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 ...
TY - JOUR. T1 - Positive predictive value of computed tomography coronary angiography in clinical practice. AU - Groothuis, J.G.J.. AU - Beek, A.M.. AU - Meijerink, M.R.. AU - Brinckman, S.L.. AU - Heijmans, M.W.. AU - van Kuijk, C.. AU - van Rossum, A.C.. PY - 2012. Y1 - 2012. N2 - Background: Several studies have investigated the diagnostic performance of computed tomography coronary angiography (CTCA) for the detection of significant coronary artery disease (CAD). These studies were performed in patients that were already referred for invasive coronary angiography (ICA) and prevalence of significant CAD was high. Although the negative predictive value of CTCA was consistently high, a wide range of positive predictive values (PPVs) was reported. Thus, the PPV of CTCA in patients that undergo CTCA as part of a clinical diagnostic evaluation remains unclear. This study investigated the PPV of CTCA for the detection of significant CAD in clinical practice. Methods: A total of 181 patients with ...
BACKGROUND: Quantitative flow ratio (QFR) is a novel diagnostic modality for functional testing of coronary artery stenosis without the use of pressure wires and induction of hyperemia. QFR is based on computation of standard invasive coronary angiographic imaging. The purpose of WIFI II (Wire-Free Functional Imaging II) was to evaluate the feasibility and diagnostic performance of QFR in unselected consecutive patients.. METHODS AND RESULTS: WIFI II was a predefined substudy to the Dan-NICAD study (Danish Study of Non-Invasive Diagnostic Testing in Coronary Artery Disease), referring 362 consecutive patients with suspected coronary artery disease on coronary computed tomographic angiography for diagnostic invasive coronary angiography. Fractional flow reserve (FFR) was measured in all segments with 30% to 90% diameter stenosis. Blinded observers calculated QFR (Medis Medical Imaging bv, The Netherlands) for comparison with FFR. FFR was measured in 292 lesions from 191 patients. Ten (5%) and 9 ...
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 ...
2020 Singapore Medical Association. All rights reserved. Computed tomography coronary angiography (CTCA) is a robust and reliable non-invasive alternative imaging modality to invasive coronary angiography, which is the reference standard in evaluating the degree of coronary artery stenosis. CTCA has high negative predictive value and can confidently exclude significant coronary artery disease (CAD) in low to intermediate risk patients. Over the years, substantial effort has been made to reduce the radiation dose and increase the cost efficiency of CTCA. In this review, we present the evolution of computed tomography scanners in the context of coronary artery imaging as well as its clinical applications and limitations. We also highlight the future directions of CTCA as a one-stop non-invasive imaging modality for anatomic and functional assessment of CAD ...
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 ...
Dual imaging stress echocardiography, combining the evaluation of wall motion and coronary flow reserve (CFR) on the left anterior descending artery (LAD), and computed tomography coronary angiography (CTCA) are established techniques for assessing prognosis in chest pain patients. In this study we compared the prognostic value of the two methods in a cohort of patients with chest pain having suspected coronary artery disease (CAD). A total of 131 patients (76 men; age 68 ± 9 years) with chest pain of unknown origin underwent dipyridamole (up to 0.84 mg/kg over 6 min) stress echo with CFR assessment of LAD by Doppler and CTCA. A CFR ≤ 1.9 was considered abnormal, while | 50% lumen diameter reduction was the criterion for significant CAD at CTCA. Of 131 patients, 34 (26%) had ischemia at stress echo (new wall motion abnormalities), and 56 (43%) had reduced CFR on LAD. Significant coronary stenosis at CTCA was found in 69 (53%) patients. Forty-six patients (84%) with abnormal CFR on LAD showed
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 - Contemporary trends in coronary intervention. T2 - A report from the registry of the society for cardiac angiography and interventions. AU - Laskey, Warren K.. AU - Kimmel, Steven. AU - Krone, Ronald J.. PY - 2000/1/17. Y1 - 2000/1/17. N2 - This report of the Registry for the Society for Cardiac Angiography and Interventions provides data on the trends in coronary interventional procedures from the time period June 1966 through December 1998. A total of 19,510 consecutive coronary interventional procedures were recorded. Over this time period, significant trends in coronary stent implantation were recorded along with a decreasing reliance on balloon angioplasty as sole therapy. Patients with acute myocardial infarction comprised an increased fraction of all procedures. Almost half of all interventions were performed in patients with multivessel disease. Finally, decreasing rates of in- hospital death and emergent bypass surgery compared to prior reports from the registry ...
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 ...
TY - JOUR. T1 - Automated Interpretation and Reporting of Coronary CT Coronary Angiography. AU - Rajiah, Prabhakar. AU - Schoenhagen, Paul. PY - 2013/6. Y1 - 2013/6. N2 - Coronary CT angiography (CTA) has become a well-accepted imaging modality in the evaluation of coronary artery disease (CAD) due to its high negative predictive value. The ability to exclude CAD in patients presenting with chest pain in a low to intermediate risk population makes it very useful in emergency departments for optimizing resource utilization and reducing expenditure. The limited availability of trained cardiac imagers is a potential obstacle in implementing this strategy. Towards the goal of prompt and accurate interpretation of coronary CTA, there has been a recent interest in the development of automated coronary CTA interpretation and reporting. This article aims to review the current applications and scientific evidence on the utility of automated techniques for interpretation and reporting of coronary ...
