OBJECTIVE: To assess the success of percutaneous transluminal angioplasty (PTA) in treating infrainguinal graft-related stenoses. DESIGN: Retrospective analysis of stenoses undergoing PTA over 6 years. MATERIALS: Fifty-seven stenoses in 42 grafts. METHODS: Site, length and type of stenoses recorded. Follow-up till discharge, graft occlusion or death. RESULTS: PTA was successful ...

OBJECTIVES: We sought to evaluate the prognostic ability of cardiac exercise stress tests in predicting cardiac mortality and morbidity in a low risk group of patients with established coronary artery disease (CAD). BACKGROUND: Although previous studies have demonstrated the superior value of stress nuclear cardiac scintigraphy in the prognosis of ...

In a prospective study, the role of various hemostatic factors known to be associated with thrombotic risk was investigated in 71 patients with peripheral arterial occlusive disease (PAOD, stages II through IV, Fontaine; aged 68 +/- 13 years). Laboratory investigations were done before; 1, 24, and 48 hours after; and ...

Since 1988, 49 limbs of 47 patients underwent intraarterial urokinase infusion for acute native artery occlusion. The time from the onset of ischemic symptoms ranged from 1 to 45 days (mean = 17.5). The arterial sectors involved were femoropopliteal in 32 cases, followed by aortoiliac in 13 cases, distal in ...

In patients with coronary artery disease and severe ischemia, angioplasty and coronary artery bypass surgery have been shown to reduce symptoms, improve functional capacity and, in some patients, prolong life. Six major randomized trials have recently been reported comparing bypass surgery with angioplasty in patients with multivessel coronary disease. Uniformly, ...

Central venous stenosis occurs as a complication of central venous catheterization and significantly complicates delivery of dialysis through arteriovenous grafts in the ipsilateral upper limb. This report includes two separate studies. Functioning expanded polytetrafluorethylene grafts have been prospectively evaluated using duplex scanning and angiography performed in all patients with stenoses ...

The intraaortic balloon pump (IABP) is useful in the treatment of failing hearts. Although most experience with IABPs has been with acute short-term use, the safe duration of therapy and possible complications of long-term IABP use are uncertain. We evaluated the feasibility, management, and complications associated with long-term IABP therapy. ...

OBJECTIVES: This study was undertaken to investigate the long-term outcome of balloon angioplasty for recurrent coarctation of the aorta in a large series of patients. BACKGROUND: Balloon angioplasty has become the standard treatment for residual or recurrent aortic coarctation. Despite the widespread use of this treatment modality, there are few ...

PURPOSE: To evaluate the efficacy of intraarterial urokinase in the treatment of superior mesenteric arterial (SMA) embolism. MATERIALS AND METHODS: Within 3 years, 10 patients (six men, four women; aged 62-82 years) with angiographically proved SMA emboli were selected on the basis of absence of peritoneal signs of intestinal necrosis ...

BACKGROUND: Oxidizing metabolites generated at the site of coronary angioplasty can induce chain reactions that may lead to restenosis. Antioxidants may counter oxidative stress and modify neointimal formation and vascular remodeling. Experimental data and small clinical studies have suggested that antioxidants may prevent restenosis after angioplasty. In a double-blind, randomized ...

BACKGROUND: Endovascular treatment of arterial disease of the lower extremity is performed by radiologists, cardiologists, and some vascular surgeons. This retrospective review was performed to measure complications and success rates in patients with extensive occlusive disease treated by vascular surgeons. METHODS: Balloon angioplasties were performed on 336 vascular segments as ...

Rapid improvements in walking distance and quality of life have been identified in patients with intermittent claudication following percutaneous transluminal angioplasty, but the medium-term results are less well defined. The aim of this study was to assess quality of life and walking distance in the medium term. Walking distance was ...

BACKGROUND: Transluminal balloon angioplasty offers advantages to patch angioplasty. We evaluated the primary patency of thrombosed hemodialysis grafts that had undergone balloon angioplasty versus patch angioplasty as a salvage method. METHODS: We reviewed our experience with 22 consecutive intraoperative balloon angioplasties that were done in a 6-months period. The balloons ...

