MedWorm: Baloon Angioplasty

Cardiovascular Outcomes Using Intra-Aortic Balloon Pump in High-Risk Acute Myocardial Infarction With or Without Cardiogenic Shock: A Meta-Analysis

Journal of Cardiovascular Pharmacology and Therapeutics — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: The present meta-analysis suggests that patients with high-risk AMI without cardiogenic shock do not seem to benefit from the use of IABP as measured by in-hospital mortality, rate of reinfarction, and recurrent angina. However, in patients with AMI with cardiogenic shock (systolic blood pressure [SBP] < 90), there was significant reduction in mortality using IABP. The use of IABP is associated with increase in the rate of both moderate and severe bleeding. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)

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Chronic mesenteric ischaemia: 28-year experience of endovascular treatment

European Radiology — Thu, 02 Feb 2012 18:12:25 +0100

Conclusion Technical success rates are improved with the use of stents; however, PTA use in the SMA seems to offer better primary patency rates. Key Points • Superior mesenteric artery (SMA) stenosis is often responsible for ischaemic symptoms. • Treatment with percutaneous transluminal angioplasty (PTA) seems superior to stenting • Although technical success rates are improved with the use of stents. • Higher mortality in the elderly and those presenting with nausea/vomiting/bloody stools. Content Type Journal ArticleCategory Vascular-InterventionalPages 1-13DOI 10.1007/s00330-011-2376-zAuthors Ulku Cenk Turba, Interventional Radiology, University of Virginia, Charlottesville, VA, USAWael E. Saad, Intervention...

Isoproterenol stress test during catheterization of patients with coarctation of the aorta

Pediatrics International — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Significant pressure gradients over the coarctation site develop at IST in pediatric patients with repaired CoA or in preoperative patients with mild coarctation.© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society (Source: Pediatrics International)

Balloon angioplasty vs nitinol stent placement in the treatment of venous anastomotic stenoses of hemodialysis grafts after surgical thrombectomy

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:15 +0100

In 2010, CPT code 36147 was created and bundles the work of establishing single catheter access with the diagnostic contrast imaging of the dialysis circuit. In 2012, the introductory wording was updated to clarify reporting concerns voiced by the insurance industry and coding groups. (Source: Journal of Vascular Surgery)

Invited commentary

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:14 +0100

The increasingly aggressive endovascular management of tibial artery occlusive disease is understandable given the fact that endovascular surgeons have routinely acquired increased technical skill and gained access to enabling endovascular hardware. However, the many options available to treat atheromatous lesions, including balloon angioplasty, cryoplasty, excisional atherectomy, rotational atherectomy, self-expanding stent placement, covered stent placement, balloon expandable stent placement, and drug-eluting stent placement, have driven the treatment of lesions faster than data has provided guidance. (Source: Journal of Vascular Surgery)

Cilostazol suppression of arterial intimal hyperplasia is associated with decreased expression of sialyl Lewis X homing receptors on mononuclear cells and E-selectin in endothelial cells

Journal of Vascular Surgery — Fri, 27 Jan 2012 11:25:14 +0100

Conclusions: These results demonstrate that the protective effect of cilostazol against neointimal hyperplasia may be mediated by its anti-inflammatory actions of mononuclear cells homing to endothelial cells by decreasing SLX and E-selectin expression. Clinical Relevance: It is reported that cilostazol inhibits neointimal hyperplasia by decreasing the expression of some cell-adhesion molecules. We evaluated the effects of cilostazol for the expression of sialyl Lewis X (SLX) on mononuclear cells and E-selectin on endothelial cells, which interaction is the first step of inflammation action. Cilostazol was thought to show the anti-inflammatory actions by decreasing SLX and E-selectin expression in addition to decreasing the expression of some cell-adhesion molecules. (Source: Journal of...

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[Stent implantation in recoarctation of aorta in infant.]

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

We present the case of a 12 month-old infant with critical coarctaion of aorta, arch hypoplasia, atrial and ventricular septal defects who underwent interventional treatment with stent implantation due to recoarctation of aorta. In neonatal period the patient went through complete surgical correction. At the age of four months balloon angioplasty of recurrent coractation was conducted. Eight months later the patient was hospitalised with heart failure (HF) symptoms. Clinical and echographic examination confirmed critical stenosis of aortic isthmus. We performed heart catheterisation with stent implantation to transverse and descending arch with immediate reduction of gradient from 45 mm Hg to 0 mm Hg, widening of the isthmus from 2 to 8 mm and gradual regression of HF symptoms. At 3 years ...

A Venotomy and Manual Propulsion Technique to Treat Native Arteriovenous Fistulas Occluded by Thrombi

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. The venotomy and manual propulsion technique is effective and safe for the removal of chronic and organized thrombi from occluded native AVFs. (Source: American Journal of Roentgenology)

Management of Infrapopliteal Peripheral Arterial Occlusive Disease

Current Treatment Options in Cardiovascular Medicine — Tue, 17 Jan 2012 07:07:16 +0100

Opinion statement The management of infrapopliteal peripheral arterial occlusive disease (PAD) is challenging. For patients with asymptomatic disease or claudication, exercise and optimal medical management, including antiplatelet agents, blood pressure control, statin therapy and tight glucose control for patients with diabetes mellitus, are the mainstays of therapy. However, patients with isolated tibial artery occlusive disease often have diabetes mellitus or renal insufficiency and present with critical limb ischemia (CLI). CLI is advanced occlusive disease marked by the development of rest pain, ischemic ulceration, or gangrene and is associated with a high mortality rate. Limb salvage requires an intervention in cases of CLI, but careful operative planning is require...

Fulminant Postpartum Cerebral Vasoconstriction Syndrome [Original Contribution]

Archives of Neurology — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions Postpartum vasoconstriction can be fatal, with rapid progression of vasoconstriction, ischemia, and brain edema. Clinicians need to be aware of the potential consequences of this condition. Postpartum women with acute neurologic symptoms require prompt investigation with noninvasive cerebrovascular imaging and close monitoring for possible secondary deterioration. (Source: Archives of Neurology)

Intracranial Angioplasty and Stent Placement After Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) Trial: Present State and Future Considerations⋆

Journal of Neuroimaging — Sun, 01 Jan 2012 05:00:00 +0100

CONCLUSIONThe need for developing new and effective treatments for patients with symptomatic intracranial stenosis cannot be undermined. The data support modification but not discontinuation of our approach to intracranial angioplasty and/or stent placement for intracranial stenosis. There are potential patients in whom angioplasty and/or stent placement might be the best approach, and a new trial with appropriate modifications in patient selection and design may be warranted. (Source: Journal of Neuroimaging)

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Thrombosis in Behçet’s disease: a Behçet’s disease patient with complete thrombotic obstruction of IVC and both iliac veins and decreased protein S activity

Rheumatology International — Mon, 26 Dec 2011 16:44:10 +0100

Abstract Behçet’s disease represents a multisystemic inflammatory disease characterized by recurrent oral ulcers, genital ulcers, and uveitis. Although vascular attack and thrombosis are not major complications in Behçet’s disease, they can still pose risks that must not be overlooked. In this paper, we reported that a 25-year-old female Behçet’s disease patient with complete thrombotic obstruction of the inferior vena cava that was successfully treated by aspiration thrombectomy and balloon angioplasty. The procedure produced marked symptomatic improvement. Currently, data about the treatment and the prophylaxis of thrombotic events in Behçet’s disease are lacking. In this case report, we hope to discuss the future direction of such studies, how we understand ...

Classification and Clinical Impact of Restenosis After Femoropopliteal Stenting

Journal of the American College of Cardiology — Thu, 22 Dec 2011 02:25:47 +0100

Conclusions: Restenotic patterns after FP stenting are important predictors of recurrent ISR and occlusion. (Source: Journal of the American College of Cardiology)

The Treatment of Femoropopliteal In-Stent Restenosis: Back to the Future⁎

Journal of the American College of Cardiology — Thu, 22 Dec 2011 02:25:47 +0100

Femoropopliteal in-stent restenosis (ISR) remains one of the most frustrating problems for the endovascular specialist. It is relatively common, occurring in 18% to 40% of patients within the first year after femoropopliteal artery stenting ( ). Femoropopliteal ISR is even more common after stenting of longer lesions (>15 cm) and may occur in association with femoropopliteal stent fracture ( ). Despite the frequent occurrence of femoropopliteal ISR in clinical practice, there are few data available regarding the effectiveness of endovascular interventions for this condition ( ). Experience to date suggests that restenotic lesions can be treated with high immediate procedural success, but durable long-term patency remains elusive. Dick et al. ( ) compared balloon angioplasty to cutting ball...

Bard buys drug-coated PTA balloon maker for $225M

Cardiovascular Business News — Wed, 21 Dec 2011 11:35:10 +0100

C. R. Bard has acquired Lutonix for a purchase price of approximately $225 million paid at closing, with an additional $100 million to be paid upon pre-market application (PMA) approval of Lutonix’s drug-coated percutaneous transluminal angioplasty (PTA) balloon. (Source: Cardiovascular Business News)

Long-Term Outcome of Direct Neopulmonary Artery Reconstruction During the Arterial Switch Procedure [ORIGINAL ARTICLES: PEDIATRIC CARDIAC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions Direct neopulmonary artery anastomosis during arterial switch is an interesting alternative to patch reconstructions and ensures a good postoperative result with low rates of complications and SVPS. (Source: The Annals of Thoracic Surgery)

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Succinobucol induces apoptosis in vascular smooth muscle cells.

Free Radical Biology and Medicine — Wed, 21 Dec 2011 05:00:00 +0100

Authors: Midwinter RG, Maghzal GJ, Dennis JM, Wu BJ, Cai H, Kapralov AA, Belikova NA, Tyurina YY, Dong LF, Khachigian L, Neuzil J, Kagan VE, Stocker R Abstract Probucol inhibits the proliferation of vascular smooth muscle cells in vitro and in vivo, and the drug reduces intimal hyperplasia and atherosclerosis in animals via induction of heme oxygenase-1 (HO-1). Because the succinyl ester of probucol, succinobucol, recently failed as an antiatherogenic drug in humans, we investigated its effects on smooth muscle cell proliferation. Succinobucol and probucol induced HO-1 and decreased cell proliferation in rat aortic smooth muscle cells. However, whereas inhibition of HO-1 reversed the antiproliferative effects of probucol, this was not observed with succinobucol. Instead, succinobuc...

Liberation Procedure in the Treatment of Chronic Cerebro-Spinal Venous Insufficiency - Is Chronic Cerebro-Spinal Venous Insufficiency Related To Brain Congestive Syndrome Rather Than Multiple Sclerosis

Journal of Vascular Surgery — Mon, 19 Dec 2011 23:06:58 +0100

Chronic cerebro-spinal venous insufficiency (CCSVI) is a term developed to describe compromised flow of blood in the veins draining the central nervous system. It has been suggested by some authors that this condition is related to Multiple Sclerosis (MS). Balloon angioplasty and stenting have been proposed as a treatment option for CCSVI in MS. The proposed treatment has been termed ”liberation procedure” though the name has been criticized for suggesting unrealistic results. (Source: Journal of Vascular Surgery)

Balloon angioplasty vs nitinol stent placement in the treatment of venous anastomotic stenoses of hemodialysis grafts after surgical thrombectomy

Journal of Vascular Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions: Graft thrombectomy plus angioplasty with self-expanding nitinol stent placement provides significantly higher patency rates compared with thrombectomy plus plain balloon angioplasty of the venous anastomosis. (Source: Journal of Vascular Surgery)

Evaluation of in-stent neointimal tissue components using integrated backscatter intravascular ultrasound: comparison of drug-eluting stents and bare-metal stents

The International Journal of Cardiovascular Imaging — Sat, 17 Dec 2011 16:42:16 +0100

Abstract Although in-stent restenosis (ISR) occurs after drug-eluting stents (DES) implantation, neointimal tissue characteristics have not been fully investigated. We assessed neointimal tissue components using integrated backscatter intravascular ultrasound (IB-IVUS) after DES and bare-metal stents (BMS) implantation. Fifty-seven consecutive patients with 61 lesions underwent repeated percutaneous coronary intervention (PCI) for the treatment of ISR (DES: 24 lesions, BMS: 37 lesions). PCI was performed using plain old balloon angioplasty (POBA). Before PCI, we assessed neointimal tissue characteristics using IB-IVUS. Neointima was divided into four categories: category 1 (−11 to −29 dB), category 2 (−29 to −35 dB), category 3 (−35 to −49 dB), an...