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 ...
TY - JOUR. T1 - Impact of contrast agent type (ionic versus nonionic) used for coronary angiography on angiographic, electrocardiographic, and clinical outcomes following thrombolytic administration in acute myocardial infarction. AU - Michael Gibson, C.. AU - Kirtane, Ajay J.. AU - Murphy, Sabina A.. AU - Marble, Susan J.. AU - de Lemos, James A. AU - Antman, Elliot M.. AU - Braunwald, Eugene. PY - 2001/5/16. Y1 - 2001/5/16. N2 - The goal of this study was to examine the relationship between contrast agent type (ionic vs. nonionic) and angiographic, electrocardiographic, and clinical outcomes after thrombolytic administration. Ionic or nonionic contrast agents were selected in a nonrandomized fashion for 90-min angiography and percutaneous coronary intervention (PCI) following thrombolytic administration in the TIMI 14 trial [tissue plasminogen activator (tPA) or reteplase (rPA) vs. low-dose lytic + abciximab]. There was no relationship between contrast agent type and overall patency, rate of ...
High coronary calcium score and post-procedural CK-MB are noninvasive predictors of coronary stent restenosis Jae-Beom Lee,1 Yun-Seok Choi,2 Woo-Baek Chung,2 Ami Kwon,2 Chul-Soo Park,2 Man-Young Lee2 1Anyang Sam Hospital, 2Division of Cardiology, Department of Internal Medicine, Youido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Purpose: High coronary calcium score (CCS) and post-procedural cardiac enzyme may be related with poor outcomes in patients with coronary stent implantation. Methods: A total of 1,072 patients (63.2% male, mean age: 61.7±10.3 years) who underwent coronary multi-detect computed tomography at index procedure and follow-up coronary angiography (CAG) after drug-eluting stent (DES) were divided into two groups: those with and without target lesion revascularization (TLR; >50% reduction in luminal stent diameter or angina symptoms on follow-up CAG). The CCSs for predicting stent revascularization were elucidated. Results:
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.
TY - GEN. T1 - Feature-based non-rigid volume registration of serial coronary CT angiography. AU - Woo, Jonghye. AU - Hong, Byung Woo. AU - Dey, Damini. AU - Cheng, Victor. AU - Ramesh, Amit. AU - Sundaramoorthi, Ganesh. AU - Kuo, C. C.Jay. AU - Berman, Daniel S.. AU - Germano, Guido. AU - Slomka, Piotr J.. PY - 2009/12/15. Y1 - 2009/12/15. N2 - Coronary CT angiography (CTA) with multi-slice helical scanners is becoming the integral part of major diagnostic pathways for coronary artery disease. In addition, coronary CTA has demonstrated substantial potential in quantitative coronary plaque characterization. If serial comparisons of plaque progression or regression are to be made, accurate 3D volume registration of these volumes would be particularly useful. In this work, we propose a coronary CTA volume registration of the paired coronary CTA scans using feature-based non-rigid volume registration. We achieve this with a combined registration strategy, which uses the global rigid registration as ...
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TY - JOUR. T1 - Long-term prognostic utility of computed tomography coronary angiography in older populations. AU - Gnanenthiran, Sonali R.. AU - Naoum, Christopher. AU - Leipsic, Jonathon A.. AU - Achenbach, Stephan. AU - Al-Mallah, Mouaz H.. AU - Andreini, Daniele. AU - Bax, Jeroen J.. AU - Berman, Daniel S.. AU - Budoff, Matthew J.. AU - Cademartiri, Filippo. AU - Callister, Tracy Q.. AU - Chang, Hyuk Jae. AU - Chinnaiyan, Kavitha. AU - Chow, Benjamin J.W.. AU - Cury, Ricardo C.. AU - Delago, Augustin. AU - Feuchtner, Gudrun. AU - Hadamitzky, Martin. AU - Hausleiter, Joerg. AU - Kaufman, Philipp A.. AU - Kim, Yong Jin. AU - Maffei, Erica. AU - Marques, Hugo. AU - De Araújo Goncalves, Pedro. AU - Pontone, Gianluca. AU - Raff, Gilbert L.. AU - Rubinshtein, Ronen. AU - Shaw, Leslee J.. AU - Villines, Todd C.. AU - Gransar, Heidi. AU - Lu, Yao. AU - Jones, Erica C.. AU - Penã, Jessica M.. AU - Lin, Fay Y.. AU - Kritharides, Leonard. AU - Min, James K.. PY - 2019/11/1. Y1 - 2019/11/1. N2 - Aims: ...
Evidence-based recommendations on QAngio XA 3D QFR and CAAS vFFR imaging software for assessing coronary stenosis during invasive coronary angiography
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 ...
