bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of balloon material and lesion characteristics on the incidence of angiographic and clinical complications of coronary angioplasty
Authors: Raymenants Erwin , Bhandari Suman , Desmet Walter , Scheerder Ivan De , Reniers Romain , Willems Jos Louis , Piessens Jan H. 
Published: March 2007

AbstractTo assess the importance of balloon material used for percutaneous transluminal coronary angioplasty (PTCA), we compared the complication rates observed with low compliant plastomer (PM 300), intermediately compliant polyethylene (PE 600), and highly compliant polyolefin copolymer (POC) balloons. In a total of 1,650 procedures, one of these balloon materials was used to dilate 2,040 lesions. The dissection rate tended to be slightly lower with the use of more compliant balloon material. The total clinical complication rate (death, emergency coronary surgery, myocardial infarction, need for bail‐out stenting or for prolonged heparin treatment, abrupt out‐of‐laboratory vessel closure) was 8.1%, 7.4%, and 4.2% in the procedures exclusively performed with PM 300 (N = 653), PE 600 (N = 543) and POC (N = 454) balloons, respectively (P=0.03). In multivariate analysis, the use of less compliant balloon material emerged as an independent correlate of clinical complications (P=0.007). However, the predictive power of the lesion complexity (B2, C versus A, B1) was four times stronger. In contrast to current concerns, the use of compliant balloon material seems at least as safe as the use of less compliant material. © 1994 Wiley‐Liss,Inc..
Discordance in the predictors of mortality vs. those of ischemic complications following transcatheter coronary intervention
Authors: Lindsay Joseph , Pinnow Ellen E. , Reddy Venugopal M. , Pichard Augusto D. 
Published: March 2007

AbstractOutcomes of percutaneous transluminal coronary angioplasty (PTCA) depend upon the skill of the angioplasty team and on the characteristics of the patient population. Comparisons of outcomes from different laboratories must take into account the latter. A discordance may exist between the baseline predictors of death in hospital following PTCA and those for periprocedural ischemia. Baseline clinical and procedural characteristics of 3,725 patients who underwent PTCA during 1991 and 1992 were compared with complications by multivariate analysis. The age of the patient and the occurrence of an Ml within the previous 30 days were the most powerful independent predictors of death. Ischemic complications were not independently associated with these factors. Emergency CABG was associated independently with target lesion complexity and abrupt reclosure, with unstable angina or attempted saphenous vein graft dilatation. Thus, mortality may more directly reflect baseline clinical characteristics than the skill of operators in avoiding ischemic complications. © 1994 Wiley‐Liss,Inc..
Angiographic evidence of right coronary bridging
Authors: Woldow Andrew B. , Goldstein Steven , Yazdanfar Shahriar 
Published: March 2007

AbstractSystolic constriction of the left anterior descending coronary artery is a well‐recognized angiographic and autopsy finding. The etiology of this phenomenon is an intramural course of the coronary artery. Even though there has been autopsy evidence of an intramural course of the right coronary artery, this rare finding has not been associated with systolic constriction, “bridging” on coronary angiography. There is evidence that strenuous exercise can induce ischemia in an intramural left coronary artery. We therefore present a case report of angiographic evidence of systolic constriction of the right coronary artery. © 1994 Wiley‐Liss,Inc..
Iliocaval reconstruction with metallic stents
Authors: Roy Sumit , Baijal Sanjay S. , Rastogi Harsh 
Published: March 2007

AbstractPercutaneous stenting is now the preferred first line of treatment for occlusive lesions of the great veins. A case is presented in which multiple metallic stents were used to reestablish communication between the suprahepatic inferior vena cava and both iliac veins. The clinical result was satisfactory: venous claudication was relieved, and the progress of chronic venous insufficiency arrested. Stent implantation offers a minimally invasive therapeutic option even when extensive revascularisation is indicated. © 1994 Wiley‐Liss,Inc..
Rotational coronary atherectomy with adjunctive balloon angioplasty for the treatment of ostial lesions
Authors: Zimarino Marco , Corcos Thierry , Favereau Xavier , Commeau Philippe , Tamburino Corrado , Spaulding Christian , Guérin Yves 
Published: March 2007

