Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.
The veins and arteries of the HEART.
The circulation of blood through the CORONARY VESSELS of the HEART.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Narrowing or constriction of a coronary artery.
Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Damage to the MYOCARDIUM resulting from MYOCARDIAL REPERFUSION (restoration of blood flow to ischemic areas of the HEART.) Reperfusion takes place when there is spontaneous thrombolysis, THROMBOLYTIC THERAPY, collateral flow from other coronary vascular beds, or reversal of vasospasm.
Exposure of myocardial tissue to brief, repeated periods of vascular occlusion in order to render the myocardium resistant to the deleterious effects of ISCHEMIA or REPERFUSION. The period of pre-exposure and the number of times the tissue is exposed to ischemia and reperfusion vary, the average being 3 to 5 minutes.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
Use of a balloon CATHETER to block the flow of blood through an artery or vein.
Elements of limited time intervals, contributing to particular results or situations.
Prolonged dysfunction of the myocardium after a brief episode of severe ischemia, with gradual return of contractile activity.
The hollow, muscular organ that maintains the circulation of the blood.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Spasm of the large- or medium-sized coronary arteries.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
The act of constricting.
Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.
Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.
Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
The presence of an increased amount of blood in a body part or an organ leading to congestion or engorgement of blood vessels. Hyperemia can be due to increase of blood flow into the area (active or arterial), or due to obstruction of outflow of blood from the area (passive or venous).
Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.
A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.
The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.
Contractile activity of the MYOCARDIUM.
Blockage of the RETINAL VEIN. Those at high risk for this condition include patients with HYPERTENSION; DIABETES MELLITUS; ATHEROSCLEROSIS; and other CARDIOVASCULAR DISEASES.
A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.
Sudden ISCHEMIA in the RETINA due to blocked blood flow through the CENTRAL RETINAL ARTERY or its branches leading to sudden complete or partial loss of vision, respectively, in the eye.
Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Tantalum. A rare metallic element, atomic number 73, atomic weight 180.948, symbol Ta. It is a noncorrosive and malleable metal that has been used for plates or disks to replace cranial defects, for wire sutures, and for making prosthetic devices. (Dorland, 28th ed)
Sense of awareness of self and of the environment.
A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST.
Drugs used to cause dilation of the blood vessels.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.
Small uniformly-sized spherical particles, of micrometer dimensions, frequently labeled with radioisotopes or various reagents acting as tags or markers.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
The number of times the HEART VENTRICLES contract per unit of time, usually per minute.
Application of a ligature to tie a vessel or strangulate a part.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
Motion pictures of the passage of contrast medium through blood vessels.
The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.
A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.
Period of contraction of the HEART, especially of the HEART VENTRICLES.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
10-carbon saturated monocarboxylic acids.
The species Oryctolagus cuniculus, in the family Leporidae, order LAGOMORPHA. Rabbits are born in burrows, furless, and with eyes and ears closed. In contrast with HARES, rabbits have 22 chromosome pairs.
Organic compounds that contain technetium as an integral part of the molecule. These compounds are often used as radionuclide imaging agents.
The hospital unit in which patients with acute cardiac disorders receive intensive care.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Treatment process involving the injection of fluid into an organ or tissue.
Agents that have a strengthening effect on the heart or that can increase cardiac output. They may be CARDIAC GLYCOSIDES; SYMPATHOMIMETICS; or other drugs. They are used after MYOCARDIAL INFARCT; CARDIAC SURGICAL PROCEDURES; in SHOCK; or in congestive heart failure (HEART FAILURE).
Organic compounds containing both the hydroxyl and carboxyl radicals.
The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.
The return of a sign, symptom, or disease after a remission.
The relationship of all the components of the masticatory system in normal function. It has special reference to the position and contact of the maxillary and mandibular teeth for the highest efficiency during the excursive movements of the jaw that are essential for mastication. (From Jablonski, Dictionary of Dentistry, 1992, p556, p472)
Genetically developed small pigs for use in biomedical research. There are several strains - Yucatan miniature, Sinclair miniature, and Minnesota miniature.
The flow of BLOOD through or around an organ or region of the body.
The degree to which BLOOD VESSELS are not blocked or obstructed.
The pathological process occurring in cells that are dying from irreparable injuries. It is caused by the progressive, uncontrolled action of degradative ENZYMES, leading to MITOCHONDRIAL SWELLING, nuclear flocculation, and cell lysis. It is distinct it from APOPTOSIS, which is a normal, regulated cellular process.
Disease having a short and relatively severe course.
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)
A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.
A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)
Radionuclide ventriculography where a bolus of radionuclide is injected and data are recorded from one pass through the heart ventricle. Left and right ventricular function can be analyzed independently during this technique. First-pass ventriculography is preferred over GATED BLOOD-POOL IMAGING for assessing right ventricular function.
The circulation of the BLOOD through the MICROVASCULAR NETWORK.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
Obstruction of flow in biological or prosthetic vascular grafts.
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.
A technetium imaging agent used to reveal blood-starved cardiac tissue during a heart attack.
Isotopes that exhibit radioactivity and undergo radioactive decay. (From Grant & Hackh's Chemical Dictionary, 5th ed & McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed)
Substances used to allow enhanced visualization of tissues.
A technique in which tissue is rendered resistant to the deleterious effects of prolonged ISCHEMIA and REPERFUSION by prior exposure to brief, repeated periods of vascular occlusion. (Am J Physiol 1995 May;268(5 Pt 2):H2063-7, Abstract)
NECROSIS occurring in the MIDDLE CEREBRAL ARTERY distribution system which brings blood to the entire lateral aspects of each CEREBRAL HEMISPHERE. Clinical signs include impaired cognition; APHASIA; AGRAPHIA; weak and numbness in the face and arms, contralaterally or bilaterally depending on the infarction.
The innermost layer of the heart, comprised of endothelial cells.
A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.
Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION.
Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.
A derivative of the NIACINAMIDE that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.
Pathologic deposition of calcium salts in tissues.
A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
The geometric and structural changes that the HEART VENTRICLES undergo, usually following MYOCARDIAL INFARCTION. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle.
A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.
A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.
The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx).
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
The vessels carrying blood away from the heart.
Sulfhydryl acylated derivative of GLYCINE.
Unstable isotopes of thallium that decay or disintegrate emitting radiation. Tl atoms with atomic weights 198-202, 204, and 206-210 are thallium radioisotopes.
Diet modification and physical exercise to improve the ability of animals to perform physical activities.
A conical fibro-serous sac surrounding the HEART and the roots of the great vessels (AORTA; VENAE CAVAE; PULMONARY ARTERY). Pericardium consists of two sacs: the outer fibrous pericardium and the inner serous pericardium. The latter consists of an outer parietal layer facing the fibrous pericardium, and an inner visceral layer (epicardium) resting next to the heart, and a pericardial cavity between these two layers.
A free radical gas produced endogenously by a variety of mammalian cells, synthesized from ARGININE by NITRIC OXIDE SYNTHASE. Nitric oxide is one of the ENDOTHELIUM-DEPENDENT RELAXING FACTORS released by the vascular endothelium and mediates VASODILATION. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic GUANYLATE CYCLASE and thus elevates intracellular levels of CYCLIC GMP.
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).
Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)
The condition of an anatomical structure's being constricted beyond normal dimensions.
A catecholamine derivative with specificity for BETA-1 ADRENERGIC RECEPTORS. It is commonly used as a cardiotonic agent after CARDIAC SURGERY and during DOBUTAMINE STRESS ECHOCARDIOGRAPHY.
Adverse functional, metabolic, or structural changes in ischemic tissues resulting from the restoration of blood flow to the tissue (REPERFUSION), including swelling; HEMORRHAGE; NECROSIS; and damage from FREE RADICALS. The most common instance is MYOCARDIAL REPERFUSION INJURY.
Radiography of blood vessels after injection of a contrast medium.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.
Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.
Electronic instruments that produce photographs or cathode-ray tube images of the gamma-ray emissions from organs containing radionuclide tracers.
A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia.
Obstruction of the flow in the SPLANCHNIC CIRCULATION by ATHEROSCLEROSIS; EMBOLISM; THROMBOSIS; STENOSIS; TRAUMA; and compression or intrinsic pressure from adjacent tumors. Rare causes are drugs, intestinal parasites, and vascular immunoinflammatory diseases such as PERIARTERITIS NODOSA and THROMBOANGIITIS OBLITERANS. (From Juergens et al., Peripheral Vascular Diseases, 5th ed, pp295-6)
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The treatment of patients without the use of allogeneic BLOOD TRANSFUSIONS or blood products.
Streptococcal fibrinolysin . An enzyme produced by hemolytic streptococci. It hydrolyzes amide linkages and serves as an activator of plasminogen. It is used in thrombolytic therapy and is used also in mixtures with streptodornase (STREPTODORNASE AND STREPTOKINASE). EC 3.4.-.
The pressure within a CARDIAC VENTRICLE. Ventricular pressure waveforms can be measured in the beating heart by catheterization or estimated using imaging techniques (e.g., DOPPLER ECHOCARDIOGRAPHY). The information is useful in evaluating the function of the MYOCARDIUM; CARDIAC VALVES; and PERICARDIUM, particularly with simultaneous measurement of other (e.g., aortic or atrial) pressures.
A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system.
Contact between opposing teeth during a person's habitual bite.
A hemeprotein from leukocytes. Deficiency of this enzyme leads to a hereditary disorder coupled with disseminated moniliasis. It catalyzes the conversion of a donor and peroxide to an oxidized donor and water. EC
Non-human animals, selected because of specific characteristics, for use in experimental research, teaching, or testing.
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.
Methods used to temporarily or permanently block the flow of BODY FLUIDS through various ducts and tubules throughout the body, including BLOOD VESSELS and LYMPHATIC VESSELS such as by THERAPEUTIC EMBOLIZATION or LIGATION.
The formation of an area of NECROSIS in the CEREBRUM caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., INFARCTION, ANTERIOR CEREBRAL ARTERY), and etiology (e.g., embolic infarction).
An NADPH-dependent enzyme that catalyzes the conversion of L-ARGININE and OXYGEN to produce CITRULLINE and NITRIC OXIDE.
Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.
The arterial blood vessels supplying the CEREBRUM.
An antidiabetic sulfonylurea derivative with actions similar to those of chlorpropamide.
A method of hemostasis utilizing various agents such as Gelfoam, silastic, metal, glass, or plastic pellets, autologous clot, fat, and muscle as emboli. It has been used in the treatment of spinal cord and INTRACRANIAL ARTERIOVENOUS MALFORMATIONS, renal arteriovenous fistulas, gastrointestinal bleeding, epistaxis, hypersplenism, certain highly vascular tumors, traumatic rupture of blood vessels, and control of operative hemorrhage.
Pressure, burning, or numbness in the chest.
Radiography of the vascular system of the brain after injection of a contrast medium.
A family of iminourea derivatives. The parent compound has been isolated from mushrooms, corn germ, rice hulls, mussels, earthworms, and turnip juice. Derivatives may have antiviral and antifungal properties.
An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart.
Non-invasive method of vascular imaging and determination of internal anatomy without injection of contrast media or radiation exposure. The technique is used especially in CEREBRAL ANGIOGRAPHY as well as for studies of other vascular structures.
A macrolide compound obtained from Streptomyces hygroscopicus that acts by selectively blocking the transcriptional activation of cytokines thereby inhibiting cytokine production. It is bioactive only when bound to IMMUNOPHILINS. Sirolimus is a potent immunosuppressant and possesses both antifungal and antineoplastic properties.
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
A photographic fixative used also in the manufacture of resins. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance may reasonably be anticipated to be a carcinogen (Merck Index, 9th ed). Many of its derivatives are ANTITHYROID AGENTS and/or FREE RADICAL SCAVENGERS.
Injections made into a vein for therapeutic or experimental purposes.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
Pathological conditions involving the CAROTID ARTERIES, including the common, internal, and external carotid arteries. ATHEROSCLEROSIS and TRAUMA are relatively frequent causes of carotid artery pathology.
Formation and development of a thrombus or blood clot in the blood vessel.
The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).
The relationship between the dose of an administered drug and the response of the organism to the drug.
The circulation of blood through the BLOOD VESSELS of the BRAIN.
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
A type of cardiac arrhythmia with premature contractions of the HEART VENTRICLES. It is characterized by the premature QRS complex on ECG that is of abnormal shape and great duration (generally >129 msec). It is the most common form of all cardiac arrhythmias. Premature ventricular complexes have no clinical significance except in concurrence with heart diseases.
Pathological conditions of intracranial ARTERIES supplying the CEREBRUM. These diseases often are due to abnormalities or pathological processes in the ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; and POSTERIOR CEREBRAL ARTERY.
Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.
The main artery of the thigh, a continuation of the external iliac artery.
Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)
Cell membrane glycoproteins that are selectively permeable to potassium ions. At least eight major groups of K channels exist and they are made up of dozens of different subunits.
A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.
Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.
Regulation of the rate of contraction of the heart muscles by an artificial pacemaker.
The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS.
Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)
An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).
The vein which drains the foot and leg.
Compounds that are used in medicine as sources of radiation for radiotherapy and for diagnostic purposes. They have numerous uses in research and industry. (Martindale, The Extra Pharmacopoeia, 30th ed, p1161)
A non-selective inhibitor of nitric oxide synthase. It has been used experimentally to induce hypertension.
A class of cell surface receptors that prefer ADENOSINE to other endogenous PURINES. Purinergic P1 receptors are widespread in the body including the cardiovascular, respiratory, immune, and nervous systems. There are at least two pharmacologically distinguishable types (A1 and A2, or Ri and Ra).
A class of drugs that act by inhibition of potassium efflux through cell membranes. Blockade of potassium channels prolongs the duration of ACTION POTENTIALS. They are used as ANTI-ARRHYTHMIA AGENTS and VASODILATOR AGENTS.
A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.
The physiological narrowing of BLOOD VESSELS by contraction of the VASCULAR SMOOTH MUSCLE.
Lesions formed within the walls of ARTERIES.
Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called EMBOLECTOMY.
An effective inhibitor of platelet aggregation commonly used in the placement of STENTS in CORONARY ARTERIES.
Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.
An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter.
An acute, febrile, mucocutaneous condition accompanied by swelling of cervical lymph nodes in infants and young children. The principal symptoms are fever, congestion of the ocular conjunctivae, reddening of the lips and oral cavity, protuberance of tongue papillae, and edema or erythema of the extremities.
Striated muscle cells found in the heart. They are derived from cardiac myoblasts (MYOBLASTS, CARDIAC).
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing REPERFUSION INJURY.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.

