Volume 14 - Issue 3 - March, 2002
Transradial Renal Artery Angioplasty and Stenting
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Percutaneous transluminal angioplasty and stent implantation to treat renal artery stenosis have been proven to be beneficial in atherosclerotic lesions.1,2 The indications for the treatment of renal artery stenosis (RAS) are renovascular hypertension, azotemia secondary to ischemic nephropathy, or renal parenchyma preservation.3–5 The most frequent access site for endovascular treatment of RAS is the common femoral artery. Anatomically, the renal artery courses from the aorta in a caudal direction in most patients. This angle may make access via the femoral approach technically demanding an
Interview with Frank J. Criado, MD
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LG: What are you doing now? What are your primary areas of interest?
FC: As you know, I am a vascular surgeon by training and background. However, along with a few of my peers, I began to develop an interest in performing percutaneous non-surgical procedures in the mid-1980s. In a short time, this “interest” became my raison d’etre as I totally embraced intervention in all its expressions. So, what and where I am now reflects such evolution that occurred in my life and practice over the past 15 years. My own personal practice today consists of 75–80% percutaneous diagnostic and
Editor’s Message - March 2002
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Dear Readers,
This issue of the Journal of Invasive Cardiology includes original research articles, commentaries, case reports, an article from the Journal special section “Acute Coronary Syndromes,” a special CME offering and an interview with Dr. Frank Criado.
The research articles in this issue cover a broad range of topics that touch on important aspects of patient care. In the first research article, Drs. Paul Teirstein and John Reilly of the Scripps Clinic in La Jolla, California discuss the problem of late stent thrombosis following brachytherapy. They indicate that patients
New Techniques for the Evaluation of the Vulnerable Plaque
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Evidence accumulated along converging lines of investigation indicates that acute coronary syndromes are due to the activation of a vulnerable plaque. The tools available for interventionalists to identify such vulnerable plaques are currently limited to angiography and intravascular ultrasound (IVUS) imaging. However, within the next decade, catheter-based research techniques will emerge into the clinical setting to address and treat the vulnerable plaque. This review will discuss various current and future anatomic and physiologic methods to characterize the vulnerable plaque.
Anatomy
Transcatheter Endovascular Therapy of a Traumatic Common Hepatic Artery Aneurysm
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We present a case in which a computerized tomographic scan was initially misleading, resulting in confusion over the diagnosis and treatment of a progressively increasing pulsatile abdominal mass. Angiography further clarified the situation, and led to the diagnosis of a large aneurysm arising from the common hepatic artery.
Case Report. A 62-year-old farmer presented with a palpable, pulsatile mass in the right hypochondrium and epigastrium progressively gaining in size for last 3 months. Six months prior, he had received a blunt injury to his abdomen when he was dashed by a cow in his
The Relationship Between Corrected TIMI Frame Count and Myocardial Fractional Flow Reserve
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Thrombolysis in myocardial infarction (TIMI) frame count (TFC) is a reproducible, objective and quantitative index of coronary flow that allows standardization of TIMI flow grades.1 The quality of coronary flow restored by percutaneous coronary interventions (PCI) mainly depends on the success of the mechanical intervention. TIMI grade flow achieved in infarct-related arteries (IRA) after PCI is directly related to the degree of improvement in minimal luminal diameter and residual stenosis. After myocardial infarction (MI), coronary blood flow decreases in the infarct region due to residual
Coronary Collaterals and Their Assessment
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Evidence suggests that collateralization may be impaired in diabetics.1,2 This issue of the Journal provides interesting new support for these data.3 The factors responsible for deficient collateral development in diabetes are incompletely understood. Generalized endothelial dysfunction, reduced nitric oxide production and impaired arteriogenesis due to high tissue levels of glucose may be factors. Collateralization may be impaired in other settings as well.
See Nisanci et al. on pages 118–122
Early studies of coronary collaterals were primarily based on angiographic assessment
Relationship Between Pressure-Derived Collateral Blood Flow and Diabetes Mellitus in Patients with Stable Angina Pectoris: A Stu
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Collaterals are vessels structured as a connecting network between different coronary arteries. They are probably remnants of the embryonic arterial network and may develop under influence of various stimuli. The pressure gradient between the normal and stenotic vascular regions appears to be the most important factor for collateral development.1 However, there are considerable variations between patients with ischemic heart disease with respect to collateral development. The factors responsible for these variations are not clearly known.2 Predominant localization of the collaterals in the hum
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