucosal tunnelling endoscopic resection has also been reported for tumours situated in the muscular layer of the gastrointestinal tract. To overcome the difficulty of intestinal closure after NOTES, researchers have collaborated with the industry in developing different endoscopic suturing devices such as the Eagle Claw (Olympus Medical Systems, Tokyo, Japan) and Overstitch™ (Apollo Endosurgery, Austin TX, USA). These devices allow precise and secure suture application with the ordinary flexible endoscope, achieving tissue approximation similar to open surgical suturing. To further expand the potential of NOTES, investigators had also developed multitasking platforms enabling the performance of surgical procedures of even higher complexity. Recently, a novel endoscopic robotic system 'Master and Slave Transluminal Endoscopic Robot' (MASTER) has been developed. Early results of endoscopic resection utilizing this system have been encouraging, allowing both experts and novices in endoscopy to perform difficult endoscopic resection with a

  5. Angioplasty - Multiple Languages: MedlinePlus

    Science.gov (United States)

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

  6. Design Issues for Therapeutic Ultrasound Angioplasty Waveguides

    OpenAIRE

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

    2008-01-01

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

  7. Endovascular treatment for right subclavian artery occlusion: techniques and results

    International Nuclear Information System (INIS)

    Objective: To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion. Methods: Seventeen patients [13 males, 4 females; (56 ± 11) years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization, balloon angioplasty and stenting via femoral or brachial artery route. Cerebral protection devices were used in 6 cases to avoid cerebral embolism. Results: Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100% technical success rate) and in other 8 cases with subclavian artery occlusion (88.9% technical success rate). Five cases were treated with balloon angioplasty, and 11 cases were treated with balloon angioplasty combined with stenting. Good patency was seen in the 16 cases immediately after the procedure. The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved successfully. Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months]. Restenosis was found in one case 10 months later and was successfully treated with re-PTA. One case with aortoarteritis died of cerebral infarction 18 months later. No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency. Conclusions: Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion. (authors)

  8. 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

  9. RENOVASCULAR HYPERTENSION DUE TO RENAL ARTERY STENOSIS IN KLIPPEL-FEIL SYNDROME

    Directory of Open Access Journals (Sweden)

    Foyaca-Sibat H. MD.

    2003-01-01

    Full Text Available ABSTRACT We report one patient with Klippel-Feil (KFS syndrome, other associated anomalies, uncontrolled arterial hypertension, and renal artery stenosis. Because this patient underwent for surgical revascularization with unsuccessful result, all proposed way of treatments are revised, and we have hypothesized that probably for patients with KFS and unilateral renal artery stenosis, medical treatment with ACE inhibitors can provide more benefits than surgical revascularization or percutaneous transluminal angioplasty. We considered that those patients should be manage by a team of medical doctors being aware of their common associated anomalies, identifying all of them when it is possible then, making an integral evaluation of the each individual situation for establishing their medical priorities in order, and then address its treatments accordingly. If at this stage any surgical treatment is required, is important to bring those problems to the anesthesiologist’s attention for a very careful manipulation of the neck and head during induction of anesthesia. The final results will be strongly related with the capacity of management of the underlying cardio-respiratory, renal, skeletal, urogenital, and nervous system problems. . We also propose the term of Klippel-Feil syndrome "Plus" for those patients with cervical vertebral fusion and many other associated deformities rather than to add new eponyms to the long list that already exist. _____________ RESUMEN: HIPERTENSION RENOVASCULAR DEBIDO A ESTENOSIS DE LA ARTERIA RENAL EN EL SÍNDROME DE KLIPPEL-FEIL Reportamos un paciente afectado por un syndrome de Klippel-Feil, otras anormalias congenitas, hipertension arterial incontrolada y una estenosis unilateral de la arteria renal. Este paciente fue sometido a un tratamiento quirÚrgico de la estenosis de la arteria renal, cuyos resultados fueron no satisfactorios por lo que revisamos todas las alternativas de tratamiento para la estenosis

  10. Cervical carotid pseudoaneurysm: A carotid artery stenting complication

    OpenAIRE

    Raso, Jair; Darwich, Rogerio; Ornellas, Carlos; Cariri, Gustavo

    2011-01-01

    Background: As carotid artery stenting becomes increasingly used, more complications are likely to occur. We present a case of Staphylococcus septicemia and pseudoaneurysm arising in the neck portion of the carotid artery after stenting. Case Description: A 51-year-old man was admitted with mild left hemiparesis. CT and MRI showed right hemisphere ischemia. Duplex Scan and MRA showed bilateral severe stenosis of the carotid arteries in the neck. A percutaneous angioplasty with stenting of the...

  11. Prognostic significance of normal quantitative Tl-201 stress scintigraphy in relation to pretest likelihood of coronary artery disease

    International Nuclear Information System (INIS)

    A previous study reported an excellent prognosis and low cardiac event rate in patients(pts) with chest pain and normal quantitative T1-201 scintigraphy(SC). Such result would not be unexpected if the population under study had a predominance of pts with low pre-T1-201 likelihood(L) of significant coronary artery disease (CAD). Hence, the authors undertook telephone follow-up in pts with chest pain syndrome and normal quantitative T1-201 exercise SC, and related outcome to pretest L of CAD. Pretest L was determined by serial L analysis on the basis of: symptoms, age, sex, and exercise ECG. All pts had T1-201 SC immediately post exercise and 2 hrs later. After interpolative background correction, circumferential count and washout profiles were generated. All pts had unequivocally normal studies. Of a total of 96 pts studied in 1981-82, 20 pts were lost to follow-up. Of the remaining 76 pts, 45 were males and 31 females. The pretest L of CAD had an inverted Gaussian distribution: thirty-four pts(47%) had 66% L of CAD. Mean follow-up was 22+- 3 months. No deaths occurred. Two pts(3%) (with pretest L of 54% and 94%) had myocardial infarctions, 8 and 22 months respectively after T1-201 stress SC. One pt underwent percutaneous transluminal coronary angioplasty (PTCA) 16 months after T1-201 stress SC. These findings confirm excellent prognostic significance of normal quantitative T1-201 stress scintigraphy

  12. 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.