Reciprocal changes in 12-lead electrocardiography can predict left main coronary artery lesion in patients with acute myocardial infarction. (1/321)

Acute left main coronary artery (LMCA) occlusion may result in acute myocardial infarction (AMI) or sudden death. ST elevation in the aVR and V1 leads is reported to be valuable in recognizing LMCA occlusion. Early recognition of electrocardiogram (ECG) changes, such as reciprocal ST depression in other leads, is helpful in averting this disaster. This study aimed to determine the reciprocal ST segment depression of 12-lead ECGs associated with acute LMCA occlusion. From January 2000 to December 2004, 61 patients who underwent emergency percutaneous coronary intervention in 3 hospitals due to AMI associated with LMCA (n = 18) and a left anterior descending coronary artery (LADCA) (n = 43) proximal lesion were selected. Reciprocal ST segment depression occurred in leads aVF, V(2), V(3), V(4), V(5), and V(6) with significantly higher incidence in the LMCA group than in the LADCA group. Stepwise linear multivariate discriminant analysis indicated that ST segment depression in leads aVF, V(2), and V(4) could distinguish the LMCA group from the LADCA group. We concluded that reciprocal ST segment depression in leads V(2), V(4), and aVF of a 12-lead ECG is an important predictor of acute LMCA occlusion.  (+info)

Embolised stent into the circumflex coronary artery during percutaneous coronary intervention. (2/321)

Dislodgement and embolisation of the new generation of coronary stents before deployment are rare. If it is impossible to withdraw the embolised stent from the coronary artery, the stent may be crushed into the side wall of the coronary artery with a balloon over a wire passed alongside the embolised stent.  (+info)

Microcirculatory dysfunction in ST-elevation myocardial infarction: cause, consequence, or both? (3/321)

AIMS: Despite advancements over the past years, normal reperfusion at the myocardial level is not achieved in approximately every other patient with ST-elevation myocardial infarction. In the current work, we aimed at reviewing the role of the coronary microcirculation in the development and outcome of this acute coronary syndrome entity. METHODS AND RESULTS: A PubMed/Medline search was performed with the key words acute coronary syndrome, acute myocardial infarction, coronary artery disease, endothelial dysfunction, microcirculation, and reperfusion. The synthesis of the information points to myocardial microcirculatory dysfunction as a consequence of a primary epicardial event, based on the vulnerable plaque concept. As an alternative theory, microcirculatory dysfunction may contribute to the clinical course of the acute coronary event, based on the vulnerable patient concept. The pros and cons of these two viewpoints are to be discussed and their influence on patient management is to be considered. CONCLUSION: Microcirculatory dysfunction in ST-elevation myocardial infarction can be cause, consequence or both according to non-traditional and traditional concepts.  (+info)

Troponin-I concentration 72 h after myocardial infarction correlates with infarct size and presence of microvascular obstruction. (4/321)

OBJECTIVES: The aim of this study was to use late gadolinium hyper-enhancement cardiac magnetic resonance (LGE-CMR) imaging to determine if a 72-h troponin-I measurement would provide a more accurate estimation of infarct size and microvascular obstruction (MVO) than serial creatine kinase (CK) or early troponin-I values. METHODS: LGE-CMR was performed 3.7+/-1.4 days after medical treatment for acute ST elevation or non-ST elevation myocardial infarction. Infarct size and MVO were measured and correlated with serum troponin-I concentrations, which were sampled 12 h and 72 h after admission, in addition to serial CK levels. RESULTS: Ninety-three patients, of whom 71 had received thrombolysis for ST elevation myocardial infarction, completed the CMR study. Peak CK, 12-h troponin-I, and 72-h troponin-I were related to infarct size by LGE-CMR (r = 0.75, p<0.0001; r = 0.56, p = 0.0003; r = 0.62, p<0.0001 respectively). Serum biomarkers demonstrated higher values in the group with MVO compared with those without MVO (Peak CK 3085+/-1531 vs 1471+/-1135, p<0.001; 12-h troponin-I 58.3+/-46.9 vs 33.4+/-40.0, p = 0.13; 72-h troponin-I 11.5+/-9.9 vs 5.5+/-4.6, p<0.005). The correlation between the extent of MVO and 12-h troponin-I was not significant (r = 0.16), in contrast to the other serum biomarkers (peak CK r = 0.44, p<0.0001; 72-h troponin-I r = 0.46, p = 0.0002). CONCLUSION: A single measurement of 72-h troponin-I is similar to serial CK measurements in the estimation of both myocardial infarct size and extent of MVO, and is superior to 12-h troponin-I measurements.  (+info)

Type A aortic dissection with partial ostial occlusion of left main coronary artery. (5/321)

A 48-year-old hypertensive male presented with acute retrosternal pain and aortic regurgitation. The electrocardiogram showed ST-segment depression with T-wave inversion in anterolateral leads. Transesophageal echocardiography in long axis view of aorta revealed a spiral intimal flap in ascending aorta extending to the arch, diagnostic of Type A aortic dissection. The short axis view of the aorta showed partial obstruction of the left main coronary artery (LMCA) by the intimal flap with turbulent flow at its ostium. An emergency repair of aortic dissection with reconstruction of aortic wall was done. Postoperative period and ECG were normal. At 12-months of follow up, patient was doing well.  (+info)

Detection and characterization of coronary bifurcation lesions with 64-slice computed tomography coronary angiography. (6/321)

AIMS: To compare the performance of 64-slice computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) in the detection and classification (according to the Medina system) of bifurcation lesions (BLs). METHODS AND RESULTS: We studied 323 consecutive patients undergoing 64-slice CTCA prior to ICA. All coronary segments >or=2 mm in diameter were evaluated for the presence of a significant (>or=50% diameter reduction on quantitative coronary angiography) BL. Evaluation of BL by CTCA included the assessment of significant lumen obstruction in both main and side branch vessels. Forty-one out of 43 patients (46/48 lesions) with significant BL were identified by CTCA. Excluding coronary segments with non-diagnostic image quality (5%), the sensitivity, specificity, and positive and negative predictive values of CTCA for detecting significant BL were 96, 99, and 85 and 99%, respectively. In 39 of these 41 patients, CTCA assessment was concordant with the Medina lesion classification on ICA. CONCLUSION: Sixty-four-slice CTCA allows accurate assessment of complex BL.  (+info)

Mechanistic investigation into the arrhythmogenic role of transmural heterogeneities in regional ischaemia phase 1A. (7/321)

AIMS: Studies of arrhythmogenesis during ischemia have focused primarily on reentrant mechanisms manifested on the epicardial surface. The goal of this study was to use a physiologically-accurate model of acute regional ischemia phase 1A to determine the contribution of ischaemia-induced transmural electrophysiological heterogeneities to arrhythmogenesis following left anterior descending artery occlusion. METHODS AND RESULTS: A slice through a geometrical model of the rabbit ventricles was extracted and a model of regional ischaemia developed. The model included a central ischaemic zone incorporating transmural gradients of I(K(ATP)) activation and [K+]o, surrounded by ischaemic border zones (BZs), with the degree of ischaemic effects varied to represent progression of ischaemia 2-10 min post-occlusion. Premature stimulation was applied over a range of coupling intervals to induce re-entry. The presence of ischaemic BZs and a transmural gradient in I(K(ATP)) activation provided the substrate for re-entrant arrhythmias. Increased dispersion of refractoriness and conduction velocity in the BZs with time post-occlusion led to a progressive increase in arrhythmogenesis. In the absence of a transmural gradient of I(K(ATP)) activation, re-entry was rarely sustained. CONCLUSION: Knowledge of the mechanism by which specific electrophysiological heterogeneities underlie arrhythmogenesis during acute ischaemia could be useful in developing preventative treatments for patients at risk of coronary vascular disease.  (+info)

The mechanistic basis for the disparate effects of angiotensin II on coronary collateral growth. (8/321)

OBJECTIVE: We hypothesize that controversial effects of angiotensin II (Ang II) are attributable to its regulation of reactive oxygen species (ROS) and ROS-dependent signaling. METHODS AND RESULTS: Coronary collateral growth (CCG) was stimulated in normal (WKY) and syndrome X (JCR) rats by transient/repetitive ischemia (RI). Blood flow was measured in the normal (NZ) and the collateral-dependent (CZ) zone. In WKY, RI increased CZ flow (0.84 mL/min/g), but RI+subpressor Ang II increased it more (1.24 mL/min/g). This was associated with transient p38 and sustained Akt activation. A hypertensive dose of Ang II decreased CZ flow (0.69 mL/min/g), which was associated with sustained p38 and transient Akt activation. AT1R blockade by candesartan abrogated CZ flow in WKY (0.58 mL/min/g), reduced myocardial superoxide, and blocked p38 and Akt activation. RI-induced CZ flow in JCR was significantly decreased compared with WKY (0.12 mL/min/g), associated with a large increase in superoxide and lack of p38 and Akt activation. CZ flow in JCR was partially restored by candesartan (0.45 mL/min/g), accompanied by reduction in superoxide and partial restoration of p38 and Akt activation. CONCLUSIONS: Ang II/AT1R blockade, at least in part, regulates CCG via generating optimal ROS amounts and activating redox-sensitive signaling.  (+info)

