bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of radiation safety in the cardiac catheterization laboratory
Authors: Johnson Lewis W. , Moore Robert J. , Balter Stephen 
Published: March 2007

AbstractWith the increasing use of coronary arteriography and interventional procedures, radiation exposure to patients and personnel working in cardiac catheterization laboratories has increased. Proper technique to minimize both patient and operator exposure is necessary. A practical approach to radiation safety in the cardiac catheterization laboratory is presented. This discussion should be useful to facilities with well‐established radiation safety programs as well as facilities that require restructuring to cope with the radiation environment in a modern cardiac catheterization laboratory.
Excimer laser coronary angioplasty: Results in restenosis versus de novo coronary lesions
Authors: Reeder Guy S. , Bresnahan John F. , Holmes David R. , Litvack Frank ,   Excimer Laser Coronary Angioplasty Investigators
Published: March 2007

AbstractThere is limited information regarding the use of excimer laser coronary angioplasty (ELCA) in patients with restenotic lesions. The purpose of this investigation was to compare the results of ELCA in patients with restenosis following prior PTCA with results obtained in de novo (no restenosis) patients. A retrospective review was obtained of all patients undergoing attempted ELCA at each of the 12 participating clinical investigative centers. There were 620 patients in the prior restenosis group and 949 in the de novo group. Both laser success (88% vs 78%) and procedural success (92% vs 88%) were higher in restenosis lesions compared with de novo lesions (P <0.001). Six‐month follow‐up was available in 40% of patients. Restenosis occurred in 49% of the prior restenosis group vs 44% of the de novo group (P nonsignificant) but death was more common in the de novo group (2.2 vs 0.4%, P = 0.01). ELCA can be performed with a high success rate in patients with restenosis following prior balloon angioplasty but recurrent restenosis following laser procedure remains a significant problem.
Initial experience with the disarticulated (one‐half) palmaz‐schatz stent: A technical report
Authors: Colombo Antonio , Hall Patrick , Thomas Jack , Almagor Yaron , Finci Leo 
Published: March 2007

AbstractWe developed an alternative method to stent suitable lesions located in anatomical settings considered to be too complex for regular Palmaz‐Schatz stent placement. This method consists of using a disarticulated (one‐half) Palmaz‐Schatz stent. Eight patients underwent stenting utilizing this method. The left anterior descending was stented in five patients, the right coronary artery in one patient, the proximal and mid shaft of a vein graft in one patient, and a protected left main coronary artery in one patient. In all patients the stents were placed in addition to full stents. In four patients, 11/2 stents were placed; two patients had 21/2 stents; one patient had 31/2 stents and the last patient had a total of 5 stents placed (1 full stent and 8 half stents). One patient had 8 disarticulated stents placed. All half stents prepared for delivery were successfully deployed to the pre‐designated angiographic site without complication.
Aortic dissection as complication of percutaneous transluminal coronary angioplasty
Authors: Moles Victor P. , Chappuis François , Simonet François , Urban Philip , De La Serna Fernando , Pande Abhay K. , Meier Bernhard 
Published: March 2007

AbstractWe report two cases of aortic dissection during coronary angioplasty with a disparate evolution that was due to the different location of the entry port of the dissection. Aortic dissection occurring during coronary angioplasty may be self‐limiting, but it may also be life‐threatening and may call for urgent surgical repair. © 1992 Wiley‐Liss, Inc.
High‐speed rotational angioplasty‐induced echo contrast in vivo and in vitro optical analysis
Authors: Zotz Rainer J. , Erbel Raimund , Philipp Achim , Judt Andreas , Wagner Hasso , Lauterborn Werner , Meyer Jürgen 
Published: March 2007

