Search Results
Results 301 - 350 of 1266
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Albuquerque F C - - 2000
OBJECTIVE: We describe a method of protecting the distal cerebral circulation during carotid angioplasty and report results using the technique in 17 procedures. METHODS: Eleven men and five women with carotid stenoses ranging in severity from 70 to 95% underwent the procedure. The technique was used bilaterally in one patient. ...
Batchelor W B - - 2000
The clinical impact of contrast medium selection during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (AMI) has not been studied. We compared the clinical outcomes of patients who received ionic versus nonionic low osmolar contrast medium in the setting of primary percutaneous transluminal coronary angioplasty for AMI in ...
Fransson S G - - 2000
PURPOSE: To prospectively register fluoroscopic and cine times in a random fashion, and to measure patient radiation exposure from routine coronary angiography and coronary balloon angioplasty. We also evaluated an optional dose reduction system used during interventions. MATERIAL AND METHODS: The incident radiation to the patient was measured as kerma ...
Dauerman H L - - 2000
We determined acute outcome in 148 consecutive patients with ST segment elevation myocardial infarction undergoing angioplasty including 72 patients (48.7%) considered ineligible for primary angioplasty trials. Overall, in-hospital mortality for acute infarct angioplasty was 12%, with fivefold higher mortality in the trial-ineligible group (21% vs. 4%, P = 0.003). Thus, ...
Culler S D - - 2000
OBJECTIVE: To identify factors responsible for the variation in real hospital costs and length of stay for patients with diabetes undergoing coronary angioplasty or coronary bypass surgery. STUDY DESIGN: Retrospective study of patients with diabetes and coronary artery disease treated at a single hospital. PATIENTS AND METHODS: The study population ...
Kok W E - - 2000
OBJECTIVES: We investigated whether the greater late lumen loss after coronary balloon angioplasty in the proximal left anterior descending artery (P-LAD) compared with that in other segments might be related to differences in vascular dimensions or morphology as determined by angiography and intravascular ultrasound imaging. BACKGROUND: The greater late lumen ...
Hong M K - - 2000
We studied 1,267 patients with 2,186 saphenous vein graft (SVG) lesions to determine the time course of target lesion revascularization (TLR) after successful SVG angioplasty. We found that the time course of TLR in SVG appears prolonged, with only 54% occurring within the first 6 months and continued TLR even ...
Saucedo J F - - 2000
The influence of vessel size on clinical and angiographic outcomes after new device angioplasty has not been well documented. We reviewed clinical and angiographic outcomes of 2,044 patients undergoing new device angioplasty of native vessels enrolled in the New Approaches to Coronary Interventions (NACI) Registry. Quantitative angiography was performed using ...
Wiegman P J - - 2000
All-trans-retinoic acid (atRA) has potent in vitro effects on a number of processes involved in vascular injury and repair, such as modulating smooth muscle cell (SMC) proliferation and inducing SMC differentiation, and may play an important role in the in vivo response to vascular injury. We hypothesized that atRA would ...
Gambhir D S - - 2000
We report the cases of two patients where catheter-based laser direct myocardial revascularisation has been coupled with conventional coronary angioplasty at the same sitting using the Biosense left ventricular electromechanically guided laser procedure. In both the cases, the non-revascularizable ischaemic target zone was identified using left ventricular electromechanical mapping signals, ...
Brodie B R - - 2000
Primary percutaneous transluminal coronary angioplasty has become the preferred reperfusion strategy for acute myocardial infarction in most institutions with interventional facilities and experienced operators. The benefit of establishing coronary reperfusion, with or without pharmacologic therapy, before primary angioplasty has not been established. Consecutive patients (n = 1,490) with acute myocardial ...
Brodie B R - - 2000
Small vessel size is associated with worse outcomes after elective angioplasty, but the effect of vessel size on outcomes after primary angioplasty for acute myocardial infarction has not been studied. We evaluated outcomes in 1,490 consecutive patients treated with primary angioplasty comparing patients with small (< 3.0 mm) versus large ...
Hakim J - - 2000
Percutaneous transluminal primary angioplasty (PTCA) has become an accepted therapy for treatment of acute myocardial infarction. Coronary stenting in the setting of acute myocardial infarction has been found to have several advantages, and has been successfully performed routinely at various centers. However, we are unaware of any report that describes ...
