bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary angioplasty of anomalous coronary arteries: Notes on technical aspects
Authors: Topaz On , Disciascio Germano , Goudreau Evelyne , Cowley Michael J. , Nath Amar , Kohli Ravinder S. , Vetrovec George W. 
Published: March 2007

AbstractFive patients with significant atherosclerotic lesions of anomalous coronary arteries underwent coronary angiopiasty of the anomalous vessel. Four patients had anomalous circumflex artery and 1 had an anomalous right coronary artery. Angiographic and clinical success was achieved in all 5 patients. To ensure adequate equipment selection special consideration should be given to angiographic characteristics of these vessels, such as the orifice configuration, exit angulation, the route the artery traverses and the location of the stenotic lesions. Major determinants for successful angioplasty in these patients are guiding catheter selection and advancement of the balloon catheter to the very proximal portion of the anomalous vessel to subsequently facilitate guide wire advance ment. This data indicates that balloon angioplasty can be successfuily utilized in patients with significant atherosclerotic disease of anomalous coronary arteries.
Probe™ angioplasty of total coronary occlusion using the probing catheter™ technique
Authors: Little Thomas , Rosenberg Joel , Seides Stuart , Lee Benjamin , Lindsay Joseph , Pichard Augusto D. 
Published: March 2007

AbstractCoronary angioplasty (PTCA) of total coronary occlusion is limited by the inability of guidewires and conventional dilating catheters to cross all such lesions. A new technique was therefore prospectively evaluated for PTCA of these lesions using the ultra‐low‐profile Probe™ “balloon on a wire” device. An intracoronary Probing Catheter™ was used to facilitate crossing the stenosis with a guidewire and then to deliver a Probe™ Into the obstruction for balloon dilatation. This technique was utilized in 64 consecutive patients with “absolute” coronary occlusions demonstrating no angiographically detectable antegrade coronary flow. Successful dilatation was achieved in 47 (73%). Among 33 occlusions of less than 3 mo duration 31 (94%) were successfully dilated whereas only 16 of 31 more chronic occlusions were dilated (P<.01). Chronic occlusions with a tapered morphology and those located more than 1 cm from a branch point were more frequently dilatable. There were no Serious complications including no vessel perforations with this technique.The Probing Catheter™ technique offers a safe and effective method for the dilatation of recent coronary occlusions by using balloon on a wire technology.
Physical examination and echo doppler study in the assessment of femoral arterial complications following cardiac catheterization
Authors: Cohen Gerald I. , Chan Kwan‐Leung 
Published: March 2007

AbstractFemoral arterial complications following cardiac catheterization have been well recognized. The development of an inguinal mass in these patients can represent a simple hematoma, a pseudoaneurysm, or an arteriovenous fistula. The utility of the physical examination in diagnosing these complications was assessed by using the echo Doppler study for comparison. This study shows that any single clinical sign should not be used in isolation, but a constellation of physical findings can suggest the correct diagnosis.
Inflation pressure requirements during coronary angioplasty
Authors: Kahn Joel K. , Rutherford Barry D. , McConahay David R. , Hartzler Geoffrey O. 
Published: March 2007

AbstractTo examine the balloon inflation pressures required for successful percutaneous transluminal coronary angioplasty (PTCA), the maximal inflation pressure required for 477 coronary lesions in 200 consecutive patients was determined retrospectively. When graded balloon infaltions just sufficient to achieve full expansion were used, the maximal inflation pressure used was ≤8 atm in 412 stenoses (86%) and was ≤10 atm in 463 stenoses (97%). Successful PTCA was achieved in 98% of lesions with a 3.5% major procedural complication rate. In a second group of 100 patients studied prospectively, the inflation pressure required to achieve full balloon expansion was ≤8 atm in 214 of 232 stenoses (92%) and ≤10 atm in 228 stenoses (98%). Thus, PTCA of coronary stenoses can be achieved with high success rates and low complication rates when graded inflations to pressures just sufficient to achieve full balloon expansion are performed. Most coronary stenoses will respond to pressures ≤8–10 atm.
Evaluation of catheters and metallic catheter markers as calibration standard for measurement of coronary dimension
Authors: Leung Wing‐Hung , Demopulos Peter A. , Alderman Edwin L. , Sanders William , Stadius Michael L. 
Published: March 2007

