ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00816.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A 37‐year‐old male with a hyperlipidemia type Ha underwent three conventional percutaneous transluminal coronary angioplasty procedures and three surgical revascularizations for recurrent restenosis of the saphenous vein bypass graft. Despite these interventions, a long‐term success was never achieved. Stern implantation at the site of a rerestenosis was successful. However, a second stent implantation to prevent further progression of another previously nonmanipulated atheromateous lesion resulted in a stenosis within the stent for which a new surgical intervention was indicated. At surgery the stented graft was replaced by a fresh venous graft. The partly removed venous graft containing the two stents provides a unique opportunity to study the long‐term histologic effects of intravascular

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00817.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The initial single center experience of percutaneous coronary excimer laser angioplasty is described for the first three series of 147 patients. Sixty patients were treated with a prototype 1.4‐mm laser catheter, 40 patients with improved transmission devices, and the third series of 47 patients with an increased pulse width of the laser system allowing improved energy transmission. In 17 patients (12%) laser angioplasty could not be initiated due to inability to cross the lesion with the guidewire or to place the catheter coaxially within the vessel. In 32 patients (58%) of series I, II patients (31%) of series 2, and 17 patients (43%) of series 3, additional balloon dilatation following laser treatment was necessary due to vessel closure (24%) or due to an insufficient angiographic result (35%). There was one death in series 1(2%) and 2 (3%) each, one perforation in series 2 (3%), two transmural myocardial infarctions in series 1 (4%), and one myocardial infarction in series 2 (3%). During the 6‐month follow‐up period one patient in series 2 (2%), and one patient in series 3 (3%) died. Angiographic restenosis was found in 22, 12, and 11 patients of series 1 (40%), 2 (34%), and 3 (27%), respectively. No patient developed a transmural myocardial infarction. Thus, percutaneous coronary excimer laser angioplasty can be performed as a safe and feasible procedure in patients with coronary artery disease. However, the need for additional balloon angioplasty due to vessel closure or due to an insufficient angiographic result demands further improvement in laser and catheter technology. The overall incidence of restenosis following excimer laser angioplasty was comparable to balloon dilatation in this limited series of patients. (J Interven Cardiol 1992; 5:

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00818.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A 69‐year‐old woman was admitted with clinical symptoms of an acute abdominal aortic occlusion. Femoral and distal pulses were absent with lower extremity paralysis and loss of sensation. Digital subtraction angiogram confirmed the infrarenal abdominal aortic occlusion. A selective urokinase infusion was initiated from a left brachial approach and continued in conjunction with heparin therapy for 48 hours. Clinical improvement was noted in 24 hours. By 48 hours there was complete abdominal aorta thrombolysis with angiograms revealing bilateral common iliac stenosis. The percutaneous intervention was completed from a brachial approach utilizing conventional (5 French) balloon angioplasty catheters using a double wire “kissing” balloon technique. Following angioplasty, distal pulses were present; the angiograms confirmed patent vessels with excellent distal flow. (J Interven Cardiol 1991;

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00819.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Trials that pertain to angioplasty and restenosis are a major focus of clinical research in cardiology at present. Investigators, especially those involved in multicenter studies, have become experts in the derivation of acronyms to identify these trials. Meant to capture the spirit of the trial and the attention of those reading the eventual publication of the results, these abbreviations have proliferated in recent times. This article summarizes the major trials with acronym titles, spells out what they stand for, defines what was investigated, and reviews the reported results. (J Interven Cardiol 1992; 5:29–3

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00820.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00821.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00822.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00823.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00824.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

One hundred and ten patients, age 2 days to 35 years (mean 7.0 ± 7.0 years), have undergone 118 percutaneous balloon angioplasty procedures for discrete coarctation of the aorta since April 1982. The mean systolic gradient was significantly decreased from 48 ± 22 to 8 ± 7 mmHg after angioplasty (P<0.0001). Long‐term results were evaluated in 95 patients, by follow‐up catheterization in 30 and Doppler echocardiography in 65 patients. The follow‐up period was 1–9 years (4.2 ± 2.1). At follow‐up the mean residual gradient was 9 ± 8 mmHg. On the basis of follow‐up data, four groups of patients were identified:group I consisted of 53 patients over 3 months of age with native coarctation of the aorta; group II consisted of 13 patients with postoperative coarctation restenosis; group III consisted of 21 infants 3 months of age or younger with native coarctation of the aorta; and group IV consisted of eight infants who developed postdilatation restenosis. Patients in groups I and II had good results and required no redilatation or surgical repair. In group III successful redilatation in eight and surgical repair in seven infants were performed 1 month to 5 years after the initial dilatation. There were no mortalities related to the 118 dilatation procedures. Of the seven patients who had surgical repair of the coarctation and the associated cardiac anomalies, four expired in the immediate postoperative period. Percutaneous balloon coarctation angioplasty is an effective definitive treatment for native as well as postoperative aortic coarctation in patients over the age of 3 months. Infants with coarctation of the aorta associated with other cardiac anomalies may require repeat dilatation or

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00825.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY