bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bailout techniques for failed coronary angioplasty using 6 french guiding catheters
Authors: Kiemeneij Ferdinand , Laarman Gert Jan 
Published: March 2007

AbstractCoronary angioplasty (PTCA) through 6 French (F) guiding catheters is feasible, although acute or threatened closure following coronary artery dissections may occur. This report describes our experience with the treatment of suboptimal results in 13 patients from a population of 144 patients who had PTCA through 6F guiding catheters. Patients were treated with a new low profile autoperfusion catheter (ACS®, Flowtrack40™) or with Palmaz Schatz stents, advanced through 6F guiding catheters. PTCA was performed via the radial artery in 11 pts (85%) or via the femoral artery in two patients (15%). In two patients, (15%) PTCA was complicated by an dissection associated with complete loss of flow (TIMI 0) and a dissection was considered to lead to abrupt closure in the remaining 11 patients (85%), despite the presence of normal flow. A Flow‐track40™ perfusion catheter was successfully applied in three of four patients. In one patient a persisting dissection after restoration of flow by a perfusion catheter was treated with three Palmaz Schatz stents. Implantation of Palmaz Schatz stents was attempted as primary technique in nine patients. In one patient the stent could not cross a dissection in the proximal LAD via the radial artery. With an 8F system via the femoral artery, two stents could successfully be deployed with the stent delivery system. In another patient the stent could not be advanced across a subtotal residual stenosis in a tortuous left anterior descending coronary artery. Despite normal antegrade flow and emergency bypass surgery, this patient developed a non‐Q‐myocardial infarction. In the remaining patients, the clinical course was uncomplicated. With the limitations of the bare stent technique kept in mind, applying bailout techniques such as perfusion balloons and implantation of bare Palmaz Schatz coronary stents should be considered for improvement of suboptimal angioplasty results in a selected group of patients after PTCA with 6F guiding catheters. © 1994 Wiley‐Liss,Inc..
Should we avoid ostial implantations of wiktor stents?
Authors: Chalet Yann , Panes François , Chevalier Bernard , Monassier Jean‐Pierre , Spaulding Christian , Lancelin Bernard , Elkouby Arie 
Published: March 2007

AbstractComplications arising during stent implantations in coronary arteries have been reduced by technological progress and the accumulated experience of interventional cardiologists. Retrospective and prospective randomized studies with several types of stents are currently available and show improved short and mid‐term results. Wiktor stent provides increased flexibility for ease of implantation particularly in curved lesions. However, the flexibility of the Wiktor stent is also associated with low resistance in the longitudinal axis. We report four cases (in 4 out of 6 ostial lesions treated and 4 out of 43 Wiktor stents implanted during a 9‐month period) in which stents have become unraveled during procedures on ostial lesions (2 saphenous venous grafts and 2 native coronary arteries). Death occurred in one case and one patient was treated by emergency coronary bypass surgery. In three cases the distal extremity of the guiding catheter streched the stent meshes during the final control angiograms, and in one case the stent was stretched during withdrawal of the deflated balloon into the guiding catheter. We believe that it is preferable to avoid using this stent in ostial lesions. © 1994 Wiley‐Liss,Inc..
Percutaneous mitral commissurotomy for severe mitral stenosis during pregnancy
Authors: Kalra Gurcharan S. , Arora Ramesh , Khan Javed A. , Nigam Madhuri , Khalillulah M. 
Published: March 2007

