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The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC
Mattos, Luiz Alberto;Sousa, Amanda G.M.R.;Campos Neto, Cantídio de Moura;Labrunie, André;Alves, Cláudia Rodrigues;Feres, Fausto;Soares Neto, Milton Macedo;Saad, Jamil;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001000600006
Abstract: objective: we conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (ptca) or stent implantation because of an acute myocardial infarction (ami) related to an acute vein graft occlusion. methods: since 1991 the brazilian society of hemodynamic and interventional cardiology has maintained a large database (cenic). from these, we selected all consecutive patients, who underwent primary ptca or stenting in the first 24 hours of ami, with the target vessel being an occluded vein graft. immediate results and major coronary events occurring up until hospital discharge were analyzed. results: during this period, 5,932 patients underwent primary ptca or stenting; 158 (3%) of the procedures were performed because of an acute vein graft occlusion. stenting was performed in 74 (47%) patients. patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon ptca. the incidence of reinfarction and death were similar for stenting and balloon ptca. conclusion: primary percutaneous treatment of ami related to acute vein graft occlusion is still an uncommon practice. primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with ptca treatment.
The use of primary stenting or balloon percutaneous transluminal coronary angioplasty for the treatment of acutely occluded saphenous vein grafts. Results from the Brazilian National Registry - CENIC  [cached]
Mattos Luiz Alberto,Sousa Amanda G.M.R.,Campos Neto Cantídio de Moura,Labrunie André
Arquivos Brasileiros de Cardiologia , 2001,
Abstract: OBJECTIVE: We conducted a comparative analysis of the in-hospital outcomes of patients who underwent primary percutaneous transluminal angioplasty (PTCA) or stent implantation because of an acute myocardial infarction (AMI) related to an acute vein graft occlusion. METHODS: Since 1991 the Brazilian Society of Hemodynamic and Interventional Cardiology has maintained a large database (CENIC). From these, we selected all consecutive patients, who underwent primary PTCA or stenting in the first 24 hours of AMI, with the target vessel being an occluded vein graft. Immediate results and major coronary events occurring up until hospital discharge were analyzed. RESULTS: During this period, 5,932 patients underwent primary PTCA or stenting; 158 (3%) of the procedures were performed because of an acute vein graft occlusion. Stenting was performed in 74 (47%) patients. Patients treated with stents had a higher success rate and lower mean residual stenosis compared with those who underwent primary balloon PTCA. The incidence of reinfarction and death were similar for stenting and balloon PTCA. CONCLUSION: Primary percutaneous treatment of AMI related to acute vein graft occlusion is still an uncommon practice. Primary stenting improved luminal diameter and offered higher rates of success; however, this strategy did not reduce the in-hospital reinfarction and death rate, compared with that occurring with PTCA treatment.
A Study to Assess The Efficacy of Balloon Angioplasty of The femoropopliteal Arteries in The Relief of Critical Limb Ischemia (CLI)  [PDF]
Ehab M. Abdo*, Hatem A. Mgahid,Abdel Aziz Abo Elella
Egyptian Journal of Hospital Medicine , 2009,
Abstract: Purpose: The aim of the study was to evaluate the results of percutaneous transluminal angioplasty (PTA) of femoropopliteal arteries in patients with critical lower limb ischemia; Materials and methods: From June 2006 till May 2008, 40 patients underwent 40 PTA procedures, 18 were of the superficial femoral artery (SFA), 7 of the popliteal artery, 9 of both arteries and 6 of the common femoral artery (CFA). Twenty-nine procedures were performed for treatment of stenoses and 11 for occlusion. The patients were monitored clinically with non-invasive hemodynamic studies. Results: The technical success rate was 97.5%. Overall primary patency rates at 24 months were 67.5%. Primary patency rates in limbs with occlusion were 45.5% compared with 75.9 in limbs with stenoses. Two major amputations were performed. The overall survival rate was 95%. Conclusion: The 2 years results of femoropopliteal PTA performed for treatment of CLI seemed to be near the results of infrainguinal bypass grafting reported in literature. Because PTA does not preclude the performance of future surgery and associated with low morbidity and mortality rates, it should be a first choice treatment for patients with CLI for selected lesions.
