bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transcatheter closure of very large (≥ 25 mm) atrial septal defects using the Amplatzer septal occluder
Authors: Kannan Bhava Ramalingam Jawahar , Francis Edwin , Sivakumar Kothandam , Anil Sivadasan Radha , Kumar Raman Krishna 
Published: July 2003

AbstractBetween June 1999 and September 2002, 45 patients (age, 34 ± 13 years; mean shunt ratio, 2.6 ± 0.6) underwent transcatheter atrial septal defect (ASD) closure at our institution with the Amplatzer septal occluder (mean device size, 31.4 ± 3 mm). Patients were selected by transesophageal echocardiography. The mean ASD dimension was 25.3 ± 3.7 mm and 33 (73%) patients had deficient anterior rim. Specific procedural details included the use of 13 or 14 Fr introducer sheaths and the right upper pulmonary vein approach if the conventional approach failed. There were two procedural failures, with device embolization in both (surgical retrieval in one, catheter retrieval in one). During follow‐up (3–30 months; median, 16 months), one patient (59 years) with previous atrial flutter had pulmonary embolism and was managed with anticoagulation. Two patients developed symptomatic atrial flutter. Fluoroscopy time was 31.6 ± 19.5 min for the first 22 cases and 19.6 ± 11.4 min for the rest (P = 0.04). Transcatheter closure of large ASDs is technically feasible but careful long‐term follow‐up is needed to document its safety. Cathet Cardiovasc Intervent 2003;59:522–527. © 2003 Wiley‐Liss, Inc.
Platelet glycoprotein IIb/IIIa inhibition with eptifibatide: Prolongation of inhibition of aggregation in acute renal failure and reversal with hemodialysis
Authors: Sperling Robert T. , Pinto Duane S. , Ho Kalon K.L. , Carrozza Joseph P. 
Published: July 2003

AbstractWe report the time course to the restoration of normal platelet aggregation in three patients who were treated with eptifibatide in the setting of severe renal failure. There was prolonged platelet inhibition in the first patient who developed acute renal failure. The second patient with acute on chronic renal failure developed an intracerebral hemorrhage. Normal platelet aggregation was restored after acute hemodialysis. In a third patient with end‐stage renal disease, platelet function returned to the normal range following hemodialysis. There is a prolonged time course to the restoration of normal platelet aggregation in patients with severe renal dysfunction who are treated with eptifibatide. Acute renal hemodialysis may reverse the inhibitory effect of eptifibatide on platelet aggregation in these patients. Cathet Cardiovasc Intervent 2003;59:459–462. © 2003 Wiley‐Liss, Inc.
Preliminary experience with a new 18 mm Amplatzer PFO occluder for small persistent foramen ovale
Authors: Ewert Peter , Kretschmar Oliver , Peters Bjoern , Nuernberg Jan H. , Khaliq Hashim Abdul , Nagdyman Nicole , Lange Peter E. 
Published: July 2003

AbstractWe report our initial experience with a new 18 mm Amplatzer PFO device for the closure of small PFO. Patients were selected by a semiquantitative sizing procedure using the circle of a diagnostic pigtail catheter instead of a sizing balloon. In all eight patients, the device was easy to implant without problems. Due to its size, it has the potential to minimize the risk of inadvertent atrial erosion or perforation after deployment and thus will enhance the safety of interventional PFO closure. Cathet Cardiovasc Intervent 2003;59:518–521. © 2003 Wiley‐Liss, Inc.
Direct stenting with a combined intravascular ultrasound‐coronary stent delivery platform: A feasibility trial
Authors: Eeckhout Eric , Berger Alexandre , Roguelov Christan , Lyon Xavier , Imsand Christophe , Fivaz‐Arbane Malika , Girod Grégoire , De Benedetti Edoardo 
Published: July 2003

