Coronary Occlusion: Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.Coronary Vessels: The veins and arteries of the HEART.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Coronary Artery Disease: Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.Coronary Disease: 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.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.Dogs: 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)Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Coronary Stenosis: Narrowing or constriction of a coronary artery.Myocardial Reperfusion: 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.Myocardial Ischemia: 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).Myocardial Reperfusion Injury: 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.Ischemic Preconditioning, Myocardial: 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.Coronary Artery Bypass: 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.Myocardium: 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.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Coronary Thrombosis: Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.Balloon Occlusion: Use of a balloon CATHETER to block the flow of blood through an artery or vein.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Myocardial Stunning: Prolonged dysfunction of the myocardium after a brief episode of severe ischemia, with gradual return of contractile activity.Heart: The hollow, muscular organ that maintains the circulation of the blood.Arterial Occlusive Diseases: 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.Electrocardiography: 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.Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Constriction: The act of constricting.Coronary Aneurysm: 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.Coronary Restenosis: Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.Swine: 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).Treatment Outcome: 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.Hyperemia: 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).Disease Models, Animal: 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.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Adenosine: 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.Ventricular Function, Left: 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.Myocardial Contraction: Contractile activity of the MYOCARDIUM.Retinal Vein Occlusion: Blockage of the RETINAL VEIN. Those at high risk for this condition include patients with HYPERTENSION; DIABETES MELLITUS; ATHEROSCLEROSIS; and other CARDIOVASCULAR DISEASES.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Retinal Artery Occlusion: 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.Arrhythmias, Cardiac: 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.Prospective Studies: 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.Follow-Up Studies: 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: 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)Consciousness: Sense of awareness of self and of the environment.Ventricular Fibrillation: 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.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Risk Factors: 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.Heart Ventricles: 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.Percutaneous Coronary Intervention: 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.Microspheres: Small uniformly-sized spherical particles, of micrometer dimensions, frequently labeled with radioisotopes or various reagents acting as tags or markers.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Ligation: Application of a ligature to tie a vessel or strangulate a part.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Cineangiography: Motion pictures of the passage of contrast medium through blood vessels.Vascular Resistance: 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.Creatine Kinase: 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.Systole: Period of contraction of the HEART, especially of the HEART VENTRICLES.Ultrasonography, Interventional: 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.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Decanoic Acids: 10-carbon saturated monocarboxylic acids.Rabbits: 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.Organotechnetium Compounds: Organic compounds that contain technetium as an integral part of the molecule. These compounds are often used as radionuclide imaging agents.Coronary Care Units: The hospital unit in which patients with acute cardiac disorders receive intensive care.Predictive Value of Tests: 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.Perfusion: Treatment process involving the injection of fluid into an organ or tissue.Cardiotonic Agents: 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).Hydroxy Acids: Organic compounds containing both the hydroxyl and carboxyl radicals.Vasodilation: The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.Recurrence: The return of a sign, symptom, or disease after a remission.Dental Occlusion: 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)Swine, Miniature: Genetically developed small pigs for use in biomedical research. There are several strains - Yucatan miniature, Sinclair miniature, and Minnesota miniature.Regional Blood Flow: The flow of BLOOD through or around an organ or region of the body.Vascular Patency: The degree to which BLOOD VESSELS are not blocked or obstructed.Necrosis: 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.Acute Disease: Disease having a short and relatively severe course.Chronic Disease: 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)Nitroglycerin: A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.Dipyridamole: 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)Ventriculography, First-Pass: 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.Microcirculation: The circulation of the BLOOD through the MICROVASCULAR NETWORK.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Stroke Volume: 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.Graft Occlusion, Vascular: Obstruction of flow in biological or prosthetic vascular grafts.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Diastole: Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.Technetium Tc 99m Sestamibi: A technetium imaging agent used to reveal blood-starved cardiac tissue during a heart attack.Radioisotopes: 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)Contrast Media: Substances used to allow enhanced visualization of tissues.Ischemic Preconditioning: 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)Infarction, Middle Cerebral Artery: 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.Endocardium: The innermost layer of the heart, comprised of endothelial cells.Tomography, Emission-Computed, Single-Photon: 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.Brain Ischemia: 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.Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Thrombolytic Therapy: Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.Nicorandil: 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.Calcinosis: Pathologic deposition of calcium salts in tissues.Random Allocation: 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.Biological Markers: 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.Rats, Sprague-Dawley: 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.Angina Pectoris: 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, Off-Pump: 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).Angina, Unstable: Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.Retrospective Studies: 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.Ventricular Remodeling: 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.Rats, Wistar: A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.Ventricular Dysfunction, Left: 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.Vagus Nerve: 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).Platelet Aggregation Inhibitors: 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.Arteries: The vessels carrying blood away from the heart.Tiopronin: Sulfhydryl acylated derivative of GLYCINE.Thallium Radioisotopes: Unstable isotopes of thallium that decay or disintegrate emitting radiation. Tl atoms with atomic weights 198-202, 204, and 206-210 are thallium radioisotopes.Physical Conditioning, Animal: Diet modification and physical exercise to improve the ability of animals to perform physical activities.Pericardium: 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.Nitric Oxide: 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.Aspirin: 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)Catheterization: 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.Cardiac Output: 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).Models, Cardiovascular: 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.Sensitivity and Specificity: 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)Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Dobutamine: 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.Reperfusion Injury: 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.Angiography: Radiography of blood vessels after injection of a contrast medium.Prognosis: 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.Reproducibility of Results: 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.Echocardiography, Doppler: 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.Carotid Artery, Internal: Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose.Gamma Cameras: Electronic instruments that produce photographs or cathode-ray tube images of the gamma-ray emissions from organs containing radionuclide tracers.Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.Tachycardia: 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.Mesenteric Vascular Occlusion: 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)Risk Assessment: 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)Bloodless Medical and Surgical Procedures: The treatment of patients without the use of allogeneic BLOOD TRANSFUSIONS or blood products.Streptokinase: 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.-.Ventricular Pressure: 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.Acetylcholine: 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.Dental Occlusion, Centric: Contact between opposing teeth during a person's habitual bite.Peroxidase: 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 1.11.1.7.Models, Animal: Non-human animals, selected because of specific characteristics, for use in experimental research, teaching, or testing.Anesthesia: 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.Therapeutic Occlusion: 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.Cerebral Infarction: 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).Nitric Oxide Synthase: An NADPH-dependent enzyme that catalyzes the conversion of L-ARGININE and OXYGEN to produce CITRULLINE and NITRIC OXIDE.Anti-Arrhythmia Agents: 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.Cerebral Arteries: The arterial blood vessels supplying the CEREBRUM.Glyburide: An antidiabetic sulfonylurea derivative with actions similar to those of chlorpropamide.Embolization, Therapeutic: 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.Chest Pain: Pressure, burning, or numbness in the chest.Cerebral Angiography: Radiography of the vascular system of the brain after injection of a contrast medium.Guanidines: 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.Heart Conduction System: 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.Magnetic Resonance Angiography: 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.Sirolimus: 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.Stroke: 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)Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction.Cohort Studies: 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.Thiourea: 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, Intravenous: Injections made into a vein for therapeutic or experimental purposes.Postoperative Complications: 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.Carotid Artery Diseases: 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.Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Observer Variation: 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).Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Cerebrovascular Circulation: The circulation of blood through the BLOOD VESSELS of the BRAIN.Exercise Test: 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.Ventricular Premature Complexes: 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.Cerebral Arterial 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.Fibrinolytic Agents: Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery.Ischemic Attack, Transient: 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)Potassium Channels: 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.ROC Curve: 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.Angioplasty, Balloon: 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.Cardiac Pacing, Artificial: Regulation of the rate of contraction of the heart muscles by an artificial pacemaker.Platelet Aggregation: 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.Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Oxygen Consumption: 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)Tachycardia, Ventricular: 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).Saphenous Vein: The vein which drains the foot and leg.Radiopharmaceuticals: 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)NG-Nitroarginine Methyl Ester: A non-selective inhibitor of nitric oxide synthase. It has been used experimentally to induce hypertension.Receptors, Purinergic P1: 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).Potassium Channel Blockers: 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.Ischemia: 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.Vasoconstriction: The physiological narrowing of BLOOD VESSELS by contraction of the VASCULAR SMOOTH MUSCLE.Plaque, Atherosclerotic: Lesions formed within the walls of ARTERIES.Thrombectomy: 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.Ticlopidine: An effective inhibitor of platelet aggregation commonly used in the placement of STENTS in CORONARY ARTERIES.Magnetic Resonance Imaging: 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.SulfonesAdenosine Triphosphate: 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.Mucocutaneous Lymph Node Syndrome: 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.Myocytes, Cardiac: Striated muscle cells found in the heart. They are derived from cardiac myoblasts (MYOBLASTS, CARDIAC).Chi-Square Distribution: 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.Reperfusion: 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.

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
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
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 ...
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 ...
Philips, in collaboration with Radcliffe Cardiology, are pleased to present an in-depth interview with Prof. Gerald Werner (Darmstadt, DE) discussing the important role that IVUS imaging plays in his CTO procedures
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The ESC congress in Vienna heard that drug eluting stents are highly effective in chronically occluded arteries, when compared with bare metal stents. Derek Thorne got more on this German study from Gerald Werner, of Klinikum Darmstadt in Germany ...
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by Physicians Weekly , Aug 23, 2012. The Occluded Artery Trial (OAT) was a large, randomized controlled study funded by the National Heart, Lung, and Blood Institute that tested routine percutaneous recanalization of persistently totally occluded infarct-related arteries identified a minimum of 24 hours after myocardial infarction (MI) in stable patients who did not have triple vessel disease or severe inducible ischemia. In 2006, results from OAT were released, showing that there appears to be no benefit to routinely using PCI for persistently totally occluded infarct-related arteries in this patient population. Routine PCI for these arteries did not reduce mortality, reinfarction, or class IV heart failure. These results subsequently led to updates of guidelines from the American College of Cardiology (ACC) and American Heart Association (AHA) on unstable angina/non-STEMI, STEMI, and PCI in 2007. The revised guidelines recommended that PCI not be performed in this context. Prior to OAT data ...
by Physicians Weekly , Aug 23, 2012. The Occluded Artery Trial (OAT) was a large, randomized controlled study funded by the National Heart, Lung, and Blood Institute that tested routine percutaneous recanalization of persistently totally occluded infarct-related arteries identified a minimum of 24 hours after myocardial infarction (MI) in stable patients who did not have triple vessel disease or severe inducible ischemia. In 2006, results from OAT were released, showing that there appears to be no benefit to routinely using PCI for persistently totally occluded infarct-related arteries in this patient population. Routine PCI for these arteries did not reduce mortality, reinfarction, or class IV heart failure. These results subsequently led to updates of guidelines from the American College of Cardiology (ACC) and American Heart Association (AHA) on unstable angina/non-STEMI, STEMI, and PCI in 2007. The revised guidelines recommended that PCI not be performed in this context. Prior to OAT data ...
