bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of a tapered teflon dilator to percutaneous transluminal coronary angioplasty
Authors: Garnic J. Daniel , Polito Santo S. , Lee Don W. , Tonnemacher David P. , O'Connor Lawrence R. 
Published: March 2007

AbstractA tapered teflon dilator has been applied to 12 cases of percutaneous transluminal coronary angioplasty (PTCA). The technique was first used to predilate stenoses that could not initially be crossed with low profile over the wire PTCA ballons. In the first five cases, three angioplasties that would have been failures were converted to successes by this method. The dilator was used in place of a balloon catheter as an initial step to assess the ability of a guidewire to cross a lesion to reduce cost in five additional cases. Modification of an existing family of peripheral vascular dilators is described. The method of application of this technique to PTCA is outlined.
Subclavian‐coronary steal through a LIMA‐to‐LAD bypass graft
Authors: McLvor Michael E. , Williams G. Melville , Brinker Jeffrey 
Published: March 2007

AbstractEighteen months after coronary artery bypass grafting with a left internal mammary artery (LIMA) graft, a 58‐year‐old woman had a change in the character of her angina to include pain in the left arm, especially with upper extremity work, culminating in an episode of prolonged rest pain. Cardiac catheterization revealed retrograde flow through the LIMA graft to the subclavian artery and stenosis of the left subclavian artery at its origin from the aorta. Restoration of antegrade flow through the LIMA graft to the coronary arteries was achieved by a carotid‐subclavian bypass resulting in a resolution of symptoms. The evaluation of recurrent angina after LIMA bypass grafting should exclude the possibility of subclavian artery stenosis as well as disease of the native and graft coronary anatomy.
Changes in epicardial coronary arterial diameter following intracoronary papaverine in man
Authors: Carlson Eric B. , Gilliam F. Roosevelt , Bashore Thomas M. 
Published: March 2007

AbstractThe effect of intracoronary papaverine administration on epicardial coronary arterial diameter was examined in 18 male patients. Coronary‐artery cineangiograms were acquired with a power injector before intervention, 20 sec after intracoronary saline (control), and 20 sec after administration of papaverine into either the left (12 mg) or right (8 mg) coronary artery. Absolute coronary arterial diameter of a normal‐appearing segment was quantified using a previously validated, fully automated digital edge detection program with an ADAC digital radiographic unit. Baseline coronary arterial diameter of 3.1 ± 0.8 mm did not significantly change after saline administration (3.1 ± 0.9 mm) but did significantly increase (p < .001) to 3.4 ± 0.9 mm after papaverine administration. No significant percent change in diameter occurred in either the left anterior descending (−.5 ± 1.7%), left circumflex (−.2 ± 1.1%), or right (−3.0 ± 3.8%) coronary arteries with saline, but significant (p <.001) increases occurred with papaverine (7.2 ± 4.1%, 7.0 ± 4.5%, 6.8 ± 2.7%, respectively). The response of 7 coronary arteries examined immediately proximal to a significant lesion was not significantly different from the response of the remaining 11 coronary arteries. In conclusion, intracoronary papaverine causes a significant increase in coronary arterial diameter. This has clinical implications for assessing coronary flow reserve with devices that detect flow velocity.
Disappearance of high‐grade left anterior descending stenosis after revasculatization
Authors: Houghton Jan Laws , Callaghan William E. , Frank Martin J. 
Published: March 2007

AbstractComplete resolution of a high‐grade left anterior descending (LAD) stenosis 6 months after revascularization with a left internal mammary artery (IMA) graft and the first reported case of spontaneous IMA graft spasm during repeat cardiac catheterization for continued atypical chest pain in the same patient are reported. Mechanisms involving regression of atherosclerosis and atypical spasm are briefly discussed.
Kinking of internal mammary grafts: Report of two cases and surgical correction
Authors: Brenot P. , Mousseaux E. , Relland J. , Gaux J. C. 
Published: March 2007

AbstractTwo patients who underwent left internal mammary artery (IMA) anastomoses to the left anterior descending artery (LAD) developed sudden angina associated with anterior ischemic changes on EKG in the early postoperative period, one at 4 hr and the other at 3 days following operation. Digitalized arteriography via retrograde injection of the left brachial artery revealed the IMAs, which were partially obstructed because of looping and Kinking, although the anastomoses to the LAD were patent. Reoperation was successful in relieving obstruction by reducing these abnormalities and resulted in an uncomplicated postoperative course following the second operation. Discussion of the etiology, radiological technique of diagnosis, correction, and prevention of this cause of internal mammary graft failure is presented.
Use of angioplasty guidewire for technically difficult angiography
Authors: Nakhjavan Fred K. 
Published: March 2007

