41 research outputs found
Incidence, predictors, and economic impact of contrast induced nephropathy: results in 8,628 patients treated with percutaneous coronary interventions
Atherosclerotic coronary lesions with inadequate compensatory enlargement have smaller plaque and vessel volumes: observations with three dimensional intravascular ultrasound in vivo.
OBJECTIVE: To compare vessel, lumen, and plaque volumes in atherosclerotic coronary lesions with inadequate compensatory enlargement versus lesions with adequate compensatory enlargement. DESIGN: 35 angiographically significant coronary lesions were examined by intravascular ultrasound (IVUS) during motorised transducer pullback. Segments 20 mm in length were analysed using a validated automated three dimensional analysis system. IVUS was used to classify les
Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis
BACKGROUND: Treatment of in-stent restenosis presents a critical
limitation of intracoronary stent implantation. Ionizing radiation has
been shown to decrease neointimal formation within stents in animal models
and in initial clinical trials. We studied the effects of intracoronary
gamma-radiation therapy versus placebo on the clinical and angiographic
outcomes of patients with in-stent restenosis. METHODS AND RESULTS: One
hundred thirty patients with in-stent restenosis underwent successful
coronary intervention and were then blindly randomized to receive either
intracoronary gamma-radiation with (192)Ir (15 Gy) or placebo. Four
independent core laboratories blinded to the treatment protocol analyzed
the angiographic and intravascular ultrasound end points of restenosis.
Procedural success and in-hospital and 30-day complications were similar
among the groups. At 6 months, patients assigned to radiation therapy
required less target lesion revascularization and target vessel
revascularization (9 [13.8%] and 17 [26.2%], respectively) compared with
patients assigned to placebo (41 [63.1%, P=0.0001] and 44 [67.7%,
P=0.0001], respectively). Binary angiographic restenosis was lower in the
irradiated group (19% versus 58% for placebo, P=0.001). Freedom from major
cardiac events was lower in the radiation group (29.2% versus 67.7% for
placebo, P<0.001). CONCLUSIONS: Intracoronary gamma-radiation used as
adjunct therapy for patients with in-stent restenosis significantly
reduces both angiographic and clinical restenosis
An Integrated Collection of Tools for Continuously Improving the Processes by Which Health Care Is Delivered: A Tool Report
Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies
Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ∼10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. Methods: The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. Results: Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. Conclusions: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data