Volume 16 - Issue 3 - March, 2004
Cutting Balloon Angioplasty to Treat Carotid In-Stent Restenosis
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ABSTRACT: We describe a case of carotid artery restenosis following carotid artery stenting for treatment of post-endarterectomy stenosis. The goal is to highlight the risk of recurrent restenosis following endarterectomy. In this case report, we describe the use of cutting balloon therapy as a reasonable alternative to repeat surgical revascularization.
Key words: arteriosclerosis, cerebrovascular disorders, endarterectomy
With the recent presentation of the SAPPHIRE trial1 favoring carotid stenting with protection compared to carotid endarterectomy in
Simple Clinical Risk Stratification and the Safety of Ambulation Two Hours After 6 French Diagnostic Heart Catheterization
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ABSTRACT: Heart catheterization is frequently applied in patients with coronary artery disease for diagnostic and therapeutic implications. Using the femoral approach, post-procedure bed rest of 4–6 hours is recommended to prevent groin complications. This extended strict bed rest is associated with patient discomfort and increased medical costs, and interferes with more efficient catheterization laboratory management of referred outpatients. Accordingly, we tested a simple clinical approach to identify low-risk patients who may benefit from ambulation within two hours after sheath re
Comparison of the Radial and Femoral Approaches in Left Main PCI: A Retrospective Study
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ABSTRACT: Transradial percutaneous coronary intervention (PCI) is a safe and effective method of percutaneous revascularization. However, there are no data on the efficacy of the transradial approach in left main (LM) PCI. We studied 80 patients (pts) who underwent LM PCI between February 1994 and January 2002, and compared the radial (27 pts) and femoral (53 pts) approaches. Patients were considered free of restenosis if they were free of angina and had a negative treadmill or nuclear imaging study 6 months post-PCI. Mean follow-up time was 27.4 ± 23.0 months. Reason for PCI (stable a
Validation of 4 French Catheters for Quantitative Coronary Analysis: In Vivo Variability Assessment Using 6 French Guiding Cathe
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ABSTRACT: Although numerous studies have established the utility of 4 French (Fr) catheters for routine coronary angiography, its adequacy for automatic quantitative coronary analysis has not been previously assessed. Methods. In 32 consecutive patients, coronary angiography was performed sequentially with 4 Fr diagnostic catheters and 6 Fr guiding catheters after intracoronary nitroglycerin. A total of 43 lesions were evaluated for quantitative analysis using both types of catheter as scaling devices. Possible differences in the reference diameter, minimal luminal diameter and p
Transcatheter Closure of Secundum Atrial Septal Defects with Complex Anatomy (Part I)
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ABSTRACT: The aim of this study was to evaluate the feasibility, safety and efficacy of transcatheter closure of secundum atrial septal defects (ASD) in patients with complex anatomy. From September 1997 to July 2003, a total of 40 patients (median age, 34 years; 65% female) with complex ASDs, defined as the presence of a large defect (stretched diameter > 26 mm) associated with a deficient rim (n = 23); multiple defects (n = 8); a multi-fenestrated septum (n = 5); and defects associated with an aneurysmal septum irrespective of their size (n = 4) underwent closure. The Helex device was
Transcatheter Closure of Secundum Atrial Septal Defects with Complex Anatomy (Part II)
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Transcatheter closure was successful in the remaining 35 patients (87.5%). The calculated Qp/Qs was 2.5 ± 0.8. All patients had normal to mildly elevated pulmonary artery pressures. The fluoroscopic and total procedure times ranged from 3–63 minutes (median time, 20 minutes) and 20–210 minutes (median time, 90 minutes), respectively. All patients with a single, large defect (n = 19) received an Amplatzer device, ranging in size from 26–38 mm (median, 32 mm; mean
Management of a Patient with ST-Segment Elevation Myocardial Infarction Immediately After Successful Coiling of a Basilar Tip An
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Case Report. We present the case of a 52-year-old male with a history of hypertension who presented to the Emergency Room (ER) of a community hospital with a 2-month history of progressively worsening exertional chest pressure. While in the ER, the patient had sudden onset of severe headache and lost consciousness. A stat CT scan of the head was performed, which revealed a subarachnoid hemorrhage with evidence of hydrocephalus. He was emergently transferred to a tertiary medical care center, where he was found to be unresponsive but with spontaneous movement of all extremities. Urgen
Percutaneous Occlusion of Complex Atrial Septal Defects
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Since the pioneering investigations by King, Rashkind and their colleagues1–6 in mid 1970s of percutaneous device occlusion of secundum atrial septal defects (ASDs), a number of other investigators have designed and tested other devices as reviewed elsewhere.7,8 The interventional cardiologist has therefore, lots of devices to choose from. But the selection of one device over the other is difficult because of lack of prospective randomized clinical trials.9,10 Such trials involving all the eligible devices is necessary to provide accurate information on usefu
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