Hybrid intra-operative pulmonary artery stenting in congenital heart disease

Indian Journal of Thoracic and Cardiovascular Surgery — Wed, 14 Dec 2011 16:40:31 +0100

Conclusion Hybrid PA stenting during surgery for congenital heart disease in cases of complex branch PA stenosis is an alternative to traditional angioplasty. The procedure is safe and effective, and ameliorates right-ventricular dysfunction. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s12055-011-0127-zAuthors Kouakou Grégoire Ayegnon, Cardiac Pediatric Surgery Unity, Clochville of Tours, FranceEric Bergoend, Cardiac Pediatric Surgery Unity, Clochville of Tours, FranceThierry Bourguignon, Cardiac Pediatric Surgery Unity, Clochville of Tours, FranceRoland Bonnefoy, Pediatric Cardiology Unity, Clochville of Tours, FrancePaul Neville, Cardiac Pediatric Surgery Unity, Clochville of Tours, France Journal Indian Journal of Thoracic and...

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AngioScore Announces Successful Initiation Of Enrollment In Drug-Coated AngioSculpt Scoring Balloon Catheter First-In-Human Study

Medical Design Online News — Wed, 14 Dec 2011 13:05:00 +0100

AngioScore, Inc., a developer of novel angioplasty catheters for use in the treatment of cardiovascular disease, today announced the successful initiation of enrollment in the Drug-Coated AngioSculpt Scoring Balloon Catheter First-in-Human (FIH) Study (Source: Medical Design Online News)

Comparison of Surgical, Stent, and Balloon Angioplasty Treatment of Native Coarctation of the Aorta: An Observational Study by the CCISC (Congenital Cardiovascular Interventional Study Consortium)

Journal of the American College of Cardiology — Sat, 10 Dec 2011 02:32:49 +0100

Conclusions: Stent patients had significantly lower acute complications compared with surgery patients or BA patients, although they were more likely to require a planned reintervention. At short-term and intermediate follow-up, stent and surgical patients achieved superior hemodynamic and integrated aortic arch imaging outcomes compared with BA patients. Because of the nonrandomized nature of this study, these results should be interpreted with caution. (Source: Journal of the American College of Cardiology)

Stenting, surgery more effective than angioplasty for coarctation of the aorta

Modern Medicine — Thu, 08 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Patients with native coarctation of the aorta did better with surgical correction or stenting than with balloon angioplasty in an observational study. (Source: Modern Medicine)

Detached tip of a transseptal sheath during left atrial ablation

Catheterization and Cardiovascular Interventions — Thu, 08 Dec 2011 05:00:00 +0100

We report a case of a 46 year‐old female diagnosed with idiopathic dilated cardiomyopathy that presented with atypical left atrial flutter. During electrophysiologic study, a Swartz braided SL1 (SL‐1) transseptal sheath was used to introduce the ablation catheter to the left atrium. During left atrial mapping, the radiopaque tip of the sheath detached from the rest of the sheath and was seen floating in the LA. After exchanging the SL‐1 sheath with a deflectable sheath, the detached segment was retrieved out of the LA and eventually out of the vascular system using an angioplasty balloon advanced over a wire and inflated distal to the lumen of the detached tip. The root cause of this malfunction was found to be lack of a secondary bonding process that these sheaths generally undergo ...

Hydrogen-rich saline prevents neointima formation after carotid balloon injury by suppressing ROS and the TNF-α/NF-κB pathway

Atherosclerosis — Wed, 07 Dec 2011 05:00:00 +0100

Conclusion: HRSS may have a protective role in the prevention of neointima hyperplasia and restenosis after angioplasty. HRSS may partially exert its role by neutralizing the local ROS and suppressing the TNF-α/NF-κB pathway. (Source: Atherosclerosis)

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Salvianolic acid B inhibits SDF-1α-stimulated cell proliferation and migration of vascular smooth muscle cells by suppressing CXCR4 receptor.

Vascular Pharmacology — Sun, 04 Dec 2011 05:00:00 +0100

In conclusion, suppressing the expression levels of CXCR4 receptor and downstream molecules of SDF-1α/CXCR4 axis could possibly explain one of the pharmacological mechanisms of Sal B on prevention of cell proliferation, migration and subsequently neointimal hyperplasia. PMID: 22166584 [PubMed - as supplied by publisher] (Source: Vascular Pharmacology)

Transient Locked-in Syndrome and Basilar Artery Vasospasm

Neurocritical Care — Thu, 01 Dec 2011 06:58:55 +0100

Conclusion LIS can reveal BAVS. Its diagnosis relies on clinical examination. In this case, rapid neuro-interventional treatment permitted reversal of symptoms. This could not have been possible under sedation. Content Type Journal ArticleCategory Practical PearlPages 1-3DOI 10.1007/s12028-011-9655-zAuthors G. Lacroix, Department of Anesthesiology and Intensive Care, Sainte Anne Teaching Military Hospital, Toulon, FranceD. Couret, Department of Anesthesiology and Intensive Care, Aix-Marseille University, 13284 Marseille, FranceX. Combaz, Department of Neuroradiology, Aix-Marseille University, 13284 Marseille, FranceB. Prunet, Department of Anesthesiology and Intensive Care, Sainte Anne Teaching Military Hospital, Toulon, FranceN. Girard, Department of Neuroradiology,...

The “SAFARI” Technique Using Retrograde Access Via Peroneal Artery Access

CardioVascular and Interventional Radiology — Thu, 01 Dec 2011 06:57:17 +0100

We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially give more options for endovascular interventions in lower limb CTOs. Content Type Journal ArticleCategory Technical NotePages 1-5DOI 10.1007/s00270-011-0297-5Authors Kun Da Zhuang, Interventional Radiology Centre, Singapore General Hospital, Outram Road, Singapore City, 169608 SingaporeSeck Guan Tan, Department of General Surgery, Singapore General Hospital, Outram Road, Singapore City, 169608 SingaporeKiang Hiong Tay, Interventional Radiology Centre, Singapore General Hospital, Outram Road, Singapore City, 169608 Singapore Journal CardioVascular and Interventional RadiologyOnline I...

Early Experience in the Use of Stent Grafts to Convert Unusable Arteriovenous Fistulas into a Functioning Hemodialysis Access

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Not all newly created arterio-venous fistulas (AVF) successfully mature and develop into a functioning access for hemodialysis. Percutaenous balloon angioplasty (PTA) and balloon assisted maturation (BAM) have been utilized to either treat flow limiting stenoses or to promote and accelerated maturation. We reviewed our experience rescuing unusable AVFs by conversion to a functional access using the percutaneous placement of a stent graft. (Source: Journal of Vascular Surgery)

Vascular biomechanics: constitutive modelling and characterisation of the arterial wall

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

Insight into the mechanical properties of the arterial wall can give valuable information concerning the understanding of pulse wave propagation in the arterial tree, the genesis and progress of atherosclerosis, vessel wall adaptation and remodelling, and the prediction of the effects of medical intervention, such as blood-pressure regulating drug admission, balloon angioplasty, and bypass surgery. A widely used approach to characterize the mechanical properties of arteries is based on a mixed experimental–numerical method, in which parameters of mathematical constitutive models are fitted to experimental stress–strain data. For wall remodelling studies (Machchyn et al., 2010) these parameters preferably are based on micro-structural information such as collagen content and morphology ...

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9.4% Of Percutaneous Coronary Intervention Patients Back In Hospital Within A Month

Health News from Medical News Today — Wed, 30 Nov 2011 16:00:00 +0100

According to a study published Online First by the Archives of Internal Medicine, one of the JAMA/Archives journals, an examination of the outcomes of over 15,000 individuals who underwent a percutaneous coronary intervention (PCI; balloon angioplasty or stent placement procedures to open narrow coronary arteries) revealed that almost 1 in 10 individuals were readmitted to hospital within 30 days. Furthermore, these patients also had an increased risk of death within one year... (Source: Health News from Medical News Today)

Transfer To Another Hospital For Percutaneous Coronary Intervention - Recommended Guidelines Rarely Met

Health News from Medical News Today — Wed, 30 Nov 2011 16:00:00 +0100

According to an investigation in the Nov. 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals, the estimated time for patients in need of transfer to another hospital for percutaneous coronary intervention (PCI; procedures such as stent placement of balloon angioplasty used to open narrow coronary arteries) seldom meets the recommended guidelines of 30 minutes or less... (Source: Health News from Medical News Today)

Nearly 10 percent of patients undergoing procedure such as balloon angioplasty or stent placement readmitted to hospital within 30 days

ScienceDaily Headlines — Tue, 29 Nov 2011 06:05:01 +0100

In an analysis of the outcomes for more than 15,000 patients who underwent a percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries), nearly one in 10 were readmitted to the hospital within 30 days, and these patients had a higher risk of death within one year, according to a new study. Various factors were associated with hospital readmission, including female sex, Medicare insurance, unstable angina and others. (Source: ScienceDaily Headlines)

Patients requiring transfer to another facility for percutaneous coronary intervention rarely meet recommended guidelines for transfer to treatment times

ScienceDaily Headlines — Mon, 28 Nov 2011 23:33:33 +0100

Among patients requiring transfer to another hospital for percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries), the estimated time from arrival to transfer rarely meets recommended guidelines of 30 minutes or less, according to a new report. (Source: ScienceDaily Headlines)

Magnoliae Cortex inhibits intimal thickening of carotid artery through modulation of proliferation and migration of vascular smooth muscle cells.

Food and Chemical Toxicology — Mon, 28 Nov 2011 05:00:00 +0100

The objective of this study was to examine the effect of Magnoliae Cortex extract (MOE) on intimal thickening of rat carotid artery injured by balloon endothelial denudation. MOE was administered orally using gastric sonde at three different doses MOE200 (200mg/kg), MOE400 (400mg/kg), and MOE800 (800mg/kg) for 14days from the day of balloon injury. Also, in vitro assays of proliferation, migration and expression of matrix metalloproteinase-2 (MMP-2) in human aortic smooth muscle cells (HASMCs) were carried out using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, transwell boyden chamber method and gelatin zymography, respectively. Oral administration of MOE400 and MOE800 for 14days significantly inhibited intimal area, intimal/medial ratio (I/M), stenosis rate, e...

