Read e-book online Interventional Techniques in Cardiovascular Medicine PDF

By H. Roskamm (auth.), V. Hombach, M. Kochs, A. J. Camm (eds.)

ISBN-10: 9401056919

ISBN-13: 9789401056915

ISBN-10: 9401138028

ISBN-13: 9789401138024

Since the creation of balloon angioplasty for the relaxation of coronary artery stenoses and of anginal indicators in sufferers with coronary artery sickness by way of Andreas Griintzig in 1977, the sphere of interventional know-how and therapy innovations has grown tremendously. For the relief of hemodynamically major coronary artery stenoses balloon angioplasty is the normal and reference technique with a excessive basic luck and coffee problem expense. as a result of the really excessive recurrence premiums of 30-40% of balloon angioplasty a complete relations of alternative angioplasty options has been built considering the fact that then. between these are atherectomy units, laser angioplasty, radiofrequency angioplasty, low and high pace rotational angioplasty and stenting of stenosed vessels. Balloon angioplasty has been prolonged to aortic and mitral valve stenoses, and supraventricular and ventricular tachycardias can now be handled through catherter ablation ideas. In 1989 a world Symposium on average and more recent inter­ ventional concepts has been held on the college of Ulm. This quantity comprises the basic elements and shows of the overseas school of specialists within the box. In 4 chapters the foundations, benefits, pitfalls and destiny advancements of coronary angiopiasty, angioplasty of peripheral arteries, balloon valvuloplasty and of catheter ablation of supraventricular and ventricular tachycardias are defined intimately. we are hoping that this 'State-of-the-Art' illustration might be of serious worth for either the non­ professional reader and the lively researcher within the fields addressed in the e-book. V. Hombach, M. Kochs and A. J. Camm ix checklist of individuals U. U.

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Kochs M, Hoher M, Haerer W, Eggeling T, Schmidt A, Hombach V (1991) Excimer laser coronary angioplasty-preliminary results, in: Hombach V, Kochs M, Camm AJ (eds), lntervemional Techniques in Cardiovascular Medicine, p. 55. Dordrecht, Lancaster, Boston: Kluwer Academic Publishers. Litvack F, Grundfest WS, Goldenberg T, Laudenslager J, Forrester JS (1989) Percutaneous excimer laser angioplasty of aortocoronary saphenous vein grafts. J Am Coli Cardiol 14: 803. Margolis JR, Litvack F, Grundfest W, Eigler N, Goldenberg T, Laudenslager J, Tsoi D, Wong S, Segalowitz J, Hestrin L, Rothbaum D, Linnemeier T, Helfant R, Forrester J (1989) Excimer laser coronary angioplasty: Results of a multicenter study.

At present we are working on the development of such a mUltipurpose RFCA-catheter with variable tip size, in order simplify the angioplasty procedure and to improve the acute success rate of radiofrequency coronary angioplasty. With respect to acute side effects we were happy that in none of the patients a perforation of the vessel wall was observed during application of RFCA. The reasons for this are that we have used relatively short exposure times of RF-current (up to 2-3 s) and that the catheterization was performed with the over-the-wire technique.

In one patient a restenosis and in a second one a repeat occlusion of a formerly recanalized and collateralized vessel occurred 3 months following angioplasty. Thus, the recurrency rate was 2/8 (25%). In 6/9 patients followed so far a significant improvement of the clinical status was observed. Discussion This pilot study demonstrates that hemodynamically relevant coronary artery stenoses can be successfully reduced by the new RFCA-technique. If one takes the initial (Griintzig's) definition of success rates (reduction of equal or more than 20%) RFCA is effective to a similar degree as communicated for the PTCA success rates within the first series of NHLB-registry reports [1,2].

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Interventional Techniques in Cardiovascular Medicine by H. Roskamm (auth.), V. Hombach, M. Kochs, A. J. Camm (eds.)


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