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Percutaneous transluminal angioplasty

Aman Kansal, Chandler A Long, Manesh R Patel, W Schuyler Jones
Peripheral artery disease (PAD) is a major health concern affecting more than 200 million people worldwide and studies have shown PAD to be a strong predictor of mortality, morbidity, and disability. The management of PAD is multi-tiered and advancements in technology have given physicians more options for endovascular revascularization if medical therapy does not result in substantial improvement. Many randomized controlled trials (RCT) have reported efficacy of various therapies including laser atherectomy, stent technology, and drug-coated balloons over standard percutaneous transluminal angioplasty; however, uncertainty regarding the best standard of care remains unclear due to a lack of head to head comparisons between novel therapies...
October 15, 2018: Clinical Cardiology
Steve M D'Souza, Christopher L Stout, Emilia Krol, David J Dexter, Sadaf Sadie Ahanchi, Jean M Panneton
PURPOSE: To compare outcomes of outpatient tibial artery procedures between an office endovascular center and a hospital angiography suite. METHODS: A retrospective review was conducted of 204 outpatient tibial interventions performed on 161 patients (mean age 72±11.5 years; 81 men) in either an office (n=100) or hospital (n=104) angiography suite from April 2011 through September 2013. Patients who had an existing ipsilateral bypass that was completely proximal to the tibial trifurcation were eligible, as were patients with prior proximal endovascular interventions...
October 15, 2018: Journal of Endovascular Therapy
Fengyi Du, Jiangbing Zhou
Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Clinically, CAD can be potentially managed through surgical artery bypass. However, due to the highly invasive nature, surgical intervention has been gradually replaced by percutaneous transluminal coronary angioplasty and recently by percutaneous coronary revascularization using metallic stents. However, the permanent presence of metallic scaffolds inevitably impairs arterial physiology and may induce a variety of adverse effects, such as inflammation, restenosis, thrombosis, and neoatherosclerosis...
2018: Advances in Experimental Medicine and Biology
Fernando Luis Bernal Páez, Miguel Alcaraz Baños, Jose Manuel Felices Abad, Ana Bernal Belmonte, Gabriel Gijon-Nogueron, Manuel Pardo Rios
To assess the quality of life (QoL) of treated patients in order to evaluate the success of peripheral transluminal angioplasty (PTA) and correlate physical parameters with clinical progress at 6 months post-PTA.According to TASC II classifications, 69 patients were selected for PTA. Clinical evaluation and diagnostic tests were performed before, after and after 6 months following PTA. The SF-36 QoL questionnaire was added as an additional parameter.Fifty one patients were included in the study. The ankle-brachial index (ABI) increased from 0...
October 2018: Medicine (Baltimore)
Sik Namgoong, Jong-Phil Yang, Ki-Hyun Yoo, Seung-Kyu Han, Seung-Woon Rha, Ye-Na Lee
Percutaneous transluminal angioplasty (PTA) is now more frequently used to improve tissue perfusion in ischemic diabetic feet. However, there are concerns about its feasibility and effectiveness in severely ischaemic feet. This study aimed to compare the perfusion values after PTA according to the ischaemic degree of diabetic feet. This study included 133 ischaemic diabetic feet. The foot transcutaneous oxygen pressure (TcPO2 ) and toe pressure were measured before the procedure and every second postoperative week for 6 weeks...
October 12, 2018: International Wound Journal
Yusuke Watanabe, Koji Hozawa, Kawamoto Hiroyoshi, Toru Naganuma, Hisaaki Ishiguro, Sunao Nakamura
OBJECTIVE/BACKGROUND: The aim was to evaluate the impact of patent tibial arteries on stenting for chronic total occlusions (CTO) in superficial femoropopliteal artery (SFA) lesions. Additionally, the efficacy of additive tibial percutaneous transluminal angioplasty (PTA) was evaluated. METHODS: A total of 238 limbs in 199 patients with de novo SFA CTO lesions treated with bare nitinol stents between 2009 and 2015 were retrospectively identified. These limbs were divided into two groups (group A [number of patent tibial arteries at baseline angiogram ≥ 2, 127 limbs in 104 patients] vs...
October 8, 2018: European Journal of Vascular and Endovascular Surgery
Wataru Higashiura, Hiroaki Takara, Ryoichi Kitamura, Tadashi Yasutani, Hitoshi Miyasato, Toshiho Tengan
PURPOSE: To evaluate the efficacy of percutaneous transluminal angioplasty for early failing hemodialysis arteriovenous fistulas (AVFs) and predictors of secondary functional patency (FP). METHODS: A review of our endovascular registry database showed that 61 patients with early failure after a surgically created AVF underwent endovascular intervention between 2011 and 2016. Median time from AVF creation to first intervention was 5.6 weeks. Median duration of follow-up was 14 months...
October 4, 2018: Cardiovascular and Interventional Radiology
Lars J J Bolt, Tim Anton Sigterman, Atilla G Krasznai, Cees-Jan J M Sikkink, Geert-Willem H Schurink, Lee Hans Bouwman
INTRODUCTION: Percutaneous transluminal angioplasty (PTA) is often complicated due to postcontrast acute kidney injury (PC-AKI) in patients diagnosed with chronic kidney disease (CKD). Hydration therapy is the cornerstone in the prevention of PC-AKI. Furosemide forced diuresis with matched hydration using the RenalGuard system enables a steady balance between diuresis and hydration. A randomised controlled trial will be performed in order to investigate whether furosemide forced diuresis with matched hydration in combination with the RenalGuard system decreases incidence of PC-AKI in patients with CKD receiving a PTA of the lower extremities...
October 4, 2018: BMJ Open
L J J Bolt, A G Krasznai, T A Sigterman, C J J M Sikkink, G W H Schurink, L H Bouwman
OBJECTIVES: Percutaneous transluminal angioplasty (PTA) requires the use of nephrotoxic contrast. Patients with chronic kidney disease (CKD) are more prone to develop contrast-induced-nephropathy (CIN) after utilization of contrast. Doppler ultrasound (duplex) guided PTA (DuPTA) is a novel technique and has recently proven to be a successful alternative to conventional PTA in the treatment of iliac stenotic disease, without the use of contrast. In this randomized controlled trial we evaluated whether duplex-guided PTA is as effective as conventional PTA in the treatment of iliac arterial stenotic disease...
October 1, 2018: Annals of Vascular Surgery
John Canfield, Hana Totary-Jain
The field of interventional cardiology has evolved significantly since the first percutaneous transluminal coronary angioplasty was performed 40 years ago. This evolution began with a balloon catheter mounted on a fixed wire and has progressed into bare-metal stents (BMS), first-generation drug-eluting stents (DES), second- and third-generation biodegradable polymer-based DES, and culminates with the advent of bioabsorbable stents, which are currently under development. Each step in technological advancement has improved outcomes, while new persisting challenges arise, caused by the stent scaffolds, the polymers employed, and the non-selective cytostatic and cytotoxic drugs eluted from the stents...
October 1, 2018: Journal of Personalized Medicine
Pawel Burchardt, Maura Farinacci, Magdalena Mayer, Klaus Luecke, Thomas Krahn, Jaroslaw Manczak, Marek Slomczynski, Jaroslaw Hiczkiewicz, Janusz Rzezniczak
BACKGROUND: Circulating endothelial cells (CEC) may be used to find new strategies for the early diagnosis of cardiovascular diseases. The major objective of the project is to broaden knowledge of CEC biology by determining their phenotypic characteristics. The additional aim is to clarify whether on the basis of these information it is possible to identify the origin of CEC release (from various cardiovascular compartments). METHODS: Circulating endothelial cells were collected from arterial blood prior to angiography, as well as from arterial and venous blood obtained after angiography/coronary angioplasty, from 18 patients with non-ST-segment elevation myocardial infarction (NSTEMI)...
September 20, 2018: Cardiology Journal
Yanhua Zhen, Zhihui Chang, Zhaoyu Liu, Jiahe Zheng
We investigated the relationship of postoperative neutrophil-lymphocyte ratio (NLR) with 6-month primary patency of percutaneous transluminal angioplasty (PTA) in femoropopliteal disease using drug-coated balloon (DCB) or uncoated balloon (UCB). This retrospective study included 106 patients who received DCB (n = 44) or UCB (n = 62). The postoperative NLR was lower in the DCB group than that in the UCB group (2.60 vs 3.23; P = .004), and 6-month primary patency rate was significantly higher in DCB group than that in the UCB group (77...
September 16, 2018: Angiology
Ru Yu Tan, Tze Tec Chong, Fu Chieh Tsai, Suh Chien Pang, Kian Guan Lee, Apoorva Gogna, Alicia Huiying Ong, Chieh Suai Tan
BACKGROUND: Two-dimensional digital subtraction angiography (DSA) is the gold standard for angiographic evaluation of dysfunctional haemodialysis access. We aim to investigate the utility of parametric colour coded DSA in providing hemodynamic analysis during haemodialysis access interventions. METHODS: We retrospectively studied 20 patients who underwent access intervention and applied parametric colour-coding on selected DSA acquisitions before and after percutaneous transluminal angioplasty (PTA)...