Ross A M - - 1999
OBJECTIVES: The study evaluated the efficacy and safety of a short-acting reduced-dose fibrinolytic regimen to promote early infarct-related artery (IRA) patency during the inherent delay experienced by infarct patients referred for angioplasty as the principal recanalization modality. BACKGROUND: Previous approaches using long-acting, full-dose thrombolytic infusions rarely showed benefit, but they ...
Gunn J - - 1999
Ultrasound at high energy, as distinct from the low energy used in ultrasound imaging, has found many uses in varied branches of medicine and surgery. Clinical trials of catheter-delivered, high-energy, low-frequency (kHz) ultrasound over the past 6 years have shown the safety of this modality in the treatment of coronary ...
van Liebergen R A - - 1999
OBJECTIVES: This study evaluated the acute physiological gain of adjunctive intravascular ultrasound (IVUS) guided balloon angioplasty and stent implantation. BACKGROUND: Recent studies indicate safe coronary luminal enlargement and "stent-like" long-term outcomes using upsized balloons guided by IVUS. METHODS: After angiographically guided balloon angioplasty in 20 patients with 1-vessel disease and ...
Kurbaan A S - - 1999
The medium term (4-year post randomization) results from CABRI indicate that the principal difference between those randomized to coronary angioplasty and those to coronary surgery has been the much greater need for repeat revascularization in the former. A number of factors may play a role in the greater repeat revascularization ...
Zahn R - - 1999
BACKGROUND: Concern exists regarding the results of primary angioplasty for acute myocardial infarction when the procedure is performed during night hours. METHODS AND RESULTS: Between June 1994 and January 1997, 491 patients with acute myocardial infarction who underwent primary angioplasty procedures were consecutive registered in the Maximal Individual Therapy in ...
Hueb W A - - 1999
BACKGROUND: Although coronary angioplasty and myocardial bypass surgery are routinely used, there is no conclusive evidence that these interventional methods offer greater benefit than medical therapy alone. This study is intended to evaluate, in a prospective, randomized, and comparative analysis, the benefit of the 3 current therapeutic strategies for patients ...
Petronio A S - - 1999
To assess the effects of percutaneous transluminal coronary angioplasty on endothelin-1 (ET-1) release, we assessed ET-1 concentrations at different sites of the coronary circulation in patients submitted to elective procedures. ET-1 levels immediately downstream from the plaque and ET-1 aortocoronary gradient increased significantly after the procedure, which was related to ...
Mehra Anil - - 1999
The elderly, particularly those over 80, are the fastest growing component of the population. Coronary artery disease accounts for 44% of all deaths in the elderly. Age is also one of the strongest predictors of mortality from acute myocardial infarction (AMI) and in those that survive, long term outcome is ...
Dunne M - - 1999
Clinical trials to assess the merit of antibiotic intervention in the treatment of ischemic cardiovascular disease are now underway, spurred on by an association between Chlamydia pneumoniae and atherogenesis noted in epidemiologic investigations, histopathologic studies, and results from various animal models. The design of such clinical trials must take into ...
Zahn R - - 1999
OBJECTIVE: To determine the frequency of the use of primary angioplasty in patients with acute myocardial infarction and the factors influencing its indications in hospitals with the facilities to perform this treatment. DESIGN: Data from the maximal individual therapy in acute myocardial infarction (MITRA) trial were analysed, concerning the effects ...
Weintraub W S - - 1999
OBJECTIVE: This study was conducted to assess the impact of GPIIb/IIIa blockade with tirofiban on costs during the initial hospitalization and at 30 days among patients undergoing high-risk coronary angioplasty. BACKGROUND: GPIIb/IIIa blockers are a new class of compounds that have been shown in clinical studies to prevent complications after ...
Brener S J - - 1999
We investigated the effect of platelet fibrinogen receptor blockade on infarct size after primary angioplasty. Abciximab significantly reduced the time-to-peak creatine kinase without affecting enzymatic infarct size, suggesting a beneficial effect on the pattern and speed of reperfusion.