Objectives: To evaluate the diagnostic and prognostic benefits of CT coronary angiography (CTCA) using the 2016 National Institute for Health and Care Excellence (NICE) guidelines for the assessment of suspected stable angina. Methods: Post hoc analysis of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial of 4146 participants with suspected angina randomised to CTCA. Patients were dichotomised into NICE guideline-defined possible angina and non-anginal presentations. Primary (diagnostic) endpoint was diagnostic certainty of angina at 6 weeks and prognostic endpoint comprised fatal and non-fatal myocardial infarction (MI). Results: In 3770 eligible participants, CTCA increased diagnostic certainty more in those with possible angina (relative risk (RR) 2.22 (95% CI 1.91 to 2.60), p,0.001) than those with non-anginal symptoms (RR 1.30 (1.11 to 1.53), p=0.002; pinteraction ,0.001). In the possible angina cohort, CTCA did not change rates of invasive angiography (p=0.481) but markedly ...
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,
TY - JOUR. T1 - Likelihood of obstructive coronary disease in metabolic syndrome patients with abnormal stress echocardiography. AU - Al Badarin, Firas J.. AU - From, Aaron M.. AU - McCully, Robert B.. AU - Lopez-Jimenez, Francisco. PY - 2011/10/20. Y1 - 2011/10/20. N2 - Background: Metabolic syndrome (MetSx) encompasses several risk factors for macrovascular coronary artery disease. An association between MetSx and coronary syndrome X has also been reported, suggesting that patients with MetSx are more likely to have endothelial dysfunction in the setting of angiographically normal coronary arteries. It remains unknown whether MetSx patients with abnormal stress echocardiography (SE) are more likely to have obstructive coronary disease (CAD) compared to patients without MetSx. Methods: We identified symptomatic patients without known CAD and abnormal SE who underwent coronary angiography within 4 weeks after the SE. Patients were grouped according to their MetSx and impaired fasting glucose ...
TY - JOUR. T1 - Metabolic syndrome and angiographic coronary artery disease prevalence in association with the framingham risk score. AU - Konstantinou, Dimitris M.. AU - Chatzizisis, Yiannis S.. AU - Louridas, George E.. AU - Giannoglou, George D.. PY - 2010/6/1. Y1 - 2010/6/1. N2 - Background: The association of metabolic syndrome with coronary artery disease (CAD) has been studied extensively. However, little is known about the effect of Framingham risk score (FRS) and metabolic syndrome components on the association of metabolic syndrome with angiographically significant CAD. Our aim was to investigate whether that relationship is influenced by individuals 10-year CAD risk profile as assessed by FRS. Furthermore, we sought to elucidate whether metabolic syndrome is associated with angiographically significant CAD independently of its individual components. Methods: We studied a consecutive sample of 150 patients undergoing coronary angiography for the evaluation of chest pain. Metabolic ...
TY - JOUR. T1 - Internal pudendal artery stenoses and erectile dysfunction. T2 - Correlation with angiographic coronary artery disease. AU - Rogers, Jason H. AU - Karimi, Houshang. AU - Kao, John. AU - Link, Daniel P. AU - Javidan, Javid. AU - Yamasaki, Dwayne S.. AU - Dolan, Mark. AU - Laird, John R.. AU - Low, Reginald. PY - 2010/11/15. Y1 - 2010/11/15. N2 - Objectives: To describe the angiographic characteristics of pelvic arterial disease in patients with erectile dysfunction (ED) nonresponsive to phosphodiesterase-5 inhibitors (PDE5i) and suspected coronary artery disease (CAD). Background: ED and CAD share common risk factors which can result in endothelial dysfunction, atherosclerosis and flow-limiting stenoses in the coronary and internal pudendal arteries. Methods: Ten patients undergoing cardiac catheterization with ED and a history of unsatisfactory response to a PDE5i were studied. ED severity was quantified using the International Index of ED scoring system. We performed angiography ...
OBJECTIVES: This study sought to ascertain the relationship of 9p21 locus with: 1) angiographic coronary artery disease (CAD) burden; and 2) myocardial infarction (MI) in individuals with underlying CAD. BACKGROUND: Chromosome 9p21 variants have been robustly associated with coronary heart disease, but questions remain on the mechanism of risk, specifically whether the locus contributes to coronary atheroma burden or plaque instability. METHODS: We established a collaboration of 21 studies consisting of 33,673 subjects with information on both CAD (clinical or angiographic) and MI status along with 9p21 genotype. Tabular data are provided for each cohort on the presence and burden of angiographic CAD, MI cases with underlying CAD, and the diabetic status of all subjects. RESULTS: We first confirmed an association between 9p21 and CAD with angiographically defined cases and control subjects (pooled odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.20 to 1.43). Among subjects with angiographic CAD (n
BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients). Anatomic complexity was assessed at the sites and defined by a Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score of 32 or lower (the SYNTAX score reflects a comprehensive angiographic assessment of the coronary vasculature, with 0 as the lowest score and higher scores [no upper limit] indicating more complex coronary anatomy). The primary end point was
We have developed a novel approach that allows rapid computation of FFR during diagnostic coronary angiography. In the study population of 73 patients with intermediate coronary lesions in 84 vessels, the QFR showed good agreement with the pressure wire-determined standard FFR measurements. The agreement was particularly favorable with QFR derived from contrast-flow (cQFR) and adenosine-flow models (aQFR), which both incorporated patient-specific flow by frame count analysis. Positive and negative likelihood ratios were of diagnostic value for use in the individual patient with cQFR and aQFR, although the positive likelihood ratio was of insufficient diagnostic value to be clinically useful with fQFR and a DS% of ≥50% (21).. In this study, the vessel-based diagnostic accuracy for determining the functional significance of an intermediate stenosis (i.e., FFR ≤ 0.80) was only 65%, if based on a single 3D QCA anatomic parameter of diameter stenosis of ≥50%. This is in line with a recent study ...
