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Circulation. Cardiovascular... Oct 2018
Topics: Angioplasty, Balloon, Coronary; Brachytherapy; Drug-Eluting Stents
PubMed: 30354643
DOI: 10.1161/CIRCINTERVENTIONS.118.007365 -
Cardiovascular and Interventional... Jan 2021
Topics: Angioplasty, Balloon; Angioplasty, Balloon, Coronary; Humans; Pharmaceutical Preparations; Popliteal Artery; Registries
PubMed: 32968830
DOI: 10.1007/s00270-020-02620-4 -
BMJ Case Reports Jan 2015This case outlines an unusual complication of coronary intervention, the likely mechanisms leading to this and possible retrieval options. It is the first case to the... (Review)
Review
This case outlines an unusual complication of coronary intervention, the likely mechanisms leading to this and possible retrieval options. It is the first case to the best of our knowledge reporting this complication. A 78-year-old Caucasian man underwent coronary stenting. During the procedure kinking and subsequent fracture of a non-compliant percutaneous transluminal coronary angioplasty (PTCA) balloon occurred. Injection of contrast down the guide to opacify the coronary arteries resulted in 'inflation' of the balloon with air, and embolisation of the inflated balloon into the proximal left anterior descending artery. The embolised balloon was retrieved by removal of the guide catheter and wire as a unit. The patient had a good angiographic outcome. This case highlights risks associated with usage of kinked balloons catheters, and describes for the first time to our knowledge, the inflation of a PTCA balloon with air from its shaft within the catheter, causing 'floatation' embolisation into the coronary artery.
Topics: Angioplasty, Balloon, Coronary; Coronary Angiography; Device Removal; Embolization, Therapeutic; Equipment Failure; Humans; Intraoperative Complications; Stents; Treatment Outcome
PubMed: 25576524
DOI: 10.1136/bcr-2014-205307 -
Clinical Cardiology May 1997At the initial stages of percutaneous transluminal coronary angioplasty (PTCA), several studies reported on the feasibility of coronary artery incision and dilatation... (Comparative Study)
Comparative Study
BACKGROUND
At the initial stages of percutaneous transluminal coronary angioplasty (PTCA), several studies reported on the feasibility of coronary artery incision and dilatation leading to the extension of the PTCA technique.
HYPOTHESIS
This study was designed to determine the immediate and chronic results of cutting balloon (CB) angioplasty.
METHODS
This procedure was performed on 127 lesions in 110 patients (male 83%, age 61.8 +/- 9.3 years).
RESULTS
The overall procedural success rates for the CB were 93.7% (119 lesions) and 92.7% (102 patients), while solitary CB without pre- and/or postdilatation was 76.4% (91 lesions). There was one major in-hospital complication (Q-wave myocardial infarction, 0.9%), but there were no deaths or emergency coronary artery bypass graftings. Significant angiographic dissections (> or = grade C) occurred in four patients, and coronary perforation occurred in one. The successfully treated CB group (95 lesions) was matched with the successful conventional angioplasty group (PTCA group) for chronic result assessment in regard to reference vessel size and lesion characteristics. In the CB group, postprocedural minimal luminal diameters were significantly larger and the percentage of stenosis at the stenotic site was significantly lower compared with the PTCA group. Restenosis occurred in 22 lesions (23.1%). This showed a significantly lower restenosis rate compared with the PTCA group (42.1%). In addition, the restenosis rate of the CB without inclusion of the pre- and/or postdilatation-treated lesions was 19.7%.
CONCLUSIONS
(1) Cutting balloon angioplasty procedures can be performed with high success rates with few major inhospital events. (2) The restenosis rate in the CB group was significantly lower compared with the PTCA group.
Topics: Angioplasty, Balloon, Coronary; Atherectomy; Coronary Angiography; Coronary Disease; Coronary Vessels; Equipment Design; Female; Follow-Up Studies; Humans; Male; Middle Aged; Time Factors; Treatment Outcome
PubMed: 9134278
DOI: 10.1002/clc.4960200511 -
EuroIntervention : Journal of EuroPCR... May 2012Informed consent is indispensable in contemporary medicine, especially in cases where the risks are high or there is true clinical equipoise, as in much invasive... (Review)
Review
Informed consent is indispensable in contemporary medicine, especially in cases where the risks are high or there is true clinical equipoise, as in much invasive cardiology and cardiothoracic surgery practice. In this article we illustrate the principle of informed consent and describe how consent requirements have become more exacting in response to the rise of autonomy as the dominant principle in biomedical ethics. We outline some criticisms of informed consent, discuss why current requirements may never be achievable, and describe some of the vast literature aimed at "solving" the problem. We argue that respect for autonomy is just one of the principles of biomedical ethics and that the implementation of this principle must be weighed in the clinical context against the other principles, namely beneficence, non-maleficence and justice. The way we implement informed consent should be based on an ethical assessment of the clinical situation, including the invasiveness of the procedure, equipoise and the importance of patient values, and not on practical issues. We conclude that focusing on the whole decision-making process, effective communication, and a proportionate and individualised approach to consent could go some way to improve the experience of many patients in cardiology.