AbstractIVUS is considered as the most accurate tool for the assessment of optimal stent deployment. Direct stenting has shown to be a safe, efficient, and resource‐saving procedure in selected patients. In a prospective 1‐month feasibility trial, a new combined IVUS‐coronary stent delivery platform (Josonics Flex, Jomed, Helsingborn, Sweden) was evaluated during direct stenting in consecutive patients considered eligible for direct stenting. The feasibility endpoint was successful stent deployment without any clinical adverse event, while the efficacy endpoint was strategic adaptation according to standard IVUS criteria for optimal stent deployment at the intermediate phase (after a result considered angiographically optimal) and at the end of the intervention (after optimization according to IVUS standards). A total of 16 patients were successfully treated with this device without any major clinical complication. At the intermediate phase, optimal stent deployment was achieved in four patients only, while at the end only one patient had nonoptimal IVUS stent deployment. In particular, the minimal in‐stent cross‐section area increased from 6.3 ± 1.2 to 8.3 ± 2.5 mm2. These preliminary data demonstrate the feasibility of direct stenting with a combined IVUS‐stent catheter in selected patients and confirm the results from larger randomized trials on the impact of IVUS on strategic adaptations during coronary stent placement. Cathet Cardiovasc Intervent 2003;59:451–454. © 2003 Wiley‐Liss, Inc.
Clinical outcomes following stent implantation in internal mammary artery grafts
Authors: Sharma Arvind K. , McGlynn Scott , Apple Sue , Pinnow Ellen , Canos Daniel A. , Gevorkian Natalie , Tebeica Mihaela , Gruberg Luis , Pichard Augusto D. , Lindsay Joseph 
Published: July 2003

AbstractWe evaluated our experience with percutaneous coronary intervention (PCI) of internal mammary artery (IMA) grafts. From the institution's database we identified 288 patients with 311 IMA lesions. Of these, 82 (26.4%) had stents placed during PCI. Angiographic success was 92%. Mortality at 1 month was 1.7%, myocardial infarction (MI) 15.7%, and target lesion revascularization (TLR) 0.4%. Cumulative 1‐year event rates were mortality 6.4%, MI 20.4%, and TLR 8.0%. TLR rates were significantly higher in the stented lesions than lesions treated with angioplasty alone (19.2% vs. 4.9%; P = 0.004). The higher TLR rate in stented lesions was most apparent at the anastomotic site (25.0% vs. 4.2%; P = 0.006). Percutaneous revascularization of IMA grafts can be performed safely with high procedural success and excellent short‐ and long‐term results. Stenting, particularly at the anastomotic site, was associated with significantly greater rates of TLR than angioplasty alone. Cathet Cardiovasc Intervent 2003;59:436–441. © 2003 Wiley‐Liss, Inc.
Safety and effectiveness of stent implantation without predilation for small coronary arteries
Authors: Caputo Ronald P. , Flately Michael , Ho Kalon K.L. , Baim Donald S. 
Published: July 2003

AbstractThe purpose of this study was to examine the safety and effectiveness of stenting without predilation (direct stenting) in small (< 2.5 mm) coronary arteries. Clinical and angiographic data from the multicenter randomized PREDICT trial was examined. Direct stenting was performed on 42 small and 158 large vessels. Predilation was performed prior to stenting for 37 small vessels. In the small‐vessel group, mean reference vessel diameter was 2.24 ± 0.19 mm for direct stenting vs. 2.24 ± 0.22 mm for predilation (P = NS). Mean reference vessel diameter was 3.17 ± 0.48 mm in the large‐vessel group. Device success for direct stenting was similar for small vs. large vessels (90.5% vs. 92.4%; P = NS). At 180 days, a trend toward increased MACE between small vs. large vessels in the direct‐stenting group was observed (26.8% vs.16.7%; P = NS), and significantly higher target lesion revascularizations (TLRs) in the small‐vessel group (19.5% vs.7.7%; P = 0.03) were observed. In small vessels, differences in device success rate (90.5% vs. 100 %; P = NS) and lesion success rate (100% vs. 100%; P = NS) for direct stenting vs. predilation were not significant. At 180 days, no differences between direct stenting and predilation for MACE (26.8% vs. 29.7%; P = NS) or TLR (22.0% vs. 21.6%; P = NS) were seen in small vessels, although binary angiographic restenosis rate tended to be higher in direct‐stenting group (38.2% vs. 18.5%; P = NS). Direct stenting of small vessels can be performed safely and successfully in selected cases. Restenosis rates may be higher for small vessel treated by direct stenting compared to predilation. Cathet Cardiovasc Intervent 2003;59:455–458. © 2003 Wiley‐Liss, Inc.
The VB‐1 catheter: A novel catheter for peripheral arterial revascularization
Authors: Kandzari David E. , Zidar James P. , Behar Victor S. 
Published: July 2003

