Search results for "ANGIOPLASTY"
showing 10 items of 201 documents
High-Frequency rotablation of occluded coronary artery during heart catheterization
1989
High-frequency rotation atherectomy of an occluded left circumflex coronary artery was performed in a 45-year-old man. Over a 0.009 inch flexible tip steel wire a diamond-coated brass burr fasten to a flexible drive shaft that rotates and tracks was advanced. The drive shaft was connected to a turbine and driven by compressed air with 150,000 rpm. After rotablation of the posterior lateral branch over 3 cm with a 1.5 mm burr and rotablation with a 1.75 mm burr of the posterior branch of the left circumflex coronary artery the vessel was reopened with a smooth surface without perforation and dissection. 24 h control and 6 mo control revealed an open coronary vessel. High frequency rotating c…
Troponin I Assay for Identification of a Significant Coronary Stenosis in Patients with Suspected Acute Myocardial Infarction and Wide QRS Complex
2016
Background Common ECG criteria such as ST-segment changes are of limited value in patients with suspected acute myocardial infarction (AMI) and bundle branch block or wide QRS complex. A large proportion of these patients do not suffer from an AMI, whereas those with ST-elevation myocardial infarction (STEMI) equivalent AMI benefit from an aggressive treatment. Aim of the present study was to evaluate the diagnostic information of cardiac troponin I (cTnI) in hemodynamically stable patients with wide QRS complex and suspected AMI. Methods In 417 out of 1818 patients presenting consecutively between 01/2007 and 12/2008 in a prospective multicenter observational study with suspected AMI a pro…
Late carotid artery stent erosion and pseudoaneurysm after accidental hyperextension of the neck
2010
A 75-year-old man was referred to our unit complaining of a large pulsatile neck mass that appeared 2 days after an accidental fall and hyperextension of the neck. One month earlier, he was submitted to left carotid artery stenting for symptomatic high-grade stenosis. His medical history included diabetes mellitus, coronary artery disease, and a right femoropopliteal bypass for critical limb ischemia. At the time of admission, he was afebrile and had no evidence of local erythema, draining sinus, or leukocytosis. Moreover, C-reactive protein was 1 mg/dL. The clinical examination revealed a large swelling in the region of the left carotid bifurcation and mild dyspnea. Arterial duplex imaging…
The Full Revasc (Ffr-gUidance for compLete non-cuLprit REVASCularization) Registry-based randomized clinical trial
2021
Publisher Copyright: © 2021 Background: Complete revascularization in ST elevation myocardial infarction (STEMI) patients with multivessel disease has resulted in reduction in composite clinical endpoints in medium sized trials. Only one trial showed an effect on hard clinical endpoints, but the revascularization procedure was guided by angiographic evaluation of stenosis severity. Consequently, it is not clear how Fractional Flow Reserve (FFR)-guided percutaneous coronary intervention (PCI) affects hard clinical endpoints in STEMI. Methods and Results: The Ffr-gUidance for compLete non-cuLprit REVASCularization (FULL REVASC) – is a pragmatic, multicenter, international, registry-based rand…
Intramural delivery of Sirolimus prevents vascular remodeling following balloon injury
2005
Abstract Objective. Several studies have demonstrated that Sirolimus-eluting stents reduce restenosis in patients with coronary artery disease. Here, we tested whether direct delivery of Sirolimus into the vessel wall during balloon angioplasty can modify vascular remodeling over several weeks. Methods and Results. During angioplasty of the rabbit iliac artery we administered an intramural infusion of Sirolimus or its vehicle directly through a balloon catheter into the vessel wall. After 3 weeks neointimal formation was decreased (0.71 ± 0.1 vs. 1.4 ± 0.12 intima/media ratio), and this process was attributed to the inhibitory properties of Sirolimus on ECM deposition and smooth muscle cell…
Computational Fluid-Dynamic Analysis after Carotid Endarterectomy: Patch Graft versus Direct Suture Closure.
2017
Background Closure technique after carotid endarterectomy (CEA) still remains an issue of debate. Routine use of patch graft (PG) has been advocated to reduce restenosis, stroke, and death, but its protective effect, particularly from late restenosis, is less evident and recent studies call into question this thesis. This study aims to compare PG and direct suture (DS) by means of computational fluid dynamics (CFD). To identify carotid regions with flow recirculation more prone to restenosis development, we analyzed time-averaged oscillatory shear index (OSI) and relative residence time (RRT), that are well-known indices correlated with plaque formation. Methods CFD was performed in 12 pati…
Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue
2017
Purpose Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin. Methods Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin acce…
Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI…
2001
Summary Background Despite the use of aspirin, there is still a risk of ischaemic events after percutaneous coronary intervention (PCI). We aimed to find out whether, in addition to aspirin, pretreatment with clopidogrel followed by long-term therapy after PCI is superior to a strategy of no pretreatment and short-term therapy for only 4 weeks after PCI. Methods 2658 patients with non-ST-elevation acute coronary syndrome undergoing PCI in the CURE study had been randomly assigned double-blind treatment with clopidogrel (n=1313) or placebo (n=1345). Patients were pretreated with aspirin and study drug for a median of 6 days before PCI during the initial hospital admission, and for a median o…
A novel approach to define risk of stent thrombosis after percutaneous coronary intervention with drug-eluting stents: the DERIVATION score.
2009
Recent studies of drug-eluting stents (DES) use in routine clinical practice have led to concern regarding their long-term safety and to questions about the adequacy of current antiplatelet therapy guidelines. This study sought to derivate a risk score for predicting stent thrombosis after drug-eluting stenting. The large single center DES Real-world Incremental Value in the erA of percutaneous revascularizaTION (DERIVATION) database, collecting data about 1,377 patients of any age undergoing PCI with DES as treatment for symptomatic coronary artery disease, was use for this purpose. Logistic regression and bootstrap procedure were used to select correlates of stent thrombosis that were sub…
Long-term follow-up study of endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis trial
2014
Background and Purpose— We aimed at comparing the long-term benefit–risk balance of carotid stenting versus endarterectomy for symptomatic carotid stenosis. Methods— Long-term follow-up study of patients included in Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3S), a randomized, controlled trial of carotid stenting versus endarterectomy in 527 patients with recently symptomatic severe carotid stenosis, conducted in 30 centers in France. The main end point was a composite of any ipsilateral stroke after randomization or any procedural stroke or death. Results— During a median follow-up of 7.1 years (interquartile range, 5.1–8.8 years; maximum 1…