Stenting of coronary bifurcation lesions by using modified crush technique with double kissing balloon inflation (sleeve technique): immediate procedure result and short-term clinical outcomes.

BACKGROUND: Sleeve technique is a modified version of crush technique. It is specifically designed to increase the success rate of final kissing balloon inflation, which used to be a major limitation of the latter. OBJECTIVES: The aim of this study was to examine the feasibility, safety, and early clinical outcomes of sleeve technique in stenting different types (de novo, in-stent restenotic or in-stent bifurcation) of coronary bifurcation lesions at different locations. METHODS: From August 2005 to May 2006, 41 consecutive patients with symptomatic, nonleft-main coronary bifurcation stenoses of diameter narrowing >or=50% were treated with two-stent strategy, using sleeve technique. RESULTS: The mean age was 63.6 +/- 11.6 years with male predominance (70.7%). High prevalence of diabetes mellitus (31.7%), total occlusion (22.0%), and multi-vessel disease (65.9%) was observed in this cohort. Intravenous abciximab was given in 35 (85.4%) patients. Final kissing balloon inflation was successfully performed in all patients. The minimal luminal diameter in main vessel and side branch was increased from 0.97 +/- 0.53 mm and 0.81 +/- 0.45 mm to 2.76 +/- 0.34 mm and 2.22 +/- 0.35 mm, respectively. The mean procedure time was only 66.6 +/- 24.6 min. There was one (2.4%) case of subacute stent thrombosis presented as non-Q-wave myocardial infarction at day 3 postprocedure. The resultant in-hospital and 30-day major adverse cardiac event rate were both 2.4%. CONCLUSIONS: Sleeve technique is a feasible and efficient approach in stenting of coronary bifurcation stenoses.     

通心络胶囊对冠心病治疗效果的临床对照观察

目的观察通心络胶囊对冠心病（CHD）常见临床症状的改善效果。方法对照组维持原有药物治疗不变,治疗组在此基础上加服通心络胶囊4粒/次,3次/日,疗程4周。病人接受观察前进行常规化验检查,检测心率、血压、心功能等指标。疗程结束时对上述指标再进行检查,并观察病人的临床症状改善情况。结果两组病人的胸痛、胸闷、气憋、心悸、乏力等常见临床症状均有改善,且治疗组明显优于对照组（P〈0.05）;治疗组每搏量和心排血量的较对照组提高较为明显（P〈0.01）。结论加服通心络胶囊治疗CHD能增强西药的治疗效果,进一步改善CHD病人的常见临床症状。     

Coronary stenting for coronary artery narrowing in a heart transplant recipient

Transplant atherosclerotic coronary disease remains the leading cause of death in heart transplant recipients. We report the first case of coronary stent implantation in a heart graft for epicardial focal stenosis. Due to the lower rate of restenosis after stenting in the native coronary artery, we suggest that coronary stenting be considered an acceptable, first intention therapeutic option instead of angioplasty alone whenever possible.     

西宁地区冠心病113例临床分析

本文通过西宁地区１１３例住院冠心病人的临床分析，认为西宁地区冠心病患病率低，患者年龄大，男性患病率高于女性，而且绝经期后的高龄女性患者患病率仍然远比男性低，这些与低海拔地区不同。而冠心病各型的分布、临床症状、病死率等与低海拔地区相似。     

Coronary venous retroperfusion of arterial blood for the treatment of acute myocardial ischemia

Synchronized coronary venous retroperfusion of autologous arterial blood was offered to patients referred for medically refractory unstable angina or evolving myocardial infarction with contraindications to thrombolytic therapy. Primary endpoints of angina, ST segment deviation, and two-dimensional echocardiographic systolic wall motion were followed to determine the efficacy of retroperfusion in patients prior to and then during angioplasty, surgical intervention, or pharmacological management, as the clinical picture warranted. Over a 12 month period, 21 patients were referred and 15 received retroperfusion. All experienced full relief of angina (p = 0·008). ST segment deviations and systolic wall motion of ischemic zones were observed to improve (p = 0·06 ST changes; p = 0·0001 wall motion changes) with synchronized retrograde perfusion. During attempts to remove patients from retroperfusion, statistically significant (p < 0·01) reproducible changes in these same endpoints were documented. Retroperfusion appears to improve acute myocardial ischemia. This technique functions well in the intensive care unit environment with only fluoroscopy as technical imaging support.     

50例冠心病某些生化基础观测的临床诊断意义

对５０例冠心病患者进行某些生化基础观测，发现冠心病肾阴虚与糖耐量减低有关，肾阳虚患者尿１７－羟低於正常；而冠心病标证有其生化基础，与甘油三酯增高有密切相关。     

Parallel angioplasty dilatation catheter and guide wire: A new technique for the dilatation of calcified coronary arteries

Percutaneous transluminal coronary angioplasty (PTCA) of heavily calcified rigid coronary arteries has decreased success and increased complication rates. Three cases are presented describing a new technique for the dilatation of severely calcified coronary arteries that were not dilatable by conventional angioplasty methods. This technique involves the use of a balloon dilatation catheter system parallel to a guide wire. © 1993 Wiley-Liss, Inc.     

Coronary artery and saphenous vein graft remodeling: A review of histologic findings after various interventional procedures—part V

Catheter balloon angioplasty is a well accepted form of nonsurgical treatment of acutely and chronically obstructed coronary artery vessels. It is also the centerpiece for various new intervention techniques. Their morphologic effect on the site of obstruction has been termed “remodeling.” Part V of this six-part series focuses on remodeling effects of balloon angioplasty on obstructed young (≤ 1 year) and old (> 1 year) saphenous vein bypass grafts.     

Possible injury to the branches of the peroneal nerve during fibular osteotomies

Conclusions The peroneal nerves and their blood supply are at risk during high tibial osteotomies. Fixation of nerves by fibrous tissues, compression by tendinous arcades of the peroneus longus tendon, and narrow passages for nerves crossing dense fibrous septa are all factors which favor the development of peroneal nerve lesions. Intraoperative soft tissue retraction and pull by retractors may damage nerves and vessels. The muscle branch for the extensor hallucis longus muscle is particularly at risk during the fibular osteotomy since it runs directly on the bone.     

西雅图心绞痛调查量表对冠心病患者机体功能及生活质量的评估研究

目的对冠心病患者机体功能状态及生活质量进行评估。方法采用Ｓｐｅｔｕｓ等设计的ＳｅａｔｔｌｅＡｎｇｉｎａＱｕｅｓｔｉｏｎｎａｉｒｅ问卷对１００例冠心病患者躯体活动受限程度、心绞痛稳定状态及发作情况、治疗满意程度和疾病认识程度进行测评研究。结果重复测定显示该量表有良好的重复性，心理疗法配合药物治疗组的评分明显优于单纯药物治疗组（Ｐ＜０．０５）。结论该量表用于我国冠心病患者有较满意的信度，同时也证实了心理疗法在冠心病治疗中的重要地位。