bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the results of percutaneous transluminal coronary angioplasty using an integrated ultrasound imaging‐angioplasty Catheter
Authors: Wolfe Christopher L. , Klette Melissa A. , Trask Robert V. , Rothbaum Donald A. , Landin Ronald J. , Ball Michael W. , Hodes Zachary I. , Linnemeier Thomas J. 
Published: March 2007

AbstractTo evaluate the results percutaneous transluminal coronary angioplasty (PTCA), intra‐vascular ultrasound imaging was performed in 32 proximal coronary arterial segments and in 16 atherosclerotic lesions after PTCA in 13 patients using a 5 Fr balloon catheter with an ultrasound transducer mounted just proximal to the balloon. Simultaneous angiographic measurements of vessel diameter were also performed using electronic calipers from contrast cine angiograms. There was good correlation between ultrasound and angiographic minimum luminal diameters of the normal proximal vessel (y = 0.59x + 1.49, r = 0.70, P<0.01, n = 32). However, the luminal diameter measured by intravascular ultrasound was significantly greater than when measured by contrast angiography (2.81±0.10 vs. 2.34±0.12mm, n = 16, P<0.001, mean ±SEM). Post‐PTCA, there was good correlation between ultrasound and angiographic minimum luminal diameters of the lesion (y = 0.62x + 1.42, r=0.76, P<0.001, n = 16), but again luminal diameters were significantly greater when measured by intravascular ultrasound compared to contrast angiography (2.61±0.08 vs. 1.89 ± 0.10mm, n = 16, P<0.001). Furthermore, residual stenosis was significantly less when determined by intravascular ultrasound than by contrast angiography (7.3±2.0 vs. 18.1 ± 2.1%, n = 16, P<0.001). Intravascular ultrasound was able to detect coronary calcification that was not evident by contrast coronary angiography in 8 of 16 lesions. Post‐PTCA, dissection was evident in four lesions by ultrasound, whereas dissection was appreciated in only three lesions by contrast angiography. We conclude that intravascular ultrasound can accurately measure the luminal diameter of coronary arteries both before and after PTCA and reveals more information about the lesion characteristics than does conventional contrast angiography.
Sudden cardiac death from coronary artery spasm in a healthy subject
Authors: Tecce Marc A. , Schalet Bennett D. , Roberts Steven A. , Iskandrian Abdulmassih S. , Mette Stephen A. , Segal Bernard L. 
Published: March 2007

AbstractThe true incidence of sudden cardiac death (SCD) from coronary artery spasm is unknown. The following case involves SCD in a previously asymptomatic young man with reasonable evidence to implicate coronary artery spasm as a potential cause for his clinical event. Ergonovine provocation may be warranted in patients who present with SCD and no discernable cause. © 1994 Wiley‐Liss,Inc..
Utilization of the wallstent for the treatment of innominate vein obstruction: a case report
Authors: Gencheff Nelson E. , Schmidt Donald H. , Jean William J. , Bajwa Tanvir K. 
Published: March 2007

AbstractDebilitating obstruction of the large veins may occur from external compression, neointimal proliferation or thrombosis. Appropriate interventions are contingent upon the underlying etiology and the local vascular anatomy. A case of innominate vein obstruction is presented illustrating the available intravascular therapeutic options, with special emphasis placed on intravenous stenting. © 1994 Wiley‐Liss,Inc..
Results of percutaneous transseptal mitral commissurotomy in patients 40 years and above with those under 40 years of age: immediate and 5‐year follow‐up results
Authors: Chan Charles N. S. , Berland Jacques , Cribier Alain , Rocha Paolo , Stix Gunter , Derumeaux Genevieve , Letac Brice 
Published: March 2007

