TY - JOUR. T1 - Discrepancy between computed tomography coronary angiography and selective coronary angiography in the pre-stenting assessment of coronary lesion length. AU - Soon, K. H.. AU - Farouque, H. M.O.. AU - Chaitowitz, I.. AU - Cox, N.. AU - Selvanayagam, J. B.. AU - Zakhem, B.. AU - Bell, K. W.. AU - Lim, Y. L.. PY - 2007/10/1. Y1 - 2007/10/1. N2 - We aimed to compare the lesion length measured on computed tomography coronary angiography (CT-CA) with the selective coronary angiography (SCA) lesion length measured on quantitative coronary angiography (QCA). Compared with SCA, CT-CA has the advantage of showing the lumen and the atherosclerotic plaque in the arterial wall. This prospective observational study involved 44 coronary lesions. Computed tomography coronary angiography was carried out with an electrocardiogram-gated 16-slice CT before percutaneous coronary intervention. A cardiologist and a radiologist measured CT lesion lengths in consensus, whereas an interventional ...
Computed tomography coronary angiography (CTCA) has evolved as a non-invasive imaging technology that can be used as an alternative first-line diagnostic test in symptomatic patients with low to intermediate likelihood of coronary artery disease (CAD).1 Nevertheless, it has not (yet) fulfilled initial expectations that it would be able to replace conventional invasive coronary angiography because CTCA tends to overestimate the severity of the coronary stenosis, resulting in a number of patients with false-positive outcomes that is too high. This is mainly caused by the blooming effect of calcified lesions in combination with the still too limited spatial resolution of CTCA as compared with invasive coronary angiography. CTCA provides, additional to luminography, comprehensive assessment of the anatomical manifestations of coronary atherosclerosis, including the distribution (proximal, mid and distal) and extent (one-, two-, three-vessel disease, left main disease) of CAD, the presence of ...
Coronary angiography is a key diagnostic tool in the management of patients with coronary artery disease. Coronary angiography is used to identify narrowing in coronary arteries and is used for decision support to ascertain the need for revascularization to minimize the risk of myocardial infarction. Various research studies have evaluated trends in the use and results of coronary angiography as key contributory factors to the variations seen in rates for coronary revascularization across the US. For example, a large study by Chan, et al. highlighted that inappropriate revascularization rates ranged from 0% to 55% in different facilities[i]. The use of diagnostic angiography has been advocated in different guidelines to ensure that the revascularization is warranted, however, this approach does not address inappropriate selection of patients for a diagnostic angiography.. According to the American Heart Association (AHA), coronary angiography is not recommended in patients who are at low risk ...
The Combined Coronary angiography and myocardial perfusion imaging using 320 detectors computed tomography (CORE-320) was designed as a prospective, multi-center, international, blinded study designed to evaluate the diagnostic accuracy of multi-detector computed tomography using 320 detectors for identifying coronary artery luminal stenosis and corresponding myocardium perfusion defects in patients with suspected coronary artery disease. The primary analysis will be a comparison of the diagnostic capability of the combination of quantitative 320-MDCT angiography and quantitative perfusion imaging to the combination of conventional coronary angiography and SPECT myocardial perfusion imaging at the patient level. A positive patient will be defined as having at least one vessel with a ≥ 50% diameter stenosis defined by quantitative coronary angiography and a corresponding positive SPECT territorial myocardial perfusion defect ...
Coronary angiography remains the gold standard for imaging coronary anatomy and defining the extent and precise location of coronary artery disease. Optimal coronary angiography is dependent on a thorough knowledge of coronary anatomy and a systematic imaging sequence protocol that enables visualization of all coronary segments, particularly areas of vessel overlap, bifurcations, or tortuous anatomy. A basic map of the coronary anatomy is delineated in Figure 69-1, and the optimal views for imaging each coronary segment are summarized in Table 69-1 (Figs. 69-2, 69-3, 69-4, 69-5). Although standard views are generally consistent from one patient to the next, the precise angulations tend to vary based on the variations in anatomic orientations. A number of coronary segment numbering systems have been established; the most commonly used is the Coronary Artery Surgery Study (CASS) numbering system derived from the Bypass Angioplasty Revascularization Investigation (BARI) study,1 which assigns a ...
INTRODUCTION. Over the past few years, multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA), allowing noninvasive evaluation of the coronary arteries.1-4 However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT.5,6 With the first generations of MDCT scanners, severe coronary calcifications were recognized as an important factor hampering precise evaluation of coronary artery stenosis, thereby limiting diagnostic accuracy. Calcified plaques produce artifacts (blooming) which may affect the evaluation of luminal obstruction.7 At the same time, more extensive coronary calcification increases the likelihood that the patient has obstructive coronary artery disease,8,9 and ICA is usually required for definitive diagnosis and treatment. Advances in temporal and spatial resolution, especially the introduction of 64-detector rows, and growing ...
TY - JOUR. T1 - Recent progress in quantitative coronary angiography. AU - Ozaki, Y.. AU - Keane, D.. AU - Serruys, P. W.. PY - 1995/1/1. Y1 - 1995/1/1. N2 - The recent progress of quantitative coronary angiography (QCA) has paralleled our advances in interventional cardiology and has contributed significantly to our current understanding of coronary artery disease. QCA offers a scientific medium for the study of acute procedural results and serial changes over long term follow up. Changes in the absolute minimal luminal diameter (MLD) have been utilized for the study of acute luminal gain and subsequent restenosis following coronary interventional procedures and changes in both the minimal and the mean luminal diameter (MEAN) have been utilized for the study of progression/regression of coronary artery disease. While there has been a growth in the deployment of videotape as a recording medium ml account of the recent development of digital acquisition systems, the suitability of video ...
Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the inside of your coronary arteries. The coronary arteries supply blood and oxygen to your heart. A material called plaque can build up on the inside walls of the coronary arteries and cause them to narrow. When this happens, its called coronary artery disease (CAD). This can prevent enough blood from flowing to your heart and can lead to angina (an-JI-nuh or AN-juh-nuh) (chest discomfort or pain) and heart attack. Coronary angiography shows if you have CAD. Most of the time, the coronary arteries cant be seen on an x ray. During coronary angiography, a special dye is injected into the bloodstream to make the coronary arteries show up on an x ray. To deliver the dye to your coronary arteries, a procedure called cardiac catheterization (KATH-e-ter-i-ZA-shun) is used. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is then ...
A look at the following clinical trial: Prevalence Of Internal Pudendal Artery Disease In Patients With Erectile Dysfunction Undergoing Diagnostic Coronary Angiography.
A 34-year-old Coloured man had typical angina pectoris which was unresponsive to medical therapy. There was no history of factors predisposing to atherosclerosis apart from moderate cigarette smoking. A resting ECG suggested a previous nontransmural anterolateral myocardial infarction, and a submaximal effort test was strongly positive for myocardial ischaemia. Serological investigation for syphilis was positive, and initially the possibility that coronary ostial stenosis was the cause of his symptoms was strongly considered. Cardiac catheterization and selective coronary angiography showed evidence of an anterolateral myocardial infarction and that there was no coronary ostial stenosis, but total occlusion of the left anterior descending coronary artery (LAD) proximally with retrograde filling from the right coronary artery was revealed. The left circumflex coronary artery also showed some insignificant internal luminal irregularities. The patient was subjected to coronary artery bypass graft ...
TY - JOUR. T1 - Rapid disappearance of an endothelial ulceration in the left main coronary artery. AU - Bokhari, Ismail A H. AU - Bokhari, Ravia. AU - Alpert, Joseph S. PY - 2007/3. Y1 - 2007/3. N2 - A case is presented of a 65-year-old male who presented with an acute anterior wall myocardial infarction. An initial coronary angiogram demonstrated an ulcerated atherosclerotic plaque in the left main coronary artery. After 48 h of aggressive medical therapy including a 2b3a glycoprotein blocking agent, repeat angiography demonstrated resolution of the ulcerated plaque. The process of atherosclerotic plaque rupture is of dynamic nature.. AB - A case is presented of a 65-year-old male who presented with an acute anterior wall myocardial infarction. An initial coronary angiogram demonstrated an ulcerated atherosclerotic plaque in the left main coronary artery. After 48 h of aggressive medical therapy including a 2b3a glycoprotein blocking agent, repeat angiography demonstrated resolution of the ...
Learn more about Coronary Artery Angiography (Cardiac Catheterization) at Memorial Hospital function replaceEmbed(anmationName, embedContainerName) { var...
TY - JOUR. T1 - Anthropometric and bioclinical parameters in patients of coronary artery disease. AU - Venugopal, D.. AU - Vishesh, K.. AU - Shyamala, K. V.. PY - 2012/7/1. Y1 - 2012/7/1. N2 - The economic burden of CAD on any country is tremendous. It is expected that the rate of CAD will accelerate in the next decade. The obstructive impairment and number of vessels affected can interfere with the therapeutic strategy. Selective coronary angiography is the clinical diagnostic test for evaluating the coronary anatomy. Therefore, we can presume that if anthropometric values and biochemical parameters are predictive of the degree of anatomical impairment on coronary angiography, it will potentially be able to influence the decision of a strategy on invasive investigation in patients with ACS. Our project is hence an Endeavour to study the anthropometric and bioclinical profile of the patients with coronary artery disease and assessing them in relation to their angiographic severity. Methods: 100 ...
To study the role of 320-detector coronary computed tomography angiography (CTA) in assessing native coronary arteries in patients treated with coronary stents. 123 patients with coronary stenting received both CTA and conventional coronary angiography (CCA) within 1 day. The clinical parameters, coronary calcium scoring, CTA and CCA were analyzed to determine the prevalence of significant stenosis of native coronary arteries (SSNCA), the predictive value of CTA and the factors correlating with SSNCA and newly developed SSNCA after stenting (NDSSNCAS), with CCA as the standard of reference, using both vessel-based analysis (VBA) and patient-based analysis (PBA). Both the source and the reconstructed images were analyzed by CTA. All native coronary arteries were interpretable independent of cardiac motion. CTA showed a sensitivity/specificity of 93.5 %/97.3 % and 92.5 %/92.5 % in diagnosing SSNCA in VBA and PBA, respectively. The significant factors related to SSNCA were higher calcium scores (P ...
Acute coronary obstruction occurred in two patients during coronary angiography. In one case the obstruction was in the left main coronary artery; in the other it was close to the origin of the left anterior descending artery. In both cases acute cardiac ischaemia ensued, with electromechanical dissociation and collapse, which was not reversible by resuscitation. Rapid disobliteration of the occluded coronary artery was done with a guide-wire pushed through the obstruction via the coronary catheter. The recanalisation was completed by an intracoronary perfusion of streptokinase in one case. In both cases recovery was rapid and spectacular. The occurrence of acute ischaemia during coronary angiography should suggest accidental coronary occlusion. If a thromboembolic origin is suspected, transluminal disobliteration should be attempted. It is simple and can reverse a dangerous condition ...
