bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term safety and durability of percutaneous septal sinus shortening (The PS3 System™) in an ovine model
Authors: Rogers Jason H. , Rahdert David A. , Caputo Gary R. , Takeda Patricia A. , Palacios Igor F. , Tio Fermin O. , Taylor Elizabeth A. , Low Reginald I. 
Published: October 2008

AbstractObjectives: Chronic implants of the PS3™ system were conducted in an ovine model to assess durability and safety at up to 1 year follow‐up. Background: The long‐term durability and safety of emerging percutaneous devices for functional mitral regurgitation remain largely unknown. Methods: The PS3 system (consisting of interatrial septal and great cardiac vein devices connected by an adjustable suture bridge) was placed in eight healthy adult sheep. The mitral annular septal‐lateral dimension in systole (SLS) was acutely reduced by 15–20%. Animals were sacrificed at up to 12 months postimplant and characterized by intracardiac echocardiography, cardiac computed tomography (CT), and histopathology. In vivo forces exerted on the PS3 bridge were measured by means of a novel load cell catheter. Results: At 3, 6, and 12 months after implantation, intracardiac echocardiographic and CT showed the PS3 systems to be intact without erosion and with overall sustained reductions in the SLS. Histopathologic assessment revealed each component correctly deployed in its respective target site without evidence of erosion, thrombus, or device fracture. The SLS was 26.5 ± 1.7 mm preimplant, 22.0 ± 1.4 mm post‐PS3 (17.0% reduction), and 22.0 ± 2.1 mm at latest follow‐up. Mean forces exerted on the bridge in vivo ranged from 1.16 N to 1.87 N. Conclusions: The PS3 System demonstrated excellent biocompatibility without evidence of erosion, thrombosis, or perforation at up to one‐year follow‐up in this chronic healthy ovine model. Forces exerted in the PS3 system were relatively modest and should contribute to the durability of the device. © 2009 Wiley‐Liss, Inc.
A suture not always the ideal solution: Problems encountered in developing a suture‐based PFO closure technique
Authors: Majunke Nicolas , Baranowski Andreas , Zimmermann Wibke , Heinisch Corinna , Wilson Neil , Robertson Greg , Wunderlich Nina , Sievert Horst 
Published: October 2008

AbstractObjectives: To summarize our experiences with the first‐in‐man suture‐based patent foramen ovale (PFO) closure technique. Background: PFO is often present with the occurrence of cryptogenic stroke and migraine with aura. Successful PFO closure can be performed percutaneously using catheter techniques with many different closure devices. The described novel closure system is intended to deliver, via endovascular access, a suture into the atrial septal wall tissue for closure of PFO. Methods: Eleven patients, between 22 and 58 years of age (mean 46.6 ± 9.6), who had a cryptogenic ischemic stroke, TIA, or a peripheral embolism and a PFO were considered for percutaneous closure with this technique. Results: The mean stretched diameter of the defect evaluated during balloon sizing was 8.8 ± 0.4 mm (range 7–12.5). Delivery of the suture was successful in all patients. No intraprocedural complications occurred. During the follow up, complete closure could be achieved in one patient. Six patients with significant residual shunting during follow‐up had successful closure using a conventional device. One patient was lost for follow‐up after the 3‐month visit. The residual shunt in the remaining three patients was very small and they declined to be treated with a conventional device. No complications occurred during the follow up. Conclusions: Transcatheter application of a suture for closure of PFO is technically feasible and safe. However, despite successful suturing of the septum primum to the septum secundum, the PFO did not close in most of the patients. © 2008 Wiley‐Liss, Inc.
Implantation of two self‐expanding aortic bioprosthetic valves during the same procedure—Insights into valve‐in‐valve implantation (“Russian doll concept”)
Authors: Piazza Nicolo , Schultz Carl , de Jaegere Peter P.T. , Serruys Patrick W. 
Published: October 2008

