bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repeat balloon aortic valvuloplasty
Authors: Koning R. , Cribier A. , Asselin C. , Mouton‐Schleifer D. , Derumeaux G. , Letac B. 
Published: March 2007

AbstractThis paper attempts to determine limitations and indications of performing a second balloon aortic valvuloplasty procedure (BAV2) because of restenosis, which is the major limitation of this technique. From September 1985 to December 1989, 357 patients underwent a primary BAV (BAV1) and 67 patients had a BAV2. Forty‐two patients (group A) had repeat catheterization because they were markedly symptomatic 11 ± 7 months after BAV1. Twenty‐five patients (group B) came from a group of 73 patients who had been systematically scheduled for repeat catheterization in order to evaluate the hemodynamic restenosis rate 8 ± 3 months after BAV. At time of BAV2 most of the patients of group A were severely disabled. Comparison of pre‐BAV2 gradient and aortic valve area with pre‐BAV1 measurements showed in a slightly less severe degree of aortic stenosis in group A and in group B with any difference in cardiac index and ejection fraction. Immediately following BAV2, the gradient decreased from 72 ± 22 to 33 ± 15 mm Hg (P ± and aortic valve area increased from 0.56 ± 0.18 to 0.85 ± 0.28 cm 2) (p < 0.001) in group A. In group B, gradient decreased from 68 ± 15 to 33 ± 15 mm Hg (p < 0.001) and aortic valve area increased from 0.70 ± 0.16 to 0.90 ± 0.25 cm2 (p < 0.001). Comparison of the post‐BAV2 peak systolic gradient, aortic valve area, ejection fraction, and cardiac index with post‐BAV1 measurements revealed no significant differences in the two groups, but the absolute increase in aortic valve area obtained at BAV2 was significantly less than at BAV1 in group B (0.20 ± 0.22 vs 0.31 ± 0.16 cm2 p < 0.02). The larger balloon size used for BAV2 than for BAV1 did not increase the final valve area at BAV2. In‐hospital mortality was 3%. The use of a better profiled catheter with an arterial introducer explained the lower rate of vascular complications (4%). This report demonstrates that when BAV is indicated a second procedure can be performed safely and with low risk in symptomatic patients. © 1992 Wiley‐Liss, Inc.
Use of twenty‐four hour infusions of intracoronary tissue plasminogen activator to increase the application of coronary angioplasty
Authors: Pitney Mark R. , Cumpston Neil , Mews Geoffrey C. , Cope Geoffrey D. , Gibbons Frances 
Published: March 2007

AbstractCoronary arteries occluded by long lengths of thrombus are usually considered unattractive for angioplasty. Nine patients (8 male, mean age 50.1 years) undergoing angiography for unstable angina were found to have single vessel disease considered unsuitable for angioplasty as the vessel was occluded by a long length of thrombus. These patients were treated with 24 hr intracoronary infusions of 100 mg tPA in an attempt to make angioplasty feasible. Marked thrombolysis occurred in 7 patients who received uncomplicated infusions. One case was unsuccessful due to catheter displacement, while another had the infusion ceased due to an intracerebral bleed from a previously silent A‐V malformation. This was the only major complication. Angioplasty was attempted in 6 of 7 cases where lysis had been achieved, with success in all lesions attempted. This reports shows that intracoronary tPA infused over prolonged periods produces excellent thrombolysis, making angioplasty feasible in some patients who were previously unsuitable. © 1992 Wiley‐Liss, Inc.
Activated clotting times and activated partial thromboplastin times in patients undergoing coronary angioplasty who receive bolus doses of heparin
Authors: Dougherty Kathy G. , Gaos Carlos M. , Bush Howard S. , Leachman D. Richard , Ferguson James J. 
Published: March 2007