Purchase Manual of Coronary Chronic Total Occlusion Interventions - 1st Edition. Print Book & E-Book. ISBN 9780124201293, 9780128004326
TY - JOUR. T1 - Retrograde coronary chronic total occlusion revascularization. T2 - Procedural and in-hospital outcomes from a multicenter registry in the united states. AU - Karmpaliotis, Dimitri. AU - Michael, Tesfaldet T.. AU - Brilakis, Emmanouil S.. AU - Papayannis, Aristotelis C.. AU - Tran, Daniel L.. AU - Kirkland, Ben L.. AU - Lembo, Nicholas. AU - Kalynych, Anna. AU - Carlson, Harold. AU - Banerjee, Subhash. AU - Lombardi, William. AU - Kandzari, David E.. PY - 2012/12/1. Y1 - 2012/12/1. N2 - Objectives: This study sought to examine the contemporary outcomes of retrograde chronic total occlusion (CTO) interventions among 3 experienced U.S. centers. Background: The retrograde approach, pioneered and developed in Japan, has revolutionized the treatment of coronary CTO, yet limited information exists on procedural efficacy, safety, and reproducibility of outcomes in other settings. Methods: Between 2006 and 2011, 462 consecutive retrograde CTO interventions were performed at 3 U.S. ...
Increased interest focusing on coronary chronic total occlusions has emerged since several studies have proven improved cardiovascular outcomes and quality of life after successful chronic total occlusion (CTO) revascularization. CTO of an epicardial coronary artery is one of the leading challenging complex lesion type when percutaneous coronary intervention (PCI) is indicated.
Looking for online definition of Mayo-Japan Investigation for Chronic Total Occlusion in the Medical Dictionary? Mayo-Japan Investigation for Chronic Total Occlusion explanation free. What is Mayo-Japan Investigation for Chronic Total Occlusion? Meaning of Mayo-Japan Investigation for Chronic Total Occlusion medical term. What does Mayo-Japan Investigation for Chronic Total Occlusion mean?
BACKGROUND: Coronary chronic total occlusions (CTO) are the most challenging lesions to treat percutaneously. Thus, consistent efforts are made to develop new approaches to treat CTO. OBJECTIVE: To explore the key points of a novel ``crowbar effect
TY - JOUR. T1 - Advances in the management of coronary chronic total occlusions. AU - Brilakis, Emmanouil S.. AU - Karmpaliotis, Dimitri. AU - Vo, Minh N.. AU - Garcia, Santiago. AU - Michalis, Lampros. AU - Alaswad, Khaldoon. AU - Doshi, Parag. AU - Lombardi, William L.. AU - Banerjee, Subhash. N1 - Funding Information: Conflict of Interest Dr. Brilakis is a consulting/speaker honoraria from St. Jude Medical, Terumo, Janssen, Sanofi, Asahi, Abbott Vascular, and Boston Scientific and received research support from Guerbet. His spouse is an employee of Medtronic. Dr. Karmpaliotis was supported by speaker bureau, Abbott Vascular, Medtronic, and Boston Scientific. Dr. Vo is a consultant from Boston Scientific. Dr. Garcia received consulting fees from Medtronic; he is a recipient of a career development award from the VA Office of Research and Development. Dr. Michalis has no conflict of interest. Dr. Alaswad received consulting fees from Terumo and Boston Scientific; he is a consultant, with no ...
TY - JOUR. T1 - Comparison of Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusion Using Everolimus- Versus Sirolimus- Versus Paclitaxel-Eluting Stents (from the Korean National Registry of Chronic Total Occlusion Intervention). AU - Lee, Min Ho. AU - Lee, Joo M.. AU - Kang, Si Hyuck. AU - Yoon, Chang Hwan. AU - Jang, Yangsoo. AU - Yu, Cheol W.. AU - Park, Hun S.. AU - Lee, Seung Hwan. AU - Hur, Seung Ho. AU - Kim, Moo H.. AU - Rha, Seung Woon. AU - Gwon, Hyeon Cheol. AU - Chae, In Ho. AU - Kim, Hyo Soo. N1 - Funding Information: This study was supported by the Bio and Medical Technology Development Program of the National Research Foundation funded by the Ministry of Education, Science, and Technology ( 2010-0020258 ), Republic of Korea and by the Basic Science Research Program through the National Research Foundation funded by the Ministry of Education, Science, and Technology ( 2012M3A9C7050140 ), Republic of Korea. Dr. Kim is also a professor of Molecular Medicine ...
Background: With the improved lifestyle of people, the incidence of coronary artery disease is gradually increasing. Approximately 15% - 20% of patients undergoing diagnostic catheterization had one or more chronically occluded coronary arteries. Method: The patients who were diagnosed with chronic total occlusion (CTO) in our hospital within one year period have been included. They were initially divided into two groups based on angiographic reports: single vessel disease (SVD) and non-single vessel disease (non-SVD) group, then into optimal medical therapy (OMT) group, percutaneous coronary intervention (PCI) group and coronary artery bypass graft (CABG) group. Finally, PCI group is further divided into PCI of CTO lesion (CTO PCI group) and PCI of non-CTO lesion (non-CTO PCI group). Results: A total of 261 patients were enrolled as CTO patients, mean age was 62.83 years, 70.1% were male patients. The incidence rate of common risk factors was hypertension (64.4%), followed by smoking (48.3%), diabetes
AbstractBackgroundThe benefits of chronic coronary total occlusion (CTO) percutaneous coronary intervention (PCI) are being questioned. The aim of this study was to assess the effects of CTO PCI on absolute myocardial perfusion, as compared with PCI of hemodynamically significant non ‐CTO lesions.MethodsConsecutive patients with a preserved left ventricular ejection fraction ( ≥50%) and a CTO...
The reverse CART technique provides the potential to modify the retrograde procedure by improving the controlled movement of the retrograde wire and improve the success rates of percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Development of interventricular hematoma is a rare complication of CTO PCI. A 63-year-old man with effort angina with a right coronary artery CTO lesion underwent PCI by retrograde approach from the LAD to a septal branch. A contrast stain was demonstrated surrounding the septal collateral channel used for the retrograde approach at the end of the procedure without symptom ...
TY - JOUR. T1 - Coronary Computed Tomography Angiography Predicts Guidewire Crossing and Success of Percutaneous Intervention for Chronic Total Occlusion. AU - Yu, Cheol Woong. AU - Lee, Hyun Jong. AU - Suh, Jon. AU - Lee, Nae Hee. AU - Park, Sang Min. AU - Park, Taek Kyu. AU - Yang, Jeong Hoon. AU - Song, Young Bin. AU - Hahn, Joo Yong. AU - Choi, Seung Hyuk. AU - Gwon, Hyeon Cheol. AU - Lee, Sang Hoon. AU - Choe, Yeon Hyeon. AU - Kim, Sung Mok. AU - Choi, Jin Ho. PY - 2017/4/1. Y1 - 2017/4/1. N2 - Background - We developed a model that predicts difficulty of percutaneous coronary intervention for coronary chronic total occlusion (CTO) using coronary computed tomographic angiography. Methods and Results - A total of 684 CTO lesions with preprocedural computed tomographic angiography were enrolled from 4 centers. Data were randomly divided into derivation and validation datasets at 2:1 ratio. The end point was successful guidewire crossing ≤30 minutes, which was met in 50%. The KCCT (Korean ...
A 73-year-old man with unstable angina was found to have a severely calcified chronic total occlusion (CTO) of the mid left anterior descending coronary artery (LAD). Diagnostic coronary angiography confirmed the CTO to be complex, with a flush occlusion occurring in a segment associated with proximal septal and diagonal branches. Retrograde filling of the distal LAD occurred via 2 large septal perforators from the right coronary artery (RCA). Cardiac magnetic resonance imaging demonstrated preserved left ventricular systolic function with viability.. After discussion, the patient opted for percutaneous coronary intervention. Intervention was performed by 2 high-volume CTO operators with extensive experience of retrograde CTO percutaneous coronary intervention. An initial antegrade approach failed to negotiate the calcific CTO lesion (Figure 1A). A subsequent attempt was made to treat the CTO via … ...
Contributors All authors have read and approved the manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Each author has contributed significantly to the submitted work and namely: CG, AG, AS and FM started the study and did the final validation of the results; LB, CAP, AM and AB were responsible for the collection analysis and interpretation of the data. AC, MC, GFrag and LA revised the manuscript for intellectual content. GBZ and GFrat revised the manuscript for the statistical methods; the paper received an important input from MC, MM, AM and AC. CG is responsible for the overall content as guarantor. ...
By and For the Interventional Cardiovascular community. Sharing knowledge, experience and practice in cardiovascular interventional medicine. ...
Since data from the 2 landmark studies, the BENESTENT and STRESS studies, showed that coronary stenting significantly decreases restenosis as compared with conventional balloon angioplasty, this treatment modality has shown to be superior in an increasing number of indications. Percutaneous coronary intervention of chronic total occlusions (CTO), however, is still limited by high restenosis rates. Although coronary stenting using bare metal stents significantly decreases restenosis in CTO, restenosis rates still reach 32% to 55%.. In 200 patients with CTO randomized in the PRISON I study, we demonstrated a restenosis rate of 22% after bare metal stent implantation as compared with 33% after conventional balloon angioplasty. During the past few years, sirolimus (rapamycin), a cytostatic macrocyclic lactone with anti-inflammatory and antiproliferative properties, delivered from a polymer-encapsulated stent was shown to almost eliminate the risk of restenosis in selected groups of patients.. In ...
Chronic total coronary occlusions (CTO) still remain one of the most technically challenging clinical scenarios in which to perform interventions. Although the antegrad..
Purpose: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is still one of the challenging procedures. Multislice computed tomographic coronary angiography (CTCA) allows reliable non-invasive evaluation of coronary artery by visualizing calcium deposit, vessel tortuosity, distal flow, etc. even in the occluded site. The aim of this study is to determine the morphological predictors of procedural success in PCI for CTO using CTCA, and to estimate the value of CTCA to predict procedural outcome.. Methods: Using Somatom Sensation Cardiac 64, we performed CTCA in 91 patients who have CTO prior to PCI, and 93 CTO lesions were scanned. CTO was defined as complete occlusion of a major coronary artery on catheter coronary angiography, which was deemed to be of , 3 months duration. Procedural success was defined as complete cross of the guidewire to the occluded site. Retrograde approach, in which the guidewire was advanced from the distal end of the occluded site through the ...
TY - JOUR. T1 - Endovascular crossing of Chronic Total Occlusions using an impulse. T2 - An explorative design study. AU - Sakes, Aimée. AU - van der Wiel, Marleen. AU - Dodou, Dimitra. AU - Breedveld, Paul. PY - 2017. Y1 - 2017. N2 - In this study we investigated whether exerting an impulse on a Chronic Total Occlusion (CTO) improves the success rate of CTO crossing as compared to the currently used method of statically pushing the guidewire against the CTO. A prototype (Ø2 mm) was developed that generates translational momentum using a spring-loaded indenter and converts it to an impulse during impact. Mechanical performance was evaluated by measuring the peak force and momentum for different spring compressions and strike distances in air and blood-mimicking fluid. Puncture performance, in terms of number of punctures, number of strikes to puncture, and energy transfer from the indenter to the CTO, was assessed for six tip shapes (stamp, wedge, spherical, pointed, hollow spherical, and ...
First, a 5-F catheter was inserted via a femoral vein and advanced to the right atrium to record mean right atrial pressure (PRA). This catheter also served as central venous line. Then the donor artery was visualized by a 6-F guiding catheter, and a pressure wire (PressureWire, RADI Medical Systems, Uppsala, Sweden) was advanced into artery. The pressure sensor was positioned exactly at the takeoff of the collateral, and the local pressure (PD) together with the mean aortic root pressure (PAo) were recorded during 3 min of maximum peripheral vasodilation induced by central venous infusion of adenosine (140 μg/kg/min). The pressure difference along the epicardial donor artery segment was measured as: PAo− PD. Before and during adenosine infusion, PRAwas recorded. The FFRDwas calculated as: (PD− PRA)/(PAo− PRA) (17,18). After stopping adenosine and returning to baseline pressures, the wire was advanced further distal into the donor artery in order to assess the CFRDusing the recently ...