When coronary artery disease is extensive and of relatively uniform severity, regional myocardial hypoperfusion may be balanced during stress, precluding development of spatially relative perfusion defects. Assessment of the washout of thallium-201 from myocardial regions may provide diagnostic assistance in these cases because washout analysis is spatially nonrelative and hypoperfused myocardial regions manifest a slow thallium-201 washout rate. In 1,265 consecutive patients having quantitatively analyzed stress-redistribution scintigraphy, 46 had a diffuse slow washout pattern with no or a maximum of one regional perfusion defect. Thirty-two underwent clinically indicated coronary angiography, and 23 (72%) of these were found to have three vessel or left main disease. Of 30 similar patients without a diffuse slow washout pattern and with no or a maximum of one perfusion defect, only 5 (17%) had extensive coronary disease. An independent relation between diffuse slow washout and extensive ...
Have we then found the "holy grail" of non-invasive coronary imaging?. The ability to visualise coronary arteries directly, assess cardiac function, and detect subclinical disease from a 20 second scan make MDCT more attractive than conventional stress testing. However, the significant radiation exposure makes it unattractive to screen the low risk population. Similarly, there is no justification for imaging high risk patients who clearly require coronary angiography and percutaneous intervention, without additional radiation exposure. It is unlikely that the financially constrained UK health system will adopt routine MDCT in the accident and emergency department to triage chest pain patients for "rule out" of pulmonary embolism, aortic dissection, and coronary disease.. The present niche of MDCT should be as an adjunct to coronary catheterisation in the assessment of patients and a useful gatekeeper ensuring appropriate triage of patients for catheterisation. This is especially true in the ...
Subjects in this study have recently had or are scheduled for a coronary angiography as part of their normal, routine medical care. This procedure uses x-ray imaging to see the inside of the hearts blood vessels.. This research study will evaluate the possible relationship between erectile dysfunction and vascular disease (diseases of the veins). In order to look at this possible relationship, subjects will complete a questionnaire which will ask questions regarding their sexual activity. Additionally, we will gather information from their medical records and take extra images during the coronary angiography procedure. ...
AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed tomography (SPECT). METHODS AND RESULTS: We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon emission computed tomography (SPECT/MPI). Sixteen centres enroled 381 patients who underwent combined CTA-CTP and SPECT/MPI prior to conventional coronary angiography. All four image modalities were analysed in blinded independent core laboratories. The prevalence of obstructive CAD defined by combined ICA-SPECT/MPI and ICA alone was 38 and 59%, respectively. The patient-based diagnostic accuracy ...
Coronary calcium predicts the angiographic extent of CAD in symptomatic patients and provides independent and incremental information to the more conventional clinical parameters derived from SPECT or risk assessment.
Results of the ReACT Trial Presented at TCT 2016 and Published Simultaneously in JACC: Cardiovascular Interventions. WASHINGTON - November 1, 2016 - A randomized evaluation of routine follow-up coronary angiography after percutaneous coronary intervention (PCI) found that there was no long-term clinical benefit compared to clinical follow-up alone among unselected patients following PCI.. Findings from the ReACT trial were reported today at the 28th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the worlds premier educational meeting specializing in interventional cardiovascular medicine. The study was also simultaneously published in JACC: Cardiovascular Interventions.. In this prospective, multicenter, open label, randomized study, patients who underwent successful PCI without planned staged PCI were randomly assigned to the routine angiographic follow-up (AF) group, in which they received coronary ...
Anomalous coronary arteries: Location, degree of atherosclerosis and effect on survival-a report from the Coronary Artery Surgery Study. J Am Coll Cardiol, 1989, 12, 531- 7. 27. , et al. Coronary anatomy in congenitally corrected transposition of the great arteries. Int J Cardiol, 2002, 86, 207-16. 28. B. Congenital heart defects and coronary anatomy. Tex Heart Inst J, 2002, 29, 279-89. 29. , et al. Influence of coronary anatomy on the anatomic repair of transposition of great arteries. Rev Esp Cardiol, 1996, 49, 451-6. Clinical importance of intramural blood vessels in the sino-atrial segment of the conducting system of the heart. Surg Radiol Anat, 1997, 19, 359-63. 17. , et al. A clinical angiographic study of the arterial blood supply to the sinus node. Chest, 1988, 94, 1054-7. 18. Gorlin, R. Coronary anatomy. Major Probl Intern Med, 1976, 11, 40-58. 19. , P. D. Leachman. Variations in coronary artery anatomy: Normal versus abnormal. Cardiovasc Dis, 1980, 7, 357- 70. 20. Angelini, P. Normal ...
Early identification of vulnerable plaques by remodeling index prior to rupture and development of acute event is of considerable importance especially by a reliable non-invasive method as CT coronary angiography (CTA), so we aim to evaluate coronary artery remodeling index in patients with low- to intermediate-risk stable angina by CTA. This single-center, cross-sectional, observational study included 150 patients with stable angina with normal resting ECG, negative markers, normal systolic function by 2D echocardiography (EF | 50%), and without regional wall motion abnormality at rest who were referred to MSCT evaluation of the coronary artery tree; the mean age was 56.8 ± 6.4 years, 83.3% had one-vessel disease, and 16.7% had two-vessel diseases. The mean remodeling index (RI) was 1.04 ± 0.28, 38% had significant positive remodeling, LAD was the most affected vessel (55.3), and proximal lesions were predominant in 48.5%; there was a statistically significant positive correlation between RI and
Routinely measuring fractional flow reserve (FFR) with pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significan
PURPOSE: To evaluate the performance of a computer aided algorithm for automated stenosis detection at coronary CT angiography (cCTA) using quantitative coronary angiography (QCA) as the reference standard.. METHODS: 59 patients (38 men, mean age 58±12y) underwent cCTA and QCA. In 29 patients cCTA was performed using dual-source CT (Definition™, Siemens, Forchheim, Germany) and in 30 patients using 64-slice CT (Sensation 64™, Siemens). All cCTA data sets were analyzed using a software algorithm (COR Analyzer™, Rcadia, Haifa, Israel) aimed at automated detection of coronary artery stenosis. The performance of the automated algorithm for detection of significant (≥50%) stenosis was compared with QCA based on a 10-segment coronary model. Performance of the automated algorithm was determined on a per-vessel and per-patient basis.. RESULTS: All cCTA data sets were successfully processed by the automated algorithm. QCA revealed a total of 40 stenoses ≥50% of which the software application ...
