bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ticlopidine and subcutaneous heparin as an alternative regimen following coronary stenting
Authors: Barragan P. , Sainsous J. , Silvestri M. , Bouvier J. L. , Comet B. , Siméoni J. B. , Charmasson C. , Bremondy M. 
Published: March 2007

AbstractSubacute thrombosis of coronary stents may occur up to the end of the first month after their implantation and remains the major problem associated with the technique. A cohort of 238 patients with placement of one or more stents in 244 arteries was monitored for this period. All patients were given 500 mg/day of ticlopidine (started 3 days before) and a push dose of 10,000 IU of heparin during the procedure, then 1,000–1,500 IU/hr for 20 hr. Following removal of the arterial introducer, they were kept on subcutaneous heparin for 1 week and ticlopidine (500 mg/day) for 3–6 months. Nine patients (3.8%) showed evidence of thrombosis at 7 days. The overall thrombosis rate at 30 days was 4.2% (3.5% for elective stents, as compared with 7.9% associated with occlusive dissections). Emergency treatment by further angioplasty (8 cases) and intracoronary thrombolysis (5 cases) was undertaken. Complications were as follows: 5 deaths (2%), 3 Ml (1.2%), 2 non‐Q Ml (1.7%). Three predictive factors for subacute thrombosis were identified: age <70 (p = 0.00006), unstable angina (p = 0.006) and arterial diameter less than 3 mm (p = 0.043). The peripheral vascular complication rate was 4.6%. This study suggests that preventive treatment with ticlopidine appears to reduce the incidence of sub‐acute thrombosis of stents in patients >70 years of age. Furthermore, the combination of ticlopidine and heparin facilitates laboratory monitoring after stenting. Stenting is thought to represent definitive treatment in situations where placement for occlusive dissection is the indication. © 1994 Wiley‐Liss,Inc..
Stenting the distal anastomotic site of the left internal mammary artery graft: a case report
Authors: Hadjimiltiades Stavros , Gourassas John , Louridas George , Tsifodimos Dimitrios 
Published: March 2007

AbstractThe major problem associated with the long‐term patency of the internal mammary artery graft is the early occurrence of stenosis usually at its distal anastomotic site; its management by balloon angioplasty has been associated with a high success rate. We report the case of an unsuccessful balloon angioplasty of an anastomotic stenosis of a left internal mammary artery graft that was successfully managed by stenting with one‐half of a Palmaz‐Schatz stent. © 1994 Wiley‐Liss,Inc..
Self‐Expandable nitinol stent for cardiovascular applications: canine and human experience
Authors: Beyar Rafael , Shofti Rona , Grenedier Ehud , Henry Michel , Globerman Oren , Beyar Mordechai 
Published: March 2007

AbstractThe initial experimental and clinical experience with the cardiovascular self‐expandable Nitinol stent (vascular and coronary versions) is described. The stent is designed as a helical coil with two terminal balls that are used for restraining it on the delivery catheter. Upon release, the stent self‐expands immediately. A temporary stent version continues with a long wire that can be removed by pulling it as a straight wire through a small profile catheter. The stent uncoils in its own groove upon removal, a relatively atraumatic procedure. The stents have been studied in dogs and in peripheral arteries in patients. The results show a transient nonocclusive proliferative response to the stent that is maximal at 3–6 mo. The removability of the permanent stent has been proven in dogs. The preliminary results in patients are encouraging and demonstrate its feasibility for permanent and potentially temporary arterial support. © 1994 Wiley‐Liss,Inc..
Angiographic evaluation of a carotid‐subclavian bypass graft in a patient with subclavian artery stenosis and left internal mammary artery bypass graft
Authors: Rossum Alfred C. , Weinstein Eric , Holland Matthew 
Published: March 2007

AbstractThe incidence of coronary subclavian steal syndrome is estimated to be 0.4%. When revascularization is necessary, the preferred technique is the carotid‐subclavian bypass graft. Failure of a carotid‐subclavian graft is rare. We present a patient with subclavian stenosis who required reevaluation of both the carotid subclavian conduit and the left internal mammary bypass graft. A combined femoral and left brachial approach is recommended for evaluating the carotid‐subclavian graft and left internal mammary artery graft in patients with bypassed subclavian artery stenosis and prior myocardial revascularization. © 1994 Wiley‐Liss,Inc..
A dual‐purpose angioplasty‐drug infusion catheter for the treatment of intragraft thrombus
Authors: Hong Mun K. , Wong S. Chiu , Popma Jeffrey J. , Kent Kenneth M. , Pichard Augusto D. , Satler Lowell F. , Mintz Gary S. , Nikonow Karen , Leon Martin B. 
Published: March 2007

