ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00554.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00555.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Objectives:To determine the relation between guiding catheter size, procedural and angiographic details, and cost of coronary angioplasty.Background:Miniaturized angiographic equipment used during coronary angioplasty is proposed as a method to decrease the duration of supine bed rest, length of hospital stay, and cost of expensive inpatient hospitalization.Methods:One hundred and sixty patients were randomized to undergo elective coronary angioplasty with a 6Fr (external diameter, 0.079‐in; internal diameter 0.062‐in) or 8Fr (external diameter, 0.105‐in internal diameter, 0.078–0.079‐in) guiding catheter. Standard balloon dilatation catheters were used. End points: 1° peripheral vascular complications, 2° technical and procedural outcomes; quantitative and qualitative quality of the coronary angiograms; and the in‐hospital (“bottom up” cost accounting of equipment, supplies, support personnel, postcoronary angioplasty room), and physician cost (using Resource Based Relative Value Scale).Results:There was no difference in peripheral vascular complications between the two groups (6Fr, 21%; 8Fr, 30%; P = NS). Less contrast medium was used with the 6Fr guiding catheters (6Fr, 178 ± 102 mL; 8Fr, 257 ± 147 mL; P = 0.0001). The qualitative quality of the angiograms was better with 8Fr than with 6Fr guiding catheters. For the entire population, the total cost of coronary angioplasty was less with 6Fr guiding catheters ($3,956 ±$2,415) than with 8F guiding catheters ($5,073 ±$3,985, P = 0.03). Excluding patients with either a coronary or peripheral vascular complication, there was less cost savings (6F, $3,720 ±$1,338; 8F, $4,376 ± 2,699, P = 0.05). Independent variables associated with increased cost included: large body mass index; hypercholesterolemia; nonionic contrast media; 8F guiding catheter; complex lesions; and duration of procedure.Conclusions:The use of smaller guiding catheters led to use of less contrast medium with a modest decrease in angiographic visualization. The cost savings seen with 6F guiding catheters is multifactorial due to smaller arteriotomy accompanying sheath insertion and reduced rate of clinically significant coronary and peripheral vascular complications. (J Interven

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00556.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

While radiation therapy has been known to cause myocardial and pericardial damage, its role in accentuating coronary artery disease in the absence of traditional cardiovascular risk factors has been controversial. As younger patients with treatable cancers are being treated with mediastinal radiation, coronary artery disease as a cause for severe chest pain should be entertained as a possible diagnosis. We describe a 25‐year‐old male who presented with an inferior wall myocardial infarction 6 years after receiving mediastinal radiation and chemotherapy for Hodgkin's disease. He was subsequently treated by directional atherectomy to a 95% lesion in the right coronary artery. Histological examination of the atherectomy specimen revealed evidence of radiation‐induced endothelial damage that had resulted in plaque formation and subsequent ischemia. Possible mechanisms for radiation‐induced coronary artery disease and treatment options are discussed. (J Interven Cardiol 1995;8:

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00557.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

We report a case of coronary angioplasty to the right coronary artery, the circumflex, and the left anterior descending artery in a patient with anomalous left main coronary artery arising from the right aortic sinus of Valsalva. At angiographically documented follow‐up of more than 2 years, the patient remains well without restenosis. This case represents the only such report in the literature. Angioplasty hardware was an important factor in successful crossing and dilatation of multiple severe and distal stenoses in the anomalous left system; appropriate technical details are discussed. (J Interven Cardiol 1995;8:359–

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00558.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00559.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00560.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00561.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00562.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1995.tb00563.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY