Publications by authors named "Ramazanali Ahmadi"
Improvement of neurocognitive function after protected carotid artery stenting.
Catheter Cardiovasc Interv
January 2008
Objective: To investigate the effect of protected carotid artery stenting on neurocognitive function with particular consideration of the angiographic filling of the ipsilateral anterior cerebral artery (ACA).
Background: An improved inflow to the supply area of the anterior cerebral artery after revascularisation of severe carotid artery stenosis may beneficially affect frontal lobe cognitive functions.
Methods: We prospectively included 71 consecutive patients who underwent carotid artery stenting (CAS) due to high grade carotid artery stenosis.
Background And Purpose: Plaque characteristics are suggested to play a potentially important role as risk factors for poor outcome after carotid artery stenting (CAS). We therefore correlated objectively and subjectively determined carotid plaque morphology with neurological complications after CAS.
Methods: We enrolled 698 consecutive patients undergoing elective CAS from a prospective single-center registry database and classified the preinterventional plaque status according to gray-scale median levels and the standardized Beletsky and Gray-Weale plaque scores.
Purpose: To prospectively evaluate if high-grade (> or = 80% luminal narrowing) internal carotid artery stenosis is associated with depressive symptoms and if carotid artery stent placement (CAS) potentially improves depressive symptoms.
Materials And Methods: The study was approved by the local ethics committee, and informed consent was obtained from all subjects. One hundred forty-three patients (91 men, 52 women; interquartile range, 63-76 years) undergoing CAS because of asymptomatic high-grade (> or = 80% luminal narrowing) carotid artery stenosis and 102 control subjects (64 men, 38 women; interquartile range, 63-73 years) with advanced peripheral artery disease and without carotid artery stenosis undergoing lower-limb percutaneous transluminal angioplasty were included.
Purpose: To investigate whether the use of rapid-exchange (RX) systems adds to the safety of percutaneous renal artery procedures compared to the conventional over-the-wire (OTW) technique.
Methods: The interventional registry in our department was interrogated to identify patients who underwent plain balloon angioplasty and/or stent implantation for >60% renal artery stenosis and intractable hypertension or decreasing renal function between 1998 and 2004. In this time period, 63 consecutive patients (36 men; mean age 67 years, range 57-80) underwent 78 renal artery angioplasty procedures.
Purpose: To evaluate, in a propensity score-adjusted analysis, the intermediate-term primary patency rates associated with nitinol versus stainless steel self-expanding stent placement for treatment of atherosclerotic lesions in femoropopliteal arteries.
Materials And Methods: The authors analyzed the clinical and imaging data of 175 consecutive patients with peripheral artery disease and either intermittent claudication (n = 150) or critical limb ischemia (n = 25) who underwent femoropopliteal artery implantation of nitinol (n = 104) or stainless steel (n = 123) stents in a nonrandomized setting. The stents were placed owing to either significant residual stenosis (ie, >30% lumen diameter reduction) or flow-limiting dissection after initial balloon angioplasty of the femoropopliteal artery.
Purpose: To compare 13 previously published sets of duplex ultrasonographic (US) criteria with the US criteria used at the authors' institution in terms of agreement with carotid artery angiographic results.
Materials And Methods: The authors studied 1,006 carotid arteries in 503 patients at duplex US and angiography. The degree of stenosis was determined by using duplex flow US velocities and applying 13 previously published sets of criteria and the criteria used at the authors' institution.
Background And Purpose: The German Societies of Angiology and Radiology have instituted a prospective registry of carotid angioplasty and stenting (CAS) to limit uncontrolled use of CAS and to collect data about technique and results of CAS outside clinical trials.
Methods: A total of 38 centers register their patients prospectively before CAS is performed. At discharge, technical details, periprocedural medication, and the clinical course are reported on a standardized form.
Purpose: To examine if excessive in-stent neointimal formation causing a subcritical stenosis may indicate enhanced vascular reactivity in response to injury, thus predicting late cardiovascular events.
Methods: One hundred consecutive patients (64 men; median age 71 years) with high-grade internal carotid artery stenoses (68 asymptomatic, 32 symptomatic) underwent carotid artery stenting (CAS). High-sensitivity C-reactive protein (hs-CRP) was measured before CAS.