Measuring fractional flow reserve (FFR) during coronary angiography for diagnosis of chest pain can provide significant changes in the management of almost quarter of the patients.
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Pre-operative assessment of coronary artery disease with conventional coronary angiography has been recommended in the guidelines of the American College of Cardiology/American Heart Association for selected patients scheduled for cardiac valve surgery (15). Recently introduced multislice CT allows noninvasive coronary artery imaging and has been shown to reliably exclude significant coronary artery stenosis (8,9). The major advantage of multislice CT over conventional coronary angiography in patients with acute IE is its noninvasiveness and thus avoidance of the high embolization risk of valvular vegetations during catheter manipulation. Once spread into the systemic arterial circulation, those vegetations can cause severe complications such as cerebral or peripheral embolization (17).. In this study, multislice CT showed an excellent diagnostic performance in assessing morphologic abnormalities commonly seen in patients with IE. Accuracy of vegetation, abscess, and pseudoaneurysm detection ...
Introduction: Coronary CT angiography (CCTA) is an accurate and emerging diagnostic tool for evaluation of patients suspected of having coronary artery disease (CAD). Data on downstream testing, patient management and prognosis are important to further delineate the role of CCTA in clinical practice.. Hypothesis: We hypothesized that a normal CCTA in symptomatic patients does not lead to multiple diagnostic testing, influences patient management and indicates a favorable prognosis.. Methods: Prospective observational investigation of consecutive chest pain patients (without known CAD) having a normal 64-slice dual source CCTA study (no coronary plaques) from February 2007 to April 2009. Patient use of anitplatelet and lipid lowering therapy before and after the index CCTA, the use of additional downstream diagnostic testing (stress testing, myocardial perfusion imaging and invasive coronary angiography), and the occurrence of all-cause death or non-fatal myocardial infarction was recorded from ...
About Coronary Angiography Coronary Angiography, or Angiogram, is a minimally invasive procedure which is done to show the amount of coronary artery disease in the blood vessels that supply the heart. Coronary arteries can become clogged from a build-up of cholesterol, cells or other substances (plaque). This can reduce the flow of blood to your heart, causing chest pain,
Overall, 699 patients were randomized. The mean age was 50 years, 55% were women, mean body mass index was 28 kg/m2, and 6% had diabetes. The proportion of patients that underwent invasive coronary angiography during the index hospitalization was 6.6% with coronary CT angiography versus 6.2% with standard stress testing (p = NS).. In the coronary CT angiography group, no significant stenosis was detected in 82%, at least one severe stenosis (,70%) in 3.6%, and moderate stenosis (25-70%) in 10.2%. Stress testing was additionally required in 37 patients. Ultimately, nine percutaneous coronary intervention (PCI) and four coronary artery bypass grafting (CABG) procedures were performed. No acute coronary syndrome occurred when there was no evidence of severe obstruction ...
This thesis focus on the physiological information, on left ventricular (LV) motion in the long axis, evaluated in routine coronaty angiography sequences and based on previous knowledge from echocardiographic studies. As coronary angiography has become a very frequent examination, a method for assessment of LV function from routine coronary angiograms would probably have a significant impact on clinical work. Therefore, the motion of the left coronary artery is analysed in the studies described below.. In a pilot study of 84 patients, refetTed for coronaty and LV angiography, the systolic descent of the left coronary ostium (LCO) towards apex was measured. This simple manual measure from routine coronary angiograms showed a mean amplitude of 9.6 mm (range 3.0-15.0) and significant linear correlation to ejection fraction (EF) (r = 0.72, SEE = 10.1, p , 0.001).. In the second study, including 28 patients, coronary angiography and echoeardiography was used for measurement of circumflex artery ...
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CORONARY ANGIOGRAPHY/CARDIAC CATHETERISATION. Coronary angiography is performed in an X-ray lab (known as the Catheterisation Lab). A small calibre plastic tube (known as catheter) is positioned non-surgically through the skin in the groin or the wrist into an artery (figure 1). The catheter is then moved without pain to the heart and contrast injection is delivered to the arteries that supply the heart muscles. This allows the cardiologist to delineate and study the coronary arteries in great details and to determine if there are significant narrowings or blockages of the arteries (figure 2, figure 3).. ...
Li M, Zhang GM, Zhao JS, Jiang ZW, Peng ZH, Jin ZT, Sun G. Diagnostic performance of dual-source CT coronary angiography with and without heart rate control: systematic review and meta-analysis. Clinical Radiology 2014; 69(2): 163- ...
Interventional device developer Stentys has received CE Mark approval of its disconnectable and self-expanding stent platform for treatment of coronary artery bifurcations.
This TIMI classification was developed by the TIMI (Thrombolysis In Myocardial Infarction) study group to semiquantitatively assess coronary artery perfusion beyond point of occlusion on coronary angiography.
