==================================HSR37==================================
37. Percutaneous transluminal coronary angioplasty when multi-vessel disease
is involved.
1
UI - 87118684
AU - Shaw RE ; Cohen F ; Fishman-Rosen J ; Murphy MC ; Stertzer SH ; Clark DA
; Myler RK
TI - Psychologic predictors of psychosocial and medical outcomes in patients
undergoing coronary angioplasty.
AB - The relationship between psychologic variables (the match between
repressive style and level of cardiac information, and anxiety level) and
medical complications, re-stenosis (renarrowing), and psychosocial
adjustment was studied in 97 patients undergoing percutaneous
transluminal coronary angioplasty (PTCA) for treatment of narrowed
coronary arteries. Three major findings emerged for outcomes measured 6
months after PTCA: repressors with a high level of cardiac information
(coping style-information level mismatch) and no history of heart attack
were at higher risk for late medical complications (p less than 0.001);
sensitizers with a low level of cardiac information (coping
style-information level mismatch) and whose PTCA was only moderately
successful were at higher risk for re-stenosis of the artery previously
widened during PTCA (p less than 0.01); and patients who were more
anxious during hospitalization had poorer social functioning and more
mood disturbance 6 months after PTCA (p less than 0.05). Thus,
psychologic, information, and medical factors are important in predicting
6-month outcomes in patients undergoing PTCA.
MH - *Adaptation, Psychological ; Adult ; Aged ; Angioplasty, Transluminal/
ADVERSE EFFECTS/*PSYCHOLOGY ; Coronary Arteriosclerosis/PSYCHOLOGY/
*THERAPY ; Follow-Up Studies ; Human ; Middle Age ; Prognosis ;
Recurrence ; Repression ; Risk ; Support, Non-U.S. Gov't
SO - Psychosom Med 1986 Nov-Dec;48(8):582-97
2
UI - 87111647
AU - Br:uckmann H ; Ringelstein EB ; Buchner H ; Zeumer H
TI - Percutaneous transluminal angioplasty of the vertebral artery. A
therapeutic alternative to operative reconstruction of proximal vertebral
artery stenoses.
AB - Percutaneous transluminal angioplasty (PTA) of the proximal vertebral
artery was performed in 13 patients with stenosis of the proximal
vertebral arteries. All of these patients had symptoms indicating
vertebrobasilar insufficiency. PTA was performed only if an extreme
reduction of the total diameter of both vertebral arteries was present.
Only 13 patients have fulfilled the strict selection criteria in the last
3 years. All patients were monitored during the procedure by means of
continuous-wave Doppler ultrasound and electrophysiological techniques.
After PTA their neurological and vascular conditions were serially
examined. Of the 13 patients, 8 showed marked improvement of both
subjective and objective clinical symptoms. During an observation period
of 2-25 months (average: 15 months) reocclusion of the angioplasty was
observed in only 2 cases, without any additional neurological sequelae.
Electrophysiological and Doppler sonographic monitoring during PTA helped
to minimize the risk of angioplasty.
MH - *Angioplasty, Transluminal ; Cerebral Angiography ; Cerebrovascular
Disorders/RADIOGRAPHY/*THERAPY ; Constriction, Pathologic/RADIOGRAPHY/
THERAPY ; Follow-Up Studies ; Human ; *Vertebral Artery
SO - J Neurol 1986 Nov;233(6):336-9
3
UI - 87102739
AU - Geschwind HJ ; Teisseire B ; Boussignac G ; Vieilledent C
TI - Laser angioplasty of arterial stenoses.
AB - To establish the optimal conditions for recanalization of obstructed
arteries without damage to vessel walls, an Nd-YAG laser coupled to a
0.2-mm-diameter optical fiber was used on obstructed human cadaver
coronary and peripheral arteries and on popliteal arteries in amputated
limbs. Vaporization of atheromatous plaques was consistently obtained
with energy of 360-600 J and a diluted blood perfusate (3 g/100 ml
hemoglobin) at a rate of 30 ml/min. The arterial wall was protected from
thermal injury by inserting the optical fiber into an inflated balloon
catheter and by cooling the system with the perfusate. Since
recanalization of occluded arteries was consistently obtained without
damage to the arterial wall or debris and thin and flexible optical
fibers were easy to guide in the arteries, percutaneous transluminal
Nd-YAG laser angioplasty was used in obstructed femoral and popliteal
arteries in 12 patients. The first trials in man with Nd-YAG laser showed
the method to be feasible, effective, and at low risk, although further
studies are required to improve penetration of the obstruction and
increase the diameter tunnel.