Purpose: To investigate whether smoking has an effect on recurrent lumen narrowing after percutaneous transluminal angioplasty (PTA) or stent placement in lower-limb arteries.
Materials And Methods: A total of 650 patients (median age, 70 years; 389 men) with peripheral artery disease who underwent iliac artery PTA (n = 95), iliac artery stent placement (n = 83), femoropopliteal PTA (n = 406), or femoropopliteal stent placement (n = 66) were selected from a prospective database. Patients were categorized according to their preintervention smoking habits as nonsmokers (n = 352), light smokers (one to nine cigarettes daily) (n = 54), habitual smokers (10-20 cigarettes daily) (n = 82), or heavy smokers (>20 cigarettes daily) (n = 162).
Objective: This study was undertaken to study negative and positive arterial remodeling processes within self-expanding carotid stents, their interaction, and the resulting changes in hemodynamics over 2 years, with duplex ultrasound scanning.
Subjects And Methods: One hundred twelve consecutive patients with 121 successfully stented carotid arteries were examined with color-coded duplex ultrasound scanning the day after the stent procedure and at 3, 6, 12, and 24 months of follow-up. The stent diameters at the proximal, middle, and distal regions, and the maximal neointimal thickness (B-mode) and hemodynamic parameters were recorded.
Renal artery stenosis (RAS) leading to hypertension or ischemic nephropathy can be treated by endovascular revascularization using balloon angioplasty or stent implantation. Although high technical success rates > 95%, relatively low frequencies of complications and good long-term patency can be achieved, the indications for interventional treatment are a matter of ongoing debate. Curing hypertension by means of angioplasty rarely occurs, although the number of antihypertensive medication usually can be reduced after successful treatment.
View Article and Find Full Text PDFPurpose: To compare neurologic outcome after elective internal carotid artery (ICA) stents have been placed in patients with and in patients without contralateral ICA obstructions.
Materials And Methods: This study included 471 consecutive patients from a registry database who underwent elective ICA stent placement without cerebral protection for high-grade (greater than 70% stenosis of the ICA, according to the North American Symptomatic Carotid Endarterectomy Trial) symptomatic (n = 147) or asymptomatic (n = 324) ICA stenosis. Contralateral carotid arteries were investigated with angiography.
Purpose: To investigate the frequency of and risk factors for hypotension and bradycardia in response to elective carotid stenting and their association with neurological complications.
Methods: A retrospective analysis was conducted of 471 patients (321 men; median age 72 years, interquartile range 64-77) who underwent elective carotid artery stenting without cerebral protection for high-grade (>70%) symptomatic (n=147) or asymptomatic (n=324) internal carotid artery stenosis at a single center. Frequency and potential risk factors for severe hypotension (systolic blood pressure <80 mmHg) or bradycardia (heart rate <50 bpm) were studied.
Background And Purpose: Magnesium (Mg) deficiency is thought to be a risk factor for cerebrovascular atherosclerosis and complications. We investigated the prognostic impact of Mg serum levels with respect to the occurrence of neurological events in patients with advanced atherosclerosis.
Methods: We prospectively studied 323 patients with symptomatic peripheral artery disease and intermittent claudication (197 men; median age, 68 years).
Objective: We studied the fate of the ipsilateral external carotid artery (ECA) after stenting of the internal carotid artery (ICA) compared with the contralateral ECA.
Subjects And Methods: One hundred twenty-one ipsilateral ECAs in 112 consecutive patients who underwent carotid artery Wallstent placement were prospectively studied with color-coded duplex sonographic scanning (CCDS) and compared with 83 contralateral ECAs over 2 years. CCDS was scheduled for the day before (day 0), the day after (day 1) and 3, 6, 12, and 24 months after stenting.
Background And Purpose: Abciximab, a nonselective glycoprotein IIb/IIIa inhibitor, was shown to reduce peri-interventional stroke rate in carotid stenting. We evaluated the effect of adjunct abciximab therapy on monocyte-platelet cross talk and neurological deficit in unprotected carotid stenting and compared its efficacy with distal filter protection.
Methods: Fifty patients were randomized to either standard antithrombotic therapy (n=30) consisting of aspirin, clopidogrel, and heparin or adjunct bolus (0.
