RESUMO
Endovascular intervention is a mainstay treatment of peripheral artery disease (PAD) in addition to aggressive risk factor modification and exercise programs in patients with favorable anatomy or in those who are considered too high risk for surgical intervention. Treatment with percutaneous transluminal angioplasty (PTA) and bare metal stents (BMS) has been limited by high rates of in-stent restenosis (ISR) requiring repeat revascularization. Drug-eluting stents (DES), developed and designed to reduce ISR, offer a promising solution to the current challenges in endovascular management of PAD. Several randomized clinical trials have shown improved short- and mid-term outcomes with DES as compared with both PTA and BMS. Herein we provide an up-to-date review of the current literature on DES use in PAD.
Assuntos
Stents Farmacológicos , Procedimentos Endovasculares , Doença Arterial Periférica/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
Objective To investigate the safety and effectiveness of left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter. Methods Left internal mammary artery (LIMA) angiography via right transradial approach with 5F universal coronary angiography catheter was performed following coronary angiography in 86 patients.The success rate of the procedure, the result of LIMA angiography, the time to LIMA, the volume of contrast, the incidence of complications and bypass vessels in patients who received coronary artery bypass grafting (CABG) were recorded and analysed. Results The success rate was 97.6%(84/86), and the result of LIMA angiography was satisfied; the time to LIMA was (6.5 ± 2.8) min, and the volume of contrast was (17.6 ± 11.1) ml;the incident of complications was 4.7%(4/86);56 patients received CABG. LIMA was harvested in all cases and left radial artery in 53 cases. Conclusions LIMA angiography via right transradial approach with 5F universal coronary angiography catheter is safe and effective, and it has significant sense to patients who will receive CABG.
RESUMO
Objective To summarize the experience and technique of complex transradial percutaneous coronary intervention ( PCI) using a 4F KIWAMI ST01 catheter with Mother-Child technique for patients with coronary heart disease. Methods Retrospectively analyzed the data from 30 patients who had received PCI using a 4 F catheter with Mother-Child method. Results PCI were performed on a total of 30 patients with complex lesions. Angiographic success was achieved in 100% of lesions. 19 patients were found to have moderate-to-severe calcified lesions, 13 patients had chronic total occlusion ( CTO ) , 11 patients had moderate-to-severe tortuous lesions, and 6 patients had moderate-to-severe angulated lesions. Four patients suffered from in-stent restenosis. 4 F catheter with Mother-Child method was used in all patients, and all 4F catheters successfully passed through the target lesions with all stents implanted in place along the 4 F catheter. There were no 4 F catheter-related complications in all patients. Conclusions Use of 4F catheter with Mother-Child method is safe and effective for patients where stent delivery is difficult by the conventional method.
RESUMO
Objective To investigate the coronary characteristics and interventional treatment results of coronary artery patients on dialysis due to uremia.Methods Twenty-five cases coronary artery disease patients,including 3 cases with stable coronary disease,7 cases with ST elevation myocardial infarction,and 15 cases with non-ST elevation myocardial infarction,who were treated with uremia dialysis from January 2001 to December 2014 in Friendship Hospital of Beijing Affiliated to Capital Medical University were selected.Emergency or regular coronary angiography was done after admission,and coronary angiography characteristics of vascular lesions and interventional treatment outcomes,clinical results during hospitalization and 12-month follow-up were observed.Results (1) The proportion of three-vessel disease of 19 cases,moderate and severe calcification of 20 cases,and diffuse disease of 11 cases were observed in coronary artery disease with dialysis.No differences were found in the proportion of three-vessel disease(x2=1.08,P=0.58),moderate and severe calcification(x2 =0.48,P =0.79),and diffuse disease (x2 =4.52,P =0.11) among the groups of stable coronary disease,ST elevation myocardial infarction and non-ST elevation myocardial infarction.(2) The interventional therapy in 24 patients with coronary heart disease complicated with uremia was successful,and the average total operation time was (55.3±7.1) min,the average contrast volume was (126.0±12.6) ml.There was 1 case with complication of side branch occlusion.(3) Cardiovascular events rates during hospitalization and after 12-month follow-up were 20.0% (5/25) and 48.0% (12/25),respectively.Conclusion In coronary artery patients with uremic on dialysis,the proportion of three-vessel disease,moderate and severe calcification,and diffuse disease are relatively high.The success rate of intervention therapy is high and safe but with a relatively high cardiac events during hospitalization and 12-month follow-up.
RESUMO
Objective To summarizes the experiences and technique of complex transradial percutaneous coronary intervention (PCI) using sheathless guide catheter (Sheathless Eaucath, ASAHI) for 60 patients with coronary heart disease. Methods Retrospectively analyzed the data from 60 patients received PCI using sheathless guide catheter. Results PCI were performed on a total of 60 patients with complex lesions. Angiographic success was achieved in 95.0%and failed in three patients with CTO. 7 patients were with left main lesions, and 32 patients were with bifurcation lesions(including 7 patients with left main lesions and 2 patients with CTO), and 13 patients were with CTO, and the other 17 patients were with tortuous and calcified lesions. Sheathless guide catheters of 7.5Fr were used for PCI in all patients, and all catheters successfully passed through the radial artery and were put in place. No other vascular complications associated with the use of the catheter occurred. Sheathless guide catheters were respectively JL(8 patients), PB(2 patients), AL(2 patients), and JR(1 patient) in 13 patients with CTO, and were respectively JL(8 patients), JR(6 patients), SPB(2 patients), AL(1 patient) in 17 patients with tortuous and calcified lesions. JL or JR were used in all 32 patients with bifurcation. Conclusions Use of the Sheathless of 7.5 Fr is safe and feasible, and allows complex interventions to be undertaken transradially with a high success rate.
RESUMO
Objective To explore the diagnostic value of video bronchoscope-guide transbronchial needle aspiration(TBNA) combined with transbronchial lung biopsy(TBLB) on pulmonary sarcoidosis.Methods Twenty-two patients,definitely diagnosed as stage Ⅰ pulmonary sarcoidosis,were enrolled into the study and accepted TBNA and TBLB.Results The positive diagnostic rates of TBNA and TBLB were 63.6%(14/22) and 40.9%(9/22),but the rate increased to 90.9%(20/22) when the two methods were used together,which showed significant differences(x2=12.24,4.66,P<0.01 or <0.05).Conclusion TBNA combined TBLB test is a safety method with high diagnostic accuracy for pulmonary sarcoidosis.
RESUMO
Objective To evaluate the effects of Cypher~(TM) Stent on endothelium regeneration and platelet activation after angioplasty. Methods Six mongrel dogs were implanted Cypher~(TM) stent and Bx sonic stent in the same artery.The target vessels were ablated after angiography and observed by scanning electron microscope at one month and three months after implantation of stents respectively.Result At one month,target vessels of Cypher~(TM) stent were covered with endothelium partly and platelet activation was observed.Target vessels of Bx sonic stent were entirely covered with endothelium and platelet activation wasn't observed.Three months later,target vessels of Cypher~(TM) stent and Bx sonic stent were entirely covered with endothelium and there was no platelet activation on the vessel surface for both groups.Conclusion Endothelium regeneration after implantation of Cypher~(TM) stent was much slower than that of implantation of bare metallic stent,and at three months,the endothelialization was finished.Intensive anti-platelet therapy should be considered after implantation of Cypher~(TM) stent.