AbstractAn investigational angioplasty‐drug infusion catheter (Transport, CardioVascular Dynamics, Irvine, CA) was used to treat a saphenous vein graft stenosis associated with a thrombus. The catheter was successfully used both to infuse urokinase at the site of angioplasty and to perform effective angioplasty, demonstrating the feasibility and utility of a dual‐purpose angioplasty catheter capable of angioplasty and/or local drug infusion with the same catheter. © 1994 Wiley‐Liss,Inc..
Mediastinal arteriovenous fistulae in the adult: case report and review of the literature
Authors: Borik Anne , Battista David , Granato Jerome E. , Fallert Michael A. , Grill Howard P. 
Published: March 2007

AbstractAn adult with an asymptomatic mediastinal arterio‐venous fistula is presented. The diagnosis was established using angiography and oximetry after noninvasive imaging failed to identify the source of a continuous murmur. The literature is reviewed. © 1994 Wiley‐Liss,Inc..
Coronary angioplasty through a new 6 french guiding catheter
Authors: Resar Jon R. , Prewitt Kerry C. , Wolff Matthew R. , Brinker Jeffrey A. 
Published: March 2007

AbstractCoronary angioplasty through smaller‐diameter guiding catheters using predominantly fixed‐wire balloon systems has been possible, but has had some limitations. The purpose of this prospective, nonrandomized study was to investigate the results of percutaneous transluminal coronary angioplasty using a new 6F guiding catheter with over‐the‐wire balloon systems. Coronary angioplasty using over‐the‐wire balloon systems through a new 6F guiding catheter was evaluated in 79 lesions in 70 patients and then compared to randomly selected procedures using 7F guiding catheters in 70 patients performed over the same time period. Coronary angioplasty through 6F guiding catheters and over‐the‐wire balloons including 8 long (30‐mm) and 3 perfusion balloons was successful in 94.9% of lesions and in 94% of patients. Coronary angioplasty through 7F guiding catheters was successful in 97.5% of lesions and in 97.1% of patients, respectively. Success rates between 6F and 7F guiding catheter groups were similar overall and for proximal, mid, distal, or complex (total, subtotal, or length > 10‐mm) lesions. There were no failures to withdraw the deflated balloon into the 6F guiding catheter. Vessel opacification after dilatation with the guidewire across the lesion was similar between the 6F and 7F guiding catheter groups. The mean change in hematocrit for the 6F procedures (−1.4±3.7%) was significantly lower than for the 7F procedures (−3.3±3.2%, P<0.001). Coronary angioplasty using a variety of over‐the‐wire balloon catheters through a new 6F guiding catheter is feasible with success rates comparable to 7F guiding catheters. Angioplasty with this 6F guiding catheter reduces procedural blood loss compared to larger‐lumen guiding catheters. © 1994 Wiley‐Liss,Inc..
Optimal data acquisition for volumetric intracoronary ultrasound
Authors: Dhawale Paritosh J. , Wilson David L. , Hodgson John Mc B. 
Published: March 2007

AbstractThree‐dimensional analysis using intracoronary ultrasound (ICUS) pull‐back data provides the unique ability to quantitate lumen and atherosclerotic plaque volumes. Optimal data acquisition parameters for volumetric acquisition were established using simulations on computer phantoms of stenotic arteries. Eleven computer phantoms were generated using cross‐sectional area data from quantitative angiography of stenotic coronary arteries. Three methods of data acquisition were simulated: conventional manual pull‐back; motorized pull‐back; and manual pull‐back with measured displacement. Effects of pull‐back velocity and cardiac gating on cross‐sectional area profiles and volumes were studied. Cardiac gating eliminated errors introduced by vessel deformation within a cardiac cycle. With cardiac gating, pull‐backs with mean velocities up to 1.2 mm/sec allowed reconstruction of cross‐sectional area profiles within 5% RMS error. With faster pull‐backs, cardiac gating resulted in sparse spatial sampling and significant errors in cross‐sectional area profiles.The accuracy of both motorized and measured required equal displacements of the catheter proximal and distal ends. This assumption was validated with in vitro experiments where X‐ray fluoroscopy was used to measure the displacement of the imaging tip. Excellent correlation was found between the two displacements (r = 0.99). Finally, slow pull‐backs were performed by 3 operators, and pull‐back velocities were measured. It was found that mean pull‐back velocities as low as 0.8 mm/sec were achievable. From our simulations, we predict that accurate volumetric analysis requires cardiac gated, calibrated, slow (< 1.2 mm/sec) pull‐backs. © 1994 Wiley‐Liss,Inc..
Percutaneous deployment of a polytetrafluoroethylene (ptfe) graft to repair a pseudoaneurysm produced by a graft to graft anastomotic dehiscence
Authors: Dorros Gerald , Bates Mark , Kumar Krishna 
Published: March 2007

