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At least 811 records · Page 45Linked to original sources
PubMed1999

Clinical significance of denervated but viable myocardium in patients with recanalized acute myocardial infarction.

In patients with acute myocardial infarction (MI), myocardial sympathetic innervation evaluated by 123I-metaiodobenzylguanidine myocardial scintigraphy is more sensitive to ischaemia than the associated perfusion abnormality of 201Tl myocardial scintigraphy. The purpose of this study was to evaluate the scintigraphic indices related to the recovery of left ventricular function after acute MI. 123I-metaiodobenzylguanidine and 201Tl-chloride imaging were performed in 15 patients (mean age 60 years, 13 men and 2 women) 2 weeks after the onset of acute MI. Using a 20-segment visual interpretation of the 201Tl image, myocardial segments were classified into persistent defect, redistribution or reverse redistribution, and normal 201Tl uptake. The extent of denervated segments showed a fair correlation with the ejection fraction on admission (r = -0.53, P = 0.04), whereas the extent of persistent defect had a close correlation with the ejection fraction at 4 months (r = -0.79, P = 0.01). There was a good correlation between the extent of denervated but viable myocardium and the change in ejection fraction from admission to 4 months (r = 0.68, P = 0.01). Thus, denervated but viable myocardium is a scintigraphic index related to the functional recovery of left ventricular pump function after acute MI.

3-Iodobenzylguanidine↗
PubMed1995

Effects of delayed recanalization of an occluded acute myocardial infarction-related artery using coronary angioplasty on late potentials.

BACKGROUND: Recent evidence suggests that late reperfusion of an occluded infarct-related artery after an acute myocardial infarction may reduce the frequency of subsequent arrhythmic events. Late mechanical reperfusion by percutaneous transluminal coronary angioplasty (PTCA) under these circumstances has a high success rate. The present study was performed to test the hypothesis that the late mechanical restoration of anterograde flow in an occluded infarct artery after an acute myocardial infarction causes a resolution of late potentials. METHODS: Twenty subjects (10 men, one woman; aged 32-77 years) suffering a first acute myocardial infarction, with signal-averaged electrocardiographic (ECG) recordings and a severely occluded infarct-related artery, were prospectively identified. RESULTS: Eighteen patients underwent successful PTCA of the occluded artery 6-32 days after a first acute myocardial infarction. Late potentials were observed in 14 patients 5-22 days after the infarction. A follow-up signal-averaged ECG was performed 1-8 days later. In the subgroup of 12 patients with successful reperfusion and an abnormal signal-averaged ECG before PTCA, seven (58.3%) showed resolution of the late potentials at follow-up; in these patients the filtered QRS duration showed a significant reduction (112.1 +/- 14.2 to 96.7 +/- 12.7 ms, P = 0.02), the root-mean-square voltage increased (9.8 +/- 6.5 to 33.1 +/- 15.5 microV, P = 0.017), and the duration of low-amplitude signals < 40 microV decreased after angioplasty (46.3 +/- 11.0 to 28.5 +/- 6.5 ms, P < 0.022). In contrast, two patients with late potentials before PTCA and unsuccessful reperfusion had no significant changes in signal-averaged ECG. CONCLUSIONS: In some patients with an acute myocardial infarction, late mechanical reperfusion of the culprit vessel may reduce the incidence of abnormalities on the signal-averaged ECG. Whether this will improve long-term survival has yet to be confirmed in a large trial.

Adult↗
PubMed2005

Sharp recanalization of an esophageal occlusion after repair of esophageal atresia and tracheoesophageal stricture.

Esophageal atresia with an associated tracheoesophageal fistula is a congenital anomaly requiring surgical correction. Recurrent stricture is the most common complication of surgical repair and is usually treated with mechanical dilation. Rarely, a recurrent completely obstructive stricture can cause obliteration of the anastomosis, preventing passage of a wire for dilation. This condition requires operative correction. In the case presented herein, the obliterated esophageal lumen from an obstructing stricture was operatively corrected with use of a novel transluminal technique. The obstruction was successfully crossed with a modified Chiba biopsy needle covered in a dilator through a gastrostomy. After subsequent balloon dilation, the lumen has remained patent for more than 3 years without significant complication.

Catheterization↗
PubMed2006

Non-cavernomatous superior mesenteric thrombosis successfully recanalized with interventional radiological procedures carried out with a combination transmesenteric and transjugular approaches.

This is the study of a 52-year-old man with oesophageal, rectal and anal varices caused by portal hypertension with complete obstruction of the superior mesenteric vein. Treatment by two sessions of interventional radiological procedures was successful. The first was a catheter-directed thrombolysis using the transmesenteric approach. The second was percutaneous transluminal angioplasty and stent implantation for the obstructed segment of the superior mesenteric vein and the creation of a transjugular intrahepatic portosystemic shunt. In the second session, devices were advanced over a guidewire inserted from the right jugular vein and pulled out of the ileocolic vein using the pull-through technique.

Angioplasty, Balloon↗
PubMed2001

Massive cerebral edema after recanalization post-thrombolysis.

BACKGROUND: Intravenous thrombolysis with tissue plasminogen activator is an approved and effective therapy for acute ischemic stroke within the first 3 hours from onset. In addition to the risk of hemorrhage, there is a risk of postrecanalization cerebral edema. The authors present the case of a patient with an ischemic stroke treated successfully with intra-arterial thrombolysis who subsequently developed massive brain edema in the face of clinical improvement. CASE: An 81-year-old man presented within 1 hour of developing a full right middle cerebral artery (MCA) syndrome. Computed tomography (CT) was normal. A cerebral angiogram demonstrated an occlusion of the M1 segment of the right MCA. The patient was treated with intra-arterial urokinase 750,000 units. He recovered during the procedure. Serial CT scans demonstrated progressive edema with mass effect in the right MCA distribution. The patient remained asymptomatic except for a mild sensory deficit. DISCUSSION: Postrecanalization cerebral edema is an uncommon but potentially lethal complication of thrombolysis. It is postulated that the edema is due to ischemic injury aggravated by reperfusion with vasogenic edema. The presence of this massive edema is usually associated with clinical worsening. The present case illustrates that this disorder can be associated with good outcome.

Aged↗
PubMed1980

Percutaneous transluminal dilatation and recanalization in the treatment of peripheral vascular disease.

Ninety-four successful transluminal angioplasties were followed up for as long as 15 months, during which time 15 failures occurred. Life-table analysis of this series gave a cumulative patency rate of 64%. The patency rate of 70% for iliac lesions, compared to 50% for the femoral-popliteal group, suggests that the former are likely to have a better long-term prognosis. In selected cases, transluminal angioplasty is a viable alternative to surgery that should be available to both patient and physician.

Adult↗