Search results for "Percutaneous"
showing 10 items of 471 documents
High-frequency rotational ablation following failed percutaneous transluminal coronary angioplasty.
1994
Percutaneous transluminal coronary angioplasty (PTCA) failed in 29 of 1,150 patients (2.5%) after successful passage of the guide wire. The reasons for failure were inability to pass the lesion with a balloon in 28 patients and inability to dilate the lesion in 1 patient. In these patients (15 stenoses and 14 chronic occlusions) rotational ablation was performed. We were able to pass the burr through the lesion in all of them, resulting in a reduction of diameter stenosis from 87 +/- 15 to 51 +/- 18%. Rotational ablation alone was initially successful (stenoses reduction > 20% and residual stenoses < 50%) in 15 of 29 (52%) patients. Additional PTCA was performed in 21 of 29 (72%) patients, …
Successful use of impella CP through femoral access in a patient with bilateral iliac and aortic endoprosthesis in the setting of cardiogenic shock
2019
We report the case of a 67-year-old male, with previous history of severe peripheral vascular disease (abdominal aorta aneurism and bilateral iliac stenosis) requiring the implantation of 3 endoprostheses 7 months ago (Figure 1(A)), and previous myocardial infarction 10 years ago. The left ventricular ejection fraction (LVEF) was preserved at last control (58%). The patient was referred for acute coronary syndrome complicated with pulmonary oedema and cardiogenic shock. Echocardiography showed a severe impairment of LVEF (18%) and the patient was transferred to cathlab for emergency percutaneous coronary intervention (PCI). Coronary angiography via right femoral 7Fr access showed a chronic …
Excimer laser atherectomy in an uncrossable long chronic total occlusion through the subintimal space
2020
We present a successfully chronic total occlusions (CTO) coronary recanalisation with the subadventitial space by excimer laser atherectomy (ELCA) adjunctive therapy. Angiogram revealed non-significant diffuse disease of the left coronary system with a complex long proximal right coronary artery (RCA) CTO (J-CTO score 4) and collaterals (Rentrop Grade 2 and Werner classification CC1) from the septal branches (Figure 1, Panel A). CTO PCI of the RCA was then indicated and planned. Initially, antegrade approach and a retrograde approach technique were attempted without success. Thereafter, a rescue Antegrade Dissection Reentry strategy (ADR) was applied. A Pilot 200 (Abbott) was advanced in a …
Imaging in the catheterization laboratory
1993
Recent work confirms that visual assessment of the effect of widely employed coronary interventions is highly inaccurate. Rapid and reliable on-line angiographic quantitation is a useful advance, but problems in the application of the technique are encountered in a substantial number of cases. New algorithms have been devised to provide a comprehensive assessment of the geometry and likely functional significance of lesions as well as an objective evaluation of lesion morphology, and recent work has provided the framework for the quantitation of diffuse disease. Studies with intravascular ultrasound confirm the inadequate sensitivity of angiography in demonstrating mild to moderate atheroma…
Initiation and duration of dual antiplatelet therapy after inpatient percutaneous coronary intervention with stent implantation in Germany: An electr…
2017
Abstract Background Studies assessing the routine outpatient dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in Germany are scarce. The aim of this study was (i) to investigate the initiation and duration of DAPT after inpatient PCI with stent implantation in Germany, and (ii) to identify factors associated with DAPT discontinuation during the recommended treatment period. Methods This retrospective cohort study was based on data from a large German electronic healthcare database of the years 2004 to 2009. The study population comprised four groups of patients with acute coronary syndrome (ACS) or stable angina pectoris undergoing inpatient PCI with either ba…
Role of genetic factors on the effect of additional loading doses and two maintenance doses used to overcome clopidogrel hyporesponsiveness.
2014
Background and objective: Additional loading doses and higher maintenance doses (MDs) have been used to overcome hyporesponsiveness of clopidogrel. We aimed to investigate whether genetic polymorphisms of two cytochromes (CYP2C19 and CYP2C9) and ABCB1 modify effect of such dose-adjustment strategy.Materials and methods: We enrolled 118 patients undergoing elective or acute percutaneous coronary intervention (PCI) with drug eluting stent (DES). Platelet reactivity index (PRI) was measured using the vasodilator-stimulated phosphoprotein (VASP) index and a cut-off value of ≥60% was defined as hyporesponsiveness. Polymorphism of two cytochromes (CYP2C19, CYP2C9) and gene ABCB1 were determined. …
Safety and efficacy of left atrial appendage occlusion with the ACP or Watchman device guided by intracardiac echocardiography from the left atrium
2021
Abstract Background There is a paucity of randomized data regarding the safety and efficacy of the use of intracardiac echocardiography (ICE) from the left atrium (LA) to guide left atrial appendage occlusion (LAAO) procedures under local anesthesia using either of the available devices. Hypothesis The aim of this study was to compare the efficacy and safety of ICE from the LA with transesophageal echocardiography (TEE) for guidance during transcatheter LAAO procedures. Methods Single‐center, cohort study of patients undergoing LAAO with the Amplatzer Cardiac Plug or Watchman device. Procedures were guided by ICE from the LA with local anesthesia (n = 175) or TEE under general anesthesia (n…
Centre procedural volume and adverse in‐hospital outcomes in patients undergoing percutaneous transvenous edge‐to‐edge mitral valve repair usingMitra…
2021
AIMS The number of transcatheter mitral valve repair (TMVr) procedures has increased substantially during the last years. A better understanding of the relationship between hospital volume of transcatheter transvenous mitral valve repairs using MitraClip® and patient outcomes may provide information for future policy decisions to improve patient management. METHODS AND RESULTS We analysed patient characteristics and in-hospital outcomes for all TMVr procedures using MitraClip® performed in Germany from 2011 to 2017. Hospitals were stratified according to centre volumes and patients were compared for baseline characteristics and adverse in-hospital events. Overall, 24 709 inpatients were tre…
Thrombosis, fracture, and percutaneous removal of a patent foramen ovale closure device 1 month after successful deployment
2010
Several different devices have been developed for the percutaneous closure of interatrial defects and patent foramen ovale. Although the implantation of these devices is both safe and effective, a number of complications, both in the early and the late follow-up, may occur. We describe a case of device fracture manifested early (1 month after implantation) with the formation of massive thrombosis on the right atrial disc. The patient was treated with anticoagulants and the device was percutaneously retrieved. Our images allowed early noninvasive therapy and emphasize the need for echocardiographic follow-up early after implantation. © 2010 Wiley-Liss, Inc.
Recanalization of Totally Occluded Coronary Vessels by Percutaneous Transluminal Coronary Angioplasty
1986
Since its introduction in 1977, percutaneous transluminal coronary angioplasty (PTCA) has become an effective approach for treatment of patients with single-vessel disease [1–3, 5]. Treatment of double- and multiple-vessel disease has also been attempted [5, 6]. In patients with angina pectoris total occlusion of coronary vessels is found, and PTCA has also been used in an attempt to restore coronary blood flow in such patients [8, 10]. Even main stem occlusions have been recanalized [11]. In patients with total occlusion of coronary vessels, collateral flow is sufficient to maintain cardiac function at rest but not during exercise [12–14]. Therefore, PTCA seems to be an ideal method for re…