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Elective percutaneous intervention for intracranial atherosclerotic stenoses by interventional cardiologists

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions:For patients with symptomatic intracranial arterial stenosis who have failed medical therapy or are considered very high risk for stroke, CBT performed by experienced interventional cardiologists is safe and offers both high procedural success rates and excellent clinical outcomes at one year. CBT is an attractive option for this high risk patient population considering the expected 12‐15% rate of recurrent stroke at 1 year. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Cell-specific effects of miR-221/222 in vessels: Molecular mechanism and therapeutic application

Journal of Molecular and Cellular Cardiology — Wed, 23 Nov 2011 05:00:00 +0100

Abstract: MicroRNAs (miRNAs) are noncoding RNAs that impact almost every aspect of biology and disease. Until now, the cell-specific effects of miRNAs in cardiovascular system have not been established. In the current study, the cellular functions of miR-221 and miR-222 (miR-221/222) in vascular smooth muscle cells (VSMCs) and vascular endothelial cells (ECs) were compared. In cultured cells, we identified that the effects of miR-221/222 on proliferation, migration, and apoptosis are opposite between VSMCs and ECs. In VSMCs, miR-221/222 had effects of pro-proliferation, pro-migration, and anti-apoptosis. In contrast, miR-221/222 had effects of anti-proliferation, anti-migration, and pro-apoptosis in ECs. The different expression profiles of their target genes, p27(Kip1), p57(kip2), and c-k...

Durable Patency With Superficial Femoral Artery StentingDurable Patency With Superficial Femoral Artery Stenting

Medscape Today Headlines — Mon, 21 Nov 2011 15:18:04 +0100

Three-year data from RESILIENT show that the LifeStent stent has durable patency and better quality of life and function than balloon angioplasty in the superficial femoral artery. Medscape Medical News (Source: Medscape Today Headlines)

The COBRA Trial Results Reported At TCT 2011

Health News from Medical News Today — Mon, 14 Nov 2011 09:00:00 +0100

A clinical trial of patients with diabetes has demonstrated that cryoplasty post-dilitation compared to conventional balloon angioplasty in the superficial femoral artery (SFA) decreased the risk of in-stent restenosis (ISR). Results from the COBRA clinical trial were presented at the 23rd Annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF). Diabetes is associated with increased risk of in-stent restenosis after superficial femoral artery (SFA) stenting with nitinol self-expanding stents (nSES)... (Source: Health News from Medical News Today)

ROTAXUS Trial Results Reported At TCT 2011

Health News from Medical News Today — Mon, 14 Nov 2011 09:00:00 +0100

A clinical trial testing the efficacy of rotational atherectomy (or rotablation, a process of drilling through plaque deposits) prior to implantation of a drug-eluting stent found that the process was not superior to standard balloon angioplasty and decreased the efficacy of the stent in reducing new tissue growth within the blood vessel... (Source: Health News from Medical News Today)

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PEPCAD-DES Trial Results Reported At TCT 2011

Health News from Medical News Today — Mon, 14 Nov 2011 09:00:00 +0100

A clinical trial of patients with restenosis in drug-eluting stents (DES) in native coronary arteries found that treatment with paclitaxel-coated balloon angioplasty demonstrated superior results over plain old uncoated-balloon angioplasty (POBA). Results from the PEPCAD-DES clinical trial were presented at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation. The incidence of drug-eluting stent restenosis (DES-ISR) remains frequent due to the continuous increase in DES implantations... (Source: Health News from Medical News Today)

Results of the PEPCAD-DES trial reported at TCT 2011

EurekAlert! - Medicine and Health — Fri, 11 Nov 2011 05:00:00 +0100

(Cardiovascular Research Foundation) A clinical trial of patients with restenosis in drug-eluting stents (DES) in native coronary arteries found that treatment with paclitaxel-coated balloon angioplasty demonstrated superior results over plain old uncoated-balloon angioplasty (POBA). Results from the PEPCAD-DES clinical trial were presented today at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation. (Source: EurekAlert! - Medicine and Health)

Results of the COBRA trial reported at TCT 2011

EurekAlert! - Medicine and Health — Fri, 11 Nov 2011 05:00:00 +0100

(Cardiovascular Research Foundation) A clinical trial of patients with diabetes has demonstrated that cryoplasty post-dilitation compared to conventional balloon angioplasty in the superficial femoral artery (SFA) decreased the risk of in-stent restenosis (ISR). Results from the COBRA clinical trial were presented today at the 23rd Annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF). (Source: EurekAlert! - Medicine and Health)

Results of the ROTAXUS trial reported at TCT 2011

EurekAlert! - Medicine and Health — Fri, 11 Nov 2011 05:00:00 +0100

(Cardiovascular Research Foundation) A clinical trial testing the efficacy of rotational atherectomy (or rotablation, a process of drilling through plaque deposits) prior to implantation of a drug-eluting stent found that the process was not superior to standard balloon angioplasty and decreased the efficacy of the stent in reducing new tissue growth within the blood vessel. Results of the ROTAXUS trial were presented today at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (Source: EurekAlert! - Medicine and Health)

A method for the making and utility of gadolinium-labeled albumin microbubbles

Magnetic Resonance Imaging — Mon, 07 Nov 2011 05:00:00 +0100

Conclusions: HSA was successfully labeled, and an albumin-based microbubble with Gd was synthesized. This contrast agent, Gd-PESDA, may serve as an additional agent for the MRI evaluation of innate inflammation and used to noninvasively image early vascular pathophysiologic processes.Condensed Abstract: In this study, Gd-PESDA microbubbles and were synthesized and shown to detect the binding of these microbubbles using MRI in injured aortic tissue. The method for synthesizing Gd-PESDA is detailed, and the proposed utility of this new contrast agent is discussed. (Source: Magnetic Resonance Imaging)

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Cryoplasty for the treatment of femoropopliteal arterial disease

Jornal Vascular Brasileiro — Fri, 04 Nov 2011 08:22:32 +0100

CONCLUSIONS: Cryoplasty is a safe technique for the treatment of femoropopliteal arterial disease that presents low morbidity rates, short-term and mid-term results comparable to conventional angioplasty, as well as potential advantages of lower dissection, recoil and mid-term restenosis rates. (Source: Jornal Vascular Brasileiro)

Bayer HealthCare's MEDRAD Interventional Business Announces Five-Year Data of Cotavance(R) Drug Eluting Balloon with Paccocath(R) Technology to be Presented at 2011 TCT

HSMN NewsFeed — Thu, 03 Nov 2011 16:37:48 +0100

Data represent first five-year evaluation of target lesion revascularization rates with Cotavance balloon catheter compared to standard balloon angioplasty in PAD patients WARRENDALE, Pa., Nov. 3, 2011 (HSMN NewsFeed) -- MEDRAD Interventional, a busi... Devices, InterventionalMEDRAD, Bayer HealthCare, Cotavance, Drug Eluting Balloon (Source: HSMN NewsFeed)

Successful treatment of delayed aortobifemoral graft thrombosis with manual aspiration thrombectomy.

Diagnostic and Interventional Radiology : The Turkish Society of Radiology — Tue, 01 Nov 2011 04:00:00 +0100

We present a 67-year-old man who had undergone aortobifemoral synthetic graft surgery one year earlier. The patient experienced thrombosis of the graft nine months after the operation, and thrombectomy of the graft was planned. However, the patient refused to undergo repeat surgery for thrombus removal and was referred to our center for possible endovascular treatment. We treated the patient with percutaneous aspiration thrombectomy. The thrombi were chronic in nature but could be removed with minimal residue in any part of the graft by using repeated aspiration thrombectomy with 7-F guiding catheters. Underlying stenosis of both distal graft anastomoses was treated with percutaneous balloon angioplasty, and a self-expanding stent was deployed on the right distal anastomosis. A small fragm...

Percutaneous transluminal angioplasty versus primary stenting in infrapopliteal arteries in critical limb ischemia.

VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: Primary stenting with balloon expandable stents in the infrapopliteal arteries does not outway the benefit of PTA alone with the application of modern hydrophilic balloon catheters in patients with CLI. PMID: 22090182 [PubMed - in process] (Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases)

Randomized Trial of Cutting Balloon Compared With High-Pressure Angioplasty for the Treatment of Resistant Pulmonary Artery Stenosis.

Circulation — Mon, 31 Oct 2011 04:00:00 +0100

Conclusion-CB therapy for pulmonary artery stenosis not responsive to low-pressure balloon is more effective than HPB therapy and has an equivalent safety profile. PMID: 22042887 [PubMed - as supplied by publisher] (Source: Circulation)

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Malignant hypertension secondary to renovascular disease during infancy--an unusual cause of failure to thrive

Nephrology Dialysis Transplantation — Fri, 28 Oct 2011 04:00:00 +0100

An 11-month-old girl presented with a history of failure to thrive, vomiting, polydipsia, polyuria and visual inattention. She was found to have malignant hypertension due to unilateral renal artery stenosis. This was successfully treated with percutaneous transluminal balloon angioplasty. Nearly 10 years following this initial presentation, she remains normotensive on no anti-hypertensive medications. (Source: Nephrology Dialysis Transplantation)

Mechanical Embolectomy and Recanalization of Superior Mesenteric Artery Embolism Using the MERCI Retrieval Device

Journal of Vascular and Interventional Radiology : JVIR — Thu, 27 Oct 2011 08:56:23 +0100

We present a case of mesenteric ischemia successfully treated with the MERCI retrieval device. Submission of this case report does not require permission of the institutional review board of our hospital. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Tabletop Resheathing of a Partially Deployed Viatorr Endoprosthesis

Journal of Vascular and Interventional Radiology : JVIR — Thu, 27 Oct 2011 08:56:23 +0100

The clear plastic access sleeve that constrains a Viatorr transjugular intrahepatic portosystemic shunt (TIPS) endoprosthesis (W.L. Gore & Associates, Inc, Flagstaff, Arizona) may be confused for a device similar to the protective profile-reducing sheath of an angioplasty balloon catheter. When the Viatorr endoprosthesis is being prepared on the table, this access sleeve may be inadvertently removed, causing immediate flaring of the leading 2-cm uncovered segment and of the leading 5 mm of the expanded polytetrafluoroethylene (ePTFE)–covered segment of the stent graft. Alternatively, the sleeve may be incompletely advanced to the far margin of the hemostatic valve body of the 10-F delivery sheath (). Both maneuvers lead to partial maldeployment of the Viatorr endoprosthesis outside of th...

Comparison of epicardial potential maps derived from the 12-lead electrocardiograms with scintigraphic images during controlled myocardial ischemia

Journal of Electrocardiology — Wed, 26 Oct 2011 08:41:35 +0100

In conclusion, our findings demonstrate that noninvasive ECG imaging based on just the 12-lead ECG might provide useful estimates of the regions of myocardial ischemia that agree with those provided by scintigraphic techniques. (Source: Journal of Electrocardiology)

Iliac-Femoral Venous Stenting for Lower Extremity Venous Stasis Symptoms

Annals of Vascular Surgery — Mon, 24 Oct 2011 04:00:00 +0100

Conclusion: Over half of our patients with open ulcers had stenotic lesions. The ulcers healed in 58% of the stented limbs. That indicates that outflow obstruction may play a significant role in patients with chronic venous stasis symptoms, especially those with open ulcers who failed to respond to other treatment modalities. The procedure itself is relatively safe and simple and can be performed on an ambulatory basis. (Source: Annals of Vascular Surgery)

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[Percutaneous, endovascular treatment of innominate artery lesions is a safe and effective procedure].

Orvosi Hetilap — Sun, 23 Oct 2011 04:00:00 +0100

Authors: Paukovits TM, Nemes B, Hüttl K, Bérczi V Abstract Percutaneous endovascular treatment (transluminar balloon angioplasty with or without stent implantation) of innominate artery lesions has become the treatment of choice prior to surgery in the past decades. Authors present the diagnostics, treatment and follow-up of two patients as examples from their largest series in the literature. A 74-year-old male patient with a history of hyperlipidemia, hypertension, nicotine abuse and lower limb claudication was admitted because of acute upper limb claudication and dizziness. Physical examination revealed blood pressure difference of 30 mmHg between his arms, and poststenotic flow pattern in the common carotid artery with retrograde flow in the vertebral artery on carotid duplex...

