bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrapericardial administration of basic fibroblast growth factor: Myocardial and tissue distribution and comparison with intracoronary and intravenous administration
Authors: Laham Roger J. , Rezaee Mehrdad , Post Mark , Xu Xunyu , Sellke Frank W. 
Published: February 2003

AbstractGrowth factor‐induced angiogenesis is being investigated in ischemic heart disease. Intracoronary and intravenous delivery are the most practical, but are limited by low myocardial uptake and significant systemic recirculation. The pericardial space may act as a drug delivery reservoir with increased myocardial uptake and reduced systemic toxicities. This study was designed to investigate the myocardial and tissue deposition and retention of basic fibroblast growth factor (FGF‐2) after intrapericardial administration in normal and chronically ischemic animals. Twelve Yorkshire pigs were used for the study [six normal and six animals with chronic myocardial ischemia (ameroid constrictor on LCx)] with bolus intrapericardial administration of 125I–FGF‐2 (25 μCi) with 30 μg of cold FGF‐2 and 3 mg of heparin. Tissue and myocardial distribution was determined at 1 and 24 hr by measuring 125I‐bFGF–specific activity. In addition, regional myocardial deposition was determined using 125I‐bFGF activity and organ level autoradiography. The heart (pericardium and myocardium) accounted for the majority of 125I‐bFGF activity in ischemic animals (30.9% at 1 hr and 23.9% at 24 hr). Left anterior descending artery territory activity/gm of tissue for nonischemic and ischemic animals was 0.01% and 0.01% at 1 hr and 0.0009% and 0.12% at 24 hr, respectively. LCx territory activity for nonischemic and ischemic animals was 0.006% and 0.008% at 1 hr and 0.03% and 0.05% at 24 hr, respectively. Endocardial activity was low at all time points. Liver uptake was 0.47% (nonischemic) and 0.34% (ischemic) at 1 hr and 0.23% (nonischemic) and 0.54% (ischemic) at 24 hr. Intrapericardial delivery of FGF‐2 provides markedly higher myocardial deposition and retention and lower systemic recirculation than intracoronary or intravenous delivery at the expense of poor subendocardial penetration. This limitation, however, did not affect its efficacy. Cathet Cardiovasc Intervent 2003;58:375–382. © 2003 Wiley‐Liss, Inc.
Prevalence of renal artery stenosis requiring revascularization in patients initially referred for coronary angiography
Authors: Khosla Sandeep , Kunjummen Binu , Manda Ravi , Khaleel Rizwan , Kular Rajnishpaul , Gladson Marina , Razminia Mansour , Guerrero Mayra , Trivedi Atul , Vidyarthi Vasundhara , Elbzour Monther , Ahmed Aziz 
Published: February 2003

AbstractTo evaluate the prevalence of clinically significant renal artery stenosis (RAS) in patients referred for coronary angiography, we analyzed data on 2,439 consecutive patients. Patients underwent selective renal angiography in conjunction with coronary angiography if refractory hypertension (blood pressure > 140/90 on two drugs) or flash pulmonary edema was present. A total of 1,089 renal arteries of 534 patients were evaluated. Twelve percent (137/1,089) of the renal arteries in 19% (101/534) of patients had > 70% diameter stenosis in at least one vessel. Bilateral renal artery stenosis was present in 26% (26/101) of patients. One hundred and thirty‐two of the 137 vessels underwent stent revascularization due to clinical renovascular hypertension. Acute clinical success (< 20% diameter stenosis without death or urgent surgery) was 98% (99/101). Due to high prevalence and effective available treatment, we recommend routine screening for RAS in all patients with refractory hypertension referred for coronary angiography. Cathet Cardiovasc Intervent 2003;58:400–403. © 2003 Wiley‐Liss, Inc.
Oral acetylcysteine does not protect renal function from moderate to high doses of intravenous radiographic contrast
Authors: Boccalandro Fernando , Amhad Muhammad , Smalling Richard W. , Sdringola Stefano 
Published: February 2003