A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion. By appropriately maneuvering each member and applying radiofrequency energy between the proximal and distal ends of the occlusion, a continuous channel is created.
TCTMD is produced by the Cardiovascular Research Foundation (CRF). CRF is committed to igniting the next wave of innovation in research and education that will help doctors save and improve the quality of their patients lives. For more information, visit http://www.crf.org.. ...
A dual lumen guidewire support catheter for accurately crossing a chronic total occlusion in a vessel is disclosed. The dual lumen guidewire support catheter includes a first lumen portion and a second lumen portion sharing a common side and a common distal end. The first lumen portion can be a rapid exchange or over-the-wire portion, while the second lumen portion is an over the wire portion. One or both of the portions can include a discontinuity to enable removal of a guidewire following placement through or at an occlusion or lesion.
Avinger has received FDA clearance to market its Wildcat catheter for crossing chronic total occlusions (CTOs) to help treat peripheral artery disease (PAD).
The trial aims to investigate the safety and tolerability of acute intracoronary injected collagenase in patients with chronic total coronary artery occlusions
About Spectranetics. The Spectranetics Corporation develops, manufactures, markets and distributes medical devices used in minimally invasive procedures within the cardiovascular system. The Companys products are available in over 65 countries and are used to treat arterial blockages in the heart and legs and in the removal of pacemaker and defibrillator leads.. The Companys Vascular Intervention (VI) products include a range of laser catheters for ablation of blockages in arteries above and below the knee, the AngioSculpt scoring balloon used in both peripheral and coronary procedures, and the Stellarex drug-coated balloon peripheral angioplasty platform, which received European CE mark approval in December 2014. The Company also markets support catheters to facilitate crossing of peripheral and coronary arterial blockages, and retrograde access and guidewire retrieval devices used in the treatment of peripheral arterial blockages, including chronic total occlusions. The Company markets ...
News and information on minimally invasive coronary disease therapies, covering valvular, structural, radial access, chronic total occlusion, and imaging issues.
PGOcclsion is dedicated to the toughtful discussion of concept of Posterior Guided Occlusion, this page provides a subset of the papers that form the basis of the idea.
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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December 1, 2016-A prospective, multicenter, observational study evaluated the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). The study demonstrated that tibiopedal access appears to be safe and can be used effectively for the crossing of infrainguinal lesions in patients with severe lower limb ischemia. Craig M. Walker, MD, et al published the studys findings in the Journal of Endovascular Therapy (JEVT; 2016;23:839-846).. The study was conducted at 12 sites around the world from May 2012 to July 2013. Investigators prospectively enrolled 197 patients (mean age, 71 ± 11 years; range, 41-93 years; 129 men) who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary. The study population was composed of 64 (32.5%) claudicants (Rutherford categories 2/3) and 133 (67.5%) patients with critical limb ischemia (Rutherford category ≥ 4).. The ...
A new study found that intravascular ultrasound (IVUS)-guided intervention in patients with chronic total occlusion (CTO) could improve outcomes compared to a conventional angiography-guided approach during percutaneous coronary intervention. The IVUS-CTO study is the first randomized trial to examine the clinical impact of IVUS guidance for CTO intervention.
Coronary CT angiography (CCTA) has revealed the presence of well-developed distal collaterals in patients with chronic total occlusion and the extent of downstream myocardial infarction, according to a study published online Feb. 19 by Radiology.
This program is geared toward the interventionalist seeking to increase their knowledge on the evaluation and comprehensive management of complex and higher-risk patients undergoing coronary revascularization. Emphasizing a case-based presentation format with audience interactivity, participants will learn how to assess and plan indicated procedures from access through post-procedural care, tackling issues such as revascularization of complex lesions (calcified lesions, bifurcations, chronic total occlusions, in-stent restenosis, and lesions in the post-CABG setting), and when and how to use hemodynamic support. The use of simulator training will further enhance the learning experience for interventionalists and fellows. Expert faculty will offer insights into selecting devices and patients, optimizing technique, and overcoming difficult anatomy. The latest clinical data and guidelines for complex, higher-risk procedures also will be reviewed. ...
Cardiology Division at ZHUMC recognized as one of Lebanons first centers to treat Chronic Total Occlusion (CTO) and perform complex PCI.
In our study, the success rate of A-PCI was 74.1% and the total PCI success rate was 87.0%. Both are higher than the rates reported in previous studies (1,12,17). Negative remodeling and lesion length ,31.89 mm on coronary CTA, and ostial or bifurcation lesions on CCA were independent predictors of failed A-PCI guided by coronary CTA and CCA. In the absence of these 3 risk factors, the success rate of A-PCI was 98.0%. In contrast, the success rate of A-PCI was especially low (20.0%) if 2 or more risk factors were present. Other signs, such as calcification and tortuous course, were not significantly different between the successful and failed A-PCI groups. R-PCI during the same procedure after failed A-PCI in patients with a satisfactory appearance of the occluded distal segment on coronary CTA and well-developed collaterals (score of 3) on CCA was feasible.. Similar to our results, Rolf et al. (3) reported that performing coronary CTA before PCI of CTO lesions was associated with a higher ...
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South pole…North pole, hot…cold, on earth…in space, below the sea…on Mount Everest, alone and far, far away. Ultrasound will.... ...
I have got the email of Dr. Castillo in Madrid, Spain. I have written him. The test are 400 euro and the intervention will depend of the result of the test. If somebody wants to write him, PM me for ...
