Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.
Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called ENDARTERECTOMY.
The veins and arteries of the HEART.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
The circulation of blood through the CORONARY VESSELS of the HEART.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Narrowing or constriction of a coronary artery.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
A technique utilizing a laser coupled to a catheter which is used in the dilatation of occluded blood vessels. This includes laser thermal angioplasty where the laser energy heats up a metal tip, and direct laser angioplasty where the laser energy directly ablates the occlusion. One form of the latter approach uses an EXCIMER LASER which creates microscopically precise cuts without thermal injury. When laser angioplasty is performed in combination with balloon angioplasty it is called laser-assisted balloon angioplasty (ANGIOPLASTY, BALLOON, LASER-ASSISTED).
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
The return of a sign, symptom, or disease after a remission.
Techniques using laser energy in combination with a balloon catheter to perform angioplasty. These procedures can take several forms including: 1, laser fiber delivering the energy while the inflated balloon centers the fiber and occludes the blood flow; 2, balloon angioplasty immediately following laser angioplasty; or 3, laser energy transmitted through angioplasty balloons that contain an internal fiber.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
Spasm of the large- or medium-sized coronary arteries.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.
Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.
A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Use of a balloon catheter for dilation of an occluded artery. It is used in treatment of arterial occlusive diseases, including renal artery stenosis and arterial occlusions in the leg. For the specific technique of BALLOON DILATION in coronary arteries, ANGIOPLASTY, BALLOON, CORONARY is available.
Pathologic deposition of calcium salts in tissues.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Elements of limited time intervals, contributing to particular results or situations.
The condition of an anatomical structure's being constricted beyond normal dimensions.
Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.
The degree to which BLOOD VESSELS are not blocked or obstructed.
The main artery of the thigh, a continuation of the external iliac artery.
Motion pictures of the passage of contrast medium through blood vessels.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
Obstruction of flow in biological or prosthetic vascular grafts.
The hospital unit in which patients with acute cardiac disorders receive intensive care.
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
A condition that is caused by recurring atheroembolism in the lower extremities. It is characterized by cyanotic discoloration of the toes, usually the first, fourth, and fifth toes. Discoloration may extend to the lateral aspect of the foot. Despite the gangrene-like appearance, blue toes may respond to conservative therapy without amputation.
The vein which drains the foot and leg.
Radiography of blood vessels after injection of a contrast medium.
Hospitals organized and controlled by a group of physicians who practice together and provide each other with mutual support.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
Endoscopic examination, therapy or surgery performed on the interior of blood vessels.
Lack of perfusion in the EXTREMITIES resulting from atherosclerosis. It is characterized by INTERMITTENT CLAUDICATION, and an ANKLE BRACHIAL INDEX of 0.9 or less.
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
The continuation of the femoral artery coursing through the popliteal fossa; it divides into the anterior and posterior tibial arteries.
Lesions formed within the walls of ARTERIES.
Pathological processes which result in the partial or complete obstruction of ARTERIES. They are characterized by greatly reduced or absence of blood flow through these vessels. They are also known as arterial insufficiency.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
The region of the lower limb in animals, extending from the gluteal region to the FOOT, and including the BUTTOCKS; HIP; and LEG.
The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
The hollow, muscular organ that maintains the circulation of the blood.
Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART.
The period following a surgical operation.
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.
Analyses for a specific enzyme activity, or of the level of a specific enzyme that is used to assess health and disease risk, for early detection of disease or disease prediction, diagnosis, and change in disease status.
An alternative to amputation in patients with neoplasms, ischemia, fractures, and other limb-threatening conditions. Generally, sophisticated surgical procedures such as vascular surgery and reconstruction are used to salvage diseased limbs.
Drugs used to cause dilation of the blood vessels.
Methods of creating machines and devices.
Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.
The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina.
A symptom complex characterized by pain and weakness in SKELETAL MUSCLE group associated with exercise, such as leg pain and weakness brought on by walking. Such muscle limpness disappears after a brief rest and is often relates to arterial STENOSIS; muscle ISCHEMIA; and accumulation of LACTATE.
A clinically significant reduction in blood supply to the BRAIN STEM and CEREBELLUM (i.e., VERTEBROBASILAR INSUFFICIENCY) resulting from reversal of blood flow through the VERTEBRAL ARTERY from occlusion or stenosis of the proximal subclavian or brachiocephalic artery. Common symptoms include VERTIGO; SYNCOPE; and INTERMITTENT CLAUDICATION of the involved upper extremity. Subclavian steal may also occur in asymptomatic individuals. (From J Cardiovasc Surg 1994;35(1):11-4; Acta Neurol Scand 1994;90(3):174-8)
The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful.
The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
A technique for assisting the circulation by decreasing the afterload of the left ventricle and augmenting the diastolic pressure. It may be achieved by intra-aortic balloon, or by implanting a special pumping device in the chest, or externally by applying a negative pressure to the lower extremities during cardiac systole.
The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.
Thickening and loss of elasticity of the walls of ARTERIES of all sizes. There are many forms classified by the types of lesions and arteries involved, such as ATHEROSCLEROSIS with fatty lesions in the ARTERIAL INTIMA of medium and large muscular arteries.
Pressure, burning, or numbness in the chest.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
Narrowing below the PULMONARY VALVE or well below it in the infundibuluar chamber where the pulmonary artery originates, usually caused by a defective VENTRICULAR SEPTUM or presence of fibrous tissues. It is characterized by restricted blood outflow from the RIGHT VENTRICLE into the PULMONARY ARTERY, exertional fatigue, DYSPNEA, and chest discomfort.
Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, circumflex artery, or anterior descending coronary artery. The internal mammary artery is the most frequent choice, especially for a single graft, for coronary artery bypass surgery.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
The nonstriated involuntary muscle tissue of blood vessels.
Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.
A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.
Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Stents that are covered with materials that are embedded with chemicals that are gradually released into the surrounding milieu.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
The middle layer of blood vessel walls, composed principally of thin, cylindrical, smooth muscle cells and elastic tissue. It accounts for the bulk of the wall of most arteries. The smooth muscle cells are arranged in circular layers around the vessel, and the thickness of the coat varies with the size of the vessel.

The relationship between periprocedural myocardial infarction and subsequent target vessel revascularization following percutaneous coronary revascularization: insights from the EPIC trial. Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications. (1/228)

OBJECTIVES: We sought to determine whether periprocedural myocardial infarction complicating percutaneous coronary revascularization is associated with subsequent clinical restenosis, as judged by the need for target vessel revascularization. BACKGROUND: Although myocardial enzyme elevation following angioplasty is associated with increased late mortality, its effect on subsequent clinical restenosis, as assessed by the need for late target vessel revascularization (TVR), is unknown. METHODS: Serial myocardial enzyme determinations were performed on 2,099 patients who underwent angioplasty or atherectomy in the Evaluation of IIb/IIIa platelet receptor antagonist 7E3 in Preventing Ischemic Complications (EPIC) trial. Thirty-day survivors were prospectively followed for three years for adverse clinical events including death and need for TVR. RESULTS: Within the study population, periprocedural creatine kinase (CK) elevation was a predictor of late mortality. Among patients with elevated CK, however, a paradoxical decrease in the need for late TVR was present. This relationship became progressively more profound as the magnitude of CK release increased. Late TVR occurred in 29.8% of patients with no CK elevation, 24.8% with CK elevation to >3 times normal, and 16.9% with >10 times elevation (hazard ratio 0.51, 95% CI 0.29, 0.91). CONCLUSIONS: In the EPIC study, patients with periprocedural MI were less likely to develop clinical restenosis as measured by the need for TVR. Mechanistically, although it is unlikely that CK elevation prevents vascular renarrowing per se, myocardial necrosis impairs the clinical manifestation of restenosis, thereby reducing the need for ischemia-driven TVR. This novel finding 1) highlights the potential discordance between angiographic and clinical measures of restenosis, and 2) has implications for clinical trials, as therapies that reduce periprocedural MI may be associated with a perceived excess of restenosis when measured by the need for TVR.  (+info)

Influence of a platelet GPIIb/IIIa receptor antagonist on myocardial hypoperfusion during rotational atherectomy as assessed by myocardial Tc-99m sestamibi scintigraphy. (2/228)

OBJECTIVES: This study evaluated the effect of the glycoprotein IIb/IIIa (GPIIb/IIIa) antagonist abciximab on myocardial hypoperfusion during percutaneous transluminal rotational atherectomy (PTRA). BACKGROUND: PTRA may cause transient ischemia and periprocedural myocardial injury. A platelet-dependent risk of non-Q-wave infarctions after directional atherectomy has been described. The role of platelets for the incidence and severity of myocardial hypoperfusion during PTRA is unknown. METHODS: Seventy-five consecutive patients with complex lesions were studied using resting Tc-99m sestamibi single-photon emission computed tomography prior to PTRA, during, and 2 days after the procedure. The last 30 patients received periprocedural abciximab (group A) and their results were compared to the remaining 45 patients (group B). For semiquantitative analysis, myocardial perfusion in 24 left ventricular regions was expressed as percentage of maximal sestamibi uptake. RESULTS: Baseline characteristics did not differ between the groups. Transient perfusion defects were observed in 39/45 (87%) patients of group B, but only in 10/30 (33%) patients of group A (p < 0.001). Perfusion was significantly reduced during PTRA in 3.3 +/- 2.5 regions in group B compared to 1.4 +/- 2.5 regions in group A (p < 0.01). Perfusion in the region with maximal reduction during PTRA in groups B and A was 76 +/- 15% and 76 +/- 15% at baseline, decreased to 56 +/- 16% (p < 0.001) and 67 +/- 14%, respectively, during PTRA (p < 0.01 A vs. B), and returned to 76 +/- 15% and 80 +/- 13%, respectively, after PTRA. Nine patients in group B (20%) and two patients in group A (7%) had mild creatine kinase and/or troponin t elevations (p = 0.18). Patients with elevated enzymes had larger perfusion defects than did patients without myocardial injury (4.2 +/- 2.7 vs. 2.3 +/- 2.5 regions, p < 0.05). CONCLUSIONS: These data indicate that GPIIb/IIIa blockade reduces incidence, extent and severity of transient hypoperfusion during PTRA. Thus, platelet aggregation may play an important role for PTRA-induced hypoperfusion.  (+info)

Mechanisms of acute lumen gain and recurrent restenosis after rotational atherectomy of diffuse in-stent restenosis: a quantitative angiographic and intravascular ultrasound study. (3/228)

OBJECTIVES: This quantitative angiographic and intravascular ultrasound study determined the mechanisms of acute lumen enlargement and recurrent restenosis after rotational atherectomy (RA) with adjunct percutaneous transluminal coronary angioplasty in the treatment of diffuse in-stent restenosis (ISR). BACKGROUND: In-stent restenosis remains a significant clinical problem for which optimal treatment is under debate. Rotational atherectomy has become an alternative therapeutic approach for the treatment of diffuse ISR based on the concept of "tissue-debulking." METHODS: Rotational atherectomy with adjunct angioplasty of ISR was used in 45 patients with diffuse lesions. Quantitative coronary angiographic (QCA) analysis and sequential intravascular ultrasound (IVUS) measurements were performed in all patients. Forty patients (89%) underwent angiographic six-month follow-up. RESULTS: Rotational atherectomy lead to a decrease in maximal area of stenosis from 80+/-32% before intervention to 54+/-21% after RA (p < 0.0001) as a result of a significant decrease in intimal hyperplasia cross-sectional area (CSA). The minimal lumen diameter after RA remained 15+/-4% smaller than the burr diameter used, indicating acute neointimal recoil. Additional angioplasty led to a further decrease in area of stenosis to 38+/-12% due to a significant increase in stent CSA. At six-month angiographic follow-up, recurrent restenosis rate was 45%. Lesion and stent length, preinterventional diameter stenosis and amount of acute neointimal recoil were associated with a higher rate of recurrent restenosis. CONCLUSIONS: Rotational atherectomy of ISR leads to acute lumen gain by effective plaque removal. Adjunct angioplasty results in additional lumen gain by further stent expansion and tissue extrusion. Stent and lesion length, severity of ISR and acute neointimal recoil are predictors of recurrent restenosis.  (+info)

Heparin after percutaneous intervention (HAPI): a prospective multicenter randomized trial of three heparin regimens after successful coronary intervention. (4/228)

OBJECTIVES: The purpose of this study was to determine the incidence of bleeding, vascular, and ischemic complications using three different heparin regimens after successful intervention. BACKGROUND: The ideal dose and duration of heparin infusion after successful coronary intervention is unknown. METHODS: Patients were randomized to one of three heparin strategies after coronary intervention: Group 1 (n = 157 patients) received prolonged (12 to 24 h) heparin infusion followed by sheath removal; Group 2 (n = 120 patients) underwent early removal of sheaths, followed by reinstitution of heparin infusion for 12 to 18 h; Group 3 (n = 137 patients) did not receive any further heparin after intervention with early sheath removal. The primary end point of the study was the combined incidence of in-hospital bleeding and vascular events. Secondary end points included in-hospital ischemic events, length of stay, cost and one-month outcome. RESULTS: After successful coronary intervention, 414 patients were randomized. Unstable angina or postinfarction angina was present in 83% of patients before intervention. The combined incidence of bleeding and vascular events was 21% in Group 1, 14% in Group 2 and 8% in Group 3 (p = 0.01). The overall incidence of in-hospital ischemic complications was 2.2%; there were no differences between groups. Length of hospital stay was shorter (p = 0.033) and adjusted hospital cost was lower (p < 0.001) for Group 3. At 30 days, the incidence of delayed cardiac and vascular events was similar for all three groups. CONCLUSIONS: Heparin infusion after successful coronary intervention is associated with more minor bleeding and vascular injury, prolonged length of stay and increased cost. In-hospital and one-month ischemic events rarely occur after successful intervention, irrespective of heparin use. Routine postprocedure heparin is not recommended, even in patients who present with unstable ischemic syndromes.  (+info)

Low prevalence of Chlamydia pneumoniae in atherectomy specimens from patients with coronary heart disease. (5/228)

Coronary atherectomy specimens from 50 patients with coronary heart disease were examined for the presence of Chlamydia pneumoniae by two different methods of polymerase chain reaction (PCR) and by in situ hybridization. C. pneumoniae DNA was detected by PCR in atherosclerotic plaques of four patients (8%). Two patients' coronary atheromas were positive, both by a single-step 16S rRNA-based PCR and by an omp1-based nested PCR. The other two patients' specimens were positive only by the nested PCR. In contrast, C. pneumoniae was not detected by in situ hybridization in any of the cardiovascular tissues tested. Of three patients with evidence of C. pneumoniae in coronary atheromas, two had an antibody titer of 1:32 and the third had no specific antibodies detectable. Results of this study demonstrate a low prevalence of C. pneumoniae DNA in coronary atheromas. These findings do not support the hypothesis that the organism plays a major role in atherogenesis.  (+info)

In vitro examination of the safety of rotational atherectomy of side branches jailed by stents. (6/228)

In vitro experimental models of branch orifices jailed by various stents were created to estimate the safety and the efficacy of rotational atherectomy when rotational burrs were advanced through the struts of stents. The scaffolding structures of the stents were destroyed due to loss and deflection of the struts, and the size of ablated stent-particles differed: the maximal size was 1.7 mm in slotted stents, and 17.6 mm in coiled stents. Thus, there is a definite potential for ablating stents when rotational atherectomy of restenotic lesions of side-branch orifices jailed by stents is performed.  (+info)

Expression of cytokine and adhesion molecule mRNA in atherectomy specimens from patients with coronary artery disease. (7/228)

Coronary arteriosclerosis is an underlying condition in acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP), and is also related to restenosis (RS) following coronary intervention. To investigate the pathogenesis of this condition, a quantitative reverse transcriptase polymerase chain reaction was used to determine relative levels of mRNA for interleukin (IL)-1beta, IL-6, IL-8, transforming growth factor beta (TGF-beta), intercellular adhesion molecule (ICAM)-1, E-selectin and vascular cell adhesion molecule (VCAM)-1 using directional coronary atherectomy (DCA) specimens. Eleven patients with AMI, 7 with UAP, 10 with SAP and 6 with RS following a previous coronary intervention underwent DCA. The mRNA intensity for each molecule was expressed by comparing it with that of beta-actin mRNA. The AMI and UAP patients showed high frequencies of mRNA for IL-1beta, IL-8, TGF-beta, and ICAM-1 together with strong intensities of expression, whereas SAP patients showed decreased mRNA expression for these molecules. Increased IL-6 mRNA expression was observed only in AMI samples. Specimens from RS patients revealed an accumulated expression of proinflammatory cytokines, except for IL-6, as well as of TGF-beta. The study suggests that variation in mRNA expression may reflect the pathophysiology of specific types of coronary artery disease, and remodeling following vascular injury.  (+info)

Creatine kinase-MB elevation after coronary intervention correlates with diffuse atherosclerosis, and low-to-medium level elevation has a benign clinical course: implications for early discharge after coronary intervention. (8/228)

OBJECTIVES: The study evaluated the incidence and predictors of creatine kinase-MB isoenzyme (CK-MB) elevation after successful coronary intervention using current devices, and assessed the influence on in-hospital course and midterm survival. BACKGROUND: The CK-MB elevation after coronary intervention predominantly using balloon angioplasty correlates with late cardiac events of myocardial infarction (MI) and death. Whether CK-MB elevation after nonballoon devices is associated with an adverse short and midterm prognosis is unknown. METHODS: The incidence and predictors of CK-MB elevation after coronary intervention were prospectively studied in 1,675 consecutive patients and were followed for in-hospital events and survival. RESULTS: CK-MB elevation was detected in 313 patients (18.7%), with 1-3x in 12.8%, 3-5x in 3.5% and >5x normal in 2.4% of patients. Procedural complications or electrocardiogram changes occurred in only 49% of the CK-MB-elevation cases; CK-MB elevation was more common after nonballoon devices (19.5% vs. 11.5% after percutaneous transluminal coronary angioplasty; p < 0.01). Predictors of CK-MB elevation on multivariate analysis were diffuse coronary disease (p = 0.02), systemic atherosclerosis (p = 0.002), stent use (p = 0.04) and absence of beta-blocker therapy (p = 0.001). Adverse in-hospital cardiac events were more frequent in patients with >5x CK-MB elevation, with no significant difference between 1-5x CK-MB elevation versus normal CK-MB group. During a mean follow-up of 13 +/- 3 months, the incidence of death in the CK-MB-elevation group was 1.6% versus 1.3% in the normal CK-MB group (p = NS). CONCLUSIONS: The CK-MB elevation after coronary intervention was observed even in the absence of discernible procedural complications and was more common in patients with diffuse atherosclerosis. In-hospital clinical events requiring prolonged monitoring were higher in >5x CK-MB-elevation patients only. Midterm survival of CK-MB-elevation patients was similar to those with normal CK-MB. Our prospective analysis shows a lack of adverse in-hospital cardiac events and suggests that early discharge of stable 1-5x normal CK-MB-elevation patients after successful coronary intervention is safe.  (+info)

Atherectomy, coronary, is a medical procedure used to treat narrowed or blocked coronary arteries due to the buildup of plaque (atherosclerosis). The goal of coronary atherectomy is to improve blood flow to the heart muscle by removing the obstructive material within the vessel.

During the procedure, a specialized catheter with a cutting device on its tip is inserted into a peripheral artery, usually in the groin or arm, and advanced to the affected coronary artery. The cutting device can be a rotating blade, a high-speed spinning burr, or a laser fiber that is used to shave, drill, or vaporize the plaque, respectively. The removed material is collected in a chamber within the catheter or washed away by blood flow.

There are different types of coronary atherectomy devices, including:

1. Directional atherectomy (DCA): A rotating blade cuts and removes the plaque in a targeted direction.
2. Rotational atherectomy (Rotablator): A high-speed spinning burr is used to abrade and pulverize the plaque into tiny particles that can be safely carried away by blood flow.
3. Laser atherectomy: A laser fiber is used to vaporize or break down the plaque into gaseous or small particle form.

Coronary atherectomy is typically performed in conjunction with angioplasty and stenting, as it helps prepare the narrowed artery for these procedures by creating a larger lumen and reducing the risk of complications like dissections or restenosis (re-narrowing). However, its use may be limited to specific cases due to the potential risks, such as vessel trauma, distal embolization, or perforation.

It is essential to consult with a medical professional for detailed information and personalized treatment recommendations regarding coronary atherectomy.

Atherectomy is a medical procedure in which the accumulated plaque or deposits in the inner lining of the artery (the endothelium) are removed using a specialized catheter with a cutting device on its tip. The goal of this procedure is to improve blood flow through the artery by physically removing the obstruction, as opposed to other procedures like angioplasty and stenting which use balloons and/or metal scaffolds to open up the artery.

There are several types of atherectomy devices available, including:

1. Directional atherectomy (DA): A rotating blade cuts and removes plaque from the artery wall into a collection chamber within the catheter.
2. Rotational atherectomy (RA): A high-speed burr-like device abrades and pulverizes the plaque, which is then carried away by blood flow.
3. Laser atherectomy: A laser beam vaporizes the plaque, turning it into gas that is absorbed or removed through irrigation.
4. Orbital atherectomy: A high-speed spinning diamond-coated crown abrades and removes plaque while minimizing the risk of damaging the artery wall.

Atherectomy can be an effective treatment option for peripheral arterial disease (PAD) and coronary artery disease (CAD), particularly in cases where angioplasty and stenting are not feasible or have failed. However, like any medical procedure, atherectomy carries certain risks, such as bleeding, infection, perforation of the artery, and distal embolization (the release of plaque particles downstream). Proper patient selection, careful technique, and close follow-up are essential for successful outcomes.

Coronary vessels refer to the network of blood vessels that supply oxygenated blood and nutrients to the heart muscle, also known as the myocardium. The two main coronary arteries are the left main coronary artery and the right coronary artery.

The left main coronary artery branches off into the left anterior descending artery (LAD) and the left circumflex artery (LCx). The LAD supplies blood to the front of the heart, while the LCx supplies blood to the side and back of the heart.

The right coronary artery supplies blood to the right lower part of the heart, including the right atrium and ventricle, as well as the back of the heart.

Coronary vessel disease (CVD) occurs when these vessels become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow to the heart muscle. This can result in chest pain, shortness of breath, or a heart attack.

Coronary angiography is a medical procedure that uses X-ray imaging to visualize the coronary arteries, which supply blood to the heart muscle. During the procedure, a thin, flexible catheter is inserted into an artery in the arm or groin and threaded through the blood vessels to the heart. A contrast dye is then injected through the catheter, and X-ray images are taken as the dye flows through the coronary arteries. These images can help doctors diagnose and treat various heart conditions, such as blockages or narrowing of the arteries, that can lead to chest pain or heart attacks. It is also known as coronary arteriography or cardiac catheterization.

Coronary artery disease (CAD) is a medical condition in which the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of cholesterol, fatty deposits, and other substances, known as plaque. Over time, this buildup can cause the arteries to harden and narrow (a process called atherosclerosis), reducing blood flow to the heart muscle.

The reduction in blood flow can lead to various symptoms and complications, including:

1. Angina (chest pain or discomfort) - This occurs when the heart muscle doesn't receive enough oxygen-rich blood, causing pain, pressure, or discomfort in the chest, arms, neck, jaw, or back.
2. Shortness of breath - When the heart isn't receiving adequate blood flow, it can't pump blood efficiently to meet the body's demands, leading to shortness of breath during physical activities or at rest.
3. Heart attack - If a piece of plaque ruptures or breaks off in a coronary artery, a blood clot can form and block the artery, causing a heart attack (myocardial infarction). This can damage or destroy part of the heart muscle.
4. Heart failure - Chronic reduced blood flow to the heart muscle can weaken it over time, leading to heart failure, a condition in which the heart can't pump blood efficiently to meet the body's needs.
5. Arrhythmias - Reduced blood flow and damage to the heart muscle can lead to abnormal heart rhythms (arrhythmias), which can be life-threatening if not treated promptly.

Coronary artery disease is typically diagnosed through a combination of medical history, physical examination, and diagnostic tests such as electrocardiograms (ECGs), stress testing, cardiac catheterization, and imaging studies like coronary computed tomography angiography (CCTA). Treatment options for CAD include lifestyle modifications, medications, medical procedures, and surgery.

Coronary balloon angioplasty is a minimally invasive medical procedure used to widen narrowed or obstructed coronary arteries (the blood vessels that supply oxygen-rich blood to the heart muscle) and improve blood flow to the heart. This procedure is typically performed in conjunction with the insertion of a stent, a small mesh tube that helps keep the artery open.

During coronary balloon angioplasty, a thin, flexible catheter with a deflated balloon at its tip is inserted into a blood vessel, usually through a small incision in the groin or arm. The catheter is then guided to the narrowed or obstructed section of the coronary artery. Once in position, the balloon is inflated to compress the plaque against the artery wall and widen the lumen (the inner space) of the artery. This helps restore blood flow to the heart muscle.

The procedure is typically performed under local anesthesia and conscious sedation to minimize discomfort. Coronary balloon angioplasty is a relatively safe and effective treatment for many people with coronary artery disease, although complications such as bleeding, infection, or re-narrowing of the artery (restenosis) can occur in some cases.

Coronary circulation refers to the circulation of blood in the coronary vessels, which supply oxygenated blood to the heart muscle (myocardium) and drain deoxygenated blood from it. The coronary circulation system includes two main coronary arteries - the left main coronary artery and the right coronary artery - that branch off from the aorta just above the aortic valve. These arteries further divide into smaller branches, which supply blood to different regions of the heart muscle.

The left main coronary artery divides into two branches: the left anterior descending (LAD) artery and the left circumflex (LCx) artery. The LAD supplies blood to the front and sides of the heart, while the LCx supplies blood to the back and sides of the heart. The right coronary artery supplies blood to the lower part of the heart, including the right ventricle and the bottom portion of the left ventricle.

The veins that drain the heart muscle include the great cardiac vein, the middle cardiac vein, and the small cardiac vein, which merge to form the coronary sinus. The coronary sinus empties into the right atrium, allowing deoxygenated blood to enter the right side of the heart and be pumped to the lungs for oxygenation.

Coronary circulation is essential for maintaining the health and function of the heart muscle, as it provides the necessary oxygen and nutrients required for proper contraction and relaxation of the myocardium. Any disruption or blockage in the coronary circulation system can lead to serious consequences, such as angina, heart attack, or even death.

Coronary artery disease, often simply referred to as coronary disease, is a condition in which the blood vessels that supply oxygen-rich blood to the heart become narrowed or blocked due to the buildup of fatty deposits called plaques. This can lead to chest pain (angina), shortness of breath, or in severe cases, a heart attack.

The medical definition of coronary artery disease is:

A condition characterized by the accumulation of atheromatous plaques in the walls of the coronary arteries, leading to decreased blood flow and oxygen supply to the myocardium (heart muscle). This can result in symptoms such as angina pectoris, shortness of breath, or arrhythmias, and may ultimately lead to myocardial infarction (heart attack) or heart failure.

Risk factors for coronary artery disease include age, smoking, high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and a family history of the condition. Lifestyle changes such as quitting smoking, exercising regularly, eating a healthy diet, and managing stress can help reduce the risk of developing coronary artery disease. Medical treatments may include medications to control blood pressure, cholesterol levels, or irregular heart rhythms, as well as procedures such as angioplasty or bypass surgery to improve blood flow to the heart.

Coronary stenosis is a medical condition that refers to the narrowing of the coronary arteries, which supply oxygen-rich blood to the heart muscle. This narrowing is typically caused by the buildup of plaque, made up of fat, cholesterol, and other substances, on the inner walls of the arteries. Over time, as the plaque hardens and calcifies, it can cause the artery to become narrowed or blocked, reducing blood flow to the heart muscle.

Coronary stenosis can lead to various symptoms and complications, including chest pain (angina), shortness of breath, irregular heart rhythms (arrhythmias), and heart attacks. Treatment options for coronary stenosis may include lifestyle changes, medications, medical procedures such as angioplasty or bypass surgery, or a combination of these approaches. Regular check-ups and diagnostic tests, such as stress testing or coronary angiography, can help detect and monitor coronary stenosis over time.

Coronary artery bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure used to improve blood flow to the heart in patients with severe coronary artery disease. This condition occurs when the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of fatty deposits, called plaques.

During CABG surgery, a healthy blood vessel from another part of the body is grafted, or attached, to the coronary artery, creating a new pathway for oxygen-rich blood to flow around the blocked or narrowed portion of the artery and reach the heart muscle. This bypass helps to restore normal blood flow and reduce the risk of angina (chest pain), shortness of breath, and other symptoms associated with coronary artery disease.

There are different types of CABG surgery, including traditional on-pump CABG, off-pump CABG, and minimally invasive CABG. The choice of procedure depends on various factors, such as the patient's overall health, the number and location of blocked arteries, and the presence of other medical conditions.

It is important to note that while CABG surgery can significantly improve symptoms and quality of life in patients with severe coronary artery disease, it does not cure the underlying condition. Lifestyle modifications, such as regular exercise, a healthy diet, smoking cessation, and medication therapy, are essential for long-term management and prevention of further progression of the disease.

Interventional ultrasonography is a medical procedure that involves the use of real-time ultrasound imaging to guide minimally invasive diagnostic and therapeutic interventions. This technique combines the advantages of ultrasound, such as its non-ionizing nature (no radiation exposure), relatively low cost, and portability, with the ability to perform precise and targeted procedures.

In interventional ultrasonography, a specialized physician called an interventional radiologist or an interventional sonographer uses high-frequency sound waves to create detailed images of internal organs and tissues. These images help guide the placement of needles, catheters, or other instruments used during the procedure. Common interventions include biopsies (tissue sampling), fluid drainage, tumor ablation, and targeted drug delivery.

The real-time visualization provided by ultrasonography allows for increased accuracy and safety during these procedures, minimizing complications and reducing recovery time compared to traditional surgical approaches. Additionally, interventional ultrasonography can be performed on an outpatient basis, further contributing to its appeal as a less invasive alternative in many clinical scenarios.

Angioplasty, laser is a medical procedure that uses laser energy to open up narrowed or blocked blood vessels. The term "angioplasty" refers to the general class of procedures used to restore blood flow through a narrowed or obstructed blood vessel, typically by inflating a small balloon within the vessel to widen it. In laser angioplasty, a thin catheter with a laser fiber at its tip is inserted into the affected blood vessel and guided to the site of the blockage. The laser is then used to vaporize or break up the blockage, allowing blood to flow more freely through the vessel. This procedure may be used to treat conditions such as peripheral artery disease (PAD), coronary artery disease (CAD), and carotid artery stenosis.

Coronary thrombosis is a medical condition that refers to the formation of a blood clot (thrombus) inside a coronary artery, which supplies oxygenated blood to the heart muscle. The development of a thrombus can partially or completely obstruct blood flow, leading to insufficient oxygen supply to the heart muscle. This can cause chest pain (angina) or a heart attack (myocardial infarction), depending on the severity and duration of the blockage.

Coronary thrombosis often results from the rupture of an atherosclerotic plaque, a buildup of cholesterol, fat, calcium, and other substances in the inner lining (endothelium) of the coronary artery. The ruptured plaque exposes the underlying tissue to the bloodstream, triggering the coagulation cascade and resulting in the formation of a thrombus.

Immediate medical attention is crucial for managing coronary thrombosis, as timely treatment can help restore blood flow, prevent further damage to the heart muscle, and reduce the risk of complications such as heart failure or life-threatening arrhythmias. Treatment options may include medications, such as antiplatelet agents, anticoagulants, and thrombolytic drugs, or interventional procedures like angioplasty and stenting to open the blocked artery. In some cases, surgical intervention, such as coronary artery bypass grafting (CABG), may be necessary.

Recurrence, in a medical context, refers to the return of symptoms or signs of a disease after a period of improvement or remission. It indicates that the condition has not been fully eradicated and may require further treatment. Recurrence is often used to describe situations where a disease such as cancer comes back after initial treatment, but it can also apply to other medical conditions. The likelihood of recurrence varies depending on the type of disease and individual patient factors.

Laser-assisted angioplasty is a medical procedure used to open narrowed or blocked blood vessels. The term "angioplasty" refers to the use of a balloon to widen the affected blood vessel, while "laser-assisted" describes the use of a laser to help remove any blockages or obstructions in the vessel.

During the procedure, a catheter is inserted into a blood vessel through a small incision in the groin or arm. The catheter is then guided to the narrowed or blocked section of the blood vessel using imaging techniques such as X-ray or ultrasound. Once the catheter is in place, a laser fiber is passed through the catheter and directed at the blockage.

The laser emits high-energy light that vaporizes the blockage, allowing it to be removed from the blood vessel. After the blockage has been removed, a balloon angioplasty may be performed to widen the blood vessel and improve blood flow. The catheter is then removed and the incision is closed.

Laser-assisted angioplasty is typically used in cases where traditional balloon angioplasty is not effective or when the blockage is composed of materials that are difficult to remove with conventional methods, such as calcified plaque. It may also be used in patients who have complex lesions or multiple blockages in their blood vessels.

While laser-assisted angioplasty is generally safe and effective, it does carry some risks, including bleeding, infection, damage to the blood vessel, and recurrence of the blockage. As with any medical procedure, it is important for patients to discuss the potential benefits and risks with their healthcare provider before undergoing treatment.

Treatment outcome is a term used to describe the result or effect of medical treatment on a patient's health status. It can be measured in various ways, such as through symptoms improvement, disease remission, reduced disability, improved quality of life, or survival rates. The treatment outcome helps healthcare providers evaluate the effectiveness of a particular treatment plan and make informed decisions about future care. It is also used in clinical research to compare the efficacy of different treatments and improve patient care.

