Coronary perforation is a rare complication of percutaneous interventional procedures, occurring in 0.2-3% of procedures, which may require emergency coronary bypass surgery. We describe here an alternative method to deal with such complication, which proved effective in a patient with active bleeding from the left anterior descending (LAD) coronary artery. ...

AIMS: Primary angioplasty is superior to thrombolysis in ST elevation myocardial infarction (STEMI). This advantage is dependent on how quickly angioplasty can be performed. Several strategies have been suggested to cut door to balloon (D2B) times. We aimed to audit and reorganise the admission process to accelerate D2B times, in ...

We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique.

BACKGROUND: In primary angioplasty (primary percutaneous coronary intervention [PPCI]) for acute myocardial infarction, institutional logistical delays can increase door-to-balloon times, resulting in increased mortality. METHODS: We moved from a thrombolysis (TL) service to 24/7 PPCI for direct access and interhospital transfer in April 2004. Using autonomous ambulance diagnosis with open ...

BACKGROUND: Primary angioplasty is becoming an established treatment for myocardial infarction. Yet we have a limited understanding of patients' attitudes toward this treatment and their experiences of receiving it in practice. AIMS: Exploration of patients' experiences and perceptions of primary angioplasty as treatment for their heart attack. METHODS: Qualitative study ...

OBJECTIVE: To estimate the cost-effectiveness of primary angioplasty compared to thrombolysis for acute ST-elevation myocardial infarction. DESIGN: Cost analysis of UK observational database, incorporated into decision analytic model. METHODS: We compared patients receiving treatment within a comprehensive angioplasty service to control patients receiving thrombolysis-based care. The treatment costs and delays ...

BACKGROUND: Primary angioplasty is being used increasingly as an alternative to intravenous thrombolysis for patients with acute ST-elevation myocardial infarction. AIMS: To explore positive and negative views of patient and carer experiences of undergoing primary angioplasty. METHODS: We undertook semi-structured qualitative interviews (n=16). We identified a thematic framework from transcripts ...

AIMS: Primary angioplasty for ST-segment elevation myocardial infarction (STEMI) is recommended only if symptom duration is <12 h. We evaluated final infarct size (FIS) and myocardial salvage in early presenters (<12 h) vs. late presenters (12-72 h) undergoing primary angioplasty. METHODS AND RESULTS: Myocardial perfusion imaging (MPI) was performed acutely ...

Patients with catheter fragments that were entrapped during percutaneous transluminal coronary angioplasty remain a particular challenge because little is known about the clinical outcome. Absolutely unique is the partially cutting of the dilator and the pushing of the fragment by the guidewire advancing into the femoral artery to the coronary ...

Plasma levels of asymmetrical dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide production, correlate with endothelial dysfunction and the development of cardiovascular events in patients with uremia. It is not known whether endothelial dysfunction contributes to the dysfunction of arteriovenous fistulas (AVFs) in hemodialysis patients. Here, we studied the predictive ...

OBJECTIVES: To evaluate clinical reinfarction during a 3-year follow-up after randomization to primary angioplasty versus fibrinolysis in anterior and non-anterior ST elevation myocardial infarction (STEMI). METHODS: Clinical reinfarction was prospectively assessed by an endpoint committee blinded to the study treatment. RESULTS: At 30 days, primary angioplasty compared with fibrinolysis reduced ...

INTRODUCTION: In diagnostic and interventional cardiology procedures performed with the use of X-ray diagnostic imaging systems, the long fluoroscopy time and the large number of cine projections, as well as the repetition of the procedure due to the recurrence of the lesion--a common event--result in a high locally delivered skin ...

Laser lead extraction in adult patients with congenital heart disease is safe and effective. Baffle angioplasty for obstruction in patients with a Mustard procedure is well established. We describe a unique combined interventional and electrophysiological approach on a patient with superior baffle obstruction. This technique utilized the channel created after ...

Doctor: "Ma'am you need an angioplasty". Patient: "Doctor, the newspaper says that medicine is as good as angioplasty". Doctor: "Ma'am you're having a heart attack". The COURAGE trial was published 1 year ago and received attention from the media, patients, and other medical specialties concerning the value of percutaneous coronary ...

We describe a case of dissection of the coronary ostium and sinus of Valsalva during a recanalization procedure to address chronic total occlusion of the right coronary artery (RCA). The patient was treated conservatively, and 1 month later, underwent angioplasty of the RCA and marginal branch. Based on a review ...

Restenosis following coronary angioplasty represents a major clinical problem. Irreversible electroporation (IRE) is a nonthermal, nonpharmacological cell ablation method. IRE utilizes a sequence of electrical pulses that produce permanent damage to tissue within a few seconds. METHODS AND RESULTS: The left carotid arteries of eight rats underwent in vivo intimal ...

Chronic critical limb ischemia (CLI) occurs when arterial perfusion is reduced below a threshold level that results in rest pain and/or tissue breakdown in the lower extremities. Importantly, it is associated with high cardiovascular morbidity and mortality. Without prompt revascularization, CLI may result in loss of a limb (i.e. amputation) ...

