bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventricular fibrillation during coronary angiography: Reduced incidence with nonionic contrast media
Authors: Missri Joseph , Jeresaty Robert M. 
Published: March 2007

AbstractVentricular fibrillation during coronary angiography with Renografin‐76 has been attributed to the high osmolar ionic and calcium binding additive properties. Isovue‐370 is a new low osmolar nonionic contrast medium lacking calcium binding additives. The present investigation compared the incidence of contrast media‐induced ventricular fibrillation in patients undergoing coronary angiography with Renografin‐76 to that with Isovue‐370. Group I consisted of 2,000 consecutive patients undergoing coronary angiography with Renografin‐76, and group II consisted of 2,000 subsequent consecutive patients in whom lsovue‐370 was employed as the contrast medium. There was no significant difference between groups I and II with respect to volume of contrast media used per patient (125 ± 35 vs. 140 ± 45 ml), age (63.5 ± 15 vs. 60 ± 17 years), sex (74% male vs. 76% male), ejection fraction (55% vs. 55%), valvular heart disease (8% vs. 9%), prior coronary artery bypass graft surgery (5.8% vs. 5%), or extent of coronary artery disease. Contrast media‐induced ventricular fibrillation occurred in 20 patients in group I (incidence 1%), whereas eight episodes occurred in group II (incidence 0.4%) (P < 0.03). Thus the present investigation suggests that the incidence of ventricular fibrillation during coronary angiography can be significantly decreased by using low osmolar nonionic contrast media lacking calcium binding additives.
Nonselective preoperative digital subtraction angiography of internal mammary arteries
Authors: Finci Leo , Meier Bernhard , Steffenino Giuseppe , Doriot Pierre‐André , Rutishauser Wilhelm 
Published: March 2007

AbstractIn preparation for coronary bypass surgery, digital subtraction angiography (DSA) was used to assess the caliber of the left and right internal mammary arteries and to exclude stenoses of their feeding arteries. In 100 patients (86 males, mean age 56 ± 9 years) DSA was performed with a Siemens Digitron 2 device. A frontal projection was used in 18 patients, and a 10–20 degree right anterior oblique projection was used in 82 patients. The flow was 10 to 25 ml/sec; 20 ml was injected in 45 patients, 30 ml in 41, 40 ml in 5, 50ml in 8, and 60 ml in 1 patient, Judged on the proximal third, visualization of the left and the right internal mammary artery was good in 80 and 72, fair in 17 and 20, and bad in 3 and 8 arteries, respectively. The diameter (mm) was 2.7 ± 0.4 (range 1.8–3.4) and 2.7 ± 0.3 (range 2.0–3.5), and visible length (cm) was 8 ± 5 (range 1–24) and 9 ± 4 (range 2–22) for the two arteries, respectively. The 10–20 degree right anterior oblique view separated the left internal mammary artery better from the descending aorta than the frontal view. In more pronounced right anterior oblique views the ascending aorta interfered with the right internal mammary artery. The quality was not different with 20 ml or 30 ml injections. The feeding arteries could not be assessed in 4 patients. One left subclavian artery was found occluded at the orifice. Incidentally, 2 distal right subclavian stenoses and 2 carotid stenoses were detected. In conclusion, DSA with 20 ml (10 ml/sec) of contrast medium, injected into the ascending aorta in a 15 degree right anterior oblique view, sufficiently visualizes the internal mammary arteries and their feeding vessels before bypass surgery in most patients. Any catheter inserted for coronary or left ventricular angiography can be used.
Restenosis after transluminal coronary angioplasty: A risk factor analysis
Authors: Arora Rohit R. , Konrad Katherine , Badhwar Kavita , Hollman Jay 
Published: March 2007

AbstractIn order to determine the relationship of restenosis following percutaneous transluminal coronary angioplasty (PTCA) to risk factors such as hypercholesterolemia, hyperglycemia, smoking, and weight, we performed a univariate analysis to test the association of these variables with restenosis in 723 patients who had percutaneous transluminal coronary angioplasty and follow‐up catheterization.Cholesterol levels were higher in younger and female subjects (<0.0001). Initial cholesterol did not predict restenosis, and follow‐up cholesterol levels showed an inverse relationship with restenosis (P <.02). There was a trend (P <.09) toward decreased restenosis in those who were active smokers at the time of follow‐up catheterization. No differences were seen in diabetics with hyperglycemia, in both treated and untreated groups (P = NS). A stepwise multiple logistic regression was used to simultaneously test the association of the above risk factor variables to restenosis. None of the interactions were found to be significant, except cholesterol at follow‐up (P =.001).Therefore, the status of serum cholesterol, blood sugar, smoking, and weight during the time of PTCA and at follow‐up catheterization may be unimportant in predicting restenosis. Thus, we conclude 1) that to better determine the effect of these variables on restenosis, they should be estimated at times other than follow‐up and 2) that the pathophysiological mechanism of restenosis may have different risk factors than progression of atherosclerotic coronary artery disease.
Venobronchial fistula: A complication associated with central venous catheterization for chemotherapy
Authors: Beauregard John F. , Matsumoto Alan H. , Paul Martin G. , Holt Richard W. 
Published: March 2007

