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At least 667 records · Page 37Linked to original sources
PubMed1989

Lasers: applications in cardiovascular atherosclerotic disease.

Laser angioplasty is a new, yet experimental intervention in the vascular setting. This technique forces artificially stimulated electrons to generate light energy. This energy can be used to achieve tissue abatement by a variety of mechanisms. Reducing resultant complications from this technique is the goal of current laser research. Techniques like angioscopy, photochemical interaction, pulsing modes, and alternative catheter designs have the common goal of improved tissue abatement, with minimal or the absence of secondary normal tissue injury. This population of patients requires comprehensive nursing care aimed at meeting the patient's nursing diagnoses and collaborative medical problems. In this manner, both the acute needs of the patient during hospitalization and his or her functional needs out of the hospital are identified. A plan of action is then formulated, performed, and evaluated.

Coronary Artery Disease↗
PubMed1989

[Retinal vasculitis].

Retinal vasculitis is an inflammatory permeability disorder of the retinal vascular wall affecting chiefly the veins and capillary vessels. It is diagnosed at ophthalmoscopy which demonstrates vascular sheathing and even better at fluorescein angioscopy which shows the colouring agent diffusing from the vessels. As regards its aetiology and treatment, retinal vasculitis is disconcerting. Except in those cases where a systemic disease can be blamed, the condition is isolated, usually chronic and often recurrent. It may result in visual impairment or, exceptionally, blindness.

Fluorescein Angiography↗
PubMed1987

[Rotation angioplasty--a new procedure for reopening and dilating blood vessels. Experimental findings].

16 fresh postmortem specimens of human femoral and popliteal arteries with severe atherosclerosis were removed and angiography was performed. Eight vessels were completely occluded and eight showed stenoses of up to 60%. All occluded vessels were heavily calcified. The duration of occlusion, estimated according to the patient's history, ranged from 1 to 2 years. In one case, a duration of 18 months was documented by angiography. The lengths of the occlusions were between 5 and 12 cm. A rotating catheter was introduced through a 9F guiding catheter. All stenosed vessels were passed and seven out of eight occluded vessels, in which passage was not possible using conventional wires, were successfully reopened at low speed rotation of 200 rpm. Angiography, as well as histology, showed no perforation, and angioscopy revealed a smooth surface of the new channel. In three vessels this new channel was dilated with a balloon catheter and in one with an elastic element under rotation. It is concluded that with the new technique it is possible to reopen totally occluded human arteries which cannot be passed by conventional methods.

Angioplasty, Balloon↗
PubMed1988

[Transluminal coronary angioplasty. Ambitions and difficulties of the second generation].

Proposed in all functional forms of coronary heart disease and by gradually surmounting the obstacles of coronary arteriography, ballon catheter angioplasty, at the same time measures its limitations. These are recurring stenoses and failure of this procedure to cure chronic coronary occlusions, and they specifically characterize a method which, at the expense of unavoidable parietal lesions, does not eliminate the cause of the stenosis. It appears more desirable to remove atheromatous tissue by its extraction, vaporization or pulverization, to reinforce the wall of the coronary vessel, and these are the objectives of second-generation procedures. Development of angioscopy, lasers, atherotomies, and endoprostheses illustrates the vitality and the innovation present in invasive methods of cardiac therapeutic management. However, for the time being their clinical development of such procedures is incomplete and has not been sufficiently perfected. Future methods of angioplasty will be more satisfactory and have better control, but at present it is difficult to accurately predict the future aspects of such procedures.

Angioplasty, Balloon↗
PubMed1979

The management of patients with intraocular lenses. Guidelines for those who do not perform this operation.

The management of patients with intraocular lenses can be done quite well by any knowledgeable ophthalmologist. Every examination must include the measurement of intraocular pressure and a thorough slit-lamp examination, specifically noting: Corneal edema, local or diffuse; Increasing corneal guttata; Touch of lens or iris suture to the cornea; Aqueous ray or cells, KP, LP (lens precipitates); Lens displacement; Iris suture problems; Pupil margin erosion; Secondary cataract; Vitreous face: loss or thickening; Retrolenticular membrane formation; Vitreous cells. Ophthalmoscopy should include examination of the peripheral retina for detachment, but visual fields should be done whenever detachment is suspected. Contact lens--slit-lamp examination of the macula for cystoid edema should be supplemented by Flourescein angioscopy when needed. Lens removal should be done only after careful consideration. The damage induced by such surgery must be weighed against the problems of leaving the lens in place. Consultation is mandatory. When in doubt, refer.

Edema↗
PubMed1988

The effect of valvulotomy on the flow rate through the saphenous vein graft: clinical implications.