September 15, 2018: BMC Medical Imaging
Valentina Izzo, Marco Meloni, Laura Giurato, Luigi Uccioli
PURPOSE: The aim of this study is to evaluate the role of Iloprost as an early predictor of successful revascularization in patients affected by ischemic diabetic foot ulcers (DFUs). METHODS: Consecutive patients with ischemic DFUs with persistent low TcPO2 (<30mmHg) one day after a technical successful Percutaneous Transluminal Angioplasty (PTA) have been included. All patients underwent Iloprost infusion and TcPO2 has been recorded at days 3, 14 and 30. According to the TcPO2 reported at day 3, patients were divided into two groups: group A (patients with TcPO2 ≥30mmHg) and group B (patients with TcPO2 <30mmHg)...
August 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Nadja Kröger, Alexander Kopp, Mareike Staudt, Mihaela Rusu, Alexander Schuh, Elisa A Liehn
Percutaneous transluminal coronary angioplasty and subsequent vascular scaffold implantation remains the prevalent invasive treatment of coronary heart disease. In-stent restenosis remained a problem with bare metal stents, until drug-eluting stents were introduced. The inhibition of the healing process by the antimitotic drug coating and the permanent metallic remnant can promote sub-acute and delayed stent thrombosis. Thus, the development of biodegradable stents emerged as a subject of research. Magnesium-based bioabsorbable devices can provide sufficient radial force in the acute phase of vessel-treatment and degrade thoroughly in aqueous environment, making them potential new candidates for vascular scaffold applications...
November 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
Domenico Patanè, Giovanni Failla, Giovanni Coniglio, Giorgio Russo, Walter Morale, Giuseppe Seminara, Giacomo Calcara, Paola Bisceglie, Pierantonio Malfa
The aim of our study is to report the results of two types (type A, type B) paclitaxel drug-coated balloon compared with standard percutaneous transluminal angioplasty in the treatment of juxta-anastomotic stenoses of mature but failing distal radiocephalic hemodialysis arteriovenous fistulas. Two groups of 26 and 44 patients treated with two different drug-coated balloon are compared with a control group of 86 treated with standard percutaneous transluminal angioplasty. A color Doppler ultrasound was performed to evaluate stenosis and for treatment planning...
August 30, 2018: Journal of Vascular Access
Katharina Schoene, Arash Arya, Cosima Jahnke, Ingo Paetsch, Sotirios Nedios, Sebastian Hilbert, Andreas Bollmann, Gerhard Hindricks, Philipp Sommer
OBJECTIVES: The aim of the present study was to analyze and report a single-center experience with catheter interventional treatment of radiofrequency-induced pulmonary vein stenosis (PVS) following atrial fibrillation (AF) ablation. BACKGROUND: Catheter interventional treatment of radiofrequency-induced PVS following AF ablation remains a challenging field because of a lack of randomized data and treatment guidelines. METHODS: All patients at a single center who underwent catheter interventional treatment for radiofrequency-induced PVS were retrospectively assessed...
August 27, 2018: JACC. Cardiovascular Interventions
Tufan Çınar, Ibrahim Rencüzoğulları, Yavuz Karabağ, Metin Çağdaş
BACKGROUND: Renal artery stenosis (RAS) is a leading cause of hypertension, renal failure, pulmonary edema, and loss of renal mass. Atherothrombotic renal disease is a well-described entity, known primarily for its high mortality rate. CASE: Here, we present a case of acute unrecognized atherothrombosis of RAS due to catheter-induced dissection in a patient with a limited functioning renal artery and solitary kidney. A fifty-two-year-old patient recently diagnosed with hypertension was admitted to our cardiology clinic showing symptoms of uncontrolled hypertension...
August 15, 2018: Heart & Lung: the Journal of Critical Care
Mingxi Lu, Hua Li, Jian Feng, Weiming Hu
Pharmacomechanical thrombolysis (PMT) and percutaneous transluminal angioplasty (PTA) for the treatment of acute thrombotic prosthetic arteriovenous access (PAVA) are conventionally guided by radiography, which may cause radiation injury and requires the use of radiographic contrast media. The aim of the present study was to summarize our experience with ultrasound-guided PMT and PTA as an alternative to radiographic guidance. Between December 2012 and October 2016, 114 patients with acute thrombosis of PAVA were treated urgently with ultrasound-guided PMT and PTA to restore blood flow...
August 13, 2018: Ultrasound in Medicine & Biology
Michael Schulte-Hermes, Oliver Klein-Wiele, Marc Vorpahl, Melchior Seyfarth
AIMS: Transradial access (TRA) has become a standard approach for cardiac catheterization. However, an obstacle to TRA is the risk of radial artery occlusion (RAO) after radial access in about 5%-10% of patients. We analyzed the safety and efficacy of getting vascular access after RAO by percutaneous transluminal angioplasty in cases of chronic radial occlusion. METHODS AND RESULTS: Chronic RAO was confirmed by Allen test and color Doppler in 8 patients. TRA was achieved by puncture in the distal tabatiere (anatomical snuffbox) using Seldinger's technique followed by insertion of a 5 Fr radial introducer sheath...
October 2018: Journal of Invasive Cardiology
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