AbstractConventional balloon angioplasty (PTCA) of ostial lesions (OL) is associated with suboptimal results and a higher complication rate. Partial plaque ablation with rotational atherectomy (RA) before PTCA might improve results. This approach was used in 63 patients (pts) (mean age 64±10 yrs; 44 men, 19 women) with 69 OL. There were 15 aorto‐OL and 54 branch‐OL. Calcification was more frequent in aorto‐OL than in branch‐OL (67% vs. 35%, P< 0.05). Mean burr size was 1.8±0.3 mm. Burr‐artery ratio was 0.74±0.10. Adjunctive PTCA was systematically performed.Procedural success was achieved in 58 pts (92%): 14 aorto‐OL (93%) and 50 branch‐OL (93%) were successfully treated; major complications occurred in 1 (7%) aorto‐OL and 1 (2%) branch‐OL. Uncomplicated failure occurred in three cases. Minimal lumen diameter (MLD) increased from 0.69±0.31 mm before RA to 1.43±0.28 mm after RA (P<0.001) and 2.16±0.29 mm after PTCA (P<0.001). Diameter stenosis (DS) decreased from 75±13% before RA to 32±12% after RA (P<0.001) and 14±10% after PTCA (P<0.001). All successfully treated pts underwent repeat angiography 24 h later and exercise testing or repeat cardiac catheterization >6 mo later. At 24 h repeat angiography, DS was 17±15% (P=NS vs. after PTCA); no lesion had a DS ≥ 50%. Follow‐up coronary angiography was performed in 30 pts (52%) who had abnormal stress testing: 13 pts (43%) showed angiographic restenosis in at least one successfully treated OL.In conclusion, RA with adjunctive PTCA is a safe and effective treatment of OL. It is associated with higher success and lower major complications rates when compared with conventional PTCA. Restenosis remains a major limitation of all percutaneous approaches. © Wiley‐Liss, Inc.
Initial experience with the Europass™: A new ultra‐low profile monorail balloon catheter
Authors: Zimarino Marco , Corcos Thierry , Favereau Xavier , Tamburino Corrado , Toussaint Marcel , Spaulding Christian , Guérin Yves 
Published: March 2007

AbstractOne of the causes for percutaneous transluminal coronary angioplasty (PTCA) failure is the inability to cross the lesion with the balloon catheter after guidewire positioning. The Europass™ coronary angioplasty catheter is a monorail Duralyn™ balloon catheter developed to enhance lesion crossability and to overcome this limitation. This system was evaluated in 50 patients in which target lesions were chronic total coronary occlusions (12 cases) or stenoses that could not be reached or crossed by other new monorail balloon catheters. Overall procedural success was obtained in 49/50 patients (98%), using a single Europass™ balloon catheter in 46/50 patients (92%), with no in‐hospital complications.Its low profile, small distal shaft, and excellent trackability allowed successful angioplasty in cases where other catheters failed. This balloon catheter represents a significant advance in angioplasty technology and can be considered as a first‐choice device for a safe and expeditious single‐operator procedure. © Wiley‐Liss, Inc.
Quantification of intracoronary volume by videodensitometry: Validation study using fluid filling of human coronary casts
Authors: Haase Jürgen , Slager Cornelis J. , Keane David , Foley David P. , Boer Ad Den , Doriot Pierre A. , Serruys Patrick W. 
Published: March 2007

AbstractChanges in intracoronary volume reflect the hemodynamic significance of progression or regression of diffuse coronary artery disease where intracoronary catheters cannot be applied for direct measurements due to small vessel dimensions. We have validated the videodensitometric measurement of intracoronary volume with epoxy casts of postmortem human coronary arteries. The volume of 31 coronary segments (cross‐sectional areas in a range of 2–13 mm2) measured by fluid‐filling using a precision dispenser was compared with the respective single plane intracoronary volume assessments obtained by the videodensitometric algorithm of the new generation Cardiovascular Angiography Analysis System (CAAS II). The true and measured values of volume were compared by calculation of the mean of the signed differences ± standard deviation and by linear regression analysis. Videodensitometric measurement of intracoronary volume correlate well with fluid‐filling of human coronary artery casts (correlation coefficient: r = 0.99, y = 1.96 + 0.99x, standard error of estimate: SEE = 3.96) with a significant trend towards overestimation of true volume values (mean difference = 1.73 ± 3.64 mm3, P<0.05). Intracoronary volume estimations can be used to measure changes of luminal dimensions of coronary arteries and may offer a new approach to assessment of progression or regression of diffuse coronary artery disease. © Wiley‐Liss, Inc.
Peripheral arterial angioplasty balloons as adjuncts to percutaneous coronary revascularization
Authors: Feldman Ted , Carroll John D. , Follman Duane F. , Al‐Hani Arfan , Levin Thomas N. 
Published: March 2007

