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Sample records for angioplastie und stentimplantation

  1. MedlinePlus: Angioplasty

    MedlinePlus

    ... Angioplasty updates by email What's this? GO GO MEDICAL ENCYCLOPEDIA Angioplasty and stent - heart - discharge Angioplasty and stent placement - heart Balloon angioplasty - short segment Coronary artery balloon angioplasty - slideshow ...

  2. Coronary Angioplasty

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Percutaneous Coronary Intervention? Español Percutaneous (per-ku-TA-ne-us) coronary intervention (PCI), commonly known as coronary angioplasty (AN-jee- ...

  3. Angioplasty and stent placement -- peripheral arteries

    MedlinePlus

    Percutaneous transluminal angioplasty - peripheral artery; PTA - peripheral artery; Angioplasty - peripheral arteries; Iliac artery -angioplasty; Femoral artery - angioplasty; Popliteal artery - angioplasty; Tibial artery - angioplasty; Peroneal artery - ...

  4. Ultrasonic angioplasty

    NASA Astrophysics Data System (ADS)

    Siegel, Robert J.

    1990-08-01

    Over the past 3 years we have developed a percutaneous ultrasonic angioplasty device and recently applied it in human peripheral arteries. This paper describes some of the background preceding the development of intravascular ultrasound for arterial recanalization. The chronology of our development of ultrasonic angioplasty is discussed from in vitro studies on atherosclerotic plaque to in vivo studies in canine models with differing types of arterial occlusions (thrombotic fibrotic calcific-atherosclerotic) and to initial human application. SPIE Vol. 1321 Modern Technologies Applied to Medical Practice (1989) / 69

  5. Laser Angioplasty

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The principal method of dealing with coronary artery blockage is bypass surgery. A non-surgical alternative available to some patients is balloon angioplasty. For several years, medical researchers have been exploring another alternative that would help a wider circle of patients than the balloon treatment and entail less risk than bypass surgery. A research group is on the verge of an exciting development: laser angioplasty with a 'cool' type of laser, called an excimer laser, that does not damage blood vessel walls and offers non-surgical cleansing of clogged arteries with extraordinary precision. The system is the Dymer 200+ Excimer Laser Angioplasty System, developed by Advanced Intraventional Systems. Used in human clinical tests since 1987, the system is the first fully integrated 'cool' laser capable of generating the requisite laser energy and delivering the energy to target arteries. Thirteen research hospitals in the U.S. have purchased Dymer 200+ systems and used them in clinical trials in 121 peripheral and 555 coronary artery cases. The success rate in opening blocked coronary arteries is 85 percent, with fewer complications than in balloon angioplasty. Food and Drug Administration approval for the system is hoped for in the latter part of 1990. * Advanced Intraventional Systems became Spectranetics in 1994 and discontinued the product.

  6. Angioplasty and stent placement - heart

    MedlinePlus

    ... angioplasty; Coronary artery angioplasty; Percutaneous transluminal coronary angioplasty; Heart artery dilatation ... to carefully guide the catheter up into your heart and arteries. Dye will be injected into your ...

  7. Angioplasty and stent placement - carotid artery

    MedlinePlus

    Carotid angioplasty and stenting; CAS; Angioplasty - carotid artery; Carotid artery stenosis - angioplasty; ... Carotid angioplasty and stenting (CAS) is done using a small surgical cut. Your surgeon will make a surgical cut in your groin after using some ...

  8. Angioplasty and Vascular Stenting

    MedlinePlus

    ... the narrowed vein is also needed. narrowing in dialysis fistula or grafts. When there is decreased flow ... the graft or fistula making it inadequate for dialysis, angioplasty is generally the first line of treatment. ...

  9. Balloon angioplasty - short segment

    MedlinePlus Videos and Cool Tools

    Angioplasty is a procedure to open narrowed or blocked arteries caused by deposits of plaque. If the blockage is not major, ... passage for the blood to flow through. Typically, a device called a stent is placed within the ...

  10. Balloon catheter coronary angioplasty

    SciTech Connect

    Angelini, P.

    1987-01-01

    The author has produced a reference and teaching book on balloon angioplasty. Because it borders in surgery and is performed on an awake patient without circulatory assistance, it is a complex and demanding procedure that requires thorough knowledge before it is attempted. The text is divided into seven sections. The first section describes coronary anatomy and pathophysiology, defines the objectives and mechanisms of the procedure and lists four possible physiologic results. The next section describes equipment in the catheterization laboratory, catheters, guidewires and required personnel. The following section is on the procedure itself and includes a discussion of examination, testing, technique and follow-up. The fourth section details possible complications that can occur during the procedure, such as coronary spasms, occlusion, thrombosis, perforations and ruptures, and also discusses cardiac surgery after failed angioplasty. The fifth section details complex or unusual cases that can occur. The sixth and seventh sections discuss radiation, alternative procedures and the future of angioplasty.

  11. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. The procedure ...

  12. Angioplasty and stent - heart - discharge

    MedlinePlus

    ... discharge; PTCA - discharge; Percutaneous transluminal coronary angioplasty - discharge; Heart artery dilatation - discharge ... the blood vessels that supply blood to your heart. You may have had a heart attack or ...

  13. Coronary artery balloon angioplasty - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100160.htm Coronary artery balloon angioplasty - series To use the sharing features ... out of 9 Normal anatomy Overview The coronary arteries supply blood to the heart muscle. The right ...

  14. Coronary angioplasty guidewire technology.

    PubMed

    McDermott, E A

    1987-01-01

    The technology of coronary guide wires has advanced rapidly since Simpson and Robert performed the first angioplasty with a movable guidewire system in 1981. The technology involved in engineering guidewires encompasses three areas: (1) selection of materials, (2) design of the configuration, and (3) development of the construction process to fabricate the guidewire. Each of these areas must be considered concurrently; that is, the functional effects of manufacturing a wire must be considered along with material selection and configuration design. Another critical area is functional testing to ensure safe and effective performance of the guidewire in the clinical setting and to confirm its functional limits. Research is directed continually toward advancing existing guidewire technology to improve functional performance and develop more efficient manufacturing processes. Additionally under development are new guidewire devices incorporating microsensors and fiberoptics to provide real-time feedback. Advances in technology require miniaturization of guidewire components and application of new materials and processes to manufacture new designs. PMID:2964145

  15. Angioplasty - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Angioplasty URL of this page: https://medlineplus.gov/languages/angioplasty.html Other topics A-Z A B ...

  16. Angioplasty - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Angioplasty URL of this page: https://www.nlm.nih.gov/medlineplus/languages/angioplasty.html Other topics A-Z A B ...

  17. Focused force angioplasty Theory and application

    SciTech Connect

    Solar, Ronald J.; Ischinger, Thomas A

    2003-03-01

    Focused force angioplasty is a technique in which the forces resulting from inflating an angioplasty balloon in a stenosis are concentrated and focused at one or more locations within the stenosis. While the technique has been shown to be useful in resolving resistant stenoses, its real value may be in minimizing the vascular trauma associated with balloon angioplasty and subsequently improving the outcome.

  18. Laser angioplasty for cardiovascular disease

    NASA Astrophysics Data System (ADS)

    Okada, Masayoshi

    2005-07-01

    Recently, endovascular interventions such as balloon angioplasty, atherectomy and the stenting method, except for conventional surgery have been clinically employed for the patients with atheromatous plaques of the peripheral- and the coronary arteries, because the number of patients with arteriosclerosis is now increasing in the worldwide. Among these procedures, restenoses after endovascular interventions have been remarkably disclosed in 20-40 % of the patients who underwent percutaneous coronary interventions. Thus, there are still some problems in keeping long-term patency by means of endovascular techniques such as balloon angioplasty and atherectomy (1, 2). For reduction of these problems , laser angioplasty using Argon laser was applied experimentally and clinically. Based on excellent experimental studies, laser was employed for 115 patients with stenotic ,or obstructive lesions occluding more thasn 75 % of the peripheral and the coronary arteries angiographycally.

  19. Septic endarteritis following percutaneous transluminal coronary angioplasty.

    PubMed

    Kardaras, F G; Kardara, D F; Rontogiani, D P; Mpourazanis, I A; Flessas, L P

    1995-01-01

    We report a case of bacterial arteritis of the external iliac artery complicated by mycotic aneurysm following coronary angioplasty. To our knowledge, this is the first reported instance of arterial wall infection caused by coronary angioplasty at a distance from the insertion site equal to the length of the sheath. PMID:7728855

  20. [Uncommon indications for coronary angioplasty].

    PubMed

    Vojácek, J; Krupicka, P; Aschermann, M; Holm, F; Humhal, J

    1993-07-01

    During the period between March 16, 1989 and October 7, 1992 at the Second Medical Clinic of the First Medical Faculty, Charles University Prague a total of 173 coronary angioplasties were performed. With expanding experience and greater availability of controllable super thin conductors and balloon catheters with a small profile, gradually the indication criteria of coronary angioplasty were extended. In 93.1% of patients simple balloon dilatation of a significant stenosis of the coronary arteries was performed and in 6.9% before dilatation in addition an attempt of recanalization of a chronic occlusion of the coronary artery was made. In 74% of the patients one coronary stenosis was dilated, in 16.7% several stenoses, in 1.2% of the patients a covered stenosis of the trunk of the left coronary was dilated and in the same number an aortocoronary bypass was performed. Even in the group of patients where only one coronary stenosis was dilated the type B coronary affection according to the classification ACC/AHA predominated and the same applied to the entire group of patients. PMID:8372458

  1. Sleep Apnea Tied to Complications After Angioplasty

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  2. Angioplasty and stent placement - peripheral arteries - discharge

    MedlinePlus

    ... Supplements Videos & Tools Español You Are Here: Home → ... the sharing features on this page, please enable JavaScript. You had procedure that used a balloon catheter to open a narrowed vessel (angioplasty) that ...

  3. Sleep Apnea Tied to Complications After Angioplasty

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_159391.html Sleep Apnea Tied to Complications After Angioplasty Nightly breathing ... 15, 2016 WEDNESDAY, June 15, 2016 (HealthDay News) -- Sleep apnea may increase the risk of serious complications ...

  4. Outpatient angioplasty: 4-year experience in one practice.

    PubMed Central

    Payne, S. P.; Stanton, A.; Travers, P.; Glenn, D.; Hanel, K. C.

    1997-01-01

    Angioplasty is often performed as an inpatient procedure after preliminary angiography. In order to increase efficiency and patient comfort we introduced a policy of performing angioplasty for chronic leg ischaemia as an outpatient whenever possible, using duplex scanning to select suitable lesions. This paper examines the safety and feasibility of this policy over a 4-year period. We prospectively assessed 168 consecutive cases which were planned for outpatient angioplasty from a total of 190 cases undergoing angioplasty and found full agreement between duplex scanning and angiography in 92%. Six patients (4%) developed complications of angioplasty requiring admission and another five were admitted for unexpected organisational reasons. Thus, the complication rate of outpatient angioplasty was 4%. All complications were noted at the time of angioplasty with no unexpected readmissions. Angioplasty for leg ischaemia is feasible and safe to perform as an outpatient using duplex scanning to select appropriate cases. PMID:9326123

  5. Percutaneous angioscopy after excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Nakamura, Fumitaka; Kvasnicka, Jan; Geschwind, Herbert J.; Uchida, Yasumi

    1992-08-01

    Angioscopy has proved to provide more detailed information on lesion morphology before and after interventional procedures than angiography. Therefore, to evaluate the effects of laser angioplasty, angioscopy was performed in five patients with peripheral or coronary vascular disease who underwent excimer laser angioplasty. The excimer laser was operated at 308 nm, 135 nsec, 25 Hz, and 40 - 60 mJ/mm2 and was coupled into multifiber wire-guided catheters of 1.4 to 2.0 mm diameter for coronary lesions and 2.2 mm for peripheral lesions. There were three coronary (one left anterior descending, one circumflex, one right coronary artery) and two peripheral (one common iliac artery, one superficial femoral artery) lesions. Angioscopy was successfully performed before and after laser ablation without any complications in all five lesions. The characteristics of angioscopic findings after excimer laser angioplasty consisted of flaps, fractures of plaques, and abundant tissue remnants. There was no apparent thermal injury. Recanalized channels were small and irregular. These results indicate that (1) angioscopy is effective and safe for evaluation of lesion morphology after laser angioplasty, (2) laser ablation does not result in thermal injury, and (3) irregular channels after recanalization and abundant tissue remnants may explain the suboptimal results after laser angioplasty.

  6. Video-assisted thoracoscopic bronchoplasty/pulmonary arterial angioplasty.

    PubMed

    Xu, Xin; Huang, Jun; Pan, Hui; Chen, Hanzhang; He, Jianxing

    2016-03-01

    Thoracoscopic bronchoplasty combined with pulmonary arterial angioplasty can be particularly challenging. In the past, it was often done by using a conventional incision or hybrid video-assisted small incision. In recent years, anecdotal articles have described the application of thoracoscopic bronchoplasty/pulmonary arterial angioplasty. This chapter will describe the details associated with thoracoscopic bronchoplasty/pulmonary arterial angioplasty. PMID:27076953

  7. Video-assisted thoracoscopic bronchoplasty/pulmonary arterial angioplasty

    PubMed Central

    Xu, Xin; Huang, Jun; Pan, Hui; Chen, Hanzhang

    2016-01-01

    Thoracoscopic bronchoplasty combined with pulmonary arterial angioplasty can be particularly challenging. In the past, it was often done by using a conventional incision or hybrid video-assisted small incision. In recent years, anecdotal articles have described the application of thoracoscopic bronchoplasty/pulmonary arterial angioplasty. This chapter will describe the details associated with thoracoscopic bronchoplasty/pulmonary arterial angioplasty. PMID:27076953

  8. [Subintimal angioplasty and diabetic foot revascularisation].

    PubMed

    Pierret, Charles; Tourtier, Jean-Pierre; Bordier, Lise; Blin, Emmanuel; Duverger, Vincent

    2011-01-01

    Diabetic wounds foot are responsible for 5-10% minor or major amputation in France. In fact, amputation risk of lower limbs is 15-30% higher for diabetic patients. University of Texas classification (UT) is the reference for diabetic foot wound. It distinguish non ischemic and ischemic wound with more amputation. If ischaemia is combined, revascularization may be considered for salvage of the limb. Some revascularization techniques are well known: as surgical by-pass, angioplasty with or without stent, or hybrid procedures with the both. Subintimal angioplasty is a more recent endovascular technique, in assessment for old patients who are believed to be unsuitable candidates for conventional by-pass or angioplasty. PMID:20980123

  9. Tandem balloon catheter for coronary angioplasty.

    PubMed

    Finci, L; Meier, B; Steffenino, G; Rutishauser, W

    1986-01-01

    The Tandem balloon catheter is a triple lumen steerable catheter for coronary angioplasty with two separately inflatable balloons of different diameters. Indications and results of 26 consecutive patients treated with a Tandem balloon catheter are reviewed. Adequate distal pressure measurements were obtained in 71% of the cases. In ten patients, the Tandem balloon catheter was selected for two stenoses in different segments of the same coronary artery. Angioplasty was successful for all lesions in five and for at least the strategic lesions in five patients (in one only after changing to a single-balloon catheter). In the seven patients with stenoses in two different coronary arteries of various calibers, angioplasty was successful for both vessels in three and for one vessel in four patients. In the six patients with a very tight stenosis, where the Tandem balloon catheter was selected to predilate with the small balloon, the procedure was technically successful in all, but there was a myocardial infarction in one patient. In the three patients with a chronic total occlusion, where the stiffness of the Tandem balloon was the reason for selection, one recanalization was successful. The Tandem balloon catheter provides a handy tool for complex coronary angioplasty. It offers comparable ease in manipulation and pressure transmission and may save time, money, and radiation exposure by avoiding catheter exchanges. PMID:2949848

  10. Restenosis After Balloon Angioplasty for Cerebral Vasospasm

    SciTech Connect

    Sedat, J. Chau, Y.; Popolo, M.; Gindre, S.; Rami, L.; Orban, J. C.

    2009-03-15

    Transluminal balloon dilatation for symptomatic vasospasm after subarachnoid hemorrhage is effective, and clinical studies have shown that it achieves long-lasting dilatation of spastic cerebral arteries. Delayed arterial renarrowing has not been reported. Here we report the case of a 58-year-old woman who presented asymptomatic and permanent restenosis after angioplasty for cerebral vasospasm.

  11. Arterio-Ureteric Fistula Following Iliac Angioplasty

    SciTech Connect

    Aarvold, Alexander; Wales, Lucy Papadakos, Nikolaos; Munneke, Graham; Loftus, Ian; Thompson, Matt

    2008-07-15

    Arterio-ureteric fistulae are rare but can be associated with significant morbidity and mortality. We describe a novel case in which an arterio-ureteric fistula occurred as a complication following external iliac artery angioplasty and stenting, in a patient who had undergone previous pelvic surgery, radiotherapy, ureteric stenting, and urinary diversion surgery. Prompt recognition enabled successful endovascular management using a covered stent.

  12. [Coronary angioplasty in elderly patients].

    PubMed

    Liistro, Francesco; Colombo, Antonio

    2002-01-01

    the two different strategies (5-year survival rate: 85.7% for the coronary artery bypass grafting group vs 81.4% for the percutaneous revascularization group) with a clear benefit in favor of surgery only in diabetic patients. The only constant difference is the need of a repeat intervention which is significantly higher for the percutaneous approach. Furthermore, the introduction of newer percutaneous devices suitable for the recanalization of totally occluded coronary arteries could increase the completeness of the revascularization achieved with the percutaneous approach with a positive effect on the long-term outcome. These considerations could be "out of time" if the results obtained with the use of drug-eluting stents observed in selected patient populations will be confirmed in larger trials and in routine clinical practice. Whereas the advantages of the percutaneous versus the surgical approach in the elderly have not been fully clarified in patients with stable or unstable angina, primary angioplasty appears to be a very promising strategy in old patients with acute myocardial infarction. The improved clinical success with percutaneous revascularization in the elderly (acute mortality in patients > 85 years: 28.4% reperfused vs 38.5% not reperfused; p = 0.001) has to be related to the use of stents and to IIb/IIIa antagonists. In conclusion, when an old patient needs myocardial revascularization, the percutaneous approach should, in our opinion, be considered the treatment of choice in subjects either with stable or unstable angina and in those with acute myocardial infarction. At present, surgical revascularization provides better results in diabetic patients. The advent of drug-eluting stents may change many of the current limitations of percutaneous revascularization and further expand the use of this strategy. PMID:11899566

  13. Paget-Schroetter Syndrome Treated with Cutting-Balloon Angioplasty

    SciTech Connect

    Gosling, J.; Nayeemuddin, M.; Cowling, M.; Pherwani, A.; Asquith, J.

    2012-06-15

    Here, a case of Paget-Schroetter Syndrome in a 25-year-old guitar player is reported. After thrombolysis, conventional angioplasty failed to dilate the underlying subclavian stenosis both before and after first-rib excision with scalenus anterior and medius division. For the third attempt at angioplasty, a cutting balloon was used, which immediately produced a good result. Venography at 4-year follow-up showed no restenosis and no functional deficit. This case report demonstrates that cutting-balloon angioplasty may be considered when conventional balloon fails and may have greater durability than conventional balloon angioplasty in the treatment of Paget-Schroetter syndrome.

  14. Paget-Schroetter syndrome treated with cutting-balloon angioplasty.

    PubMed

    Gosling, J; Nayeemuddin, M; Cowling, M; Pherwani, A; Asquith, J

    2012-06-01

    Here, a case of Paget-Schroetter Syndrome in a 25-year-old guitar player is reported. After thrombolysis, conventional angioplasty failed to dilate the underlying subclavian stenosis both before and after first-rib excision with scalenus anterior and medius division. For the third attempt at angioplasty, a cutting balloon was used, which immediately produced a good result. Venography at 4-year follow-up showed no restenosis and no functional deficit. This case report demonstrates that cutting-balloon angioplasty may be considered when conventional balloon fails and may have greater durability than conventional balloon angioplasty in the treatment of Paget-Schroetter syndrome. PMID:21845509

  15. A new catheter system for coronary angioplasty.

    PubMed

    Simpson, J B; Baim, D S; Robert, E W; Harrison, D C

    1982-04-01

    A new catheter system has been designed for percutaneous transluminal coronary angioplasty. An independently movable, flexible-tipped guide wire within the balloon dilation catheter facilitates selection of the involved vessel. This guide wire can be passed slowly and carefully beyond the coronary stenosis, permitting safe advancement of the balloon catheter. After testing in animal and cadaver hearts, this system was used in 53 patients (56 stenoses) with single vessel coronary artery disease, with an overall primary success rate of 64 percent. In the last 41 of these 56 cases, use of a balloon catheter with a smaller deflated diameter increased the success rate to 73 percent. In patients with lesions of the left anterior descending coronary artery, the success rate was 89 percent. Three (6 percent) of the 53 patients had complications during coronary arterial dilation that necessitated emergency coronary arterial bypass graft surgery. There were no procedure-related or late cardiac deaths. During the mean follow-up period of 8 months (range 1 to 21), there were one late death (of noncardiac causes) and no late myocardial infarctions. Clinical status was persistently improved in 31 of the 36 patients who had successful dilation. The remaining five patients experienced restenosis at the angioplasty site and return of angina pectoris within 3 months of dilation. Two of these patients had repeat coronary angioplasty with restoration of asymptomatic status, and three had elective coronary bypass graft surgery. PMID:6461241

  16. Percutaneous transluminal angioplasty of radiation-induced arterial stenoses

    SciTech Connect

    Guthaner, D.F.; Schmitz, L.

    1982-07-01

    A case of atherosclerosis resulting from previous irradiation was successfully treated using percutaneous transluminal angioplasty for recanalization of the vessel. Irradiation may result in extensive perivascular fibrosis around an area of arterial narrowing; percutaneous transluminal angioplasty appears to be the method of choice for treatment of such lesions.

  17. Primary Infrainguinal Subintimal Angioplasty in Diabetic Patients

    SciTech Connect

    Bargellini, Irene Petruzzi, Pasquale; Scatena, Alessia; Cioni, Roberto; Cicorelli, Antonio; Vignali, Claudio; Rizzo, Loredana; Piaggesi, Alberto; Bartolozzi, Carlo

    2008-07-15

    The aim of this study was to prospectively evaluate technical and clinical results of infrainguinal subintimal angioplasty in a series of diabetic patients with limb-threatening ischemia. From July 2003 to December 2007, 60 consecutive diabetic patients (M/F = 41/19; mean age, 69.4 {+-} 9.4 years) with Fontaine stage IV critical limb ischemia, not suitable for surgical recanalization, underwent primary infrainguinal subintimal angioplasty. The technical success, perioperative morbidity and mortality, and clinical success (defined by ulcer healing) were evaluated. Kaplan-Meier life-table analysis was obtained for cumulative clinical success, limb salvage, and survival rates. The procedure was technically successful in 55 of 60 (91.7%) patients; in 5 cases we were not able to achieve a reentry. Periprocedural mortality was 5% (3 patients); three patients (5%) required major amputation periprocedurally. Mean follow-up was 23 months (range, 0-48 months). On an intention-to-treat basis, the limb salvage rate was 93.3% (56/60 patients); ulcer healing was observed in 45 of 60 (75%) patients and it was significantly (p < 0.05) associated with serum creatinine and HbA1c levels, diabetes duration, and infrapopliteal recanalization. One- and three-year cumulative survival rates were 91.5% and 83.1%, respectively; serum creatinine levels, patient age, and clinical success were significant predictors of survival. In conclusion, infrainguinal primary subintimal angioplasty is a safe and effective treatment in diabetic patients with limb-threatening ischemia not suitable for surgical recanalization. This procedure is aimed to create a 'temporary bypass' that facilitates ulcer healing.

  18. Percutaneous transluminal angioplasty: radiological-pathological correlation

    SciTech Connect

    Saffitz, J.E.; Totty, W.G.; McClennan, B.L.; Gilula, L.A.

    1981-12-01

    Radiological and pathological assessment of the degree and extent of arterial injury caused by balloon angioplasty was performed in 20 renal arteries obtained at autopsy. Intact arteries were studied angiographically before and after dilatation and then examined histologically. Both normal and diseased arteries were subjected to varying degrees of dilatation. Damage ranged from minimal inimal disruption to major tears of the muscular media. Equivalent dilatory force created greater damage in the distal (muscular) than in the proximal (elastic) portion of the renal artery. There was no evidence of plaque remodling or compression.

  19. Primary coronary angioplasty in patients with acute myocardial infarction.

    PubMed Central

    Popma, J J; Chuang, Y C; Satler, L F; Kleiber, B; Leon, M B

    1994-01-01

    In some patients with acute myocardial infarction, thrombolytic therapy may be limited by its failure to reperfuse the occluded artery, by recurrent ischemia (despite initially successful reperfusion), and by major hemorrhagic complications. Primary coronary angioplasty may circumvent these limitations. This article reviews the results of primary angioplasty reported in patients with myocardial infarction and makes recommendations for its use. The review includes pertinent articles found in the English language literature from July 1987 to July 1993 on MEDLINE. Nonrandomized series of primary angioplasty in acute myocardial infarction have demonstrated high procedural success rates (86% to 99%) and infrequent recurrent ischemia (4%). Two randomized trials comparing primary angioplasty and thrombolytic therapy have shown that primary angioplasty results in lower mortality, less recurrent ischemia, shorter length of hospital stay, and improved left ventricular function. Two other randomized studies have shown little benefit from primary angioplasty on myocardial salvage, recurrent ischemia, or ventricular function. One major limitation of primary angioplasty is that it requires 24-hour availability of a catheterization laboratory and experienced surgical personnel. Primary angioplasty may be the preferred approach in patients with extensive myocardial infarction who have immediate (< 120 min) access to a cardiac catheterization laboratory with experienced personnel. Patients having 1) contraindications to thrombolytic therapy, 2) cardiogenic shock, 3) prior coronary bypass surgery, or 4) "stuttering" onset of pain may also benefit from primary angioplasty. Poor candidates for this procedure are those with a small myocardial infarction, those in whom undue delays in access to a cardiac catheterization facility would be expected, or those with complex coronary anatomy, including left main coronary artery disease. PMID:8061539

  20. Thermoelastic analysis of high-pressure angioplasty balloons.

    PubMed

    Eaton-Evans, J; Dulieu-Barton, J M; Little, E; Brown, I

    2006-04-01

    Failures in angioplasty balloons are investigated using typical destructive techniques. The material properties of moulded balloons are derived from tensile tests and used to establish the reasons for failure of the balloons. Thermoelastic stress analysis is used to determine the stress distribution in the balloons, and a means of interpreting the data to derive actual stresses is described. The departure from linear elastic behaviour in the angioplasty balloons is identified using thermoelastic analysis. The results from the thermoelastic analysis are discussed and compared with those from the destructive tests, and the thermoelastic technique is shown to be a potential new means for non-destructive analysis of angioplasty balloons. PMID:16808075

  1. Clopidogrel Responsiveness in Patients Undergoing Peripheral Angioplasty

    SciTech Connect

    Pastromas, Georgios Spiliopoulos, Stavros Katsanos, Konstantinos Diamantopoulos, Athanasios Kitrou, Panagiotis Karnabatidis, Dimitrios Siablis, Dimitrios

    2013-12-15

    Purpose: To investigate the incidence and clinical significance of platelet responsiveness in patients receiving clopidogrel after peripheral angioplasty procedures. Materials and Methods: This prospective study included patients receiving antiplatelet therapy with clopidogrel 75 mg after infrainguinal angioplasty or stenting and who presented to our department during routine follow-up. Clopidogrel responsiveness was tested using the VerifyNow P2Y12 Assay. Patients with residual platelet reactivity units (PRU) {>=} 235 were considered as nonresponders (NR group NR), whereas patients with PRU < 235 were considered as normal (responders [group R]). Primary end points were incidence of resistance to clopidogrel and target limb reintervention (TLR)-free survival, whereas secondary end points included limb salvage rates and the identification of any independent predictors influencing clinical outcomes. Results: In total, 113 consecutive patients (mean age 69 {+-} 8 years) with 139 limbs were enrolled. After clopidogrel responsiveness analysis, 61 patients (53.9 %) with 73 limbs (52.5 %) were assigned to group R and 52 patients (46.1 %) with 66 limbs (47.5 %) to group NR. Mean follow-up interval was 27.7 {+-} 22.9 months (range 3-95). Diabetes mellitus, critical limb ischemia, and renal disease were associated with clopidogrel resistance (Fisher's exact test; p < 0.05). According to Kaplan-Meier analysis, TLR-free survival was significantly superior in group R compared with group NR (20.7 vs. 1.9 %, respectively, at 7-year follow-up; p = 0.001), whereas resistance to clopidogrel was identified as the only independent predictor of decreased TLR-free survival (hazard rate 0.536, 95 % confidence interval 0.31-0.90; p = 0.01). Cumulative TLR rate was significantly increased in group NR compared with group R (71.2 % [52 of 73] vs. 31.8 % [21 of 66], respectively; p < 0.001). Limb salvage was similar in both groups. Conclusion: Clopidogrel resistance was related with

  2. Comparison of angioscopic findings between coronary balloon and laser angioplasty

    NASA Astrophysics Data System (ADS)

    Larrazet, Fabrice S.; Dupouy, Patrick J.; Dubois-Rande, Jean Luc; Hirosaka, Akira; Kvasnicka, Jan; Geschwind, Herbert J.