Potential differences in flow rates between reversed and in situ saphenous vein bypass grafts were evaluated. One hundred ten greater saphenous vein segments containing isolated valves were examined with fiber-optic angioscopy during pulsatile and nonpulsatile flow. Valve competency was determined, and the degree of luminal obstruction caused by the valve during reversed flow was calculated with caliper measurements of the video image. Flow measurements were obtained before and after valvulotomy, in reversed and nonreversed vein orientations. Increased flow rates occurred during pulsatile irrigation only, after valvulotomy in vein segments with diameters less than 2.5 mm (p less than 0.001, Bonferroni t test). In these small-diameter vein segments, the flow rate in reversed valve-intact vein was 94.4 +/- 28.9 ml/min (mean +/- 1 standard deviation), the flow rate in reversed valve-disrupted vein was 136.4 +/- 36.5 ml/min, and the flow rate in nonreversed valve-disrupted vein was 137.8 +/- 31.3 ml/min. In 22 vein segments, luminal obstruction caused by the intact valve was measured angioscopically. A small valve orifice was found to be related to a large increase in flow rate after valvulotomy (p less than 0.02, least-squares regression). In addition, veins with diameters less than 2.5 mm have significantly smaller valve orifices compared with veins with diameters greater than 2.5 mm. These results present important clinical implications as the number of distal extremity reconstructions increases.

Blood Flow Velocity↗
PubMed1987

Pulmonary vascular imaging.

A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any "ideal" technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the "gold standard" for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques.

Blood Platelets↗
PubMed1987

Direct vision valvulotomy in in situ venous bypass.

The autogenous saphenous venous bypass is accepted as an optimal procedure for distal arterial reconstruction. However, serious complications, including incomplete valvulotomy, laceration of the venous wall and persistent arteriovenous communications, are found in in situ bypasses. To avoid these complications, a new and simple technique using an angioscope in the in situ venous bypass has been developed. Angioscopy prevents tearing of the vein wall and avoids inaccurate incision of the valves.

Endoscopy↗
PubMed1985

[State of microcirculation and the system of hemostasis in Sjögren's disease, Sjögren's syndrome and chronic parenchymatous parotitis].

Microcirculation and hemocoagulation were examined in 88 patients with Sjögren's disease and Sjögren's syndrome (SD and SS) in 20 patients with chronic parenchymatous parotitis (CPP) without a "dry syndrome", and in 20 healthy donors by conjunctival angioscopy, capillaroscopy of the nail matrix, and histological study of the salivary glands. Hemostasis was explored with the use of 37 tests. SD and SS patients manifested significantly more pronounced microcirculatory disorders versus donors (P less than 0.001) and CPP patients (P less than 0.001). In patients with hypergammaglobulinemic purpura, microcirculatory disorders were found to be enhanced (P less than 0.05). An indirect relationship between these disorders and the degree of lacrimation lowering was established. Intravascular disturbances increased as the process activity rose and diminished under the effect of prednisolone therapy. It is assumed that microcirculatory and hemocoagulation disorders play an important role in the pathogenesis of SD and SS.

Adult↗
PubMed1978

[Characteristics of the classification of acute cholecystitis in the elderly].

On the grounds of the analysis of 1300 case records and own observations with the use of angioscopy and angiography the authors have come to the conclusion that acute cholecystitis in elderly individuals results from the blood supply disorder in the gallbladder wall, caused by the thrombosis of the vascular branches of the cystic artery. They have suggested the classification of acute cholecystitis, mirroring the stage character of the disease and the nature of pathological changes in the gallbladder.

Acute Disease↗
PubMed1984

[Capillaroscopy and Raynaud's phenomenon].

Nailfold capillary microscopy is a simple and noninvasive screening test for the etiological diagnosis of Raynaud's phenomenon: --dilating capillary dystrophia, with its large capillary loops (megacapillaries), it is a very specific sign of connective tissue disorders, especially systemic sclerosis; --meshed or branched-tree shaped capillaries are neocapillaries, the meaning of which is very often a dermal vasculitis (S. L. E., rheumatoid arthritis, paraneoplastic Raynaud's phenomenon, or even chilblains); --when numerous abnormal capillary loops and hemorrhages are seen without any special pattern, the diagnosis of idiopathic Raynaud's disease is very unlikely and an extensive biological investigation is needed; --nailfold capillaries look like normal in idiopathic Raynaud's disease and, in this case, only a sharp physical examination and a few biological tests are required. Conjunctival angioscopy is a useful complementary test in some cases when nailfold capillaroscopy is unreliable. Capillary video microscopy is an interesting method for further investigations about the physiopathology of Raynaud's phenomenon.

Capillaries↗
PubMed1982

[Ophthalmological and angiographic findings in workers exposed to carbon disulfide (author's transl)].

Microaneurysms are important in the diagnosis of vascular changes caused by carbon disulfide. They can be diagnosed by ophtholmoscopy, angiography or angioscopy. In our opinion even a careful ophthalmoscopic investigation is sufficient for diagnosis, so that angiography is not absolutely necessary for any mass survey. The incidence of microaneurysms correlates with the duration (both daily and total) as well as with the intensity of exposure to carbon disulfide. The quantity correlates closely with the intensity of exposure. The incidence of microaneurysms is not correlated to age; however it was found to be highest in 40-50-year-old men working with staple fibers, whereas in the spinning department it occurred in 50-55-old men. Microaneurysms are found equally frequently in active workers and invalids. There was no difference between the two groups with regard to degenerative changes of the macula. However, the changes found in the eyes of men from the staple fiber department were more pronounced than in those from the spinning department.