AbstractTranscatheter aortic value implantation has gained acceptance as a treatment for elderly patients considered high risk for surgical aortic valve replacement. There are still, however, many unresolved clinical and technical issues. The occurrence of transcatheter aortic valve‐in‐valve implantation has been reported anecdotally. Aside from a single case report, there is little literature on this topic. This study was conducted to evaluate the procedural, imaging, and clinical outcomes of patients who underwent transcatheter valve‐in‐valve implantation with two self‐expanding aortic valve bioprostheses during the same procedure. We discuss also the potential valve of on‐line quantitative angiography for assessing the depth of valve implantation and the need to implant a second valve. © 2009 Wiley‐Liss, Inc.
Endovascular carotid artery stenting and early coronary artery bypass grafting for asymptomatic carotid artery stenosis: Long‐term outcomes and neurologic events
Authors: Ranaweera Priyantha S. , Bigelow Brian C. , Leary Megan C. , de la Torre Ralph , Sellke Frank , Garcia Lawrence A. 
Published: October 2008

AbstractBackground:Optimal management of patients with asymptomatic critical carotid artery stenoses prior to coronary artery bypass grafting (CABG) has no clear consensus. Further, optimal timing for surgical coronary revascularization has not been defined after or with any carotid revascularization.Methods:We reviewed the data from 2002 to 2007, of all patients in our institution who underwent carotid artery stenting (CAS) for critical carotid artery stenoses, prior to CABG. Twenty patients with critical carotid disease were referred for preoperative carotid intervention prior to CABG. Carotid duplex demonstrated evidence of critical stenoses in all patients. Patients were serially assessed by a stroke neurologist before and after the procedure (immediately, at 24 hr, at 48 hr, immediately following CABG, and at 30 days). We evaluated initial procedural success as well as freedom from periprocedure stroke.Results:Prior to undergoing CABG, 20 patients had stents placed in a single carotid artery for unilateral asymptomatic critical carotid artery stenoses. All the procedures, except one, were performed with distal embolic protection. Patients received aspirin and clopidogrel. There were no strokes or deaths up to a mean follow up of 486 days. The mean time from CAS to CABG performed in the same hospital admission was 6.4 days. Transfusion rates were not excessive despite dual antiplatelet therapy.Conclusion:In a real‐world setting, endovascular extracranial CAS for asymptomatic carotid artery stenosis by experienced operators, prior to CABG was safe and permitted early coronary revascularization without increased risk of strokes or death in this high‐risk cardiovascular patient population. © 2009 Wiley‐Liss, Inc.
Treatment of aortic arch aneurysm with a NuMED‐covered stent and restoration of flow to excluded left subclavian artery: Perforation and dilation of e‐PTFE can be done!
Authors: Tsai Shane F. , Hill Sharon L. , Cheatham John P. 
Published: October 2008

AbstractWe describe a case using a NuMED‐covered Cheatham‐Platinum (CP) stent (NuMED, Hopkinton, NY) to treat an aneurysm after previous balloon angioplasty and bare stent implantation for coarctation of the aorta (CoA). Exclusion of the left subclavian artery (LSCA) was anticipated. After wire perforation of the covered CP stent, balloon angioplasty was performed through a stent cell to recannulize the LSCA. © 2009 Wiley‐Liss, Inc.
Successful percutaneous closure of coronary artery fistula with angiographic follow‐up at 6 months
Authors: Hendry Cara , Mahadevan Vaikoms , Fath‐Ordoubadi Farzin 
Published: October 2008

AbstractCongenital coronary artery fistula can present later in life. We describe a case in a 56 year old, who was managed percutaneously with coil embolization leading to complete closure of the fistula, which was confirmed by follow‐up angiography at 6 months. © 2008 Wiley‐Liss, Inc.
Amplatzer occlusion of accessory ventriculopulmonary connections
Authors: Petko Colin , Gray Robert G. , Cowley Collin G. 
Published: October 2008

