Coronary Artery Disease
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Angioplasty, Balloon, Laser-Assisted
Percutaneous Coronary Intervention
Coronary Care Units
Blue Toe Syndrome
Hospitals, Group Practice
Peripheral Arterial Disease
Platelet Aggregation Inhibitors
Predictive Value of Tests
Arterial Occlusive Diseases
Severity of Illness Index
Coronary Artery Bypass, Off-Pump
Peripheral Vascular Diseases
Blood Flow Velocity
Clinical Enzyme Tests
Subclavian Steal Syndrome
Tomography, X-Ray Computed
Pulmonary Subvalvular Stenosis
Internal Mammary-Coronary Artery Anastomosis
Analysis of Variance
The relationship between periprocedural myocardial infarction and subsequent target vessel revascularization following percutaneous coronary revascularization: insights from the EPIC trial. Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications. (1/228)OBJECTIVES: We sought to determine whether periprocedural myocardial infarction complicating percutaneous coronary revascularization is associated with subsequent clinical restenosis, as judged by the need for target vessel revascularization. BACKGROUND: Although myocardial enzyme elevation following angioplasty is associated with increased late mortality, its effect on subsequent clinical restenosis, as assessed by the need for late target vessel revascularization (TVR), is unknown. METHODS: Serial myocardial enzyme determinations were performed on 2,099 patients who underwent angioplasty or atherectomy in the Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications (EPIC) trial. Thirty-day survivors were prospectively followed for three years for adverse clinical events including death and need for TVR. RESULTS: Within the study population, periprocedural creatine kinase (CK) elevation was a predictor of late mortality. Among patients with elevated CK, however, a paradoxical decrease in the need for late TVR was present. This relationship became progressively more profound as the magnitude of CK release increased. Late TVR occurred in 29.8% of patients with no CK elevation, 24.8% with CK elevation to >3 times normal, and 16.9% with >10 times elevation (hazard ratio 0.51, 95% CI 0.29, 0.91). CONCLUSIONS: In the EPIC study, patients with periprocedural MI were less likely to develop clinical restenosis as measured by the need for TVR. Mechanistically, although it is unlikely that CK elevation prevents vascular renarrowing per se, myocardial necrosis impairs the clinical manifestation of restenosis, thereby reducing the need for ischemia-driven TVR. This novel finding 1) highlights the potential discordance between angiographic and clinical measures of restenosis, and 2) has implications for clinical trials, as therapies that reduce periprocedural MI may be associated with a perceived excess of restenosis when measured by the need for TVR. (+info)
Influence of a platelet GPIIb/IIIa receptor antagonist on myocardial hypoperfusion during rotational atherectomy as assessed by myocardial Tc-99m sestamibi scintigraphy. (2/228)OBJECTIVES: This study evaluated the effect of the glycoprotein IIb/IIIa (GPIIb/IIIa) antagonist abciximab on myocardial hypoperfusion during percutaneous transluminal rotational atherectomy (PTRA). BACKGROUND: PTRA may cause transient ischemia and periprocedural myocardial injury. A platelet-dependent risk of non-Q-wave infarctions after directional atherectomy has been described. The role of platelets for the incidence and severity of myocardial hypoperfusion during PTRA is unknown. METHODS: Seventy-five consecutive patients with complex lesions were studied using resting Tc-99m sestamibi single-photon emission computed tomography prior to PTRA, during, and 2 days after the procedure. The last 30 patients received periprocedural abciximab (group A) and their results were compared to the remaining 45 patients (group B). For semiquantitative analysis, myocardial perfusion in 24 left ventricular regions was expressed as percentage of maximal sestamibi uptake. RESULTS: Baseline characteristics did not differ between the groups. Transient perfusion defects were observed in 39/45 (87%) patients of group B, but only in 10/30 (33%) patients of group A (p < 0.001). Perfusion was significantly reduced during PTRA in 3.3 +/- 2.5 regions in group B compared to 1.4 +/- 2.5 regions in group A (p < 0.01). Perfusion in the region with maximal reduction during PTRA in groups B and A was 76 +/- 15% and 76 +/- 15% at baseline, decreased to 56 +/- 16% (p < 0.001) and 67 +/- 14%, respectively, during PTRA (p < 0.01 A vs. B), and returned to 76 +/- 15% and 80 +/- 13%, respectively, after PTRA. Nine patients in group B (20%) and two patients in group A (7%) had mild creatine kinase and/or troponin t elevations (p = 0.18). Patients with elevated enzymes had larger perfusion defects than did patients without myocardial injury (4.2 +/- 2.7 vs. 2.3 +/- 2.5 regions, p < 0.05). CONCLUSIONS: These data indicate that GPIIb/IIIa blockade reduces incidence, extent and severity of transient hypoperfusion during PTRA. Thus, platelet aggregation may play an important role for PTRA-induced hypoperfusion. (+info)
