bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous extraction of fractured guidewire from distal right coronary artery
Authors: Savas Vicky , Schreiber Theodore , O'Neill William 
Published: March 2007

AbstractThe incidence of retained hardware components in the coronary artery tree is likely to parallel the growing number and types of percutaneous coronary revascularization procedures being performed. Management has extended from the conservative option of simply leaving behind the retained components to the more aggressive approach of surgical removal. A percutaneous method is described herein which offers the interventional cardiologist an alternative method of managing patients with retained wire fragments contained entirely in the coronary artery.
Treatment of congenital coronary arteriovenous malformations with micro‐particle embolization
Authors: Strunk Brian L. , Hieshima Grant B. , Shafton Eugene P. 
Published: March 2007

AbstractThe successful treatment of a symptomatic coronary arteriovenous malformation (CAVM) by a percutaneous embolization technique with micro‐particles is described. Objective evidence of ischemia and its subsequent disappearance after embolization is presented. The embolization technique and possible indications and contraindications are discussed.
Transseptal catheterization technique: A simple safety procedure
Authors: Bloomfield Dennis A. 
Published: March 2007

AbstractThe major complication of transseptal catheterization, that of inadvertent perforation of other structures, can best be avoided by maintenance of the correct needle tip position during introduction and maneuvering of the assembly. The addition of a needle‐stop to the transseptal needle shaft and a sterile ruler to check its preset position assures the maintenance of the needle tip position, freeing the operator's concern for accurate location of landmarks.The method of utilizing and setting the needle‐stop is described.
Angioplasty of coronary bifurcation stenoses: Immediate and long‐term results of the protecting branch technique
Authors: Renkin Jean , Wijns William , Hanet Claude , Michel Xavier , Cosyns Jacques , Col Jacques 
Published: March 2007

AbstractPercutaneous transluminal angioplasty (PTCA) of coronary stenoses involving major bifurcations carries a small but significant risk of side branch occlusion which can be avoided by simultaneously using multiple dilatation systems. Among 1,275 PTCA procedures performed between 1984 and 1988 in 1,035 consecutive patients, 42 double wire procedures were applied (4%) to protect and/or dilate major coronary side branches. A total of 80 coronary stenoses were attempted of which 76 were located on a bifurcation and 4 on other segments. In the first 11 patients (group A), 2 guiding catheters were used and PTCA of each vessel was successfully performed by means of separate double lumen over‐the‐wire balloon catheters. In the next 31 patients (group B), 2 guidewires were advanced through a single guiding catheter and PTCA was attempted using “Monorail” balloon catheters sequentially advanced over the wires. In group B, a successful PTCA was obtained in 29 patients (93%) but twisting of the wires hampered balloon progression in 5 cases, such that dilatation could only be performed by stepping back to a single wire technique. The procedure time in group B was significantly shorter than in group A: 144 ± 30 versus 230 ± 52 minutes (p = .01).Repeat angiography was performed in 35 out of 40 patients (87%) after a mean of 180 ± 46 days following successful PTCA. Angiographic restenosis was present in 37% (24/65) of bifurcation segments which, in our experience, is not significantly different from the angiographic restenosis rate in less complex lesions (248/740; 34%; NS).It is concluded that 1) the need for using a protecting branch technique in PTCA practice is uncommon (4%); 2) among other approaches, the use of a “Monorail” system allows successful dilatation in 93% of cases with a shortened procedure time; 3) the restenosis rate at repeat angiography is similar to that of non‐bifurcated lesions.
Ptca of gastroepiploic bypass
Authors: Watson Linley E. , Schoolar E. 
Published: March 2007

AbstractA technique for percutaneous transluminal coronary angioplasty (PTCA) of gastroepiploic bypass is described using standard PTCA devices. Severe spasm of gastroepiploic bypass occurred. Modification of guide catheter position is suggested to avoid inducing gastroepiploic bypass spasm.
Dual purpose computer aided program for cardiac catheterization laboratory data management
Authors: Weaver Walt F. , Costello Donald F. 
Published: March 2007