Coronary restenosis is the re-narrowing or re-occlusion of a coronary artery after a previous successful procedure to open or widen the artery, such as angioplasty or stenting. This narrowing is usually caused by the excessive growth of scar tissue or smooth muscle cells in the artery lining, which can occur spontaneously or as a response to the initial procedure. Restenosis can lead to recurrent symptoms of coronary artery disease, such as chest pain or shortness of breath, and may require additional medical intervention.

A stent is a small mesh tube that's used to treat narrow or weak arteries. Arteries are blood vessels that carry blood away from your heart to other parts of your body. A stent is placed in an artery as part of a procedure called angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries by inflating a tiny balloon inside the blocked artery to widen it.

The stent is then inserted into the widened artery to keep it open. The stent is usually made of metal, but some are coated with medication that is slowly and continuously released to help prevent the formation of scar tissue in the artery. This can reduce the chance of the artery narrowing again.

Stents are also used in other parts of the body, such as the neck (carotid artery) and kidneys (renal artery), to help maintain blood flow and prevent blockages. They can also be used in the urinary system to treat conditions like ureteropelvic junction obstruction or narrowing of the urethra.

Coronary vasospasm refers to a sudden constriction (narrowing) of the coronary arteries, which supply oxygenated blood to the heart muscle. This constriction can reduce or block blood flow, leading to symptoms such as chest pain (angina) or, in severe cases, a heart attack (myocardial infarction). Coronary vasospasm can occur spontaneously or be triggered by various factors, including stress, smoking, and certain medications. It is also associated with conditions such as coronary artery disease and variant angina. Prolonged or recurrent vasospasms can cause damage to the heart muscle and increase the risk of cardiovascular events.

Myocardial infarction (MI), also known as a heart attack, is a medical condition characterized by the death of a segment of heart muscle (myocardium) due to the interruption of its blood supply. This interruption is most commonly caused by the blockage of a coronary artery by a blood clot formed on the top of an atherosclerotic plaque, which is a buildup of cholesterol and other substances in the inner lining of the artery.

The lack of oxygen and nutrients supply to the heart muscle tissue results in damage or death of the cardiac cells, causing the affected area to become necrotic. The extent and severity of the MI depend on the size of the affected area, the duration of the occlusion, and the presence of collateral circulation.

Symptoms of a myocardial infarction may include chest pain or discomfort, shortness of breath, nausea, lightheadedness, and sweating. Immediate medical attention is necessary to restore blood flow to the affected area and prevent further damage to the heart muscle. Treatment options for MI include medications, such as thrombolytics, antiplatelet agents, and pain relievers, as well as procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Follow-up studies are a type of longitudinal research that involve repeated observations or measurements of the same variables over a period of time, in order to understand their long-term effects or outcomes. In medical context, follow-up studies are often used to evaluate the safety and efficacy of medical treatments, interventions, or procedures.

In a typical follow-up study, a group of individuals (called a cohort) who have received a particular treatment or intervention are identified and then followed over time through periodic assessments or data collection. The data collected may include information on clinical outcomes, adverse events, changes in symptoms or functional status, and other relevant measures.

The results of follow-up studies can provide important insights into the long-term benefits and risks of medical interventions, as well as help to identify factors that may influence treatment effectiveness or patient outcomes. However, it is important to note that follow-up studies can be subject to various biases and limitations, such as loss to follow-up, recall bias, and changes in clinical practice over time, which must be carefully considered when interpreting the results.

A coronary aneurysm is a localized dilation or bulging of a portion of the wall of a coronary artery, which supplies blood to the muscle tissue of the heart. It's similar to a bubble or balloon-like structure that forms within the artery wall due to weakness in the arterial wall, leading to abnormal enlargement or widening.

Coronary aneurysms can vary in size and may be classified as true or false aneurysms based on their structure. True aneurysms involve all three layers of the artery wall, while false aneurysms (also known as pseudoaneurysms) only have one or two layers involved, with the remaining layer disrupted.

These aneurysms can lead to complications such as blood clots forming inside the aneurysm sac, which can then dislodge and cause blockages in smaller coronary arteries (embolism). Additionally, coronary aneurysms may rupture, leading to severe internal bleeding and potentially life-threatening situations.

Coronary aneurysms are often asymptomatic but can present with symptoms such as chest pain, shortness of breath, or palpitations, especially if the aneurysm causes a significant narrowing (stenosis) in the affected artery. They can be diagnosed through imaging techniques like coronary angiography, computed tomography (CT), or magnetic resonance imaging (MRI). Treatment options include medications to manage symptoms and prevent complications, as well as surgical interventions such as stenting or bypass grafting to repair or reroute the affected artery.

Coronary occlusion is the medical term used to describe a complete blockage in one or more of the coronary arteries, which supply oxygenated blood to the heart muscle. This blockage is usually caused by the buildup of fatty deposits, called plaques, inside the artery walls, a condition known as atherosclerosis. Over time, these plaques can rupture, leading to the formation of blood clots that completely obstruct the flow of blood through the coronary artery.

Coronary occlusion can lead to serious complications, such as a heart attack (myocardial infarction), angina (chest pain), or even sudden cardiac death, depending on the severity and duration of the blockage. Immediate medical attention is required in case of coronary occlusion to restore blood flow to the affected areas of the heart and prevent further damage. Treatment options may include medications, minimally invasive procedures like angioplasty and stenting, or surgical interventions such as coronary artery bypass grafting (CABG).

Percutaneous Coronary Intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure that opens up clogged coronary arteries to improve blood flow to the heart. It involves inserting a thin, flexible catheter into an artery in the groin or wrist and guiding it to the blocked artery in the heart. A small balloon is then inflated to widen the narrowed or blocked artery, and sometimes a stent (a tiny mesh tube) is placed to keep the artery open. This procedure helps to restore and maintain blood flow to the heart muscle, reducing symptoms of angina and improving overall cardiac function.

Unstable angina is a term used in cardiology to describe chest pain or discomfort that occurs suddenly and unexpectedly, often at rest or with minimal physical exertion. It is caused by an insufficient supply of oxygen-rich blood to the heart muscle due to reduced blood flow, typically as a result of partial or complete blockage of the coronary arteries.

Unlike stable angina, which tends to occur predictably during physical activity and can be relieved with rest or nitroglycerin, unstable angina is more severe, unpredictable, and may not respond to traditional treatments. It is considered a medical emergency because it can be a sign of an impending heart attack or other serious cardiac event.

Unstable angina is often treated in the hospital with medications such as nitroglycerin, beta blockers, calcium channel blockers, and antiplatelet agents to improve blood flow to the heart and prevent further complications. In some cases, more invasive treatments such as coronary angioplasty or bypass surgery may be necessary to restore blood flow to the affected areas of the heart.

Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.

Angioplasty, balloon refers to a medical procedure used to widen narrowed or obstructed blood vessels, particularly the coronary arteries that supply blood to the heart muscle. This procedure is typically performed using a catheter-based technique, where a thin, flexible tube called a catheter is inserted into an artery, usually through the groin or wrist, and guided to the site of the narrowing or obstruction in the coronary artery.

Once the catheter reaches the affected area, a small balloon attached to the tip of the catheter is inflated, which compresses the plaque against the artery wall and stretches the artery, thereby restoring blood flow. The balloon is then deflated and removed, along with the catheter.

Balloon angioplasty is often combined with the placement of a stent, a small metal mesh tube that helps to keep the artery open and prevent it from narrowing again. This procedure is known as percutaneous coronary intervention (PCI) or coronary angioplasty and stenting.

Overall, balloon angioplasty is a relatively safe and effective treatment for coronary artery disease, although complications such as bleeding, infection, or re-narrowing of the artery can occur in some cases.

Calcinosis is a medical condition characterized by the abnormal deposit of calcium salts in various tissues of the body, commonly under the skin or in the muscles and tendons. These calcium deposits can form hard lumps or nodules that can cause pain, inflammation, and restricted mobility. Calcinosis can occur as a complication of other medical conditions, such as autoimmune disorders, kidney disease, and hypercalcemia (high levels of calcium in the blood). In some cases, the cause of calcinosis may be unknown. Treatment for calcinosis depends on the underlying cause and may include medications to manage calcium levels, physical therapy, and surgical removal of large deposits.

Medical Definition:

"Risk factors" are any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury. They can be divided into modifiable and non-modifiable risk factors. Modifiable risk factors are those that can be changed through lifestyle choices or medical treatment, while non-modifiable risk factors are inherent traits such as age, gender, or genetic predisposition. Examples of modifiable risk factors include smoking, alcohol consumption, physical inactivity, and unhealthy diet, while non-modifiable risk factors include age, sex, and family history. It is important to note that having a risk factor does not guarantee that a person will develop the disease, but rather indicates an increased susceptibility.

In the field of medicine, "time factors" refer to the duration of symptoms or time elapsed since the onset of a medical condition, which can have significant implications for diagnosis and treatment. Understanding time factors is crucial in determining the progression of a disease, evaluating the effectiveness of treatments, and making critical decisions regarding patient care.

For example, in stroke management, "time is brain," meaning that rapid intervention within a specific time frame (usually within 4.5 hours) is essential to administering tissue plasminogen activator (tPA), a clot-busting drug that can minimize brain damage and improve patient outcomes. Similarly, in trauma care, the "golden hour" concept emphasizes the importance of providing definitive care within the first 60 minutes after injury to increase survival rates and reduce morbidity.

Time factors also play a role in monitoring the progression of chronic conditions like diabetes or heart disease, where regular follow-ups and assessments help determine appropriate treatment adjustments and prevent complications. In infectious diseases, time factors are crucial for initiating antibiotic therapy and identifying potential outbreaks to control their spread.

Overall, "time factors" encompass the significance of recognizing and acting promptly in various medical scenarios to optimize patient outcomes and provide effective care.

Pathological constriction refers to an abnormal narrowing or tightening of a body passage or organ, which can interfere with the normal flow of blood, air, or other substances through the area. This constriction can occur due to various reasons such as inflammation, scarring, or abnormal growths, and can affect different parts of the body, including blood vessels, airways, intestines, and ureters. Pathological constriction can lead to a range of symptoms and complications depending on its location and severity, and may require medical intervention to correct.

An embolism is a medical condition that occurs when a substance, such as a blood clot or an air bubble, blocks a blood vessel. This can happen in any part of the body, but it is particularly dangerous when it affects the brain (causing a stroke) or the lungs (causing a pulmonary embolism). Embolisms can cause serious harm by preventing oxygen and nutrients from reaching the tissues and organs that need them. They are often the result of underlying medical conditions, such as heart disease or deep vein thrombosis, and may require immediate medical attention to prevent further complications.

Vascular patency is a term used in medicine to describe the state of a blood vessel (such as an artery or vein) being open, unobstructed, and allowing for the normal flow of blood. It is an important concept in the treatment and management of various cardiovascular conditions, such as peripheral artery disease, coronary artery disease, and deep vein thrombosis.

Maintaining vascular patency can help prevent serious complications like tissue damage, organ dysfunction, or even death. This may involve medical interventions such as administering blood-thinning medications to prevent clots, performing procedures to remove blockages, or using devices like stents to keep vessels open. Regular monitoring of vascular patency is also crucial for evaluating the effectiveness of treatments and adjusting care plans accordingly.

The femoral artery is the major blood vessel that supplies oxygenated blood to the lower extremity of the human body. It is a continuation of the external iliac artery and becomes the popliteal artery as it passes through the adductor hiatus in the adductor magnus muscle of the thigh.

The femoral artery is located in the femoral triangle, which is bound by the sartorius muscle anteriorly, the adductor longus muscle medially, and the biceps femoris muscle posteriorly. It can be easily palpated in the groin region, making it a common site for taking blood samples, measuring blood pressure, and performing surgical procedures such as femoral artery catheterization and bypass grafting.

The femoral artery gives off several branches that supply blood to the lower limb, including the deep femoral artery, the superficial femoral artery, and the profunda femoris artery. These branches provide blood to the muscles, bones, skin, and other tissues of the leg, ankle, and foot.

Cineangiography is a medical imaging technique used to visualize the blood flow in the heart and cardiovascular system. It involves the injection of a contrast agent into the bloodstream while X-ray images are taken in quick succession, creating a movie-like sequence that shows the movement of the contrast through the blood vessels and chambers of the heart. This technique is often used to diagnose and evaluate various heart conditions, such as coronary artery disease, valvular heart disease, and congenital heart defects.

The procedure typically involves threading a catheter through a blood vessel in the arm or leg and guiding it to the heart. Once in place, the contrast agent is injected, and X-ray images are taken using a specialized X-ray machine called a fluoroscope. The images captured during cineangiography can help doctors identify areas of narrowing or blockage in the coronary arteries, abnormalities in heart valves, and other cardiovascular problems.

Cineangiography is an invasive procedure that carries some risks, such as bleeding, infection, and reactions to the contrast agent. However, it can provide valuable information for diagnosing and treating heart conditions, and may be recommended when other diagnostic tests have been inconclusive.

Retrospective studies, also known as retrospective research or looking back studies, are a type of observational study that examines data from the past to draw conclusions about possible causal relationships between risk factors and outcomes. In these studies, researchers analyze existing records, medical charts, or previously collected data to test a hypothesis or answer a specific research question.

Retrospective studies can be useful for generating hypotheses and identifying trends, but they have limitations compared to prospective studies, which follow participants forward in time from exposure to outcome. Retrospective studies are subject to biases such as recall bias, selection bias, and information bias, which can affect the validity of the results. Therefore, retrospective studies should be interpreted with caution and used primarily to generate hypotheses for further testing in prospective studies.

Graft occlusion in the context of vascular surgery refers to the complete or partial blockage of a blood vessel that has been surgically replaced or repaired with a graft. The graft can be made from either synthetic materials or autologous tissue (taken from another part of the patient's body).

Graft occlusion can occur due to various reasons, including:

1. Thrombosis: Formation of a blood clot within the graft, which can obstruct blood flow.
2. Intimal hyperplasia: Overgrowth of the inner lining (intima) of the graft or the adjacent native vessel, causing narrowing of the lumen and reducing blood flow.
3. Atherosclerosis: Deposition of cholesterol and other substances in the walls of the graft, leading to hardening and narrowing of the vessel.
4. Infection: Bacterial or fungal infection of the graft can cause inflammation, weakening, and ultimately occlusion of the graft.
5. Mechanical factors: Kinking, twisting, or compression of the graft can lead to obstruction of blood flow.

Graft occlusion is a significant complication following vascular surgery, as it can result in reduced perfusion to downstream tissues and organs, leading to ischemia (lack of oxygen supply) and potential tissue damage or loss.

Coronary Care Units (CCUs) are specialized hospital wards that provide intensive care to patients with severe, life-threatening heart conditions. These units are equipped with advanced monitoring and treatment technologies to continuously monitor a patient's cardiac function and provide immediate medical interventions when necessary. Common conditions treated in CCUs include acute myocardial infarction (heart attack), unstable angina, cardiac arrhythmias, and heart failure. The primary goal of a CCU is to stabilize the patient's condition, prevent further complications, and facilitate recovery.

Angina pectoris is a medical term that describes chest pain or discomfort caused by an inadequate supply of oxygen-rich blood to the heart muscle. This condition often occurs due to coronary artery disease, where the coronary arteries become narrowed or blocked by the buildup of cholesterol, fatty deposits, and other substances, known as plaques. These blockages can reduce blood flow to the heart, causing ischemia (lack of oxygen) and leading to angina symptoms.

There are two primary types of angina: stable and unstable. Stable angina is predictable and usually occurs during physical exertion or emotional stress when the heart needs more oxygen-rich blood. The pain typically subsides with rest or after taking prescribed nitroglycerin medication, which helps widen the blood vessels and improve blood flow to the heart.

Unstable angina, on the other hand, is more severe and unpredictable. It can occur at rest, during sleep, or with minimal physical activity and may not be relieved by rest or nitroglycerin. Unstable angina is considered a medical emergency, as it could indicate an imminent heart attack.

Symptoms of angina pectoris include chest pain, pressure, tightness, or heaviness that typically radiates to the left arm, neck, jaw, or back. Shortness of breath, nausea, sweating, and fatigue may also accompany angina symptoms. Immediate medical attention is necessary if you experience chest pain or discomfort, especially if it's new, severe, or persistent, as it could be a sign of a more serious condition like a heart attack.

Blue toe syndrome, also known as acrocyanosis or digital ischemia, is a medical condition characterized by the bluish discoloration of the toes due to insufficient blood supply. This can occur due to various reasons such as chilblains, vasospasms, blood clots in the small arteries of the feet, or certain medications that affect blood flow. Prolonged exposure to cold temperatures, smoking, and underlying health conditions like Raynaud's disease, Buerger's disease, or autoimmune disorders can increase the risk of developing blue toe syndrome. Severe cases may require medical intervention such as medication, surgery, or lifestyle changes to improve blood flow and prevent tissue damage.