[Role of angioplasty in the treatment of renal artery stenosis.]

Annales de Cardiologie et d'Angeiologie — Tue, 18 Oct 2011 04:00:00 +0100

Authors: Armero S, Bonello L, Paganelli F, Barragan P, Roquebert PO, Commeau P Abstract Atherosclerotic renal artery stenosis is frequent and is associated with a high incidence of morbidity and mortality, with a strong correlation with coronary artery disease, (Kalra et al., 2005; Cheung et al., 2002; Guo et al., 2007 [1-3]). The atherosclerotic renal artery stenosis is an independent predictive factor of death (Conlon et al., 1998 [4]). The treatment of this lesion does not have strong evidence. A lot of studies in this area suggest the angioplasty is superior in a big majority between surgery, and angioplasty with stent is superior between balloon angioplasty, but some studies fail to prove the superiority of angioplasty versus medical treatment. These studies have sadly a lot o...

Thrombus Aspiration Alone: A Potential Strategy in ST Elevation Myocardial Infarction Intervention

Heart, Lung and Circulation — Sat, 15 Oct 2011 01:44:50 +0100

We are reporting a case of 46 year-old man, smoker with strong family history of coronary artery disease, presenting with acute anterolateral ST elevation myocardial infarction (STEMI). Diagnostic angiography revealed thrombus at the distal left main, occluding the anterior descending and intermediate arteries. Thrombus aspiration was performed with successful return of flow in the left coronary system. Stenting was deferred due to absence of occlusive lesion. He was commenced on glycoprotein (GP) IIbIIIa inhibitor and received intra-aortic balloon pulsation for haemodynamic support. Follow-up angiography revealed good flow in left coronary artery with normal ventricular function and no significant disease. He remained event-free at one-year follow-up. This case demonstrated that in the ab...

Long-Term Impact of Periprocedural Bleeding: When Does It End?⁎

Journal of the American College of Cardiology — Sat, 15 Oct 2011 01:35:22 +0100

The landmark observation by DeWood et al. () that acute myocardial infarctions result from in situ coronary thrombosis ushered in a new era of therapy for patients with acute coronary syndromes. Since that time, a variety of pharmacologic treatments have been developed to inhibit the coagulation cascade, targeting almost all cellular and protein constituents of the thrombotic process. Not surprisingly, strategies aimed at thrombolysis, clot dissolution, and prevention of its recurrence within the coronary tree may have similar effects in other vascular beds. The unintended consequences of these antithrombotic therapies at noncoronary artery sites may result in significant bleeding that in some cases, such as an intracranial hemorrhage, may be fatal. Although bleeding as a “side effect”...

Unusual presentation of Takayasu's arteritis as posterior reversible encephalopathy syndrome

Annals of Indian Academy of Neurology — Tue, 11 Oct 2011 04:00:00 +0100

We report a child with Takayasu's arteritis who presented a posterior reversible encephalopathy syndrome. He also had associated abdominal tuberculosis for which anti-tuberculous treatment was started. PRES was diagnosed by magnetic resonance imaging with fluid-attenuated inversion recovery sequences. The child was started on nifedipine and propranolol. The child regained his consciousness within 48 h of admission. Prompt treatment of hypertension led to rapid reversal of neurological symptoms. In view of hypertension a computed tomography aortogram was done, which showed features suggestive of high grade (>75%) focal proximal left renal artery stenosis. EULAR (European League Against Rheumatism)/PReS (Paediatric Rheumatology European Society) consensus criteria was used f...

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A dietary approach to increase in-stent stenosis and face validity of a rat model for arterial angioplasty and stenting

Atherosclerosis — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Arterial stenting, in combination with the atherogenic diet, led to exacerbated endothelial dysfunction, inflammation, platelet activation, and vascular remodeling compared with stented rats on normal chow. By reproducing key features of clinical restenosis that are lacking in other rat models, this modified rat model may serve as a valuable screening tool to rapidly evaluate new coatings and devices before moving candidates into expensive, more time-consuming rabbit or porcine models. (Source: Atherosclerosis)

Elective Coronary Angioplasty Or Stent Placement Same Day Discharge - No Greater Risk Of Death

Health News from Medical News Today — Fri, 07 Oct 2011 15:00:00 +0100

A study published in the October 5 issue of JAMA shows that selected low-risk Medicare patients who underwent an elective percutaneous coronary intervention (PCI), such as balloon angioplasty or stent placement were rarely discharged the same day even though there is no increased risk of being readmitted to hospital or having a higher risk of death 2 or 30 days after the procedure compared with patients who remain in hospital overnight... (Source: Health News from Medical News Today)

New Approach To Keeping Coronary Arteries Open After Angioplasties

Health News from Medical News Today — Mon, 03 Oct 2011 07:00:00 +0100

Research at Loyola University Chicago Stritch School of Medicine could help lead to new ways to prevent coronary arteries from reclogging after balloon angioplasties. The latest in a series of studies in this effort is published online ahead of print in Arteriosclerosis, Thrombosis and Vascular Biology, a journal of the American Heart Association. Senior author is Allen M. Samarel, MD, and first author is Yevgeniya E. Koshman, PhD. In an angioplasty, a tiny balloon is inflated to open a clogged coronary artery... (Source: Health News from Medical News Today)

Ultrasound-Guided Angioplasty of Autogenous Arteriovenous Fistulas in the Office Setting

Journal of Vascular Surgery — Sat, 01 Oct 2011 04:00:00 +0100

This study reviews our experience with ultrasound-guided angioplasty of AVFs in the office setting. (Source: Journal of Vascular Surgery)

Researchers report new approach to keeping coronary arteries open after angioplasties

EurekAlert! - Medicine and Health — Fri, 30 Sep 2011 04:00:00 +0100

(Loyola University Health System) Loyola University Chicago researchers report a possible new approach to preventing coronary arteries from reclogging after balloon angioplasties. (Source: EurekAlert! - Medicine and Health)

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Infrapopliteal Angioplasty versus Bypass for Critical Limb Ischemia

Journal of Pakistan Medical Students — Fri, 30 Sep 2011 04:00:00 +0100

The objective evidence includes ankle-brachial index (ABI, <0.5), toe systolic pressure (<30mmHg), or ankle systolic pressure (<50mmHg) 1, 2, 3. The prevalence of PAD based on objective testing ranges from 3% to 10% in general population 1. CLI occurs in 1-2% of PAD patients who are over 50 years 1. CLI has a grave prognosis with a one-year mortality rate of 20% and a one-year amputation rate of 25% after the initial diagnosis 2. Within six months of initial diagnosis, 40% of the patients with unreconstructable disease require a major amputation 2. A major amputation is one in which a prosthesis is required to allow standing and walking; for example Syme’s amputations, and all of the amputations above the ankle 3. Interventions for the treatment of CLI include conservative thera...

Limb Salvage after Infrapopliteal Angioplasty for Critical Limb Ischemia in Surgically High Risk patients in Iran

Journal of Pakistan Medical Students — Fri, 30 Sep 2011 04:00:00 +0100

Conclusions: Infrapopliteal angioplasty alone or with stenting is a valuable treatment option for the prevention of amputations in patients with CLI for whom surgical bypass is not an option and in whom the risk of amputation is high. Key words: Critical limb ischemia; below-the-knee; percutaneous transluminal angioplasty; Peripheral Arterial Disease. INTRODUCTION Atherosclerosis is a common cause of morbidity and mortality with a prevalence of 11.4% to 33.8% in individuals above 60 years of age1,2. The prevalence of intermittent claudication, a symptom of peripheral arterial atherosclerosis, is estimated to be present in 6-10% of the elderly population. Of these, 10–20% may develop severe limb-threatening ischemia, requiring endovascular or surgical revascularization and in some cases...

Polarcath cryoplasty enhances smooth muscle cell apoptosis in a rabbit iliac artery model: An experimental in vivo controlled study.

Cryobiology — Thu, 29 Sep 2011 04:00:00 +0100

CONCLUSION: Cryoplasty demonstrated superior rates of SMC apoptosis at 30min and 72h and was associated to relatively low arterial injury and inflammation scores. An immediate second PolarCath inflation did not achieve superior apoptosis. PMID: 21982952 [PubMed - as supplied by publisher] (Source: Cryobiology)

Open Aortic Stent Grafting and Prosthetic Bypass in a Child [CASE REPORTS]

The Annals of Thoracic Surgery — Wed, 28 Sep 2011 04:00:00 +0100

Pseudoaneurysm is a major complication of percutaneous balloon angioplasty to treat recoarctation and restenosis after an interrupted aortic arch repair. Endovascular stent grafting to manage this complication has rarely been performed in children. We used a combination of open stent grafting and a prosthetic ascending aorta-to-descending aorta bypass to treat a pseudoaneurysm and ascending aorta stenosis in a 7-year-old child. (Source: The Annals of Thoracic Surgery)

Up Your Nose with a Rubber Hose: Balloon Sinuplasty

DukeHealth.org: Duke Health Features — Tue, 27 Sep 2011 17:33:58 +0100

Alicia Pierce used to feel the sinus pressure in her teeth. Each spring, her lifelong allergies flared up and her chronic sinus problems took a turn for the worse. The pain and pounding migrated south from her forehead and nose down to her mouth. It was awful.Every few years since 1992, Pierce went in for surgery to open up sinuses so prone to infection that twice she suffered from methicillin-resistant Staphylococcus aureus (MRSA), a bacterial infection highly resistant to antibiotics. In all, she had five surgeries and countless courses of antibiotics. Often, recovery from surgery was just as unpleasant as a sinus infection -- blood drained down her throat, and she needed several days to get over the effects of the anesthesia. New Hope for Sinus Sufferers Then, last March, with a raging ...

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Acute aortic dissection after balloon angioplasty of a recoarctation and treatment by stenting and distal membrane fenestration in a child

Heart — Fri, 23 Sep 2011 04:00:00 +0100

We report of a 10-year-old patient after neonatal end-to-end coarctation repair who developed recoarctation. During balloon angioplasty, an acute type B dissection of the complete descending aorta occurred. Because of multiple entrances, the false lumen could not be excluded from blood flow by stent implantation (panel A). Abdominal organs were partially perfused via the true and false lumen. Due to obstruction of the true lumen and signs of abdominal organ and lower... (Source: Heart)

Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit.

Journal of Orthopaedic Surgery and Research — Fri, 23 Sep 2011 04:00:00 +0100

Background: All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact obtaining a pre-operative echocardiogram on the management of hip fracture patients. Methods: All hip fracture patients (N=349) between 01/06/08 and 01/06/09 were included in the study. 29 patients had pre-operative echocardiogram (echo group). A computer generated randomised sample of 40 patients was generated from N, 'non-echo' group. Data was obtained from medical records and the Hospital Information Support System (HISS). The groups were compared using Student's t test. Approval was obtained locally from the clinical governance department for this project. Results: Age and gender distribution were...

Intracranial Stenting of Subacute Symptomatic Atherosclerotic Occlusion Versus Stenosis.