  13. Bare metal stenting of the iliac arteries.

    Science.gov (United States)

    Kim, Tanner I; Schneider, Peter A

    2016-06-01

    A significant subset of patients with peripheral artery disease (PAD) has iliac artery involvement that requires treatment. The development of bare metal stents has improved the short- and long-term outcomes of endovascular repair and has become first line therapy. Open surgical bypass has been reserved for extremely complex anatomic morphologies or endovascular failures. It is unclear whether primary stenting is superior to angioplasty with provisional stenting but if angioplasty is used alone, it is likely only appropriate for the most focal lesions. Self-expanding and balloon-expandable stents have unique characteristics that are suitable to different lesion morphologies. Both stent-types have demonstrated similar outcomes. Herein, we review the practice and results of bare metal stents in the iliac arteries. PMID:27035892

  14. [Current management of renal artery stenosis].

    Science.gov (United States)

    Lenz, T

    2013-12-01

    Severe renal artery stenosis may cause renovascular hypertension; in case of bilateral narrowing or in a stenotic solitary kidney, renal insufficiency (ischemic kidney disease) or rarely pulmonary flush edema may occur. Renal artery stenosis may be treated by revascularization, using either percutaneous (balloon angioplasty, stenting) or less common open surgical procedures, both with excellent primary patency rates. However, randomized trials of renal artery angioplasty or stenting have failed to demonstrate a longer-term benefit with regard to blood pressure control and renal function over medical management alone (except for fibromuscular disease). Furthermore, endovascular procedures are associated with substantial risks. It has not yet been demonstrated that renal revascularization leads to a prolongation of event-free survival. Careful patient selection is essential to maximize the potential benefit. PMID:24217529

  15. 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

  16. 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.)

  17. 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.

  18. Flexible platforms for natural orifice transluminal and endoluminal surgery.

    Science.gov (United States)

    Patel, Nisha; Seneci, Carlo; Yang, Guang-Zhong; Darzi, Ara; Teare, Julian

    2014-06-01

    The flexible endoscope is playing an increasingly pivotal role in minimally invasive transluminal and endoluminal surgery. Whilst the flexible nature of the platform is desirable in order to navigate through the abdominal cavity or through a lumen, there are a number of issues with using the platform for this purpose. The challenges associated with using flexible endoscopes such as a lack of triangulation of instruments and force transmission, which is often inadequate for endoscopic surgery are discussed in this review. As a result of these difficulties, a number of mechanically and robotically driven devices based upon the flexible endoscope are emerging. The design of these devices and potential problems are also reviewed. Finally, future robotic systems which are still in the development and validation stage are briefly discussed. The field of gastroenterology is diverging. The narrowing divide between minimally invasive and endoluminal surgery has led to a surge of innovative and novel devices which may in the future enable precise, seamless and scar less surgery. PMID:26135256

  19. 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.

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  2. Intravascular brachytherapy after percutaneous recanalization of occluded femoral artery: a case report

    International Nuclear Information System (INIS)

    The paper presents the use of introvascular brachytherapy after percutaneus recanalization and angioplasty of the femoral artery in a 65-year old patient with hypertension, a history of heavy smoking, and early stage diabetes. The patient was admitted to hospital with rest ischeamia of the right crus and trophic skin changes in that region. After primary pharmacological treatment angiography was performed revealing the femoro-popliteal artery to be occluded in the distal part of the adductor canal. The patency of the artery was established. Subsequently the occluded par of the artery was completely dilated without residual stenosis. Control angiography revealed good contrast flow through the dilated artery and correct configuration of the arteries below the open and dilated part of the femoro-popliteal artery. These arteries were, however, anatomically narrow. On clinical examination the pulse was present on peripheral arteries, while cyanosis of the right foot and the pain had disappeared. To prevent restenosis after angioplasty intravascular brachytherapy was performed with Microselectron192Ir. A PARIS catheter was used as the applicator. It was introduced into the artery using the same access as angiography and angioplasty. The target for irradiation was the dilated part of the artery with bilateral 1.5 cm margins - altogether 10 cm. One dose of 15 Gy was applied 2 mm from the inner surface of the arterial wall (2 mm from the applicator surface). There were no early side effects after the treatment. (author)

  3. Diabetic peripheral arterial disease: lower limb angiography results and one year outcomes of interventional treatment

    International Nuclear Information System (INIS)

    Objective: To demonstrate lower limb angiography results of peripheral arterial disease (PAD) in diabetics and evaluate one-year curative effect after interventional therapy. Methods: Lower limb angiography results and the efficiency of interventional therapy for 44 limbs with PAD in 38 diabetics were retrospectively analyzed. Post-treatment clinical manifestations, signs and ankle-brachial-index (ABI) at 1 week, 1 month, 3 months, 6 months and 12 months were compared with those before treatment. Clinical evaluation was divided into four grades: apparent, effective, ineffective and deterioration. Efficiency = (apparent + effective) / total cases × 100%. ABI was compared using analysis of variance. Results: Lower limb angiography revealed multi-branch lesions, with multi-segmental stenoses or obstructions. Lesions involved both above- and below-the-knee arteries in 25 limbs (56.8%), only above-the-knee arteries in 3 limbs (6.8%) and only below-the-knee arteries in 16 limbs (36.4%). In the limbs only with below-the-knee arterial lesions, the involved artery branches were one in one limb (2.3%), two in six limbs (13.6%) and three in nine limbs (20.5%), respectively. The technical success rate of percutaneous transluminal angioplasty (PTA) was 91.4% (53/58) for diseased below-the-knee arteries. Among the 12 cases with foot and ankle ulcers, ulcers healed within 3 months in 9 cases; however, the other three cases suffered below-the-ankle (in one case) or below-the-knee amputation (in two cases) within 6 months. Four cases with gangrene suffered below-the-knee amputation within one month after PTA. The amputation rate was 15.9% (7/44). At 1 week, 1, 3, 6 and 12 months after PTA, the effective rates were 79.6% (35/44), 83.3% (30/36), 85.7% (24/28), 85.0% (17/20) and 81.3% (13/16), respectively; ABI values were 0.86±0.10, 0.85±0.10, 0.83±0.11, 0.79±0.12 and 0.75±0.12, respectively. Compared with pie-PTA ABI value (0.53±0.20), post-PTA ABI value was significant

  4. 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.