Percutaneous transluminal coronary angioplasty in Nepalese diabetic patients: Do they carry extra risk to revascularization process?  [PDF]
F Khatun,B Rawat,A Vaidya,S Rajbhandari,Y Bhatta
Journal of Kathmandu Medical College , 2012, DOI: 10.3126/jkmc.v1i1.7250
Abstract: Background and Objectives: There is evidence that diabetes carries risk of various complications and adverse outcome with coronary revascularisation procedures. The aim of this study was to analyze the outcomes and complications of Percutaneous Transluminal Coronary Angioplasty in Nepalese diabetic patients compared to non-diabetic patients. Method: A hospital-based comparative cross-sectional study was conducted at Norvic International Hospital, Kathmandu, Nepal. A total of 702 consecutive Percutaneous Transluminal Coronary Angioplasty patients coming to the hospital from 2002 to 2010 were included. Angioplasty was performed using radial and femoral routes in a standard setting with standard techniques. Information on other background risk factors was recorded. Success of the procedures and presence of major and minor complications were observed. Results: Of the 702 patients participating in this study, 259 were diabetic and 443 were non-diabetic. Success rates were similar: 256 (98.8%) of diabetic and 438 (98.8%) of non-diabetic had a successful Percutaneous Transluminal Coronary Angioplasty. Complications of the procedure were however higher in the diabetic patients with higher in-hospital death (odds ratio 3.4, 95% confidence Interval: 0.6-19.1), compared to non-diabetic patients. Conclusion: The overall outcome of Percutaneous Transluminal Coronary Angioplasty was equally successful in diabetic and non-diabetic populations groups. But the complications were higher with the diabetic group which were because of presence of other co-morbidities in this group and were not procedure-related. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7250 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.16-20
Percutaneous transluminal coronary angioplasty in the right ventricle myocardial infarction treatment  [PDF]
Rafajlovski Sa?a I.,Orozovi? Vjekoslav,Risti?-An?elkov An?elka,Ra?en Goran
Vojnosanitetski Pregled , 2005, DOI: 10.2298/vsp0510731r
Abstract: Background/Aim. To present the results of percutaneous transluminal coronary angioplasty (PTCA) in the treatment of the patients with acute right ventricle myocardial infarction (ARVMI), with adjuvant analyses of the obtained results in the period of five years (2000-2004). Methods. Thrombolytic therapy and the primary percutaneous transluminal coronary angioplasty (PPTCA) was applied within the first 6 hours from the onset of anginous disorders, and rescue PTCA in the period from 6 24 hours from the onset of ARVMI. Results. A total number of 1175 patients, both sexes, 763 (64.8%) males and 412 females (35.2%), mean age 58.4 ± 7.8 years, were treated for acute myocardial infarction (AIM) of different localization in the period of five years (2000-2004). Anterior infarction was found in 645 (54.8%) of the patients, and inferoposterior infarction (IPI) was localized in 530 patients (45.2%) patients of which in 134 (25.2%) AIMDK was proven. Out of 134 patients with proven acute myocardial of the right ventricle AIMDK, 53 (39.5%) got thrombolytic therapy, 64 patients (47.7%) were treated with the conservative heparin therapy, whereas in 17 patients (12.8%), primary percutaneous coronary angioplasty (PPTCA) was done. Delayed or rescue PTCA was done in 22 (18.8%) patients, in 8 (36.3%) from the group which got thrombolytic therapy, and in 14 (63.7%) treated with the heparin therapy. Out of the total number of 22 patients who got heparin or thrombolytic therapy combined with rescue PTCA, in 7 patients (31.8%) the complete clinical and angiographic effect of thrombolysis with AIM was achieved only by using a balloon. Baloon dilatation with the implantantion of intracoronary stent was performed in another 11 patients (50%), while 2 (9.1%) were sent to revascularization of the myocard due to diffusion changes in each of the 3 blood vessels, and 2 patients (9.1%) died. Of the patients, 17 (12.6%) had PPTCA with the implantation of intracoronary stent with the additional direct inhibitor of the platelet membrane glycoproteins IIb/IIIa (abciximab). All the patients treated in this way survived. They had no side effects nor serious complications. Their clinical recovery was satisfactory. In the first three weeks of the intrahospital period in the group of 45 patients (33.5%) with AIMDK, who got only thrombolytic therapy, 7 patients (15.5%) died, whereas in the group of 50 patients (37.3%) treated only with heparin, 13 (26%) died. In the group of 22 patients (18.8%) treated with the combined therapy with rescue PTCA and heparin or thrombolytic therapy, 2 patients (9.1
Intraaortic balloon pump support during coronary angioplasty. Initial experience
Osterne, Evandro C.V.;Alexim, Gustavo A.;Motta, Vicente P. da;Lins, Rosaly M.M.;Carvalho, Eustáquio F.;Carneiro, Marcos V.;Morais, Elio Ribeiro de;Brick, Alexandre V.;
Arquivos Brasileiros de Cardiologia , 1999, DOI: 10.1590/S0066-782X1999000800007
Abstract: objective: to evaluate the use of the intraaortic balloon (iaob) in association with coronary angioplasty in high-risk patients. methods: fourteen high-risk patients unresponsive to clinical therapy and with formal contraindication to surgical revascularization were treated by coronary angioplasty, most of which was followed by stenting. all procedures were performed with circulatory support with the iaob. this study reports the early results and the late findings after 12 months of follow-up. six patients had multivessel coronary disease; of these, four had left main equivalent lesions and two had unprotected left main coronary artery disease, one of whom had severe "end-vessel" stenosis and the other was a patient with chagas' disease with single-vessel lesion. eleven patients had a left ventricular ejection fraction <30%. results: in 100% of the patients, the procedures were initially successful. two patients had severe bleeding during the withdrawal of the left femoral sheath. at the end of twelve months, 4 patients were asymptomatic and the others were clinically controlled. there were two late deaths in the 7th and 11th months. conclusion: the combined use of the intraaortic balloon pump and percutaneous coronary angioplasty in high-risk patients with acute ischemic syndromes provides the necessary hemodynamic stability to successfully perform the procedures.