AbstractArterial injuries, creating a pseudonauerysm or arteriovenous fistula have, in the main, been managed through surgical ligation of the involved segments, arterial reconstruction, embolization of the involved artery, and percutaneous placement of a stented graft [Marin ML, et al: J Vasc Surg 18:299–302, 1993].This communication describes the percutaneous repair of a large popliteal pseudoaneurysm created by dehiscence of the anastomotic suture line of a composite polytetrafluoroethylene (PTFE) femoropopliteal and a popliteal‐posterior tibial graft using a PTFE graft without stent assistance. © 1994 Wiley‐Liss,Inc..
Quantitation of in vitro coronary artery calcium using ultrafast computed tomography
Authors: Mahaisavariya Paiboon , Detrano Robert , Kang Xingping , Garner Dan , Vo Anthony , Georgiou Demetrios , Molloi Sabee , Brundage Bruce H. 
Published: March 2007

AbstractUltrafast computed tomography (UFCT) has the potential to quantify coronary hydroxyapatite (HAP). However, no definitive studies validating this technique are available. We constructed a human chest phantom model with coronary arteries represented by cylindrical holes containing: (1) calcium chloride solutions, (2) a block of HAP immersed in paraffin (without partial volume effect), and (3) HAP granules embedded in a gelatin matrix (with partial volume effect). We scanned this model to determine the relationship between measured CT number per voxel and density of the calcium per voxel. The relationships between CT number and concentration of calcium chloride was linear (r = 0.992 to 0.999). Using a commercially available standard bone mineral phantom, we were able to estimate the concentration of HAP to an accuracy from 94 to 97% when partial volume effects were absent. However, when partial volume effects were present, two methods of estimating HAP produced significant errors (1 to 384%, and 17 to 52%). We conclude that significant partial voluming errors degrade the accuracy of HAP quantitation and that further evaluation and corrections are needed before such quantitation is clinically applied. © 1994 Wiley‐Liss,Inc..
CAAS II: A second generation system for off‐line and on‐line quantitative coronary angiography
Authors: Gronenschild Ed , Janssen Johan , Tijdens Folkert 
Published: March 2007

AbstractThe Cardiovascular Angiography Analysis System (CAAS) has been completely redesigned and transferred to a modern platform. The user‐friendly environment together with a number of image processing techniques and tools allow easy and fast analysis of cardiovascular angiographic images. These images are obtained either on‐line by means of a frame grabber hooked on the video output of the X‐ray equipment or off‐line by digitising 35‐mm cine film frames. In addition, images can be acquired more directly by means of a network link. Images stored on disk in different formats, including MS‐DOS, can also be analysed. Accurate and reliable quantitative analysis of coronary stenoses and assessment of their related functional significance may offer the clinician a tool in a stratification of patients at risk. The semireal‐time environment will make it possible for the cardiologist to quickly respond to the results of recanalisation procedures while the patient is still in the catheterisation laboratory. The addition of a video front end makes the system available to all clinically relevant X‐ray imaging equipment. A detailed comparison with the former CAAS on the basis of analysis of 40 arterial segments in routinely acquired cineangiograms demonstrated no statistically significant differences between the two analysis systems. Repeated analysis of the same segments yielded inter‐ and intraobserver variabilities for the obstruction diameter of 0.096 and 0.108 mm, respectively. For the computed reference diameter the values are 0.099 and 0.096 mm, respectively, and for the percentage diameter stenosis 4.67 and 5.37%, respectively. © Wiley‐Liss, Inc.
Use of cutoff pigtail catheters with intraluminal guidewires in interventional procedures in congenital heart disease
Authors: Verma Rajiv , Keane John F. 
Published: March 2007

