International journal of cardiovascular interventions最新文献

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Drug-eluting stents for the treatment of in-stent restenosis--'real world' double centre experience in consecutive patients. 药物洗脱支架治疗支架内再狭窄——连续患者的“真实世界”双中心经验
International journal of cardiovascular interventions Pub Date : 2005-01-01 DOI: 10.1080/14628840500466687
Richard A Anderson, Farzin Fath-Ordoubadi, Sheraz Younas, Anthony Bainbridge, Rosie A Swallow, Keith D Dawkins, Nicholas P Curzen
{"title":"Drug-eluting stents for the treatment of in-stent restenosis--'real world' double centre experience in consecutive patients.","authors":"Richard A Anderson,&nbsp;Farzin Fath-Ordoubadi,&nbsp;Sheraz Younas,&nbsp;Anthony Bainbridge,&nbsp;Rosie A Swallow,&nbsp;Keith D Dawkins,&nbsp;Nicholas P Curzen","doi":"10.1080/14628840500466687","DOIUrl":"https://doi.org/10.1080/14628840500466687","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated clinical outcome of consecutive patients with in stent restenosis (ISR) treated with drug-eluting stents (DES) at two intervention centres from April 2002 to April 2004, reflecting 'real world' practice.</p><p><strong>Background: </strong>ISR is the major limitation to successful long-term outcome after implantation of bare metal stents during percutaneous coronary intervention (PCI). The optimal strategy for the treatment of ISR has yet to be determined.</p><p><strong>Methods: </strong>121 consecutive patients with significant ISR were treated with DES. Sirolimus DES were used in 60 patients and paclitaxel DES in the remainder. All patients were followed up to evaluate the incidence of major adverse cardiac events (MACE), angina class and clinically driven angiography. Data were collected between 7 and 27 months after the procedure (mean follow up of 16.5 months).</p><p><strong>Results: </strong>Overall MACE rate at 16.5 months was 13.2% (16 patients) including 4 deaths (3%). Fifteen (12.3%) patients underwent clinically driven angiography. Eight patients (6.6%) developed ISR within the treated segment, of whom, four underwent further PCI and 4 CABG. Mean Canadian angina class decreased from 2.46+/-0.7 pre-procedure to 0.69+/-0.6 at follow up. All patients achieved an improvement in angina, with 59% being rendered angina free and 87% free of MACE. There were no differences in clinical outcome in those who received a paclitaxel and sirolimus DES.</p><p><strong>Conclusions: </strong>The use of DES implantation for the treatment of ISR is safe, effective and associated with low recurrence rates in a 'real world' large cohort of patients with a complex mix of anatomical and clinical factors.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"7 4","pages":"188-92"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840500466687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25766686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Cerebral embolic protection devices and percutaneous carotid artery stenting. 脑栓塞保护装置和经皮颈动脉支架植入术。
International journal of cardiovascular interventions Pub Date : 2005-01-01 DOI: 10.1080/14628840500280542
Luis Gruberg, Rafael Beyar
{"title":"Cerebral embolic protection devices and percutaneous carotid artery stenting.","authors":"Luis Gruberg,&nbsp;Rafael Beyar","doi":"10.1080/14628840500280542","DOIUrl":"https://doi.org/10.1080/14628840500280542","url":null,"abstract":"Ancient Greek physicians named the principal arteries of the neck as the carotid arteries as they believed that pressing hard on these arteries made mammals and humans become sleepy or lose consciousness (Karotides Greek, the arteries of the neck vkaros heavy sleep vkaroun to choke, to stupefy). The carotid artery bifurcation is the most common location of craniocervical atheromatous disease, which may induce brain ischaemia or be a source of thromboembolic material, accounting for 20–30% of strokes. The current indication for revascularization of carotid stenosis is prevention of stroke, and therefore, it is clear that the risk of the procedure has to be smaller than the clinical benefit rendered. Thus, individualized assessment of the risk–benefit ratio is heavily affected by