AbstractThe accurate assessment of coagulation status is an important part of interventional procedures performed in the cardiac catheterization laboratory. While the traditional clinical means of assessing heparin anticoagulation has been with the activated partial thromboplastin time (APTT), the activated coagulation time (ACT) has come into widespread use in the catheterization laboratory as an assay of whole blood clotting time which can be performed rapidly at the bedside. The purpose of the present study was to (1) assess the anticoagulant effect of a 10,000 U bolus of heparin in PTCA patients and (2) document the relationship between ACTs and APTTs in a subset of these patients. Baseline and postheparin ACTs were measured using a HemoTec coagulation timer in 545 unselected PTCA patients. The average baseline ACT was 120 ± 22 sec. After a 10,000 U bolus of heparin the average ACT was 249 ± 44 sec; 58% of patients had an ACT < 250 sec, 17% had an ACT between 250 and 275 sec, 12% had an ACT between 275 and 300 sec, and 13% had an ACT >300 sec. A total of 175 paired ACT and APTT measurements were obtained in a random subset of these patients at baseline, after heparinization, and at 4–6 hr intervals after the procedure. The APTT was limited by absolute upper and lower limits of 150 and 22 sec; there were no such limits on the ACT. When limiting values were excluded, there was a strong overall correlation between ACT and APTT measurements (r = 0.92, p 0.001). We conclude that the activated coagulation time provides an accurate and reliable assessment of anticoagulation status. This test appears to be ideally suited for patients undergoing interventional procedures. There are, however, substantial differences in the automated systems currently in clinical use. The percent of patients achieving a target ACT of greater than 300 sec, as measured by a HemoTec system, after a 10,000 U bolus of heparin is low. These results are not extrapolatable to other ACT measurement techniques. © 1992 Wiley‐Liss, Inc.
Antegrade selective coronary angiography via the transseptal approach in a patient with severe vascular disease
Authors: Pearce A. Craig , Schwengel Robert H. , Simione Linda M. , Patrick Carol J. , Santiago Carlos , Ziskind Andrew A. 
Published: March 2007

AbstractWe describe a case of a woman with severe vascular disease in whom retrograde access to the aortic root was limited by both aortoiliac and axillary disease. Transseptal cathe‐terization was performed in anticipation of percutaneous aortic valvuloplasty. Selective antegrade angiography was successfully performed using catheters introduced through the transseptal sheath. © 1992 Wiley‐Liss, Inc.
Percutaneous vascular hemostasis device for interventional procedures
Authors: Merino Alvaro , Faulkner Catherine , Corvalan Alejandro , Sanborn Timothy A. 
Published: March 2007

AbstractA new 11.5F over‐the‐wire vascular hemostasis device was compared to conventional manual compression in normal swine femoral arteries. Using percutaneous techniques, the collagen was deposited and hemostasis achieved in 7 vessels after 1 minute total, plus 4 minutes partial compression, while control manual compression required more than 5 minutes total compression to avoid hematoma formation. One month follow‐up of treated arteries (n = 4) and controls (n = 3) showed no impairment in distal pulse or differences in histology at the puncture site in the control and treated arteries. Thus, the vascular hemostasis device technique is safe and effective, achieves hemostasis with less compression time and complications, and does not interfere with arterial wall healing or compromise the lumen.© 1992 Wiley‐Liss, Inc.
Comparison of angiographic center and local site analysis of PTCA results in a multicenter angioplasty‐restenosis trial
Authors: Martinelli Michael J. , Deutsch Ezra , Ferraro Angelo , Bove Alfred A. 
Published: March 2007

AbstractWe compared three methods of coronary stenosis (S) sizing in a multihopsital PTCA restenosis trial: visual analysis by independent observers, single point caliper measurements, and quantitative coronary angiography (QCA). Cine films from 50 patients were submitted from the clinical site to the quantitative angiographic center, where visual analysis and computer quantitation were performed. Regression analysis revealed a correlation coefficient of .857 for caliper vs. QCA (p <.0001) and .876 for visual observation vs. QCA (p <.0001). No significant differences were found between any of the 3 methods for pre‐ or post‐PTCA stenosis values. However, QCA yielded smaller PTCA changes in stenosis severity than either caliper or visual observation (p <.05). Both caliper and visual methods correlated well with QCA in assessing stenosis size pre‐ and post‐PTCA. Trained observers can visually assess lesion severity with accuracy approaching QCA. QCA is likely to be less expensive when compared to visual analysis by three experienced observers and should be the method used for estimating the results of PTCA in clinical trials.© 1992 Wlley‐LIM, Inc
Acute coronary thrombotic occlusion following exercise testing 6 weeks after percutaneous transluminal coronary angioplasty
Authors: Goodman Shaun G. , Holloway Richard M. , Adelman Allan G. 
Published: March 2007