TY - JOUR. T1 - Noninvasive visualization of the left main coronary artery by cross sectional echocardiography. AU - Weyman, A. E.. AU - Feigenbaum, Harvey. AU - Dillon, J. C.. AU - Johnston, K. W.. AU - Eggleton, R. C.. PY - 1976. Y1 - 1976. N2 - Real time cross sectional echocardiographic studies of the left main coronary artery (LMCA) were performed in 15 normal patients, 15 patients with angiographically proven coronary artery disease but normal left main coronary segments, three patients with greater than 75% obstruction of the left main coronary artery, and one patient with a large aneurysm of the left main coronary artery. In normal subjects the LMCA evaginates from the inferolateral wall of the aorta. The artery appears as two dominant parallel linear echoes separated by a clear space representing the lumen of the vessel. The LMCA courses beneath the right ventricular outflow tract and can generally be followed to its expected point of bifurcation. Confirmation that this structure was in ...
BACKGROUND: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease.. OBJECTIVES: The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS.. METHODS: The VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial (NCT02061891) evaluated the outcome of patients with confirmed NSTEACS randomized 1:1 to very early (within 12 h) or standard (48 to 72 h) invasive coronary angiography (ICA). As an observational component of the trial, a clinically blinded coronary CTA was conducted prior to ICA in both groups. The primary endpoint was the ability of coronary CTA to rule out coronary artery stenosis (≥50% stenosis) in the entire population, expressed as the negative predictive value (NPV), using ICA as ...
BACKGROUND: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease.. OBJECTIVES: The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS.. METHODS: The VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial (NCT02061891) evaluated the outcome of patients with confirmed NSTEACS randomized 1:1 to very early (within 12 h) or standard (48 to 72 h) invasive coronary angiography (ICA). As an observational component of the trial, a clinically blinded coronary CTA was conducted prior to ICA in both groups. The primary endpoint was the ability of coronary CTA to rule out coronary artery stenosis (≥50% stenosis) in the entire population, expressed as the negative predictive value (NPV), using ICA as ...
Background: Coronary artery disease is sometimes associated with chronic conduction block. Our aim is to correlate between chronic conduction block and coronary artery disease. We performed ECG and coronary angiography of all patients who were admitted for permanent pacemaker implantation to find correlation between them. Methods: Coronary angiography was performed in all 160 patients of chronic conduction block during twenty four months of study period who were admitted for pacemaker implantation. We compared the coronary artery disease in different types of conduction block. Results: Among the study population 35(22%) patients are of single vessel coronary artery disease (CAD),13 (8%) patients had double vessel coronary artery disease, 6 (4%) patients had triple vessel coronary artery disease, 2 (1%) patients had left main disease and 104 (65%) patients had normal or insignificant coronary anatomy. Conclusion: Coronary artery disease is quite common in chronic conduction disorder. So there ...
Endogenous oxidative DNA damage is caused by multiple endogenous and exogenous factors. It is not completely known whether coronary angiography has an effect on DNA damage. The aim of this study was to investigate whether coronary angiography causes oxidative DNA damage. Fifty-four patients who underwent elective coronary angiography for diagnostic purpose were enrolled to the study. For each subject, the frequency of oxidative DNA damage was analyzed by using the comet assay, which is a sensitive biomarker of DNA damage, before and after diagnostic procedures. A highly significant increase of DNA damage mean score was observed in all patients after the coronary angiography procedure (p < 0.001). No significant associations were found between the change in oxidative DNA damage and dose of contrast media and radiation exposure time. A significant correlation was observed between the change of DNA damage and age, hyperlipidemia, hypertension, smoking, Gensini score index, and vitamin B,2 (r = ...