both the initial risk (i.e. death or stroke rate) associated with the procedure and the natural history of the atherosclerotic carotid disease treated conservatively. Several prospective, randomized trials (1–6) have supported the benefit of carotid endarterectomy (CEA) over medical therapy for the treatment of significant obstructive carotid lesions. Since its introduction half a century ago, CEA has become one of the most commonly performed peripheral vascular procedures. Importantly, the benefit of CEA has been directly related to the severity of stenosis (3,7) and the projected benefit is clinically justified only if CEA can be performed with a risk of post-procedural death or disabling stroke of less than 6% for symptomatic patients and 3% for asymptomatic patients. When an inappropriately high complication rate occurs the clinical benefit is markedly impeded, thereby questioning the performance of CEA under those circumstances (7,8). Therefore, there is a rationale for exploring alternative revascularization techniques in patients considered at high surgical risk for periprocedural events. Accordingly, the 30-day rate of death or disabling stroke rate has been proposed to be a unifying standard for the evaluation of the postprocedural risk (9), that can be used to compare horizontally different revascularization methods. The 30-day rate of death or disabling stroke was 5.8% in the North American Symptomatic Carotid Endarterectomy Trial (NASCET) (2) and 7.1% rate in the European Carotid Surgery Trial (ECST) trial (6). In this context, carotid artery stenting (CAS) as a new method that achieves percutaneous carotid artery revascularization should first be evaluated with respect to its 30-day safety results. Elective CAS was initiated in the mid 1990s, using an endovascular approach avoiding all surgical wound-related complications of CEA, and the need for general anaesthesia. Therefore, CAS has the potential for becoming the preferred revascularization method, especially in patients who would be considered at significantly high risk for CEA. However, while the prospective, multicentre Carotid and Vertebral Transluminal Angioplasty Study (CAVATAS) conducted between the ","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"7 3","pages":"117-21"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840500280542","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25651709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 14
Seeing transient regional myocardial ischaemia through new eyes. 用新眼睛观察短暂性局部心肌缺血。
International journal of cardiovascular interventions Pub Date : 2005-01-01 DOI: 10.1080/14628840510039522
Robert Hatrick, Stewart Teece, Nicholas Curzen
{"title":"Seeing transient regional myocardial ischaemia through new eyes.","authors":"Robert Hatrick,&nbsp;Stewart Teece,&nbsp;Nicholas Curzen","doi":"10.1080/14628840510039522","DOIUrl":"https://doi.org/10.1080/14628840510039522","url":null,"abstract":"Exercise tolerance testing (ETT) is the commonest non-invasive method for investigating stable patients presenting with cardiac-sounding chest pain. The sensitivity and specificity of the ETT for the detection of myocardial ischaemia are approximately 70% in men (1). However, this test is less sensitive for large patient sub-groups including women and patients with abnormal resting ECG’s (2,3). Myocardial Perfusion Scintigraphy has a higher sensitivity and specificity than ETT (4) and its use is less dependent on the functional capacity of the patient. Nevertheless, it remains a relatively expensive test with limited availability. PRIME ECG (manufactured by Meridian Medical Technologies, Belfast, Northern Ireland) is a Body Surface Mapping (BSM) system that utilizes an 80electrode ECG ‘vest’ to detect electro cardiac activity over a much wider distribution of the thorax than the conventional 12-lead ECG electrodes. Electrocardiac data is recorded for all 80 electrodes. A beat marker is manually positioned at the end of the QRS complex. Isopotential map recordings are then taken at 60 ms after the beat marker (ST60) for all leads. The ST 60 data acquired at baseline can be subtracted, for each electrode, from the