AbstractPatients with mitral stenosis in Western countries are relatively old. It is anticipated that percutaneous transseptal mitral commissurotomy (PTMC) may have more complications and may not be as effective in this group of patient as in younger patients due to more calcification and fibrosis of the mitral valve. We analysed the clinical, hemodynamic, echocardiographic data in 296 consecutive patients divided prospectively into two groups; group 1 consisted of 184 patients ≥ 40 years and group 2 of 112 patients < 40 years coming mostly from developing countries. The immediate gain in valve area was 2.18 ± 0.61 cm2 in group 1 vs. 2.31 ± 0.65 cm2 in group 2 (P = ns). The incidence of acute regurgitation requiring surgical intervention was similar in both groups. Follow‐up data up to 5 years after PTMC was available in 170 patients (92.4%) in group 1 (mean 20 ± 13 months) and 83 patients (74.1%) in group 2 (mean 29 ± 17 months). Restenosis by Doppler method (valve area less than 1.5 cm2 with loss of at least 50% initial gain in valve area) was found in 33 patients in group 1 (29.2%) vs. 11 (14.9%) in group 2 (P < 0.05). Events free from death, need for mitral valve replacement or repeat PTMC at 5 year follow‐up was 76% in group 1 vs. 87% in group 2 (P < 0.05). We conclude that the immediate effectiveness and acute complications of PTMC in patients 40 years and above are comparable to younger patients. Restenosis is clearly higher and there is a trend towards need for mitral valve replacement in patients 40 years and above at follow‐up. However, the continuing benefit for the majority of the patients 40 years and above (76% free from adverse events) would suggest that PTMC is an appropriate treatment modality even in the older patients. © 1994 Wiley‐Liss,Inc..
Double perfusion system for coronary angioplasty at the origin of the main vessel
Authors: Kitazume Hidemasa , Kubo Ichirou , Iwama Toru , Ageishi Yoshio 
Published: March 2007

AbstractFor the treatment of stenosis near the origin of either the left anterior descending artery or the left circumflex artery, one autoperfusion catheter was used to dilate the lesion while another was used to maintain perfusion of the nonstenosed vessel, which would normally suffer from a decrease in blood flow. This technique was applied to nine procedures in six patients. The balloon could be inflated for more than 60 sec in all cases. Satisfactory dilation was achieved without a significant decrease of systemic blood pressure during the procedure. © 1994 Wiley‐Liss,Inc..
The technique and safety of transseptal left heart catheterization: the massachusetts general hospital experience with 1,279 procedures
Authors: Roelke Marc , Smith A. J. Conrad , Palacios Igor F. 
Published: March 2007

AbstractWith the introduction of interventional procedures such as percutaneous mitral valvuloplasty and radiofrequency ablation of left‐sided bypass tracts, there has been renewed interest in the technique of transseptal left heart catheterization. We review our experience with 1,279 transseptal catheterizations performed over the last 10 years. The most common indications for transseptal catheterization included direct measurement of left atrial pressure or access to the left ventricle in patients with prosthetic aortic or mitral valves, and in patients undergoing percutaneous mitral valvuloplasty. A total of 17 major complications occurred (1.3%), including cardiac tamponade (15 patients, 1.2%), systemic emboli (1 patient, 0.08%), and death secondary to aortic perforation (0.08%). We conclude that when performed by experienced operators, transseptal left heart catheterization is associated with low morbidity and mortality. © 1994 Wiley‐Liss,Inc..
Initial experience with an extendable and reusable probe balloon‐on‐a‐wire dilatation catheter in multivessel coronary angioplasty
Authors: Koh Tian‐Hai 
Published: March 2007

AbstractThe “probe” balloon‐on‐a‐wire device is an excellent balloon catheter for traversing very tight stenoses. Extending the probe by transecting its proximal inflation hub and then linking it to an extension wire has further enhanced its utility, as a wire exchange can then be performed without loosing wire access across a dilated lesion. We now report a previously undescribed technique for reconstituting and reusing an extended probe. The probe is initially transected at its proximal end. It is then extended by connecting a “Linx” wire into the open central lumen of the probe's hypotube. An over‐the‐wire balloon dilatation system is then substituted, via a wire exchange using a probing catheter, for final definitive dilatation. The probe is then reconstituted in the following manner. The inflation hub of the probe is recreated by modifying a standard USCI Tuohy‐Borst Y adaptor and attaching this to the transected probe hypotube. It is subsequently used for dilating other stenotic arteries during multivessel angioplasty. The utility of this method was demonstrated in 5 consecutive cases. All cases underwent successful dilatations. There were no complications. This initial experience would suggest that the probe can be reused quite safely and effectively. © 1994 Wiley‐Liss,Inc..
Comparison of hemodynamic and Doppler echocardiographic effects of a new low osmolar nonionic and a standard ionic contrast agent after left ventriculography
Authors: Werner Gerald S. , Schmidt Thomas , Scholz Karl H. , Figulla Hans‐R. , Kreuzer Heinrich 
Published: March 2007

