bluuebunny/crossref_metadata_2025_split huggingface dataset:
High‐Frequency rotablation of occluded coronary artery during heart catheterization
Authors: Erbel R. , O'Neill W. , Auth D. , Haude N. , Nixdorf U. , Rupprecht H. J. , Dietz U. , Meyer J. 
Published: March 2007

AbstractHigh‐frequency rotation atherectomy of an occluded left circumflex coronary artery was performed in a 45‐year‐old man. Over a 0.009 inch flexible tip steel wire a diamond‐coated brass burr fasten to a flexible drive shaft that rotates and tracks was advanced. The drive shaft was connected to a turbine and driven by compressed air with 150,000 rpm. After rotablation of the posterior lateral branch over 3 cm with a 1.5 mm burr and rotablation with a 1.75 mm burr of the posterior branch of the left circumflex coronary artery the vessel was reopened with a smooth surface without perforation and dissection. 24 h control and 6 mo control revealed an open coronary vessel.High frequency rotating coronary angioplasty seems to be a promising alternative method to PTCA in opening totally occluded coronary arteries.
Percutaneous transluminal angioplasty of stenotic saphenous vein right coronary bypass grafts utilizing a peripheral balloon dilatation catheter without a guiding catheter
Authors: Arafah Mohammed , Aldridge Harold E. , Schwartz Leonard 
Published: March 2007

AbstractEffective angioplasty of stenosed saphenous vein coronary bypass grafts may be impossible with the standard‐size coronary dilatation catheters because the large diameter of these grafts results in unacceptable balloon‐to‐vessel ratios. We avoided this problem by using a peripheral arterial dilatation catheter with an inflation diameter of 6 mm and obtained a satisfactory short‐ and long‐term result in two patients in whom previous attempts with the largest coronary dilatation catheter (4 mm) had failed. This technique, which precludes the use of a guiding catheter, is suitable only for right bypass grafts.
Comparison of iced and room temperature injectate for thermodilution cardiac output
Authors: Bourdillon Patrick D. V. , Fineberg Naomi 
Published: March 2007

AbstractCardiac output estimation by thermodilution is carried out using room temperature or iced injectate, but the accuracy and variability of the two methods is not well documented. Room temperature and iced injectate were compared in 21 patients undergoing diagnostic cardiac catheterization. Dextrose injectate (10 ml) was administered in prefilled syringes left to stand either in iced water or in room air. Four injections were made sequentially with room temperature and iced injectate. Cardiac output by room temperature and iced injectate were not significantly different (4.70 ± 1.22 for room temperature and 4.90 ± 1.37 for iced injectate, n = 21, P = 0.155). There was a significant difference in the variance of the estimations by the two methods (room temperature = 0.296, iced = 0.120, P < 0.005). From this variance the calculated number of measurements needed to estimate cardiac output to ± 0.5 L/min with 95% confidence is seven for room temperature and four for iced injectate. For five patients with cardiac output < 4.00 L/min with room temperature injectate, cardiac output with iced injectate was significantly higher (3.33 ± 0.34 for room temperature vs. 3.69 ± 0.49 for iced injectate, P = 0.05). Thus room temperature injectate generally gives a satisfactory cardiac output estimation but with significantly greater variability than iced injectate. Sample size for accurate cardiac output estimation must be greater with room temperature injectate. Iced injectate may overestimate output when cardiac output is low.
Clinical experience with the use of the angled‐balloon dilatation catheter
Authors: Vivekaphirat Visuit , Zapala Catherine , Foschi Alberto E. 
Published: March 2007

