Catheterization and cardiovascular diagnosis
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Cathet Cardiovasc Diagn · Jul 1995
Case ReportsRetrieval of directional coronary atherectomy guiding catheter with angioplasty balloon catheter.
Directional coronary atherectomy (DCA) has been shown to be a safe and effective treatment for occlusive coronary artery disease. We report a case of an atherectomy guiding catheter severing in two with successful retrieval of the dislodged segment by an integrated angioplasty balloon catheter system.
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Cathet Cardiovasc Diagn · Apr 1995
Review Case ReportsAneurysm of saphenous vein graft to coronary artery presenting as non-Q-wave myocardial infarction secondary to mass effect.
Large aneurysms (> 4 cm) of saphenous vein grafts (SVG) to coronary arteries are a rare complication of coronary artery bypass graft surgery (CABG). A 64-year-old male, status post-CABG 14 years ago, presented with dyspnea and diaphoresis. Pneumonia and non-Q-wave myocardial infarction (MI) were diagnosed. ⋯ At the time of surgery, the left internal mammary artery (grafted to the left anterior descending artery) was found to be stretched tautly over the aneurysm, resulting in impaired flow. The aneurysm was successfully resected. This is the first published case implicating a SVG aneurysm as the direct cause of a MI by mass effect.
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Cathet Cardiovasc Diagn · Feb 1995
Case ReportsSuccessful transcatheter management of Palmaz Stent embolization after superior vena cava stenting.
A 34-year-old patient with benign superior vena cava syndrome (SVCS) was treated with thrombolytic therapy, balloon angioplasty, and placement of two peripheral Palmaz stents. Embolization of one stent to the right atrium occurred 10 min after successful implantation. ⋯ Complete resolution of SVCS symptoms occurred within 24 hr and moderate superior vena cava restenosis was successfully dilated 8 months later. At 12-month follow-up the patient continues to be asymptomatic.
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Cathet Cardiovasc Diagn · Dec 1994
Case ReportsPart XII: Assessment of serial lesions in the proximal right coronary artery following intracoronary thrombolysis.
Assessment of angiographically serial coronary lesions at the time of diagnostic catheterization remains a difficult clinical problem. Doppler flow velocity data is easily obtainable and allows physiologic interrogation of the distal coronary microcirculation, but has limitations in the detection of some flow-limiting stenoses. In cases of serial lesions or distal arterial disease, particularly after thrombolysis, flow velocity data may be insufficient to identify the hemodynamic significance of the coronary lesions. Translesional pressure measurements may be combined with flow velocity data to support an appropriate physiologically based therapeutic approach.
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Cathet Cardiovasc Diagn · Aug 1994
Case ReportsInternal mammary artery collateral to the external iliac artery: an angiographic consideration prior to coronary bypass surgery.
The role of routine selective angiography of the internal mammary artery prior to myocardial revascularization is controversial. We report a patient with coronary artery disease and peripheral vascular disease in whom the left internal mammary artery supplied blood flow to the left external iliac artery via a collateral network. Thus, selective angiography of the internal mammary artery did play a major role in the proper management of this patient who required coronary bypass surgery. A major potential postoperative complication of left lower extremity ischemia may have been prevented.