AbstractHigh‐speed rotational angioplasty is being evaluated as an alternative interventional device for the endovascular treatment of chronic coronary occlusions. It has been postulated that this type of angioplasty device may produce particulate debris or cavitations that induce myocardial ischemia. To determine the clinical presence of myocardial ischemia during rotational angioplasty, echocardiographic monitoring for wall motion abnormalities was performed in 9 patients undergoing rotational atheroablation using the Auth Rotablator for 10‐sec intervals at 150,000 and 170,000 rpm. No wall motion abnormalities were detected in 5 patients evaluated with transesophageal echocardiography or in 4 patients monitored transthoracically, although AV block developed in one patient. Video intensitometry of the myocardial contrast effect for rotation times ranging from 3 to 20 sec found transient contrast enhancement of the myocardium supplied by the treated vessel. Intensity varied over time with half‐time decay between 5.6 and 40 sec, indicating the likelihood of microcavitation. An in vitro model was constructed to measure the cavitation potential of the Auth Rotablator. A burr of 1.25 mm diameter rotating at 160,000 rpm achieves a velocity in excess of the 14.7 m/sec critical cavitation velocity. Testing the device in fresh human blood and distilled water produced microcavitations responsible for the enhanced echo effect, with the intensity and longevity of cavitation more pronounced in blood and proportional to the rotation time and speed. The mean size of the microcavitation bubbles in water was 90 ± 33 (52–145) μm measured from photographs taken with a copper vapour laser emitting light pulses of 50 nsec duration as light source. The mean velocity of bubbles was found to be 0.62 ± 0.30 ranging from 0.23 to 1.04 m/sec. It was measured via the motion of the bubbles during 5 laser pulses within 800 nsec. Clearly, microcavitations are associated with enhanced myocardial echo contrast effect. © 1992 Wiley‐Liss, Inc.
Atrial septal puncture technique in percutaneous transvenous mitral commissurotomy: Mitral valvuloplasty using the inoue balloon catheter technique
Authors: Hung Jui‐Sung 
Published: March 2007

AbstractTransseptal catheterization is a vital component of percutaneous transvenous mitral commissurotomy. Therefore, a well‐executed transseptal catheterization is the key to a safe and successful percutaneous transvenous mitral commissurotomy. Two major problems inherent in atrial septal puncture for percutaneous transvenous mitral commissurotomy are cardiac perforation and puncture of an inappropriate atrial septal site. The former may lead to serious complication of cardiac tamponade and the latter to possible difficulty in maneuvering the Inoue balloon catheter across the mitral orifice. This article details atrial septal puncture technique, including landmark selection for optimal septal puncture sites, avoidance of inappropriate puncture sites, and step‐by‐step description of atrial septal puncture. © 1992 Wiley‐Liss, Inc.
Excimer laser coronary angioplasty for failed PTCA
Authors: Watson Linley E. , Gantt Scott 
Published: March 2007

AbstractSpecific indications for excimer laser coronary angioplasty (ELCA) are yet undefined. We report two specific applications of ELCA when percutaneous transluminal coronary angioplasty (PTCA) failed: (1) to facilitate balloon crossing a long rigid stenosis that could not be crossed after the lesion was wired, and (2) to overcome prominent elastic recoil of the stenosis after PTCA. © 1992 Wiley‐Liss, Inc.
Pseudoaneurysm of coronary artery following rupture of coronary artery during coronary angioplasty
Authors: Saito Shigeru , Arai Hidekazu , Kim Kunikane , Aoki Naoto 
Published: March 2007

AbstractRupture of the coronary artery is a rare complication of percutaneous transluminal coronary angioplasty (PTCA). We describe a case of coronary artery rupture during PTCA resulting in the formation of a coronary artery pseudoaneurysm. The pseudoaneurysm was successfully treated by percutaneous spring‐coil embolization of the coronary artery. © 1992 Wiley‐Liss, Inc.
Inoue balloon usefulness in case of failure to stabilize bifoil catheter balloons during percutaneous mitral valvotomy
Authors: Rocha P. , Berland J. , Lefebvre J.M. , Strumza P. , Lacombe P. , Fernandez F. 
Published: March 2007

AbstractA new bifoil balloon catheter has been used in the last 120 percutaneous mitral valvotomies carried out in our institution. The shaft segment between the two balloons of the bifoil catheter has been adjusted to the guide‐wire diameter, allowing its introduction through a 14F sheath. This thinner shaft does not always offer enough back up to the balloons during inflation. An Inoue balloon replaced an unstable bifoil balloon in 5 cases of mitral dilatation failure due to balloon instability, regularly providing firm stability until full balloon inflation. © 1992 Wiley‐Liss, Inc.
ST segment alternans during coronary angioplasty
Authors: Sochanski Mirek , Feldman Ted , Chua K. G. , Benn Andrew , Childers Rory 
Published: March 2007

AbstractFour patients with severe proximal or mid‐LAD stenosis were noted to have ST alternans during balloon angioplasty. Neither mechanical alternans nor increased ventricular ectopy were noted. In contrast to prior descriptions in animals or patients with variant angina, ST alternans did not occur following a premature ventricular contraction. Frequent use of calcium channel blockers during PTCA may interfere with the mechanism leading to electrical alternans and its consequences as seen in animal studies, accounting for the low frequency with which this phenomenon is noted during PTCA.
Changing incidence and management of abrupt closure following coronary intervention in the new device era
Authors: Kuntz Richard E. , Piana Robert , Pomerantz Richard M. , Carrozza Joseph , Fishman Robert , Mansour Michael , Safian Robert D. , Baim Donald S. 
Published: March 2007