AbstractExercise stress testing is often performed following percutaneous transluminal coronary angioplasty (PTCA) in order to evaluate the efficacy of the procedure [1]. Together with thallium‐201 (T1‐201) scintigraphy, these noninvasive tests provide valuable data for predicting the recurrence of angina and restenosis [2]. However, concerns regarding the safe timing of exercise testing post‐PTCA have been raised in 3 previous case reports [3–5]. Each case documents acute coronary occlusion shortly after stress testing performed within several days of successful angioplasty, leading to the recommendation that such testing be deferred up to 4 weeks following PTCA. This paper reports a patient in whom acute thrombotic occlusion of the left anterior descending coronary artery (LAD) occurred immediately after a mildly abnormal exercise T1‐201 stress test done 6 weeks after PTCA.
Left main coronary artery aneurysm following percutaneous transluminal angioplasty: A report of a case and review of the literature
Authors: Desai Prakash K. , Ro Jae H. , Pucillo Anthony , Weiss Melvin B. , Herman Michael V. 
Published: March 2007

AbstractSince its introduction in 1977, the number of PTCAs and its indications have grown. Along with more frequent usage, newer complications have been reported. Aneurysm of left main coronary artery is rare. This report describes the formation of a new non‐obstructing aneurysm in the left main coronary artery after PTCA of left circumflex artery. The patient has had 7 yr of follow‐up with a benign clinical course.
Balloon dilation of the completely occluded blalock‐taussig anastomosis: A case report
Authors: Jacob José Luiz Balthazar , Machado Nilton Carlos Spínola , Garzon Sérgio Aloísio Coimbra , Lorga Adalberto Menezes , Braile Domingo Marcolino 
Published: March 2007

AbstractWe report successful balloon dilation of a completely occluded classical Blalock‐Taussig shunt in a 3‐yr and 6‐mo‐old boy with univentricular heart and severe valvar and subvalvar pulmonary stenoses.
Modified “kissing” atherectomy procedure with dependable protection of side branches by two‐wire technique
Authors: Leya F.S. , Lewis B. E. , Sumida C. W. , McKiernan T. L. , Grassman E. D. , Bhatia S. , Killian D. M. , Halle A. A. , Ward K. A. , Johnson S. A. , Scanlon P. J. 
Published: March 2007

AbstractWe report a new two‐wire atherectomy technique for side branch protection. Newer, more resilient wire designs are capable of withstanding cutting forces of the Simpson atherocath device. This technique expands atherectomy application to lesions previously excluded from atherectomy as high risk lesions.
Balloon catheter requirements during contemporary percutaneous transluminal coronary angioplasty
Authors: Kahn Joel K. 
Published: March 2007

AbstractIn order to examine the outcome of utilizing multiple balloon catheters during the percutaneous transluminal coronary angioplasty (PTCA), 300 consecutive PTCAs were analyzed. PTCA was performed in a single lesion in 163 patients (54%), in multiple lesions in 52 patients (18%), and in multiple vessels in 85 patients (28%). A total of 488 balloon catheters were used (1.6/case, range 1–9) and in 112 cases (37%) ≥2 catheters were used. Multiple balloon catheters were needed in 27 single lesion (17%), 24 multilesion (48%), and 61 multivessel (72%) cases (p < .05). There was no difference in the angiographic success rate in cases completed with 1 balloon catheter (238/251, 95%) compared to those requiring ≥2 catheters (260/274, 95%). Emergency bypass was required in 5 patients (1.7%) and there were 2 deaths (0.6%). Thus, although contemporary PTCA frequently requires multiple balloon catheters for completion, success rates remain high and appear to offset the increased procedural expenses.
Measurements of central blood vessels in infants and children: Normal values
Authors: Steinberg Charlotte , Weinstock David J. , Gold Jeffrey P. , Notterman Daniel A. 
Published: March 2007

AbstractIn order to provide physicians interpreting vascular radiographic studies with normal data regarding central blood vessel size in children and to facilitate the design and adaptation of intravascular devices for pediatric use, we measured lengths and diameters of central blood vessels in 141 radiographic studies in 136 children. The diameters of the following vessels were determined: right and left internal jugular veins and common carotid arteries; the inferior vena cava and the descending thoracic aorta; right and left iliac veins; and right and left femoral veins and arteries. In addition, the lengths of the inferior vena cava and the descending aorta were also determined. Blood vessel dimensions were highly correlated with age, height, weight, and body surface area. The linear regression equations for each measured dimension against age, weight, height, and surface area are provided, along with a table of predicted vessel size as a function of age.
Shearing of the plastic coating of a hydrophilic guide wire in a right femoropopliteal bypass graft: Removal from the contralateral side
Authors: Kemper F. J. M. , Tielbeek A. V. , El Biltagiu S. , El Gamal M. I. H. , van Gelder L. M. 
Published: March 2007

