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  • 1
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Rescue percutaneous coronary intervention (PCI) has been used to treat patients after failed thrombolysis in acute myocardial infarction. However, the short- and long-term benefits of rescue PCI have not been known exactly. The goal of this study was to examine the clinical and angiographic outcomes, the success rate of the procedure, and the long-term survival rate after rescue PCI. The clinical and angiographic outcomes of 31 patients (Group I; 59.7 ± 11.4 years, 80.6% male), who underwent rescue PCI were compared with those of 177 patients (Group II; 59.7 ± 9.7 years, 79.7% male), who underwent primary PCI at Chonnam National University Hospital between January 1997 and December 1999. There were no significant differences in the risk factors for coronary artery diseases except for smoking (Group I; 24/31, 77.4% vs. Group II; 76/177, 42.9%, P = 0.011 ). The incidence of cardiogenic shock was higher in Group I than in Group II (Group I; 7/31, 22.6% vs. Group II; 11/177, 6.2%, P = 0.021 ). The coronary angiographic findings were not different between two groups, except for Thrombolysis in Myocardial Infarction (TIMI) flow of Group I was lower than in Group II (Group I; 1.14 ± 0.93 vs. Group II; 1.61 ± 1.14, P = 0.001 ). The primary success rate was 93.6% (29/31) in Group I and 94.9% (168/177) in Group II (P = 0.578) . The baseline ejection fraction was lower in Group I than in Group II (Group I;44.2 ± 8.9%vs. Group II;50.8 ± 11.7, P = 0.023), which improved in both groups (Group I;51.7 ± 7.9%vs. Group II;60.7 ± 13.4%, P = 0.001respectively) at 6 months after the procedures. The survival rates of Group I were 93.5%, 93.5%, and 90.3% and those of Group II were 94.5%, 93.7%, and 91% at 1, 6, and 12 months, respectively. Rescue PCI is associated with the risk factor of smoking. The indication for rescue PCI was more common in patents with cardiogenic shock. The success rate of rescue PCI was comparable to that of primary PCI, and left ventricular function is improved after rescue PCI on long-term clinical follow-up with relatively high survival rate. (J Interven Cardiol 2003;16:209–216)
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: With the introduction of high pressure balloon inflations and antiplatelet therapy, the incidence of stent thrombosis has been markedly reduced, but the incidence of late stent restenosis has not. A new strategy may be local drug delivery, which maintains sustained local concentration and limits systemic complications. To evaluate the efficacy of local nitric oxide (NO) donor delivery on stent thrombosis and complications, local NO donor delivery was performed in stented patients. NO donor (2.0-mg molsidomine) was delivered (1.0 mL/min 〉 10 min) using the Dispatch Catheter after predilation of target lesions in 13 patients (6 angina, 7 myocardial infarction, age 53.1 ± 11.4 years). After local NO donor delivery, Palmaz-Schutz stents were placed using standard methods. Follow-up coronary angiograms were performed 48 hours and 6 months after stenting. None of the patients had hypotensive effects, ischemic symptoms, or ECG changes during and after local NO donor delivery. APTT and CK values were unchanged at 3 and 24 hours after local NO donor delivery and stenting. Follow-up coronary angiograms at 48 hours and 6 months showed all stents patent with TIMI III flow and without intrastent thrombus. No target lesion revascularization and 100% event-free survival were observed during the 6-month clinical follow-up period. Intracoronary stenting may be performed safely and effectively by local NO donor delivery prior to stent implantation.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract  We report a successful stent implantation for a coarctation lesion of the lower thoracic aorta in a 44-year-old male. This patient had suffered from claudication of both legs for 30 years. An aortogram revealed a coarctation of the distal thoracic aorta at T11 level with 60 mmHg peak systolic pressure gradient of across the lesion. A balloon angioplasty followed by an 18 mm × 40 mm sized stent implantation was performed successfully. The peak systolic gradient across the coarctation decreased from 60 to 15 mmHg. The patient's symptom was relieved immediately after stenting. No significant or adverse events were observed during 7 months clinical follow-up. Follow-up aortogram after 7 months revealed no restenosis with an improved pressure gradient. Adults with congenital coarctation of the descending thoracic aorta can be successfully treated by stent implantation.
    Type of Medium: Electronic Resource
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