Mechanisms of acute lumen gain and recurrent restenosis after rotational atherectomy of diffuse in-stent restenosis: a quantitative angiographic and intravascular ultrasound study. (3/228)OBJECTIVES: This quantitative angiographic and intravascular ultrasound study determined the mechanisms of acute lumen enlargement and recurrent restenosis after rotational atherectomy (RA) with adjunct percutaneous transluminal coronary angioplasty in the treatment of diffuse in-stent restenosis (ISR). BACKGROUND: In-stent restenosis remains a significant clinical problem for which optimal treatment is under debate. Rotational atherectomy has become an alternative therapeutic approach for the treatment of diffuse ISR based on the concept of "tissue-debulking." METHODS: Rotational atherectomy with adjunct angioplasty of ISR was used in 45 patients with diffuse lesions. Quantitative coronary angiographic (QCA) analysis and sequential intravascular ultrasound (IVUS) measurements were performed in all patients. Forty patients (89%) underwent angiographic six-month follow-up. RESULTS: Rotational atherectomy lead to a decrease in maximal area of stenosis from 80+/-32% before intervention to 54+/-21% after RA (p < 0.0001) as a result of a significant decrease in intimal hyperplasia cross-sectional area (CSA). The minimal lumen diameter after RA remained 15+/-4% smaller than the burr diameter used, indicating acute neointimal recoil. Additional angioplasty led to a further decrease in area of stenosis to 38+/-12% due to a significant increase in stent CSA. At six-month angiographic follow-up, recurrent restenosis rate was 45%. Lesion and stent length, preinterventional diameter stenosis and amount of acute neointimal recoil were associated with a higher rate of recurrent restenosis. CONCLUSIONS: Rotational atherectomy of ISR leads to acute lumen gain by effective plaque removal. Adjunct angioplasty results in additional lumen gain by further stent expansion and tissue extrusion. Stent and lesion length, severity of ISR and acute neointimal recoil are predictors of recurrent restenosis. (+info)
Heparin after percutaneous intervention (HAPI): a prospective multicenter randomized trial of three heparin regimens after successful coronary intervention. (4/228)OBJECTIVES: The purpose of this study was to determine the incidence of bleeding, vascular, and ischemic complications using three different heparin regimens after successful intervention. BACKGROUND: The ideal dose and duration of heparin infusion after successful coronary intervention is unknown. METHODS: Patients were randomized to one of three heparin strategies after coronary intervention: Group 1 (n = 157 patients) received prolonged (12 to 24 h) heparin infusion followed by sheath removal; Group 2 (n = 120 patients) underwent early removal of sheaths, followed by reinstitution of heparin infusion for 12 to 18 h; Group 3 (n = 137 patients) did not receive any further heparin after intervention with early sheath removal. The primary end point of the study was the combined incidence of in-hospital bleeding and vascular events. Secondary end points included in-hospital ischemic events, length of stay, cost and one-month outcome. RESULTS: After successful coronary intervention, 414 patients were randomized. Unstable angina or postinfarction angina was present in 83% of patients before intervention. The combined incidence of bleeding and vascular events was 21% in Group 1, 14% in Group 2 and 8% in Group 3 (p = 0.01). The overall incidence of in-hospital ischemic complications was 2.2%; there were no differences between groups. Length of hospital stay was shorter (p = 0.033) and adjusted hospital cost was lower (p < 0.001) for Group 3. At 30 days, the incidence of delayed cardiac and vascular events was similar for all three groups. CONCLUSIONS: Heparin infusion after successful coronary intervention is associated with more minor bleeding and vascular injury, prolonged length of stay and increased cost. In-hospital and one-month ischemic events rarely occur after successful intervention, irrespective of heparin use. Routine postprocedure heparin is not recommended, even in patients who present with unstable ischemic syndromes. (+info)
Low prevalence of Chlamydia pneumoniae in atherectomy specimens from patients with coronary heart disease. (5/228)Coronary atherectomy specimens from 50 patients with coronary heart disease were examined for the presence of Chlamydia pneumoniae by two different methods of polymerase chain reaction (PCR) and by in situ hybridization. C. pneumoniae DNA was detected by PCR in atherosclerotic plaques of four patients (8%). Two patients' coronary atheromas were positive, both by a single-step 16S rRNA-based PCR and by an omp1-based nested PCR. The other two patients' specimens were positive only by the nested PCR. In contrast, C. pneumoniae was not detected by in situ hybridization in any of the cardiovascular tissues tested. Of three patients with evidence of C. pneumoniae in coronary atheromas, two had an antibody titer of 1:32 and the third had no specific antibodies detectable. Results of this study demonstrate a low prevalence of C. pneumoniae DNA in coronary atheromas. These findings do not support the hypothesis that the organism plays a major role in atherogenesis. (+info)
In vitro examination of the safety of rotational atherectomy of side branches jailed by stents. (6/228)In vitro experimental models of branch orifices jailed by various stents were created to estimate the safety and the efficacy of rotational atherectomy when rotational burrs were advanced through the struts of stents. The scaffolding structures of the stents were destroyed due to loss and deflection of the struts, and the size of ablated stent-particles differed: the maximal size was 1.7 mm in slotted stents, and 17.6 mm in coiled stents. Thus, there is a definite potential for ablating stents when rotational atherectomy of restenotic lesions of side-branch orifices jailed by stents is performed. (+info)