Background and Purpose: Acute myocardial infarction(AMI) occurs in 1-2% of patients treated with carotid artery stenting(CAS), and is considered as one of the most serious perioperative complication. We assessed coronary artery stenosis in patients treated with CAS using coronary CTA or coronary angiography.. Methods: Consecutive sixty-two patients (47 men, mean age 73.4 years) treated with CAS were examined by coronary CTA or angiography within 3 months before CAS between January 2010 and August 2012. In patients suspected coronary artery stenosis by coronary CTA, coronary angiography was performed. Significantly coronary artery stenosis was defined as that greater than 75%.. Results: CAS was performed in 62 patients, and coronary artery was evaluated in 57 patients. Patients with allergic reaction for contrast agents, renal failure, and poor general condition were excluded from this study. Thirty-eight patients had significant coronary artery stenosis. Twenty-nine of them had any history of ...
Definition of Left main coronary artery in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is Left main coronary artery? Meaning of Left main coronary artery as a legal term. What does Left main coronary artery mean in law?
The role of vaspin in the pathogenesis of stable coronary artery disease (SCAD) have been repeatedly addressed in clinical studies. However, from the point of view of clinical practice, the results of earlier studies are still inconclusive. The data of 106 SCAD patients who received coronary angiography and 85 coronary artery disease-free controls were collected and analysed. The patients were divided into subgroups according to their pre-test probability (PTP) and according to the result of coronary angiography. Fasting vaspin concentrations were compared between subgroups of SCAD patients and between target group and controls. The effect of age and smoking on the result of coronary angiography was compared to the effect of vaspin using the binomial regression. We did not find significant difference in vaspin level between target group and controls. Unless the pre-test probability was taken into account, we did not find vaspin difference in the target group, when dividing patients on the basis of
Background: Although a shorter hemostasis duration would be expected when compared with the conventional radial approach as the diameter of the distal radial artery is smaller than that of the conventional radial artery, the optimal duration of hemostasis in diagnostic coronary angiography (CAG) via the distal radial approach, termed the snuffbox approach, has not been well investigated. Methods: Data from 171 patients were retrospectively collected (55 and 116 patients in the 4-French [Fr] and 5-Fr sheath groups, respectively). The patients had suspected myocardial ischemia and were undergoing diagnostic CAG via the snuffbox approach at a single center between January 2019 and August 2019. Results: The mean age of the study population was 67.6 ± 11.0 years, and 69% were male. The left snuffbox approach was performed in 146 (85.4%) patients. The mean snuffbox puncture time, defined as the time interval between local anesthesia and sheath cannulation, was 145.1 ± 120.8 s. The hemostasis ...
Background The dimensions of the coronary arteries have been shown to vary among ethnic groups. There are no data available regarding the normal size of coronary arteries in Iranians. This study aimed to investigate normal coronary artery dimensions in a Northwestern Iranian population and to compare it with pooled data of Indo-Asians and Caucasians in previous studies. Methods The study included 200 adults with suspected coronary disease who were referred for elective coronary angiography between June 2012 and March 2013 and were found to have normal epicardial flow in the coronary arteries. Quantitative coronary angiography was carried out on the longest atheroma-free part of the proximal segment of each coronary artery in all patients. Two Indo-Asian and Caucasian groups were selected and pooled for comparison with the available reports on individuals without coronary artery disease. Results The mean diameters of the left main coronary artery, proximal left anterior descending artery, ...
BACKGROUND: Adverse cardiac event rates are higher for percutaneous coronary intervention (PCI) of bifurcation lesions. Currently, provisional stenting or a simple stenting strategy is the standard treatment for bifurcated lesions, but its performance remains limited because of a risk of side-branch (SB) closure and a higher rate of target lesion revascularization (TLR). We report a new provisional side-branch stenting strategy to treat coronary bifurcation lesions using a balloon-stent kissing technique (BSKT).. METHODS: From January 2011 to December 2012, a total of 60 patients with 60 bifurcation lesions underwent PCI using BSKT. Baseline and postprocedural quantitative coronary angiography (QCA) analyses were performed. Procedural and immediate clinical outcomes were reviewed.. RESULTS: The majority of patients presented with acute coronary syndrome (98%) and had true bifurcation lesions (98%). TIMI-3 flow was established in 100% of the main branch and SB lesions. QCA revealed preservation ...
Background: The aim of our study is to determine the incidence of single coronary artery (SCA). SCA is a rarely seen coronary anomaly in which the right coronary artery and the left main coronary artery arise from single aortic sinus. Although SCA has a benign course in most cases and its clinical significance is unknown, in some autopsy studies it was shown to be related to sudden cardiac death.. Materials and methods: SCA patients detected among 215,140 coronary angiographies (CAG) performed between 1998 and 2013 in SANKO Hospital were included in our study. The classification of CAG was made according to the two different classifications defined by Smith and Lipton and colleagues.. Results: A total number of 215,140 patients who underwent routine CAG were included in the study, and SCA was detected in 67 (0.031%) patients. There were 6 (9%) type R-I, 23 (34%) type R-II, 10 (15%) type R-III, 16 (24%) type L-I and 12 (18%) type L-II patients according to the angiographic ...
