bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnum system for routine coronary angioplasty: A randomized study
Authors: Nukta Emad Dean , Meier Bernhard , Urban Philip , Muller Thierry , Dorsaz Pierre A. , Favre Josiane 
Published: March 2007

AbstractThe Magnum system, initially designed for coronary angioplasty (PTCA) of chronic total occlusion, consists of a balloon catheter and a solid steel 0.021 inch (0.53 mm) steerable and removable wire with a soft and moldable distal portion, tipped with a 1 mm olive. To evaluate its performance in routine PTCA, 200 unselected consecutive patients were randomized to two equal groups, i.e., group Magnum (100 patients, 115 vessels) and group Standard (100 patients, 118 vessels) including 18 and 21 patients with chronic total occlusions, respectively.Randomization was performed by the sealed envelope system in the catheterization laboratory and crossover of system was imposed if it was not possible to place a balloon correctly within 20 min of fluoroscopy time.There were no significant differences between groups concerning clinical and angiographic baseline characteristics, size of initial balloons (3.0±0.3 mm in both groups), fluoroscopy time to cross the lesion with the wire (Magnum: 4±5, Standard: 5±6 min), total fluoroscopy time (Magnum: 11 ± 9, Standard: 12±12 min), and need for crossover (Magnum: 10%, Standard: 16%). Success rates per lesion were comparable with 90% in group Magnum and 84% in group Standard, as were the complications with one inhospital death in group Standard, occurring three weeks after PTCA and stent implantation. There was no emergency operation. Six patients per group had myocardial infarction of whom two in group Magnum and one in group Standard developed a Q‐wave.The following variables were significantly in favor of the Magnum system compared with the Standard system: success rate in nontotal lesions (97% versus 90%) crossover success in total occlusions (0 vs. 33%), fluoroscopy time to cross the lesion with the balloon once the wire was in place (1 ± 2 vs. 2 ± 4 min), and use of a single versus 1.2±0.5 wires per lesion. The only advantage of the Standard systems was the more common use of 7 French guiding catheters (Magnum: 40%, Standard: 53%, p = 0.09).The Magnum system compares favorably with standard systems for routine PTCA. The robust design of the Magnum wire does not impair ease of placement and safety but saves material and facilitates balloon advancement across the lesion.
Preprocedure warfarinization and brachial approach for elective coronary stent placement—a possible strategy to decrease cost and duration of hospitalization
Authors: Rosenschein Uri , Ellis Stephen G. 
Published: March 2007

AbstractIntracoronary stenting, while potentially beneficial to treat abrupt closure and to prevent restenosis after angioplasty, requires intermediate‐term warfarinization to prevent stent thrombosis. Hospitalization is often prolonged because of the need to establish antico‐agulation. Hospital charges have been reported to be considerably higher with stenting than with balloon angioplasty alone, although the long‐term cost ramifications remain uncertain due to the fact that stenting may limit restenosis. We describe a technique wherein stent placement is performed while the patient is already partially anticoagu‐lated, which may decrease costs associated with stenting.
Virtual real‐time digital processing of hemodynamic data
Authors: Corin William J. , George David T. , Reilley Joanne Y. , Santamore William P. 
Published: March 2007

AbstractAt present, the majority of cardiac catheterization laboratories acquire and store hemo‐dynamic data in analog form. To examine the possibility of performing complex analysis of digital data during the catheterization procedure, we examined whether virtual realtime digital (fast Fourier) analysis improves the accuracy of clinical data. We compared digital filtering of fluid manometry during right heart catheterization with 10‐Hz and 250‐Hz analog filters. Using the simultaneously acquired micromanometry as the “gold standard,” we found that analog filtering is associated with a greater error and time delay than digital filtering. This study demonstrates that digital hemodynamic data analysis performed during cardiac catheterization can improve the quality of data obtained during right heart catheterization, with the results available within seconds. More extensive use of computers in the cardiac catheterization laboratory may be useful for both clinical and research purposes. © 1992 Wiley‐Liss, Inc.
Intracoronary thrombolysis followed by directional atherectomy: A combined approach for thrombotic vein graft lesions considered unsuitable for angioplasty
Authors: Sabri M. Nagui , Johnson Danna , Warner Mark , Cowley Michael J. 
Published: March 2007