AbstractDespite recent advances in catheter‐based technologies for peripheral arterial revascularization, adequate guide catheter positioning and support remains a leading procedural challenge. This report describes the adaptation of the Behar Internal Mammary VB‐1 catheter for peripheral revascularization procedures in patients with complex anatomy not amendable to other conventional peripheral guide catheters. Cathet Cardiovasc Intervent 2003;59:514–517. © 2003 Wiley‐Liss, Inc.
Assessment of the trackability, flexibility, and conformability of coronary stents: A comparative analysis
Authors: Rieu Régis , Barragan Paul , Garitey Vincent , Roquebert Pierre O. , Fuseri Jean , Commeau Philippe , Sainsous Joel 
Published: July 2003

AbstractThe efficacy and safety of coronary stent implantation depend on the mechanical features of these devices when deployed in atheromatous lesions of various morphologies. We evaluated the trackability, flexibility, and conformability of 17 coronary stents using specific mechanical bench tests. The quantifications used a dynamometer for assessment of trackability (maximal strength) and flexibility (stiffness) and a 3D optical gauging machine for assessment of conformability (distance between stent and arterial wall in a curvature). The maximal strength (measuring the trackability) ranged respectively from 0.24 ± 0.06 and 0.38 ± 0.03 N (Seaquest) to 1.31 ± 0.42 and 1.34 ± 0.35 N (Carbostent), concerning respectively curvatures of 90° (P < 0.0001) and 135° (P < 0.0001). The stiffness (measuring the flexibility) ranged from 0.53 ± 0.16 (Seaquest) to 1.28 ± 0.10 N/mm (NIR Royal; P < 0.0001). The mean distance between stent and external curvature (external conformability) ranged from 0.15 ± 0.06 mm (S7) to 0.57 ± 0.4 mm (NIR Royal; P < 0.0001). The mean distance between stent and internal curve (internal conformability) ranged from 0.26 ± 0.13 (S7) to 0.44 ± 0.12 mm (S670; P < 0.0001). These results may influence the choice of a particular stent adapted to a specific coronary anatomy. Cathet Cardiovasc Intervent 2003;59:496–503. © 2003 Wiley‐Liss, Inc.
Radial loop and extreme vessel tortuosity in the transradial approach: Advantage of hydrophilic‐coated guidewires and catheters
Authors: Barbeau Gérald R. 
Published: July 2003

AbstractBetween October 2000 and October 2001, all transradial cases performed by the author necessitating radial and upper arm angiography because of difficult advancement of standard guidewires or catheters were analyzed retrospectively. Fourteen of 594 (2.4%) transradial cases met the study criteria. Radial loops or stenosis and tortuosity in the subclavian or innominate artery were responsible for the difficult access. Several examples of patients with access problems are presented. A technique using a hydrophilic‐coated guidewire and a new hydrophilic‐coated guiding catheter is described. Cathet Cardiovasc Intervent 2003;59:442–450. © 2003 Wiley‐Liss, Inc.
Clinical course and management strategies for hemolysis after transcatheter closure of patent arterial ducts
Authors: Anil Sivadasan Radha , Sivakumar Kothandam , Philip Ancil Kora , Francis Edwin , Kumar R. Krishna 
Published: July 2003