AbstractPercutaneous mitral commissurotomy was performed in 27 pregnant females aged 24.9 ± 3.14 years (range 20–30 years) with severe mitral stenosis at 22.2 ± 4.3 weeks (range 18–32 weeks) of gestation. All patients were in New York Heart Association functional class IV at the time of procedure. The procedure was performed using the flow guided Inoue balloon in 25 patients and double balloon technique in 2 patients. Percutaneous mitral commissurotomy was successful in 26 patients. The mitral valve area assessed by Doppler echocardiography (pressure half time) increased from 0.78 ± 0.19 cm2 (range 0.5–1.0 cm2) to 2.2 ± 0.12 cm2 (range 1.9—2.6 cm2) (P <0.001). The mean mitral gradient decreased from 30.5 ± 7.6 mm Hg (range 22.5–41.4 mm Hg) to 6.1 ± 2.6 mm Hg (range 4.2–12.3 mm Hg) (P <0.001). The end diastolic gradient decreased from 28.3 ± 4.2 mm Hg (range 23–37 mm Hg) to 2.8 ± 1.5 mm Hg (range 0–5 mm Hg) (P <0.001). The total fluoroscopy time was 5.6 ± 2.2 min (range 2.7–8.9 min). Mitral regurgitation increased by one grade in 7 patients. One patient developed severe mitral regurgitation with anterior mitral leaflet tear needing immediate mitral valve replacement. Twenty‐six patients improved to New York Heart Association class I after the procedure. Twenty‐four patients had full‐term, normal delivery and gave birth to healthy infants. The patients were followed up for 1–36 months (mean 16.6 ± 7.8 months). All patients were in New York Heart Association functional class I. No patient has shown any evidence of restenosis. The mitral valve area on follow‐up was 2.1 ± 0.21 cm2. The degree of mitral regurgitation remained unchanged. The results of this study indicate that percutaneous mitral commissurotomy is a safe and effective procedure for severe mitral stenosis in pregnancy. There are no immediate detrimental effects of radiation on the fetus, though long‐term effects of this amount of radiation are yet to be ascertained. © Wiley‐Liss, Inc.
Epidural abscess as a complication of coronary angioplasty: A rare but dangerous complication
Authors: Oriscello Ralph G. , Fineman Sanford , Vigario Jose C. , Robertello Michael E. 
Published: March 2007

AbstractWe report a rare case of lumbosacral epidural abscess as a complication of coronary angioplasty in a 56‐year‐old male. We outline the mechanism of the abscess and the need for increased awareness and swift management of this entity. © Wiley‐Liss, Inc.
Radiological quality of coronary guiding catheters: A quantitative analysis
Authors: Herrman Jean‐Paul R. , Keane David , Ozaki Yukio , Boer Ad Den , Serruys Patrick W. 
Published: March 2007

AbstractQuantitative coronary angiography (QCA) is a validated and widely accepted method to investigate changes in arterial dimension over time. Calibration of measurements is enabled by the use of the coronary catheter as a scaling device. The dimensions and laminar composition of coronary catheters, however, have changed significantly over recent years and the suitability of the current generation of coronary catheters for calibration purposes has not been validated. We therefore recorded 57 coronary guiding catheters on cinefilm, and compared their automated quantitative measurements (Cardiovascular Angiography Analysis System, CAAS) with their true values (precision micrometer). We found an overall underestimation of quantitatively derived dimensions, ranging from −8.9 to +4% for water‐filled catheters and from −15.5 to −3.9% for contrast‐filled catheters. In conclusion, while the current generation of coronary guiding catheters shows a wide variety in radiological quality, it can be clearly detected by the CAAS system, and is suitable for calibration of QCA measurements (with the exception of the DVI atherectomy catheter), provided that calibration is done on contrast‐empty catheters. © Wiley‐Liss, Inc.
Catheter sizes for quantitative coronary arteriography
Authors: Reiber Johan H. C. , Jukema Wouter , van Boven Ad , van Houdt Ronald M. , Lie Kong I. , Bruschke Albert V. G. 
Published: March 2007

AbstractIn quantitative coronary arteriography (QCA), the outer diameter of the contrast catheter is used almost exclusively as the calibration device. Since the true outer diameter of these catheters are smaller than the French sizes listed by the manufacturer, it has been advocated to measure the actual sizes with a precision micrometer. However, this represents a significant effort in the organizations of the QCA Angiographic Core Laboratories and of the participating cardiac catheterization laboratories. In the Dutch REGRESS trial on regression/progression of coronary artery disease, we have measured a total of 2,104 catheters from four different manufacturers. In 2,048 of the 2,104 catheters the variabilities in the measurements were 0.02–0.03 mm, which represents an error of only 1% of the average catheter sizes. In the remaining 56 catheter measurements, the variability was 0.04 mm. From these data we may conclude that from now on the stated mean values can be used for calibration purposes. This has important practical consequences for running clinical trials and QCA Core Laboratory operations. © Wiley‐Liss, Inc.
Transesophageal echocardiography assisted retrieval of embolized inferior vena cava stent
Authors: Kamalesh Masoor , Stokes Kenneth , Burger Andrew J. 
Published: March 2007