The main finding from this large prospective, observational, multicenter registry of consecutive CTO recanalizations across all U.K. PCI centers between 2005 and 2009 is the strong association between successful CTO revascularization and improved survival over a median follow-up of 2.65 years (interquartile range: 1.59 to 3.83 years). This is important because a recent large observational study found an association between successful CTO intervention and fewer cardiovascular deaths but did not demonstrate an increase in absolute survival (9). The improvement in survival remained after multivariate analysis, suggesting that it is independent of measurable confounding factors. The survival outcome of successful revascularization did not vary between the different epicardial vessels.. Increasing age, diabetes, heart failure, smoking, and renal disease were confirmed as factors associated with increased all-cause mortality, whereas increasing age, smoking history, increasing body mass index, ...
Chronic total occlusions (CTO) are encountered in almost one-fourth of patients undergoing coronary angiography. The presence of an untreated CTO has been related to adverse clinical prognosis, both in stable angina and acute myocardial infarction, and is often associated with persistent symptomatic angina. Depending on their symptomatic and functional status as well as anatomical complexity, CTO can be treated by optimal medical therapy only or therapy combined with coronary revascularization.. The potential benefits of percutaneous coronary intervention (PCI) in CTO include symptom relief, improved left ventricular function, and potentially a survival advantage associated with success when compared with failed revascularization. Of note, marked advances in endovascular techniques and device technology have resulted in substantial improvements of procedural success rates of PCI in CTO.. In spite of these advances, the vast majority of patients with CTO are still being managed medically or ...
OBJECTIVE: Chronic total occlusion (CTO) of coronary arteries represents a challenge for percutaneous treatment. Although ameroid constrictors have been used to create CTOs from extrinsic compression of coronary arteries, this model is not suitable f
The prevalence of heart failure depends on the definition used, but it is estimated that it affects approximately 1% to 2% of the general population and approximately 10% of those ,70 years of age, with coronary artery disease being the most common etiology (1). Chronic total occlusions (CTO) are found in ∼20% of patients without prior surgical revascularization undergoing nonurgent coronary angiography (2). This incidence is even higher in selected subgroups of patients such as those presenting with an acute coronary syndrome (47%), prior surgical bypass (coronary artery bypass grafting [CABG]) (89%), or in implantable cardioverter defibrillator recipients due to ischemic cardiomyopathy (∼50%) (3-6). It has largely been shown that the presence of a CTO confers a negative impact on long-term prognosis in several clinical scenarios. In the setting of acute coronary syndrome (with or without cardiogenic shock), a coexisting CTO is associated with worse early and late mortality (3,7,8). In ...
Percutaneous revascularisation of chronic total occlusions (CTO) is limited by failure of guidewire crossing. Neovascularisation within the proximal CTO segment may be important for guidewire crossing and dramatically declines in CTO beyond six weeks
OBJECTIVE: This study aimed to examine predictors and clinical outcomes of periprocedural myocardial infarction (PMI) after chronic total occlusion (CTO) intervention. BACKGROUND: There are limited data on the clinical implications of PMI after CTO intervention in the new-generation drug-eluting stent (DES) era. METHODS: We enrolled 337 patients who underwent CTO intervention and met the study criteria. We evaluated the incidence and predictors of PMI, defined as an increase in creatine kinase-MB ≥3× the upper limit of normal (ULN) after intervention and compared the occurrence rates of major adverse cardiac and cerebrovascular events (MACCE, defined as the composite of cardiac death, myocardial infarction, stent thrombosis, target-vessel revascularization, or cerebrovascular accidents) between the PMI and non-PMI groups ...
The study is the largest in the United States to examine the safety and effectiveness of a so-called retrograde approach to angioplasty and stenting of chronic total occlusions (CTOs). Using this innovative technique, interventional cardiologists at three medical centers were successful in tunneling through the obstruction, opening the blocked artery and restoring blood flow to the heart in about 80 percent of patients, many of whom had no alternative treatment options.. Patients with chronic total occlusions experience chest pain, shortness of breath and other disabling symptoms, said Tesfaldet T. Michael, MD, a cardiology research fellow at the University of Texas Southwestern Medical Center inDallas. When medical therapy fails, percutaneous coronary intervention (PCI) may be the last resort. It really helps patients to have a better quality of life.. Up to one-third of patients who undergo diagnostic angiography have cholesterol plaque that completely blocks a coronary artery. If they ...
Several large studies (2,5) have reported on the clinical impact of successful percutaneous CTO revascularization. In particular, studies have shown that successful PCI of a CTO lesion reduces the incidence of MI, cardiac death, and bypass surgery, resulting in enhanced 1-year survival. From this point of view, the influence of the immediate result of a CTO procedure on long-term outcomes is an important factor. In recent contemporary series, procedural success rates have ranged from 55% to 80%, with the variability reflecting differences in operator technique and experience, availability of advanced guidewires, CTO definitions, and case selection (2,15). Recent procedural outcomes after PCI for CTO lesions have increased significantly due to improved device technology, as well as technique and experience, such that successful recanalization of true CTOs may now be achieved in approximately 80% of attempted lesions (2,5,16). We reported that technical success was achieved in 207 (92.4%) of 224 ...
Expertise, Disease and Conditions: Acute Myocardial Infarction (AMI), Cardiac Catheterization, Cardiovascular Diseases, Cardiovascular Interventions, Carotid Artery Disease, Carotid Artery Stenosis, Carotid Artery Stenting, Chronic Total Coronary Occlusion, Chronic Total Occlusions, Circulatory Support Devices, Coronary Angiography, Coronary Artery Disease, Coronary Artery Stenting, Coronary Care Unit, Emboli-Protection Devices, Endovascular Therapies, Fractional Flow Reserve, Heart Disease, Hypertension, Interventional Cardiology, Intravascular Ultrasound (IVUS), Invasive Cardiology, Laser Atherectomy, Lower Extremity Revascularization, Pericardiocentesis, Peripheral Angiography, Peripheral Arterial Disease (PAD), Peripheral Vascular Disease, Renal Artery Disease, Restenosis, Rotational Atherectomy, Trans-Radial Intervention, Valvular Heart Disease, Valvuloplasty for Valvular ...
PCI was successful in a total of 582 (69.6%) procedures. Stents were implanted in 97.0% of successful procedures and drug-eluting stents were used in 73%. Procedural complications, including coronary dissection, were more frequent in unsuccessful cases (20.5% vs. 4.9%; p < 0.0001), but there was no difference in in-hospital major adverse cardiac events (3% vs. 2.1%; p = not significant). All-cause mortality at 5 years was significantly higher in patients with failed recanalization (17.2% vs. 4.5%; p < 0.0001). The need for coronary artery bypass grafting was significantly lower following successful CTO PCI (3.1% vs. 22.1%; p < 0.0001). After adjusting for the differences in baseline variables, successful PCI of a CTO was independently associated with a lower mortality (hazard ratio, 0.32; 95% confidence interval, 0.18-0.58).. ...
Expertise, Disease and Conditions: Acute Coronary Care, Acute Coronary Syndrome (ACS), Acute Myocardial Infarction (AMI), Adult Congenital Heart Disease, Angina, Angioplasty, Atherosclerosis, Atherosclerosis Imaging, Cardiac Catheterization, Cardiac Disease, Cardiac Imaging, Cardiology, Cardiomyopathy, Cardiovascular Computed Tomography, Cardiovascular Disease in Women, Cardiovascular Disease with Chronic Renal Disease, Cardiovascular Diseases, Cardiovascular Interventions, Cardiovascular Medicine, Cardioversion, Chest Pain, Chronic Total Coronary Occlusion, Chronic Total Occlusions, Clinical Cardiology, Congenital Heart Disease, Congestive Heart Failure (CHF), Coronary Angiography, Coronary Artery Disease, Coronary Artery Stenting, Coronary CT Angiography, Coronary Endothelial Function, CT Angiography, General Cardiology, Heart Attack, Heart Conditions, Heart Disease, Heart Disease Prevention and Treatment in Women, Hypertrophic Cardiomyopathy, Interventional Cardiology, Intravascular ...
The data were statistically analyzed by SPSS Statistics version 24 (IBM, Armonk, NY, USA) and Medcalc 11.1 statistical program (Medcalc, Gent, Belgium). Continuous values are expressed as means±standard deviation. Categorical data are presented as frequencies and percentages. Normality was evaluated by the Shapiro-Wilk test. Normally distributed values were compared by an unpaired t test, and non‐normally distributed values were compared by the Kruskal-Wallis rank test or the Mann-Whitney U test. Categorical data were compared by the χ2 test or Fisher exact test. We used logistic regression models to identify predictors of technical failure in overall CTO‐PCI by univariate and multivariate analysis with a forward stepwise algorithm and forced inclusion models. However, logistic regression analyses are sometimes difficult to apply directly to patients in daily clinical practice because of variation in the number, type, and severity of their comorbidities. Therefore, recursive partitioning ...
The procedural success rates of percutaneous intervention for chronic total coronary occlusions (CTOs) over the past decade have been increasing, driven by the development of specialized guidewires and microcatheters and the introduction of new technical strategies, including antegrade subintimal re-entry and the retrograde transcollateral approach. An ongoing challenge is to select the most promising strategy early to reduce total procedure time, to reduce radiation and contrast exposure, and to further improve complication-free procedural success rates. In this regard, procedural planning is typically based on the angiographic assessment of the occluded lesion, including features of the proximal cap, the extent of calcification, and the apparent length of the lesion (1). Pre-procedural coronary computed tomographic angiography (CTA) with modern high-resolution scanners may provide incremental information about the features of the coronary occlusion, which might enhance procedural planning and ...
SAN DIEGO, CA-One-fifth of patients undergoing PCI for a chronic total occlusion (CTO) have chronic kidney disease (CKD), according to new registry data. However, while the incidence of contrast-induced acute kidney injury (CI-AKI) was almost doubled for patients with CKD, this did not lead to higher rates of new dialysis or target lesion failure over follow-up.. Lorenzo Azzalini, MD, PhD (San Raffaele Scientific Institute, Milan, Italy), who presented the results Friday at TCT 2018, told TCTMD that these results should encourage dedicated CTO operators in that they should not be scared to perform this procedure in patients with CKD. Rather, good results can be achieved by paying attention to identifying high-risk patients, using intravenous hydration, avoiding ad hoc procedures, setting a maximum contrast level, and defaulting to a retrograde approach, he stressed.. The study, also appearing in the October 2018 issue of the Canadian Journal of Cardiology, included 1,092 patients-19.6% with ...
Abstract To define the prevalence of total coronary occlusion in the hours after transmural myocardial infarction, we used coronary arteriography to study the degree of coronary obstruction in 322 patients admitted within 24 hours of infarction. Total coronary occlusion was observed in 110 of 126 patients (87 per cent) who were evaluated within four hours of the onset of symptoms; this proportion decreased significantly, to 37 of 57 (65 per cent), when patients were studied 12 to 24 hours after the onset of symptoms. Among 59 patients with angiographic features of coronary thrombosis, the thrombus was retrieved by Fogarty catheter in 52 (88 per cent) but was absent in seven (12 per cent false positive). Among an additional 20 patients without angiographic features of thrombosis, a thrombus was discovered in five (25 per cent false negative). Thus, total coronary occlusion is frequent during the early hours of transmural infarction and decreases in frequency during the initial 24 hours, ...
