Subject(s)
Aged , Hypolipidemic Agents/adverse effects , Coronary Artery Disease/drug therapy , Drug Interactions , Fluorobenzenes/adverse effects , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Male , Muscular Diseases/chemically induced , Fenofibrate/adverse effects , Pyrimidines/adverse effects , Rhabdomyolysis/chemically induced , Sulfonamides/adverse effectsABSTRACT
Out of 321 consecutive cases of Percutaneous Transluminal Coronary Angioplasty (PTCA), 28 (8.7%) patients underwent PTCA for nonacute total occlusion with no visible antegrade flow. All patients had evidence of reversible ischaemia in the territory of totally occluded artery. Overall initial success rate was 66% and was mainly related to the duration of the occlusion (85% for occlusion of 1 month or less, 70% for 1-6 months, and nil for more than 6 months duration). In 21 (75%) cases where collateral circulation to the occluded vessel could be demonstrated before PTCA, was not visible after successful PTCA. Failure was mainly due to inability to cross the lesion with the guide wire (8 out of 10 failures). Emergency Coronary Artery Bypass Graft (CABG) surgery was required in 2 cases where dissection of nontarget vessels occurred during manipulation of the guide wire. Acute reocclusion occurred in 2 cases, both were redilated successfully. There was no death. Although the primary success rate is lower than that associated with conventional stenotic lesions, with improvement in the hardware-balloon catheters and guide wires, coronary angioplasty can be performed successfully in majority of the patients with total coronary occlusion.
Subject(s)
Adult , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary , Constriction, Pathologic/therapy , Coronary Disease/therapy , Female , Humans , Male , Middle AgedABSTRACT
Of 210 patients in whom percutaneous transluminal coronary angioplasties [PTCA] were performed during the period of 2 years (June 1987 to August 1989), 55 had distal lesions. These included 50 males and 5 females with the lesions in left anterior descending [LAD] artery after the origin of the second diagonal branch, circumflex [Cx] artery after the origin of the obtuse marginal [OM], and right coronary artery [RCA] after the acute marginal branch. There were a total of 71 distal lesions, involving the LAD [51%], Cx [20%], and RCA [29%]. The overall success rate with PTCA was 91%. There were 4 acute closures of vessels; all were redilated with balloon angioplasty. One of these was sent for emergency bypass surgery after balloon dilatation. There was no death. With improvement in balloon catheters and guidewires, the feasibility and success of PTCA in distal lesions have increased remarkably, thus expanding the horizon of PTCA.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Disease/therapy , Evaluation Studies as Topic , Female , Humans , MaleABSTRACT
A 75-year-old male patient presented with resistant congestive cardiac failure. Echocardiographic examination revealed normal left ventricular size with symmetrical hypertrophy and generalised hypokinesia. In addition, there was a characteristic granular sparkling appearance of the myocardium. Cardiac catheterization showed biventricular diastolic restriction with normal coronary arteries. Possibility of cardiac amyloid was considered, and the diagnosis was confirmed on rectal biopsy.