OBJECTIVE: To define cumulative risk of reconstruction, amputation or death following percutaneous transluminal angioplasty (PTA). DESIGN: Non-randomised observational study. PATIENTS AND METHODS: Two hundred and thirty-four PTAs in 212 patients. Minimum follow-up 6 months. Examination of data collected prospectively on manual card index. Examination of radiology and theatre ledgers over ...

BACKGROUND: Limited data are available on the changes that occur at the dilated site late after coronary angioplasty. The aim of this study was to evaluate with quantitative angiography the natural history of changes that occur in the dilated segment between "early" (approximately 6 months) and "late" (approximately 5 years) ...

This debate examines the proposition that surgery is unnecessary or obsolete in the management of intermittent claudication. The case for this argument is that many patients have stable disease or respond well to conservative measures, that claudication is an expression of a systemic cardiovascular illness and that surgery can be ...

BACKGROUND: Balloon angioplasty is an accepted treatment for recurrent coarctation of the aorta. Application of this technique to patients with native coarctation is controversial. OBJECTIVE: To report on the immediate and mid-term results of this procedure in patients with native coarctation, including infants <6 months of age. METHODS AND RESULTS: ...

The outcome of percutaneous transluminal angioplasty (PTA) of lower extremity peripheral arterial disease (PAD) in females is not well documented. Between June 1988 and June 1994, 206 patients underwent 293 PTA procedures for symptomatic PAD. Females (63 patients, 97 PTA procedures) and males (143 patients, 196 PTA procedures) were analyzed ...

PURPOSE: A few authors have suggested treating double-level atherosclerotic lesions in high risk patients by an association of iliac transluminal angioplasty (ITA) and distal surgical restoration in a two-step technique with an interval of one to three weeks between the two procedures. Previous reports of ITA showed the influence of ...

The aim of this study was to analyze the results of a questionnaire survey regarding acute and late effects of balloon angioplasty for aortic coarctation in Japan. Considerable controversy still exists regarding the effectiveness and safety of balloon angioplasty in native coarctation. Moreover, little information about this mode of treatment ...

PURPOSE: To evaluate the clinical efficacy of the Amplatz device for the treatment of acute occlusions of the lower limb arteries. MATERIALS AND METHODS: Forty patients with acute occlusion of the lower limb arteries (3 hours to 8 days; mean, 2 days) were treated using the Amplatz clot macerator. Acute ...

The following study was designed to evaluate the effectiveness and safety of ultrasound guided compression therapy (UGCT) of iatrogenic postcatheterization pseudo-aneurysms (PA) on the one hand and to justify the usefulness of the routine colour duplex control of the puncture site following transfemoral catheterization, on the other hand. During the ...

AIMS: Prospectively to compare success rate and complications in percutaneous transluminal coronary angioplasty using two doses of heparin. METHODS AND RESULTS: Four hundred patients undergoing coronary angioplasty were randomly assigned to receive 15,000 IU (group A) or 100 IU.kg-1 (group B) of heparin. The angioplasty success rate was 95% of ...

PURPOSE: To evaluate the efficacy of thrombolytic therapy in the treatment of acute axillosubclavian vein thrombosis in patients with Paget-Schroetter syndrome. MATERIALS AND METHODS: A 4.5-year, retrospective study of all patients with "effort" thrombosis of the axillosubclavian vein was performed. RESULTS: Six men and eight women (age range, 18-56 years; ...

PURPOSE: To assess the predictive value of immediate angiographic results after percutaneous transluminal angioplasty (PTA) for stenoses in femoral bypass grafts using duplex ultrasound (DUS) criteria. METHODS: A 1-year follow-up with DUS was performed in 38 patients with 50 stenoses in 41 grafts, treated with PTA for a graft stenosis. ...