Stroke — Thu, 22 Sep 2011 04:00:00 +0100

CONCLUSIONS: In a cohort of patients undergoing angioplasty/stenting for subacute atherosclerotic intracranial artery occlusion, no significant difference in the rates of adverse events was observed. However, several factors, including age, tended to be associated with a higher event rate. PMID: 21940974 [PubMed - as supplied by publisher] (Source: Stroke)

Coating Stents With Medication May Allow Targeted Delivery

Health News from Medical News Today — Mon, 19 Sep 2011 07:00:00 +0100

Researchers at Cleveland Clinic have discovered that cardiac patients receiving medicated stents - a procedure that occurs often when blood vessels are blocked - have a lower likelihood of suffering heart attacks or developing new blockages in the vessel downstream from the stent. Stents have been used to prevent re-narrowing of coronary arteries after balloon angioplasty and newer designs have included coatings with medications to prevent re-narrowing from occurring within the stent after implantation. The recent study - led by Richard Krasuski, M.D... (Source: Health News from Medical News Today)

One‐year Outcomes with Angiographic Follow‐Up of Paclitaxel‐Eluting Balloon for the Treatment of In‐Stent Restenosis: Insights from Spanish Multicenter Registry

Journal of Interventional Cardiology — Thu, 15 Sep 2011 04:00:00 +0100

Conclusion: In a real‐world population, treatment of ISR (including 48% DES‐ISR) with this DEB provides good mid‐term results with 12% TLR at 1 year, especially in ISR pattern IC (9% MACE). (J Interven Cardiol 2011;00:1–11) (Source: Journal of Interventional Cardiology)

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Infrainguinal disease treatment: to stent or not to stent.

The Journal of Cardiovascular Surgery — Thu, 15 Sep 2011 00:09:11 +0100

Authors: Dosluoglu H, Lall P Abstract Infrainguinal endovascular interventions have increasingly played a central role in relieving symptoms of claudication and limb salvage over the last decade. Multiple modalities currently exist for treating these arteries; however, balloon angioplasty with or without stenting still remains the most commonly used technique. Despite the concerns regarding the use of stents with stent fractures and in-stent restenosis, there is increased evidence from randomized and non-randomized studies that use of nitinol stents improves patency rates in most patients with >5 cm long lesions. However, the optimal endovascular treatment of the longest lesions is still debated. Infrapopliteal vessels are still mostly treated with balloon angioplasty, but selec...

Creighton Gets $2.58 Million To Explore Novel Cardiovascular Treatment

Health News from Medical News Today — Wed, 14 Sep 2011 08:00:00 +0100

Creighton University researcher Devendra K. Agrawal, Ph.D., has received a $2.58 million, four-year grant from the National Institutes of Health to explore a potential new treatment for a problem that plagues many cardiovascular disease patients - re-narrowing of the coronary arteries after angioplasty and the implantation of stents. The research ultimately could eliminate the need for stents in cardiovascular care. With angioplasty, a catheter-guided balloon is inserted to open a narrowed coronary artery... (Source: Health News from Medical News Today)

Endovascular Treatment of Diabetic Foot Syndrome: Results from a Single Center Prospective Registry Using Mixed Coronary and Peripheral Techniques and Equipment

Journal of Interventional Cardiology — Mon, 12 Sep 2011 04:00:00 +0100

To assess the long‐term results of interventional treatment of diabetic foot using mixed coronary and peripheral equipments and techniques. The interventional diabetic foot syndrome treatment is rapidly becoming the therapy of choice in such patients, but proper materials and techniques are still debated. From January 2006 to December 2010, we prospectively enrolled 220 diabetic patients (78.5 ± 15.8 years, 107 females, all with Fontaine III or IV class), referred to our center for diabetic foot syndrome and severe limb ischemia. Mixed coronary and peripheral guidewires and balloons techniques were used. Doppler ultrasonography and foot transcutaneous oxygen pressure (TCPO2) before and after the procedure were calculated as well as the amputation rate. The preferred approach was ipsilat...

Angioslide Announces The European Launch Of New 300 mm Long Device Allowing Treatment Of Entire Superficial Femoral Artery (SFA) With One Device

Medical Design Online News — Thu, 08 Sep 2011 08:13:00 +0100

Angioslide Ltd. announces the first procedures with its new 5x300mm PROTEUS device for treating the Superficial Femoral Artery (SFA). PROTEUS technology combines a Percutaneous Transluminal Angioplasty (PTA) balloon and embolic capture of particles in one device. The new 5x300 mm size joins Angioslide's current dedicated product line solutions for the lower limbs (Source: Medical Design Online News)

AngioScore Launches New 100 mm AngioSculpt(R) Scoring Balloon Catheters for Treatment of Peripheral Artery Disease

HSMN NewsFeed — Tue, 06 Sep 2011 15:35:41 +0100

FREMONT, Calif.--(Healthcare Sales & Marketing Network)-- AngioScore, Inc., a developer of novel angioplasty catheters for use in the treatment of cardiovascular disease, today announced the launch of its new 100 mm AngioSculpt PTA Scoring Balloon Catheter... Devices, InterventionalAngioScore, AngioSculpt, Scoring Balloon Catheter (Source: HSMN NewsFeed)

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Cryo-Balloon Angioplasty for Pulmonary Vein Stenosis in Pediatric Patients

Pediatric Cardiology — Sun, 04 Sep 2011 10:55:07 +0100

This study sought to determine the safety and effectiveness of cryo-balloon angioplasty (CbA) for pulmonary vein stenosis (PVS) in pediatric patients. Current therapy options for PVS are less than satisfactory due to recurrent progressive restenosis and neointimal proliferation. Catheterization database, hospital records, imaging studies, and pathologic specimens were reviewed for procedural-related and outcomes data in all patients who underwent pulmonary vein (PV) CbA using the Boston Scientific PolarCath Peripheral Dilation System between August 2006 and June 2009. Thirteen patients (19 PVs; median age 13 months [range 3.5 months to 18.5 years] and weight 7.9 kg [range 3.8 to 47.7]) underwent CbA. Mean PVS diameter after CbA increased from 2.19 (±0.6) to 3.77 ...

First Experience With Drug-Eluting Balloons in Infrapopliteal Arteries: Restenosis Rate and Clinical Outcome

Journal of the American College of Cardiology — Sat, 03 Sep 2011 13:27:50 +0100

Conclusions: The early restenosis rate of long-segment infrapopliteal disease is significantly lower after treatment with DEBs compared with historical data using uncoated balloons. Randomized trials are required to show whether this difference will lead to improvement in clinical outcomes. (Source: Journal of the American College of Cardiology)

Trends in lower extremity surgical and endovascular revascularization in Germany.

VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases — Thu, 01 Sep 2011 04:00:00 +0100

Conclusions: The numbers of endovascular procedures overweigh the numbers of open surgical procedures for treatment of lower extremity PAD in Germany today. In contrast to data from the USA we could not demonstrate a decrease of open surgical procedures in Germany in recent years. PMID: 21948783 [PubMed - in process] (Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases)

Influence and Critique of the ASTRAL and CORAL Trials

Seminars in Vascular Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Optimal management of renal artery atherosclerotic occlusive disease has been widely debated and studied. Although the accepted invasive treatment has evolved into favoring balloon angioplasty and stenting, the indications for intervention or medical therapy have not been universally agreed upon. The Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial was conducted to answer the question of whether medical therapy or angioplasty and stenting is the best treatment for hemodynamically significant renal artery stenosis. However, the ASTRAL trial's study design was faulty and therefore did not provide conclusive evidence to answer the question. The Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) trial was designed to answer the same question as to which treatment ...

Reprinted Article "Subintimal Angioplasty of Femoropopliteal Artery Occlusions: The Long-term Results".

PubMed: Eur J Vasc Endovasc ... — Wed, 31 Aug 2011 23:00:00 +0100

In conclusion, the technical success rate (80%) of subintimal angioplasty for femoropopliteal occlusions is unrelated to occlusion length and for all procedures, including technical failures, cumulative symptomatic and haemodynamic patencies of 46 and 48% can be achieved at 3 years. The factors influencing long-term patency were smoking, the number of calf run-off vessels and occlusion length. PMID: 21855032 [PubMed - in process] (Source: PubMed: Eur J Vasc Endovasc ...)

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Dyslipidemia Regulates Thrombospondin-1–Induced Vascular Smooth Muscle Cell Chemotaxis

Journal of Vascular Surgery — Wed, 31 Aug 2011 23:00:00 +0100

Nearly one-third of Americans have dyslipidemia, as assessed by decreased high-density lipoprotein (HDL) and increased low-density lipoprotein (LDL) levels. Dyslipidemia and increased oxidized LDL (oxLDL) levels are risk factors for atherosclerosis and restenosis due to intimal hyperplasia (IH) after balloon angioplasty. A key process in IH development is vascular smooth muscle (VSMC) cell migration. LDL and oxLDL stimulate VSMC migration and potentiate agonist-induced migration. In contrast, HDL inhibits VSMC migration to pro-migratory agonists. LDL may induce migration through its lysophosphatidic acid (LPA) moiety, and HDL may inhibit migration through its sphingosine-1-phosphate (S1P) moiety, which stimulates cyclooxygenase 2 (COX2)-dependent prostacyclin release. The effect of LDL, ox...

Standard Versus Prolonged Inflation Time in Balloon Angioplasty of Atherosclerotic Rat Aortas

Journal of Vascular Surgery — Wed, 31 Aug 2011 23:00:00 +0100

The ideal balloon inflation time in balloon angioplasty remains unknown. There are theoretic benefits for a prolonged inflation time in peripheral vessels, including reduced intimal trauma and recoil, but studies have been inconclusive. Our research compared the arterial response to prolonged inflation time (3 minutes) and standard inflation time (30 seconds) in a rat aortic angioplasty model. (Source: Journal of Vascular Surgery)

Endovascular Treatment of Stenoses in a Pediatric Patient With Incomplete Aortic Duplication, Mesenteric Ischemia, and Renovascular Hypertension

Journal of Vascular Surgery — Wed, 31 Aug 2011 23:00:00 +0100

We present a pediatric patient with symptoms of chronic mesenteric ischemia, labile hypertension, and lower extremity claudication who had congenital stenoses within an incompletely duplicated abdominal aorta that was successfully treated by balloon angioplasty. (Source: Journal of Vascular Surgery)

Open plugging and extra-anatomical bypass for iatrogenic rupture of coarctation of the aorta.

The Annals of Thoracic Surgery — Wed, 31 Aug 2011 23:00:00 +0100

We report a successful repair of aortic rupture after balloon angioplasty for re-coarctation using a unique approach and method. A 22-year-old woman underwent emergency surgery for aortic rupture after balloon angioplasty for postoperative aortic re-coarctation. We performed extra-anatomic bypass from the ascending aorta to the descending thoracic aorta through a median sternotomy and incision in the posterior pericardium. The transverse aortic arch was transected, and the distal aortic arch was opened under deep hypothermic circulatory arrest of the lower extremities. The proximal aorta was closed. To seal the aortic rupture site, a tube graft was inserted through the aortotomy and was oversewn with the aorta. Repair of the right ventricular outflow stenosis was concomitantly performed. T...