AbstractA new technique for negotiating severe vessel tortuosity or stenosis is described whereby a PTCA guidewire is initially used to cross the tortuosity or stenosed area. After introduction of a long‐tipped Sones catheter over the PTCA wire and past the stenosis, the latter is exchanged for the usual 0.035‐in guidewire. The Sones catheter is then removed and angiography proceeds as usual.
Variabilities in measurement of coronary arterial dimensions resulting from variations in cineframe selection
Authors: Reiber J. H. C. , van Eldik‐Helleman P. , Visser‐Akkerman N. , Kooijman C. J. , Serruys P. W. 
Published: March 2007

AbstractTo quantitatively analyze a coronary arterial segment from a cineangiogram, an enddiastolic or neighboring cineframe is usually selected, such that a possibly existing coronary lesion is visualized optimally, as judged by the cardiologist. However, different cardiologists may select different (although usually neighboring) frames, even when following the same selection criteria. It is also possible that the frames are selected from different cardiac cycles. In this study the effects of such phase shifts on the reproducibility of the quantitative measurements were studied.In a total of 38 consecutive patient films obtained at a filmspeed of 25 frames/sec, the frame O demonstrating the severity of a lesion optimally, as judged by a senior cardiologist, the three preceding frames, the three following frames and one frame exactly one cycle prior to or following frame O were selected; frame O was always chosen in the end‐diastolic phase of the cardiac cycle. In each film one coronary arterial segment with a focal lesion was analyzed quantitatively in these eight frames with the Cardiovascular Angiography Analysis System (CAAS).No significant differences were found in the mean difference and the standard deviations of the differences (variabilities) in the obstruction diameter, interpolated reference diameter, percent diameter stenosis, extent of the obstruction and area of atherosclerotic plaque obtained in the various frames with respect to frame O. Therefore, it may be concluded that the selection of a cineframe for quantitative analysis in the end‐diastolic phase of the cardiac cycle is not very critical; in other words, the obstruction measurements are not time‐dependent for frames in the end‐diastolic phase. It is argued that the quality of mixing of the contrast agent in the arterial segment is a major source of the observed variations; filling artefacts are potentially present in each of the selected frames.
Probe™, a balloon wire: Initial experience
Authors: Dorros Gerald , Lewin Ruben F. , Mathiak Lynne 
Published: March 2007

AbstractCoronary angioplasty is unsuccessful in <3–5% of cases because the balloon catheter fails to follow a guidewire that has traversed a lesion. Between June 1986 and August 1987, 31 lesions were unable to be crossed with at least two standard angioplasty catheters. Finally, a 2.0‐mm‐diameter Hartzler LPS (ACS) was utilized and successfully crossed and dilated 16 out of 31 lesions (52%). In the remaining 15 lesions, the ProbeTM (USCI) 2.0 mm diameter × 1.5 cm long balloon wire was able to cross the lesions in 13 (82%) and successfully dilated 12. In one case, lesion rigidity prevented the balloon from expanding at 14 atm. A right coronary artery lesion was attempted in 11 cases, and a left anterior descending and circumflex artery lesion in two patients each. No complications were encountered. In seven out of 12 successful ProbeTM cases, a larger balloon catheter was used to further dilate the artery. This new balloon wire has increased our success rate in severe stenoses and in tortuous vessels with severe distal lesions, in which presently available angioplasty equipment has failed.
Bilateral coronary thrombosis in the absence of inducible coronary spasm, thrombocytosis, coagulation abnormalities, or angiographic evidence of coronary artery disease: Previously undescribed method of myocardial infarction
Authors: Md Alan Feit, , Hazday Marcos S. , Reddy C.V.R. , Md Robert Kipperman, 
Published: March 2007