OBJECTIVE: Imaging to determine myocardial infarct size is difficult in the emergency setting because the current gold standards, MRI and nuclear medicine techniques, are difficult to perform in unstable patients. Delayed enhanced MDCT has recently been proposed as a technique to study contrast uptake in infarcted myocardium. In this study, ...

BACKGROUND: The radial artery is currently regarded as a useful vascular access site for coronary procedures. This study was conducted to investigate the feasibility and safety of the percutaneous radial artery approach for angioplasty in the elderly. METHODS: Two thousand and fifty-eight consecutive patients (762 elderly, age = 65 years; ...

In a patient with acute myocardial infarction treated with primary angioplasty, a large amount of thrombus was removed from the middle segment of the right coronary artery using a Pronto V3 extraction catheter (Vascular Solutions, Inc., Minneapolis, Minnesota). Repeat angiography revealed no significant residual stenosis and no further intervention was ...

To assess the feasibility and safety of coronary angiography combined, where necessary, with ad hoc angioplasty in an outpatient setting; a prospective, single-center study. The first 172 patients (154 men, 59 +/- 11 years) considered at low risk for complications were enrolled for outpatient-coronary angiography with or without angioplasty via ...

BACKGROUND: The DANAMI-2 trial showed that in patients with ST-elevation myocardial infarction (STEMI), a strategy of inter-hospital transfer for primary angioplasty was superior to on-site fibrinolysis at 30 days follow-up. This paper reports on the pre-specified long-term composite endpoint at 3 years follow-up in DANAMI-2. METHODS AND RESULTS: We randomized ...

OBJECTIVE: To determine the frequency of myocardial damage in elective, successful, single vessel percutaneous coronary angioplasty by assessing myocardial band (MB), creatinine kinase levels and to find out the association of common modifiable risk factors with myocardial damage in patients undergoing single vessel coronary angioplasty. STUDY DESIGN: Descriptive. PLACE AND ...

A female patient suffering from dermatomyositis in whom symptoms of heart failure without angina is described. An impairment of left ventricular function and significant coronary lesions were diagnosed using noninvasive and invasive procedures. Coronary angioplasty with stent implantation was successfully applied to improve the quality of life and clinical symptoms.

BACKGROUND: Distal protection during primary angioplasty in acute myocardial infarction (AMI) is the subject of recent controversy. The present study was designed to determine whether the distal embolic protection preserves myocardial microvascular integrity and improves clinical outcomes in patients with AMI. METHODS: A total of 116 AMI patients presenting within ...

Vascular access-related procedures commonly performed by nephrologists include percutaneous balloon angioplasty, intravascular coil and stent insertion, thrombectomy, vascular mapping and tunneled hemodialysis catheter-related procedures. In addition, using vein obliteration and percutaneous balloon angioplasty techniques, nephrologists have recently documented successful salvage of arteriovenous fistulas that had failed to mature, whereas traditionally ...

INTRODUCTION: Mortality rates for coronary heart disease (CHD) have declined markedly since the early 1970s. However, CHD remains the number one cause of death in the United States. The decline in mortality has been attributed to declines in CHD risk factors (tobacco use, hypertension) and the increase in protective behaviors ...

INTRODUCTION: Acute myocardial infarction (AMI) due to left main coronary artery (LMCA) occlusion carries a grave prognosis. Large series reporting on the outcome of emergency revascularisation (percutaneous or surgical) of acute LMCA occlusion have been scarce. We seek to identify, in our local population, the clinical presentation and outcome of ...

OBJECTIVES: The aim of this study was to compare clinical outcomes for transradial and transfemoral percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction undergoing rescue angioplasty. BACKGROUND: Transfemoral percutaneous coronary intervention in patients with acute myocardial infarction treated with systemic thrombolysis is associated with a significant risk of ...

We report a rare case of primary coronary angioplasty in a patient with acute myocardial infarction due to thrombotic occlusion of an anomalous right coronary artery arising from the left sinus of Valsalva. The non-invasive method of ischaemia localisation, such as ST-segment elevation on the electrocardiogram, was useful in identifying ...

OBJECTIVE: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. DESIGN: Prospective study. MATERIALS AND METHODS: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic ...

Low-dose (250 mg daily) oral probucol produces a significant antioxidant effect in coronary patients: increases activity of glutathione peroxidase (enzyme utilizing lipoperoxides) and reduces the content of free-radical oxidation products in the blood. Probucol therapy for 7 days before and for 6 months after coronary angioplasty significantly reduces the severity ...

We report the case of a young woman referred to our hospital for anterior ST-elevation myocardial infarction to be treated with primary coronary angioplasty. Angiography showed total dissection of the left anterior descending coronary artery, which was successfully treated with primary coronary angioplasty and multiple coronary stent implantation. Spontaneous coronary ...

A 59-year-old female was hospitalised with the diagnosis of infective endocarditis. On the fifth day of her antibiotic treatment, she experienced an anterior ST segment elevation myocardial infarction. Emergency transthoracic echocardiography showed that the vegetation on the aortic valve did not exist anymore. It was thought to be an embolic ...

