Pattern of Restenosis after Percutaneous Transluminal Coronary Angioplasty of Bifurcation Stenoses

Bifurcation stenoses have been recognized to be at a "high risk" for acute closure during percutaneous transluminal coronary angioplasty. Development of advanced techniques using simultaneous ("kissing") balloon inflation or sequential balloon inflations, using two guidewires to preserve access to both branches while avoiding the trauma produced by inflating two balloons in a small artery simultaneously, has allowed safe and effective dilatation of bifurcation stenoses. Little is known, however, about the restenosis rate and pattern of bifurcation stenoses. This article reports on 44 patients who were treated successfully using the sequential inflation technique on their bifurcation stenoses. A total of 88 lesions were dilated. Restenosis occurred in 25 of the 88 lesions (28%) within 8.5 ± 2.25 months. Eleven patients had restenosis in one vessel while seven patients had restenosis in both branches (18 of 44–41%). All 18 underwent a second PTCA attempt and 15 patients had successful repeat PTCA. Thus, the primary restenosis rate in bifurcation stenosis is acceptably low, occurring in both branches in a minority of cases (7/18). The total restenosis rate is no greater than expected with single vessel PTCA. Repeat PTCA is usually easily accomplished with good secondary success, aided by the fact that the majority of the restenoses involve only one rather than both branches of the bifurcation stenosis. (J Interven Cardiol 1989:2:3)     

False positive gel-acetylcholinesterase results in blood-stained amniotic fluids

Summary. The effect of blood contamination on the gel-acetylcholinesterase (AChE) test used in the diagnosis of fetal open neural-tube defects was studied with amniotic fluid samples artificially contaminated with fetal or maternal blood in concentrations covering a range exceeding that usually found in clinical practice. Amniotic fluid samples contaminated with maternal blood gave negative gel-AChE results at all concentrations. Contamination with fetal blood yielded positive results if the erythrocyte concentration was greater than about 60 × 10⁶ cells/ml. Thus contamination of amniotic fluid with blood is only likely to cause false positive gel-AChE results if this critical concentration is exceeded. Such samples will occur only rarely in clinical practice but when they do the diagnosis should be made with caution.     

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