AbstractA special balloon catheter has been developed for use in coronary angioplasty. The balloon portion has a 135°–145° angle at its mid portion. It is designed for stenosis located at an angle of the coronary artery.We investigated the use of this catheter in 39 patients who underwent percutaneous transluminal coronary angioplasty (PTCA): 29 men and 10 women. PTCA was attempted in 43 stenotic sites. Thirty‐two stenoses were located at the angled portion of the dilated arteries. Eleven stenoses were located at the side branches of the acutely angled bifurcations. Twenty stenoses were in the right coronary artery distribution. Twenty‐two stenoses were in the left coronary artery distribution. One stenosis was at the origin of the left internal mammary artery. Forty‐one stenoses were angioplastied successfully (95.4%). No angiographic evidence of intimal tear or dissection was noted in all of the dilated vessels. Acute closure was not observed. The mean follow‐up period was 239.5 days. Six patients (15.4%) were found to have restenosis. We conclude that the use of the angled‐balloon dilatation catheter provides the potential benefit of reducing intimal trauma and dissection during PTCA of certain coronary anatomies–stenosis at the angled portion or at the takeoff of the side branch of a bifurcation.
Analysis of aortic valve gradients by transseptal technique: Implications for noninvasive evaluation
Authors: Gordon John B. , Folland Edward D. 
Published: March 2007

AbstractThe peak instantaneous aortic valve gradient derived from Doppler echocardiography is commonly used to predict the severity of aortic stenosis. Peak instantaneous gradient should not be equated with the mean gradient or “peak to peak” gradient measured at cardiac catheterization. The primary purpose of this study is to assess the relationship between the aortic valve gradients, using a two‐catheter transseptal technique in 102 patients with aortic stenosis, mixed aortic stenosis and regurgitation, and following aortic valve replacement. These cases were drawn from a series of 111 consecutive transseptal procedures for patients with isolated aortic valve disease. No major complications occurred, and the most common reason for technical failure was inability to engage the atrial septum in postoperative patients.Although the peak instantaneous gradient correlates well with the mean gradient in aortic stenosis (r = .94, P < .001), mixed stenosis and regurgitation (r = .95, P < .001), and after aortic valve replacement (r = .86, P < .001), it systematically overestimates both the mean gradient and the peak to peak gradient. Neither the peak instantaneous nor the mean gradient correlates highly with aortic valve area in aortic stenosis (r = −.48, P < .01 peak; r = −.58, P < .001 mean gradient), mixed aortic stenosis and regurgitation (r = −.39, P NS peak; r = −.42, P NS mean gradient) or following aortic valve replacement (r = −.26, P NS peak; r = −.53, P < .01 mean gradient). Systolic time intervals also were analyzed from the simultaneous left ventricular and ascending aortic pressure tracings. The systolic ejection period, time to peak gradient, time to peak left ventricular pressure, and time to peak aortic pressure correlated poorly with aortic valve area.This study indicates that the mean gradient, which is consistently smaller than the peak instantaneous gradient, can be estimated by a simple regression formula: mean gradient = 0.70 peak instantaneous gradient. The mean gradient, which is usually less than the peak to peak gradient over 58 mm Hg and greater than the peak to peak gradient under 58 mm Hg, can be estimated by: mean gradient = 0.71 peak to peak gradient + 17 mm Hg. The limitations of isolated gradients in predicting aortic valve area indicate the importance of accurate flow measurements for optimal determination of the severity of aortic valve obstruction.
Myocardial infarction and sudden death after sport: Acute coronary angiographic findings
Authors: Ciampricotti Renzo , El Gamal Mamdouh I. H. , Bonnier Johannes J. , Relik Theodorus H. F. M. 
Published: March 2007

AbstractThirteen patients, seven with acute myocardial infarction and six survivors of sudden death after sport, underwent coronary angiography within a mean of 104 min after the onset of symptoms. The admission electrocardiogram showed transmural myocardial ischemia in all patients.The ischemia‐related vessel was occluded in all cases of sudden death and in three cases of acute myocardial infarction. Reperfusion was achieved in eight vessels: after intracoronary streptokinase in three, after intracoronary nitroglycerin in three, and mechanically in two. Coronary spasm was demonstrated in three vessels, and coronary thrombi, in four. The coronary lesion was described as either concentric in two or eccentric with irregular borders in eight. There was a high incidence of eccentric lesions consistent with ruptured plaques.The acute coronary angiographic findings of acute myocardial infarction and sudden death after sport are similar. Physical exercise can provoke myocardial infarction and sudden death probably by inducing plaque rupture that can evoke coronary spasm, thrombosis, or both.
Percutaneous aspiration of a thromboembolus
Authors: Dorros Gerald , Jamnadas Pradip , Lewin Ruben F. , Sachdev Naveen 
Published: March 2007