  5. 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

  6. Factors influencing technical success and outcome of percutaneous balloon angioplasty in de novo native hemodialysis arteriovenous fistulas

    International Nuclear Information System (INIS)

    Objective: To determine predictors of technical success, dysfunction recurrence and patency after percutaneous transluminal angioplasty (PTA) of de novo dysfunctional hemodialysis arteriovenous fistulas (AVFs). Methods: Retrospective analysis of first time PTA of 167 AVF in 162 patients (100 men, 66 ± 13 years). Anatomical (location, length, grade and number of stenoses) and clinical variables (sex, age, prior AVF, diabetes mellitus and AVF age, side and location) were reviewed. Results: 217 stenoses or segmental occlusions were treated. Technical success rate (84.4%) was higher in radiocephalic AVF compared to brachial artery–median vein AVF (p = 0.030) and was negatively correlated with initial stenosis (p = 0.049). Dysfunction recurrence was seen in 52.7% and correlated negatively with technical success (p = 0.013) and AVF age (p = 0.008). Early dysfunction (within 6 months) was negatively correlated with AVF age (p = 0.016) and positively with diabetes (p = 0.003). Higher AVF age resulted in higher primary (p = 0.005) and secondary patency rates (p = 0.037–0.005). Conclusions: Technical success of PTA in hemodialysis AVF is affected by AVF type and initial stenosis and has significant effect on dysfunction recurrence, but not on AVF longevity. Younger AVF has increased risk for (early) recurrent dysfunction and lower patency rates. Patients with diabetes mellitus have higher risk for early dysfunction

  7. Patient and physician perception of natural orifice transluminal endoscopic appendectomy

    Institute of Scientific and Technical Information of China (English)

    Tomas Hucl; Adela Saglova; Marek Benes; Matej Kocik; Martin Oliverius; Zdenek Valenta; Julius Spicak

    2012-01-01

    AIM:To investigate perception of natural orifice transluminal endoscopic surgery (NOTES) as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients (50%) and only 21 physicians (21%) preferred NOTES (P < 0.001).Patients had previously heard of NOTES less frequently (7% vs 73%,P < 0.001) and had undergone endoscopy more frequently (88% vs 36%,P < 0.001) than physicians.Absence of hernia was the most common reason for NOTES preference in physicians (80% vs 44%,P =0.003),whereas reduced pain was the most common reason in patients (66% vs 52%).Physicians were more likely to refuse NOTES as a novel and unsure technique (P < 0.001) and having an increased risk of infection (P < 0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education [odds ratio (OR):2.68,95%confidence interval (CI):1.23-5.83] and prior colonoscopy (OR:2.10,95% CI:1.05-4.19) were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians (P =0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.

  8. 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

  9. 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

  10. Congenital Pulmonary Artery Stenoses Masquerading as Chronic Thromboembolic Disease

    OpenAIRE

    Hemnes, Anna R.; Doyle, Thomas P.; Janssen, Dana; Robbins, Ivan M.

    2009-01-01

    Stenotic pulmonary vascular lesions, often amenable to balloon angioplasty, can erroneously appear to suggest chronic thromboembolic disease on ventilation/perfusion (V/Q) scan. We report a case of multiple peripheral pulmonary artery stenoses and describe radiologic findings and treatment options.

  11. Bifurcating stents in the pulmonary arteries: A novel technique to relieve bilateral branch pulmonary artery obstruction.

    Science.gov (United States)

    Narayan, Hari K; Glatz, Andrew C; Rome, Jonathan J

    2015-10-01

    Balloon angioplasty and stent placement in close proximity to the bifurcation of the branch pulmonary arteries can be challenging. Multiple approaches have been previously described, though none of these approaches both treats bilateral proximal branch pulmonary artery stenosis and provides an anchor for a transcatheter pulmonary valve replacement. We report a novel approach that involves serial stent placement and balloon dilation through the struts of the stent in each pulmonary artery, along with balloon expansion of the proximal portion of the stents to the diameter of the main pulmonary artery. In the two cases we describe, this strategy resulted in significant relief of branch pulmonary artery obstruction without compromising the anatomy of the main pulmonary artery segment. This technique can be an effective way to alleviate stenoses of the bilateral proximal branch pulmonary arteries and provides a landing zone for a future transcatheter pulmonary valve. PMID:26256829

  12. 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.

  13. 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.

  14. New stent developments for peripheral arterial occlusive disease

    International Nuclear Information System (INIS)

    Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.)

  15. Natural orifice transluminal endoscopic surgery vs laparoscopic ovariectomy: Complications and inflammatory response

    Czech Academy of Sciences Publication Activity Database

    Martínek, J.; Ryska, O.; Filípková, T.; Doležel, R.; Juhás, Štefan; Motlík, Jan; Holubová, Monika; Nosek, V.; Rotnáglová, B.; Zavoral, M.; Ryska, M.

