Volume 15 - Issue 8 - August, 2003
Balloon Sizing of Pulmonary Branch Stenosis: A Useful Method to Guide Stent Implantation
- Wed, 3/14/12 - 4:00pm
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ABSTRACT: Among patients with congenital heart disease, pulmonary branch stenosis is a common indication for stent implantation. Selective calibrated angiography is the standard method of vessel sizing to guide angioplasty balloon and stent selection.
Patients at Low Risk for Periprocedural Myocardial Infarction Can Be Identified by Assessment Immediately Following Percutaneous
- Fri, 8/1/08 - 12:13pm
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Despite advances in the technical and pharmacologic aspects of percutaneous coronary intervention (PCI), periprocedural myocardial infarction (PPMI) remains a significant complication of the procedure. Previous studies identified clinical characteristics including age, unstable angina, renal insufficiency and low operator volume to be risk factors for unsuccessful PCI and subsequent PPMI.1–3 Similarly, angiographic characteristics considered to be features placing patients at high risk for PPMI during PCI include multivessel coronary artery disease, left ventricular dysfunction, lesion compl
Extraction of the Radial Artery During Transradial Coronary Angiography: An Unusual Complication
- Fri, 8/1/08 - 12:13pm
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The transradial technique is a currently accepted alternative to the femoral site for vascular access during coronary percutaneous interventions. While in some laboratories it is only used when the femoral entry site proves troublesome or impossible, in others it is routinely used as the access site of choice. The procedure can be performed safely, with few access-site complications, better patient comfort and earlier ambulation.1,2 We describe a patient in whom the radial artery was inadvertently extracted during sheath removal.
Case Report. A 58-year-old, hypertensive, dyslipide
Bivalirudin as a Foundation Anticoagulant in Peripheral Vascular Disease: A Safe and Feasible Alternative for Renal and Iliac In
- Fri, 8/1/08 - 12:13pm
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Over 200,000 peripheral interventions were performed in 1997; this number continues to grow at a rapid pace.1 Peripheral artery disease (PAD), also referred to as peripheral vascular disease (PVD), affects 12–20% of Americans >= 65 years old, resulting in 4.5–7.6 million people with PAD.2 Many of these people will be candidates for percutaneous peripheral intervention (PPI).
Unfractionated heparin (UFH) has been the antithrombotic foundation for percutaneous coronary intervention (PCI) and PPI since the first reported angioplasty by Andreas Gruentzig in 1979.3 Despite significant therapeu
Complete Heart Block Due to Lyme Carditis
- Fri, 8/1/08 - 12:13pm
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Lyme disease is an arthropod born disease caused by the bacterium Borrelia burgdorferi. These bacteria are transmitted by deer ticks of the Ixodes species, Ixodes scapularis on the east coast of the United States and Ixodes pacificus on the west coast.1 It is estimated that 4–10% of patients in the United States with untreated Lyme disease develop Lyme carditis. The incidence in Europe is estimated to be 0.3–4.0%. The difference in incidence is unclear, but could be the result of the difference in virulence in European and United States species of Borrelia burgdorferi.2
We present a case
Parameters of Left Ventricular Diastolic Function 48 Hours After Coronary Angioplasty and Stent Implantation
- Fri, 8/1/08 - 12:13pm
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Over the past 20 years, percutaneous transluminal coronary angioplasty (PTCA) has emerged as the treatment of choice for many patients with atherosclerotic coronary artery disease. With increased experience and technical advances, the procedural success rate has risen to about 90%. Despite dramatic improvements in technology, the incidence of restenosis within 6–12 months of successful PTCA remains 30–45%.1,2 Intracoronary stents were designed to prevent coronary restenosis after coronary angioplasty.3–5 Stents scaffold coronary arteries after angioplastic treatment and inhibit elastic r
Comparison of Two Platelet Glycoprotein IIb/IIIa Inhibitors, Eptifibatide and Abciximab: Outcomes, Complications and Thrombocyto
- Fri, 8/1/08 - 12:13pm
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The development of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors has been a major advance in reducing ischemic complications among a broad spectrum of patients undergoing percutaneous coronary intervention (PCI).1–9 Currently, three intravenous GP IIb/IIIa inhibitors, abciximab (ReoPro, Johnson and Johnson, Malvern, Pennsylvania), eptifibatide (Integrilin, Cor Therapeutics, South San Francisco, California) and tirofiban (Aggrastat, Merck, West Point, Pennsylvania) are approved by the United States Food and Drug Administration (FDA) for medical management of acute coronary syndromes
Prevention of Radiocontrast-Induced Nephropathy with N-Acetylcysteine in Patients Undergoing Coronary Angiography
- Fri, 8/1/08 - 12:13pm
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Acute transient renal insufficiency after exposure to radiocontrast agents has been well described. The incidence varies among studies depending on the definition and the patient population studied.1 One of the more commonly accepted definitions for radiocontrast-induced nephropathy (RCIN) is a greater than 25% increase in serum creatinine within 48 hours of contrast exposure.2 Risk factors for RCIN include baseline renal dysfunction, congestive heart failure, diabetes mellitus, dehydration, peripheral vascular disease, hypertension, multiple myeloma and treatment with nephrotoxic drugs.1,3,4
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