Subject(s)
Blood Pressure/physiology , Cardiomyopathy, Hypertrophic/diagnostic imaging , Echocardiography, Doppler, Color/methods , Pacemaker, Artificial , Ventricular Outflow Obstruction/diagnostic imaging , Aged , Cardiomyopathy, Hypertrophic/complications , Cardiomyopathy, Hypertrophic/therapy , Female , Humans , Time Factors , Treatment Outcome , Ventricular Outflow Obstruction/complications , Ventricular Outflow Obstruction/therapyABSTRACT
Recent advances in interventional devices and technology have greatly improved the results of percutaneous transluminal angioplasty (PTA), and it is now being widely used. However, it is important to obtain information regarding its results and its long-term patency. We examined the primary success rates and long-term patency in 29 limbs out of 27 patients with superficial femoral artery (SFA) occlusion who underwent PTA with self-expandable stents. Among the 29 lesions, 19 were long occlusions (>10 cm) and 10 were short (<10 cm). Overall primary success was achieved in 26 of the 29 limbs (90%). There were three unsuccessful cases in which the patients were on dialysis and had hard calcification in the arterial walls. After 3 years, primary patency, primary-assisted patency, and secondary-assisted patency were 81%, 86%, and 96%, respectively. In the case of short occlusions (<10 cm), the 3-year patency was 100%. Both the primary success rate and the long-term patency were considerably better than expected. Our results with self-expanding stents were superior to previously reported results and were not inferior to those of surgical bypass. Therefore, PTA may be considered as a good first option for the treatment of SFA occlusions.
Subject(s)
Angioplasty, Balloon/instrumentation , Arterial Occlusive Diseases/therapy , Femoral Artery , Stents , Aged , Aged, 80 and over , Angioplasty, Balloon/adverse effects , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/physiopathology , Constriction, Pathologic , Female , Femoral Artery/diagnostic imaging , Femoral Artery/physiopathology , Follow-Up Studies , Humans , Male , Middle Aged , Radiography, Interventional , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Vascular PatencyABSTRACT
Congestive heart failure developed in a 42-year-old man who had very mild acromegalic features. Echocardiography showed a marked dilatation of the left ventricle and decreased systolic function. Laboratory examinations revealed the elevated levels of growth hormone and insulin-like growth factor-1 and pituitary microadenoma was demonstrated by magnetic resonance imaging. Although the extensive conventional medical treatment was ineffective, short-term addition of somatostatin analog, octreotide, rapidly improved his cardiac function. After discontinuation of octreotide, further improvement was observed with minimal residual diastolic dysfunction. All medical treatment could be stopped after successful trans-sphenoidal surgery. Early diagnosis and effective treatment is important to reverse the acromegalic cardiomyopathy.
Subject(s)
Acromegaly/drug therapy , Heart Failure/drug therapy , Octreotide/therapeutic use , Acromegaly/diagnostic imaging , Echocardiography , Electrocardiography , Heart Failure/diagnostic imaging , Humans , Male , Middle Aged , RadiographyABSTRACT
Systolic anterior motion (SAM) of the anterior mitral leaflet with mitral-septal contact was generally thought to be a major contributor to dynamic left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy. We report an interesting case of SAM of the posterior mitral leaflet in a patient without left ventricular hypertrophy, which led to dynamic left ventricular obstruction.