AbstractWe report a case in which a venobronchial fistula developed 4 months after insertion of a silicone rubber chronic central venous catheter for chemotherapy administration. In retrospect, the tip of the catheter was in the azygous vein rather than in the superior vena cava. The suboptimal position of the catheter tip, in combination with the infusion of sclerosing chemotherapeutic agents and hyperalimentation solution, may have predisposed the patient to this complication. Accurate localization of the tip of central venous catheters at the time of placement should minimize catheter‐related complications, including the rare complication of venobronchial fistula. After placement of chronic central venous catheters, biplanar chest X‐rays should be obtained to determine catheter tip location prior to the instillation of chemotherapeutic agents. Any residual questions concerning the catheter tip location after biplanar X‐rays should be addressed by prompt venography through the catheter.
Atrialization of right ventricular pressure during acute cardiac allograft rejection
Authors: de Marchena Eduardo , Madrid William , Wozniak Paula , Futterman Laurie , Mitrani Alberto , Bolooki Hooshang 
Published: March 2007

AbstractWe describe a patient who, during an episode of acute cardiac rejection, developed such severe systolic dysfunction that there was transient near‐adynamic function of the right ventricle. This right ventricular dysfunction was reflected hemodynamically by the unusual finding of atrialization of right ventricular pressures. The patient's cardiac function returned to normal after treatment with extensive immunotherapy.
Pinhole balloon rupture during coronary angioplasty causing rupture of the coronary artery
Authors: Lemay Michel R. , Beanlands Donald S. 
Published: March 2007

AbstractWe report a case of pinhole balloon rupture during percutaneous transluminal coronary angioplasty using one of the newer catheters. Pinhole balloon rupture resulted in rupture and occlusion of the vessel being dilated.
Unusual guidewire maneuver to enter an acute angulation during complex percutaneous transluminal coronary angioplasty
Authors: Avedissian Michael G. , Angelini Paolo 
Published: March 2007

AbstractGuidewire manipulation may be the deciding factor for success in percutaneous transluminal coronary angioplasty (PTCA). A case involving a complex lesion forming an acute angle within the left anterior descending (LAD) coronary artery, which precluded guidewire advancement, is presented. Successful dilatation was achieved after an unusual guidewire maneuver.
Spontaneous reversal of flow through jeopardized collateral vessels during non–Q wave myocardial infarction
Authors: Klutstein Marc W. , Lefkowitz Charles A. , Goldman Bernard , Adelman Allan G. 
Published: March 2007

AbstractThis case report documents that, when a severely diseased donor artery occludes, sufficient spontaneous reversal of flow through the collaterals can occur to prevent an extensive and possibly fatal transmural infarction.
CO2 Power‐assisted hand‐held syringe: Better visualization during diagnostic and interventional angiography
Authors: Krieger Richard A. , Furst Ariel E. , Hildner Frank J. , Midwall Jay , Kieval Joshua 
Published: March 2007

AbstractRecent technology has produced high‐flow and large‐lumen catheters as well as other angiographic accessories to enhance the visualization of the coronary arteries during diagnostic and percutaneous transluminal coronary angioplasty (PTCA) procedures. In spite of these technological advances, there are still many cases in which the quality of the coronary angiography could be significantly improved. This paper reports on a clinical evaluation of a hand‐held power syringe. The syringe offers the ability to power inject contrast safely and effectively during routine angiograms as well as through guiding catheters with the balloon catheter present during PTCA. At the same time, control of the injection is equal to that associated with manual syringes.
Analysis of risk factors for restenosis after PTCA
Authors: Rupprecht Hans J. , Brennecke Rüdiger , Bernhard Gudrun , Erbel Raimund , Pop Tiberius , Meyer Jürgen 
Published: March 2007