AbstractThis communication describes the design criteria used in the early systems analysis activity of the cardiac laboratory. This analysis activity required an understanding of the cardiology laboratory environment, the establishment of needs to be answered by the program, and the goals of the entire system. The rationale for inclusion of various cardiologic, demographic, quality assurance, and personnel safety parameters is discussed. The input forms used, the database structure created, and the information provided by an applications system are described. Since the system is built around a general‐purpose computer (the IBM PC™ or compatible) and widely available powerful general purpose software, the entire system may be used for many other cardiology laboratory data management tasks.
Choice of contrast agents for cardiac angiography: Review and recommendations based on clinically important distinctions
Authors: Matthai William H. , Hirshfeld John W. 
Published: March 2007

AbstractLow osmolal contrast agents (LOCA) are measurably superior to high osmolal contrast agents (HOCA) in a number of properties. However, LOCA are substantially more expensive than HOCA, and universal use of LOCA for cardiac angiography would strain the health care budget. Therefore, the choice to use LOCA in place of HOCA should be based on clinically important differences. Review of available published data suggests that HOCA can be used safely and effectively for cardiac angiography in patients with mild or moderately severe heart disease. When HOCA are used, those that do not bind calcium should be chosen as they cause fewer clinically important adverse reactions than those that do bind calcium. Use of LOCA may offer added safety in high risk patients, although to date, this conclusion has not been proved with clinical experience. Nonionic LOCA may be safer to use than ionic LOCA.
Balloon diameter of the inoue balloon catheter during percutaneous transvenous mitral commissurotomy: Clinical and experimental study
Authors: Nagata Seiki , Ishikura Fuminobu , Yamabe Takashi , Akaike Masashi , Kimura Kohji , Miyatake Kunio 
Published: March 2007

AbstractTo determine adequate and effective balloon diameters of the Inoue balloon catheter, we reviewed clinical results and characteristics of the Inoue balloon catheter, especially the relationship between the intra‐balloon pressure and the balloon diameter, experimentally and clinically, in 46 patients with mitral stenosis undergoing percutaneous transvenous mitral commissurotomy (PTMC). Mitral valve area increased from 1.1 ± 0.3 to 2.1 ± 0.3 cm2 in all patients after PTMC. Based on balloon diameter settings, mitral valve area increased from 1.3±0.4 to 2.3±0.5 cm2 in patients treated with a balloon setting greater than 26 mm in diameter, from 1.1 ±0.3 to 2.0±0.5 cm2 in patients with a balloon setting at 26 mm in diameter, and from 1.1±0.4 to 1.7±0.4 cm2 in those treated with a balloon setting less than 26 mm in diameter, with an increase in mitral valve area of 1.0±0.6, 0.9±0.4, and 0.7±0.2 cm2, respectively. There was a significant difference between the increase in mitral valve area at a setting of 26 mm in diameter and that observed at a setting less than 26 mm in diameter. We next investigated differences between balloon diameter settings and actual balloon diameters measured from cineangiograms at maximum balloon inflation. The ratio of actual balloon diameter to a setting diameter of less than 26 mm was smaller than that of 26 mm. To evaluate the reason for the difference, we investigated the relationship between intra‐balloon pressure and balloon diameter. In the prototype Inoue balloon catheter, intra‐balloon pressure increases from 1.0 kg/cm2 at 20 mm in diameter to 2.2 kg/cm2 at 30 mm in diameter at atmospheric pressure. In conclusion, the increase in mitral valve area was inadequate when the balloon was less than 26 mm in diameter because of inadequate intra‐balloon pressure. We, therefore, recommend a balloon size set above 26 mm to obtain adequate intra‐balloon pressure when using the Inoue balloon catheter.
Proximal rupture and intracoronary entrapment of a rotating device during low‐speed rotational coronary angioplasty
Authors: Juilliere Yves , Danchin Nicolas , Amrein Daniele , Suty‐Selton Christine , Cherrier Francois 
Published: March 2007

AbstractWhile attempting to recanalize a right coronary artery obstruction by using a low‐speed rotating catheter (Rotacs), proximal rupture of the catheter body occurred with entrapment of the blunt tip in the obstruction. To retrieve the device, it was necessary to sever the guiding catheter and the flexible tube of the Rotacs. At low‐speed rotation the flexible segment of the catheter was then pulled back.
Multivessel ptca using the hugging balloon technique based on single guide catheter and dual balloon‐on‐a‐wire systems
Authors: Yoshida Satoru , Yabe Yoshimasa , Nakano Hajime , Muramatsu Toshiya , Noike Hirofumi 
Published: March 2007