AbstractA 32‐year‐old male with Budd‐Chiari syndrome and stenosis of the inferior vena cava presented to the hospital with severe abdominal pain. Two contiguous, 14 mm, overlapping (joined) Palmaz stents were placed across the area of stenosis in the inferior vena cava. The stents later embolized to the left pulmonary artery and were retrieved nonsurgically over a Grollman balloon catheter with transesophageal echocardiographic assistance. This case report highlights the advantages and limitations of transesophageal echocardiographic assistance in such a procedure. © Wiley‐Liss, Inc.
A single center randomized trial assessing use of a vascular hemostasis device vs. conventional manual compression following ptca: What are the potential resource savings?
Authors: Slaughter Pamela M. P. , Chetty Rajendra , Flintoft Virginia F. , Lewis Sheldon , Sykora Kathy , Beattie Dorothy M. , Fscai Leonard Schwartz 
Published: March 2007

AbstractWe undertook a randomized controlled trial comparing VasoSealTM, a collagen vascular hemostasis device (VHD), with manual compression to assess its role and potential cost savings in the PTCA population. Of 460 patients, 359 were excluded due to clinical instability (30%), groin problems (18%), suboptimal PTCA result (15%), and other reasons (37%). The remaining 101 patients were randomized to either VHD (51) or manual compression (50). Hemostasis time, time to ambulation, duration of hospital stay, and nursing time and intensity were significantly reduced in the VHD group. There were no major groin complications in either treatment arm but there was a trend toward more minor groin complications in the VHD patients. The application of VasoSealTM reduced resource use in this randomized study and may translate into significant cost reductions in the general coronary angioplasty population.
Successful repair of combined septal and biventricular free wall rupture after acute myocardial infarction
Authors: Blau William , Ong Lawrence , Stelzer Paul E. , Subramanian Valavanur A. 
Published: March 2007

AbstractThe following case is the first report of successful repair of combined left and right ventricular free wall and ventricular septal rupture. Reports of left ventricular free wall and septal rupture and reports of right ventricular free wall and septal rupture have been published both with and without successful surgical repair. This case demonstrates the presence of left and right ventricular free wall rupture along with septal rupture based upon cardiac catheterization and operative findings. In spite of her severe mechanical complications and prolonged hospital course, the patient is completely functional 1 year after surgical repair.
Right ventricular infarction following percutaneous coronary rotational atherectomy
Authors: Hetterich Frank S. , McEniery Paul T. 
Published: March 2007

AbstractWe describe a case of right ventricular infarction complicating percutaneous coronary rotational atherectomy of sequential calcified right coronary artery lesions. Right ventricular infarction resulted from occlusion of two right ventricular marginal branches during successful atherectomy of the right coronary artery.
Techniques for palmaz‐schatz stent deployment in lesions with a large side branch
Authors: Nakamura Shigeru , Hall Patrick , Maiello Luigi , Colombo Antonio 
Published: March 2007

AbstractPalmaz‐Schatz coronary stent implantation in lesions with a large side branch are reported. The first case describes how to manage plaque shifting after stent implantation. The second and third cases demonstrate a kissing balloon predilatation and stent dilatation technique of a bifurcational lesion. The final case demonstrates a stent implantation technique through the stent struts of a previously deployed stent.
Clinical application of a new palmaz‐schatz coronary stent delivery system with a short (8 mm) nonarticulated stent
Authors: Wong Philip H. C. , Wong C. M. , Ko Patrick T. H. 
Published: March 2007

AbstractThe standard Palmaz‐Schatz coronary stent delivery system (SDS), with a 15 mm articulated stent and a 5F protective sheath, is relatively rigid and high in profile. Its use is contraindicated in vessels where there is severe tortuosity proximal to or in the lesion itself. Recently a new SDS, with a short (8 mm) nonarticulated stent, has become available. We present three patients with complex coronary anatomy solved with this new SDS. The first patient had a distal stenosis in an extremely tortuous and diffusely diseased right coronary artery (RCA). The second patient had a severe proximal RCA stenosis occurring at a bend of more than 90 degrees. The third patient had a very long stenosis of the left anterior descending coronary artery involving the ostium, requiring multiple tandem stenting. The availability of this short stent will greatly expand the clinical application of intracoronary stenting to patients with complex coronary anatomy.
Effect of data compression on quantitative coronary measurements
Authors: Koning Gerhard , Van Meurs Bert A. , Haas Hein , Reiber Johan H. C. 
Published: March 2007