AbstractBackground: Children with complex congenital heart disease often require staged palliation to regulate systemic and pulmonary blood flow. Accessory sources of pulmonary blood flow including aortopulmonary collaterals, aortopulmonary shunts, and ventriculopulmonary connections following Glenn or Fontan palliation can be associated with elevated central venous pressures and persistent pleural drainage. Occlusion of accessory ventriculopulmonary connections in this setting has traditionally been accomplished surgically. Objective: To review the efficacy of Amplatzer devices in transcatheter occlusion of accessory ventriculopulmonary connections in children with complex congenital heart disease. Methods: Patients were identified and their records retrospectively reviewed for indication, procedural details, and clinical efficacy and outcome. Results: Between December 2004 and March 2008, seven patients underwent occlusion of accessory ventriculopulmonary connections using an Amplatzer Septal Occluder (3), an Amplatzer Duct Occluder (3), or an Amplatzer Vascular Plug (1). Underlying single ventricle physiology was present in six of these patients. The site of occlusion was the right ventricle to pulmonary artery (Sano) conduit in two patients, the native main pulmonary artery in three patients, the pulmonary valve in one patient, and a left ventricle to pulmonary artery homograft in one patient with biventricular physiology. There were no complications associated with these procedures. Conclusions: Amplatzer occlusion devices provide a safe and effective means of eliminating accessory ventriculopulmonary connections in children who have undergone surgical palliation of congenital heart disease. © 2008 Wiley‐Liss, Inc.
A comparison of the mechanical performance characteristics of seven drug‐eluting stent systems
Authors: Schmidt W. , Lanzer P. , Behrens P. , Topoleski L.D.T. , Schmitz K.‐P. 
Published: October 2008

AbstractObjectives: Mechanical properties of drug eluting stents (DES) will be measured to provide comparable numerical data to assess deliverability, and thus clinical performance. Background: DES are routinely used in coronary interventions to reduce the rates of restenosis and target vessel revascularizations. Current research is primarily concerned with issues related to late stent thrombosis. However, mechanical properties of DES are a critical determinant of deliverability, and consequently the ultimate arbiter of their clinical performance. Methods: Mechanical properties (pushability, trackability, crossability) were measured under standardized in‐vitro conditions. The vessel models were derived from typical vessel anatomy but adapted to the individual tests. Additionally, profile and bending forces of the stent segment of the delivery system were measured. Seven different commercially available balloon‐expandable coronary DES systems were included. All stents were 3.0 mm diameter with a stent length from 14 to 18 mm. Results: The pushability expressed as the ratio of distal force at a specific proximal push force (4N) ranged between 38.66 and 18.53%. The trackability as the mean track‐forces ranged from 0.551 N to 1.137 N. One stent system could not pass this test. The mean crossing forces at a 1.4 mm stenosis model ranged from 0.038 N up to 0.103 N. The mean crimped stent profiles ranged from 1.055 mm to 1.198 mm and the bending stiffness of the crimped stent was 17.22 to 47.20 Nmm2. Conclusion: Better understanding of mechanical properties of DES shall improve tactile skills of the interventionists during PCI and to improve criteria for DES selection in specific clinical settings. © 2008 Wiley‐Liss, Inc.
Use of magnetic guidewire navigation in the treatment of lower extremity peripheral vascular disease: Report of the first human clinical experience
Authors: Iyengar Srinivas , Gray William A. 
Published: October 2008

AbstractThe use of a magnetic navigation system (MNS) to facilitate catheter placement in electrophysiologic procedures has been increasingly documented over the past decade. Recently, the utilization of MNS to aid guidewire directionality in complex coronary lesions has also been described. Given the multifaceted ability of MNS to be applied to varying vascular beds, we describe the successful employment of this modality to facilitate treatment of lower extremity peripheral arterial disease in a symptomatic male with gangrenous toe ulceration. © 2009 Wiley‐Liss, Inc.
Concomitant renal and iliac fibromuscular dysplasia
Authors: Chin Ashley , Ntsekhe Mpiko 
Published: October 2008

AbstractFibromuscular dysplasia (FMD) usually involves the renal arteries and is an important cause of secondary hypertension in younger women. We report an unusual case of FMD in a middle‐aged woman, not only involving both the renal and iliac arteries but also presenting in a pattern more typical of atherosclerosis. © 2009 Wiley‐Liss, Inc.
Percutaneous coronary intervention for a right coronary artery stent occlusion using retrograde delivery of a sirolimus‐eluting stent via a septal perforator
Authors: Utunomiya Makoto , Katoh Osamu , Nakamura Shigeru 
Published: October 2008