Expression of cytokine and adhesion molecule mRNA in atherectomy specimens from patients with coronary artery disease. (7/228)Coronary arteriosclerosis is an underlying condition in acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP), and is also related to restenosis (RS) following coronary intervention. To investigate the pathogenesis of this condition, a quantitative reverse transcriptase polymerase chain reaction was used to determine relative levels of mRNA for interleukin (IL)-1beta, IL-6, IL-8, transforming growth factor beta (TGF-beta), intercellular adhesion molecule (ICAM)-1, E-selectin and vascular cell adhesion molecule (VCAM)-1 using directional coronary atherectomy (DCA) specimens. Eleven patients with AMI, 7 with UAP, 10 with SAP and 6 with RS following a previous coronary intervention underwent DCA. The mRNA intensity for each molecule was expressed by comparing it with that of beta-actin mRNA. The AMI and UAP patients showed high frequencies of mRNA for IL-1beta, IL-8, TGF-beta, and ICAM-1 together with strong intensities of expression, whereas SAP patients showed decreased mRNA expression for these molecules. Increased IL-6 mRNA expression was observed only in AMI samples. Specimens from RS patients revealed an accumulated expression of proinflammatory cytokines, except for IL-6, as well as of TGF-beta. The study suggests that variation in mRNA expression may reflect the pathophysiology of specific types of coronary artery disease, and remodeling following vascular injury. (+info)
Creatine kinase-MB elevation after coronary intervention correlates with diffuse atherosclerosis, and low-to-medium level elevation has a benign clinical course: implications for early discharge after coronary intervention. (8/228)OBJECTIVES: The study evaluated the incidence and predictors of creatine kinase-MB isoenzyme (CK-MB) elevation after successful coronary intervention using current devices, and assessed the influence on in-hospital course and midterm survival. BACKGROUND: The CK-MB elevation after coronary intervention predominantly using balloon angioplasty correlates with late cardiac events of myocardial infarction (MI) and death. Whether CK-MB elevation after nonballoon devices is associated with an adverse short and midterm prognosis is unknown. METHODS: The incidence and predictors of CK-MB elevation after coronary intervention were prospectively studied in 1,675 consecutive patients and were followed for in-hospital events and survival. RESULTS: CK-MB elevation was detected in 313 patients (18.7%), with 1-3x in 12.8%, 3-5x in 3.5% and >5x normal in 2.4% of patients. Procedural complications or electrocardiogram changes occurred in only 49% of the CK-MB-elevation cases; CK-MB elevation was more common after nonballoon devices (19.5% vs. 11.5% after percutaneous transluminal coronary angioplasty; p < 0.01). Predictors of CK-MB elevation on multivariate analysis were diffuse coronary disease (p = 0.02), systemic atherosclerosis (p = 0.002), stent use (p = 0.04) and absence of beta-blocker therapy (p = 0.001). Adverse in-hospital cardiac events were more frequent in patients with >5x CK-MB elevation, with no significant difference between 1-5x CK-MB elevation versus normal CK-MB group. During a mean follow-up of 13 +/- 3 months, the incidence of death in the CK-MB-elevation group was 1.6% versus 1.3% in the normal CK-MB group (p = NS). CONCLUSIONS: The CK-MB elevation after coronary intervention was observed even in the absence of discernible procedural complications and was more common in patients with diffuse atherosclerosis. In-hospital clinical events requiring prolonged monitoring were higher in >5x CK-MB-elevation patients only. Midterm survival of CK-MB-elevation patients was similar to those with normal CK-MB. Our prospective analysis shows a lack of adverse in-hospital cardiac events and suggests that early discharge of stable 1-5x normal CK-MB-elevation patients after successful coronary intervention is safe. (+info)
Coronary artery disease (CAD) is a condition in which the blood vessels that supply blood to the heart muscle become narrowed or blocked due to the buildup of plaque. This can lead to reduced blood flow to the heart, which can cause chest pain (angina), shortness of breath, and other symptoms. Over time, CAD can also lead to a heart attack if the blood flow to the heart is completely blocked. CAD is a common condition that affects many people, particularly those who are middle-aged or older, and is often associated with other risk factors such as high blood pressure, high cholesterol, smoking, and diabetes. Treatment for CAD may include lifestyle changes, medications, and in some cases, procedures such as angioplasty or coronary artery bypass surgery.
Coronary disease, also known as coronary artery disease (CAD), is a condition in which the blood vessels that supply blood to the heart muscle become narrowed or blocked due to the buildup of plaque. This can lead to reduced blood flow to the heart, which can cause chest pain (angina), shortness of breath, and other symptoms. In severe cases, coronary disease can lead to a heart attack, which occurs when the blood flow to a part of the heart is completely blocked, causing damage to the heart muscle. Coronary disease is a common condition that affects many people, particularly those who are middle-aged or older, and is often associated with other risk factors such as high blood pressure, high cholesterol, smoking, and diabetes. Treatment for coronary disease may include lifestyle changes, medications, and in some cases, procedures such as angioplasty or coronary artery bypass surgery.
Coronary stenosis is a medical condition in which the coronary arteries, which supply blood to the heart muscle, become narrowed or blocked. This can occur due to the buildup of plaque, a fatty substance that can accumulate on the inner walls of the arteries over time. When the arteries become narrowed, it can reduce the amount of blood and oxygen that reaches the heart muscle, which can lead to chest pain, shortness of breath, and other symptoms. Coronary stenosis is a common condition, particularly in older adults, and can be a serious health concern if left untreated. Treatment options for coronary stenosis may include medications, lifestyle changes, and procedures such as angioplasty or coronary artery bypass surgery.