Petersen L A - - 1999
To determine the positive predictive value of ICD-9-CM coding of acute myocardial infarction and cardiac procedures. Using chart-abstracted data as the standard, we examined administrative data from the Veterans Health Administration for a national random sample of 5,151 discharges. The positive predictive value of acute myocardial infarction coding in the ...
Colombo A - - 1999
Early patency of the infarct-related vessel improves in-hospital and long-term survival. Mechanical reopening is as effective as or superior to pharmacological therapy in the treatment of acute myocardial infarction. However, in patients treated with primary percutaneous transluminal coronary angioplasty, recurrent ischemia occurs in 10% to 15% before hospital discharge, and ...
Parmley W W - - 1999
Reperfusion of acute myocardial infarction has become the standard of management during the first few hours. Cost per year of life saved is one measure of the effectiveness of reperfusion strategies. Estimates of the cost per year of life saved have been approximately $17,000 for streptokinase and percutaneous transluminal coronary ...
Losordo D W - - 1999
In patients in whom antianginal medications fail to provide sufficient symptomatic relief, additional interventions such as angioplasty or bypass surgery may be required. Although both types of intervention have been shown to be effective for various types of patients, a certain group of patients may not be candidates for either ...
Van Belle E - - 1999
OBJECTIVES: We studied angiographic outcome and its predictors after traditional coronary balloon angioplasty in diabetics. We further examined whether changes in ejection fraction were influenced by the status of the dilated site(s) at follow-up. BACKGROUND: Recent studies have suggested that diabetics have a particularly poor outcome after balloon angioplasty. The ...
Hlatky M A - - 1999
BACKGROUND: Medical costs vary substantially among patients. Understanding the baseline factors that predict subsequent cost may allow better selection of therapy for individual patients. Understanding the postprocedure events that increase cost should help to improve efficiency and effectiveness of coronary revascularization. METHODS: Data on 4-year costs were collected from patients ...
Berger P B - - 1999
BACKGROUND: Time to treatment with thrombolytic therapy is a critical determinant of mortality in acute myocardial infarction. Little is known about the relationship between the time to treatment with direct coronary angioplasty and clinical outcome. The objectives of this study were to determine both the time required to perform direct ...
Köster R - - 1999
OBJECTIVES: This study evaluated safety and efficacy of excimer laser angioplasty for treatment of restenosed or occluded coronary stents. BACKGROUND: Balloon angioplasty of in-stent restenosis is limited by a high recurrence rate. Debulking by laser angioplasty is a novel concept to treat in-stent restenosis. METHODS: A total of 440 patients ...
Cohen E A - - 1999
BACKGROUND: The impact of recent developments in coronary angioplasty on the broad spectrum of patients treated in routine practice is largely undefined. Analysis of population-based data can provide insight into trends in clinical outcomes and associated costs of coronary angioplasty procedures. METHODS AND RESULTS: With the use of a comprehensive ...
Shen A Y - - 1999
Primary angioplasty for acute myocardial infarction is frequently performed. Not uncommonly, more than one occluded artery may be present. Usually only one is an acute event, the others being chronic occlusions. We encountered a patient who presented with two simultaneous occlusions; both were successfully recanalized. We discuss some observations that ...
Danchin N - - 1999
BACKGROUND: Recent randomized trials comparing primary coronary angioplasty and intravenous thrombolysis at the acute stage of myocardial infarction have shown a limited but definite advantage for primary angioplasty. The aim of this study was to document 1-year outcome in patients receiving either thrombolysis or primary angioplasty for acute myocardial infarction ...
McLachlan J E - - 1999
Interventional cardiology is only 22 years old, but its successes at the end of this century stand heavily on the shoulders of innovative pioneers who labored earlier in the century. Balloon angioplasty gradually developed and eventually achieved great success in treating America's greatest health risk, coronary artery disease, through the ...
Marks M P - - 1999
BACKGROUND AND PURPOSE: We sought to assess the long-term outcome and efficacy of percutaneous transluminal angioplasty in the treatment of symptomatic intracranial atherosclerotic stenoses. METHODS: Twenty-three patients with fixed symptomatic intracranial stenoses were treated over a 5-year period with percutaneous transluminal angioplasty. Patients who underwent successful angioplasty were followed up ...