AbstractIn percutaneous coronary intervention for chronic total occlusion (CTO), the retrograde approach is an advanced technique. To improve the long‐term patency rate, stent implantation is necessary for CTO, however, antegrade stent delivery to the lesion is contraindicated in cases where there is an anomalous origin or deviation of the coronary artery, or the edge of a previously implanted stent extends into the aorta. We report a successful case of retrograde stent implantation via a septal perforator in a patient with marked deviation of the RCA origin. In this case, antegrade stent implantation was difficult because antegrade catheter insertion carried a risk of crush deformation of an ostial stent. © 2009 Wiley‐Liss, Inc.
Percutaneous coronary interventions in octogenarians: Acute and 12 month results in a large single‐centre experience
Authors: Varani Elisabetta , Aquilina Matteo , Balducelli Marco , Vecchi Giuseppe , Frassineti Valeria , Maresta, Aleardo 
Published: October 2008

AbstractObjectives: To review the results of PCI in patients aged ≥80 years. Background: Octogenarians represent a growing proportion of patients treated with PCI; in this subset of high‐risk patients, the role of complete revascularization is still controversial. Methods: We examined in‐hospital, 30 days, and 12‐month events in 356 patients aged ≥80 years submitted to PCI from 2004 to 2006 and 754 patients aged <80 years treated in 2006. Results: Octogenarians had a higher risk profile. A complete revascularization was obtained in 48% of them and in 65% of younger patients (P < 0.001); glycoprotein IIb/IIIa inhibitors (GPI) use was common in both groups (43 vs. 46.5%). In‐hospital mortality was higher in octogenarians (3.9 vs. 1.3%, P = 0.01) as well as vascular complications (2.8 vs. 1%, P = 0.058). Mortality resulted 5.9 vs. 1.2% at 30 days (P < 0.001), and 16.3 vs. 3.9% at 12 months (P <0.001) in the two groups whereas repeat revascularization procedures did not differ (9.3 vs. 8.4%, respectively). In patients aged ≥80, there was no difference in 12 months total events (20 vs. 28%, P = 0.07) and repeat revascularizations (8 vs. 10%, P = 0.498) in completely or uncompletely revascularized subjects. At multivariate analysis age (P = 0.002), diabetes (P = 0.002), three vessel disease (P = 0.020) and procedural success (P = 0.002) were independent predictors of total events at 12 months. Conclusions: In our experience, frequent GPI use and multivessel PCI in 41% of ≥80 years‐old patients resulted in good immediate and mid‐term clinical outcomes, irrespective of the completeness of revascularization achieved. © 2009 Wiley‐Liss, Inc.
A novel 0.010‐inch guidewire for crossing jailed sidebranches
Authors: Otsuka Yoritaka 
Published: October 2008

AbstractComplete occlusion of a side branch sometimes occurs due to a jailed‐stent during treatment of bifurcation lesions. In this report, we describe a novel 0.010‐inch coronary guidewire (Decillion™) that is effective for crossing a completely occluded side branch through the jailed‐stent strut, whereas another standard 0.014‐inch guidewire was unable to cross the same lesion. This novel 0.010‐inch guidewire may be useful for crossing of completely occluded side branches that are difficult to cross through the stent strut after stent implantation. © 2009 Wiley‐Liss, Inc.
Chronotropic impairment after surgical or percutaneous closure of atrial septal defect
Authors: Massin Martial M. , Dessy Hugues , Malekzadeh‐Milani Sophie‐Guiti , Khaldi Karim , Topac Beyhan , Edelman Raymond 
Published: October 2008

AbstractBackground:In previous studies, an attenuated heart rate response to exercise has been noted in patients after surgical closure of atrial septal defect. The aim of this study was to compare the prevalence of chronotropic impairment after surgical and percutaneous closure of atrial septal defect.Methods:Thirty‐eight pediatric patients who underwent a surgical (group A, n = 18) or transcatheter closure (group B, n = 20) of atrial septal defect in our institution were prospectively included in the study. Treadmill exercise testing was performed using the Bruce walking treadmill protocol to voluntary exhaustion, with continuous monitoring of heart rate and oxygen consumption.Results:All the children were in sinus rhythm, and had normal values for peak oxygen uptake and endurance time. Exercise heart rate was significantly lower than normal in group A at the end of stage 2 (Z‐score = −0.71 ± SD 1.02), and in both groups at the end of stage 3 (Z‐score = −2.06 ± 1.76 in A and −1.00 ± 0.71 in B) and at peak exercise (Z‐score = −2.78 ± 2.14 in A and −0.81 ± 0.75 in B). However, the heart rate response to exercise was significantly less attenuated in group B than in group A. Moreover, maximal heart rate was <−2 SD in 8/18 surgical patients but in no patient of the group B.Conclusion:The chronotropic impairment is significantly less important after transcatheter closure of atrial septal defect than after surgical closure. It is an additional argument in favor of the interventional catheterization. © 2009 Wiley‐Liss, Inc.
Rheolytic thrombectomy in patients with massive and submassive acute pulmonary embolism
Authors: Chechi Tania , Vecchio Sabine , Spaziani Gaia , Giuliani Gabriele , Giannotti Federica , Arcangeli Chiara , Rubboli Andrea , Margheri Massimo 
Published: October 2008