    1994-07-01

    Percutaneous intracoronary angioscopy was used to study the morphological changes occurring in coronary arteries after balloon or laser angioplasty. Angioscopy is thought to provide details on the coronary vessel lumen and the inner wall. Coronary lesion were studied in 44 patients with a 4.5 F Imagecath angioscope before and after each interventional procedure. Balloon and laser angioplasty were performed on 21 (group I) and 23 patients (group II), respectively. There was no difference in age, sex, or angiographic lesion appearance before the procedure between the two groups. Circumferential visualization of the target lesion was successfully completed in 17 group I patients and 19 group II patients. A larger lumen than that observed at control was seen in all 17 dilatation patients and in 13 of the 19 laser patients. Tissue remnants were observed in all balloon and laser patients. Laser irradiation resulted in characteristic sharp edged craters. Dissection was identified in 2 of 19 before versus 9 of 19 patients after balloon angioplasty (p<0.05) and in 0 of 23 before versus 4 of 23 patients after laser angioplasty. Subintimal hemorrhage was observed in 3 of 19 before versus 11 of 19 patients after balloon angioplasty (p<0.05) and in 2 of 23 before versus 4 of 23 patients after laser angioplasty. The frequency of hemorrhage was higher in the post balloon group than in the post laser group (11 of 19 versus 4 of 23, respectively, p<0.02). Angioscopy provides valuable information on lesion morphology after coronary interventions. Balloon dilation results in a high rate of dissection and subintimal hemorrhage. Laser angioplasty is able to ablate obstructing tissue and results in a lower rate of subintimal hemorrhage than balloon dilatation.

  3. Excimer laser coronary angioplasty: relative risk analysis of clinical results

    NASA Astrophysics Data System (ADS)

    Bittl, John A.

    1992-08-01

    Reports of successful use of excimer laser coronary angioplasty for complex coronary artery disease abound, yet firm indications for its use have not been defined. We attempted to treat 858 coronary stenoses in 764 consecutive patients (mean age 61 years; range 32 - 91 years; 75% men; 76% with Class III or IV angina) with excimer laser angioplasty at 308 nm. Successful treatment was achieved in 86% of patients, as indicated by angioplasty, we used relative risk analysis. This showed that certain angiographic features, such as lesions at a vessel bifurcation (odds ratio, OR equals 0.46; 95% confidence interval 0.23, 0.88; P equals 0.017;) or in a tortuous segment (OR equals 0.54; 95% CI equals 0.34, 0.88; P equals 0.041), have decreased likelihood of clinical success. On the other hand, ostial stenoses (OR equals 1.06; 95% CI equals 0.44, 2.56, P equals 0.903) and saphenous vein graft lesions (OR equals 2.17; 95% CI equals 0.98, 4.82; P equals 0.051) have acceptable success rates. Diffuse disease (> 20 mm), total occlusions and calcified lesions were treated as successfully as all other lesion types. Successful treatment with excimer laser coronary angioplasty was also achieved in almost all patients (15/16) who had a prior unsuccessful attempt at balloon angioplasty in the lesion was crossed with a guidewire yet resists either balloon catheter passage or full dilatation. Follow-up angiography was obtained in 70% of eligible patients. Angiographic restenosis, defined by > 50% stenosis, was seen in 60% of patients. Relative risk analysis showed an increased risk of restenosis when adjunctive balloon angioplasty was not used (OR equals 1.68; 95% CI equals 1.02, 2.28; P equals 0.039). Other variables known to affect the outcome of balloon angioplasty, such as lesion length or stenosis in degenerated saphenous vein bypass graft, did not influence the

  4. Intravascular ultrasound imaging following balloon angioplasty.

    PubMed

    Tobis, J M; Mahon, D J; Moriuchi, M; Honye, J; McRae, M

    1991-01-01

    Despite its long history and reliability, contrast angiography has several inherent limitations. Because it is a two-dimensional projection image of the lumen contour, the wall thickness cannot be measured and the plaque itself is not visualized. This results in an underestimation of the amount of atherosclerotic disease by angiography. An assessment of atherosclerosis could be improved by an imaging modality: (1) that has an inherent larger magnification than angiography and (2) that directly visualizes the plaque. Intravascular ultrasound fulfils these criteria. This presentation will provide evidence that intravascular ultrasound may prove complimentary or even superior to angiography as an imaging modality. Intravascular ultrasound demonstrates excellent representations of lumen and plaque morphology of in vitro specimens compared with histology. There is very close intraobserver and interobserver variability of measurements made from intravascular ultrasound images. Phantom studies of stenoses in a tube model demonstrate that angiography can misrepresent the severity of stenosis when the lumen contour is irregular and not a typical ellipse, whereas intravascular ultrasound reproduces the cross-sectional morphology more accurately since it images the artery from within. In vitro studies of the atherosclerotic plaque tissue characteristics compare closely with the echo representation of fibrosis, calcification, and lipid material. In addition, in vitro studies of balloon angioplasty demonstrate that intravascular ultrasound accurately represents the changes in the structure of artery segments following balloon dilatation. PMID:1833473

  5. Mechanical and acoustic analysis in ultrasonic angioplasty

    NASA Astrophysics Data System (ADS)

    Detwiler, Paul W.; Watkins, James F.; Rose, Eric A.; Ratner, A.; Vu, Louis P.; Severinsky, J. Y.; Rosenschein, Uri

    1991-05-01

    The goal of this study was to investigate the relationship between ultrasonic tissue ablation and passive mechanical elasticity. Experience with ultrasonic angioplasty in experimental settings (in-vivo and in-vitro) together with clinical experience in peripheral vascular disease is reported. A model composed exclusively of a hydroxyproline ballistic gelatin matrix showed a negative correlation between material elasticity and the rate of ultrasonic ablation. This model provided a means of studying the effects of collagen content on ablation, exclusive of other biologic components. Ballistic gelatin ablation (mg/sec) was found to increase logarithmically with decreasing protein concentration over the range studied (20.00 to 1.25%). Ablation as a function of gelatin elasticity behaved in a similar manner. Temperature of the material ablated was also demonstrated to affect the rate of ablation. We conclude that the previously reported differences in ablation between thrombi and blood vessel are predictable based on the large difference in their mechanical elasticity, and that this difference provides a wide margin of safety.

  6. Angioplasty and Stenting for Intracranial Stenosis

    PubMed Central

    IZUMI, Takashi; IMAMURA, Hirotoshi; SAKAI, Nobuyuki; MIYACHI, Shigeru

    2014-01-01

    Of the patients enrolled in the Japanese Registry of Neuroendovascular Therapy (JR-NET), a surveillance study in Japanese, 1133 patients who underwent intracranial percutaneous transluminal angioplasty (PTA)/stenting for intracranial stenosis during the period from 2005 to 2009 were investigated. A technical success was achieved in 98.3% of the patients, and 70.5% and 7.5% had a residual stenosis of < 30% and ≥ 50%, respectively. The incidence of ischemic complications and hemorrhagic complications was as low as 7.7% and 2.5%, respectively, but tended to increase in patients who underwent stenting. While a significant correlation with ischemic complications was observed in previously untreated patients and patients who underwent stenting followed by post-dilatation, a significant correlation with hemorrhagic complications was observed in patients who received emergency treatment and those treated between 24 hours and 14 days of the onset. Flexible intracranial stents are expected to contribute to improvement in the treatment outcome. PMID:24390191

  7. Cutting Balloon Angioplasty Versus Standard Balloon Angioplasty for Failing Infra-inguinal Vein Grafts: Comparative Study of Short- and Mid-Term Primary Patency Rates

    SciTech Connect

    Vikram, Raghunandan; Ross, Rose A.; Bhat, Rajesh; Griffiths, Gareth D.; Stonebridge, Peter A.; Houston, J. Graeme; Chakraverty, S.

    2007-07-15

    Purpose. To evaluate the results of a recent change in practice in our institution using cutting balloon angioplasty instead of standard balloon angioplasty as the primary treatment for failing infra-inguinal vein bypass grafts. Methods. In this nonrandomized cohort study with a historical control, failing infra-inguinal vein grafts were identified at duplex surveillance or clinical examination. Patients had confirmatory arteriography and balloon angioplasty at the same attendance. Interventions proximal or distal to the graft itself and prosthetic grafts were not included. Patients were entered into a duplex graft surveillance program. Initial assessment of technical success was duplex or improvement 4-6 weeks after the primary angioplasty. Results. Twenty-seven consecutive patients were treated with standard balloon angioplasty, then 11 consecutive patients were treated with cutting balloon angioplasty. Initial technical success was 74% for the standard balloon versus 82% for the cutting balloon. The primary patency rate at 6 months was 16/26 (62%) for standard balloon angioplasty and 8/10 (80%) for cutting balloon angioplasty (p = 0.44). The primary patency rate at 12 months was 9/25 (36%) for standard balloon angioplasty and 5/10 (50%) for cutting balloon angioplasty (p = 0.47). Conclusion. The use of cutting balloons for primary angioplasty of infra-inguinal vein grafts offers no definite advantage over standard balloon angioplasty in this institution or compared with patency rates after standard balloon angioplasty reported elsewhere. Larger multicenter studies would be required to demonstrate whether there was any real difference between the two techniques.

  8. Early hospital discharge after direct angioplasty for acute myocardial infarction.

    PubMed

    Hanlon, J T; Combs, D T; McLellan, B A; Railsback, L; Haugen, S

    1995-07-01

    To determine the feasibility and safety of early hospital discharge after myocardial infarction, we reviewed a 3-yr experience with direct angioplasty: 204 patients had direct angioplasty with in-hospital mortality of 3.4%. Of these patients, 125 were discharged < 5 days after infarction and 98% of these were available for 30-day follow-up. There was one early death (0.8% mortality), two early readmissions without complications, and three late readmissions. Thus early hospital discharge a mean of 3.4 days after infarction can be achieved in > 60% of patients undergoing direct angioplasty with no significant early complications and excellent 30-day survival (99.2%). PMID:7553817

  9. Aspirin inhibition of platelet deposition at angioplasty sites: demonstration by platelet scintigraphy

    SciTech Connect

    Cuningham, D.A.; Kumar, B.; Siegel, B.A.; Gilula, L.A.; Totty, W.G.; Welch, M.J.

    1984-05-01

    In-111 platelet scintigraphy was used to evaluate the effects of prior aspirin administration on the accumulation of In-111-labeled autologous platelets at sites of arterial injury resulting from iliac, femoral, or popliteal transluminal angioplasty in a nonrandomized study of 17 men. The degree of platelet localization at angioplasty sites was significantly less in nine men who had received aspirin in varying doses within the 4 days before angioplasty than in eight men who had not received aspirin for at least two weeks. The results suggest that aspirin treatment before angioplasty limits the early platelet deposition at the angioplasty site in men.

  10. The case for angioplasty in patients with symptomatic intracranial atherosclerosis.

    PubMed

    McTaggart, Ryan A; Marks, Michael P

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients. PMID:24782816

  11. The Case for Angioplasty in Patients with Symptomatic Intracranial Atherosclerosis

    PubMed Central

    McTaggart, Ryan A.; Marks, Michael P.

    2014-01-01

    Intracranial atherosclerotic disease (ICAD) is likely the most common cause of stroke worldwide and remains highly morbid even with highly monitored medical therapy. Recent results of the SAMMPRIS trial, which randomized patients to stenting plus aggressive medical management versus aggressive medical management alone have shown that additional treatment of intracranial atherosclerotic lesions with the Wingspan stent is inferior to aggressive medical management alone. In light of these results, there has been renewed interest in angioplasty alone to treat symptomatic ICAD. This article will briefly review the natural history of ICAD and discuss the possible future for endovascular treatment of ICAD with primary intracranial angioplasty in appropriately selected patients. PMID:24782816

  12. Applicability of laser to assist coronary balloon angioplasty.

    PubMed

    Lee, G; Chan, M C; Ikeda, R M; Rink, J L; Dukich, J; Peterson, L; Lee, K K; Reis, R L; Mason, D T

    1985-12-01

    Severe atherosclerotic obstructed coronary artery disease (CAD) may preclude passage of a balloon catheter for transluminal coronary angioplasty (TCA). Since lasers have been shown to effectively vaporize CAD plaque, the initial application of laser to effect a lumen large enough to accommodate the angioplasty catheter for further dilatation was explored. Eleven postmortem human CAD segments which did not permit passage of a 1.33 mm shaft diameter angioplasty catheter were studied. Argon laser radiation (14 to 90 J) transmitted via 400 micron core diameter quartz fiber onto the stenotic channel of 0.58 mm created a vaporized lumen of 1.77 mm (mean increase of 1.31 +/- 0.25 mm, p less than 0.001). The laser procedure allowed the balloon angioplasty catheter to be pushed into the stenosis. TCA was then performed (7 atm, 45 seconds) and expanded the channel to 2.12 mm (additional mean increase of 0.38 +/- 0.07 mm, p less than 0.001). In terms of percent luminal narrowing, laser radiation reduced obstruction from 80% to 45% (mean difference of -38.7 +/- 4.6%, p less than 0.001), and TCA caused a further decrease to 37% (mean difference of -9.3 +/- 1.9%, p less than 0.001). Thus, in tight atherosclerotic lesions, the laser may be useful in creating an initial opening enabling the placement of the balloon angioplasty catheter which, in turn, can further dilate the lased stenotic coronary lumen. PMID:2933943

  13. Carotid Artery Stenosis with Acute Ischemic Stroke: Stenting versus Angioplasty

    PubMed Central

    Villwock, Mark R.; Padalino, David J.; Deshaies, Eric M.

    2015-01-01

    Background When a patient with carotid artery stenosis presents emergently with acute ischemic stroke, the optimum treatment plan is not clearly defined. If intervention is warranted, and open surgery is prohibitive, endovascular revascularization may be performed. The use of stents places the patient at additional risk due to their thrombogenic potential. The intent of this study was to compare outcomes following endovascular approaches (angioplasty alone vs. stent) in the setting of acute stroke. Methods We extracted a population from the National Inpatient Sample (2012) and the Nationwide Inpatient Sample (2003–2011) composed of patients with carotid artery stenosis with infarction that were admitted nonelectively and received endovascular revascularization. Patients treated with mechanical thrombectomy or thrombolysis were excluded. Categorical variables were compared between treatment groups with Chi-squared tests. Binary logistic regression was performed to evaluate mortality and iatrogenic stroke while controlling for age, case severity, and comorbidity burden. Results About 6,333 admissions met our criteria. A majority were treated via stenting (89%, n = 5,608). The angioplasty-alone group had significantly higher mortality (9.0% vs. 3.8%, p < 0.001) and iatrogenic stroke rate (3.9% vs. 1.9%, p < 0.001) than the stent group. The adjusted odds ratios of mortality and iatrogenic stroke for patients treated with angioplasty alone were 1.953 (p < 0.001) and 1.451 (p = 0.105), respectively, in comparison to patients treated with carotid stenting. Conclusion Multivariate analysis found the risk of mortality to be elevated following angioplasty alone. This may represent selection bias, but it also may indicate that symptomatic patients with stroke suffer from severe stenosis and unstable plaques that would benefit from stent placement. These results would caution angioplasty alone as an arm of a future randomized trial involving this severely burdened patient

  14. Branchen und Unternehmensbereiche

    NASA Astrophysics Data System (ADS)

    Kramer, Regine

    Dieses Kapitel gibt einen Überblick über die Haupteinsatzgebiete von Mathematikern, Informatikern, Naturwissenschaftlern und Ingenieuren in den wichtigsten Wirtschaftsbranchen und Unternehmensbereichen. Dabei werden ausbildungsnahe Aufgabenbereiche ebenso beschrieben wie eher fachferne Tätigkeiten und neben den klassischen Branchen und Berufsbildern auch neue Tätigkeitsfelder für MINT-Fachkräfte beschrieben.

  15. Spontaneous Coronary Dissection: "Live Flash" Optical Coherence Tomography Guided Angioplasty.

    PubMed

    Bento, Angela Pimenta; Fernandes, Renato Gil Dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  16. 'Transcollateral' Renal Angioplasty for a Completely Occluded Renal Artery

    SciTech Connect

    Chandra, Subash; Chadha, Davinder S. Swamy, Ajay

    2011-02-15

    Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension. A renal angiogram in this patient showed ostial stenosis of the right renal artery, which was filling by way of the collateral artery. Renal angioplasty for chronic total occlusion of right renal artery was successfully performed in a retrograde fashion through a collateral artery, thereby leading to improvement of renal function and blood pressure control.

  17. Laser angioplasty of totally occluded arteries of the limb

    NASA Astrophysics Data System (ADS)

    Szopinski, Piotr; Hara, Marek; Noszczyk, Wojciech

    1996-03-01

    The authors summarize their experience in the use of Nd-YAG laser in chronic occlusion of lower limb arteries. Percutaneous transluminal laser angioplasty (PTLA) with laser-heated metal and sapphire tips were used as an adjuvant to conventional balloon angioplasty. In cases of reocclusions, endovascular stents were implanted. Laser recanalization was performed in 46 arteries (iliac, superficial femoral, and popliteal). Indications for the procedure were: limb salvage, claudication below 100 m, and temporal or rest pain. Initial clinical and hemodynamic improvement was observed in 37 (80%) patients. Four perforations occurred without clinical sequel. The one-year cumulative clinical patency was 27 (58%) of the 46 lesions. PTLA may be appropriate for high-risk patients, who are unsuitable for surgical reconstruction because of the concomitant diseases. The combination of laser recanalization and implantation of vascular stents may be a promising method in the management of limb ischemia.

  18. Spectroscopic feedback in laser lithotripsy and laser angioplasty

    NASA Astrophysics Data System (ADS)

    Jiang, Zhi X.; King, Terence A.; Shah, T.; Watson, Graham M.

    1992-08-01

    The feasibility of new forms of monitoring the fragmentation and ablation process through the plasma feedback signals in laser lithotripsy and laser angioplasty has been investigated. In laser lithotripsy it has been found that shock wave feedback monitoring is not as reliable as the plasma emission feedback monitoring. The plasma emission spectra indicate clearly plasma formation on calculi or calcified plaque, while an audible signal can be observed on targets such as dark tissue, catheter, and blood. This technique was successful in ex-vivo experiments in which calculi were inserted into pigs' ureter and then fragmented. Spectra were obtained in vivo indicating calcium abundance in calculi and the feasibility of real-time stone composition analysis. Ex-vivo gallstone fragmentation was also performed successfully under plasma spectra feedback monitoring. In laser angioplasty, in vitro experiments have shown a discriminative effect at laser pulse energies of 40 mJ or greater. Strong plasma spectra can only be observed from calcified plaque and not from normal artery tissue or fibrous plaque. The threshold for plasma formation on calcified plaque increases in blood compared to that in saline while the spectral structure becomes more specific. This study shows promising prospects for the technique in both laser lithotripsy and laser angioplasty.

  19. Transluminal coronary angioplasty in the treatment of silent ischemia

    SciTech Connect

    Bergin, P.; Myler, R.K.; Shaw, R.E.; Stertzer, S.H.; Clark, D.A.; Ryan, C.; Murphy, M.C.

    1988-01-01

    Fifty-four asymptomatic patients with positive thallium exercise tests underwent coronary angiography followed by coronary angioplasty (PTCA), as the primary therapy for silent ischemia. The procedure was technically successful in 89% of these patients. Emergency bypass graft surgery was necessary in 2 (3.6%) and q-wave myocardial infarction occurred in 1 (1.8%) of these. All fifty-four patients have been followed for a mean of 35 months since angioplasty. Of the 48 patients with initially successful PTCA, 12 had either clinical restenosis (9/14 or 19%) or a new lesion (3/48 or 6%) during follow-up, which required a repeat PTCA. At the longest follow-up, 46 (85%) had been successfully treated with on or more PTCA procedures. Two patients (3.6%) had sustained late q-wave myocardial infarction and two additional patients reported angina pectoris. There were no deaths. Angioplasty as a primary therapy for silent ischemia appears efficacious, with success and restenosis rates comparable to those in the symptomatic population. Event-free survival is improved, compared with natural history data for patients with silent ischemia from other studies. Prudent risk/benefit analysis may help to define subgroups most likely to benefit from this intervention.

  20. Effectiveness of the hugging balloon technique in coronary angioplasty for a heavy, encircling, calcified coronary lesion.

    PubMed

    Ahn, Min Soo; Yoon, Junghan; Lee, Jun Won; Lee, Kyoung Hoon; Kim, Jang Young; Yoo, Byung Su; Lee, Seung Hwan; Choe, Kyung Hoon

    2009-11-01

    We report our experience in coronary angioplasty and intravascular ultrasonography (IVUS) on a heavy, encircling, calcified lesion that was not dilated with the use of a cutting balloon and a non-compliant balloon. The angioplasty was successfully performed with a simple and inexpensive hugging balloon technique. PMID:19997547

  1. Arteriovenous fistula at the site of balloon dilatation complicating femoropopliteal angioplasty

    SciTech Connect

    Malcolm, Paul N.; King, David H.; Crabbe, Ray W.; Taylor, Peter R.; Reidy, John F.

    1997-01-15

    We describe an arteriovenous fistula (AVF) at the site of balloon dilatation immediately after percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery. This occurred during an otherwise uncomplicated angioplasty with a good clinical result. The AVF closed spontaneously within 2 months as monitored by color duplex ultrasound. This uncommon complication of PTA is not widely recognized.

  2. Welt und Wirkungsprinzip

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    1997-05-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ≈ 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ≈ G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten

  3. Primary Angioplasty for the Treatment of Acute ST-Segment Elevated Myocardial Infarction

    PubMed Central

    2004-01-01

    Executive Summary One of the longest running debates in cardiology is about the best reperfusion therapy for patients with evolving acute myocardial infarction (MI). Percutaneous transluminal coronary angioplasty (ANGIOPLASTY) is a surgical treatment to reopen a blocked coronary artery to restore blood flow. It is a type of percutaneous (through-the-skin) coronary intervention (PCI) also known as balloon angioplasty. When performed on patients with acute myocardial infarction, it is called primary angioplasty. Primary angioplasty is an alternative to thrombolysis, clot-dissolving drug therapy, for patients with acute MI associated with ST-segment elevation (STEMI), a change recorded with an electrocardiogram (ECG) during chest pain. This review of the clinical benefits and policy implications of primary angioplasty was requested by the Ontario Health Technology Advisory Committee and prompted by the recent publication of a randomized controlled trial (RCT) in the New England Journal of Medicine (1) that compared referred primary angioplasty with on-site thrombolysis. The Medical Advisory Secretariat reviewed the literature comparing primary angioplasty with thrombolysis and other therapies (pre-hospital thrombolysis and facilitated angioplasty, the latter approach consisting of thrombolysis followed by primary angioplasty irrespective of response to thrombolysis) for acute STEMI. There have been many RCTs and meta-analyses of these RCTs comparing primary angioplasty with thrombolysis and these were the subject of this analysis. Results showed a statistically significant reduction in mortality, reinfarction, and stroke for patients receiving primary angioplasty. Although the individual trials did not show significant improvements in mortality alone, they did show it for the outcomes of nonfatal reinfarction and stroke, and for an end point combining mortality, reinfarction, and stroke. However, researchers have raised concerns about these studies. A main concern

  4. Factors contributing to perforations resulting from laser coronary angioplasty: observations in an intact human postmortem preparation of intraoperative laser coronary angioplasty.

    PubMed

    Isner, J M; Donaldson, R F; Funai, J T; Deckelbaum, L I; Pandian, N G; Clarke, R H; Konstam, M A; Salem, D N; Bernstein, J S

    1985-09-01

    This investigation was designed to assess the potential use of laser coronary angioplasty as an intraoperative adjunct in the surgical treatment of ischemic heart disease. Among 17 postmortem hearts, simulated laser coronary angioplasty was performed at 53 sites with a No. 4F guiding catheter and 240 micron (200 micron core) quartz optical fiber. Perforation complicated laser coronary angioplasty in 33 (62%) of the 53 attempts. Most (n = 29) perforations were thermal; four were purely mechanical. Perforation sites were characterized by extensive calcific deposits (21 of 33 cases [64%] ) and the origin of a side branch (13 of 33 [39%] ). Excessive tortuosity of the extramural coronary artery contributed to arterial perforation in four cases, and precluded attempts to perform laser coronary angioplasty in two other cases. In 19 of the 53 attempts to perform laser coronary angioplasty, a high-frequency two-dimensional echocardiographic probe was used to image the coronary artery during antegrade manipulation of the optical fiber/guiding catheter and laser irradiation of the target arterial stenosis. Although perforation nevertheless occurred in 11 (58%) of 19 sites, only one mechanical perforation resulted; the remaining 10 were thermal. Characteristics of the perforation sites in this group were similar to those noted for the group as a whole. Experience with this model of laser coronary angioplasty indicates that even when access problems associated with percutaneous laser coronary angioplasty are obviated by a simulated intraoperative approach, perforation of the underlying coronary arterial wall continues to represent the "rate-limiting" complication of laser coronary angioplasty. Most perforations occurred in relation to calcific deposits, branch points, and tortuous coronary segments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3161660

  5. Physikunterricht und Kalter Krieg

    NASA Astrophysics Data System (ADS)

    Rieß, Falk; Kremer, Armin

    Die Indienstnahme des Physikunterrichts für militaristische und politische Zwecke ist in Deutschland nichts Neues: Die Wurzeln liegen im Kaiserreich und im Faschismus ("Wehrphysik"), und die Praxis im Kalten Krieg stellt hier nichts Außergewöhnliches, sondern lediglich eine auffällige Kontinuität dar.