AbstractPercutaneous aspiration of a thromboembolus was successfully performed in 12 out of 13 patients with in situ thrombosis (4 patients), distal embolization (7 patients), or both (2 patients). The flow was improved from TIMI 0 (10 patients, no flow) or TIMI 1 (2 patients, impaired flow) to TIMI 3 (10 patients, normal flow) or TIMI 2 (2 patients, normal but slower flow). A custom‐made 8 F Teflon‐coated sheath was introduced in the superficial femoral and proximal below‐the‐knee arteries to aspirate the debris. Distal embolization in below‐the‐knee arteries was concomitantly treated with short‐term intraarterial Urokinase in nine patients. Complications included one in‐hospital (not procedure related) death, two patients with below‐the‐knee amputations (above‐the‐knee amputation averted), and one transmetatarsal amputation (prior established gangrene present and below‐the‐knee amputation avoided). The remaining nine patients left the hospital with improved limb status and peripheral pulses. This technique is a rapid, reliable, and efficient method to treat in‐situ clot or procedure‐related distal embolization as an adjuvant or complement to lytic treatment.
Effect of respiration on angiographic assessment of saphenous vein graft stenoses
Authors: Laramee Louise A. , Hartzler Geoffrey O. 
Published: March 2007

AbstractCoronary angiography in two patients, one 11 yr and the second 15 yr following coronary bypass surgery demonstrated striking focal decrease in vein graft diameter related to the inspiratory phase of the respiratory cycle. The pathophysiology, potential role of mechanical traction, and the clinical implications of this observation are discussed.
Improved method for transcatheter retrieval of intracoronary detached angioplasty guidewire segments
Authors: Serota Harvey , Deligonul Ubeydullah , Lew Brian , Kern Morton J. , Aguirre Frank , Vandormael Michel 
Published: March 2007

AbstractA transcatheter technique using a probing catheter and 0.014 wire to form a loop snare was used percutaneously to safely retrieve segments of retained guidewire fragments in mid‐ and distal coronary arteries in three patients.
Valve injury and repair in balloon aortic valvuloplasty
Authors: Farb Andrew , Moses Jeffrey W. , Wallerson Donald C. , Gold Jeffrey P. , Subramanian Valavanur A. 
Published: March 2007

AbstractAortic valves 0.5, 2.0, and 4.5 months after successful percutaneous balloon aortic valvuloplasty (BAV) were examined. BAV caused macroscopic and microscopic fractures in calcific deposits. An inflammatory response was identified that may lead to valvular scarring. This process may be an important factor in the development of restenosis after BAV.
False detection of left atrial thrombus by the angiographic sign of “neovascularity”
Authors: Chow Wing‐Hing , Tai Yau‐Ting , Cheung King‐Loong 
Published: March 2007

Abstract“Neovascularity” in the region of the left atrial appendage was demonstrated by coronary arteriography preoperatively in five patients with mitral valve disease and was attributed to the presence of thrombus in the left atrium. Subsequently, they underwent surgery, but thorough inspection of the left atrium did not reveal thrombus in any of the five patients. The presence of neovascularity without apparent thrombosis or false detection may be a result of tissue reaction and organization in an effort to resorb the thrombus.
Sequential multivessel coronary angioplasty assessed by thallium‐201 tomography
Authors: DePuey E. Gordon , Roubin Gary S. , Depasquale Eugene E. , Nody Agatha C. , Garcia Ernest V. , King Spencer B. , Berger Harvey J. 
Published: March 2007