BACKGROUND: A circadian variation in the time of onset of ST-segment elevation myocardial infarction (STEMI) with peak in the morning hours has been described. We sought to investigate the impact of circadian patterns on the practice of primary angioplasty in individuals residing in Tenerife Island (Spain). METHODS: 90 consecutive patients ...

PURPOSE: To evaluate the results of a recent change in practice in our institution using cutting balloon angioplasty instead of standard balloon angioplasty as the primary treatment for failing infra-inguinal vein bypass grafts. METHODS: In this nonrandomized cohort study with a historical control, failing infra-inguinal vein grafts were identified at ...

Primary percutaneous coronary intervention of the culprit lesion is the treatment of choice for acute myocardial infarction, while treatment of the severe non culprit lesion is not indicated in the guidelines (Class III indication). More aggressive strategies that include initial treatment of the severe non culprit lesion may reduce the ...

PURPOSE: To compare the efficacy of subintimal angioplasty combined with primary stenting to intraluminal angioplasty with stenting for revascularization of long (>10 cm) femoropopliteal arterial occlusions. METHODS: Baseline characteristics and outcomes of 52 patients (40 men; mean age 65.6+/-9.7 years) with superficial femoral artery (SFA) occlusions in 61 limbs (mean ...

* Angioplasty has significantly reduced the bypass rate by 60%. * There is proof of tangible benefit in regards to ulcer healing of diabetic feet. * We agree with other big series on this matter to say 'Angioplasty reduces the rate of major amputation' at least by 41%. * Angioplasty ...

Growing evidence from experimental models suggests that relief of myocardial ischemia in a stuttering manner (i.e., 'postconditioning' [PostC] with brief cycles of reperfusion-reocclusion) limits infarct size. However, the potential clinical efficacy of PostC has, to date,been largely unexplored. Using a retrospective study design, our aim was to test the hypothesis ...

BACKGROUND: Risk stratification of patients with ST-elevation myocardial infarction (STEMI) undergoing primary angioplasty is important in order to predict outcomes and to delineate targeted therapeutic strategies. Although the prognostic implications of reduced left ventricular ejection fraction (LVEF) and creatinine clearance (CrCl) have been recognized, the clinical and prognostic impact of ...

A 50-year-old man presented with acute myocardial infarction. Coronary angiography showed the left anterior descending artery (segment 6) was totally occluded. Direct percutaneous transluminal coronary angioplasty was performed, but a distal embolism occurred by the procedure. Consequently, he suffered cardiogenic shock and sustained ventricular tachycardia/fibrillation which exacerbated his condition. Finally, ...

OBJECTIVE: We aimed to assess the safety and feasibility of thrombectomy with the Export Aspiration Catheter (EAC) before angioplasty, and its ability to improve angiographic results in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Distal embolization of atherothrombotic material often occurs during angioplasty in STEMI, compromising optimal myocardial reperfusion. ...

AIMS: In patients with acute myocardial infarction and ST-segment elevation (STEMI), primary angioplasty is frequently not available or performed beyond the recommended time limit. We designed a non-inferiority, randomized, controlled study to evaluate whether lytic-based early routine angioplasty represents a reasonable reperfusion option for victims of STEMI irrespective of geographic ...

AIMS: We compared the prevalence and prognostic implications of non-sustained ventricular tachycardia (nsVT) detected early after ST-segment elevation myocardial infarction (STEMI) in patients randomized to either fibrinolysis or primary angioplasty in the DANAMI-2 trial. METHODS AND RESULTS: Holter recordings were available in 1017 patients (fibrinolysis: n=501; primary angioplasty: n=516). Primary ...

To cut costs, many centres around the world utilise previously used, re-sterilized balloon catheters to perform coronary angioplasty. The fracture and lodging of an angioplasty device within the coronary arteries is a rare but increasingly noted complication. In this article, we report on the inadvertent retrieval of a coronary angioplasty ...

A young male presented 22 h following onset of symptoms with an anterior ST-elevation myocardial infarction. He was transferred for rescue angioplasty after failing to reperfuse with thrombolytic therapy. On arrival, his symptoms had settled. Following administration of intracoronary abciximab and passage of an angioplasty wire into the distal LAD, ...

This study assessed the impact of patient and facility characteristics on patient outcomes for coronary artery disease. The sample data studied and analyzed (i.e., hospital financial and administrative data) were from patients discharged in 2004, from hospitals in Florida with principal diagnoses codes indicating diseases of the circulatory system. Patient ...

OBJECTIVE: To describe our experience of primary angioplasty in ST-segment elevation myocardial infarction. SUBJECTS AND METHODS: During a period of 2 years (April 2003 to May 2005), 83 high-risk patients presenting with acute ST-segment elevation myocardial infarction underwent primary angioplasty subject to availability of balloon dilation within 90 min of ...

BACKGROUND: Because subintimal angioplasty (SA) is a technique that can achieve recanalization of long arterial occlusions, it is considered an alternative to lower limb bypass operations. The aim of this prospective study was to identify the risk factors that affect patency of SA in patients suffering from critical limb ischemia ...