    2012-01-01

    Roč. 18, č. 27 (2012), s. 3558-3564. ISSN 1007-9327 Institutional research plan: CEZ:AV0Z50450515 Keywords : Natural orifice transluminal endoscopic surgery * Laparoscopy * Ovariectomy Subject RIV: FP - Other Medical Disciplines Impact factor: 2.547, year: 2012

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-15

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

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

    International Nuclear Information System (INIS)

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

  18. Pulmonary Arterial Stent Implantation in an Adult with Williams Syndrome

    International Nuclear Information System (INIS)

    We report a 38-year-old patient who presented with pulmonary hypertension and right ventricular dysfunction due to pulmonary artery stenoses as a manifestation of Williams syndrome, mimicking chronic thromboembolic pulmonary hypertension. The patient was treated with balloon angioplasty and stent implantation. Short-term follow-up showed a good clinical result with excellent patency of the stents but early restenosis of the segments in which only balloon angioplasty was performed. These stenoses were subsequently also treated successfully by stent implantation. Stent patency was observed 3 years after the first procedure

  19. Experimental examinations with a new percutaneously insertable, expandable vascular endoprosthesis

    International Nuclear Information System (INIS)

    Restenosis and occlusion are the most common reasons why transluminal balloon angioplasty may fail to provide long-term benefit. To prevent restonosis and occlusion of diseased arteries after angioplasty an arterial endoprosthesis has been developed which is positioned to the balloon of an angioplasty catheter and which consists of a stainless steel pliable and elastic tube. With the inflation of the balloon the endoprosthesis will dilate and give the arterial wall a new mechanical support. This new device has been implanted in 12 experimental dogs in arteries of different size and lumen. The longest patency rate of nine months was observed with the completely developed method. (orig.)

  20. Intravaskulaer ultralyd og perkutan transluminal angioplastik. Praeliminaere resultater

    DEFF Research Database (Denmark)

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

    1995-01-01

    measuring the reduction of stenosis and increment of the luminal area. The increased luminal area following PTA was partly due to stretching of the artery and partly due to compression of the atheroma. We found a correlation between the amount of calcium in the plaque and the size of the dissection after...

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

    International Nuclear Information System (INIS)

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

  2. 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.

  3. 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

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

    Institute of Scientific and Technical Information of China (English)

    万镇; 范修才

    2011-01-01

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

  5. 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.

  6. Classificação angiográfica na revascularização do membro inferior isquêmico: pode a angiografia definir a resistência do leito receptor do enxerto? Angiographic classification in ischemic lower limb revascularization: can it define arterial outflow resistance?

    Directory of Open Access Journals (Sweden)

    Fabio Henrique Rossi

    2009-09-01

    Full Text Available CONTEXTO: A arteriografia é muitas vezes utilizada como único método pré-operatório para a definição da conduta terapêutica na revascularização do membro isquêmico, seja ela realizada através de angioplastia transluminal, ou de cirurgia convencional. Ainda hoje, sua utilização é assunto de debate. OBJETIVO: Comparar um método de classificação arteriográfica simples com estudos hemodinâmicos pré e intraoperatórios do leito arterial isquêmico a ser revascularizado, com o objetivo de verificar seu poder para definir a resistência desse leito arterial. MÉTODOS: Foram analisadas 68 cirurgias de revascularização de membros inferiores isquêmicos realizadas no período de julho de 1999 a julho de 2004 no Setor de Cirurgia Vascular do Instituto Dante Pazzanese de Cardiologia. As características do leito arterial receptor do enxerto foram estudadas e comparadas através de método de classificação arteriográfica pré-operatória proposto pelos autores, análise hemodinâmica pré-operatória por eco-Doppler colorido e intraoperatória por medidas diretas de vazão, pressão e resistência. RESULTADOS: Foram observados índices de correlação de Spearman positivos (p BACKGROUND: Angiography is often used as the only preoperative method to define the therapeutic approach for ischemic lower limb revascularization, either by transluminal angioplasty or surgery. Today its use is still controversial. OBJECTIVE: To compare a simple method of angiographic classification with hemodynamic preoperative and intraoperative studies of the ischemic arterial bed in order to verify its efficacy in defining arterial bed resistance. METHODS: We analyzed 68 cases of surgical revascularization of ischemic lower limbs performed from July 1999 to July 2004 at the Division of Vascular Surgery of Instituto Dante Pazzanese de Cardiologia. The characteristics of the graft recipient arterial runoff were studied and compared using the method of

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

    Science.gov (United States)

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

    1990-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  9. 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

  10. Interventional therapy of arteriosclerotic obliterations of iliaco-femoral artery via radial artery

    International Nuclear Information System (INIS)

    Objective: To study the safety and effect of interventional treatment for arteriosclerotic obliterations of iliaco-fermoral artery via radial artery retrospectively. Methods: Sixteen cases were treated with interventional procedure via radial artery. The duration of disease was from 3 days to 2 years. All cases presented with rest pain and intermittent claudicating (with distance less than 500 m). Unilateral lesions were found in 9 cases, and bilateral lesions in 7 cases. Iliaco-femoral arteries were obliterated completely in 6 cases, while the other ten cases had arterial stenosis more than 75%. After visualization of obliterative artery, urokinase was administrated consecutively from catheter indwelled in or above thrombus. Transcatheter thrombolysis would be cancelled if the therapeutic effect was negligible after using urokinase for 72 hours. After thrombolysis, the balloon angioplasty and the stent implantation were performed in the cases with residual stenosis more than 50%. In all of 16 cases, 5 cases underwent continuous intraarterial thrombolysis only, 11 cases received balloon angioplasty and/or stent implantation additionally. The ankle/ brachial index (ABI) post-treatment and pre-treatment was analyzed. Results: The duration of transcatheter thrombolysis was 3.0-15.0 days, averaged (8.4±2.9) days. The obliterative arteries were recanalized in 15 cases. The symptoms of rest pain disappeared in all cases, while intermittent claudicating was still present in 4 cases, but the claudicating distance increased significantly (92.50±60.21 and 625.00± 84.26 m for pre- and post- operation respectively). The ABI was 0.63-1.10 (0.91±0.12)for post-treatment and 0-0.57 (0.32±0.14)for pre-treatment respectively (t=21.73, P<0.01). During 6- 24 months' follow-up, restenosis occurred in 1 case, which was treated successfully once again after balloon angioplasty. There was no serious complication related to the procedure. Conclusion: It is safe and effective to apply

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

    International Nuclear Information System (INIS)

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

  12. 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

  13. Current developments in natural orifices transluminal endoscopic surgery: An evidence-based review

    Directory of Open Access Journals (Sweden)

    Anthony Yuen Bun Teoh, Philip Wai Yan Chiu, Enders Kwok Wai Ng

    2010-10-01

    Full Text Available Tremendous advances have been made in recent years addressing the key obstacles to safe performance and introduction of human natural orifice transluminal endoscopic surgery (NOTES. Animal studies have focused on identifying optimal solutions to these obstacles, in particular methods of creating transluminal access, safe closure of the point of access, and development of a multitasking platform with dedicated instruments. Whether the performance data generated from these animal studies can be reproduced in humans has yet to be determined. Reports of human NOTES procedures are emerging, and the possibility of accomplishing human NOTES based on existing technology has been demonstrated. However, dedicated platforms and devices are still lacking to allow for pure NOTES procedures, and whether NOTES can deliver the postulated benefits of earlier recovery and improved cosmesis remains uncertain.