Thomann jest największym na świecie sklepem wysyłkowym w zakresie instrumetnów muzycznych, sprzętu nagłośnieniowego oraz oświetleniowego. Posiadamy prawie 10 milonów klientów w 120-krajach. Obecnie w naszym asortymencie znajduje się 80.000 produków. Sami jesteśmy myzykami i dzielimy się naszą pasją. Jako firma mamy jedną domenę: Ty jako klient. 09546 9223-66 [email protected] ...
http://www.4shared.com/file/ad_UvCo9/occlusion_7.html Occlusal Analysis *This lecture is NOT included in the midterm exam Occlusal analysis is an integral part
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 ...
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
0003] In a typical coronary procedure a guiding catheter having a preformed distal tip is percutaneously introduced into a patients peripheral artery, e.g. femoral or brachial artery, by means of a conventional Seldinger technique and advanced therein until the distal tip of the guiding catheter is seated in the ostium of a desired coronary artery. There are two basic techniques for advancing a guidewire into the desired location within the patients coronary anatomy, the first is a preload technique which is used primarily for over-the-wire (OTW) devices and the bare wire technique which is used primarily for rail type systems. With the preload technique, a guidewire is positioned within an inner lumen of an OTW device such as a dilatation catheter or stent delivery catheter with the distal tip of the guidewire just proximal to the distal tip of the catheter and then both are advanced through the guiding catheter to the distal end thereof. The guidewire is first advanced out of the distal end ...
UNDOK, ABDUL WAHAB BIN (2012) Association Between Postoperative Troponin Levels and 30-Day Mortality Among Patients Undergoing Noncardiac Surgery. JAMA. UNDOK, ABDUL WAHAB BIN (2012) Left main bifurcation stenting in Acute myocardial infarction. UNSPECIFIED. UNDOK, ABDUL WAHAB BIN (2012) SAFARI technique in Chronic Total Occlusion of Superficial Femoral artery via Retrograde Posterior Tibial artery. UNSPECIFIED. UNDOK, ABDUL WAHAB BIN (2010) Brachiocephalic stenting of ruptured brachiocephalic artery aneurysm. UNSPECIFIED. UNDOK, ABDUL WAHAB BIN (2008) Association of Severity of Coronary Artery Disease and Peripheral Artery Disease. UNSPECIFIED. ...
Case Reports in Cardiology is a peer-reviewed, Open Access journal that publishes case reports and case series related to hypertension, arrhythmia, congestive heart failure, valvular heart disease, vascular disease, congenital heart disease and cardiomyopathy.
Guidewire exit ramp members that may be placed over a tubular member having a guidewire lumen, which longitudinally extending and laterally accessible, and methods of use. The guidewire exit ramp member can be placed to force a guidewire loaded through the lumen in a first direction to be forced out of the lumen via an opening, slit or channel. The guidewire exit ramp member, in an illustrative embodiment, takes the form of a relatively short member having a proximal portion and a distally extending flap. The flap may be designed to enter and remain in a longitudinally accessible guidewire lumen. Combinations of such ramp members and device shafts having longitudinally extending laterally accessible guidewire lumens are also disclosed, as are methods for securing such combinations together. A method of backloading a guidewire into a catheter while causing lateral exit of the guidewire at a desired location is also shown.
Forest plots of peri-procedural complications associated with RD.A, Pooled univariate hazard ratio of patients without RD compared with patients with RD for all
The high rate of acute coronary occlusion, the lack of clear means to select ideal candidates, and the benefit associated with early PCI strongly encourage performing a systematic coronary angiography in all OHCA patients, providing that there is no obvious noncardiac cause of arrest. Several questions remain unsolved but at this time, this strategy appears to be the most secure and the best adapted in these patients. ...
A medical instrument includes a flexible catheter, a medical guidewire, and a mechanized guidewire drive assembly. The catheter has a distal end insertable into a body lumen of a patient. The mechanized guidewire drive assembly is adapted for operable engagement with the medical guidewire. The mechanized guidewire drive assembly includes a motor and includes a controller which drives the motor with a driving force. The driving force has a predetermined upper limit.
Superb case by Pendell Meyers & Steve Smith! Wonderful description by Pendell, leaving me with little to add. The only point Id emphasize is how when ECG findings are subtle - the KEY resides in looking a multiple leads. As per Pendell, Lead aVL provides an initial major clue - but it is lead I that then tells me without doubt that the T inversion in aVL is "real" and reciprocal to what we see in lead III. And then the subtle but real flattened and depressed ST segment in lead V2 just cannot be a normal finding. So, as per Pendell - there are no less than 8 leads that show subtle-but-real ST-T wave changes ( = leads I, II, III; aVL, aVF; V2,V3,V4) - and putting these abnormal findings in multiple leads together allows synthesis into a cohesive picture of acute coronary occlusion. THANKS for presenting! P.S. I understand that at times it "may be difficult to convince certain cardiologists" from just the initial tracing - BUT - in a patient with new-onset worrisome chest pain and THIS initial ECG ...
Acute STEMI complicated by no-flow due to extensive distal thromboembolic coronary occlusion...a novel approach using stent retriever mechanical th ...
This briefing will provide a current market snapshot, including use cases, ongoing deployments, competitive landscape and future outlook for SDN, as seen from enterprise CIOs and operators CTOs. Why you should attend: - Grasp the market situation, includ...
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Guidewire delivers the industry platform that property and casualty insurers require to power their business. As of the end of our fiscal year 2019, we were privileged to serve more than 380 customers in 34 countries.