AbstractAbrupt closure of the dilated segment occurs in approximately 4 to 7% of cases following conventional percutaneous coronary angioplasty. Additional balloon angioplasty reverses roughly 40% of these closures, to yield an overall 1.6 to 3.4% rate of emergent surgery. The impact of new devices on the incidence and reversal rate of abrupt closure has not been examined.Abrupt closure occurred in 80 (4.2%) of 1,919 consecutive coronary angioplasties performed in our single center, 389 (20%) of which were performed using newer interventions (208 Palmaz‐Schatz stents, 170 directional coronary atherectomies, and 11 elective laser balloon angioplasties). Abrupt closure was less frequent following newer coronary interventions (1.8%) compared to standard balloon angioplasty (4.9%, P < 0.01), possibly reflecting case selection. When abrupt closure did occur, percutaneous rescue was successful in 53 (66%) patients, including 42 (53%) who were rescued using standard or perfusion balloon angioplasty, and 11 (13%) who were rescued using laser balloon balloon angioplasty after failure of additional angioplasty attempts. Medical therapy alone was used in 8 (10%), while emergent coronary bypass surgery was performed in 18 (23%), yielding an overall emergent surgery rate of 0.9%. Q‐wave myocardial infarction was significantly less frequent (0.2%) following percutaneous rescue, compared to either medical therapy (25%) or emergent surgery (33%, P < 0.001).In our catheterization laboratory, use of these 3 new coronary interventional devices coincides with a trend towards a lower incidence of abrupt closure, a higher percutaneous rescue rate with reduced incidence of myocardial infarction, and a lower emergent bypass surgery rate.
Early coronary artery stent restenosis: Utility of percutaneous coronary angioscopy
Authors: Resar Jon R. , Brinker Jeffrey 
Published: March 2007

AbstractRestenosis of an endovascular stent may be caused by thrombus, intimal hyperplasia, or extrinsic compression. Angiography may not adequately define the etiology of restenosis. We describe a patient in whom angioscopy proved important in diagnosing intimal hyperplasia obviating the need for thrombolytic therapy and prolonged anti‐coagulation.
The tracker catheter: A new vascular access system
Authors: Hibbard Michael D. , Holmes David R. 
Published: March 2007

AbstractTechnologic advances in dilation equipment have been important in improving angioplasty success rates and in expanding the indications of dilation. Despite these improvements, approximately 7% to 10% of attempted dilations may ultimately fail because of inability to cross the culprit lesion. As angioplasty techniques are applied to an increasingly complex cohort of patients, the ultimate success of a given procedure depends more and more on the ability of the operator to select the appropriate equipment for a given procedure. We report the unique application of a commercially available perfusion catheter which may improve patient outcome during complex angioplasty.
Rotational atherectomy in anomalous coronary arteries
Authors: Bass Theodore A. , Gilmore Paul S. , Ceithaml Eric L. 
Published: March 2007

AbstractWe describe two cases of high speed rotational atherectomy performed in patients with anomalous coronary anatomy. These procedures are performed with standard equipment requiring no modifications using a percutaneous femoral approach. We feel these cases clearly illustrate the facile application of this new technology to unusual anatomical situations.
Improved support for right coronary artery angioplasty with a new guiding catheter
Authors: Shubrooks Samuel J. 
Published: March 2007

AbstractInadequate guiding catheter support is a frequent cause for failure in right coronary angioplasty (PTCA). A new guiding catheter designed to provide easy placement in the right coronary and improved stability and backup support is described. Use of this catheter for PTCA of right coronary lesions, the majority of which were considered technically difficult to dilate, in 100 patients resulted in successful dilatations in 88% of patients. Failures were due to inability to seat the guide adequately in 8 patients with narrow aortic roots or unusual coronary origins and to inability to cross a lesion in 4 patients despite good support. In 4 patients successful dilatation was achieved after failure using another presently available guide.
Discordant results of visual and quantitative estimates of stenosis severity before and after coronary angioplasty
Authors: Bertrand Michel E. , Lablanche Jean M. , Bauters Christophe , Leroy Fabrice , Mac Fadden Eugene 
Published: March 2007