Aneurysm↗
PubMedDate not supplied

[Current status of reconstructive surgery of the sub-inguinal artery].

Saphenous vein bypass is the optimal operation for arterial reconstruction in the subinguinal region. There has been no demonstrated advantage to using a devalvulated saphenous vein in situ rather than an inverted dissected vein. Prosthetic bypass may be preferred over saphenous bypass with a vein < or = 4 mm if the lower anastomosis is situated on the upper popliteal artery, if the life expectancy is short or if on the contrary the downstream bed is normal. Permeability after percutaneous transluminal angioplasty does not last as long as after bypass surgery for obliterations, but the operation is less aggressive and does not compromise a subsequent procedure. The best indications are short stenoses in patients with a long walking distance in whom surgery would be excessive. Angiography or ultrasound angioscopy after a bypass procedure or endoluminal dilatation can check the technical quality of the operation and help improve permeability duration. Adjuvant treatment such as a venous patch on a prosthetic anastomosis or various drugs are highly important in improving the duration of permeability. A prospectively planned follow-up should be an integral part of arterial reconstruction surgery in order to identify subsequent stenoses and programme their treatment before occlusion occurs.

Arterial Occlusive Diseases↗
PubMed1995

New developments in the diagnosis and management of cardiac allograft vasculopathy.

The major cause of late death in cardiac transplant recipients is cardiac allograft vasculopathy, also referred to as cardiac transplant atherosclerosis, which occurs in as many as 45% of transplant recipients who survive longer than 1 year. It differs from typical atherosclerosis in that intimal hyperplasia is concentric and diffuse, the internal elastic lamina remains intact, calcification is rare, and the disease tends to develop rapidly. Intravascular ultrasound and coronary angioscopy are more sensitive diagnostic measures of cardiac allograft vasculopathy than is coronary angiography. Although retransplantation at present seems to be the only definitive therapy for cardiac allograft vasculopathy, it has shown only fair results. Recent studies have suggested that calcium entry blockers and angiotensin-converting enzyme inhibitors may play a beneficial role in delaying the progression of cardiac allograft vasculopathy.

Angioplasty, Balloon, Coronary↗
PubMed1995

[Coronary angiography (including PTCA)].

Coronary arteriography (CAG) is one of the gold standards for diagnosing the severity of ischemic heart disease (IHD). Characterization of the angiographic findings of the focal coronary lesion was discussed on the basis of Rosch's and American Heart Association (AHA) classification. Recently, progression and regression of coronary atherosclerotic lesions have been assessed by serial CAG. Regression was believed to result from the dissolution or remodeling of thrombus or from the removal of plaque lipid and cellular elements. Accordingly, we also discussed the pitfalls in the evaluation of coronary stenosis. Recent modalities including intravascular ultrasound (IVUS) and angioscopy have been applied to assess the maternal characteristics of coronary atherosclerotic lesions, such as soft plaque, hard plaque, and calcification along with the extent of intimal thickening.

Angioplasty, Balloon, Coronary↗
PubMed1995

[Postoperative digital subtraction angiography after infrainguinal bypass operation].

Bypass occlusions in infrainguinal arterial reconstructions occur in up to 20% within the first postoperative month and are caused by technical defects in most cases. In a prospective study to evaluate the importance of imaging techniques in infrainguinal bypass grafting 81 of 103 bypasses were examined by intraarterial DSA 10 days postoperatively. The findings of early postoperative DSA were compared with the results of intraoperative angioscopy and completion angiography. In 11 cases (13.6%) there were additional pathological findings. In 6 patients stenoses were localized at the proximal anastomosis, which could not be visualized intraoperatively due to technical reasons. In 2 more patients postoperative DSA revealed an occlusion of the distal segment of the recipient artery with a retrograde blood flow in the proximal segment. Further pathological findings were one perianastomotic stenosis caused by a thrombus at a venous valve site and one arteriovenous fistula in an in-situ-bypass. In one more patient angiography showed a stenosis in the outflow tract. The duplex-derived PSV, however, was normal and no revision was made. At present, examination of the proximal anastomosis is possible by intraoperative DSA, but initially unrecognized and secondary bypass defects can only be identified by early postoperative DSA in asymptomatic patients. A final scrutiny of the arterial reconstruction can be achieved by postoperative DSA without any recognizable morbidity before subsequent bypass function is monitored by non invasive methods like duplex sonography.

Adult↗
PubMed1994

[Medical and economic advantages of percutaneous transluminal angioplasty].

Percutaneous transluminal angioplasty (PTA) has been used for nearly 30 years. This method was refused in the past because of lack of knowledge of its effectiveness, and insufficient technical equipment for its safe realization. The further factor negatively affecting usage of this method in common clinical practice in occlusive diseases of the lower limbs arteries was an essentially shorter long-term patency than that after reconstructive arterial surgery. Currently this method is widespread in common clinical practice and with the help of angioscopy, argon-laser angioplasty and rotary transluminal catheter system (RO-TACS) it can still be improved. In this study the authors deal in detail with medical and economical advantages of this widely used method.

Aged↗