TY - JOUR. T1 - Adult endopyelotomy. T2 - Impact of etiology and antegrade versus retrograde approach on outcome. AU - Shalhav, Arieh L.. AU - Giusti, Guido. AU - Elbahnasy, Abdelhamid M.. AU - Hoenig, David M.. AU - McDougall, Elspeth M.. AU - Smith, Deborah S.. AU - Maxwell, Keegan L.. AU - Clayman, Ralph V.. PY - 1998. Y1 - 1998. N2 - Purpose: We evaluate our experience with endopyelotomy for ureteropelvic junction obstruction by stratifying the results of an antegrade versus a retrograde approach for primary, secondary, calculi related, high insertion and impaired renal function related obstruction, individually. Materials and Methods: We retrospectively reviewed results of 149 nonrandomized patients treated for ureteropelvic junction obstruction, of whom 83 underwent antegrade percutaneous endopyelotomy using a right angle Greenwald electrode and 66 underwent retrograde endopyelotomy using a cutting balloon device. Subjective results were based on an analog pain scale, objective results on ...
A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.
Abstract. Laser angioplasty has been reported as a debulking tool in highly calcified stenosis and in chronic total occlusions followed by a conventional balloon angioplasty/stenting. This systematic review includes one randomized controlled trial and two case series reporting on totally 444 patients. Due to limitation in study designs, one RCT with per randomization and per protocol analysis and two case series without controls the evidence of effectiveness and safety is low. An inclusion in the reimbursement catalogue of Austrian hospitals is currently not recommended. ...
Avinger has announced the US launch of an enhanced version of the companys Lightbox imaging console. The Lightbox provides a dual display of images to physicians using Avingers Lumivascular system, which Avinger says is "the first-ever image-guided atherectomy and chronic total occlusion (CTO) recanalisation devices for the treatment of peripheral artery disease, providing physicians with a view inside diseased arteries." A company press release states that the upgraded Lightbox L250 console is designed to be more intuitive, provide sharper imaging, and reduce start-up times before procedures begin.. Physician feedback and a commitment to provide the most advanced Lumivascular guided treatment were the driving forces behind the development of the Lightbox L250.. Lumivascular technology allows physicians to see from inside the artery during a directional atherectomy procedure by using an optical coherence tomography (OCT), which is displayed on the Lightbox console. In the past, physicians have ...
Certain factors like ostial disease, chronic total occlusion, and long, multiple stents are the main causes of multiple stent fractures, as were present in this case. Such stent fractures are usually associated with significant in-stent restenosis; however, this patient had a patent lumen despite multiple fractures.
LCX artery occlusions are estimated to account for 20% of MIs.5,6 They may pose a diagnostic dilemma, primarily if the ECG findings are non-diagnostic for STEMI. Subsequently, these patients are more likely to undergo PCI more than 24 hours from onset of symptoms compared to patients with more readily recognizable left anterior descending (LAD) and right coronary artery (RCA) occlusions.5 LCX lesions are associated with increased risk of heart failure and mortality at 90 days and 1 year compared to RCA and LAD lesions.7 In addition, there have been multiple reports indicating higher peak levels of cardiac biomarkers, suggesting larger infarct sizes and thus more myocardial necrosis.8. Attempts at improving early diagnosis of total occlusion lesions in the LCX have had limited success. According to one study, angiography-proven LCX total artery occlusions only met STEMI criteria 46% of the time, and the addition of posterior leads (V7-V9) only improved sensitivity 6-14% of the time.9 Isolated V2 ...
Guidewire exit ramp members that may be placed over a tubular member having a guidewire lumen, which longitudinally extending and laterally accessible, and methods of use. The guidewire exit ramp member can be placed to force a guidewire loaded through the lumen in a first direction to be forced out of the lumen via an opening, slit or channel. The guidewire exit ramp member, in an illustrative embodiment, takes the form of a relatively short member having a proximal portion and a distally extending flap. The flap may be designed to enter and remain in a longitudinally accessible guidewire lumen. Combinations of such ramp members and device shafts having longitudinally extending laterally accessible guidewire lumens are also disclosed, as are methods for securing such combinations together. A method of backloading a guidewire into a catheter while causing lateral exit of the guidewire at a desired location is also shown.
Define components of occlusion. components of occlusion synonyms, components of occlusion pronunciation, components of occlusion translation, English dictionary definition of components of occlusion. occlusion top: in a cold-front occlusion cold air moves under a mass of warm air and under the cool air in front bottom: in a warm-front occlusion cool air...
Define working occlusion. working occlusion synonyms, working occlusion pronunciation, working occlusion translation, English dictionary definition of working occlusion. occlusion top: in a cold-front occlusion cold air moves under a mass of warm air and under the cool air in front bottom: in a warm-front occlusion cool air...
Guideliner should be advanced all the way into the coronary artery over the Rota sheath/burr, then forcefully pull the burr. Other approach could be tried is to advance the another guide Cather by additional access and try to advance a guidewire and a small balloon alongside the burr; If successful then gradually dilate with PTCA balloon at the level of stuck burr which will then allow burr to become free and to be pulled out safely. We have tried this approach 3 times in the past and always failed to advance the guidewire alongside the burr as burr is deeply entrapped in the artery. If all these maneuvers still fails, then last option will be to send pt for CT surgery to remove the burr openly.. ...
Guidewire Software, Inc., provider of the industry platform P&C insurers rely upon, today announced that 18 new specializations have been awarded to 7 Guidewire PartnerConnect™ Consulting partners across the Americas, APAC, and EMEA regions. Alchemy Technology Services: ClaimCenter- EMEA PolicyCenter- EMEA InsuranceSuite Integration- EMEA Cognizant:...