Coronary thrombosis is a medical condition in which a blood clot forms in one of the coronary arteries, which supply blood to the heart muscle. This can lead to a blockage of blood flow to the heart, which can cause chest pain (angina), heart attack, or even sudden death. Coronary thrombosis is a serious condition that requires prompt medical attention. It is often caused by the buildup of plaque in the coronary arteries, which can rupture and form a blood clot. Risk factors for coronary thrombosis include high blood pressure, high cholesterol, smoking, diabetes, obesity, and a family history of heart disease. Treatment for coronary thrombosis may include medications to dissolve the clot or surgery to open the blocked artery.
In the medical field, recurrence refers to the reappearance of a disease or condition after it has been treated or has gone into remission. Recurrence can occur in various medical conditions, including cancer, infections, and autoimmune diseases. For example, in cancer, recurrence means that the cancer has come back after it has been treated with surgery, chemotherapy, radiation therapy, or other treatments. Recurrence can occur months, years, or even decades after the initial treatment. In infections, recurrence means that the infection has returned after it has been treated with antibiotics or other medications. Recurrence can occur due to incomplete treatment, antibiotic resistance, or other factors. In autoimmune diseases, recurrence means that the symptoms of the disease return after they have been controlled with medication. Recurrence can occur due to changes in the immune system or other factors. Overall, recurrence is a significant concern for patients and healthcare providers, as it can require additional treatment and can impact the patient's quality of life.
Coronary restenosis is a condition in which a previously narrowed or blocked coronary artery becomes partially or completely blocked again after a procedure to open or bypass the artery. This can occur due to the formation of scar tissue or the growth of new blood vessels that can occlude the artery again. Restenosis is a common complication of coronary artery bypass surgery and percutaneous coronary intervention (PCI), also known as angioplasty. It can lead to chest pain, shortness of breath, and other symptoms of heart disease. Treatment options for coronary restenosis include medications, repeat PCI, or coronary artery bypass surgery.
Coronary vasospasm is a condition in which the coronary arteries, which supply blood to the heart muscle, suddenly narrow or spasm. This can cause a temporary reduction in blood flow to the heart, which can lead to chest pain or angina. In severe cases, coronary vasospasm can cause a complete blockage of the coronary artery, leading to a heart attack. The exact cause of coronary vasospasm is not fully understood, but it is thought to be related to the constriction of the smooth muscle cells in the walls of the coronary arteries. Risk factors for coronary vasospasm include smoking, high blood pressure, and a family history of the condition. Treatment for coronary vasospasm typically involves medications to relax the smooth muscle cells in the coronary arteries and improve blood flow to the heart. In some cases, more invasive procedures such as angioplasty or coronary artery bypass surgery may be necessary.
Myocardial infarction (MI), also known as a heart attack, is a medical condition that occurs when blood flow to a part of the heart muscle is blocked, usually by a blood clot. This lack of blood flow can cause damage to the heart muscle, which can lead to serious complications and even death if not treated promptly. The most common cause of a heart attack is atherosclerosis, a condition in which plaque builds up in the arteries that supply blood to the heart. When a plaque ruptures or becomes unstable, it can form a blood clot that blocks the flow of blood to the heart muscle. Other causes of heart attacks include coronary artery spasms, blood clots that travel to the heart from other parts of the body, and certain medical conditions such as Kawasaki disease. Symptoms of a heart attack may include chest pain or discomfort, shortness of breath, nausea or vomiting, lightheadedness or dizziness, and pain or discomfort in the arms, back, neck, jaw, or stomach. If you suspect that you or someone else is having a heart attack, it is important to call emergency services immediately. Early treatment with medications and possibly surgery can help to reduce the risk of serious complications and improve the chances of a full recovery.
A coronary aneurysm is a bulge or balloon-like dilation of a coronary artery, which is a blood vessel that supplies oxygen-rich blood to the heart muscle. It occurs when the arterial wall weakens and becomes thin, causing it to balloon outwards. Coronary aneurysms can be caused by a variety of factors, including high blood pressure, atherosclerosis (the buildup of plaque in the arteries), and infections such as Kawasaki disease. They can also be a complication of certain medical conditions, such as Marfan syndrome or Ehlers-Danlos syndrome. If left untreated, coronary aneurysms can rupture, causing a heart attack or other serious complications. Treatment options for coronary aneurysms may include medications to manage symptoms and prevent further damage, lifestyle changes such as quitting smoking and eating a healthy diet, and in some cases, surgical repair or removal of the aneurysm.
Coronary occlusion refers to the blockage or narrowing of the coronary arteries, which are the blood vessels that supply oxygen-rich blood to the heart muscle. This blockage can occur due to the buildup of plaque, a fatty substance that can harden and narrow the arteries over time. When a coronary artery becomes completely blocked, it can lead to a heart attack, as the heart muscle is unable to receive the oxygen it needs to function properly. Coronary occlusion is a serious medical condition that requires prompt diagnosis and treatment.
Angina, unstable is a type of chest pain that occurs when the blood flow to the heart muscle is restricted, usually due to a blockage in one or more of the coronary arteries. Unlike stable angina, which typically occurs during physical exertion or emotional stress, unstable angina can occur at rest or with minimal exertion, and the pain may be more severe and last longer than usual. Unstable angina is a medical emergency because it can be a sign of an impending heart attack. Treatment typically involves medications to reduce the risk of a heart attack, such as aspirin, beta blockers, and nitrates, as well as hospitalization and further diagnostic testing to determine the underlying cause of the angina and the best course of treatment.