Bourassa M G - - 1999
OBJECTIVES: Our objective was to determine whether a strategy of intended incomplete percutaneous transluminal coronary angioplasty revascularization (IR) compromises long-term patient outcome. BACKGROUND: Complete angioplasty revascularization (CR) is often not planned nor attempted in patients with multivessel coronary disease, and the extent to which this influences outcome is unclear. METHODS: ...
van den Merkhof L F - - 1999
We sought to study the effect of early infusion of abciximab on coronary patency before primary angioplasty in patients with acute myocardial infarction. Glycoprotein IIb/IIIa antagonists have proved to be effective in reducing ischemic events associated with coronary angioplasty. The present study explores whether abciximab alone, without administration of thrombolytic ...
Vassanelli C - - 1999
Mechanical revascularization in the acute myocardial infarction by primary angioplasty has several advantages over thrombolytic therapy. The short-term patency rates of the infarct-related artery range from 95 to 99% and a normal flow is achieved in more than 90% of the cases. This prompt and effective reperfusion is probably responsible ...
Wharton T P TP - - 1999
OBJECTIVES: We sought to establish the safety and efficacy of primary percutaneous transluminal coronary angioplasty in patients with acute myocardial infarction (AMI) at two community hospitals without on-site cardiac surgery. BACKGROUND: Though randomized studies indicate that primary angioplasty in AMI may result in superior outcomes compared with fibrinolytic therapy, the ...
Watson P S - - 1999
Acute infarct angioplasty on aortocoronary saphenous vein grafts (SVGs) poses significant challenges because of their degenerate morphology and presence of significant thrombus. Of 370 acute, primary, or rescue myocardial infarct angioplasties performed over 3 years, 21 (5.7%) were on SVGs in patients who had undergone previous coronary artery bypass grafting ...
Appels A - - 1999
Feelings of exhaustion have been found to belong to the precursors of acute coronary events. Guided by the current views of the pathogenesis of acute coronary syndromes, a two-stage model describing a feedback relationship between mental state and the disease process is presented. According to the presented model prolonged exposure ...
Ribichini F - - 1999
Growing evidence suggests that primary angioplasty is superior to thrombolysis for the treatment of acute myocardial infarction, in particular in some high-risk subsets. The performance of primary angioplasty in centres without on-site cardiac surgery may extend the availability of this effective reperfusion therapy. This will benefit in particular those patients ...
Meier B - - 1999
Angioplasty therapy for acute myocardial infarction (direct or primary coronary angioplasty) has been a hot issue of the medical literature since 1982. It was first presented as a rescue therapy in the case of failed intracoronary thrombolysis. Later it was described as a useful complement to thrombolysis before it emerged ...
Brueren B R - - 1999
The prediction of the risk of a percutaneous transluminal coronary angioplasty has either been based on coronary lesion morphology or on clinical parameters, but a combined angiographic and clinical risk assessment system has not yet been evaluated prospectively. Five experienced interventionalists categorized 7,144 patients with 10,081 stenoses (1.4 lesion/patient) for ...
Blankenship J C - - 1999
Previous studies suggest that slow and/or oscillating balloon inflation during coronary angioplasty may decrease the incidence of coronary dissection and improve clinical outcomes. To compare the effect of slow oscillating versus conventional fast inflation techniques on the incidence of severe coronary dissection during angioplasty, 622 patients were randomized to slow ...
Nunn C M - - 1999
OBJECTIVES: This study sought to compare the two-year outcome after primary percutaneous coronary angioplasty or thrombolytic therapy for acute myocardial infarction. BACKGROUND: Primary angioplasty, that is, angioplasty without antecedent thrombolytic therapy, has been shown to be an effective reperfusion modality for patients suffering an acute myocardial infarction. This report reviews ...
Zijlstra F - - 1999
Timely restoration of antegrade coronary blood flow by primary angioplasty of the infarct-related vessel of a patient with an acute myocardial infarction results in myocardial salvage and improved survival. The main issues pertinent to the delivery of primary angioplasty therapy are discussed, and the 'Zwolle approach' is described with regard ...
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