AbstractAdvances in interventional cardiac catheterization have necessitated technique modifications to ensure patient safety while allowing data acquisition. The use of cutoff pigtail catheters over guidewires for pressure recordings and angiography exemplifies such a modification. The primary purpose of this study was to ascertain contast volume and flow rates achievable using such a system. A total of 140 used catheters of various sizes, with intraluminal guidewires (0.035 inch in 6, 7, and 8F; 0.025 inch in 5F) were subjected ot contast injectins at increasing rates and volumes until rupture occurred. The 7F catheters allowed volume delivery at 15–40 ml at 15 ml/sec, 8F catheters 40 ml at 30 ml/sec, and 5 and 6F catheters 10 ml/sec. All ruptured within 3 cm of the hub, at⩾900 PSI. A review of 737 clinical procedures revealed adequate pressure recordins and angiogrphic detail inall, uncomplicated save for one intracardiac wire dislodgement. © Wiley‐Liss, Inc.
Gianturco‐Roubin stent placement for variant angina refractory to medical treatment
Authors: Lopez J. Alberto , Angelini Paolo , Leachman D. Richard , Lufschanowski Roberto 
Published: March 2007

AbstractA 43‐yr‐old man with mild, fixed obstruction of the left anterior descending (LAD) coronary artery and severe, uncontrolled variant angina underwent placement of an endovascular stent to preserve patency of the artery. The decision for stent placement was based on several factors, including refractoriness to medical treatment and standard balloon angioplasty, documented spasm localized to the proximal LAD lesion, and the morbidity, mortality, and costs associated with the surgical approach in this type of patient. At follow‐up, there was moderate restenosis of the stented coronary segment; the vasospastic angina syndrome had totally resolved. © Wiley‐Liss, Inc.
Treatment of intracoronary thrombus with local urokinase infusion using a new, site‐specific drug delivery system: The Dispatch™ catheter
Authors: McKay Raymond G. , Fram Daniel B. , Hirst Jeffrey A. , Kiernan Francis J. , Primiano Charles A. , Rinaldi Michael J. , Azrin Michael A. , Mitchel Joseph F. , Waters David D. 
Published: March 2007

AbstractBackground: The presence of intracoronary thrombus significantly increases the risk of conventional balloon angioplasty because of a high incidence of abrupt closure, distal embolization, and no‐reflow phenomenon. The purpose of this study was to assess a new technique for treating intracoronary thrombus consisting of the local delivery of urokinase directly to the angioplasty site with a novel, catheter‐based, drug delivery system. Methods: The Dispatch catheter is a new local, drug‐delivery device that allows for the prolonged infusion of therapeutic agents at an angioplasty site while still maintaining distal coronary perfusion. Six patients with angiographic or clinical evidence of intracoronary thrombus were treated with 150,000 units of urokinase over a 30‐min period using this device prior to or following conventional balloon angioplasty and/or directional atherectomy. Results: Successful delivery of urokinase directly to the angioplasty site was achieved in all 6 patients without hemodynamic or electrocardiographic compromise. In all six cases, local urokinase therapy resulted in complete dissolution of angiographic intracoronary thrombus and/or reduction of the coronary stenosis. Limited ischemia due to sidebranch occlusion by the catheter's coils was noted in one patient. Distal embolization or no‐reflow phenomenon were not observed in any case. CONCLUSION: The local drug‐delivery catheter used in this study was able to successfully and rapidly achieve intracoronary thrombolysis by delivering limited quantities of urokinase directly to the angioplasty site, while still maintaining distal coronary perfusion. This technique of local, thrombolytic drug delivery may be useful in the percutaneous treatment of intracoronary thrombus and thrombus‐containing stenoses. © Wiley‐Liss, Inc.
Restenosis presented with unstable angina and myocardial infarction: One explanation for late cardiac events following directional coronary atherectomy
Authors: Hwang Ming H. , Lewis Bruce E. , Hsieh Annming , Jones Paul A. , Leya Ferdinand , Loeb Henry S. 
Published: March 2007

AbstractThree cases of restenosis after directional coronary atherectomy (DCA) presented with unstable angina and then myocardial infarction. Two of them were complicated with malignant ventricular dysrhythmia. A total or subtotal thrombotic occlusion at the DCA site was shown. This fulminating course of restenosis could partially explain the higher late cardiac morbidity and mortality after DCA than after percutaneous transluminal balloon angioplasty. © Wiley‐Liss, Inc.
Serial angiographic appearance of healing dissection after balloon angioplasty
Authors: Amin Nishith , De Vito Dabbs Annette , Gilchrist Ian C. 
Published: March 2007