AbstractFor percutaneous transluminal coronary angioplasty (PTCA) of oversized arteries, oftentimes a satisfactory dilatation cannot be achieved with conventional balloon systems due to the unavailability of adequately sized balloons. This fact has contributed to a higher restenosis rate for this group of patients. We were able to obtain a satisfactory dilatation result in an oversized right coronary artery with a shepherd's crook configuration and eccentric anatomy at the origin using two balloon‐on‐a‐wire systems and an Amplatz type guiding catheter. Although such favorable dilatation of an oversized artery using this „hugging balloon technique'' can be expected, issues do exist such as difficult maneuverability and estimation of the balloon size obtained through simultaneous dual balloon inflation wherein size does not simply equal the sum of the two balloon catheters. It is hoped that there will be further improvements of the technique and development of new systems. At this time, however, it is felt that this is the most effective and reasonable strategy to achieve a high chance of success in oversized vessel lesions.
A new technique for sheathless percutaneous intraaortic balloon catheter insertion
Authors: Nash Ira S. , Lorell Beverly H. , Fishman Robert F. , Baim Donald S. , Donahue Colleen , Diver Daniel J. 
Published: March 2007

AbstractIntraaortic balloon counterpulsation is helpful for controlling myocardial ischemia and providing hemodynamic support, but its applicability is limited by lower extremity ischemic complications in a significant percentage of patients. We developed a new sheathless technique for percutaneous intraaortic balloon catheter insertion which reduces the effective catheter diameter. A pilot study using this new technique resulted in a 10% rate of limb ischemia, without compromise of balloon function. We conclude that this technique may be useful in reducing the incidence of limb ischemia associated with intraaortic balloon counterpulsation.
Angioplasty of long or tandem coronary artery lesions using a new longer balloon dilatation catheter: A comparative study
Authors: Brymer James F. , Khaja Fareed , Kraft Phillip L. 
Published: March 2007

AbstractTo determine whether or not a new 3 cm long angioplasty balloon was more effective in treatment of long (15–25 mm) or tandem (< 25 mm overall length) coronary lesions, 44 consecutive patients with suitable lesions were alternately assigned to treatment with shorter, standard, 2 cm length, or long, 3 cm balloons. Primary success of PTCA was achieved in 95%. Those treated with long balloons required fewer inflations (3.3 ± 1.5 vs. 5.7 ± 2.1, P=0001) and showed fewer moderate or severe intimal dissections of the lesions (4/22 vs. 12/22, p =.028.) The use of 3cm PTCA balloons in long or tandem lesions appears to be efficacious and less likely to cause dissections than shorter, 2 cm length devices.
Reduction in injection pain using buffered lidocaine as a local anesthetic before cardiac catheterization
Authors: Sapin Peter , Petrozzi Regina , Dehmer Gregory J. 
Published: March 2007

AbstractPrevious reports have suggested that pain associated with the injection of lidocaine is related to the acidic pH of the solution. To determine if the addition of a buffering solution to adjust the pH of lidocaine into the physiologic range would reduce pain during injection, we performed a blinded randomized study in patients undergoing cardiac catheterization. Twenty patients were asked to quantify the severity of pain after receiving standard lidocaine in one femoral area and buffered lidocaine in the opposite femoral area. The mean pain score for buffered lidocaine was significantly lower than the mean score for standard lidocaine (2.7 ± 1.9 vs. 3.8 ± 2.2, P=0.03). The pH adjustment of standard lidocaine can be accomplished easily in the catheterization laboratory before injection and results in a reduction of the pain occuring during the infiltration of tissues.
Accordion right coronary artery: An unusual complication of ptca guidewire entrapment
Authors: Deligonul Ubeydullah , Tatineni Satyanarayana , Johnson Randy , Kern Morton J. 
Published: March 2007

AbstractThe contour of the epicardial coronary vessels may change considerably during coronary angioplasty. We report the extreme and unique „accordion‐like”︁ wrinkling of the mid right coronary artery as a result of distal guidewire entrapment during coronary angioplasty. Recognition of this artifact and its treatment may prevent further complications of coronary angioplasty.
Subacute bilateral coronary ostial stenoses following cardiac catheterization and ptca
Authors: Wilson Vance E. , Bates Eric R. 
Published: March 2007