AbstractEccentric complex vein graft lesions with abundant luminal thrombus have been generally considered unfavorable for balloon angioplasty. We present 3 patients in whom such lesions were successfully treated by a combined approach: intracoronary urokinase (1 million units over 1 hr) administered in the catheterization laboratory followed by directional atherectomy of the residual lesions in 2 separate procedures; with the patients maintained on heparin infusion between the 2 stages. No distal embolizations were encountered. Two of the 3 patients developed a groin hematoma without vascular compromise. This combined approach may prove to be an attractive alternative to reoperation in select patients with unfavorable vein graft lesions. © 1992 Wiley‐Liss, Inc.
A doppler guided retrograde catheterization system
Authors: Frazin Lee J. , Vonesh Michael J. , Khasho Fouad , Lanza Gregory , Chandran Krishnan B. , Talano James V. , McPherson David D. 
Published: March 2007

AbstractA Doppler guided retrograde catheterization system was developed to accurately cathe‐terize the aortic root and left ventricular chamber without X‐ray. This system consists of a 20 MHz, 0.076 mm thick × 1.016 mm diameter pulsed Doppler crystal integrated into the tip of a 100 cm multipurpose triple lumen catheter. Two lumens (0.61 mm) are used for electrodes; a third lumen (1.245 mm) may be used for guidewire and pressure determination; and the system is attached to a flow velocimeter. In an aortic arch flow model, the principles of Doppler signal guidance were confirmed with flow toward the catheter tip demonstrating positive signals and flow away from the catheter tip demonstrating negative signals. The magnitude and polarity (direction) of the detected phasic and mean velocities were utilized to guide catheterization in six dogs. Using the reversal of Doppler signal polarity to indicate branch entry and manipulating the catheter so as to maintain maximal positive axial velocity, the Doppler catheter was successfully advanced from the femoral artery to the aortic valve. Branches detected by the Doppler system were confirmed by fluoroscopy. The aortic valve was audible when approached and the left ventricular chamber was recognized by its characteristic pressure waveform. The Doppler guided retrograde catheterization system offers new technology to perform left heart catheterization without X‐ray and may prove useful in a variety of settings including the development of invasive ultrasonic diagnostic and therapeutic technology. © 1992 Wiley‐Liss, Inc.
A technique to access severely diseased arteries
Authors: Goudreau Evelyne , Vetrovec George W. 
Published: March 2007

AbstractCardiac catheterization performed in patients with severe peripheral vascular disease may represent a difficult technical challenge and is associated with a higher incidence of vascular complications. We describe a technique that uses angioplasty equipment to access severely diseased arteries. This technique allows a percutaneous transluminal coronary angioplasty (PTCA) guide wire to be steered across vascular lesions under direct visualization of the lumen and continuous pressure monitoring, potentially reducing the risk of vascular complications. © 1992 Wiley‐Liss, Inc.
Acquired postoperative coronary arteriovenous fistula
Authors: Pattee P.L. , Chambers R.J. 
Published: March 2007

AbstractA patient is described who underwent closed mitral valvotomy and presented 21 years later with left ventricular failure. Coronary angiography revealed a coronary artery to pulmonary vein arteriovenous fistula. This is the first report of an acquired fistula of this type developing secondary to trauma associated with cardiac surgery. Diagnosis and treatment implications are discussed. © 1992 Wiley‐Liss, Inc.
A word of caution: Reopening chronic coronary occlusions
Authors: Burger Wolfram , Kadel Christoph , Keul Hans Georg , Vallbracht Christian , Kaltenbach Martin 
Published: March 2007

AbstractReopening of chronically occluded coronary arteries by angioplasty, initially considered a low risk procedure, may carry similar risks at PTCA of coronary stenoses. We report 3 cases with ventricular fibrillation or sudden death 2–4 days after reopening of 1‐ to 5‐month‐old coronary occlusions.
Aspiration of a mobile thromboembolus from saphenous vein graft
Authors: Cohen Harry M. , Kleiman Jay H. 
Published: March 2007

AbstractAn 81‐year‐old woman who was 4 years post 3‐vessel coronary artery bypass graft (CABG) surgery suffered a non‐Q‐wave myocardial infarction. Angiography revealed the recent occlusion of a saphenous vein graft (SVG) to an obtuse marginal coronary artery. Five days following failure of intragraft urokinase and systemic heparinization to recanalize the SVG, balloon angioplasty was undertaken. A mobile thrombus was observed to migrate spontaneously in a retrograde manner in the SVG and was removed during PTCA by aspiration through the guiding catheter.
The usefulness of a tracking catheter in complex coronary angioplasty
Authors: Tatineni Satyanarayana , Kern Morton J. , Aguirre Frank , Donohue Thomas , Bach Richard , Bell Calvin 
Published: March 2007

