Intravascular ultrasound of normal left main arteries: Insights for stent optimization and standardization

• Left main (LM) lumen diameters >4 mm are the norm and diameter >4.5 mm is present in almost 50% of patients by intravascular ultrasound (IVUS).
• Normal LM minimum lumen area averages 14.1 mm² for women and 16.2 mm² for men, requiring an area stenosis of 57–63% for LM lesion to be hemodynamically significant using the prevailing criterion of 6 mm² as a cut‐off for revascularization.
• Incomplete LM visualization with IVUS is common (68%) without dedicated and specific LM IVUS techniques.

     

7-甲氧基-4′-羟基-3′-二乙胺甲基异黄酮(MHDF)对大鼠血流动力学和主动脉的作用

本实验观察了MHDF对整体大鼠血流动力学和离体大鼠胸主动脉的作用。结果表明iv MHDF(3～12.8 mg/kg)能降低大鼠左心室±dp/dt_max,V_max,V_pm和LVSP,延长T-dp/dt_max,减慢心率。MHDF还能舒张大鼠胸主动脉,ED₅₀为6.5×10^-6mol/L;非竞争拮抗NA和CaCl₂致主脉收缩,pD₂′为3.11±0.21和3.73±0.07;抑制高K⁺致主动脉收缩,IC₅₀为1.76×10^-5mol/L。提示MHDF对血管的作用与α受体阻断剂不同,而可能与钙拮抗有关。     

Long-term follow-up of brachytherapy for treatment of allograft in-stent restenosis.

The experience of brachytherapy in the treatment of in-stent restenosis of allograft arteries is limited. We present two cases of in-stent restenosis treated with brachytherapy with favorable angiographic follow-up at 10 months in one patient and at 17 months in the other.     

The degree of atherosclerosis in the descending aorta does not predict poor in-hospital outcome after surgery requiring cardiopulmonary bypass

OBJECTIVE: This study examined if the degree of atherosclerosis in the descending aorta is an independent predictor of poor in-hospital outcome for patients presenting for surgery involving cardiopulmonary bypass. DESIGN: The degree of atherosclerosis of the descending aorta was retrospectively reviewed in patients presenting for surgical procedures involving cardiopulmonary bypass from January 1, 2000, to December 31, 2003. Preoperative risk factors and in-hospital postoperative outcome parameters were obtained. SETTING: University teaching hospital. PARTICIPANTS: There were 310 consecutive patients enrolled in the study. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Two hundred forty-seven patients had coronary artery bypass grafting with or without valvular surgery, and 63 patients had isolated valvular surgery. The degree of atherosclerosis was rated as normal in 86 (28%), mild in 106 (34%), moderate in 69 (22%), and severe in 49 (16%) patients. Adjusting only for the degree of atherosclerosis, the total intensive care unit (ICU) time and the number of deaths were significantly higher in those patients with severe disease. Multivariable models adjusting for patients' risk factors showed a significant influence of atherosclerosis on total ICU time but not on other outcomes. The strongest predictor of poor outcome was a history of previous stroke (cerebral vascular accident). Other significant factors predicting poor outcome included previous coronary artery bypass surgery, a history of congestive heart failure, a history of dialysis, advanced age, and female sex. CONCLUSIONS: The degree of atherosclerosis in the descending aorta is not an independent predictor of poor in-hospital outcome after surgery involving cardiopulmonary bypass.