1 Kavteladze Z. Retrograde recanalization of tibial CTOs. Presented at: TCT 2010; September 21-25, 2010; Washington, DC.. 2 Montero-Baker M, Schmidt A, Bräunlich S, et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther. 2008;15(5):594-604.. 3 Belch JJ, Topol EJ, Agnelli G, et al. Critical issues in peripheral arterial disease detection and management: a call to action. Arch Intern Med. 2003;163(8):884-892.. 4 Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33(suppl 1):S1-S75.. 5 Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputations in diabetes. In: Harris MI, Cowie CC, Stern MP, et al., eds. Diabetes in America. 2nd ed. Washington, DC: National Institute of Diabetes and Digestive and Kidney Diseases, 1995:409-428.. ABOUT COOK MEDICAL. A global pioneer in medical breakthroughs, Cook Medical is committed to creating effective ...
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Besides severity of coronary obstruction [37, 38], numerous factors that could possibly attenuate the development and biological function of coronary collaterals have been reported such as old age [39], traditional risk factors for coronary artery disease [40-44], hyperlipoprotein (a) [45], hyperuricemia [46] and elevated serum levels of CRP [47], TNF-a [48], N-terminal pro-brain natriuretic peptide [38] and mimecan [49], and high neutrophil/lymphocyte ratio [50]. In contrast, higher plasma levels of MCP-1 [51] or apelin [52] were associated with better coronary collateral development. The presence and extent of spontaneously visible coronary collaterals was also affected by plasma chemokine concentrations, as higher collateralization was associated with increased concentration of the angiogenic ligand and decreased concentrations of angiostatic ligands, and interferon-c [53]. It is known that diabetes mellitus aggressively induces atherosclerosis and may be more susceptible to myocardial ...
Περιγραφή: A 60 year gentleman underwent PCI of a CTO of the RCA. We used a 7F AL1 guide catheter through the right femoral artery, and a 6F JL3.5 through the right radial artery for contralateral injection. While trying to cross the lesion with a hydrophilic wire loaded to a microcatheter, contrast extravasation was noticed (type II perforation). The patient was hemodynamically stable without signs of overt extravasation. We thus tried to conservatively treat the perforation by prolonged infusion of a 3.0mm balloon (~5 min). During the inflation, the patient was asymptomatic and we tried again to cross the occlusion using a hydrophilic wire through the balloon catheter. Crossing was successful, while contrast extravasation was no longer present. We subsequently treated the lesion with two 3.0x30mm and 2.5x30mm DES, following predilation with 2.0mm and NC 3.0mm balloons ...
Prognostic impact of recanalizing chronic total occlusion in non-infarct related arteries on long-term clinical outcomes in acute myocardial infarction patients undergoing primary percutaneous coronary intervention (2020 ...
CLEVELAND, July 20, 2011 /PRNewswire/ -- One of Frantz Medical Groups (FMG) subsidiaries, VasoStar Inc., Mentor, Ohio today announced that it has been awarded an Ohio Third Frontier grant to further develop and commercialize a novel electromagnetic guidewire system for penetrating through vascular Chronic Total Occlusions (CTOs), in lieu of invasive open heart surgery such as Coronary Artery Bypass Graft (CABG). VasoStars primary clinical development partner is the Cleveland Clinics Lerner Research Institute. The VasoStar advisory team consists of world renowned cardiovascular clinicians including Dr. Patrick Whitlow, Director of Interventional Cardiology, Cleveland Clinic; Dr. Kiyo Fukamachi, Director of the Cardiovascular Dynamics Laboratory, Lerner Research Institute, Cleveland Clinic; Dr. Marc Penn, Director of Research, Summa Cardiovascular Institute; and Dr. Peter Fitzgerald, Director of the Center for Cardiovascular Technology and Director of the Cardiovascular Core Analysis Laboratory ...
A guidewire having a flexible coil with a tapered distal tip. Preferably, the flexible coil has a polymer coating at least at its tapered distal portion. The polymer coating may comprise polyurethanes or other suitable polymers. The guidewires of the invention provide desirable performance characteristics, particularly when used to cross relatively tight lesions such as chronic total occlusions.
Medical excimer laser developer Ra Medical said it won FDA 510(k) clearance for its Dabra system designed to treat patients with peripheral artery disease.. The Carlsbad, Calif.-based company said that the system is designed to destroy arteriosclerotic blockages through the use of radiation ablation, touting the device and associated procedures as cost and time saving.. Dabras pivotal study demonstrated 95% success without any clinically significant adverse events. Furthermore, the Dabra Catheter is unique in its ability to cross Chronic Total Occlusions without having to cross the lesion with a wire, and it also debulks and modifies arterial blockages, making it an invaluable clinical tool, Dr. Ehtisham Mahmud of the UC San Diego School of Medicine. Dabra is what we have been waiting for to better treat our patients. It is a two-in-one. You cross the blockage and remove the plaque from the artery. It is safe, because it stays in the patients true lumen and does not go subintimal or ...
The Jetstream Navitus offers greater flexibility, unsurpassed cutting effectiveness and improved guidewire performances. This catheter is a highly effective option for treating calcium blockages and chronic total occlusions in the peripheral vascular disease patient population.. The Jetstream Navitus offers interventionalists an evolutionary new tool to treat the most calcified lesions in the infra-inguinal vascular space, said Andrey Espinoza, medical director, Hunterdon Medical Center, New Jersey, USA. The design iterations provide a superior cutting platform with enhanced flexibility and an excellent deliverability profile. The Jetstream Navitus will allow a wider spectrum of patients to benefit from this generational technology.. Jetstream Navitus features: • Improved performance in tortuous anatomy-Enhanced drive line design provides for coaxial guidewire movement through the length of the catheter, offering enhanced flexibility, reduced friction and smooth movement through the ...
A rotating cutting head catheter for passage through chronic total occlusions or other refractory atherosclerotic plaque from diseased arteries is disclosed. The catheters rotating cutting head is designed to reside safely within an outer protective sheath when not in use. The outer protective sheath contains one or more helical grooves or slots, and the cutting head contains protruding blades or projections that fit into these helical grooves or slots. Application of torque to an inner catheter or wire attached to the cutting head applies spin to the cutting head, and the force of the sheaths helical grooves or slots against the cutting heads protruding blades or projections advances the cutting head outward from the protective sheath. Once extended, the cutting head may now rotate freely. The device may use a guidewire to direct the cutting head to the desired position.
Though endovascular interventions for venous obstructive lesions have evolved, chronic total occlusions are difficult to negotiate. We are describing our experience of su..
Provided herein is a copolymer that includes a soft block (A) and a hard block (B) comprising a tyrosine di-peptide. The copolymer can be any of AB, ABA or BAB type block copolymers. The soft block can include a PEA polymer. A coating formed of the copolymer may also include a bioactive agent. The implantable device can be implanted in a patient to treat, prevent, or ameliorate a disorder such as atherosclerosis, thrombosis, restenosis, hemorrhage, vascular dissection or perforation, vascular aneurysm, vulnerable plaque, chronic total occlusion, claudication, anastomotic proliferation for vein and artificial grafts, bile duct obstruction, ureter obstruction, and/or tumor obstruction.
Dr. Shariq Shamim is a Board Certified Interventional Cardiologist who was named one of the top cardiologists in America in 2017 by Consumer Research Council of America. He is fellowship trained in Interventional Cardiology and in Cardiovascular Disease. He has a special interest in Chronic Total Occlusion PCI and Limb Salvage Interventions to improve patients quality of life. His philosophy is several cardiac issues are preventable and strongly believes in lifestyle and diet interventions to prevent these. Dr. Shamim is proud to be a part of the New Mexico Cardiac Care team and the community of Las Cruces.. ...
Computer-assisted image segmentation can be a challenging problem. In previous research, manual segmentation was used for the detection of key features in cervical and lumbar x-ray images. In this research, a semi-automated live wire technique is investigated and is evaluated for the detection of anterior osteophytes in lumbar vertebrae--Abstract, leaf iii.
A coronary occlusion is the partial or complete obstruction of blood flow in a coronary artery. This condition may cause a heart attack. In some patients coronary occlusion causes only mild pain, tightness or vague discomfort which may be ignored; however, the myocardium, the muscle tissue of the heart, may be damaged. According to Robert K. Massies Nicholas and Alexandra: The Fall of the Romanov Dynasty, Tsar Nicholas II may have suffered a coronary occlusion right before he was toppled from his throne during the Russian Revolution in 1917. Arterial embolism Massie, Robert K. (2012), Nicholas and Alexandra: The Fall of the Romanov Dynasty. New York, The Modern Library, p. 433. ISBN 0679645616. Accessed 2016-11-19. Originally published in 1967 by Artheneum (United States) as Nicholas and Alexandra: An Intimate Account of the Last of the Romanovs and the Fall of Imperial Russia. ISBN 978-0-679-64561-0 ...
News and information on minimally invasive coronary disease therapies, covering valvular, structural, radial access, chronic total occlusion, and imaging issues.
Roly has undertaken two interventional fellowships, firstly locally at Princess Alexandra Hospital in Brisbane. He was then awarded the Chamberlain Scholarship in Advanced Coronary and Structural Intervention at the world renowned Royal Sussex County Hospital, England. During his time there Roly was involved in many international trials and several first-in-man developments. Rolys main interest is in clinical cardiology with a focus on coronary and structural intervention. Unusually for an interventional cardiologist, Roly is also trained, accredited and performs cardiac CT giving a unique perspective in the diagnosis, investigation and management of cardiovascular diseases. Roly performs a wide range of percutaneous interventional procedures including coronary stents, rotablation and chronic total occlusion revascularisation. He performs the full range of structural interventions including TAVI, PFO / ASD closure, percutaneous treatments of aortic and mitral valves, left atrial appendage ...
BACKGROUND: Total occlusion of the infrarenal abdominal aorta is a very rare disease in clinical practice. The clinical outcome may be poor unless management is attempted promptly. Surgical bypass has been recommended as the treatment of choice for these lesions. However, there was relatively high surgical mortality and morbidity associad with aorto-bifemoral bypass graft in patients with other systemic disease, especially coronary artery disease. As a result, the use of, thrombolysis with percutaneous transluminal angioplasty (PTA) has recently been extended to this disease as an alternative method to surgery. PTA is technically simpler with less morbidity and mortality than surgery.We report our experience with thrombolysis and balloon angioplasty of total aortic occlusion in 14 patients between March 1991 and December 1996. METHODS: Fourteen patients, whose mean age was 59+/-13 years (11 male, 3 female), serve as the studys patients. Aortography was introduced via transbrachial artery. The ...
Approach and Results-Rats underwent transient, repetitive left anterior descending occlusion (resultant myocardial ischemia [RI]) for 0 to 10 days. CCG was measured in the collateral-dependent and normal zones using microspheres, MMP activation by Western blot, and endostatin and angiostatin by ELISA on days 0, 3, 6, 9, or 10 of RI. Endostatin and angiostatin were increased in JCR but not in Sprague Dawley rats on days 6 and 9 of RI. Increased endostatin and angiostatin correlated with increased MMP12 (≈4-fold) activation in JCR but not in Sprague Dawley rats on days 6 and 9 of RI. Inhibition of MMP12 in JCR rats nearly completely blocked endostatin (≈85%) and angiostatin (≈90%) generation and significantly improved CCG (collateral-dependent zone flow was ≈66% of normal zone flow versus ≈12% for JCR RI).. ...