MH - *Angioplasty, Transluminal ; Arterial Occlusive Diseases/SURGERY/*THERAPY
; Constriction, Pathologic/SURGERY/THERAPY ; Fiber Optics ; Human ;
*Laser Surgery
SO - Cardiovasc Intervent Radiol 1986;9(5-6):313-7
4
UI - 87101807
AU - Korogi Y ; Takahashi M
TI - Percutaneous transluminal angioplasty of totally occluded iliac arteries
in high-risk patients.
AB - Percutaneous transluminal angioplasty was performed successfully in five
of six patients with complete iliac artery occlusion. All of the patients
were at high risk because of various co-existing diseases. The length of
occlusion ranged from 3.0 cm to 12.0 cm. No significant complications
requiring surgery occurred during or after the procedures. Follow-up of
patients revealed that the vessels were still patent after 3-22 months.
Percutaneous transluminal angioplasty of totally occluded iliac arteries
may represent the therapy of first choice even in the high-risk group.
MH - Aged ; Aged, 80 and over ; *Angioplasty, Transluminal ; Arterial
Occlusive Diseases/*THERAPY ; Case Report ; Female ; Human ; *Iliac
Artery ; Male ; Middle Age ; Risk
SO - Br J Radiol 1986 Dec;59(708):1167-70
5
UI - 87003324
AU - Cumberland DC ; Tayler DI ; Procter AE
TI - Laser-assisted percutaneous angioplasty: initial clinical experience in
peripheral arteries.
AB - Experimental and animal studies have shown that laser energy can vaporize
intra-vascular thrombus and atheroma, suggesting that it may have a role
in percutaneous angioplasty. Argon laser energy transmitted via a
flexible fibre introduced through a percutaneous catheter was used in 15
patients undergoing balloon angioplasty of femoral or popliteal arteries.
Of four stenoses, laser alone produced improvement of the lumen in two.
Of 11 occlusions some degree of clearance of the lumen was achieved by
laser in eight prior to balloon dilatation. Extravasation of contrast
medium indicating wall perforation occurred in two patients, without
clinical sequelae. No other complications, such as embolism, arterial
spasm or toxic effects were observed. There was one acute re-occlusion,
almost certainly not related to the use of laser. There have been no late
complications. The ability of laser to influence favourably vascular
occlusion is confirmed, but technical advances are necessary to avoid
vessel wall perforation consistently and to improve the production of an
adequate lumen before its potential can be fully realized.
MH - *Angioplasty, Transluminal/ADVERSE EFFECTS ; Arterial Occlusive Diseases/
RADIOGRAPHY/*THERAPY ; Femoral Artery/RADIOGRAPHY ; Human ; Lasers/
ADVERSE EFFECTS/*THERAPEUTIC USE ; Popliteal Artery/RADIOGRAPHY
SO - Clin Radiol 1986 Sep;37(5):423-8
6
UI - 87003115
AU - Mallmann R ; Roth FJ
TI - Treatment of neurofibromatosis associated renal artery stenosis with
hypertension by percutaneous transluminal angioplasty.
AB - A 12 year old girl with severe arterial hypertension was found to have
neurofibromatosis associated bilateral stenoses of the main renal
arteries and elevated plasma renin activity in the right main renal vein.
Antihypertensive treatment was unable to normalize blood pressure. PTA of
the right renal artery from a left axillary approach resulted in
normalization of blood pressure and peripheral plasma renin activity. PTA
seems to be an effective and safe method for treatment even of
complicated forms of renal artery stenosis.