  14. 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.

  15. Natural orifice transluminal endoscopic surgery: New minimally invasive surgery come of age

    OpenAIRE

    Huang, Chen; Huang, Ren-Xiang; Qiu, Zheng-Jun

    2011-01-01

    Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo’s first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedur...

  16. Technical skill set training in natural orifice transluminal endoscopic surgery: how should we approach it?

    LENUS (Irish Health Repository)

    Nugent, Emmeline

    2011-03-01

    The boundaries in minimally invasive techniques are continually being pushed further. Recent years have brought new and exciting changes with the advent of natural orifice transluminal endoscopic surgery. With the evolution of this field of surgery come challenges in the development of new instruments and the actual steps of the procedure. Included in these challenges is the idea of developing a proficiency-based curriculum for training.

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

    Directory of Open Access Journals (Sweden)

    Weinstock B

    2014-03-01

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

  18. Behandling af renovaskulær hypertension med transluminal angioplastik--13 års erfaring--sekundærpublikation

    DEFF Research Database (Denmark)

    Øvrehus, Kristian Altern; Andersen, Poul Erik; Jacobsen, Ib Abildgaard

    2008-01-01

    angioplasty. A total of 124 patients were treated; 31% were normotensive immediately after angioplasty, 59% had improved blood pressure control and 10% had unchanged hypertension. The corresponding figures after six months and at the latest follow-up were 13, 72 and 15%. Udgivelsesdato: 2008-Jan-21...

  19. 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

  20. 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.

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. Arterial Catheterization

    Science.gov (United States)

    ... version AMERICAN THORACIC SOCIETY Patient Information Series Arterial Catheterization An arterial catheter is a thin, hollow tube ... PHYSICIANS: AND COPY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ■ ...

  7. Treatment of iliac artery aneurysms by placement of a coated stent

    International Nuclear Information System (INIS)

    Isolated iliac artery aneurysms are associated with high rates of morbidity and mortality when left untreated. Transluminally placed endovascular stended graft have recently been proposed as an alternative to surgery. The major advantages are their simplicity and reduce invasiveness, morbidity and mortality. Moreover, the hospital stay is shorter and the overall costs lower. We present our experience in two patient treated with these devices. (Author) 21 refs

  8. Renal Artery Stenosis in a Young Female without Fibromuscular Dysplasia with Literature Review

    OpenAIRE

    Peralta, Paloma; Cholankeril, Matthew; Goldberg, Daniel; Koneru, Jayanth; Shamoon, Fayez

    2016-01-01

    Renal artery stenosis (RAS) is rare in young patients without fibromuscular dysplasia (FMD). RAS is primarily classified as having two major etiologies, namely, atherosclerosis and FMD, with 90% and 10%, respectively. We report a case of a female in her mid 20s who developed hypertension due to RAS with no evidence of FMD or underlying renal dysfunction and underwent successful angioplasty and stenting.

  9. Disease-specific questionnaire for quality of life in patients with peripheral arterial occlusive disease in the stage of critical ischemia (FLeQKI) - methodical development of a specific measuring instrument and psychometric evaluation of its validity and reliability. Pt. 1

    International Nuclear Information System (INIS)

    Purpose: To develop a disease-specific measuring instrument for quality of life in German-speaking patients with peripheral arterial occlusive disease in the stage of critical ischemia and to test it in a prospective study for validity and reliability. Materials and methods: We developed a questionnaire compiling items representing subjective disease relevant health states. With 35 of these items, we designed the scales comorbidity (KO), physical pain (SZ), physical functioning (KF), physical state (KS), social functioning (SB), mental health (PB), and therapy-induced limitations (TE). Each item was to be valued as never, seldom, often or always. The scales were standardized with a control group of 40 individuals without peripheral arterial occlusive disease who were interviewed twice in an interval of 6 months using both the FLeQKI and the Medical Outcomes Study Group Short Form 36 (SF-36). Convergent and discriminative validity was determined in 65 consecutive in-patients with peripheral occlusive arterial disease in the stage of critical ischemia who were interviewed with FLeQKI and SF-36 prior to percutaneous transluminal angioplasty (PTA) or bypass operation and 1 month and 6 months after. The internal consistency and test-retest reliability of the FLeQKI were determined in the control group. For statistical analysis, Cronbach's α Test and Pearsons Product Moment Correlation were used. Results: The control group consisted of 21 men and 19 women with an age of 73.4 ± 7.8, and the treatment group was comprised of 35 men and 30 women with an age of 75.1 ± 7.0. In the treatment group, convergent validity reached high values in the scales SB, KF, PB, and SZ (r = 0.41 - 0.70). With their discriminative validity (r = -0.04 - 0.30), TE and KS were independent, specific dimensions of life quality. The control group showed good values for internal consistency (Cronbach's α = 0.54 - 0.93) and for test-retest reliability (r = 0.44 - 0.96). Conclusion: The FLeQKI is

  10. Endovascular Intervention in the Treatment of Peripheral Artery Disease.

    Science.gov (United States)

    Couto, Marian; Figueróa, Alejandro; Sotolongo, Antonio; Pérez, Reynerio; Ojeda, José Martinez

