ISSN:0098-6569    

DOI:10.1002/ccd.1810230102

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

年代:1991

数据来源: WILEY

摘要:

AbstractCoronary angioplasty was performed in 74 patients 80 years of age and older (mean 83±3). Single vessel coronary disease was present in 34% and multivessel coronary disease in 66%. Angioplasty of a single vessel was performed in 51 patients (69%), while 23 (31%) had angioplasty of multiple vessels.Angioplasty was successful in 59 of 74 patients (80%). Angioplasty was unsuccessful but uncomplicated in 12 (16%) due to (unyielding) calcified lesions or (impassable) old occlusions. Of these 12, 8 were discharged on medical therapy and 4 underwent elective uncomplicated bypass surgery prior to discharge. Three (4%) patients required emergency coronary bypass surgery due to abrupt vessel closure during the angioplasty procedure, with one hospital death (1.4%).Follow‐up (mean 24±22 months) was obtained in all patients. Of the 59 successful angioplasty patients, late mortality was 10% (cardiac 7% and non‐cardiac 3%). Survival and survival without myocardial infarction were both 90%; survival without either infarction or bypass surgery was 86%. Actuarial 3‐year survival was 91% and 3‐year freedom from death, infarction or bypass surgery was 87% by life‐table analysis. Repeat angioplasty for restenosis was performed in 7 patients (12%) without co

ISSN:0098-6569    

DOI:10.1002/ccd.1810230103

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

年代:1991

数据来源: WILEY

摘要:

AbstractA guiding catheter was used in seven patients who underwent balloon dilation of nine renal arteries. The advantages of using a guiding catheter for renal angioplasty are analogous to the benefits obtained with a coronary angioplasty guiding catheter used in coronary angioplasty. The guiding catheter provides back‐up support to cross lesions and allows selective contrast visualization of the lesion before, during, and after dilation. It is also possible, when using a guiding catheter, to measure pressure gradients across lesions without having to recross the lesion which may help to ensure that adequate dilation of the stenosis has been accomplishe

ISSN:0098-6569    

DOI:10.1002/ccd.1810230104

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

年代:1991

数据来源: WILEY

摘要:

AbstractTo determine adequate and effective balloon diameters of the Inoue balloon catheter, we reviewed clinical results and characteristics of the Inoue balloon catheter, especially the relationship between the intra‐balloon pressure and the balloon diameter, experimentally and clinically, in 46 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). Mitral valve area increased from 1.1 ± 0.3 to 2.1 ± 0.3 cm2in all patients after PTMC. Based on balloon diameter settings, mitral valve area increased from 1.3±0.4 to 2.3±0.5 cm2in patients treated with a balloon setting greater than 26 mm in diameter, from 1.1 ±0.3 to 2.0±0.5 cm2in patients with a balloon setting at 26 mm in diameter, and from 1.1±0.4 to 1.7±0.4 cm2in those treated with a balloon setting less than 26 mm in diameter, with an increase in mitral valve area of 1.0±0.6, 0.9±0.4, and 0.7±0.2 cm2, respectively. There was a significant difference between the increase in mitral valve area at a setting of 26 mm in diameter and that observed at a setting less than 26 mm in diameter. We next investigated differences between balloon diameter settings and actual balloon diameters measured from cineangiograms at maximum balloon inflation. The ratio of actual balloon diameter to a setting diameter of less than 26 mm was smaller than that of 26 mm. To evaluate the reason for the difference, we investigated the relationship between intra‐balloon pressure and balloon diameter. In the prototype Inoue balloon catheter, intra‐balloon pressure increases from 1.0 kg/cm2at 20 mm in diameter to 2.2 kg/cm2at 30 mm in diameter at atmospheric pressure. In conclusion, the increase in mitral valve area was inadequate when the balloon was less than 26 mm in diameter because of inadequate intra‐balloon pressure. We, therefore, recommend a balloon size set above 26 mm to obtain adequate intra‐balloon pressure when using the In

ISSN:0098-6569    

DOI:10.1002/ccd.1810230105

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

年代:1991

数据来源: WILEY

摘要:

AbstractAn attempt to reposition an Integra™ PTCA balloon‐on‐a‐wire failed although the whole stenosed segment could be crossed before inflation. After careful removal the device showed a grossly altered shape. Deflated balloon profiles, quite different from the initial shape, can determine the outcome both in dissections and in multilesio

ISSN:0098-6569    

DOI:10.1002/ccd.1810230106

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

年代:1991

数据来源: WILEY

摘要:

AbstractA 48‐yr‐old woman presented with a loud continuous precordial murmur and symptoms of fatigue. Color‐flow doppler imaging and nuclear magnetic resonance imaging failed to show the cause of the murmur. Diagnostic catheterization showed a large left anterior descending coronary artery to pulmonary artery fistula with impaired left ventricular wall motion. Two detachable balloons were deployed in the fistula with complete abolition of flow in the main fistula channel. A small parallel channel of the fistula, previously not appreciated due to vessel overlap, remained patent but had trivial flow as assessed by green‐dye and oximetric techniques. The patient had immediate resolution of her symptoms and return of normal ventricular wall

ISSN:0098-6569    

DOI:10.1002/ccd.1810230107

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

年代:1991

数据来源: WILEY

摘要:

AbstractAneurysms of the coronary arteries occur in from 0.3% to 4.9% of angiograms. Only 12 cases of left main artery (LMA) aneurysms have been reported. Of these, seven were associated with atherosclerosis in patients more than 56 years old. This report details the case of a 39‐year‐old patient with a large LMA aneurysm associated with atherosclero

ISSN:0098-6569    

DOI:10.1002/ccd.1810230108

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

年代:1991

数据来源: WILEY

摘要:

AbstractDuring percutaneous transvenous endomyocardial biopsy, two cardiac transplant recipients developed symptoms of focal cerebral ischemia. Cerebrovascular injury has not been previously associated with endomyocardial biopsy. This procedure should be recognized as one of the causes of stroke following heart transplantation.

ISSN:0098-6569    

DOI:10.1002/ccd.1810230109

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

年代:1991

数据来源: WILEY

摘要:

AbstractWhile attempting to recanalize a right coronary artery obstruction by using a low‐speed rotating catheter (Rotacs), proximal rupture of the catheter body occurred with entrapment of the blunt tip in the obstruction. To retrieve the device, it was necessary to sever the guiding catheter and the flexible tube of the Rotacs. At low‐speed rotation the flexible segment of the catheter was then pulled b

ISSN:0098-6569    

DOI:10.1002/ccd.1810230110

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

年代:1991

数据来源: WILEY

摘要:

AbstractFor percutaneous transluminal coronary angioplasty (PTCA) of oversized arteries, oftentimes a satisfactory dilatation cannot be achieved with conventional balloon systems due to the unavailability of adequately sized balloons. This fact has contributed to a higher restenosis rate for this group of patients. We were able to obtain a satisfactory dilatation result in an oversized right coronary artery with a shepherd's crook configuration and eccentric anatomy at the origin using two balloon‐on‐a‐wire systems and an Amplatz type guiding catheter. Although such favorable dilatation of an oversized artery using this „hugging balloon technique'' can be expected, issues do exist such as difficult maneuverability and estimation of the balloon size obtained through simultaneous dual balloon inflation wherein size does not simply equal the sum of the two balloon catheters. It is hoped that there will be further improvements of the technique and development of new systems. At this time, however, it is felt that this is the most effective and reasonable strategy to achieve a high chance of success in oversized vessel

ISSN:0098-6569    

DOI:10.1002/ccd.1810230111

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

年代:1991

数据来源: WILEY