AbstractMeasurement of coronary dimension requires an accurate and reproducible dimensional reference. Angiographic catheters are frequently used for this purpose. We measured the angiographic diameters of a broad range of diagnostic and angioplasty guiding catheters by using two commonly used edge‐detection algorithms. Angiographic diameters are significantly less than true catheter outer diameter. Therefore the use of contrast‐filled catheters as a dimensional reference may lead to considerable error in vessel measurement with overestimation of absolute dimension. Tables of reference values for multiple catheters are included. We also evaluated the suitability of a metallic‐tipped “marker” catheter as calibration standard, tested under a variety of angiographic conditions. The metallic‐tipped marker was found to have a better degree of reproducibility than catheters. These findings have implications for studies employing serial measurements of coronary artery dimension and for the clinical practice of estimating vessel diameter for choice of balloon size during angioplasty.
Standby percutaneous transluminal coronary angioplasty for coronary artery bypass surgery
Authors: Schieman Gregory , Cohen Barry M. , Buchbinder Maurice 
Published: March 2007

AbstractUrgent PTCA of a distal anastomotic stenosis in a saphenous vein aortocoronary bypass graft was successful in relieving recurrent ischemia within 24 h of CABG surgery.
Correction of subclavian artery stenosis by percutaneous angioplasty
Authors: Gershony Gary , Basta Lofty , Hagan Arthur D. 
Published: March 2007

AbstractSubclavian artery stenosis is an infrequently recognized cause of left‐sided chest and arm pain that can mimic the signs and symptoms of angina pectoris. In addition, more proximal subclavian artery stenoses can be associated with cerebrovascular symptoms in the “subclavian steal syndrome.” This article reviews the clinical experience in four patients who presented with different manifestations of subclavian artery stenosis and who were all successfully treated by percutaneous angioplasty. Their clinical presentation, angiographic findings, and post‐angioplasty results are documented. In conclusion, it is felt that nonsurgical correction of critical subclavian artery stenosis, using current angioplasty techniques, is the preferred method of treatment.
Influence of low osmolality contrast media on electrophysiology and hemodynamics in coronary angiography: Differences between an ionic (loxaglate) and a nonionic (lohexol) agent
Authors: Vik‐Mo Harald , Følling Magne , Barth Philippe , Nordrehaug Jan Erik , Bjørkhaug Aud , Rosland Gunnar A. 
Published: March 2007

AbstractIt has recently been suggested that the addition of sodium to low osmolality contrast media may reduce the incidence of ventricular fibrillation and conduction disturbances during coronary angiography. In a randomized, double blind study of 30 patients undergoing coronary angiography we therefore examined the electrophysiological and hemodynamic effects of the two low osmolality contrast media—ioxaglate (with sodium) and iohexol (without sodium). Standard ECG, aortic blood pressure, and His bundle electrocardiogram were recorded.The contrast media were well tolerated and no serious arrhythmias were observed. Both induced a transient decrement in systolic blood pressure and reduction in heart rate 10 s following contrast injection (all P<0.01). Ioxaglate prolonged the QT interval at 10 s (P<0.01) and also when analysed for the whole observation period (120 s) (P<0.05), whereas iohexol did not cause any significant changes in the QT‐interval. The AH‐interval was prolonged by ioxaglate at 10 s (P<0.01), but not altered by iohexol.Thus, other factors than osmolality and sodium content might contribute to QT prolongation, since only the contrast agents with sodium (ioxaglate) induced QT prolongation in this study.
Postoperative angiographic evaluation of gastroepiploic artery grafts: Technical considerations and short‐Term patency
Authors: Isshiki Takaaki , Yamaguchi Tetsu , Nakamura Masato , Saeki Fumihiko , Itaoka Yoshinori , Nagahara Toshihiro , Furuta Yuko , Ikari Yuji , Wanibuchi Yasuhiko , Suma Hisayoshi 
Published: March 2007

AbstractFollow‐up angiography was performed in 37 patients with right gastroepiploic artery (GEA) grafts at 27 ± 32 days postoperatively. By the femoral approach, a 5F cobra or twist catheter was advanced selectively into the gastroduodenal artery (GDA) over a plasticcoated guidewire. In 29 patients, the GDA was successfully catheterized, and the GEA grafts were clearly visualized by the injection of 3–7 ml of contrast medium. GDA catheterization was unsuccessful in 8 patients, but in 4 of them the grafts were well visualized when 15–20 ml of contrast was injected. In the other 4 patients, visualization of the GEA grafts was poor, but the distal portions were outlined by retrograde perfusion from the native right coronary arteries. A total of 34 GEA grafts were patent (92%), and the diameters of these grafts were adequate when compared with respective recipient coronary arteries (2.8 ± 0.9 and 2.3 ± 0.6 mm, respectively; P <.05). No complications were noted except for transient vasospasm (3 patients) in the GEA, hepatic artery, or both, which was relieved by the intra‐arterial injection of isosorbide dinitrate (2.5 mg). Thus, the overthe‐wire technique allows simple and safe GDA catheterization, which is essential for obtaining good visualization of GEA grafts.
Mitral valve disruption following percutaneous balloon valvuloplasty
Authors: Ramondo Angelo , Chirillo Fabio , Dan Maurizio , Sorbara Carlo , Fracasso Alberto , Mazzucco Alessandro , Rampazzo Carlo , Isabella Giambattista , Chioin Raffaello 
Published: March 2007

