RESUMO
Stenting of muscle bridge is still a controversial issue with concerns regarding high restenosis rates, plaque prolapse and stent fracture. We report a case with significant atherosclerotic disease of right coronary artery and left anterior descending artery associated with a muscle bridge, proximal to the diseased segment which became more prominent after stenting the fixed lesion. This was managed by implanting another drug eluting stent, covering the bridge. Angiographic follow-up at 9 months revealed no difference in quantitative coronary angiography parameters in the stented segment of the bridge, as compared to other stented segments.
Assuntos
Doença da Artéria Coronariana/cirurgia , Stents Farmacológicos/efeitos adversos , Ponte Miocárdica/etiologia , Idoso , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/fisiopatologia , Reestenose Coronária/prevenção & controle , Humanos , Masculino , Ponte Miocárdica/diagnóstico , Ponte Miocárdica/fisiopatologiaRESUMO
Air travel is implicated as a predisposing factor for thromboembolism, which at times can have catastrophic consequences. We present 3 cases who developed deep vein thrombosis (DVT) and subsequent pulmonary thromboembolism (PTE) after transatlantic air travel. The relevant literature is discussed.
Assuntos
Medicina Aeroespacial , Aeronaves , Embolia Pulmonar/etiologia , Viagem , Trombose Venosa/etiologia , Adulto , Anticoagulantes/uso terapêutico , Enoxaparina/uso terapêutico , Fibrinolíticos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/tratamento farmacológico , Fatores de Risco , Ativador de Plasminogênio Tipo Uroquinase/uso terapêutico , Trombose Venosa/tratamento farmacológico , Varfarina/uso terapêuticoAssuntos
Dengue/diagnóstico , Dengue/epidemiologia , Surtos de Doenças , Ecocardiografia , Eletrocardiografia , Miocardite/diagnóstico , Miocardite/virologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Lactente , Masculino , Pessoa de Meia-Idade , Miocardite/epidemiologia , Estudos ProspectivosRESUMO
BACKGROUND: Coronary angiography using 4 F catheters may reduce access-site complications and enable early ambulation, although earlier studies suggested that the quality of images may be an issue of concern. METHODS AND RESULTS: To ascertain the quality of angiographic images and safety of early ambulation, 500 patients were randomized to coronary angiography with either 4 F or 6 F catheters. Procedural characteristics, angiographic quality scores and results of ambulation were analyzed in the two groups. Patients in the 4 F group were mobilized at 2 hours post-procedure while those in the 6 F group were ambulated at 6 hours. There was no procedure-related complication in either group. The procedure was successfully completed in 250 of 252 patients randomized to the 4 F group. In two patients in the 4 F group, sheaths were upgraded to 6 F to complete the procedure, as difficulty was encountered in hooking the coronary ostium with a 4 F Judkin's catheter. Coronary angiographic quality scores in these two groups were comparable. Angiographic scores for the 4 F and 6 F groups for the left coronary artery averaged 4.45+/-0.5 and 4.58+/-0.3 (p>0.1), respectively. The right coronary artery scores averaged 4.30+/-0.4 and 4.35+/-0.2 (p>0.1) in the 4 F and 6 F groups. Angiographic scores for the left ventricular angiogram averaged 4.22+/-0.1 and 4.44+/-0.3 (p>0.1) in the 4 F and 6 F groups, respectively. None of the angiograms were assigned a score of <3.0 (not diagnostic). The total contrast volume consumed in the two groups was also equivalent. There were no groin-related complications in the 4 F group although these patients were ambulated 2 hours after the procedure. CONCLUSIONS: Coronary angiography performed with a 4 F catheter is a safe and reliable procedure. The quality of image obtained with a 4 F catheter is equivalent to that obtained with a 6 F catheter. Early ambulation at 2 hours is feasible without compromising safety.