Angioplasty and provisional stent treatment of common femoral artery lesions.

Purpose: Isolated atherosclerotic common femoral artery (CFA) disease is a rare cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice, little is known about outcomes of percutaneous treatment.

Materials And Methods: A prospectively maintained single-center database was retrospectively analyzed for outcomes of consecutive patients undergoing isolated percutaneous revascularization of CFA disease between 1996 and 2007.

Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures.

Objectives: The purpose of this study was to evaluate the technical feasability, safety, and 1-year efficacy of the endovascular treatment of atherosclerotic common femoral artery (CFA) obstructions.

Background: Atherosclerotic CFA obstruction is a known cause of symptomatic peripheral arterial disease. Although surgical endarterectomy is considered the therapy of choice for this condition, little is known about the percutaneous options.

Why can pulmonary vein stenoses created by radiofrequency catheter ablation worsen during and after follow-up? A potential explanation.

Background: Radiofrequency catheter ablation of excitation foci inside pulmonary veins (PV) generates stenoses that can become quite severe during or after the follow-up period. Since severe PV stenoses have most often disastrous consequences, it would be important to know the underlying mechanism of this temporal evolution. The present study proposes a potential explanation based on mechanical considerations.

Could increased axial wall stress be responsible for the development of atheroma in the proximal segment of myocardial bridges?

Background: A recent model describing the mechanical interaction between a stenosis and the vessel wall has shown that axial wall stress can considerably increase in the region immediately proximal to the stenosis during the (forward) flow phases, so that abnormal biological processes and wall damages are likely to be induced in that region. Our objective was to examine what this model predicts when applied to myocardial bridges.

Method: The model was adapted to the hemodynamic particularities of myocardial bridges and used to estimate by means of a numerical example the cyclic increase in axial wall stress in the vessel segment proximal to the bridge.

Thresholds and complications with right ventricular septal pacing compared to apical pacing.

Background: Right ventricular septal pacing has been proposed as an alternative to apical pacing. However, data concerning thresholds and requirement for lead repositioning with this technique are scant.

Methods: We reviewed data at implantation and follow-up of 362 consecutive recipients of the same model of active fixation lead (Medtronic 5076-58, Minneapolis, MN, USA) to avoid differences due to lead characteristics.

Utility of the surface ECG before VDD pacemaker implantation.

Background: VDD pacemakers may be implanted in the setting of atrioventricular block with preserved sinus function. Their main advantage over DDD pacemakers is use of a single lead. However, low-amplitude atrial electrograms (EGMs) recorded from the free-floating atrial electrode may lead to undersensing.

Prospective study of axillary vein puncture with or without contrast venography for pacemaker and defibrillator lead implantation.

Axillary vein puncture may be used to implant pacemaker (PM) or cardioverter defibrillator leads, though usually requires venography. We prospectively compared punctures guided by venography versus a new radiological landmark. In 232 patients, the puncture was guided by injecting diluted contrast material via an ipsilateral peripheral vein (group A, n = 142), or without venography using the intersection of the lateral borders of the second and third rib as a radiological landmark, followed by contrast injection in case of failure (group B, n = 90).

Residual stenosis poststenting and subsequent decrease in the proximal reference diameter are correlated: excessive axial wall stress is a plausible explanation.

Purpose: To test the hypothesis that edge restenosis in stented lesions might be due to an increase in axial wall stress in the adjacent proximal vessel segment by examining whether the proximal reference diameters of conventionally stented lesions are reduced at follow-up and whether this reduction depends on the degree of residual stenosis poststenting.

Methods: The literature published in the past 5 years dealing with restenosis following implantation of standard stents was screened for the availability of (1) reference vessel diameters poststenting, (2) mean residual stenosis poststenting, and (3) mean reference vessel diameters at follow-up in the same patients or groups of patients. Data collected from 11 publications were pooled and used to compute the change in reference segment diameter over time.

Thoracic aortic plaques, transoesophageal echocardiography and coronary artery disease.

Background: The purpose of this study was to assess whether the detection of atherosclerotic aortic plaques by transoesophageal echocardiography (TEE) could be used as a marker of coronary artery disease (CAD), relying on their number, cross-sectional surface, depth and localisation.

Methods: The thoracic aortas of 102 consecutive patients (77 men, mean age 67 +/- 12 years) undergoing elective cardiac surgery were assessed by TEE. Atherosclerotic plaques were defined as > or = 5 mm thick focal hyperechogenic zones of the aortic intima and/or lumen irregularities with mobile structures or ulcerations.

In-hospital complications of percutaneous intraaortic balloon counterpulsation.

Complications related to intraaortic balloon counterpulsation pumping (IABP) remain a problem despite the development of small caliber balloon catheter shafts and introducer sheaths. The authors report their experience in counterpulsation-related complications of 201 consecutive patients who underwent 212 percutaneous counterpulsation balloon insertions from June 1989 to June 1996 by use of balloons with 8-9.5 French shafts.