AbstractResidual flows following transcatheter coil or device closure of the patent ductus arteriosus (PDA) can result in hemolysis. Of 611 patients who underwent transcatheter PDA closure at our institution, 5 patients (age, 6–63 years) developed overt hemolysis (after coil occlusion in 4 and Amplazter device closure in 1). All had ducts > 3 mm and residual flows after the procedure. In one patient, hemolysis occurred 3 months after coil occlusion following a period of uncontrolled hypertension. The occurrence of hemolysis correlated significantly with both age as well as duct size (P < 0.00001). Hemolysis was associated with a fall in hemoglobin of 3–6 g/100 ml (n = 3), jaundice (n = 2), and renal failure (n = 1). Hemolysis subsided spontaneously in one patient and four patients required flow elimination. Deploying additional coils in three patients eliminated residual flows. In one patient (after Amplatzer device closure for 12.5 mm duct with aneurysm), flow persisted after 25 additional coils, transient balloon occlusion, and gel foam instillation. Flow elimination was eventually achieved through thrombin instillation after balloon occlusion of the ampulla. All patients recovered completely and were well on follow‐up. Although hemolysis after duct occlusion is rare (0.8% in this series), residual flow at the end of the procedure merits careful monitoring. Aggressive elimination of residual flows is often necessary to control hemolysis. Cathet Cardiovasc Intervent 2003;59:538–543. © 2003 Wiley‐Liss, Inc.
Rotaglide‐facilitated stent delivery: Mission accomplished
Authors: Chan Albert W. , Ramee Stephen R. , Collins Tyrone , Quintana Hugo , White Christopher J. 
Published: July 2003

AbstractPercutaneous coronary interventions are performed with a high success rate, though failures still occur. Inability to deliver stents to the target lesion is the most common cause for failures. We present two cases using Rotaglide applied on the stents to enable delivery, showing that Rotaglide is effective in improving stent delivery. Cathet Cardiovasc Intervent 2003;59:477–481. © 2003 Wiley‐Liss, Inc.
Disassembly of a rotablator: Getting out of a trap
Authors: Prasan Ananth M. , Patel Manish , Pitney Mark R. , Jepson Nigel S. 
Published: July 2003

AbstractThe rotablator burr rarely becomes trapped within calcified lesions. Manual traction can be ineffective and dangerous. We report a case that illustrates a novel technique involving use of a percutaneous snare in conjunction with partial disassembly of the rotablator device to remove a trapped burr without need for open surgical intervention. Cathet Cardiovasc Intervent 2003;59:463–465. © 2003 Wiley‐Liss, Inc.
Epithelioid variant of gastrointestinal stromal tumor: Diagnosis by fine‐needle aspiration
Authors: Dong Qun , McKee Grace , Pitman Martha , Geisinger Kim , Tambouret Rosemary 
Published: July 2003

AbstractEpithelioid gastrointestinal stromal tumors (GISTs) may cause significant diagnostic confusion on fine‐needle aspiration (FNA) with carcinomas, neuroendocrine tumors, and melanoma, particularly when metastatic. This study characterizes the cytologic features of nine cases of epithelioid GISTs that were obtained by computerized tomographic guidance in five, by endoscopic ultrasound in three, and from an excised liver tumor in one. Six cases presented as liver masses, one as a perisplenic mass, one as an abdominal mass, and one as a gastric mass. The aspirates revealed mainly single or small clusters of epithelioid cells with a moderate amount of granular to clear cytoplasm, small uniform nuclei with mild to marked nuclear envelope irregularities. Binucleation and intranuclear inclusions were frequent findings. Collagenous stroma was seen in most cases. In three cases, a neuroendocrine tumor was the initial diagnosis. Immunocytochemical staining for c‐kit (CD117) was performed on cellblocks in six cases and was positive in five cases. On the subsequent surgical specimen, CD117 was positive in the c‐kit‐negative cytology case. The diagnosis of GIST should be considered in aspirates of the gastrointestinal tract, liver, mesentery, or abdominal wall mass lesions when epithelioid cells are the predominant cell type. Ancillary studies such as immunohistochemical stains are usually helpful in making a definitive diagnosis. Diagn. Cytopathol. 2003;29:55–60. © 2003 Wiley‐Liss, Inc.
Metastatic islet cell carcinoma to the umbilicus: Diagnosis by fine‐needle aspiration
Authors: Zhang Yanlong , Selvaggi Suzanne M. 
Published: July 2003

