[Complete revascularisation of multivessel coronary artery disease during acute myocardial infarction. Results following hospitalization and after 30 months. Series of 86 interventions carried out with 167 multivessel disease patients; causes of failure].

This series studied 167 patients with multivessel disease, admitted consecutively for acute myocardial infarction (excluding cardiogenic shock), who underwent systematic angioplasty and stenting before the 12th hour of the culprit artery and the other vessels with >70% (QCA) angiographic stenosis, and followed up for a period of 8 to 68 months with an average follow-up of 2.5 years. The criteria of evaluation were: numbers of asymptomatic patients, deaths, new infarctions, residual ischaemias, cardiac failure, angioplasties or bypass surgeries.

Indications of coronary angioplasty and stenting in 2003: what is left to surgery?

Unlabelled: For many years, coronary artery by-pass graft (CABG) remained the only effective treatment of multivessel disease compared to medical treatment. The first technical revolution was in 1977 when Gruentzig introduced balloon percutaneous transluminal coronary angioplasty (PTCA), the 2nd in the 90's with the developments of stents and antiaggregant protocols. The equipment for PTCA became more and more sophisticated, and the skill of cardiologists greater.

[Primary angioplasty associated with systemic coronary stenting in acute myocardial infarction. Results at the end of the hospitalization period and at 24 months].

A series of 149 consecutive patients admitted for myocardial infarction (excluding cardiogenic shock), dilated and systematically stented in the acute phase before the 12th hour and followed up for a period from 30 days to 2 years, was studied. The criteria of follow-up were: number of asymptomatic patients, deaths, reinfarction, residual ischaemia, cardiac failure, angioplasty or bypass surgery. On admission, 40.

[Coronary artery stenting without antivitamin K. Results after a month].

This paper reports experience with a new antithrombotic agent prescribed to reduce the incidence of subacute occlusions during the first month after coronary stenting. Therefore, a powerful association of platelet antiaggregant agents was tested. From December 1992 to October 1994, coronary stenting was successfully achieved in 1,294 patients (1,118 men, average age 60.

[Evaluation, by flow cytometry, of activated platelet levels after coronarography and intraluminal angioplasty].

Coronarography and intraluminal angioplasty induce platelet activation. In this study, activated platelets were evaluated by measuring platelet-bound fibrinogen using a polyclonal fluorescent antibody in flow cytometry on whole blood. For normal subjects, the percentage of platelets binding fibrinogen was low (16.

Recoil following Wiktor stent implantation for restenotic lesions of coronary arteries.

The purpose of this study was to determine acute recoil of the vessel wall immediately after Wiktor stent implantation in native coronary arteries of 77 consecutive patients and to assess whether there was compression or "late recoil" of the stent itself at long-term follow-up. Furthermore, the relationship between recoil and a number of clinical, angiographic, and procedural variables was studied in addition to the relation between acute recoil renarrowing or restenosis was assessed. All angiograms were analyzed with the Cardiovascular Angiography Analysis System using automated edge detection.

Angiographic predictors of recurrence of restenosis after Wiktor stent implantation in native coronary arteries.

Intracoronary stenting has been proposed as an adjunct to balloon angioplasty to improve the immediate and long-term results. However, late luminal narrowing has been reported following the implantation of a variety of stents. One of the studies conducted with the Wiktor stent is a prospective registry designed to evaluate the feasibility, safety and efficacy of elective stent implantation in patients with documented restenosis of a native coronary artery.

Wiktor stent implantation in patients with restenosis following balloon angioplasty of a native coronary artery.

Intracoronary stenting has been introduced as an adjunct to balloon angioplasty aimed at overcoming its limitations, namely acute vessel closure and late restenosis. This study reports the first experience with the Wiktor stent implanted in the first 50 consecutive patients. All patients had restenosis of a native coronary artery lesion after prior balloon angioplasty.

Morphologic change in coronary artery stenosis with the Medtronic Wiktor stent: initial results from the core laboratory for quantitative angiography.

The purpose of this study was to assess the early changes in stenosis geometry after implantation of the Medtronic Wiktor stent in human coronary arteries. Morphologic changes were evaluated by quantitative coronary angiography using automated edge detection. The hemodynamic significance of the morphologic changes were assessed by the calculation of the theoretical pressure drop across the dilated and stented stenosis derived from the Poiseuile and turbulent resistances assuming a coronary blood flow of either 0.

[Value of the combined Lastac laser-angioplasty technic in symptomatic superficial femoral occlusion].

The results of peripheral transluminal angioplasty are satisfactory in stenotic arteries but those observed in the recanalisation of occluded peripheral arteries are not so good. There would therefore seem to be a good therapeutic opportunity for laser between angioplasty and surgery for patients with symptomatic arterial occlusion. The authors report their experience with the Lastac laser in 12 patients with symptomatic superficial femoral arterial occlusion.

[Transluminal coronary angioplasty using a percutaneous axillary route with an arterial sheath].

Out of 1400 percutaneous transluminal coronary angioplasties (PTCA), 23 (1.6 p. 100) were performed by the left percutaneous axillary approach because the bifemoral approach could not be used.

[Electro-mechanical dissociation concomitant with myocardial reperfusion in the acute phase of myocardial infarction].

An unusual case of transient electro-mechanical dissociation concomitant with myocardial reperfusion is reported. The patient had myocardial infarction caused by occlusion of the middle anterior interventricular artery relieved by injection of urokinase and plasminogen in situ. The dissociation could be documented by simultaneous ECG recording on 3 leads and direct intravascular recording of femoral arterial pressure, the patency of that artery, and its maintenance, being demonstrated by angiography.

[Delayed filling of the anterior interventricular artery. Apropos of 9 cases].

Selective coronary angiography has shown that typical angina pectoris may occur in the absence of atheromatous coronary stenosis. Other causes of these attacks of pain have been found: coronary spasm, small vessel disease, abnormal dissociation of haemoglobin or metabolic disturbances of the myocardial cell. Of all the patients undergoing coronary angiography in 1984 at the Centre Cantini, 9 had no classical coronary lesions but delayed filling of the left anterior descending artery.

[Intracavitary extraction of fragments of intracardiac catheters using a pigtail catheter. Apropos of 14 operations].

Endocavitary extraction of intracardiac fragments of intravenous catheters was attempted in 14 patients over a 7 year period. The fragments were recovered in 13 cases under local anaesthesia without complications. The average duration of the procedure was less than 15 minutes.

[Coronary revascularization at the acute phase of myocardial infarction. Short and median-term survival of 359 patients. Multicenter study].

Three hundred and fifty nine consecutive patients from 4 different French centres who underwent attempted early coronary revascularisation during the acute phase of myocardial infarction by intracoronary thrombolysis (309 cases) intravenous thrombolysis (26 cases) and transluminal angioplasty (24 cases) were reviewed to evaluate the short and medium term results of these non-surgical techniques. Three groups of patients were identified from the results of initial and secondary coronary angiography: 1) deaths during the procedure (1.9%), 2) successes, with immediate and stable revascularisation (65%), 3) failures, also including initial successes with secondary reocclusion (33.

[Treatment of recurrent ventricular tachycardias using oral propafenone].

The effect of oral propafenone on prevention of pacing-induced ventricular tachycardia (VT) was studied in 11 patients. All patients experienced documented sustained VT refractory to 4.1 +/- 2 antiarrhythmic agents per patient including amiodarone in 8.

[Supraventricular tachycardia induced by effort and by catecholamines].

The role played by catecholamines in the initiation of certain forms of ventricular tachycardia is now recognised. On the other hand, a similar predominant or exclusive mechanism has not been demonstrated in supraventricular tachycardia. We observed a rate case of reproducible attacks of junctional tachycardia on effort in a 45 year old man.

[Treatment of recurrent ventricular tachycardia with hydroquinidine. Evaluation of its efficacy with electrophysiological technics].

Electrophysiological investigations were used to test the efficacy of dihydroquinidine chlorhydrate (600 or 1 200 mg/day) in a prospective study of 18 patients with recurrent ventricular tachycardia documented by electrocardiography. These patients did not respond to an average of 3.1 +/- antiarrhythmic drugs, including amiodarone in 12 patients.

Alternate ventriculo-atrial Wenckebach conduction during ventricular tachycardia.

Although pacing-induced ventriculo-atrial (VA) Wenckebach conduction has been previously described, the occurrence of this phenomenon during ventricular tachycardia has received little attention. The latter is defined as 2:1 VA block in which the conducted beats show progressive lengthening of VA conduction until the sequence is terminated by two or three blocked ventricular beats. This phenomenon was observed in a 16-year-old boy who underwent electrophysiologic study for ventricular tachycardia as a late complication of surgical correction of tetralogy of Fallot.

[Immediate coronary angioplasty in the acute phase of myocardial infarction. French multicenter study: December 1983].

Following the introduction of intracoronary thrombolysis in the acute phase of myocardial infarction (AMI), transcutaneous coronary angioplasty (TCA) was originally conceived as a logical complementary procedure to treat residual stenosis and so prevent the frequent post-thrombolysis reocclusion (20-30 p. 100 of cases). With increasing experience TCA of first intent appeared rational, more rapid and effective, ensuring coronary recanalisation (CR), suppression of residual stenosis and the prevention of reocclusion in the same procedure with with the objective of reducing the number of coronary bypass grafts (CBG) in patients with single vessel disease.

[Complications of transluminal coronary angioplasty. A multicenter French study (1983)].

The authors report the complications observed during 1 247 transluminal coronary angioplasties (TCA) performed in 1 187 patients in 17 french centers between 1979 and October 1983. There were 855 primary successes (68.9 p.

[Long-term effects of transluminal coronary angioplasty. French multicenter study].

Although transluminal coronary angioplasty is now acknowledged as an effective treatment for coronary artery disease, the long-term outcome of patients treated by this method is still under evaluation. A french multicenter trial was set up and the long-term efficacy of transluminal coronary angioplasty was assessed in 546 patients undergoing the procedure before the 31/3/83. 380 initial successes (69 p.