AbstractComplex lesion angioplasty, such as chronic total occlusions, coronary vessels with right angle take‐offs, tortuous vessels, and tortuous internal mammary artery or saphenous vein grafts is a continuing challenge. The complex problems have been successfully managed with novel guiding catheter shapes and ultralow profile balloons. However, on occasion steerable guidewire placement remains extremely difficult, despite significantly improved means of intracoronary manipulations.
Does the AHA/ACC task force grading system predict outcome in multivessel coronary angioplasty?
Authors: Moushmoush Bassam , Kramer Barry , Hsieh Ann‐Ming , Klein Lloyd W. 
Published: March 2007

AbstractTo assess the ACC/AHA task force grading system as a predictor of outcome in patients undergoing multivessel percutaneous transluminal coronary angioplasty we analyzed all failures (residual stenosis >50%, Q‐wave myocardial infarction, coronary artery bypass grafting during hospitalization, or death) in 97 patients with 328 stenoses. There were 70 males and 27 females; 60 patients had stable angina, and 37 had unstable angina. The mean number of lesions dilated per patient was 3.4 (range 2‐8). The mean preangioplasty percent luminal diameter narrowing was 80 ± 14%. Thirty‐eight stenoses were AHA/ACC classification type A, 192 type B, and 98 type C. One hundred twenty‐eight lesions were located in the left anterior descending artery or its distribution, 89 in the left circumflex, 96 in the right coronary artery, and 15 in other vessels. Procedural success (<50% residual diameter narrowing and no major ischemic complications) was achieved in 266 lesions (81.1%). Major ischemic complications (death, myocardial infarction, or emergency bypass surgery) occurred in 8 patients (8.2%) and in‐hospital mortality was 2%. Analysis on a per stenosis basis demonstrated 84% success in type A, 89% in type B, and 64% in type C (p <0.0001). When type B was divided into type B1 (1 type B characteristic) and type B2 (two or more type B characteristics) the success rate was 90% vs. 88% and the complication rate was 1% vs. 2%, respectively (p = n.s.). Logistic regression analysis showed that the best single predictor of failed angioplasty was total occlusion >3 months, followed by total occlusion <3 months and severely angulated (>90°) segment. No clinical variables (age, sex, angina type, previous PTCA, or previous thrombolytic therapy) were predictive of adverse outcome. Thus, the standard ACC/AHA grading system does predict lesions at increased risk of adverse outcome in multivessel percutaneous coronary angioplasty; however, the use of only a few criteria open to less subjective interpretation would be simpler and more relevant to clinical use.
An unusual cause of recurrent angina two years after coronary artery bypass grafting: Fistula between internal mammary artery graft to pulmonary vasculature
Authors: Birnbaum Yochai , Wurzel Mordechai , Nili Moshe , Vidne Bernardo A. , Menkes Hanoch , Teplitsky Igal 
Published: March 2007

AbstractA 55‐year‐old man developed recurrent angina pectoris 2 years after coronary artery bypass grafting. Cardiac catheterization demonstrated that the venous grafts were patent, but selective left internal mammary angiogram showed multiple fistulous connections between the internal mammary artery and the pulmonary vasculature of the left upper lobe. After surgical correction of the fistula, the angina resolved. Only three previous cases of acquired internal mammary artery graft fistulas draining to the pulmonary vasculture have been described. The etiology, clinical presentation, and management of an internal mammary artery fistula to the pulmonary vasculature are discussed.
The perfusion pattern in coronary artery occlusion: Comparison of exercise and adenosine
Authors: Iskandrian Abdulmassih S. , Kegel Jeffrey , Heo Jaekyeong , Ogilby J. David , Untereker William J. , Cave Virginia 
Published: March 2007

