bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brachial approach to emergency cardiac catheterization during thrombolytic therapy for acute Myocardial Infarction
Authors: George Barry S. , Candela Richard J. , Topol Eric J. , Stack Richard S. , Kereiakes Dean J. , Abbottsmith Charles W. , Masek Ramona , Pickel Ann , Dillon Joanne , Harrelson Lynn , Califf Robert M. 
Published: March 2007

AbstractThe use of the brachial approach to acute coronary intervention has not been previously studied. In the course of the Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) trials, we used the transbrachial approach to cardiac catheterization with or without angioplasty in 202 of 704(28.6%) patients. The baseline characteristics of age, sex, risk factors, medical history, time from symptom onset to therapy, and left ventricular function were similar for the 2 different approaches. Time from therapy to coronary angiography was not delayed by the brachial approach compared with the femoral approach: 97.1±26 min vs. 99.9±133.8 min, respectively. Chemical patency was established in 78 vs. 73% of patients and technical success with acute PTCA with the brachial approach was 89% vs. 78% with the femoral approach. Clinical outcomes were quite similar with respect to death(6 vs. 6%), reocclusion (10 vs. 14%), and emergency coronary bypass surgery (5 vs. 6%). Baseline hematocrit was 43.9±4.4 and 43.5±4.8, respectively with a nadir of 32.9±5.6 vs. 33.0±5.4. The need for vascular repair occurred in 1% vs. 3% of patients and retroperitoneal hemorrhage was documented in 1% vs. 1% of patients. This study indicates that in thehands of experienced operators the transbrachial approach to acute coronary intervention in theacute phase of treatment with thrombolytic therapy can be used with equal risks and efficacy asthe femoral approach.
Use of a guiding catheter for contralateral femoral artery angioplasty
Authors: White Christopher J. , Nguyen Minh , Ramee Stephen R. 
Published: March 2007

AbstractWe describe a unique method employing a transseptal sheath as a “guiding catheter” that allows contralateral retrograde femoral artery access to perform balloon angioplasty of proximal superficial femoral artery lesions. This technique simplifies arterial access, provides support for crossing lesions, and allows angiographic visualization of target lesions during the procedure.
Left ventricular rupture complicating percutaneous mitral commissurotomy: Salvage using percutaneous cardiopulmonary bypass support
Authors: Shawl Fayaz A. , Domanski Michael J. , Yackee John M. , Wish Marc H. , Dullum Mercedes , Neimat Samir 
Published: March 2007

AbstractLeft ventricular rupture resulting in death has been reported to be a complication of percutaneous mitral commissurotomy. We report a 71‐year‐old man in whom a left ventricular rupture occurred during percutaneous mitral commissurotomy and resulted in hemodynamic collapse due to acute cardiac tamponade. The patient was stabilized using percutaneously instituted cardiopulmonary bypass support with subsequent repair of the left ventricle and successful mitral valve replacement. Three months later this patient remains in New York Heart Class I.
A rapid, effective technique for retrograde crossing of valvular aortic stenosis using standard coronary catheters
Authors: Harrison J. Kevin , Davidson Charles J. , Phillips Harry R. , Harding Michael B. , Kisslo Katherine B. , Bashore Thomas M. 
Published: March 2007

AbstractRetrograde crossing of valvular aortic stenosis can be challenging even to experienced angiographers. In 446 of 447 consecutive patients with aortic stenosis catheterized during the past 3 years, a technique using a standard Judkins right coronary catheter and a floppy straight tipped guide wire was successful in rapidly and efficiently crossing these pathologically distorted valves in retrograde fashion. Once the valve was crossed, the coronary catheter was replaced with a pigtail catheter for pressure and ventriculography. The majority of these valves required less than 2 min to cross using this technique.This method is valuable in limiting the time required for catheterization, thus helping to reduce procedure related morbidity in these oftimes critically ill patients.
Diagnosis of left atrial thrombi in mitral valve disease by coronary arteriography
Authors: Russo Giovanni , Tamburino Corrado , Ali Antonino , Monaco Orazio , Calvi Valeria , Drago Antonino , Cinnirella Carmelo , Abbate Mauro , Giuffrida Giuseppe 
Published: March 2007

