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101.
Vinicius Esteves MD PhD Marco A. P. Oliveira MD PhD Fernanda S. Feitosa MD José Mariani Jr MD PhD Carlos M. Campos MD PhD Ludhmila A. Hajjar MD PhD Luiz A. Lisboa MD PhD Fabio B. Jatene MD PhD Roberto K. Filho MD PhD Pedro A. Lemos Neto MD PhD 《Catheterization and cardiovascular interventions》2021,97(2):259-264
102.
103.
Increase in Interleukin-6 in the First Hour after Coronary Stenting: An Early Marker of the Inflammatory Response 总被引:8,自引:0,他引:8
Aggarwal A Schneider DJ Terrien EF Gilbert KE Dauerman HL 《Journal of thrombosis and thrombolysis》2003,15(1):25-31
Background: Inflammation after coronary stenting presages adverse outcomes after percutaneous coronary intervention (PCI). While changes in inflammatory markers have been defined 24–72 hours after PCI, potential changes during the first few hours have not. This study was designed to determine if a systemic inflammatory response could be measured within the first hour after stenting.
Methods: Patients (n = 25) undergoing coronary stenting, with predominantly (n = 23) acute coronary syndromes were enrolled prospectively in this registry. Blood samples were collected before PCI, and 10 minutes, 1 hour and 18–24 hours later. No patient received a glycoprotein IIb-IIIa inhibitor. Concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1Ra) and soluble CD40 ligand (sCD40L) were measured using ELISA.
Results: CRP and sCD40L did not change in the first hour after stenting. By contrast, IL-6 increased in the first hour (before = 7.6 ± 7.7 pg/ml, 1 hour = 12 ± 12 pg/ml; p < 0.001). The concentration of IL-1Ra tended to be greater after 1 hour (before = 426 ± 261 pg/ml, 1 hour = 511 ± 406 pg/ml; p = 0.11). Increase in IL-1Ra was apparent only in female subjects (p = 0.004 for the difference in trend between the two genders). A correlation was not observed between the increase in IL-6 at 1 hour and the increase in CRP at 24 hours (r = –0.21).
Conclusions: In patients undergoing coronary stenting, increase in IL-6 can be detected 1 hour after PCI, and thus IL-6 may be an early initiator of the systemic inflammatory response to stenting. 相似文献
104.
颞浅动脉-大脑中动脉吻合术结合脑-硬脑膜-肌肉血管融合术治疗烟雾病 总被引:8,自引:1,他引:8
目的探讨颞浅动脉-大脑中动脉吻合结合脑-硬膜-肌肉血管融合术治疗烟雾病的临床疗效。方法选择27例烟雾病患者。采用Matsushima(1990)的分型标准,27例患者中6例为第3期,11例为第4期,7例为第5期,3例为第6期;以缺血首发21例,出血首发6例。27例均行颞浅动脉-大脑中动脉分支吻合与脑-硬脑膜-肌肉血管融合术相结合的手术治疗,其中3例行同侧颞浅动脉2个分支吻合,1例行双侧手术。术中采用多普勒超声,术后采用CTA、DSA观察吻合血管通畅情况,并采用TCD、CT灌注评价脑血流改善情况。结果①吻合口通畅情况:27例患者吻合口全部通畅。7例DSA复查显示,与间接手术相关的脑膜动脉和颞中深动脉均与皮质动脉之间形成新生血管吻合。②脑血流改善情况:26例术后1周内复查CT灌注成像,显示吻合侧血流量、血容量及血流峰值时间明显优于对侧。③临床症状改善情况:缺血患者术后TIA未再发作,原有缺血症状改善或消失;6例出血患者随访至今,未再有出血。④并发症:1例Ⅳ型患者术后第3天CT复查显示,距吻合口约3~4cm的前方左侧额叶出现新发小片梗死灶。全部患者未出现由于破坏原有自发血管吻合、颞肌占位效应及过度灌注等并发症。结论颞浅动脉-大脑中动脉分支直接吻合术结合脑-硬脑膜-肌肉血管融合术对脑烟雾病患者具有较好的疗效。 相似文献
105.