AbstractTwo cases of massive mitral regurgitation due to mitral valve disruption following percutaneous balloon valvuloplasty are reported. This severe complication occurred in two elderly women with recurrent mitral stenosis after previous surgical commissurotomy. Due to their unstable hemodynamic and clinical condition, both patients underwent emergency valve replacement. At surgery, the commissures appeared fused and heavily calcified; the chordae tendineae thickened, shortened, and fused; and the leaflets presented a large tear with sheared edges. Because the technical aspects of both procedures were unremarkable, the anatomic features of the mitral valve seemed to affect the occurrence of severe mitral regurgitation. Percutaneous balloon valvuloplasty should be therefore applied carefully to patients with prior surgical valvotomy, in whom the structural alterations of the mitral apparatus may predispose to severe valvular damage.
Percutaneous balloon pulmonary valvuloplasty in sickle cell anemia: A case report
Authors: Muthusamy R. , Sriram R. , Dunn B. 
Published: March 2007

AbstractPercutaneous balloon pulmonary valvuloplasty was performed on a 19‐year‐old female who had moderate pulmonary valve stenosis with sickle cell anemia. The patient developed sickle cell crisis resulting in occipital infarction, but she made a good recovery. We describe this case and the methods of reducing the risk of sickle cell crisis.
“Woven” Right coronary artery: Case report and therapeutic implications
Authors: Berman Aaron D. , Kim Ducksoo , Baim Donald S. 
Published: March 2007

AbstractWe report an unusual anomaly of the right coronary artery consisting of proximal branching of the artery and subsequent interweaving of the branches, referred to as a “woven” coronary artery. Implications and differential diagnosis are discussed.
Coronary stent implantation in acute vessel closure 48 hours after an unsatisfactory coronary angioplasty
Authors: Haude M. , Erbel R. , Straub U. , Dietz U. , Schatz R. , Meyer J. 
Published: March 2007

AbstractWe report the implantation of a balloon‐expandable stent in a patient with acute vessel closure in the state of evolving myocardial infarction following 48 hr after unsatisfactory coronary angioplasty. The stent was implanted after successful recanalization of an occluded left anterior descending artery, with repeated unsatisfactory results of balloon angioplasty. Adjunct thrombolytic therapy was contraindicated. No residual stenosis was documented in immediate control angiograms, or after 24 hr, 3 weeks, and 4 months.
Effect of heparin in nonionic contrast media on blood coagulation and its dose response curve
Authors: Hwang Ming H. , Piao Zhen En , Sheu Sheng Hsiung 
Published: March 2007

AbstractTo investigate the local effect of heparin on blood clot formation and partial thromboplastin time (PTT), blood was withdrawn into the catheters filled with iopamidol and heparin at 0, 1, 2, 3, 5, and 10 U per ml concentrations as debubbling. After 30 min incubation, blood clotting was observed in all 8 experiments with heparin concentrations of 0 and 1 U per ml; in 3 of 8 with 2 U per ml; and in none with ≥ 3 U per ml. PTT of blood and contrast mixture in catheters increased significantly when heparin concentrations were increased from 2 to 3 U per ml and reached a level of > 110 sec at 5 or more U per ml.Thus, the addition of heparin to nonionic contrast media at concentrations of 5 U per ml may be an easy measure with which to prevent blood clotting and reduce thromboembolic complications during coronary arteriography.
Application of coronary angioplasty to the septal perforator arteries
Authors: Topaz On , Disciascio Germano , Vetrovec George W. , Goudreau Evelyne , Sabri Nagui , Nath Amar , Kohli Ravinder S. , Cowley Michael J. 
Published: March 2007

