RESUMO
OBJECTIVES: The aim of this study was to assess the utility of percutaneous transluminal coronary rotational ablation in the treatment of coronary artery disease. BACKGROUND: Although numerous advances have been made in the treatment of coronary artery disease, there are lesions with complex morphology that are not amenable to current intravascular therapy. METHODS: A consecutive series of 242 patients having 302 coronary rotational ablation procedures was analyzed. One hundred nineteen (49%) of the patients had previously undergone attempted coronary angioplasty, which was unsuccessful in 31 patients (13%). The left ventricular ejection fraction was normal in 196 patients (81%). The ablation procedure was attempted in 308 vessels and 346 lesions. Of the 346 lesions treated, 26 (7.5%) were classified as American College of Cardiology/American Heart Association type A, and 320 (92.5%) as either type B or type C. RESULTS: Procedural success was achieved in 284 (94%) of the 302 procedures and 330 (95.4%) of the 346 lesions in which ablation was attempted. Five procedures (1.7%) were unsuccessful, but no cardiac event occurred during the hospital stay. A major cardiac event occurred in 13 cases (4.3%); 9 (3%) of these complications were due to the ablation procedure. Six patients sustained a Q wave myocardial infarction alone, two had a Q wave infarction and required emergency surgery and one needed emergency surgery but did not have a Q wave infarction. No procedural deaths were attributed to the ablation procedure. Follow-up has been obtained in 182 of the 242 patients at a mean interval of 9 +/- 5 months. Of the 182 patients, 174 (95.6%) were alive and free of myocardial infarction. Angiographic follow-up is available thus far in 87 patients. By combining angiographic and clinical outcome, an overall estimated restenosis rate of 37.4% (68 of 182) was calculated. CONCLUSIONS: These data suggest that coronary rotational ablation can be performed on lesions with a variety of morphologic features with high initial success rates. The overall rate of restenosis is similar to that of balloon angioplasty.
Assuntos
Aterectomia Coronária , Doença da Artéria Coronariana/cirurgia , Angioplastia Coronária com Balão , Aterectomia Coronária/efeitos adversos , Aterectomia Coronária/métodos , Terapia Combinada , Angiografia Coronária , Doença da Artéria Coronariana/epidemiologia , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Fatores de Tempo , Resultado do TratamentoRESUMO
The efficacy and acceptability of a single half-tablet daily of a fixed combination of 400 mg acebutolol and 25 mg hydrochlorothiazide was assessed in a study of 35 patients suffering from mild to moderate essential hypertension. The results of the 22 patients who completed the 3-month active drug period showed that treatment produced a significant reduction in supine systolic and diastolic blood pressure. This effect was apparent from the first week and was maintained throughout the trial. Pulse rate was also lowered by therapy. No clinically significant changes from normal were observed in mean serum potassium and uric acid levels, and no side-effects of treatment were reported.