AbstractAlthough PTCA balloon technology has improved dramatically since the first catheters were introduced over a decade ago, some limitations remain. The largest conventional balloon size available is 4.0 mm diameter. Larger size balloons are sometimes necessary for saphenous vein graft dilatation or in very large native coronary arteries. Also, adjunctive balloon angioplasty is used frequently after atherectomy and other coronary device therapy. Current generation balloons are not always necessary in this setting, since a large luman has already been established. Thus, it has become useful in our laboratory to use peripheral arterial angioplasty balloons for both large coronary vessel dilatation, and also for adjunctive dilatation after device use. We describe our initial experience with peripheral arterial angioplasty balloons as adjuncts to percutaneos coronary revascularization. © Wiley‐Liss, Inc.
Coronary artery ectasia: Local pathology or diffuse disease?
Authors: Williams Michael J. A. , Stewart Ralph A. H. 
Published: March 2007

AbstractIt is not known whether general or local factors influence the pathogenesis of coronary ectasia. We analyzed prospectively coronary angiograms from 2,186 consecutive patients with 32 patients (1.5%), identified as having coronary artery ectasia. Sixteen subjects had coronary ectasia in more than one segment of the same or a different artery. In 20 of 72 (28%) ectatic segments there was a proximal, related stenosis. In these cases ectasia was more often saccular than fusiform (16 vs. 4) compared to ectasia without a proximal, related stenosis (21 vs. 31, P = 0.003), and the mean length of the ectatic segment was shorter (8.0 vs. 15.1mm, P = 0.013). Subjects with ectasia after a stenosis often had other ectatic segments unrelated to stenoses. The high incidence of multisegment involvement suggests that coronary ectasia results from a diffuse abnormality of the vessel wall. In predisposed individuals localized ectasia may follow a stenosis, suggesting poststenotic dilatation. © Wiley‐Liss, Inc.
Restenosis following subclavian artery angioplasty for treatment of coronary‐subclavian steal syndrome: Definitive treatment with Palmaz‐stent placement
Authors: Mufti Shahid I. , Young Kevin R. , Schulthesis Thomas 
Published: March 2007

AbstractWe report a case of progressive angina pectoris 4 years post coronary bypass surgery, in which the left internal mammary artery (LIMA) was grafted to the native left anterior descending coronary artery. The coronary‐subclavian steal phenomenon was proven angiographically with retrograde reflux through the LIMA graft into the distal subclavian vessel, downstream from a critical stenosis at the origin of the subclavian artery. After initially successful angioplasty of the ostial subclavian lesion, restenosis and return of angina prompted repeat dilatation and placement of a Palmaz 154‐M stent. Follow‐up catheterization has demonstrated persistent patency at the stented site and absence of coronary steal. © Wiley‐Liss, Inc.
Comparison of three coronary stents: Clinical and angiographic outcome after elective placement in 134 consecutive patients
Authors: Maclsaac Andrew I. , Ellis Stephen G. , Muller David W. , Topol Eric J. , Whitlow Patrick L. 
Published: March 2007

AbstractOne hundred and thirty‐four consecutive patients undergoing elective coronary stenting were studied to assess the relative performance of Palmaz‐Schatz (PS), Gianturco‐Roubin (GR), and Wiktor (W) stents. Eighty‐six percent of patients underwent follow‐up angiography. Initial and follow‐up angiograms were assessed by a central angiographic core laboratory. Attempts were made to place 81 Palmaz‐Schatz (PS) stents, 21 Giant‐urco‐Roubin (GR), and 32 Wiktor (W) stents. PS stents were less frequently successfully deployed (88% PS vs. 100% GR vs. 97% W; P = 0.03). The final percent stenosis was greater with the GR stent (32% GR vs. 14% PS vs. 19% W; P < 0.001). The restenosis rate was lower in the PS group (PS 48.2% vs. GR 66.7% and W 68.4%; P = 0.044). After accounting for the effect of prior restenosis (P = 0.005) and saphenous vein site (P = 0.006) in muitivariate testing, lesion severity at follow‐up was still less with the Palmaz‐Schatz stent (P = 0.037). © Wiley‐Liss, Inc.
Rationale and application of coronary transstenotic pressure gradient measurements
Authors: De Bruyne Bernard , Paulus Walter J. , Pijls Nico H. J. 
Published: March 2007