Objective: To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents. Design: Prospective, observational single centre study. Setting: A single tertiary referral centre. Patients: Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure. Interventions: MSCT and IVUS imaging at 9-12 months follow-up were performed for all patients. Main outcome measures: Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm2 by IVUS. Results: 52 patients were analysed. Passing-Bablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was ...
Dislodgement and embolization of the new generation of coronary stents before their deployment are rare but could constitute a very serious complication. We report a case of a stent dislodgement into the left main coronary artery during the pri
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A 57-year-old homeless man presented to the emergency room after a syncopal episode. He reported a two-day history of shortness of breath and upper back pain. He was noted to be hypotensive with a blood pressure of 92/69 mmHg. An electrocardiogram showed ST-segment elevations in the inferolateral leads. Emergent coronary angiography revealed diffuse obstructive disease in the left anterior descending coronary artery, occlusion of the distal left circumflex coronary artery and complete total occlusion of the proximal right coronary artery. The left circumflex lesion was felt to be the culprit and it was treated with balloon angioplasty. Echocardiography revealed a left ventricular ejection fraction (LVEF) of 15-20% with a contained rupture and pseudoaneurysm involving the lateral wall. He was recommended coronary artery bypass graft surgery and repair of the left ventricular (LV) pseudoaneurysm, which he refused. He was discharged with medical treatment and presented with NYHA Class III heart ...
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Objectives: To evaluate spatial plaque distribution patterns in coronary arteries based on computed tomography coronary angiography data sets and to express the learned patterns in prediction rules. An application is proposed to use these prediction rules for the detection of initially missed plaques. Material and Methods: Two hundred fifty two consecutive patients with chronic coronary artery disease underwent contrast-enhanced dual-source computed tomography coronary angiography for clinical indications. Coronary artery plaques were manually labeled on a 16-segment coronary model and their position (ie, segments and bifurcations) and composition (ie, calcified, mixed, or noncalcified) were noted. The frequent itemset mining algorithm was used to statistically search for plaque distribution patterns. The patterns were expressed as prediction rules: given plaques at certain locations as conditions, a prediction rule gave evidence-with a certain confidence value-for a plaque at another location ...
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In some cases, the diagnosis of coronary heart disease (CHD) can be assumed with a high degree of probability after a careful study of the patients complaints and his lifestyle. An electrocardiogram helps clarify the diagnosis (recorded at rest and during exertion). If the heart muscle has been damaged, then a cardiac ultrasound (echocardiograph) is of great help in diagnosing coronary heart disease along with MSCT (multi-slice computed tomography) of the coronary arteries. However, the gold standard study for diagnosing this disease is coronary angiography.
Structural simulations have been particularly useful in assessing the outcomes of kissing balloon inflation (KBI) after bifurcation stenting strategies. Previous studies have demonstrated that KBI may cause an elliptic deformation and coating damage of the proximal segment, altered strut configuration, possible arterial injury at the side branch ostium, and high wall stresses that may lead to arterial injury (36,37). Therefore, a minimal balloon overlap was suggested, which would diminish the elliptic deformation after KBI (38). In addition, a short noncompliant balloon in the proximal segment may correct local stent deformation (39). A recent study in 54 computer-simulated stent deployments compared the standard final KBI with a modified approach where the side branch balloon was inflated first and then both balloons were inflated simultaneously with unequal pressures. This study demonstrated that the modified technique for final KBI reduces the elliptical stent deformation in the proximal main ...
TY - JOUR. T1 - Feasible scan timing for 320-row coronary CT angiography generated by the time to peak in the ascending aorta. AU - Shirasaka, Takashi. AU - Nagao, Michinobu. AU - Yamasaki, Yuzo. AU - Kojima, Tsukasa. AU - Kondo, Masatoshi. AU - Shimomiya, Yamato. AU - Kamitani, Takeshi. AU - Honda, Hiroshi. PY - 2019/3/1. Y1 - 2019/3/1. N2 - Purpose: A 320-row CT scanner can briefly scan the entire heart. Therefore, the feasible scan timing is required. The aim of this study was to propose a refined method for feasible scan timing for coronary CT angiography (CCTA) using a time-density curve of the ascending aorta (AAo). Methods: One-hundred and twenty-nine patients were prospectively enrolled. All patients were performed test-bolus method. For the initial 65 patients, the scan timing was determined as a 3.0 s delay at the peak time in the AAo, which was defined as the conventional protocol (COV-P). For the next 64 patients, a scan timing of 1.0, 3.0, or 5.0 s delay was determined according to ...
This editorial refers to Changes in symptoms of anxiety and depression following diagnostic angiography: a prospective cohort study, by T.A. Hanssen et al., on page 106 ...
Average age was 57 ± 10 years and 56% of subjects were male. Patients were followed for 3-49 months (median 20). Of those randomized to CCTA, 1,778 (86%) had the study accomplished. CCTA revealed normal coronary arteries in 654 (37%), mild nonobstructive disease in 372 (21%), intermediate nonobstructive in 300 (17%), and obstructive in 452 (25%) of study subjects. At 6 weeks, CCTA was associated with a higher rate of referral for standard coronary arteriography (94 vs. 8; odds ratio [OR], 12.85; p < 0.0001). Over the total trial period, the number of standard coronary arteriograms performed did not differ between the CCTA and standard of care groups (409 vs. 401; hazard ratio [HR], 1.06; p = 0.451). Standard coronary arteriography demonstrated normal coronary arteries in 20 patients in the CCTA group versus 56 in the standard of care group (HR, 0.39; p < 0.001) and was more likely to show obstructive disease (283 vs. 30; HR, 1.29; p = 0.005) in the CCTA cohort. Compared to standard care, more ...