AbstractArteriographic findings of neovascularity and fistula formation between coronary arteries and left atrium have occasionally been described in association with left atrial thrombosis in patients with mitrai valve disease. The validity of these coronary arteriographic findings in diagnosis of atrial thrombi has been evaluated in 112 patients with mitral valve disease. Comparison was made with surgery. The study furnished these diagnostic values: sensitivity 70%, specificity 85%, positive predictive value 72%. Even if this angiographic finding is complementary in diagnosis of atrial thrombosis, its identification during coronary arteriography in patients with mitral valve disease is useful. Its detection could improve diagnostic prediction of thrombosis, especially in patients without previous emboiic events or where echocardiography failed to reveal thrombi.
Catheterization of coronary artery bypass graft from the descending aorta
Authors: Bilazarian Seth D. , Shemin Richard J. , Mills Roger M. 
Published: March 2007

AbstractThe increasing frequency of reoperation for coronary artery disease has led to the use of a variety of grafts. This report describes the catheter technique for selective opacification of a saphenous vein graft from the descending thoracic aorta to the posterior coronary circulation.
Percutaneous transluminal coronary angioplasty of gastroepiploic artery graft
Authors: Komiyama Nobuyuki , Nakanishi Shigemoto , Yanagishita Yoshiki , Nishiyama Shinichiro , Seki Akira , Watanabe Yasunori , Konishi Toshio , Fuse Katsuo 
Published: March 2007

AbstractThe right gastroepiploic artery is being used as a third arterial conduit for coronary artery bypass surgery. Presented here is a case demonstrating successful percutaneous transluminal coronary angioplasty of the gastroepiploic artery graft. This successful accomplishment may avoid repeat surgical revascularization in case of failure of the gastroepiploic artery graft, hence may encourage people to use it more often.
Balloon valvuloplasty for fungal endocarditis induced stenosis of a bioprosthetic tricuspid valve
Authors: Benedick Bruce A. , Davis Stacy F. , Alderman Edwin 
Published: March 2007

AbstractPalliative treatment was provided without complications by double balloon valvuloplasty of a stenotic porcine tricuspid valve in a patient with fungal endocarditis. With two 15 mm diameter valvulotomy balloons the peak tricuspid gradient decreased from 21 to 7 mm Hg and valve area increased from 0.3 to 1.2 cm2. After the procedure the patient clinically improved; however, valve replacement was not performed as planned because the patient developed an intracranial hemorrhage. She subsequently died of complications of fungemia. The present report demonstrates the possible use of valvuloplasty as a palliative procedure in selected patients with valvular stenosis involved with endocarditis.
Emergent saphenous vein graft stenting for acute occlusion during percutaneous transluminal coronary angioplasty
Authors: Mehl John Kurt , Schieman Gregory , Dittrich Howard , Buchbinder Maurice 
Published: March 2007

AbstractThis report describes the initial use in the United States of emergency intravascular stenting for the treatment of acute coronary occlusion complicating elective saphenous vein graft angioplasty. This case adds further support to the role of the balloon expandable stent as an effective “bail out” device for failed angioplasty.
Ex‐Vivo results using a new pullback atherectomy catheter (pac)
Authors: Fischell Tim A. , Fischell Robert E. , White Robert I. , Chapolini Robert 
Published: March 2007

AbstractIn order to evaluate the feasibility of performing definitive atheromatous plaque removal using a novel retrograde cutting (Pullback) atherectomy catheter, pullback atherectomy was performed in 13 severely diseased cadaveric superficial femoral arteries. All experiments were performed using cadaver tissue either mounted in a perfusion/mounting chamber (n = 10) or left in situ (n = 3). In general, a single cut was made with each of three sequentially larger atherectomy catheters (2.5 mm, 3.0 mm, and then 3.5 mm devices). The results were evaluated by angiography and by light microscopy. Nine of the 13 experiments were performed in totally occluded vessels. The mean pre‐atherectomy stenosis (all specimens) was 95 ± 3%, with a final mean postatherectomy stenosis of 21 ± 5%. There was one vessel performation. We conclude from these preclinical studies that retrograde atherectomy with the Pullback Atherectomy Catheter is a feasible means of performing definitive atherectomy. Despite the promising potential of retrograde atherectomy, little can be said with certainty about the clinical utility of such a device at this early stage.
Preservation of regional myocardial function during coronary angioplasty with an autoperfusion balloon catheter: A case report
Authors: Simonton Charles A. , Kowalchuk Glen J. , Austin W. Kenneth 
Published: March 2007