AbstractPresence, extent, and evolution of atherosclerotic coronary narrowings, as well as the anatomic possibilities for revascularization, can be reliably defined at (and only at) selective coronary angiography. The latter remains, therefore, the pivotal diagnostic tool for patients with suspected coronary artery disease. However, in spite of the increasing availability of on‐line quantitative coronary angiography, it still holds that the functional (physiologic) consequences of an epicardial coronary narrowing cannot be completely derived from geometric (anatomic) information. Clinical decision making can be particularly difficult in lesions of intermediate severity (40–70% diameter reduction), in postinterventional segments, and in some particular anatomic settings, namely, ostial stenoses, bifurcation lesions, and diffuse atherosclerotic disease. This has led to an explosive growth of new methods for assessing the physiological significance of coronary narrowings documented at angiography. Among them, Doppler blood flow velocitometry and transstenotic pressure gradient measurements have emerged as the only techniques easily applicable in most catheterization laboratories. Here, we briefly review the clinical interest of measuring transstenotic pressure gradients. © Wiley‐Liss, Inc.
Severe mitral incompetence following balloon mitral valvuloplasty: Complete resolution during follow‐up
Authors: Kannan P. , Jeyamalar R. 
Published: March 2007

AbstractMitral incompetence (MR) is a complication of balloon mitral valvuloplasty. There are few reports of long‐term outcome. We beleive this is the first report in the literature of complete resolution during follow‐up of severe mitral regurgitation resulting from balloon valvuloplasty.
The “dented bladder”: Diagnosis of a retroperitoneal hematoma
Authors: Chambers Charles E. , Griffin David C. , Omarzai Reza K. 
Published: March 2007

AbstractRetroperitoneal hemorrhage and associated hematoma is a rare but potentially life threatening complication of cardiac catheterization and coronary artery interventions. This case presents the potential diagnostic utility of a supine film of the abdomen for early identification of a retroperitoneal hematoma in a patient following acute infarction PTCA.
A dual blood supply protects the right gastroepiploic arterial graft: Report of two cases
Authors: Hashimoto Hideki , Isshiki Takaaki , Ikari Yuji , Hara Kazuhiro , Saeki Fumihiko , Tamura Tsutomu , Yamaguchi Tetsu , Suma Hisayoshi 
Published: March 2007

AbstractWe report two cases whose right gastroepiploic arterial bypass grafts were protected by a dual blood supply due to the anatomical anastomosis between the celiac and the superior mesenteric artery systems. This unique characteristic of the graft adds an advantage for its use as a graft conduit.
Dual guiding catheters for saphenous venous graft protection during native coronary angioplasty
Authors: Freund Neil , Holland Matthew R. 
Published: March 2007

AbstractThe simultaneous use of two guiding catheters during angioplasty has been previously described for native coronary artery bifurcation lesions. We describe a case in which a dual guiding catheter, dual guidewire technique is used for angioplasty of a native vessel lesion spanning the anastomotic site of a sequential saphenous vein graft.
Kinetics of drugs delivery to the arteriall wall via polyurethane‐coated removable nitinol stent: Comparative study of two drugs
Authors: Dev Vishva , Eigler Neal , Sheth Sushil , Lambert Tom , Forrester James , Litvack Frank 
Published: March 2007

AbstractPolymer‐coated removable stents were used to deliver 14C‐labeled etretinate and 3H‐labeled forskolin to the vessel wall in 31 New Zealand White rabbits to study their kinetics. Stents loaded with etretinate (n = 8) and forskolin (n = 14) were implanted in the rabbit carotid arteries, and the animals were euthanized at different time intervals. Drug levels were measured in the media and adventitia of the stented segment, in distant tissues, and in blood. In four rabbits, forskolin‐loaded stents were percutaneously retrieved 2 hr after implantation in the carotid artery, and the tissue and blood levels were determined 2 and 24 hr after retrieval. In seven rabbits etretinate‐loaded stents were retrieved 72 hr after implantation in abdominal aorta, and drug levels were measured in the tissues and blood immediately after and at 1 and 4 days after retrieval.Levels of etretinate in the vessel wall peaked at 24 hr (250 ng/mg) and remained high up to 72 hr (185 ng/mg) after stent placement. Levels of forskolin peaked within 2 hr of stent placement (135 ng/mg) and rapidly declined to 4.9 ng/mg at 24 hr with the stent in situ. About 50% (1.4 mg) of the original etretinate remained in the stent at 72 hr compared to about 5% (0.08 mg) of forskolin at 24 hr. Ratio of peak drug levels in the vessel wall to those in the blood was 6,000 for etretinate and 780 for forskolin. After stent removal at 72 hr, levels of etretinate in the aortic wall declined from 74 ng/mg to 29 ng/mg at 1 day and to 14 ng/mg at 4 days. Levels of forskolin declined rapidly within 2 hr of stent removal from 134 ng/mg to 1.2 ng/mg and further to 0.12 ng/mg within 24 hr. Polymer‐coated stents could be used for local drug delivery to the vessel wall. Kinetics of delivery and washout vary between drugs.
Myocardial bridging involving more than one site of the left anterior descending coronary artery: An uncommon cause of acute ischemic syndrome
Authors: Mazzù Antonio , Tano Giuseppe Di , Cogode Riccardo , Presti Giacomo Lo 
Published: March 2007

