ISSN:0098-6569    

DOI:10.1002/ccd.1810110602

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

年代:1985

数据来源: WILEY

摘要:

AbstractIn order to gain understanding of how percutaneous transluminal coronary angioplasty (PTCA) is taught and practiced in the United States, two questionnaires were devised to survey all adult cardiology training programs and all adult cardiac catheterization laboratories in this country. Of the 184 programs that responded to the training questionnaire, 102 (55%) teach PTCA, usually in the form of fellowship training and especially as a specialized year, and less commonly in the form of a preceptorship. Though many programs expose trainees to an adequate number of cases as defined by the program directors, at least 37% do not. Of 388 laboratories responding to the practice questionnaire, 74% perform PTCA. The total number of PTCA's in this country seems to be doubling yearly, but many laboratories do relatively few cases per year, and 79% of physicians doing PTCA do fewer than one case per week. Average laboratory success rate for PTCA is in the range of 80–85%. Though there is now a proliferation of PTCA training programs, 93% of those practicing angioplasty are self‐ or preceptor‐trained, and have not learned the procedure as part of a fello

ISSN:0098-6569    

DOI:10.1002/ccd.1810110603

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

年代:1985

数据来源: WILEY

摘要:

AbstractTwo hundred fifty‐three patients underwent cardiac catheterization with selective cineangiography of the carotid arteries. Diagnostic angiograms of both the right and left carotid arteries were obtained in 240 patients (95%). Of these, 217 patients (90%) were studied without complication, 18 (8%) had minor complications, and five (2%) had major complications. Four of the five major complications occurred in patients with bilateral carotid atherosclerosis obliterans. Variations of catheterization technique used in an effort to reduce risk are discusse

ISSN:0098-6569    

DOI:10.1002/ccd.1810110604

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

年代:1985

数据来源: WILEY

摘要:

AbstractNeurologic complications are a known and at times tragic consequence of cardiac catheterization. During a four‐year period, 1,362 procedures were performed at our institution on children less than 15 years of age. Eighteen children, without prior nervous system disease, developed neurologic sequelae within 24 hours of cardiac catheterization (1.3%). Three presented with seizures only, ten with neurologic deficits, and five with both focal seizures and stroke. Computerized tomography scans (16 patients) demonstrated areas of nonhemorrhagic infarction in all but one. The 18 patients were studied retrospectively for possible factors contributing to the neurologic complications. They were matched to controls by age, cardiac lesion, and catheterization technique. Data examined included catheterization duration and approach, contrast agent, precatheterization urine specific gravity, pre‐ and postcatheterization hematocrit, blood loss, and intracatheterization events. Catheter and catheter sheath clots were noted in both patient groups. The neurologic complication group had 7/18 intracatheterization neurologic events versus only one in the controls and the change in hematocrit was greater in the complication group (t = 2.89, p<0.01). Due to this study's results and to prevent possible thromboembolic events, a heparinization protocol was instituted and patients were prospectively observed for neurologic complications. No neurologic complications have occurred over three years since the institution of this proto

ISSN:0098-6569    

DOI:10.1002/ccd.1810110605

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

年代:1985

数据来源: WILEY

摘要:

AbstractA patient undergoing percutaneous transluminal angioplasty of a critical proximal stenosis of his anterior descending coronary artery died as a result of coronary air embolism from a defective dilatation catheter. The probable mechanism responsible for this lethal complication is discussed. Simple precautions are described that will prevent its future occurrence.

ISSN:0098-6569    

DOI:10.1002/ccd.1810110606

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

年代:1985

数据来源: WILEY

摘要:

AbstractSuccessful percutaneous transluminal coronary angioplasty is achieved by fracture of the atheromatous plaque and perhaps dilatation of the arterial walls to increase the luminal diameter of the artery. Because this „controlled”︁ injury stimulates platelet adhesion on the subendothelial matrix, the use of dextran‐40 in addition to heparin has been advocated. The overall incidence of Dextran‐induced anaphylactoid reactions at our institution was 0.6% and of severe life‐threatening reactions, 0.2%. With the recent doubts cast on the efficacy of dextran‐40, the question arises regarding its routin

ISSN:0098-6569    

DOI:10.1002/ccd.1810110607

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

年代:1985

数据来源: WILEY

摘要:

AbstractThe first reported case of a patient with left internal mammary artery bypass graft dissection secondary to selective coronary and graft arteriography is presented. The intimal tear and false lumen could not be seen with flouroscopy during catheterization. This later led to antero‐septal myocardial infarctio

ISSN:0098-6569    

DOI:10.1002/ccd.1810110608

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

年代:1985

数据来源: WILEY

摘要:

AbstractPercutaneous transluminal coronary angioplasty (PTCA) was successfully used for the first time in 1977. With experience, its application broadened to include multiple lesions, complex anatomical stenoses, multiple vessels, and saphenous vein aortocoronary bypass grafts. This case demonstrates successful internal mammary graft angioplasty with continued long‐term (eight months) success, documented angiographicall

ISSN:0098-6569    

DOI:10.1002/ccd.1810110609

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

年代:1985

数据来源: WILEY

摘要:

AbstractWe report a patient who had an asymptomatic total occlusion of a left anterior descending coronary artery after PTCA for unstable angina. A clinical success with a negative maximal exercise test and absence of symptoms after PTCA can not be presumed to correlate with coronary patency.

ISSN:0098-6569    

DOI:10.1002/ccd.1810110610

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

年代:1985

数据来源: WILEY

摘要:

AbstractPercutaneous transluminal coronary angioplasty (PTCA) was performed unsuccessfully, resulting in disruption and near‐total closure of the proximal right coronary artery at the site of stenosis following balloon inflation. The artery could not be reopened in the catheterization laboratory despite intracoronary nitroglycerin, sublingual nifedipine, and multiple balloon inflations. Myocardial revascularization surgery was immediately performed with excellent graft flow. No apparent myocardial infarction resulted. Catheterization performed at one year showed normal left ventriculography, total occlusion of the bypass graft, and reopening and normalization of the right coronary artery at the site of PTCA‐induced occlusion. Possible mechanisms for this phenomenon and its clinical implications are discus

ISSN:0098-6569    

DOI:10.1002/ccd.1810110611

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

年代:1985

数据来源: WILEY