Topics: Angioplasty, Balloon, Coronary; Beneficence; Communication; Comprehension; Forms and Records Control; Humans; Informed Consent; Patient Education as Topic; Personal Autonomy; Physician-Patient Relations; Risk Assessment; Risk Factors; Therapeutic Equipoise
PubMed: 22580258
DOI: 10.4244/EIJV8I1A22 -
Cardiovascular Therapeutics Dec 2011Local drug delivery (LDD), the direct application of a therapeutic agent to a focal location, has been used in cardiovascular interventions to prophylactically reduce... (Review)
Review
Local drug delivery (LDD), the direct application of a therapeutic agent to a focal location, has been used in cardiovascular interventions to prophylactically reduce neointimal hyperplasia and relieve clot burden. LDD allows targeted use of drugs whose toxicities inhibit their systemic use while stent delivery allows for consistent and prolonged delivery. Stents eluting limus family drugs or paclitaxel inhibit vascular smooth muscle cell hyperplasia and migration and clinical use of such stents have reduced restenosis rates after percutaneous coronary procedures. However, associated with the increased efficacy is an increased rate of late stent thrombosis associated with death and myocardial infarction. Recent innovations, including bioabsorbable polymers and completely bioabsorbable stents may expand the use of drug-eluting stents. In this review, we discuss the development, the clinical use, and the effects of LDD from balloon and stent-based platforms in the treatment of restenosis and thrombus.
Topics: Absorbable Implants; Angioplasty, Balloon; Angioplasty, Balloon, Coronary; Animals; Cardiovascular Agents; Catheters; Coated Materials, Biocompatible; Coronary Artery Disease; Drug Delivery Systems; Drug-Eluting Stents; Equipment Design; Humans; Peripheral Arterial Disease; Prosthesis Design; Treatment Outcome
PubMed: 20553281
DOI: 10.1111/j.1755-5922.2010.00187.x -
EuroIntervention : Journal of EuroPCR... Feb 2018As bifurcation PCI can often be resource-demanding due to the use of multiple guidewires, balloons and stents, different technical options are sometimes being explored,... (Review)
Review
As bifurcation PCI can often be resource-demanding due to the use of multiple guidewires, balloons and stents, different technical options are sometimes being explored, in different local settings, to meet the need of optimally treating a patient with a bifurcation lesion, while being confronted with limited material resources. Therefore, it seems important to keep a proper balance between what is recognised as the contemporary state of the art, and what is known to be potentially harmful and to be discouraged. Ultimately, the resource-tailored approach to bifurcation PCI may be characterised by the notion of minimum technical requirements for each step of a successful procedure. Hence, this paper describes the logical sequence of steps when performing bifurcation PCI with provisional SB stenting, starting with basic anatomy assessment and ending with the optimisation of MB stenting and the evaluation of the potential need to stent the SB, suggesting, for each step, the minimum technical requirement for a successful intervention.
Topics: Angioplasty, Balloon, Coronary; Cardiac Catheters; Clinical Decision-Making; Coronary Artery Disease; Critical Pathways; Decision Support Techniques; Humans; Manuals as Topic; Percutaneous Coronary Intervention; Prosthesis Design; Risk Factors; Stents; Treatment Outcome
PubMed: 29175768
DOI: 10.4244/EIJ-D-17-00580 -
JACC. Cardiovascular Interventions Aug 2013
Topics: Angioplasty, Balloon, Coronary; Clinical Competence; Coronary Restenosis; Education, Medical, Continuing; Hemodynamics; Humans; Learning Curve; Mass Media; Multimodal Imaging; Patient Care Team; Predictive Value of Tests; Severity of Illness Index; Teaching; Treatment Outcome
PubMed: 23968709
DOI: 10.1016/j.jcin.2013.07.001 -
The Journal of Invasive Cardiology Mar 2023When dislodged stents remain on the coronary wire, the wire can be snared outside of the body (presnaring), and the snare loop advanced over the wire into the body to...
When dislodged stents remain on the coronary wire, the wire can be snared outside of the body (presnaring), and the snare loop advanced over the wire into the body to retrieve the stent. Presnaring may be a valuable technique to retrieve dislodged coronary stents when the stent remains on the coronary wire, as demonstrated in the 2 patients described.
Topics: Humans; Angioplasty, Balloon, Coronary; Coronary Vessels; Stents; Coronary Angiography
PubMed: 36884363
DOI: No ID Found -
EuroIntervention : Journal of EuroPCR... Feb 2017
Topics: Angioplasty, Balloon, Coronary; Coronary Vessels; Humans; Physicians; Stents
PubMed: 28216469
DOI: 10.4244/EIJV12I14A275