摘要:

AbstractAngiographic and clinical follow‐up data were obtained in 115/126 patients who underwent directional atherectomy for peripheral vascular disease; of the 126, ten were excluded for appropriate reasons and one was lost to follow‐up. Thus, 115/116 successful atherectomy patients (99%) had follow‐up of 182/213 lesions (86%): 74 patients (64%) with angiography (mean time 5.4 mon), and 41 patients (36%) clinically. One hundred twenty‐eight of 183 lesions (70%) had angiographic follow‐up; the lesion recurrence as a stenosis or as an occlusion was 53%. Lesion distribution did not differ between angiography and clinical follow‐up groups: nearly 85% were within the superficial femoral or popliteal arteries. Despite data stratification, angiographic follow‐up indicated that patients after successful directional atherectomy, at a mean follow‐up time of>5 mos, have more than a 50% lesion recurrence rate. Although directional atherectomy (Simpson AtheroCath™) utilizing present techniques has excellent primary success and acceptable complication rates, angiographic follow‐up statis

ISSN:0098-6569    

DOI:10.1002/ccd.1810220202

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe natural history of coronary aneurysms, defined as local dilatations exceeding the diameter of the normal adjacent vessel segments by at least 1.5 times, is not significantly different from the natural history of nonaneurysmal coronary disease. However, little is known about the prognosis of percutaneous transluminal coronary angioplasty (PCTA)‐induced coronary aneurysms. Therefore, we investigated the occurrence and the medium long‐term prognosis of such aneurysms in 728 patients who, after successful PTCA, underwent repeat coronary angiography at mean 4.5 months post‐PTCA. A coronary aneurysm at the site of PTCA ws noted in 3.9% of patients (n + 28). Of the potentially predictive factors analyzed, only a coronary dissection at the time of PTCA had statistically significant influence. The long‐term prognosis of PTCA‐induced coronary aneurysms was excellent. One patient underwent (unrelated) cardiac surgery, all other 27 patients remained eventfree. We conclude that the same benign nature of coronary aneurysmal disease holds true for those aneurysms that develop a

ISSN:0098-6569    

DOI:10.1002/ccd.1810220203

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

年代:1991

数据来源: WILEY

摘要:

AbstractA hyperdynamic left ventricle can lead to post‐dilation mid‐cavitary obstruction in the absence of any preballoon mid‐cavitary obstruction in children with aortic valve stenosis. The purpose of this study was to define the incidence and course of post‐dilation midcavitary obstruction. We reviewed the catheterization and echocardiographic data of 35 patients, ages 3 days to 18 years (mean + 7.9 years), with isolated aortic valve stenosis who underwent balloon dilation with a fall in aortic valve gradient to less than 20 mm Hg. Post‐dilation mid‐cavitary obstruction was suspected from post‐dilation left ventricular angiogram and was quantitated by echocardiographic and Doppler examinations performed immediately after dilation and in a 1–3 month follow‐up period. Continuous wave Doppler directed by color flow Doppler was used for evaluation and differentiation of post‐dilation mid‐cavitary obstruction and residual aortic valve stenosis. Three children (3/35 [9%]) all under 2 years of age developed post‐dilation mid‐cavitary obstruction immediately after dilation. The obstruction within the cavity resolved spontaneously in all three patients.Conclusions: 1) Post‐dilation left ventricular mid‐cavitary obstruction can occur in children under 2 years of age after balloon dilation of severe aortic valve stenosis, and 2) total regression of post‐dilation mid‐cavitary obstruction occ

ISSN:0098-6569    

DOI:10.1002/ccd.1810220204

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe pulmonary and systemic flow (Qp/Qs) and resistance ratios (RP/Rs) were determined in children with isolated ventricular septal defects (VSD) to derive an “effective defect resistance” (Rd/Rs) representing the ratios of the resistance of the defect to the systemic vascular resistance. The defect size (expressed as the ratio of the area of the defect to the cross‐sectional area of the ascending aorta) was related to the calculated “effective defect resistance,” where a significant (non‐linear) correlation was found. The effective resistance of the defect is a useful aid for estimation of the anatomical size of a ventricular septal defect. The close correlation between anatomical size and the hemodynamic parameter Rd/Rs allows one to calculate the ratio Rp/Rs with this concept using nonin‐vasive Doppler‐ultrasound and echocardiography. This was performed in 21 children with VSD who underwent cardiac catheterisation. The noninvasive calculated flow ratio Qp/Qs and the resistance ratio Rp/Rs showed a close correlation to the values measured at cardiac