AbstractEchocardiographic assessment of regional myocardial function was performed during standard balloon coronary angioplasty followed by autoperfusion balloon angioplasty of a proximal left anterior descending artery stenosis. Septal and apical akinesis occurred within 60 seconds of standard balloon inflation, but regional function was well preserved during prolonged autoperfusion balloon inflation.
Successful mitral valvuloplasty using the inoue balloon in a patient with mitral stenosis associated with subvalvular fibrosis and reduced left ventricular inflow cavity: A case report
Authors: Benit Edouard , Rocha Paulo , Geest Hilaire De , Werf Frans Van De 
Published: March 2007

AbstractPercutaneous transvenous mitral valvuloplasty (PTMV) was performed with two cylindric pigtail balloon catheters in a 52‐year‐old woman with symptomatic mitral stenosis. The subvalvular apparatus was fibrous with welded chordae and the subvalvular left ventricular space was markedly reduced. As a result of this distorted anatomy, during the inflations, the two balloons constantly slipped back into the left atrium before full inflation was obtained. After the procedure, the mitral valve area (MVA), as estimated by echo‐doppler (ED), increased from 1.00 to 1.34 cm2. After 2 months of mild clinical improvement, the patient again became symptomatic and ED examination showed a MVA of 1.25 cm2. A second PTMV was performed with an Inoue balloon, the entire procedure taking less than 1 hour. A stable position of the Inoue balloon and complete dilatation were achieved. ED examination showed a mitral valve area of 2.30 cm2. There was no mitral regurgitation nor atrial septal defect. After 3 months, she has only N.Y.H.A. class I symptoms and MVA, as estimated by ED, was 2.40 cm2.
Takayasu's disease with axillary, right coronary artery, and right internal mammary stenosis treated with angioplasty
Authors: Lannone Liberato A. , Rayl Koreen Lemaster 
Published: March 2007

AbstractA 47‐year‐old woman presented with progressive angina and failed medical therapy. After an unsuccessful attempt at angioplasty of a totally occluded right coronary artery, coronary artery bypass using the right internal mammary artery was performed. She presented 2 years later with stenosis in the mammary graft, right coronary artery, and axillary artery. These lesions were all treated with angioplasty.
Rate‐related left bundle branch block as a cause of non‐ischemic chest pain
Authors: Perin Emerson , Petersen Fernando , Massumi Ali 
Published: March 2007

AbstractA case is presented of rate‐dependent left bundle branch block associated with chest pain in a patient with angiographically normal coronary arteries. Lactate extraction showed no evidence of myocardial ischemia. It appears that in this case, chest pain was associated with sudden ventricular asynergy rather than myocardial ischemia.
Accuracy and reproducibility of quantitative coronary arteriography using 6 and 8 french catheters with cine angiographic acquisition
Authors: Ellis Stephen G. , Pinto Ibraim M. F. , McGillem Mark J. , Deboe Scott F. , Lefree Michael T. , Mancini G. B. John 
Published: March 2007

AbstractTo determine the suitability of 6 French catheters for quantitative coronary arteriography, the relative accuracy and reproducibility of one type of these catheters was compared to that obtained with standard 8 French catheters in 20 stenoses. Duplicate injections with polyurethane 6 French catheters were obtained using hand and power injection technique with cineangiographic acquisition (four 6 French catheter injections total per stenosis). Measurements of both percent diameter stenosis and absolute dimensions were compared to those obtained with hand injection and cine acquisition using 8 French catheters as a “gold standard.” While the reproducibility of dimension determination with the 6 French catheter was generally similar to that obtained with the 8 French catheter (0.27 ± 0.23 mm for absolute diameter and 8.1 ± 7.4% for percent diameter stenosis), accuracy was significantly less for the 6 French catheter for measurement of absolute dimensions. Thus, while apparently well suited for serial measurements of the same stenoses, 6 French catheters may not be as accurate in the determination of absolute artery dimensions as 8 French catheters.
Coronary balloon angioplasty through diagnostic 6 french catheters
Authors: Villavicencio Ramon , Urban Philip , Muller Thierry , Favre Josiane , Meier Bernhard 
Published: March 2007