AbstractTo identify risk factors for restenosis, we evaluated data in 473 patients with singlevessel percutaneous transluminal coronary angioplasty (PTCA) and control angiography after 6 months. Restenosis, defined as (1) loss >50% of the initial gain, and (2) stenosis >50% was found in 138 patients (29.2%). Univariate analysis revealed eight factors related to restenosis: (1) duration of symptoms <1 month (P = 0.005), (2) unstable angina (P = 0.004), (3) high‐grade stenosis before PTCA (P = 0.014), (4) large residual stenosis after PTCA (P = 0.001), (5) insufficient improvement of stenosis (P = 0.042), (6) prolonged single inflation time (P = 0.017), (7) prolonged total inflation time (P = 0.055), and (8) low inflation pressure (P = 0.028). Multivariate analysis revealed four factors significantly related to restenosis: (1) large residual stenosis after PTCA (P = 0.0001), (2) prolonged single inflation time (P = 0.0047), (3) unstable angina (P = 0.0127), and (4) high‐grade stenosis before PTCA (P = 0.0179). Modification of procedural factors might be helpful to reduce the risk of restenosis after successful PTCA.
“High‐risk” percutaneous transluminal coronary angioplasty with preventive intra‐aortic balloon counterpulsation
Authors: Voudris Vassilis , Marco Jean , Morice Marie‐Claude , Fajadet Jean , Royer Thierry 
Published: March 2007

AbstractBetween January 1987 and February 1988, 1,385 patients underwent percutaneous transluminal coronary angioplasty; 27 procedures were performed using prophylactic intraaortic balloon counterpulsation. Twenty‐four patients had poor left ventricular function (EF < 40%), and coronary dilatation was performed in arteries opposite to an occluded myocardial necrosis related vessel. In three patients of advanced age with distal stenoses and normal left ventricular function a multivessel dilatation was performed. Primary success rate was achieved in all patients. There were no deaths, myocardial infarctions or emergency bypass operations in the hospiatilation period. During the follow‐up (9 to 21 months) there were 2 deaths, 1 cardiac transplantation, and 6 restenosis with repeated dilatation. If revascularization is warranted, in high‐risk patients, coronary angioplasty can be performed safely and successfully with protection by intraaortic balloon counterpulsation. However the long‐term prognosis of these patients is complicated by the presence of other high‐risk variables, such as advanced age or poor left ventricular function.
Percutaneous balloon valvuloplasty of pulmonary valve stenosis, dysplasia, and residual stenosis after surgical valvotomy for pulmonary atresia with intact ventricular septum: Long‐term results
Authors: Ballerini Luigi , Mullins Charles E. , Cifarelli Alberta , Pasquini Luciano , De Simone Giuseppe , Giannico Salvatore , Guccione Paolo , Di Donato R. , Di Carlo Duccio 
Published: March 2007

AbstractEighty‐six children (aged 20 days to 14 years, 20 under age 1 year) underwent 94 percutaneous balloon valvuloplasty for pulmonary valve stenosis. The patients were divided into three groups: typical pulmonary valve stenosis (71), pulmonary valve dysplasia (9), and residual stenosis after surgical valvotomy for pulmonary atresia with intact ventricular septum (PAIS) (6).Each of the three groups was divided into two subgroups. In the early cases, balloon catheters with diameter 10‐20% exceeding pulmonary valve annulus were used and the drop of the gradient was 39.5%. In the later cases, balloon diameters 30‐40% greater than the valve anulus or double balloons were used and a drop of 66.7% in the RV‐PA pressure gradient was achieved.The dilation in patients with dysplastic valve and residual stenosis after surgical valvotomy for PAIS was less effective. Doppler echocardiography was the technique used to evaluate residual gradient. Six months to 4 years follow‐up demonstrated a persistent decrease of the valve gradient.
Splenic abscess due to Peptostreptococcus spp. as a complication of cardiac catheterization
Authors: Conley Thomas D. , Vernino Lisa A. 
Published: March 2007

AbstractWe describe the development of a splenic abscess, due in part to Peptostreptococcus, as a complication of cardiac catheterization. The etiologies of splenic abscess should include Peptostreptococcus, and splenic abscesses should be added to the list of complications of cardiac catheterization.
Iatrogenic aorto‐sinus of Valsalva fistula: Angiographic and cine computerized tomography delineation
Authors: Blaker Alan M. , De Marchena Eduardo , Hansen Patricia , Schob Alan , Janowitz Warren , Chakko Simon , Kessler Kenneth M. 
Published: March 2007