AbstractThe plastic coating of a hydrophilic guide wire tore off during introduction through a beveled single wall arterial entry needle in a 75 year old male. The sheared piece of coating got stuck in his femoropopliteal bypass. It was removed by means of a modified arterial filter set from the contralateral side. The technique of its removal is described.
Long‐tip guiding catheter: Successful and safe for left coronary artery angioplasty
Authors: Voda Jan 
Published: March 2007

AbstractA long‐tip guiding catheter was designed for angioplasty of the left coronary artery. Principal factors of guiding catheter function were identified, and the catheter's shape was designed to utilize them efficiently. Emphasis was placed on an overbent secondary curve (150–180°) for more precise catheter control. The distal tip of the catheter is 2 cm long in the 4.0 size and the primary bend is shallow, ∼20%. A 1.5 cm long segment between the secondary and tertiary curves enhances stability and support. Catheter performance was studied during procedures on 90 patients; 89 patients underwent coronary artery angioplasty and one patient underwent diagnostic angiography. The success rate for angioplasty was 95% with no major complications. Mild pressure damping occurred in 18 patients, and mild catheter displacement from the left main coronary artery occurred in 24 patients. Catheter support was judged as excellent to very good in 82 patients. Judkins or Amplatz catheters were not required during this study. The observed disadvantages of the long‐tip catheter were the risk of catheter buckling up during advancement into the left main coronary artery and, perhaps, a higher risk of pressure damping. Superselective engagement of the catheter in the left anterior descending or circumflex arteries may be a problem when the left main coronary artery is very short. This study showed the long‐tip catheter to be safe and highly successful for angioplasty of the left coronary artery.
Coronary perforation during angioplasty: Angiographic detection and demonstration of complete healing
Authors: Topaz On , Cowley Michael J. , Vetrovec George W. 
Published: March 2007

AbstractA patient is presented with localized perforation of the left anterior descending artery secondary to angioplasty balloon rupture. Despite a remarkable angiographic picture of coronary tear and dye extravasation into the surrounding pericardial tissue, the patient remained hemodynamically stable, and was medically treated. Five years later she redeveloped angina, and repeated coronary arteriography revealed complete healing of the perforation site. This case attests to the remarkable ability of the coronary artery to completely heal from a major wall trauma. Although a rare complication of coronary angioplasty, perforation can occur, and various management aspects should be considered.
Laser facilitated angioplasty and thrombolysis in acute myocardial infarction complicated by prolonged or recurrent chest pain
Authors: Topaz On , Rozenbaum Eliezer A. , Battista Stephen , Peterson Craig , Wysham Douglas G. 
Published: March 2007

AbstractTo date, application of laser angioplasty in acute myocardial infarction (MI) has not been reported. In nine patients with acute myocardial infarction complicated by continuous or recurrent severe ischemia and chest pain, a mid‐infrared, solid‐state, pulse‐wave holmium/thulium:YAG coronary laser was applied. In six of these patients the laser was specifically utilized for the purpose of coronary thrombolysis. In each case a guidewire was placed across the stenosis and a multifiber laser catheter was utilized, emitting 250–600 mJ/pulse at 5 Hz, followed by adjunctive balloon angioplasty. Laser success (defined as ability to cross the lesion, reduction of ±20% in stenosis and thrombolysis when a thrombus is present) was achieved in all patients. Final angiograms revealed residual stenosis ±30%, adequate thrombolysis and no major complication (MI, perforation, emergency CABGS, CVA, death) in each patient. Clinically, all nine patients improved, survived the acute infarction and were discharged. This initial clinical experience demonstrates the feasibility and safety of holmium/thulium:YAG laser application in thrombolysis and plaque ablation in selected patients who experience acute myocardial infarction complicated by prolonged or recurrent ischemia and chest pain.
Acute myocardial infarction complicating urokinase infusion for total saphenous vein graft occlusion
Authors: Blankenship James C. , Modesto Thomas A. , Madigan N. Patrick 
Published: March 2007

AbstractSaphenous vein graft occlusions have been successfully treated with extended urokinase infusions. We report a case of myocardial infarction complicating this treatment. A review of reported cases suggests that this complication may not be uncommon. The optional drug, dose, and infusion technique for intra‐graft lytic therapy has not been determined. The costs, risks, and difficulty of this technique may limit its application.
Platelet adhesion/aggregation in an in vitro model of coronary artery stenosis
Authors: Grabowski Eric F. , Rodriguez Marisol , McDonnell Sonam L. 
Published: March 2007