  6. Modeling plaque fissuring and dissection during balloon angioplasty intervention.

    PubMed

    Gasser, T Christian; Holzapfel, Gerhard A

    2007-05-01

    Balloon angioplasty intervention is traumatic to arterial tissue. Fracture mechanisms such as plaque fissuring and/or dissection occur and constitute major contributions to the lumen enlargement. However, these types of mechanically-based traumatization of arterial tissue are also contributing factors to both acute procedural complications and chronic restenosis of the treatment site. We propose physical and finite element models, which are generally useable to trace fissuring and/or dissection in atherosclerotic plaques during balloon angioplasty interventions. The arterial wall is described as an anisotropic, heterogeneous, highly deformable, nearly incompressible body, whereas tissue failure is captured by a strong discontinuity kinematics and a novel cohesive zone model. The numerical implementation is based on the partition of unity finite element method and the interface element method. The later is used to link together meshes of the different tissue components. The balloon angioplasty-based failure mechanisms are numerically studied in 3D by means of an atherosclerotic-prone human external iliac artery, with a type V lesion. Image-based 3D geometry is generated and tissue-specific material properties are considered. Numerical results show that in a primary phase the plaque fissures at both shoulders of the fibrous cap and stops at the lamina elastica interna. In a secondary phase, local dissections between the intima and the media develop at the fibrous cap location with the smallest thickness. The predicted results indicate that plaque fissuring and dissection cause localized mechanical trauma, but prevent the main portion of the stenosis from high stress, and hence from continuous tissue damage. PMID:17385047

  7. Resistance to Clopidogrel among Iranian Patients Undergoing Angioplasty Intervention

    PubMed Central

    Haji Aghajani, Mohammad; Kobarfard, Farzad; Safi, Olia; Sheibani, Kourosh; Sistanizad, Mohammad

    2013-01-01

    To study the resistance to standard dosage of clopidogrel among Iranian patients following percutaneous coronary intervention measured by platelet aggregation test. Patients undergoing percutaneous coronary intervention in Imam Hussein Medical center, Tehran, Iran, who were under treatment with aspirin, but had no history of clopidogrel usage, entered the study. Patients received standard dosage of clopidogrel (Plavix®, Sanofi, France, 600 mg loading dose and 75 mg/day afterward). Platelet aggregation was measured using light transmission aggregometer. The response to the drug was categorized as complete resistance (platelet aggregation decreased less than 10%), intermediate resistance (platelet aggregation decreased between 10 to 30%) and complete response (platelet aggregation decreased to 30% or more). All patients were evaluated for major adverse cardio vascular events one month after the angioplasty based on MACE criteria by phone contact. Thirty-one patients with a mean age of 59 ± 13 entered the study. Sixty-five percent of patients showed complete response to clopidogrel (95% CI: 45% to 81%), 22% showed intermediate resistance (95% CI: 10-41%) and 13% showed complete resistance (95% CI: 4-30%). One month after the angioplasty, no major adverse cardiovascular event was recorded. Based on our findings, it seems that there is no major difference between Iranian population and other studies regarding the resistance to clopidogrel. Due to the limited number of participants in our study, further investigations with higher number of patients are recommended to more precisely calculate the percentage of resistance among Iranian patients. PMID:24250685

  8. Three years of clinical experiences on excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Viligiardi, Riccardo; Galiberti, Sandra; Pini, Roberto; Salimbeni, Renzo

    1992-03-01

    We report here the experience of our multidisciplinary group that has been working since 1986 on excimer laser angioplasty. After having selected the excimer laser between the available sources because of the negligible lesions left on the residual tissue, we had the purpose to develop a suitable laser and catheter system. Neglecting here all the preliminary studies, we outline only a typical phenomenon related to the energy delivery and useful for the comprehension of the recanalization process. The energy emitted by every single fiber determines, under a certain threshold, independent recanalized channels in the plaque with residual flaps. At a higher energy level the overposition of the lobes, due to the intrinsic divergence, up to the recanalization in a single large channel. In our opinion this condition is crucial in the design of the catheters to obtain an optical instead of a mechanical recanalization. The biological experimentation conducted during the preliminary tests on human hearts obtained from transplants or cadavers, convinced us that the correct goal to pursue was unique laser angioplasty without the need for further balloon dilation.

  9. Early Results of Retrograde Transpopliteal Angioplasty of Iliofemoral Lesions

    SciTech Connect

    Saha, Saumitra; Gibson, Matthew; Magee, Timothy R.; Galland, Robert B.; Torrie, E. Peter H.

    2001-12-15

    Purpose: To assess whether the retrograde transpopliteal approach is a safe, practical and effective alternative to femoral puncture for percutaneous transluminal angioplasty (PTA).Methods: Forty PTAs in 38 patients were evaluated. Intentional subintimal recanalization was performed in 13 limbs. Ultrasound evaluation of the popliteal fossa was carried out 30 min and 24 hr post procedurally in the first 10 patients to exclude local complications. All patients had a follow-up of at least 6 weeks.Results: The indication for PTA was critical ischemia in seven limbs and disabling claudication in the remainder.Stenoses (single or multiple) were present in 24 and occlusion in 15.The superficial femoral artery (SFA) was the commonest segment affected(36) followed by common femoral artery (CFA) in four and iliac artery in four. Technical success was achieved in 38 of 39 limbs where angioplasty was carried out. In one limb no lesion was found.Immediate complications were distal embolization in two and thrombosis in one. None of these required immediate surgery. There were no puncture site hematomas or popliteal arteriovenous fistulae.Symptomatic patency at 6 weeks was 85%. Further reconstructive surgery was required in three limbs and amputation in two.Conclusion: The transpopliteal approach has a high technical success rate and a low complication rate with a potential to develop into an outpatient procedure. It should be considered for flush SFA occulsions or iliac disease with tandem CFA/SFA disease where the contralateral femoral approach is often technically difficult.

  10. Exploring expectations and needs of patients undergoing angioplasty.

    PubMed

    Aazami, Sanaz; Jaafarpour, Molouk; Mozafari, Mosayeb

    2016-09-01

    This study aimed to explore needs and expectations of Iranian patients who undergone angioplasty procedures. Coronary artery disease is the leading cause of morbidity and mortality worldwide. Recently, Percutaneous Coronary Intervention (PCI) has frequently been used as a substitute for coronary artery surgery, representing a less invasive and more cost-effective procedure. However, little information is known about the experiences and needs of patients undergone PCI. This research involved a qualitative study that employed the content analysis method. A semi-structured in-depth interview protocol was carried out using a face-to-face approach. Researchers reached to theoretical saturation by interviewing 18 patients who undergone angioplasty. Constant comparison analysis was used with simultaneous data collection. Three themes emerged from this study including Uncertainty, Procedural knowledge and Social Support. The findings from this study enhance our understanding on expectations and needs of patients who undergone PCI. These findings help nurses and health-care providers to develop and provide pre and post-procedural care according to each individual needs and experiences. This Iranian study not only contributes to other international study but also, emphasizes on the need for pre-procedural awareness and post-procedural support of patients who undergone PCI. PMID:27568316

  11. The Role of Coagulation and Inflammation After Angioplasty in Patients with Peripheral Arterial Disease

    SciTech Connect

    Wahlgren, C.M. Sten-Linder, M.; Egberg, N.; Kalin, B.; Blohme, L.; Swedenborg, J.

    2006-08-15

    Purpose. Restenosis remains a frequent complication after angioplasty in peripheral arterial disease. Inflammation plays a critical role in the vascular response to injury. Effective medical treatment to improve patency after angioplasty is still elusive. The aims of this prospective clinical study were to investigate changes in blood coagulation and inflammatory markers after angioplasty and their significance for restenosis. Methods. Thirty-four patients with peripheral arterial disease underwent angioplasty of the iliac and superficial femoral arteries. Ten patients undergoing diagnostic angiography were included in the study as controls. Plasma levels of tissue factor, prothrombin fragment 1 + 2, D-dimer, P-selectin, C-reactive protein (CRP), and fibrinogen were analyzed before and after angioplasty. Patients were followed up with angiography after 6 months to assess restenosis. Results. CRP was elevated the day after angioplasty (6.6 mg/l, p = 0.0001) and tended to peak after 1 week (11 mg/l, p = 0.09). There was a significant increase of D-dimer and P-selectin 1-4 hr after angioplasty (0.4 mg/l, p = 0.001 and 68 ng/ml, p = 0.05, respectively). None of the biochemical markers was a statistically significant predictor of restenosis. Conclusion. We have observed a much more prolonged inflammatory response than previously noted, but only minor changes in coagulation activity after angioplasty. The biochemical markers, before and after angioplasty, were not related to restenosis. Further studies are needed to delineate the molecular mechanisms behind these observations and their involvement in thrombosis and restenosis. If these pathways are further defined, improved treatment strategies, including antithrombotic treatments and statins, could be tailored to modulate postprocedural inflammation.

  12. Digital coronary roadmapping as an aid for performing coronary angioplasty.

    PubMed

    Tobis, J; Johnston, W D; Montelli, S; Henderson, E; Roeck, W; Bauer, B; Nalcioglu, O; Henry, W

    1985-08-01

    In an attempt to improve visualization of the position of the guidewire and dilatation balloon during coronary angioplasty, a method was developed called digital coronary roadmapping. With this method a digitally acquired coronary angiogram is interlaced with the live fluoroscopic image of the guidewire and balloon catheter. The digital coronary angiogram is superimposed at the same magnification and radiologic projection as the live fluoroscopic image onto the video monitor above the catheterization table. The digital roadmap image thus provides immediate feedback to the angiographer to assist in directing the guidewire into the appropriate coronary artery branch and to help in placement of the balloon so that it straddles the site of stenosis. PMID:3161319

  13. More accurate assessment of stenotic lesions in percutaneous transluminal angioplasty.

    PubMed

    Janevski, B K; Breslau, P J; Jorning, P J

    1986-01-01

    Eighty patients underwent percutaneous transluminal dilatation and recanalisation of atheromatous lesions of the arteries of the lower extremities in the University Hospital of Maastricht in the period of 1980 to 1984. Out of 80 attempted procedures of the iliac and femoro-popliteal tract 71 (89%) were technically possible and were considered initially successful. In all cases of iliac artery lesions a retrograde arteriogram was performed prior to PTA. Intra-arterial pressure measurements at rest and after hyperemia were used for exact assessment of the hemodynamic significance of the stenosis before and after PTA. A follow-up of all patients successfully treated by angioplasty was performed. The early hemodynamic success rate of PTA for iliac lesions was 90 per cent and for femoral-popliteal segment 83 per cent. There was no morbidity or mortality. The cumulative 3-year patency rate for both segments was 74 per cent. PMID:2943842

  14. Geoinformation und Staat

    NASA Astrophysics Data System (ADS)

    Zypries, Brigitte

    2002-09-01

    Geoinformationen besaßen als Grundlage militärischer Interventionen schon immer einen hohen Stellenwert für den Staat. Im Zeitalter der modernen Informations- und Kommunikationstechnologien wächst in demokratischen Staaten die Bedeutung von Geodaten weit über den Verteidigungsbereich hinaus. Brigitte Zypries, Staatssekretärin im Bundesministerium des Innern (BMI) und Vorsitzende des Interministeriellen Ausschusses für Geoinformationswesen (IMAGI), sprach mit Dipl.-Geogr. Ute C. Bauerüber die Anwendung und Koordinierung von Geodaten in Politik und Staat.

  15. Roboter und Zuckerstangen

    NASA Astrophysics Data System (ADS)

    Siebert, Heike

    Bei Produktion und Logistik denkt man sofort an Fabriken, Lagerhallen und Gabelstapler und nicht unbedingt an Zellbiologie. Sieht man etwas genauer hin erscheint dieser Gedankensprung jedoch gar nicht mehr so unpassend. In einer lebenden Zelle laufen eine Vielzahl von Produktions-, Transport- und Regulationsprozessen ab. Soll etwa ein gerade verfügbarer Rohstoff abgebaut werden, muss vielleicht ein Signal ein Gen erreichen, das ein geeignetes Enzym kodiert. Die Aktivierung des Gens führt über mehrere Zwischenstationen zur Produktion des Enzyms, das schließlich noch dahin gelangen muss, wo es gebraucht wird. Ist der Bedarf gedeckt, muss wiederum die Enzymproduktion eingestellt werden.

  16. Sternbilder und ihre Mythen

    NASA Astrophysics Data System (ADS)

    Fasching, Gerhard

    Die Sternbilder, die seit alters her die Menschen in ihren Bann gezogen haben, und die damit verbundenen Mythen werden in zweifacher Weise vorgestellt. Erstens ist es die Absicht, dem Leser zu helfen, sich am Sternenhimmel zurechtzufinden, und zweitens will es ihm die Vielfalt der Bilder vermitteln, die damit verbunden sind. Am Anfang des Buches stehen die prächtigen Erzählungen aus Ovids Metamorphosen. Dann ist vom Sternenhimmel im Jahreskreis die Rede, um den Leser anzuregen, diesen fast unendlichen Bilderreichtum sich selbst durch eigene Beobachtungen zu erschließen. Ein umfangreicher Abschnitt behandelt die einzelnen Sternbilder und das hierzu überlieferte Wissen. Sternkarten und alte Kupferstiche aus dem Bestand der Österreichischen Nationalbibliothek zeigen, wie man sich in früheren Jahrhunderten den Sternenhimmel vorgestellt hat. Sternsagen und Mythen werden erzählt und auch das ptolemäische und das kopernikanische Weltsystem werden einander gegenübergestellt. Ausführliche Sachverzeichnisse mit über 3000 Suchbegriffen erleichtern den Zugang zu Stern- und Sternbildnamen und zur Mythologie.

  17. Integument und Anhangsorgane

    NASA Astrophysics Data System (ADS)

    Schliemann, Harald

    Das Integument umhüllt den Wirbeltierkörper lückenlos. In der embryonalen Mundbucht (Stomodaeum) und der Afterbucht (Proctodaeum) grenzt es an die Auskleidung des Darmrohres. Über die generelle Bedeutung einer Haut als Abgrenzung zwischen Körperinnenraum und Außenmedium hinaus hat es bei Schädeltieren ein breites Spektrum von Funktionen. Die wichtigsten sind: Mechanischer Schutz durch Verhornungen und Verknöch erungen; Wundheilung; Schutz vor Wasserverlust; Schutz vor Infektionen durch bakterizide Drüsensekrete und immunkompetente Zellen; Schutz vor kurzwelliger Strahlung durch Pigmente; Schutz vor Überwärmung durch Schweißdrüsensekrete und Schutz vor Wärmeverlust durch Federn und Haare; Ausbildung lokomotorisch wichtiger Strukturen wie Federn, Flug- und Schwimmhäute, Krallen und Hufe; Redukt ion des Strömungswiderstandes durch Dämpfungshaut; Abgabe von Sekreten zur Ernährung (Milch); Ausbildung von Strukturen zu Nahrungserwerb und_-bearbeitung, z. B. Zähne, Barten;

  18. Long term outcome and cost-effectiveness of stenting versus balloon angioplasty for acute myocardial infarction

    PubMed Central

    Suryapranata, H; Ottervanger, J; Nibbering, E; van't, H; Hoorntje, J; de Boer, M J; Al, M; Zijlstra, F

    2001-01-01

    OBJECTIVE—To investigate the long term clinical outcome and cost-effectiveness of stenting compared with balloon angioplasty in patients with acute myocardial infarction.
METHODS—Patients with acute myocardial infarction were randomly allocated to primary stenting (112) or balloon angioplasty (115). The primary end point was the cumulative first event rate of death, non-fatal reinfarction, or target vessel revascularisation. Secondary end points were restenosis at six months and the cost-effectiveness at follow up.
RESULTS—After 24 months, the combined clinical end point of death/reinfarction was 4% after stenting and 11% after balloon angioplasty (p = 0.04). Subsequent target vessel revascularisation was necessary in 15 patients (13%) after stenting and in 39 (34%) after balloon angioplasty (p < 0.001). The cumulative cardiac event-free survival rate was also higher after stenting (84% v 62%, p < 0.001). The angiographic restenosis rate after stenting was less than after balloon angioplasty (12% v 34%, p < 0.001). Despite the higher initial costs of stenting (Dfl 21 484 v Dfl 18 625, p < 0.001), the cumulative costs at 24 months were comparable with those of balloon angioplasty (Dfl 31 423 v Dfl 32 933, p = 0.83).
CONCLUSIONS—Compared with balloon angioplasty, primary stenting for acute myocardial infarction results in a better long term clinical outcome without increased cost.


Keywords: stenting; angioplasty; myocardial infarction; cost-benefit analysis PMID:11359749

  19. Nd:YAG iliac and femoropopliteal laser angioplasty: results with large probes as "sole therapy".

    PubMed

    Rosenthal, D; Wheeler, W G; Seagraves, A; Erdoes, L; Lamis, P A; Jones, M; Clark, M D; Pallos, L L

    1991-01-01

    Laser assisted balloon angioplasty with a laser heated metallic capped fiberoptic catheter may be effective in the treatment of femoral and iliac artery occlusive disease. In order to avoid the inherent trauma of balloon angioplasty, yet at the same time "debulk" atheroma, 75 patients underwent laser angioplasty of the superficial femoral and iliac arteries as "sole therapy". Laser angioplasty was performed using an Nd:YAG laser coupled to a 600 micron fiber and a 3.5 mm probe (22-28 watts), 4.2 mm or 5.0 probe (32-40 watts). Fifty-nine patients had laser angioplasty for claudication and 16 for limb salvage. The initial angiographic success rate was 84% (41/49) (lesion length 2-14 cm) for the superficial femoral and 69% (18/26) (lesion length 2-14 cm) for the iliac arteries. In follow-up extending to 21 months (mean 14.4 months) 73% (30/41) of the superficial femoral artery and 76% (14/18) of the initially recanalized iliac arteries remain patent. When initial failures are included, this represents an overall intermediate-term patency rate of 52% (32/49) for superficial femoral and 49% (14/26) for iliac arteries respectively. By avoiding the disruptive effect on the arterial wall architecture caused by balloon angioplasty, while at the same time ablating and vaporizing more atheromatous material with larger laser probes, the long-term patency rates of laser angioplasty as "sole therapy" may prove to be superior to those of laser assisted balloon angioplasty. PMID:2019619

  20. Results of coronary surgery after failed elective coronary angioplasty in patients with prior coronary surgery.

    PubMed

    Weintraub, W S; Cohen, C L; Curling, P E; Jones, E L; Craver, J M; Guyton, R; King, S B; Douglas, J S

    1990-11-01

    The results of coronary artery bypass surgery after failed elective coronary angioplasty in patients who have undergone prior coronary surgery are unknown. Coronary angioplasty may be performed to relieve angina after surgery either to the native coronary vessels or to grafts. Failure of attempted coronary angioplasty may mandate repeat coronary surgery, often in the setting of acute ischemia. From 1980 to 1989, 1,263 patients with prior coronary bypass surgery underwent angioplasty; of these patients, 46 (3.6%) underwent reoperation for failed angioplasty during the same hospital stay. Of the 46 patients who underwent reoperation, 33 had and 13 did not have acute ischemia. In the group with ischemia, 3 patients (9.1%) died and 14 (42.4%) died or had a Q wave myocardial infarction in the hospital compared with no deaths (p = NS) and no deaths or Q wave myocardial infarction (p = 0.005) in the group without ischemia. At 3 years, the actuarial survival rate was 88 +/- 6% in the group with ischemia, whereas there were no deaths in the group without ischemia (p = NS), and freedom from death or myocardial infarction was 51 +/- 10% in the group with ischemia, versus no events in the group without ischemia (p = 0.006). In most patients with prior coronary bypass surgery, coronary angioplasty was performed without the need for repeat coronary bypass surgery. Should coronary angioplasty fail, reoperation in patients without acute ischemia can be performed with overall patient survival comparable to that of elective reoperative coronary bypass without coronary angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2229784

  1. Subintimal Angioplasty for Peripheral Arterial Occlusive Disease: A Systematic Review

    SciTech Connect

    Met, Rosemarie Lienden, Krijn P. Van; Koelemay, Mark J. W.; Bipat, Shandra; Legemate, Dink A.; Reekers, Jim A.

    2008-07-15

    The objective of this study was to summarize outcomes of subintimal angioplasty (SA) for peripheral arterial occlusive disease. The Cochrane Library, Medline and Embase databases were searched to perform a systematic review of the literature from 1966 through May 2007 on outcomes of SA for peripheral arterial occlusive disease of the infrainguinal vessels. The keywords 'percutaneous intentional extraluminal revascularization,' 'subintimal angioplasty,' 'peripheral arterial disease,' 'femoral artery,' 'popliteal artery,' and 'tibial artery' were used. Assessment of study quality was done using a form based on a checklist of the Dutch Cochrane Centre. The recorded outcomes were technical and clinical success, primary (assisted) patency, limb salvage, complications, and survival, in relation to the clinical grade of disease (intermittent claudication or critical limb ischemia [CLI] or mixed) and location of lesion (femoropopliteal, crural, or mixed). Twenty-three cohort studies including a total of 1549 patients (range, 27 to 148) were included in this review. Methodological and reporting quality were moderate, e.g., there was selection bias and reporting was not done according to the reporting standards. These and significant clinical heterogeneity obstructed a meta-analysis. Reports about length of the lesion and TASC classification were too various to summarize or were not mentioned at all. The technical success rates varied between 80% and 90%, with lower rates for crural lesions compared with femoral lesions. Complication rates ranged between 8% and 17% and most complications were minor. After 1 year, clinical success was between 50% and 70%, primary patency was around 50% and limb salvage varied from 80% to 90%. In conclusion, taking into account the methodological shortcomings of the included studies, SA can play an important role in the treatment of peripheral arterial disease, especially in the case of critical limb ischemia. Despite the moderate patency

  2. Overview Of Angioplasty: Need For Imaging And Sensing

    NASA Astrophysics Data System (ADS)

    Borst, Cornelius; Rienks, Rienk; Verdaasdonk, Rudolph M.

    1989-08-01

    Balloon angioplasty is a well established non-surgical treatment of ischemic vascular disease. Balloon dilatation increases the lumen in a stenosed artery by overstretching the wall and fracturing the atherosclerotic plaque. Fluoroscopy is adequate to guide the proper placement of guide wire and balloon catheter. Fluoroscopy largely fails, however, when a different recanalization strategy is choosen to address the major problems associated with balloon dilatation. In the past few years, more than twenty different recanalization catheters have been developed that physically remove obstructing plaque. In the femoral artery, both mechanical and thermal methods appear to be quite successful in traversing total occlusions in spite of 'blind' guidance by fluoroscopy. However, subsequent balloon dilatation is often needed. The femoral artery is large and runs a fairly straight course. Perforation of the femoral artery is a minor complication. In the coronary arteries, in contrast, the novel angioplasty methods have met with variable success. These arteries are small, tortuous and move continuously. The anatomy and composition of the plaque is complex and the remainder of the diseased wall may be thin. In the coronary arteries, the margin between recanalization and perforation is small. The latter is a potentially fatal complication. Thus, there is a great need for a catheter that is capable of high resolution imaging and tissue identification in obstructed arteries of small caliber. Intra-arterial echo imaging, possibly combined with laser fluorescence spectroscopy, seems a promising approach. The design of a catheter that combines these powerful diagnostic features with steerability, flexibility and controlled ablation is now the major engineering challenge in interventional cardiology.

  3. Endovascular Stenting for Unsuccessful Angioplasty of the Aorta in Aortoarteritis

    SciTech Connect

    Tyagi, Sanjay; Kaul, Upkar A.; Arora, Ramesh

    1999-11-15

    Purpose: The efficacy and safety of endovascular stent implantation to correct dissection or a suboptimal result after percutaneous transluminal angioplasty (PTA) was evaluated in patients suffering from aortic stenosis due to aortoarteritis. Methods: Twelve children and young adults [aged (mean {+-} SD) 18.2 {+-} 8.7 years] underwent stent implantation after PTA of the aorta, seven for obstructive dissection, four for ineffective balloon dilatation, and one for recurrent restenosis. Nine patients underwent implantation of self-expandable stents and three received balloon-expandable Palmaz stents. Results: Stent implantation could be successfully performed in all 12 patients. After stent implantation, the peak systolic pressure gradient decreased from 91 {+-} 33.5 mmHg to 12.4 {+-} 12.5 mmHg (p < 0.001). The diameter of the stenosed segment increased from 4.6 {+-} 0.8 mm to 11.1 {+-} 1.9 mm (p < 0.001). The dissection was completely covered in all seven patients with dissection. Except for epigastric pain with vomiting in one patient, there was no complication. On follow-up, over 12-57 months (mean 26.8 {+-} 10.8 months), 11 patients (91.6%) had marked improvement in their blood pressure. Patients with congestive heart failure and claudication also showed improvement. Repeat catheterization in five patients, between 6-30 months (mean 16.8 {+-} 9.1 months) after stent implantation, showed sustained improvement in four and a fusiform, long segment, intrastent restenosis after 30 months in one child. The stenosis was safely redilated. Conclusion: Endovascular aortic stent implantation is safe and provides good immediate relief in patients with unsatisfactory results after balloon angioplasty. Improvement is sustained in most patients on intermediate-term follow-up.

  4. Balloon valvuloplasty and angioplasty in congenital heart disease.

    PubMed Central

    Miller, G A

    1985-01-01

    Balloon dilatation valvuloplasty was performed in 16 patients with pulmonary valve stenosis aged 10 days to 17 years. Gradients were reduced in all but two patients and were less than or equal to 20 mm Hg after the procedure in all but these two and one other. Unsatisfactory initial results in these three patients were attributed to the use of too small a balloon in one patient (gradient subsequently abolished at repeat valvuloplasty), to a dysplastic valve in a neonate, and to the fact that there had been a previous surgical valvotomy with scar tissue formation in one patient. The good result was retained in six of seven patients followed up at three to six months. In one the gradient, having been reduced from 60 to 18 mm Hg, had risen to 35 mm Hg. Repeat valvuloplasty was technically impossible in this patient, but in two others residual gradients of 24 and 22 mm Hg were reduced to 4 and 8 mm Hg respectively by repeat valvuloplasty. Balloon dilatation angioplasty was successful in dilating a severe stenosis at the lower limb of an atrial baffle (previous correction of complete transposition) and in dilating supravalvar stenosis of the pulmonary artery resulting from previous banding and debanding. Thus balloon pulmonary valvuloplasty, though still a new technique, appears to be the treatment of choice in patients with typical pulmonary stenosis and thin mobile valves. Patients with dysplastic valves may be less suitable candidates for the procedure. Balloon angioplasty is likely to have other applications, including the treatment of postoperative stenotic lesions. Images PMID:2931093

  5. [Role of laser angioplasty in the management of peripheral arteriopathies. Report of 79 cases].