AbstractThe use of radiographic contrast during cardiac catheterization can cause acute renal failure with an increase in morbidity and mortality. Prophylactic acetylcysteine plus intravenous hydration have been shown to prevent contrast‐induced nephropathy (CIN) in patients with chronic renal failure undergoing computed tomography scan, who receive low doses of intravenous contrast. Whether the use of prophylactic acetylcysteine can decrease the incidence of CIN when larger doses of contrast are used remains to be determined. We sought to evaluate whether the prophylactic administration of acetylcysteine plus intravenous hydration is superior to intravenous hydration alone in prevention of CIN in patients with chronic renal failure undergoing cardiac catheterization and receiving moderate to high doses of intravenous contrast (> 1 cc/kg). Seventy‐three consecutive patients with renal insufficiency who received intravenous hydration and 600 mg of acetylcysteine twice a day 24 hr before and the day of the cardiac catheterization were compared with 106 consecutive patients who received hydration alone. Baseline and 48‐hr serum creatinine concentrations were compared between the two groups before and after cardiac catheterization. Multivariate and univariate analysis were performed to assess the effects of acetylcysteine and other clinical variables in the change of serum creatinine after the procedure. Both groups had comparable clinical characteristics and received similar volumes of intravenous hydration. The volume of contrast used was similar for the two groups (2.2 ± 1.7 vs. 2.3 ± 1.5 cc/kg; P = 0.67). A mean change in serum creatinine of 0.17 ± 0.54 mg/dl for the acetylcysteine group vs. 0.19 ± 0.40 mg/dl for the control group (P = 0.77) was observed at 48 hr. The incidence CIN was 13% in the acetylcysteine vs. 12% in the control group (P = 0.84). Acetylcysteine, whether analyzed with multivariate or univariate analysis, failed to demonstrate a significant effect in the change of serum creatinine after cardiac catheterization. In patients with chronic renal insufficiency, acetylcysteine in a dose of 600 mg twice a day before and after cardiac catheterization, along with intravenous fluids, is as effective as fluids alone in the prevention of CIN when moderate to high doses of contrast are used. Cathet Cardiovasc Intervent 2003;58:336–341. © 2003 Wiley‐Liss, Inc.
Procedural outcomes of repeated transradial coronary procedure
Authors: Yoo Byung‐Su , Lee Seung‐Hwan , Ko Ji‐Yean , Lee Bong‐Ki , Kim Seung‐Nyun , Lee Myung‐Ok , Hwang Sung‐Oh , Choe Kyung‐Hoon , Yoon Junghan 
Published: February 2003

AbstractWe evaluated the changes in radial arterial diameter and the procedural outcomes of repeated transradial procedures through the same radial artery in 117 cases. No significant differences were found in the mean diameter of the radial artery between preprocedure and 1 day after procedure on initial and repeated procedures. However, the mean radial arterial diameter was significantly decreased from 2.63 ± 0.35 to 2.51 ± 0.29 mm during follow‐up after the initial procedure (P = 0.01). There was no significant difference in the vascular access times of the initial and repeated procedures (2.9 ± 3.1 vs. 3.3 ± 3.6 min; P = 0.08), and procedural success of repeated procedure was similar to those of the initial procedure. However, the incidence of radial arterial occlusion was higher for repeated procedures (2.6% vs. 0%; P = 0.01). We conclude that the repeated use of the radial artery is feasible in most patients with a high procedural success rate and low vascular complications. Cathet Cardiovasc Intervent 2003;58:301–304. © 2003 Wiley‐Liss, Inc.
Percutaneous closure of a ruptured sinus of Valsalva aneurysm using the Amplatzer duct occluder
Authors: Fedson Savitri , Jolly Neeraj , Lang Roberto M. , Hijazi Ziyad M. 
Published: February 2003

