Non-invasive diagnosis of pulmonary hypertension: ESC/ERS Guidelines with Updated Commentary of the Cologne Consensus Conference 2011.

The 2009 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension have been adopted for Germany. The guidelines contain detailed recommendations for the diagnosis of pulmonary hypertension. However, the practical implementation of the European Guidelines in Germany requires the consideration of several country-specific issues and already existing novel data.

Stent-supported angioplasty of severe atherosclerotic renal artery stenosis preserves renal function and improves blood pressure control: long-term results from a prospective registry of 456 lesions.

Purpose: To report a prospective study evaluating the long-term impact of stent-supported angioplasty on renal function and blood pressure control.

Methods: In a 6-year period, 456 hemodynamically significant de novo renal artery stenoses > or =70% were treated in 340 consecutive hypertensive patients (223 men; mean age 66+/-10 years, range 44-84) with or without impaired renal function. Baseline data on serum creatinine (sCr), intrarenal resistance index, ambulatory 24-hour blood pressure monitoring, and documentation of the number and dose of antihypertensive drugs were compared to values obtained during follow-up.

Technological advances in the design of catheters and devices used in renal artery interventions: impact on complications.

Purpose: To analyze the impact of technical improvements in stent devices and guiding catheters (e.g., reduced device diameter, increased flexibility) on the complication rates associated with percutaneous renal artery interventions.

Predictors of improved renal function after percutaneous stent-supported angioplasty of severe atherosclerotic ostial renal artery stenosis.

Background: Percutaneous stent-supported angioplasty is a treatment option for atherosclerotic ostial renal artery stenosis. Improvement of renal function by such intervention, however, is controversial and thought to be limited to specific subsets, such as nondiabetic patients and bilateral stenoses. In this prospective study, we investigated predictors for improvement of renal function and blood pressure after renal artery stent placement.

Gold coating and restenosis after primary stenting of ostial renal artery stenosis.

Predictors of restenosis after stent angioplasty of ostial renal artery stenosis (RAS) and long-term technical success, particularly the influence of gold coating, are unknown. During a 4-year period (1996-2000), we treated 156 consecutive patients with 219 ostial RAS of > or = 70% diameter stenosis. Gold-coated stents were used in 29% of RAS (n = 64); the vessel diameter ranged from 3 to 9 mm.

Acute thrombotic subclavian artery occlusion treated with a new rotational thrombectomy device.

Purpose: To report the use of a new rotational thrombectomy device for percutaneous thrombectomy of an acutely occluded subclavian artery.

Case Report: A 71-year-old woman with a history of multivessel coronary disease complained of sudden onset of pain at rest and paleness of the left arm. Duplex ultrasound showed a localized thrombotic occlusion of the postvertebral subclavian artery and another at the bifurcation of the brachial artery.

Gadodiamide as an alternative contrast agent during angioplasty in patients with contraindications to iodinated media.

Purpose: To evaluate gadodiamide as an alternative contrast agent for peripheral and renal angioplasty in patients with contraindications to iodinated contrast media.

Methods: Seventeen patients (10 men; mean age 74 years, range 68-83) with contraindication to iodinated contrast media were given gadodiamide as the contrast agent during peripheral and renal intra-arterial digital subtraction angiography (DSA) and subsequent percutaneous interventions (balloon angioplasty, stent placement).

Results: The mean volume of gadodiamide used was 136 +/- 46 mL (range 60-200).