摘要:

AbstractTo identify risk factors for restenosis, we evaluated data in 473 patients with singlevessel percutaneous transluminal coronary angioplasty (PTCA) and control angiography after 6 months. Restenosis, defined as (1) loss>50% of the initial gain, and (2) stenosis>50% was found in 138 patients (29.2%). Univariate analysis revealed eight factors related to restenosis: (1) duration of symptoms<1 month (P= 0.005), (2) unstable angina (P= 0.004), (3) high‐grade stenosis before PTCA (P= 0.014), (4) large residual stenosis after PTCA (P= 0.001), (5) insufficient improvement of stenosis (P= 0.042), (6) prolonged single inflation time (P= 0.017), (7) prolonged total inflation time (P= 0.055), and (8) low inflation pressure (P= 0.028). Multivariate analysis revealed four factors significantly related to restenosis: (1) large residual stenosis after PTCA (P= 0.0001), (2) prolonged single inflation time (P= 0.0047), (3) unstable angina (P= 0.0127), and (4) high‐grade stenosis before PTCA (P= 0.0179). Modification of procedural factors might be helpful to reduce the risk of restenosis after successful P

ISSN:0098-6569    

DOI:10.1002/ccd.1810190302

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

年代:1990

数据来源: WILEY

摘要:

AbstractBetween January 1987 and February 1988, 1,385 patients underwent percutaneous transluminal coronary angioplasty; 27 procedures were performed using prophylactic intraaortic balloon counterpulsation. Twenty‐four patients had poor left ventricular function (EF<40%), and coronary dilatation was performed in arteries opposite to an occluded myocardial necrosis related vessel. In three patients of advanced age with distal stenoses and normal left ventricular function a multivessel dilatation was performed. Primary success rate was achieved in all patients. There were no deaths, myocardial infarctions or emergency bypass operations in the hospiatilation period. During the follow‐up (9 to 21 months) there were 2 deaths, 1 cardiac transplantation, and 6 restenosis with repeated dilatation. If revascularization is warranted, in high‐risk patients, coronary angioplasty can be performed safely and successfully with protection by intraaortic balloon counterpulsation. However the long‐term prognosis of these patients is complicated by the presence of other high‐risk variables, such as advanced age or poor left ventricular

ISSN:0098-6569    

DOI:10.1002/ccd.1810190303

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

年代:1990

数据来源: WILEY

摘要:

AbstractEighty‐six children (aged 20 days to 14 years, 20 under age 1 year) underwent 94 percutaneous balloon valvuloplasty for pulmonary valve stenosis. The patients were divided into three groups: typical pulmonary valve stenosis (71), pulmonary valve dysplasia (9), and residual stenosis after surgical valvotomy for pulmonary atresia with intact ventricular septum (PAIS) (6).Each of the three groups was divided into two subgroups. In the early cases, balloon catheters with diameter 10‐20% exceeding pulmonary valve annulus were used and the drop of the gradient was 39.5%. In the later cases, balloon diameters 30‐40% greater than the valve anulus or double balloons were used and a drop of 66.7% in the RV‐PA pressure gradient was achieved.The dilation in patients with dysplastic valve and residual stenosis after surgical valvotomy for PAIS was less effective. Doppler echocardiography was the technique used to evaluate residual gradient. Six months to 4 years follow‐up demonstrated a persistent decrease of the valve

ISSN:0098-6569    

DOI:10.1002/ccd.1810190304

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

年代:1990

数据来源: WILEY

摘要:

AbstractConventional balloon angioplasty (PTA) was attempted in 111 patients (60% male; mean age 67≥9 years) with 168 below‐the‐knee, tibioperoneal vessels (TPV) lesions. The presenting predominant symptoms were claudication in 52 (47%), non‐healing ulcer/gangrene in 30 (27%), and rest pain in 29 (26%) of patients. An above‐the‐knee vessel was dilated before TPV angioplasty in 62 patients (56%). A successful PTA was achieved in 152/168 (90%)TPV: stenoses, 124/125 (99%); occlusions, 28/43 (65%). Complications encountered included contrast‐induced renal failure (4%), distal embolization (4%), entry site arterial repair or embolectomy (2%), dissection or occlusion (2%), and groin hematoma (2%). A significant complication (death, emergency bypass surgery, or distal embolization) occurred in only 3 patients (3%); no complications whatsoever were found in 100 patients (90%). At discharge, 106 patients (95%) were clinically improved. A restenosis and/or second PTA procedure occurred in 44/108 patients (40%) (mean time: 9≥6 months) with the presenting predominant symptom being claudication in 38 patients (86%). However, only 36% of patients had lesion recurrence with or without new disease, and 64% showed evidence of disease progression with symptoms. Angiographic and clinical success was achieved in 42 patients undergoing second PTA (96%). These data indicate that balloon angioplasty can be successfully utilized in patients with symptomatic obliterative disease of the tibioperoneal vessels with excellent success, a low risk of complications, and good clinical improvement. PTA of the below‐knee vessels should not be restricted to patients in limb s