Intravascular imaging catheters are provided that include a distal sheath portion having a lumen that is configured to optionally receive a guidewire or an imaging assembly. The distal sheath portion may be configured to have dimensions such that when a guidewire is inserted through the lumen and extends through a distal exit port, the distal sheath portion may be employed as a microcatheter. External tissue may be imaged at a location at or near the distal end of the catheter, enabling, for example, the controlled imaging of a total occlusion, and the positioning of the distal end (and guidewire) within a true lumen associated with a total occlusion. A structural stop may be provided at or near the distal end of the distal sheath portion to prohibit extension of the imaging assembly out of the distal exit port, while permitting the extension of the guidewire through the distal exit port.
For patients with type 2 diabetes and coronary artery disease, CABG plus optimal medical therapy is superior to PCI plus optimal medical therapy.
Join Adam Crespi for an in-depth discussion in this video Fine-tuning ambient occlusion and bounced light, part of Unity: Materials and Lighting
A coronary occlusion is the partial or complete obstruction of blood flow in a coronary artery. This condition may cause a ... Tsar Nicholas II may have suffered a coronary occlusion right before he was toppled from his throne during the Russian ... In some patients coronary occlusion causes only mild pain, tightness or vague discomfort which may be ignored; however, the ...
Brownell and J. Edgar Hoover"; of a coronary occlusion; in-his Manhattan apartment. Statement issued by the Julius and Ethel ...
He died of a coronary occlusion in Fort Worth leaving two sons and a former wife. Self-taught, he learned to play the trumpet ... Coronary occlusion "004478201". Standard Certificate of Birth (Microfilm) (Report). Fort Worth, Tarrant, Texas: Texas State ...
Akcay, Murat (July 2018). "Evaluation of thrombotic left main coronary artery occlusions; old problem, different treatment ... Coronary thrombosis refers to the formation and presence of thrombi in the coronary arteries of the heart. Note that the heart ... The coronary sinus is the venous counterpart to the coronary arteries, where de-oxygenated blood returns from heart tissue. A ... Coronary "microembolization" is being explored as a focal point for coronary thrombus formation and subsequent sudden death due ...
March 5, 1950: Showman Sid Grauman - coronary occlusion. May 29, 1951: Comedienne Fanny Brice - cerebral hemorrhage. December 5 ...
Bramwell, C. (12 April 1930). "A British Medical Association Lecture on Coronary Occlusion". Br Med J. 1 (3614): 681-685. doi: ...
Onus died in 1968 of a coronary occlusion. His business enterprises had created a model for cultural maintenance, and helped to ...
He died of coronary occlusion at age 49. Fewster played for the Yankees in the 1921 World Series. He was the first player to ...
He died in 1956 of a coronary occlusion. Lawrence, T. F. C. Upton, Thomas Haynes (1889-1956). Australian Dictionary of ...
He died in 1962, from a coronary occlusion. Australian Dictionary of Biography, online Lane, Richard (2000). The Golden Age of ...
... refers to when a coronary artery suddenly undergoes either complete or sub-total temporary occlusion. In ... When coronary vasospasm causes an artery to undergo complete occlusion, an EKG might show evidence of ST-segment elevation in ... Ultimately, when large coronary arteries undergo vasospasm, this can lead to either complete or transient occlusion of blood ... When coronary vasospasm occurs, the occlusion temporarily produces ischemia. A wide array of symptoms or presentations can ...
He died of coronary occlusion in Mt. Lebanon, Pennsylvania. Pennsylvania portal Biography portal District Attorney Pittsburgh ...
... (February 1943). "The Electrocardiographic Diagnosis and Treatment in Recent Coronary Occlusion". Journal ... Harvey N. Middleton (July 1947). "Electrocardiographic Diagnosis and Prognosis of Recent Coronary Thrombosis or Occlusion". ... "Electrocardiographic Diagnosis and Prognosis of Recent Coronary Thrombosis or Occlusion", Journal of the Indiana State Medical ... "The Electrocardiographic Diagnosis and Treatment in Recent Coronary Occlusion", Journal of the Indiana State Medical ...
Ivins died in Salt Lake City of a coronary occlusion. He was buried at Salt Lake City Cemetery. Grave marker of Anthony W. ...
In 1979, Finklea survived a coronary occlusion and bypass surgery. He had a second coronary occlusion and repeated bypass ...
He died of a coronary occlusion on 22 February 1959. List of Olympic medalists in swimming (men) World record progression 4 × ...
He died at Salt Lake City of a coronary occlusion. State of Utah Death Certificate S. Dilworth Young, "The Seventies: A ...
Dougall died in Salt Lake City of a coronary occlusion. She was the mother of three children. Descendants of Brigham Young " ...
Stern died suddenly on March 27, 1938 of coronary occlusion. Stern studied at the University of Berlin under the guidance of ...
An autopsy showed nearly complete occlusion of the main coronary arteries. In accordance with his wishes, his body was cremated ...
Whitta died at his home in Darebin from a coronary occlusion. It was reported that he had just driven his wife and two sons ...
He was found dead in bed after suffering a coronary occlusion. List of college football coaches with 100 losses List of college ...
He died of coronary occlusion on June 8, 1936, in Gloucester, Massachusetts. He married Natalie Harris (1859 - 1931), of ...
He died at age 42 in Sandusky, Ohio, of a coronary occlusion. "Cliff Fannin". Retrieved 15 February ...
Thomas died in Philadelphia on December 2, 1935 of a coronary occlusion. She had returned to the city to address Bryn Mawr ...
O'Sullivan died unexpectedly of a coronary occlusion while visiting Sydney in 1968. He was survived by his wife and two sons. ...
The cause of death was a coronary occlusion, causing a heart attack. Associates in the Chicago Outfit took charge of his ...
"Widow of Automobile Pioneer, Victim of Coronary Occlusion, Survived Him Three Years". Associated Press. September 29, 1950. " ...
... , namely coronary ostial stenosis, is the occlusion of coronary ostium. Causing factors include atherosclerosis, ... Angelini, P (2012). "Congenital Coronary Artery Ostial Disease". Tex Heart Inst J. 39 (1): 55-9. PMC 3298900. PMID 22412228. ( ...
Bannan died of a coronary occlusion on 26 July 1977 in Ballina. "Centenary Ball For "Fortians"". The Sydney Morning Herald. ...
NOS 433 Occlusion and stenosis of precerebral arteries 433.0 Occlusion and stenosis of basilar artery 433.1 Occlusion and ... 414.11 Aneurysm of coronary vessels 414.12 Dissection of coronary artery 414.8 Ischemic heart disease, chronic, other 414.9 ... stenosis of carotid artery 433.2 Occlusion and stenosis of vertebral artery 434 Occlusion of cerebral arteries 434.0 Cerebral ... Angina pectoris 413.0 Angina decubitus 413.1 Prinzmetal angina 414 Other forms of chronic ischemic heart disease 414.0 Coronary ...
... chronic total occlusion) and thrombus. The lab achieved the world's first microrobot navigation through artery in a live pig. ... Microrobot moving controlled through blood vessel for drug delivery and treatment of coronary artery disease such as CTO( ...
... of the CMTM5 gene's or its products can be used as makers for patient susceptibilities to coronary artery/stent occlusions; and ... and/or one of its CMTM5 proteins may promote atherosclerosis-based coronary artery disease and the stenosis of coronary artery ... Liu TF, Lin T, Ren LH, Li GP, Peng JJ (December 2020). "[Association between CMTM5 gene and coronary artery disease and the ... Association of CMTM5 gene expression with the risk of in-stent restenosis in patients with coronary artery disease after drug- ...
Active infection, central vein occlusion, coronary occlusion, and need for other surgeries such as for arrhythmia are ... If coronary compression (which impairs coronary blood flow) is observed with balloon dilation in the right ventricular outflow ... A balloon dilation test is performed first, to confirm that coronary compression will not occur and the procedure can continue ... Rare complications that may require urgent surgery include valve migration, valve embolization, pulmonary artery occlusion, ...
... due to deteriorating health following a coronary occlusion, he sold his orchard and moved to Dural, New South Wales. He ...
technique is also used to assess the amount of occlusion (or blockage) in a coronary artery, often described as a percentage of ... Coronary angiography is a diagnostic procedure that allows visualization of the coronary vessels. Fluoroscopy is used to ... A common example of cardiac catheterization is coronary catheterization that involves catheterization of the coronary arteries ... Acute coronary syndromes: ST elevation MI (STEMI), non-ST Elevation MI (NSTEMI), and unstable angina Evaluation of coronary ...
... which results from an occlusion of one of the major coronary arteries, is currently still the leading cause of morbidity and ...
most of the occlusions are too small to see by angiography). Most ruptures and clotting events are too small to produce ... While a single ruptured plaque can be identified during autopsy as the cause of a coronary event, there is currently no way to ... Some of the CT derived plaque characteristics can help predict for acute coronary syndrome. In addition, because these lesions ... 2013). "Additive value of semi-automated quantification of coronary artery disease using cardiac CT-angiography to predict for ...
Irwin died in 1955 of a coronary occlusion in Asheville, North Carolina, and was buried at Arlington National Cemetery. Irwin ...
... results of a randomized controlled pilot study of left atrial appendage occlusion during coronary bypass surgery in patients at ... 2003). "Left Atrial Appendage Occlusion Study (LAAOS): a randomized clinical trial of left atrial appendage occlusion during ... Left atrial appendage occlusion is an experimental alternative to anticoagulants. During cardiac catheterization, a device ( ... routine coronary artery bypass graft surgery for long-term stroke prevention". Am. Heart J. 145 (1): 174-78. doi:10.1067/mhj. ...
... died from a coronary occlusion at the age of 75 on January 24, 1971, at her home at 740 Park Avenue in ...
In addition to initial RSI, it may also be necessary to adjust the occlusion (bite) to prevent excessive force on teeth that ... Humphrey LL, Fu R, Buckley DI, Freeman M, Helfand M (December 2008). "Periodontal disease and coronary heart disease incidence ... "Periodontal disease and coronary heart disease: a reappraisal of the exposure". Circulation. 112 (1): 19-24. doi:10.1161/ ... "Relationship of periodontal disease and tooth loss to prevalence of coronary heart disease". Journal of Periodontology. 75 (6 ...
He had battled diabetes since the early 1960s, and finally succumbed to a coronary occlusion on 26 August 1971 at his Metung ...
... allowing physicians to assess the extent of occlusion in the coronary arteries, usually in order to diagnose coronary artery ... Coronary CT angiography (CTA or CCTA) is the use of computed tomography (CT) angiography to assess the coronary arteries of the ... It may be useful in the diagnosis of suspected coronary heart disease, for follow-up of a coronary artery bypass, for the ... Effective dose using MSCT coronary imaging can average less than the dose in conventional coronary angiography. Zhi-hui Hou; ...
In coronary catheterization, for instance, the incidence is 1.4%. Furthermore, cholesterol embolism may develop after the ... Flory CM (1945). "Arterial occlusions produced by emboli from eroded aortic atheromatous plaques". Am J Pathol. 21 (3): 549-565 ...
... coronary artery dilation), occlusion (fallopian tube ligation), restriction (cervical cerclage) always involve devices: ... 0L occlusion; 0M reattachment; 0N release; 0P removal; 0Q repair; 0R replacement; 0S reposition; 0T resection; 0U supplement ; ...
... a new strategy to avoid early bleeding and subacute radial artery occlusion after percutaneous coronary intervention". J ... "A new kaolin-based haemostatic bandage compared with manual compression for bleeding control after percutaneous coronary ...
Wurn BF, Wurn LJ, King CR, Heuer MA, Roscow AS, Hornberger K, Scharf ES (February 2008). "Treating fallopian tube occlusion ... An example of cardiac surgery is coronary bypass surgery. The primary goals of this specialty include increasing endurance and ... Pulmonary disorders, heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis ...
... such as mitral regurgitation in the case of left-sided coronary occlusion that disrupts the blood supply of the papillary ... If diagnostic coronary angiography does not reveal a culprit blockage that is the cause of the cardiogenic shock, the prognosis ... Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock" (PDF). N Engl J Med. 341 (9): 625-34. doi:10.1056 ... which may occur in the domain of another atherosclerotic coronary artery, or in the same zone if there are any live cells left ...
He died from coronary occlusion at the age of 65 in his home on 23 June 1964. His sister, Christina Mary "Tena" Burke was ...
He died at the presbytery there in 1975, aged 68, of a coronary occlusion and was interred at Mona Vale beside his wife. ...
