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1.
Minerva Cardioangiol ; 60(5): 461-72, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23018427

RESUMO

Retrograde approach via collateral channels in coronary angioplasty for chronic total occlusion (CTO) can improve recanalization success rate. Most interventionalists will meet few cases where the retrograde approach will provide unequaled advantages, but many are held back from taking retrograde approach by lack of proper equipment and expertise. In this article, we give detailed description of all techniques to traverse the collateral channels, and to cross the CTO by retrograde approach. We also illustrate the difficulties in collateral channel crossing with different examples providing a basic guide for case selection purposes.


Assuntos
Oclusão Coronária/cirurgia , Revascularização Miocárdica/métodos , Doença Crônica , Humanos
2.
Minerva Cardioangiol ; 59(3): 271-84, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21516075

RESUMO

Chronic total occlusion (CTO) is a common finding on diagnostic coronary angiography and represents one of the most challenging lesion subset in interventional cardiology. The introduction of dedicated guidewires and the development of new techniques have led to improve the success rate in the crossing of CTO lesion while the use of bare metal stent first, and, then, the use of drug eluting stent (DES) have significantly reduced the occurrence of restenosis and the need for target lesion revascularization in short and mid-term follow-up after CTO recanalization. However, new unsolved issues about the use of DES in CTO, that might impact long-term outcome, are emerging. The aim of this article is to review the current stage of knowledge on the application of stents in the treatment of CTO, with a particular attention to DES use and to DES-related challenges.


Assuntos
Oclusão Coronária/terapia , Stents Farmacológicos , Angioplastia Coronária com Balão , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico , Reestenose Coronária/prevenção & controle , Medicina Baseada em Evidências , Humanos , Medição de Risco , Índice de Gravidade de Doença , Stents , Resultado do Tratamento
3.
Transplant Proc ; 47(9): 2757-62, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26680088

RESUMO

OBJECTIVE: To investigate the effects of N-acetylcysteine (NAC) and high-dose atorvastatin (ATOR) in reducing oxidative stress in a rat kidney model of ischemia-reperfusion injury. METHODS: Forty female rats underwent clamping of the left renal artery for 30 minutes, followed by reperfusion. The effects of pre-ischemic administration of NAC and/or ATOR were evaluated within 4 groups: a) control (no NAC, no ATOR); b) NAC (intraperitoneal NAC administration); c) ATOR (oral ATOR administration); and d) NAC+ATOR (both drugs). Oxidative stress was assessed by measuring the activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and myeloperoxidase (MPO). Post-ischemia-reperfusion injury was evaluated by means of renal histology. RESULTS: NAC, ATOR, and NAC+ATOR in rats showed lower MPO (P < .05) and higher GPx activity (P < .05) versus control; SOD activity was lower in NAC versus ATOR (P < .05). No difference among groups was found at histology. However, a lower rate of tubular ischemic lesions was evident in NAC+ATOR versus control (P = .07). CONCLUSIONS: Atorvastatin pretreatment provides protection against oxidative stress in a rat kidney model of ischemia-reperfusion injury, reinforcing the evidence of a beneficial effect of statins beyond their cholesterol-lowering properties.


Assuntos
Acetilcisteína/farmacologia , Atorvastatina/farmacologia , Sequestradores de Radicais Livres/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Nefropatias/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Traumatismo por Reperfusão/tratamento farmacológico , Animais , Atorvastatina/administração & dosagem , Catalase/metabolismo , Feminino , Glutationa Peroxidase/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Rim/irrigação sanguínea , Rim/lesões , Rim/patologia , Nefropatias/metabolismo , Oxirredução , Peroxidase/metabolismo , Ratos , Traumatismo por Reperfusão/metabolismo , Superóxido Dismutase/metabolismo
4.
Atherosclerosis ; 217(2): 531-5, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21601206

RESUMO

OBJECTIVE: Previous studies have shown a high cardiovascular risk in patients with autoimmune diseases, such as type 1 diabetes mellitus (T1DM). Conversely, few data are available about patients with celiac disease (CD). The aim of our study was to assess carotid intima-media thickness (c-IMT), in patients with T1DM, CD or both (T1DM+CD) as compared with age- and sex-matched healthy individuals (H). METHODS: We enrolled 120 patients, 30 with T1DM, 30 with CD, 30 with T1DM+CD and 30 H. Clinical, metabolic and anthropometric data were collected. All T1DM patients were on insulin while all CD patients were on a gluten-free diet. c-IMT was evaluated by high frequency linear digital ultrasound. RESULTS: c-IMT was significantly greater in patients with T1DM+CD than in patients with T1DM or CD (P<0.001 for both), while no difference was found between T1DM and CD. Moreover, c-IMT was greater in CD than in H (P<0.001). Glycemic control and disease duration were similar between T1DM+CD and T1DM. Lipid and anthropometric parameters were similar among groups. Furthermore, in a pooled multivariate analysis, only age and disease type were significantly correlated with c-IMT (P<0.001 for both). CONCLUSION: Our study demonstrates that celiac patients have greater c-IMT as compared with healthy individuals. Thus, non-invasive monitoring of c-IMT in CD might be useful in preventing cardiovascular disease. Moreover, patients with T1DM+CD show more severe subclinical atherosclerosis as compared with those presenting T1DM or CD only, suggesting that the association of these autoimmune diseases might accelerate the atherosclerotic process.


Assuntos
Aterosclerose/etiologia , Doença Celíaca/complicações , Diabetes Mellitus Tipo 1/complicações , Adulto , Fatores Etários , Análise de Variância , Aterosclerose/diagnóstico por imagem , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Doença Celíaca/diagnóstico , Doença Celíaca/dietoterapia , Distribuição de Qui-Quadrado , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Dieta Livre de Glúten , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Itália , Lipídeos/sangue , Masculino , Análise de Regressão , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Ultrassonografia
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