data derived from subsequent acquisitions taken during exercise or pharmacological stress. The PRIME software allocates a colour scale proportional to the degree of ST segment shift and displays this on a diagramatic torso corresponding to the position of the leads detecting the ST shift (ST elevation—red scale, ST depression—blue scale). Only the ST60 change from baseline for a given electrode is therefore displayed as a colour. This is the visually intuitive ‘Delta Map’. This novel technique has been used to demonstrate transient regional myocardial ischaemia following balloon inflation during percutaneous coronary angioplasty in patients with single vessel coronary artery disease (5). We report, for the first time, a case in which transient regional ischaemia induced during stress nuclear perfusion imaging is also accurately displayed using the PRIME Delta Map, and correlates with a significant stenosis in the epicardial coronary artery perfusing this territory.","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"7 3","pages":"155-8"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840510039522","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25651661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Multimodality imaging of borderline left main coronary disease using fluoroscopy, IVUS and CT coronary angiography. 冠状动脉左主干病变的多模态成像应用透视、IVUS和CT。
International journal of cardiovascular interventions Pub Date : 2005-01-01 DOI: 10.1080/14628840510011306
Arthur Kerner, Eduard Ghersin, Ariel Roguin
{"title":"Multimodality imaging of borderline left main coronary disease using fluoroscopy, IVUS and CT coronary angiography.","authors":"Arthur Kerner,&nbsp;Eduard Ghersin,&nbsp;Ariel Roguin","doi":"10.1080/14628840510011306","DOIUrl":"https://doi.org/10.1080/14628840510011306","url":null,"abstract":"<p><p>A borderline left main narrowing was discovered during coronary angiography in a young asymptomatic man with positive stress test. IVUS demonstrated minimal diameter of 2.9 mm and the cross-sectional area was 11.5 mm(2). CTs were performed, and an eccentric calcific plaque was imaged at the ostium of the left main. Based on all three image modalities after discussing the different therapeutic options with the patient he was referred for bypass surgery.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"7 2","pages":"108-9"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840510011306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25242182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The ACIST power injection system reduces the amount of contrast media delivered to the patient, as well as fluoroscopy time, during diagnostic and interventional cardiac procedures. ACIST动力注射系统减少了在诊断和心脏介入过程中向患者输送造影剂的量,以及透视时间。
International journal of cardiovascular interventions Pub Date : 2005-01-01 DOI: 10.1080/14628840500390812
David Brosh, Abid Assali, Hana Vaknin-Assa, Shmuel Fuchs, Igal Teplitsky, Nurit Shor, Ran Kornowski
{"title":"The ACIST power injection system reduces the amount of contrast media delivered to the patient, as well as fluoroscopy time, during diagnostic and interventional cardiac procedures.","authors":"David Brosh,&nbsp;Abid Assali,&nbsp;Hana Vaknin-Assa,&nbsp;Shmuel Fuchs,&nbsp;Igal Teplitsky,&nbsp;Nurit Shor,&nbsp;Ran Kornowski","doi":"10.1080/14628840500390812","DOIUrl":"https://doi.org/10.1080/14628840500390812","url":null,"abstract":"<p><p>The ACIST injection system is an automatic power injection device that allows for online control of injection rate and volume of contrast. Limited data is available whether this technology allows reducing use of contrast and fluoroscopy time. Accordingly, we compared the use of this system to manual injection among 450 consecutive patients who underwent diagnostic coronary angiography and/or angioplasty who were randomly assigned to either manual contrast injection (control; n=198) or to the ACIST system (study group; n=252). The amount of contrast, fluoroscopy and total procedural times were recorded for each patient. In the diagnostic group, the mean total amount of contrast (including wasted) was reduced by 63% when the ACIST was used compared to