AbstractAccelerated coronary ostial stenosis is an infrequent late complication of coronary artery catheter instrumentation during aortic valve surgery, PTCA, or coronary angiography. We report the first case of bilateral coronary artery ostial stenoses developing after cardiac catheterization and right coronary artery PTCA. In patients with worsening angina following cardiac catheterization or PTCA, accelerated ostial stenoses should not be overlooked in the differential diagnosis.
Lack of evidence for small vessel disease in a patient with „slow dye progression”︁ in the coronary arteries
Authors: Van Lierde Johan , Vrolix Matty , Sionis Dimitris , De Geest Hilaire , Piessens Jan 
Published: March 2007

AbstractA patient with chest pain of recent onset, suggestive for angina pectoris, was referred for diagnostic coronary angiography, which showed the typical phenomenon of „slow dye progression”︁ in the absence of any significant coronary artery stenosis. While intracoronary Doppler measurements confirmed the extremely slow blood flow velocity, the coronary flow reserve and the calculated coronary blood flow proved to be within normal range.The present findings suggest that, in contrast with a previous hypothesis, the phenomenon of slow dye progression may not always be due to a microvascular cause. Epicardial artery disease, as suggested by the marked coronary artery ectasia, may be linked to the slow dye progression and predispose to coronary artery thrombosis.
Coronary artery narrowing due to extrinsic compression by myocardial abscess
Authors: Wickline Cindy L. , Goli Vasu D. , Buell James C. 
Published: March 2007

AbstractA case of aortic valve endocarditis complicated by perivalvular abscess extending into myocardium is presented. Echocardiography and aortography failed to detect the abscess, but coronary angiography revealed its presence by extrinsic compression of left anterior descending and diagonal arteries. Morphological features of this rare cause for coronary narrowing are described.
Successful angioplasty of a chronically occluded saphenous vein graft using a prolonged urokinase infusion from the brachial route
Authors: Doorey Andrew J. , Rosenbloom Mark A. , Zolnick Mark R. 
Published: March 2007

AbstractA 68‐year‐old man who presented with unstable angina had had cardiac bypass surgery 12 years earlier and successful angioplasty of a native circumflex lesion 18 months previously. Repeat catheterization showed a widely patent angioplasty site but interval closure of a saphenous vein graft to a large marginal branch that was totally occluded proximally. A stress test revealed significant myocardial ischemia. Severe peripheral vascular disease with known bilateral iliac artery occlusions mandated a brachial approach. Because of his high risk for repeat cardiac surgery, it was elected to attempt saphenous graft angioplasty following a prolonged urokinase infusion. After an infusion of urokinase for 36 hr, antegrade flow was restored and angioplasty was carried out successfully on a discrete mid‐graft legion. Subsequent stress testing showed resolution of the ischemia. There were no vascular complications.
Multiple coronary artery‐left ventricular fistulae: Clinical, angiographic, and pathologic findings
Authors: Black Mbbs Ian W. , Loo Mbbs Christine K. C. , Allan Mbbs Roger M. 
Published: March 2007

AbstractMultiple fistulae between all 3 major coronary arteries and the left ventricle were found at cardiac catheterization in a 69‐year‐old woman presenting with typical angina. Subsequent necropsy showed abnormal intramyocardial vessels communicating with the left ventricular lumen. This is the first report to document clinical, angiographic, and pathologic findings in this anomaly.
Clinical factors affecting the immediate outcome of ptca in patients with unstable angina and poor candidates for surgery
Authors: Colle Jean‐Pierre , Delarche Nicolas 
Published: March 2007

