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Biomedical subjects

U Kaul

Publications and source records attributed to U Kaul.

At least 37 records · Page 2Linked to original sources
PubMed1998

Intravascular Red Light Therapy after Coronary Stenting Ñ Angiographic and Clinical Follow-up Study in Humans.

In animal models of coronary restenosis, intravascular red light therapy (IRLT) using a diode laser source has been shown to reduce neointimal hyperplasia following balloon-induced injury and coronary stenting. We studied the safety and efficacy of catheter-based IRLT for preventing restenosis after coronary stenting in 22 patients with angina pectoris. IRLT was performed using a diode laser (650 nm) at an energy level of 10 megawatts delivered through a rapid exchange balloon system containing the fiberoptics. The procedure was successful in all patients, with no procedural or in-hospital complications. Two patients with recurrence of symptoms had angiography at 3 and 4.1 months respectively. Angiographic follow-up was also done after 6 months in the 20 remaining asymptomatic patients. The mean minimal lumen diameter (MLD) for the whole group at 6 months follow-up was 2.57 +/- 0.62 mm. The calculated late lumen loss was 0.49 +/- 1.12 mm with a late loss index of 0.21 +/- 0.54. Four patients (2 symptomatic and 2 asymptomatic) in the series developed angiographic restenosis. Clinical events at follow-up of 10.9 +/- 3.5 months were repeat angioplasty in 2 patients for symptomatic restenosis with a 91% event free survival. These preliminary results demonstrate that IRLT after coronary artery stenting is safe and feasible; it is associated with low rates of angiographic indices of restenosis.

Journal Article↗
PubMed1997

Head-Up Tilt Test (HUTT) in Patients with Episodic Bradycardia and Hypotension Following Percutaneous Coronary Interventions.

We investigated the possible association of post catheterization hypotension/bradycardia and neurocardiogenic syncope. Head up tilt test (HUTT) was performed in 12 consecutive patients (age 32Ð65 years) who developed transient hypotension (systolic blood pressure < 80 mmHg) and/or bradycardia (heart rate < 50/min) with or without syncope following a percutaneous coronary intervention. Ten patients had undergone percutaneous transluminal coronary angioplasty (PTCA) with stent implantation and one each PTCA alone and diagnostic coronary angiography. This event occurred at the time of sheath removal in 7 patients (58%). HUTT was performed with and without intravenous edrophonium (10 mg intravenous). The tilt test was negative in all patients. Post-catheterization hypotension/bradycardia responds promptly to conservative measures and it is unclear whether this is related to neurocardiogenic syncope.

Journal Article↗
PubMed1996

Embolization of a Wiktor stent within a stent: successful nonsurgical management.

A case of embolization of an unexpanded Wiktor stent while attempting to traverse an expanded Wiktor stent is reported. The embolized stent was subjected to longitudinal axial traction, using a balloon catheter to cause stretching and partial unraveling. This partially unraveled stent was deployed across the dissection to scaffold it. The patient had no postprocedure complications.

Aged↗
PubMed1996

Management of idiopathic obstruction of the hepatic and suprahepatic inferior vena cava with a self-expanding metallic stent.

Ten patients (median age 36 yr, 5 male) with idiopathic IVC obstruction underwent balloon angioplasty followed by placement of a self-expanding stent due to unfavourable lesion characteristics. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and 1 had a suboptimal result after initial dilatation. Median minimum IVC diameter increased from 0 to 14.5 mm, and the median gradient across the lesion decreased from 16.5 to 1 mmHg. Follow-up venography (median interval 69 d) in six patients revealed no restenosis with further enlargement at the lesion site (median 4.5 mm) and abolition of gradients. Follow-up ultrasound in nine patients revealed no restenosis in the IVC. One patient died 6 mo after the procedure with acute Budd-Chiari syndrome due to hepatic vein occlusion. Autopsy revealed a widely patent stent with hepatic vein thrombus. Stent implantation is useful in the management of IVC obstruction with prior restenosis, total occlusion, or suboptimal result of balloon angioplasty.

Adult↗
PubMed1996

Comparative study of the efficacy of metoprolol and verapamil in patients with syncope and positive head-up tilt test response.

Head-up tilt testing is a reliable diagnostic tool for patients with recurrent unexplained syncope. It has also been used to assess the drug efficacy for the treatment of patients with syncope. The objective of this study was to assess the efficacy of verapamil compared with metoprolol in a randomized crossover design for patients with syncope and a positive tilt test response. Twenty-eight patients with a positive head-up tilt test were randomized to receive either metoprolol or verapamil; the test was repeated after 7 days of therapy. Of the 15 patients initially given metoprolol, 2 (13.3%) did not respond; both were crossed over to verapamil, to which they remained unresponsive. Of the 13 patients who initially received verapamil, 8 (61%) did not respond; after crossing over to metoprolol therapy, 1 remained unresponsive. Overall, 20 of 23 patients receiving metoprolol had negative results on repeat tilt testing, whereas only 5 of 15 patients receiving verapamil had negative results (p < 0.001). In conclusion, the results of this study suggest that verapamil is considerably less efficacious than metoprolol in managing neurocardiogenic syncope.

Adolescent↗
PubMed1996

Reversibility of "tachycardia induced cardiomyopathy" following the cure of idiopathic left ventricular tachycardia using radiofrequency energy.

We report a case of incessant ventricular tachycardia with right bundle branch block and left axis deviation morphology resulting in severe LV dysfunction and congestive heart failure. Radiofrequency ablation of the appropriate site in the region of posteroapical part of the LV septum resulted in the cure of the arrhythmia. On a 3-month follow-up, the LV size and function returned to normal.

Adolescent↗