MH - *Angioplasty, Transluminal ; Blood Pressure ; Case Report ; Child ;
Female ; Human ; Hypertension, Renovascular/COMPLICATIONS/PHYSIOPATHOLOGY/
*THERAPY ; Neurofibromatosis/*COMPLICATIONS ; Renal Artery Obstruction/
COMPLICATIONS/PHYSIOPATHOLOGY/*THERAPY ; Renin/BLOOD
SO - Clin Exp Hypertens [A] 1986;8(4-5):893-9
7
UI - 86311535
AU - Mahler F ; Triller J ; Weidmann P ; Nachbur B
TI - Complications in percutaneous transluminal dilatation of renal arteries.
AB - We propose a classification of the complications in renal artery
percutaneous transluminal angioplasty (PTA) according to their severity
and their direct or indirect relationship to PTA. Minor complications are
reversible within the normal recovery period after PTA, while major
complications are irreversible or reversible but necessitate extended
hospitalization or surgery. The following complications are reported in
the literature as being directly related to PTA: hemorrhage at the
puncture site, hemorrhage from renal or access artery perforation or
rupture, occlusive or nonocclusive dissection of the renal or access
arteries, renal artery thrombosis, renal artery spasm or embolism leading
to segmental renal infarction, peripheral artery embolisation, and
balloon rupture complications. The indirectly related complications
include transient or irreversible renal insufficiency, contrast media
hypersensitivity, pressure-drop-related cerebral or myocardial ischemia,
and anticoagulation-related hemorrhage infections. In our own series of
105 PTA in 80 patients, complications occurred in 11% of which 4% were
major, 1% indirectly related to PTA leading to death. In the reports
available, the rate of major complication ranges between 3 and 10%, and
the death rate around 1%.
MH - Adult ; Angioplasty, Transluminal/*ADVERSE EFFECTS/MORTALITY ; Female ;
Hemorrhage/ETIOLOGY ; Human ; Middle Age ; Renal Artery/INJURIES/
RADIOGRAPHY ; Renal Artery Obstruction/*THERAPY ; Rupture/ETIOLOGY
SO - Nephron 1986;44 Suppl 1:60-3
8
UI - 86308282
AU - Braun IF ; Battey PM ; Fulenwider JT ; Per-Lee JH
TI - Transcatheter carotid occlusion: an alternative to the surgical treatment
of cervical carotid aneurysms.
AB - The treatment of choice for various aneurysms of the common and internal
carotid arteries may involve carotid artery occlusion rather than a
reconstructive approach. Carotid occlusion may be accomplished either
surgically or via an endovascular method. We present two cases of
patients with cervical carotid artery aneurysms in which the endovascular
method was used for carotid occlusion, describe our rationale for using
this approach rather than surgical intervention, and discuss the role of
this method of treatment for this condition.
MH - Adolescence ; Aged ; Aneurysm/PATHOLOGY/RADIOGRAPHY/*THERAPY ;
*Angioplasty, Transluminal/INSTRUMENTATION ; Carotid Artery Diseases/
PATHOLOGY/RADIOGRAPHY/*THERAPY ; Carotid Artery, External/RADIOGRAPHY ;
Carotid Artery, Internal/RADIOGRAPHY ; Case Report ; Female ; Human ;
Male
SO - J Vasc Surg 1986 Sep;4(3):299-302
9
UI - 86306190
AU - Janevski BK ; Breslau PJ ; Jorning PJ
TI - More accurate assessment of stenotic lesions in percutaneous transluminal
angioplasty.
AB - Eighty patients underwent percutaneous transluminal dilatation and
recanalisation of atheromatous lesions of the arteries of the lower
extremities in the University Hospital of Maastricht in the period of
1980 to 1984. Out of 80 attempted procedures of the iliac and
femoro-popliteal tract 71 (89%) were technically possible and were
considered initially successful. In all cases of iliac artery lesions a
retrograde arteriogram was performed prior to PTA. Intra-arterial
pressure measurements at rest and after hyperemia were used for exact
assessment of the hemodynamic significance of the stenosis before and
after PTA. A follow-up of all patients successfully treated by
angioplasty was performed. The early hemodynamic success rate of PTA for
iliac lesions was 90 per cent and for femoral-popliteal segment 83 per
cent. There was no morbidity or mortality. The cumulative 3-year patency
rate for both segments was 74 per cent.
