bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does percutaneous transluminal coronary angioplasty accelerate atherosclerotic lesions?
Authors: Nguyen Khiem P. V. , Shaw Richard E. , Myler Richard K. , Webb John G. , Stertzer Simon H. 
Published: March 2007

AbstractRecent reports have suggested that angioplasty may cause or accelerate coronary arterial stenoses secondary to traumatic injury. Ninety‐four coronary angiograms performed in a 1 yr period were reviewed in patients who had successful coronary angioplasty 6 to 30 mo (mean 10.7) prior to restudy. Restenosis was found in 43 of 140 dilated lesions (31%) and in 41 of 94 patients (44%). Thirty‐three (35%) patients had new or progressive lesions outside the angioplasty site. New or progressive lesions occurred with similar frequency in the arteries that did not have angioplasty (23/155 = 15%) as in the arteries that did (13/127 = 10%; chi‐square n.s.). In the arteries which underwent angioplasty, new or progressive lesions occurred as commonly proximal to the PTCA site (7/14, 50%) as distal (6/13, 46%). New or progressive lesions occurred in 29% of patients with concomitant restenosis, and 40% of those without restenosis (chi‐square n.s.). No clinical, angiographic, or procedural factors distinguished patients with new and progressive lesions in target vessels from those without these lesions in target vessels. Patients with progressive lesions anywhere in the coronary tree were more likely to have had a shorter duration of anginal symptoms before angioplasty and a family history of coronary disease when compared with patients without progressive atherosclerosis. In conclusion, new and progressive lesions outside the angioplasty site occur after the procedure but appear unrelated to the restenosis process or traumatic injury by angioplasty instrumentation.
Coronary artery anomalies in 126,595 patients undergoing coronary arteriography
Authors: Yamanaka Osamu , Hobbs Robert E. 
Published: March 2007

AbstractCoronary artery anomalies were found in 1,686 patients (1.3% incidence) undergoing coronary arteriography at the Cleveland Clinic Foundation from 1960 to 1988. Of the 1,686 patients, 1,461 (87%) had anomalies of origin and distribution, and 225 (13%) had coronary artery fistulae. Most coronary anomalies did not result in signs, symptoms, or complications, and usually were discovered as incidental findings at the time of catheterization. Eighty‐one percent were “benign” anomalies: (1) separate origin of the left anerior descending and circumflex from the left sinus of Valsalva; (2) ectopic origin of the circumflex from the right sinus of Valsalva; (3) ectopic coronary origin from the posterior sinus of Valsalva; (4) anomalous coronary origin from the ascending aorta; (5) absent circumflex; (6) intercoronary communications; and (7) small coronary artery fistulae. Other anomalies may be associated with potentially serious sequelae such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. Potentially serious anomalies include: (1) ectopic coronary origin from the pulmonary artery; (2) ectopic coronary origin from the opposite aortic sinus; (3) single coronary artery; and (4) large coronary fistulae. Coronary artery anomalies require accurate recognition, and at times, surgical correction.
Left main percutaneous transluminal coronary angioplasty with the autoperfusion catheter in an animal model
Authors: Turi Zoltan G. , Rezkella Shereif , Campbell Colin A. , Kloner Robert A. 
Published: March 2007

AbstractLeft main coronary angioplasty is associated with high risk because of interruption of blood flow to much of the left ventricle during balloon inflation. An “autoperfusion” balloon angioplasty catheter that allows blood to flow passively distal to an inflated balloon was tested in dogs and compared with inflations with standard balloon catheters. During 3 min occlusions of the left main coronary artery with the autoperfusion catheter, regional myocardial blood flow was preserved at 0.60 ± 0.14 ml/min/g, compared with 0.07 ± 0.03 ml/min/g during inflation with standard balloon catheters (P < 0.01). Similarly, at the end of 3 min of inflation, left ventricular systolic pressure and dP/dt were maintained with autoperfusion catheter inflation, but they were severely depressed after standard angioplasty balloon inflation. All seven dogs survived autoperfusion balloon inflation, whereas five of seven developed sustained ventricular tachycardia and/or ventricular fibrillation during or after standard balloon inflation. Thus, distal blood flow, hemodynamics, and survival were preserved during autoperfusion balloon inflation in the left main coronary artery.
Influence of catheter technology and adjuvant medication on acute complications in percutaneous coronary angioplasty
Authors: Spielberg Christoph , Schnitzer Luise , Linderer Thomas , Schröder Rolf 
Published: March 2007