Calcinosis is a medical condition characterized by the deposition of calcium phosphate crystals in the skin and other tissues. It is most commonly seen in people with certain medical conditions, such as scleroderma, lupus, and kidney disease, as well as in people who have undergone long-term treatment with certain medications, such as corticosteroids. The calcium phosphate crystals that accumulate in the skin and other tissues can cause hard, raised areas that may be painful or itchy. In severe cases, calcinosis can lead to scarring, skin thickening, and limited joint mobility. Treatment for calcinosis depends on the underlying cause and the severity of the condition. In some cases, medications may be used to help reduce the formation of calcium phosphate crystals, while in other cases, surgery may be necessary to remove the affected tissue.
Pathologic constriction refers to a medical condition in which a blood vessel or other tubular structure becomes narrowed or blocked, leading to reduced blood flow or obstruction of the flow of other substances through the vessel. This can occur due to a variety of factors, including inflammation, scarring, abnormal growths, or the presence of a foreign object. Pathologic constriction can have serious consequences, depending on the location and severity of the constriction, and may require medical intervention to treat.
Embolism is a medical condition that occurs when a blood clot or other material travels through the bloodstream and becomes lodged in a blood vessel, blocking the flow of blood to a particular area of the body. This can cause a range of symptoms, depending on the location and size of the clot, and can lead to serious health problems if left untreated. There are several types of embolism, including: 1. Pulmonary embolism: This occurs when a blood clot lodges in the lungs, which can cause shortness of breath, chest pain, and other symptoms. 2. Deep vein thrombosis (DVT): This occurs when a blood clot forms in a deep vein, usually in the legs, and can cause pain, swelling, and redness in the affected area. 3. Arterial embolism: This occurs when a blood clot lodges in an artery, which can cause tissue damage or organ failure. Embolism can be caused by a variety of factors, including blood clots that form in the veins of the legs (deep vein thrombosis), blood clots that form in the heart (cardiac embolism), or air bubbles that enter the bloodstream during surgery or other medical procedures. Treatment for embolism typically involves anticoagulant medications to dissolve the clot, or in some cases, surgical intervention to remove the clot or repair the affected blood vessel.
Graft occlusion, vascular, refers to the blockage or narrowing of a blood vessel or graft that has been surgically implanted to bypass a blocked or narrowed artery or vein. This can occur due to various factors, including the formation of scar tissue, the buildup of plaque, or the development of blood clots. Graft occlusion can lead to reduced blood flow to the affected area, which can cause symptoms such as pain, swelling, and tissue damage. Treatment options for graft occlusion may include medications to dissolve blood clots or prevent further clot formation, angioplasty to open up the blocked vessel, or surgery to replace the occluded graft.
Angina pectoris is a medical condition characterized by chest pain or discomfort due to reduced blood flow to the heart muscle. It is caused by a narrowing of the coronary arteries, which supply blood to the heart. The pain is usually described as a squeezing, pressure, or burning sensation in the chest and may radiate to the neck, jaw, arms, or back. Angina pectoris is a common symptom of coronary artery disease, which is a major cause of heart attacks. Treatment options for angina pectoris include lifestyle changes, medications, and in some cases, surgery.
Blue Toe Syndrome, also known as cyanosis of the toes, is a medical condition characterized by blue or purple discoloration of the toes. It is caused by a lack of oxygen in the blood, which can be due to a variety of factors such as poor circulation, low blood pressure, or a blockage in the blood vessels. The most common cause of Blue Toe Syndrome is frostbite, which occurs when the skin and underlying tissues freeze due to exposure to cold temperatures. Other causes can include heart disease, peripheral artery disease, and certain medications that affect blood flow. Symptoms of Blue Toe Syndrome may include blue or purple discoloration of the toes, numbness or tingling, pain or discomfort, and in severe cases, tissue damage or gangrene. Treatment for Blue Toe Syndrome depends on the underlying cause. In cases of frostbite, the affected area should be kept warm and dry, and medical attention should be sought immediately. For other causes, treatment may include medications to improve blood flow, surgery to remove blockages, or lifestyle changes to manage underlying health conditions.
Peripheral Arterial Disease (PAD) is a medical condition that occurs when the blood vessels that supply blood to the legs, arms, stomach, and other parts of the body become narrowed or blocked due to atherosclerosis, a buildup of plaque in the arteries. This can lead to reduced blood flow to the affected area, which can cause pain, numbness, and weakness in the legs and feet, especially during physical activity. PAD is a common condition that affects millions of people worldwide, and it is more common in older adults, smokers, and people with diabetes, high blood pressure, and high cholesterol.，PAD，、、。
Postoperative complications are adverse events that occur after a surgical procedure. They can range from minor issues, such as bruising or discomfort, to more serious problems, such as infection, bleeding, or organ damage. Postoperative complications can occur for a variety of reasons, including surgical errors, anesthesia errors, infections, allergic reactions to medications, and underlying medical conditions. They can also be caused by factors such as poor nutrition, dehydration, and smoking. Postoperative complications can have serious consequences for patients, including prolonged hospital stays, additional surgeries, and even death. Therefore, it is important for healthcare providers to take steps to prevent postoperative complications and to promptly recognize and treat them if they do occur.