AbstractSignificant coronary artery disease affecting the septal perforator arteries can cause anginal pain, rhythm disturbances, or septal infarction. However, since these vessels are usually inaccessible to coronary bypass surgery, there is a tendency among angiogra‐phers and angioplasters to overlook lesions of the septal perforator arteries. Our experience suggests that if medical treatment is not sufficient to treat clinical manifestations resulting from septal perforator disease, then coronary angioplasty can be considered a therapeutic alternative for revascularization. We herein present 11 patients who underwent coronary angioplasty of a major septal artery and discuss angiographic and technical aspects of the procedure.
Comparison of exercise performance in left main and three‐vessel coronary artery disease
Authors: Gibbons Raymond J. , Earl F. Fyke , Brown Manuel L. , Lapeyre Andre C. , Zinsmeister Alan R. , Clements Ian P. 
Published: March 2007

AbstractFrom a consecutive series of patients who underwent rest and exercise radionuclide angiography over several years, we retrospectively identified 34 patients with left main coronary artery disease and 103 patients with three‐vessel coronary artery disease who did not have significant left main disease. The results of gated equilibrium radionuclide angiography were compared in these 2 groups. Multiple exercise hemodynamic, exercise electrocardiographic, and exercise radionuclide angiographic parameters were considered in an attempt to separate the 2 groups. The only parameter that was significantly different between the 2 groups was exercise heart rate. However, no value of the exercise heart rate could meaningfully separate the 2 groups. Despite their known difference in prognosis, patients with left main and three‐vessel disease had very similar exercise performance and could not be distinguished from one another by exercise electrocar‐diography or exercise radionuclide angiography. The inability to distinguish these two groups is a clear limitation of noninvasive exercise modalities.
Percutaneous transluminal coronary angioplasty of anomalous right coronary artery
Authors: Musial Bart , Schob Alan , Marchena Eduardo De , Kessler Kenneth M. 
Published: March 2007

AbstractCoronary angioplasty of tortuous anomalous coronary arteries can be technically challenging. We describe a successful percutaneous transluminal coronary angioplasty (PTCA) of an anomalous right coronary artery after a failed previous attempt. The anatomic limitations of anomolous right coronary arteries and technical considerations for PTCA are discussed.
Predictability and prognosis of ptca‐induced coronary artery aneurysms
Authors: Bal Egbert T. , Plokker H. W. Thijs , van den Berg Eduard M. J. , Ernst Sjef M. P. G. , Gijs Mast E. , Gin R. Melvyn Tjon Joe , Ascoop Carl A. P. L. 
Published: March 2007

AbstractThe natural history of coronary aneurysms, defined as local dilatations exceeding the diameter of the normal adjacent vessel segments by at least 1.5 times, is not significantly different from the natural history of nonaneurysmal coronary disease. However, little is known about the prognosis of percutaneous transluminal coronary angioplasty (PCTA)‐induced coronary aneurysms. Therefore, we investigated the occurrence and the medium long‐term prognosis of such aneurysms in 728 patients who, after successful PTCA, underwent repeat coronary angiography at mean 4.5 months post‐PTCA. A coronary aneurysm at the site of PTCA ws noted in 3.9% of patients (n + 28). Of the potentially predictive factors analyzed, only a coronary dissection at the time of PTCA had statistically significant influence. The long‐term prognosis of PTCA‐induced coronary aneurysms was excellent. One patient underwent (unrelated) cardiac surgery, all other 27 patients remained eventfree. We conclude that the same benign nature of coronary aneurysmal disease holds true for those aneurysms that develop after PTCA.
Identification of ischemic and hibernating myocardium: Feasibility of post‐exercise f‐18 deoxyglucose positron emission tomography
Authors: Marwick Thomas H. , Maclntyre William J. , Salcedo Ernesto E. , Go Raymundo T. , Saha Gopal , Beachler Annette 
Published: March 2007