One way to alleviate dry eye is to help the eyes retain the small amount of lubricating tears they do produce. This is accomplished by closing off the small fun
TY - JOUR. T1 - Transplantation of expanded bone marrow-derived very small embryonic-like stem cells (VSEL-SCs) improves left ventricular function and remodelling after myocardial infarction. AU - Zuba-Surma, Ewa K.. AU - Guo, Yiru. AU - Taher, Hisham. AU - Sanganalmath, Santosh K.. AU - Hunt, Greg. AU - Vincent, Robert J.. AU - Kucia, Magda. AU - Abdel-Latif, Ahmed. AU - Tang, Xian Liang. AU - Ratajczak, Mariusz Z.. AU - Dawn, Buddhadeb. AU - Bolli, Roberto. PY - 2011/6. Y1 - 2011/6. N2 - Adult bone marrow-derived very small embryonic-like stem cells (VSEL-SCs) exhibit a Sca-1+/Lin-/CD45- phenotype and can differentiate into various cell types, including cardiomyocytes and endothelial cells. We have previously reported that transplantation of a small number (1 × 106) of freshly isolated, non-expanded VSEL-SCs into infarcted mouse hearts resulted in improved left ventricular (LV) function and anatomy. Clinical translation, however, will require large numbers of cells. Because the frequency of ...
Brownell and J. Edgar Hoover"; of a coronary occlusion; in-his Manhattan apartment. Statement issued by the Julius and Ethel ...
Ischemic events during coronary artery balloon occlusion. In: Rutishauser W, Roskamm H, eds. Silent Myocardial Ischemia. Berlin ... Coronary Stents, Springer 1992 (ISBN 9780387545417) (Coronary Stents) U. Sigwart: Endoluminal Stenting, W. B. Saunders 1996 ( ... Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel ... a landmark paper on the use intravascular stents in humans to prevent occlusion and re-stenosis after angioplasty of coronary ...
Coleman died of a coronary occlusion in 1973. Abilene Christian University coaching records College Football Reference Abilene ...
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 Sydney Morning Herald 18 August 1934 ...
... (February 1943). "The Electrocardiographic Diagnosis and Treatment in Recent Coronary Occlusion". Journal ... "Electrocardiographic Diagnosis and Prognosis of Recent Coronary Thrombosis or Occlusion", Journal of the Indiana State Medical ... "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 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 " ...
He died of coronary occlusion on June 8, 1936, in Gloucester, Massachusetts. He married Natalie Harris, of Harrisville, ...
He died at age 42 in Sandusky, Ohio, of a coronary occlusion. "Cliff Fannin - Stats, Bio - MLB Baseball". sportsillustrated.cnn ...
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 ...
... , 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: 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. ...
When examined, it was determined that he had suffered a coronary occlusion. The deceased governor was provided a state funeral ...
... protects remote virgin myocardium from subsequent sustained coronary occlusion". Circulation. 87 (3): 893-9. doi:10.1161/01.cir ... Brief renal ischemia and reperfusion applied before coronary artery reperfusion reduces myocardial infarct size via endogenous ... "Remote preconditioning by infrarenal occlusion of the aorta protects the heart from infarction: a newly identified non-neuronal ...
... protects remote virgin myocardium from subsequent sustained coronary occlusion". Circulation. 87 (3): 893-899. doi:10.1161/01. ... "Remote Ischemic Conditioning in Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting". Circulation Journal. ... In the first prospectively designed trial to examine the effect of RIC on clinical outcomes in coronary artery bypass grafting ... The development of CIN after percutaneous coronary intervention is independently associated with an increased risk of short- ...
He died suddenly, of a coronary occlusion, while on holiday in Keswick, Cumbria. Samuel Gee gave the first modern-day ...
She died at Toorak Gardens in 1947 of coronary occlusion and was cremated. She was associated with the Kindergarten Union in SA ...
The effect of propranolol on blood viscosity changes induced by experimental coronary occlusion. Biro GP, Beresford-Kroeger D. ... 2011 Early deleterious hemorheologic changes following acute experimental coronary occlusion and salutary antihyperviscosity ...
Leviero died of a coronary occlusion in Pittsfield, Massachusetts, on September 3, 1956. A military funeral was held at ...
This may be aided by fibrinolytic drugs such as Tissue Plasminogen Activator (tPA) in instances of coronary artery occlusion. ... This drug is administered intravenously and can be used to dissolve blood clots in coronary vessels. However, streptokinase is ...
Bypass/Coronary artery bypass MIDCAB. Off-pump CAB. TECAB. Coronary stent. Bare-metal stent. Drug-eluting stent. *Bentall ...
Purchase Manual of Coronary Chronic Total Occlusion Interventions - 1st Edition. Print Book & E-Book. ISBN 9780124201293, ... Manual of Coronary Chronic Total Occlusion Interventions 1st Edition. A Step-by-Step Approach. 3 Reviews ... Manual of Coronary Chronic Total Occlusion Interventions: A Step-by-Step Approach is a practical, easy to read reference for ... case-oriented and easy to read reference with illustrations and step-by-step guidance for coronary chronic total occlusion ...
Management of acute coronary occlusion during coronary angioplasty. BMJ 1990; 300 :1016 ... Management of acute coronary occlusion during coronary angioplasty.. BMJ 1990; 300 doi: https://doi.org/10.1136/bmj.300.6730. ...
Chronic coronary total occlusion is a block in the arteries lasting more than three months and can be treated with a variety of ... What Is Chronic Coronary Total Occlusion?. Chronic coronary total occlusion (CTO) occurs when either the left main or right ... Chronic coronary total occlusion symptoms. During the early stages of chronic coronary total occlusion (CTO), there may be no ... Chronic Coronary Total Occlusion Treatment. Chronic coronary total occlusion (CTO) treatment aims to restore blood flow through ...