Open Plugging and Extra-Anatomical Bypass for Iatrogenic Rupture of Coarctation of the Aorta [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 30 Aug 2011 23:00:00 +0100

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Heart Attack Damage Not Reduced by Adding Balloon Pump to Angioplasty

The Doctors Lounge - Health News — Tue, 30 Aug 2011 14:00:00 +0100

But some patients with rapid deterioration might still benefit from it, researchers say (Source: The Doctors Lounge - Health News)

Balloon pump use prior to angioplasty does not reduce heart muscle damage, study shows

ScienceDaily Headlines — Tue, 30 Aug 2011 12:21:21 +0100

Inserting intra-aortic balloon pumps prior to angioplasty in patients with acute myocardial infarction does not reduce the scope of heart muscle damage, a condition referred to as infarct size, according to a new study. (Source: ScienceDaily Headlines)

Increasing Pre- And Post-Bloodflow After A Percutaneous Coronary Intervention Might Not Be Beneficial

Health News from Medical News Today — Tue, 30 Aug 2011 10:00:00 +0100

Permanent damage to heart muscle was not reduced when intra-aortic balloon counter-pulsation procedure was used to increase pre- and post-bloodflow after a percutaneous coronary intervention among patients with certain types of heart attacks, researchers reported in JAMA (Journal of the American Medical Association). Examples of percutaneous coronary intervention include stent placement for widening narrowed coronary arteries or balloon angioplasty... (Source: Health News from Medical News Today)

Heart Attack Damage Not Reduced by Adding Balloon Pump to Angioplasty

MedicineNet Heart General — Tue, 30 Aug 2011 07:00:00 +0100

Title: Heart Attack Damage Not Reduced by Adding Balloon Pump to AngioplastyCategory: Health NewsCreated: 8/30/2011 10:05:00 AMLast Editorial Review: 8/30/2011 (Source: MedicineNet Heart General)

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Study shows balloon pump use prior to angioplasty does not reduce heart muscle damage

EurekAlert! - Medicine and Health — Tue, 30 Aug 2011 04:00:00 +0100

(Duke University Medical Center) Inserting intra-aortic balloon pumps prior to angioplasty in patients with acute myocardial infarction does not reduce the scope of heart muscle damage, a condition referred to as infarct size, according to a new study conducted by Duke University Medical Center researchers. (Source: EurekAlert! - Medicine and Health)

Percutaneous stent implantation into coronary arteries in infants

Catheterization and Cardiovascular Interventions — Mon, 29 Aug 2011 23:00:00 +0100

Conclusions: Our experience suggests that coronary artery stent implantation is a feasible and relatively safe palliative option in infants and toddlers with coronary stenosis. It is a viable strategy for bridging patients with acute ischemia or poor ventricular function to elective surgical revascularization or transplantation. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Thrombectomy of Prosthetic Dialysis Grafts Using Mechanical Plus “No‐Wait Lysis” Approach Requires Less Procedure Time and Radiation Exposure

Seminars In Dialysis — Sat, 27 Aug 2011 23:00:00 +0100

In conclusion, our data support that the use of “no‐wait lysis” approach for dialysis graft thrombectomy substantially reduces procedure time and radiation exposure, and it may serve as an efficient and economical alternative to other existing approaches. (Source: Seminars In Dialysis)

Thrombectomy of Prosthetic Dialysis Grafts Using Mechanical Plus "No-Wait Lysis" Approach Requires Less Procedure Time and Radiation Exposure.

Seminars in Dialysis — Sat, 27 Aug 2011 23:00:00 +0100

In conclusion, our data support that the use of "no-wait lysis" approach for dialysis graft thrombectomy substantially reduces procedure time and radiation exposure, and it may serve as an efficient and economical alternative to other existing approaches. PMID: 21883466 [PubMed - as supplied by publisher] (Source: Seminars in Dialysis)

Angioplasty of a persistent sciatic artery: case report

Jornal Vascular Brasileiro — Sat, 27 Aug 2011 21:52:06 +0100

Transluminal balloon angioplasty is a good choice for the treatment of lower limb arterial occlusion. Although there are some guidelines addressing its indications, some situations are so unusual that there is no consensus on their management. The presence of a persistent sciatic artery is a rare congenital anomaly of the circulatory system and may be associated with early atheromatous degeneration and occlusion. The authors describe the case of an 81-year-old woman that presented with a history of rest pain, atrophic lesion and no distal pulses. Angiogram depicted a persistent sciatic artery with segmental occlusion and distal disease. The therapeutic option was balloon angioplasty of the occluded segment, with technical and clinical success at mid-term follow-up.A angioplastia translumin...

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"Door-To-Balloon" Time Improves For Heart Attack Patients

Health News from Medical News Today — Tue, 23 Aug 2011 09:00:00 +0100

Almost all heart attack patients who need the emergency artery-opening procedure known as angioplasty are receiving it within 90 minutes of being admitted to the hospital, a marked improvement from five years ago when most patients waited longer for the life-saving procedure, according to a report by Yale School of Medicine researchers and their colleagues. Published in Circulation: Journal of American Heart Association, the five-year study is one of the most comprehensive analyses of angioplasty timeliness... (Source: Health News from Medical News Today)

Over 90% Of Heart Attack Patients Requiring Angioplasty Getting It Within Recommended 90 Minutes

Health News from Medical News Today — Tue, 23 Aug 2011 02:00:00 +0100

The vast majority of patients who have a heart attack and require angioplasty are receiving the right treatment within 90 minutes, compared to just 44% in 2005, researchers from Yale University School of Medicine reported in the journal Circulation. Among those who underwent angioplasty, the time from hospital admission to the procedure dropped from 96% to 64% from 2005 to 2010. An Angioplasty, also known as a Percutaneous Transluminal Coronary Angioplasty (PTCA) is an emergency procedure - a balloon-tipped catheter is used to enlarge a blocked artery, restoring blood flow... (Source: Health News from Medical News Today)

Thrombin and vascular inflammation.

Molecular and Cellular Biochemistry — Mon, 22 Aug 2011 23:00:00 +0100

Authors: Popović M, Smiljanić K, Dobutović B, Syrovets T, Simmet T, Isenović ER Abstract Vascular endothelium is a key regulator of homeostasis. In physiological conditions it mediates vascular dilatation, prevents platelet adhesion, and inhibits thrombin generation. However, endothelial dysfunction caused by physical injury of the vascular wall, for example during balloon angioplasty, acute or chronic inflammation, such as in atherothrombosis, creates a proinflammatory environment which supports leukocyte transmigration toward inflammatory sites. At the same time, the dysfunction promotes thrombin generation, fibrin deposition, and coagulation. The serine protease thrombin plays a pivotal role in the coagulation cascade. However, thrombin is not only the key effector of coagul...

Paget–Schroetter Syndrome Treated with Cutting-Balloon Angioplasty

CardioVascular and Interventional Radiology — Tue, 16 Aug 2011 06:10:08 +0100

Abstract Here, a case of Paget–Schroetter Syndrome in a 25-year-old guitar player is reported. After thrombolysis, conventional angioplasty failed to dilate the underlying subclavian stenosis both before and after first-rib excision with scalenus anterior and medius division. For the third attempt at angioplasty, a cutting balloon was used, which immediately produced a good result. Venography at 4-year follow-up showed no restenosis and no functional deficit. This case report demonstrates that cutting-balloon angioplasty may be considered when conventional balloon fails and may have greater durability than conventional balloon angioplasty in the treatment of Paget–Schroetter syndrome. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00270-011-0...

Total sleep deprivation augments balloon angioplasty‐induced neointimal hyperplasia in rats

Experimental Physiology — Tue, 16 Aug 2011 04:00:00 +0100

Sleep deprivation has been shown to be associated with an increase in inflammation that is also involved in the development of neointimal hyperplasia (or restenosis). The purpose of this study was to investigate whether total sleep deprivation (TSD) would worsen neointimal formation by balloon injury. Sixteen rats were randomly allocated into the following four groups: group 1, balloon angioplasty alone; group 2, TSD prior to angioplasty; group 3, angioplasty before TSD; and group 4, TSD before and after angioplasty. Total sleep deprivation was induced by the disc‐over‐water method, and balloon angioplasty was performed in the carotid artery. Histopathological analysis and assay of cytokines were applied to evaluate the effects of TSD in this study. Total sleep deprivation significantl...

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Total sleep deprivation augments balloon angioplasty‐induced neointimal hyperplasia in rat

Experimental Physiology — Mon, 15 Aug 2011 23:00:00 +0100

Abstract Sleep deprivation has been shown to be associated with an increase in inflammation that also involved in the development of neointimal hyperplasia (or restenosis). The purpose of this study was to investigate whether total sleep deprivation (TSD) will worsen neointimal formation by balloon injury. Sixteen rats were randomly allocated into four groups: Group 1, balloon angioplasty alone; Group 2, TSD prior to angioplasty; Group 3, angioplasty before TSD; Group 4, TSD before and after angioplasty. TSD was induced by the disc‐on‐water method, and balloon angioplasty was performed in rat carotid artery. The histopathological analysis and cytokines assay were applied to evaluate the effects of TSD in this study. TSD significantly increased the ratio of post‐injury neointima‐...

Study looks at early liberation therapy of MS patients

CTV Health — Sat, 13 Aug 2011 00:44:34 +0100

A small study of 15 patients with multiple sclerosis suggests those who get balloon angioplasty treatment earlier have fewer disease relapses, and may have decreased brain volume that could indicate a lessening of inflammation in their brains. (Source: CTV Health)

Endovascular Treatment of Common Femoral Artery Disease: Medium-Term Outcomes of 360 Consecutive Procedures

Journal of the American College of Cardiology — Wed, 10 Aug 2011 16:23:42 +0100

Conclusions: This large series suggests that the percutaneous approach may be a valid alternative to surgery for CFA atherosclerotic obstructions. (Source: Journal of the American College of Cardiology)

Stent thrombosis and drug-eluting stents.

Journal of Cardiology — Tue, 09 Aug 2011 23:00:00 +0100

Authors: Takayama T, Hiro T, Hirayama A Abstract Coronary stents have been used for the treatment of patients with coronary artery disease (CAD), and significantly improved procedural safety and are associated with a lower rate of restenosis compared with balloon angioplasty alone. Drug-eluting stents (DES) have been dominant for the treatment of CAD with efficacy in significantly reducing both restenosis and target lesion revascularization. However, late and very late stent thrombosis have become a major concern in DES-implanted arteries compared with those treated with bare-metal stents (BMS). This review focuses on the feature of DES thrombosis and pathological examination and dual antiplatelet therapy for prevention of stent thrombosis. Currently, the incidence of stent thrombo...

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A case of successful angioplasty by the “double retrograde” approach for chronic total occlusion in the left circumflex artery

Catheterization and Cardiovascular Interventions — Mon, 01 Aug 2011 23:00:00 +0100

This article describes a case of CTO in the left circumflex artery (LCX), which did not allow the regular retrograde approach to deliver a guide wire. At first, a guide wire was attempted to advance from the apical collateral channel, which supplied the distal LCX. However, wiring was extremely difficult because the collateral channel was headed reversely against the direction that the wire was going. Different angle angiogram revealed the existence of another collateral artery, which supplied the distal RCA (posterior descending branch). A guide wire was successfully advanced from the distal RCA, through apical collateral channel, and reached the distal LCX. After the wire was retrieved from the guiding catheter engaged in the left main trunk, antegrade access for balloon and stent delive...

Confluent Two-Balloon Technique: An Alternative Method for Subintimal Recanalization of Peripheral Arterial Occlusion

Journal of Vascular and Interventional Radiology : JVIR — Fri, 29 Jul 2011 17:55:11 +0100

Abstract: The present report describes a technique of simultaneous confluent balloon inflation in cases in which conventional subintimal angioplasty failed. Eight patients with peripheral vascular occlusive disease (n = 4 each with iliac arterial lesions and superficial femoral arterial lesions) of clinical category 3–5 received treatment with the confluent two-balloon technique. Recanalization was successfully completed with this technique in all eight patients, without any major complications. All patients with claudication and rest pain were relieved of their symptoms, and both patients with ulcers showed improvement. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Kissing drug eluting balloons for in‐stent restenosis complicating bifurcations treated with drug‐eluting stents

Catheterization and Cardiovascular Interventions — Thu, 28 Jul 2011 23:00:00 +0100

We report two cases where the SeQuent Please was used in this setting with angiographic success and freedom from target vessel failure and angina at 24 months. In both cases the Sheathless Eau Cath guide (Asahi Intecc, Japan) was employed to perform a kissing‐balloon dilatation with the SeQuent Please, so allowing treatment via radial access. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Successful treatment for refractory coronary thrombus with scoring balloon angioplasty

Catheterization and Cardiovascular Interventions — Thu, 28 Jul 2011 23:00:00 +0100

AbstractA female with chronic atrial fibrillation presented with an acute myocardial infarction. The angiogram revealed total occlusion of the right coronary artery. A combined strategy using intracoronary thrombolysis, aspiration catheter, plain old balloon angioplasty, and “Fogarty‐like” procedure was performed. However, we failed to achieve good coronary flow because the thrombus was large and hard with a calcified surface revealed by intravascular ultrasound examination. Ultimately, compression of the thrombus with the AngioSculpt™ scoring balloon catheter (AngioScore, Fremont, CA) led to resolution of normal coronary flow without the need for implantation of a coronary stent. Calcified thrombus is rarely observed in a coronary artery embolism, especially one formed in the left...

