bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Kissing” stents for bifurcational coronary lesion
Authors: Colombo Antonio , Gaglione Antonio , Nakamura Shigeru , Finci Leo 
Published: March 2007

AbstractThe coronary stents implantation into each vessel of a bifurcational lesion (“kissing” stents) in two patients is reported. The first patient had two short “kissing” stents implanted in an ostial lesion of the left anterior descending and the intermediate branch. The second patient had successful “kissing” stents implantation in the bifurcational lesion of the left main coronary artery.© 1993 Wlley‐Liss, Inc
Miniaturized pressure‐guide‐wire: evaluation in vitro and in isolated hearts
Authors: Görge Günter , Erbel Raimund , Nießing Stephanie , Schön Frank , Kearney Peter , Meyer JÜRgen 
Published: March 2007

AbstractThe present study focused on the accuracy and reproducability of measurements performed with a miniaturized pressure guidewire system (PGWS) under standardized in vitro conditions and in an isolated pig heart model. We used a pressure guide wire system provided by Pressure Guide™, Radi Medical Systems, Uppsala, Sweden. Pressures were recorded by a fiber optic pressure sensor located laterally and 3 cm from the distal end. The basic principle is that the element modulates an optical reflection by pressure induced elastic movements. The light source is an emitting diode in the control unit. The PGWS replaces a standard 0.018 in. guidewire. The PGWS was introduced through a Y‐adapter in a recirculating perfusion model, consisting of tubing with internal diameters from 1.00 to 4.00 mm. Different perfusion pressures (range 20–140 mm Hg) were generated by a pressure controlled roller pump.Results: Different lumen sizes from 1 to 4 mm had no influence on the measurements. (a) In a range from 20 to 140 mm Hg no significant differences were found between the perfusion pressure and the pressures obtained by the PGWS, resulting in an r‐value of 0.99 and an equation of y = 1.04x + 1.9. (b) In pressure measurements proximal and distal of an artificial stenoses resulting in gradients from 0 to 100 mm Hg, the PGWS correctly identified the pressure difference with an equally high accuracy, 1,2, and 3 cm behind the stenoses. The equation was y = 1.06x + 5, with an r‐value of 0.97. (c) If the PGWS was introduced in curved segments of the phantoms, differences were found that correlated with the diameter of the bend and the angulation. If the transducer element was positioned in the convexity of the tubing, pressures were higher than the perfusion pressure. They were lower when if the pressure element was moved towards the concave part of the tubing. At a perfusion pressure of 100 mm Hg, a diameter of 2 cm and an angulation of 45°, no significant difference was found; but an angulation of 160° in the same phantom caused a difference of ± 45 mm Hg. (d) In isolated swine hearts (n = 6), the correlation of aortic perfusion pressure with the PGWS values (proximal LAD) was y = 1.02x + 3, r = 0.92. In the most bended part of the left circumflex artery, the maximal mean pressure difference was ± 28 mm Hg at a perfusion pressure of 100 mm Hg, depending on the position of the catheter.Conclusion: The PGWS has the potential to accurately determine pressures within coronary arteries, if measurements within bends of > 45° are avoided.© 1993 Wlley‐Liss, Inc
Comparison of a low osmolarity nonionic radiographic contrast agent with a standard medium on renal function in cyanotic and normal dogs
Authors: Pridjian Ara K. , Bove Edward L. , Beekman Robert H. , Lupinetti Flavian M. 
Published: March 2007

AbstractRenal dysfunction may follow administration of iodinated radiographic contrast agents. This complication may be less common when low osmolarity nonionic agents are used. Although potential benefits from the use of low osmolarity nonionic contrast may be minimal in individuals with normal physiology, a greater benefit has been postulated in the presence of chronic cyanosis. To test this hypothesis, six adult mongrel dogs underwent anastomosis of the inferior vena cava to the left atrium. This produced chronic cyanosis with a mean pO2 of 48 ± 4 mm Hg and polycythemia with a mean hematocrit of 56 ± 2 gm%. Three to 5 months after preparation, these cyanotic dogs and five control dogs each received diatrizoate (a high osmolarity ionic agent) or ioversol (a low osmolarity nonionic agent), 465 mg iodine/kg body weight, by intravenous bolus injection. One month later, each animal received the other agent. The order of administration was randomized. Renal function studies, including serum creatinine and creatinine clearance, were performed precontrast, after 60 min, and 24 hr postcontrast. Neither agent adversely affected renal function in either the cyanotic or the normal group. We conclude that at the doses that are commonly used in clinical practice, high osmolarity ionic contrast agents do not create a greater risk of renal injuiry than do low osmolarity nonionic agents in this model of cyanosis.
Coronary thrombus: A novel catheter‐based approach to treatment
Authors: Gershony Gary , Glass Pete R. 
Published: March 2007