AbstractPercutaneous Transluminal Coronary Angioplasty (PTCA) has been successfully applied in unstable angina to carefully selected patients. In this study, PTCA was performed in 277 consecutive patients suffering from unstable angina and for whom bypass surgery was not a valid alternative because either of inoperable conditions or of emergency, or because surgery was not the best option. All patients were admitted first to the intensive care unit where an attempt was made to control unstable angina under conventional medical therapy using at least iv nitroderivative, heparin, and calcium blockers. After a standardized preparation PTCA was performed either as an emergency procedure in medically refractory unstable angina (107 cases) or as an elective procedure in controlled situations after a 7 to 10 days symptom‐free period. Three hundred fifty‐three coronary vessels were attempted.Results of this group are compared with those of a control group made of 670 consecutive stable patients recruited during the same period, and clinical characteristics are envisaged as potential predictive factors. Unstable angina is undoubtedly associated with a higher overall complication rate, but the immediate outcome is strongly affected by the clinical context. As an example, respective success and mortality rates are: 93% and 0% when a full revascularization is attempted; 91% and 0% in elective procedures in patients under 60; 87% and 1.2% in elective PTCA for multiple vessel disease; 80% and 6.5% in emergency PTCA; 80% and 11% in the overall triple vessel disease; 84% and 16% in patients with deeply altered ejection fraction; and 58% and 26% in triple vessel disease with 2 previously occluded coronary arteries. Mortality rate can reach as high as 33% in life saving procedures engaged for cardiogenic shock or single patent vessels. Multiple clinical factors are powerful predictive factors, isolated or associated, and they must be taken into account when weighing the risks before any decision to treat.
Protamine allergy reactions during cardiac catheterization and cardiac surgery: Risk in patients taking protamine‐insulin preparations
Authors: Vincent G. Michael , Janowski Mauro , Menlove Ronald 
Published: March 2007

AbstractProtamine insulin use may immunologically sensitize patients to protamine, leading to anaphylactoid reactions upon subsequent exposure to protamine sulfate during cardiac catheterization or cardiovascular surgery. The risk of such reactions in protamine insulin‐dependent patients is uncertain. One catheterization study reported a 50‐fold greater risk while a second showed no increased risk! To clarify the risk, the records of 7,750 cardiac catheterization procedures between 1984 and 1987 were analyzed for presence of NPH or PZI insulin use, protamine administration, and any complications or adverse reactions. Protamine was administered in 3,341/7,750 procedures (43%), including 171 in diabetics receiving NPH insulin. Adverse reactions to protamine occurred in 2/3,170 noninsulin patients, 0.06%, and adverse reactions due to probable NPH insulin sensitization occurred in 1/171,0.6%, of NPH diabetics, p =.034. Meta‐analysis of risk showed an odds ratio of 7.96 for the NPH diabetic patients, and combining these results with the other large series in the literature (269 NPH diabetics total) showed an odds ratio of 4.19 compared to a non‐NPH insulin group. Meta‐analysis of the surgical literature showed the risk in surgical patients to be 2.1% in NPH patients versus 0.12% with no NPH, with an odds ratio of 15.52. The greater incidence in surgical patients may be due to protamine sensitization at prior catheterization and to the larger dose of protamine administered to surgical patients.
Dislodgement of a vein graft thrombus by angiographic injection of native coronary artery
Authors: Evans Bradley H. , Schapira Jay N. , Eigler Neal L. 
Published: March 2007

AbstractA case of retrograde dislodgement of thrombus in a saphenous vein graft during injection of the native right coronary artery is presented. Attention to this previously undescribed complication may allow for timely treatment with emergency surgery or thrombolysis.
Holmium laser angioplasty after failed coronary balloon dilation: Use of a new solid‐state, infrared laser system
Authors: Heuser Richard R. , Mehta Stephen S. 
Published: March 2007

AbstractA new solid‐state laser system was used in a case of saphenous vein graft occlusion untreatable by standard very low‐profile balloon angioplasty. The 2100 nm infrared pulsed thulium/holmium:YAG laser successfully recanalized an obtuse marginal bypass graft without complications. The holmium laser has several advantages over excimer systems and may prove an effective adjunct or alternative to coronary balloon angioplasty.
Total occlusion of the circumflex artery with collateral supply from the conus artery
Authors: Mishkel Gregory J. , Biagioni Eugene , Stolberg Harold 
Published: March 2007

AbstractThe conus artery has long been recognized as an important source of collateral blood supply to a significantly diseased left anterior descending artery. This artery which arises 50% of the time from a separate orifice in the right sinus of Valsalva may also provide collateral circulation to a diseased right coronary artery. To date, there have been no reported instances of the conus artery supplying collateral flow to a totally occluded circumflex artery. In this report we describe such a case in a patient with severe three vessel disease. The implications of such a finding in patient management are also discussed.