The saphenous vein is a term used in anatomical description to refer to the great or small saphenous veins, which are superficial veins located in the lower extremities of the human body.

The great saphenous vein (GSV) is the longest vein in the body and originates from the medial aspect of the foot, ascending along the medial side of the leg and thigh, and drains into the femoral vein at the saphenofemoral junction, located in the upper third of the thigh.

The small saphenous vein (SSV) is a shorter vein that originates from the lateral aspect of the foot, ascends along the posterior calf, and drains into the popliteal vein at the saphenopopliteal junction, located in the popliteal fossa.

These veins are often used as conduits for coronary artery bypass grafting (CABG) surgery due to their consistent anatomy and length.

Angiography is a medical procedure in which an x-ray image is taken to visualize the internal structure of blood vessels, arteries, or veins. This is done by injecting a radiopaque contrast agent (dye) into the blood vessel using a thin, flexible catheter. The dye makes the blood vessels visible on an x-ray image, allowing doctors to diagnose and treat various medical conditions such as blockages, narrowing, or malformations of the blood vessels.

There are several types of angiography, including:

* Cardiac angiography (also called coronary angiography) - used to examine the blood vessels of the heart
* Cerebral angiography - used to examine the blood vessels of the brain
* Peripheral angiography - used to examine the blood vessels in the limbs or other parts of the body.

Angiography is typically performed by a radiologist, cardiologist, or vascular surgeon in a hospital setting. It can help diagnose conditions such as coronary artery disease, aneurysms, and peripheral arterial disease, among others.

A "Group Practice" within the context of hospitals refers to a group of physicians, healthcare professionals, or specialists who come together to form a single organization to provide medical services. They share administrative resources, staff, and facilities while maintaining their own clinical autonomy and patient base. This model allows for more efficient use of resources, improved coordination of care, and increased access to specialized services for patients.

A "Hospital-based Group Practice" is a group practice that operates within a hospital or healthcare system. The physicians in this arrangement are typically employed by the hospital and provide medical services on its behalf. This model allows hospitals to attract top talent, expand their service offerings, and improve patient care through better coordination of services. Additionally, it can help hospitals reduce costs, increase efficiency, and enhance their reputation as a comprehensive healthcare provider.

Cardiac catheterization is a medical procedure used to diagnose and treat cardiovascular conditions. In this procedure, a thin, flexible tube called a catheter is inserted into a blood vessel in the arm or leg and threaded up to the heart. The catheter can be used to perform various diagnostic tests, such as measuring the pressure inside the heart chambers and assessing the function of the heart valves.

Cardiac catheterization can also be used to treat certain cardiovascular conditions, such as narrowed or blocked arteries. In these cases, a balloon or stent may be inserted through the catheter to open up the blood vessel and improve blood flow. This procedure is known as angioplasty or percutaneous coronary intervention (PCI).

Cardiac catheterization is typically performed in a hospital cardiac catheterization laboratory by a team of healthcare professionals, including cardiologists, radiologists, and nurses. The procedure may be done under local anesthesia with sedation or general anesthesia, depending on the individual patient's needs and preferences.

Overall, cardiac catheterization is a valuable tool in the diagnosis and treatment of various heart conditions, and it can help improve symptoms, reduce complications, and prolong life for many patients.

Angioscopy is a medical diagnostic procedure that uses a small fiber-optic scope, called an angioscope, to directly visualize the interior of blood vessels. The angioscope is inserted into the vessel through a small incision or catheter and allows physicians to examine the vessel walls for abnormalities such as plaque buildup, inflammation, or damage. This procedure can be used to diagnose and monitor conditions such as coronary artery disease, peripheral artery disease, and vasculitis. It can also be used during surgical procedures to assist with the placement of stents or other devices in the blood vessels.

Peripheral Arterial Disease (PAD) is a medical condition characterized by the narrowing or blockage of arteries that supply blood to the extremities, most commonly the legs. This results in reduced blood flow, leading to symptoms such as leg pain, cramping, numbness, or weakness during physical activity, and in severe cases, tissue damage or gangrene. PAD is often indicative of widespread atherosclerosis, which is the hardening and narrowing of arteries due to the buildup of fatty deposits called plaques. It's important to note that early detection and management can help prevent serious complications.

Platelet aggregation inhibitors are a class of medications that prevent platelets (small blood cells involved in clotting) from sticking together and forming a clot. These drugs work by interfering with the ability of platelets to adhere to each other and to the damaged vessel wall, thereby reducing the risk of thrombosis (blood clot formation).

Platelet aggregation inhibitors are often prescribed for people who have an increased risk of developing blood clots due to various medical conditions such as atrial fibrillation, coronary artery disease, peripheral artery disease, stroke, or a history of heart attack. They may also be used in patients undergoing certain medical procedures, such as angioplasty and stenting, to prevent blood clot formation in the stents.

Examples of platelet aggregation inhibitors include:

1. Aspirin: A nonsteroidal anti-inflammatory drug (NSAID) that irreversibly inhibits the enzyme cyclooxygenase, which is involved in platelet activation and aggregation.
2. Clopidogrel (Plavix): A P2Y12 receptor antagonist that selectively blocks ADP-induced platelet activation and aggregation.
3. Prasugrel (Effient): A third-generation thienopyridine P2Y12 receptor antagonist, similar to clopidogrel but with faster onset and greater potency.
4. Ticagrelor (Brilinta): A direct-acting P2Y12 receptor antagonist that does not require metabolic activation and has a reversible binding profile.
5. Dipyridamole (Persantine): An antiplatelet agent that inhibits platelet aggregation by increasing cyclic adenosine monophosphate (cAMP) levels in platelets, which leads to decreased platelet reactivity.
6. Iloprost (Ventavis): A prostacyclin analogue that inhibits platelet aggregation and causes vasodilation, often used in the treatment of pulmonary arterial hypertension.
7. Cilostazol (Pletal): A phosphodiesterase III inhibitor that increases cAMP levels in platelets, leading to decreased platelet activation and aggregation, as well as vasodilation.
8. Ticlopidine (Ticlid): An older P2Y12 receptor antagonist with a slower onset of action and more frequent side effects compared to clopidogrel or prasugrel.

Postoperative complications refer to any unfavorable condition or event that occurs during the recovery period after a surgical procedure. These complications can vary in severity and may include, but are not limited to:

1. Infection: This can occur at the site of the incision or inside the body, such as pneumonia or urinary tract infection.
2. Bleeding: Excessive bleeding (hemorrhage) can lead to a drop in blood pressure and may require further surgical intervention.
3. Blood clots: These can form in the deep veins of the legs (deep vein thrombosis) and can potentially travel to the lungs (pulmonary embolism).
4. Wound dehiscence: This is when the surgical wound opens up, which can lead to infection and further complications.
5. Pulmonary issues: These include atelectasis (collapsed lung), pneumonia, or respiratory failure.
6. Cardiovascular problems: These include abnormal heart rhythms (arrhythmias), heart attack, or stroke.
7. Renal failure: This can occur due to various reasons such as dehydration, blood loss, or the use of certain medications.
8. Pain management issues: Inadequate pain control can lead to increased stress, anxiety, and decreased mobility.
9. Nausea and vomiting: These can be caused by anesthesia, opioid pain medication, or other factors.
10. Delirium: This is a state of confusion and disorientation that can occur in the elderly or those with certain medical conditions.

Prompt identification and management of these complications are crucial to ensure the best possible outcome for the patient.

Myocardial ischemia is a condition in which the blood supply to the heart muscle (myocardium) is reduced or blocked, leading to insufficient oxygen delivery and potential damage to the heart tissue. This reduction in blood flow typically results from the buildup of fatty deposits, called plaques, in the coronary arteries that supply the heart with oxygen-rich blood. The plaques can rupture or become unstable, causing the formation of blood clots that obstruct the artery and limit blood flow.

Myocardial ischemia may manifest as chest pain (angina pectoris), shortness of breath, fatigue, or irregular heartbeats (arrhythmias). In severe cases, it can lead to myocardial infarction (heart attack) if the oxygen supply is significantly reduced or cut off completely, causing permanent damage or death of the heart muscle. Early diagnosis and treatment of myocardial ischemia are crucial for preventing further complications and improving patient outcomes.

Electrocardiography (ECG or EKG) is a medical procedure that records the electrical activity of the heart. It provides a graphic representation of the electrical changes that occur during each heartbeat. The resulting tracing, called an electrocardiogram, can reveal information about the heart's rate and rhythm, as well as any damage to its cells or abnormalities in its conduction system.

During an ECG, small electrodes are placed on the skin of the chest, arms, and legs. These electrodes detect the electrical signals produced by the heart and transmit them to a machine that amplifies and records them. The procedure is non-invasive, painless, and quick, usually taking only a few minutes.

ECGs are commonly used to diagnose and monitor various heart conditions, including arrhythmias, coronary artery disease, heart attacks, and electrolyte imbalances. They can also be used to evaluate the effectiveness of certain medications or treatments.

The Predictive Value of Tests, specifically the Positive Predictive Value (PPV) and Negative Predictive Value (NPV), are measures used in diagnostic tests to determine the probability that a positive or negative test result is correct.

Positive Predictive Value (PPV) is the proportion of patients with a positive test result who actually have the disease. It is calculated as the number of true positives divided by the total number of positive results (true positives + false positives). A higher PPV indicates that a positive test result is more likely to be a true positive, and therefore the disease is more likely to be present.

Negative Predictive Value (NPV) is the proportion of patients with a negative test result who do not have the disease. It is calculated as the number of true negatives divided by the total number of negative results (true negatives + false negatives). A higher NPV indicates that a negative test result is more likely to be a true negative, and therefore the disease is less likely to be present.

The predictive value of tests depends on the prevalence of the disease in the population being tested, as well as the sensitivity and specificity of the test. A test with high sensitivity and specificity will generally have higher predictive values than a test with low sensitivity and specificity. However, even a highly sensitive and specific test can have low predictive values if the prevalence of the disease is low in the population being tested.

The Chi-square distribution is a continuous probability distribution that is often used in statistical hypothesis testing. It is the distribution of a sum of squares of k independent standard normal random variables. The resulting quantity follows a chi-square distribution with k degrees of freedom, denoted as χ²(k).

The probability density function (pdf) of the Chi-square distribution with k degrees of freedom is given by:

f(x; k) = (1/ (2^(k/2) * Γ(k/2))) \* x^((k/2)-1) \* e^(-x/2), for x > 0 and 0, otherwise.

Where Γ(k/2) is the gamma function evaluated at k/2. The mean and variance of a Chi-square distribution with k degrees of freedom are k and 2k, respectively.

The Chi-square distribution has various applications in statistical inference, including testing goodness-of-fit, homogeneity of variances, and independence in contingency tables.

The popliteal artery is the continuation of the femoral artery that passes through the popliteal fossa, which is the area behind the knee. It is the major blood vessel that supplies oxygenated blood to the lower leg and foot. The popliteal artery divides into the anterior tibial artery and the tibioperoneal trunk at the lower border of the popliteus muscle. Any damage or blockage to this artery can result in serious health complications, including reduced blood flow to the leg and foot, which may lead to pain, cramping, numbness, or even tissue death (gangrene) if left untreated.

Atherosclerotic plaque is a deposit of fatty (cholesterol and fat) substances, calcium, and other substances in the inner lining of an artery. This plaque buildup causes the artery to narrow and harden, reducing blood flow through the artery, which can lead to serious cardiovascular conditions such as coronary artery disease, angina, heart attack, or stroke. The process of atherosclerosis develops gradually over decades and can start in childhood.

Arterial occlusive diseases are medical conditions characterized by the blockage or narrowing of the arteries, which can lead to a reduction in blood flow to various parts of the body. This reduction in blood flow can cause tissue damage and may result in serious complications such as tissue death (gangrene), organ dysfunction, or even death.

The most common cause of arterial occlusive diseases is atherosclerosis, which is the buildup of plaque made up of fat, cholesterol, calcium, and other substances in the inner lining of the artery walls. Over time, this plaque can harden and narrow the arteries, restricting blood flow. Other causes of arterial occlusive diseases include blood clots, emboli (tiny particles that travel through the bloodstream and lodge in smaller vessels), inflammation, trauma, and certain inherited conditions.

Symptoms of arterial occlusive diseases depend on the location and severity of the blockage. Common symptoms include:

* Pain, cramping, or fatigue in the affected limb, often triggered by exercise and relieved by rest (claudication)
* Numbness, tingling, or weakness in the affected limb
* Coldness or discoloration of the skin in the affected area
* Slow-healing sores or wounds on the toes, feet, or legs
* Erectile dysfunction in men

Treatment for arterial occlusive diseases may include lifestyle changes such as quitting smoking, exercising regularly, and eating a healthy diet. Medications to lower cholesterol, control blood pressure, prevent blood clots, or manage pain may also be prescribed. In severe cases, surgical procedures such as angioplasty, stenting, or bypass surgery may be necessary to restore blood flow.

Risk assessment in the medical context refers to the process of identifying, evaluating, and prioritizing risks to patients, healthcare workers, or the community related to healthcare delivery. It involves determining the likelihood and potential impact of adverse events or hazards, such as infectious diseases, medication errors, or medical devices failures, and implementing measures to mitigate or manage those risks. The goal of risk assessment is to promote safe and high-quality care by identifying areas for improvement and taking action to minimize harm.

A Severity of Illness Index is a measurement tool used in healthcare to assess the severity of a patient's condition and the risk of mortality or other adverse outcomes. These indices typically take into account various physiological and clinical variables, such as vital signs, laboratory values, and co-morbidities, to generate a score that reflects the patient's overall illness severity.

Examples of Severity of Illness Indices include the Acute Physiology and Chronic Health Evaluation (APACHE) system, the Simplified Acute Physiology Score (SAPS), and the Mortality Probability Model (MPM). These indices are often used in critical care settings to guide clinical decision-making, inform prognosis, and compare outcomes across different patient populations.

It is important to note that while these indices can provide valuable information about a patient's condition, they should not be used as the sole basis for clinical decision-making. Rather, they should be considered in conjunction with other factors, such as the patient's overall clinical presentation, treatment preferences, and goals of care.

I believe there might be a misunderstanding in your question. "Dogs" is not a medical term or condition. It is the common name for a domesticated carnivore of the family Canidae, specifically the genus Canis, which includes wolves, foxes, and other extant and extinct species of mammals. Dogs are often kept as pets and companions, and they have been bred in a wide variety of forms and sizes for different purposes, such as hunting, herding, guarding, assisting police and military forces, and providing companionship and emotional support.

If you meant to ask about a specific medical condition or term related to dogs, please provide more context so I can give you an accurate answer.

Coronary artery bypass, off-pump refers to a surgical procedure used to treat coronary artery disease (CAD), which is the narrowing or blockage of the coronary arteries due to the buildup of fatty deposits called plaques. This procedure is also known as off-pump coronary artery bypass (OPCAB) or beating heart bypass surgery.

In a coronary artery bypass, off-pump procedure, the surgeon creates a new pathway for blood to flow around the blocked or narrowed portion of the coronary artery using a healthy blood vessel from another part of the body, such as the chest wall (internal mammary artery) or the leg (saphenous vein). This allows oxygen-rich blood to bypass the blockage and reach the heart muscle directly.

The key difference between on-pump and off-pump coronary artery bypass surgery is that in an off-pump procedure, the heart continues to beat during the operation, and no heart-lung machine (cardiopulmonary bypass) is used. This approach has several potential advantages over on-pump CABG, including reduced risks of bleeding, stroke, and kidney failure. However, it may not be suitable for all patients, particularly those with complex or extensive coronary artery disease.

Overall, coronary artery bypass, off-pump surgery is a safe and effective treatment option for many patients with CAD, and can help improve symptoms, quality of life, and long-term outcomes.

The term "lower extremity" is used in the medical field to refer to the portion of the human body that includes the structures below the hip joint. This includes the thigh, lower leg, ankle, and foot. The lower extremities are responsible for weight-bearing and locomotion, allowing individuals to stand, walk, run, and jump. They contain many important structures such as bones, muscles, tendons, ligaments, nerves, and blood vessels.

Myocardial revascularization is a medical term that refers to the restoration of blood flow to the heart muscle (myocardium), typically through a surgical or interventional procedure. This is often performed in patients with coronary artery disease, where the buildup of plaque in the coronary arteries restricts blood flow to the heart muscle, causing symptoms such as chest pain (angina) or shortness of breath, and increasing the risk of a heart attack (myocardial infarction).

There are two main types of myocardial revascularization:

1. Coronary artery bypass grafting (CABG): This is a surgical procedure in which a healthy blood vessel from another part of the body is used to create a detour around the blocked or narrowed coronary artery, allowing blood to flow more freely to the heart muscle.
2. Percutaneous coronary intervention (PCI), also known as angioplasty and stenting: This is a minimally invasive procedure in which a thin catheter is inserted into an artery in the groin or arm and threaded up to the blocked or narrowed coronary artery. A balloon is then inflated to widen the artery, and a stent may be placed to keep it open.