AbstractA patient is reported who underwent cardiac catheterization 4 years following coronary artery bypass grafting. Cardiac catheterization revealed the presence of a fistulous tract in the wall of the ascending aorta, originating at the site of aortic anastomosis of a saphenous vein bypass graft and ending in the superior aspect of the right sinus of Valsalva. This complication was felt to have resulted from a inadvertent localized dissection of the aorta during bypass surgery. The fistula was also imaged by ultrafast cine computerized tomography which proved a useful non‐invasive method for follow‐up examination.
Torsion of an internal mammary graft during percutaneous transluminal angioplasty: A case report
Authors: Grewe Kathy , Presti Charles F. , Perez Jose A. 
Published: March 2007

AbstractA successful percutaneous transluminal angioplasty of the distal anastomosis of a tortuous left internal mammary artery graft to the left anterior descending coronary artery was complicated by the development of a focal lesion in the mid‐graft region. Dilatation at the site failed to improve the angiographic appearance. Withdrawal of the guidewire resulted in immediate resolution of the apparent mid‐graft lesion. The abnormality is felt to have been due to torsion of the graft upon itself, caused by guidewire and balloon catheter manipulation.
Systemic and local saphenous vein graft thrombolysis using a tissue plasminogen activator
Authors: Salinger Michael H. , Lopez Alvaro , Frohlich Thomas G. , McDonough Timothy J. , Hueter David C. , Stagl Richard D. 
Published: March 2007

AbstractMany studies are currently evaluating the potential role of thrombolytic therapy in patients with ischemic syndromes who have undergone previous coronary artery bypass grafting. Limited experience has been published regarding the use of local urokinase and streptokinase infusions and the use of systemic recombinant tissue‐type plasminogen activator as thrombolytic agents in patients with previous coronary artery bypass surgery. To date, however, there has been no published experience regarding the use of recombinant tissue‐type plasminogen activator (rt‐PA) either systemically or locally in the post‐bypass patient where angiographic demonstration of aortocoronary saphenous vein graft obstruction was available pre‐ and post‐therapy. Similarly there has been no previous report of the use of rt‐PA infused locally to recanalize an occluded aortocoronary saphenous vein graft. This report describes successful thrombolysis and subsequent balloon angioplasty of saphenous vein grafts with angiographically documented thrombus using systemic and local rt‐PA infusion.
Accuracy of 20‐MHz doppler catheter coronary artery velocimetry for measurement of coronary blood flow velocity
Authors: Tadaoka Shinichiro , Kagiyama Mitsuyasu , Hiramatsu Osamu , Ogasawara Yasuo , Tsujioka Katsuhiko , Wada Yoshifumi , Sawayama Toshitami , Kajiya Fumihiko 
Published: March 2007

AbstractThe accuracy of 20‐MHz Doppler catheter coronary artery velocimetry (Millar Instruments) was evaluated by model experiments using a turntable and a flow tube. In the turntable experiments, the flow away from the catheter tip (away flow) was significantly lower than that toward the catheter (toward flow), but the measured velocities for both away and toward flows were always lower than the known velocities. Nevertheless, the blood velocities measured at a sampling point 4 mm from the catheter tip showed excellent correlation with the known velocities irrespective of flow direction. The shape of the FFT spectra of the Doppler shift frequency from blood was broadened, and the frequency corresponding to the known velocity was always close to the maximum Doppler shift frequency. We concluded that zero‐cross detection of blood velocity by the 20‐MHz pulsed Doppler catheter provides a reliable measure for evaluating relative velocity changes, although it underestimates the blood velocity.
Attempted balloon catheter obstruction of pulmonary arterial flow in ventricular septal rupture
Authors: Webb John G. , Daly Paul A. 
Published: March 2007

AbstractLeaving a standard balloon flotation catheter inflated in the main pulmonary artery has been recommended as a temporizing measure in patients with post‐myocardial infarction ventricular septal rupture. Potential benefit has been ascribed to effective “banding” of the pulmonary artery as in congenital ventricular septal defects. We attempted this technique in five patients with post‐infarction septal rupture and shock. In no patient was a significant hemodynamic benefit or reduction in shunt observed. Because of the lack of clearly documented efficacy, the inadequate size of standard pulmonary balloons to produce significant obstruction to pulmonary flow, and the inherent risks of this technique we recommend that it not be lightly attempted.
Removal of retained intracoronary percutaneous transluminal coronary angioplasty equipment by a percutaneous twin guidewire method
Authors: Gurley John C. , Booth David C. , Hixson Clair , Smith Mikel D. 
Published: March 2007