    PubMed

    Henry, M; Beron, R; Chastel, A; Voiriot, P

    1990-01-01

    From May 1988 to November 1989, 79 of the 341 patients admitted to our center requiring angioplasty for peripheral artery disease were treated by laser angioplasty (LA) associated with secondary dilatation. Laser angioplasty was performed with and Nd-YAG laser coupled by an optical fiber to 1.8, 2.2 and 3 mm sapphires. The population studied included 64 men and 15 women (mean age: 66 years). Functional outcome before LA was class II in 85% of cases (n = 67) and class III and IV respectively in 10 (13%) and 2 patients. Laser angioplasty was the primary indication in 61 patients (77%) with a femoropopliteal (n = 53), iliac (n = 7) or axillary (n = 1) arterial obstruction. Laser angioplasty was the secondary indication in stenoses which could not be negotiated by a guide or balloon (23%; n = 18). Laser angioplasty led to repermeabilization of arterial occlusions in 82% of cases. The best results were obtained for short occlusions of less than 3 cm (n = 5; 100%) and for femoropopliteal lesions (n = 60; 85%). Stenoses were revascularized in all cases. Complementary dilatation was performed at the same time in all revascularized patients. Forty-seven revascularized patients were followed up 3 to 6 months after LA. Results were good in 36 cases (77%); restenosis occurred in 7 cases (15%); and reocclusion in 4 cases (8%). It was possible to treat all restenoses percutaneously (dilatation: n = 5; extruder: n = 1; stent: n = 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2286812

  6. Angioplasty or Primary Stenting for Infrapopliteal Lesions: Results of a Prospective Randomized Trial

    SciTech Connect

    Randon, C. Jacobs, B.; De Ryck, F.; Vermassen, F.

    2010-04-15

    Excellent results with small stents in coronary arteries have led endovascular therapists to their use in infrapopliteal vessels. However, to date no level I evidence exists to recommend primary stenting over infrapopliteal angioplasty alone. The aim of this randomized single-center trial was to compare their 1-year outcome. A total of 38 limbs in 35 patients with critical limb ischemia were randomized to angioplasty (22 pts) or primary stenting (16 pts). Target lesions were infrapopliteal occluded (36) or stenotic (20) lesions ranging from <2 to >15 cm in length. The mean age was 72 years. At 12 months, there was no statistical difference in survival (angioplasty, 69.3%; primary stenting, 74.7%), in limb salvage (angioplasty, 90%; primary stenting, 91.7%), or in primary and secondary patency (angioplasty, 66 and 79.5%; primary stenting, 56 and 64%) between the groups Renal insufficiency was the only significant negative predicting factor for limb salvage in both groups. In conclusion, the 1-year results for both groups were broadly similar. Stenting has its place in infrapopliteal angioplasty if the procedure is jeopardized by a dissection or recoil, but our results do not support primary stenting in all cases.

  7. Clinical significance of perfusion defects by thallium-201 single photon emission tomography following oral dipyridamole early after coronary angioplasty

    SciTech Connect

    Jain, A.; Mahmarian, J.J.; Borges-Neto, S.; Johnston, D.L.; Cashion, W.R.; Lewis, J.M.; Raizner, A.E.; Verani, M.S.

    1988-05-01

    The clinical significance of myocardial perfusion defects present early after angiographically successful percutaneous transluminal coronary angioplasty was assessed in 53 patients using thallium-201 single photon emission computed tomography combined with pharmacologic vasodilation induced by a large dose (300 mg) of orally administered dipyridamole. Myocardial tomographic images were obtained at a mean of 20 +/- 6 h (SD) before and 2.9 +/- 2.7 days after angioplasty. Before angioplasty, 15 (28%) of the 53 patients developed angina after dipyridamole administration, in contrast to only 3 (7.5%) of 40 patients after angioplasty (p less than 0.001). The mean percent luminal area stenosis decreased from 93 +/- 6% before angioplasty to 34 +/- 17% after angioplasty (p less than 0.001). Myocardial perfusion defects, present in 49 (93%) of the 53 patients before angioplasty, were reversible in 44 patients (83%), all of whom underwent dilation of arteries supplying the ischemic areas. After angioplasty, 26 (65%) of 40 patients had no ischemic defects, whereas 14 (35%) of the patients still had an ischemic defect in the vascular territory of the dilated artery. After a mean follow-up period of 21.7 months, 13 (33%) of 39 patients developed restenosis, 10 of whom had an ischemic defect early after angioplasty. Restenosis developed in 10 (71%) of 14 patients with an ischemic defect after angioplasty, but in only 3 (11.5%) of the patients without an ischemic defect (p = 0.007). In conclusion, thallium-201 tomography after oral dipyridamole affords convenient assessment of the physiologic significance of coronary stenosis present before angioplasty and the residual stenosis after angioplasty.

  8. Katzenaugen und Sternsteine: Spielwiese

    NASA Astrophysics Data System (ADS)

    Ucke, Christian; Schlichting, Hans-Joachim

    2004-07-01

    Edelsteine vom Typ Chrysoberyll sind auch unter der Kurzbezeichnung Katzenauge bekannt. Im Chrysoberyll eingelagert sind feine, parallel angeordnete, metallisch glänzende Nadeln aus Rutil (Titandioxid). Auch Hohlkanäle und Risse durchziehen das Material. Lichtreflexion an diesen Einlagerungen und Kanälen erklärt das Lichtband, das dem Stein zu seinem Namen verhalf.

  9. Falten und fliegen: Papierflieger und ihre Physik

    NASA Astrophysics Data System (ADS)

    Gruber, Werner

    2004-09-01

    Mit Papierfliegern können wichtige Eigenschaften der Aerodynamik anschaulich vermittelt werden: ein Blatt Papier, ein paar Faltungen und schon kann man experimentieren. Allerdings sind beim Trimmen des Fliegers einige Punkte zu beachten. Besonders wichtig ist die Y-Stellung der Flügel, die ihm Flugstabilität verleiht. Ist der Flieger fertig, dann gilt es, die dem Modell am besten angepasste Wurftechnik herauszufinden. Dazu variiert man Wurfgeschwindigkeit und Abwurfwinkel. Den Boden kann ein Papierflieger auf vier prinzipiell verschiedenen Flugkurven erreichen: Optimal ist die Gerade, dann fliegt er am weitesten.

  10. A Model of Primary Atherosclerosis and Post-Angioplasty Restenosis in Mice

    PubMed Central

    Leidenfrost, Jeremy E.; Khan, M. Faisal; Boc, Kenneth P.; Villa, Brian R.; Collins, Emily T.; Parks, William C.; Abendschein, Dana R.; Choi, Eric T.

    2003-01-01

    Although mice deficient in various genes are providing greater insight into the mechanisms of restenosis after angioplasty, there have been limitations with murine models not simulating human vascular disease. To develop a more clinically applicable model of primary atherosclerosis and restenosis following angioplasty of the primary lesion, we fed apolipoprotein E-deficient mice a Western diet and occluded the left common carotid artery for 2 days. Three weeks after flow was restored, the temporarily occluded carotids demonstrated atherosclerotic lesions containing foam cells, cholesterol clefts, necrotic cores, and fibrous capsules. The atherosclerotic carotids in other animals underwent angioplasty with a beaded probe, resulting in plaque and medial layer disruption. Three weeks after angioplasty, although there was significant neointimal lesion formation, the luminal narrowing did not change significantly secondary to overall vessel enlargement (positive remodeling). Neointimal lesions were composed of smooth-muscle cells and extracellular matrix observed adjacent to the original atherosclerotic plaques. Similarly, even at 3 months after the angioplasty the lumen was maintained despite greater neointimal lesion formation caused by progressive positive remodeling. This new murine model of primary atherosclerosis and postangioplasty intimal hyperplasia and remodeling mimics the human disease pattern of postangioplasty intimal hyperplasia. Used in transgenic animals, this model will likely facilitate understanding of the mechanisms of restenosis in humans. PMID:12875996

  11. Use of Reactor-Produced Radioisotopes for Prevention Restenosis After Angioplasty

    SciTech Connect

    Knapp, F.F.; Pipes, D.W.

    1999-12-21

    Coronary heart disease leads to myocardial infarction and is a major cause of death in the US. Myocardial infarctions result from atherosclerotic plaque deposits in the coronary arteries, reducing blood flow through these arteries which supply oxygen and nutrients to the heart muscle. The two major approaches for restoring adequate blood flow are coronary bypass graft surgery and coronary angioplasty. Angioplasty is a routinely used clinical procedure, where a deflated balloon attached to the end of a long catheter is inserted into an artery in the leg and then advanced through the aorta into the blocked regions of the coronary arteries. After positioning in the occluded region of the artery, the balloon is inflated with a pressurized saline solution which opens the artery restoring blood flow by pressing the atherosclerotic plaque into the vessel wall. Angioplasty is a widely performed procedure with the coronary arteries and is a much less expensive alternative to coronary bypass surgery. The best patients for angioplasty are those with single occlusions and this method is preferred over bypass grafting because of the significantly reduced expense. The reformation of plaque deposits in arteries (restenosis) following angioplasty, however, is a major clinical problem encountered in as high as 40 percent of patients. Because reduction of health care costs is a major national priority, development of effective new preventative methods for restenoses is an important national priority.

  12. Clinical Outcomes of Infrapopliteal Angioplasty in Patients With Critical Limb Ischemia

    PubMed Central

    Ryu, Hyeon Min; Kim, Jung-Sun; Ko, Young Guk; Hong, Myeong-Ki; Jang, Yangsoo

    2012-01-01

    Background and Objectives With recent advances in equipment and techniques, infrapopliteal angioplasty has shown results that are comparable to those of surgical bypass in patients with critical limb ischemia (CLI). In this study, we evaluated the efficacy and the feasibility of infrapopliteal angioplasty in patients with CLI. Subjects and Methods Between March 2002 and May 2008, infrapopliteal angioplasty was performed on 118 limbs of 101 patients (79 males; mean age 66 years) with CLI (Rutherford category 4, 5 or 6). Freedom from reintervention, limb salvage, and overall survival were analyzed. Results The median follow-up duration was 30 months. Initial technical and clinical success rates were 69.5% and 83.1%, respectively. No major complication requiring surgical intervention developed after angioplasty. Among 82 limbs with initial technical success, the rate of freedom from any reintervention at 2 years was 70.7% and that from limb salvage was 97.6%. Young age and Rutherford category 6 at initial presentation were independent predictors associated with poor 2 year primary patency in these patients with CLI. Overall survival at 1 year was 86.4% and that at 2 years 76.3%. A history of cerebrovascular accident was an independent predictor associated with poor 2 year survival in these patients. Conclusion Infrapopliteal angioplasty as a primary choice of treatment in CLI patients showed favorable clinical outcomes and feasibility. PMID:22563339

  13. Messung und Analyse

    NASA Astrophysics Data System (ADS)

    Bathelt, Hartmut; Scheinhardt, Michael; Sell, Hendrik; Sottek, Roland; Guidati, Sandro; Helfer, Martin

    Für die Beurteilung von Akustik und Fahrkomfort eines Fahrzeugs gilt in der Fahrzeugentwicklung immer noch der alte Grundsatz: "Der Kunde fährt nicht am Prüfstand, sondern auf der Straße“. Daher werden Gesamtbeurteilungen des Entwicklungsstandes und Konkurrenzvergleiche (Benchmarking) nach wie vor auf der Straße durchgeführt, meist auf ausgewählten Fahrbahnen am Prüfgelände oder im Rahmen der regelmäßigen Winter- und Sommererprobungen unter extremen Witterungsverhältnissen.

  14. Holmium:YAG laser angioplasty: treatment of acute myocardial infarction

    NASA Astrophysics Data System (ADS)

    Topaz, On

    1993-06-01

    We report our clinical experience with a group of 14 patients who presented with acute myocardial infarction. A holmium:YAG laser was applied to the infarct-related artery. This laser emits 250 - 600 mJ per pulse, with a pulse length of 250 microseconds and repetition rate of 5 Hz. Potential benefits of acute thrombolysis by lasers include the absence of systemic lytic state; a shortened thrombus clearing time relative to using thrombolytics; safe removal of the intracoronary thrombus and facilitation of adjunct balloon angioplasty. Potential clinical difficulties include targeting the obstructive clot and plaque, creation of debris and distal emboli and laser-tissue damage. It is conceivable that holmium:YAG laser can be a successful thrombolytic device as its wave length (2.1 microns) coincides with strong water absorption peaks. Since it is common to find an atherosclerotic plaque located under or distal to the thrombotic occlusion, this laser can also be applied for plaque ablation, and the patient presenting with acute myocardial infarction can clearly benefit from the combined function of this laser system.

  15. Tool/tissues interaction modeling for transluminal angioplasty simulation.

    PubMed

    Le Fol, T; Haigron, P; Lucas, A

    2007-01-01

    In this paper, a simulation environment is described for balloon dilation during percutaneous transluminal angioplasty. It means simulating tool/tissues interactions involved in the inflation of a balloon by considering patient specific data. In this context, three main behaviors have been identified: soft tissues, crush completely under the effect of the balloon, calcified plaques, do not admit any deformation but could move in deformable structures and blood vessel wall and organs, try to find their original forms. A deformable soft tissue model is proposed, based on the Enhanced ChainMail method to take into account tissues deformation during dilatation. We improved the original ChainMail method with a "forbidden zone" step to facilitate tool/tissues interactions. The simulation was implemented using five key steps: 1) initialization of balloon parameters; 2) definition of the data structure; 3) dilatation of the balloon and displacement approximation; 4) final position estimation by an elastic relaxation; and 5) interpolation step for visualization. Preliminary results obtained from patient CT data are reported. PMID:18002311

  16. Effect of percutaneous transluminal coronary angioplasty on coronary reserve

    SciTech Connect

    Lassar, T.; Hendrix, L.; Ray, G.; Schmidt, D.

    1984-01-01

    This study was done to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on regional myocardial perfusion (RMP) in the region distal to a stenosis in 48 patients. Quantitative RMP in ml/100g/min was measured from the washout of Xe-133 following selective injection into the involved coronary artery. After successful dilation, determined by a reduction in %stenosis to a less than or equal to 50% lesion and in pressure gradient across the lesion, the RMP measurement was repeated. In these patients, means %stenosis was 85% pre PTCA and 29% post PTCA with mean pressure gradient of 60 Hg pre PTCA and 21 mm Hg post PTCA. 21 of these 48 patients also had RMP measured after isoproterenol (ISO) both pre and post PTCA to increase myocardial oxygen demand to assess coronary reserve. Heart rate (HR) and systolic blood pressure (SBP) were constant pre and post PTCA which allowed a valid comparison. The results are presented. A group of 13 patients with normal coronary arteries and ventricular function showed a mean control RMP of 78 +- 15 and a mean ISO RMP of 140 +- 26. The data demonstrate that following successful PTCA quantitative RMP improves both at rest and with an ISO challenge and is similar to RMP in normal coronary arteries.

  17. Successful Percutaneous Transluminal Angioplasty and Stenting in Acute Mesenteric Ischemia

    SciTech Connect

    Gartenschlaeger, Soeren Bender, Siegfried; Maeurer, Juergen; Schroeder, Ralf J.

    2008-03-15

    Acute mesenteric ischemia (AMI) is a life-threatening emergency. The complications are high by the time of diagnosis in most cases and therefore only few data on primary percutaneous intervention with percutaneous transluminal angioplasty (PTA) and stenting in AMI are available. We present the case of an 84-year-old woman who presented to our emergency department complaining of an acute worsening of pre-existing abdominal periumbilical pain, nausea, vomiting, and diarrhea. She had previously undergone percutaneous transluminal embolectomy for an acute occlusion of the left common femoral artery. Due to suspicion of intestinal infarction, conventional angiography of the aorta and the superior mesenteric artery (SMA) was performed and confirmed a proximal occlusion of the SMA. Percutaneous SMA recanalization with balloon dilation and subsequent stent implantation was carried out successfully. The abdominal symptoms subsided after this procedure. In AMI that is diagnosed early, endovascular stenting should be considered as an alternative treatment to the surgical approach that avoids the need for surgical bowel resection.

  18. Arterial healing response after angioplasty and its contributions to restenosis

    NASA Astrophysics Data System (ADS)

    Borst, Cornelius; van Erven, Lieselotte; Velema, Evelyn; Post, Mark J.

    1992-08-01

    Balloon angioplasty of coronary obstructions is limited by a 40% angiographic restenosis rate six months after the intervention. Myointimal hyperplasia is a major contributor to restenosis. In 77 normal rabbits we examined the question whether severe thermal interventional injury to the iliac artery wall would result in less myointimal hyperplasia than severe mechanical injury induced by balloon dilation. Eight weeks after percutaneous injury by electrical spark erosion, the metal laser probe, cw Nd:YAG laser energy through the sapphire contact probe, 90 degree(s)C RF heated balloon dilation, or standard balloon dilation the neointima thickness measured up to 380 micrometers . When thermally and mechanically damaged walls were compared, myointimal hyperplasia was similar. We conclude that in the normal rabbit the arterial wall healing response after any injury is neointima formation which is the vessel wall's expression of the general pattern of wound healing. It is inferred that alternative modes of injury in new recanalization techniques will lead to induced restenosis rates.

  19. Getreide, Brot und Feine Backwaren

    NASA Astrophysics Data System (ADS)

    von Grabowski, Hans-Uwe; Rolfe, Birgit

    Getreide und Getreideerzeugnisse sind ebenso wie Brot und Feine Backwaren nach dem Lebensmittel- und Futtermittel-Gesetzbuch (LFGB) [1] Lebensmittel im Sinne des Artikels 2 der VO (EG) Nr. 178/2002 (BasisVO) (s. auch Kap. 1.6/2.4.1/3.2). Gesetzlich festgelegte Begriffsbestimmungen gibt es für diese Lebensmittel nicht. Man muss sich daher allgemeiner Verkehrsauffassungen bedienen, wie sie von der Deutschen Lebensmittelbuch-Kommission in Form von Leitsätzen erarbeitet und veröffentlicht wurden [2]. Der Gesundheitsschutz und der Schutz des Verbrauchers vor Täuschung sind in der Basis-VO und dem LFGB geregelt.

  20. Does Coronary Stenting Following Balloon Angioplasty Improve Myocardial Fractional Flow Reserve?

    SciTech Connect

    Takeuchi, Masaaki; Himeno, Etsuro

    1998-11-15

    Purpose: Suboptimal distal coronary flow reserve after successful balloon angioplasty has been attributed to angiographically unrecognized inadequate lumen expansion, and adjunct coronary stenting has been shown to improve coronary flow reserve. The aim of this study was to investigate whether myocardial fractional flow reserve (FFRmyo) would increase further after coronary stenting compared with balloon angioplasty alone in the same patient group. Methods: FFRmyo and quantitative coronary angiography were obtained before and after pre-stent balloon dilation, and again after stent placement in 11 patients (7 left anterior descending artery, 3 right coronary artery and 1 left circumflex artery). FFRmyo was calculated as the ratio of Pd/Pa during intracoronary adenosine 5'-triphosphate (50 {mu}g and 20 {mu}g in the left and right coronary arteries, respectively)-induced maximum hyperemia, where Pd represents mean distal coronary pressure measured by a 2.1 Fr infusion catheter and Pa represents mean aortic pressure measured by the guiding catheter. Results: Percent diameter stenosis significantly decreased after balloon angioplasty (74% {+-} 15% vs 37% {+-} 17%, p < 0.001), and decreased further after stent placement (18% {+-} 10%, p < 0.001 vs baseline and balloon angioplasty). FFRmyo after coronary stenting (0.85 {+-} 0.09) was significantly higher than that at baseline (0.51 {+-} 0.16, p < 0.001) and after balloon angioplasty (0.77 {+-} 0.11, p < 0.05). There was a significant correlation between angiographic variables and FFRmyo. The increase in lumen dimensions after coronary stenting was followed by a further significant improvement of FFRmyo. Conclusion: These results suggest that coronary stenting may provide a more favorable functional status and lumen geometry of residual coronary stenosis compared with balloon angioplasty alone.

  1. Reaction to injury following balloon angioplasty and intravascular stent placement in the canine femoral artery.

    PubMed

    Salam, T A; Taylor, B; Suggs, W D; Hanson, S R; Lumsden, A B

    1994-05-01

    Intravascular stents are used clinically as an adjunct to coronary and iliac angioplasty. This study was performed to evaluate the thrombogenicity and intimal hyperplasia incited by stents deployed in non-injured and in balloon-injured femoral arteries in the canine model. Medinvent stents (4 mm) were placed in the femoral arteries bilaterally in five mongrel dogs via cut down. This was preceded by balloon catheter angioplasty of the stent site on one side. Platelet deposition was measured at 30, 60, and 90 minutes and at 24 and 48 hours after stent placement, using gamma camera imaging of Indium111 platelets. The animals were killed after 2 months using a pressure perfusion technique, and the stents harvested. All vessels were patent at the time of harvest. Neointimal thickness was measured by computer image analysis. Platelet deposition was significantly increased on the angioplastied side compared to the non-angioplastied side at 60 minutes (5.67 x 10(9) +/- 1.4 versus 2.17 x 10(9) +/- 0.5 platelets/cm; P < 0.05), at 90 minutes (8.13 x 10(9) +/- 1.8 versus 2.33 x 10(9) +/- 0.6 platelets/cm; P < 0.05), and at 24 hours (stent-to-blood ratio = 15.86 +/- 6.3 versus 3.75 +/- 1.5; P < 0.05). Neointimal thickness was also significantly greater on the side of combined angioplasty and stent placement (0.45 +/- 0.21 mm versus 0.33 +/- 0.09 mm; P < 0.05). These results demonstrate that placement of intravascular stents in normal arteries is associated with a certain degree of thrombogenicity and formation of neointimal hyperplasia. Combining balloon angioplasty with stent placement significantly augments both thrombogenicity and production of intimal hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8161086

  2. [Percutaneous coronary Excimer laser angioplasty in patients with coronary heart disease].

    PubMed

    Karsch, K R; Haase, K K; Mauser, M; Ickrath, O; Voelker, W; Baumbach, A; Seipel, L

    1990-07-01

    To verify the efficacy and safety of percutaneous coronary excimer laser angioplasty in patients with coronary artery disease a prospective study was conducted in 60 patients. The application of laser light was possible in 55 of the 60 patients. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter, each arranged concentrically around a central lumen suitable for an 0.014-inch flexible guide wire was used. The light source was a commercial excimer laser emitting energy at a wavelength of 308 nm, with a pulse duration of 60 ns. The laser was operated at 20 Hz; mean energy transmission was 30 +/- 5 mJ/mm2. In 23 of the 55 patients treated with excimer laser energy the qualitative angiographic results were sufficient. In 32 patients additional balloon angioplasty was necessary, either because of an insufficient result or due to vessel closure after laser ablation. In 47 of the 55 patients control angiography was performed within the 6-month follow-up period. Rate of restenosis was higher in patients treated with laser ablation and subsequent balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (6 of 19). Results of the 6-month observation period suggest that 1) coronary excimer laser angioplasty in combination with subsequent balloon angioplasty results in a considerable increase of the restenosis rate; 2) the exclusive use of laser ablation also results in a restenosis rate comparable to balloon angioplasty alone; and 3) the impact of this new method using improved application systems and higher energy transmission has to be determined in further studies. PMID:2399764

  3. Unternehmens- und Marktstatistik

    NASA Astrophysics Data System (ADS)

    Grömling, Michael; Scheinost, Ulrich

    Deutschland verfügt über ein gut ausgebautes System amtlicher und nicht amtlicher Unternehmens- und Marktstatistiken, das sich in einem fortwährenden Wandel befindet. Wird es sinnvoll genutzt, können für einzelne Marktteilnehmer wie für die gesamte Gesellschaft kostspielige Fehlentwicklungen vermieden werden. Dazu bedarf es eines sachkundigen Überblicks über die Vielfalt der Statistiken und der zwischen ihnen bestehenden Beziehungen sowie einer ständigen Anpassung an die wirtschaftliche Entwicklung. Als eine mögliche Orientierung kann der auf der Güter- und Faktorebene zu beobachtende Wandel dienen. Einer adäquaten Abbildung der ökonomischen Realität stehen in Deutschland mit seiner starken Verrechtlichung der Statistik jedoch mancherlei Schwierigkeiten im Wege. Teilweise tiefgreifende Reformbestrebungen sind vor allem auf europäischer Ebene im Gange. Als eine ergebnisorientierte Innovation für das Gesamtsystem der Unternehmens- und Marktstatistik wird ein modular aufgebautes System vorgestellt, das auch bei unterschiedlichen und sich wandelnden Rahmenbedingungen schrittweise realisiert werden kann.

  4. Datenintegration und Deduplizierung

    NASA Astrophysics Data System (ADS)

    Bleiholder, Jens; Schmid, Joachim

    In Unternehmen liegen viele Daten heutzutage immer seltener vollständig an einem einzigen physikalischen Ort vor, sondern sind weltweit verteilt. Dies liegt zum einen an der immer besser gewordenen Infrastruktur, die eine solche Verteilung auf einfache Art und Weise ermöglicht, und zum anderen an der Tatsache, dass viele Unternehmen weltweit tätig sind. So fallen Daten weltweit an, werden aber jeweils lokal - vor Ort - gespeichert. Daher müssen oft mehrere Datenquellen genutzt werden, um einen aktuellen, vollständigen und genauen Überblick über die vorhandenen Daten zu gewinnen. Datenintegration hilft, indem sie Daten aus mehreren Quellen zusammenführt und einheitlich darstellt. Diese integrierten Daten können genutzt werden, um sich einen Überblick über das Unternehmen zu verschaffen, z.B. wenn Unternehmen fusionieren und nur noch eine Kundendatenbank bestehen bleiben soll, oder wenn zu einem Kunden die Daten aus den verschiedenen Fachabteilungen zusammengeführt werden sollen. Anhand eines solchen Beispiels, der Integration von Kundendaten zu Kfz- und Lebensversicherungen erläutern wir im Folgenden einzelne Techniken.

  5. Balloon Angioplasty Optimization: Should We Measure Balloon Volume As Well As Pressure?

    SciTech Connect

    Shehab, M.; Michalis, L. K.; Rees, M. R.