AbstractWe investigated the use of ultralow profile balloon catheters (Scimed ACE, USCI Probe, Cordis, Orion) for coronary angioplasty through 6 French diagnostic catheters (Schneider, Cordis). Contrast injection was assisted with a Hercules pump (Cordis) in all cases. During 21 procedures, angioplasty of 27 lesions in 20 selected patients was attempted (1.3 lesion/procedure). Twelve lesions were in the right, 10 in the left anterior descending, and 5 in the left circumflex coronary artery. Balloon size varied between 2.5 and 3.5 mm. Twenty lesions could be successfully dilated (74%) through the 6 French catheter and 7 lesions required an exchange to a 7 French angioplasty guiding catheter. For 5 cases, another balloon was also necessary to complete the procedure. The final overall success rate was 100% per patient and per lesion and there were no major complications. Despite the small internal catheter lumen (1.22 mm) coronary visualization was adequate, and mechanical support was good. Failures of 6 French catheters were attributed to insufficient torque control and excessive friction when the balloon crossed the tapered end of the diagnostic catheter.Coronary angioplasty through a diagnostic 6 French catheter is feasible and may represent a reasonable alternative for simple cases that are done during the same session as the diagnostic angiography. Once available, 6 French high flow angioplasty guiding catheters without a tapered tip should improve success while retaining the advantage of a small femoral puncture site.
Preliminary experience with 5 and 6 french diagnostic catheters as guiding catheters for coronary angioplasty
Authors: Kern Morton J. , David Talley J. , Deligonul Ubeydullah , Serota Harvey , Aguirre Frank , Gudipati Chalapathirao , Ring Michael , Joseph Abraham , Yussman Zoe Ann , Kulick Daniel , Salinger Michael 
Published: March 2007

AbstractWith the reduction in profile of balloon dilation catheters, until recently, it has been the internal dimensions and performance of the guiding catheter that has mandated the use of 7,8 or 9 French (F) systems for the performance of percutaneous transluminal coronary angioplasty (PTCA). A new 5F catheter design (Sherwood Medical Co., St. Louis, MO) provided a large inner lumen (0.46″) permitting use of 0.20–0.22″ fixed‐wire PTCA balloon catheters with good coronary visualization. Potential advantages include reduced coronary artery ostial trauma and catheter induced damping and enhanced patient comfort. We report our initial experience in 14 patients undergoing PTCA with a 5 and 6F guide/fixed‐wire system. Mean age was 63 ± 10 (43–78 years). PTCA indications: Cardiogenic shock (1), post‐myocardial infarction angina pectoris (2), grade III angina (5) and unstable angina pectoris (6). Vessel attempted: Left anterior descending (3), circumflex (4), obtuse marginal (2), diagonal (1), right coronary artery (3), and internal thoracic artery (1). Twelve patients had femoral approach; two brachial approach. The USCI Probe® (USCI Division, Billerica, MA) was used in 8 lesions and SCIMED ACE® (SCIMED Life Systems, Maplegrove, MN) catheter in 7 lesions. Successful 5 or 6F guide/fixed‐wire dilations reduced the stenosis (77 ± 14 to 37 ± 30%) and were successfully performed in 79% (11/14). One 5F patient required 8F guiding catheter and was dilated with 2.0 fixed‐wire balloon. A second failed 5F PTCA could not be dilated with any larger conventional system. A third total occlusion could not be crossed with a guidewire or fixed wire balloon. No patient had a complication. Difficulty in retracting the deflated fixed‐wire balloon into the 5 and 6F guide catheter was encountered in fixed‐wire balloons sized >2.5mm.This preliminary experience suggests that, in selected patients, large lumen 5 and 6F diagnostic catheters can be used as a satisfactory guiding catheter system for fixed‐wire PTCA.
Anatomic and machine projection angles of various radiographic imaging systems used for cardiac angiography
Authors: Burge Christopher , Sanders William , Alderman Edwin L. 
Published: March 2007

AbstractQuantitation of coronary artery dimensions in serial angiographic studies requires an awareness of the variety, complexity, and implications of radiographic imaging equipment used for coronary arteriography. Recognition of the geometric complexities inherent in angiographic imaging systems is important in understanding complex image rotations and ensuring identity of projections when serial comparison is desired. Tables, figures, and formulae are provided to permit translation of machine angles into patient reference angles and vice versa.
Vasospasm in a coronary artery aneurysm
Authors: Gutowski Ted , Tannenbaum Alan K. , Moreyra Abel E. 
Published: March 2007

AbstractCoronary artery aneurysms are not believed to have enough intact smooth muscle to generate significant vasoconstriction. A case is presented illustrating vasospasm of a large fusiform aneurysm of a right coronary artery during angioplasty. Pathophysiology of aneurysms is discussed.
Vascular entrapment of intra‐aortic balloon after short‐term balloon counterpulsation
Authors: Schechter David , Murali Srinivas , Uretsky Barry F. , Reddy P. Sudhakar , Makaroun Michel , Dekker Andrew 
Published: March 2007