AbstractDigital coronary and left ventricular angiography demand high transfer rates and very large data storage if all the clinical data are to be archived. If appropriate compression schemes were available without compromising the quality and resolution of the image data, such demands could be lessened. In this study we compared the influence of different compression factors of the Adaptive Real Time Image Compression (ARTIC) scheme used on the Philips DCI‐SX systems on coronary measurements assessed with the Automated Coronary Analysis (ACA) package.Loss‐free acquired images of size 5122× 8 bits, which had been stored digitally on tape, were reloaded into the DCI with compression factors of 2, 3, and 4; only the factor 2 is loss free. To evaluate the effect of the different data compressions on the accuracy of the measurements, the diameters of a vessel phantom (tube sizes ranging from 0.687 to 5.062 mm) were determined. To evaluate the reproducibility of the results, the intraobserver variability was determined for the different compression factors from 40 coronary obstructions. The differences in the reference diameter measurements of the vessel phantom were ‐0.03 ± 0.06 mm, 0.01 ± 0.07 mm, and 0.04 ± 0.08 mm for the compression factors 2 (loss free), 3, and 4, respectively. The results were not statistically significantly different.The intraobserver variabilities in the obstruction diameter measurements of the coronary obstructions were ‐0.04 ± 0.13 mm, 0.00 ± 0.14 mm, and 0.02 ± 0.13 mm for the compression factors 2, 3 and 4, respectively. The intraobserver variabilities in the reference diameter measurements were ‐0.02 ± 0.12 mm, 0.01 ± 0.09 mm, and 0.03 ± 0.09 mm for the compression factors 2,3, and 4, respectively. The intraobserver variabilities of the percent diameter stenosis were 0.96 ± 4.19%, ‐0.01 ± 4.88%, and ‐0.04 ± 4.68% for the compression factors 2,3, and 4, respectively. None of these differences were statistically significant.Both from a qualitative and quantitative point of view, data compression factors 3 and 4 are acceptable in digital coronary arteriography.
Acute myocardial infarction during coronary angioplasty associated with heparin‐induced thrombocytopenia
Authors: Gupta Bhavdeep K. , Savage Michael P. , Brest Albert N. 
Published: March 2007

AbstractHeparin‐induced thrombocytopenia is a well‐recognized complication after cardiac or vascular surgery, but it has not been previously reported during percutaneous coronary interventions. This case study describes a patient who developed an acute myocardial infarction during coronary angioplasty in association with the abrupt onset of heparininduced thrombocytopenia. Since balloon angioplasty achieved a satisfactory angiographic result with a widely patent epicardial vessel, it is postulated that acute myocardial infarction in this patient may have been caused by platelet aggregation and activation resulting in distal small vessel thrombosis and spasm. © 1995 Wiley‐Liss, Inc.
Effects of chronic β‐blockade on rest and exercise hemodynamics in mitral stenosi
Authors: Ashcom Thomas L. , Johns Joseph P. , Bailey Steven R. , Rubal PhD Bernard J. 
Published: March 2007

Abstractβ‐blocker therapy for mitral stenosis is controversial. This study compares right and left heart hemodynamics at rest and supine submaximal exercise in patients (n = 7) receiving chronic β‐antagonists with untreated patients (n = 17) matched for age (mean ± SD = 51 ± 12 years) and valve area (0.7 ± 0.2 cm2/m2). Little benefit was observed with treatment at rest. Although pulmonary capillary wedge pressures (PCWP) were lower during exercise in the β‐blocker group (22±4 vs. 31 ± 9 mmHg; P>0.05), exercise performance was not enhanced and cardiac output response during exercise was reduced (control = 41% increase vs. 12% for β‐blockade). PCWP rose rapidly when diastolic filling periods were >300 msec in both groups. Pulmonary capillary wedge pressure was found to be a nonlinear functions (P<0.001) of diastolic filling period (PCWP = 15.9 + 5.84 × 105/dfp2). These data suggest that there is a critical heart rate in patients with mitral stenosis above which hemodynamic compromise rapidly occurs. © 1995 Wiley‐Liss, Inc.This article is a US Government work and, as such, is in the public domain in the United States of America.
Physiological significance of a proximal coronary artery stenosis on a distal intramyocardial bridge: Coronary flow velocity patterns pre‐ and post‐angioplasty
Authors: Tobias S. Leslie , Videlefsky Searle W. , Misra Vijay K. 
Published: March 2007

