Volume 14 - Issue 5 - May, 2002
Aortic Dissection Complicating Failed Coronary Stenting
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Coronary dissection is a well-known complication of coronary interventions; however, proximal progression of the dissection into the aortic root happens rarely.1 The outcome and therapeutic strategy for this iatrogenic complication need to be established.
Case Report. A 75-year-old man with exertional angina was admitted to our hospital for coronary angioplasty. Angiography showed a long stenotic lesion of the mid-right coronary artery and a more proximal mildly stenotic curvature with calcification (Figure 1A). The former required treatment by coronary intervention. There were no ot
Standardized, Angiographically-Guided “Over-Dilatation” of Stents Using High-Pressure Technique Optimizes Results Without Incre
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The introduction of stents in clinical practice resulted in a reduction of the restenosis rate from 30–40% to 16–27% and a target lesion revascularization (TLR) rate of 6–15% after 6 months, although angio-guided stent implantation often resulted in suboptimal stent expansion and significant residual in-stent stenosis.1–6 Intravascular ultrasound (IVUS) has shown that an intrastent minimal lumen area (MLA) of >= 90% of the reference segments, together with complete apposition and symmetric expansion of the stent, or a minimal in-stent area >= 9 mm2 (Table 1) are associated with a low r
Endovascular Treatment of Carotid Artery Aneurysms with Stent Grafts
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Aneurysms of the carotid arteries is a rare but well described entity. Cervical carotid artery aneurysms can cause cerebral embolism and transient ischemic attacks.1 Surgery, however, is often difficult because of the location and the damaged arterial wall and may result in sacrifice of the internal carotid artery. We present two cases of carotid aneurysms successfully treated with stent grafts.
Case Report #1: A right-handed, 65-year-old male presented with right carotid territory transient ischemic attacks in the form of recurrent amaurosis fugax and left arm weakness. Duplex ultrasound r
A Simple Step Towards Better Stent Deployment
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The idea of achieving an optimal stent deployment is a simple one: a stent deployed in a lesion has to reach its nominal size which should be close to the measured vessel size, taking into account that the plaque is still there and that the adventitia can be dilated at a certain extent. However, in the current clinical practice there are several drawbacks leading to a high incidence of “suboptimal” stent expansion.
First, the final dimensions of a successfully deployed stent evaluated by angiography are very often below its “nominal” dimension. Several studies using an intravascular
LETTER TO THE EDITOR: Letting the Air out of the Follow-up Balloon
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To the Editor:
We’ve read the editorial comment1 made by Dr. Turi on our study “Percutaneous Mitral Valvotomy: Six Year Follow-up”.2 Although we thank Dr. Turi for his insights, we disagree profoundly with the core of his criticism concerning lack of follow-up for 46 patients. We clearly stated that this was an analysis of patients with more than 6 months of follow-up. The rest of the population that he claims we didn’t follow is explained because we didn’t have the data regarding restenosis at 6 months, simply by the fact that they haven’t yet reached that time point. Neverthel
May Letter to Readers
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Dear Readers,
This issue of the Journal of Invasive Cardiology includes original research articles, a special teaching collection on catheter treatments for aneurysms, articles from four of the Journal special sections, and a case report.
In the first research article, Dr. Benny Johansson and colleagues from the Divisions of Cardiology and Radiology at Orebro Medical Centre and Division of Cardiology at Sahlgrenska University Hospital in Goteborg, Sweden present their study demonstrating the use of standardized angiographically guided “over-dilatation” of stents with a high pressur
Optimized Combination of Antiplatelet Treatment and Anticoagulation for Percutaneous Coronary Intervention: The Final Word is
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The term acute coronary syndromes (ACS) comprise a continuum of diseases of various risks and severities including unstable angina pectoris, non-Q and Q-wave myocardial infarction (MI) and sudden death.1 These conditions share a similar pathologic pattern of intracoronary plaque rupture leading to formation of a platelet thrombus with either partial or complete coronary occlusion. Unstable angina and non-Q wave myocardial infarction are due to platelet thrombi that are often less stable and cause a smaller amount of ischemia than the occlusive thrombi that cause Q-wave myocardial infarction. T
Early and Late Clinical and Angiographic Outcomes Following Terumo Coronary Stent Implantation
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Coronary stenting has evolved into the principal non-balloon device in percutaneous coronary intervention (PCI) procedures.(1) Continual improvement in stent designs promises greater deliverability and durability. Indeed, widespread application of this technology in an unselected population has improved patients outcomes.(2) Importantly, different stent characteristics and compositions may impact the interaction with the vessel wall, and the incidence of subsequent angiographic restenosis and clinical events.(3)
The Terumo stent (Terumo® Corporation, Osaka, Japan) is a new, balloon-expanda
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