Three-dimensional rotational coronary angiography (3DRCA) is a new technique for imaging coronary vessels in the human body. Due to the residual cardiac motion, projections being in the same cardiac motion state are extracted from the acquired series using electrocardiogram (ECG) information. A gating window is determined at a pre-defined trigger delay relative to the R-peaks with a constant width. In order to achieve the best possible image quality, cardiac phases must be found during which the heart is nearly stationary. However, the (ECG) signal represents the electrical activity of the heart and corresponds to the heart movement only approximately. Currently, the optimum gating window positioning is based on values derived by experience. It is difficult to determine where the heart is most stable in the cycle due to a high patient variability. Furthermore, the optimal gating window position is depending on the coronary vessel segment. The purpose of this work is to introduce a simple and ...
... usually takes 30 minutes to 2 hours to be performed. The procedure is performed in the X-ray room. You will be asked to lie on the X-ray table, that has a few cameras that can move around your chest area for taking pictures. Sedatives will be given to you via the intravenous line (IV) instered in your arm. You will be asked to stay awake during the procedure so that you can do deep breathing, coughing and move your arms. Catheter will be inserted into your blood vessel via arm or groin. Catheter will be tactfully threaded to your coronary arteries. Blood pressure and oximonitor will be used your blood. Anticoagulants will be given to ensure there is no blood clotting on the catheter or coronary artery. You will feel a brief flushing when a contrast material (dye) is inserted in your body through the catheter. The dye moves through your arterties and the doctor observes the flow. X-ray images will be taken continously ...
Left heart cath, selective coronary angiography, LV gram, right femoral arteriogram, and Mynx closure device. Normal stress test.
A computerized tomography (CT) coronary angiogram is an imaging test that looks at the arteries that supply your heart with blood. Unlike traditional coronary angiograms, CT angiograms dont use a catheter threaded through your blood vessels to your heart.
An angiographic catheter includes a relatively soft, tip portion having a preformed curvature, and a resilient body portion extending therefrom having a preformed curvature in the opposite direction. A lumen extends through the catheter for the injection of angiographic dye therethrough to the right coronary artery. The part of the body portion of the catheter which it in the aortic arch of the patient during use has an amount of curvature which is less than the amount of curvature of the aortic arch, so that the body portion of the catheter is resiliently deformed where it passes through the aortic arch. The deformation results in the biassing of the tip portion of the catheter into the ostium of the right coronary artery. Upon insertion into the aorta the preformed catheter is oriented so that the curvature of the body portion of the catheter corresponds in direction to the curvature of the aortic arch, the tip portion of the catheter being disposed above the ostium of the right coronary artery with
Coronary angiography is a specialized X-ray test which gives perfect insight in the structure and functioning of the coronary arteries.
Summary: Concerning international comparison for the year 2011, Austria is situated under the top nations with 6,383 diagnostic coronary angiographies (CA), 2,407 percutaneous coronary interventions (PCI), and 47 transarterial aortic valve implantations (TAVI) per 1 million inhabitants in Europe. Although the number of TAVI increases rapidly since its first introduction in 2007 (47 TAVI per 1 million inhabitants in 2011, not including surgical cases from the transapical route), the data for CA and PCI remained constant during the past years. The rates of stent (91 %) and drug-eluting stent implantations (78 % of stents) also remained constant on a high level. Little fluctuation is also reflected in the complication data (including mortality evaluation). An increased morality is well known, especially in patients with the so-called ST-segment elevation myocardial infarction and consecutive shock (19-35 % in the past years). The application of certain special devices increased (clot catcher) or decreased
With the hybrid positron emission tomography (PET) and computed tomography (CT) systems, coronary artery anatomy and physiology can be realized during the same imaging session. Whereas the coronary CT angiography provides information on the presence and extent of the luminal stenosis in coronary artery disease (CAD), PET blood flow tracers provide information on the downstream functional consequence of these lesions. Current clinical applications of these imaging studies are focused predominantly on the identification of coronary artery lesions, which can be treated by coronary interventions. With the evolving technology, CT angiography may allow interrogation of the plaque morphology beyond the assessment of the luminal stenosis and the new radio-labeled ligands may expand the application of PET to assess plaque biology and instability. This is particularly relevant in asymptomatic subjects with coronary risk factors in whom the diagnosis often remains elusive before the actual occurrence of an ...
The present analysis gives a representative overview of sex‐associated differences in PCI in Germany from 2007 until 2009. We found that 27.8% of all PCIs were performed in women despite the fact that mortality rates due to coronary heart disease in Germany are almost the same in women and men.1, 2 This rate of PCI is comparable to that in the United States.3 It is not yet completely understood why this difference in use of invasive coronary procedures between men and women exists in spite of the established benefits of PCI in reducing fatal and nonfatal ischemic complications.21. Women with PCI were older than men, and they had more comorbidity. The largest difference of about 10 years was found in STEMI patients, which has been described before.5 We did not find any evidence that primary success rate of PCI was lower in women than in men. In elective PCI and NSTE‐ACS, it was even higher in women than in men, as was the percentage of implanted stents. This finding is in line with former ...
Coronary CT angiography has become a robust imaging technique for visualization of the coronary arteries. The most common application is to use this noninvas...
... is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart.