    2008-01-15

    Purpose. To investigate the influence that measurement of balloon volume as a controlled variable in addition to balloon pressure has on the outcome of balloon angioplasty in an experimental model. Methods. One hundred and three segments of explanted normal porcine carotid arteries were obtained. Five were used as controls, and the remaining 98 were subjected to balloon angioplasty with simultaneous measurement of balloon volume and pressure. These arteries were randomized into two groups. In one group the endpoint of the angioplasty was determined by balloon pressure (pressure-limited group, PLG) and in the other group by balloon volume (volume-limited group, VLG). Pressure/volume curves for each procedure were constructed by continuous measurement of both parameters by a purpose-designed computer-controlled inflation device. The diameter of each arterial segment was measured by intravascular ultrasound (IVUS) and the ratio of the inflated balloon to arterial diameter calculated. Arterial appearances after angioplasty were recorded using IVUS. Results. The balloon volumes measured at the endpoint of angioplasty were significantly smaller in the PLG compared with the VLG (p < 0.001). Three types of pressure/volume curves were identified: A, B, and C. In the type A curves, IVUS identified fissures in 28% (17/60) and the examination was normal in 72% (43/60). In the type B curves, IVUS identified fissures in 44% (4/9), dissections in 22% (2/9), and the examination was normal in 33% (3/9). In the type C curves, IVUS identified fissures in 44% (4/9) and dissection in 56% (5/9) with no normal examinations. In undamaged arterial segments a very high correlation was achieved between balloon volume and the balloon/artery ratio (Pearson correlation = -0.979, R{sup 2} = 0.957, p < 0.0001, n = 27). Conclusion. The measurement of pressure and volume during angioplasty enabled the construction of pressure/volume curves that showed deviations from the curves obtained in air. The

  6. Reliability of pressure recordings via catheters used for transluminal coronary angioplasty.

    PubMed

    Busch, U W; Sebening, H; Beeretz, R; Heinze, R

    1984-06-01

    Because of common difficulties in obtaining adequate pressure tracing during transluminal coronary angioplasty, the pressure transmission characteristics of catheter systems used for angioplasty were determined. Transmission of cine wave pressures (0.2 to 14 Hz) and of arterial pressure pulses reproduced in vitro was evaluated. Following adequate elimination of air bubbles from the system, the Grüntzig dilatation catheters yielded satisfactory frequency response curves and thus good reproduction of arterial pressure waveforms. The Simpson-Robert catheter showed clearly inferior frequency response characteristics, explaining the more significant damping of the pressure tracings. However, mean pressures were reliably recorded with each type. PMID:15227077

  7. Dobutamine stress--Doppler echocardiography before and after coronary angioplasty.

    PubMed

    el-Said, E S; Fioretti, P M; Roelandt, J R; McNeill, A J; Rijsterborgh, H; Forster, T; Di Mario, C; Linker, D T

    1993-08-01

    To determine if dobutamine-induced myocardial ischaemia causes abnormalities in Doppler parameters of left ventricular ejection and filling and to assess early effects of successful coronary angioplasty (PTCA) on these parameters, dobutamine stress echocardiography and Doppler studies were performed once in 11 normal volunteers and twice in 17 patients (within 1 day pre- and post-PTCA). Dobutamine induced wall motion abnormalities, ST changes and angina in 11, five and five patients, respectively, before and three, two and one patients, respectively, after PTCA. Doppler indices of both systolic and diastolic function were comparable at rest, before and after PTCA. Dobutamine induced similar increases in peak aortic velocity and average acceleration in healthy individuals (39% and 53%) and in patients with one-vessel disease both before (38% and 39%) and after PTCA (39% and 40%). In the three patients with multivessel disease, peak aortic velocity showed a blunted response (-0.3%) before PTCA but increased by 17% after PTCA, while acceleration decreased both before (12%) and after PTCA (14%). There were significant differences (P < 0.0001) between healthy individuals and pre-PTCA patients in the effect of dobutamine on peak early (E) filling velocity (+34% vs -19%), E-acceleration (+35% vs -26%), peak early to atrial filling velocity ratio (E/A) (-0.7% vs -37%) and diastolic time velocity integral (TVI) (+34% vs -22%). After PTCA, the response of Doppler diastolic indices improved during dobutamine, as shown by the increase in E and E-acceleration (+8%, +24%), respectively) and by the decline in the reduction of E/A and TVI (-17% and -10%, respectively). Thus, the response of Doppler diastolic parameters to dobutamine stress is a sensitive indicator of significant coronary disease and is superior to changes in ejection indices. Successful PTCA resulted in an improved diastolic filling response to dobutamine stress. PMID:8404930

  8. Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting

    PubMed Central

    Rhim, Jong Kook; Park, Jeong Jin; Choi, Hyuk Jai; Cho, Young Dae; Sheen, Seung Hun; Jang, Kyung-Sool

    2016-01-01

    Purpose The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. Materials and Methods Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. Results Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). Conclusion Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort. PMID:27621949

  9. [Exercise tolerance in patients after successful percutaneous transluminal coronary angioplasty].

    PubMed

    Tsumoto, S; Nakagawa, Y; Asakuma, S; Naruse, H; Komasa, N; Ohyanagi, M; Tateishi, J; Yasutomi, N; Fujitani, K; Iwasaki, T

    1991-01-01

    In 32 patients with successful percutaneous transluminal coronary angioplasty (PTCA), we performed treadmill exercise tests (TMET) before and about one month after PTCA to assess the correlation between the improvement in coronary artery lesions and exercise tolerance. Either the Bruce protocol (B: n = 12) or the modified Bruce protocol (MB: n = 20) was used; with the latter being applied to patients whose cardiac function seemed depressed. In 15 patients, oxygen consumption (VO2) was measured by analyzing the expired gases, 13 patients underwent exercise thallium-201 myocardial perfusion scintigraphy before and after PTCA, whose results were compared with those of TMET. In both B and MB protocols, the treadmill walking time was significantly prolonged after PTCA, compared to that before PTCA (B: 7.4 +/- 1.3 vs 9.5 +/- 1.9, MB: 11.4 +/- 3.5 vs 12.7 +/- 3.5 min). Heart rates (HR) and rate pressure products (RPP) were significantly increased after PTCA in both protocols (HR B: 139 +/- 18 vs 154 +/- 17, MB: 121 +/- 20 vs 137 +/- 19 bpm, RPP B: 26,500 +/- 5,600 vs 30,300 +/- 6,700, MB: 19,400 +/- 6,200 vs 22,700 +/- 6,600 mmHg.bpm), however, systolic blood pressure did not change significantly after PTCA in either protocol. While there was a significant improvement in VO2 after PTCA (21.6 +/- 6.3 vs 25.7 +/- 4.2 ml/kg/min), the O2-pulse remained unchanged. Thallium-201 myocardial scintigraphy revealed improvement of myocardial perfusion in 8 of the 13 cases examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1841916

  10. Salvage of Immature Arteriovenous Fistulas with Percutaneous Transluminal Angioplasty

    SciTech Connect

    Shin, Sung Wook; Do, Young Soo Choo, Sung Wook; Lieu, Wei Chiang; Choo, In-Wook

    2005-05-15

    The purpose of this study was to assess the value of percutaneous transluminal angioplasty (PTA) for the salvage of arteriovenous fistulas (AVFs) that fail to mature. From November 1998 to February 2003, 19 patients who were treated with PTA due to immature forearm AVFs were selected. Fistulography and PTA were performed via a retrograde transvenous approach after direct puncture of the fistular vein. Technical success was defined as less than a 30% residual stenosis, whereas clinical success was defined as the ability to perform at least one session of normal hemodialysis after PTA. Findings of fistulograms, success rates of PTA, and patency rates were evaluated. On initial fistulograms, stenoses were observed in all cases and 68% (13/19) of the stenoses were located in the perianastomotic area of these immature AVFs. The initial technical success rate was 84% (16/19). Technical failures comprised two patients with diffuse narrowing and segmental thrombosis of the cephalic veins and one case of elastic recoil of the anastomotic site stenosis after PTA. Two patients were immediately lost on follow-up. The remaining 14 cases underwent successful hemodialysis 0 to 33 (mean = 15) days after PTA, showing 74% (14/19) clinical success. Although accessory branch veins were noted in most cases (74%, 14/19), leaving them alone did not affect the maturation of AVFs following PTA. There was no significant procedural or late complication. Primary and secondary patency rates at 1 year were 61 and 82%, respectively. For those AVFs that failed to mature, there were stenoses along their vascular courses as underlying causes. For the percutaneous procedure, the retrograde transvenous approach was a reasonable one. As PTA is effective and quick for the salvation of immature AVFs, it can be considered a primary method for salvaging these immature AVFs.

  11. Geologie der terrestrischen Planeten und Monde.

    NASA Astrophysics Data System (ADS)

    Stöffler, D.

    Contents: 1. Inhalt und Aufgabe der Planetologie. 2. Aufbau des Sonnensystems. 3. Methoden der Exploration und Analyse der Planeten und Monde. 4. Geologische Grundprozesse auf den terrestrischen Planeten und Monden. 5. Geologische Formationen der planetaren Oberflächen. 6. Gesteine und Mineralien der planetaren Krusten. 7. Der innere Aufbau der terrestrischen planetaren Körper. 8. Vergleichende geologische Entwicklungsgeschichte der terrestrischen Planeten und des Mondes. 9. Ursprung und Entstehung der terrestrischen planetaren Körper.

  12. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    SciTech Connect

    Poncyljusz, Wojciech Falkowski, Aleksander; Safranow, Krzysztof Rac, Monika; Zawierucha, Dariusz

    2013-12-15

    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  13. Coronary flow reserve in the contralateral artery increases after successful coronary angioplasty in patients with spontaneously visible collateral vessels

    PubMed Central

    Kyriakides, Z; Antoniadis, A; Kolettis, T; Kremastinos, D

    1998-01-01

    Objective—To test the hypothesis that coronary flow reserve could increase in the angiographically normal contralateral artery after successful coronary angioplasty of an ipsilateral coronary artery.
Design—Coronary flow reserve was estimated using a Doppler flow guide wire, by giving intracoronary adenosine in the contralateral artery, before and 15 minutes after the end of angioplasty.
Setting—Tertiary referral centre.
Patients—31 patients, mean (SD) age 56 (11) years, with stable angina and single vessel disease, undergoing angioplasty of the right coronary or the left anterior descending artery.
Results—In the contralateral artery baseline average peak velocity was 21 (9) cm/s before angioplasty and decreased to 12 (6) cm/s after (p < 0.005), while hyperaemic average peak velocity was 47 (19) cm/s before and decreased to 34 (15) cm/s after (p < 0.005). However, coronary flow reserve in the contralateral artery was 2.4 (0.7) before angioplasty and increased to 2.9 (0.6) after (p < 0.05). The contralateral coronary flow reserve after angioplasty increased by 0.8 (0.4) in 11 patients with visible collaterals before angioplasty and by 0.3 (0.6) in the remaining patients without visible collaterals (p < 0.05). Blood pressure and heart rate were unchanged after the procedure.
Conclusions—Coronary flow reserve in an angiographically normal contralateral artery increases after successful coronary angioplasty of the ipsilateral artery in patients with spontaneously visible collateral vessels before the procedure.

 Keywords: coronary flow reserve;  contralateral coronary artery;  angioplasty PMID:9930051

  14. Patentierung und Patentlage

    NASA Astrophysics Data System (ADS)

    Herrmann, Uwe

    Gewerbliche Schutzrechte nehmen in der nationalen Rechts- und Wirtschaftsordnung sowie auch auf internationaler Ebene stetig an Bedeutung zu. Sie dienen dem Schutz geistigen Eigentums und sind für jeden Gewerbetreibenden nicht nur im Hinblick darauf von Bedeutung, eigene Rechte zu sichern, sondern auch insofern von Relevanz, dass ein Verstoß gegen Rechte Dritter zu vermeiden ist. Zu den gewerblichen Schutzrechten gehören unter anderem Kennzeichenrechte, Geschmacksmusterrechte sowie die sogenannten technischen Schutzrechte in Form des Patents sowie des Gebrauchsmusters. Die folgenden Ausführungen befassen sich ausschließlich mit den technischen Schutzrechten und geben eine kurze Einführung in die Voraussetzungen, das Entstehen und den Wegfall sowie in die Wirkungen technischer Schutzrechte. Beleuchtet wird die Situation im Wesentlichen im Hinblick auf nationale technische Schutzrechte, d. h. auf Deutsche Patente und Gebrauchsmuster sowie auf Europäische Patente, die Schutz in Deutschland entfalten. Die Möglichkeit der Erlangung von Schutzrechten im außereuropäischen Ausland wird nur am Rande gestreift.

  15. Technikwissenschaft - Erfinden und Entdecken

    NASA Astrophysics Data System (ADS)

    Linnemann, Gerhard

    Umrissen wird das allgemeine Ziel der Technikwissenschaft, konstruktiv zu verwerten und nicht-natürlich Entdeckbares zu erfinden. Wir befinden uns in einer Umwälzung der Technik im Verlauf der wissenschaftlich-technischen Revolution, auf dem Wege zu einem neuen Techniktyp. Dieser schafft und nutzt die künstliche Intelligenz. Dazu benötigt der in der Technik tätige Mensch spezielle Kenntnisse und Erfahrungen in kreativ-konstruktiver, -gestalterischer und erfinderischer Sicht mit dem Einsatz spezieller Strukturen und Sprachen. Vorschläge zur Arbeitsweise in der Technik werden gegeben.Translated AbstractTechnological Science-Invent and DiscoverThe general aim of engineering science is outlined to utilize results constructively and to invent something that cannot be discovered in nature. We are now in a period of transformation of technology in the course of scientific-technological revolution, on the way to a new type of technology. This new type creates and utilizes artificial intelligence. For this, man acitive in this field requires special knowledge and experiences in a creative, constructive, design-oriented and ultimately inventive way by deploying special structures and languages. There are also made some proposals concerning the method of working in the field of technology.

  16. Unusual Case of Exercise-Induced ST Segment Elevation Alternans: Successful Treatment with Transluminal Angioplasty

    PubMed Central

    Mammen, George; Krajcer, Zvonimir; Leachman, Robert D.

    1983-01-01

    Alternans of the ST segment is sometimes observed in experimental studies but is rarely seen in the clinical setting. Described is a case of exercise-induced ST segment elevation alternans that was successfully treated with transluminal coronary artery angioplasty. Theories regarding the cause and mechanism of this phenomenon are discussed. Images PMID:15227140

  17. Influence of elastic recoil on restenosis after successful coronary angioplasty in unstable angina pectoris.

    PubMed

    Ardissino, D; Di Somma, S; Kubica, J; Barberis, P; Merlini, P A; Eleuteri, E; De Servi, S; Bramucci, E; Specchia, G; Montemartini, C

    1993-03-15

    The elastic behavior of the dilated coronary vessel has been reported to affect the immediate results of coronary angioplasty. To determine whether elastic recoil may also influence the long-term restenosis process, 98 consecutive patients with unstable angina and 1-vessel disease were studied. An automated coronary quantitative program was used for the assessment of balloon and coronary luminal diameters. Elastic recoil was defined as the percent reduction between minimal balloon diameter at the highest inflation pressure and minimal lesion diameter immediately after coronary angioplasty. Follow-up coronary arteriography was performed 8 to 12 months after the procedure in all patients. The mean elastic recoil averaged 17.7 +/- 16% and was correlated to the degree of residual stenosis immediately after coronary angioplasty (r = 0.64; p < 0.001). Restenosis, defined as > 50% diameter stenosis at follow-up, developed in 53 patients (54%). There was no correlation between the degree of elastic recoil and the changes in minimal lesion diameter observed during follow-up, whereas a positive correlation between the amount of elastic recoil and the incidence of restenosis was documented (r = 0.84; p < 0.05). Thus, the elastic properties of the dilated vessel do not influence the active process of restenosis. However, because elastic recoil negatively influences the initial results of angioplasty, it is more likely that further reductions in lumen diameter during follow-up can reach a threshold of obstruction considered critical for a binary definition of restenosis. PMID:8447261

  18. Vertebral artery origin angioplasty and primary stenting: safety and restenosis rates in a prospective series

    PubMed Central

    Cloud, G; Crawley, F; Clifton, A; McCabe, D; Brown, M; Markus, H

    2003-01-01

    Objectives: To report a single centre ongoing experience of endovascular treatment for atherosclerotic vertebral artery origin stenosis in a series of symptomatic patients, with follow up imaging to determine the incidence of restenosis. Methods: 14 patients with vertebral artery origin stenosis on catheter angiography were treated. Angioplasty without stenting was undertaken in the first four patients, all of whom had follow up catheter angiography at one year. Subsequently, patients were treated by primary stenting and followed up with colour Doppler ultrasound examination. Results: The procedure was technically successful in all treated arteries, with no immediate complications. The degree of stenosis was reduced from (mean (SD)) 73 (18)% before treatment to 21 (26)% immediately after treatment in the angioplasty alone group (p = 0.059). In the primary stenting patients, the severity of stenosis was reduced from 82 (8)% to 13 (13)% immediately after treatment (p < 0.001). Restenosis to 70% or greater occurred at one year in all four patients initially treated by angioplasty without stenting. One patient subsequently developed further symptoms and was retreated by stenting. One of the 10 patients treated by primary stenting developed restenosis. None of the remaining patients had further posterior circulation ischaemic symptoms during a mean follow up period of 33.6 months (range 1 to 72 months). Conclusions: Restenosis occurs often after vertebral artery origin balloon angioplasty without stenting but is uncommon after stenting. Primary stenting is therefore recommended to maintain patency at this site, and had a low complication rate in this series. PMID:12700299

  19. Risks and benefits of coronary angioplasty: the patients perspective: a preliminary study.

    PubMed Central

    Kee, F; McDonald, P; Gaffney, B

    1997-01-01

    OBJECTIVES: To describe what cardiac patients in Northern Ireland understand to be the benefits of coronary angioplasty and assess the extent to which they have been able to make informed choices about their treatment. DESIGN: An interview based questionnaire survey completed after the patients had undergone coronary angiography, within hours of treatment counselling. SUBJECTS: 150 patients consecutively recruited from two regional cardiology centres in Belfast, Northern Ireland. MAIN OUTCOME MEASURES: The perceived complication rate and the perceived gain in life expectancy from coronary angioplasty. RESULTS: Although most subjects had asked the consultant questions, 70% (n = 104) thought that they contributed negligibly or not at all to the treatment decision. Although 75% (n = 112) recalled discussing the complication rate from the procedure, only 27% accurately estimated this rate (as between 0.5 and 1.5%). Eighty eight per cent (n = 131) thought that their mortality risks would be substantially or greatly reduced by having the procedure. The patients anticipated a gain in life expectancy of some 10 years (median) and this was significantly in excess of the potential gain in life expectancy which dietary prudence to lower blood cholesterol, not smoking, and taking more exercise might produce (median 5 years respectively; P < 0.0001, Wilcoxon matched pairs signed rank test). CONCLUSIONS: Patients vastly overrate the capacity of angioplasty to control their disease: angioplasty is seen as more effective than risk factor modification. PMID:10173770

  20. [A myocardial infarction during pregnancy treated by percutaneous transluminal coronary angioplasty and stent implantation. Case report].

    PubMed

    Dubois, N; de Muylder, X; Foading, B

    2007-01-01

    Acute myocardial infarction is an un-frequent event during pregnancy. It clearly causes an increase in both maternal and fetal mortality. We describe a case of pregnancy complicated during the second trimester by an acute myocardial infarction witch was treated by percutaneous transluminal coronary angioplasty combined with stenting. The challenge involved in managing this condition during pregnancy is briefly discussed. PMID:17567523

  1. Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty

    SciTech Connect

    Tetteroo, Eric; Haaring, Cees; Engelen, Andries D. van; Graaf, Yolanda van der; Mali, Willem P.T.M.

    1997-11-15

    Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD {+-} SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg. Results: MD {+-} SD for repeated measurements at rest and during flow augmentation were 0 {+-} 2 mmHg and 1 {+-} 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 {+-} 7 mmHg at rest and 17 {+-} 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions. Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.

  2. Percutaneous Mural Fenestration and Angioplasty for the Treatment of a Refractory Hemodialysis-Related Venous Stenosis

    SciTech Connect

    Denison, Gregory L. Funaki, Brian

    2006-12-15

    Venous stenoses are the leading cause of dialysis graft and mature dialysis fistula malfunction. We report a simple, inexpensive technique for treating stenoses that are refractory to conventional balloon angioplasty and present a case in which this technique was successfully applied.

  3. Cutting-Balloon Angioplasty in Transplant Renal Artery Stenosis as First-Line Treatment in the Early Postoperative Period

    SciTech Connect

    Ucar, Adem; Yahyayev, Aghakishi; Bakkaloglu, Huseyin; Agayev, Ayaz; Aydin, Ali Emin; Rozanes, Izzet

    2011-02-15

    Percutaneous transluminal angioplasty has been successfully used for the treatment of transplant renal artery stenosis (RAS). Cutting-balloon angioplasty (CBA) is being used as a second option in pressure-resistant stenosis. It is thought that CBA is less traumatic and therefore restenosis occurs less frequently than in conventional angioplasty. This case report describes the unusual use of a cutting balloon in transplant RAS as a first option in the early postoperative period. Long-term follow-up data are also presented.

  4. Venture Kapital und Life Science

    NASA Astrophysics Data System (ADS)

    Moss, Sebastian; Beermann, Christian

    Um sich weiter im internationalen Wettbewerb behaupten zu können, müssen deutsche Unternehmen heute in Schlüsseltechnologien wie die Medizintechnik und die Biotechnologie, zusammenfassend unter dem Begriff der Life Sciences bekannt, investieren. Eine führende Wettbewerbsposition erfordert immer die konsequente Weiterentwicklung von Produkten und Lösungen, um Innovationspotenziale in medizinische Verfahren umzusetzen. Die damit unmittelbar verbundenen hohen Ausgaben für Forschung und Entwicklung stellen ein bedeutendes Problem junger Life Science Unternehmen dar. Vor allem die, verglichen mit nicht-medizinischen Branchen, längeren Forschungs- und Entwicklungszyklen in der Frühphase eines Life Science Unternehmens und die längere Dauer bis zur Profitabilität erhöhen das Risiko der Finanzinvestoren. Die Zeitdauer, um ein medizinisches Produkt bis zur Marktreife zu entwickeln und letztlich auf dem Markt anzubieten, kann aufgrund der notwendigen intensiven Forschung nur unscharf geplant werden und erhöht die Unsicherheit über den Zeitpunkt der ersten Einnahmen. Damit verschärfen sich gerade im Life Science Bereich allgemeine Problematiken von Gründungs- und Wachstumsfinanzierungen wie starke Informationsasymmetrien zwischen Gründer und potentiellen Kapitalgebern. Oftmals ist die Entwicklung einer innovativen Technologie abhängig von einzelnen Personen, von deren Wissen und Engagement die Umsetzung und der Erfolg eines gesamten Produktkonzeptes abhängen.

  5. Retrospective Study of Rapid-Exchange Monorail Versus Over-the-Wire Technique for Femoropopliteal Angioplasty

    SciTech Connect

    Jahnke, Thomas Schaefer, Jost Philipp; Bolte, Hendrik; Schaefer, Fritz; Michalek, Jens; Charalambous, Nicholas; Sapoval, Marc; Mueller-Huelsbeck, Stefan

    2008-09-15

    PurposeThe purpose of this study was to compare procedural outcome of rapid-exchange (RX) monorail versus conventional over-the-wire (OTW) technique for femoropopliteal angioplasty.Materials and MethodsDemographic data, procedure details, angioplasty success, and complications of 328 consecutive percutaneous transluminal angioplasties (PTAs) were collected from a prospective database and retrospectively analyzed. Procedure details included duration of fluoroscopy, area-dose product, amount of contrast agent, sheath sizes, access route, length of stenosis, presence of total occlusion, technical and anatomical success (residual stenosis <30% in the absence of complications), need for bail-out stenting, and periprocedural complications. The RX technique alone was used in 102 of 328 cases (31%); the OTW technique, in 226 of 328 of cases (68%).ResultsTechnical success was 98% for the RX versus 95.4% for the OTW technique (p = 0.2). A significantly greater number of stents had to be implanted due to angioplasty failure when the OTW technique was used (RX, 5.9%; OTW, 13.7%; p = 0.04). There were no significant differences in fluorocopy time, dose-area product, or amount of contrast medium used. The RX system facilitated the use of smaller sheath sizes (5 Fr = 38% and 6 Fr = 59% for RX versus 5 Fr = 16.8% and {>=}6 Fr = 82.5% for OTW) but showed only a tendency toward lower overall complication rates (16.6% [17/102] in the RX group versus 19.9% [45/226] in the OTW group; p = 0.09). There was no effect on length of hospitalization. RX monorail systems were not associated with higher procedural costs when compared to conventional OTW technique.ConclusionWe conclude that RX monorail systems seem to enhance the technical success of femoropopliteal angioplasty. Although smaller sheath sizes can be used due to the lower profile of the RX systems, there is only a tendency toward lower complication rates.

  6. Primary Angioplasty Versus Stenting for Endovascular Management of Intracranial Atherosclerotic Disease Following Acute Ischemic Stroke

    PubMed Central

    Villwock, Mark R.; Padalino, David J.; Ramaswamy, Raghu; Deshaies, Eric M.

    2016-01-01

    Background The future of neuroendovascular treatment for intracranial atherosclerotic disease (ICAD) has been debated since the results of SAMMPRIS reflected poor outcomes following endovascular therapy. There is currently a large spectrum of current management strategies. We compared historical outcomes of patients with ICAD and stroke that were treated with angioplasty-alone versus stent placement. Methods We extracted a population from the Nationwide Inpatient Sample (NIS) (2005–2011) and the National Inpatient Sample (NIS) (2012) composed of patients with ICAD and infarction that were admitted nonelectively and received endovascular revascularization. Patients treated with thrombectomy or thrombolysis were excluded. Categorical variables were compared with Chi-squared tests. Binary logistic regression was performed to evaluate mortality while controlling for age, sex, severity, and comorbidities. Results About 2059 admissions met our criteria. A majority were treated via stent placement (71%). Angioplasty-alone had significantly higher mortality (17.6% vs. 8.4%, P<0.001), but no difference in iatrogenic stroke rate (3.4% vs. 3.6%, P=0.826), compared to stent placement. The adjusted odds ratio of mortality for stented patients was 0.536 (95% CI: 0.381–0.753, P<0.001) in comparison to patients treated with angioplasty alone. Conclusions This study found the risk of mortality to be elevated following angioplasty alone in comparison to revascularization with stent placement, without a corresponding significant difference in iatrogenic stroke rate. This may represent selection bias due to patient characteristics not defined in the database, but it also may indicate that patients with ICAD and acute stroke have increased odds of stenosis that is refractory to angioplasty alone and have a high risk of mortality without revascularization. PMID:27403216

  7. A New Approach: Regional Nerve Blockade for Angioplasty of the Lower Limb

    SciTech Connect

    Marcus, A.J. Lotzof, K.; Kamath, B.S.K.; Shanthakumar, R.E.; Munir, N.; Loh, A.; Bird, R.; Howard, A.

    2006-04-15

    Purpose. An audit study investigated the pilot use of regional nerve block analgesia (as an alternative to sedative/opiate, general or central neuraxial anesthesia) performed by radiologists with the assistance of imaging techniques during complex prolonged angiography. Methods. Radiologists were trained by anesthetic consultants to administer and use lower limb peripheral nerve block for difficult prolonged angioplasty procedures for patients with severe lower limb rest pain who were unable to lie in the supine position. In a pilot study 25 patients with limb-threatening ischemia received sciatic and femoral nerve blockade for angioplasty. The technique was developed and perfected in 12 patients and in a subsequent 13 patients the details of the angiography procedures, peripheral anesthesia, supplementary analgesia, complications, and pain assessment scores were recorded. Pain scores were also recorded in 11 patients prior to epidural/spinal anesthesia for critical ischemic leg angioplasty. Results. All patients with peripheral nerve blockade experienced a reduction in their ischemic rest pain to a level that permitted angioplasty techniques to be performed without spinal, epidural or general analgesia. In patients undergoing complex angioplasty intervention, the mean pain score by visual analogue scale was 3.7, out of a maximum score of 10. Conclusions. The successful use of peripheral nerve blocks was safe and effective as an alternative to sedative/opiate, epidural or general anesthesia in patients undergoing complex angiography and has optimized the use of radiological and anesthetic department resources. This has permitted the frequent radiological treatment of patients with limb-threatening ischemia and reduced delays caused by the difficulty in enlisting the help of anesthetists, often at short notice, from the busy operating lists.