AbstractThe presence of coronary thrombus during intracoronary interventions increases the risk of complications during the procedure. We describe a novel approach to infusing thrombolytic agents selectively into a coronary artery utilizing a new low‐profile perfusion balloon. This approach may add a useful new treatment for resistant intracoronary thrombi.
High‐Frequency rotational ablation following failed percutaneous transluminal coronary angioplasty
Authors: Dietz Ulrich , Erbel Raimund , Rupprecht Hans‐Jürgen , Weidmann Stephan , Meyer Jürgen 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) failed in 29 of 1,150 patients (2.5%) after successful passage of the guide wire. The reasons for failure were inability to pass the lesion with a balloon in 28 patients and inability to dilate the lesion in 1 patient. In these patients (15 stenoses and 14 chronic occlusions) rotational ablation was performed. We were able to pass the burr through the lesion in all of them, resulting in a reduction of diameter stenosis from 87 ± 15 to 51 ± 18%. Rotational ablation alone was initially successful (stenoses reduction >20% and residual stenoses <50%) in 15 of 29 (52%) patients. Additional PTCA was performed in 21 of 29 (72%) patients, in 8 to optimize the initially successful result and in 13 because the outcome was unsatisfactory. After dilatation the diameter stenosis was reduced to 41 ± 14% immediately after the procedure and to 36 ± 13% at 24 hr control. Overall success was achieved in 21 of 29 (72%) patients immediately after the procedure and in 26 of 29 (90%) patients at 24 hr control. No acute major complications occurred. We conclude that rotational ablation can be used as a safe and effective alternative when PTCA is not successful.
Acute results and long‐term outcome of transluminal extraction catheter atherectomy for saphenous vein graft stenoses
Authors: Twidale Nicholas , Barth Charles W. , Kipperman Robert M. , Bowles Mark H. , Galichia Joseph P. 
Published: March 2007

AbstractDistal embolization of atheroma and thrombus is a major concern when performing balloon angioplasty in coronary saphenous vein grafts (SVGs). The transluminal extraction catheter (TEC) is designed to remove this material and may improve the safety of percutaneous treatment of SVG disease. We assessed the acute results and long‐term outcome of 67 patients (mean age 65.6 ± 8.1 years; range 47–83 years) who underwent 73 separate TEC atherectomy procedures. Eighty‐eight SVG lesions were treated (mean age 8.7 ± 3.8 years from bypass surgery). Procedural success (< 50% final diameter stenosis and absence of major complications) was obtained in 63 patients (86%). Adjunctive balloon angioplasty and/or directional coronary atherectomy was required in 69 of the procedures (95%). Major complications, occurring in 8 patients (ll%), were acute closure in 4 (5%), resulting in Q‐wave myocardial infarction in 3 and urgent bypass surgery in 1, and distal embolization in 4 (5%; 1 associated with Q‐wave myocardial infarction). Angiographic follow‐up was available for 50 patients and restenosis was present in 26 (52%). These data suggest TEC atherectomy can be performed in SVGs with an acceptable procedural risk, but restenosis remains a significant limitation which will require other strategies to overcome. o 1994 Wiley‐Liss, Inc.
Resection of guide catheter fragments during coronary atherectomy in aorto‐ostial lesions: A note of caution
Authors: Bauriedel Gerhard , Höfling Berthold 
Published: March 2007