TY - JOUR. T1 - Variation among cardiologists in the utilization of right heart catheterization at time of coronary angiography. AU - Malone, Michael L.. AU - Bajwa, Tanvir K.. AU - Battiola, Richard J.. AU - Fortsas, Michael. AU - Aman, Saleem. AU - Solomon, David J.. AU - Goodwin, James S.. PY - 1996/2. Y1 - 1996/2. N2 - To describe how often a right heart catheterization was performed at the time of coronary angiography, the patient characteristics that predicted the use of this procedure, and the variation among cardiologists in the use of this test, we reviewed all cases of coronary angiography (n = 1,282) during the first 2 mo of 1993 at two large community hospitals. Fifty-two percent of the cases received a right heart catheterization at the time of their coronary angiography. The following characteristics were associated with the receipt of a right heart catheterization in a logistic regression analysis: cardiomyopathy (odds ratio = 2.59, 95% Cl = 1.01, 6.62), congestive heart failure ...
LMT compression may occur in patients with PAH with severely dilated PAs and can be identified with either computed tomographic coronary angiography or selective coronary angiography (1). There are several reports of the safety of stent implantation and resolution of typical angina in such patients (1,2). In patients with LMT compression, atypical symptoms, and no evidence of rest ischemia, further testing is warranted to assess the physiological significance of the stenosis. This is relevant in this context because coronary blood flow and subendocardial perfusion are diastolic events (3,4), and LMT compression from an enlarged PA is a systolic event; hence, not all such lesions lead to ischemia. Exercise stress testing is relatively contraindicated in patients with severe PAH, and vasodilator stress nuclear testing may miss global ischemia in patients with left main disease. Thus, instantaneous wave-free ratio and fractional flow reserve are best suited for evaluating stenosis significance in ...
BACKGROUND: Conventional coronary angiography (CA) is still recommended before valvular surgery. Preliminary studies suggest that multislice spiral computed tomography coronary angiography (MSCT-CA) can be used to rule out coronary artery disease (CAD). AIM: To assess prospectively the safety of ruling out CAD before surgery solely on the basis of normal MSCT-CA in patients with severe aortic valve disease. METHODS: We included all consecutive patients scheduled for aortic valve surgery. We first estimated the calcium score (Agatston score equivalent [ASE]). Patients underwent injected MSCT if the ASE was|1000. CA was cancelled when MSCT-CA quality was sufficient and showed no significant CAD. Our primary endpoint was the occurrence of perioperative myocardial infarction in patients who underwent surgery with no prior CA. RESULTS: Between 1st July 2005 and 30th June 2008, we included 199 patients with severe aortic valve disease: 118 men (59%); mean age 69+/-12 years; 63 patients (32%) underwent CA
TY - JOUR. T1 - Sequential follow-up results of catheter intervention for coronary artery lesions after Kawasaki disease. T2 - Quantitative coronary artery angiography and intravascular ultrasound imaging study. AU - Ishii, Masahiro. AU - Ueno, Takafumi. AU - Ikeda, Hisao. AU - Iemura, Motofumi. AU - Sugimura, Tetsu. AU - Furui, Jun. AU - Sugahara, Yoko. AU - Muta, Hiromi. AU - Akagi, Teiji. AU - Nomura, Yuichi. AU - Homma, Tomoki. AU - Yokoi, Hiroyoshi. AU - Nobuyoshi, Masakiyo. AU - Matsuishi, Toyojiro. AU - Kato, Hirohisa. PY - 2002/6/25. Y1 - 2002/6/25. N2 - Background - The purpose of this study was to assess the sequential follow-up results of catheter intervention in Kawasaki disease by use of quantitative coronary angiography (QCA) and intravascular ultrasound imaging. Methods and Results - Catheter intervention was performed on 23 stenotic lesions in 22 patients (aged 2 to 24 years). Percutaneous balloon angioplasty (PBA) was performed in 4 patients, stent implantation in 7, ...
Quantitation of coronary luminal diameter with a 20 MHz mechanically rotating intravascular ultrasound (IVUS) catheter was compared with orthogonal-view cineangiography by use of a semiautomated edge-detection algorithm in 48 patients undergoing coronary angioplasty. Quantitative comparison of 196 matched segments was attempted, but in only 174 (88.8%) was a direct comparison of the two techniques possible. In angiographically normal coronary arteries (46 segments) the correlation between the values obtained by quantitative coronary angiography (QCA) and those achieved by IVUS was excellent (r = 0.92, p , 0.0001). For mild stenoses (80 segments) the correlation coefficient was only fair (r = 0.467, p , 0.001). After percutaneous transluminal coronary angioplasty the correlation coefficient between IVUS and QCA data (48 segments) was very weak (r = 0.282, p , 0.05). In conclusion, coronary IVUS is feasible and safe and even for a limited range of coronary arterial narrowing, significant ...