Both procedures aim to improve symptoms, reduce the risk of heart attack, and prolong survival in appropriately selected patients with coronary artery disease.

Multivariate analysis is a statistical method used to examine the relationship between multiple independent variables and a dependent variable. It allows for the simultaneous examination of the effects of two or more independent variables on an outcome, while controlling for the effects of other variables in the model. This technique can be used to identify patterns, associations, and interactions among multiple variables, and is commonly used in medical research to understand complex health outcomes and disease processes. Examples of multivariate analysis methods include multiple regression, factor analysis, cluster analysis, and discriminant analysis.

In medical terms, the heart is a muscular organ located in the thoracic cavity that functions as a pump to circulate blood throughout the body. It's responsible for delivering oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. The human heart is divided into four chambers: two atria on the top and two ventricles on the bottom. The right side of the heart receives deoxygenated blood from the body and pumps it to the lungs, while the left side receives oxygenated blood from the lungs and pumps it out to the rest of the body. The heart's rhythmic contractions and relaxations are regulated by a complex electrical conduction system.

Peripheral Vascular Diseases (PVD) refer to a group of medical conditions that affect the blood vessels outside of the heart and brain. These diseases are characterized by a narrowing or blockage of the peripheral arteries, which can lead to reduced blood flow to the limbs, particularly the legs.

The primary cause of PVD is atherosclerosis, a buildup of fats, cholesterol, and other substances in and on the walls of the arteries, forming plaques that restrict blood flow. Other risk factors include smoking, diabetes, hypertension, high cholesterol levels, and a family history of vascular disease.

Symptoms of PVD can vary depending on the severity of the condition but may include leg pain or cramping during exercise (claudication), numbness or tingling in the legs, coldness or discoloration of the feet, sores or wounds that heal slowly or not at all, and in severe cases, gangrene.

PVD can increase the risk of heart attack and stroke, so it is essential to diagnose and treat the condition as early as possible. Treatment options include lifestyle changes such as quitting smoking, exercising regularly, and maintaining a healthy diet, medications to control symptoms and reduce the risk of complications, and surgical procedures such as angioplasty or bypass surgery to restore blood flow.

The postoperative period is the time following a surgical procedure during which the patient's response to the surgery and anesthesia is monitored, and any complications or adverse effects are managed. This period can vary in length depending on the type of surgery and the individual patient's needs, but it typically includes the immediate recovery phase in the post-anesthesia care unit (PACU) or recovery room, as well as any additional time spent in the hospital for monitoring and management of pain, wound healing, and other aspects of postoperative care.

The goals of postoperative care are to ensure the patient's safety and comfort, promote optimal healing and rehabilitation, and minimize the risk of complications such as infection, bleeding, or other postoperative issues. The specific interventions and treatments provided during this period will depend on a variety of factors, including the type and extent of surgery performed, the patient's overall health and medical history, and any individualized care plans developed in consultation with the patient and their healthcare team.

A feasibility study is a preliminary investigation or analysis conducted to determine the viability of a proposed project, program, or product. In the medical field, feasibility studies are often conducted before implementing new treatments, procedures, equipment, or facilities. These studies help to assess the practicality and effectiveness of the proposed intervention, as well as its potential benefits and risks.

Feasibility studies in healthcare typically involve several steps:

1. Problem identification: Clearly define the problem that the proposed project, program, or product aims to address.
2. Objectives setting: Establish specific, measurable, achievable, relevant, and time-bound (SMART) objectives for the study.
3. Literature review: Conduct a thorough review of existing research and best practices related to the proposed intervention.
4. Methodology development: Design a methodology for data collection and analysis that will help answer the research questions and achieve the study's objectives.
5. Resource assessment: Evaluate the availability and adequacy of resources, including personnel, time, and finances, required to carry out the proposed intervention.
6. Risk assessment: Identify potential risks and challenges associated with the implementation of the proposed intervention and develop strategies to mitigate them.
7. Cost-benefit analysis: Estimate the costs and benefits of the proposed intervention, including direct and indirect costs, as well as short-term and long-term benefits.
8. Stakeholder engagement: Engage relevant stakeholders, such as patients, healthcare providers, administrators, and policymakers, to gather their input and support for the proposed intervention.
9. Decision-making: Based on the findings of the feasibility study, make an informed decision about whether or not to proceed with the proposed project, program, or product.

Feasibility studies are essential in healthcare as they help ensure that resources are allocated efficiently and effectively, and that interventions are evidence-based, safe, and beneficial for patients.

Blood flow velocity is the speed at which blood travels through a specific part of the vascular system. It is typically measured in units of distance per time, such as centimeters per second (cm/s) or meters per second (m/s). Blood flow velocity can be affected by various factors, including cardiac output, vessel diameter, and viscosity of the blood. Measuring blood flow velocity is important in diagnosing and monitoring various medical conditions, such as heart disease, stroke, and peripheral vascular disease.

Clinical enzyme tests are laboratory tests that measure the amount or activity of certain enzymes in biological samples, such as blood or bodily fluids. These tests are used to help diagnose and monitor various medical conditions, including organ damage, infection, inflammation, and genetic disorders.

Enzymes are proteins that catalyze chemical reactions in the body. Some enzymes are found primarily within specific organs or tissues, so elevated levels of these enzymes in the blood can indicate damage to those organs or tissues. For example, high levels of creatine kinase (CK) may suggest muscle damage, while increased levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) can indicate liver damage.

There are several types of clinical enzyme tests, including:

1. Serum enzyme tests: These measure the level of enzymes in the blood serum, which is the liquid portion of the blood after clotting. Examples include CK, AST, ALT, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH).
2. Urine enzyme tests: These measure the level of enzymes in the urine. An example is N-acetyl-β-D-glucosaminidase (NAG), which can indicate kidney damage.
3. Enzyme immunoassays (EIAs): These use antibodies to detect and quantify specific enzymes or proteins in a sample. They are often used for the diagnosis of infectious diseases, such as HIV or hepatitis.
4. Genetic enzyme tests: These can identify genetic mutations that cause deficiencies in specific enzymes, leading to inherited metabolic disorders like phenylketonuria (PKU) or Gaucher's disease.

It is important to note that the interpretation of clinical enzyme test results should be done by a healthcare professional, taking into account the patient's medical history, symptoms, and other diagnostic tests.

Limb salvage is a medical term used to describe the surgical procedures and treatments aimed at preserving and restoring the functionality of a severely injured or diseased limb, rather than amputating it. The goal of limb salvage is to improve the patient's quality of life by maintaining their mobility, independence, and overall well-being.

Limb salvage may involve various surgical techniques such as vascular reconstruction, bone realignment, muscle flap coverage, and external fixation. These procedures aim to restore blood flow, stabilize bones, cover exposed tissues, and prevent infection. Additionally, adjuvant therapies like hyperbaric oxygen treatment, physical therapy, and pain management may be employed to support the healing process and improve functional outcomes.

Limb salvage is typically considered when a limb is threatened by conditions such as severe trauma, tumors, infections, or peripheral arterial disease. The decision to pursue limb salvage over amputation depends on factors like the patient's overall health, age, and personal preferences, as well as the extent of the injury or disease, potential for recovery, and likelihood of successful rehabilitation.

Vasodilator agents are pharmacological substances that cause the relaxation or widening of blood vessels by relaxing the smooth muscle in the vessel walls. This results in an increase in the diameter of the blood vessels, which decreases vascular resistance and ultimately reduces blood pressure. Vasodilators can be further classified based on their site of action:

1. Systemic vasodilators: These agents cause a generalized relaxation of the smooth muscle in the walls of both arteries and veins, resulting in a decrease in peripheral vascular resistance and preload (the volume of blood returning to the heart). Examples include nitroglycerin, hydralazine, and calcium channel blockers.
2. Arterial vasodilators: These agents primarily affect the smooth muscle in arterial vessel walls, leading to a reduction in afterload (the pressure against which the heart pumps blood). Examples include angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and direct vasodilators like sodium nitroprusside.
3. Venous vasodilators: These agents primarily affect the smooth muscle in venous vessel walls, increasing venous capacitance and reducing preload. Examples include nitroglycerin and other organic nitrates.

Vasodilator agents are used to treat various cardiovascular conditions such as hypertension, heart failure, angina, and pulmonary arterial hypertension. It is essential to monitor their use carefully, as excessive vasodilation can lead to orthostatic hypotension, reflex tachycardia, or fluid retention.

Equipment design, in the medical context, refers to the process of creating and developing medical equipment and devices, such as surgical instruments, diagnostic machines, or assistive technologies. This process involves several stages, including:

1. Identifying user needs and requirements
2. Concept development and brainstorming
3. Prototyping and testing
4. Design for manufacturing and assembly
5. Safety and regulatory compliance
6. Verification and validation
7. Training and support

The goal of equipment design is to create safe, effective, and efficient medical devices that meet the needs of healthcare providers and patients while complying with relevant regulations and standards. The design process typically involves a multidisciplinary team of engineers, clinicians, designers, and researchers who work together to develop innovative solutions that improve patient care and outcomes.

Catheterization is a medical procedure in which a catheter (a flexible tube) is inserted into the body to treat various medical conditions or for diagnostic purposes. The specific definition can vary depending on the area of medicine and the particular procedure being discussed. Here are some common types of catheterization:

1. Urinary catheterization: This involves inserting a catheter through the urethra into the bladder to drain urine. It is often performed to manage urinary retention, monitor urine output in critically ill patients, or assist with surgical procedures.
2. Cardiac catheterization: A procedure where a catheter is inserted into a blood vessel, usually in the groin or arm, and guided to the heart. This allows for various diagnostic tests and treatments, such as measuring pressures within the heart chambers, assessing blood flow, or performing angioplasty and stenting of narrowed coronary arteries.
3. Central venous catheterization: A catheter is inserted into a large vein, typically in the neck, chest, or groin, to administer medications, fluids, or nutrition, or to monitor central venous pressure.
4. Peritoneal dialysis catheterization: A catheter is placed into the abdominal cavity for individuals undergoing peritoneal dialysis, a type of kidney replacement therapy.
5. Neurological catheterization: In some cases, a catheter may be inserted into the cerebrospinal fluid space (lumbar puncture) or the brain's ventricular system (ventriculostomy) to diagnose or treat various neurological conditions.

These are just a few examples of catheterization procedures in medicine. The specific definition and purpose will depend on the medical context and the particular organ or body system involved.

Hemodynamics is the study of how blood flows through the cardiovascular system, including the heart and the vascular network. It examines various factors that affect blood flow, such as blood volume, viscosity, vessel length and diameter, and pressure differences between different parts of the circulatory system. Hemodynamics also considers the impact of various physiological and pathological conditions on these variables, and how they in turn influence the function of vital organs and systems in the body. It is a critical area of study in fields such as cardiology, anesthesiology, and critical care medicine.

Vasodilation is the widening or increase in diameter of blood vessels, particularly the involuntary relaxation of the smooth muscle in the tunica media (middle layer) of the arteriole walls. This results in an increase in blood flow and a decrease in vascular resistance. Vasodilation can occur due to various physiological and pathophysiological stimuli, such as local metabolic demands, neural signals, or pharmacological agents. It plays a crucial role in regulating blood pressure, tissue perfusion, and thermoregulation.

Tunica intima, also known as the intima layer, is the innermost layer of a blood vessel, including arteries and veins. It is in direct contact with the flowing blood and is composed of simple squamous endothelial cells that form a continuous, non-keratinized, stratified epithelium. These cells play a crucial role in maintaining vascular homeostasis by regulating the passage of molecules and immune cells between the blood and the vessel wall, as well as contributing to the maintenance of blood fluidity and preventing coagulation.

The tunica intima is supported by a thin layer of connective tissue called the basement membrane, which provides structural stability and anchorage for the endothelial cells. Beneath the basement membrane lies a loose network of elastic fibers and collagen, known as the internal elastic lamina, that separates the tunica intima from the middle layer, or tunica media.

In summary, the tunica intima is the innermost layer of blood vessels, primarily composed of endothelial cells and a basement membrane, which regulates various functions to maintain vascular homeostasis.

Intermittent claudication is a medical condition characterized by pain or cramping in the legs, usually in the calf muscles, that occurs during exercise or walking and is relieved by rest. This symptom is caused by insufficient blood flow to the working muscles due to peripheral artery disease (PAD), a narrowing or blockage of the arteries in the limbs. As the individual walks, the muscle demands for oxygen and nutrients increase, but the restricted blood supply cannot meet these demands, leading to ischemia (lack of oxygen) and pain. The pain typically subsides after a few minutes of rest, as the muscle's demand for oxygen decreases, allowing the limited blood flow to compensate. Regular exercise and medications may help improve symptoms and reduce the risk of complications associated with PAD.

Subclavian Steal Syndrome is a medical condition that occurs when there is a narrowing or blockage (stenosis) in the subclavian artery, usually at or near its origin from the aorta. This stenosis causes reduced blood flow to the ipsilateral upper extremity. The decreased blood supply to the arm leads to reversal of flow in the vertebral artery, which normally supplies blood to the brain and neck structures. As a result, the brain may receive insufficient blood flow, causing symptoms such as dizziness, lightheadedness, syncope (fainting), or transient ischemic attacks (TIAs or "mini-strokes").

The syndrome is called 'subclavian steal' because the vertebral artery essentially "steals" blood from the circle of Willis (the network of arteries at the base of the brain) to compensate for the reduced flow in the subclavian artery. The condition most commonly affects the left subclavian artery, but it can also occur on the right side or both sides.

Subclavian Steal Syndrome is typically diagnosed through a combination of physical examination, medical history, and imaging tests such as Doppler ultrasound, CT angiography (CTA), or magnetic resonance angiography (MRA). Treatment options include surgical bypass, endovascular stenting, or medication to manage symptoms and reduce the risk of stroke.

In medical terms, "retreatment" refers to the process of providing additional treatment or courses of therapy to an individual who has previously undergone a medical intervention but has not achieved the desired outcomes or has experienced a recurrence of symptoms. This may apply to various medical conditions and treatments, including dental procedures, cancer therapies, mental health treatments, and more.

In the context of dentistry, specifically endodontics (root canal treatment), retreatment is the process of repeating the root canal procedure on a tooth that has already been treated before. This may be necessary if the initial treatment was not successful in eliminating infection or if reinfection has occurred. The goal of retreatment is to preserve the natural tooth and alleviate any persistent pain or discomfort.

The inguinal canal is a narrow passage in the lower abdominal wall. In males, it allows for the spermatic cord and blood vessels to travel from the abdomen to the scrotum. In females, it provides a pathway for the round ligament of the uterus to pass through. The inguinal canal is located in the groin region, and an inguinal hernia occurs when a portion of the intestine protrudes through this canal.

In epidemiology, the incidence of a disease is defined as the number of new cases of that disease within a specific population over a certain period of time. It is typically expressed as a rate, with the number of new cases in the numerator and the size of the population at risk in the denominator. Incidence provides information about the risk of developing a disease during a given time period and can be used to compare disease rates between different populations or to monitor trends in disease occurrence over time.

X-ray computed tomography (CT or CAT scan) is a medical imaging method that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of the body. These cross-sectional images can then be used to display detailed internal views of organs, bones, and soft tissues in the body.

The term "computed tomography" is used instead of "CT scan" or "CAT scan" because the machines take a series of X-ray measurements from different angles around the body and then use a computer to process these data to create detailed images of internal structures within the body.

CT scanning is a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. CT imaging provides detailed information about many types of tissue including lung, bone, soft tissue and blood vessels. CT examinations can be performed on every part of the body for a variety of reasons including diagnosis, surgical planning, and monitoring of therapeutic responses.

In computed tomography (CT), an X-ray source and detector rotate around the patient, measuring the X-ray attenuation at many different angles. A computer uses this data to construct a cross-sectional image by the process of reconstruction. This technique is called "tomography". The term "computed" refers to the use of a computer to reconstruct the images.

CT has become an important tool in medical imaging and diagnosis, allowing radiologists and other physicians to view detailed internal images of the body. It can help identify many different medical conditions including cancer, heart disease, lung nodules, liver tumors, and internal injuries from trauma. CT is also commonly used for guiding biopsies and other minimally invasive procedures.

In summary, X-ray computed tomography (CT or CAT scan) is a medical imaging technique that uses computer-processed combinations of many X-ray images taken from different angles to produce cross-sectional images of the body. It provides detailed internal views of organs, bones, and soft tissues in the body, allowing physicians to diagnose and treat medical conditions.

Counterpulsation is a medical treatment used in critical care medicine, particularly in the management of cardiovascular conditions. It refers to a technique that involves delivering therapies that counter or oppose the patient's own cardiac cycle. The most common form of counterpulsation is through the use of an intra-aortic balloon pump (IABP).

During IABP, a catheter with a sausage-shaped balloon at its tip is inserted into the patient's aorta, usually through the femoral artery in the groin. The balloon is then connected to a console that controls its inflation and deflation. The console is programmed to detect the patient's cardiac cycle using either the ECG or arterial pressure waveform.