    2015-01-01

    Endovascular therapy has emerged as an essential part of the management we can offer patients suffering from peripheral arterial disease. The AHA/ACCF guidelines deemed ballon angioplasty as a reasonable alternative for patients with limb threatening lower extremity ischemia who are not candidates for an autologus venous graft. Endovascular treatment is most useful for the treatment of critical limb ischemia and should ensure adequate proximal flow before engaging in interventions of distal disease.To increase procedure success rate, a thorough diagnostic evaluation is fundamental. This evaluation must take into account amount of calcium, no flow occlusion, length of occlusion, and presence of collaterals. There are different tools and procedure techniques available. Among these are the medicated ballon angioplasty and atherectomy by laser or high-speed drill, among others. Further studies may consolidate endovascular intervention as a safe and effective management for patients with lower extremity arterial disease and possibly cause a change in the actual practice guidelines. PMID:26742196

  11. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

    International Nuclear Information System (INIS)

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 ± 0.31 mm on digital subtraction angiography (DSA), 0.93 ± 0.20 mm on CTA using B30, 1.18 ± 0.27 mm on CTA using B50, and 1.29 ± 0.29 mm on CTA using B60. The mean ALN was 55.7 ± 6.0% on CTA using B30, 43.8 ± 7.5% on CTA using B50, and 38.7 ± 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  12. Evaluation of middle cerebral artery stents using multidetector row CT angiography in vivo study: comparison of the three different kernels

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Jin Hee; Lim, Yeon Soo; Lee, Youn Joo; Yoo, Won Jong; Sung, Mi Sook (Dept. of Radiology, Bucheon St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Bucheon (Korea, Republic of)), email: wjyu@catholic.ac.kr; Kim, Bum Soo (Dept. of Radiology, Seoul St Mary' s Hospital, Coll. of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of))

    2012-05-15

    Background: There are very few reports assessing middle cerebral artery (MCA) stents using multidetector computed tomography (MDCT). Purpose: To assess MCA stents using multidetector CT angiography (CTA) in vivo evaluation: the differences in the CTA results according to the three different kernels. Material and Methods: We retrospectively evaluated 27 MCA stents from 26 patients who underwent CTA with 16- and 64-slice MDCT after percutaneous transluminal angioplasty and stenting (PTAS). By CTA, using medium-smooth kernel (B30), medium-sharp kernel (B50), and sharp kernel (B60), the lumen diameter, artificial luminal narrowing (ALN), and subjective visibility score of the stented vessels were evaluated. The subjective visibility score ranged from 1 (poor quality) to 5 (excellent) using a five-point scale. Results: There were excellent inter-observer agreements for the lumen diameter measurements (P < 0.001). The mean diameter of the stented vessels was 2.10 +- 0.31 mm on digital subtraction angiography (DSA), 0.93 +- 0.20 mm on CTA using B30, 1.18 +- 0.27 mm on CTA using B50, and 1.29 +- 0.29 mm on CTA using B60. The mean ALN was 55.7 +- 6.0% on CTA using B30, 43.8 +- 7.5% on CTA using B50, and 38.7 +- 8.3% on CTA using B60. CTA with higher kernels had a smaller ALN than images with smaller kernels. The median subjective visibility score on the CTA using B50 was 3, which was higher than for the other kernels. The differences in the lumen diameter, ALN, and the subjective visibility score of the stented vessels on CTA using the three different kernels was statistically significant (P < 0.001). Conclusion: The sharp kernel was better to assess the lumen diameter and ALN, but was inferior to the medium-sharp kernel for in-stent evaluation due to high image-to-noise. CTA with medium-sharp kernel showed good lumen visibility and acceptable ALN for MCA stents. This could therefore be a non-invasive, readily applicable clinical method for assessing MCA stent patency after

  13. Hyperperfusion syndrome after carotid stent angioplasty

    International Nuclear Information System (INIS)

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

  14. 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.)

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

    Directory of Open Access Journals (Sweden)

    Alexandrescu V

    2011-08-01

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

  16. Surgical treatment of internal carotid artery restenosis following eversion endarterectomy

    OpenAIRE

    Radak Đorđe; Tanasković Slobodan; Vukotić Miloje; Babić Srđan; Aleksić Nikola; Kolar Jovo; Popov Petar; Nenezić Dragoslav; Vučurević Goran; Gajin Predrag; Ilijevski Nenad

    2012-01-01

    Introduction. Carotid angioplasty and internal carotid artery stenting is the therapeutic method of choice in the treatment of carotid restenosis, but when it is not technically feasible (expressed tortuosity of supraaortic branches, calcifications, presence of pathological elongation of very long lesions) a redo surgery is indicated. Objective. The aim of our study was to examine the benefits and risks of redo surgery in patients with symptomatic and asymptomatic significant internal c...

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

    Directory of Open Access Journals (Sweden)

    Ryan A Mctaggart

    2014-04-01

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

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

    International Nuclear Information System (INIS)

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

  19. Drug-eluting stents:is it the beginning of the end for coronary artery bypass surgery?

    Institute of Scientific and Technical Information of China (English)

    Shahzad G Raja

    2004-01-01

    @@ Myocardial revascularization therapy of coronary artery disease is one of the most important medical advances of the past 50 years.1 Coronary revascularization by either bypass surgery or coronary angioplasty relieves angina and may improve the prognosis in patients with coronary artery disease.2,3 Randomized comparisons reveal no difference in survival free from myocardial infarction (MI) between surgery and balloon angioplasty.4,5 Stenting significantly improved the long-term outcome, while surgery is still associated with fewer reinterventions during follow-up.6-10 However, subsequent improvements in both percutaneous and surgical techniques may now limit the validity of any conclusions that have been drawn from the earlier studies. In fact, the lines of demarcation for patients suited for bypass or angioplasty are becoming blurry with each passing day.

