Treatment of post-catheterization femoral artery pseudo-aneurysm with para-aneurysmal saline injection.

Femoral artery pseudoaneurysm is a common complication associated with cardiac catheterization procedures. Ultrasound-based techniques (e.g.

The LightWire technology for catheter-based interventions.

Background: The LightWire is a newly developed opto-acoustic coronary imaging guidewire that was designed to be used during angioplasty procedures and provide 'online' information on lumen and vessel wall dimensions.

Methods: We designed in vitro models and performed animal trials to confirm proper device sensing capabilities and performance in the coronary arteries. This report focuses on maneuverability, compatibility with other catheterization devices, and vessel measurements.

Circulating endothelial progenitor cells in patients with cardiac syndrome X.

Background: Cardiac syndrome X (CSX) encompasses the constellation of anginal chest pain in the presence of a pathological functional test and a normal coronary angiogram. Endothelial progenitor cells (EPCs) in the peripheral circulation contribute to tissue vascularisation.

Objective: To investigate the number and functional properties of circulating EPCs in patients with CSX.

Comparative analysis of methods for assessment of circulating endothelial progenitor cells.

The number and properties of endothelial progenitor cells (EPC) in disease states is of considerable interest due to the importance attributed to this distinct cell population. However, there has been no study comparing each of the methods employed in the same sampled individuals. Herein, we performed an analysis of several methods used for circulating EPC assessment and correlated them with humoral factors known to influence their numbers.

Transfer of endothelial progenitor and bone marrow cells influences atherosclerotic plaque size and composition in apolipoprotein E knockout mice.

Objective: Recent clinical trials use cell therapy with bone marrow (BM) cells or endothelial progenitor cells (EPCs) for ischemic syndromes. We explored the effect of BM cell- or spleen cell-derived EPC transfer on plaque size and stability markers in the apolipoprotein E knockout (apoE KO) mouse model.

Methods And Results: ApoE KO mice aged 10 weeks served as recipients.

Stent thrombosis in patients treated with thienopyridines: clinical description of 10 cases.

Subacute stent thrombosis (SAST) is a major thrombotic complication of coronary stenting. Its occurrence has been substantially reduced by thienopyridine treatment. However, information on clinical profile of patients with SAST in clopidogrel era is limited.

Eptifibatide does not influence lymphocyte activation and CRP levels in patients with undergoing coronary angioplasty.

Inhibitors of the IIB-IIIA integrin are widely used to prevent stent thrombosis. Abciximab has been shown to attenuate the inflammatory response in patients undergoing PCI. Herein, we tested the effect of eptifibatide infused during PCI on peripheral lymphocyte activation and CRP levels before, and one month after the procedure showing no noticeable effect.

Transfer of endothelial progenitor cells improves myocardial performance in rats with dilated cardiomyopathy induced following experimental myocarditis.

Endothelial progenitor cells (EPCs) home to sites of tissue injury and differentiate into mature endothelial cells. Their transfer feasibility has been proven in models of hindlimb ischemia and myocardial infarction. We investigated, the effect of delivery of spleen-derived EPC in a rat model of inflammatory-mediated myocardial damage.

Erythropoietin promotes endothelial progenitor cell proliferative and adhesive properties in a PI 3-kinase-dependent manner.

Objectives: Patients with congestive heart failure (CHF) suffer considerable morbidity and mortality despite advances in therapy. Treatment with erythropoietin (Epo) has shown promise in CHF patients, yet its mechanisms of action remain elusive. Endothelial progenitor cells (EPC) contribute to postnatal angiogenesis and vasculogenesis, and Epo was shown to promote EPC mobilization.

Clinical value of 16-slice multi-detector CT compared to invasive coronary angiography.

Background: Multi-detector row spiral CT (MDCT) can be applied as a noninvasive tool for the assessment of coronary artery stenoses. Few, confounding reports have been published using 16 detector rows. The aim of the present study was to determine the accuracy of 16-detector row MDCT for the detection of significant stenoses in the coronary arteries, in comparison to conventional invasive coronary angiography.

Temporal association between circulating proteolytic, inflammatory and neurohormonal markers in patients with coronary ectasia.

Background: The prevalence of coronary ectasia (CE) appears to rise in recent years. However, the pathogenetic mechanisms that underlie this entity are not understood. We hypothesized that dysregulation of circulating matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinase (TIMPs) contributes to ectasia formation.

Serum levels of interleukin-18 in patients with stable and unstable angina pectoris.

Recent evidence suggests that atherosclerosis is an inflammatory disorder in which cytokines appear to play an important role. Special attention centered over the possible contribution of cytokines to the destabilization of the plaque. IL-18 is a proinflammatory cytokine of the IL-1 family, recognized for its ability to promote IFN-gamma secretion.

The predictive value of white blood cell count on the success of primary percutaneous intervention of the left anterior descending artery in patients admitted with acute anterior wall myocardial infarction.