AbstractAngioplasty of coronary aorto‐ostial lesions is considered to be troublesome with decreased acute and long‐term results and high complication rates. We report a patient with an ostial right coronary artery lesion which was treated after failed PTCA with directional atherectomy as a rescue intervention. After a favorable angiographic and clinical outcome, plastic material was found in the AtheroCath's housing due to resection of the tip of the guide catheter.
Ergot induced peripheral vascular insufficiency, non‐interventional treatment
Authors: McKiernan T. L. , Bock K. , Leya F. , Grassman E. , Lewis B. , Johnson S. A. , Scanlon P. J. 
Published: March 2007

AbstractWe report a case of ergotamine tartrate induced severe vasospasm in the renal arteries and the arteries of the lower extremities. Classic features seen on peripheral angiography make the diagnosis. Anticoagulation, thrombolysis, vasodilation, steroids, and prostaglandin inhibitors all have been successfully used to treat symptomatic ergot induced arterial vasospasm. Although balloon angioplasty of ergot induced vasospasm has been described in case reports, ergot vasospasm is a self limited and medically treatable condition that does not require peripheral mechanical intervention, unless the immediate threat of necrosis and gangrene exists.
Alternative approaches to right ventricular endomyocardial biopsy
Authors: Corley David D. , Strickman Neil 
Published: March 2007

AbstractCardiologists are performing endomyocardial biopsy procedures with increasing frequency, particularly in patients who have undergone cardiac transplantation. Because of the necessity for performing multiple biopsies in many of these patients and the subsequent complications that may arise, we have developed a simple and efficient technique for obtaining endomyocardial biopsy samples. As an alternative to retrieving biopsy samples by the conventional right internal jugular or femoral venous approach, we use the right or left internal jugular or subclavian approach. The procedure utilizes a 7 Fr 35 cm sheath and dilator system placed into the right ventricle over a balloon‐tipped catheter. After the sheath is positioned via either the internal jugular or subclavian vein, multiple samples can be obtained with standard available bioptomes. The sheath may then be exchanged for a triple‐lumen catheter if desired. This approach permits routine changing of the central venous access lines within the sterile confines of the catheterization laboratory, with minimal discomfort to patients. We believe that this method represents an important alternative to conventional biopsy techniques.
Success, complications, and restenosis following rotational and transluminal extraction atherectomy of ostial stenoses
Authors: Koller Patrick T. , Freed Mark , Grines Cindy L. , O'Neill William W. 
Published: March 2007

AbstractOur objectives were to determine procedural success, clinical complications, and follow‐up restenosis rates after rotational burr and transluminal extraction atherectomy of coronary artery and saphenous vein graft ostial stenoses. Balloon angioplasty of ostial lesions has been associated with low rates of success and high rates of clinical complications and restenosis compared to nonostial lesions. Atherectomy, due to its ability to excise (extraction atherectomy) or pulverize (rotational atherectomy) atheroma and the internal elastic lamina, may result in improved procedural outcome.We retrospectively studied 101 patients with ostial stenoses treated by rotational burr and transluminal extraction atherectomy over a 3‐yr period. Quantitative angiography and clinical follow‐up were reviewed to determine success, complication, and restenosis rates. Rotational burr (n = 29) and transluminal extraction (n = 72) atherectomy were associated with high procedural success (93% and 90%, respectively) and a low incidence of complications (6.9% and 4.2%, respectively). Postatherectomy angiographic success was low (52% and 69%, respectively) and required adjunctive balloon angioplasty in 85% of patients overall. This lower success rate likely reflects device undersizing as the overall postatherectomy artery to device ratio was near unity (0.95). The rates of angiographic ostial restenosis remain high (39.1% and 65.9%, respectively, P < 0.05). The high rate of restenosis after transluminal extraction atherectomy was due to the higher rate of restenosis in saphenous vein grafts (80%) compared to TEC treated coronary arteries (59%). When only coronary artery lesions were compared, there was no significant difference between atherectomy device groups with respect to restenosis rates or late loss. Rotational or transluminal extraction atherectomy of ostial stenoses is associated with high procedural success rates and a low incidence of complications; however, the rates of restenosis in these lesions remain high.
Directional coronary atherectomy can be successfully performed in the elderly
Authors: Movsowitz Herman D. , Manginas Athanassios , Emmi Ronald P. , Bruss Jeffrey , Kothapali Sri , Wells Elizabeth , Ledley Gary S. , Kotler Morris N. , Nakhjavan Fred K. , Yazdanfar Shahriar 
Published: March 2007

