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Treatment of Palmaz-Schatz In-stent Restenosis: 6–Month Clinical Follow-up (2000)

TAN, HUAY-CHEEM ; CROWLEY, JAMES ; TCHENG, JAMES E. ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

Journal of interventional cardiology 13 (2000), S. 0

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ISSN: 1540-8183

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine

Notes: To identify predictors of Palmaz-Schatz in-stent restenosis and determine outcomes of treatment, we assessed 6–month outcomes in 402 patients who had coronary intervention with stent placement; 60 (15%) developed angiographic and clinical evidence of restenosis. Predictors of restenosis included family history of cardiovascular disease, prior bypass surgery, nonelective stenting, stenting of a vein graft, and multiple stents. Of 60 patients with stent restenosis, 47 had repeat percutaneous intervention and 10 had bypass surgery; only 1 of these 10 patients developed symptoms requiring repeat revascularization. Of the 47 with repeat percutaneous intervention, 32 (68%) had conventional balloon angioplasty; the others had perfusion balloon catheters, laser ablation, and repeat coronary stenting. During follow-up, 22 (47%) of these 47 patients suffered recurrent angina, myocardial infarction, or death. A third revascularization procedure was performed in 14 (30%), including 5 referred for bypass. This study shows the limitations of percutaneous modalities for patients with Palmaz-Schatz in-stem restenosis. Such patients are likely to have recurrent symptoms and to undergo repeat target-vessel revascularization.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1111/j.1540-8183.2000.tb00309.x

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Ventricular septal defect with bidirectional shunting: Mathematical considerations (1966)

Thompson, Howard K. ; Peter, Robert H. ; McIntosh, Henry D.

Springer

Bulletin of mathematical biology 28 (1966), S. 167-179

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ISSN: 1522-9602

Source: Springer Online Journal Archives 1860-2000

Topics: Biology , Mathematics

Notes: Abstract Previously proposed formulae for the quantitative estimation of bidirectional shunts across ventricular septal defects require determination of the oxygen contents of mixed venous, pulmonary artery, pulmonary venous, and aortic blood. Because these formulae do not take into account the mixing of oxygenated with unoxygenated blood within the ventricles, their use must result in underestimation of shunt flows in each direction. A mathematical model for a ventricular defect is examined, in which it is assumed that mixing of blood occurs in each of six sites in the venae cavae or right atrium, right ventricle, pulmonary artery, left atrium, left ventricle, and aorta. A total of fourteen streams of blood can flow from one to another of these mixing sites. As long as complete mixing occurs in the six specified mixing sites, any degree of mixing or non-mixing of the various streams is permitted. From the equations characterizing the model, formulae are derived in which the shunt flow in each direction is expressed in terms of the oxygen contents in the six mixing sites and the fractions of blood which enter the shunt from either side without prior mixing in a ventricular mixing site. The previously reported formulae, which apply when no ventricular mixing is allowed to occur, lead to theoretical minimum values for the shunt flows in each direction. At the opposite extreme where all the shunting blood is required to mix in a ventricle before entering the shunt, formulae for maximum possible shunt flows are also obtained. The absolute values for the left-to-right and right-to-left shunt flows, which must lie somewhere between the theoretical maximum and minimum values, cannot be computed from blood gas data alone.