AbstractSinus of Valsalva aneurysms are rare congenital anomalies. When they rupture, they can lead to the development of biventricular failure as a result of systemic‐pulmonary shunting. Surgical repair has been the traditional treatment for these aneurysms. We present a case of a 54 year old man in whom a ruptured sinus of Valsalva aneurysm was successfully closed using a catheter‐based approach with the Amplatzer Duct Occluder. Cathet Cardiovasc Intervent 2003;58:406–411. © 2003 Wiley‐Liss, Inc.
Gadolinium‐based percutaneous coronary intervention in a patient with renal insufficiency
Authors: Bokhari Syed W. , Wen Yung‐Hsi J. , Winters Rex J. 
Published: February 2003

AbstractWe report the first case of using gadolinium as a contrast agent to perform percutaneous coronary intervention in a patient with an acute coronary syndrome and a history of renal insufficiency. The procedure was well tolerated without any complications or nephrotoxicity. The images obtained with gadolinium were of good quality. Cathet Cardiovasc Intervent 2003;58:358–361. © 2003 Wiley‐Liss, Inc.
Debulking does not benefit patients undergoing intracoronary beta‐radiation therapy for in‐stent restenosis: Insights from the START trial
Authors: Bass Theodore A. , Gilmore Paul , Zenni Martin , Sasseen Brett , Savage Michael , Bonan Raoul , Laskey Warren , Popma Jeffrey J. , Costa Marco A. 
Published: February 2003

AbstractIntracoronary brachytherapy has become the current treatment of choice for patients with in‐stent restenosis (ISR). The aim of the present study was to determine whether plaque extraction using debulking techniques prior to brachytherapy would improve the outcomes of patients with ISR. Patients enrolled into the START (n = 476) and START‐40 (n = 205) trials were divided into four subgroups according to their treatment assignments: debulking‐radiation, debulking‐placebo, balloon angioplasty (BA) radiation, and BA placebo. Patients were further divided according to their ISR lesion length: all lesions, > 15 mm, and > 19 mm. Restenosis rates were higher in placebo, nonradiated lesions undergoing debulking (52.7%) vs. BA alone (38.5%; P = 0.04). Postprocedural minimal lumen diameter (MLD) was similar among the subgroups. Outcomes were similar between debulking and BA within each therapeutic arm. MLD after debulking radiation was greater in patients with ISR > 15 mm (post‐MLD was 1.9 vs. 1.7 mm; P = 0.06) but not in the placebo. Debulking radiation patients had greater MLD at follow‐up, but restenosis (23.5% after debulking vs. 32.7% BA alone) and late loss (0.3 mm in both subgroups) were not statistically different. There was a trend toward higher mortality among debulked patients (3.7%) compared to BA alone (0.8%). In patients with ISR > 19 mm, four patients died following debulking radiation as compared to no death after BA (P = 0.05). Our results do not support the strategy of plaque extraction prior to intracoronary beta‐radiation for ISR. Cathet Cardiovasc Intervent 2003;58:331–335. © 2003 Wiley‐Liss, Inc.
In‐hospital outcomes of contemporary percutaneous coronary interventions in the very elderly
Authors: Dynina Olga , Vakili Babak A. , Slater James N. , Sherman Warren , Ravi Kumar L. , Green Stephen J. , Sanborn Timothy A. , Brown David L. 
Published: February 2003