AbstractA 32‐year‐old man presented with symptoms and electrocardiographic changes consistent with acute anterolateral myocardial infarction. Selective coronary angiography revealed thromboses in the infarct related artery as well as in the right coronary artery. This case is unique because bilateral in‐situ coronary thrombosis producing acute myocardial infarction was documented in the absence of previously proposed mechanisms.
Concurrent percutaneous balloon valvuloplasty for combined tricuspid and pulmonic stenoses
Authors: Chen Chuan Rong , Lo Zheng Xiang , Huang Zheng Dong , Cheng Tsung O. 
Published: March 2007

AbstractPercutaneous balloon valvuloplasty was successfully performed in a 55‐year‐old Chinese woman with severe recurrent tricuspid and pulmonic stenoses 11½ years following open valvotomies. An lnoue balloon catheter with the balloon made of double‐layered rubber and nylon micromesh was used. The orifices of the tricuspid and pulmonic valves increased from 13 to 27 mm in diameter and from 6 to 14 mm in diameter, respectively, following concurrent balloon valvuloplasties. The present report demonstrated for the first time the feasibility of percutaneous balloon valvuloplasty for combined valvular stenoses.
Hematologic changes occurring with cardiac catheterization
Authors: Friedman Howard S. , Trivelli Lillian A. , Md Thach Nguyen , Bs Reine Benamor , Cpt Marietta Dorsa, Bs 
Published: March 2007

AbstractThe composition of the blood influences rheology and therefore might affect hemodynamics. During cardiac catheterization and angiography, blood is sampled and contrast media, fluid, and heparin are administered. To determine the effects of these perturbations on the blood cell count and coagulation, femoral vein samples were obtained at the beginning of cardiac catheterization, before heparin, 4,000 U; at the end, before protamine reversal; and after protamine, 40 mg, was administered. At the end of catheterization, 41 ± 3 min after heparin administration, all cellular constituents were significantly lower than control: White (W) blood cells (BC) were 8.1 ± 2.7% lower (P > 0.05), red (R) BC, 10 ± 1.8% (P< 0.05), and platelets (P) 10.9 ± 1.5% (P > 0.05). Protamine lowered further WBC by 23 ± 4% (P > 0.05 and P) by 14 ± 2% (P > 0.05), but did not change RBC (4.13 ± 0.20 × 106 to 4.25 ± 0.23 × 106). Before protamine administration, all patients had a partial thromboplastin time (PTT) 1.5 times the control value and ten of 13 patients had a value greater than 100 sec. Although four of 13 patients had an incomplete reversal of PTT after protamine, none suffered an untoward event. In conclusion, cardiac catheterization produces changes in the cellular composition of the blood, and such changes might influence hemodynamic measurements.
New nonsurgical technique for multiple pericardial biopsies
Authors: Md Jiři Endrys , Md Michal Šimo , Shafie Mohamed Z. , Md Babu Uthaman , Mrcp Yahia Kiwan , Md Tulsidas Chugh , Ali Syed M. , Md Karel Spaček , Yousef A. M. , Cherian George 
Published: March 2007

AbstractWe report a new, nonsurgical technique for obtaining multiple pericardial biopsies in patients with pericardial effusion. A short catheter is introduced by the Seldinger technique under fluoroscopy through the subxiphoid approach. The pericardial fluid is aspirated and the catheter replaced by an 8F teflon sheath with a curved tip. A bioptome is inserted through the sheath, and air is allowed to enter the pericardium. This method outlines the parietal pericardium. The curved sheath directs the bioptome to the left or right wall. Eighteen consecutive patients had an average of eight pieces of pericardium removed. On histological examination, three patients had malignancy. Six had tuberculous granuloma, and mycobacterium tuberculosis was cultured from all six tissue specimens but only once from the fluid. Tissue smears showed acid fast bacilli in four out of six, whereas the fluid was negative in all. The biopsy yielded diagnostic information in nine out of ten patients with a thickened pericardium. There were no complications.
Use of a metal ring‐marked catheter for geometric calibration in quantitative coronary angiography
Authors: Jacobs James H. , Bove Phd Alfred A. , Md , Smith Hugh C. , Chesebro James H. 
Published: March 2007