Intraaortic balloon pump support during coronary angioplasty. Initial experience
Osterne Evandro C.V.,Alexim Gustavo A.,Motta Vicente P. da,Lins Rosaly M.M.
Arquivos Brasileiros de Cardiologia , 1999,
Abstract: OBJECTIVE: To evaluate the use of the intraaortic balloon (IAoB) in association with coronary angioplasty in high-risk patients. METHODS: Fourteen high-risk patients unresponsive to clinical therapy and with formal contraindication to surgical revascularization were treated by coronary angioplasty, most of which was followed by stenting. All procedures were performed with circulatory support with the IAoB. This study reports the early results and the late findings after 12 months of follow-up. Six patients had multivessel coronary disease; of these, four had left main equivalent lesions and two had unprotected left main coronary artery disease, one of whom had severe "end-vessel" stenosis and the other was a patient with Chagas' disease with single-vessel lesion. Eleven patients had a left ventricular ejection fraction <30%. RESULTS: In 100% of the patients, the procedures were initially successful. Two patients had severe bleeding during the withdrawal of the left femoral sheath. At the end of twelve months, 4 patients were asymptomatic and the others were clinically controlled. There were two late deaths in the 7th and 11th months. CONCLUSION: The combined use of the intraaortic balloon pump and percutaneous coronary angioplasty in high-risk patients with acute ischemic syndromes provides the necessary hemodynamic stability to successfully perform the procedures.
Urotensin-II Immunoreactivity in Normolipidemic and Hyperlipidemic New Zealand White Rabbits Following Balloon Angioplasty and Stenting
Nicolas Bousette,Fazila Chouiali,Eliot H. Ohlstein,Stephen A. Douglas
International Journal of Biomedical Science , 2007,
Abstract: Treatment for symptomatic atherosclerosis is being carried out by balloon mediated angioplasty, with or without stent implantation, more and more frequently. Although advances with the development of drug eluting stents have improved prognosis, restenosis is still the most limiting factor for this treatment modality. Urotensin-II (UII), a small pleiotropic vasoactive peptide is increasingly being recognized as a contributory factor in cardiovascular diseases. We qualitatively evaluated UII immunoreactivity (Ir) in three models of balloon angioplasty mediated restenosis. Specifically, we performed balloon angioplasty in the ilio-femoral arteries of New Zealand White rabbits (NZWr) fed either a normal chow or high fat diet. In addition, UII Ir was also assessed in stent implanted abdominal aortae of NZWr fed a high fat diet. UII was constitutively expressed in the endothelium of all arterial segments evaluated. Abundant expression of UII was associated with lesion progression, particularly in myointimal cells, and less so in medial smooth muscle cells (sMc). the strongest UII-Ir was observed in foam cells of animals fed a high fat diet. We demonstrate abundant expression of UII in regenerating endothelial cells and myointimal cells in vascular lesions following balloon mediated angioplasty and stent implantation in both animals fed a normal chow and high fat diet.
Treatment of subclavian steal syndrome with percutaneous transluminal angioplasty and stenting: case report
Fregni, Felipe;Castelo-Branco, Luiz Eduardo Coutinho;Conforto, Adriana Bastos;Yamamoto, Fabio Iuji;Campos, Cynthia Resende;Puglia Jr., Paulo;Caldas, José Guilherme Mendes Pereira;Scaff, Milberto;
Arquivos de Neuro-Psiquiatria , 2003, DOI: 10.1590/S0004-282X2003000100018
Abstract: subclavian steal syndrome refers to the association of neurological symptoms related to vertebrobasilar insufficiency and the phenomenon of subclavian steal. we report the case of a 63 year-old male patient that presented subclavian steal syndrome and severe proximal (80%) stenosis of the left subclavian artery. the patient was submitted to percutaneous transluminal angioplasty and stenting on the left sa. the procedure was well tolerated and immediately afterwards, there was complete remission of the symptoms and of the phenomenon of subclavian steal evaluated by angiography and transcranial doppler. we propose that percutaneous transluminal angioplasty with stenting placement is a good therapeutic option for subclavian steal syndrome.
Treatment of subclavian steal syndrome with percutaneous transluminal angioplasty and stenting: case report
Fregni Felipe,Castelo-Branco Luiz Eduardo Coutinho,Conforto Adriana Bastos,Yamamoto Fabio Iuji
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: Subclavian steal syndrome refers to the association of neurological symptoms related to vertebrobasilar insufficiency and the phenomenon of subclavian steal. We report the case of a 63 year-old male patient that presented subclavian steal syndrome and severe proximal (80%) stenosis of the left subclavian artery. The patient was submitted to percutaneous transluminal angioplasty and stenting on the left SA. The procedure was well tolerated and immediately afterwards, there was complete remission of the symptoms and of the phenomenon of subclavian steal evaluated by angiography and transcranial doppler. We propose that percutaneous transluminal angioplasty with stenting placement is a good therapeutic option for subclavian steal syndrome.
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