AbstractCoronary heart disease is the leading cause of death among the elderly (> 65 years) and the very elderly (> 85 years). Little information is available regarding the outcome of very elderly patients referred for PCI in the current era of improved techniques, devices, and pharmacotherapy. The objective of the current study was to evaluate the clinical characteristics and outcomes of very elderly patients ≥ 85 years of age in a large, contemporary, multi‐institutional PCI database. Five hospitals in the New York City metropolitan area contributed these prospectively defined data elements on consecutive patients undergoing PCI from 1 January 1998 to 1 October 1999. Of 10,847 patients, 5,341 (49%) were younger than 65 years, 3,342 (31%) were 65–74 years, 1,885 (17%) were 75–84 years, and 279 (2.6%) were at least 85 years of age. Following PCI, the very elderly developed stroke (P < 0.001) and renal failure requiring dialysis (P = 0.002) more commonly than younger patients following PCI. The very elderly had a significantly increased in‐hospital mortality rate at 2.5% (P < 0.001). However, on multivariate analysis, age ≥ 85 years was not an independent predictor of in‐hospital mortality (OR = 1.22; 95% CI = 0.37–4.07). The very elderly should not be refused PCI on the basis of advanced age alone. Cathet Cardiovasc Intervent 2003;58:351–357. © 2003 Wiley‐Liss, Inc.
Successful treatment of distal coronary guidewire‐induced perforation with balloon catheter delivery of intracoronary thrombin
Authors: Fischell Tim A. , Korban Elie H. , Lauer Michael A. 
Published: February 2003

AbstractDistal coronary artery perforation with a coronary guidewire is a relatively rare but potentially fatal complication during PTCA. Historically, these types of perforations have been easy to control with reversal of heparin anticoagulation combined with prolonged distal balloon inflation. In the modern era, with widespread use of potent glycoprotein IIb/IIIa inhibitors, this type of distal wire perforation has become more difficult to manage and potentially lethal. In this article, we report two cases of guidewire‐related distal coronary artery perforation, successfully treated using a new technique using localized, distal intracoronary thrombin injection. During prolonged low‐pressure balloon inflation, a small dose of thrombin was injected just proximal to the wire perforation site via the lumen of a coronary balloon catheter. This approach appears to be a relatively rapid and effective way to control this troublesome complication. Cathet Cardiovasc Intervent 2003;58:370‐374. © 2003 Wiley‐Liss, Inc.
Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures
Authors: Kiemeneij Ferdinand , Vajifdar Bhavesh U. , Eccleshall Simon C. , Laarman GertJan , Slagboom Ton , Wieken Ron van der 
Published: February 2003

AbstractRadial artery spasm is a frequent complication of the transradial approach for coronary angiography and angioplasty. Recently, we have been able to quantify spasm using the automatic pullback device. The objective of this study was to assess the efficacy of an intra‐arterial vasodilating cocktail in reducing the incidence and severity of radial artery spasm. A hundred patients undergoing coronary procedures via the radial artery were divided into two groups of 50 each. Patients in group A received intra‐arterial cocktail (5 mg of verapamil plus 200 μg nitroglycerine in 10 ml of normal saline), while patients in group B did not receive any vasodilating drug. The pullback device was used for sheath removal at the end of the procedure. Seven (14%) patients in group A experienced pain (i.e., pain score of III–V) during automatic sheath removal, as compared to 17 (34%) in group B (P = 0.019). The mean pain score was significantly lower in group A than in group B (1.7 ± 0.94 vs. 2.08 ± 1.07; P = 0.03). The maximal pullback force (MPF) was also significantly lower for group A (0.53 ± 0.52 kg; range, 0.10–3.03 kg) as compared to group B (0.76 ± 0.45 kg; range, 0.24–1.99 kg; P = 0.013). Only 4 (8%) patients in group A had an MPF value greater than 1.0 kg, suggesting the presence of significant radial artery spasm, as opposed to 11 (22%) in group B (P = 0.029). Administration of an intra‐arterial vasodilating cocktail prior to sheath insertion reduces the occurrence and severity of radial artery spasm. Cathet Cardiovasc Intervent 2003;58:281–284. © 2003 Wiley‐Liss, Inc.
Treatment of recurrent stroke and pulmonary thromboembolism with percutaneous closure of a patent foramen ovale and placement of inferior vena cava filter
Authors: Donti Andrea , Giardini Alessandro , Formigari Roberto , Bronzetti Gabriele , Prandstraller Daniela , Bonvicini Marco , Picchio Fernando M. 
Published: February 2003