Aged 45, Morris died of a coronary occlusion September 14, 1959, aboard the USS Bon Homme Richard. During his naval service, ... contract players, Deaths from coronary artery disease). ...
Nuttall served in this position for twelve years until he died in Salt Lake City in 1944 of a coronary occlusion. State of Utah ...
Its use for acute coronary syndrome is of unknown benefit. In Britain and Canada, Entonox and Nitronox are used commonly by ... Nitrous oxide at 75% by volume reduces ischemia-induced neuronal death induced by occlusion of the middle cerebral artery in ... 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and ... oral surgery and acute coronary syndrome (includes heart attacks). Its use during labour has been shown to be a safe and ...
Demonstrating the role of platelets in coronary artery bypass graft (CABG) occlusion based on imaging studies in dogs, and a ... "The Pathogenesis of Coronary Artery Disease and the Acute Coronary Syndromes". New England Journal of Medicine. 326 (5): 310- ... Fuster, V.; Fayad, Z. A.; Badimon, J. J. (1999). "Acute coronary syndromes: biology". Lancet. 353 Suppl 2: SII5-9. doi:10.1016/ ... 2000s: Following upon experience with CABG and DES for revascularization in patients with diabetes and multivessel coronary ...
Connor's wife died in April 1977 and he died suddenly in Canberra of a coronary occlusion in August of that year. He was ...
Ischemic heart disease develops when stenosis and occlusion of coronary arteries develops, leading to reduced perfusion of the ... Lassaletta, Antonio D.; Chu, Louis M.; Sellke, Frank W. (November 2011). "Therapeutic neovascularization for coronary disease: ...
  • CASE REPORT A 40-year-old man was admitted with unstable angina and diagnosed with CTO of the left anterior descending artery (LAD) and right coronary artery . (
  • METHODS AND RESULTS: Ten subjects with single-vessel right coronary artery disease undergoing percutaneous coronary intervention with normal ventricular function were studied in the BO group. (
  • CONCLUSIONS: RP and right coronary artery balloon occlusion both cause ischemic right ventricular dysfunction with stunning observed later during the procedure. (
  • We present here a case where a patient who had undergone coronary artery bypass grafting presented with headache and on evaluation found to have complete occlusion of right coronary artery. (
  • A 55-year-old man was admitted to our hospital with a history of recent inferior wall myocardial infarction with angioplasty of right coronary artery (RCA) 2 weeks back. (
  • Fig. 1 Complete occlusion of right coronary artery post-revascularization. (
  • This image showed focal dilatation of the proximal right coronary artery (RCA), just distal to the origin of the artery (Figures 2 and 3) corresponding to the soft-tissue abnormality identified on the non-contrast CT scan. (
  • The focal dilatation within the proximal right coronary artery contained a small amount of nonocclusive mural thrombus, as well as a thin rim of calcification (Figure 4). (
  • A few smaller areas of focal dilatation were identified within the distal right coronary artery (Figure 3). (
  • The right coronary artery is most commonly affected. (
  • We report here a case of embolic portion of the right coronary artery 5 mm (Figure 2). (
  • Thirty minutes and six hours after intravenous administration of the benzenesulfonate compound, (CLS 2210) cardiac lymphatics in the distribution of the left anterior descending coronary artery (LAD) were determined and further delineated by postmortem cardiac lymphangiograms. (
  • The death certificate, completed by the county chief deputy coroner, and the autopsy report, completed by the pathologist, listed "cardiac dysrhythmia due to atherosclerotic coronary artery disease and myocardial bridging of anterior descending coronary artery" as the cause of death. (
  • Male Sprague-Dawley rats were submitted to permanent occlusion of the left descending coronary artery. (
  • Coronary angiography images showed severe stenosis of the left anterior descending coronary artery, which was dilated by percutaneous transluminal coronary angioplasty. (
  • From a central database of two hospitals in Milan (San Raffaele Hospital and GVM-EMO Centro Cuore Columbus) a total of 9,789 consecutive patients referred to us over 10 years (January 1998 to March 2008) for coronary angiography, we identified 1,345 patients (13%) who matched the inclusion and exclusion criteria for CTO. (
  • Triglycerides, HDL level, triglyceride/HDL ratio and atherogenic plasma index before coronary angiography were assessed for the 451 patients who met the study criteria. (
  • Most notably, they specifically indicated for the first time that patients with left bundle branch block (LBBB) patterns or right ventricular pacemakers who manifest Sgarbossa criteria or modified Sgarbossa criteria, and patients with de Winter sign, should undergo emergent coronary angiography. (
  • Coronary angiography done at that time showed discrete lesions with critical left main coronary artery stenosis and significant blockage in obtuse marginal artery. (
  • 1 Catheter angiography historically was used in detecting coronary artery aneurysms, but due to invasiveness and morbidity, as well as technological advances in other modalities, it is performed less commonly now. (
  • With the evolution of multidetector CT, coronary CT angiography (CTA) is becoming more common. (
  • Therefore, he underwent emergent coronary angiography. (
  • Following diagnostic coronary angiography, PCI for RCA total occlusion was performed. (
  • On relook coronary angiography, we could not find any potential cause of cardiac tamponade including coronary arterial perforation ( Figure 4 ). (
  • Coronary angiography examination revealed a functional mi- problem. (
  • As the heart's arteries become narrowed over time due to atherosclerosis (the buildup of plaque) and coronary artery disease, they can become completely blocked. (
  • It offers an option to those whose quality of life is impacted by their coronary artery disease. (
  • A growing number of patients, particularly those with advanced, chronic coronary artery disease, experience symptoms of angina that are refractory to treatment with β-blockers, calcium-channel blockers, and long-acting nitrates, despite revascularization. (
  • Given the Chief's underlying coronary heart disease, NIOSH investigators concluded that the physical stress of performing physical fitness training may have triggered a cardiac arrhythmia and a possible heart attack resulting in his sudden cardiac death. (
  • Also known as CAD, coronary artery disease is the main cause of heart attacks. (
  • Symptoms of coronary artery disease include shortness of breath, chest pain, palpitations, and even fatigue, according to the American Heart Association. (
  • Coronary artery disease is preventable in many instances, and you can reduce your risk by eating a healthy diet, maintaining a normal weight, and getting plenty of exercise. (
  • The death certificate listed "ASCVD" (atherosclerotic coronary vascular disease) as the immediate cause of death, with hyperlipidemia and smoking as contributing factors. (
  • Atypical presentation of coronary artery disease (CAD) is not uncommon and is seen in females and diabetics. (
  • Coronary artery aneurysms are a rare complication of a variety of disease processes. (
  • Kawasaki disease is the most common cause of coronary artery aneurysms worldwide, particularly in children. (
  • Interestingly, clinical disease activity and serological markers do not seem to correlate well with coronary artery vasculitis or aneurysm. (
  • Systemic lupus erythematosus is an uncommon cause of coronary artery aneurysms, with Kawasaki disease being a much more common cause in children. (
  • However, children with known SLE who present with chest pain should be evaluated for coronary artery disease, including aneurysms, with echocardiograms or contrast enhanced CT. (
  • Karrar A, Sequeira W, Block J. Coronary artery disease in systemic lupus erythematosus: A review of the literature. (
  • Scientists identified a transcription factor that can change the epigenetic signaling for atherosclerotic plaque formation, potentially heralding a new line of therapy for coronary artery disease. (
  • giving hope to those with coronary artery disease. (
  • Bumrungrad International Hospital would like to share with you some information on coronary artery disease, including both controllable and uncontrollable risk factors for the condition. (
  • These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension. (
  • Reduction of platelet adhesiveness in patients with coronary artery disease. (
  • Measures used to prevent other blood vessel (vascular) diseases, such as coronary artery disease , may decrease the risk for retinal artery occlusion. (
  • New York City has one of the highest reported death rates from coronary heart disease in the United States. (
  • We conducted a cross-sectional validation study by using a random sample of death certificates that recorded in-hospital deaths in New York City from January through June 2003, stratified by neighborhoods with low, medium, and high coronary heart disease death rates. (
  • We computed a comparability ratio (coronary heart disease deaths recorded on death certificates divided by validated coronary heart disease deaths) to quantify agreement between death certificate determination and clinical judgment. (
  • Coronary heart disease appears to be substantially overreported as a cause of death in New York City among in-hospital deaths. (
  • Coronary heart disease (CHD) is the leading cause of death for adults in the United States, and stroke ranks third (1). (
  • Age-adjusted deaths from coronary heart disease in New York City (NYC) versus the United States overall. (
  • She had no risk factors for coronary artery disease in her medical history but it was learned that she had undergone a mitral valve replacement 2 years before because of rheumatic mitral stenosis and that no international normalized ratio (INR) analysis had been done in the last 6 months. (
  • Coronary artery bypass grafting (CABG) is performed for patients with coronary artery disease (CAD) to improve quality of life and reduce cardiac-related mortality. (
  • Impact of age on clinical outcomes of antihypertensive therapy in patients with hypertension and coronary artery disease: A sub-analysis of the Heart Institute of Japan Candesartan Randomized Trial for Evaluation in Coronary Artery Disease. (
  • Optimal Blood Pressure in Patients With Coronary Artery Disease and Chronic Kidney Disease: HIJ-CREATE Substudy. (
  • Relationships between blood pressure lowering therapy and cardiovascular events in hypertensive patients with coronary artery disease and type 2 diabetes mellitus: The HIJ-CREATE sub-study. (
  • I25.119 is a valid billable ICD-10 diagnosis code for Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris . (
  • His research plan over the next 5 years is to develop hybrid and innovative surgical and percutaneous revascularisation strategies to improve outcomes of patients with multivessel and complex coronary artery disease. (
  • Coronary Artery Disease (CAD) is the most prevalent single cause of death and loss of Disability Adjusted Life Years (DALYs) around the world. (
  • Prevention of coronary heart disease : practical management of the risk factors / [edited by] Norman M. Kaplan, Jeremiah Stamler. (
  • Pressure-controlled intermittent coronary sinus occlusion (PICSO), known to induce angiogenetic and vasoactive molecules as well as to reduce regional ischemia, may activate endogenous regenerative processes in failing myocardium. (
  • Pressure-controlled Intermittent Coronary Sinus Occlusion study (OxAMI-PICSO study). (
  • AIMS: The Oxford Acute Myocardial Infarction PICSO (OxAMI-PICSO) study aimed to assess the efficacy of index of microcirculatory resistance (IMR)-guided therapy with pressure-controlled intermittent coronary sinus occlusion (PICSO) in anterior ST-elevation myocardial infarction (STEMI). (
  • An autopsy revealed near-total occlusion of two coronary arteries. (
  • Echocardiography is commonly used as a screening exam, with excellent visualization of the proximal coronary arteries. (
  • IVUS ) , uses a specially designed ultrasound probe attached to a catheter that is inserted into the coronary arteries. (
  • Wiener I, Tilkian AG, Palazzolo M "Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: temporal relationship to pseudoephedrine ingestion. (
  • Retinal artery occlusion is a blockage in one of the small arteries that carry blood to the retina . (
  • Complete blockage of blood flow through one of the CORONARY ARTERIES , usually from CORONARY ATHEROSCLEROSIS . (
  • Central retinal artery occlusion (CRAO) first was described by Van Graefe in 1859 as an embolic event to the central retinal artery in a patient with endocarditis. (
  • The risk for stroke is higher in patients with central retinal artery occlusion (CRAO). (