Myocardial ischemia is a medical condition that occurs when the blood flow to the heart muscle is reduced or blocked, leading to a lack of oxygen and nutrients to the heart cells. This can cause chest pain or discomfort, shortness of breath, and other symptoms. Myocardial ischemia is often caused by atherosclerosis, a condition in which plaque builds up in the arteries, narrowing or blocking the flow of blood. It can also be caused by other factors, such as heart valve problems or blood clots. Myocardial ischemia can be a serious condition and requires prompt medical attention to prevent heart attack or other complications.
Atherosclerotic plaque is a hard, fatty deposit that builds up inside the walls of arteries. It is a common condition that can lead to serious health problems, such as heart attack and stroke. Atherosclerosis is the medical term for the buildup of plaque in the arteries. The plaque can narrow the arteries, reducing blood flow to the heart or brain. Over time, the plaque can rupture, causing a blood clot that can block blood flow and lead to a heart attack or stroke.
Arterial occlusive diseases refer to a group of medical conditions in which the arteries become narrowed or blocked, leading to reduced blood flow to the affected area. This can result in a range of symptoms, depending on the location and severity of the blockage. The most common types of arterial occlusive diseases include: 1. Atherosclerosis: A condition in which plaque builds up inside the arteries, causing them to narrow and harden. 2. Peripheral artery disease (PAD): A condition that affects the arteries in the legs, causing pain, cramping, and weakness in the legs, especially during physical activity. 3. Coronary artery disease (CAD): A condition that affects the arteries that supply blood to the heart, leading to chest pain, shortness of breath, and other symptoms. 4. Carotid artery disease: A condition that affects the arteries in the neck, leading to a reduced blood flow to the brain, which can cause stroke. Treatment for arterial occlusive diseases may include lifestyle changes, such as quitting smoking, eating a healthy diet, and exercising regularly, as well as medications to manage symptoms and prevent further progression of the disease. In some cases, surgery or other medical procedures may be necessary to open or bypass blocked arteries.
Peripheral Vascular Diseases (PVDs) are a group of conditions that affect the blood vessels outside of the heart and brain. These vessels include the arteries and veins in the arms, legs, pelvis, and abdomen. PVDs can cause a range of symptoms, including pain, numbness, and weakness in the affected areas, as well as skin changes and ulcers. PVDs can be caused by a variety of factors, including smoking, high blood pressure, diabetes, and high cholesterol. Treatment for PVDs depends on the specific condition and may include lifestyle changes, medications, and surgery.
Intermittent claudication is a medical condition characterized by pain, cramping, or numbness in the legs, usually in the calf muscles, that occurs during physical activity and resolves with rest. The pain is usually described as a "pins and needles" sensation or a burning ache, and it is caused by reduced blood flow to the muscles due to narrowed or blocked arteries in the legs. Intermittent claudication is a common symptom of peripheral artery disease (PAD), which is a condition that affects the blood vessels in the legs and feet. PAD occurs when the buildup of plaque, a fatty deposit that can harden and narrow the arteries, restricts blood flow to the legs. As a result, the muscles in the legs may not receive enough oxygen and nutrients, leading to pain and discomfort during physical activity. Treatment for intermittent claudication typically involves lifestyle changes, such as quitting smoking, exercising regularly, and maintaining a healthy diet, as well as medications to improve blood flow and reduce inflammation. In some cases, surgery may be necessary to remove plaque buildup or bypass blocked arteries.
Subclavian steal syndrome is a condition in which blood flow from the aorta to the upper extremities is blocked or reduced, causing blood to flow in the opposite direction through the subclavian artery. This can lead to symptoms such as weakness, numbness, and pain in the arm, as well as decreased blood flow to the brain, which can cause dizziness, fainting, and even stroke. Subclavian steal syndrome is typically caused by a blockage in the subclavian artery, which can be due to atherosclerosis, a buildup of plaque in the arteries, or a blood clot. Treatment may involve medications to dissolve the clot or surgery to open the blocked artery.
Arteriosclerosis is a medical condition characterized by the hardening and thickening of the walls of arteries due to the buildup of plaque. This buildup can restrict blood flow to the organs and tissues that the arteries supply, leading to a range of health problems, including heart disease, stroke, and peripheral artery disease. The process of arteriosclerosis involves the accumulation of fatty deposits, cholesterol, calcium, and other substances in the inner lining of the arteries. Over time, these deposits can harden and form plaques, which can narrow the arteries and reduce blood flow. The plaques can also rupture, causing blood clots that can block blood flow and lead to serious complications. Arteriosclerosis is a common condition that can affect people of all ages, but it is more likely to occur in older adults and people with certain risk factors, such as high blood pressure, high cholesterol, smoking, diabetes, and a family history of heart disease. Treatment for arteriosclerosis typically involves lifestyle changes, such as quitting smoking, eating a healthy diet, and exercising regularly, as well as medications to lower blood pressure, cholesterol, and blood sugar levels. In some cases, surgery may be necessary to remove plaque or open blocked arteries.