MH - Adult ; Aged ; *Angioplasty, Transluminal ; Arterial Occlusive Diseases/
PHYSIOPATHOLOGY/RADIOGRAPHY/*THERAPY ; Blood Pressure ; Female ; *Femoral
Artery ; Hemodynamics ; Human ; *Iliac Artery/PHYSIOLOGY/PHYSIOPATHOLOGY/
RADIOGRAPHY ; Male ; Middle Age ; *Popliteal Artery
SO - Int Angiol 1986 Apr-Jun;5(2):97-103
10
UI - 86227846
AU - Akaba N ; Ujiie H ; Umezawa K ; Miura K ; Yamamoto Y ; Horihoshi S ;
Ijima H
TI - Management of acute aortic dissections with a cylinder-type balloon
catheter to close the entry.
AB - Despite recent advances in medical treatment, an acute aortic dissection
is still now often fatal because of the seriousness of its condition. The
currently available therapies include blocking the progress of dissection
with intensive drug therapy, a process leading to the chronic stage.
However, the dissection often proceeds rapidly and may result in death.
Various surgical procedures have been attempted so far, but they produce
highly invasive stress and high risks. Accordingly, we designed a
cylinder-type balloon catheter and developed a new closing procedure,
wherein a balloon catheter is introduced and inflated at the site with an
intimal tear to maintain the blood flow to the distal vessels and also to
close the entry. With this procedure, the complaints will be relieved or
disappear, the progress of the dissection can be stopped, and the blood
flow can be restored to the reduced and collapsed true lumen. When the
blood in the pseudolumen becomes coagulated and organized, the balloon is
removed. If this catheter is introduced from the femoral artery (similar
to an intra-aortic balloon pumping method), the invasive stress will be
further reduced. This method appears to be the most useful for DeBakey
type III dissections. We are now intensively studying the safe and
effective application of this balloon catheter under various clinical
conditions.
MH - Aneurysm, Dissecting/*THERAPY ; Angioplasty, Transluminal/
*INSTRUMENTATION ; Animal ; Aorta ; Aortic Aneurysm/*THERAPY ; Dogs ;
Human
SO - J Vasc Surg 1986 Jun;3(6):890-4
11
UI - 86218051
AU - Erbel R ; Clas W ; Busch U ; von Seelen W ; Brennecke R ; Bl:omer H ;
Meyer J
TI - New balloon catheter for prolonged percutaneous transluminal coronary
angioplasty and bypass flow in occluded vessels.
AB - A new balloon catheter was developed for continuous perfusion of coronary
arteries during angioplasty (CPC catheter). Steerable Gr:untzig balloon
catheters (3.7 mm) with two lumina were formed. The first lumen was used
for balloon inflation. Side holes to the second lumen proximally and
distally to the balloon were created for coronary perfusion even during
inflation phase. At a perfusion pressure of 120 mmHg, a flow rate of 63
+/- 3 ml/min with 0.9% saline and 43 +/- 1 ml/min with plasma expander
were measured. In experiments on five dogs, dilation time until
appearance of signs of ischemia could be prolonged in three of five dogs
from 30 to 40 s, 120 to 203 s, and 180 to 420 s comparing conventional
and CPC balloon catheters. In 11 patients with proximal lesions, dilation
time could be increased from 39.5 +/- 23.9 s to 81.1 +/- 36.3 s (p less
than 0.01) until appearance of angina pectoris. ST segment changes were
observed in 10/11 patients using conventional catheters. Using CPC
catheters, no ST segment changes were observed in four patients; time
until appearance of ST segment changes was delayed in the other seven
patients. The CPC catheter seems to be an alternative catheter in
proximal lesions of the left and right coronary artery, allowing the
possibility of prolonged dilation and increased safety to the patient. In
case of dissection or perforation, the CPC catheter can be used for
perfusion of the distal part of the coronary vessel until emergency
bypass surgery.
MH - Adult ; Angioplasty, Transluminal/*INSTRUMENTATION ; Animal ; Arterial
Occlusive Diseases/*THERAPY ; Coronary Disease/*THERAPY ; Dogs ; Human ;
Male ; Middle Age ; Perfusion ; Regression Analysis ; Review ; Time
Factors
SO - Cathet Cardiovasc Diagn 1986;12(2):116-23
12
UI - 86172141
AU - Walden R ; Siegel Y ; Rubinstein ZJ ; Morag B ; Bass A ; Adar R
TI - Percutaneous transluminal angioplasty. A suggested method for analysis of
clinical, arteriographic, and hemodynamic factors affecting the results
of treatment.