Maintenance of dialysis access continues to plague care of the patient with ESRD. Because of the poor outcomes from surgical revision, there is increasing interest in balloon angioplasty as a technique for dilating stenoses in the functioning, but compromised graft. Forty patients treated with percutaneous transluminal angioplasty (PTA), without subsequent ...

Seventy-one patients with peripheral arterial occlusive disease (PAOD) were randomized into two groups of different treatment modalities. The diagnosis of PAOD was established by history of intermittent claudication, clinical examination, and by Doppler pressure assessment or lower extremity arteriography. After a three-month washout period, 35 patients (Group 1) started treatment ...

BACKGROUND: We examine the technique of combining percutaneous transluminal angioplasty and secondary intravascular stent deployment with femorofemoral bypass graft in patients with bilateral aortoiliac occlusive disease. STUDY DESIGN: Retrospective review. RESULTS: During the 5-year period from June 1988 to October 1993, 18 patients with iliac occlusion and a hemodynamically significant ...

PURPOSE: To review the results of intravascular stents used to treat superficial femoral artery (SFA) occlusive disease and to assist in patient selection for this procedure. METHODS AND RESULTS: We evaluated 55 patients who underwent balloon angioplasty and stenting of SFA long-segment disease and compared the results with those in ...

To assess the emerging use of ultrasound-guided compression (USGC) to treat iatrogenic femoral artery pseudoaneurysm (PA), we reviewed the experience in the accredited vascular laboratory of a large community teaching hospital from June 1993 to August 1994. Femoral duplex ultrasonography was done on 94 consecutive patients suspected of having PA. ...

To evaluate the efficacy of intravascular stents used to treat long-segment stenoses and occlusions of the superficial femoral artery (SFA) after suboptimal angioplasty. Fifty-eight limbs in 55 patients who underwent stenting of the SFA were identified from a vascular registry. Indications for stent placement after suboptimal PTA included flow-limiting dissection, ...

Knowledge and technology for cardiovascular disease are growing at a rapid rate. Interventional cardiology offers patients several options of therapy, including percutaneous transluminal coronary angioplasty, directional coronary atherectomy, and percutaneous transluminal coronary rotoblator angioplasty procedures. Patients with these procedures require femoral intra-arterial sheath insertion and postprocedure management of these sheaths. ...

Clinical investigations studying the effect of newer medications on such complex pathophysiology as the formation of an arterial or venous mural thrombus have been limited to clinical symptomatic endpoints. Biochemical markers so far have not been convincing in quantifying ongoing thrombus formation. Consequently, clinical development of new antithrombotic compounds has ...

Acute reocclusion after successful angioplasty is a severe complication. The preventive effects of heparin, the synthetic antithrombin, argtroban, and the defibrinogenating agent batroxobin on reocclusion after balloon angioplasty of thrombotic occlusions were evaluated in canine iliac arteries. After the 2-hour-old thrombus was evaluated by angiography and angioscopy, percutaneous transcatheter angioplasty ...

We report a case of venous rupture complicating percutaneous transluminal angioplasty (PTA) applied on a failed dialysis vascular access (VA) in a patient on chronic steroid therapy. This complication resulted in a rapidly growing hematoma which was successfully controlled by a prolonged reinflation of the balloon catheter at the angioplasty ...

OBJECTIVES: This study sought to report the long-term result (up to 8 years) of percutaneous transluminal balloon angioplasty (PTBA) for Budd-Chiari syndrome (BCS) caused by membranous obstruction of the inferior vena cava (MOVC). BACKGROUND: We previously reported on this nonoperative form of therapy in a smaller series of patients and ...

It has been shown that the incidence of recurrent stenosis following successful percutaneous transluminal coronary angioplasty (PTCA) is correlated with serum Lipoprotein(a) [Lp(a)] levels. The aim of the present study was to examine the influence of Lp(a) on restenosis after primary successful femoropopliteal PTA. One hundred and thirty nine consecutive ...

OBJECTIVE: To analyse the clinical results and long-term patency rates of 108 patients with subclavian carotid transposition (SCT) and compare the outcomes to other clinical series using the same technique, as well as to those reported for other surgical procedures and PTA in the treatment of proximal subclavian artery disease. ...

