Assessment of optimum stent deployment by stent boost imaging: comparison with intravascular ultrasound.

Stent boost (SB) imaging is an enhancement of the radiologic edge of the stent by digital management of regular X-ray images. The purpose of the present study was to validate SB imaging by comparison with the anatomical standard using intravascular ultrasound (IVUS). We investigated SB and IVUS after stent implantation in 68 arteries in 60 patients.

Type B aortic dissection resulting in acute esophageal necrosis.

In the present article, we report a case in which acute esophageal necrosis (AEN) of the intrathoracic esophagus was caused by extensive thrombosis in the false lumen of an aortic dissection, thereby occluding the blood flow to the intercostal arteries and thus the esophagus. According to the previously published data, AEN after aortic dissection is very rare and usually fatal. Besides esophageal ischemia secondary to arterial occlusion, direct extrinsic compression of the arteriovenous network surrounding the esophagus, caused by the traumatic pathology of the aorta, by extensive extravasation may also cause AEN.

Effect of phentolamine on the hyperemic response to adenosine in patients with microvascular disease.

For accurate measurement of the fractional flow reserve (FFR) of the myocardium, the presence of maximum hyperemia is of paramount importance. It has been suggested that the hyperemic effect of the conventionally used hyperemic stimulus, adenosine, could be submaximal in patients who have microvascular dysfunction and that adding alpha-blocking agents could augment the hyperemic response in these patients. We studied the effect of the nonselective alpha-blocking agent phentolamine, which was administered in addition to adenosine after achieving hyperemia, in patients who had microvascular disease and those who did not.

Long-term clinical outcome after fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease.

Objectives: In the present study, we analyzed the clinical outcome of patients with multivessel coronary artery disease in whom at least one vessel was treated by percutaneous coronary intervention (PCI) and at least one other vessel was deferred on the basis of fractional flow reserve (FFR) measurements during the same session.

Background: Myocardial FFR is an established tool for assessing the severity of epicardial stenoses. It has been shown that it is safe to defer an intervention in single vessel disease patients when FFR >0.

Percutaneous coronary intervention or bypass surgery in multivessel disease? A tailored approach based on coronary pressure measurement.

The optimal revascularization strategy, percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG), for patients with multivessel coronary artery disease (MVD) remains controversial. The aim of the present study was to compare the long-term outcomes after selective PCI of only hemodynamically significant lesions (fractional flow reserve, or FFR < 0.75) to CABG of all stenoses in patients with MVD.

False-negative myocardial scintigraphy in balanced three-vessel disease, revealed by coronary pressure measurement.

In nuclear perfusion imaging of the myocardium, a false-negative test result in patients with balanced three-vessel disease is a well-known pitfall. This paper describes a patient with typical chest pain and a negative myocardial perfusion scintigram. At coronary angiography, intermediate stenoses in the left anterior descending (LAD), left circumflex (LCX), and right coronary (RCA) arteries were present.