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Biomedical subjects

R Ilia

Publications and source records attributed to R Ilia.

At least 55 records · Page 3Linked to original sources

Percutaneous transluminal angioplasty of coronary arteries with anomalous origin.

Coronary angioplasty to diseased anomalous coronary arteries is being more readily applied in revascularization of these vessels. Several cases of angioplasty have been described in various coronary anomalies. Probably more attempts of PTCA to anomalous coronary arteries are performed but not reported. For this reason, we cannot assume that the success rate is the same as in "normal" origin arteries or which complications occurred, including the need for coronary bypass. Although not yet reported, in some instances other techniques, such as laser atherectomy and coronary stents, may be applied, provided the artery is not tortuous, as it may be in some anomalous coronaries. The key to a successful procedure depends on angiographic knowledge of their course and appropriate equipment selection.

Angioplasty, Balloon, Coronary↗

Angiographic follow-up of coronary artery ectasia.

Of 1,125 patients catheterized over a period of 8 years, 68 (6%) had coronary ectasia. Twenty-five of them were catheterized at least twice and constituted the study group. The time between the first and last catheterization ranged from 2 to 8 years (mean +/- SD = 4.2 +/- 1.6). Coronary ectasia was more frequent in males (88%). The frequency of involvement was: the right coronary (47%), the left circumflex (30%), the left anterior descending (21%) and the left main arteries (2%). Proximal segments were most frequently involved (48%). Diffuse involvement was found in 29%. Severity of ectasia progressed in 6 segments (14%) and 2 new ectatic segments appeared over the follow-up period. During that period, 2 patients had myocardial infarction, 1 of them due to a total occlusion of an ectatic segment. There were no deaths. In conclusion, coronary ectasia has a relatively benign course.

Adult↗

Unusual coronary collateral circulation: filling of a totally occluded left anterior descending artery by direct continuity from a left posterior descending artery. A case report.

A patient with an unusual coronary collateral circulation is presented. The left anterior descending artery, which was totally occluded proximally, was filled directly by a continuation of the left posterior descending artery. A thallium stress test revealed normal perfusion in the territory of the left anterior descending artery.

Collateral Circulation↗

Absent left circumflex coronary artery.

This is the first reported case of a coronary artery anomaly in which the left circumflex artery was absent. The lateral and posterior aspects of the left ventricle were supplied by a large diagonal artery and a very long right coronary artery which continued along the atrioventricular groove.

Coronary Angiography↗

Abnormal coronary perfusion in experimental scorpion envenomation.

Perfusion defects and left ventricular dilation after experimental scorpion envenomation were evaluated in five dogs. Left Left ventricular dilation was observed in three dogs and right ventricular dilation in one other, in scans immediately after envenomation. Perfusion defects were inferred from scans in four dogs. The data are strongly suggestive of coronary hypoperfusion, and the mechanics of abnormal coronary flow after scorpion envenomation are discussed.

Animals↗

Left ventricular performance in patients with normal coronary arteries: hemodynamic characteristics and clinical follow-up.

Of 111 patients with normal coronary angiograms, 68 patients had elevated left-ventricular end diastolic pressure and 'low-normal' ejection fraction (Group I) while the other 43 patients had normal left ventricular end diastolic pressure and 'high normal' ejection fractions (Group II). Although the number of patients was too small for meaningful statistical analysis, systematically a higher percentage of patients with diabetes mellitus, hypertension, hypercholesterolemia and smoking history was found in Group I. In contrast to the patients in Group II, patients in Group I tended to have more angina and ischemic events.

Blood Pressure↗

Predictors of coronary dissection following percutaneous transluminal coronary balloon angioplasty.

To determine predictors of acute coronary dissection after coronary angioplasty, we studied 170 consecutive patients who underwent arterial dilatations of 234 arteries. Coronary dissection occurred in 103 (44%) arteries. More dissections occurred in women [40/73 (55%) versus 63/161 (39%), p < 0.03] and in patients with long lesions [45/74 (61%) versus 56/158 (35%), p < 0.0005]. Balloon/arterial diameter ratio was higher in patients with dissection (1.1 +/- 0.2 versus 1.0 +/- 0.2, p < 0.02). Complications did not differ in patients with and without dissection except for non-Q wave myocardial infarctions which were more frequent in patients with coronary dissection [10/12 (83%) versus 2/12 (17%), p < 0.01]. Thus coronary dissection during angioplasty is relatively frequent. However, most dissections are not associated with complications. Balloon dilatation of lesions in female patients and in patients with long lesions are more likely to result in dissection.