  20. The use of interventional radiology in hepatic artery stenosis after liver transplantation

    International Nuclear Information System (INIS)

    Objective: To define the role of interventional techniques in hepatic artery stenosis after liver transplantation. Methods: Of the 200 patients after liver transplantation, 18 cases with hepatic artery stenosis were encountered, and PTA or stent treatment in those patients was retrospectively summarized. Results: Stenoses of hepatic artery were successfully treated in 15 patients (PTA in 13 case, stent in 2 case). Seven of 15 patients had a better outcome following angioplasty, whereas eight patients had a bad outcome. Conclusion: Interventional techniques carries little risk and is a useful procedure for the treatment of stenoses of hepatic artery after liver transplantation. Early identification and reconstruction of adequate blood flow are critical

  1. Disease-specific questionnaire for quality of life in patients with peripheral arterial occlusive disease in the stage of critical ischemia (FLeQKI) - methodical development of a specific measuring instrument and psychometric evaluation of its validity and reliability. Pt. 1; Fragebogen zur gesundheitsbezogenen Lebensqualitaet von Patienten mit peripherer arterieller Verschlusskrankheit (pAVK) im Stadium kritischer Ischaemie (FLeQKI) - methodische Entwicklung eines krankheitsspezifischen Messinstruments und psychometrische Bestimmung seiner Validitaet und Reliabilitaet. T. 1

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, W.A.; Bohndorf, K.; Kirchhof, K. [Klinikum Augsburg (Germany). Klinik fuer Diagnostische Radiologie und Neuroradiologie; Olbricht, W. [Bayreuth Univ. (Germany). Lehrstuhl fuer Mathematik VII; Klarmann, S. [Klinikum Augsburg (Germany). Klinik fuer Neurologie und Klinische Neurophysiologie; Engelhardt, M. [Bundeswehrkrankenhaus Ulm (Germany). Klinik fuer Gefaesschirurgie; Freitag, M.H. [Bayreuth Univ. (Germany). Inst. fuer Medizinmanagement und Gesundheitswissenschaften; Woelfle, K. [Klinikum Augsburg (Germany). Klinik fuer Gefaesschirurgie

    2007-12-15

    Purpose: To develop a disease-specific measuring instrument for quality of life in German-speaking patients with peripheral arterial occlusive disease in the stage of critical ischemia and to test it in a prospective study for validity and reliability. Materials and methods: We developed a questionnaire compiling items representing subjective disease relevant health states. With 35 of these items, we designed the scales comorbidity (KO), physical pain (SZ), physical functioning (KF), physical state (KS), social functioning (SB), mental health (PB), and therapy-induced limitations (TE). Each item was to be valued as never, seldom, often or always. The scales were standardized with a control group of 40 individuals without peripheral arterial occlusive disease who were interviewed twice in an interval of 6 months using both the FLeQKI and the Medical Outcomes Study Group Short Form 36 (SF-36). Convergent and discriminative validity was determined in 65 consecutive in-patients with peripheral occlusive arterial disease in the stage of critical ischemia who were interviewed with FLeQKI and SF-36 prior to percutaneous transluminal angioplasty (PTA) or bypass operation and 1 month and 6 months after. The internal consistency and test-retest reliability of the FLeQKI were determined in the control group. For statistical analysis, Cronbach's {alpha} Test and Pearsons Product Moment Correlation were used. Results: The control group consisted of 21 men and 19 women with an age of 73.4 {+-} 7.8, and the treatment group was comprised of 35 men and 30 women with an age of 75.1 {+-} 7.0. In the treatment group, convergent validity reached high values in the scales SB, KF, PB, and SZ (r = 0.41 - 0.70). With their discriminative validity (r = -0.04 - 0.30), TE and KS were independent, specific dimensions of life quality. The control group showed good values for internal consistency (Cronbach's {alpha} = 0.54 - 0.93) and for test-retest reliability (r = 0.44 - 0

  2. 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

    OpenAIRE

    Silvio Romero de Barros Marques; Esdras Marques Lins; José Lamartine de Andrade Aguiar; Maria Claudia Sodré Albuquerque; Renata de Oliveira Rossiter; Luciano Tavares Montenegro; Roberto José Vieira

    2007-01-01

    CONTEXTO: A obtenção de um substituto arterial ideal para o emprego nas reconstruções das artérias de pequeno e médio calibre é ainda o principal objetivo da maioria das pesquisas científicas desenvolvidas no campo dos substitutos vasculares. A membrana de biopolímero de cana-de-açúcar pode ser de grande utilidade para a realização das reconstruções arteriais em vasos de calibre inferior a 4 mm e assim permitir o tratamento de doenças que afetam milhões de pessoas no Brasil e em todo o mundo....

  3. Natural orifice transluminal endoscopic surgery and localized resection for colorectal neoplasia

    Directory of Open Access Journals (Sweden)

    Ronan A Cahill

    2010-06-01

    Full Text Available Modern methods of surgical intervention have the potential to provide effective, definitive management of early stage colorectal neoplasia by truly minimally invasive means. Margin-free clearance of early colonic neoplasia from within the intestinal lumen can already now be effected by endoscopic submucosal dissection in the colon and transluminal endoscopic microsurgery (TEM in the rectum. Natural orifice transluminal endoscopic surgery (NOTES offers the potential for providing transmural, full thickness excision as TEM does but at sites in the colon proximal to the rectum. The next conceptual advance required to make this practice an effective reality lies in evolving surgical regional staging strategies to effectively partner localized resective approaches and allow their deployment as definitive curative therapy. As the most compelling modality for nodal status ascertainment in the absence of lymphatic basin excision for other malignant disease processes, it seems timely to reconsider sentinel node biopsy in cancer of the colon and rectum. Whether by this means or indeed any other, such an ability to confidently identify patients with node negative disease would allow nascent innovative techniques flourish as definitive management for confined (N0 T1 and T2 cancers and so allow the application of available advanced technology for clinical benefit. Conversely, the development of a specific clinical niche for NOTES (whether, as here, for full thickness localized colonic excision or nodal staging alone would greatly benefit the evolution and incorporation of this surgical strategy into clinical care paradigms.

  4. Arterial stick

    Science.gov (United States)

    ... the main arteries in the forearm (radial and ulnar arteries). The procedure is done as follows: The ... Arteries also have thicker walls and have more nerves. When the needle is inserted, there may be ...