AbstractThis study compared exercise to adenosine thallium‐201 single photon emission computed tomography in detecting occlusion of left anterior descending or right coronary arteries in patients with no previous myocardial infarction. There were 41 patients who underwent adenosine thallium imaging (adenosine infusion at a rate of 140 μg/kg/min for 6 min), and 143 patients who underwent exercise thallium imaging. There were more patients with right coronary than left anterior descending coronary artery occlusion. Thus, in the adenosine group, there were 15 patients with left anterior descending artery occlusion, and 26 with right coronary artery occlusion, and in the exercise group, there were 46 patients with left anterior descending artery occlusion, and 97 patients with right coronary artery occlusion. In the adenosine group, the thallium images were abnormal in 41 patients (100%), while in the exercise group, the thallium images were abnormal in 125 patients (87%, P < 0.02) in the territories of the occluded arteries. ST segment depression was noted in 19 patients (46%) in the adenosine group, and 69 patients (48%) in the exercise group (P: NS). In patients with isolated single vessel occlusion, the size of the perfusion abnormality was 28 ± 9% with adenosine, and 21 ± 12% with exercise (P: NS). Thus, most patients with occlusion of the left anterior descending or right coronary artery have regional perfusion abnormality during stress; the different role of collaterals with each type of stress may explain the higher percentage of abnormal results with adenosine than exercise.
Early postoperative occlusion of a left internal mammary artery bypass graft with subsequent restoration of patency
Authors: Feld Harry , Navarro Victor , Kleeman Harris , Shani Jacob 
Published: March 2007

AbstractTotal occlusion of a left internal mammary artery (LIMA) bypass graft is a rare complication, and reversal of a documented occlusion has not been reported. This is a case of an early postoperative occlusion of a LIMA graft that was found to be patent 4 months later.A patient with three vessel disease (including a moderate lesion in the proximal left anterior descending artery and a severe lesion in its mid‐portion) underwent coronary artery bypass grafting with a LIMA to the mid‐left anterior descending artery (LAD) and saphenous vein grafts to the right coronary and left circumflex arteries. Coronary angiography 3 months after surgery revealed a totally occluded internal mammary artery and saphenous vein grafts. The patient then underwent a successful angioplasty of the more distal lesion in the LAD. She subsequently returned with recurrent angina. Repeat coronary angiography revealed rapid progression of the disease in the proximal LAD with the more distal angioplasty site being widely patent. Selective arteriography of the internal mammary artery at that time revealed a patent vessel.Thus, the internal mammary graft is a physiologically active conduit that is dependent on flow dynamics. Competitive flow through the nonobstructive native LAD in combination with impedance of flow through the internal mammary artery due to a severe lesion in the LAD distal to the anastomosis led to a functionally occluded LIMA. When the obstruction in the proximal LAD progressed and the distal obstruction was successfully angioplastied, the flow dynamics in the internal mammary improved, allowing for its dilatation and restoration of patency. Therefore, an angiographically occluded internal mammary graft may be only functionally occluded and reversible even when the occlusion is demonstrated several days apart.
Parallel angioplasty dilatation catheter and guide wire: A new technique for the dilatation of calcified coronary arteries
Authors: Yazdanfar Shahriar , Ledley Gary S. , Alfieri Anthony , Strauss Clifford , Kotler Morris N. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) of heavily calcified rigid coronary arteries has decreased success and increased complication rates. Three cases are presented describing a new technique for the dilatation of severely calcified coronary arteries that were not dilatable by conventional angioplasty methods. This technique involves the use of a balloon dilatation catheter system parallel to a guide wire. © 1993 Wiley‐Liss, Inc.
Direct deployment of the iliofemoral balloon expandable (PalmazTM) stent utilizing a small (7.5 French) arterial puncture
Authors: Dorros Gerald , Mathiak Lynne 
Published: March 2007

AbstractA new, smaller (7.5F) stent delivery sheath system is described for deployment of the iliofemoral large balloon expandable (PalmazTM) stainless steel stent which allows a brachial or ipsilateral retrograde femoral or popliteal approach. The procedure described does not require predilatation of the lesion prior to stent deployment. © 1993 Wiley‐Liss, Inc.
Selective coronary angiography via antegrade venous route in congenital cyanotic heart disease
Authors: Loya Yunus S. , Pinto Robin J. , Desai Dhruman M. , Sundaram Usha , Bhagwat Ajit R. , Sharma Satyavan 
Published: March 2007

AbstractAn antegrade venous technique was utilised to perform selective coronary angiography in cyanotic infants and children. The procedure was successful in 88% (37/42) cases and excellent quality angiograms were recorded. The importance of proper catheter selection and details of the technique are discussed. © 1993 Wiley‐Liss, Inc.
Digital geometric measurements in comparison to cinefilm analysis of coronary artery dimensions
Authors: Haase JÜRgen , Nugteren Stineke K. , Swijndregt Eline Montauban Van , Slager Cornelis J. , Mario Carlo Di , De Feyter Pim J. , Serruys Patrick W. 
Published: March 2007