AbstractAn infrequent angiographic finding is reported of myocardial bridging involving more than one site of the left anterior descending coronary artery in a symptomatic patient with ischemia exacerbated by nitroglycerin administration. Beta‐blocker therapy alone was followed by a favorable long‐term outcome.
Activated clotting times in acute coronary syndromes and percutaneous transluminal coronary angioplasty
Authors: Wilson James M. , Dougherty Kathryn G. , Ellis Karen O. , Ferguson James J. 
Published: March 2007

AbstractA discrete fall in the ACT (activated coagulation time) has been observed in patients with known activation of the coagulation cascade. Injury to the coronary artery resulting in thrombin activation, whether spontaneous as in the case of acute myocardial infarction or planned as with percutaneous transluminal coronary angioplasty (PTCA), may there‐fore be reflected in a change in ACT values. We reviewed the records of patients under‐going PTCA at St. Luke's Episcopal Hospital/Texas Heart Institute from January 1990 through December 1992 for information regarding ACT values and clinical events. A total of 469 patients, whose record contained adequate information for study inclusion, were divided into four separate groups: acute myocardial infarction (group I, n = 62), unstable angina with heparin therapy that was withdrawn at least 4 hr prior to PTCA (group II, n = 102), unstable angina with heparin therapy continued until the time of PTCA (group III, n = 154), and stable angina undergoing elective PTCA (group IV, n = 151). Heparin was discontinued 12–15 hr after the procedure in all but group I where anticoagulation was often maintained up to 72 hr. ACT values were measured prior to the PTCA procedure (baseline), after the initial heparin bolus of 10,000 U (postheparin) and ∼ 12–18 hr after the procedure (heparin withdrawal). The “baseline” ACT was significantly lower in patients with unstable angina (93 ± 13 sec) or acute myocardial infarction (78 ± 9 sec) who had their baseline value obtained off of heparin therapy than in patients with stable angina (136 ± 21 sec) or those receiving heparin at the time of baseline measurement (135 ± 14 sec,P< 0.001). All patients with unstable coronary syndromes had a blunted response to heparin (group 1–189 sec, group II‐221 sec, group III‐248 sec). Although groups I‐III were not significantly different compared to one another, each was significantly lower than group IV whose past heparin ACT was 279 sec. Heparin withdrawal ACT values fell within the ranges seen in patients with unstable coronary syndromes untreated with heparin in all but group I (whose heparin therapy was continued through the time of the 12–18‐hr postprocedure measurement time). Recurrent ischemic events were seen with increased frequency (16.6%) only in patients with unstable angina whose heparin therapy was interrupted prior to PTCA.In conclusion, low baseline ACT values and a blunted ACT response to heparin are associated with clinical syndromes known to result from thrombus formation. The possibility that the ACT may be of value in reflecting thrombus activity requires prospective evaluation.
Echocardiographic predictors of candidacy for successful transcatheter atrial septal defect closure
Authors: Rosenfeld Howard M. , Van Der Velde Mary E. , Sanders Stephen P. , Colan Steven D. , Parness Ira A. , Lock James E. , Spevak Philip J. 
Published: March 2007

AbstractWe reviewed pre‐closure echocardiograms on all patients undergoing transcatheter atrial septal defect (ASD) closure with the Bard double‐umbrella occluder device aided by simultaneous transesophageal echocardiography to determine precatheterization predictors of outcome. Transesophageal echocardiograms were performed on 28 of 132 patients (22%) undergoing device closure (age = 3–72 years, mean = 14 years; weight = 15–68 kg, mean = 35 kg). Three devices were removed because of unstable position. Of the remaining 25 patients, 21 had effective closure (residual flow diameter ≤ 3 mm) and 18 had favorable arm position (device arm on proper side of the septum and not in contact with an atrioventricular valve leaflet).Only ASD size predicted effective closure. All patients with a maximum defect size of < 13 mm had effective closure. Among the 17 patients with defects ≥ 13 mm, 10 had effective closure, 4 had significant residual flow, and 3 had devices removed for unstable position. Atrial dimensions and rim size did not predict effective closure. There were no pre‐closure predictors of favorable arm position which was associated only with the size of the device implanted.