During diastole (when the heart muscle relaxes and fills with blood), the balloon inflates, increasing the volume of blood in the aorta and improving coronary artery perfusion. This helps to increase oxygen delivery to the myocardium (heart muscle) and reduce its workload.

During systole (when the heart muscle contracts and ejects blood), the balloon deflates, reducing afterload (the resistance against which the heart must pump). This reduces the workload of the left ventricle, allowing it to fill more easily during diastole and improving overall cardiac output.

In summary, counterpulsation is a medical intervention that uses therapies, such as intra-aortic balloon pumps, to counter or oppose the patient's own cardiac cycle. This technique aims to improve coronary artery perfusion, reduce afterload, and enhance overall cardiac function.

The myocardium is the middle layer of the heart wall, composed of specialized cardiac muscle cells that are responsible for pumping blood throughout the body. It forms the thickest part of the heart wall and is divided into two sections: the left ventricle, which pumps oxygenated blood to the rest of the body, and the right ventricle, which pumps deoxygenated blood to the lungs.

The myocardium contains several types of cells, including cardiac muscle fibers, connective tissue, nerves, and blood vessels. The muscle fibers are arranged in a highly organized pattern that allows them to contract in a coordinated manner, generating the force necessary to pump blood through the heart and circulatory system.

Damage to the myocardium can occur due to various factors such as ischemia (reduced blood flow), infection, inflammation, or genetic disorders. This damage can lead to several cardiac conditions, including heart failure, arrhythmias, and cardiomyopathy.

Arteriosclerosis is a general term that describes the hardening and stiffening of the artery walls. It's a progressive condition that can occur as a result of aging, or it may be associated with certain risk factors such as high blood pressure, high cholesterol, diabetes, smoking, and a sedentary lifestyle.

The process of arteriosclerosis involves the buildup of plaque, made up of fat, cholesterol, calcium, and other substances, in the inner lining of the artery walls. Over time, this buildup can cause the artery walls to thicken and harden, reducing the flow of oxygen-rich blood to the body's organs and tissues.

Arteriosclerosis can affect any of the body's arteries, but it is most commonly found in the coronary arteries that supply blood to the heart, the cerebral arteries that supply blood to the brain, and the peripheral arteries that supply blood to the limbs. When arteriosclerosis affects the coronary arteries, it can lead to heart disease, angina, or heart attack. When it affects the cerebral arteries, it can lead to stroke or transient ischemic attack (TIA). When it affects the peripheral arteries, it can cause pain, numbness, or weakness in the limbs, and in severe cases, gangrene and amputation.

Chest pain is a discomfort or pain that you feel in the chest area. The pain can be sharp, dull, burning, crushing, heaviness, or tightness. It may be accompanied by other symptoms such as shortness of breath, sweating, nausea, dizziness, or pain that radiates to the arm, neck, jaw, or back.

Chest pain can have many possible causes, including heart-related conditions such as angina or a heart attack, lung conditions such as pneumonia or pleurisy, gastrointestinal problems such as acid reflux or gastritis, musculoskeletal issues such as costochondritis or muscle strain, and anxiety or panic attacks.

It is important to seek immediate medical attention if you experience chest pain that is severe, persistent, or accompanied by other concerning symptoms, as it may be a sign of a serious medical condition. A healthcare professional can evaluate your symptoms, perform tests, and provide appropriate treatment.

Collateral circulation refers to the alternate blood supply routes that bypass an obstructed or narrowed vessel and reconnect with the main vascular system. These collateral vessels can develop over time as a result of the body's natural adaptation to chronic ischemia (reduced blood flow) caused by various conditions such as atherosclerosis, thromboembolism, or vasculitis.

The development of collateral circulation helps maintain adequate blood flow and oxygenation to affected tissues, minimizing the risk of tissue damage and necrosis. In some cases, well-developed collateral circulations can help compensate for significant blockages in major vessels, reducing symptoms and potentially preventing the need for invasive interventions like revascularization procedures. However, the extent and effectiveness of collateral circulation vary from person to person and depend on factors such as age, overall health status, and the presence of comorbidities.

Pulmonary subvalvular stenosis is a rare cardiac condition that refers to the narrowing or obstruction of the pulmonary valve or the outflow tract below it, within the right ventricle of the heart. This results in restricted blood flow from the right ventricle to the pulmonary artery and subsequently to the lungs.

The narrowing can be caused by various factors such as a membranous shelf-like structure (dysplasia), a fibrous ring, or a tunnel-like narrowing of the outflow tract (tunneling). The severity of the stenosis may vary from mild to severe, and symptoms can range from shortness of breath, fatigue, and chest pain to more serious complications like heart failure or arrhythmias.

Diagnosis typically involves imaging tests such as echocardiography, cardiac MRI, or cardiac catheterization. Treatment options depend on the severity of the stenosis and may include monitoring, medications, or invasive procedures such as balloon dilation or surgical repair.

Internal mammary-coronary artery anastomosis is a surgical procedure in which the internal mammary artery (IMA) is connected to the coronary artery of the heart. This type of surgery, also known as internal thoracic artery-coronary artery bypass grafting (ITA CABG), is performed to improve blood flow to the heart muscle and reduce symptoms of coronary artery disease such as angina and shortness of breath.

The IMA is a small artery that branches off the subclavian artery and runs along the inside of the chest wall. It has several advantages over other conduits used for bypass grafting, including its size, length, and excellent long-term patency rates. The procedure involves harvesting the IMA through a small incision in the chest wall and then sewing it to the coronary artery using fine sutures.

The internal mammary-coronary artery anastomosis can be performed as a single bypass graft or in combination with other conduits such as the saphenous vein. The choice of conduit and number of grafts depends on various factors, including the location and severity of coronary artery disease, patient's age and overall health status.

Overall, internal mammary-coronary artery anastomosis is a safe and effective surgical procedure that has been shown to improve symptoms, quality of life, and survival in patients with coronary artery disease.

Prognosis is a medical term that refers to the prediction of the likely outcome or course of a disease, including the chances of recovery or recurrence, based on the patient's symptoms, medical history, physical examination, and diagnostic tests. It is an important aspect of clinical decision-making and patient communication, as it helps doctors and patients make informed decisions about treatment options, set realistic expectations, and plan for future care.

Prognosis can be expressed in various ways, such as percentages, categories (e.g., good, fair, poor), or survival rates, depending on the nature of the disease and the available evidence. However, it is important to note that prognosis is not an exact science and may vary depending on individual factors, such as age, overall health status, and response to treatment. Therefore, it should be used as a guide rather than a definitive forecast.

A smooth muscle within the vascular system refers to the involuntary, innervated muscle that is found in the walls of blood vessels. These muscles are responsible for controlling the diameter of the blood vessels, which in turn regulates blood flow and blood pressure. They are called "smooth" muscles because their individual muscle cells do not have the striations, or cross-striped patterns, that are observed in skeletal and cardiac muscle cells. Smooth muscle in the vascular system is controlled by the autonomic nervous system and by hormones, and can contract or relax slowly over a period of time.

The endothelium is a thin layer of simple squamous epithelial cells that lines the interior surface of blood vessels, lymphatic vessels, and heart chambers. The vascular endothelium, specifically, refers to the endothelial cells that line the blood vessels. These cells play a crucial role in maintaining vascular homeostasis by regulating vasomotor tone, coagulation, platelet activation, inflammation, and permeability of the vessel wall. They also contribute to the growth and repair of the vascular system and are involved in various pathological processes such as atherosclerosis, hypertension, and diabetes.

Adenosine is a purine nucleoside that is composed of a sugar (ribose) and the base adenine. It plays several important roles in the body, including serving as a precursor for the synthesis of other molecules such as ATP, NAD+, and RNA.

In the medical context, adenosine is perhaps best known for its use as a pharmaceutical agent to treat certain cardiac arrhythmias. When administered intravenously, it can help restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT) by slowing conduction through the atrioventricular node and interrupting the reentry circuit responsible for the arrhythmia.

Adenosine can also be used as a diagnostic tool to help differentiate between narrow-complex tachycardias of supraventricular origin and those that originate from below the ventricles (such as ventricular tachycardia). This is because adenosine will typically terminate PSVT but not affect the rhythm of VT.

It's worth noting that adenosine has a very short half-life, lasting only a few seconds in the bloodstream. This means that its effects are rapidly reversible and generally well-tolerated, although some patients may experience transient symptoms such as flushing, chest pain, or shortness of breath.

"Swine" is a common term used to refer to even-toed ungulates of the family Suidae, including domestic pigs and wild boars. However, in a medical context, "swine" often appears in the phrase "swine flu," which is a strain of influenza virus that typically infects pigs but can also cause illness in humans. The 2009 H1N1 pandemic was caused by a new strain of swine-origin influenza A virus, which was commonly referred to as "swine flu." It's important to note that this virus is not transmitted through eating cooked pork products; it spreads from person to person, mainly through respiratory droplets produced when an infected person coughs or sneezes.

Regression analysis is a statistical technique used in medicine, as well as in other fields, to examine the relationship between one or more independent variables (predictors) and a dependent variable (outcome). It allows for the estimation of the average change in the outcome variable associated with a one-unit change in an independent variable, while controlling for the effects of other independent variables. This technique is often used to identify risk factors for diseases or to evaluate the effectiveness of medical interventions. In medical research, regression analysis can be used to adjust for potential confounding variables and to quantify the relationship between exposures and health outcomes. It can also be used in predictive modeling to estimate the probability of a particular outcome based on multiple predictors.

A registry in the context of medicine is a collection or database of standardized information about individuals who share a certain condition or attribute, such as a disease, treatment, exposure, or demographic group. These registries are used for various purposes, including:

* Monitoring and tracking the natural history of diseases and conditions
* Evaluating the safety and effectiveness of medical treatments and interventions
* Conducting research and generating hypotheses for further study
* Providing information to patients, clinicians, and researchers
* Informing public health policy and decision-making

Registries can be established for a wide range of purposes, including disease-specific registries (such as cancer or diabetes registries), procedure-specific registries (such as joint replacement or cardiac surgery registries), and population-based registries (such as birth defects or cancer registries). Data collected in registries may include demographic information, clinical data, laboratory results, treatment details, and outcomes.

Registries can be maintained by a variety of organizations, including hospitals, clinics, academic medical centers, professional societies, government agencies, and industry. Participation in registries is often voluntary, although some registries may require informed consent from participants. Data collected in registries are typically de-identified to protect the privacy of individuals.

Logistic models, specifically logistic regression models, are a type of statistical analysis used in medical and epidemiological research to identify the relationship between the risk of a certain health outcome or disease (dependent variable) and one or more independent variables, such as demographic factors, exposure variables, or other clinical measurements.

In contrast to linear regression models, logistic regression models are used when the dependent variable is binary or dichotomous in nature, meaning it can only take on two values, such as "disease present" or "disease absent." The model uses a logistic function to estimate the probability of the outcome based on the independent variables.

Logistic regression models are useful for identifying risk factors and estimating the strength of associations between exposures and health outcomes, adjusting for potential confounders, and predicting the probability of an outcome given certain values of the independent variables. They can also be used to develop clinical prediction rules or scores that can aid in decision-making and patient care.

Drug-eluting stents (DES) are medical devices used in the treatment of coronary artery disease. They are small, flexible tubes that are coated with a medication that is slowly released (eluted) over time to prevent the formation of scar tissue and reduce the risk of renarrowing (restenosis) of the artery after it has been treated with angioplasty and stenting.

The stent is typically placed in a narrowed or blocked coronary artery during a percutaneous coronary intervention (PCI) procedure, such as angioplasty, to open up the blood vessel and improve blood flow to the heart muscle. The medication on the DES helps to prevent the growth of smooth muscle cells and the formation of scar tissue in the artery, which can cause restenosis and require additional treatments.

The most commonly used medications on DES are sirolimus, paclitaxel, zotarolimus, and everolimus. These drugs work by inhibiting the growth of smooth muscle cells and reducing inflammation in the artery. While DES have been shown to reduce the risk of restenosis compared to bare-metal stents, they also carry a small increased risk of late stent thrombosis (blood clots forming in the stent), which can lead to serious complications such as heart attack or stroke. Therefore, patients who receive DES are typically prescribed long-term antiplatelet therapy to reduce this risk.

A biological marker, often referred to as a biomarker, is a measurable indicator that reflects the presence or severity of a disease state, or a response to a therapeutic intervention. Biomarkers can be found in various materials such as blood, tissues, or bodily fluids, and they can take many forms, including molecular, histologic, radiographic, or physiological measurements.

In the context of medical research and clinical practice, biomarkers are used for a variety of purposes, such as:

1. Diagnosis: Biomarkers can help diagnose a disease by indicating the presence or absence of a particular condition. For example, prostate-specific antigen (PSA) is a biomarker used to detect prostate cancer.
2. Monitoring: Biomarkers can be used to monitor the progression or regression of a disease over time. For instance, hemoglobin A1c (HbA1c) levels are monitored in diabetes patients to assess long-term blood glucose control.
3. Predicting: Biomarkers can help predict the likelihood of developing a particular disease or the risk of a negative outcome. For example, the presence of certain genetic mutations can indicate an increased risk for breast cancer.
4. Response to treatment: Biomarkers can be used to evaluate the effectiveness of a specific treatment by measuring changes in the biomarker levels before and after the intervention. This is particularly useful in personalized medicine, where treatments are tailored to individual patients based on their unique biomarker profiles.

It's important to note that for a biomarker to be considered clinically valid and useful, it must undergo rigorous validation through well-designed studies, including demonstrating sensitivity, specificity, reproducibility, and clinical relevance.

Analysis of Variance (ANOVA) is a statistical technique used to compare the means of two or more groups and determine whether there are any significant differences between them. It is a way to analyze the variance in a dataset to determine whether the variability between groups is greater than the variability within groups, which can indicate that the groups are significantly different from one another.

ANOVA is based on the concept of partitioning the total variance in a dataset into two components: variance due to differences between group means (also known as "between-group variance") and variance due to differences within each group (also known as "within-group variance"). By comparing these two sources of variance, ANOVA can help researchers determine whether any observed differences between groups are statistically significant, or whether they could have occurred by chance.

ANOVA is a widely used technique in many areas of research, including biology, psychology, engineering, and business. It is often used to compare the means of two or more experimental groups, such as a treatment group and a control group, to determine whether the treatment had a significant effect. ANOVA can also be used to compare the means of different populations or subgroups within a population, to identify any differences that may exist between them.

The tunica media is the middle layer of the wall of a blood vessel or hollow organ in the body. It is primarily composed of smooth muscle cells and elastic fibers, which allow the vessel or organ to expand and contract. This layer helps regulate the diameter of the lumen (the inner space) of the vessel or organ, thereby controlling the flow of fluids such as blood or lymph through it. The tunica media plays a crucial role in maintaining proper organ function and blood pressure regulation.