Chest pain, also known as angina, is a common symptom experienced by individuals with heart disease. It is a sensation of discomfort, pressure, squeezing, or burning in the chest that can radiate to the neck, jaw, arms, or back. Chest pain can be caused by a variety of factors, including stress, anxiety, or physical exertion. However, it can also be a sign of a serious medical condition, such as a heart attack or aortic dissection. In the medical field, chest pain is typically evaluated by a healthcare provider through a physical examination, medical history, and diagnostic tests such as an electrocardiogram (ECG), stress test, or coronary angiogram. Treatment for chest pain depends on the underlying cause and may include medications, lifestyle changes, or surgery.
Pulmonary subvalvular stenosis is a type of congenital heart defect that affects the pulmonary valve, which is responsible for regulating blood flow from the heart to the lungs. In this condition, the valve is narrowed or obstructed, which can cause an increase in blood pressure in the pulmonary artery and restrict blood flow to the lungs. The subvalvular portion of the pulmonary valve is made up of three small flaps called the leaflets, which are attached to the valve ring. In pulmonary subvalvular stenosis, the leaflets may be thickened or malformed, causing them to obstruct the flow of blood through the valve. Symptoms of pulmonary subvalvular stenosis may include shortness of breath, fatigue, chest pain, and heart palpitations. In severe cases, the condition can lead to heart failure or other complications. Treatment for pulmonary subvalvular stenosis may include medications to manage symptoms and improve blood flow, or surgery to repair or replace the affected valve. The specific treatment approach will depend on the severity of the condition and the individual patient's needs.
Adenosine is a naturally occurring nucleoside that plays a crucial role in various physiological processes in the human body. It is a component of the nucleic acids DNA and RNA and is also found in high concentrations in the cells of the heart, brain, and other organs. In the medical field, adenosine is often used as a medication to treat certain heart conditions, such as supraventricular tachycardia (SVT) and atrial fibrillation (AFib). Adenosine works by blocking the electrical signals that cause the heart to beat too fast or irregularly. It is typically administered as an intravenous injection and has a short duration of action, lasting only a few minutes. Adenosine is also used in research to study the function of various cells and tissues in the body, including the nervous system, immune system, and cardiovascular system. It has been shown to have a wide range of effects on cellular signaling pathways, including the regulation of gene expression, cell proliferation, and apoptosis (cell death).
Percutaneous coronary intervention
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- Procedures include carotid and peripheral arty angioplasty and stent placement, carotid artery surgery, varicose vein stripping, and atherectomy percutaneous coronary revascularization, a minimally invasive procedure to remove plaque from coronary arteries. (sutterhealth.org)
- A rotablator is used to treat hardened, calcified coronary lesions that are not effectively treated with standard angioplasty balloons. (partoheart.com)
- Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD). (medscape.com)
- Example of an intravascular ultrasound (IVUS) image in percutaneous transluminal coronary angioplasty (PTCA). (medscape.com)
- DCA, or directional coronary atherectomy is a minimally invasive procedure to remove blockage from coronary arteries to improve blood flow to the heart muscle and ease pain. (medlineplus.gov)
- With the catheter at the opening of one of the coronary arteries, the doctor injects dye and takes an X-ray. (medlineplus.gov)
- Cardiac catheterization was generally followed by interventional or therapeutic procedures to open blocked arteries-e.g., atherectomy, stent placement, grafting, or pacemaker implantation. (uspharmacist.com)
- Recently, CRP was identified within early atherosclerotic lesions in human coronary arteries obtained at necropsy. (bmj.com)
- The new updates, aimed at innovating and advancing procedures including percutaneous coronary intervention (PCI) to treat the narrowing of coronary arteries, are being announced at the Transcatheter Cardiovascular Therapeutics (TCT) annual meeting (Orlando, USA, November 4-6). (philips.com)
- Coronary and peripheral interventions refer to non-surgical procedures that use a catheter (a thin flexible tube) and small tools to remove plaque (a mixture of cholesterol, fat, calcium and other substances) and restore blood flow through the vessels in the heart and peripheral arteries. (partoheart.com)
- Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause. (bvsalud.org)
- Thickening and loss of elasticity of the CORONARY ARTERIES, leading to progressive arterial insufficiency (CORONARY DISEASE). (bvsalud.org)
- The Onyx Frontier™ zotarolimus-eluting coronary stent system is indicated for improving coronary luminal diameters in patients, including those with diabetes mellitus or high bleeding risk, with symptomatic ischemic heart disease due to de novo lesions of length ≤ 35 mm in native coronary arteries with reference vessel diameters of 2.0 mm to 5.0 mm. (medtronic.com)
Directional coronary atherectomy1
- n = 18) underwent directional coronary atherectomy for coronary lesions. (bmj.com)
- ELCA coronary laser atherectomy catheters are designed to cross, prepare and treat the most complex coronary lesions. (philips.ie)
- A new coronary atherectomy system, the Diamondback-360, is the first in more than 20 years to be FDA-approved to treat severely calcified lesions. (uspharmacist.com)
- In addition, the Onyx Frontier™ zotarolimus-eluting coronary stent system is indicated for treating de novo chronic total occlusions and non-left main bifurcation lesions utilizing the provisional bifurcation stenting technique. (medtronic.com)