Serum Levels After Everolimus-Stent Implantation and Paclitaxel-Balloon Angioplasty in an Infant with Recurrent Pulmonary Vein Obstruction After Repaired Total Anomalous Pulmonary Venous Connection

Pediatric Cardiology — Wed, 27 Jul 2011 15:50:39 +0100

Abstract Everolimus-eluting stents and paclitaxel-coated balloons are used in the interventional treatment of coronary artery disease in adults to reduce the restenosis rate and in small-vessel disease. Both substances are released into the circulation. We report systemic drug exposure after implantation of one everolimus-eluting stent and dilation with one paclitaxel-coated balloon in an 8-month-old infant, which was used as an innovative therapy for recurrent pulmonary vein stenosis. Content Type Journal ArticlePages 1-4DOI 10.1007/s00246-011-0054-1Authors Matthias J. Müller, Department for Pediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, GermanyUlrich Krause, Department for Pediatric Cardio...

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Bare-Metal Stents Versus Drug-Eluting Stents for Primary Angioplasty: Long-Term Outcome

Current Cardiology Reports — Tue, 26 Jul 2011 15:47:41 +0100

Abstract Percutaneous transluminal coronary intervention (PCI) is the most used myocardial revascularization technique for patients with coronary artery disease. Primary PCI with stent implantation is widely considered the gold standard for the treatment of ST-elevation myocardial infarction patients. Coronary stents, compared with balloon angioplasty, have reduced focal lesion restenosis. To reduce in-stent restenosis, drug-eluting stents (DES) were designed to locally release drugs inhibiting neointimal growth. Recent concerns have emerged on the potential higher risk of stent thrombosis with DES that might be even more pronounced among myocardial infarction patients. For these reasons, DES for primary PCI remains an “off-label” use. In the last several years, a numb...

Outcomes of Coronary Arterial Perforations During Percutaneous Coronary Intervention With Bivalirudin Anticoagulation

The American Journal of Cardiology — Mon, 25 Jul 2011 04:00:00 +0100

In conclusion, our study suggests that choice of procedural anticoagulant agent does not influence outcome when CP occurs. Therefore, use of BIV should not be discouraged in patients undergoing high-risk intervention for perforations. (Source: The American Journal of Cardiology)

Rationale and Design of a Randomised Controlled Trial Comparing Stent-Protected Angioplasty with Bypass Surgery for Intermittent Claudication: The ABC Study.

PubMed: Eur J Vasc Endovasc ... — Sun, 24 Jul 2011 23:00:00 +0100

Authors: Zimmermann A, Berger H, Ulm K, Hoffmann U, Assadian A, Wildgruber M, Eckstein HH, INTRODUCTION: Advanced atherosclerotic lesions of the superficial femoral artery (SFA) may cause intermittent claudication (IC). Besides optimal medical therapy and walking exercise, revascularisation is necessary in many patients. Since short lesions and long occlusions are clearly good indications for angioplasty and bypass surgery respectively, the optimal method for lesions with a length of more than 10 cm and the possibility for an above-the-knee bypass anastomosis is uncertain and widely based on personal preference and institution policy rather than on evidence-based randomised trials. METHODS AND DESIGN: A protocol for a randomised, controlled, open, multicentre study was designed to co...

Prospective randomised trial evaluating a paclitaxel-coated balloon in patients treated with endothelial progenitor cell capturing stents for de novo coronary artery disease

Heart — Tue, 19 Jul 2011 23:00:00 +0100

Conclusions Paclitaxel-coated balloon plus EPC stent implantation is superior to EPC stent implantation alone for treatment of de novo coronary artery disease. Trial registration NCT00732953. (Source: Heart)

Critical Care Guidelines on the Endovascular Management of Cerebral Vasospasm

Neurocritical Care — Fri, 15 Jul 2011 05:53:57 +0100

Abstract Cerebral vasospasm and delayed cerebral ischemia account for significant morbidity and mortality after aneurysmal subarachnoid hemorrhage. While most patients are managed with triple-H therapy, endovascular treatments have been used when triple-H treatment cannot be used or is ineffective. An electronic literature search was conducted to identify English language articles published through October 2010 that addressed endovascular management of vasospasm. A total of 49 articles were identified, addressing endovascular treatment timing, intra-arterial treatments, and balloon angioplasty. Most of the available studies investigated intra-arterial papaverine or balloon angioplasty. Both have generally been shown to successfully treat vasospasm and improve neurological ...

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The 'docking maneuver' for Gore Excluder positioning in the treatment of abdominal aortic aneurysms with an ectatic neck.

Vascular — Thu, 14 Jul 2011 23:00:00 +0100

Authors: Celoria GM, Stefanini T, Brancaccio G, Vecchiati E The aim was to present a technical modification to the 'funnel technique' that allows endovascular repair of infrarenal abdominal aortic aneurysms with an ectatic neck. The body of the Excluder endograft is opened inside the aneurysm, using the slow deployment technique, stopping as soon as the contralateral limb is open. The gate is cannulated in the usual fashion. A percutaneous transluminal angioplasty (PTA) balloon is introduced in the contralateral limb and inflated to nominal pressure. By pulling the introducer of the Excluder delivery system on one side and the PTA balloon on the other, the graft is positioned on the bifurcation with the contralateral leg inside the common iliac artery. At this point, the ipsilateral il...

Percutaneous Lower-extremity Arterial Interventions with Primary Balloon Angioplasty Versus SilverHawk Atherectomy and Adjunctive Balloon Angioplasty: Randomized Trial

Journal of Vascular and Interventional Radiology : JVIR — Tue, 12 Jul 2011 23:00:00 +0100

Conclusions: TLR and TVR at 1 year were statistically similar in atherectomy and primary PTA. Atherectomy reduced the need for bailout stent placement compared with primary PTA. (Source: Journal of Vascular and Interventional Radiology : JVIR)

Stents in Renal Artery Bifurcation Stenosis: A Case Report

Infectious Diseases in Obstetrics and Gynecology — Tue, 12 Jul 2011 13:58:53 +0100

A 39-year-old patient presented with poorly controlled hypertension, and she was referred to renal angiogram and potential renal angioplasty. Renal angiogram showed a bifurcation lesion of the right renal artery. A guide wire was used to cross the upper branch, while the lower branch was protected by another same-type guide wire through the same introducer. Two thin monorail balloons were used to dilate the two branches; however, despite balloon dilatation, the stenosis of the vessels persisted. The “kissing balloon” technique was then attempted by simultaneously inflating both branches using the same balloons, but more than a 70% residual stenosis persisted in each branch. Two stents were finally placed in a “kissing” way through the main renal artery. The imaging ...

Endovascular treatment of symptomatic intracranial stenosis with the Wingspan stent system and Gateway PTA balloon: a multicenter series of 60 patients with acute and midterm results.

Journal of Neurosurgery — Thu, 07 Jul 2011 23:00:00 +0100

Conclusions Endovascular treatment of SIAS demonstrates a moderate risk of neurological complication. Nevertheless, considering the critical natural history of severe refractory lesions, this may be considered the first alternative in cases of failed medical therapy. Technical failure, residual stenosis, or in-stent restenosis did not lead to systematic recurrent stroke in this series, which suggests the importance of plaque stabilization and neoendothelialization. PMID: 21740123 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

Percutaneous transluminal angioplasty and stenting of the vertebral artery ostium with balloon-mounted bare coronary stents

Neurology India — Wed, 06 Jul 2011 23:00:00 +0100

Conclusion : Percutaneous transluminal angioplasty and stenting of the proximal VA was feasible and safe. The risk of restenosis should be analyzed in long-term studies with angiographic follow-up. (Source: Neurology India)

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Perfusion-diffusion mismatch in MRI to indicate endovascular treatment of cerebral vasospasm after subarachnoid haemorrhage

Journal of Neurology, Neurosurgery and Psychiatry — Wed, 06 Jul 2011 23:00:00 +0100

Conclusion The present series suggests that PWI/DWI mismatch is predictive of the development of infarct in the case of CVS. The infarct rate could, however, be improved if proximal CVS was sufficiently reduced. (Source: Journal of Neurology, Neurosurgery and Psychiatry)

Clinical study of the electrophysiological effects of ischemic post-conditioning in patients with acute myocardial infarctions.

Journal of Cardiology — Wed, 06 Jul 2011 23:00:00 +0100

CONCLUSIONS: In the majority of the AMI patients studied, post-CON exhibited significant antiarrhythmic effects as assessed by the change in the QTd. The ventricular dysarrhythmias were also suppressed during the PCI. PMID: 21741800 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Renal Artery Stenosis: Optimizing Diagnosis and Treatment

Progress in Cardiovascular Diseases — Thu, 30 Jun 2011 23:00:00 +0100

Abstract: Renal artery stenosis (RAS) is the most commonly caused by atherosclerosis, with fibromuscular dysplasia being the most frequent among other less common etiologies. A high index of suspicion based on clinical features is essential for diagnosis. Revascularization strategies are currently a topic of discussion and debate. When revascularization is deemed appropriate, atherosclerotic RAS is most often treated with stent placement, whereas patients with fibromuscular dysplasia are usually treated with balloon angioplasty. Ongoing randomized trials should help to better define the optimal management of RAS. (Source: Progress in Cardiovascular Diseases)

Claudication: Treatment Options for Femoropopliteal Disease

Progress in Cardiovascular Diseases — Thu, 30 Jun 2011 23:00:00 +0100

Abstract: Intermittent claudication due to chronic femoropopliteal obstruction is a common disease, and patients are potentially severely disabled by the painful limitation of walking capacity. Despite major advances in pharmacological therapy of atherosclerosis, effective medication specifically for treatment of intermittent claudication is still not available. Training programs work well for patients with mild to moderate symptoms but frequently fail in patients with very compromised walking capacity. Patients with severe symptoms and markedly reduced quality of life therefore are candidates for revascularization. The preferred method of revascularization is endovascular treatment; this includes simple balloon angioplasty, debulking techniques, stent implantation, and, more recently, dru...

Regarding the Commentary for “Novel sutureless telescoping anastomosis revascularization technique of supra-aortic vessels to simplify combined open endovascular procedures in the treatment of aortic arch pathologies”

Journal of Vascular Surgery — Thu, 30 Jun 2011 23:00:00 +0100

We thank Dr Ballard for his comments. Although skepticism can be a good thing, we might remind him that such skepticism greeted innovative disruptive technologies like balloon angioplasty and endovascular aneurysm repair. While our technique may not be as important as these procedures, we believe it does provide a simpler, safer way of performing aortic branch anastomoses, particularly in adverse circumstances. As such it should be helpful to vascular surgeons and at least deserves their attention and evaluation. (Source: Journal of Vascular Surgery)

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Nanotechnology in interventional cardiology

Wiley Interdisciplinary Reviews: Nanomedicine and Nanobiotechnology — Thu, 30 Jun 2011 23:00:00 +0100

AbstractHigh‐grade atherosclerotic stenoses are reduced to zero or minimal residual stenosis grades by a single or a series of balloon angioplasties. Currently, stents are implanted to prevent immediate vascular recoil and elution of an antimitotic drug from the stent struts minimizes restenosis. An unwanted side‐effect of this drug elution is delayed re‐endothelialization which requires treatment with two anti‐platelet drugs, in many cases for a minimum of 1 year to prevent acute in‐stent thrombosis. Advances in stent design and drug elution technology, now in its fourth generation, have not abated this issue. Nanotechnology‐based local drug delivery has the potential to achieve restenosis prevention while not impeding endothelial healing. Molecularly targeted drugs can be aim...

