RESUMO
Objective Coronary arteriography(CAG)and percutaneous coronary intervention(PCI)are the most effective methods for the treatment of coronary atherosclerotic heart disease(CAD),but radial artery vascular variation,especially the presence of 360° tortuous(annular tortuous)radial artery seriously affects the success rate of trans-radial artery approach(TRA)interventional operation.This article provides a preliminary exploration of CAG and PCI through the annular tortuous radial artery.Methods We retrospectively analyzed 15 patients with annular tortuous right radial artery who successfully completed CAG or PCI by annular tortuous radial artery,and summarized the procedures performed through the annular tortuous radial artery.Results We found that the annular tortuous radial artery could be passed through by the catheter with the assistance of percutaneous transluminal coronary angioplasty(PTCA)guide wire or combined with a diameter of 2.0 mm balloon(6-8 atm dilatation state),and then the PTCA wire and the balloon can be replaced with a coronary angiography guide wire after the catheter passed through annular tortuous radial artery,and finally the annular tortuous radial artery could be straightened by fixing the coronary angiography guide wire and rotating and pulling the catheter.Finally,the catheter could be advanced to the coronary orifice and subsequent CAG or PCI could be performed while the annular tortuous radial artery was kept straightening.Both the left and right coronary arteries could perform coronary intervention using this technique,and there were no complications such as forearm hematoma or vascular rupture after this operation.Conclusions It is possible to successfully complete the coronary interventional therapy through annular tortuous radial artery by using the technique with the help of PTCA wire combined with balloon.
RESUMO
<p><b>BACKGROUND</b>Tong-xin-luo capsule (TXL), used as a traditional Chinese herb, offeres a therapeutic potential for treatment of cardiovascular diseases. It has been shown to exert a variety of pharmacological effects, including antihypertensive effects, and is able to improve ventricular remodeling. However, the mechanisms of its action are not completely understood. The aim of this study was to evaluate the molecular mechanisms of Tong-xin-luo capsule on left ventricular remodeling in spontaneously hypertensive rats (SHR).</p><p><b>METHODS</b>Sixteen eight-week-old SHRs were randomized into an SHR group (n = 8) and a TXL group (n = 8) that were given Tong-xin-luo capsule (1.5 mg x kg(-1) x d(-1)). Eight Wistar Kyoto (WKY) rats fed with 0.9% NaCl served as the control group (WKY group). Systolic blood pressure (BP), body weight and heart rate were monitored once every two weeks. Ventricular remodeling was detected by histopathological examination. Nuclear factor kappa B P65 (NF-kappaB P65) and peroxisome proliferators activated receptor gamma (PPAR-gamma) protein and phosphorylated inhibitor kappa alpha (IkappaBalpha) protein were detected by immunohistochemistry and western blot respectively. The physical interaction of the P65-P50 heterodimer with IkappaBalpha and NF-kappaB were measured by co-immunoprecipitation. PPAR-gamma mRNA, collagen I mRNA and collagen III mRNA were measured by real-time PCR.</p><p><b>RESULTS</b>TXL inhibited NF-kappaB P65 expression and ventricular remodeling and suppressed the activation of NF-kappaB compared with the SHR group (P < 0.01, P < 0.05). TXL reduced IkappaBalpha phosphorylation, increased expression of PPAR-gamma protein and enhanced the physical interaction of the P65-P50 heterodimer with IkappaBalpha. The mRNA expression of PPAR-gamma was enhanced but the mRNA expression of collagen I mRNA and collagen I mRNA were suppressed by TXL.</p><p><b>CONCLUSIONS</b>In spontaneously hypertensive rats, TXL could inhibit ventricular remodeling induced by hypertension, and the inhibitory effect might be associated with the process of TXL increasing the expression of PPAR-gamma that could result in the inhibition of the activation of NF-kappaB.</p>