AIMS:. To investigate whether the use of intravascular ultrasound virtual histology (IVUS-VH) leads to any improvements in stent deployment, when performed in patients considered to have had an optimal percutaneous coronary intervention (PCI) by quantitative coronary angiography (QCA).. METHODS AND RESULTS:. After optimal PCI result (residual stenosis by QCA,30%), IVUS-VH was performed in 100 patients by protocol, with the option to use the information left to the discretion of the operators. Patients were categorised as: Group1 (n=54), where the IVUS-VH findings were used to evaluate the need for further optimisation of the stent deployment; and Group2 (n=46), where the IVUS-VH was documentary such that the stenting results were considered optimal according to QCA. Optimal stent deployment on IVUS-VH was defined as: normal stent expansion, absence of stent malapposition, complete lesion coverage as indicated by a plaque burden (PB%) between 30-40% and necrotic core confluent to the lumen,10% or ...
Unhealthy lifestyle factors such as smoking, obesity, inactivity and type 2 diabetes are endemic in the Middle East. The public health consequences might be detrimental; however, local studies on risk factors for coronary artery disease (CAD) are scarce. Patients referred for coronary angiography at a tertiary hospital in Amman, Jordan, between January and December 2015, were included in this study. Risk factors for CAD were assessed in a multivariate logistic regression model, and presented as odds ratio (OR) with 95% confidence interval (CI). Among 557 participants, 356 (63.9%) had CAD and 201 (36.1%) had a normal cardiogram. The majority (n = 395, 70.9%) were male, and median age was 55 years (interquartile range 47-64). Two-hundred-and-fifteen (38.6%) individuals reported previous diabetes, and 287 (51.5%) were current or previous smokers. In multivariate analysis, male gender (OR 3.7, 95% CI 2.3-6.0), age (45-54 years: OR 4.8, 95% CI 2.7-8.5; 55-64 years: OR 6.0, 95% CI 3.2-11.4; ≥65 years: OR 15
OBJECTIVES: The aim of the present study was to evaluate, in low-to-intermediate pre-test probability patients who were referred for coronary computed tomography angiography (CTA) and did not show obstructive coronary artery disease (CAD), whether an intramural course of a coronary artery is associated with worse outcome compared with patients without an intramural course of the coronary arteries. BACKGROUND: The prognostic value of an intramural course of the coronary arteries on coronary CTA in patients without obstructive CAD is not well-known. METHODS: The study population consisted of 947 patients with a low-to-intermediate pre-test probability who were referred for coronary CTA and who did not have obstructive CAD. During follow-up, the occurrence of unstable angina pectoris that required hospitalization, nonfatal myocardial infarction, and all-cause mortality was evaluated. Results : On coronary CTA, 210 patients (22%) had an intramural course of a coronary artery. The median depth of the ...
Background: Renal insufficiency plays a critical role in the pathogenesis of ischemic heart disease. The aim of the present study was to investigate the prevalence of renal dysfunction and its impact on prognosis in patients with left main coronary artery disease (LMCAD) and stable angina pectoris. Methods and Results: A total of 626 consecutive patients with significant coronary artery stenosis were enrolled. Renal insufficiency was graded using estimated glomerular filtration rate (eGFR) before coronary angiography. Chronic kidney disease (CKD) was defined as eGFR ...
Blockages prevent your heart from getting oxygen and important nutrients. This procedure is used to diagnose coronary heart disease and coronary microvascular disease after chest pain, sudden cardiac arrest, or abnormal results from tests such as an electrocardiogram (EKG) of the heart or an exercise stress test. It is important to detect blockages because over time they can cause chest pain, especially with physical activity or stress, or a heart attack. If you are having a heart attack, coronary angiography can help your doctors plan your treatment.. Cardiologists, or doctors who specialize in the heart, will perform coronary angiography in a hospital or specialized laboratory. You will stay awake so you can follow your doctors instructions, but you will get medicine to relax you during the procedure. You will lie on your back on a movable table. Often, coronary angiography is done with a cardiac catheterization procedure. For this, your doctor will clean and numb an area on the arm, groin or ...
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TY - JOUR. T1 - Feasibility of an automatic computer-assisted algorithm for the detection of significant coronary artery disease in patients presenting with acute chest pain. AU - Kang, Ki Woon. AU - Chang, Hyuk Jae. AU - Shim, Hackjoon. AU - Kim, Young Jin. AU - Choi, Byoung Wook. AU - Yang, Woo In. AU - Shim, Jee Young. AU - Ha, Jongwon. AU - Chung, Namsik. N1 - Funding Information: This work was supported by Industrial Strategic Technology Development Program, 10038419, Intelligent Image Diagnosis and Therapy-support System funded by the Ministry of Knowledge Economy (MKE, Republic of Korea).. PY - 2012/4. Y1 - 2012/4. N2 - Automatic computer-assisted detection (auto-CAD) of significant coronary artery disease (CAD) in coronary computed tomography angiography (cCTA) has been shown to have relatively high accuracy. However, to date, scarce data are available regarding the performance of auto-CAD in the setting of acute chest pain. This study sought to demonstrate the feasibility of an auto-CAD ...