Background: Epidemiological studies have shown correlations between the white blood cell (WBC) count and the risk of acute myocardial infarction (AMI) and stroke. The risk of AMI is four times as great in patients with WBC counts in the high-normal range (>9000/microl) as it is in those in the low-normal range (<6000/microl). A high WBC count also predicts a greater risk of re-infarction and in-hospital death.

Circulating endothelial progenitor cells in patients with unstable angina: association with systemic inflammation.

Background: Endothelial progenitor cells (EPC) are present in peripheral blood and can develop a functional endothelial phenotype. The number and function of circulating EPCs are altered in atherosclerosis, diabetes, and after myocardial infarction and EPCs have been shown to promote postnatal angiogenesis and vasculogenesis. We investigated the number and adhesive properties of EPCs from patients with unstable angina and no evidence of cardiac necrosis.

L-arginine attenuates lymphocyte activation and anti-oxidized LDL antibody levels in patients undergoing angioplasty.

Background: Patients with acute coronary syndromes exhibit evidence of peripheral T lymphocyte activation, elevated acute phase proteins and enhanced oxidative stress. Nitric oxide (NO) has been recognized as one of the relaxant factors synthesized and released by normal endothelium, and acts as a double-edged sword on the immune system. L-arginine ameliorates experimental atherosclerosis and restenosis as well as endothelial dysfunction.

Number and adhesive properties of circulating endothelial progenitor cells in patients with in-stent restenosis.

Objective: Intact endothelialization machinery is essential to facilitate vessel healing after stent placement and to prevent restenosis. Circulating endothelial progenitor cells (EPC) have been demonstrated in the peripheral blood and shown to display endothelial functional properties, along with the ability to traffic to damaged vasculature. We reasoned that robust in-stent intimal growth could be partially related to impaired endothelialization resulting from reduced circulating EPC number or function.

Clinical parameters and functional tests are not predictive for in-stent restenosis.

Objective: To study the correlation between clinical parameters and the occurrence of in-stent restenosis in a cohort of patients from the Tel Aviv Medical Center who underwent repeat angiograms for clinical indications following stenting.

Background: After stenting, recurrences of symptoms or ischemia on functional tests are considered to be clinical signs of restenosis.

Methods: The authors' study group consisted of 149 out of 1469 patients (10%) who underwent stent implantation between 1996 and 1998 and were under clinical follow-up.

Intravascular ultrasound imaging of myocardial-infarction-related arteries after percutaneous transluminal coronary angioplasty reveals significant plaque burden and compensatory enlargement.

We studied patients with acute myocardial infarction (MI) by intravascular ultrasound (IVUS) to elucidate the controversy as to the amount and severity of the atherosclerotic disease at the culprit lesion site in acute MI, as discrepancies exist between angiographic and pathological reports. Twenty-five consecutive patients (age 56 3 10.5 years), with acute MI, underwent IVUS study of the MI-related artery immediately following successful PTCA to the culprit lesion.

The effects of L-arginine on atherosclerosis and heart disease.

L-arginine, a semi-essential amino acid, can enhance the synthesis of nitric oxide (NO) via the nitric oxide synthase pathway. Enhanced bioavailability of NO may prevent activation of pro-inflammatory endothelial genes by the inhibition of nuclear transcription factor NF 3B, thus preventing the expression of adhesion molecules on endothelial surfaces. Animal studies have demonstrated that the chronic administration of L-arginine reduces the extent of atherosclerosis and prevents xanthoma development in LDL receptor knockout mice.

Ultrasound angioplasty: an update review.

The use of therapeutic ultrasound to treat atherosclerosis and thrombosis has been appreciated for decades. However, it was only the explosive growth of angioplasty in the 1980s that brought real momentum to the development of therapeutic catheter ultrasound. The idea behind this technique was that ultrasound, by its bioselectivity, might provide a solution to some of the shortcomings of balloon angioplasty.

Effects of an acute dose of L-arginine during coronary angiography in patients with chronic renal failure: a randomized, parallel, double-blind clinical trial.

Background: Contrast media (CM) are nephrotoxic and might further worsen renal function in patients with chronic renal failure. L-Arginine, the substrate of nitric oxide, protects kidney function and may improve endothelial function in patients with coronary artery disease.

Hypothesis: Acute administration of L-arginine in a subset of patients with combined coronary artery disease and impaired kidney function during coronary angiography might prevent superimposed acute renal failure.

Pulse transmission coefficient: a novel nonhyperemic parameter for assessing the physiological significance of coronary artery stenoses.

Objectives: We sought to test the hypothesis that the pulse transmission coefficient (PTC) can serve as a nonhyperemic physiologic marker for the severity of coronary artery stenosis in humans.

Background: Coronary lesions may impair the transmission of pressure waves across a stenosis, potentially acting as a low-pass filter. The PTC is a novel nonhyperemic parameter that calculates the transmission of high-frequency components of the pressure signal through a stenosis.