AbstractThe ability to accurately estimate the severity of epicardial coronary stenoses is critical in the assessment of the immediate and long‐term results of percutaneous transluminal coronary angioplasty (PTCA). We prospectively compared visual estimates, performed by experienced interventional cardiologists, with computerized quantitative angiographic measurements of stenosis severity in a group of patients (n = 305) before, immediately after and 6 months after PTCA. Before PTCA the visual estimate of the mean (±SD) percentage stenosis severity, 80.6 (±9.7)%, was significantly (P<0.001) higher than the equivalent value, 73.4 (±11.1)%, obtained with use of quantitative angiography. Immediately after PTCA the visual estimate of the mean residual stenosis, 18.8 (±12.3)%, was significantly (P<0.0001) lower than the equivalent quantitative estimate, 37.4 (±14)%. Additionally, the residual stenosis was more frequently (18% vs. 3%) classified as significant (>50%) by quantitative angiography. At follow‐up, quantitative measurements of stenosis severity showed a Gaussian distribution with a mean of 54.8 (±21)%, whereas visual estimates had a bimodal distribution with populations greater than 70% and less than 50%.Visual estimates provide an inaccurate assessment of the immediate and medium term results of PTCA. Quantitative measurements suggest that the immediate results of PTCA are frequently misclassified as successful by the operator. Conversely, restenosis rates are underestimated by the operators suggesting that a more objective method must be used in trials to assess the impact of new therapies on the rate of restenosis.
Use of excimer laser in the treatment of chronic total occlusion of a coronary artery that cannot be crossed with a balloon catheter
Authors: Berger Peter B. , Bresnahan John 
Published: March 2007

AbstractThe inability to advance a balloon across a chronically occluded coronary artery that has been crossed with a guidewire occurs in 5% of patients with chronic occlusions. In this report, a new indication for the excimer laser is described: the recanalization of a chronic occlusion that has been crossed with a guidewire that cannot be crossed with a balloon catheter. © 1993 Wiley‐Liss,Inc.
Examination of the effects of hemodynamic and pharmacologic interventions on coronary collateral flow in a patient during cardiac catheterization
Authors: Donohue Thomas , Kern Morton J. , Bach Richard , Aguirre Frank , Wolford Thomas 
Published: March 2007

AbstractThe vasomotor response of native human collateral vessels to pharmacologic or hemodynamic vasodilatory stimuli is not well known. We describe a case where retrograde collateral flow velocity was measured both at baseline and following selected hemodynamic and pharmacologic interventions. This index case represents the first in a series of potential human physiologic studies designed to address questions pertaining to control of collateral blood supply in humans. © 1993 Wiley‐Liss, Inc.
High flow coronary fistula closure by percutaneous coil packing
Authors: Lacombe P. , Rocha P. , Marchand X. , Mulot R. , Rigaud M. , Jondeau G. , Weber J. M. , Kahn J. C. 
Published: March 2007

AbstractFew cases of transcatheter coronary fistula closure have been reported. High flow coronary fistulae are usually treated by surgery. This case report presents a 5.4 liters/min flow coronary fistula percutaneously closed by steel coils. This large flow needed the packing of 25 coils, 10‐15 cm long, for its total occlusion. © 1993 Wiley‐Liss, Inc.
Percutaneous mitral valvotomy using inoue and double balloon technique: Comparison of clinical and hemodynamic short term results in 350 cases
Authors: Sharma Satyavan , Loya Yunus S. , Desai Dhruman M. , Pinto Robin J. 
Published: March 2007