Purpose: To study the dynamics of carotid stent healing over a 2-year period using duplex ultrasound imaging.
Methods: One hundred twelve patients with 121 successfully stented carotid arteries were examined with color-coded duplex ultrasound the day after the stent procedure and at 1, 3, 6, 12, and 24 months in follow-up. The maximal thickness and echogenicity of the layer between the stent and the perfused lumen (SPL) were evaluated.
Purpose: To investigate the association of baseline peripheral blood monocyte counts and restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA) and PTA plus elective stent implantation.
Methods: Three hundred thirty consecutive patients (170 men; median age 71 years, interquartile range 61-78) with peripheral artery disease underwent femoropopliteal PTA (n=258) or PTA plus elective stent implantation (n=72). Multivariate Cox regression analysis was used to determine the predictive value of baseline peripheral blood monocyte counts on the rate of restenosis (> or =50% luminal reduction) in follow-up.
Purpose: To investigate patency rates after percutaneous transluminal angioplasty (PTA) and PTA plus elective stenting in de novo versus recurrent femoropopliteal lesions.
Methods: The data were collected from a prospective registry including 533 consecutive patients (284 men; median age 71 years, interquartile range [IQR] 72-78) with severe claudication (n=387) or critical limb ischemia (n=146) who underwent femoropopliteal percutaneous interventions during a 36-month period. PTA was used to treat 357 de novo and 99 recurrent lesions; PTA plus elective stent implantation was performed in 58 de novo and 19 recurrent lesions.
Background: The evolving technique of carotid stenting (CS) requires optimal antithrombotic strategies to reduce periinterventional thromboembolic risk. In animal models of balloon injury, tissue factor (TF) was shown to be the major procoagulant of the atherosclerotic plaque mediating prolonged procoagulant activity.
Methods: We analyzed TF and TF-dependent hemostatic markers before and 2, 6 and 24 h after CS with two antithrombotic drug regimens.
Objective: To investigate long-term clinical and morphological outcome of patients with subclavian-axillary vein thrombosis treated with systemic thrombolysis compared to anticoagulation in a retrospective, nonrandomised study.
Methods: We studied 95 consecutive inpatients with subclavian-axillary vein thrombosis treated either with systemic urokinase thrombolysis and subsequent oral anticoagulation (n=33) or with anticoagulation only (n=62). Anticoagulation was performed with heparin and phenprocoumon.
Purpose: To determine the prognostic importance of periintervention serum levels of acute-phase reactants in 6-month restenosis after stent implantation in the carotid artery.
Materials And Methods: One hundred eight consecutive patients with 70% or greater stenosis of the internal carotid artery (ICA) according to the North American Symptomatic Carotid Endarterectomy Trial criteria underwent successful stent implantation in the ICA in a prospective cohort study. Six-month patency was evaluated at color-coded duplex ultrasonography.
Purpose: To determine the association between pre- and postintervention serum C-reactive protein (CRP) levels and 6-month restenosis after endovascular treatment of atherosclerotic lesions in arteries below the knee.
Materials And Methods: Eighty-nine patients with peripheral arterial disease underwent primary successful percutaneous transluminal angioplasty (PTA) of the distal popliteal, anterior tibial, posterior tibial, and fibular arteries. Six-month patency was evaluated with the ankle brachial index (ABI) and color-coded duplex ultrasonography (US).
Purpose: To evaluate initial technical success, procedural complications, and 12-month patency of duplex-guided angioplasty compared to conventional fluoroscopically-guided procedures.
Methods: One hundred four patients (65 men; mean age 69 years) who underwent duplex-guided femoropopliteal angioplasty were compared to 104 patients undergoing fluoroscopically-guide procedures who were matched for age, sex, baseline ankle-brachial index (ABI), and length and grade of lesion. Patients were followed for 12 months, and restenosis was assessed by ABI and duplex sonography.
Purpose: To assess the impact of age on technical success and complications of carotid stenting in a prospective single-center cohort study.
Methods: One hundred eleven consecutive patients (74 men; median age 70 years) with >or=70% symptomatic (n=33) or >or=90% asymptomatic (n=78) internal carotid artery (ICA) stenosis underwent carotid artery stent implantation. Primary technical success and periprocedural complications were compared in patients aged >75 years (n=28) to patients <75 years (n=83).