AbstractThe angiographic incidence of intramyocardial bridging (MB) is 0.7–4.5% [Angelini et al.: Prog Cardiovasc Dis 25:75–88, 1983]. Morphological and physiological patterns of MB have recently been described, observing coronary flow velocity patterns, intravascular ultrasound, and angiography [Flynn et al.: Cathet Cardiovasc Diagn 32:36–39, 1994; Ge et al.: Circ Res 89:1725–1732, 1994]. We describe a reversal of the normal flow velocity characteristics within a MB, due to a hemodynamically significant stenosis in the proximal left anterior descending artery (LAD). After successful percutaneous transluminal coronary angioplasty (PTCA) of the proximal LAD stenosis, there was normalization of the flow velocity pattern within the MB and the appearance of a spike and dome pattern distal to the MB. © 1995 Wiley‐Liss, Inc.
Coronary angioplasty to relieve a kinked venous bypass conduit
Authors: Broderick Thomas M. , Wolf Randall K. 
Published: March 2007

AbstractAn unusual case of kinking of a freshly placed venous bypass conduit was treated by PTCA and catheter traction. This provided translational movement of the conduit with loss of angulation, relief of kinking, and resumption of normal flow. © 1995 Wiley‐Liss, Inc.
Early hospital discharge after direct angioplasty for acute myocardial infarction
Authors: Hanlon J. Timothy , Combs D. Thomas , McLellan Bruce A. , Railsback Laura , Haugen Sue 
Published: March 2007

AbstractTo determine the feasibility and safety of early hospital discharge after myocardial infarction, we reviewed a 3‐yr experience with direct angioplasty: 204 patients had direct angioplasty with in‐hospital mortality of 3.4%. Of these patients, 125 were discharged < 5 days after infarction and 98% of these were available for 30‐day follow‐up. There was one early death (0.8% mortality), two early readmissions without complications, and three late readmissions. Thus early hospital discharge a mean of 3.4 days after infarction can be achieved in > 60% of patients undergoing direct angioplasty with no significant early complications and excellent 30‐day survival (99.2%). © 1995 Wiley‐Liss, Inc.
Timing, mode, and predictors of death after direct angioplasty for acute myocardial infarction
Authors: Krikorian Raffi K. , Vacek James L. , Beauchamp Gary D. 
Published: March 2007

AbstractThe timing and mechanisms of early (30 day) mortality in 330 consecutive patients treated with direct angioplasty less than 12 hr after onset of myocardial infarction without antecedent thrombolysis were studied. There were 38 deaths (11.5% of pts), with a majority being due to cardiogenic shock (76%). Other causes included acute closure (11 %), death after emergency bypass surgery (5%), ventricular arrhythmias (5%), and respiratory failure (3%). No deaths from stroke or cardiac rupture were seen, in contrast to trials of thrombolytic agents. Most deaths were seen early, with 47% occurring within 1 day, 35% from days 2–7, and 18% from days 8–30. Death from cardiogenic shock was the most common cause of death throughout this period: 83% of deaths in days 0–3, 88% of deaths in days 4–6, and 43% of deaths in days 8–30.Significant predictors of early death included older age (P <.0001), multi‐vessel disease (P <.05), direct angioplasty failure (P <.05), reduced ejection fraction (P <.0001), and anterior myocardial infarction (P <.0005). Gender, prior myocardial infarction, and prior bypass surgery did not affect mortality.Cardiogenic shock is the most common cause of early death after direct angioplasty for myocardial infarction. Patients with one or more risk factors for early death may benefit from additional myocardial salvage or revascularization efforts in the early postinfarct period. Certain causes of death after direct angioplasty (cardiac, rupture, stroke) appear to be less common than data reported for lytic therapy for myocardial infarction. © 1995 Wiley‐Liss, Inc.
Retrieval of undeployed intracoronary Palmaz‐Schatz stents
Authors: Wong Philip H. C. 
Published: March 2007

AbstractTwo patients undergoing stent placement with the Palmaz‐Schatz coronary stent delivery system experienced intracoronary stent embolization. Using a two‐wire technique, the stents were successfully removed from the coronary circulation, and this allowed completion of the percutaneous revascularization procedure without any clinical sequelae. These two cases represent the first report of successful percutaneous retrieval of undeployed, retained intracoronary Palmaz‐Schatz stents. © 1995 Wiley‐Liss, Inc.