AbstractInternal malignancies rarely metastasize to the umbilical region. The gastrointestinal tract and female genital tract are the most common primary sites. Although the pancreas is frequently involved, the majority of these metastases are adenocarcinoma. Here, we present a case of umbilical metastasis from an islet cell carcinoma diagnosed by fine‐needle aspiration in a young woman 2 yr after distal pancreatectomy. This finding led to further radiological studies and surgical intervention, which revealed intraabdominal tumor spread. Neuroendocrine tumors represent a rare tumor type that can give rise to umbilical metastases. Only two cases of carcinoid tumor metastasizing to the umbilicus have been reported. Diagn. Cytopathol. 2003;29:91–94. © 2003 Wiley‐Liss, Inc.
Flow cytometry as an adjunct to cytomorphologic analysis of serous effusions
Authors: Czader Magdalena , Ali Syed Z. 
Published: July 2003

AbstractThe role of flow cytometry (FC) in the diagnosis of lymphoid lesions by fine‐needle aspiration (FNA) is well established. However, studies evaluating the usefulness of FC in serous cavity effusions (SCE) are few. We performed a retrospective review of 115 consecutive SCE with concurrent FC analysis, comparing the provisional cytopathologic diagnosis (PCD), i.e., before the FC results were added, with final diagnoses as modified by subsequent FC immunophenotyping. The predominant clinical indication for the FC analysis was the presence of a spontaneous SCE in a patient with a history of malignant lymphoma. Three‐ or four‐color analysis was performed using antibodies against CD45, CD71, CD33, CD22, CD19, CD20, κ, λ, CD5, CD3, and CD56. The PCD was benign in 47%, atypical in 16%, and malignant in 37% of cases. The latter category consisted mostly of malignant lymphoma (n = 32), but also included acute lymphoblastic leukemia (1 case), T‐cell lymphoma/leukemia (2 cases), acute myelogenous leukemia (1 case), multiple myeloma (1 case), Hodgkin's lymphoma (1 case), sarcoma (1 case), and adenocarcinoma (4 cases). In 18 cases (16%), the PCD was later modified by the FC results from atypical/suspicious to benign (8) and from benign or atypical/suspicious to malignant (10 cases). The latter group included acute natural killer (NK) cell leukemia (1 case), chronic lymphocytic leukemia (1 case), mantle cell lymphoma (2 cases), follicular lymphoma (3 cases), angioimmunoblastic lymphoma (1 case), large cell lymphoma (1 case), and multiple myeloma (1 case). As expected, FC was noncontributory in cases of Hodgkin's lymphoma and nonlymphoid malignancies. In summary, immunophenotyping by FC modified the PCD significantly in 16% of SCE, permitting appropriate cancer staging and management. The above data underscore the importance of FC as an adjunct to cytomorphology in SCE. Diagn. Cytopathol. 2003;29:74–78. © 2003 Wiley‐Liss, Inc.
Aspiration cytology of ameloblastic fibroma: A diagnostic challenge
Authors: Kumar Neeta , Jain Shyama 
Published: July 2003