AbstractBalloon rupture during percutaneous transluminal coronary angioplasty (PTCA) resulted in embolization of a guidewire‐balloon fragment into the distal circumflex artery. Access to the circumflex was technically difficult because of aortic root dilation. The fragment was removed by inserting two PTCA guidewires into the artery and twisting them together to produce a helix. The helix propagated distally, entrapping the embolized fragment for removal. This report describes an unusual mode of failure for a balloon‐ona‐ wire dilating catheter and a new percutaneous removal technique that may be applied to retained catheter debris in small, inaccessible vessels.
Distal embolization during mechanical thrombolysis: Rotational thrombectomy vs. balloon angioplasty
Authors: Titus Bradley G. , Auth David C. , Ritchie James L. 
Published: March 2007

AbstractTo determine the incidence and extent of distal embolization during percutaneous transluminal balloon angioplasty (PTA) and rotational thrombectomy (PRT), we collected, filtered, and weighed the distal effluent of acute thrombotically occluded canine arteries following mechanical thrombolysis. PRT (n = 11) and PTA (n = 10) were equally effective in recanalizing occluded vessels (91% vs. 90%) and reduced percent diameter stenosis to a similar degree (97 ± 6% to 8 ± 11% and 100 ± 0% to 17 ± 23%, respectively). Distal embolization following mechanical intervention was observed in 10 of 10 and 8 of 9 arteries recanalized with PRT and PTA, respectively. The mean weights of collected emboli were similar between the two groups (18 ± 24 mg vs. 37 ± 79 mg, PRT vs. PTA, P = NS), although the range of size and weight of thromboemboli was larger in the PTA group (0–206 mg vs. 2–51 mg, PRT). Angiographically defined residual thrombus was significantly less frequent in arteries recanalized with PRT as compared with PTA (10% vs. 55%, P = 0.03). In summary, PRT and PTA are equally effective in recanalizing acutely occluded canine arteries and result in similar reductions in percent diameter stenosis. Each intervention results in distal embolization of thrombi. PRT is associated with a reduced incidence of angiographically evident residual thrombus at the site of arterial injury and may avoid embolization of large fragments occasionally produced by PTA. Thus PRT may serve as a useful alternative to coronary angioplasty during acute myocardial infarction.
Acute infarction during triple‐vessel coronary angioplasty due to acute occlusion of a nonattempted vessel
Authors: Ricou Fraņlois , Nukta Emad , Meier Bernhard 
Published: March 2007

AbstractDuring angioplasty of the left coronary artery, an acute thrombotic occlusion of the right coronary artery occurred at the site of a borderline stenosis. The source of the unexplained chest pain at the end of the procedure was identified but the next day when inferior Q‐waves appeared. It was documented by repeat angiography. The coronary angiogram of the right coronary artery preceding the angioplasty of the left coronary artery is likely to have triggered the occlusion. Chest pain during or after angioplasty without apparent cause in the dilated artery must prompt a contrast medium injection into the nonattempted artery, paricularly if the latter had undergone a diagnostic sutdy at the beginning of the procedure.
Exit block: A new technique for difficult side branch angioplasty
Authors: Nakhjavan Fred. K. , Najmi Moosa 
Published: March 2007

AbstractAngioplasty of a stenosis at the origin of a diagonal branch was initially unsuccessful because of the straight course of the anterior descending artery and a sharp bend at the diagonal branch. Therefore, in a second attempt, the anterior descending artery was blocked by inflating a balloon distal to the diagonal branch, thereby facilitating the passage of guidewire and ballooninto the diagonal branch.
Coronary artery spasm and Myocardial infarction in a patient with normal Coronary arteries: Temporal relationship to pseudoephedrine ingestion
Authors: Wiener Isaac , Tilkian Ara G. , Palazzolo Michael 
Published: March 2007

AbstractA 28 yr‐old male presented with chest pain and acute ST elevation following ingestion of pseudoephedrine. The pain and electrocardiographic changes disappeared after the administration of sublingual Nitroglycerin. Myocardial enzymes did show some evidence for myocardial necrosis. A subsequent coronary arteriogram showed no occlusive lesions. Pseudoephedrine, a sympathomimetic agent, may be implicated in the initiation of coronary spasm and myocardial infarction in some patients.