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Biomedical subjects

O Santaera

Publications and source records attributed to O Santaera.

6 recordsLinked to original sources
PubMed1996

Coronary stenting in patients undergoing percutaneous transluminal coronary angioplasty during acute myocardial infarction.

Although coronary stenting has been useful in the treatment of patients with suboptimal results, abrupt closure, and threatening occlusion after percutaneous transluminal coronary angioplasty (PTCA), its use in patients with acute myocardial infarction (AMI) is controversial because of the presence of intracoronary thrombus. In this study intracoronary stenting was used to treat suboptimal results and complications in 30 patients (35 lesions) undergoing PTCA during AMI. There were 28 men and 2 women, mean age 58 +/- 12 years. Thirteen patients (43%) had undergone rescue PTCA because of unsuccessful thrombolysis. Four patients had Killip's grade IV, 5 Killip's grade III, and 21 Killip's grade < or = 2 heart failure. Stents were placed in the 35 lesions because of suboptimal result (n = 19), early loss (n = 9), abrupt closure (n = 2), and coronary dissection with threatening occlusion (n = 5). All stents were deployed successfully. In-hospital complications included 1 in-hospital death (3.0%); no patient required emergency coronary artery bypass graft surgery. One patient (3.0%) developed abrupt closure and was successfully treated with PTCA and intracoronary thrombolysis. Vascular complications requiring blood transfusion developed in 3 of 30 patients (10%). At 11.8 months (range 4 to 24) follow-up, there were no deaths or myocardial infarction. One patient underwent coronary artery bypass grafting. The remaining patients were free of angina at follow-up. Thus, intracoronary stents can be used successfully to treat both suboptimal results and complications occurring in patients undergoing PTCA during AMI.

Adult↗
PubMed1995

Coronary stenting decreases restenosis in lesions with early loss in luminal diameter 24 hours after successful PTCA.

BACKGROUND: Early loss of minimal luminal diameter (MLD) after successful percutaneous transluminal coronary angioplasty (PTCA) is associated with a higher incidence of late restenosis. METHODS AND RESULTS: Sixty-six patients (66 lesions) with > 0.3 mm MLD loss at 24-hour on-line quantitative coronary angiography were randomized into two groups: 1, Gianturco-Roubin stent (n = 33) and 2, Control, who received medical therapy only (n = 33). All lesions were suitable for stenting. Baseline demographic, clinical, and angiographic characteristics were similar in the two groups. Restenosis (> or = 50% stenosis) for the overall group occurred in 32 of 66 patients (48.4%) at 3.6 +/- 1-month follow-up angiography. Restenosis was significantly greater in group 2 than in group 1 (75.7% versus 21.2%, P < .001). Vascular complications (21.2% versus 0%) and length of hospital stay (7.3 +/- 1 versus 2.4 +/- 0.5 days, P < .01) were higher for the stent group. Although at follow-up there were no differences in mortality or incidence of acute myocardial infarction between the two groups, patients in the control group had a higher incidence of repeat revascularization procedures (73% versus 21%, P < .001). CONCLUSIONS: In patients with successful PTCA but reduced luminal diameter demonstrated by repeat angiography at 24 hours, the Gianturco-Roubin stent appears to reduce angiographic restenosis at follow-up.

Angioplasty, Balloon, Coronary↗
PubMed1993

Early decrease in minimal luminal diameter after successful percutaneous transluminal coronary angioplasty predicts late restenosis.

Eighty-eight patients underwent serial coronary arteriography before, immediately after, 24 hours after and 7 +/- 2 months after successful percutaneous transluminal coronary angioplasty (PTCA) of 102 lesions. Severity of coronary obstruction was measured using quantitative digital angiography. Three groups of lesions were defined when comparing angiograms recorded immediately after and 24 hours after PTCA: group I--lesions with either no change or < or = 10% increase in arterial diameter stenosis after PTCA (n = 71); group II--lesions with > 10% increase in diameter stenosis after PTCA (n = 19); and group III--patients with total occlusion (n = 12). There were no significant differences in the severity of stenosis before or immediately after PTCA among the 3 groups of lesions. Twenty-four hours after PTCA the diameter stenosis was 14.2 +/- 6.3% in group I, 34.7 +/- 8.1% in group II and 100 in group III (p < 0.0001). At 7.1 +/- 2 months after PTCA the diameter stenosis was 21.2 +/- 16.8% in group I, 61.3 +/- 1.1% in group II, and 98.5 +/- 1.3% in group III (p < 0.0001). Restenosis (> or = 50% stenosis diameter) at follow-up per lesion was significantly greater in group II than in group I (73.6 vs 9.8%) (p < 0.0001). Thus, early angiographic study after successful PTCA stratifies lesions into angiographic subsets with low (group I) and high (group II) risk of coronary restenosis.

Adult↗
PubMed1991

[Digital coronary angiography. A new approach in the analysis of the arteriosclerotic plaque].

In order to define the coronary lesions we prospectively performed digital coronary angiographies in 61 patients. The degree of stenosis was measured in 100 lesions by quantitative analysis using densitometric and geometric methods. Two groups of lesions were found by comparing these two methods: Group A, 47 lesions with a poor correspondence in the degree of stenosis between densitometric and geometric analysis (p greater than 0.01; and group B, 53 lesions with a good correspondence. Both groups were correlated with plaque characteristics (unstable or stable), following angiographic criteria. The mean degree of stenosis in all lesions, for densitometric and geometric analysis was 50.04 +/- 21.1% and x 60.66 +/- 22.1% (p less than 0.01), respectively. Unstable plaque was more frequent in group A (80.9%) than in B (17.9%) (p less than 0.0001), and stable plaque was more frequent in B (81.1%) than in A (19.1%) (p less than 0.0001). Less degree of stenosis between A (41.5 +/- 13.2) and B (61.3 +/- 16.05) was found by densitometric analysis (p less than 0.0001) but it was similar by geometric method (60.02 +/- 11.3 in A and 58.6 +/- 14.4 in B) so that the degree of stenosis in unstable plaque was lower by densitometric method. We conclude that densitometric analysis showed poor correlation with geometric analysis in unstable plaques; the difference could be due to the soft component expression of the unstable plaque.

Aged↗
PubMed1990

[Early angiographic study post successful angioplasty. Predictor of late restenosis].

Consecutive prospective coronary angiographies following 24 hours were studied to find early angiographic predictors of post-PTCA restenosis in the follow-up of 71 patients who had been dilated successfully. Conventional cine coronary and quantitative digital angiography was used to analyse the degree of obstruction previous to dilatation following 24 hours and 30 minutes after the procedure. Following 24 hours, angiographic findings showed: Group A: patients having the same lumen as at immediate post-PTCA time (65.9%); Group B: patients with 20% or more immediate post-PTCA time (21.5%). Group C: patients with total obstruction of vessel (12.6%). The basal clinical conditions were similar in the three groups. The degree of basal obstruction and the clinical findings were similar in the three groups; the dilated arteries in Groups A and B were similar and total occlusion before PTCA was more frequent in Group C than in B and A; 30 minutes post PTCA lesions in group A had less residual stenosis than group B (p less than .01) and C (p = NS), this difference increased significantly (p less than .0001) at 24 hours and in the late follow-up. In the follow-up (means 6.4 months) there was total restenosis per lesion in 32.9%. In Group A, there was 8.6%; in Group B, 68.4% (p less than .0001) and in Group B plus C, 80%. Patients with more than 10% obstruction had a greater degree of restenosis (43.9%) than when the initial lesion was less than 10% (23.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon, Coronary↗