AbstractWe report on the complication rates in 660 consecutive coronary angioplasties (725 lesions) performed using four procedures that differed with respect to catheter technology and adjuvant medication. After the PTCA regimen in our laboratory had beem changed from conventional steerable systems to the monorail technique, we observed a significant increase in the incidence of transient vessel occlusions from 2.6% to 7.7%, of permanent occlusions from 3.6% to 8.8%, and of intracoronary thrombus‐formation from 2.6% to 5.5%. This was associated with the frequent observation of thrombotic material on the partially Tefloncoated guidewires. Coronary perfusion with urokinase (1,670‐ 6,670 U/min) lead to a further increase in the complication rates (10.4%/10.3%/6.5%). Our present percutaneous transluminal coronary angioplasty (PTCA)‐regimen (monorail technique with P.E.T. balloons, fully silicon‐coated guidewires, no urokinase) shows an incidence of 3.8% for intermittent and recurrent coronary occlusions and 1.9% for permanent occlusions.Urokinase did not prevent intracoronary thrombus formation with the monorail technique. Furthermore, we suspect that in the case of PTCA‐induced regional lntimal dissection, fibrinolysis can prevent reestablishment of intima adherence to the vessel wall. Because five procedural deaths were observed in the 212 patients treated with i.c. urokinase as opposed to three deaths in the 448 procedures without urokinase, we feel that i.c. urokinase in PTCA is a potentially harmful regimen. We suggest that the monorail technique should be performed with fully silicon‐coated guidewires and without urokinase.
Balloon rupture due to lesion morphology during coronary angioplasty
Authors: Kahn Joel K. , Hartzler Geoffrey O. 
Published: March 2007

AbstractWe report a case of coronary angioplasty of a left anterior descending artery lesion that was complicated by the rupture of three successive balloon catheters. Each rupture occurred as a pinhole jet of contrast into a diagonal side branch, causing subintlmal staining. This case demonstrates that balloon rupture may result from lesion morphology.
Unusual case of pacemaker lead migration
Authors: Dalvi B. V. , Rajani R. M. , Lokhandwala Y. Y. , Sathe S. V. , Kulkarni H. L. , Kale P. A. 
Published: March 2007

AbstractPulmonary artery migration of pacemaker lead is rare and may result in pulmonary emboli originating from the thrombus around the infected catheter and causing multiple pulmonary infarcts. We report an unusual case of pacemaker lead migration to the right pulmonary artery with septic pulmonary embolism. While being treated with intravenous Cefuroxamine, the patient had spontaneous migration of the lead to the left pulmonary artery with subsequent left pulmonary embolism.
Percutaneous puncture of a nondeflatable coronary artery angioplasty balloon
Authors: Forcier Nancy J. , Cascade Philip N. , Maltzman Jerald B. 
Published: March 2007

AbstractWe report a case in which a balloon catheter became permanently inflated in a coronary artery saphenous vein bypass graft. While still inflated, the balloon was forcibly withdrawn from the graft into the external iliac artery and successfully deflated via percutaneous puncture using a CHIBA needle.
Treatment of ventricular tachycardia induced cardiogenic shock by percoronary chemical ablation
Authors: Demaio Samuel J. , Walter Paul F. , Douglas John S. 
Published: March 2007

AbstractIncessant ventricular arrhythmias pose an especially challenging therapeutic dilemma. We describe the successful treatment and follow‐up of a patient with refractory ventricular tachycardia‐induced cardiogenic shock with percoronary chemical ablation. After endocardial mapping was used to identify the “tachycardia‐related” coronary artery, temporary termination of the arrhythmia with balloon occlusion and subselective intracoronary installation of iced saline as previously advocated was unsuccessful. This was probably due to a dual arterial blood supply to the arrhythmogenic focus. However, infusion of 2 cc ethanol (99%) permanently terminated the arrhythmia. Contrary to previous experience, ethanol‐induced arrhythmia termination did not result in arterial occlusion, further supporting a direct toxic effect on the myocardium as its mode of action. Use of standard angioplasty balloon inflation prevents “backwash” of distally infused ethanol and more generalized cell death. The only complication of this procedure was temporary third‐degree AV block, requiring permanent pacemaker implantation.
Usefulness of digital angiography in the assessment of left ventricular ejection fraction
Authors: Koning Gerhard , Van Den Brand Marcel , Zorn Inge , Loois Geerling , Reiber Johan H. C. 
Published: March 2007