AB - Sixty-nine percutaneous transluminal angioplasties (PTAs) were performed
in the iliac and the femoral arteries of 54 patients. The main factors
that might affect the results were reviewed: associated diseases,
severity of ischemic symptoms, location and type of lesions (stenosis or
occlusion and their length), and presence of disease distal to the site
dilated. The vascular status of the patients in our series was more
severe than in most others. Improvement at follow-up (average 15 months)
was maintained in 74% of 66 radiographically successful PTAs. Poor runoff
was the only factor found to affect the outcome deleteriously.
Intra-arterial pressure measurements performed during the procedure and
vascular laboratory studies were most valuable in assessing immediate and
long-term results. Wide variations in results of PTA published in the
literature are due to differences in methods of selection, evaluation,
and reporting. A plea is made for future presentations of PTA series in
an analyzable and comparable way, including and correlating all relevant
variables as in the model suggested by the present study.
MH - Adult ; Aged ; *Angioplasty, Transluminal ; Arteriosclerosis/PATHOLOGY/
RADIOGRAPHY/*THERAPY ; Female ; Femoral Artery/PATHOLOGY/RADIOGRAPHY ;
Follow-Up Studies ; Hemodynamics ; Human ; Iliac Artery/PATHOLOGY/
RADIOGRAPHY ; Leg ; Male ; Middle Age
SO - J Vasc Surg 1986 Apr;3(4):583-90
13
UI - 86155268
AU - Colapinto RF ; Stronell RD ; Johnston WK
TI - Transluminal angioplasty of complete iliac obstructions.
AB - Of 64 complete iliac obstructions, 50 (78%) were recanalized using the
Gruntzig balloon catheter. Life-table analysis of the patency rate over a
4-year period gives a cumulative success rate of 78%. Only three of eight
obstructions that involved both the common and external iliac arteries
were successfully dilated. The only serious complication was distal
embolization, which occurred in two cases (3.1%). Although the procedure
is difficult, with a relatively low technical success rate, the high
cumulative patency rate should make it an option in the treatment of all
patients with totally occluded iliac artery segments.
MH - Adult ; Aged ; *Angioplasty, Transluminal ; Arteriosclerosis/*THERAPY ;
Female ; Follow-Up Studies ; Human ; *Iliac Artery ; Male ; Middle Age
SO - AJR 1986 Apr;146(4):859-62
14
UI - 86121715
AU - Vitek JJ ; Keller FS ; Duvall ER ; Gupta KL ; Chandra-Sekar B
TI - Brachiocephalic artery dilation by percutaneous transluminal angioplasty.
AB - Percutaneous transluminal angioplasty (PTA) was used to dilate stenotic
lesions in 38 brachiocephalic arteries in 36 patient. Complete evaluation
of the central nervous system blood supply is a prerequisite for the
brachiocephalic PTA when cerebral symptoms are present. The femoral
artery is the best vascular entry site; use of digital subtraction
angiography equipment for arterial mapping is helpful. Balloon diameter
should be the same as or slightly wider than the diameter of the normal
artery adjacent to the stenotic segment. Spasm was successfully treated
with intraarterial injection of nitroglycerin. The only drug therapy
consistently used with PTA was aspirin. Complete dilation of the stenosis
is the best prevention of thrombotic or embolic complications. In
properly selected cases, proximal subclavian artery stenoses can be
safely dilated, and the balloon can eventually be placed across the
origin of the vertebral artery. Because of potential complications
associated with brachiocephalic PTA, indications must be well
established, and interventions should not be performed on marginal or
asymptomatic stenoses.
MH - Aged ; Angiography ; Angioplasty, Transluminal/*METHODS ; Arterial
Occlusive Diseases/*THERAPY ; Carotid Artery Diseases/*THERAPY ; Female ;
Human ; Male ; Middle Age ; *Subclavian Artery
SO - Radiology 1986 Mar;158(3):779-85