AbstractObjectives: To appraise the impact of AngioJet rheolytic thrombectomy (RT) on angiographic and clinical endpoints in patients with acute pulmonary embolism (PE). Background: The management of patients with acute PE and hemodynamic compromise, based mainly on anticoagulant and thrombolytic therapies, is challenging and still suboptimal in many patients. In such a setting, mechanical removal of thrombus from pulmonary circulation holds the promise of significant clinical benefits, albeit remains under debate. Methods: We retrospectively report on 51 patients referred to our catheterization laboratory and treated with AngioJet RT. Patients were classified according to the degree of hemodynamic compromise (shock, hypotension, and right ventricular dysfunction) to explore thoroughly the degree of angiographic pulmonary involvement (angiographic massive PE was defined as the presence of a Miller index ≥ 17) and the impact on angiographic (obstruction, perfusion, and Miller indexes) and clinical (all‐cause death, recurrence of PE, bleeding, renal failure, and severe thrombocytopenia) endpoints of AngioJet RT. Results: Angiographic massive PE was present in all patients with shock, whereas patients with right ventricular dysfunction and hypotension showed a similar substantial pulmonary vascular bed involvement. Technical success was obtained in 92.2% of patients, with a significant improvement in obstruction, perfusion and Miller indexes in each subgroup (all P < 0.0001). Four patients reported major bleedings and eight (15.7%) died in‐hospital. Laboratory experience was significantly associated to a lower rate of major bleedings. All survivors were alive at long‐term follow‐up (35.5 ± 21.7 months) except three who expired due to cancer and acute myocardial infarction. Conclusions: In experienced hands AngioJet RT can be operated safely and effectively in most patients with acute PE, either massive or submassive, and substantial involvement of pulmonary vascular bed. © 2009 Wiley‐Liss, Inc.
Is routine ultrasound guidance really necessary for closure of patent foramen ovale using the Amplatzer PFO occluder?
Authors: Fateh‐Moghadam Suzanne , Steeg Martin , Dietz Rainer , Bocksch Wolfgang 
Published: October 2008

AbstractObjectives:The aim of the study was to evaluate safety, efficacy, and long‐term clinical outcome of percutaneous closure of patent foramen ovale (PFO closure) in a low volume center using the Amplatzer PFO occluder without echocardiographic guidance.Background:Most centers perform PFO closure either by transesophageal echocardiography (TEE) or intracardiac echocardiography (ICE) guidance for optimal device selection. As TEE is poorly tolerated by patients in supine position and ICE is a costly alternative that increases vascular access complications, we wanted to assess the safety and efficacy of PFO closure by fluoroscopic guidance only.Methods:Before PFO closure, all patients had a diagnostic contrast‐TEE and morphological classification of PFO. All PFO closures were performed using the 25‐mm Amplatzer PFO occluder with fluoroscopic guidance only. Intraprocedural echocardiography was replaced by right atrial opacification using contrast angiography. Contrast TEE was done after 6 weeks, contrast TTE after 3, 6, and 12 months postprocedural.Results:In all 92 patients (52.4 ± 1.5 years), a 25‐mm Amplatzer PFO occluder was implanted in the correct position. Total fluoroscopic time was 8.4 ± 0.6 minutes and the application of contrast medium was 122.5 ± 5.8 mL. By contrast‐TEE, 12 patients (13 %) showed a small residual shunt (grade 1). During follow‐up (2.09 ± 0.13 years) two patients (2.1%) suffered from a recurrent event (TIA in both cases).Conclusions:Percutaneous closure of PFO using the 25‐mm Amplatzer PFO occluder guided by fluoroscopy only is a safe and efficacious intervention for nearly all patients. © 2009 Wiley‐Liss, Inc.