AbstractWith modern digital cardiac systems the image data are digitized on‐line and in real‐time, allowing the replay and subsequent interpretation and analysis during or directly after the cardiac catheterization procedure. In this study we have evaluated the advantages and limitations of a manual tracing technique for left ventricular digital angiograms on the Philips DCI system. Thirty‐three patients who were catheterized for suspected coronary artery disease were studied. The manual tracings were performed by a senior cardiologist and an experienced function‐analyst. It was found that the short‐ and long‐term intraobserver variabilities in the assessment of the global ejection fraction were very small; short‐term mean difference ± standard deviation (correlation coefficient): 0.5±2.7 (r = 0.97) global EF%‐units; long term; 0.7±2.7 (r = 0.96) EF%‐units. The interobserver variabilities (5.1±4.8 (r = 0.93) EF%‐units) were slightly higher than the intraobserver variabilities. A decrease by 25% in the amount of contrast medium administered did not significantly influence the variabilities in the contour tracings, which would suggest the use of smaller doses. At the average, the cardiologist and the function‐analyst required 6 and 11 min of analysis time for a left ventricular study, respectively, emphasizing the need for further developments towards automated contour detection. Finally, an excellent correlation was found with a standard off‐line cinefilm analysis procedure. Thus, it may be concluded that quantitative digital left ventricular angiography based on manual tracing of the outlines performed immediately following the cardiac catheterization (postprocessing) is feasible as a routine procedure for the assessment of left ventricular function.
Reduction in radiation exposure during coronary angiography
Authors: Carpenter Margot L. , Singer Peggy R. , Jain Avanindra , Dehmer Gregory J. 
Published: March 2007

AbstractIn addition to lead shielding, increased distance between the operator and x‐ray source will lower radiation exposure. To utilize this principle, we interposed a 24 in. piece of pressure tubing between the catheter used for coronary angiography and the manifold apparatus. Radiation exposure to the hand of the operator during coronary angiography was compared with and without the extension tubing. When corrected for the differences in exposure time, operator exposure was 5.38 mrem/min without the extension and 4.84 mrem/min with the extension. Although this is a small difference in exposure/min, a substantial reduction in exposure could accumulate over a 1 yr period. Insertion of this extension tube into the catheter system is a simple and safe way to further reduce operator exposure during coronary angiography.
Temporary cardiac pacing using a new, steerable, balloon‐Tipped pacing catheter
Authors: Stefanadis Christodoulos , Gavaliatsis Isidoros , Stratos Costas , Kallikazaros John , Vasiliadis John , Chatzigeorgiou Christoforos , Toutouzas Pavlos 
Published: March 2007

AbstractA new balloon‐tipped, flow‐directed, steerable pacing catheter for unipolar temporary ventricular pacing is presented. It was successfully and uneventfully tested in 25 patients with acute myocardial infarction in the coronary care unit. The main advantage of the new catheter is the ease with which a stable contact may be achieved between the pacing electrode and the endocardium.
Precertification for percutaneous transluminal coronary angioplasty in medicare beneficiaries: A melting pot or a need for better national standards?
Authors: Butman Samuel M. 
Published: March 2007

AbstractThe Health Care Financing Administration has contracted with state peer review organizations (PROs) in its effort to assure the quality of services and eliminate unreasonable and inappropriate care provided Medicare beneficiaries. By law, each state PRO must select 10 procedures for precertification. Coronary angioplasty has been chosen by 45 PROs for precertification and criteria in each state were developed with the advice of local physicians. This report describes the findings of a survey of these precertification criteria in an effort to determine their variability and to compare the PRO criteria to published national criteria created by expert panels.Current precertification criteria of Medicare beneficiaries show significant variability in the priorities and the clinical practice of cardiologists in performing coronary angioplasty, despite established and published guidelines for its safe and efficacious use. It is likely that the establishment of locally based criteria for coronary angioplasty will be geographically uneven and probably have a less than expected impact on the care provided to Medicare beneficiaries.
Percutaneous balloon pulmonic valvuloplasty following treated endocarditis in a patient with congenital pulmonary valve stenosis
Authors: Coberly LeAnn , Harrison J. Kevin , Bashore Thomas M. 
Published: March 2007

