Effect of YQHXFF on Expression of Matrix Metalloproteinase-2 after Percutaneous Transluminal Coronary Angioplasty in Rabbits with Hyperlipidemia / 中国康复理论与实践

@#: Objective To observe the effects of YQHXFF on the expression of matrix metalloproteinase-2 （MMP-2） in the rabbits with hyperlipidemia after percutaneous transluminal coronary angioplasty (PTCA). Methods 28 male New Zealand white rabbits were randomly divided into the control group, the model group and the YQHXFF intervention group. The models of restenosis were established with injuring carotid arteries in cholesterolfied rabbits. After 8 weeks, MMP-2 were measured with reverse transcription polymerize chain reaction (RT-PCR) and pathologic alter were observed with HE staining. Results The expression of MMP-2 mRNA in injured artery were much higher in the model group. Compared with those in the model group, the expression of MMP-2 in the YQHXFF intervention group markedly decreased and intimal hyperplasia markedly lighten. Conclusion YQHXFF can inhibit the expression of MMP-2 and lighten the intimal hyperplasia after PTCA.

Percutaneous Transluminal Coronary Angioplasty for Coronary Artery Stenosis in a Young Patient with Long Term Kawasaki Disease

Kawasaki Disease (KD) is an acute, febrile, multisystem disease of children. More severe complications in 15~25% of cases include, the development of coronary aneurysms, ischemic heart disease, and sudden cardiac death. The standard treatment for significant coronary artery stenosis has generally been aortocoronary bypass surgery, although percutaneous transluminal coronary angioplasty (PTCA) has been described in a small number of patients. This report describes a 14 year old boy with a history of KD who developed multiple coronary aneurysms and stenosis. We performed PTCA, which was successful in relieving the stenosis of the left circumflex artery.

Clinical Efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) in Chronic Renal Failure / 대한신장학회잡지

BACKGROUND: Ischemic heart disease has become more important in regard to mortality in hemodialysis patients. Although PTCA has been used for the treatment of ischemic heart disease, its result has little been reported in chronic renal failure(CRF) patients not in maintenance dialysis. We examined the therapeutic outcome of PTCA in CRF group in comparison with that in control group with normal renal function. METHODS: In a retrospective case-control study, 15 patients with CRF(Scr >or=1.4 mg/dL) were compared with 29 sex, age and diabetes mellitus matched controls without renal disease who had been randomly selected from the PTCA registry of our institution. Restenosis was evaluated by follow-up angiography or recurrent angina. Twenty-two PTCAs were performed over 26 stenotic lesions in CRF group, and thirty-nine PTCAs undergone over 56 lesions in control group. RESULTS: CRF group consisted of 11 men and 4 women with a mean age of 59.2+/-9.2(mean+/-SD) years and a mean serum creatinine of 3.8+/-2.4 mg/ dL. Cause of renal failure was diabetes mellitus in 11 cases(73%). Angiographic lesion success was confirmed in 17(65%) out of the 26 stenotic sites and stents were inserted successfully in the other nine lesions. Restenosis was confirmed by angiography in 10 lesions(38.5%) over a mean of seven months and suspected by recurrent angina in 6 lesions(23.1%), so overall restenosis rate was 61.6% in CRF group. Risk of restenosis was little different compared with control group in single- and double vessel disease, but increased up to 89% in triple vessel disease in CRF in contrast with control group. Among CRF group patients with serum creatinine >or=2.5 mg/dL showed much increased restenosis rate(77%) compared with those with serum creatinine <2.5 mg/dL (46%). CONCLUSION: Restenosis rate significantly increased in CRF patients who have multivessel disease or advanced renal failure, so other reperfusion therapy should be considered for them.

Results of percutaneous transluminal coronary angioplasty of chronic total occlusion

BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.

Treatment of a Coronary Arterial Stenosis in a Child with Kawasaki Disease by Percutaneous Transluminal Coronary Angioplasty: Case Report and Literature Review

Percutaneous transluminal coronary angioplasty(PTCA) is rarely performed on patients with coronary arterial stenosis that resulted from Kawasaki disease. We experienced a 3 year 10-month-old male with a history of Kawasaki disease who developed a few numbers of fusiform aneurysm on the right and left coronary artery. We examined and followed up the patient for 21 months using eletrocardiography, echocardiography, scintigraphy, and coronary angiography. The angiography was performed at 4 months initially and repeated 21 months after the onset because of a perfusion defect at scintigraphy. A significant stenotic lesion was found on the right coronary artery. Twenty-one months after the onset, the stenotic lesion was successfully dilated after percutaneous transluminal coronary angioplasty and luminal patency was maintained for over 1 year. We report this case and a review of literatures.