[Placement of dual double-J stents following high-pressure balloon angioplasty for treatment of ureter-ileum bladder anastomosis stricture].

Journal of Southern Medical University — Thu, 30 Jun 2011 23:00:00 +0100

Authors: Yu HL, Ye LY, Lin MH, Yang Y To evaluate the benefit of placement of dual double-J stents following high-pressure balloon angioplasty for treatment of ureter-ileum anastomosis stricture after total bladder resection. PMID: 21764715 [PubMed - in process] (Source: Journal of Southern Medical University)

Inhibitory effects of OD 78 [3-(4-bromo-phenoxy)-4,5-dihydroxybenzoic acid-methyl ester] on the proliferation and migration of TNF-α-induced rat aortic smooth muscle cells.

Archives of Pharmacal Research — Thu, 30 Jun 2011 23:00:00 +0100

Authors: Lim Y, Tudev M, Park ES, Kim WS, Lim IH, Lee MY, Lee H, Jung JK, Hong JT, Yoo HS, Lee MK, Pyo MY, Yun YP The proliferation and migration of vascular smooth muscle cells (VSMCs) play important roles in the formation and progression of intimal thickening in early-phase atherosclerosis and in restenosis after vascular injury. Tumor necrosis factor-α (TNF-α) is released from macrophages in atherosclerotic lesions and from neointimal vascular smooth muscle cells after balloon-injury. Obovatol, a major biphenolic component isolated from the Magnolia obovata leaf, is known to have anti-inflammatory and antitumor activities. The goal of this study was to examine the cardioprotective effects of the obovatol derivative OD 78 on the TNF-α-induced proliferation and migration of rat aor...

Acute Thrombotic Mesenteric Ischemia: Primary Endovascular Treatment in Eight Patients

CardioVascular and Interventional Radiology — Thu, 30 Jun 2011 06:10:14 +0100

Results With Viabahn-Assisted Subintimal Recanalization for TASC C and TASC D Superficial Femoral Artery Occlusive Disease

Vascular and Endovascular Surgery — Wed, 29 Jun 2011 23:00:00 +0100

Conclusions: Despite significant early failures, we found VASIR to be durable in those who did not have early failure. Viabahn stent graft-assisted subintimal recanalization is an acceptable alternative to vein bypass in selected patients with severe SFA disease. Smaller arterial or stent graft diameter may be associated with poorer results. Warfarin may be valuable to reduce the risk of failure after VASIR. (Source: Vascular and Endovascular Surgery)

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Endovascular Therapy for Hepatic Artery Stenosis and Thrombosis Following Liver Transplantation

Vascular and Endovascular Surgery — Wed, 29 Jun 2011 23:00:00 +0100

Conclusion: Endovascular management is effective for HAS but not for HAT. (Source: Vascular and Endovascular Surgery)

Treatment of Chronic Venous Stent Occlusion With a Wildcat Catheter

Vascular and Endovascular Surgery — Wed, 29 Jun 2011 23:00:00 +0100

A 47-year-old female with an occluded iliac vein stent originally placed for deep venous thrombosis and May-Thurner syndrome presented to our clinic with complaints of left lower extremity pain and swelling. Multiple previous attempts had been made to cross this lesion with guidewire and catheter techniques without success. We were able to cross the lesion with the Wildcat catheter. Subsequent directional laser atherectomy and balloon angioplasty followed by stent placement resulted in a patent stent and resolution of her symptoms. This is the first reported use of the Wildcat catheter in chronic venous stent occlusions. (Source: Vascular and Endovascular Surgery)

Endovascular Treatment of Lower Gastrointestinal Bleeding From Systemic-to-Mesenteric Venous Collateral Vessels Caused by Inferior Vena Cava Occlusion: Report of Two Cases

Journal of Vascular and Interventional Radiology : JVIR — Tue, 28 Jun 2011 03:38:25 +0100

Abstract: The present report describes two cases of chronic lower gastrointestinal bleeding caused by systemic-to-mesenteric venous collateral vessels resulting from longstanding inferior vena cava obstruction. They were successfully treated with caval balloon angioplasty and stent placement. No recurrent bleeding was seen at 15 and 24 months of follow up, respectively. (Source: Journal of Vascular and Interventional Radiology : JVIR)

[The efficiency of cutting balloon angioplasty in the treatment of in-stent restenosis.]

Anadolu Kardiyol Der... — Mon, 27 Jun 2011 23:00:00 +0100

CONCLUSION: In the selected patients, CBA is an effective and a safe method for the treatment of bare metal stent restenosis. CBA might be considered as a first-line treatment method in patients with focal type lesions. PMID: 21712168 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

Cheatham-Platinum stent for native and recurrent aortic coarctation in children and adults: immediate and early follow-up results.

Anadolu Kardiyol Der... — Mon, 27 Jun 2011 23:00:00 +0100

CONCLUSION: Our early and short- term follow-up results indicate that stent implantation is safe and very effective in reducing coarctation gradient and increasing lesion diameter both in native coarctation and recoarctation. PMID: 21712167 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

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Classification of Raynaud’s disease based on angiographic features

Journal of Plastic, Reconstructive and Aesthetic Surgery — Mon, 27 Jun 2011 04:00:00 +0100

Summary: Accurate diagnosis and timely management are crucial to avoid an ischaemic consequence in Raynaud’s disease. There is, however, no objective classification of this disorder which guides surgical planning in refractory cases. We propose a new classification system to achieve this. From 2003 to 2009, we treated 178 patients (351 hands) who underwent surgical intervention due to an ischaemic consequence. We analysed the angiographic features of the arterial supply of the hand at three levels: (1) radial or ulnar, (2) palmar arch and common digital and (3) digital vessels. Subsequent surgical interventions were tailored according to disease types, and these included combinations of: digital sympathectomy, balloon angioplasty and end-to-end interposition venous or arterial grafting. ...

[Cutting balloon angioplasty for the treatment of multivessel coronary artery disease in a patient with unstable angina].

Kardiologia Polska — Sun, 26 Jun 2011 17:30:03 +0100

Authors: Pawłowski T, Dejryng K, Zalewski A, Wąsek W PMID: 21332070 [PubMed - indexed for MEDLINE] (Source: Kardiologia Polska)

Balloon Sinuplasty: Cutting-Edge Sinus Surgery with No Cutting Involved

DukeHealth.org: Duke Health Features — Wed, 22 Jun 2011 14:33:02 +0100

The lights are turned down low in the balloon sinuplasty room at Duke Otolaryngology of Durham. Relaxing music plays softly. A 63-year-old woman with a lifelong history of painful chronic sinusitis lies back in a reclining chair. Otolaryngologist Donna Sharpe, MD, inserts a flexible catheter into her patient’s right nostril. Using the endoscopic image on a nearby video monitor, along with a previous CT scan of the patient’s sinuses, Sharpe carefully guides the tiny catheter into the inflamed and mucus-filled frontal sinus. She follows that with a lighted guide wire that illuminates the hollow cavity. The patient’s forehead glows like a firefly, confirming that Sharpe has reached her target. The physician inserts a small balloon, similar to those used for cardiac angioplasty, along th...

Most Heart Attack Patients Needing Procedure Such As Balloon Angioplasty At Another Hospital Not Transferred In Recommended Time

Health News from Medical News Today — Tue, 21 Jun 2011 20:00:00 +0100

Only about 10 percent of patients with a certain type of heart attack who need to be transferred to another hospital for a PCI (procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) are transferred within the recommended time of 30 minutes, according to a study in the June 22/29 issue of JAMA... (Source: Health News from Medical News Today)

Coronary Artery Bypass as Adequate Treatment for Entrapped Coronary Angioplasty Catheter.

The Thoracic and Cardiovascular Surgeon — Mon, 20 Jun 2011 23:00:00 +0100

Authors: Alwaqfi N, Ibrahim K, Kharashgah MN A 47-year-old man presenting with stable angina pectoris was admitted for elective coronary angioplasty. After balloon angioplasty and uneventful deployment of the stent in the right coronary artery, the angioplasty catheter became entrapped between the stent and the wall of the right coronary artery. During attempts at percutaneous retrieval of the retained catheter, it was inadvertently broken and became embedded near the stent. The patient was stable during the procedure with no electrocardiographic changes. He underwent emergency triple coronary artery bypass, leaving the piece of catheter IN SITU. He had an uneventful postoperative recovery. After six months, he was angina-free with no electrocardiographic changes. PMID: 21695675 [P...

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Coronary Artery Bypass as Adequate Treatment for Entrapped Coronary Angioplasty Catheter

The Thoracic and Cardiovascular Surgeon — Mon, 20 Jun 2011 23:00:00 +0100

Thorac cardiovasc SurgDOI: 10.1055/s-0030-1271181AbstractA 47-year-old man presenting with stable angina pectoris was admitted for elective coronary angioplasty. After balloon angioplasty and uneventful deployment of the stent in the right coronary artery, the angioplasty catheter became entrapped between the stent and the wall of the right coronary artery. During attempts at percutaneous retrieval of the retained catheter, it was inadvertently broken and became embedded near the stent. The patient was stable during the procedure with no electrocardiographic changes. He underwent emergency triple coronary artery bypass, leaving the piece of catheter in situ. He had an uneventful postoperative recovery. After six months, he was angina-free with no electrocardiographic changes.[...]© Georg ...

Boston Scientific Announces Global Launch Of Mustang™ PTA Balloon Catheter

Health News from Medical News Today — Mon, 20 Jun 2011 17:00:00 +0100

Boston Scientific Corporation (NYSE: BSX) today announced the global launch of its Mustang™ PTA Balloon Catheter, a highly deliverable 0.035 inch percutaneous transluminal angioplasty (PTA) catheter designed for a wide range of peripheral angioplasty procedures. The Company plans to launch the product immediately in the U.S., Europe and other international markets. Boston Scientific developed the Mustang PTA Balloon Catheter to meet physician needs for a low-profile, high-pressure balloon catheter in a wide range of sizes... (Source: Health News from Medical News Today)

Boston Scientific Announces Global Launch of Mustang PTA Balloon Catheter

HSMN NewsFeed — Mon, 20 Jun 2011 15:38:26 +0100

Low-profile, high-pressure balloon offers physicians exceptional performance in a single platform for peripheral angioplasty procedures NATICK, Mass., June 20, 2011 (HSMN NewsFeed) -- Boston Scientific Corporation (NYSE:BSX ) today announced the glob... Devices, InterventionalBoston Scientific, Mustang, PTA Balloon Catheter, angioplasty (Source: HSMN NewsFeed)

Boston Scientific launches PTA balloon catheter

Cardiovascular Business News — Mon, 20 Jun 2011 09:21:34 +0100

Boston Scientific has launched its Mustang PTA Balloon Catheter, a 0.035 inch percutaneous transluminal angioplasty (PTA) catheter designed for peripheral angioplasty procedures. (Source: Cardiovascular Business News)