AbstractProlonged, continuous intra‐aortic balloon (IAB) counterpulsation for several weeks can result in balloon entrapment secondary to thrombus formation in the balloon lumen. In this report, we describe a patient who developed IAB entrapment, early (1 wk) after initiation of counterpulsation. A trace amount of blood was noted in the tubing connecting the balloon catheter to the console for 3 days prior to IAB malfunction and vascular entrapment. We suggest that the balloon catheter be removed immediately when blood is detected in the external connecting tubing even if the IAB is functioning satisfactorily.
Nondiagnosed left main ostial stenosis partly due to the use of 5 french coronary angiographic catheters
Authors: Colle Jean‐Pierre , Delarche Nicolas , Bourdeaud'Hui Alain , Laborde Nadine 
Published: March 2007

AbstractTwo cases have been reported in which the use of 5 F angiographic catheters is associated with a failure to diagnose an ostial stenosis of the left main coronary artery (LMCA). In both cases, the erroneous diagnosis led to an inappropriate indication for percutaneous transluminal coronary angioplasty (PTCA) on other stenosed vessels, and the ostial left main lesion was unexpectedly discovered when using 8F guiding catheters. It is supposed that the ability of preformed 5F catheters to pass easily through an ostial lesion makes detection of such proximal stenosis much more difficult. We suggest that the choice of 5F catheters must be approached with caution when left main disease is potentially expected from the clinical features.
Percutaneous balloon pericardial window for patients with malignant pericardial effusion and tamponade
Authors: Palacios Igor F. , Murat Tuzcu E. , Ziskind Andrew A. , Younger Jerry , Block Peter C. 
Published: March 2007

AbstractWe performed percutaneous balloon pericardial window (PBPW) in 8 patients (age 40 to 70 yrs; 4 men, 4 women) with malignant pericardial effusion and tamponade. Pericardial window was indicated because they continued to drain >100 ml/day of pericardial fluid through the pigtail catheter for >/3 days.A 0.038 inch guidewire was advanced through the pigtail catheter into the pericardial space and then the catheter was removed. A 20 mm diameter, 3 cm long balloon dilating catheter was advanced to straddle the parietal pericardium. Manual inflations were performed until the waist produced by the pericardium disappeared. All patients tolerated the procedure well with minimal discomfort and with no complications. A left or bilateral pleural effusion occurred in all patients after PBPW. No patient developed recurrent pericardial tamponade at a mean follow‐up of 6 ± 2 months. Thus, PBPW is a useful and safe technique to avoid surgery in patients with malignant pericardial effusion and tamponade.
Radiographic contrast agents and platelet function: A quenched‐flow study
Authors: Taylor Marc A. , Angello Debra A. , Ayers Carlos R. , Gear Adrian R. L. 
Published: March 2007

AbstractRadiographic contrast media (RCM) may alter platelet behavior at concentrations achieved during cardiac angiography. We used quenched‐flow aggregometry coupled to single‐particle counting to study the influence of RCM on the kinetics of platelet aggregation (< 5.0 sec) induced by adenosine diphosphate (ADP, 2.86 μM). At a concentration in platelet‐rich plasma (PRP) of 5 per cent RCM by volume, platelet aggregation was inhibited by diatrizoate, iopamidol and ioxaglate either directly or following incubation of each contrast agent with PRP for 20 minutes. Diatrizoate inhibited more than did iopamidol or ioxaglate (56 ± 6, versus 39 ± 3 and 40 ± 9 per cent respectively; P<0.003, P<0.009, n = 20 normal subjects). A small reduction (about 16 per cent) in aggregation velocity occurred within 5 seconds of exposure of PRP to all 3 RCM and the onset time (t) or lag period before aggregation begins was significantly prolonged by diatrizoate (P<0.03). The RCM vehicles alone (iodinated moiety removed, osmolality readjusted) had no effect on the ADP‐induced aggregation. Platelet counts fell significantly after incubation with diatrizoate (12%; P = 0.04). Our data therefore show that early platelet aggregation was inhibited by 3 commonly‐used ionic and nonionic contrast agents. Inhibition was apparently caused by the iodinated contrast molecule, began within seconds of platelet‐RCM contact and was independent of vehicle composition. Since diatrizoate inhibited aggregation more than iopamidol or ioxaglate, its use may be of additional value during angi‐ographic procedures in clinical situations involving enhanced platelet activation.