  8. Recombinant Human Elastase Alters the Compliance of Atherosclerotic Tibial Arteries After Ex Vivo Angioplasty

    PubMed Central

    Bingham, Karen; Moss, Emma; Gottlieb, Daniel P.; Wong, Marco D.; Bland, Kimberly S.; Franano, F. Nicholas

    2016-01-01

    Purpose: This study was designed to determine whether vonapanitase (formerly PRT-201), a recombinant human elastase, treatment can fragment the protein elastin in elastic fibers and cause dilation of atherosclerotic human peripheral arteries subjected to ex vivo balloon angioplasty. Materials and Methods: Seven patients undergoing lower limb amputation for peripheral artery disease or who died and donated their bodies to science donated 11 tibial arteries (5 anterior, 6 posterior) for this study. All arteries were atherosclerotic by visual inspection. The arteries underwent ex vivo balloon angioplasty and thereafter were cut into rings and studied on wire myographs where the rings were stretched and tension was recorded. After treatment with vonapanitase 2 mg/mL or vehicle control, myography was repeated and the rings were then subject to elastin content measurement using a desmosine radioimmunoassay and elastic fiber visualization by histology. The wire myography data were used to derive compliance, stress-strain, and incremental elastic modulus curves. Results: Vonapanitase treatment reduced elastin (desmosine) content by 60% and decreased elastic fiber histologic staining. Vonapanitase-treated rings experienced less tension at any level of stretch and as a result had shifts in the compliance and stress-strain curves relative to vehicle-treated rings. Vonapanitase treatment did not alter the incremental elastic modulus curve. Conclusions: Vonapanitase treatment of atherosclerotic human peripheral arteries after ex vivo balloon angioplasty fragmented elastin in elastic fibers, decreased tension in the rings at any level of stretch, and altered the compliance and stress-strain curves in a manner predicting arterial dilation in vivo. Based on this result, local treatment of balloon angioplasty sites may increase blood vessel diameter and thereby improve the success of balloon angioplasty in peripheral artery disease. PMID:26745001

  9. Instability of Reference Diameter in the Evaluation of Stenosis After Coronary Angioplasty: Percent Diameter Stenosis Overestimates Dilative Effects Due to Reference Diameter Reduction

    SciTech Connect

    Hirami, Ryouichi; Iwasaki, Kohichiro; Kusachi, Shozo; Murakami, Takashi; Hina, Kazuyoshi; Matano, Shigeru; Murakami, Masaaki; Kita, Toshimasa; Sakakibara, Noburu; Tsuji, Takao

    2000-03-15

    Purpose: To examine changes in the reference segment luminal diameter after coronary angioplasty.Methods: Sixty-one patients with stable angina pectoris or old myocardial infarction were examined. Coronary angiograms were recorded before coronary angioplasty (pre-angioplasty) and immediately after (post-angioplasty), as well as 3 months after. Artery diameters were measured on cine-film using quantitative coronary angiographic analysis.Results: The diameters of the proximal segment not involved in the balloon inflation and segments in the other artery did not change significantly after angioplasty, but the reference segment diameter significantly decreased (4.7%). More than 10% luminal reduction was observed in seven patients (11%) and more than 5% reduction was observed in 25 patients (41%). More than 5% underestimation of the stenosis was observed in 22 patients (36%) when the post-angioplasty reference diameter was used as the reference diameter, compared with when the pre-angioplasty measurement was used and more than 10% underestimation was observed in five patients (8%).Conclusion: This study indicated that evaluation by percent diameter stenosis, with the reference diameter from immediately after angioplasty, overestimates the dilative effects of coronary angioplasty, and that it is thus better to evaluate the efficacy of angioplasty using the absolute diameter in addition to percent luminal stenosis.

  10. Kometen und Asteroiden

    NASA Astrophysics Data System (ADS)

    Borgeest, Ulf; Staude, Jakob; Hahn, Gerhard; Harris, Alan W.; Jaumann, Ralf; Köhler, Ulrich; Kührt, Ekkehard; Schulz, Rita; Neukum, Gerhard; Arnold, Gabriele; Keller, Horst Uwe; Denk, Tilmann; Müller, Thomas; Wulff, André; Maruhn, Nicolaus; Fischer, Daniel; Trieloff, Mario; Althaus, Tilmann

    Contents: Die Kleinkörper des Sonnensystems. Kern, Koma und Schweife. Ziele der Planetenforschung. ROSETTA: Naherkundung von Kometen. Asteroiden: Trümmer aus planetarer Urzeit. Kleinkörper im Infrarotweltall. Selbs beobachten! Apocalypse - not now! Meteoriten - Boten aus der Urzeit des Sonnensystems.

  11. Tipps und Tricks

    NASA Astrophysics Data System (ADS)

    Häger, Wolfgang; Bauermeister, Dirk

    Hier wollen wir einige uns nützlich erscheinende Hinweise zur Arbeit mit dem Inventor geben. Dabei geht es vor allem darum, das Arbeiten mit dem Inventor zu vereinfachen. Die Beispiele stellen eine unvollständige Aufzählung dar und sollen dazu anregen, nach alternativen Vorgehensweisen zu suchen (hier sei noch einmal ausdrücklich auf das Internet verwiesen).

  12. Arbeitsgestaltung und Mitarbeiterqualifizierung

    NASA Astrophysics Data System (ADS)

    Weiss-Oberdorfer, Werner; Hörner, Barbara; Holm, Ruth; Pirner, Evelin

    Die Wertkette gliedert ein Unternehmen in strategisch relevante Tätigkeiten, um dadurch Kostenverhalten sowie vorhandene und potenzielle Differenzierungsquellen zu verstehen. Wenn ein Unternehmen diese strategisch wichtigen Aktivitäten billiger oder besser als seine Konkurrenten erledigt, verschafft es sich einen Wettbewerbsvorteil." Michael Porter, 1985

  13. Balloon Angioplasty - The Legacy of Andreas Grüntzig, M.D. (1939-1985).

    PubMed

    Barton, Matthias; Grüntzig, Johannes; Husmann, Marc; Rösch, Josef

    2014-01-01

    In 1974, at the Medical Policlinic of the University of Zürich, German-born physician-scientist Andreas Grüntzig (1939-1985) for the first time applied a balloon-tipped catheter to re-open a severely stenosed femoral artery, a procedure, which he initially called "percutaneous transluminal dilatation". Balloon angioplasty as a therapy of atherosclerotic vascular disease, for which Grüntzig and Charles T. Dotter (1920-1985) received a nomination for the Nobel Prize in Physiology or Medicine in 1978, became one of the most successful examples of translational medicine in the twentieth century. Known today as percutaneous transluminal angioplasty (PTA) in peripheral arteries or percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) in coronary arteries, balloon angioplasty has become the method of choice to treat patients with acute myocardial infarction or occluded leg arteries. On the occasion of the 40(th) anniversary of balloon angioplasty, we summarize Grüntzig's life and career in Germany, Switzerland, and the United States and also review the developments in vascular medicine from the 1890s to the 1980s, including Dotter's first accidental angioplasty in 1963. The work of pioneers of catheterization, including Pedro L. Fariñas in Cuba, André F. Cournand in France, Werner Forssmann, Werner Porstmann and Eberhard Zeitler in Germany, António Egas Moniz and Reynaldo dos Santos in Portugal, Sven-Ivar Seldinger in Sweden, and Barney Brooks, Thomas J. Fogarty, Melvin P. Judkins, Richard K. Myler, Dickinson W. Richards, and F. Mason Sones in the United States, is discussed. We also present quotes by Grüntzig and excerpts from his unfinished autobiography, statements of Grüntzig's former colleagues and contemporary witnesses, and have included hitherto unpublished historic photographs and links to archive recordings and historic materials. This year, on June 25, 2014, Andreas Grüntzig would have celebrated his 75(th

  14. Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis

    PubMed Central

    2016-01-01

    Purpose Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy. Methods We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the study quality, along with the Cochrane Risk of Bias Tool. We evaluated publication bias using a funnel plot. Results The search strategy identified 518 publications. After screening these, we selected four articles for review. The meta-analysis revealed that overall limb salvage and wound healing rates were significantly higher (Odds ratio = 2.209, 3.290, p = 0.001, p<0.001) in patients who received angiosome-targeted angioplasty than in those who received nonangiosome-targeted angioplasty. The revision rate between the angiosome and nonangiosome groups was not significantly different (Odds ratio = 0.747, p = 0.314). Conclusion Although a further randomized controlled trial is required for confirmation, angiosome-targeted angioplasty in diabetic foot was more effective than nonangiosome-targeted angioplasty with respect to wound healing and limb salvage. PMID:27441570

  15. [Percutaneous transluminal laser angioplasty in peripheral arterial occlusive disease--development of a new laser catheter system].

    PubMed

    Neubaur, T; Klepzig, M; Strauer, B E

    1988-04-01

    Percutaneous laser angioplasty in arterial occlusive disease has lately been performed clinically for the first time. Perforation of the arterial wall and formation of aneurysms are serious risks. Two novel laser catheters for laser angioplasty with minimized perforation risk are presented. Catheter I (5F) and II (6.3F) are designed in the same manner. The distal tip of these catheters is ovally formed and marked by a small X-ray dense metal ring. The silica fiber has a core diameter of 400 micron (I) respectively 600 micron (II). Its tip is also marked X-ray densely and therefore the position of the fiber tip can be controlled exactly during laser angioplasty. Using a guide wire and applicating short laser pulses the perforation risk can be minimized. In a total of 132 atherosclerotic stenosed or obstructed human arteries laser angioplasty was performed in vitro using a Nd:YAG laser. There were two perforations (1.5%). The degree of stenosis was reduced from 87 (90)% to 54 (52)%. Using the 600-micron-fiber (catheter II) the velocity of laser angioplasty was increased 2.5 times compared to laser angioplasty using the 400-micron-fiber. PMID:2968724

  16. Wirkstoffe, Medikamente und Mathematische Bildverarbeitung

    NASA Astrophysics Data System (ADS)

    Bauer, Günter J.; Lorenz, Dirk A.; Maaß, Peter; Preckel, Hartwig; Trede, Dennis

    Die Entwicklung neuer Medikamente ist langwierig und teuer. Der erste Schritt ist hierbei die Suche nach neuen Wirkstoffkandidaten, die für die Behandlung bislang schwer therapierbarer Krankheiten geeignet sind. Hierfür stehen der Pharma- und Biotechnologieindustrie riesige Substanzbibliotheken zur Verfügung. In diesen Bibliotheken werden die unterschiedlichsten Substanzen gesammelt, die entweder synthetisch hergestellt oder aus Pilzen, Bakterienkulturen und anderen Lebewesen gewonnen werden können.

  17. Percutaneous Angioplasty of the Sole Patent Cerebral Artery in Two Patients with Takayasu’s Aortoarteritis

    PubMed Central

    Varghese, Kiron; Adhyapak, Srilakshmi M.

    2016-01-01

    We report two female patients with Takayasu’s aortoarteritis, who presented with symptoms of cerebral ischemia due to critical stenosis of the sole patent cerebral artery. Both had occlusion of both vertebral arteries and one carotid artery with critical stenosis of the other carotid artery and presented with hemiparesis contralateral to the patent but stenosed cerebral artery. They also had transient ischemic attacks attributable to the culprit vessel. In the first patient, balloon angioplasty alone was not successful, and hence, a self-expanding stent was deployed in the right common carotid artery. In the second patient, successful balloon angioplasty was performed for the left common carotid artery. Distal protection devices were not used, and neither patient experienced any periprocedural neurological event. Clinical follow-up at six months revealed no significant cerebral events. PMID:27042151

  18. Spontaneous Coronary Dissection: “Live Flash” Optical Coherence Tomography Guided Angioplasty

    PubMed Central

    Bento, Angela Pimenta; Fernandes, Renato Gil dos Santos Pinto; Neves, David Cintra Henriques Silva; Patrício, Lino Manuel Ribeiro; de Aguiar, José Eduardo Chambel

    2016-01-01

    Optical Coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS). The diagnosis of SCAD is made mainly with invasive coronary angiography, although adjunctive imaging modalities such as computed tomography angiography, IVUS, and OCT may increase the diagnostic yield. The authors describe a clinical case of a young woman admitted with the diagnosis of ACS. The ACS was caused by SCAD detected in the coronary angiography and the angioplasty was guided by OCT. OCT use in the setting of SCAD has been already described and the true innovation in this case was this unique use of OCT. The guidance of angioplasty with live and short images was very useful as it allowed clearly identifying the position of the guidewires at any given moment without the use of prohibitive amounts of contrast. PMID:26989520

  19. Intravascular ultrasound-guided central vein angioplasty and stenting without the use of radiographic contrast agents.

    PubMed

    Matthews, Ray; Thomas, Joseph

    2008-05-01

    Patients with contraindications to iodinated radiographic contrast agents present a significant challenge during endovascular intervention. A 46-year-old man with end-stage renal disease and a normally functioning left upper extremity arteriovenous fistula presented with severe left arm edema. The patient's history included repeated severe anaphylactoid reactions with severe respiratory distress upon exposure to iodinated contrast. In an attempt to avoid the use of iodinated contrast, angioplasty and stent placement of a severe central venous stenosis were performed using only fluoroscopy and intravascular sonography. In patients unable to receive iodinated contrast secondary to anaphylactoid reactions, intravascular sonography can be used to guide angioplasty and stenting of central venous stenosis. PMID:18286503

  20. [Catheter therapy in patients with stable angina pectoris. Results of 662 coronary angioplasties].

    PubMed

    Veselka, J; Tesar, D; Urbanová, T; Honĕk, T; Neuwirth, J

    2000-12-01

    Coronary angioplasty supplemented by implantation of a stent has become a standard therapeutic method in patients with stable angina pectoris. The authors analyzed the spectrum of patients indicated for this treatment, its successfulness and complications of catheterizations. In the course of a two-year period the authors implemented 662 catheterizations in 602 patients with stable angina. 58% patients indicated for coronary angioplasty on account of stable angina had a history of myocardial Q infarction, 93% had angina grade II or III according to CCS. Affection of one artery was diagnosed in 56% patients, complete revascularization was achieved in 59% of the operations. The clinical rate of success of catheterization was 97% in stenoses of the coronary arteries and 61% in coronary occlusions. In 57% of the treated lesions a coronary stent was implanted. Serious clinical complications developed in 1% of the interventions, none of the patients died. Catheterization treatment of stable angina is very successful and safe. PMID:11214365

  1. Stenting of a renal artery stenosis achieves better relief of the obstructive lesion than balloon angioplasty.

    PubMed

    Dorros, G; Prince, C; Mathiak, L

    1993-07-01

    A balloon-expandable (Palmaz-Schatz) stainless steel stent was utilized following balloon angioplasty (PTRA) to determine if the obstructive lesion, using quantitative methods (automated measuring the diameter stenosis, and transstenotic peak systolic and mean pressure gradients), was significantly further reduced or abolished. Hemodynamic transstenotic gradient and stenoses measurements were made during 21 renal artery stenting procedures; prior and following PTRA, and subsequent to stent deployment. The stent sizes placed in the renal arteries were 5 mm (19%), 6 mm (67%), and 7 mm (14%). The results were as follows: [table: see text] The balloon-expandable (Palmaz-Schatz) stent significantly further reduced, and in fact effectively abolished, the obstructive renal artery lesion in comparison to balloon angioplasty (PTRA). The stent's effectiveness with regard lesion recurrence, maintenance, and preservation of renal function; cure or improved management of hypertension; and survival will be determined by careful clinic follow-up. PMID:8402841

  2. Characterization of vascular strain during in-vitro angioplasty with high-resolution ultrasound speckle tracking

    PubMed Central

    2010-01-01

    Background Ultrasound elasticity imaging provides biomechanical and elastic properties of vascular tissue, with the potential to distinguish between tissue motion and tissue strain. To validate the ability of ultrasound elasticity imaging to predict structurally defined physical changes in tissue, strain measurement patterns during angioplasty in four bovine carotid artery pathology samples were compared to the measured physical characteristics of the tissue specimens. Methods Using computational image-processing techniques, the circumferences of each bovine artery specimen were obtained from ultrasound and pathologic data. Results Ultrasound-strain-based and pathology-based arterial circumference measurements were correlated with an R2 value of 0.94 (p = 0.03). The experimental elasticity imaging results confirmed the onset of deformation of an angioplasty procedure by indicating a consistent inflection point where vessel fibers were fully unfolded and vessel wall strain initiated. Conclusion These results validate the ability of ultrasound elasticity imaging to measure localized mechanical changes in vascular tissue. PMID:20727172

  3. [Angioscopic evaluation of the immediate result of coronary angioplasty in relation to balloon inflation time].

    PubMed

    Eltchaninoff, H; Cribier, A; Koning, R; Jolly, N; Baala, B; Farid, N; Letac, B

    1994-06-01

    The aim of this study was to assess the effects of coronary angioplasty on the intima with respect to the duration of balloon inflation by percutaneous angioplasty. Twenty-seven patients were randomized according to the total duration of balloon inflation: Group I "standard" duration (total duration < or = 3 min, N = 13) and Group II: prolonged duration (total duration > or = 12 min, N = 14); the type and distribution of the lesions were comparable in the two groups. The results of angioplasty were evaluated immediately after dilatation by angiography and angioscopy. Angioscopy was performed without failure or complications with perfect definition of the images in all cases. Angioscopy showed 1) intimal tears, 2) thrombi, 3) longitudinal dissections. A classification in three grades was used taking the apparent gravity of the lesions into consideration. The mean duration of balloon inflation in Group I was 205 +/- 45 s and 958 +/- 129 s in Group II. The residual stenosis was 36 +/- 8% in Group I and 26 +/- 10% in Group II (p < 0.05). Angioscopy showed the frequency of intimal tears to be twice greater in Group I (9 cases) than in Group II (4 cases) (p = 0.05). Intravascular thrombi were observed in 13 cases, 6 in Group I and 7 in Group II. One case of longitudinal dissection was observed in each group: only one of these two cases was detected at angiography. The authors conclude that repeated and prolonged balloon inflations improve the immediate results of angioplasty with less residual stenosis at angiography and a lower incidence of intimal tears at angioscopy. PMID:7702414

  4. Remodelling of the Superior Caval Vein After Angioplasty in an Infant with Superior Caval Vein Syndrome

    SciTech Connect

    Mert, Murat Saltik, Levent; Gunay, Ilhan

    2004-08-15

    An 8-month old girl was presented with superior caval vein syndrome early after cardiac surgery. Angiography showed severe stenosis of the superior caval vein with 50 mmHg pressure gradient. Following balloon angioplasty, the pressure gradient was reduced to 7 mmHg with some residual stenosis of the superior caval vein. When the patient was reevaluated 5 months after the procedure, angiography revealed a normal diameter of the superior caval vein without a pressure gradient.

  5. [Comparison of the results of coronary angioplasty and stenting during one year following surgery].

    PubMed

    Simonenko, V B; Seĭdov, V G; Zakharov, S V; Evsiukov, V V; Liubchuk, I V

    2007-01-01

    The purpose of the study was to compare long-term results of angioplasty and coronary arterial stenting (CAS) depending on the initial degree of coronary arterial (CA) lesion according to morphological stenosis classification, as well as to evaluate the influence of re-stenosis on myocardial contractility dynamics, anginal recurrence rate, and exercise tolerance. The subjects, 228 men after angioplasty and 184 men after CAS with wire stents without drug coating, were included in the study between 1989 and 2005. Coronarography was repeated in 358 patients one year after surgery. The patients were divided into two groups. The first group consisted of 161 patients, to who 180 stents were implanted. The second group consisted of 197patients, in who 226 angioplasty procedures were performed. Data were processed using standard variational statistical methods, i.e. the calculation of mean values and standard deviation. Statistical calculations were carried out using Analysis ToolPak- VBA software of Microsoft Excel 2000. The study found that one year after either intervention the number of patients without anginal symptoms fell significantly compared with this number during the in-hospital period. In group 2 the frequency of restenosis was higher and the number of patients with anginal symptoms was significantly bigger than in group 1; the number of asymptomatic patients was significantly bigger in group 1. Initial morphological characteristics of CA lesion had a significant effect on the long-term frequency of restenosis following endovascular treatment. Restenosis was 2 to 2.5 times more frequent in patients with C type CA lesion vs. patients with A type regardless the method of endovascular intervention. The results of the study demonstrate the importance of taking into account initial morphological characteristics of CA lesion; CAS is more preferable than angioplasty, especially in patients with C type CA lesion. PMID:17520881

  6. Safety and outcomes of day care based coronary angioplasty – First report from India

    PubMed Central

    Singh, Vivek Raj; Jayaraman, Balachander; Satheesh, Santhosh; Ananthakrishna Pillai, Ajith

    2015-01-01

    Background The concept of day care based coronary angioplasty might be frugal especially in countries like India where epidemic of coronary disease is enduring and healthcare delivery systems are limited. Published literature addressing the feasibility and safety of day care percutaneous coronary interventions (PCI) is lacking from our country. Objectives To study the safety and outcomes in stable cardiac patients undergoing day care coronary angioplasty. Methods A single centre nonrandomized active controlled trial of patients undergoing elective transradial coronary angioplasty and same day discharge after triaging was compared with a conventional arm of hospital overnight stay. Results Fifty six patients with stable coronary artery disease underwent day care angioplasty. There were no major immediate adverse cardiac and cerebral events noted in the first 24 h. The procedural result followed by a 6-h observation period allowed adequate triage of patients to same-day discharge or to extended clinical observation. Apart from one possible stent thrombosis on day 3 in the treatment arm where the patent received fibrinolytic treatment in a local hospital, there were no major adverse cardiac or cerebral vascular events in the study group. The six month clinical follow up in the day care procedure group was also unevenful for any major adverse cardiac events. Conclusion The study albeit small shows the feasibility and safety of day care PCI in the Indian scenario. It did not lead to additional complications compared with overnight stay. Triage of patients for an extended observation period can be performed adequately on the basis of clinical and procedural criteria. PMID:26071288

  7. Hugging balloons: coronary angioplasty of oversized vessels with side-by-side balloons.

    PubMed

    Teirstein, P S; Johnson, W L; Rutherford, B D; Hartzler, G O

    1988-01-01

    Angioplasty of large (greater than 4.0-mm) saphenous vein grafts using the largest available (4.0-mm) balloon catheters may result in inadequate graft dilatation. To avoid leaving a significant residual stenosis, two balloon catheters can be inflated side by side across the stenosis. Herein, we report two cases where this "hugging balloon" technique was used to achieve wide graft patency. PMID:2970301

  8. Combination of Rotational Atherothrombectomy and Paclitaxel-Coated Angioplasty for Femoropopliteal Occlusion

    PubMed Central

    Scheer, F; Lüdtke, CW; Kamusella, P; Wiggermann, P; Vieweg, H; Schlöricke, E; Lichtenberg, M; Andresen, R; Wissgott, C

    2014-01-01

    OBJECTIVE The rotational atherothrombectomy with Straub Rotarex® is a safe and efficient treatment of acute/subactute vascular occlusions. The purpose of this study was to evaluate the benefit of paclitaxel-coated angioplasty after rotational atherothrombectomy over an observation period of six months. MATERIALS AND METHODS Overall, 29 patients were treated with the Rotarex catheter in combination with paclitaxel-coated angioplasty. All patients had acute/subacute and chronic occlusions of the superficial femoral artery (SFA) and/or popliteal arteries. The ankle-brachial index (ABI) was detected before the intervention, after the procedure, and after six months. Also clinical examination and ultrasound scans were done in the observation period. RESULTS There were no technical failures. The ABI shows a significant increase from 0.52 ± 0.17 to 0.91 ± 0.25 in the follow-up. By ultrasound examination, there were found two (6.9%) restenoses during the follow-up. There was one dissection during the intervention (3.5%). CONCLUSION The rotational atherothrombectomy in combination with paclitaxel-coated angioplasty might be an effective and safe method with a promising low rate of restenosis at six months. PMID:25983558

  9. Detection of platelet deposition at the site of peripheral balloon angioplasty using indium-111 platelet scintigraphy

    SciTech Connect

    Pope, C.F.; Ezekowitz, M.D.; Smith, E.O.; Rapoport, S.; Glickman, M.; Sostman, H.D.; Zaret, B.L.

    1985-02-01

    Restenosis after balloon angioplasty may be mediated through platelet deposition at the site of arterial dilatation. The purpose of this study was to determine whether platelet deposition at the site of dilatation could be detected using indium-111 platelet scintigraphy. Fifteen patients, aged 60 +/- 9 years, with iliac or femoral (n . 12), renal artery (n . 2) or distal aortic (n . 1) stenoses were studied. All patients received intravenous heparin at the time of dilatation. Labeled platelets containing 471 +/- 65 muCi indium-111 were injected 0.25 to 4 hours after dilatation and 1 to 24 hours after imaging. In 11 of 12 patients with iliac and femoral dilatations, focal uptake was demonstrated at the angioplasty site. In 4 patients (2 patients with renal, 1 patient with iliofemoral, and 1 with distal aortic stenoses), uptake at the dilatation sites was not detected. This preliminary study indicates that despite intravenous heparin, platelets accumulate at sites of balloon dilatation. Platelet scintigraphy may be useful in predicting sites of future narrowing after angioplasty and may be used to test the efficacy of antiplatelet therapy in retarding restenosis.

  10. Predictive value of early maximal exercise test and thallium scintigraphy after successful percutaneous transluminal coronary angioplasty.

    PubMed Central

    Wijns, W; Serruys, P W; Simoons, M L; van den Brand, M; de Feijter, P J; Reiber, J H; Hugenholtz, P G

    1985-01-01

    Restenosis of the dilated vessel after percutaneous transluminal coronary angioplasty can be detected by non-invasive procedures but their ability to predict later restenosis soon after a successful angioplasty as well as recurrence of angina has not been assessed. A maximal exercise test and myocardial thallium perfusion scintigraphy were, therefore, performed in 91 asymptomatic patients a median of 5 weeks after they had undergone a technically successful angioplasty. Primary success of the procedure was confirmed by the decrease in percentage diameter stenosis from 64(12)% to 30(13)% as measured from the coronary angiograms and in the trans-stenotic pressure gradient (normalised for mean aortic pressure) from 0.61(0.16) to 0.17(0.09). A clinical follow up examination (8.6(4.9) months later) was carried out in all patients and a late coronary angiogram obtained in 77. The thallium perfusion scintigram showing the presence or absence of a reversible defect was highly predictive for restenosis whereas the exercise test was not. The positive predictive value of an abnormal scintigram was 82% compared with 60% for the exercise test (ST segment depression/or angina or both at peak workload). Angina or a new myocardial infarction occurred in 60% of patients with abnormal and in 21% of patients with normal scintigrams. PMID:3155619

  11. Subintimal angioplasty for superficial femoral artery occlusion: poor patency in critical ischaemia.

    PubMed Central

    Smith, B. M.; Stechman, M.; Gibson, M.; Torrie, E. P. H.; Magee, T. R.; Galland, R. B.

    2005-01-01

    INTRODUCTION: Subintimal angioplasty has been proposed for the treatment of long segment occlusive disease and for patients with critical limb ischaemia (CLI) with significant co-morbidity. There is no consensus as to short- and long-term patency. We present our experience with this technique. METHODS: Between 1995 and 2000, 43 consecutive patients (48 limbs) underwent subintimal angioplasty for superficial femoral artery occlusions. Outcome measures were haemodynamic and/or symptomatic patency. RESULTS: Technical success was achieved in 14/17 limbs with CLI (82%) and 30/31 (97%) with intermittent claudication (IC). There were 7 complications (15%), 6 occurring in the claudicant group. The median occlusion length was 10 cm for CLI and 6 cm for IC. Patency at 12 and 36 months, on an intention-to-treat basis, was 69% and 58% for claudicants and 25% and 25% for patients with CLI (P = 0.0005 and P = 0.0044, respectively). Following only technically successful procedures, 12-month patency was 72% (IC) and 31% (CLI) (P = 0.009). Patients with occlusions > or = 10 cm were more likely to re-occlude than those < 10 cm (12-month patency 60% versus 25%;P = 0.037). CONCLUSIONS: In this series, short- and long-term patency in patients with CLI is poor. Subintimal angioplasty in the treatment of CLI should be reserved for those patients not fit for surgical bypass. PMID:16176697

  12. +Ophitoxaemia and myocardial infarction--the issues during primary angioplasty: a review.