Acute Disease↗

Coronary angioplasty with gradual versus rapid balloon inflation: initial results and complications.

Although a variety of coronary angioplasty balloon inflation protocols are employed, prior studies have not evaluated the relation of rate of inflation to the type and extent of arterial damage produced by angioplasty. We randomized 103 patients to either a gradual (gradual, incremental increase to peak inflation pressure) or rapid inflation protocol (rapid increase to peak inflation pressure). Fifty-one patients with 72 lesions underwent gradual and 52 patients with 73 lesions received rapid inflation protocols. There were no significant group differences with regard to age, sex, artery dilated, number of diseased vessels, presence of unstable angina and lesion morphological characteristics except for more lesions located on a bend in the gradual inflation group (p < 0.02). Although there was a tendency towards a higher success rate in patients with gradual inflation, the complete success rates were high in both groups (100% vs. 93%, p < 0.08). The dissection rate was higher in patients with rapid inflation (43/73 [59%] vs. 26/72 [36%], p < 0.01). The collective complication rate was higher in patients with rapid inflation (19% vs. 6%, p < 0.03). No deaths occurred in either group. Thus a gradual compared to rapid coronary angioplasty balloon inflation protocol reduces the frequency of dissection despite similar inflation pressure and balloon/vessel diameter ratio. Gradual inflations may reduce the frequency of procedure-related complications.

Angioplasty, Balloon, Coronary↗

Coping with the Gulf war: subculture differences among ischemic heart disease patients in Israel.

The purpose of this study was to assess short term effects of the Gulf war on ischemic heart disease patients of different ethnic origin. Three dimensions of patients' reactions to the war situation were studied: psychological, physical and behavioral. The study first focused on changes in patients' responses on these dimensions over three stages of the war, differentiated according to degree of threat. Second, differences stemming from ethnic origin were examined among patients who live in the same geographical region, use the same health services and were exposed to the same threatening life event. One hundred ischemic heart disease patients were interviewed while waiting in outpatient hospital clinics for a regular examination at the end of the war. The results of intrapersonal comparisons showed that the intensity of responses, as expected, increased significantly on the three dimensions from the week before the war started to the first week of the war, which was the most stressful period for Israelis. During the last week of the war, however, when stress was significantly reduced, the expected change was found primarily with regard to psychologic responses. That is, worries were significantly reduced, but no significant reduction in frequency of anginal pain and in drug consumption followed, indicating differences in the adjustment process on the psychologic and physical levels. Subcultural differences were found in the studied responses: Patients of Asian or North African countries of origin reported having more frequent anginal pains, and consuming more drugs than patients from Western countries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

Clinical and angiographic determinants of initial percutaneous transluminal coronary angioplasty success.

Clinical and anatomic determinants of primary success of percutaneous transluminal coronary angioplasty were retrospectively evaluated in 299 patients. Successful angioplasty (residual stenosis < 50%) was achieved in 350 (94%) of 373 lesions. The success rate in patients chronically treated with aspirin was higher than that of patients not treated with aspirin (95% versus 86%, P < 0.03). An additional finding was that the success rate in patients referred for coronary angioplasty because of acute myocardial infarction or postinfarction angina was lower than that of those without these characteristics (89% versus 96%, P < 0.01). No other clinical features studied influenced the outcome of coronary angioplasty. The angiographic characteristics of the lesions did not differ between patients with successful or failed angioplasty except for the degree of stenosis prior to the procedure, being lower in patients with successful procedure (92.4 +/- 7.6% versus 97.3 +/- 3.1%), P < 0.002). Thus coronary angioplasty can be performed with a high rate of success. Long-term pretreatment with aspirin may have a beneficial effect.

Aged↗