AbstractThe results of percutaneous mitral valvotomy (PMV) by double balloon (N = 230, Group I) and Inoue single balloon (N = 120, Group II) technique were compared. The groups were similar with respect to baseline characteristics. Following PMV there were marked symptomatic and haemodynamic benefits in both the groups. There was significant increase in mitral valve area (MVA) estimated by Gorlin's equation (Group I: from 0.83 ± 0.18 cm2 to 2.10 ± 0.45 cm2, p < 0.001; Group II: from 0.83 ± 0.17 cm2 to 2.16 ± 0.39 cm2, p < 0.001) and by echoplanimetry (Group I: from 0.84 ± 0.18 cm2 to 1.91 ± 0.35 cm2, p < 0.001; Group II: from 0.88 ± 0.17 cm2 to 1.96 ± 0.30 cm2, p < 0.001). However, the percentage increase in MVA in the two groups by echoplanimetry (Group I: 136 ± 59; Group II: 130 ± 51; p = NS) and by Gorlin's equation (Group I: 164 ± 69; Group II: 168 ± 61; p = NS) were not statistically significant. Results were considered optimal when increase in MVA was ± 1.5 cm2, percentage increase was ± 50, and mitral regurgitation was < 2/4. Out of 216 patients in Group I where PMV could be performed, optimal results were achieved in 184 (85.2%) by Gorlin's equation and 178 (82.4%) by echoplanimetry. In Group II, out of 116 patients, optimal results were achieved in 107 (92.2%) by Gorlin's equation and 103 (89%) by echoplanimetry. Incidence of mitral regurgitation although higher in Group II (24.1% vs. 18.9%) was not statistically significant. The results of both the techniques are similar and the main advantage of Inoue technique is its short procedure (Group I: 120 ± 35 minutes; Group II: 90 ± 30, p < 0.01) and fluoroscopy time (Group I: 22 ± 4.5; Group II: 11 ± 3.3, p < 0.01). © 1993 Wiley‐Liss, Inc.
Successful directional coronary atherectomy in a patient with dextrocardia and situs inversus
Authors: Lewis Bruce E. , Leya Ferdinand S. , Jones Paul , Grassman Eric D. , Stasior Christine , Haryani Vijay , McKiernan Thomas L. , Johnson Sarah A. , Scanlon Patrick J. 
Published: March 2007

AbstractWe describe a case of successful percutaneous transluminal coronary angioplasty of an infarct‐related vessel followed later by directional coronary atherectomy of a noninfarct vessel in a patient with dextrocardia using standard preformed catheters.© 1993 Wiley‐Liss, Inc.
Assessment of the hemodynamic significance of a left internal mammary artery graft‐pulmonary artery shunt in a post‐bypass patient using a doppler‐tipped guide wire
Authors: Reis Steven E. , Gloth Sean T. , Brinker Jeffrey A. 
Published: March 2007

AbstractWe assessed the hemodynamic significance of a left internal mammary artery (LIMA) graft‐pulmonary artery (PA) fistula in a post‐bypass patient with chest pain. A Dopplertipped guide wire and quantitative coronary angiography (QCA) were used to demonstrate that flow through the proximal LIMA (14.0 ml/min) was similar to the distal LIMA's contribution of flow to the left anterior descending artery (LAD) (15.6 ml/min), suggesting that the fistula was not hemodynamically significant. Therefore, intravascular Doppler and quantitative angiography may be used to assess the hemodynamic significance of a LIMA‐PA fistula in a post‐bypass patient. © 1993 Wiley‐Liss, Inc.
PTCA of “shepherd's crook” right coronary arteries with a new shape of guiding catheter
Authors: Nesto Richard W. , Sassower Michael A. 
Published: March 2007

AbstractPercutaneous transluminal coronary angioplasty (PTCA) of lesions in a right coronary artery with a “shepherd's crook” configuration may pose procedural difficulties due to inadequate guiding catheter back‐up support. We evaluated the utility of a new shape of guiding catheter, previously evaluated for PTCA of lesions in the left coronary artery, in five cases with this particular right coronary artery anatomy. Factors responsible for success in these cases relate to the catheter's shape and construction.
Pulmonary valvuloplasty in adults using the Inoue balloon catheter
Authors: Lau Kean‐Wah , Hung Jui‐Sung , Wu Jong‐Jen , Chern Ming‐Shyan , Yeh Kou‐Ho , Fu Morgan 
Published: March 2007

AbstractThis report describes a new balloon pulmonary valvuloplasty technique using the Inoue balloon catheter performed in 14 consecutive adult patients, aged 17–47 years (mean 27). The mean right ventricular systolic pressure and the pulmonary valvular peak‐to‐peak systolic gradient decreased from 102 ± 41 to 52 ± 19 mm Hg (p = 0.001) and 81 ± 40 to 7 ± 7 mm Hg (p = 0.0002), respectively. An infundibular peak‐to‐peak systolic gradient either developed (n = 13) or increased (n = 1). None of the patients were treated with beta‐adrenergic blockers before or after the valvuloplasty. Eight patients underwent repeat hemodynamic study 12–30 months (mean 17) after treatment, and had no evidence of valvular restenosis. The mean right ventricular systolic pressure and the mean infundibular peak‐to‐peak systolic gradient decreased, compared to the values immediately after valvuloplasty (54 to 40 mm Hg, p = 0.03, and 28 to 10 mm Hg, p = 0.03, respectively). The study suggests that pulmonary valvuloplasty in adults using the Inoue balloon catheter technique is feasible, safe, and effective. © 1993 Wiley‐Liss, Inc.