AbstractThe hemodynamic effects of a new nonionic low osmolar contrast agent (iomeprol) during left ventriculography (LC) was compared with a standard ionic contrast agent (meglumine diatrizoate) in a randomized double blind study in 30 patients with suspected coronary artery disease and normal systolic ventricular function. LV diastolic function was assessed by Dopper echocardiographic recording of the transmittal filling curve and by intraventricular tip‐manometry before and within 30 sec of the LC. In the group receiving the ionic contrast agent the systolic pressure fell from 126 ± 23 to 111 ± 18 mmHg (P < 0.05), and heart rate increased from 64 ± 9 to 71 ± 11 min−1 (P < 0.05), while no such effects were observed with the nonionic contrast agent, indicating differences in the vasodilator properties. The latter caused an increase of the peak early Doppler velocity (52 ± 11 to 62 ± 14 cm/sec; P< 0.05). After the ionic contrast agent, the effect on the peak early Doppler velocity was less pronounced, probably due to an interaction with the known depressant effect of the increase in heart rate on the early Doppler velocity. In both groups the left ventricular enddiastolic pressure was increased from 7 ± 3 to 10 ± 4 mmHg. No significant effects on peak ‐dp/dt and dp/dt were observed in either group.The nonionic contrast agent iomeprol had no significant effect on systolic arterial pressure and heart rate in contrast to the ionic contrast agent, probably due to a less pronounced vasodilator effect. Despite these differences of the global hemodynamic response, there were similar effects of both contrast agents on LV diastolic filling. © Wiley‐Liss, Inc.
Coronary artery dissection caused by exit of the guidewire through the distal perfusion sidehole of an auto‐perfusion angioplasty balloon catheter
Authors: Werns Steven W. , Bates Eric R. 
Published: March 2007

AbstractA previously unrecognized cause of coronary artery dissection is reported. A 67‐year‐old woman underwent angioplasty of the right coronary artery using an autoperfusion balloon catheter. Dissection occurred because the balloon catheter was advanced while the guidewire exited from one of the distal perfusion sideholes. © Wiley‐Liss, Inc.
Intracoronary stenting in acute myocardial infarction
Authors: Wong Philip H. C. , Wong Chi M. 
Published: March 2007

AbstractStent implantation into an infarct‐related artery during acute myocardial infarction is generally contraindicated because of the risk of stent thrombosis. We report on 3 patients who had successful stenting for an acute occlusive dissection that developed during direct infarct coronary angioplasty and was refractory to conventional prolonged balloon dilatation, with good long‐term clinical and angiographic results. The prerequisites for success include proper premedication, presence of only a minimal amount of thrombus in the infarct‐related artery, liberal use of intracoronary thrombolytic therapy, as perfect an angiographic result as possible, as well as careful and aggressive post‐stenting anticoagulation. © Wiley‐Liss, Inc.
Obstruction of the right pulmonary artery by an aortic aneurysm complicating previous coronary bypass grafting
Authors: Guazzi Marco , Bortone Franco , De Cesare Nicoletta , Pepi Mauro , Moruzzi Paolo 
Published: March 2007

AbstractWe report a case of right main pulmonary artery compression due to a type II dissecting aortic aneurysm simulating massive pulmonary artery embolism. Aortic tear and intimal splitting developed around an aortocoronary bypass graft performed 11 months earlier. Ultrasound detected the aortic aneurysm and pulmonary hypertension, and excluded emboli in the pulmonary artery. Pulmonary angiography explained the lung involvement, showing compression of the right main pulmonary artery. Coronary and aortic angiograms demonstrated that the aortic aneurysm developed around the right venous bypass graft. Surgery confirmed the anglographic findings and the pathogenesis of the syndrome. © Wiley‐Liss, Inc.
Percutaneous transluminal coronary angioplasty of the left main coronary artery in patients with rest angina
Authors: Crowley Stephen T. , Morrison Douglass A. 
Published: March 2007