AbstractThe identification of ischemic and hibernating myocardium facilitates the selection of patients most likely to benefit from revascularization. This study examined the feasibility of metabolic imaging, using post‐exercise F‐18 deoxyglucose positron emission tomography (FDG‐PET) for the diagnosis of both ischemia and hibernation in 27 patients with known coronary anatomy. Normal post‐exercise FDG uptake was defined in each patient by reference to normal resting perfusion and normal coronary supply. Abnormal elevation of FDG (ischemia or hibernation) was compared in 13 myocardial segments in each patient, with the results of dipyridamole stress perfusion imaging performed by rubidium‐82 positron emission tomography (Rb‐PET).Myocardial ischemia was diagnosed by either FDG‐PET or Rb‐PET in 34 segments subtended by significant local coronary stenoses. Increased FDG uptake was present in 32/34 (94%) and a reversible perfusion defect was identified by Rb‐PET in 22/34 (65%, p < .01). In 3 patients, ischemia was identified by metabolic imaging alone. In 16 patients with previous myocardial infarction, perfusion defects were present at rest in 89 regions, 30 of which (34%) demonstrated increased FDG uptake, consistent with the presence of hibernation.Increased post‐exercise FDG uptake appears to be a sensitive indicator of ischemia and myocardial hibernation. This test may be useful in selecting post‐infarction patients for revascularization.
Analysis of high‐frequency rotational angioplasty‐induced echo contrast
Authors: Zotz R. , Stähr P. , Erbel R. , Auth D. , Meyer J. 
Published: March 2007

AbstractDuring high‐frequency rotational angioplasty (HFRA), myocardial contrast enhancement (echo contrast) was observed by means of two‐dimensional echocardiography. In order to evaluate the echo contrast produced by HFRA, an in vitro experimental model was built using a cylinder with the HFRA catheter scanned in a water bath. The cylinder was filled with blood, mineral water, and distilled water. With a 2.5‐MHz transducer, echograms were recorded and analyzed by video intensitometer, and the maximum intensity IUmax and persistence time P were calculated. Rotation frequencies of 20,000–200,000 rpm with 2.0‐mm burrs and times of 10 s were tested. In another model, hyperbaric conditions for the same media were produced. The influence of debris from arterioscleroic plaque and of hematocrit on echo contrast intensity were also analyzed. The effect of HFRA on hemolysis (LDH, free hemoglobin) within 10 s and temperature were also measured.The contrast effect was transient, depending on the rotation frequency. In blood, it appeared at 20,000 rpm (IUmax at 200,000 rpm: 237 IU), in mineral water at 40,000 rpm (IUmax 165 IU), and in distilled water at 80,000 rpm (IUmax 72 IU). Persistence time was measured up to about a half‐minute. Echo contrast production was reduced at 0.5 bar and fully suppressed at 2.5 bar. Debris increased contrast intensity from about 219 IU to 225 IU (at 160,000 rpm). In blood IUmax decreased from 227 IU to 97 IU by lowering the hematocrit from 44.2% to 3.6%. Free hemoglobin increased up to 4,890 mg/L (baseline value 38 mg/L), LDH increased up to 680 U/L (baseline value 100 U/L). Temperature rose only by 1.0°C within 10 s of rotation, whereas an increase up to 7.7°C occurred within 40 s. The observed echocontrast seems to be due to microcavitation, depending on the fluid, frequency, and pressure.
Acute angiographic and clinical outcome of high speed percutaneous rotational atherectomy (rotablator®)
Authors: Dorros Gerald , Iyer Sriram , Zaitoun Rafic , Lewin Ruben , Cooley Ryan , Olson Karen 
Published: March 2007

AbstractPercutaneous rotational atherectomy (Rotablator®), a high speed (>100,000 RPM) rotational burr, was used successfully in 38 of 43 patients (88%) (mean age: 65 ± 7 years) with 82 lesions (71 stenoses and 11 occlusions). The clinical indications were claudication (84%), nonhealing ulcer (7%), and renovascular hypertension (7%). Rotablation was successful in 78 of 82 lesions (95%): 68 of 71 (96%) stenoses (12 of 12 iliac, 11 of 11 femoral, 7 of 8 popliteal, 36 of 37 tibial, and 2 of 3 renal arteries; 60% of lesions were diffuse, i.e., >/4 cm in length), and 10 of 11 (91%) occlusions (5 of 6 femoral, 1 of 1 popliteal, 3 of 3 tibioperoneal, 1 of 1 brachial artery). The Rotablator significantly (p<0.001) reduced the arterial obstruction (stenoses: 85 ± 11% to 12 ± 12%); occlusions: (100% to 25 ± 10%). The effective final burr size for arteries varied at 3.5–4.5 mm for renal, 3.0–3.5 mm for femmoral, and 2.0–3.0 mm for brachial and tibial. Complications included gross hemoglo‐binuria without sequelae in 27 patients (63%), groin hematoma in 10 (23%), arterial spasm in 10 (23%), and arterial bypass in 2 (5%). The Rotablator® was successfully used, without concomitant conventional balloon angioplasty, to open arterial lesions with excellent angiographic results in both diffuse and segmental peripheral vascular disease. There was gratifying patient clinical improvement.