control (100+/-42 ml versus 163+/-56 ml; P<0.001, respectively). When only the net amount of contrast delivered to the patient was considered, the differences were smaller (20%, P=0.004). During angioplasty, the amount of contrast was also lower in the ACIST group (206+/-65 versus 230+/-69, P=0.008), whereas no difference were noted in net amount of contrast. Fluoroscopy time was significantly shorter in the ACIST group compared to control both during diagnostic catheterization (4.7+/-3.5 min versus 6.3+/-5.5 min, respectively; P=0.014), and angioplasty (16.7+/-9.1 min versus 19.6+/-12.4 min, respectively; P=0.05). Routine utilization of the ACIST system during diagnostic and interventional procedure significantly reduced the total amount of contrast media used and fluoroscopy time.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"7 4","pages":"183-7"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840500390812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25766043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 26
Abstracts of the 9th International Live Demonstration Course, Angioplasty Summit 2004. Seoul, Korea, April 29 - May 1, 2004. 2004年第九届国际血管成形术峰会现场演示课程摘要。2004年4月29日至5月1日,韩国首尔。
International journal of cardiovascular interventions Pub Date : 2004-03-01 DOI: 10.1080/17435750410031441
{"title":"Abstracts of the 9th International Live Demonstration Course, Angioplasty Summit 2004. Seoul, Korea, April 29 - May 1, 2004.","authors":"","doi":"10.1080/17435750410031441","DOIUrl":"https://doi.org/10.1080/17435750410031441","url":null,"abstract":"","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 Suppl 1 ","pages":"1-44"},"PeriodicalIF":0.0,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17435750410031441","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24570793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"Burning tongue" sensation during routine coronary angiography--a phenomenon related to a rare coronary anomaly. 常规冠状动脉造影时的“舌痛”感——一种罕见冠状动脉异常的现象。
International journal of cardiovascular interventions Pub Date : 2004-01-01 DOI: 10.1080/14628840410030379
S Pinzur, M Brezins, N Roguin
{"title":"\"Burning tongue\" sensation during routine coronary angiography--a phenomenon related to a rare coronary anomaly.","authors":"S Pinzur,&nbsp;M Brezins,&nbsp;N Roguin","doi":"10.1080/14628840410030379","DOIUrl":"https://doi.org/10.1080/14628840410030379","url":null,"abstract":"<p><p>We present the case of rare coronary circulation anomaly discovered during the routine coronary angiography that was associated with unusual \"burning\" sensation reported by the patient.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"151-2"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25289453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of operator volume on overall major adverse cardiac events following direct coronary stent implantation versus stenting after predilatation. 手术容积对直接冠状动脉支架置入术与预扩张后支架置入术总体主要心脏不良事件的影响。
International journal of cardiovascular interventions Pub Date : 2004-01-01 DOI: 10.1080/14628840310022135
Sander IJsselmuiden, Ferdinand Kiemeneij, Geertjan Tangelder, Ton Slagboom, Ron van der Wieken, Patrick Serruys, Gertjan Laarman
{"title":"Impact of operator volume on overall major adverse cardiac events following direct coronary stent implantation versus stenting after predilatation.","authors":"Sander IJsselmuiden,&nbsp;Ferdinand Kiemeneij,&nbsp;Geertjan Tangelder,&nbsp;Ton Slagboom,&nbsp;Ron van der Wieken,&nbsp;Patrick Serruys,&nbsp;Gertjan Laarman","doi":"10.1080/14628840310022135","DOIUrl":"https://doi.org/10.1080/14628840310022135","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the impact of operator experience on procedural, clinical and angiographic outcome after (direct) coronary stent implantation.</p><p><strong>Background: </strong>Although for other forms of percutaneous coronary interventions an inverse relationship between operator volume and patient outcomes has been shown, the impact of operator volume on outcome after direct stenting has never been investigated.