AbstractLeft main coronary angioplasty may be a therapeutic revascularization procedure for a subset of patients with symptomatic coronary artery disease. The purpose of this study is to report procedural outcomes and long‐term clinical follow‐up of 15 patients who underwent either protected or unprotected left main angioplasty for rest angina. These patients represent a cohort of unstable angina patients who were considered high risk for coronary artery bypass surgery. Ten of 15 patients had Canadian Heart Class IV angina, and three patients were hemodynamically unstable. Balloon angioplasty was successful in 14 patients, and one patient was treated with directional atherectomy. Initial angiographic success was achieved in 14 of 15 patients (93%). Major complications (myocardial infarction, emergent coronary artery bypass graft, death) occurred in one patient (6%); 73% of the patients were asymptomatic or had stable exertional angina at 6 months follow‐up. One year survival was 87% (13 of 15). During the follow‐up period six patients had repeat catheterization for recurrent angina. Four of these patients had left main restenosis and underwent successful repeat left main angioplasty. No patient had coronary bypass surgery during follow‐up. This report suggests that left main angioplasty can be a safe and effective revascularization procedure for critically ill patients with unstable angina who are at high risk for coronary bypass surgery. © Wiley‐Liss, Inc.
A simple balloon‐sizing method in Inoue‐balloon percutaneous transvenous mitral commissurotomy
Authors: Lau Kean‐Wah , Hung Jui‐Sung 
Published: March 2007

AbstractThis study was carried out to examine whether the previously determined balloon sizing method based on patient height was valid for percutaneous transvenous mitral commissurotomy using the current second‐generation Inoue balloon catheter. The study consisted of 70 patients with pliable noncalcified mitral valves (group 1) and 85 patients with calcified mitral valves and/or severe subvalvular lesions (group 2). The mitral valve area was increased more in group 1 than in group 2 (1.0 ± 0.3 to 1.9 ± 0.5 cm2 versus 1.0 ± 0.3 to 1.6 ± 0.5 cm2, P = 0.002). Using the stepwise dilatation technique, none of the group 1 patients developed severe mitral regurgitation. Severe mitral regurgitation occurred in 4 patients (4.7%) in group 2. In conclusion, a simple balloon sizing method based on body height for selection of an appropriate‐sized balloon catheter, as well as an initial inflated balloon diameter for the stepwise dilatation technique is useful for optimal acute outcomes in mitral commissurotomy. © Wiley‐Liss, Inc.
Reopening of an arterial duct after total occlusion with Rashkind's double umbrella device
Authors: Galal Omar , Abbag Fuad , Fadley Fadel , Redington Andrew 
Published: March 2007

AbstractReopening of a previously totally occluded ductus arteriosus with the Rashkind umbrella device occurred in a 5‐yr‐old girl, a previously unreported occurrence. Total occlusion using a second device was successful. This report emphasizes the need for regular follow‐up with color flow Doppler echocardiography to diagnose and exclude a residual ductus even when apparent early closure has occurred. © Wiley‐Liss, Inc.
Approach to total occlusion of an aorto‐ostial “Y” saphenous vein graft with anterior descending graft limb stenosis by serial balloon angioplasty and elective stent deployment
Authors: Flynn Michael S. , Caracciolo Eugene A. , Bach Richard G. , Donohue Thomas J. , Aguirre Frank V. , Kern Morton J. 
Published: March 2007

AbstractCoronary revascularization using balloon angioplasty and stent placement for unstable angina was performed in a 74‐year‐old woman with an aorto‐ostial occlusion of a “Y‐type” saphenous vein graft and a severe stenosis in the body of a 14‐year‐old left anterior descending saphenous vein graft. Multiple prior coronary bypass graft surgeries, location of branch graft lesions, and length of the ostial stenosis must be considered in selecting the approach to revascularization. © Wiley‐Liss, Inc.
Role of side holes in guide catheters: Observations on coronary pressure and flow
Authors: De Bruyne Bernard , Stockbroeckx Jan , Demoor Danny , Heyndrickx Guy R. , Kern Morton J. 
Published: March 2007