AbstractAmeloblastic fibroma of the jaw is a rare, benign mixed odontogenic tumor, having little tendency for local invasion and a low recurrence rate. Cytologic distinction from ameloblastoma, ameloblastic fibrosarcoma, and intraosseous adenoid cystic carcinoma is necessary, in view of the different biologic behavior. A painful, slow‐growing swelling of the jaw in a 5‐yr‐old child clinicoradiologically considered as a benign cystic lesion was aspirated. Sheets of small monomorphic epithelial cells with peripheral palisading by columnar cells were seen on cytology smears. The striking feature was central hyaline globules in some tubules. A cytologic possibility of adenomatoid odontogenic tumor was suggested. Histopathology, however, confirmed it to be an ameloblastic fibroma. Diagn. Cytopathol. 2003;29:101–104. © 2003 Wiley‐Liss, Inc.
Cellular schwannoma: Report of a case diagnosed intraoperatively with the aid of cytologic imprints
Authors: Laforga Juan B. 
Published: July 2003

AbstractThe diagnosis of cellular schwannoma in intraoperative consultation is difficult because of the hypercellularity and deep location, which may lead to errors. The recognition of cytologic features together with the histological appearance are of great importance to make the correct diagnosis. An accurate diagnosis of this variant of schwannoma is important because other spindle cell tumors display differences in treatment and clinical behavior. We report a demonstrative case of cellular schwannoma arising in retroperitoneum of a 52‐yr‐old woman in which the cytologic imprints were useful to make an accurate diagnosis intraoperatively. Briefly, the differential diagnosis is discussed. Diagn. Cytopathol. 2003;29:95–100. © 2003 Wiley‐Liss, Inc.
Detection of a subset of CD30+ anaplastic large cell lymphoma by interphase fluorescence in situ hybridization
Authors: Shin Hyung Ju C. , Thorson Phataraporn , Gu Jun , Katz Ruth L. 
Published: July 2003

AbstractT/null‐cell anaplastic large cell lymphoma (ALCL) is a morphologically and clinically heterogeneous group of non‐Hodgkin's lymphoma; to date several morphologic variants have been described on histologic specimens. However, the cytologic features of these variants in the fine‐needle aspiration (FNA) specimens have not been well evaluated. The t(2;5)(p23;q35) has been identified in a subset of T/null‐ALCL and is known to be associated with a favorable prognosis. We reviewed the cytomorphologic characteristics in 24 FNA specimens of ALCL. In all cases, the diagnosis was confirmed on histologic specimens, and immunohistochemical studies for anaplastic lymphoma kinase (ALK) protein expression were performed on the aspirates. The presence of ALK breakpoints were evaluated in nine cases, using a DNA break‐apart probe on chromosome 2 covering the ALK gene by fluorescence in situ hybridization (FISH) techniques. Two hundred cells per case were examined. The results were expressed as the percentage of cells containing more than two signals of chromosome 2 to the total number of cells counted. FNA sites included lymph nodes (20), lung (2), breast (1), and soft tissue (1). The median age of the patients was 56 yr (range, 17–75 yr). Twenty cases had systemic involvement; in four cases, skin was the primary site with secondary involvement of the lymph nodes. All cases were CD30+ by immunohistochemistry; 20 were of T‐cell phenotype and 4 were null cell type. The cytologic evaluation revealed typical anaplastic morphology (common type) with many “hallmark cells” in 16 (67%) cases. Other morphologic variants identified were small cell pattern in five cases, monomorphic pattern in two cases, and lymphohistiocytic pattern in one case. FISH studies showed that six (66.7%) of nine cases had at least two signals of chromosome 2, consistent with ALK breakpoints. With careful cytomorphologic evaluation in conjunction with appropriate immunohistochemical studies, a diagnosis of ALCL can be confidently made in the FNA specimens in the cellular aspirates and its morphologic variants also can be recognized. Furthermore, the FNA specimen is suitable in detecting ALK breakpoints by FISH study, permitting rapid identification of a subset of patients with ALCL, who may have a favorable prognosis. Using a commercially available probe, detection of ALK breakpoints in the FNA specimens is simple and can be a useful diagnostic adjunct in cases where distinction from other lymphomas or lymphoid lesions is morphologically difficult. Diagn. Cytopathol. 2003;29:61–66. © 2003 Wiley‐Liss, Inc.