ISSN:0098-6569    

DOI:10.1002/ccd.1810190305

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

年代:1990

数据来源: WILEY

摘要:

AbstractMeglumine sodium diatrizoate (Urografin), iopamidol, and iohexol were compared in a double‐blind, randomized study of 287 patients undergoing elective cardiac angiography. Ninety‐six patients received Urografin, 98 received iopamidol, and 92 received iohexol. The groups were similar in all respects. Variables measured before and after contrast injection were left ventricular end‐diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), systolic arterial pressure (SAP), RR, PR, and QTc intervals, QRS duration, ST segment change greater than 2 mm, arrhythmias, and symptoms. The adequacy of coronary and ventricular opacification was assessed by two experienced observers. Following left ventriculography, small rises in LVEDP occurred with iopamidol and iohexol (mean ± SD: 187 to 21 ± 7 mmHg) and a moderate fall in LVSP with Urografin (150 ± 32 to 133 ± 32 mmHg). Following coronary angiography there was a progressive fall in SAP (130 ± 26 to 117 ± 30 mmHg) and prolongation of RR intervals (900 ± 138 to 1,266 ± 692 msec) and QTc (440 ± 61 to 471 ± 73 msec) and QRS duration (87 ± 25 to 100 ± 27 msec) with Urografin. There was a small fall in SAP with iopamidol(138 ± 25 to 128 ± 27 mmHg) and prolongation of QRS duration with iohexol (85 ± 29 to 90 ± 24 msec). Other parameters were not significantly affected. Frequent bradyarrhythmias (sinus pause 14.5%, asystole 6%) and ST segment depression occurred following Urografin. Urografin was less well tolerated, with 10% of patients experiencing severe nausea or vomiting and 30% of patients experiencing extreme heat sensation. Differences between iohexol and iopamidol were minor. Coronary and left ventricular opacification were satisfactory and not significantly different between the groups. Iopamidol and iohexol have fewer adverse hemodynamic, electrocardiographic, and symptomatic effects, and their use in preference to U

ISSN:0098-6569    

DOI:10.1002/ccd.1810190306

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

年代:1990

数据来源: WILEY

摘要:

AbstractWe describe the development of a splenic abscess, due in part toPeptostreptococcus, as a complication of cardiac catheterization. The etiologies of splenic abscess should includePeptostreptococcus, and splenic abscesses should be added to the list of complications of cardiac catheterization.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190307

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

年代:1990

数据来源: WILEY

摘要:

AbstractA patient is reported who underwent cardiac catheterization 4 years following coronary artery bypass grafting. Cardiac catheterization revealed the presence of a fistulous tract in the wall of the ascending aorta, originating at the site of aortic anastomosis of a saphenous vein bypass graft and ending in the superior aspect of the right sinus of Valsalva. This complication was felt to have resulted from a inadvertent localized dissection of the aorta during bypass surgery. The fistula was also imaged by ultrafast cine computerized tomography which proved a useful non‐invasive method for follow‐up examinat

ISSN:0098-6569    

DOI:10.1002/ccd.1810190308

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

年代:1990

数据来源: WILEY

摘要:

AbstractA case is described in which hugging balloons were used to perform coronary angioplasty through a single catheter. A discussion concerning selection of balloon combinations and technique is included.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190309

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

年代:1990

数据来源: WILEY

摘要:

AbstractA successful percutaneous transluminal angioplasty of the distal anastomosis of a tortuous left internal mammary artery graft to the left anterior descending coronary artery was complicated by the development of a focal lesion in the mid‐graft region. Dilatation at the site failed to improve the angiographic appearance. Withdrawal of the guidewire resulted in immediate resolution of the apparent mid‐graft lesion. The abnormality is felt to have been due to torsion of the graft upon itself, caused by guidewire and balloon catheter manipulat

ISSN:0098-6569    

DOI:10.1002/ccd.1810190310

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

年代:1990

数据来源: WILEY

摘要:

AbstractMany studies are currently evaluating the potential role of thrombolytic therapy in patients with ischemic syndromes who have undergone previous coronary artery bypass grafting. Limited experience has been published regarding the use of local urokinase and streptokinase infusions and the use of systemic recombinant tissue‐type plasminogen activator as thrombolytic agents in patients with previous coronary artery bypass surgery. To date, however, there has been no published experience regarding the use of recombinant tissue‐type plasminogen activator (rt‐PA) either systemically or locally in the post‐bypass patient where angiographic demonstration of aortocoronary saphenous vein graft obstruction was available pre‐ and post‐therapy. Similarly there has been no previous report of the use of rt‐PA infused locally to recanalize an occluded aortocoronary saphenous vein graft. This report describes successful thrombolysis and subsequent balloon angioplasty of saphenous vein grafts with angiographically documented thrombus using systemic and local r

ISSN:0098-6569    

DOI:10.1002/ccd.1810190311

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

年代:1990

数据来源: WILEY