AbstractQuantitative coronary angiography depends on accurate measurement of catheter shaft diameter for correction of X‐ray magnification errors. We compared the use of coronary catheters with a single metal ring (R), inserted during manufacture, with measurements using the edges of the catheter shaft (S) as a calibration mark. Both ring and shaft were 2.50 mm in diameter. On unmagnified X‐ray images, the ring measured 2.49 ± .040 mm, and the shaft measured 2.39 ± .040 mm in diameter. Quantitative coronary angiography using both ring and shaft for calibration provided the same percent stenosis (R: 72 ± 12; S: 71 ± 13), but stenosis cross‐sectional area was 28% different (R: 1.44 ± .24; S: 1.84 ± .34 mm2). Use of the catheter shaft for calibration causes overestimation of actual coronary artery dimensions. To prevent this problem, absolute measurements of coronary artery dimensions should be made with metal ring‐marked catheters.
Percutaneous entry of the brachial artery for transluminal coronary angioplasty
Authors: Kamada Roy O. , Fergusson David J. G. , Itagaki Raymond K. 
Published: March 2007

AbstractAngioplasty is most commonly performed with catheters introduced percutaneously into the femoral artery. A brachial approach has previously been described that employs arteriotomy and cutdown. We describe here the technique and initial results of an alternative method of brachial entry, wherein the catheter is introduced percutaneously. Angioplasty has been performed in 26 patients in this manner, without complications.
Use of temporary pacemakers during coronary angioplasty: An evolving experience with ventricular fibrillation in 400 cases
Authors: Johnson Lewis W. , Bowser Michael A. , Lozner Eugene C. 
Published: March 2007

AbstractBecause of a perceived high frequency of ventricular fibrillation when a pacemaker catheter was placed in the right ventricular apex during PTCA, we reviewed our first 400 cases for this complication. The incidence of ventricular fibrillation in the entire group was 10 of 400 cases (2.5%) compared with 17 of 3,806 (0.4%) diagnostic coronary arteriograms performed in our laboratory during the same time period (P < .001). Ventricular fibrillation occurred more frequently during PTCA when the pacemaker catheter tip was placed in the right ventricular apex (8 of 63 cases, 12.6%) than when it was positioned in either the pulmonary artery, vena cava, or when a pacemaker catheter was not used (2 of 337 cases, 0.6%, P < .001).Based on these data we have developed a policy of inserting temporary pacemakers prophylactically during PTCA only for patients undergoing dilation of dominant right or dominant left circumflex coronary arteries and in patients with acute myocardial infarction.
Coronary arteriography in dogs following blunt cardiac trauma: A longitudinal assessment
Authors: Sabbah Hani N. , Mohyi James , Stein Paul D. 
Published: March 2007

AbstractThe purpose of the study was to examine the effects of blunt cardiac trauma on the epicardial coronary arteries of dogs by using sequential coronary arteriographic studies. A direct impact to the anterior surface of the heart at a velocity of 12 m/sec was delivered by an air pressurized impactor in eight of ten dogs with the chest open and the pericardium intact. Selective coronary arteriograms were performed percutaneously with the chest closed starting just before trauma and repeated afterward at intervals of 3 hours, 3 days, 2 weeks, and 5 weeks. Two of ten dogs were sham operated and did not undergo impact to the heart. The coronary arteries in these two dogs remained angiographically normal throughout the study period. In dogs that underwent impact and were maintained for the entire duration of the study (seven of eight dogs), injury to the epicardial coronary arteries occurred in every instance. Injury was limited mostly to branches of the left anterior descending and right coronary arteries. The left circumflex coronary artery, which was posterior to the site of impact, was always spared. The types of injury included complete branch occlusion, partial coronary obstruction, extravasation, and in one instance, an arteriovenous fistula. In nearly all instances, these injuries became evident angiographically between 3 hours and 3 days after impact and usually were completely resolved after 2 to 5 weeks. These observations indicate that the epicardial coronary arteries may be compromised by nonpenetrating cardiac impact. The resulting coronary pathology, however, resolved within a few weeks after injury.
Acute myocardial infarction during percutaneous aortic balloon valvuloplasty
Authors: Md Ubeydullah Deligonul , Kern Morton J. , Bell Stephen T. , Md Gregory Gabliani , Md Arthur Labovitz , Md Michel Vandormael 
Published: March 2007

AbstractBalloon valvuloplasty has been shown to be a relatively safe and effective intervention in palliating the symptoms of severe calcific aortic stenosis in the elderly [1–7]. Although the mechanism of balloon valvuloplasty is plastic deformation and fracture of the calcified valve tissue [2], complications such as embolic events or acute myocardial infarction due to aortic balloon valvuloplasty are very rare. Previously published reports mentioned only one case of cerebral embolism [5] and two patients with late fatal myocardial infarction [4]. In this report we present an elderly patient with calcific aortic stenosis who developed an acute lateral myocardial infarction during percutaneous balloon aortic valvuloplasty.
Use of angioplasty guiding catheters for improved coronary artery opacification
Authors: Vetrovec George W. , Thomas John H. , Md David Alpert 
Published: March 2007

