A comparison of balloon-mounted and self-expanding stents in the carotid arteries: immediate and long-term results of more than 500 patients.

Purpose: To compare the rates of neurological complications and restenosis for balloon-mounted (BM) versus self-expanding (SE) stents deployed in the extracranial carotid arteries.

Methods: Among 513 patients (312 men; mean age 71.3 years, range 27-91) who underwent carotid artery stent placement, 496 received 520 stents.

Evaluation of glycoprotein IIb/IIIa inhibitors in carotid angioplasty and stenting.

Purpose: To review the immediate neurological and bleeding complications associated with the use of glycoprotein (GP) IIb/IIIa inhibitors in patients undergoing extracranial carotid artery stent placement.

Methods: A retrospective review was performed of 550 patients (321 men; mean age 71.1 years, range 28-91) who underwent carotid artery angioplasty and stent placement.

Management of neurological complications of carotid artery stenting.

Purpose: To review the neurological complications associated with extracranial carotid artery stenting and to preliminarily assess techniques used to manage these complications.

Methods: Between April 1994 and August 2000, 450 patients (270 men; mean age 70.2 years, range 27-89) had stents implanted to treat 472 cervical carotid artery stenoses.

New developments in endovascular interventions for extracranial carotid stenosis.

We provide an overview of recent developments in carotid interventional technique and equipment, including new stents and emboli protection devices. The newer self-expanding stents lessen the problem of external stent compression associated with balloon expandable stents, but precise deployment and the matching (by length) of stents to lesions remain problematic. We also discuss emerging pharmacologic strategies for cerebral protection in stroke.

Comparison of thrombolytic therapy of lower-extremity acute, subacute, and chronic arterial occlusions.

Our purpose was to study the effectiveness of thrombolytic therapy in treating acute, subacute, and chronic arterial occlusions in a multicenter retrospective study. Intraarterial urokinase infusion was performed in 235 patients for occluded native arteries. There were 70 (30%) with acute and 26 (5%) with subacute occlusions, and 141 (59%) with chronic symptoms for longer than 3 mo.

Endovascular stents for carotid artery occlusive disease.

Purpose: To study the feasibility and safety of endovascular stenting of cervical carotid artery stenosis.

Methods: Between April 1994 and May 1997, 108 consecutive patients (58 men; mean age 70.1 years) with > or = 70% carotid stenosis were treated with percutaneous stent implantation under a protocol that featured independent neurological review.

Infrainguinal directional atherectomy: long-term follow-up and comparison with percutaneous transluminal angioplasty.

Purpose: To assess the long-term results of directional atherectomy (DA) for femoropopliteal artery atherosclerotic lesions and to compare the results to those previously reported for percutaneous transluminal balloon angioplasty (PTA).

Materials And Methods: Eight-four percutaneous DA procedures performed on 75 patients between July 1988 and August 1992 were retrospectively reviewed and evaluated for technical and initial clinical success. Long-term patency was assessed with a combination of ankle-brachial index measurements and angiography.

Antegrade popliteal puncture: technical note.

Percutaneous transluminal angioplasty was performed via an antegrade popliteal puncture. This technique was utilized because the patient had a superficial femoral artery occlusion and coexistent popliteal stenoses, with the occlusion unable to be traversed in the usual common femoral artery antegrade approach. To our knowledge, this technique has not been described in the literature.

Subclavian artery angioplasty for treatment of coronary artery steal syndrome.

Three patients underwent percutaneous transluminal angioplasty for treatment of subclavian artery stenosis producing the coronary artery steal syndrome. Technical success and immediate relief of angina were achieved in all three patients. Clinical follow-up ranged from 4 to 16 months.

Intravascular stents in the management of superior vena cava syndrome.

Superior vena cava syndrome can be effectively palliated with the use of intravascular stents. Adjunctive modalities which may be utilized prior to stent placement are thrombolytic therapy and balloon angioplasty. Six patients with an underlying malignancy were treated with these modalities.

New reperfusion devices: the Kensey catheter, the atherolytic reperfusion wire device, and the transluminal extraction catheter.

Substantial interest exists in the development of reperfusion and recanalization devices that would aid in the management of both peripheral vascular and coronary artery occlusive disease. Several of these devices are now in multicenter investigative trials. The atherolytic reperfusion wire incorporates a 0.

Patients with hemoptysis examined by Tc-99m sulfur colloid and Tc-99m-labeled red blood cells: a preliminary appraisal.

A prospective study of 16 patients with hemoptysis was conducted over a 2 1/2-year period. Technetium-99m sulfur colloid (Tc-SC) and technetium-99m-labeled red blood cells (Tc-RBC) were sequentially used to identify the general area of bleeding. Tc-SC accurately located the bleeding area in 3 patients and Tc-RBC identified the bleeding area in 8; there were no false-positive studies.

Parathyroid adenomas studied by digital subtraction angiography.

Eighteen patients who had elevated serum calcium and parathormone levels were prospectively studied with intravenous digital subtraction angiography (DSA). Intravenous DSA of the neck and mediastinum was performed in the anteroposterior, the left anterior, and the right anterior oblique projections. The study was considered positive if an abnormal blush or blood supply was noted.

Small bowel infarction complicating intra-aortic balloon counterpulsation via the ascending aorta.

A case of small bowel infarction owing to balloon-induced thrombosis of the superior mesenteric artery is described. The tendency of thrombosis to occur when the balloon is inserted via the ascending aorta is discussed. This possibility necessitates obtaining lateral roentgenograms of the balloon tip before closure of the sternum.

Doppler-assisted percutaneous angiography.

The Doppler ultrasonic blood velocity detector was used to determine the location and patency of non-palpable femoral and brachial arteries, facilitating their percutaneous puncture. This technique was used to achieve a more optimal demonstration of the peripheral circulation distal to aorto-iliac occlusive disease as well as for retrograde catheter angiography of vascular beds distal to more central stenoses or occlusions. This technique may also aid in percutaneous puncture for emergency angiography in hypotensive patients, percutaneous transluminal angioplastsy, or femoral vein punctures.