A Treatment Case with PTCA in Osteal Stenosis of Takayasu's Arteritis

PTCA was performed in llgears old Takayasu's arteritis patient with left coronary artery osteal stenosis. A balloon angioplasty catheter was introduced by a 7-F guiding catheter with a 0.14 steerable guide wire. The balloonings were approximately 60 and 80 seconds at each duration. The procedure was performed repeat twice. The stenotic lesion was improved after PTCA. After 2years PTCA, left coronary artery was well dilatated in coronary angiogram. Until this time, the patient has not chest pain.

Angioplastia coronária utilizando material de última geraçäo: resultados imediatos / Effects of sympathetic blockade on postinfarction cardiac hy pertrophy and myocardial contractility

Objetivo Apresentar os resultados imediatos de pacientes submetidos a angioplastia coronária com cateteres de baixo perfil. Métodos No período de 16/6/89 a 28/9/90, foram tratados deforma consecutiva, 74 pacientes, com idade média de 55 anos, a maioria com doença de um vaso (92%) e boa função ventricular (88%), totalizando 80 lesões, 26 tipo A, 54 tipo B, de acordo com a classificação da Força Tarefa sobre angioplastia coronária do American College of Cardiology American Heart Association (FT-ACC/AHA). Os resultados foram analisados por quatro observadores: um cardiologista clínico (Ocli), um cirurgião cardiovascular (Ocir) e dois hemodinamicistas (H1, H2). Resultados Observou-se queda significativa do grau de obstrução pós-angioplastia, na opinião dos quatro observadores: 0cli = 83 ± 10,7/9,0 ± 14; 0cir = 86 ± 13/9,3 ± 11; H1 = 88,6 ± 7,0/8,5 ± 12; H2 = 88,5 ± 8,0/8,3 ± 12 (P < 0.001). O sucesso foi alcançado em 94,5% dos casos e a incidência de complicações foi de 2,7%. Conclusão O elevado perceptual de sucesso primário e a baixa incidência de complicações observados nessa série, podem ser creditados à seleção dos casos e à qualidade do material utilizado.

Purpose To present immediate results of percutaneous transluminal coronary angioplasty (PTCA) with the use of last generation catheter devices. Methods 74 pacients underwent PTCA meanage 55 years the majority of them with disease of one vessel (92%) and good left ventricular function (88%). There was a total of 80 lesions treated, 26 type A and 54 type B according to the Task Force for Coronary Angioplasty of the American College of Cardiology American Heart Association Classification. Results were analysed by separate observers: one clinical cardiologist (C), one cardiovascular surgeon (S) and two hemodynamicists (H1, H2). Results A significant fail in the degree of coronary obstruction was demonstrated post PTCA in the opinion of the observers: C = 83 ± 10.7/9.0 ± 14; S = 86 ± 13.0/9.3 ± 11; H1 = 88.6 ± 7.0/8.5 ±12; H2 = 88.5 ± 8.0/8.3 ± 12 (P < 0.001). Angiographic sucess was attained in 94.6% of the cases and the complication rate was low 2,7%. Conclusion The high primary success and the low complication rates seen in this series can be attributed to the careful selection of cases and advanced performance of the catheterization devices that were used

A Case of Occult Splenic Abscess Following Percutaneous Transluminal Coronary Angioplasty(PTCA): An Unrecognized Complication of PTCA

Despite the increased recognition of surgical problems related to cardiac catheterization, splenic abscess has not been perceived as a common complication. The authors encountered a case of splenic abscess following PTCA in a 61-year old male patient. The major symptom was insidious general malaise. Fever and tenderness in the left upper quadrant of the abdomen were the only positive physical findings. Gram positive anaerobic Streptococci intermedius was indentified as the pathogen in cultures of the ultrasonography-guided aspirate from the splenic abscess. Ultrasonography and abdominal CT scan were diagnostic of the splenic abscess. The patient recovered following a splenectomy.