ISSN:0098-6569    

DOI:10.1002/ccd.1810220205

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe identification of ischemic and hibernating myocardium facilitates the selection of patients most likely to benefit from revascularization. This study examined the feasibility of metabolic imaging, using post‐exercise F‐18 deoxyglucose positron emission tomography (FDG‐PET) for the diagnosis of both ischemia and hibernation in 27 patients with known coronary anatomy. Normal post‐exercise FDG uptake was defined in each patient by reference to normal resting perfusion and normal coronary supply. Abnormal elevation of FDG (ischemia or hibernation) was compared in 13 myocardial segments in each patient, with the results of dipyridamole stress perfusion imaging performed by rubidium‐82 positron emission tomography (Rb‐PET).Myocardial ischemia was diagnosed by either FDG‐PET or Rb‐PET in 34 segments subtended by significant local coronary stenoses. Increased FDG uptake was present in 32/34 (94%) and a reversible perfusion defect was identified by Rb‐PET in 22/34 (65%,p<.01). In 3 patients, ischemia was identified by metabolic imaging alone. In 16 patients with previous myocardial infarction, perfusion defects were present at rest in 89 regions, 30 of which (34%) demonstrated increased FDG uptake, consistent with the presence of hibernation.Increased post‐exercise FDG uptake appears to be a sensitive indicator of ischemia and myocardial hibernation. This test may be useful in selecting post‐infarction patients

ISSN:0098-6569    

DOI:10.1002/ccd.1810220206

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

年代:1991

数据来源: WILEY

摘要:

AbstractA 63‐year‐old male presented with an acute inferior myocardial infarction with initial clinical reperfusion following thrombolysis. Due to recurrent reocclusion, emergency catheterization was performed, demonstrating a 90% stenosis in the mid right coronary artery. Angioplasty was complicated by multiple reocclusions, ultimately requiring 5‐h autoperfusion balloon inflation to maintain pa

ISSN:0098-6569    

DOI:10.1002/ccd.1810220207

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

年代:1991

数据来源: WILEY

摘要:

AbstractA patient with rigid coronary lesions refractory to balloon dilatation is described. A Cordis Orion fixed wire balloon able to withstand 20 bar was required for successful dilatation.

ISSN:0098-6569    

DOI:10.1002/ccd.1810220208

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

年代:1991

数据来源: WILEY

摘要:

AbstractTwo cases are presented in which extraordinarily high balloon inflation pressures (20 and 17 atm) were required to successfully dilate a saphenous vein graft stenosis and a right coronary artery stenosis. The clinical application of high balloon inflation pressures and balloon selection is discussed.

ISSN:0098-6569    

DOI:10.1002/ccd.1810220209

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

年代:1991

数据来源: WILEY

摘要:

AbstractA 64‐year‐old woman underwent excimer laser angioplasty of the right coronary artery. The procedure was complicated by perforation, which was successfully managed without complication with a Stack perfusion catheter. This report describes successful non‐surgical treatment of laser‐induced coronary perforation and makes recommendations for avoiding this complication in other p

ISSN:0098-6569    

DOI:10.1002/ccd.1810220210

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

年代:1991

数据来源: WILEY

摘要:

AbstractThe incidence of retained hardware components in the coronary artery tree is likely to parallel the growing number and types of percutaneous coronary revascularization procedures being performed. Management has extended from the conservative option of simply leaving behind the retained components to the more aggressive approach of surgical removal. A percutaneous method is described herein which offers the interventional cardiologist an alternative method of managing patients with retained wire fragments contained entirely in the coronary artery.

ISSN:0098-6569    

DOI:10.1002/ccd.1810220211

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

年代:1991

数据来源: WILEY