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

    International Nuclear Information System (INIS)

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

  6. Pure natural orifice transluminal endoscopic surgery (NOTES) with ultrasonography-guided transgastric access and over-the-scope-clip closure

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Andersen, Luise; Nielsen, Ole Lerberg;

    2012-01-01

    Most natural orifice transluminal endoscopic surgery (NOTES) procedures to date rely on the hybrid technique with simultaneous laparoscopic access to protect against access-related complications and to achieve adequate triangulation for dissection. This is done at the cost of the potential benefits...

  7. 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.

  8. 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

  9. 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...

  10. 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

  11. Retrograde catheterization via politeal artery for the treatment of ipsilateral superficial femoral artery occlusive disease: its clinical application

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical effect and application of retrograde catheterization via politeal artery in treating ipsilateral superficial femoral artery occlusive diseases. Methods: During the period from Jan. 2008 to June 2011, 15 patients with superficial femoral artery occlusive diseases were collected. A total of 17 narrowed or obstructed superficial femoral arteries were detected, including right (n=10) and left (n=7) femoral arteries. The length of the diseased artery ranged from 9 to 18 cm, with a mean of (12.5±6.8) cm. Percutaneous angioplasty (PTA) through ipsilateral retrograde catheterization via politeal artery together with stent implantation was performed to reopen the narrowed or obstructed superficial femoral arteries. After the procedure all patients were followed up for 3-24 months. The clinical results were analyzed. Results: The therapeutic success rate was 100% (17/17). No serious complications occurred. After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 89.47% of patients (17/19) the superficial femoral arteries remained patent during the follow-up period. The preoperative ankle brachial index (ABI) was 0.15-0.48 (mean 0.28), while the postoperative ABI was 0.69-1.05 (mean 0.88). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusion: For the treatment of superficial femoral arterial occlusive diseases, PTA through ipsilateral retrograde catheterization via politeal artery together with stent implantation is a safe effective therapy. (authors)

  12. Medline Plus

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

  13. 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

  14. 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.

  15. Intraoperative evaluation of revascularization effect on ischemic muscle hemodynamics using near-infrared diffuse optical spectroscopies

    OpenAIRE

    Yu, Guoqiang; Shang, Yu; Zhao, Youquan; Cheng, Ran; Dong, Lixin; Saha, Sibu P

    2011-01-01

    Arterial revascularization in patients with peripheral arterial disease (PAD) reestablishes large arterial blood supply to the ischemic muscles in lower extremities via bypass grafts or percutaneous transluminal angioplasty (PTA). Currently no gold standard is available for assessment of revascularization effects in lower extremity muscles. This study tests a novel near-infrared diffuse correlation spectroscopy flow-oximeter for monitoring of blood flow and oxygenation changes in medial gastr...

  16. A review on the status of natural orifice transluminal endoscopic surgery (NOTES cholecystectomy: techniques and challenges

    Directory of Open Access Journals (Sweden)

    Michael C Meadows

    2010-09-01

    Full Text Available Michael C Meadows1,3, Ronald S Chamberlain1,2,31Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2Department of Surgery, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA; 3Saint George’s University, School of Medicine, West Indies, GrenadaIntroduction: The evolution of techniques for the performance of a cholecystectomy over the last 25 years has been swift. The laparoscopic approach is now the gold standard for removal of the gall bladder and is the most frequently performed minimally invasive procedure globally. Currently in its infancy stage, natural orifice transluminal endoscopy surgery, or NOTES, is purported to be the next leap forward in minimally invasive approaches. The safety, feasibility, and effectiveness of this procedure, as well as the significance of potential benefits to patients beyond current surgical approaches are yet undetermined.Methods: A comprehensive literature search was conducted using PubMed, a search engine ­created by the National Library of Medicine. Keywords used in the search included “natural orifice transluminal endoscopic surgery”, “NOTES”, “cholecystectomy”, “transcolonic”, “transvaginal”, and “transgastric”. The accumulated literature was critically analyzed and reviewed.Results: One-hundred and eighty-six cases of NOTES cholecystectomies have been published to date. Of these, 174 have been performed through a transvaginal approach. The remainder of the procedures were performed transgastrically. There are no published reports of ­transcolonic cholecystectomies performed in humans. Four of 186 cases (2.15% were converted to traditional laparoscopy due to intraoperative complications. No significant complications or mortalities have been reported.Conclusion: NOTES cholecystectomy appears to be a feasible procedure. However, technical, safety, and ethical issues remain relatively unresolved. Besides improved cosmesis, whether additional

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

    International Nuclear Information System (INIS)

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

  18. Vancomycin treatment and butyrate supplementation modulate gut microbe composition and severity of neointimal hyperplasia after arterial injury

    OpenAIRE

    Ho, Karen J.; Xiong, Liqun; Hubert, Nathaniel J.; Nadimpalli, Anuradha; Wun, Kelly; Chang, Eugene B; Kibbe, Melina R.

    2015-01-01

    Abstract Gut microbial metabolites are increasingly recognized as determinants of health and disease. However, whether host–microbe crosstalk influences peripheral arteries is not understood. Neointimal hyperplasia, a proliferative and inflammatory response to arterial injury, frequently limits the long‐term benefits of cardiovascular interventions such as angioplasty, stenting, and bypass surgery. Our goal is to assess the effect of butyrate, one of the principal short chain fatty acids prod...

  19. CD4+ mononuclear cells induce cytokine expression, vascular smooth muscle cell proliferation, and arterial occlusion after endothelial injury.

    OpenAIRE

    Hancock, W. W.; Adams, D. H.; Wyner, L R; Sayegh, M H; Karnovsky, M. J.

    1994-01-01

    Studies of T cell-deficient or immunosuppressed animals undergoing arterial endothelial denudation have yielded conflicting results as to the contribution of the immune system to neointimal vascular smooth muscle cell accumulation and proliferation. We investigated the cell types and cytokine expression associated with intimal hyperplasia occurring 14 days after balloon angioplasty of the carotid artery in Sprague-Dawley rats. Immunohistological studies using monoclonal antibodies showed that...

  20. Carotid angioplasty and stent placement for restenosis after endarterectomy

    International Nuclear Information System (INIS)

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