AbstractIn this report we describe the case of a patient with a significant coronary artery dissection following percutaneous transluminal coronary angioplasty (PTCA) in whom serial coronary arteriograms were obtained over a 6‐week period. These demonstrated healing of the dissected vessel and correlated with abatement of the patient's angina. © Wiley‐Liss, Inc.
Acute myocardial infarction in a young adult due to solitary giant cell arteritis of the coronary artery diagnosed antemortemly by primary directional coronary atherectomy
Authors: Saito Shigeru , Arai Hidekazu , Kim Kunikane , Aoki Naoto 
Published: March 2007

AbstractIt has been reported sporadically that several types of coronary arteritis can result in myocardial infarction. Recently, we treated a 27‐year‐old with acute anterior myocardial infarction. Primary directional coronary atherectomy was performed in order to recanalize the totally occluded coronary artery. The atherectomized tissue consisted of thrombi and intima infiltrated with inflammatory cells and multinucleated giant cells. Underlying diseases which can result in giant cell arteritis were excluded. This report documents that coronary arteritis can induce acute myocardial infarction, and that directional coronary atherectomy can be an effective tool in the diagnostic method for coronary arteritis. © Wiley‐Liss, Inc.
Reversible coronary artery kinking caused by cardiopulmonary support
Authors: Gershony Gary 
Published: March 2007

AbstractCardiopulmonary support is utilized to provide optimal hemodynamic stability in high risk patients undergoing percutaneous transluminal coronary angioplasty. This report describes a patient undergoing supported angioplasty in whom multiple new severe stenoses were noted following coronary dilation and that were completely reversed by discontinuing cardiopulmonary support. © Wiley‐Liss, Inc.
Iliac compression: A rare hindrance to percutaneous mitral valvuloplasty
Authors: Munclinger M. J. , Patel J. J. , Mitha A. S. 
Published: March 2007

AbstractPercutaneous mitral valvuloplasty using the Inoue technique was complicated by the failure to pass the dilator or balloon catheter above the vertebral level of L5 due to compression of the right common iliac vein by the right common iliac artery. The procedure was accomplished when a long sheath was used to pass the Inoue balloon catheter beyond the obstruction. © Wiley‐Liss, Inc.
Angioscopic evaluation of incompletely obstructing coronary intraluminal filling defects: Comparison to angiography
Authors: Uretsky Barry F. , Denys Bart G. , Counihan Peter C. , Ragosta Michael 
Published: March 2007

AbstractAt 66 sites in 40 patients, we evaluated the sensitivity and specificity of coronary angiography in detecting intraluminal filling defects of varying sizes and in characterizing the contents (thrombus, intimal flap, both) of such defects using coronary angioscopy as “the gold standard.” Overall angiographic sensitivity for thrombus was 37% and for intimal flap 45%. Specificity for thrombus was 100% and intimal flaps 96%. Angioscopically small flaps were less frequently seen angiographically (28%) than larger sizes (65%, p = 0.03). Angioscopically small thrombi were seen less often angiographically (30%) than larger ones (75%, p = 0.13). Filling defects (intimal flaps, thrombus, both) were characterized correctly in only 37% of sites. Angiography is relatively insensitivity in detecting intraluminal filling defects. Angioscopy may be preferred to or adjunctive with angiography in detecting these lesions. © Wiley‐Liss, Inc.
Retrograde nontransseptal balloon mitral valvuloplasty for rheumatic mitral stenosis
Authors: Bahl Vinay K. , Juneja Rajnish , Thatai Deepak , Kaul U. , Sharma Sanjiv , Wasir Harbans S. 
Published: March 2007

AbstractRetrograde nontransseptal balloon mitral valvuloplasty is a relatively new technique for dilating stenosed mitral valves, wherein a specially designed steerable catheter is used to enter the left atrium retrogradely. Over a 1‐yr period, 52 patients (34 M, 18 F; mean age 26.4 ± 6.5 yr) with symptomatic noncalcific rheumatic mitral stenosis underwent balloon mitral valvuloplasty by this technique at our center. The procedure was completed in 51 out of the 52 patients and technically successful dilatation was achieved in 47 (90.4%) patients. The mean valve area increased from 0.8 ± 0.2 cm2 to 1.86 ± 0.37 cm2 and end diastolic gradients decreased from 21.2 ± 9.4 mm Hg to 4.0 ± 2.2 mm Hg. Significant mitral regurgitation (>2+) developed in two (3.9%) patients, and both remained stable on medical treatment. In two patients, there was a significant decrease in femoral pulse, which improved with thrombolytic therapy.Our study is the first report of this technique from a center other than that of its origin. The results of this study further establish that this new retrograde technique may be a useful alternative to the conventional transseptal techniques for mitral valvuloplasty. © Wiley‐Liss, Inc.