In the past, two reliable methods leading to improvements in the accuracy of coronary angiography have been introduced. Interestingly, we demonstrated the first practical experience with intracoronary ultrasound more than a decade ago [5]. Since that time, virtual histology and optical coherence tomography have significantly improved our options for evaluation of coronary anatomy. Moreover, several studies have demonstrated that intravascular ultrasound guided interventions resulted in a reduced incidence of adverse clinical outcomes, especially in patients with proximal stenoses (left main coronary artery or proximal bifurcation lesions) [6]. On the other hand, evaluation of coronary anatomy and accurate morphology of coronary lesions have certain limitations, both with regard to hemodynamic significance and assessing the extent of ischemic myocardium, which is probably the key to choosing an optimal therapy. The only way currently to easily establish the hemodynamic significance of a ...
TY - JOUR. T1 - Usefulness of myocardial perfusion echocardiography to identify obstructive coronary artery disease in patients with abnormal ventricular septal motion. AU - Spevack, Daniel M.. AU - Shoyeb, Abu. AU - Yoon, Andrew J.. AU - Gordon, Garet M.. AU - Matros, Todd. AU - Reynolds, Harmony A.. AU - Shah, Alan. AU - Tunick, Paul A.. AU - Kronzon, Itzhak. PY - 2005/4/1. Y1 - 2005/4/1. N2 - Twenty-three patients who had septal wall motion abnormalities and who underwent angiography within 2 weeks were evaluated by myocardial perfusion echocardiography. Mean perfusion score (plateau video intensity times the wash-in rate) was lower in segments that were supplied by obstructed coronary arteries in real time (7.5 vs 22.6 dB/s, p ,0.005) and with end-systolic triggering (8.6 vs 20.9 dB/s, p ,0.001). Lower mean septal perfusion scores (,12 dB/s) were seen in 14 of 16 patients who had obstructive septal coronary artery disease, and normal mean septal perfusion scores were seen in 6 of 7 patients ...
Recent evidence suggests that higher restenosis rate is observed after coronary angioplasty of an infarct-related artery. Furthermore, angiographic restenosis seems associated with a deterioration of left ventricular function at follow-up. The aim of this study was to assess the acute results and angiographic restenosis following coronary artery stenting of infarct-related (Group 1) and non infarct-related coronary arteries (Group 2). We retrospectively analyzed the results of 381 consecutive patients treated with Palmaz-Schatz coronary stent implantation between May 1992 and January 1996. Stenting of the infarct-related artery was performed in 154 patients (Group 1), while 227 patients (Group 2) received stenting of the non infarct-related artery. Both groups had similar age, gender, clinical conditions and coronary angiographic pattern. There were no significant differences between groups, concerning type of stented coronary vessel (left anterior descending-LAD 52.4% vs non-LAD 47.6%, Group 1, ...
Health, ...23 May 2013 Paris France: Routinely measuring fractional flow reserv...The RIPCORD (Does routine pressure wire assessment influence managemen... Angiographic assessment of chest pain is flawed because it doesn...He explained that ischaemia is the most important determinant of clini...,Diagnostic,coronary,angiography:,Functional,flow,reserve,changes,decisions,in,25,percent,of,cases,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Hazy filling defect on coronary angiography: insights from optical coherence tomography Other Refereed Contribution to Refereed Journals ...
TY - JOUR. T1 - Prognostic value of combined CT angiography and myocardial perfusion imaging versus invasive coronary angiography and nuclear stress perfusion imaging in the prediction of major adverse cardiovascular events. T2 - The CORE320 multicenter study. AU - CORE320 Investigators. AU - Chen, Marcus Y.. AU - Rochitte, Carlos E.. AU - Arbab-Zadeh, Armin. AU - Dewey, Marc. AU - George, Richard T.. AU - Miller, Julie M.. AU - Niinuma, Hiroyuki. AU - Yoshioka, Kunihiro. AU - Kitagawa, Kakuya. AU - Sakuma, Hajime. AU - Laham, Roger. AU - Vavere, Andrea L.. AU - Cerci, Rodrigo J.. AU - Mehra, Vishal C.. AU - Nomura, Cesar. AU - Kofoed, Klaus F.. AU - Jinzaki, Masahiro. AU - Kuribayashi, Sachio. AU - Scholte, Arthur J.. AU - Laule, Michael. AU - Tan, Swee Yaw. AU - Hoe, John. AU - Paul, Narinder. AU - Rybicki, Frank J.. AU - Brinker, Jeffrey A.. AU - Arai, Andrew E.. AU - Matheson, Matthew B.. AU - Cox, Christopher. AU - Clouse, Melvin E.. AU - Di Carli, Marcelo F.. AU - Lima, João A.C.. N1 - ...
Left main coronary artery (LMCA) disease has been reported in up to 10% of all patients with coronary artery disease (CAD) and in the majority of cases are associated with severe three-vessel CAD. Among patients with chronic coronary syndrome revascularization of significant LMCA disease improves prognosis, while there is a debate about which revascularization strategy, CABG surgery or percutaneous coronary interventions to use. We do a review of the available evidence about the impact of LMCA lesions on patient prognosis according to CAD extension and clinical presentation, the outcome after percutaneous or surgical revascularization, the procedural challenges of LMCA PCI and the available armamentarium to optimally treat this relevant population.. ...