Sharma, Samin K.; Kini, Annapoorna S. (1999). "Coronary Atherectomy". Contemporary Concepts in Cardiology. Developments in ... Coronary artherectomy: Contemporary concepts in cardiology and (with Dr. Valentín Fuster) of Definitions of acute coronary ... Kini co-established, with Samin Sharma the Live Symposium of Complex Coronary and Vascular Cases in 1998 and has served as ... She is co-author of Atlas of Coronary Intravascular Optical Coherence Tomography, ISBN 3-319-62664-7, Practical Manual of ...
... is used to treat narrowing in arteries caused by peripheral artery disease and coronary artery disease.[citation ... While atherectomy is usually employed to treat arteries it can be used in veins and vascular bypass grafts as well. Atherectomy ... Wasiak J, Law J, Watson P, Spinks A (December 2012). "Percutaneous transluminal rotational atherectomy for coronary artery ... Directional atherectomy is an intravascular procedure guided by optical coherence tomography termed as lumivascular atherectomy ...
Atherectomy Cardiopulmonary bypass Coronary stenting Revascularization Portals: India Medicine "Doctor Profile". My Doc Advisor ... Rotational and Directional Atherectomy, Coronary stenting and Percutaneous Laser Myocardial Revascularization. He graduated in ... "Paclitaxel-Eluting versus Everolimus-Eluting Coronary Stents in Diabetes". N Engl J Med. 373 (18): 1709-1719. doi:10.1056/ ...
He specializes in coronary angioplasty, carotid stenting, coronary stenting and rotablator atherectomy. Kalarickal was born on ... 1][dead link] Serruys, Patrick W.; Michael J.B. Kutryk; Andrew T.L. Ong (2 February 2006). "Coronary-Artery Stents". New ... who is known as the father of coronary angioplasty and joined Apollo Hospitals at Chennai. Kalarickal is the Director, ...
He also performs rotational atherectomy, an alternative to angioplasty for complex, calcified coronary lesions. He has ... ISBN 978-1-4471-6581-1 Farkouh M, Sharma S, Tomey M, Puskas J, Fuster V. Coronary artery bypass grafting and percutaneous ... "Mount Sinai Hospital Earns Highest Ratings in New York State Report on Coronary Angioplasty". www.ptca.org. Retrieved 2022-04- ... In 2009, he performed a coronary angiography and angioplasty procedure on Indian Prime Minister Shri Manmohan Singh. As of 2022 ...
"Aminophylline for Preventing Bradyarrhythmias During Orbital or Rotational Atherectomy of the Right Coronary Artery". ... atherectomy of the right coronary artery). It is also used in the treatment of heart block due to acute inferior myocardial ... It acts through cellular surface receptors which effect intracellular signalling pathways to increase coronary artery blood ...
Implantation of stents Debulking strategies Rotational atherectomy Orbital atherectomy Laser atherectomy Brachytherapy (use of ... "Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery ... Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowing of the coronary arteries of the ... Coronary angioplasty, also known as percutaneous transluminal coronary angioplasty (PTCA), because it is done through the skin ...
Placement of a coronary stent (a cylinder of wire mesh that is placed in a previously blocked artery to ensure that it stays ... An atherectomy is an invasive procedure performed for removing atherosclerosis from blood vessels within the body. The narrowed ... Balloon angioplasty is an invasive test that helps to treat any blockage present in the coronary arteries. A catheter with a ...
For some patients, intervention such as coronary angioplasty or atherectomy may serve as possible alternatives to bypass ... Francis is awarded the Josh Nahum Award for Achievement in Infection Prevention and Control for its "Coronary Artery Bypass ... Patients choosing to have angioplasty and atherectomy are usually discharged 24-48 hours after the procedure and, in most cases ... such as coronary angiograms. Many of these tests can be performed on an outpatient basis. They serve as a helpful tool for ...
On July 19, 1991, Kirby underwent a coronary atherectomy to open a blockage in an artery just above his heart. After the ...
Mainstays of coronary intervention include balloon angioplasty and coronary stenting. Additional techniques include atherectomy ... coronary atherectomy and thrombectomy, intra-coronary stents, distal embolic protection devices, and evaluation of new devices ... Baim's research focused on three primary areas: 1. Coronary blood flow: physiology of large and small vessel coronary ... atherectomy, clot removal and distal embolic protection. While at BI, he also served as acting director of the coronary care ...
Overview Coronary Artery Disease Treatment - Coronary Interventions ANGIOPLASTY, STENTS AND ATHERECTOMY (Cleveland Clinic) v t ... used in percutaneous coronary interventions. It has a special balloon tip with small blades, that are activated when the ... This procedure is different from Rotoblation (Percutaneous Transluminal Rotational Atherectomy or PCRA) whereby a diamond ... tipped device spins at high revolutions to cut away calcific (chalky) atheroma usually prior to coronary stenting. Boston ...
Coronary artery disease (CAD)- Coronary artery disease is a general term for any reduction in coronary circulation. One such ... It is a form of PCI and generally what is implied when referring to "PCI." Atherectomy - Enlarging the lumen of an artery by ... Coronary artery bypass surgery (CABG): Grafting an artery or vein from elsewhere to bypass a stenotic coronary artery. ... Percutaneous coronary intervention (PCI) - Procedures to treat stenotic coronary arteries by accessing through a blood vessel. ...
"How Is Coronary Heart Disease Diagnosed?". 29 September 2014. Retrieved 25 February 2015. "How Can Coronary Heart Disease Be ... atherectomy, and stent implantation. These procedures all involve insertion of a sheath into the femoral artery or radial ... As the left and right coronary arteries run on the surface of the heart, they can be called epicardial coronary arteries. These ... Procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) may be used in severe ...
... coronary) supplying the heart muscle. The concept was first introduced by Bailey in the 1950s prior to the advent of coronary ... Atherectomy Pulmonary thromboendarterectomy Thompson, Jesse E. (August 1996). "The Evolution of Surgery for the Treatment and ... "Long-term survival from 801 adjunctive coronary endarterectomies in diffuse coronary artery disease". European Journal of ... It is still used today when coronary artery bypass surgery proves difficult. Livesay in Texas and Nair in Leeds have published ...
... atherectomy MeSH E02.148.050.120.125 - atherectomy, coronary MeSH E02.148.102.060 - angioplasty, balloon MeSH E02.148.102.060. ... percutaneous coronary MeSH E02.148.050.075 - angioplasty, laser MeSH E02.148.050.075.080 - angioplasty, balloon, laser-assisted ... 080 - angioplasty, balloon, laser-assisted MeSH E02.148.102.060.100 - angioplasty, transluminal, percutaneous coronary MeSH ...
... atherectomy, coronary MeSH E04.100.376.719.332 - coronary artery bypass MeSH E04.100.376.719.332.199 - coronary artery bypass, ... atherectomy, coronary MeSH E04.928.220.520.220 - coronary artery bypass MeSH E04.928.220.520.220.189 - coronary artery bypass, ... atherectomy MeSH E04.100.814.050.120.125 - atherectomy, coronary MeSH E04.100.814.055 - angioscopy MeSH E04.100.814.143 - ... percutaneous coronary MeSH E04.100.814.050.075 - angioplasty, laser MeSH E04.100.814.050.075.080 - angioplasty, balloon, laser- ...
Coronary stents: bare-metal stent (BMS) and drug-eluting stent (DES) Angioplasty balloons Atherectomy lasers and rotational ... Coronary angiography is a diagnostic procedure that allows visualization of the coronary vessels. Fluoroscopy is used to ... A common example of cardiac catheterization is coronary catheterization that involves catheterization of the coronary arteries ... Acute coronary syndromes: ST elevation MI (STEMI), non-ST Elevation MI (NSTEMI), and unstable angina Evaluation of coronary ...
Coronary angioplasty is indicated for coronary artery disease such as unstable angina, NSTEMI, STEMI and spontaneous coronary ... Often, peripheral angioplasty is used in conjunction with guide wire, peripheral stenting and an atherectomy. Angioplasty can ... coronary arteries of the heart found in coronary heart disease. These stenotic segments of the coronary arteries arise due to ... A percutaneous coronary intervention (PCI), or coronary angioplasty with stenting, is a non-surgical procedure used to improve ...
Coronary ischemia results in myocardial infarction, also known as a heart attack. The coronary arteries were one of the ... Modern endovascular approaches to treating atherosclerosis can include combinations of angioplasty, stenting, and atherectomy ( ... CT scans of the heart with evaluations of coronary artery calcium are also used in some instances to stratify risk of coronary ... In particular, patients with peripheral arterial disease have an increased risk of coronary artery disease, and severe ...
Coronary angiography can visualize coronary artery stenosis, or narrowing of the blood vessel. The degree of stenosis can be ... Any stenoses found may be treated by the use of balloon angioplasty, stenting, or atherectomy. Fluorescein angiography is a ... One of the most common angiograms performed is to visualize the coronary arteries. A long, thin, flexible tube called a ... X-ray images of the transient radiocontrast distribution within the blood flowing inside the coronary arteries allows ...
When narrowing occurs in the heart, it is called coronary artery disease (CAD), and in the brain, it is called cerebrovascular ... Any blood flow-limiting blockage found in the X-ray can be identified and treated by procedures including atherectomy, ... Smokers are 2-3 times more likely to have lower extremity PAD than coronary artery disease. Greater than 80%-90% of patients ... Complications may include an infection or tissue death, which may require amputation; coronary artery disease; or stroke. Up to ...
He is the first cardiologist in the region to perform an angioscopy and directional atherectomy. He is reported to be the first ... Chandra P, Cribier A, Seth A (1995). "Utility of Pilot wire in angioplasty of tortuous and highly angulated coronary arteries ... Chandra P, Cribier A, Seth A (1995). "Utility of Pilot wire in angioplasty of tortuous and highly angulated coronary arteries ... Atherectomy Drug Eluting Stents Ventricular assist device Angioscopy Embolectomy Transmyocardial revascularization India portal ...
Removal of coronary artery obstruction and insertion of stent(s) (36.1) Bypass anastomosis for heart revascularization (36.2) ... Percutaneous angioplasty or atherectomy of precerebral (extracranial) vessel(s) (01) Incision and excision of skull, brain, and ...
Percutaneous transluminal coronary rotational atherectomy (PTCRA) debulks atherosclerotic plaque from coronary arteries using ... Percutaneous transluminal rotational atherectomy for coronary artery disease. Atherosclerosis is the build-up of fat and other ... This is an update of the review on Percutaneous transluminal rotational atherectomy for coronary artery disease first ... Wasiak J, Law J, Watson P, Spinks A. Percutaneous transluminal rotational atherectomy for coronary artery disease. Cochrane ...
By clicking join, you agree to share your email address with us and Mailchimp to receive updates from us. ...
Orbital atherectomy of calcified coronary ostial lesions. Catheter Cardiovasc Interv. 2022 10; 100(4):553-559. ...
... prepare and treat the most complex coronary lesions. ... Coronary laser atherectomy catheter Find similar products ELCA ... coronary spasm, coronary embolism, coronary perforation, laser/stent damage, balloon/stent damage, and other serious. ... coronary laser atherectomy catheters are designed to cross, prepare and treat the most complex coronary lesions. This non- ... and modify plaque of multiple morphologies and is approved for the broadest range of coronary indications in atherectomy. ...
Sharma, Samin K.; Kini, Annapoorna S. (1999). "Coronary Atherectomy". Contemporary Concepts in Cardiology. Developments in ... Coronary artherectomy: Contemporary concepts in cardiology and (with Dr. Valentín Fuster) of Definitions of acute coronary ... Kini co-established, with Samin Sharma the Live Symposium of Complex Coronary and Vascular Cases in 1998 and has served as ... She is co-author of Atlas of Coronary Intravascular Optical Coherence Tomography, ISBN 3-319-62664-7, Practical Manual of ...
The medical information provided on all PromiseCare Medical Group websites (promisecare.com, promisecaremanagementservices.com, hemetcommunitymedicalgroup.com, and any other sites owned by PromiseCare) is intended for educational purposes only. It is not intended to replace or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified healthcare professionals regarding any medical condition or health concerns you may have. Read the full Medical Information Disclaimer here.. ...
Directional coronary atherectomy has recently become available to treat coronary stenoses. This study was performed to ... Directional coronary atherectomy has recently become available to treat coronary stenoses. This study was performed to ... Directional coronary atherectomy has recently become available to treat coronary stenoses. This study was performed to ... Directional coronary atherectomy has recently become available to treat coronary stenoses. This study was performed to ...
Atherectomy Procedures and Devices: Dissecting the Future of Coronary and Peripheral Interventions The medical field is ... With modern advancements, atherectomy devices have gained substantial traction as a favorable option for coronary and ... Atherectomy Devices: An In-depth Analysis of Market Trends, Growth and Opportunities Recent years have seen a significant ... Translating to non-invasive procedures for treating coronary artery disease, PCI devices have necessitated a paradigm shift in ...
Coronary Angioplasty, Atherectomy and Stent. *Interpretation of Exercise Stress Tests. *Nuclear Stress Testing ...
Coronary Angiogram. *Coronary Angioplasty, Atherectomy and Stent. *Dobutamine Thallium Stress Test. *Doppler Test ...
A new coronary atherectomy system, the Diamondback-360, is the first in more than 20 years to be FDA-approved to treat severely ... Coronary Atherectomy: This was the second most common procedure (16.2 per 10,000 population) performed on the CV system. Two- ... Coronary Artery Bypass Graft: This was by far the most frequently performed procedure in male patients (75%). With progression ... Coronary Artery Stent: This was the third most frequent (0.454 million) procedure performed on the CV system. Stent recipients ...
Transradial coronary angiography. PROCEDURES/TREATMENTS. *Angioplasty atherectomy. *Balloon valvuloplasty. *Coronary stenting. ...
Coronary Artery Atherectomy. *Coronary Balloon Angioplasty (PTCA). *Coronary Intervention. *C-Reactive Protein Testing ... Specialty Interests: Coronary artery disease (CAD), microvessel disease, coronary artery dissection, cardiovascular prevention ... Coronary artery disease (CAD), microvessel disease, coronary artery dissection, cardiovascular prevention, peripheral arterial ...
Directional coronary atherectomy (DCA) (Medical Encyclopedia) Also in Spanish * Percutaneous transluminal coronary angioplasty ... Your coronary arteries supply oxygen-rich blood to the heart. If you have coronary artery disease, a sticky material called ... Coronary Artery Disease: Angioplasty or Bypass Surgery? (Mayo Foundation for Medical Education and Research) Also in Spanish ... Reduce chest pain from blockages in the coronary arteries. This type of pain is called angina. There are different types of ...
360 degree maneuverable atherectomy and lead management laser system ... ELCA coronary laser atherectomy catheters are designed to cross, prepare and treat the most complex coronary lesions. This non- ... Laser system for coronary and peripheral atherectomy and lead management Find similar products Philips Laser System -Nexcimer- ... Turbo-Elite laser atherectomy catheter captures the power of ultraviolet light to provide a versatile and reliable tool for ...
In patients not suitable for atherectomy/thrombectomy • In the cardiopulmonary, coronary, carotid, cerebral and renal ... The Rotarex™ Atherectomy System is intended for use as an atherectomy device and to break up and remove thrombus from native ... Atherectomy + Thrombectomy For Mixed Morphology PAD lesions. The Rotarex™ Atherectomy System is designed to efficiently remove ... Rotational Excisional Atherectomy With the Rotarex™ Atherectomy Device - Miguel Montero-Baker, MD ...
Is Coronary Lithotripsy as Effective as Rotational Atherectomy?. *Optimal Duration of DAPT with Oral Anticoagulation After PCI ... ROTACUT Study: Rotational Atherectomy with Cutting Balloon for Stent Expansion Optimization. Drug-Coated Balloons (DCB): ... ROTACUT Study: Rotational Atherectomy with Cutting Balloon for Stent Expansion Optimization. *Drug-Coated Balloons (DCB): ... ROTACUT Study: Rotational Atherectomy with Cutting Balloon for Stent Expansion Optimization. 30.11.2023. ...
Coronary Angioplasty With Stent Placement. Coronary Angioplasty. Peripheral Angioplasty. Atherectomy, Endovascular. Atherectomy ... State-of-the-art technology and improvement in techniques allow effective management of patients with coronary artery disease ... Kim specializes in percutaneous interventions of coronary arteries as well as endovascular treatment of peripheral vascular ...
Coronary stenting. *Rotational atherectomy. *Rheolytic thrombectomy. *ICDs and Bi-V ICDs. *Intra-aortic balloon pump ...
Non-Coronary Angioplasty, Atherectomy, and Stenting ... View other providers who treat Non-Coronary Angioplasty, ...
Coronary Angioplasty, Atherectomy and Stent ... View other providers who treat Coronary Angioplasty, ...
Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely Calcified Coronary Lesions. Rheude T, Fitzgerald S, ... Coronary Stent Thrombosis- Predictors and Prevention. Ullrich H, Münzel T, Gori T. Ullrich H, et al. Among authors: gori t. ... Coronary Vasculitis. Gori T. Gori T. Biomedicines. 2021 May 31;9(6):622. doi: 10.3390/biomedicines9060622. Biomedicines. 2021. ... Coronary In-Stent Restenosis: Predictors and Treatment. Ullrich H, Olschewski M, Münzel T, Gori T. Ullrich H, et al. Among ...
Coronary stenting, both drug-eluding and bare-metal. *Coronary balloon angioplasty. *Coronary ROTOBLATOR atherectomy and ... Coronary interventions: *Cardiac catheterization using adjunctive diagnostic tools: *Fractional flow reserve (FFR) ... Techniques include, but are not limited to, balloon angioplasty, coronary stent deployment, balloon valvuloplasty, and valve ...
Excimer laser coronary atherectomy in severely... 10.24875/RECICE.M23000412. Implantation of a pulmonary bioprosthetic valve in ...
Novel Micro Crown Orbital Atherectomy for Severe Lesion Calcification: Coronary Orbital Atherectomy System Study (COAST). Circ ... Outcomes After Left Main Coronary Artery Revascularization by Percutaneous Coronary Intervention or Coronary Artery Bypass ... Two-year outcomes after treatment of severely calcified coronary lesions with the orbital atherectomy system and the impact of ... Impact of Pre-Diabetes on Coronary Plaque Composition and Clinical Outcome in Patients With Acute Coronary Syndromes: An ...