</p><p><strong>Methods: </strong>A retrospective analysis was performed on data from a prospective randomized trial comparing direct stenting with that after predilatation. The trial consisted of 400 patients with stable and unstable angina pectoris and/or myocardial ischemia due to a coronary stenosis of a single native vessel eligible in 1999-2001 for direct stenting. For a single-center high-volume clinic (>1500 cases/year), the authors compared the most experienced operators (case load: >4000) with well trained practitioners (case load: 175). One hundred and fifteen patients were identified who were treated by high-volume and 180 who were treated by medium-volume operators.</p><p><strong>Results: </strong>Baseline patient characteristics were evenly distributed among groups. High-volume, compared with medium-volume operators, were faster (30.8 versus 42.2 minutes, p < 0.001), needed less frequent postdilatation (15% versus 24%, p = 0.06) and had lower fluoroscopy times (7.5 versus 11.2 minutes, p < 0.001), lower contrast usage (180 versus 228 ml, p < 0.001), lower procedural costs (euro1982 versus euro2164, p = 0.05) and reduced rates of major adverse cardiac and cerebral event (MACCE) at six months (12.2 versus 21.1%, p = 0.03). The medium-volume operator group experienced higher angiographic binary restenosis rates after direct stenting compared with stenting after predilatation (31.5 versus 14.9%, p = 0.005).</p><p><strong>Conclusions: </strong>Stenting performed by high-volume operators resulted in a 50% reduction in MACCE as compared with medium-volume physicians, which also had twice as much restenosis when using direct stenting. Hence, the more demanding technique of direct stenting should not be performed by unsupervised operators who have not yet completed their training. Furthermore, prolonged training periods and even more intensive supervision by experienced operators seems mandatory.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840310022135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24572020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Chronic total occlusion due to diffuse in-stent restenosis: is brachytherapy the solution? 弥漫性支架内再狭窄引起的慢性全闭塞:近距离治疗是解决方案吗?
International journal of cardiovascular interventions Pub Date : 2004-01-01 DOI: 10.1080/14628840310004892
E Nikolsky, L Gruberg, E Rosenblatt, E Grenadier, M Boulos, Z Bernstein, A Huber, R Gitman, R Bar-Deroma, W Markiewicz, R Beyar
{"title":"Chronic total occlusion due to diffuse in-stent restenosis: is brachytherapy the solution?","authors":"E Nikolsky,&nbsp;L Gruberg,&nbsp;E Rosenblatt,&nbsp;E Grenadier,&nbsp;M Boulos,&nbsp;Z Bernstein,&nbsp;A Huber,&nbsp;R Gitman,&nbsp;R Bar-Deroma,&nbsp;W Markiewicz,&nbsp;R Beyar","doi":"10.1080/14628840310004892","DOIUrl":"https://doi.org/10.1080/14628840310004892","url":null,"abstract":"<p><p>Percutaneous coronary intervention of chronic total occlusions (CTO) is associated with a significantly higher incidence of reocclusion and restenosis compared with non-total occlusions. Randomized and observational trials have demonstrated the effectiveness of intracoronary brachytherapy (ICBT) for the prevention of recurrent in-stent restenosis. However, limited data are available on the effectiveness of ICBT in patients with totally occluded in-stent restenosis. The authors assessed the long-term outcome of patients treated with intracoronary gamma radiation for totally occluded in-stent restenotic lesions. Percutaneous coronary intervention and subsequent catheter-based irradiation with iridium-192 was performed in 100 patients (103 vessels) with diffuse in-stent restenosis. At baseline, CTO of the target vessel at the site of the stent was present in 15 vessels (14.5%). Follow-up data were collected during follow-up visits and from telephone interviews. Repeat coronary angiography was performed in symptomatic patients with clinical restenosis. Clinical and angiographic characteristics were similar between the two groups, although there was a trend towards more unstable angina at the index procedure in CTO patients (66.7% versus 41.4%; p = 0.12) compared with patients without non-total occlusions. A higher percentage of patients (53.3%) with CTO required longer radiation sources (14 