Saima Karim Sweetheart T. Ador-Dionisio Munira Karim Mohammad Karim Sadaf S. Khan Ashish Atreja 《Acute cardiac care》2016,18(1):1-6
Background: Little literature exists on the risk of performing coronary intervention (PCI) on patients who have had recent gastrointestinal bleeding (GIB), although bleeding after PCI has been identified as a risk factor for long-term mortality. Methods: Patients within the Cleveland Clinic PCI database who had acute GIB within 30 days preceding PCI during the same hospitalization (n = 79) were retrospectively compared to those who had PCI without recent GIB (n = 10 979) for mortality and need for revascularization. Baseline characteristics, laboratory values, procedures, morbidities, and mortality were compared using chi-square test for categorical variables and using Wilcoxon rank sum test for continuous variables. Mortality data was obtained using Social Security Death Index and demonstrated using Kaplan–Meier method. Results: The GIB group had more prevalent history of peptic ulcer disease, GIB, gastrointestinal or liver disease (P < 0.0001), transient ischemic accident (P = 0.017), peripheral vascular disease (P = 0.0002), significant carotid artery occlusion (P = 0.023), and myocardial infarction (P < 0.0001). 47% of patients had upper GIB with 20% needing endoscopic intervention. This group had more anemia (P < 0.0001), heart failure (P = 0.0001), cardiogenic shock (10% versus 1.4%, P < 0.001), cardiac arrest (7.6% versus 1%, P < 0.001). GIB group had worse in-hospital mortality (P < 0.0001), long-term mortality (P < 0.001), and a 7.6% re-bleeding incidence. Conclusions: Overall, the patients who had GIB preceding PCI had higher in-hospital mortality and long-term mortality compared with those without GIB before PCI. 相似文献
106.
107.
108.
Nisharahmed I. Kherada Samantha SartoriMatthew I. Tomey Marco G. MennuniOmar A. Meelu Swathi RoyBibhu D. Mohanty Usman BaberRobert Pyo Jason C. KovacicJoseph Sweeny Pedro MorenoPrakash Krishnan George D. DangasRoxana Mehran Samin K. SharmaAnnapoorna S. Kini 《International journal of cardiology》2014
Objectives
To compare the outcomes of initial one-stent (1S) versus dedicated two-stent (2S) strategies in complex bifurcation percutaneous coronary intervention (PCI) using everolimus-eluting stents (EES).Background
PCI of true bifurcation lesions is technically challenging and historically associated with reduced procedural success and increased restenosis. Prior studies comparing initial one-stent (1S) versus dedicated two-stent (2S) strategies using first-generation drug-eluting stents have shown no reduction in ischemic events and more complications with a 2S strategy.Methods
We performed a retrospective study of 319 consecutive patients undergoing PCI at a single referral center with EES for true bifurcation lesions, defined by involvement of both the main vessel (MV) and side branch (SB). Baseline, procedural characteristics, quantitative coronary angiography and clinical outcomes in-hospital and at one year were compared for patients undergoing 1S (n = 175) and 2S (n = 144) strategies.Results
Baseline characteristics were well-matched. 2S strategy was associated with greater SB acute gain (0.65 ± 0.41 mm vs. 1.11 ± 0.47 mm, p < 0.0001). In-hospital serious adverse events were similar (9% with 2S vs. 8% with 1S, p = 0.58). At one year, patients treated by 2S strategy had non-significantly lower rates of target vessel revascularization (5.8% vs. 7.4%, p = 0.31), myocardial infarction (7.8% vs. 12.2%, p = 0.31) and major adverse cardiovascular events (16.6% vs. 21.8%, p = 0.21).Conclusion
In this study of patients undergoing PCI for true coronary bifurcation lesions using EES, 2S strategy was associated with superior SB angiographic outcomes without excess complications or ischemic events at one year. 相似文献109.
Slobodan Micovic Dusko Nezic Petar Vukovic Marko Jovanovic Branko Lozuk Sinisa Jagodic Bosko Djukanovic 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2014,41(4):421-424
Surgery for acute aortic dissection is challenging, especially in cases of cerebral malperfusion. Should we perform only the aortic repair, or should we also reconstruct the arch vessels when they are severely affected by the disease process? Here we present a case of acute aortic dissection with multiple tears that involved the brachiocephalic artery and caused cerebral and right upper-extremity malperfusion. The patient successfully underwent complete replacement of the brachiocephalic artery and the aortic arch during deep hypothermic circulatory arrest, with antegrade cerebral protection. We have found this technique to be safe and reproducible for use in this group of patients. 相似文献
110.
Tara I. Chang Thomas K. Leong Derek B. Boothroyd Mark A. Hlatky Alan S. Go 《Journal of the American College of Cardiology》2014