AbstractSix months follow‐up post‐PTCA angiograms from 31 patients were acquired digitally and on cinefilm and used for a comparison of geometric coronary measurements at the site of the previous dilatation. On 70 images of 34 coronary segments quantitative analysis was performed both on‐line, using the Automated Coronary Analysis package of the Philips Digital Cardiac Imaging System (DCI, pixel matrix 512 × 512) and off‐line, using the Cardiovascular Angiography Analysis System (CAAS). With the CAAS a cine‐video conversion is performed and a 6.9 × 6.9 mm region of interest from the 18 × 24 mm cineframe is digitized into a 512 × 512 pixel matrix. In both systems the vascular contours are assessed by means of operator‐independent edge detection algorithms. The angiographic catheter was used for calibration.Best agreement between DCI and CAAS was found for obstruction diameter and minimal luminal diameter, respectively (r = 0.82; y = 0.12 + 0.97x; SEE = 0.29). The reconstructed reference diameter related to a computed reference contour yields lower correlation (r = 0.76; y = 0.27 + 0.91x; SEE = 0.37). Worst results were obtained from the relative measure of percent diameter stenosis as well as from the derived parameter of plaque area.The on‐line digital approach of geometric coronary assessments provides good agreement with cinefilm analysis when direct measurements of coronary dimensions are applied. © 1993 Wiley‐Liss, Inc.
Superior accuracy of anatomic positioning with echocardiographic‐ over fluoroscopic‐guided endomyocardial biopsy
Authors: Bell Calvin A. , Kern Morton J. , Aguirre Frank V. , Donohue Thomas , Bach Richard , Wolford Thomas , Penick Danny , Ofili Elizabeth , Miller Leslie , Labovitz Arthur J. , Anthonis Dennis , Vrain Jan S. T. 
Published: March 2007

AbstractTo assess the superior anatomic positioning of echocardiographic‐guided endomyocardial biopsy compared to traditional fluoroscopic‐guided technique, these two modalities were compared in a blinded fashion during femoral sheath endomyocardial biopsy in 21 patients, 19 being evaluated after orthotopic cardiac transplantation. The simultaneous fluoroscopic and echocardiographic imaging indicated that traditional fluoroscopic positioning of the bioptome against the septum is inaccurate in over half of patients undergoing biopsy. This finding should be considered in cardiomyopathy patients or those at high risk for biopsy‐related complications. © 1993 Wiley‐Liss, Inc.
Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three‐dimensional reconstruction
Authors: Ennis Bruce M. , Zientek David M. , Ruggie Neal T. , Billhardt Roger A. , Klein Lloyd W. 
Published: March 2007

AbstractAneurysmal dilatations in saphenous vein grafts are rare complications of coronary artery bypass surgery that mostly represent thin‐wall pseudoaneurysms at anastomotic sites. We describe a case of an enlarging distal saphenous vein graft aneurysm in which intravascular ultrasound (IVUS) and computerized three‐dimensional reconstruction (3DR) of the IVUS images was performed to conclusively demonstrate true aneurysm morphology. Although both atherosclerotic and nonatherosclerotic mechanisms for vein graft aneurysm formation have been previously suggested, IVUS images and 3DR of the aneurysm in this case did not reveal any of the features typical for atherosclerotic lesions. Further, the IVUS images and 3DR suggest that progressive atherosclerosis is not the likely cause of aneurysm formation in this case. This application of IVUS and 3DR provides detailed information about saphenous vein graft aneurysm structure, clues to aneurysm formation, and suggests a natural history that may differ from that of pseudoaneurysms. © 1993 Wiley‐Liss, Inc.
Tetralogy of fallot in a 71‐year‐old patient with new onset hypoxemia
Authors: Nottestad Sheri Y. , Slife David M. , Rubal Bernard J. , Moody Joe M. 
Published: March 2007

AbstractThis study reports the evaluation and successful surgical management of a 71 year‐old female with known Tetralogy of Fallot and symptomatic hypoxemia. A hybrid (fluid‐micromanometer) catheter system was employed to examine right heart pressure gradients. This case presents unique hemodynamics along with angiography and palliative surgical management. © 1993 Wiley‐Liss, Inc.