AbstractIn 11 patients with multivessel coronary artery disease, SPECT thallium‐201 imaging was performed prior to and within 3 days after each of two sequential percutaneous transluminal coronary angioplasties on separate days designed to achieve total revascularization. Thallium‐201 SPECT was analyzed quantitatively, and an ischemic score for the vascular bed(s) supplied by the dilated vessel(s) was derived.For the vessels dilated during the first procedure the mean diameter stenosis was 80 ± 8%, reduced to 27 ± 9%. For the second procedure mean stenosis was reduced from 67 ± 10% to 26 ± 6%. For the two procedures, the mean thallium scores decreased from 298 ± 225 to 115 ± 130 (P < .001) and from 135 ± 129 to 46 ± 60 (P < .001), respectively. Of 10 patients with abnormal thallium‐201 SPECT prior to angioplasty, nine improved after the first procedure, and seven improved further following the second procedure.Thus, utilizing staged angioplasty with a strategy of dilating the most severe lesion first, thallium‐201 SPECT documented progressive improvement in myocardial perfusion.
A randomized trial of corticosteroids for the prevention of restenosis in 102 patients undergoing repeat coronary angioplasty
Authors: Stone Gregg W. , Rutherford Barry D. , McConahay David R. , Johnson Warren L. , Giorgi Lee V. , Ligon Robert W. , Hartzler Geoffrey O. 
Published: March 2007

AbstractTo examine the effect of corticosteroid therapy on the development of restenosis following successful percutaneous transluminal coronary angioplasty (PTCA), we randomized 102 patients with restenosis following prior PTCA to receive high‐dose steroids (n = 52) or no steroids (n = 50). The steroid regimen consisted of 125 mg methylprednisolone I.M. the night before and morning of the PTCA, and prednisone 60 mg p.o. Q.D. for 1 week post‐PTCA.Angiographic follow‐up at 6 months was available in 27 steroid‐treated patients (52%) and 27 controls (54%). The per lesion incidence of restenosis was similar in the two groups (36% vs. 40%, respectively, P = NS). Clinical follow‐up was available in the remaining patients at a mean interval of 1.2 years. The clinical correlates of restenosis (incidence and severity of angina, positive treadmill exercise test, nonfatal infarction or death) were similar in the steroid treated and control groups (24% vs. 39%, respectively, P = .56). At late follow‐up, 30 steroid‐treated patients (58%) and 26 control patients (52%) had no clinical or angiographic evidence of restenosis (P = NS).In conclusion, a short course of high‐dose corticosteroid therapy does not significantly reduce the frequency of restenosis following PTCA.
Case of spontaneous healing of occlusive dissection on percutaneous transluminal coronary angioplasty
Authors: Takatsu Fumimaro , Kinoshita Atsushi 
Published: March 2007

AbstractA large pseudolumen due to dissection arose during percutaneous coronary angioplasty. The true lumen was compressed critically. However, no infarction took place because of good collaterals. During medical follow‐up, the patient's angina vanished suddenly. The repeat angiography showed healing of the dissection and patency of the coronary artery.
Intracoronary electrocardiogram during torsade des pointes secondary to intracoronary papaverine
Authors: Jain Avanindra , Jenkins Mark G. 
Published: March 2007

AbstractPapaverine, a potent coronary vasodilator, is now commonly used to measure coronary reserve. We recorded intracoronary etectrogram in a patient who developed Torsade des pointes after 10 mg of papaverine. This was associated with marked prolongation of the QT interval. The ventricular tachycardia self‐terminated with shortening of the QT interval. We believe that although papaverine is a good agent because of its short duration of action, it must be used cautiously because of its effects on repolarization, which can result in arrhythmias.
Percutaneous transluminal coronary angioplasty: A review of current balloon dilatation systems
Authors: Avedissian Michael G. , Killeavy Eugene S. , Garcia Jose M. , Dear Wayne E. 
Published: March 2007

AbstractThe interventional cardiologist is faced with an expanding armamentarium for performing percutaneous transluminal coronary angioplasty (PTCA). Because of rapid advances in technology, new devices are produced on a regular basis, making it difficult to maintain a working knowledge of what is available. Although several excellent textbooks about PTCA have been written, descriptions of available equipment are usually obsolete by the time publication occurs. In order to provide succinct specifications of equipment, we have documented data on balloon catheters, guiding catheters, and guidewires. This information may be useful in the selection of appropriate equipment for PTCA procedures. In addition, the publication of such data in a monthly periodical may provide a more current overview of equipment; information may be occasionally updated as new equipment is released.
Coronary angioplasty–unstable lesions and prolonged balloon inflation time
Authors: Arie Siguemituzo , Checchi Hedy , Coelho Wilson M. C. , Bellotti Giovanni , Pileggi Fulvio 
Published: March 2007