PURPOSE: Percutaneous transluminal angioplasty (PTA) with or without stent implantation is the accepted standard in the therapy of occlusive arterial disease. Despite improvements in the technique and medical equipment, there is still a restenosis rate of up to 40%. A high-dose-rate afterloading technique to avoid vascular stenosis or occlusion after ...

OBJECTIVES: To determine if Duplex ultrasound (DUS) 1 day after percutaneous transluminal angioplasty (PTA) is prognostic for haemodynamic and clinical results at 1 year. DESIGN: Prospective study. PATIENTS AND METHODS: Thirty-four femoropopliteal artery segments were treated with PTA. The peak systolic velocity ratio (PSV ratio = PSV in stenosis: PSV ...

PURPOSE: A new hemostatic puncture closure device (HPCD) was evaluated following femoropopliteal angioplasty. Efficacy in hemostasis and complications were compared between manual compression and the new system. METHODS: One hundred patients undergoing percutaneous interventional procedures were randomly assigned to receive either manual compression or HPCD. The time to complete hemostasis ...

The therapeutic outcome of percutaneous transluminal angioplasty (PTA) for subclavian steno-occlusive disease performed over the last 10 years was assessed in 60 consecutive patients of aortoarteritis (n = 35) and atherosclerosis (n = 25). Sixty lesions were stenotic and 6 short segment total occlusions. Twenty-five lesions were prevertebral and 41 ...

We identified a group of 24 young (less than 50 years of age) women with isolated, premature atherosclerotic aortoiliac occlusive disease and attempted to identify distinguishing hemostatic characteristics. Most of these patients (62%) presented with acute thromboembolic events (blue toe syndrome, n = 6; macroemboli, n = 6; or aortoiliac ...

Impending gangrene of the hand or digits secondary to palmar or digital artery occlusion can be a devastating complication of upper extremity thromboembolic or atheroembolic disease. Over the past 7 years, 9 patients with severe unilateral hand ischemia and impending tissue loss secondary to distal forearm, palmar arch, and digital ...

Femorofemoral bypass procedures are being performed with increasing frequency in some patients with bilateral disease in whom the "donor" iliac artery undergoes percutaneous transluminal angioplasty or stent placement. This study was undertaken to critically examine the efficacy of this approach. The records of 70 consecutive patients who over a 14-year ...

Intracoronary rt-PA has been used to treat patients with acute myocardial infarction primarily, after failure of intravenous thrombolytic therapy, and when angioplasty has not been technically possible. It has also been used to treat thrombotic closure complicating angioplasty, to treat nonocclusive thrombosis observed during angioplasty, and to pretreat patients with ...

This study was undertaken to determine the safety and efficacy of percutaneous transluminal angioplasty (PTA) in the treatment of chronic mesenteric ischemia (CMI) in very high-risk surgical patients. Twenty-four focal mesenteric stenoses treated from 1984 to 1994 by PTA in 19 patients with CMI were reviewed. All 19 patients were ...

Balloon dilatation of congenital stenotic lesions of the heart and great vessels has been used for more than a decade. Varying incidence of residual obstruction or recurrence, hereafter referred to as restenosis, has been observed at follow-up. The purpose of this study was to evaluate the feasibility and effectiveness of ...

OBJECTIVE: The objective of the present study was to assess prospectively whether serial Duplex examination was useful in identifying impending failure after endovascular interventions of the femoropopliteal arteries. SETTING: Non-university hospital. Prospective clinical study. METHODS: 124 Patients were successfully treated by endovascular procedures during a 5 year period. The follow-up ...

Three surgeons performed 180 atherectomy procedures in 161 patients using the Transluminal Extraction Catheter in 144 and the Auth Rotablator in 36. The primary patency rate was 55% at 1 year and 46% at 2 years, and failure was caused by stenosis in 28 (15.6%) and occlusion in 61 (33.7%) ...