AbstractThe association between recurrent episodes of pulmonary embolism, stroke, and congenital anomalies of the clotting system features a condition of increased risk of recurrences despite anticoagulant therapy. We report the successful management of this association with percutaneous closure of the foramen ovale and placement of an inferior caval vein filter. Cathet Cardiovasc Intervent 2003;58:413–415. © 2003 Wiley‐Liss, Inc.
New balloon‐thermography catheter for in vivo temperature measurements in human coronary atherosclerotic plaques: A novel approach for thermography?
Authors: Stefanadis Christodoulos , Toutouzas Konstantinos , Vavuranakis Manolis , Tsiamis Eleftherios , Vaina Sophia , Toutouzas Pavlos 
Published: February 2003

AbstractAlthough ex vivo studies showed marked thermal heterogeneity in atheromatic plaques, in in vivo human studies trivial temperature variations are recorded due to the cooling effect of blood flow. We investigated a new balloon‐thermogaphy catheter for temperature measurements during coronary flow interruption. A thermistor probe is positioned at the distal segment of the catheter. At the opposite site of the thermistor, a balloon is placed. By inflation of the balloon, coronary flow is interrupted. Ten patients with effort angina were studied. Coronary flow velocity was continuously recorded. Temperature was recorded at the proximal vessel wall and at the lesion before, during, and after complete interruption of blood flow by inflation of the balloon. ΔTp was assigned as the difference between the background temperature and the maximal temperature during and after balloon inflation. ΔTl was assigned as the difference between the atherosclerotic plaque and the proximal vessel wall. The procedure was not complicated. ΔTp during and after balloon inflation was 0.01 ± 0.01°C and −0.003 ± −0.01°C (P < 0.001), respectively. ΔTl was 0.07 ± 0.04°C at baseline, 0.17 ± 0.06°C (59.3% ± 11.8% increase) during, and 0.07 ± 0.05°C after flow interruption (P < 0.001). ΔTl was greater than ΔTp during and after impairment of flow (P < 0.001). In vivo atherosclerotic plaque temperature recording seems to be feasible with this new balloon‐thermography catheter. This device may introduce a new approach for the detection of thermal heterogeneity in plaques by addressing the issue of cooling effect of blood flow. Cathet Cardiovasc Intervent 2003;58:344‐350. © 2003 Wiley‐Liss, Inc.
Fluoroscopic image quality in the film and filmless eras: A standardized comparison performed in coronary interventional facilities
Authors: Laskey Warren , Wondrow Merrill , Chambers Charles 
Published: February 2003

AbstractOne hundred and one coronary interventional systems (45 primarily film‐based predigital systems, labeled group 1; and 56 filmless digital systems, labeled group 2) were examined over a 5‐year period using a standardized imaging phantom. Fluoroscopic image intensifier input dose, high‐contrast spatial resolution, low‐contrast sensitivity, and static and dynamic low‐contrast resolution were assessed under several conditions simulating patient body habitus. The distribution of spatial resolutions in group 2 facilities favored higher line pair resolution over group 1 (P = 0.01). Contrast sensitivity (smallest‐diameter hole visualized) was consistently and significantly enhanced with the use of digital imaging under both medium (P = 0.001) and large (P = 0.002) patient habitus simulations. Low‐contrast video resolution (number of wires seen) under static (P = 0.007) and dynamic (P = 0.002) conditions was also improved in the digital facilities. However, image intensifer input dose was similar in both groups (group 1 median dose, 23 mR/min; group 2 median dose, 26 mR/min; P = NS). Fluoroscopic spatial resolution in digital filmless laboratories was significantly improved when compared to predigital, film‐based laboratories. Low‐contrast sensitivity and low‐ contrast video resolution under both static and dynamic conditions were also significantly improved in the digital laboratories. Notably, the input dose of radiation required to produce these improved fluoroscopic images was similar between groups. Cathet Cardiovasc Intervent 2003;58:383–390. © 2003 Wiley‐Liss, Inc.
3‐D in vitro model of early skeletal muscle development
Authors: Cheema U. , Yang S.‐Y. , Mudera V. , Goldspink G.G. , Brown R.A. 
Published: February 2003

