Frequency, management and follow-up of patients with acute coronary occlusions after percutaneous transluminal coronary angioplasty

Simpfendorfer, Conrad; Belardi, Jorge; Bellamy, Greg; Galan, Kathy; Franco, Irving; Hollman, Jay

doi:10.1016/0002-9149(87)90797-1

Cited by 189 publications

(39 citation statements)

References 5 publications

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“…Measurement of the several arterial layers showed that the neointima covering the wires had a median thickness of 56 ,um (range, ,um) after 1 week and increased to 139 gtm (range, 84-250 gum) after 4 weeks ( Figure 5). The neointima in the open or nonstrut areas of the stented segments had a median thickness of 25 ,um (range, 9-38 ,um) after 1 week and increased to 48 ,gm (range, 6-120 jgm) after 4 weeks. The arterial media was considerably compressed under the stent wire.…”

Section: Light Microscopic Measurementsmentioning

confidence: 96%

“…After 4 weeks, the luminal surfaces of the stented coronary segments were smooth. Future studies are necessary to determine whether the increase in intimal thickness levels off after 4 weeks. However, the median thickness of the neointima in the present study was not different from that reported for other types of stents.30,3141 Schwartz et a142 emphasized that rupture of the internal elastic membrane after stenting may form a trigger for accelerated neointimal hyperplasia, but we observed considerable damage to this elastic lamina in several cases without significant restenosis (e.g., see Figure 6B).…”

Section: Neointimal Hyperplasiamentioning

confidence: 99%

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Coronary stenting with a new, radiopaque, balloon-expandable endoprosthesis in pigs.

et al. 1991

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Background. Intracoronary stents may be effective when used as "bail-out" devices for acute complications after percutaneous transluminal coronary angioplasty. Furthermore, preliminary reports have demonstrated some promising results with stents with regard to the reduction of restenosis. Several stent devices are available for preclinical and clinical evaluation. The use of these stainless-steel stents has been limited by poor visibility during fluoroscopy and thrombogenicity during the first days to weeks after implantation. We therefore investigated the immediate and short-term effects on arterial patency of a new, radiopaque, balloon-expandable coil stent in normal coronary arteries of pigs.Methods and Results. In 10 animals, a stent was placed in two of the three epicardial coronary arteries. During the implantation procedure, the animals received heparin; after the procedure, no antithrombotic drugs were administered. After 1 week (five animals and 10 stents) or 4 weeks (five animals and 10 stents), repeat angiography was performed, followed by pressurefixation of the coronary arteries for light and electron microscopic examination. Angiographic analysis revealed that all stented coronary segments were patent and without signs of intraluminal defects. Scanning electron microscopy showed complete endothelial covering of all stents within 7 days. Light microscopy showed a reduced tunica media locally under the stent wires, which resulted from exerted pressure. The neointima on top of the stent wires measured 56 ,m (range, ,um) after 1 week and 139 ,um (range, 84-250 jum) after 4 weeks.Conclusions. Results from this study show that this radiopaque endoprosthesis can be safely placed in normal coronary arteries of pigs. After 4 weeks, all stents were patent and there was no need for additional antithrombotic treatment, whereas neointimal proliferation was limited.

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Section: Light Microscopic Measurementsmentioning

confidence: 96%

Section: Neointimal Hyperplasiamentioning

confidence: 99%

Coronary stenting with a new, radiopaque, balloon-expandable endoprosthesis in pigs.

et al. 1991

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“…More commonly, abrupt closure is accompanied by chest discomfort and electrocardiographic evidence of ischemia and requires immediate revascularization of the occluded vessel to prevent or limit myocardial injury. The common Variables associated with an increased risk of abrupt closure of the artery in patients undergoing PTCA may be clinical, such as; female sex [17], unstable angina [18], MVD [19] or Anatomical such as; angiographically demonstrable intracoronary thrombus, eccentric stenosis [20], stenosis located at or near a bend or branch, severe pre PTCA stenosis [21], stenosis or 2 luminal diameter in length, sequential stenosis, diffusely diseased artery, procedural variables, extensive coronary arterial dissection and use of oversized balloon [22].…”

Section: Consequences Of Abrupt Closurementioning

confidence: 99%

Short Term and Long Term Complications after Percutaneous Transluminal Coronary Angioplasty (PTCA)

Sharma¹

2017

IJCH

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Background: The nonsurgical treatment of arteries narrowed by atherosclerosis was introduced in 1964, when Dotter and Judkin performed transluminal angioplasty of femoral artery stenoses [1]. In 1970, Gruntzig modified the dilation catheter to allow its use in coronary arteries dilation [2]. Subsequently, In 1977 he performed the first Percutaneous Transluminal Coronary Angioplasty (PTCA) in a patient. Since onward, PTCA has been used in many patients with stable angina, unstable angina or acute myocardial infarction. Its use was initially limited to the treatment of discrete stenoses in proximal segment of a coronary artery, but improvements in equipments and techniques have lead its use in patients with stenoses, that are more complex or located in distal arterial segments and in patients relatively at high risk for complications [3]. Despite the wider application of PTCA, the success rate remained high. Over the past decade, the number of procedure performed has steadily increased, with over 300,000 performed in united state in 1990 [4].

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“…ECG evidence of ischemia identifies those with significant risk for acute vessel closure (6,118,119,(778)(779)(780). When angina pectoris or ischemic ECG changes occur after PCI, the decision to proceed with further interventional procedures, CABG surgery, or medical therapy should be individualized on the basis of factors such as hemodynamic stability, amount of myocardium at risk, and the likelihood that the treatment will be successful.…”

Section: Postprocedures Evaluation Of Ischemiamentioning

confidence: 99%

“…Factors that correlate with a poor outcome after acute coronary closure include age greater than 70 years, large ischemic burden, presentation with acute coronary syndromes, and LV ejection fraction less than 30% (778)(779)(780).…”

Section: Postprocedures Evaluation Of Ischemiamentioning

confidence: 99%

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

Wilkins¹

2006

Circulation

349

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Frequency, management and follow-up of patients with acute coronary occlusions after percutaneous transluminal coronary angioplasty

Cited by 189 publications

References 5 publications

Coronary stenting with a new, radiopaque, balloon-expandable endoprosthesis in pigs.

Coronary stenting with a new, radiopaque, balloon-expandable endoprosthesis in pigs.

Short Term and Long Term Complications after Percutaneous Transluminal Coronary Angioplasty (PTCA)

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

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