A coronary occlusion is the partial or complete obstruction of blood flow in a coronary artery. This condition may cause a ... In some patients coronary occlusion causes only mild pain, tightness or vague discomfort which may be ignored; however, the ... Tsar Nicholas II may have suffered a coronary occlusion right before he was toppled from his throne during the Russian ...
The purpose of the present study was to assess whether brief, repeated coronary artery occlusions during balloon angioplasty ... In animals, brief coronary artery occlusions preceding a more prolonged occlusion result in reduced infarct size. Whether ... Repeated coronary artery occlusions during routine balloon angioplasty do not induce myocardial preconditioning in humans. * ... The purpose of the present study was to assess whether brief, repeated coronary artery occlusions during balloon angioplasty ...
For patients with limiting angina in spite of medical therapy coronary revascularisation either by coronary artery bypass ... grafting (CABG) or percutaneous coronary intervention (PCI) is extremely... ... Developments in coronary chronic total occlusion percutaneous coronary interventions: 2014 state-of-the-art update. J Invasive ... These include a patients presenting coronary syndrome, their co-morbidities and their coronary anatomy. Coronary artery ...
Percutaneous coronary intervention in chronic total occlusion is a rapidly evolving area, being considered the last frontier of ... Coronary Occlusion. Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS ... "Percutaneous Coronary Intervention in Chronic Total Occlusion.". Percutaneous coronary intervention in chronic total occlusion ... Percutaneous Coronary Intervention. A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including ...
These tracers were injected simultaneously with release of the coronary occlusion or after 5 or 20 min of reflow of coronary ... The "No-Reflow" Phenomenon after Temporary Coronary Occlusion in the Dog. Robert A. Kloner, Charles E. Ganote, and Robert B. ... phenomenon was investigated in the left ventricular myocardium of dogs subjected to temporary occlusions of a major coronary ... were used to demonstrate the distribution of coronary arterial flow in control and damaged myocardium. ...
Coronary Artery Occlusion, Chelation and Cholesterol in a 49-year Old Pilot. Yaseem Sarwar PhD1 min read ... the angiogram showed that his coronary artery system was totally normal and there were no blockages anywhere in the coronary ... He underwent heart catheterization and was found to have his left main anterior descending coronary artery completely blocked. ...
Although ameroid constrictors have been used to create CTOs from extrinsic compression of coronary arteries, this model is not ... of coronary arteries represents a challenge for percutaneous treatment. ... Coronary Angiography. Coronary Disease / pathology, radiography, surgery*. Coronary Vessels / pathology, surgery. Disease ... OBJECTIVE: Chronic total occlusion (CTO) of coronary arteries represents a challenge for percutaneous treatment. Although ...
A, Ostium analysis of distribution of acute coronary occlusions. B, Normalized segment analysis of acute coronary occlusions. C ... A, Ostium analysis of distribution of acute coronary occlusions. B, Normalized segment analysis of acute coronary occlusions. C ... A, Ostium analysis of distribution of acute coronary occlusions. B, Normalized segment analysis of acute coronary occlusions. C ... Coronary Heart Disease. Coronary Artery Spatial Distribution of Acute Myocardial Infarction Occlusions. John C. Wang, Sharon- ...
... is a complete blockage of a coronary artery that has been in place for 30 or more days. ... What is a Coronary Artery Chronic Total Occlusion?. A coronary artery chronic total occlusion (CTO) is a complete blockage of a ... Coronary Artery Chronic Total Occlusion Institutes & Services , TriHealth Heart Institute Start of Coronary Artery Chronic ... How is Coronary Artery Chronic Total Occlusion Treated at Trihealth?. To diagnose a CTO, a routine physical exam with a careful ...
Figure 2: Coronary angiography. (a) Normal left coronary artery; (b) proximal occlusion of anomalous right coronary artery ( ... to left anterior descending coronary artery thrombotic occlusion and is rarely seen in proximal right coronary occlusion [4]. ... S. E. Kim, J.-H. Lee, D.-G. Park, K.-R. Han, and D.-J. Oh, "Acute myocardial infarction by right coronary artery occlusion ... Acute coronary syndrome with precordial ST segment elevation is usually related to left anterior descending artery occlusion, ...
Coronary Artery Disease. Myocardial Ischemia. Coronary Disease. Coronary Stenosis. Coronary Occlusion. Heart Diseases. ... Coronary Artery Disease Coronary Disease Coronary Stenosis Device: sirolimus-eluting stent Phase 3 ... Sirolimus-Eluting Stents for Chronic Total Coronary Occlusions. The safety and scientific validity of this study is the ... Percutaneous coronary intervention of chronic total occlusions (CTO), however, is still limited by high restenosis rates. ...
The article considers the screening for coronary artery occlusion for patients with non-ST elevation acute coronary syndromes ( ... A study revealed that about a quarter of patients with NSTEACS suffer from a coronary artery occlusion, specially in arteries ... The article presents a clinical case of a 39-year-old immigrant who was diagnosed of having a risk of coronary heart disease ( ... Use of the treadmill test in the diagnosis of coronary artery disease in patients with chest pain. Goldschlager, Nora; ...
"Reverse coronary steal" induced by coronary vasoconstriction following coronary artery occlusion in dogs.. M Chiariello, L G ... Reverse coronary steal induced by coronary vasoconstriction following coronary artery occlusion in dogs. ... "Reverse coronary steal" induced by coronary vasoconstriction following coronary artery occlusion in dogs. ... "Reverse coronary steal" induced by coronary vasoconstriction following coronary artery occlusion in dogs. ...