AbstractA 36‐year‐old woman with congenital pulmonary valve stenosis developed the rare complication of endocarditis of the valve. After successful sterilization of the valve, the patient underwent percutaneous balloon pulmonic valvuloplasty at a later date. The procedure successfully reduced the peak pulmonary valve gradient from 94 to 45 mm Hg. Percutaneous balloon valvuloplasty is the procedure of choice for treatment of congenital pulmonary valvular stenosis, even in the unusual patient who has healed endocarditis of the pulmonary valve.
Implantation of an endoluminal prosthesis at the distal anastomosis of a bypass graft for abrupt closure following balloon angioplasty
Authors: Strauss B. H. , Leborgne O. , De Scheerder I. K. , Serruys P. W. 
Published: March 2007

AbstractA coronary Wallstent® was implanted in a 10‐year‐old saphenous vein bypass graft following a PTCA that was complicated by abrupt closure. Anterograde flow was restored and no myocardial necrosis resulted. One week later, bypass surgery was performed due to a bleeding complication associated with the anticoagulation regimen.
Salvage of branch vessels during bifurcation lesion angioplasty: Acute and long‐term follow‐up
Authors: Weinstein Joseph S. , Baim Donald S. , Sipperly Mary Ellen , McCabe Carolyn H. , Lorell Beverly H. 
Published: March 2007

AbstractTo evaluate angiographic success, frequency of branch vessel loss and salvage, and long‐term outcome, we studied the early and late outcomes of 56 consecutive patients who underwent PTCA of bifurcation lesions, which involved the left anterior descending or left circumflex coronary artery, with stenoses > 70% in both the parent and an involved branch vessel. In 35 patients (63%), the PTCA strategy was attempted dilation of both the main vessel and the involved branch vessel using predominantly a double‐wire, sequential balloon technique; in 21 (27%) the PTCA attempt was confined to the main vessel alone. Transient angiographic occlusion of the branch vessel occurred in 32% of patients in whom dilation of both vessels was attempted, and in 38% in whom the main vessel alone was dilated (p = NS); 91% of the occluded branch vessels were then salvaged when sequential angioplasty of both vessels had been initially planned, compared to only 38% when the initial strategy had been dilatation of the main vessel alone (p < .05). Predischarge exercise testing showed residual ischemia in 6% of patients who had both vessels successfully dilated, versus 37% in those in whom dilatation was confined to the main vessel (p < .01). Clinical restenosis, defined as late (> 6 weeks) recurrence of angina or a positive exercise test, occurred in 42% of patients who had both vessels successfully dilated. Thus although bifurcation lesion angioplasty frequently results in transient branch vessel loss, these branches can usually be salvaged using a double‐wire technique but tend to have a higher late restenosis than conventional single vessel PTCA.
Atrial septal occlusion improves the accuracy of mitral valve area determination following percutaneous mitral balloon valvotomy
Authors: Petrossian George A. , Tuzcu E. Murat , Ziskind Andrew A. , Block Peter C. , Palacios Igor 
Published: March 2007

AbstractWe investigated the impact of the atrial communication on the mitral valve area calculation after percutaneous mitral balloon valvotomy in 17 patients (15 women, 2 men; mean age 56 ± 4 years). The hemodynamic measurements and mitral valve area calculations were performed with and without balloon occlusion of the atrial septal puncture site. The mitral valve area determined with balloon occlusion was significantly smaller than the mitral valve area determined without occlusion (1.6 ± 0.1 vs. 1.9 ± 0.1 cm2, P < 0.01), and was similar to the echocardiographically determined valve area (1.6 ± 0.1 cm2). This decrease in the calculated mitral valve area with occlusion was associated with a decrease in the measured cardiac output, without a change in the mitral valve gradient or the diastolic filling period. Occlusion of the atrial septal puncture site may permit more accurate determination of the mitral valve area and thus provide a better reference point for future comparison should the question of restenosis arise.
Coronary angioplasty following cardiac transplantation: A case report and review of the literature
Authors: Prewitt Kerry C. , Wortham Dale C. , Banks Alan K. 
Published: March 2007