    PubMed

    Gupta, Prabha Nini; Thomas, Jinesh; Francis, Preetham Kumar; Shylaja, Sajith Vamadevan

    2014-01-01

    'The Big four' are the most poisonous snakes in India, and especially in Kerala. These include the cobra, the viper, the krait and the sea snake. Most of the poisonous snakebites in India occur in Kerala. We believe there are only a few reports of myocardial infarction after snakebites and most of these are viper bites. We believe this is the second case of primary angioplasty for a snakebite. There are at least a few potential issues in performing a primary angioplasty in a snakebite case, namely (1) Is it a thrombus or a spasm? (2) Are the bleeding parameters deranged? Will the patient tolerate tirofiban and other glycoprotein (GB) 2b3a inhibitors? Will he develop dangerous bleeding due to the high dose of heparin needed? Further, would we save the patient from myocardial infarction only to lose him to renal failure, both due to the nephrotoxicity of the venom, the kidney being further damaged by the contrast media used for the angioplasty? We discuss all these issues as they crossed our mind, and hope it will help further treatment in others. We would like to review the available literature on these points and describe a recent case of ours. PMID:25342187

  13. Percutaneous trans-ulnar artery approach for coronary angiography and angioplasty; A case series study

    PubMed Central

    Roghani-Dehkordi, Farshad; Hadizadeh, Mahmood; Hadizadeh, Fatemeh

    2015-01-01

    BACKGROUND Coronary angiography is the gold standard method for diagnosis of coronary heart disease and usually performed by femoral approach that has several complications. To reduce these complications, upper extremity approach is increasingly used and is becoming preferred access site by many interventionists. Although radial approach is relatively well studied, safety, feasibility and risk of applying ulnar approach in not clearly known yet. METHODS We followed 97 patients (man = 56%, mean ± standard deviation of age = 57 ± 18) who had undergone coronary angiography or angioplasty via ulnar approach for 6-10 months and recorded their outcomes. RESULTS In 97 patients out of 105 ones (92.38%), procedure through ulnar access were successfully done. Unsuccessful puncture (3 patients), wiring (2 patients), passing of sheet (2 patients), and anatomically unsuitable ulnar artery (1 patient) were the reasons of failure. In 94 patients (89.52%), the angiography and angioplasty was done without any complications. Five patients (5.1%) hematoma and 11 patients (11%) experienced low-grade pain that resolved with painkiller. No infection, amputation or need for surgery was reported. CONCLUSION This study demonstrated that ulnar access in our patients was a safe and practical approach for coronary angiography or angioplasty, without any major complication. Bearing in mind its high success rate, it can be utilized when a radial artery is not useful for the catheterization and in cases such as prior harvesting of the radial artery (in prior coronary artery bypass grafting). PMID:26715936

  14. Influences on vascular wall smooth muscle cells with novel short-duration thermal angioplasty

    NASA Astrophysics Data System (ADS)

    Kunio, M.; Shimazaki, N.; Arai, T.; Sakurada, M.

    2012-02-01

    We investigated the influences on smooth muscle cells after our novel short-duration thermal angioplasty, Photo-thermo Dynamic Balloon Angioplasty (PTDBA), to reveal the mechanism that can suppress neo-intimal hyperplasia after PTDBA. We obtained the sufficient arterial dilatations by short-duration heating (<=15 s, <70°C) and low dilatation pressure (<0.4 MPa) without arterial injuries in our previous in vivo studies. Smooth muscle cells, which play most important role in chronic treatment effects, were heated during PTDBA and stretch-fixed after PTDBA. The dead cell rate by heating, estimated by Arrhenius equation with A=2.5x1016 s-1 and Ea=1.17×105 J mol-1, was 15.7+/-2.2% after PTDBA. The measured deformation rate of smooth muscle cells' nuclei was 1.6+/-0.1 after PTDBA in vivo. We found that the expression of smooth muscle cells' growth factor after PTDBA was inhibited 0.52 fold compared to that after the conventional balloon angioplasty in vivo. The measured neo-intimal hyperplasia occupancy rate was less than 20% after PTDBA in vivo. We prospect that the inhibition of the growth factor's expression by stretch-fixing may result to suppress the neo-intimal hyperplasia. In addition, the decrease of smooth muscle cells' density in the vessel media by heating might be another reason for the neo-intimal hyperplasia suppression.

  15. Percutaneous peripheral laser angioplasty with a pulsed Nd:YAG laser and sapphire tips

    NASA Astrophysics Data System (ADS)

    Kvasnicka, Jan; Stanek, Frantisek; Boudik, Frantisek; Kubecek, Vaclav; Krivanek, Jiri; Keclik, Richard; Prochazkova, Helena; Hamal, Karel

    1990-07-01

    Percutaneous transluminal laser angioplasty with a pulsed Nd:YAG laser (1,064 nm wavelength, 100 jig pulse duration, up to 0.4 J per pulse, 10 Hz repetition rate) coupled to optical fibers with sapphire tips of 1.8, 2.2 and 2.9 mm diameter was performed in 17 chronic occlusions of iliac, femoral, popliteal and fibular arteries in 15 patients. Clinically the procedure was successful in 14 cases. The probe formed a primary channel of at least 2.0 mm width which was further dilated by conventional balloon catheter. Ankle/brachial systolic pressure index (ABPI) increased from 0.46 0.13 to 0.84 0.21 after the procedure. Two failures were due to an extensive dissection which occurred after balloon angioplasty and resulted in an early reocclusion. In the remaining case a balloon catheter could not be introduced through the 30 cm long primary channel which reoccluded shortly after the recanalization. The initial patency rate was 82 % and in 5 patients followed for more then 6 months the ABPI showed only a minor decrease. These first results are encouraging and it is likely that this method could become an important alternative to conventional balloon angioplasty.

  16. Influence of a variant angina on the results of percutaneous transluminal coronary angioplasty.

    PubMed Central

    Leisch, F; Schützenberger, W; Kerschner, K; Herbinger, W

    1986-01-01

    Nineteen (86%) of 22 patients with variant angina and important coronary stenoses (greater than 60%) had successful percutaneous transluminal coronary angioplasty. The acute complications in two patients were not caused by coronary spasms but by dissection with disturbance of perfusion. One of these two patients required a coronary bypass graft; the other was treated conservatively. Myocardial infarction developed in both patients. Despite long term administration of nifedipine (30-80 mg daily), restenoses occurred within six months (on average after 10 weeks) in nine patients with symptoms and one without. In four patients the restenoses exceeded the degree of stenosis before angioplasty. Five patients were revascularised by surgical means. Vessels in three out of four patients were later successfully dilated. After a mean period of observation of 24 months (6-51 months) 18 of the 19 patients are symptom free and do not require medication. The results confirm that angioplasty is an effective method of treating patients with variant angina and important coronary stenoses. The problem of the high frequency of restenosis, however, remains unresolved. PMID:2945575

  17. Suppression of Neointimal Hyperplasia Following Angioplasty-Induced Vascular Injury in Pigs Infected with Swinepox Virus

    PubMed Central

    Shimamura, Takeshi; Jeng, David; Lucas, Alexandra; Essani, Karim

    2012-01-01

    Many patients suffering from angina pectoris are treated with percutaneous coronary intervention (PCI) and quickly develop angiographic renarrowing, or restenosis, at the site of PCI treatment. Restenosis is thought to arise from the combinatorial activation of thrombotic and inflammatory responses. The inflammatory response responsible for restenosis is also thought to involve the activation of a cascade of serine proteases and its subsequent regulation. Poxviruses are known to possess a variety of immunomodulatory strategies, some of which target serine proteases, cytokines, and chemokines. To this end we evaluated whether systemic species-specific swinepox virus (SPV) infection could induce sufficient host-immune modulation to promote an anti-inflammatory and anti-proliferative effect, thereby preventing restenosis. Two groups of domestic feeder pigs were used - the first group was experimentally infected with SPV (n= 11) and the second group served as an uninfected control (n= 5). A week after infection, the pigs were anesthetized and percutaneous transluminal coronary angioplasty (PTCA) was performed in the left anterior descending coronary artery using X-ray fluoroscopy to visualize the balloon and record angiograms. Three weeks post infection, the pigs were euthanized and balloon angioplasty injured arteries were harvested and examined. We observed a statistically significant reduction of restenosis in SPV-infected pigs (p = 0.05) compared to control pigs and conclude that systemic swinepox virus infection causes sufficient host immune suppression to significantly reduce restenosis in pigs after balloon angioplasty injury. PMID:23136622

  18. Rotational atherectomy or balloon angioplasty in the treatment of intra-stent restenosis: BARASTER multicenter registry.

    PubMed

    Goldberg, S L; Berger, P; Cohen, D J; Shawl, F; Buchbinder, M; Fortuna, R; O'Neill, W; Leon, M; Braden, G A; Teirstein, P S; Reisman, M; Bailey, S R; Dauerman, H L; Bowers, T; Mehran, R; Colombo, A

    2000-12-01

    The BARASTER registry was formed to evaluate the initial success and long-term results of rotational atherectomy in the management of in-stent restenosis. Rotational atherectomy was used in 197 cases of in-stent restenosis: 46 with stand-alone rotational atherectomy or at most 1 atmosphere of balloon inflation (Rota strategy), and 151 with rotational atherectomy and adjunctive balloon angioplasty <1 atmosphere (Combination strategy). These were compared with 107 episodes of in-stent restenosis treated with balloon angioplasty alone. In this observational study, the use of Combination therapy was associated with a slightly higher initial success rate (95% vs. 87% with the Rota strategy and 89% with Balloons, P = 0.08). There was a reduction in one year clinical outcomes (death, myocardial infarction or target lesion revascularization) in the combination group (38% vs. 60% with Rota and 52% with balloons, P = 0.02). These data support a benefit of the strategy of debulking with rotational atherectomy followed by adjunctive balloon angioplasty, in the management of in-stent restenosis. PMID:11108670

  19. Coronary Angioplasty and Cancer Risk: A Population-Based Cohort Study in Sweden

    SciTech Connect

    Lambe, M. Hall, P.; Granath, F.; Azodi, O. Sadr; Nilsson, T.

    2005-01-15

    Background. Percutaneous transluminal coronary angioplasty (PTCA) has become the reperfusion method of choice in patients with coronary artery disease. This sometimes complicated and lengthy procedure is performed using fluoroscopy and cineradiography or digital imaging, which may result in considerable exposure to ionizing radiation. Possible cancer risks in PTCA patients have been discussed, but never before examined in a population-based setting. Objective. To assess the cancer risks following PTCA. Methods. A cohort study was carried out based on nationwide registration of all coronary angioplasty procedures in Sweden between 1989 and 1998. The study encompassed a total of 23,097 PTCA patients followed up for cancer outcomes in the Swedish Cancer Register until December 31, 2000. The mean and median follow-up times were 4.8 and 4.5 years, respectively. The main outcome measures were standardized incidence ratios of cancer. Results. Except for a transient excess of lung cancers, observed number of cancers in patients who had undergone coronary angioplasty did not differ from those expected in the general population. If anything, the overall cancer risk was lower in the PTCA group (SIR 0.94; 95% CI 0.88-0.99). In particular, no increased risks were detected for leukemias or thyroid cancer. Conclusion. There was no indication of increased risks of leukemia or cancers overall in PTCA patients.

  20. Matrix metalloproteinase 9 level as an indicator for restenosis following cervical and intracranial angioplasty and stenting

    PubMed Central

    Liu, Jun-peng; Wang, Yin-zhou; Li, Yong-kun; Cheng, Qiong; Zheng, Zheng

    2015-01-01

    Cervical and intracranial angioplasty and stenting is an effective and safe method of reducing the risk of ischemic stroke, but it may be affected by in-stent restenosis. The present study investigated serum level of matrix metalloproteinase 9 as a predictor of restenosis after 40 patients underwent cervical and/or intracranial angioplasty and stenting. Results showed that restenosis occurred in 30% (3/10) of patients when the serum level of matrix metalloproteinase 9 at 3 days after surgery was 2.5 times higher than preoperative level. No restenosis occurred when the serum level of matrix metalloproteinase 9 at 3 days after surgery was not 2.5 times higher than preoperative level. Restenosis occurred in 12% (2/17) of patients when the serum level of matrix metalloproteinase 9 was higher than preoperative level for more than 30 days after surgery, but only occurred in 4% (1/23) of patients when the serum level of matrix metalloproteinase 9 was higher than preoperative level for less than 30 days after surgery. However, the differences observed were not statistically significant (P > 0.05). Experimental findings indicate that when the serum level of matrix metalloproteinase 9 is 2.5 times higher than preoperative level at 3 days after cervical and intracranial angioplasty and stenting, it may serve as a predictor of in-stent restenosis. PMID:26170826

  1. ...und Einstein hatte doch recht

    NASA Astrophysics Data System (ADS)

    Will, Clifford M.; Leuchs, Anne; Leuchs, Gerd

    Keine wissenschaftliche Theorie ist auf solche Faszination auch außerhalb der Wissenschaft gestoßen wie die Allgemeine Relativitätstheorie von Albert Einstein, und keine wurde so nachdrücklich mit den Mitteln der modernen Physik überprüft. Wie hat sie diesen Test mit Raumsonden, Radioastronomie, Atomuhren und Supercomputern standgehalten? Hatte Einstein recht? Mit der Autorität des Fachmanns und dem Flair des unvoreingenommenen Erzählers schildert Clifford Will die Menschen, Ideen und Maschinen hinter den Tests der allgemeinen Relativitätstheorie. Ohne Formeln und Fachjargon wird der leser mit Einsteins Gedanken vertraut und erfährt von der Bestätigung seiner Vorhersagen, angefangen bei der Lichtablenkung im Schwerefeld der Sonne 1919 bis zu den ausgefeilten Kreiselexperimenten auf dem Space Shuttle. Die Allgemeine Relativitätstheorie hat nich nur alle diese Tests bestanden, sie hat darüber hinaus wesentlich beigetragen zu unserem Verständnis von Phänomenen wie Pulsaren, Quasaren, Schwarzen Löchern und Gravitationslinsen. Dieses Buch erzählt lebendig und spannend die Geschichte einer der größten geistigen Leistungen unserer Zeit.

  2. Pyropheophorbide und a as a catabolite of ethylene-induced chlorophyll und a degradation

    SciTech Connect

    Shimokawa, Keishi; Hashizume, Akihito ); Shioi, Yuzo )

    1990-05-01

    An enzyme extract prepared from ethylene-induced degreening Citrus fruits contains chlorophyll (Chl) degrading enzymes. The fate of Chl carbons during an enzymatic degradation was investigated using Chl {und a}-{sup 14}C. Accompanying the disappearance of labelled Chl {und a}, pheophorbide {und a} and pyropheophorbide {und a} appeared and accumulation of pyropheophorbide {und a} was observed. HydroxyChl {und a} was also detected, but this is thought to be an artifact during chromatography. Unlike ethylene-induced Citrus fruits (in vivo), further degradation of pyropheophorbide {und a} did not occur in vitro enzyme system. This suggests that there is a lack of enzyme(s) and/or cofactor(s) for further degradation. It is concluded that Chl {und a} degraded enzymatically by the following order: Chl {und a}, chlorophyllide {und a}, pheophorbide {und a} and pyropheophorbide {und a}.

  3. Beschallungstechnik, Beschallungsplanung und Simulation

    NASA Astrophysics Data System (ADS)

    Ahnert, Wolfgang; Goertz, Anselm

    Die primäre Aufgabe einer Lautsprecheranlage ist es, Musik, Sprache oder auch Signaltöne und Geräusche wiederzugeben. Diese können von einem Tonträger kommen (CD, Sprachspeicher), von einem anderen Ort übertragen (Zuspielung über Radio, TV, Telefon) oder vor Ort erzeugt werden. Letzteres umfasst Konzerte, Ansprachen, Durchsagen oder künstlerische Darbietungen, bei denen es meist darum geht, eine bereits vorhandene Quelle einer größeren oder weiter verteilten Anzahl von Personen zugänglich zu machen.

  4. Treatment of the Budd-Chiari syndrome in polycythemia vera by repeated percutaneous transluminal angioplasty of a hepatic vein stenosis

    PubMed Central

    Nishikawa, M.; Miyoshi, S.; Imai, Y.; Tarui, S.; Seki, K.; Minami, Y.; Kawata, S.; Nakamura, H.

    1982-01-01

    This report is of a 63-year-old man with polycythemia vera who developed the Budd-Chiari syndrome due to right hepatic vein stenosis. Diagnosis was made by laparoscopy and liver biopsy, and confirmed by hepatic venography. The patient was treated by percutaneous transluminal angioplasty, and recovered completely from ascites, leg oedema and venous stasis. No pulmonary embolism was observed. One month after angioplasty, a second laparoscopy and liver biopsy showed a marked improvement in hepatic congestion and haemorrhagic necrosis, thereby confirming the effectiveness of this technique in treating the Budd-Chiari syndrome. Further treatments with percutaneous transluminal angioplasty were required with a good clinical outcome. ImagesFig. 1Fig. 2Fig. 4 PMID:6215641

  5. Comparison of activation process of platelets and neutrophils after coronary stent implantation versus balloon angioplasty for stable angina pectoris.

    PubMed

    Inoue, T; Sohma, R; Miyazaki, T; Iwasaki, Y; Yaguchi, I; Morooka, S

    2000-11-15

    The pathophysiologic features of stent-induced cellular responses of platelets and leukocytes have not been established. This study was designed to clinically investigate the activation of platelets and neutrophils after coronary stenting and to identify its effects on the long-term results of coronary stents. Forty-eight consecutive patients with left anterior descending coronary artery disease indicating coronary intervention were randomly assigned to either a balloon angioplasty group or a coronary stent group. Flow cytometric analysis demonstrated that the transcardiac gradient (the value of coronary sinus blood minus the value of peripheral blood) of platelet surface expression of CD62P (p < 0.001) and CD63 (p < 0.01) increased immediately after coronary stenting, but increased less significantly immediately after balloon angioplasty (CD62P, p < 0.01; CD63, p < 0.05). These increases were persistently observed after coronary stenting but transiently after balloon angioplasty alone during a 48-hour observation period after the procedures. The gradient for neutrophil surface expression of CD11b increased, and that of CD62 L decreased 48 hours after coronary stenting (CD11b, p < 0.001; CD62 L, p < 0.05), but these changes showed less significance 48 hours after balloon angioplasty alone (CD11b, p < 0.05; CD62 L, p = NS). The gradients 48 hours after the procedures for both CD62P (r = 0.39, p < 0.05) and CD11b (r = 0.44, p < 0.01) were independently correlated with the late loss in the stent group, whereas the correlation was seen only for CD11b (r = 0.38, p < 0.05) in the balloon angioplasty group. Both platelet and neutrophil activation was greater after coronary stenting than after balloon angioplasty. Cellular interactions between platelets and neutrophils may be related to the progression of neointimal proliferation leading to restenosis after coronary stent implantation. PMID:11074199

  6. Early results of pulsed dye laser angioplasty with integral ball-tips in long femoral occlusions

    NASA Astrophysics Data System (ADS)

    Murray, Alan; Mitchell, David C.; Wood, Richard F. M.

    1990-07-01

    A Pulsed Dye laser together with specifically designed integral ball-tipped optical fibres have been used for the primary recanalisation of femoropopliteal vascular disease in 25 limbs of 23 patients. All patients had complete occlusions of the vessels ranging from 8-49cms in length (mean 22cms), having presented with critical ischaemia (18) or severe claudication warranting operative intervention (5). Pedal ulceration was present in 8 limbs and digital gangrene in 4. The laser produced visible light at 480nm in lOOmJ/lus pulses, at a frequency of 10-20Hz. The energy delivery device comprised a smooth atraumatic ball-tip constructed from the glass of the optical fibre, which was loaded retrogradely into a standard balloon angioplasty catheter. The device was introduced through a common femoral artery cutdown. Angiographic recanalisation was achieved in 22 of the 25 limbs with a mean energy of 280J(range 68-727J) and in each case the channel created by the laser fibre was augmented by balloon angioplasty. Technical failure occurred in three cases, caused by a wall dissection, persistent side-branch entry and incomplete lesion penetration respectively. Eighteen of procedures (72%) were clinically successful with marked symptomatic improvement. Of the four angiographic successful but clinical failures, acute occlusion within 48 hours occurred in 2 diabetic patients with very poor run-off and distal gangrene. The third case failed acutely due to a technically inadequate balloon dilatation and the fourth patient failed to improve symptomatically due to widespread with segmental tibial vessel disease below a successful recanalisation. Over a mean follow-up period of 7 months, three patients died of myocardial infarction. Twelve of the 23 patients (52%) remain well with patent vessels. These early results demonstrate the efficacy of pulsed dye laser angioplasty using ball-tipped optical fibres.

  7. Experimental analysis of sapphire contact probes for Nd-YAG laser angioplasty.

    PubMed

    Ashley, S; Brooks, S G; Gehani, A A; Kester, R C; Rees, M R

    1990-06-01

    Laser angioplasty may offer percutaneous recanalization of occluded vessels where conventional guidewire and balloon techniques fail. Metal laser thermal angioplasty probes may, however, cause excessive thermal damage due to high tip temperatures (greater than 400.C). Therefore, contact probes made from artificial sapphire crystal designed for general laser surgery are currently being evaluated for use in laser angioplasty with continuous wave Nd-YAG energy. The sapphire modifies the laser energy in various ways, and this paper examines the physical characteristics of five types of rounded sapphire probe (SMTR, MTR, MTRL, OS, LT) and how these properties are affected by clinical usage. The laser beam profile emitted by these probes demonstrates a focal spot 1-2 mm in front of the tip. However, the forward transmission of Nd-YAG energy through the sapphires varied (SMTR, 85%; MTR, 83%; MTRL, 75%; OS, 54%; LT, 69%). Probe heating occurs owing to energy absorption within the sapphire. The surface temperature of the sapphires was measured in air by infrared thermography and the hottest region within the probes localized by an isothermographic technique. At energy settings used clinically (20 J, 10 watts for 2 s) the SMTR, MTR, and MTRL probes exhibited higher temperature rises (94-112.C) than the OS and LT probes (30.C), and heating was localized to the front surface of the former probes. Peak sapphire temperatures remained lower than those of metal probes even at higher energies. After clinical use, the MTR probe demonstrated reduced transmission, beam defocusing, and increased heating, due to surface pitting. Thus, recanalization with sapphire probes occurs by a combination of photothermal and contact thermal effects that are localized to the probe tip and may reduce the degree of thermal injury associated with metal probes. Understanding these basic properties is important to the application and development of contact probes for laser recanalization. PMID:2142867

  8. Preclinical Feasibility of a Technology Framework for MRI-guided Iliac Angioplasty

    PubMed Central

    Rube, Martin A.; Fernandez-Gutierrez, Fabiola; Cox, Benjamin F.; Holbrook, Andrew B.; Houston, J. Graeme; White, Richard D.; McLeod, Helen; Fatahi, Mahsa; Melzer, Andreas

    2015-01-01

    Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries. Methods A 1.5T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-Ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed. Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-Ray guided procedure. Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation. PMID:25102933

  9. Cardiac release of chemoattractants after ischaemia induced by coronary balloon angioplasty.

    PubMed Central

    Neumann, F J; Richardt, G; Schneider, M; Ott, I; Haupt, H M; Tillmanns, H; Schömig, A; Rauch, B

    1993-01-01

    OBJECTIVE--To investigate the release of chemoattractants after myocardial ischaemia during balloon angioplasty. DESIGN--Sampling of femoral arterial and coronary sinus blood before and immediately after the first balloon inflation during angioplasty. In a study group of 16 patients the balloon was kept expanded for two minutes, whereas in a control group of eight patients the first balloon inflation was brief (< 10 s). MAIN OUTCOME MEASURES--Chemotaxis of neutrophils from healthy donors towards patient plasma (Boyden chamber), superoxide anion production by normal neutrophils after incubation with patient plasma (cytochrome C reduction). RESULTS--In the study group, coronary sinus plasma after balloon deflation was more chemoattractive to normal neutrophils (median relative increase 24% (quartiles: 4%, 45%), p = 0.008) and induced a higher superoxide anion production in normal neutrophils (44% (10%, 97%), p = 0.013) than arterial plasma. Concomitantly, the degree of activation of patient neutrophils was increased in coronary sinus blood compared with arterial blood, as shown by an increased proportion of neutrophils reducing nitro-blue tetrazolium (21% (9%, 38%), p = 0.006) and a decreased neutrophil filter-ability (-16%(-3%, -40%), p = 0.003) in coronary sinus blood. In the study group before balloon inflation and in the control group before and after balloon inflation differences between arterial and coronary sinus blood were not significant. Signs of ischaemia (lactate release, ST segment changes) were only detected in the study group. CONCLUSION--After transient myocardial ischaemia during balloon angioplasty there is a local release of chemoattractants, associated with neutrophil activation. PMID:8037995

  10. Percutaneous peripheral excimer laser angioplasty: immediate success rate and short-term outcome

    NASA Astrophysics Data System (ADS)

    Visona, Adriana; Liessi, Guido; Bonanome, Andrea; Lusiani, Luigi; Miserocchi, Luigi; Pagnan, Antonio

    1991-05-01

    Excimer Laser Angioplasty was attempted in 47 patients (36 males, 11 females, mean age 62+/- 7 years, range 39-77 years), affected by peripheral vascular disease. Thirty-seven patients had a total occlusion of the superficial femoral artery, 3 of the iliac artery and 1 of the popliteal artery; 6 patients showed a subocclusive stenosis of the superficial femoral artery. Occlusions and subocclusive stenoses were classified by length: < 10 cm (28 cases), > 10 cm (19 cases). A commercial excimer laser (Technolas Max-10) was used at the Xenon- Chloride wavelength of 308 nm. The laser operated at 60 ns pulse length and at 20-40 Hz repetition rate. Applied energy fluence was 20 mJ/pulse. The energy was delivered through a multifiber catheter, which combines 12 (7F) or 18 (9F) fibers (260 micron diameter each), concentrically arranged. Balloon dilatation was associated to complete the procedure in 38 cases. The treated arteries were successfully recanalized in 41 out of 47 patients (87%). Hemodynamic improvement was confirmed by a significant increase of ankle/brachial systolic pressure index (from 0.60+/- 0.17 to 0.79+/- 0.20, p < 0.005). Failure to recanalize arterial occlusion occurred in 6 cases, and was due to dissection in 3 patients and inability to cross the final segment of a long occlusion in 3 patients. The success rate was higher for lesions < 10 cm in length. Early reocclusion was observed in 7 patients and was associated with poor run-off. The cumulative patency rate at 1 month was 90.7%. Preliminary results are encouraging. More suitable catheters and better selection of patients should improve the efficacy of laser angioplasty and should allow to perform laser procedures without combining balloon angioplasty.

  11. [Correction of dyslipidemia in patients with arteriosclerosis obliterans as a method for improving the results of endovascular angioplasty].