Coronary Artery Stent Placement * Critical Limb Ischemia (CLI) * Directional Atherectomy * Embolic-Protection Devices ... Fanaroff AC, Nathan AS.: Percutaneous Coronary Intervention in Acute Coronary Syndrome and Cardiogenic Shock: Ensuring Access ... Fanaroff AC, Wang TY.: Risk Prediction in Percutaneous Coronary Intervention: Solving the Last Mile Problem Circ Cardiovasc ... Harskamp RE, Fanaroff AC, Zhen SW, Sawe HR, Weber EJ.: Recognising acute coronary syndrome BMJ 377 : e069591,2022. ...
Worldwide coronary revenue increased over 26% to $19 million, led by 10% unit growth in our domestic orbital atherectomy ... And really over time, we will be transforming our coronary business from being a business that focuses on atherectomy to being ... When combined with the GlideAssist feature on our coronary atherectomy device, the Sapphire 1 millimeter balloon and the ... The Diamondback Orbital Atherectomy System is the safest and most studied atherectomy system with real world data on more than ...
coronary artery disease (CAD). a condition that reduces the flow of blood through the coronary arteries to the myocardium, ... atherectomy. excision of fatty plaque (from a blocked artery using a specialized catheter & a rotary cutter). ... coronary stent. a supportive scaffold device implanted in the coronary artery; used to prevent closure of the artery after ... coronary occlusion. obstruction of an artery of the heart, usually from atherosclerosis. Coronary occlusion can lead to acute ...
Coronary Atherectomy. *Transesophageal Echo (TEE). Because we believe that health care delivery is a partnership between the ...
  • PTCRA has been used both as an alternative to and in conjunction with balloon angioplasty to open up blocked coronary arteries. (cochrane.org)
  • Furthermore, after appropriate stratification for morphology and clinical presentation, overall atherectomy procedural outcome may be similar to that achieved with coronary angioplasty. (elsevierpure.com)
  • However, specific subsets of patients may have relatively better outcome with either atherectomy or balloon angioplasty. (elsevierpure.com)
  • Bypassing open-heart operations, these interventions utilise stents, balloon angioplasty, and atherectomy to open obstructed cardiac vessels. (reportlinker.com)
  • Angioplasty is a procedure to improve blood flow in coronary arteries that have become narrow or blocked. (medlineplus.gov)
  • Angioplasty does not cure coronary artery disease. (medlineplus.gov)
  • Coronary Artery Disease: Angioplasty or Bypass Surgery? (medlineplus.gov)
  • Although angioplasty is done in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart. (hopkinsmedicine.org)
  • Angioplasty and Atherectomy - To open arteries clogged with plaque, our cardiovascular surgeons perform hundreds of these procedures annually. (sutterhealth.org)
  • Coronary Artery Bypass Surgery - For the one out of 10 patients who cannot be helped with angioplasty and stent placement, performed by cardiac surgeons. (sutterhealth.org)
  • Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a nonsurgical technique for treating obstructive coronary artery disease, including unstable angina, acute myocardial infarction (MI), and multivessel coronary artery disease (CAD). (medscape.com)
  • Example of an intravascular ultrasound (IVUS) image in percutaneous transluminal coronary angioplasty (PTCA). (medscape.com)
  • Several methods are used to remove this build-up including a procedure known as percutaneous transluminalcoronary rotational atherectomy (PTCRA). (cochrane.org)
  • This is an update of the review on 'Percutaneous transluminal rotational atherectomy for coronary artery disease' first published in The Cochrane Library Issue 4, 2003. (cochrane.org)
  • Percutaneous transluminal coronary rotational atherectomy (PTCRA) debulks atherosclerotic plaque from coronary arteries using an abrasive burr. (cochrane.org)
  • Is Coronary Lithotripsy as Effective as Rotational Atherectomy? (solaci.org)
  • Currently available technologies targeting such lesions, including noncompliant high-pressure balloons, intravascular lasers, cutting balloons, and orbital and rotational atherectomy, often yield suboptimal results, noted Kereiakes, medical director of the Christ Hospital Heart and Cardiovascular Center in Cincinnati. (medscape.com)
  • Left ventricle assist support for high risk coronary interventions, rotational atherectomy and STEMI (ST elevation MI) procedures (volume more than 50 cases). (spectrumhealth.org)
  • To assess the effects of PTCRA for coronary artery disease in patients with non-complex and complex lesions (e.g. ostial, long or diffuse lesions or those arising from in-stent re-stenosis) of the coronary arteries. (cochrane.org)
  • Cardiac catheterization was generally followed by interventional or therapeutic procedures to open blocked arteries-e.g., atherectomy, stent placement, grafting, or pacemaker implantation. (uspharmacist.com)
  • Your coronary arteries supply oxygen-rich blood to the heart. (medlineplus.gov)
  • If you have coronary artery disease , a sticky material called plaque builds up in the coronary arteries. (medlineplus.gov)
  • Reduce chest pain from blockages in the coronary arteries. (medlineplus.gov)
  • From a clinical standpoint, Dr. Kim specializes in percutaneous interventions of coronary arteries as well as endovascular treatment of peripheral vascular disease including carotid artery disease and aortic aneurysms. (weillcornell.org)
  • Recently, CRP was identified within early atherosclerotic lesions in human coronary arteries obtained at necropsy. (bmj.com)
  • Through interventional cardiology, minimally invasive procedures treat structural heart conditions affecting coronary arteries, heart valves and more. (ochsner.org)
  • The new updates, aimed at innovating and advancing procedures including percutaneous coronary intervention (PCI) to treat the narrowing of coronary arteries, are being announced at the Transcatheter Cardiovascular Therapeutics (TCT) annual meeting (Orlando, USA, November 4-6). (philips.com)
  • With this procedure, a long thin tube (catheter) is passed into the coronary arteries. (hopkinsmedicine.org)
  • We report on an approach for validation of an in silico 3D model of in-stent restenosis in porcine coronary arteries and illustrate this approach by comparing the modelling results to in vivo data for 14 and 28 days post-stenting. (springer.com)
  • Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause. (bvsalud.org)
  • Thickening and loss of elasticity of the CORONARY ARTERIES, leading to progressive arterial insufficiency (CORONARY DISEASE). (bvsalud.org)
  • In addition, she created a suite of educational mobile and web applications covering different aspects of interventional cardiology such as bifurcation intervention, treatment of calcified lesion, optical coherence tomography imaging, coronary angiography and PCI in patients after TAVR, management of procedural complications and selection of appropriate coronary guidewires. (wikipedia.org)
  • All participants had de novo coronary calcifications graded as severe by core laboratory assessment, with a mean calcified length of 47.9 mm by quantitative coronary angiography and a mean calcium angle and thickness of 292.5 degrees and 0.96 mm by optical coherence tomography. (medscape.com)
  • Only one-third of the MIs were clinically relevant by the Society for Coronary Angiography and Intervention definition. (medscape.com)
  • For patients with STEMI, immediate coronary angiography with PCI is recommended (primary PCI). (medscape.com)
  • Intravascular lithotripsy proved highly effective, safe, and user friendly as an adjunct to stenting for severely calcified coronary lesions at 30 days of follow-up in the pivotal Disrupt CAD III study aimed at gaining U.S. regulatory approval. (medscape.com)
  • Orbital atherectomy of calcified coronary ostial lesions. (ucdenver.edu)
  • ELCA coronary laser atherectomy catheters are designed to cross, prepare and treat the most complex coronary lesions. (philips.ie)
  • A new coronary atherectomy system, the Diamondback-360, is the first in more than 20 years to be FDA-approved to treat severely calcified lesions. (uspharmacist.com)
  • The Rotarexâ„¢ Atherectomy System is designed to efficiently remove both plaque and thrombus by utilizing three distinct mechanisms of action to treat PAD lesions including in-stent restenosis. (bd.com)
  • n = 18) underwent directional coronary atherectomy for coronary lesions. (bmj.com)
  • In so doing, the intravascular lithotripsy device developed by Shockwave Medical successfully addressed one of the banes of contemporary interventional cardiology: heavily calcified coronary lesions. (medscape.com)
  • Severely calcified coronary lesions complicate percutaneous coronary intervention. (medscape.com)
  • Translating to non-invasive procedures for treating coronary artery disease, PCI devices have necessitated a paradigm shift in cardiovascular therapies. (reportlinker.com)
  • BD is proud to offer you this exclusive learning opportunity to further support your Peripheral Arterial Disease (PAD) education and training with the use of our Rotarexâ„¢ Rotational Excisional Atherectomy System. (bd.com)
  • State-of-the-art technology and improvement in techniques allow effective management of patients with coronary artery disease and peripheral vascular disease with minimally invasive procedures. (weillcornell.org)
  • The presence of CRP, complement, and oxLDL in a high proportion of plaque tissue from patients with unstable coronary artery disease implies that these surrogate markers have important proinflammatory effects inside atherosclerotic plaques. (bmj.com)
  • Invasive therapy versus conservative therapy for patients with stable coronary artery disease: An updated meta-analysis. (yumaregional.org)
  • IntraSight Mobile brings together imaging and physiology applications on a mobile system for coronary and peripheral artery disease therapy. (philips.com)
  • The incidence of target organ damage associated to CVD increases with age, and gender studies show global higher incidence in men for stroke and coronary artery disease (CAD) [ 10 ]. (hindawi.com)
  • It provides products such as M5 catheter, M5+ catheter, and S4 catheter for the treatment of peripheral artery disease and C2 catheter for the treatment of coronary artery diseases. (medicaldevice-network.com)
  • Its treatment portfolio includes Coronary Artery Disease and atherectomy. (medicaldevice-network.com)
  • Background It has been reported previously that the measurement of plasma total adiponectin level is clinically useful to estimate the risk of coronary artery disease (CAD). (go.jp)
  • Coronary artery disease is one of the most widespread causes of mortality in industrialized countries. (springer.com)
  • Clinical features included age at least 65 years, female sex, troponin-positive acute coronary syndrome, established vascular disease, diabetes treated with medication, and chronic kidney disease. (medscape.com)
  • Angiographic criteria included multivessel coronary disease, stent length more than 30 mm, a thrombotic target lesion, a bifurcation lesion requiring two stents, an obstructive left main or proximal left anterior descending lesion, and a calcified target lesion requiring atherectomy. (medscape.com)
  • PCI procedures are expected to be more than 300 percutaneous coronary interventions to include all types of techniques used to treat obstructive coronary artery disease with more than 50 percent of procedures performed via radial artery access and approximately 50 percent from a trans-femoral approach. (spectrumhealth.org)
  • A Heart Team approach (involving interventional cardiologists and cardiac surgeons) should be used in patients with diabetes and multivessel coronary artery disease and in patients with severe left main disease and a high Syntax score. (medscape.com)
  • The medical field is constantly evolving, and procedures in coronary and peripheral interventions are no exception. (reportlinker.com)
  • With modern advancements, atherectomy devices have gained substantial traction as a favorable option for coronary and peripheral interventions. (reportlinker.com)
  • Over the last few years our fellows have averaged performing 400 coronary interventions and almost 100 peripheral interventions during training. (mainlinehealth.org)
  • Worldwide revenue increased or worldwide peripheral revenue increased over 10% to $45.5 million, led by 12% unit growth in our domestic orbital atherectomy business, with strong performance in the OBL and the hospital side of service. (nasdaq.com)
  • Worldwide coronary revenue increased over 26% to $19 million, led by 10% unit growth in our domestic orbital atherectomy business, increased sales of our procedure support products, and continued adoption of orbital atherectomy in Japan. (nasdaq.com)
  • Q1 also represented a new high point for case coverage with CSI reps and clinical specialists present in 70% of our cases, when orbital atherectomy was used. (nasdaq.com)
  • Finally, the commercial launch of orbital atherectomy in international markets continues to produce solid results. (nasdaq.com)
  • Instead, the comparator group selected under regulatory guidance was comprised of patients who had received orbital atherectomy for severe coronary calcifications in the earlier, similarly designed ORBIT II trial, which led to FDA marketing approval of that technology. (medscape.com)
  • The procedural success rate, defined as successful stent delivery with less than a 50% residual stenosis and no in-hospital MACE, was 92.4% in Disrupt CAD III, compared to 83.4% for orbital atherectomy in ORBIT II. (medscape.com)
  • Optical coherence tomography in coronary atherosclerosis assessment and intervention. (nih.gov)
  • Coronary In-Stent Restenosis: Predictors and Treatment. (nih.gov)
  • Coronary artery restenosis is an important side effect of percutaneous coronary intervention. (springer.com)
  • Drug-eluting stents were used in 73% of all coronary artery stent insertions. (uspharmacist.com)
  • For patients in whom medical and exercise therapy fail or those who have claudication symptoms that are lifestyle-limiting, surgical treatment includes either open bypass surgery or endovascular therapy (eg, stents, balloons, or atherectomy devices). (medscape.com)
  • The clinical unit is located at the Department of Cardiology and focuses on prospective studies of patients with ST-elevation myocardial infarction (STEMI) who are treated with primary percutaneous coronary intervention. (gu.se)
  • BACKGROUND AND OBJECTIVES: Aspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). (koreamed.org)
  • This non-mechanical atherectomy catheter can be delivered over any .014" wire and can de-bulk and modify plaque of multiple morphologies and is approved for the broadest range of coronary indications in atherectomy. (philips.ie)
  • Additionally, the Rotarexâ„¢ Atherectomy System does not require any warm up, infusion or catheter clean out. (bd.com)
  • The SFA occlusion was recanalized with a wire intraluminally, followed by 3 passes of a 6F Rotarex Sâ„¢ Atherectomy Catheter, after which 3 PTAs resulted in a completely restored flow. (bd.com)
  • Angiogram after 1 and 3 passes with Rotarexâ„¢ Atherectomy Catheter. (bd.com)
  • 2021. Kassab K, Jolly N, Vij A. Middle-Aged Man with Unstable Angina and an Inaccessible Right Coronary Artery. (yumaregional.org)
  • Impact of prior coronary artery bypass grafting on periprocedural and short-term outcomes of patients undergoing transcatheter aortic valve replacement: A systemic review and meta-analysis" Akshay Balakrishna, Mahmoud Ismayl, David Zhao, Andrew Goldsweig, Ahmed Aboeata, Sarachandra Vallabhajosyula. (creighton.edu)
  • 30 millimeters (mm), ii) thrombotic target lesion, iii) bifurcation lesion treated with more than one stent, iv) calcified target lesion treated with atherectomy, v) treatment of obstructive left main or proximal left anterior descending artery for index ACS (or clinical diagnosis of an anterior STEMI) 3. (who.int)
  • She researches on the field of percutaneous coronary intervention and heart valve therapy. (wikipedia.org)
  • It is also called percutaneous coronary intervention (PCI). (medlineplus.gov)
  • The cardiology clinic at Sahlgrenska University Hospital is the largest percutaneous coronary intervention center in Sweden. (gu.se)
  • We also launched the Exchangeable Atherectomy System in September, and this novel device will allow the use of multiple crowns to enable complete leg revascularization in a single intervention. (nasdaq.com)
  • SAN FRANCISCO - Dropping aspirin after 3 months and continuing ticagrelor monotherapy reduced bleeding without a price to pay in overall ischemic events among patients undergoing percutaneous coronary intervention (PCI) at high risk for either complication, results from the TWILIGHT trial show. (medscape.com)
  • Directional coronary atherectomy has recently become available to treat coronary stenoses. (elsevierpure.com)
  • This study was performed to determine the relation of patient characteristics and stenosis morphology to procedural outcome with directional coronary atherectomy to gain insight into which patients might be best treated with this device. (elsevierpure.com)
  • The procedural outcome of directional coronary atherectomy is highly associated with coronary stenosis morphology. (elsevierpure.com)
  • With the approval of our nitinol coronary ViperWire in September, we are now able to offer physicians Diamondback and a full complement of coronary procedural support devices. (nasdaq.com)
  • Within this program, fellows are evaluated during time spent in the cardiac catheterization laboratory and participation in the percutaneous coronary interventional procedures performed there. (spectrumhealth.org)
  • Fellows are expected to attend weekly heart team meetings at Spectrum Health where complex revascularization strategies are discussed with a wide variety of cardiovascular physicians in attendance, including interventional cardiologists, cardiothoracic surgeons and advanced coronary imaging cardiologists. (spectrumhealth.org)
  • PTCRA utilises small rotating devices to selectively remove the build-up of atherosclerotic plaques from within coronary vessels. (cochrane.org)
  • Philips Laser System - Nexcimer-supports catheters with coronary vascular, peripheral vascular and lead management indications. (philips.hu)
  • The system supports seven coronary indications, is the only device proven for peripheral ISR², and is the only laser system available for lead management. (philips.hu)
  • Spontaneous Coronary Artery Dissection (SCAD) Update - What Does the Interventionalist Need to Know? (promedicacme.com)
  • This is a type of X-ray test that can see if there is coronary calcification that may suggest a future heart problem. (hopkinsmedicine.org)
  • The two groups were well balanced, with a mean age of 65 years, 23.8% were female, 36.8% had diabetes, and 64.8% underwent PCI for acute coronary syndrome. (medscape.com)
  • Kini co-established, with Samin Sharma the Live Symposium of Complex Coronary and Vascular Cases in 1998 and has served as Director of the Annual Live Symposium of Complex Coronary & Vascular Cases at The Mount Sinai Medical Center. (wikipedia.org)
  • To investigate the simultaneous presence of macrophages, CRP, membrane attack complex C5b-9 (MAC), and oxidised low density lipoprotein (oxLDL) in atherectomy specimens from patients with different coronary syndromes. (bmj.com)