摘要:

AbstractPercutaneous transluminal angioplasty (PTA) of the subclavian and innominate arteries was performed in 27 patients at 33 sites (30 subclavian, 3 innominate). All procedures were successful angiographically and clinically and were without complication. The ipsilateral arm was utilized in all cases. Indications for the procedure included claudication (ten patients), neurological symptoms (seven patients), to gain vascular access for other interventions (eight patients), and scheduled coronary bypass surgery with internal mammary utilization (two patients). There were 22 stenoses and 11 occlusions. Thrombi was retrogradely recovered through the arteriotomy site in three patients with vessel occlusions. No early or late episode of neurological deficit was seen. Follow‐up was obtained in 22 patients (82%) at a mean time of 28 months (range, 2–73 months). The cumulative patency rate was 95%. The three restenosed sites were treated with successful repeat PTA. Angioplasty of stenotic or occluded subclavian or innominate arteries should be the procedure of choice in symptomatic patie

ISSN:0098-6569    

DOI:10.1002/ccd.1810190202

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

年代:1990

数据来源: WILEY

摘要:

AbstractOne of the most important complications after percutaneous transluminal coronary angioplasty is the abrupt closure of the dilated vessel (unstable lesion). The treatment of choice for this complication is a new dilation, but unfortunately many of these cases require immediate surgery to avoid an acute myocardial infarction. Prolonged balloon inflations have been suggested to control this kind of complication. In order to discover the effect of prolonged inflations on the incidence of unstable lesions we studied 439 patients enrolled in two groups: Group I (195 patients and 207 arteries) treated with balloon inflation time less than 40 sec per session and Group II (244 patients and 265 arteries) treated with inflation time over 60 sec since the first series of inflations. As a result there was a significantly lower incidence of unstable lesions and immediate surgery in Group II without an increase in the incidence of diffuse ischemia.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190203

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

年代:1990

数据来源: WILEY

摘要:

AbstractFifty‐two patients were randomized into two groups of 26 to the use of either 5 or 7/8F catheters for their first left heart cardiac catheterization. Clinical characteristics for the two groups were similar. 5F catheters were significantly inferior to 7/8F catheters in terms of torque control (P<.001), ease of engaging coronary ostia (P<.001), and quality of angiograms (P<.05). Nine patients in the 5F group required a change to 7/8F catheters for completion of the procedure. There was no difference in procedure time or fluoroscopy time between the groups. Time to haemostasis was significantly shorter in the 5F group (P<.01), but there was no difference between groups with respect to haematoma formation or rebleed after haemostasis. We conclude the slight advantage of 5F catheters in terms of haemostasis is outweighed by many disadvantages. Their routine use in cardiac catheterization, at least at this time, cannot be recommende

ISSN:0098-6569    

DOI:10.1002/ccd.1810190204

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

年代:1990

数据来源: WILEY

摘要:

AbstractAmong 100 consecutive Iraqi men aged 40 years or less with first acute myocardial infarction, coronary angiography performed 8–12 weeks later showed single‐vessel coronary artery disease in 64, multivessel disease in 26, and normal coronary arteries in ten patients. Most patients (90%) had one or more coronary risk factors.The left anterior descending artery was involved in 66 patients, the right coronary artery in 38, and the circumflex artery in 29. Total occlusion was seen in 37 patients and severe (≥ 90%) stenosis in 14 patients. Severe wall motion abnormality (aneurysm formation) on left ventriculography was found in 33 patients. Thus, in developing countries as elsewhere, one‐vessel coronary artery disease remains the most common angiographic finding in young men with first acute myocardial inf

ISSN:0098-6569    

DOI:10.1002/ccd.1810190205

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

年代:1990

数据来源: WILEY

摘要:

AbstractWe report a case of pinhole balloon rupture during percutaneous transluminal coronary angioplasty using one of the newer catheters. Pinhole balloon rupture resulted in rupture and occlusion of the vessel being dilated.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190206

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

年代:1990

数据来源: WILEY

摘要:

AbstractGuidewire manipulation may be the deciding factor for success in percutaneous transluminal coronary angioplasty (PTCA). A case involving a complex lesion forming an acute angle within the left anterior descending (LAD) coronary artery, which precluded guidewire advancement, is presented. Successful dilatation was achieved after an unusual guidewire maneuver.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190207

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

年代:1990

数据来源: WILEY

摘要:

AbstractAn unusual case of right ventricular outflow obstruction and right heart failure due to an isolated unruptured congenital sinus of Valsalva aneurysm originating from the right coronary sinus in a 75‐year‐old‐man is described. The diagnosis was made by twodimensional echocardiography and cardiac catheterization. Successful surgical resection of the aneurysm resulted in dramatic symptomatic improv

ISSN:0098-6569    

DOI:10.1002/ccd.1810190208

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

年代:1990

数据来源: WILEY

摘要:

AbstractThis case report documents that, when a severely diseased donor artery occludes, sufficient spontaneous reversal of flow through the collaterals can occur to prevent an extensive and possibly fatal transmural infarction.

ISSN:0098-6569    

DOI:10.1002/ccd.1810190209

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

年代:1990

数据来源: WILEY

摘要:

AbstractIntracoronary tissue‐type plasminogen activator (t‐PA) was employed successfully before, after, or in place of coronary artery angioplasty in four patients referred for emergency cardiac catheterization during evolving myocardial infarction. The potential roles of intracoronary thrombolysis, dose considerations for intracoronary t‐PA, factors influencing the choice of plasminogen activator, and safety issues are disc

ISSN:0098-6569    

DOI:10.1002/ccd.1810190210

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

年代:1990

数据来源: WILEY

摘要:

AbstractPercutaneous transluminal coronary angioplasty was complicated by acute coronary occlusion, dissection of the arterial wall, or angiographic evidence of intraluminal thrombosis in 33 high‐risk patients from 153 consecutive angioplasty procedures (21.5%). Ten patients (group I) were managed with nitroglycerin (0.2 to 0.4 mg i.c.) and repeated attempts at mechanical guide wire recanalization or dilation, but they did not receive thrombolytic therapy. In the remaining 23 patients (group II), intracoronary urokinase (100,000 to 360,000 U.I.) was administered over 15–20 min after onset of coronary occlusion or thrombosis and continued during attempts at repeated dilation of the stenosis. The incidence of sudden coronary artery occlusion was 70% in group I patients and 52% in group II. The angiographic evidence of thrombus formation was observed in a higher, but not significant, proportion of group II patients (65%) as compared with group I(30%). The incidence of intimal tearing or dissection was similar in the two groups of patients (40 vs. 34.7%). The overall final success rate of the complicated angioplasty series was 48% (6/33). However, the success rate was lower (10%) in group I than in group II patients (10 vs. 65%; P<0.005), and the frequency of emergency coronary artery bypass grafting was lower in group II patients (13 vs. 60%; P = 0.01), suggesting that thrombolytic therapy with urokinase may be effective in the management of acute coronary occlusion and thromboembolic complications of coronary angiopla

ISSN:0098-6569    

DOI:10.1002/ccd.1810190211

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

年代:1990

数据来源: WILEY