AbstractPlatelet adhesion/aggregation (PAA) at a site of coronary artery stenosis is believed to be a process strongly modulated by local shear rates and the functional state of neighboring endothelium. One purpose of the present work, therefore, is to describe an in vitro model for the direct imaging of such PAA. Another is to apply the model to the question as to whether the use of nonionic vs. ionic contrast media (CM) in the presence of vascular endothelium contributes to PAA at the stenosis site. Toward these ends, we utilized a special flow chamber which incorporates a monolayer of endothelial cells (ECs), a step 66% flowpath constriction at a site preadsorbed with microfibrillar collagen, and arterial shear rates. By epifluorescence microscopy and digital image analysis of video recordings, PAA was found to be greater with dysfunctional ECs (pretreated with lysine acetylsalicylate) than with normal ECs, thereby confirming a modulatory role in PAA of functionally intact ECs. When nonionic (iohexol) or ionic (ioxaglate, diatrizoate) CM was added to the flowing blood at a concentration of 20% by non‐red cell volume, PAA was inhibited in the order diatrizoate > ioxaglate > iohexol > saline control. No inhibition by any CM was seen, however, when chamber prefill culture medium containing 20% by volume CM was displaced by CM‐free blood, in simulation of bolus administration of CM. In terms of inhibition of PAA during percutaneous transluminal coronary angioplasty (PTCA), therefore, our model provides a conceptual basis by which one may anticipate in flowing blood no clear benefit of ionic over nonionic CM. This is because the greater antiplatelet effects of the ionic CM are lost with hemodilution by CM‐free blood, while a greater anti‐EC effect is likely to persist. © 1993 Wiley‐Liss, Inc.
Successful limb salvage after recanalization of an occluded infrapopliteal artery utilizing a balloon expandable (Palmaz‐Schatz) stent
Authors: Dorros Gerald , Hall Patrick , Prince Charles 
Published: March 2007

AbstractThis case describes the first reported successful management of an infrapopliteal artery intimal dissection utilizing the Palmaz‐SchatzTM balloon expandable stent. Stent deployment relieved the compromised blood flow caused by the intimal flap which could not be corrected by prolonged balloon inflation or removed with directional atherectomy, and averted any emergency surgical procedure. © 1993 Wiley‐Liss, Inc.
Pulmonary balloon valvotomy for severe valvular pulmonic stenosis with congestive heart failure beyond infancy
Authors: Shrivastava Savitri , Kumar R. Krishna , Dev Vishva , Kothari S. S. , Saxena A. 
Published: March 2007

AbstractIsolated valvular pulmonic stenosis (PS) in association with tricuspid regurgitation and congestive heart failure (CHF) is rarely encountered after infancy, and there is very little information available regarding the application of pulmonary balloon valvotomy (PBV) for this subset of patients. Since 1985, 10 patients (5 males, 5 females; mean age: 12.4 ± 7.5 years, range 4–25 years underwent PBV for severe valvular PS with CHF in our institution. All patients had associated tricuspid regurgitation and cardiomegaly. Before PBV, the mean peak systolic gradient across the right ventricular outflow was 131 ± 36 mmHg and the mean right atrial pressure was 14.4 ± 5.4 mmHg. Specific modifications in the PBV technique included the sequential use of progressively larger balloon catheters and the use of an extra stiff guidewire to support the dilatation assembly. One patient underwent PBV via the right internal jugular vein. Problems encountered during PBV included hypotension and bradycardia (2 patients) and respiratory arrest, which was transient in one patient, and prolonged and eventually fatal in one patient. A successful outcome was achieved in 8 patients (4 of these required 2 PBV attempts) with a final residual gradient of 40 mmHg or less, mean 28 ± 7; range: 21–38 mmHg) and complete resolution of CHF. One patient has had no significant change in gradients and awaits repeat dilatation. Patients with isolated severe valvular PS with TR and CHF represent a relatively high risk group for PBV. A successful outcome is, however, feasible if a carefully planned and cautious approach is used. © 1993 Wiley‐Liss, Inc.
Contained rupture following percutaneous transluminal coronary angioplasty: Long‐term outcome
Authors: Chou Tony M. , Amidon Thomas M. , Ports Thomas A. 
Published: March 2007

AbstractCoronary artery aneurysm formation can occur as a complication of balloon angioplasty. We present a case of a contained rupture of the left circumflex artery following angioplasty which resulted in an unusual pseudoaneurysm on angiography at 3‐year follow‐up. © 1993 Wiley‐Liss, Inc.