AbstractAn understanding of the mechanical and mechano‐molecular responses that occur during the differentiation of mouse c2c12 myoblasts in 3‐D culture is critical for understanding growth, which is important for progress towards producing a tissue‐engineered muscle construct. We have established the main differences in force generation between skeletal myoblasts, dermal fibroblasts, and smooth muscle cells in a 3‐D culture model in which cells contract a collagen gel construct. This model was developed to provide a reproducible 3‐D muscle organoid in which differences in force generation could be measured, as the skeletal myoblasts fused to form myotubes within a collagen gel. Maintenance of the 3‐D culture under sustained uni‐axial tension, was found to promote fusion of myoblasts to form aligned multi‐nucleate myotubes. Gene expression of both Insulin Like Growth Factor (IGF‐1 Ea) and an isoform of IGF‐1 Ea, Mechano‐growth factor (IGF‐1 Eb, also termed MGF), was monitored in this differentiating collagen construct over the time course of fusion and maturation (0–7 days). This identified a transient surge in both IGF‐1 Ea and MGF expression on day 3 of the developing construct. This peak of IGF‐1 Ea and MGF expression, just prior to differentiation, was consistent with the idea that IGF‐1 Ea stimulates differentiation through a Myogenin pathway [Florini et al., 1991: Mol. Endocrinol. 5:718–724]. MGF gene expression was increased 77‐fold on day 3, compared to a 36‐fold increase with IGF‐1 Ea on day 3. This indicates an important role for MGF in either differentiation or, more likely, a response to mechanical or tensional cues. Cell Motil. Cytoskeleton 54:226–236, 2003. © 2003 Wiley‐Liss, Inc.
Clinical outcome and survival after palliative surgery for spinal metastases
Authors: Hirabayashi Hiroki , Ebara Sohei , Kinoshita Tetsuya , Yuzawa Yohei , Nakamura Isao , Takahashi Jun , Kamimura Mikio , Ohtsuka Kuniyoshi , Takaoka Kunio 
Published: February 2003

AbstractBACKGROUNDThe authors sought to identify treatment‐related factors that influenced survival after surgical treatment for metastatic spinal tumors and to evaluate the relationship between survival and postoperative ambulation time as a factor related to quality of life.METHODSThe medical records of 81 patients with metastatic spinal tumors who underwent palliative surgery at the study institution were assessed. Univariate analysis for factors influencing survival used the Kaplan–Meier log rank statistic and multivariate analysis used the Cox proportional hazards model. The Spearman correlation test was used to analyze the relationship between postoperative ambulation and survival time.RESULTSThe patients had a median age of 59.9 years and a median survival of 10.6 months after surgery. For patients, postoperative ambulatory median survival was 16.5 months and median ambulation time was 13.8 months. By univariate analysis, anatomic site of the primary tumor, postoperative ambulation, and combined adjuvant therapy (chemotherapy plus radiotherapy) were associated with prolonged survival (P < 0.05). Multivariate analysis identified primary site and postoperative ambulatory function as independent predictors of prolonged survival (P < 0.0001). Significant correlations were found between ambulation time and survival time of patients who were able to walk after surgery (P < 0.0001), even in patients with liver (P < 0.05) or lung carcinoma (P < 0.05).CONCLUSIONSThe anatomic site of primary carcinoma and postoperative ambulation were associated with longer survival after palliative surgery for metastatic spinal tumor. When ambulation is attained after surgery, it can be preserved until late in remaining life even when the primary tumor is unfavorable. Palliative surgery for spinal metastasis can improve the quality and quantity of life. Cancer 2003;97:476–84. © 2003 American Cancer Society.DOI 10.1002/cncr.11039