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.
Cine angiographic findings in young Iraqi men with first acute myocardial infarction
Authors: Al‐Koubaisyl Omar K. , Mehdi Ryiad S. , Arem Falah D. , Ahmed Ibrahim Taha 
Published: March 2007

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 infarction.
Assessment of the “long sheath” technique for percutaneous aortic balloon valvuloplasty
Authors: Plante Sylvain , Beatt Kevin J. , van den Brand Marcel , Di Mario Carlo , Meier Bernhard , Serruys Patrick W. 
Published: March 2007

AbstractA 100 cm‐long 16.5 F valvuloplasty catheter introducer was assessed as an adjunct for percutaneous transluminal aortic valvuloplasty (PTAV) via the femoral artery in 31 patients with severe aortic stenosis. Observed improvements in peak systolic gradient (81.6 ± 29.9 mm Hg vs. 35.5 ± 16.0 mm Hg, P < 0.000001) and aortic valve area (0.6 ± 0.4 cm2 vs. 1.0 ± 0.6 cm2, P < 0.00001) were similar to those achieved in a control group (C) of 17 patients in which no femoral sheath was used. However, a shorter procedure duration (211 ± 81 min vs. 117 ± 30 min, P < 0.001) and a reduced rate of vascular complications at the femoral puncture site (41% vs. 6.5%) were observed in patients in whom the long sheath (LS) technique was used. The frequency of other PTAV‐related complications was comparable (C = 35%, LS = 29%, P = n.s.).Other technical advantages of this device are: 1) prevention of looping and bending of the balloon catheter in tortuous vessels and easy positioning of the balloon across the aortic orifice provided by the LS trackability, 2) stabilisation of the balloon during inflation, 3) monitoring of supravalvular aortic pressure provided by the side‐arm of the LS and reliable measurement of systolic gradient, and 4) the ability to perform aortograms without the need of another catheter in the ascending aorta. Thus, in our experience, the long sheath technique is a valuable adjunct for PTAV.
Below‐the‐knee angioplasty: Tibioperoneal vessels, the acute outcome
Authors: Dorros Gerald , Lewin Ruben F. , Jamnadas Pradip , Mathiak Lynne M. 
Published: March 2007

AbstractConventional balloon angioplasty (PTA) was attempted in 111 patients (60% male; mean age 67≥9 years) with 168 below‐the‐knee, tibioperoneal vessels (TPV) lesions. The presenting predominant symptoms were claudication in 52 (47%), non‐healing ulcer/gangrene in 30 (27%), and rest pain in 29 (26%) of patients. An above‐the‐knee vessel was dilated before TPV angioplasty in 62 patients (56%). A successful PTA was achieved in 152/168 (90%)TPV: stenoses, 124/125 (99%); occlusions, 28/43 (65%). Complications encountered included contrast‐induced renal failure (4%), distal embolization (4%), entry site arterial repair or embolectomy (2%), dissection or occlusion (2%), and groin hematoma (2%). A significant complication (death, emergency bypass surgery, or distal embolization) occurred in only 3 patients (3%); no complications whatsoever were found in 100 patients (90%). At discharge, 106 patients (95%) were clinically improved. A restenosis and/or second PTA procedure occurred in 44/108 patients (40%) (mean time: 9≥6 months) with the presenting predominant symptom being claudication in 38 patients (86%). However, only 36% of patients had lesion recurrence with or without new disease, and 64% showed evidence of disease progression with symptoms. Angiographic and clinical success was achieved in 42 patients undergoing second PTA (96%). These data indicate that balloon angioplasty can be successfully utilized in patients with symptomatic obliterative disease of the tibioperoneal vessels with excellent success, a low risk of complications, and good clinical improvement. PTA of the below‐knee vessels should not be restricted to patients in limb salvage situations.