THE ROLE OF HYPERTENSION IN THE ETIOLOGY AND PROGNOSIS OF CORONARY OCCLUSION1 Annals of Internal Medicine; 42 (2): 369-377 ... THE RELATIONSHIP BETWEEN HYPERTENSION AND CORONARY OCCLUSION1 FRANZ GOLDSTEIN, M.D.; WILLIAM K. JENSON, M.D.; JEROME M. WALDRON ... THE RELATIONSHIP BETWEEN HYPERTENSION AND CORONARY OCCLUSION1. Ann Intern Med. 1956;44:446-455. doi: 10.7326/0003-4819-44-3-446 ... Alcohol Consumption and Risk for Coronary Heart Disease among Men with Hypertension Annals of Internal Medicine; 146 (1): I-35 ...
... occlusion 2.6 +/- 0.3; cocaine 5.2 +/- 0.7, occlusion 1.3 +/- 0.5 ln s2) response to 2-min coronary occlusion. beta- ... To test this hypothesis, we produced a 2-min left circumflex coronary artery (LCX) occlusion in unanesthetized mongrel dogs (n ... Effects of cocaine on cardiac vagal tone before and during coronary artery occlusion: cocaine exacerbates the autonomic ... occlusion 149.7 +/- 9.6; cocaine 144 +/- 11.9, occlusion 178.3 +/- 10.4 beats/min) and vagal tone (control 5.6 +/- 0.7, ...
Atrial Fibrillation and Coronary Artery Disease as Risk Factors of Retinal Artery Occlusion: A Nationwide Population-Based ... plays roles in later retinal artery occlusion (RAO) development and examine their relative weights. The relative risks of RAO ...
Mechanisms of remote myocardial dysfunction during coronary artery occlusion in the presence of multivessel disease.. D C ... Mechanisms of remote myocardial dysfunction during coronary artery occlusion in the presence of multivessel disease. ... Mechanisms of remote myocardial dysfunction during coronary artery occlusion in the presence of multivessel disease. ... Mechanisms of remote myocardial dysfunction during coronary artery occlusion in the presence of multivessel disease. ...
Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery. To evaluate the use of different ... Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery. Cochrane Database of Systematic ... dose regimens of aspirin to prevent graft occlusion in people who have undergone coronary artery bypass grafting. ... There is not enough evidence to show that lowering body temperature can reduce nerve damage during coronary artery bypass ...
Radial Artery Spasm Leading to Occlusion in Patients Undergoing Coronary Angiogram Via Radial Access. The safety and scientific ... Development of radial artery occlusion in patients who had spasm during coronary angiogram [ Time Frame: 30 days ]. ... Radial artery occlusion (RAO) is a frequent complication of radial artery cannulation. In the perioperative period, rates of ... Radial artery occlusion can be documented by an abnormal Barbeaus test , visible obstruction on two-dimensional ultrasound or ...
Acute coronary occlusion always results in death--or does it? The observations of William T. Porter.. W B Fye ... Acute coronary occlusion always results in death--or does it? The observations of William T. Porter. ... Acute coronary occlusion always results in death--or does it? The observations of William T. Porter. ... Acute coronary occlusion always results in death--or does it? The observations of William T. Porter. ...
Predictors for New Native-Vessel Occlusion in Patients with Prior Coronary Bypass Surgery: A Single-Center Retrospective ... Predictors for New Native-Vessel Occlusion in Patients with Prior Coronary Bypass Surgery: A Single-Center Retrospective ...
Acute thrombotic occlusion of the right coronary artery treated successfully with a helical thrombectomy device ... Acute thrombotic occlusion of the right coronary artery treated successfully with a helical thrombectomy device ... In these figures we illustrate the successful removal of visible occlusive thrombus from the right coronary artery with a new ... of plaque rupture or fissure is increasingly recognised to be the pivotal event in the pathogenesis of acute coronary syndromes ...
  • A discussion is given of the results following various coronary sinus occlusion procedures in which it is indicated that it is desirable to produce a partial or gradual occlusion in order to lower the mortality rate both of the initial procedure as well as of the subsequent sudden arterial occlusion. (rupress.org)
  • Schaper summarizes the status-2009 knowledge of coronary collateral transformation in a recent review: "Following an arterial occlusion outward remodeling of pre-existent inter-connecting arterioles occurs by proliferation of vascular smooth muscle and endothelial cells. (wikipedia.org)
  • We present a case of a patient with previous inferior wall infarction and new acute ST elevation myocardial infarction (STEMI) due to proximal right coronary thrombotic occlusion resulting in right ventricular infarction with precordial ST elevation and sinus node dysfunction. (hindawi.com)
  • On the other hand, sudden and complete coronary sinus obturation by itself is associated with a high operative mortality and apparently does not affect the mortality rate following subsequent sudden left anterior descending branch occlusion. (rupress.org)
  • Although no experiments employing sudden left anterior descending coronary branch occlusion were carried out sooner than 1 week, there is available anatomic evidence that within possibly 24 hours after coronary sinus occlusion a dilatation of the vascular bed occurs. (rupress.org)
  • In subsequent experiments attempts will be made to determine whether this early vascular dilatation is adequate to compensate for subsequent sudden left anterior descending branch occlusion. (rupress.org)
  • Subintimal tracking was associated with significantly greater IVUS-detected vascular injury, angiographic dye staining/extravasation, and branch occlusion. (onlinejacc.org)