  • To evaluate in-hospital outcomes and one-year mortality of patients presenting with ULMSO treated with primary percutaneous coronary intervention (PPCI). (
  • METHODS AND RESULTS: Patients with anterior STEMI treated with primary percutaneous coronary intervention (pPCI) were enrolled. (
  • The patient was diagnosed with acute myocardial infarction (AMI) and underwent primary percutaneous coronary intervention (PCI). (
  • Variations in the eicosapentaenoic acid-arachidonic acid ratio associated with age in acute myocardial infarction patients undergoing primary percutaneous coronary intervention. (
  • Complications from coronary artery aneurysms include thrombosis, embolism, AV fistualization or rupture. (
  • If stenosis or thrombosis occurs, coronary stenting can be done, though stenosis from vasculitis can be more difficult to stent than stenosis from atherosclerosis. (
  • By written claim served on the respondent-employer on the 21st day of November, 1957, the claimant alleged that he suffered a coronary thrombosis on the 11th day of February, 1957, while in the employ of the respondent. (
  • Other names for heart attack include acute myocardial infarction, coronary thrombosis, and coronary occlusion. (
  • In this paper, we report a rare case of myocardial infarction, which occurred as a result of a coronary embolism in a patient with prosthetic mitral valve thrombosis. (
  • Patients with SLE frequently have coronary artery manifestations, with atherosclerosis being much more common than aneurysms. (
  • Coronary chronic total occlusions (CTOs) remain a technical challenge and an unresolved clinical dilemma, even after numerous successes and rapid progression in the field of interventional cardiology. (
  • Meta-Analysis of Clinical Outcomes of Patients Who Underwent Percutaneous Coronary Interventions for Chronic Total Occlusions. (
  • Chronic total occlusions - Current techniques and future directions. (
  • In conclusion, EDS-MI increases diagnostic accuracy and may serve as an automatic decision support in the early management of patients with suspected acute coronary syndrome. (
  • Retrosternal chest pain is the classical symptom of acute coronary syndrome (ACS). (
  • Acute coronary syndrome (ACS) classically presents as retrosternal pain that radiates to the left arm. (
  • Acute coronary syndrome patients with refractory no-reflow fared somewhat better being treated with intracoronary epinephrine instead of adenosine in a small randomized trial. (
  • The chest pain of the patient was assessed to be typical of acute coronary syndrome. (
  • We did not perform acute coronary syndrome, coronary elevation myocardial infarction, whereas angioplasty because the obstruction embolism should be kept in mind in the rest present with non-ST elevation was in the distal portion of the vessel those with prosthetic valves even in the myocardial infarction [8]. (
  • Long-term clinical outcomes after percutaneous coronary intervention to treat long lesions in hemodialysis patients in the era of second-generation drug-eluting stents. (
  • Comparison of safety and effectiveness between the right and left radial artery approach in percutaneous coronary intervention. (
  • A distal approach to transradial access for coronary catheterization halved rates of radial artery occlusion. (
  • We aimed to optimize the diagnostic accuracy of EDS-MI in patients with verified acute coronary occlusion as well as patients with non-ischaemic ST deviation and compare its performance with STEMI criteria. (
  • We studied 135 patients with non-ischaemic ST deviation (perimyocarditis, left ventricular hypertrophy, takotsubo cardiomyopathy and early repolarization) and 117 patients with acute coronary. (
  • Patients with an ACO need immediate reperfusion therapy via cardiac catheterization with percutaneous coronary intervention or fibrinolysis. (
  • The Complex Coronary Artery Intervention Center offers consultations for patients in need of CAD surgery who cannot undergo traditional surgery. (
  • Patients who will experience little benefit from coronary revascularization are also excluded. (
  • Annual operator volume among patients treated using percutaneous coronary interventions with rotational atherectomy and procedural outcomes : analysis based on a large national registry. (
  • Clinical outcomes in patients undergoing complex, high-risk percutaneous coronary intervention and haemodynamic support with intra-aortic balloon versus Impella pump : real-life single-centre preliminary results. (
  • Safety and Efficacy of Low-Dose Prasugrel as Part of Triple Therapy With Aspirin and Oral Anticoagulants in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention - From the TWMU-AF PCI Registry. (
  • This consensus statement notes that not all patients with COVID-19 who have ST elevation with or without an acute coronary occlusion will benefit from any reperfusion strategy or advanced mechanical support. (
  • With mechanical thrombectomy changing the management of stroke and becoming the standard of care for patients with large vessel occlusion (LVO), a new challenge has emerged, adequate access for care. (
  • In 1868, Mauthner suggested that "spasmodic contractions" could lead to retinal artery occlusion. (
  • Branch retinal artery occlusion secondary to percutaneous transluminal coronary angioplasty. (
  • The retinal artery occlusion may last for only a few seconds or minutes, or it may be permanent. (
  • Coronary artery bypass graft surgery is also performed, often with resection of aneurysms. (
  • High Success, Low Complications for Chronic Total Occlusion Revascularization in the Cath Lab: The EXPERT CTO Trial. (
  • Analysis of the Updated ACC/AHA Coronary Revascularization Guidelines With Implications for Cardiovascular Anesthesiologists and Intensivists. (
  • Conclusions: Here, we show for the first time that PICSO, a trans-coronary sinus catheter intervention, is associated with an increase in morphogens secreted into cardiac veins, normally present during cardiac development, and a significant induction of cell proliferation. (
  • HN - 2008 BX - Granulosa Cells, Cumulus MH - Coronary Sinus UI - D054326 MN - A07.231.908.194.500 MS - A short vein that collects about two thirds of the venous blood from the MYOCARDIUM and drains into the RIGHT ATRIUM. (
  • Coronary sinus, normally located between the LEFT ATRIUM and LEFT VENTRICLE on the posterior surface of the heart, can serve as an anatomical reference for cardiac procedures. (
  • Thrombotic occlusion of proximal RCA. (
  • To test immediate molecular responses, in both patient groups, coronary venous blood samples were taken at baseline and after 20 min, the time required for the intervention. (
  • 30 Acute unprotected left mainstem occlusion emergency percutaneous coronary intervention: analysis of the british cardiovascular intervention society database. (
  • Treatment of coronary pseudoaneurysm detected after percutaneous coronary intervention for chronic total occlusion: A case report. (
  • Coronary pseudoaneurysm (CPA) are associated with iatrogenic coronary artery dissection or perforation, which rarely reported formation early after percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). (
  • Figure 4: Successful percutaneous coronary intervention for chronic total occlusion is associated with reduced angina frequency. (
  • Moreover, the lack of a true randomised controlled trial with a medically treated control group raises the question of whether the survival beneï¬ t demonstrated with successful percutaneous coronary intervention (PCI) is, in fact, related to beneï¬ cial effects of opening a chronically occluded vessel versus potential harm conferred to those with CTO-PCI failed. (
  • Use of "super-glue" to seal a perforation during chronic total occlusion coronary intervention and the potential to "unglue" it. (
  • Current status of percutaneous coronary intervention of chronic total occlusion. (
  • Outcomes of Renal Transplant Recipients after Percutaneous Coronary Intervention. (
  • He is also a high-volume and world-renown coronary operator, performing over 300 percutaneous coronary intervention (PCI) per year, mostly from the transradial approach and most referred complex anatomies, and responsible of the new MUHC chronic total occlusion (CTO) and Complex Higher-risk but Indicated Procedures (CHIP) program. (
  • 25%) CDH, prenatal intervention with tracheal occlusion to reverse pulmonary hypoplasia may be contemplated within the context of the ongoing international randomized controlled trial (RCT) (Tracheal Occlusion to Accelerate Lung Growth [TOTAL] Trial), as preliminary evidence seems to suggest an improvement in survival and morbidity particularly in severe CDH. (
  • However, as in many areas of medicine, we believe that one size does not fit all and in each case we should balance the real clinical improvement after CTO-PCI recanalisation against the risk that such complex procedures can provide (such as coronary perforation and risk of radiation exposure). (
  • FineDuo is a low profile, multifunctional, dual lumen micro-catheter that provides robust support and easy access to complex coronary vasculature 1 . (
  • The Swedish Heart and Vascular Institute is seeking an Interventional Cardiologist for its complex coronary interventional program. (
  • Rotablator , used in cases of coronary artery calcification. (
  • The goals of this study were to determine relative 99m Tc-RP517 binding to human leukocyte subtypes and the 99m Tc-RP517 uptake pattern in canine myocardium where inflammation was induced by either coronary occlusion and reperfusion or tumor necrosis factor α (TNFα) injection. (
  • 99m Tc-RP517 was injected intravenously in anesthetized, open-chest dogs before coronary occlusion (90 minutes) and reperfusion (120 minutes) (n=9) or before intramyocardial TNFα injection (n=3). (
  • A balloon catheter was placed in the infarct artery at the same location as that used for induction of MI, and during dynamic 3D PET/CT 3 × 10 7 autologous 18 F-FDG progenitor cells were injected through the central lumen using either (a) 3 cycles of balloon occlusion and reperfusion or (b) high-concentration, single-bolus injection without balloon occlusion ( n = 3 for both protocols). (
  • endocarditis, atrial and ventricular mu- ing treatment of coronary embolism. (
  • ACITROM can also be used as an adjunct in the treatment of coronary occlusion (block in heart which reduces oxygen and blood supply leading to heart attack) and transient cerebral ischemic attacks (mini stroke, caused by blockage in the blood vessel supplying the brain). (
  • BACKGROUND: We sought to determine whether right ventricular stunning could be detected after supply (during coronary balloon occlusion [BO]) and supply/demand ischemia (induced by rapid pacing [RP] during transcatheter aortic valve replacement) in humans. (
  • that is, myocardium within the distribution of left circumflex coronary (LCC) artery. (
  • Consider ophthalmic artery occlusion or carotid artery obstruction if choroidal filling is significantly delayed. (
  • The patient was planned for coronary artery bypass grafting (CABG). (
  • When this blockage lasts for three months or more, it's referred to as a chronic total occlusion (CTO), which may worsen the quality of life. (
  • Investigation of mechanisms showed a significant increase in the leptin:adiponectin plasma concentration ratio in rats subjected to coronary ligation, which was abrogated by GR-1. (
  • A total of 242 male rats weighing 200-250 g were submitted to a surgical procedure (coronary artery ligation or simulated surgery). (
  • You need a cardiac catheterization and coronary artery angiogram to know if you have a chronic total occlusion. (
  • We also describe the procedures for basic electrophysiological assessment of conduction properties and atrial fibrillation induction, hemodynamic assessment via pressure-volume loops, right heart and left heart catheterization and the development of a myocardial infarction model by balloon occlusion. (
  • For in vivo experiments, CPC were harvested before induction of infarction (using 90-min coronary balloon occlusion). (
  • Dynamic scanning demonstrated a sharp rise in myocardial activity during each cycle of balloon-occlusion cell delivery, with a significant fall in activity (around 80%) immediately after balloon deflation. (
  • At 1 h, myocardial activity was 8.7% ± 1.5% of total injected dose for balloon-occlusion delivery and 17.8% ± 7.9% for high-concentration, single-bolus delivery ( P = 0.08). (
  • High-concentration, single-bolus therapy may be as effective as balloon-occlusion delivery. (
  • An endoluminal balloon is inserted into the trachea with sonoendoscopic guidance at 26-28 weeks for severe CDH and 30-32 weeks for moderate CDH with reversal of tracheal occlusion at 34 weeks. (
  • Association of total insulin-like growth factor-I, insulin-like growth factor binding protein-1 (IGFBP-1), and IGFBP-3 levels with incident coronary events and ischemic stroke. (