seeds, covering a length of 55 mm), compared with 23.9% of patients with non-total occlusion (p = 0.04). With a mean follow-up period of 47.5 +/- 24.0 months, major adverse cardiac events (MACE) were observed in 10 of 15 patients (66.7%) with CTO compared with 25 out of 88 patients (28.4%) without CTO (p = 0.009). According to multivariate analysis, total occlusion of the target vessel at baseline was the single independent predictor of MACE at one-year follow-up (relative risk 16.2, 95% confidence interval 4.2-62.9; p < 0.0001). This study shows that the use of gamma radiation for the prevention of recurrence of in-stent restenosis in patients with CTO does not seem to be as effective as in patients with non-total occlusions. Furthermore, CTO was an independent predictor of worse outcome at long-term follow-up in this study.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 1","pages":"33-8"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840310004892","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24572024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Predictors of improvement in left ventricular function after initially successful angioplasty of unprotected left main coronary artery stenoses. 无保护的左主干冠状动脉狭窄初始成功血管成形术后左心室功能改善的预测因素。
International journal of cardiovascular interventions Pub Date : 2004-01-01 DOI: 10.1080/14628840410030423
Fang-Bin Hu, Hideo Tamai, Kunihiko Kosuga, Eisho Kyo, Tatsuhiko Hata, Masaharu Okada, Takuji Nakamura, Shinya Fujita, Takafumi Tsuji, Shinsaku Takeda, Seiichio Motohara, Hiromu Uehata
{"title":"Predictors of improvement in left ventricular function after initially successful angioplasty of unprotected left main coronary artery stenoses.","authors":"Fang-Bin Hu,&nbsp;Hideo Tamai,&nbsp;Kunihiko Kosuga,&nbsp;Eisho Kyo,&nbsp;Tatsuhiko Hata,&nbsp;Masaharu Okada,&nbsp;Takuji Nakamura,&nbsp;Shinya Fujita,&nbsp;Takafumi Tsuji,&nbsp;Shinsaku Takeda,&nbsp;Seiichio Motohara,&nbsp;Hiromu Uehata","doi":"10.1080/14628840410030423","DOIUrl":"https://doi.org/10.1080/14628840410030423","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) has been increasingly applied to unprotected left main coronary artery (LMCA) lesions, with varied procedural success and clinical outcomes. However, the effect of PCI on left ventricular performance is still unclear, and there are no clinical studies assessing factors that influence left ventricular ejection fraction (LVEF) in these cases.</p><p><strong>Methods: </strong>Between April 1986 and August 2002, de novo PCI was performed for unprotected LMCA stenoses in 199 patients. Close clinical and angiographic follow-up were conducted after the procedure.</p><p><strong>Results: </strong>One hundred eighty patients survived over six months and analysis of paired left ventriculography was possible in 175 patients. Improvement in LVEF was observed in the entire population (52.9 +/- 15.7% to 56.1 +/- 14.3%, p = 0.048). The LVEF change was 6.7 +/- 9.5% (p < 0.01) in group with baseline LVEF < or = 50% and 0.7 +/- 6.7 % (p = NS) in group with LVEF > 50%. There was significant intergroup difference (p < 0.001). Patients with baseline diameter stenosis > or = 60% had an improvement of 5.3 +/- 8.3% (p < 0.05) whereas those with stenosis < 60% had no improvement (2.0 +/- 8.4%, p = NS). CK-MB elevation > or = 3 times normal after PCI had a significant inverse association with improvement in LVEF (p < 0.05). Multivariate analysis revealed baseline LVEF < or = 50% was the only independent predictor of improvement in LVEF (standard estimate = 3.509, 95% CI: 2.164-4.854, p < 0.001).</p><p><strong>Conclusions: </strong>Successful PCI procedure is associated with significant improvement in LVEF, especially in patients with depressed left ventricular function.</p>","PeriodicalId":83747,"journal":{"name":"International journal of cardiovascular interventions","volume":"6 3-4","pages":"119-27"},"PeriodicalIF":0.0,"publicationDate":"2004-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14628840410030423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24997031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
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