- This non-mechanical atherectomy catheter can be delivered over any .014" wire and can de-bulk and modify plaque of multiple morphologies and is approved for the broadest range of coronary indications in atherectomy. (philips.ie)
- Angiographic criteria included multivessel coronary disease, stent length more than 30 mm, a thrombotic target lesion, a bifurcation lesion requiring two stents, an obstructive left main or proximal left anterior descending lesion, and a calcified target lesion requiring atherectomy. (medscape.com)
- Meta-analysis comparing culprit vessel only versus multivessel percutaneous coronary intervention in patients with acute myocardial infarction and cardiogenic shock. (omeka.net)
- A Heart Team approach (involving interventional cardiologists and cardiac surgeons) should be used in patients with diabetes and multivessel coronary artery disease and in patients with severe left main disease and a high Syntax score. (medscape.com)
- SAN FRANCISCO - Dropping aspirin after 3 months and continuing ticagrelor monotherapy reduced bleeding without a price to pay in overall ischemic events among patients undergoing percutaneous coronary intervention (PCI) at high risk for either complication, results from the TWILIGHT trial show. (medscape.com)
- BACKGROUND AND OBJECTIVES: Aspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). (koreamed.org)
- BACKGROUND: Percutaneous coronary intervention (PCI) of small-vessel coronary artery disease (SVD) is associated with increased risk of restenosis. (omeka.net)
Transcatheter aortic valve repla2
- Impact of prior coronary artery bypass grafting on periprocedural and short-term outcomes of patients undergoing transcatheter aortic valve replacement: A systemic review and meta-analysis" Akshay Balakrishna, Mahmoud Ismayl, David Zhao, Andrew Goldsweig, Ahmed Aboeata, Sarachandra Vallabhajosyula. (creighton.edu)
- OBJECTIVES: This study reports on the clinical effects of complete vs incompletely revascularized coronary artery disease on transcatheter aortic valve replacement (TAVR). (omeka.net)
- Interventional procedures start out with cardiac catheterization (also called coronary angiogram). (partoheart.com)
- Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes. (nih.gov)
- We use plasma extracellular vesicle (EV) protein content of vesicles from plasma sub-fractions on plasma of stroke and peripheral artery disease(PAD) patients, patients after carotid atherectomy (CEA) and patients suspected for chronic coronary syndrome (CCS). (selectbiosciences.com)
- For patients with STEMI, immediate coronary angiography with PCI is recommended (primary PCI). (medscape.com)
- Spontaneous Coronary Artery Dissection (SCAD) Update - What Does the Interventionalist Need to Know? (promedicacme.com)
- Patient is now planned for staged PCI of LAD and Diagonal bifurcation lesion using rotational atherectomy and dedicated two stent technique. (ccclivecases.org)
- 30 millimeters (mm), ii) thrombotic target lesion, iii) bifurcation lesion treated with more than one stent, iv) calcified target lesion treated with atherectomy, v) treatment of obstructive left main or proximal left anterior descending artery for index ACS (or clinical diagnosis of an anterior STEMI) 3. (who.int)
- Drug-eluting stents were used in 73% of all coronary artery stent insertions. (uspharmacist.com)
- For patients in whom medical and exercise therapy fail or those who have claudication symptoms that are lifestyle-limiting, surgical treatment includes either open bypass surgery or endovascular therapy (eg, stents, balloons, or atherectomy devices). (medscape.com)
- The presence of CRP, complement, and oxLDL in a high proportion of plaque tissue from patients with unstable coronary artery disease implies that these surrogate markers have important proinflammatory effects inside atherosclerotic plaques. (bmj.com)
- IntraSight Mobile brings together imaging and physiology applications on a mobile system for coronary and peripheral artery disease therapy. (philips.com)
- Clinical features included age at least 65 years, female sex, troponin-positive acute coronary syndrome, established vascular disease, diabetes treated with medication, and chronic kidney disease. (medscape.com)
- Outcomes with drug-coated balloons in small-vessel coronary artery disease. (omeka.net)
- If you have PAD, you are at risk for developing serious diseases, such as coronary artery disease and cerebrovascular disease, which can put you at risk for heart attack or stroke . (adventhealth.com)
- Stability after initial decline in coronary revascularization rates in the united states. (omeka.net)
- BACKGROUND: It remains uncertain how advances in revascularization techniques, availability of new evidence, and updated guidelines have influenced the annual rates of coronary revascularization in the United States. (omeka.net)
- This is a latticed metal scaffold put inside the coronary artery to keep the vessel open. (medlineplus.gov)
- The use of this product carries the same risks associated with coronary artery stent implantation procedures, which include subacute and late vessel thrombosis, vascular complications, and bleeding events. (medtronic.com)
- Non-complain /semi complain /CTO coronary balloon. (valueadded.in)
- Abbott expects CSI's products to complement its existing coronary intervention business and expand its presence in the peripheral market. (citeline.com)
- The two groups were well balanced, with a mean age of 65 years, 23.8% were female, 36.8% had diabetes, and 64.8% underwent PCI for acute coronary syndrome. (medscape.com)
- To investigate the simultaneous presence of macrophages, CRP, membrane attack complex C5b-9 (MAC), and oxidised low density lipoprotein (oxLDL) in atherectomy specimens from patients with different coronary syndromes. (bmj.com)
- Additionally, the safety and effectiveness of using atherectomy devices with the stent have not been established. (medtronic.com)