Subject(s)
Humans , Male , Female , Cyclosporine , Vascular Diseases/diagnosis , Endarteritis , Graft Rejection , Heart Transplantation/adverse effects , Arteriosclerosis , Risk FactorsABSTRACT
PURPOSE--To study the clinical and hemodynamic aspects of a group of patient presenting non-obstructive coronary lesions. METHODS--We reviewed 963 coronary angiographies performed at a same institution. The 52 patients presenting only stenosis < or = 50 per cent after semi-quantitative measurement composed group I, which was compared with two other groups consisted of 52 patients each: one, with patients presenting univascular lesion > 50 per cent (group II) and the other with normal coronary arteriographies (group III). RESULTS--Mean age was similar in groups I and II (49.4 +/- 6.89 and 51.3 +/- 7.86, p > 0.05) and significantly higher than that of group III (44.8 +/- 6.81, p < 0.05). Risk factors did not discriminate group I (GI) from groups II (GII) and III (GIII). During a follow-up period of 63 months, the number of hospital admissions due to cardiac events and repetitions of coronary arteriography were similar in GI and GII, being significantly less frequent in GIII (p < 0.00001 and 0.001; p < 0.01 and 0.05, respectively). By the end of the follow-up period, though angina and heart failure functional classes had been similar in the three groups, patients in groups I and II were using more medications than those in group III (p < 0.0001 and 0.00001). Mean ejection fractions (per cent) were lower in GI and GII (67.04 +/- 10.13 and 68.90 +/- 11.32) than in GIII (74.69 +/- 6.40, p < 0.01). Lesions were predominantly proximal in GI when compared with GII (p < 0.05). Length, simmetry, ulceration, thrombus and proximal shoulder showed no difference between GI and GII. CONCLUSION--Patients with non-obstructive coronary lesions were similar to those with univascular lesion > 50 per cent regarding several aspects and were considerably different from those with normal coronary arteries
Subject(s)
Humans , Male , Female , Middle Aged , Coronary Artery Disease/physiopathology , Cineangiography , Retrospective Studies , Risk Factors , Follow-Up Studies , Coronary Vessels/pathology , Coronary Angiography , Coronary Artery Disease/diagnosis , Coronary Artery Disease , Ventricular Function, Left , Stroke VolumeABSTRACT
Objetivo - Avaliar o efeito da angioplastia renal transluminal percutânea (ARTP) no tratamento da hipertensäo renovascular. Métodos - Foram avaliados 23 pacientes com estenose da artéria renal e hipertensäo arterial submetidos à tentativa de ARTP. Onze indivíduos eram do sexo masculino e 12 do feminino com idades que variaram de 10 a 78 anos (45,8 ñ 17,41). Vinte Lesöes eram ateroscleróticas, 7 por displasia fibromuscular e 1 por arterite de Takayasu. Em 3 casos a dilataçäo foi bilateral e em 2 foi repetida por reestenose. Dois pacientes apresentavam insuficiencia renal aguda por estenose crítica das artérias renais. Resultados - Obteve-se sucesso técnico em 21 dos 25 procedimentos. Após 20 dilataçöes satisfatórias seguiu-se o sucesso clínico em 17(100// das lesöes por displasia fibromuscular e 77// das ateroscleróticas). A reduçäo da pressäo arterial diastólica após a ARTP foi estatisticamente significante (p<0,001). Nos dois casos de insuficiência renal aguda houve normalizaçäo da funçäo renal com a angioplastia. Ocorreram 2 complicaçöes e nenhum óbito foi relacionado ao procedimento. Conclusäo - O método foi eficaz e seguro no tratamento da hipertensäo renovascular no acompanhamento a curto prazo. Foi possível reverter a insuficiência renal aguda com a ARTP em 2 pacientes
Purpose - To analyze the effect of percutaneous transluminal renal angioplasty (PTRA) in renovascular hypertension. Methods - Twenty-three patients with renal artery stenosis and arterial hypertension underwent PTRA. There were 11 male an 12 female, 19 to 78 years old (45.8±17.41). In 20 lesions the diagnosis was atherosclerosis, in 7 fibromuscular dysplasia and in 1 Takayasu artheritis. Three patients underwent bilateral dilatation and 2 patients repeated the procedure due to reestenosis. Two patients presented with acute renal failure and severe bilateral renal artery stenosis. Results - There were 21 technical success in 25 procedures. After 20 satisfatory dilatations, clinical success followed in 17 (100% of cases of fibromascular dysplasia cases and 77% of atherosclerosis. The fall in diastolic arterial pressure after PTRA was statistical significant (p<0.001). In two cases acute renal failure the renal function became normal after angioplasty. There were 2 complications and no death attributed to PTRA. Conclusion - The method was effective and safe in the management of renovascular hypertension during the short-term follow-up. It was possible in two cases of acute renal failure to normalize renal function