AbstractA 23‐year‐old man underwent successful percutaneous transluminal coronary angioplasty of a severe stenosis of the left anterior descending artery 25 months after orthotopic heart transplantation. Four months later restenosis of the same lesion was treated by repeat PTCA. Angiography 11 months later showed no restenosis. In selected cases, PTCA may be useful in treating allograft coronary disease.
Percutaneous right brachial artery approach with 5f catheters for studying coronary artery disease
Authors: Lupon‐Rosés J. , Domingo E. , Angel J. , Anívarro I. , Soler‐Soler J. 
Published: March 2007

AbstractWe prospectively studied 60 ischemic patients with 5F catheters (Pigtail and Amplatz) using the percutaneous right brachial artery approach (group I), in order to compare this technique with two groups of 100 patients each randomly studied by the femoral route with either 5F (group II) or 8F (group III) catheters (Pigtail and Judkins). The following parameters were analyzed: need to change the initially elected catheter diameter or/and artery approach; technical difficulty for obtaining LV, LCA, and RCA angiograms; total time of X‐ray exposure; quality image of LV, LCA, and RCA angiograms; incidence of arterial puncture related hematomas or total arterial occlusion; and duration of local compression after sheath removal. There were no differences between 5F brachial and femoral approaches except for the arterial compression time (p<0.01) and the X‐ray exposure time (p=0.03) which were longer with the brachial approach. Whatever the route used, 5F showed a mild increased difficulty (brachial p=0.001; femoral p=0.01) and a mild decreased quality image for LCA (branchial p=0.006; femoral p<0.05). Mild hematomas were more frequent with 8F catheters (p<0.05). The procedure could be completed by the elected first artery and type of catheter (5F or 8F) in 57/60 patients in group I, in 95/100 in group II, and in 96/100 in group III (nonsignificant differences). Thus, the percutaneous right brachial artery approach using 5F catheters is similar to the femoral artery approach with the same catheters. Although both of them showed a mild increased technical difficulty and a mild decreased quality image compared to 8F, mainly for LCA angiograms, they allowed complete and reliable angiograms reading and analysis.
Angiographic follow‐up and clinical outcome of 126 patients after percutaneous directional atherectomy (simpson atherocath™) for occlusive peripheral vascular disease
Authors: Dorros Gerald , Iyer Sriram , Lewin Ruben , Zaitoun Rafic , Mathiak Lynne , Olson Karen 
Published: March 2007

AbstractAngiographic and clinical follow‐up data were obtained in 115/126 patients who underwent directional atherectomy for peripheral vascular disease; of the 126, ten were excluded for appropriate reasons and one was lost to follow‐up. Thus, 115/116 successful atherectomy patients (99%) had follow‐up of 182/213 lesions (86%): 74 patients (64%) with angiography (mean time 5.4 mon), and 41 patients (36%) clinically. One hundred twenty‐eight of 183 lesions (70%) had angiographic follow‐up; the lesion recurrence as a stenosis or as an occlusion was 53%. Lesion distribution did not differ between angiography and clinical follow‐up groups: nearly 85% were within the superficial femoral or popliteal arteries. Despite data stratification, angiographic follow‐up indicated that patients after successful directional atherectomy, at a mean follow‐up time of >5 mos, have more than a 50% lesion recurrence rate. Although directional atherectomy (Simpson AtheroCath™) utilizing present techniques has excellent primary success and acceptable complication rates, angiographic follow‐up statistics are bothersome.
Coronary angioplasty requiring extraordinarily high balloon inflation pressure
Authors: Willard John E. , Sunnergren Kenneth , Eichhorn Eric J. , Grayburn Paul A. 
Published: March 2007

AbstractTwo cases are presented in which extraordinarily high balloon inflation pressures (20 and 17 atm) were required to successfully dilate a saphenous vein graft stenosis and a right coronary artery stenosis. The clinical application of high balloon inflation pressures and balloon selection is discussed.
Successful treatment of an excimer laser‐associated coronary artery perforation with the stack perfusion catheter
Authors: Parker John D. , Ganz Peter , Selwyn Andrew P. , Bittl John A. 
Published: March 2007

AbstractA 64‐year‐old woman underwent excimer laser angioplasty of the right coronary artery. The procedure was complicated by perforation, which was successfully managed without complication with a Stack perfusion catheter. This report describes successful non‐surgical treatment of laser‐induced coronary perforation and makes recommendations for avoiding this complication in other patients.