A coronary angiography is a fairly common procedure. The steps which are taken during this procedure are fairly standard, however vary greatly dependi
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A 64-year-old woman was complicated with acute type A dissection arising from the left main trunk during percutaneous coronary angiography. As the extent of dissection was localized in the ascending aorta, a bare-metal stent was inserted into the lef
Based on the method described by Reiber et al. (20), we devised and validated a simplified approach for estimating linear vessel tapering and calculating luminal stenosis severity on CCTA. Our method showed strong correlation to IQCA; the Pearson r-coefficient of 0.82 is similar to that reported by Raff et al. (3) (r = 0.76) and higher than that reported by Leber et al. (12) (r = 0.54). In the latter study, quantification of CCTA stenosis was based on the luminal diameter ratio of the stenotic site to proximal "healthy" vessel (12). Our method may have achieved higher correlation with IQCA in part by accounting for reference points proximal and distal to the stenosis and by assessing strictly luminal stenosis rather than accounting for positive remodeling. That our quantitative correlation was nearly identical to Raff et al. (3) (p = 0.94) despite studying older patients (mean age of 66 vs. 59 years) with higher global coronary calcification (mean coronary calcium score of 752 vs. 326) ...
The appropriate use of any rapidly improving technology is difficult to define, and coronary angiography with computed tomography (CT-angio) is no exception (1). In the study by Hausleiter and colleagues, CT-angio with a 64-slice scanner had per-segment sensitivity and specificity , 90%. The improved resolution probably contributed to the low number of patients with poor images, all of whom were included in the analysis. Another strength of the study is the sample of intermediate-risk patients who are most likely to benefit from the test findings. Assuming that the results of this study can be extrapolated to regular practice, CT-angio seems to be useful as an alternative to traditional angiography in patients with an intermediate probability of CAD, particularly those concerned about having an invasive procedure. The high negative predictive value of CT-angio (99%) means that a negative result would end ischemic evaluation in , 40% of patients. CT-angio may have an even more important role as ...
Dapatkan estimasi biaya untuk CT Coronary Angiogram di Cikarang pada pilihan rumah sakit dan dokter terbaik. Tim ahli medis kami siap memandu Anda memilih tindakan CT Coronary Angiogram yang paling tepat
Coronary computed tomography angiography (CCTA) is a noninvasive method to image the coronary arteries. Applications include the following: Diagnosis of coronary artery disease (CAD) Diagnosis of in... more
Aims The aims of the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) are to support the improvement of care and evidence-based development of therapy of coronary artery disease (CAD). Interventions To provide users with online interactive reports monitoring the processes of care and outcomes and allowing direct comparisons over time and with other hospitals. National, regional and county-based reports are publicly presented on a yearly basis. Setting Every hospital (n=74) in Sweden providing the relevant services participates. Launched in 2009 after merging four national registries on CAD. Population Consecutive acute coronary syndrome (ACS) patients, and patients undergoing coronary angiography/angioplasty or heart surgery. Includes approximately 80 000 new cases each year. Startpoints On admission in ACS patients, at coronary angiography in patients with stable CAD. Baseline data 106 variables ...
Coronary bifurcation lesion is one of the main causes of coronary stenosis. Despite many problems concerning to the pathogenesis have been remain
A coronary angiogram is an X-ray of the coronary arteries (the arteries that supply blood to your heart) to see if they are narrowed or blocked. ...
A computerized tomography (CT) coronary angiogram is an imaging test that looks at the arteries that supply your heart with blood. Unlike traditional coronary angiograms, CT angiograms dont use a catheter threaded through your blood vessels to your heart.
The medium-term follow-up data from the ABSORB trial were published in the recent issue of the Lancet. (3) At 2 years after implantation the BVS stent was completely bioabsorbed with restoration of vasomotion and no need for ischaemia-driven repeat revascularisation. In the 29 out of the 30 patients for whom follow-up data were available, the clinical outcomes at 2 years included only 1 (3.6%) non Q-wave myocardial infarction but no cardiac deaths or ischaemia-driven target lesion revascularisation (TLR). In addition there were no instances of stent thrombosis. At 18 months, multislice CT confirmed a mean diameter stenosis of 19 ± 9%. At 2 year coronary angiography, the in-stent late loss and diameter stenosis were shown to be 0.48 mm (SD 0.28) and 27% respectively. These did not differ from the findings at 6 months. At OCT, 34.5% of the stent strut locations presented no discernable features confirming decreases in echogenicity and radiofrequency backscattering, with the remaining apparent ...
You will be given a mild sedative to help you relax. An area of your body, usually the arm or groin, is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, or catheter, through an artery and carefully moves it up into the heart. A special dye called contrast media is then injected into the coronary arteries, and x-rays are taken to see how the dye flows through your heart. The test may last 30 to 60 minutes, but the entire procedure including pre- and post-op care can take 4 to 12 hours.. ...
The study included patients who underwent implantation of drug-eluting stents of both the first and second generation. All patients who underwent implantation of the stent without complications (in the first 10 days) were offered a repeated phased clinical examination. Of this observation group, in 62 patients with repeated coronary angiography (CAG), restenosis within the stent was detected more than 50% of the proper lumen of the vessel. The observation period for patients ranged from 3 months. up to 4 years (median follow-up = 2.53 ± 1.29 years). The number of patients for whom PCI was performed ≤ 1 year ago (on average 0.93 ± 0.22) was 22 (35.5%) patients - A-subgroup. The number of people who had PCI performed> 1 year ago (on average 3.30 ± 0.85) was 40 (64.5%) people - the B-subgroup.
Angiography is a special type of x-ray that allows your coronary arteries to be viewed and recorded on film. Your doctor can see if the blood vessels to your heart are clogged.