AbstractWhen performing coronary angioplasty, guide catheter intubation of the ostium often leads to a damping of the pressure tracing. In contrast, when a guide catheter with side holes is used, the pressure tracing is most often superimposable to the pressure wave recorded through the side arm of a femoral artery sheath introducer. This pressure wave gives the reassuring impression of normal hemodynamics in the coronary artery. To IIlustrate the role of guide catheter side holes and that guide catheter pressure does not necessarily equal the actual coronary artery perfusion pressure, we report observations on trans‐ostial pressure gradients at rest and during increased coronary flow rates. An abbreviated in vivo study of side holes on the maximal achievable blood flow, employing timed blood flow collections in 7F and 8F side hole guide catheters, was made in 10 patients. At high mean aortic pressure levels, the blood flow through the side holes did not exceed 80 and 60 mL/min for 8 and 7F guide catheters, respectively. These observations suggest that, under some conditions, the guide catheter may produce a resting or hyperemic trans‐ostial gradient and that the flow provided only by the side holes of guide catheter is limited. Guide catheter interference with normal flow should be considered in interventional procedures even when arterial pressure appears normal. © Wiley‐Liss, Inc.
Modified multipurpose catheter enhances clinical utility for cardiac catheterizations
Authors: Mannino Stanley C. , Scavina Michael , Palmer Sammie 
Published: March 2007

AbstractThe Multipurpose technique for coronary arteriography employs a single catheter. The benefits are a reduction in the cost of the procedure and a shorter procedural time by experienced operators.To enhance the performance of these catheters, a modification was made in the materials and tip design, and these modifications were clinically evaluated in a small study. Compared to the control group of patients (n = 41), patients catheterized with the Multipurpose‐SM (n = 43) were shown to have a shorter procedural time as measured by a reduced fluoroscopy time (7.08 min vs. 9.52 min, P=.007). This difference is statistically significant at a 95% confidence level and resulted in less radiation exposure to the operator and cath lab staff. The procedural time was significantly reduced by fewer catheter exchanges (19% study vs. 46% control; P=.006), which were needed to successfully complete the procedure. The new Multipurpose‐SM catheter also demonstrated enhanced flexibility for cannulating coronary arteries with superior or anterior takeoffs.This study concludes that the utilization of a modified Multipurpose‐SM catheter is safe and effective in cannulating both the left and right coronary arteries, bypass grafts, and performing left ventriculography. The primary benefits of using this modified catheter are reduced fluoroscopy time and the need for fewer catheter exchanges. © Wiley‐Liss, Inc.
Endoluminal stenting of a subclavian artery stenosis to treat ischemia in the distribution of a patent left internal mammary graft
Authors: Kugelmass Aaron D. , Kim Ducksoo , Kuntz Richard E. , Carrozza Joseph P. , Baim Donald S. 
Published: March 2007

AbstractSubclavian artery stenosis is a rare cause of recurrent myocardial ischemia in patients who have undergone left internal mammary‐coronary artery bypass grafting. A patient with this syndrome was successfully treated by placement of Palmaz biliary stents in the left subclavian artery. Angiographic and hemodynamic evidence of restricted subclavian flow resolved following stenting, as did the patient's unstable angina syndrome. Endoluminal stenting of the proximal subclavian artery for the treatment of coronary‐subclavian steal can be performed safely and provides an alternative to other forms of surgical or percutaneous (PTCA, directional atherectomy) revascularization for treatment of this disorder. © Wiley‐Liss, Inc.
Comparison of 7 and 8 french guiding catheters for elective PTCA: Results of a prospective randomized trial
Authors: Talley J. David , Wilkins Charles , Ciccone John , Hattel Larry J. 
Published: March 2007

AbstractA prospective randomized trial was performed to detect technical and clinical differences of 7F compared to 8F guiding catheters (GC) used in elective coronary angiopiasty (PTCA). One hundred and fifteen patients undergoing elective PTCA with standard balloon dilatation catheters were randomized to 7F (55 pts) or 8F (58 pts) guiding catheters. The endpoints were primarily coronary artery and peripheral vascular complications; and secondarily, technical details and quantitative and qualitative angiographic quality.There was no difference between 7F or 8F GC for development of coronary or peripheral vascular complications. With 7F GC there was less blood loss (Hct, 3.5 ± 3.4% vs. 6.5 ± 9.6%, P = .033), and less contrast medium (160 ± 88 mL vs. 200 ± 119 mL, P = .049) used. Angiographic quality was similar, although visualization of lesions in the left anterior descending coronary artery in the left anterior oblique projection was improved with the 8F GC.There is no advantage of 7F GC for the prevention of coronary or peripheral vascular complications, although there was less blood loss and contrast medium used with the 7F systems. © Wiley‐Liss, Inc.