Document Detail


Bladed balloon angioplasty for peripheral pulmonary artery stenosis.
MedLine Citation:
PMID:  15103608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Treatment for peripheral pulmonary artery stenosis is challenging, and conventional balloon angioplasty has not proved to be universally effective. Evaluated was the efficacy of bladed balloon (BB) dilation to address vessels resistant to conventional high-pressure (10-15 atm) balloon angioplasty (BA). Thirty-one procedures were performed on 14 children with age range 1 month to 15 years. The diameter of the BB ranged from 3 to 8 mm. After BB dilation, all children had subsequent conventional BA (balloon size range, 3-10 mm). The minimal lumen diameter (MLD) before and after the procedure, whether there was a waist at initial BA, and BB diameter-to-MLD ratio before the procedure were measured. A > 50% increase in MLD was considered successful. Four children had Williams syndrome, two children Alagille syndrome, five children Fallot's tetralogy, and three miscellaneous lesions. The resistant stenosis was located in the right central pulmonary artery in 6, right branch pulmonary artery in 7, left central pulmonary artery in 6, and left branch pulmonary artery in 12 lesions. Median BB diameter was 253% (117-440%) of the MLD and increased from 2.0 +/- 0.7 to 3.2 +/- 0.8 mm (P < 0.0001), with a mean increase of 73% +/- 62%. There was an inverse relationship between the MLD before and increase after the procedure (r = 0.75; P < 0.001). The BB diameter-to-MLD ratio before procedure was significantly associated with the increase in MLD (r = 0.70; P < 0.001). After the procedure, 18 of the 31 procedures were considered successful. In all successful procedures, the BB diameter was greater than twice the MLD before the procedure. Comparing children with Williams and Alagille syndrome with the remaining eight children, there were no significant differences in the increase in MLD. A small aneurysm and thrombus were noticed in two and three children, respectively, but no fatal complications were reported. BB angioplasty is effective for resistant peripheral pulmonary artery stenosis when conventional BA fails. The diameter of the BB should be larger than twice the minimal luminal diameter of the stenotic lesion.
Authors:
Hisashi Sugiyama; Gruchen R Veldtman; Gunnar Norgard; Kyong-Jin Lee; Rajiv Chaturvedi; Lee N Benson
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  62     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-22     Completed Date:  2004-11-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Department of Pediatrics, Hospital for Sick Children, University of Toronto School of Medicine, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Angioplasty, Balloon*
Canada
Child
Child Welfare
Child, Preschool
Female
Humans
Infant
Infant Welfare
Male
Postoperative Complications / etiology,  physiopathology,  radiography
Prospective Studies
Pulmonary Artery / abnormalities*,  radiography,  surgery*
Pulmonary Atresia / physiopathology,  radiography,  therapy
Pulmonary Valve Stenosis / physiopathology,  radiography,  therapy*
Systole / physiology
Tetralogy of Fallot / physiopathology,  radiography,  therapy
Treatment Outcome
Ventricular Pressure / physiology
Williams Syndrome / physiopathology,  radiography,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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