Modern day cardiac scientists have legally defined a significant coronary lesion as | 70 % obstruction. Unfortunately this rule is applicable more in academic forums not in cath labs. While the guidelines seem to be clear in chronic coronary syndromes , in ACS the interventional strategies based on severity of lesion is not clearly defined.…
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Coronary artery disease can be termed as New age plague afflicting the mankind ! It probably has killed ( or Killing ) as many lives as most other diseases put together. Why only a section of our population is vulnerable is not fully understood . We are familiar with coronary risk factors for…
Jonathan Frazier, PharmD Candidate 2015, Mercer University College of Pharmacy Acute coronary syndrome (ACS), more commonly known as heart attack or unstable angina, is an umbrella term for any situation in which blood flow to the heart is suddenly blocked. The sudden blockage is often due to a build up of plaque in the arteries, causing…
Coronary CT angiography (CCTA) identified plaques in acute MI patients whose coronary angiograms did not produce evidence of significant coronary stenosis.
Before a scheduled angioplasty, your doctor will review your medical history and do a physical exam. Youll also have an imaging test called a coronary angiogram to see if your blockages can be treated with angioplasty. A coronary angiogram helps doctors determine if the arteries to your heart are narrowed or blocked.. In a coronary angiogram, liquid dye is injected into the arteries of your heart through a catheter - a long, thin tube thats fed through an artery from your groin, arm or wrist to arteries in your heart. As the dye fills your arteries, they become visible on X-ray and video, so your doctor can see where your arteries are blocked. If your doctor finds a blockage during your coronary angiogram, its possible he or she may decide to perform angioplasty and stenting immediately after the angiogram while your heart is still catheterized.. Youll receive instructions about eating or drinking before angioplasty. Usually, youll need to stop eating or drinking six to eight hours before ...
Using non-invasive CT scan technology, CCTA takes a 3D picture of a beating heart in about five seconds. The digital pictures give doctors excellent image quality. They can quickly evaluate the heart and coronary arteries for plaque, a blockage or heart disease.
Bourdillon questions guidance from the National Institute for Health and Clinical Excellence (NICE) that exercise electrocardiography (ECG) has no role in diagnosing obstructive coronary disease causing angina (or in diagnosing angina, as NICE says incorrectly).1 2 Perhaps a more cogent reason for questioning this conclusion is that NICE considered only diagnosis and took no account of downstream testing or … ...
There is no indication of postprocedural cognitive impairment for patients undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI), according to a study published in The American Journal of Cardiology.
My mother has small pain in below chest and back of chest, then doctor advise to go for an angiogram, Angiogram shows Findings: 1.left main: normal 2.LAD:type-III lad. proximal to mid lad shows long...
Question - Have chest pain, needed a coronary angiogram, diagnosed contrast induced nephropathy. What do I do?. Ask a Doctor about diagnosis, treatment and medication for Ischemic heart disease, Ask a Cardiologist
A prospective study found that the use of the Tryton side branch stent in patients undergoing PCI was effective in treating coronary artery bifurcations involving large side branches.
Coronary Angiogram clinics in Cambodia at the best price. Find doctors, specialized in Cardiology and compare prices, costs and reviews.
A new classification of coronary congenital diseases is set to help surgeons identify secondary defects in the operating theater.
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Disclosures: Dr. Bamberg has received grants/funding from Bayer Healthcare & Siemens Healthcare. Dr. Choe has nothing to disclose. Dr. Funabashi has nothing to disclose. Dr. Schoepf is a consultant for and has received grants/funding from Bayer, Bracco, GE, Medrad, & Siemens.. ...
Coronary angiography, despite current shortcomings, has been regarded as golden standard for the assessment of coronary arteries. Geodesic pattern of coronary arteries characterized by curvature, torsion and tortuosity ...
PPAR was a randomized, multicenter, double-blind, two-arm pilot study comparing the effects of rosiglitazone maleate (4 mg BID orally) before and after PCI in patients with obesity and hypertension, dyslipidemia, or glucose intolerance when compared to placebo. Between January 2002 and August 2003, a total of 200 patients from 10 centers were randomized from the population of patients undergoing diagnostic angiography followed by PCI and in those in whom coronary anatomy was known and PCI was planned. Written informed consent was obtained from all patients, and the protocol was approved by the institutional review board at each participating institution. The primary end point was progression rate in Doppler ultrasound-determined CIMT during the 12 month follow-up. The secondary end points included the net change in CIMT from baseline to 6 and 12 months; the composite of all-cause mortality, MI, stroke, or any coronary vessel revascularization at 12-month follow-up; the composite of all cause ...
Invasive imaging procedure, used to evaluate: presence of disease in the coronary arteries, valves or aorta, heart muscle function and determine need for treatment
Prospective data suggest cardiac MRI picks up culprit lesions frequently missed by invasive angiography, with implications for patients who ultimately undergo revascularization.
October 1,2018 by Dr. Manjinder Sandhu. Blocked arteries is a heart disease indicator for which the doctors perform coronary angiography treatment, which is a test conducted to find out how much narrowing is there in your arteries. Today.... Read More ...
A brand new worldwide research discovered that whereas a brand new era of quicker computed tomography (CT) scanners simply and accurately recognized folks with blocked arteries, they werent correct sufficient in comparison with the standard coronary angiography. The research was led by senior investigator and heart specialist Dr João Lima, whos a professor of drugs…
Is PAD as prevalent in women as in men? Does CAD present differently in women and men? Is coronary angiography the most accurate diagnostic modality for women? Find answers and more details, here. 1
If serial stenoses are less than 3 vessel reference diameters apart, they should be scored as one lesion. However, stenoses at a greater distance from each other (more than 3 vessel reference diameters), are considered as separate lesions ...