Subject(s)
Cysts/diagnosis , Intermittent Claudication/etiology , Popliteal Artery/pathology , Tomography, Optical Coherence/methods , Vascular Neoplasms/diagnosis , Cysts/complications , Cysts/surgery , Female , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/surgery , Middle Aged , Popliteal Artery/surgery , Vascular Neoplasms/complications , Vascular Neoplasms/surgery , Vascular Surgical Procedures/methodsABSTRACT
Sixty-four-slice multidetector row computed tomography is a noninvasive method of assessing coronary artery stenosis and plaque composition. The aim of this study was to clarify the relation between plaque composition and coronary heart disease. Three hundred sixty consecutive patients and 1,085 plaques were evaluated using 64-slice multidetector row computed tomography. On axial or cross-sectional multiplanar reconstruction images, 3 regions of interest were randomly selected within each plaque. Soft plaques and calcified plaques were defined as having computed tomographic densities <50 and >130 Hounsfield units, respectively. The association between coronary risk factors and plaque composition was analyzed. The number of plaques and the mean computed tomographic density of plaques were significantly higher in men than in women (p = 0.002 and p = 0.04, respectively). Coronary plaques were more frequent in patients with stroke, diabetes, hypertension, and dyslipidemia than in patients without these conditions (all p values <0.001). Calcified plaques were more frequent in patients with hypertension (p = 0.02), and patients with calcified plaques also had significantly lower low-density lipoprotein cholesterol levels (p <0.001). Soft plaques were more frequent in patients with dyslipidemia (p <0.001). Patients with soft plaques had significantly higher low-density lipoprotein cholesterol levels (p = 0.02) and lower high-density lipoprotein cholesterol levels (p <0.001) than those without soft plaques. In conclusion, 64-slice multidetector row computed tomography is a useful noninvasive method for quantifying coronary plaques.
Subject(s)
Coronary Disease/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Plaque, Atherosclerotic/pathology , Aged , Female , Humans , Male , Middle Aged , Risk Assessment , Risk Factors , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: The best way to treat in-stent restenosis (ISR) after drug-eluting stent (DES) implantation remains unclear. The aim of this study was to evaluate angiographic restenosis and target lesion revascularization (TLR) at 8 months after intervention in patients with DES-ISR, and to identify predictive factors of subsequent TLR after treatment of DES-ISR. METHODS AND RESULTS: A total of 100 patients with 105 lesions underwent subsequent intervention for DES-ISR between April 2004 and January 2009. At baseline, focal and diffuse ISR were observed in 76.2% and 23.8%. DES-ISR was treated by five modalities: sirolimus-eluting stent (n=42); paclitaxel-eluting stent (n=24); balloon angioplasty (n=23); cutting balloon angioplasty (n=14); and bare-metal stent (n=2). Angiographic follow-up data were available for 95 lesions (91%). The rates of angiographic restenosis and TLR were 37.9% and 33.3%. Late loss of sirolimus-eluting stent, paclitaxel-eluting stent, cutting balloon, and balloon angioplasty were 0.50 mm, 0.49 mm, 0.93 mm, and 1.10 mm. By multivariate analysis, totally occluded ISR (OR 15.43, p=0.0005), diabetes mellitus (OR 3.45, p=0.02), and re-stenting with DES (OR 0.14, p=0.0002) were identified as independent predictors of TLR. CONCLUSIONS: The restenosis rate was significant in this cohort of patients with DES-ISR. Angiographic pattern of DES-ISR and diabetes mellitus are the most important predictors of TLR, whereas re-stenting with DES is protective.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Restenosis/therapy , Drug-Eluting Stents , Aged , Angioplasty, Balloon , Coronary Angiography , Diabetes Complications , Female , Humans , Male , Paclitaxel/administration & dosage , Sirolimus/administration & dosage , StentsABSTRACT
Interruption of the inferior vena cava (IVC) is a very rare congenital abnormality. Such patients have many difficulties during ablation procedures. We report a case of successful ablation of paroxysmal atrial fibrillation using the superior vena cava in a patient with interruption of the IVC.
Subject(s)
Atrial Fibrillation/surgery , Catheter Ablation/methods , Pulmonary Veins/surgery , Vena Cava, Inferior/abnormalities , Vena Cava, Superior , Female , Humans , Middle Aged , Treatment OutcomeABSTRACT
The 12 wt% Pt-deposited carbon nanotube electrode gives 10% higher voltages than 29 wt% Pt-deposited carbon black and reduces the Pt usage by 60% in polymer electrolyte fuel cells with hydrogen and oxygen.