AbstractThe following report describes the use of the high flow injection characteristics of a coronary angioplasty guiding catheter to improve coronary opacification in a patient with exceedingly high coronary runoff. This technique offers improved coronary visualization in special cases.
Assessment, of coronary angioplasty: Comparison of visual assessment, hand‐held caliper measurement and automated digital quantitation
Authors: Md Demosthenis Katritsis , Lythall Bs David A. , Mb , Cooper Ian C. , Ba Alex Crowther , Webb‐Peploe Michael M. 
Published: March 2007

AbstractDigital subtraction coronary angiograms (DSA) of 27 patients who had undergone coronary angioplasty (PTCA) to a total of 32 lesions were analyzed using an automated border‐detecting computer program and hand‐held caliper measurement of diameter percent stenosis. The results were compared with visual interpretation of the 35‐mm cineangiograms. Visual reports significantly overestimated the pre‐PTCA diameter percent stenosis (P < .001) and underestimated the residual post‐PTCA narrowing compared with the automatic computer program (P < .001). Caliper measurements overestimated significantly the pre‐PTCA stenosis in comparison with the computer (P < .01), but post‐PTCA the two methods did not differ significantly (P = .105). There was a positive but poor correlation between caliper and computer measurements (r = .43, P < .05) performed on the pre‐PTCA digital angiograms. Post‐PTCA the two methods correlated better (r = 0.78, P < .001), but further statistical analysis showed important discrepancies between them. The correlation of visual reports and computer measurements was poor pre‐PTCA (Kendall's r = 0.32, P < .05) and not statistically significant post‐PTCA(r = 0.64, P = .5).We conclude that there is observer bias in the visual reporting of angioplasty results, so that pre‐PTCA lesions are overestimated, whereas post‐PTCA are underestimated. Hand‐held caliper measurement improves the assessment of coronary stenoses in comparison with the visual report but still may not altogether eliminate observer bias; it may overestimate the pre‐PTCA stenoses compared with automated border detection.
Simultaneous double balloon coronary angioplasty through a single guiding catheter for bifurcation lesions
Authors: Thomas Edward S. , Williams David O. 
Published: March 2007

AbstractTo enhance the safety, efflcacy and expediency of coronary bifurcation lesion angioplasty, we report the use of two dilatation catheters, advanced simultaneously through a single guide catheter in three patients. Successful dilatation was performed in each. The technique involves the use of either two new low‐profile dilatation catheters in an 8 French large lumen guide catheter or a single new low‐profile dilatation catheter coupled with a conventional over‐the‐wire catheter within a new large lumen 9 French guide.
Percutaneous double balloon aortic valvuloplasty in an adult patient with calcific aortic stenosis and a bjork‐shiley prosthetic mitral valve
Authors: Ruiz Carlos E. , Boltwood Chester M. , Lau Francis Y. K. 
Published: March 2007

AbstractPercutaneous transluminal balloon valvuloplasty is a new technique in interventional cardiology which to date has been applied successfully in the dilatation of all four cardiac valves [1–4]. Although the different techniques appear to be quite effective, the safety of these procedures has not been fully explored. In particular, because of the close anatomic relationship of the aortic and mitral annuli, the safety of aortic valvuloplasty in patients with mitral valve prosthesis is unknown. Therefore, we report the applicability of a percutaneous double balloon valvuloplasty in an elderly patient with calcific aortic stenosis and a Bjork‐Shiley mitral valve prosthesis.
Use of exchange wires in coronary angioplasty
Authors: Bogart Douglas B. , Brown Barbara , Mortko Paula , Miller John T. 
Published: March 2007

AbstractA 300 cm exchange guide wire was used as the primary wire in 59 consecutive patients referred for percutaneous transluminal coronary angioplasty. The success rate of the angioplasty using this as the only wire was 92% (54 of 59), and we were able to pass the exchange guide wire into the distal vessel in 56 of the 59 patients (95%). We believe the exchange wire technique has a place in the first‐line approach to complex coronary angioplasty.