ISSN:0098-6569    

DOI:10.1002/ccd.1810210302

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractFemoral arterial complications following cardiac catheterization have been well recognized. The development of an inguinal mass in these patients can represent a simple hematoma, a pseudoaneurysm, or an arteriovenous fistula. The utility of the physical examination in diagnosing these complications was assessed by using the echo Doppler study for comparison. This study shows that any single clinical sign should not be used in isolation, but a constellation of physical findings can suggest the correct diagnosis.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210303

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractTo examine the balloon inflation pressures required for successful percutaneous transluminal coronary angioplasty (PTCA), the maximal inflation pressure required for 477 coronary lesions in 200 consecutive patients was determined retrospectively. When graded balloon infaltions just sufficient to achieve full expansion were used, the maximal inflation pressure used was ≤8 atm in 412 stenoses (86%) and was ≤10 atm in 463 stenoses (97%). Successful PTCA was achieved in 98% of lesions with a 3.5% major procedural complication rate. In a second group of 100 patients studied prospectively, the inflation pressure required to achieve full balloon expansion was ≤8 atm in 214 of 232 stenoses (92%) and ≤10 atm in 228 stenoses (98%). Thus, PTCA of coronary stenoses can be achieved with high success rates and low complication rates when graded inflations to pressures just sufficient to achieve full balloon expansion are performed. Most coronary stenoses will respond to pressures

ISSN:0098-6569    

DOI:10.1002/ccd.1810210304

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractMeasurement of coronary dimension requires an accurate and reproducible dimensional reference. Angiographic catheters are frequently used for this purpose. We measured the angiographic diameters of a broad range of diagnostic and angioplasty guiding catheters by using two commonly used edge‐detection algorithms. Angiographic diameters are significantly less than true catheter outer diameter. Therefore the use of contrast‐filled catheters as a dimensional reference may lead to considerable error in vessel measurement with overestimation of absolute dimension. Tables of reference values for multiple catheters are included. We also evaluated the suitability of a metallic‐tipped “marker” catheter as calibration standard, tested under a variety of angiographic conditions. The metallic‐tipped marker was found to have a better degree of reproducibility than catheters. These findings have implications for studies employing serial measurements of coronary artery dimension and for the clinical practice of estimating vessel diameter for choice of balloon size during

ISSN:0098-6569    

DOI:10.1002/ccd.1810210305

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractAngioplasty using the percutaneous popliteal approach was utilized in 50 patients (PTS) to recanalize 59 occluded superficial femoral arteries which had been unsuccessfully canalized by using the antegrade approach because of either a flush origin occlusion or inability to maintain the guide wire in the true lumen. All PTS had claudication; 8 had rest pain; 3 had non‐healing ulcers. The laser Probe™ was used in 17 cases and the Rotablator™ in 3 cases. Occlusion length varied between 1 and 40 cm: 7 lesions were20 cm (group 3). An angiographic success was obtained in 48/59 lesions (81%): 14/16 (87%) in groups 1 and 2 and 34/43 (79%) in group 3. Three PTS needed complementary common femoral endarterectomy and one required percutaneous aspiration of a thromboembolus. Complications included: arterial perforation and/or dissection (without clinical sequelae) in 11 and a popliteal hematoma in 1 PT. One patient with a severely ischemic leg underwent successful emergency vascular surgery, while another limb salvage patient required belowknee amputation. There was no worsening of limb ischemia from any popliteal approach attempt. At discharge, 39 patients (78%) whose outcome would have been unsuccessful with the traditional antegrade approach were clinically improved after utilizing the popliteal approach to achieve a successful angioplasty proc

ISSN:0098-6569    

DOI:10.1002/ccd.1810210306

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractUrgent PTCA of a distal anastomotic stenosis in a saphenous vein aortocoronary bypass graft was successful in relieving recurrent ischemia within 24 h of CABG surgery.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210307

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractWe report a case in which a balloon catheter became permanently inflated in a coronary artery saphenous vein bypass graft. While still inflated, the balloon was forcibly withdrawn from the graft into the external iliac artery and successfully deflated via percutaneous puncture using a CHIBA needle.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210308

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractSubclavian artery stenosis is an infrequently recognized cause of left‐sided chest and arm pain that can mimic the signs and symptoms of angina pectoris. In addition, more proximal subclavian artery stenoses can be associated with cerebrovascular symptoms in the “subclavian steal syndrome.” This article reviews the clinical experience in four patients who presented with different manifestations of subclavian artery stenosis and who were all successfully treated by percutaneous angioplasty. Their clinical presentation, angiographic findings, and post‐angioplasty results are documented. In conclusion, it is felt that nonsurgical correction of critical subclavian artery stenosis, using current angioplasty techniques, is the preferred method of tr

ISSN:0098-6569    

DOI:10.1002/ccd.1810210309

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractIncessant ventricular arrhythmias pose an especially challenging therapeutic dilemma. We describe the successful treatment and follow‐up of a patient with refractory ventricular tachycardia‐induced cardiogenic shock with percoronary chemical ablation. After endocardial mapping was used to identify the “tachycardia‐related” coronary artery, temporary termination of the arrhythmia with balloon occlusion and subselective intracoronary installation of iced saline as previously advocated was unsuccessful. This was probably due to a dual arterial blood supply to the arrhythmogenic focus. However, infusion of 2 cc ethanol (99%) permanently terminated the arrhythmia. Contrary to previous experience, ethanol‐induced arrhythmia termination did not result in arterial occlusion, further supporting a direct toxic effect on the myocardium as its mode of action. Use of standard angioplasty balloon inflation prevents “backwash” of distally infused ethanol and more generalized cell death. The only complication of this procedure was temporary third‐degree AV block, requiring permanent pacem

ISSN:0098-6569    

DOI:10.1002/ccd.1810210310

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe right gastroepiploic artery is being used as a third arterial conduit for coronary artery bypass surgery. Presented here is a case demonstrating successful percutaneous transluminal coronary angioplasty of the gastroepiploic artery graft. This successful accomplishment may avoid repeat surgical revascularization in case of failure of the gastroepiploic artery graft, hence may encourage people to use it more often.

ISSN:0098-6569    

DOI:10.1002/ccd.1810210311

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY