The CAIRP (CAndesartan for In-stent Restenosis Prevention) Trial--a multicenter study of AT1-receptor blocker therapy in coronary stenting.

Angiotensin II (Ang II) is implicated in the development of in-stent restenosis (ISR). Ang II- and AT1-receptor blockade could possibly reduce ISR. We enrolled 206 patients into a prospective double-blind, placebo-controlled, multicenter randomized trial of candesartan cilexitil 16 mg to test this notion.

Acute renal haemodynamic effects of radiocontrast media in patients undergoing left ventricular and coronary angiography.

Background: Tubular toxicity and renal ischaemia have been implicated in the pathogenesis of radiocontrast media induced nephropathy (CIN), but their respective role remains unclear. Aims. In order to evaluate changes in renal blood flow in response to intra-arterial contrast media administration, we aimed to continuously measure renal arterial perfusion by means of renal blood flow velocity (RBFV) during left ventricular and coronary angiography and subsequent coronary intervention in patients with chronic kidney disease (CKD).

Percutaneous coronary intervention in patients with end-stage renal disease.

Patients with end-stage renal disease (ESRD) represent a growing number of patients in the cardiac catheterization laboratories worldwide. This is a consequence of the growing absolute number of ESRD patients in developed countries, better noninvasive diagnostic tools, better catheterization facilities and last-but-not-least better education of referring physicians about the incidence and prognosis of coronary artery disease (CAD) for patients with ESRD. There is growing evidence of the positive impact of coronary revascularization on long-term outcome of these patients.

Percutaneous transluminal septal artery ablation using polyvinyl alcohol foam particles for septal hypertrophy in patients with hypertrophic obstructive cardiomyopathy: acute and 3-year outcomes.

Purpose: To investigate the effect of septal artery occlusion with transluminally delivered polyvinyl alcohol (PVA) foam particles for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).

Methods: Percutaneous septal artery ablation was performed in 18 symptomatic patients (13 men; mean age 60+/-17 years, range 28-89) with drug-resistant HOCM. PVA foam particles were mixed with contrast medium and injected through an angiographic catheter under fluoroscopic control until complete stasis in the septal branch was achieved.

Balloon-protected carotid artery stenting: relationship of periprocedural neurological complications with the size of particulate debris.

Background: Carotid artery stenting (CAS) has been advocated as an alternative to endarterectomy. To prevent cerebral atheroembolism during CAS, distal balloon occlusion of the target artery increasingly is employed during the procedure. A correlation of the size of captured particles with the incidence of periprocedural neurological complications (PNCs) has not been attempted.

Determination of renal arterial stenosis severity: comparison of pressure gradient and vessel diameter.

Purpose: To determine the hemodynamic significance of arteriographically detected renal arterial stenosis by obtaining pressure gradients with a miniaturized pressure guide wire.

Materials And Methods: Forty-six renal arterial stenoses in 38 patients were assessed in terms of severity and then subjected to gradient determination before and after angioplasty. The patients (mean age, 63 years) had a mean serum creatinine value of 1.

Carotid Artery Stent Placement Prior to Coronary Angioplasty or Coronary Bypass Graft Surgery.

Patients with concomitant carotid and coronary artery disease are at high risk of both cardiac and cerebrovascular complications when they undergo revascularization procedures. The best management strategies for patients with concomitant disease have not been determined for certain. Staged surgical procedures with either coronary artery bypass grafting prior to carotid endarterectomy or vice versa appear to be associated with an increased risk of ischemic complications compared to separate procedures.

[Renovascular illness: prevalence and therapy in patients with coronary heart disease].

To explore the relationship between coronary artery disease and renal vascular disease, we performed renal arterial angiography in 609 patients undergoing coronary angiography for suspected coronary artery disease. We defined renal artery stenosis as nonsignificant (< 40%), borderline (40-60%) and significant (> 60%). One-hundred fifty-two patients had renal artery stenosis, while 457 did not.

Clinical and angiographic outcome in patients with in-stent restenosis and repeat target lesion revascularisation in small coronary arteries.

Objective: To evaluate the clinical and angiographic outcome in patients with in-stent restenosis in small coronary arteries and repeat target lesion revascularisation.

Design: Patients with in-stent restenosis in coronary arteries < or = 2.85 mm were eligible for the study and underwent target lesion revascularisation.

The value of magnetic resonance imaging of the left ventricular outflow tract in patients with hypertrophic obstructive cardiomyopathy after septal artery embolization.

Background: We tested the value of magnetic resonance imaging (MRI) in the follow-up of patients with hypertrophic obstructive cardiomyopathy after septal artery embolization. MRI provides a noninvasive visualization of transplanar turbulent flow in order to quantify left ventricular outflow tract obstruction.

Methods And Results: We followed 10 patients who were treated with septal artery embolization for 12 months.

Treatment of carotid artery stenosis by elective stent placement instead of carotid endarterectomy in patients with severe coronary artery disease.

Patients with concomitant cardiac and cerebrovascular disease undergoing revascularization procedures are at high risk of both, cardiac and cerebrovascular complications. The purpose of our study was to evaluate the feasibility of prior elective carotid artery stenting as an alternative treatment procedure to carotid endarterectomy (CEA) in patients with concomitant coronary artery disease (CAD), who clearly needed coronary revascularization. We offered extracranial internal carotid stenting to 85 patients with 89 significant carotid stenoses.

Postcatheterization pseudoaneurysms and arteriovenous fistulas: repair with percutaneous implantation of endovascular covered stents.

Purpose: To assess the effectiveness and safety of endovascular covered stents in the management of pseudoaneurysms and arteriovenous fistulas after cardiac and vascular catheterization.

Materials And Methods: Twenty-six endovascular covered stents were used to repair 16 pseudoaneurysms, nine arteriovenous fistulas, and one combined lesion after femoral arterial puncture for diagnostic coronary angiography and/or angioplasty. Fistulas and aneurysms were in the superficial femoral artery in 16 cases, in the deep femoral artery in six cases, and in the common femoral artery in four cases.

Laser angioplasty of restenosed coronary stents: results of a multicenter surveillance trial. The Laser Angioplasty of Restenosed Stents (LARS) Investigators.

Objectives: This study evaluated safety and efficacy of excimer laser angioplasty for treatment of restenosed or occluded coronary stents.

Background: Balloon angioplasty of in-stent restenosis is limited by a high recurrence rate. Debulking by laser angioplasty is a novel concept to treat in-stent restenosis.

Percutaneous treatment of pseudoaneurysms and arteriovenous fistulas after invasive vascular procedures.

Development of femoral artery pseudoaneurysms and arteriovenous fistulas represents a continuing problem after vascular diagnostic and interventional procedures. For most patients, ultrasound-guided compression is an effective method of treating such complications. However, in patients requiring a continuous anticoagulant regimen, in those with large arteriovenous fistulas or in patients suffering from painful groin hematomas, compression repair is less successful.

Elective stenting of carotid artery stenosis in patients with severe coronary artery disease.

Aims: To evaluate the feasibility and safety of elective carotid stent implantation in patients with carotid stenoses and concomitant coronary artery disease, as an alternative to combined carotid and coronary surgery.

Methods: We treated 50 patients with >70%, stenoses in 53 carotid arteries with balloon angioplasty followed by elective stent implantation. All patients had severe coronary artery disease, and/or mitral insufficiency, aortic stenosis, rhythm disorders or generalized arteriosclerosis.

Ostial renal artery stent placement for atherosclerotic renal artery stenosis in patients with coronary artery disease.

To test the utility of endoprosthetic treatment for ostial renal artery stenosis, and to examine blood pressure and its treatment, serum creatinine, and restenosis rate, 44 ostial renal stent placements were performed in 30 patients with concomitant coronary artery disease, arterial hypertension, and the indication for angiotensin converting enzyme (ACE) therapy. There was a marked decrease in systolic and diastolic blood pressure (163+/-30 to 145+/-17 and 93+/-18 to 83+/-10 mm Hg; P < 0.008) with a decrease in number of medication (3.

Sixty-minute alteplase protocol: a new accelerated recombinant tissue-type plasminogen activator regimen for thrombolysis in acute myocardial infarction.

Objectives: Our aim was to design and evaluate a new and easily administered recombinant tissue-type plasminogen activator (rt-PA) regimen for thrombolysis in acute myocardial infarction (AMI) based on established pharmacokinetic data that improve the reperfusion success rate.

Background: Rapid restoration of Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow is a primary predictor of mortality after thrombolysis in AMI. However, TIMI grade 3 patency rates 90 min into thrombolysis of only 50% to 60% indicate an obvious need for improved thrombolytic regimens.

Relation between arteriosclerosis in the coronary and renal arteries.

This study analyzes the severity of coronary artery disease in terms of the severity of renal artery disease in 609 patients undergoing coronary and renal angiography. The presence of renal artery disease of any severity is strongly suggestive of advanced coronary artery disease.

Stent implantation in patients with superior vena cava syndrome.

Objective: The purpose of this study was to determine the feasibility of using Wallstent implantation to treat superior vena cava syndrome due to malignant tumors.

Subjects And Methods: Digital subtraction angiography showed obstruction of the superior vena cava in 13 patients who then underwent transluminal dilatation and Wallstent implantation. The patients were treated with IV heparin and monitored in the emergency department.

[Stents: new studies--new trends].

The increasing frequency of stent implantation into coronary arteries is based mainly on assumptions. One of these assumptions is that stents may prevent restenosis. Stents can prevent restenosis as has been shown in two randomized studies (Stress I and Benestent I), but only in large (> 3.

[The current value of angiography within the scope of complex tumor diagnosis].

The development of noninvasive imaging methods with high diagnostic accuracy in the last decade has led to a new determination of the role of angiographic techniques in oncologic diagnosis. The disadvantages of angiography are discussed and the major indications in tumor diagnosis are delineated: preoperative vascular mapping, vascular involvement of the great vessels, CT and ultrasound equivocal, selective blood sampling and interventional procedures. The increasing importance of interventional radiology in oncology is emphasized.

[Submicroscopic indication of pathological cell growth in hypertrophic cardiomyopathy (HCM) in humans].

The increasing application of transvascular endomyocardial biopsy for diagnostic verification of various heart diseases and elucidation of their etiology relies mainly on light microscopical methods. It is shown by hypertrophic cardiomyopathy as an example that also submicroscopical findings may be of value in diagnostic work, prognosis, and investigating research for etiological relationships. Specific morphological markers for idiopathic HCM were not demonstrable; nevertheless, some characteristic alterations such as fibrillary disorder, excessive folding of nuclear-, intercalated disc-, and sarcolemmal membranes, contraction bands, accumulation of mitochondria, glycogen, and lipid droplets, among others as well as sometimes the thickening of vascular walls with its unknown relations to the so-called "small vessel disease" may be helpful when endomyocardial biopsies are examined with the electron microscope too.

[Rare vascular findings in CT of the upper mediastinum].

The CT findings of malformation of major veins near the heart are described (one case of persistent left superior vena cava and two cases of partial anomalous pulmonary veins) as well as one malformation of the pulmonary artery (vascular sling). These findings demonstrate the vascular character of the lesion and the procedure permits detailed clarification of the abnormality.