AbstractThe influence of age on the clinical and angiographic outcome of directional coronary atherectomy is evaluated. Results demonstrate that DCA can be performed successfully in the vast majority (78.7–90%) of patients in all age groups. However, there is a non‐statistical trend toward decreased success rates in the elderly (P > .05). Major ischemic complications and groin complications tend to be more common in the elderly (P > .05). Blood transfusions are required significantly more often in the elderly (P < .05). Directional coronary atherectomy is a useful method of coronary artery revascularization in all age groups, including the elderly.
Estimation of pulmonary artery pressure from pulmonary vein wedge pressure
Authors: Chern Ming‐Shyan , Yeh San‐Jou , Lin Fun‐Chung , Wu Delon , Hung Jui‐Sung 
Published: March 2007

AbstractCorrelations between pulmonary artery and pulmonary vein wedge pressures were investigated in 13 patients with atrial septal defect and 1 patient with Tetralogy of Fallot. Pulmonary vein wedge pressure wave form resembled that of pulmonary artery pressure, and the former lagged behind the latter by 70 to 110 msec (mean 88 ± 14) as observed by the fluid‐filled catheter system. Diastolic pulmonary artery and diastolic pulmonary vein wedge pressures were nearly identical. Although systolic and mean pulmonary artery pressures correlated well with respective pulmonary vein wedge pressures, there were discrepancies when systolic and mean pulmonary artery pressure exceeded 35 and 20 mm Hg, respectively. However, systolic and mean pulmonary artery pressures could be estimated by adding the difference between the diastolic pulmonary vein wedge pressure and the mean left atrial pressure to corresponding systolic or mean pulmonary artery pressure. In conclusion, pulmonary artery pressures can be estimated by measuring pulmonary vein wedge pressures and the mean left atrial pressure.
Traumatic aortopulmonary window as a complication of pulmonary artery balloon angioplasty: Transcatheter occlusion with a covered stent. a case report
Authors: Preminger Tamar J. , Lock James E. , Perry Stanton B. 
Published: March 2007

AbstractWe describe a case in which pulmonary artery balloon angioplasty was complicated by formation of an aortopulmonary window, a previously unreported complication associated with this technique. A novel transcatheter approach for occluding the defect, a covered stent, was utilized. Deployment of the covered stent significantly reduced the shunt, allowed for clinical stabilization, and averted the need for emergency surgical intervention.
Percutaneous transseptal mitral valvuloplasty in the presence of atrial septal aneurysm
Authors: Lau Kean‐Wah , Ding Zee‐Pin , Johan Abdullah 
Published: March 2007

AbstractWe demonstrate the feasibility and efficacy of Inoue balloon valvuloplasty in two patients with the rare combination of mitral stenosis and atrial septal aneurysm. Following the procedure, the mitral valve area increased from 1.3 cm2 to 2.7 cm2 and 1.2 cm2 to 2.6 cm2, respectively, with no major complications encountered.
Percutaneous transluminal coronary angioplasty in patients with prior coronary artery bypass grafting: ten years' experience
Authors: Tan Kim H. , Henderson Robert A. , Sulke Neil , Cooke Richard A. , Karani Sheila , Sowton Edgar 
Published: March 2007

AbstractWe evaluated the acute and long‐term results of percutaneous transluminal coronary angioplasty in 140 patients with prior coronary artery bypass grafting treated over a 10‐year period (1981–1991). Angioplasty was technically successful in 85% of 122 nonoccluded native vessels and in 86% of 50 saphenous vein grafts. Two patients (1.4%) had a myocardial infarction and there were three procedure‐related deaths (2.1%). The cumulative probability of survival was 91.5% and 74.5% at 1 and 5 years, respectively. Survival free from myocardial infarction and repeat bypass grafting at 1 and 5 years was 77.3% and 53.9%, respectively. At census, 31% of the 117 survivors were asymptomatic, and 47% were improved by at least two angina grades. Coronary angioplasty provides an apparently safe and effective alternative method of revascularization in selected patients with prior coronary artery bypass grafting. This treatment strategy potentially avoids reoperation with its attendant risks. © 1994 Wiley‐Liss, Inc.
Spontaneous coronary artery dissection
Authors: Pita Javier Pasalodos , Gonzalez Nicolas Vazquez , Alvarez Luisa Perez , Rodriguez Jose Manuel Vazquez , Beiras Alfonso Castro 
Published: March 2007

AbstractSpontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium‐term evolution, and optimal treatment have not yet been firmly established. This article describes five new cases with additional specific characteristics.Five of 2,241 coronary arteriograms taken between September 1989 and November 1992 showed angiographic signs of coronary dissection. Three of the patients were treated pharmacologically, and two were operated on. All were evaluated angiographically 10–18 months after diagnosis and followed up clinically for ≥20 months.Three patients exhibited acute myocardial infarction, one showed effort angina and the fifth unstable angina. In four cases, coronary dissection was associated with coronary atherosclerosis, but in the fifth the coronary tree was apparently healthy except for the dissection. Dissection affected the right coronary artery in three cases and the left in two. Angiographic evolution varied among the five and was uncorrelated with treatment. Dissection disappeared in three; it persisted, with total obstruction of the artery in the middle of the dissected segment in one case; and advanced to affect the whole left coronary tree in the fifth. After an 18‐month follow‐up, none of the five patients experienced symptoms. These cases provide a good illustration of the variability of spontaneous coronary dissection as regards etiology, clinical presentation, treatment, and evolution. Coronary dissection is always caused by hemorrhage in the media of the arterial wall; its variability in evolution and in optimal treatment may be derived from the cause of the hemorrage, which possibly was not the same in all cases. © 1994 Wiley‐Liss,Inc..
Primary directional coronary atherectomy for acute myocardial infarction
Authors: Fscai Shigeru Saito , Arai Hidekazu , Kim Kunikane , Aoki Naoto , Sakurabayashi Tai , Miyake Shogo 
Published: March 2007

AbstractThe effectiveness of primary coronary angioplasty for acute myocardial infarction (AMI) is now widely recognized. However, the reocclusion rate is as high as 10%. Directional coronary atherectomy (DCA), now used widely in the treatment of stable and unstable angina pectoris, has not been recommended as the primary reperfusion therapy for AMI. This report describes the first preliminary study of primary DCA for AMI without any antecedent thrombolytic therapy or balloon coronary angioplasty. Five patients primary DCA. The initial results were very good, but further study is necessary to determine the efficacy, particularly the long‐term results, of primary DCA in the treatment of AMI. © 1994 Wiley‐Liss,Inc..
Differential effects of synchronized coronary sinus retroperfusion on regional myocardial function during brief occlusion of the left anterior descending and circumflex coronary arteries
Authors: Feld Steven , Ekas Robert D. , Felli Patty , Amirian James , Smalling Richard W. 
Published: March 2007

AbstractTo test the hypothesis that coronary sinus retroperfusion would preserve regional myocardial function during either left anterior descending or circumflex occlusion, sonomicrometer crystals were implanted in the midmyocardium of five chronically instrumented dogs. Regional fractional shortening was measured during 5 min of coronary occlusion with and without retroperfusion. Percent fractional shortening in the left anterior descending region fell from 18% at baseline to −4% (dyskinesis) after 3 min of left anterior descending occlusion. With coronary sinus retroperfusion, the percent fractional shortening declined from 16% at baseline to 0 (akinesis) during occlusion. A modest but significant improvement in percent fractional shortening in the ischemic region during left anterior descending occlusion occurred with retroperfusion (p < .05). By contrast, no amelioration of ischemic dysfunction occurred with retroperfusion during circumflex occlusion. Coaxial flow into the great cardiac vein during retroperfusion may provide preferential protection to ischemic myocardium supplied by the left anterior descending coronary artery. However, it is unlikely that the modest degree of improvement in regional function observed during acute left anterior descending occlusion would be mechanically important in the presence of significant ischemic dysfunction. © 1994 Wiley‐Liss,Inc..