    PubMed

    Petukhov, V A; Seitmykhamedov, M D; Dibirov, A D; Dubovik, S G; Sergeeva, N A; Prokubovskiĭ, V I

    1992-01-01

    The authors analyse the results of endovascular angioplasty of the pelvic and lower limb arteries in 147 patients of various age suffering from arteriosclerosis obliterans. It was found that the results of endovascular angioplasty depended on the state of the lipid balance. The necessity for correcting the shifts in the lipid metabolism is shown. The article evaluates the results of dyslipidemia correction by dietotherapy, pharmacotherapy, and operation for partial ilio-shunting in patients with arteriosclerosis obliterans of the pelvic and lower limb arteries. The efficacy of the listed methods of treatment are analysed according to the severity of dyslipidemia. PMID:1457133

  12. Spontaneous Recanalization of Superior Mesenteric Artery Occlusion Following Angioplasty and Stenting of Inferior Mesenteric Artery

    SciTech Connect

    Akpinar, Erhan Cil, Barbaros E.; Arat, Anil; Baykal, Atac; Karaman, Kerem; Balkanci, Ferhun

    2006-02-15

    An 84-year-old woman with a history of hypertension and coronary artery disease was admitted with a progressively worsening diffuse abdominal pain. Computed tomography scan of the abdomen and angiography revealed occlusion of the origin and proximal portion of superior mesenteric artery. Aortography also showed severe origin stenosis of inferior mesenteric artery and that the distal part of the superior mesenteric artery was supplied by a prominent marginal artery of Drummond. Patient was effectively treated with percutaneous transluminal angioplasty and stenting of the inferior mesenteric artery. Follow-up imaging studies demonstrated patency of the stent and spontaneous recanalization of superior mesenteric artery occlusion.

  13. Early and Long-Term Results of Subclavian Angioplasty in Aortoarteritis (Takayasu Disease): Comparison with Atherosclerosis

    SciTech Connect

    Tyagi, Sanjay; Verma, Puneet K.; Gambhir, Daljeet S.; Kaul, Upkar A.; Saha, Renuka; Arora, Ramesh

    1998-05-15

    Purpose: To compare the early andlong-term outcomes of subclavian artery angioplasty in patients with aortoarteritis and atherosclerosis. Methods: Sixty-one subclavian artery angioplasties were performed in 55 consecutive patients with aortoarteritis (n= 32) and atherosclerosis (n= 23) between 1986 and 1995. An arch aortogram followed by a selective subclavian artery angiogram was done to profile the site and extent of the lesion, its relation to the vertebral artery, and the distal circulation. Percutaneous transluminal angioplasty (PTA) was performed via the femoral route for 56 stenotic lesions and 5 total occlusions. Results: PTA was successful in 52 (92.8%) stenotic lesions and 3 (60%) total occlusions. Three patients (5.4%) had complications, that could be effectively managed nonsurgically. Compared with atherosclerosis, patients with aortoarteritis were younger (27.4 {+-} 9.3 years vs 54.5 {+-} 10.5 years; p < 0.001), more often female (75% vs 17.4%; p < 0.001), gangrene was uncommon (0% vs 17.4%; p < 0.05), and diffuse involvement was seen more often (43.8% vs 4.4%; p < 0.001). The luminal diameter stenoses were similar before PTA (88.6 {+-} 9.7% vs 89.0 {+-} 9.1%; p= NS). Higher balloon inflation pressure was required to dilate the lesions of aortoarteritis (9.9 {+-} 4.6 ATM vs 5.5 {+-} 1.0 ATM; p < 0.001). This group had more residual stenosis (15.5 {+-} 12.4% vs 8.3 {+-} 9.4%; p < 0.05) after PTA. There were no neurological sequelae, even in PTA of prevertebral lesions. On 3-120 months (mean 43.3 {+-} 28.9 months) follow-up of 40 patients, restenosis was more often observed in patients with aortoarteritis, particularly in those with diffuse arterial narrowing. These lesions could be effectively redilated. Clinical symptoms showed marked improvement after successful angioplasty. Conclusion: Subclavian PTA is safe and can be performed as effectively in aortoarteritis as in atherosclerosis, with good long-term results. Long-term follow-up shows that it

  14. Failure and Success of Percutaneous Angioplasty in a Hypertensive Child with Bilateral Renal Artery Stenosis

    SciTech Connect

    Giavroglou, Constantinos; Tsifountoudis, Ioannis; Boutzetis, Theodoros; Kiskinis, Dimitrios

    2009-01-15

    We describe the clinical course of a 5-year-old girl with severe arterial hypertension that was uncontrollable with antihypertensive medication. Renal angiography revealed bilateral renal artery stenoses. Because percutaneous transluminal renal angioplasty (PTRA) failed to dilate the stenotic lesions, a renal artery bypass grafting in both renal arteries was performed. The patient remained normotensive for 7 months, and after that the arterial pressure increased again. Digital subtraction angiography demonstrated stenosis at the peripheral and central anastomosis of the vein graft that was used for revascularization of the left kidney. PTRA was decided on and successful patency was achieved. The patient has now been normotensive for a period of 5 years.

  15. Renaturierung und Management von Heiden

    NASA Astrophysics Data System (ADS)

    Härdtle, Werner; Assmann, Thorsten; van Diggelen, Rudy; von Oheimb, Goddert

    Heiden zählen zu den ältesten und besonders reizvollen Kulturlandschaften Nordwesteuropas. Sie sind bezeichnend für nährstoffarme Böden in wintermilden Gebieten mit hohen Sommerniederschlägen. Während Heiden vor wenigen Jahrhunderten noch weit verbreitet und für manche Landschaften sogar prägend waren, hat sich ihr Areal heute auf wenige, meist in Naturschutzgebieten gelegene Restbestände verkleinert. Zu diesem Rückgang haben maßgeblich Änderungen der Landnutzung, aber auch Nährstoffeinträge aus umgebenden Agrarflächen und atmogene Depositionen beigetragen. In den meisten Ländern der Europäischen Union sind Heiden heute gesetzlich geschützte Ökosysteme, da diese, neben ihrem Erholungswert für den Menschen, Pflanzen- und Tierarten beherbergen, die außerhalb von Heiden nicht oder kaum überlebensfähig sind.

  16. Comparison of left ventricular ejection fraction and inducible ventricular tachycardia in ST-elevation myocardial infarction treated by primary angioplasty versus thrombolysis.

    PubMed

    Chong, James J H; Ganesan, Anand N; Eipper, Vicki; Kovoor, Pramesh

    2008-01-15

    Electrophysiologic studies predict the risk for sudden death after myocardial infarction (MI). Although primary angioplasty has become the preferred method of treatment for ST-elevation MI, intravenous thrombolysis remains the first-line treatment in 30% to 70% of cases worldwide. Rates of ventricular tachyarrhythmias may vary according to type of reperfusion treatment. This study was undertaken to examine the hypothesis that the left ventricular ejection fraction (LVEF) and rates of inducible ventricular tachycardia may be more favorable in treatment with primary angioplasty rather than thrombolysis. Consecutive patients receiving primary angioplasty (n = 225) or thrombolysis (n = 195) for ST-elevation MI were included. The mean LVEF was 48 +/- 12% for the primary angioplasty group and 46 +/- 13% for the thrombolysis group (p = 0.30). The proportion of patients with LVEFs <40% was 30% in the primary angioplasty group and 30% in the thrombolysis group (p = 0.98). Patients with LVEFs <40% underwent electrophysiologic studies. Ventricular tachycardia was inducible in 23 of 66 primary angioplasty patients (34.8%) compared with 21 of 55 (38.1%) thrombolysis patients (p = 0.69). Implantable cardiac defibrillators were inserted in 30 patients, of whom 8 (27%) had appropriate device activations. The mean time from MI to first spontaneous activation was 387 +/- 458 days. In conclusion, patients treated with thrombolysis or primary angioplasty for ST-elevation MIs had similar resultant LVEFs and rates of inducible ventricular tachycardia. There was a surprisingly high rate of spontaneous defibrillator activations, often occurring late after MI. PMID:18178398

  17. Differential glomerular filtration rate in diagnosis of renovascular hypertension and follow-up of balloon angioplasty

    SciTech Connect

    Lamki, L.; Spence, J.D.; MacDonald, A.C.; Roulston, M.

    1986-03-01

    Two hundred nine hypertensive patients with high stimulated plasma renin levels were screened for renovascular hypertension using Tc-99m DTPA renal scintigraphy. Differential glomerular filtration rate (Diff-GFR) was obtained by integrating the area under the background-subtracted renogram of each kidney between 1 and 3 minutes. 50 patients who also had undergone selective renal angiography were divided into four groups according to Diff-GFR contribution by one of the kidneys. If one kidney contributed 45-50% of total GFR, this was regarded as normal. A Diff-GFR of less than 45% was very considered to be very suggestive of renovascular hypertension in the appropriate clinical setting, while a Diff-GFR of less than 20% indicated that the renal artery might not be amenable to successful balloon angioplasty. Diff-GFR following balloon angioplasty closely reflected the early clinical response of the patients--and in some cases progressive Diff-GFR improvement was observed several months later. Diff-GFR as a scintigraphic criterion for renovascular hypertension has a sensitivity of 93%, specificity of 74%, and accuracy of 85%.

  18. Fiberoptic study on the effects of transluminal angioplasty in experimental occlusive arterial thrombosis.

    PubMed

    Tomaru, T; Uchida, Y; Sugimoto, T

    1988-02-01

    Percutaneous transluminal coronary angioplasty has been proposed as definitive therapy for coronary recanalization of occluded coronary arteries in patients with acute myocardial infarction (AMI). The effects of transluminal angioplasty (TA) on experimental occlusive canine arterial thrombi that closely simulated the clinical condition was examined by a fiberoptic method. Experimental arterial thrombosis was produced by endothelial denudation and induction of luminal stenosis. Eighteen dogs that showed total occlusion of the iliac artery with thrombi were evaluated. Seven dogs (group A) with 6-hour-old thrombi received 20,000 IU/kg intravenous urokinase (UK) but did not show recanalization. TA was performed with a Gruentzig or Simpson-Robert balloon catheter and its effect was evaluated by a vascular fibroscope. Eight dogs (group B) with 6-hour-old thrombi underwent primary TA. After TA, less than 50% luminal obstruction with residual thrombi was visualized in five dogs (71%) of group A and four dogs (50%) of group B. Residual thrombi showed a doughnut-like or globular type shape and consisted of dense fibrin networks and compact platelet aggregates. All dogs in group B received 20,000 IU/kg intravenous UK after TA, but most of them showed progression of thrombus size despite UK infusion. In conclusion, the results suggest (1) that TA is effective in recanalization of an occluded artery with aged thrombus that is resistant to thrombolytic therapy and (2) that vascular fiberscope is a useful method for evaluation of the effects of TA on occlusive arterial thrombus. PMID:2963513

  19. Experience of Staged Angioplasty to Avoid Hyperperfusion Syndrome for Carotid Artery Stenosis

    PubMed Central

    UCHIDA, Kazutaka; YOSHIMURA, Shinichi; SHIRAKAWA, Manabu; SHINDO, Seigo; EGASHIRA, Yusuke; IWAMA, Toru; YAMADA, Kiyofumi

    2015-01-01

    Hyperperfusion syndrome (HPS) after carotid artery stenting (CAS) may cause hemorrhagic or ischemic events leading to serious sequelae. We previously reported the staged angioplasty (SAP) to prevent HPS. In the present study, we analyzed our treatment results of SAP to know its effectiveness and problems. The study included 43 patients scheduled for SAP in whom preoperative single photon emission computed tomography (SPECT) showed severely impaired cerebral blood flow (CBF). The analyzed subjects were 38 males and 4 females, mean age was 73 ± 8.5 years old. SAP was indicated for the patients whose CBF ratio in the affected/unaffected hemisphere (asymmetry index) was below 0.8, and cerebrovascular reactivity measured by acetazolamide challenge was below 10%. First, percutaneous transluminal angioplasty (PTA) was performed. If PTA was successful, CAS was performed 2 weeks later. If PTA was not successful due to inadequate dilatation or extensive dissection, a stent was placed. SPECT was performed immediately after PTA and CAS to confirm the presence or absence of hyperperfusion phenomenon (HPP) indicating radiologic hyperperfusion. In 39 of 43 patients (91%), SAP was successfully performed and HPP was not observed. On the other hand, in the other four patients (9%), immediate stent placement was added due to inadequate dilatations in three patients and vascular dissection in one. Among 43 candidates for SAP, 41 patients (95.4%) had favorable course, but one hemorrhagic and one ischemic complications were observed after PTA. SAP was a relatively simple procedure, and its clinical results seemed acceptable. PMID:26447098

  20. Interleukin-6 and asymmetric dimethylarginine are associated with platelet activation after percutaneous angioplasty with stent implantation.

    PubMed

    Gremmel, Thomas; Perkmann, Thomas; Kopp, Christoph W; Seidinger, Daniela; Eichelberger, Beate; Koppensteiner, Renate; Steiner, Sabine; Panzer, Simon

    2015-01-01

    Data linking in vivo platelet activation with inflammation and cardiovascular risk factors are scarce. Moreover, the interrelation between endothelial dysfunction as early marker of atherosclerosis and platelet activation has not been studied, so far. We therefore sought to investigate the associations of inflammation, endothelial dysfunction and cardiovascular risk factors with platelet activation and monocyte-platelet aggregate (MPA) formation in 330 patients undergoing angioplasty with stent implantation for atherosclerotic cardiovascular disease. P-selectin expression, activation of glycoprotein IIb/IIIa and MPA formation were determined by flow cytometry. Interleukin (IL)-6, high sensitivity C-reactive protein and asymmetric dimethylarginine (ADMA) were measured by commercially available assays. IL-6 was the only parameter which was independently associated with platelet P-selectin expression and activated GPIIb/IIIa as well as with leukocyte-platelet interaction in multivariate regression analysis (all p<0.05). ADMA was independently associated with GPIIb/IIIa activation (p<0.05). Patients with high IL-6 exhibited a significantly higher expression of P-selectin than patients with low IL-6 (p=0.001), whereas patients with high ADMA levels showed a more pronounced activation of GPIIb/IIIa than patients with low ADMA (p=0.003). In conclusion, IL-6 and ADMA are associated with platelet activation after percutaneous angioplasty with stent implantation. It remains to be established whether they act prothrombotic and atherogenic themselves or are just surrogate markers for atherosclerosis with concomitant platelet activation. PMID:25807315

  1. Use of mechanical devices for distal hemoperfusion during balloon catheter coronary angioplasty.

    PubMed

    Heibig, J; Angelini, P; Leachman, D R; Beall, M M; Beall, A C

    1988-01-01

    Previous attempts to protect the dependent myocardium during balloon catheter coronary angioplasty in animals and humans have had generally unsatisfactory results. This paper summarizes the authors' experience in investigating commercially available mechanical pumps for distal coronary hemoperfusion during balloon angioplasty. Both roller and piston pumps can attain adequate distal perfusion without significant side effects in the majority of patients. Our goal was to suppress angina for at least 5 min to prolong balloon inflation in awake patients. Minor T-wave changes without concomitant angina pectoris can be expected when the distal coronary bed is perfused with hypothermic blood. Side branch occlusion by the inflated balloon prevents effective protection of the corresponding part of the dependent myocardium during distal hemoperfusion, which may result in persistent angina and ST-T changes uncorrected by increasing the hemoperfusion rate. Distal coronary diffuse spasm, rare and transient, was the only immediate complication of this procedure. It is suggested that intense local wall stimulation could occur with a higher flow rate (jet effect). Improved balloon catheter pressure/flow characteristics and on-line continuous mechanical pumps should soon make distal coronary hemoperfusion through balloon catheters an accepted clinical technique. PMID:2973837

  2. Platelet deposition at angioplasty sites and its relation to restenosis in human iliac and femoropopliteal arteries

    SciTech Connect

    Minar, E.; Ehringer, H.; Ahmadi, R.; Dudczak, R.; Leitha, T.; Koppensteiner, R.; Jung, M.; Stuempflen, A.

    1989-03-01

    The amount and time course of platelet accumulation at angioplasty sites and influence of these platelets on restenosis after percutaneous transluminal angioplasty (PTA) in peripheral arteries were determined in 92 patients, who received either a high or low dose of aspirin. Platelet deposition was quantitated by means of dual-radiotracer scintigraphy and calculation of a platelet accumulation index (PAI). The PAI was higher (P less than .05) 4-6 hours after PTA compared with that on subsequent days. There was a trend toward greater platelet accumulation in vessels with extensive dissection. Platelet accumulation at the PTA site occurred with both doses of aspirin, with no differences between the two dosage groups. Twenty-one of 67 patients who underwent PTA in the femoropopliteal segment developed restenosis during a median follow-up of 14 months. The median PAI at 4-6 and 22-24 hours after PTA was significantly less in these 21 patients than in the 46 without restenosis. The data suggest that use of antiplatelet agents to prevent platelet deposition after PTA may not be useful for prevention of restenosis.

  3. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III.

    PubMed

    Uberoi, Raman; Milburn, Simon; Moss, Jon; Gaines, Peter

    2009-09-01

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online. PMID:19644643

  4. Primary success and one-year followup of percutaneous peripheral excimer laser angioplasty

    NASA Astrophysics Data System (ADS)

    Visona, Adriana; Liessi, Guido; Miserocchi, Luigi; Bonanome, Andrea; Lusiani, Luigi; Breggion, Giovanni; Pagnan, Antonio

    1992-08-01

    Excimer laser angioplasty was performed in 59 patients (44 males and 17 females, mean age 63 +/- 9 years, range 39 - 77) affected by peripheral vascular disease. Fifty patients had a total occlusion of the superficial femoral artery, three of the iliac artery, and one of the popliteal artery; seven patients showed a subocclusive stenosis of the superficial femoral artery. A commercial excimer laser (Technolas Max-10) was used at the Xenon-Chloride wavelength of 308 nm. The laser operated at 120 ns pulse length and at 20 Hz repetition rate. Applied energy fluence was 20 mJ/pulse. The energy was delivered through a multifiber catheter, which combines 12 (7F) or 18 (9F) fibers (260 micron diameter each), concentrically arranged. Balloon dilatation was associated in 51 patients. Successful recanalization was obtained in 59 out of 61 patients (97%). Failure to recanalize the occluded arteries occurred in two cases, and was due to dissection. Early thrombosis and reocclusion (within 48 hours) was observed in five patients. The cumulative patency rate was 56% at one year. On the basis of these results, excimer laser assisted angioplasty seems a feasible and safe procedure. However, this technique did not solve the restenosis problem. A wide application of excimer laser as a stand alone approach can be foreseen for treatment of peripheral vascular disease.

  5. British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

    SciTech Connect

    Uberoi, Raman Milburn, Simon; Moss, Jon

    2009-09-15

    The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data, and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.

  6. Interleukin-6 and Asymmetric Dimethylarginine Are Associated with Platelet Activation after Percutaneous Angioplasty with Stent Implantation

    PubMed Central

    Gremmel, Thomas; Perkmann, Thomas; Kopp, Christoph W.; Seidinger, Daniela; Eichelberger, Beate; Koppensteiner, Renate; Steiner, Sabine; Panzer, Simon

    2015-01-01

    Data linking in vivo platelet activation with inflammation and cardiovascular risk factors are scarce. Moreover, the interrelation between endothelial dysfunction as early marker of atherosclerosis and platelet activation has not been studied, so far. We therefore sought to investigate the associations of inflammation, endothelial dysfunction and cardiovascular risk factors with platelet activation and monocyte-platelet aggregate (MPA) formation in 330 patients undergoing angioplasty with stent implantation for atherosclerotic cardiovascular disease. P-selectin expression, activation of glycoprotein IIb/IIIa and MPA formation were determined by flow cytometry. Interleukin (IL)-6, high sensitivity C-reactive protein and asymmetric dimethylarginine (ADMA) were measured by commercially available assays. IL-6 was the only parameter which was independently associated with platelet P-selectin expression and activated GPIIb/IIIa as well as with leukocyte-platelet interaction in multivariate regression analysis (all p<0.05). ADMA was independently associated with GPIIb/IIIa activation (p<0.05). Patients with high IL-6 exhibited a significantly higher expression of P-selectin than patients with low IL-6 (p=0.001), whereas patients with high ADMA levels showed a more pronounced activation of GPIIb/IIIa than patients with low ADMA (p=0.003). In conclusion, IL-6 and ADMA are associated with platelet activation after percutaneous angioplasty with stent implantation. It remains to be established whether they act prothrombotic and atherogenic themselves or are just surrogate markers for atherosclerosis with concomitant platelet activation. PMID:25807315

  7. Ressourceneinsatzplanung In der Energie- und Verfahrenstechnik

    NASA Astrophysics Data System (ADS)

    Engell, Sebastian; Handschin, Edmund; Rehtanz, Christian; Schultz, Rüdiger

    Der ökologisch nachhaltige, wirtschaftlich effiziente und politisch faire Umgang mit den Ressourcen der Erde ist eine der größten Herausforderungen an die Menschheit im 21. Jahrhundert und impliziert Paradigmenwechsel in allen Bereichen des gesellschaftlichen Lebens. Energie- und Verfahrenstechnik sind traditionell Bereiche, in denen der optimale Umgang mit kostbaren und beschränkt verfügbaren Ressourcen von erstrangiger Bedeutung ist. Zur Lösung der damit verbundenen komplexen Entscheidungsprobleme sind mathematische Methoden schon seit längerem im Einsatz. Hierbei können aber noch längst nicht alle bislang aufgetretenen Probleme fundiert angegangen werden. Der wachsende wirtschaftliche und ökologische Druck auf die Effizienz der Produktions-und Versorgungssysteme sowie stärkere Schwankungen von Angebot und Nachfrage führen zu neuen Herausforderungen, für die neue mathematische Methoden und Algorithmen entwickelt werden müssen.

  8. Welt und Wirkungsprinzip (2nd Aufl.)

    NASA Astrophysics Data System (ADS)

    Landgraf, Werner

    2010-03-01

    Modell einer kausalen Bewirkung der Welt, und logische, geometrische, physikalische Interprätation dieser Kausalmenge und Fortwirkung der frühsten ihrer sukzessiv als echt Neues bewirkten und durch Vorhandenes oder Späteres nicht darstellbaren oder widerrufbaren Ereignisse als Dimensionen und sie verkörpernde primäre Naturkräfte, mit Korrespondenz zur beobachteten Welt und ihrer grundlegendsten Eigenschaften. Wirklich ist nur was wirkt, wo und wie. Entsprechend ist im Bogenelement statt der Eigenzeit die variante Anzahl Wirkungen relevant, 0 ≈ 1/h2 dS2 - 1/tpl2 (dt2 - 1/c2 {dq12 + G02/G2 [dq2,32 - ...]}) mit G0 = c4lpl/Epl ≈ G. Die heutigen Dimensionen und Naturkräfte entstanden in dieser Reihenfolge, haben 'komplementäre' aber gleichwertige statische und dynamische Aspekte, entsprechend ihren Termen in Bogenelement bzw. Vierervektor, aus derem Vergleich sowie mit denen ihrer Nachbarn folgen Grundgleichungen bzw. Erhaltungssätze. Jeweils individuelle Eigenschaften wie ihre Naturkonstante konkretisieren sie und tragen zu gattungsmäßigen wie globale Affinität und Äquivalenzen bei. Ältestes Gebiet oder räumlicher Rand jeder Dimension sind die ersten vom Vorgänger bewirkten Ereignisse, selbst raumzeitlicher Ursprung des Nachfolgers, dort einmalig und ewig maximal rotverschoben fortwirkend und nicht lokalisierbar, um neue Elementareinheiten verschieden und lichtartig mit deren Verhältnis oder dem ihrer globalen Zustandsgrößen als konstanten Anfangsimpuls, Expansion, Längen- oder Ereignisdichte zueinander. Der Übergang vom diskreten Modell weniger Informationen zum Kontinuum und die Korrespondenz zur Physik ist problemlos, Details wie ein kontinuierlicher, abrupter oder ganz fehlender Abfall der Metrik beim ältesten Gebiet sind aber nur durch Beobachtungen entscheidbar. Erörtert werden allgemeine und individuelle Eigenschaften und ihre Konsequenzen der Dimensionen mit ihren Kräften, selbst und im Verhältnis zueinander, etwa ihrer begrenzten

  9. Systemic Hypertension and Transient Ischemic Attack in a 6-Year-Old Girl with Fibromuscular Dysplasia Treated with Percutaneous Angioplasty

    SciTech Connect

    Foa-Torres, Gustavo; Ganame, Javier; Juaneda, Ernesto; Peirone, Alejandro; Barcudi, Maria Silvina; Achaval, Alberto

    2010-02-15

    We describe a 6-year-old girl with arterial hypertension secondary to fibromuscular dysplasia with stenoses of both renal arteries and transient ischemic attack due to extracranial right internal carotid artery subtotal occlusion as well as left internal carotid artery stenosis. She was treated with percutaneous angioplasty of both renal and both carotid arteries.

  10. THE CORONARY ARTERY HISTOPATHOLOGIC RESPONSE TO ANGIOPLASTY BALLOON INJURY IN A SWINE MODEL IS GENDER- AND HORMONAL-DEPENDENT

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effects of gender and exogenous estrogen on the histopathologic response of the left anterior descending coronary artery (LAD) to angioplasty balloon over-inflation were examined in this study. In addition, we sought to develop an animal model to predict adequately the effects of cardiovascular ...

  11. Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

    SciTech Connect

    Bhat, Rajesh McBride, Kieran; Chakraverty, Sam; Vikram, Raghunandan; Severn, Alison

    2007-11-15

    Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reduction ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.

  12. Cryoplasty Versus Conventional Angioplasty in Femoropopliteal Arterial Recanalization: 3-Year Analysis of Reintervention-Free Survival by Treatment Received

    SciTech Connect

    Diaz, Maria Lourdes; Urtasun, Fermin Barberena, Javier; Aranzadi, Carlos; Guillen-Grima, Francisco; Bilbao, Jose Ignacio

    2011-10-15

    Purpose: To compare long-term efficacy of cryoplasty therapy versus conventional angioplasty in the treatment of peripheral arterial atherosclerotic stenosis on the basis of our 3-year clinical experience. Materials and Methods: From January 2006 to December 2008, a total of 155 patients with 192 lesions of the femoropopliteal sector were randomized to receive either cryoplasty or conventional balloon angioplasty. The primary study end point was lesion target patency. Follow-up with clinical evaluation of patient's symptoms, ankle-brachial index, and Doppler ultrasound was scheduled at 1, 6, 9, 12, 24, and 36 months. Results: For the cryoplasty group (n = 86), technical immediate success was achieved in 74.4% of lesions. Rate of significant dissection was 13.5% and rate of stent placement of 22%. In the long term, target lesion patency rate at 6 months was 59.4%, with rates of 55.9, 52.6, and 49.1% at 1, 2, and 3 years, respectively. For the conventional angioplasty group (n = 69), the immediate technical success rate was 83.7%. Rate of significant dissection was 19%, and rate of stent placement was 72.9%. Patency rates at 6 months and at 1, 2, and 3 years were 71.5, 61.2, 60, and 56%, respectively. Conclusion: Compared with conventional angioplasty, cryoplasty showed good immediate success rates with lower stent placement rates. During the 3-year follow-up, patency rates tended to equalize between the two modalities.

  13. Efficacy of Local Molsidomine Delivery from a Hydrogel-Coated Angioplasty Balloon Catheter in the Atherosclerotic Porcine Model

    SciTech Connect

    Rolland, Pierre H.; Mekkaoui, Choukri; Palassi, Maria; Friggi, Alain; Moulin, Guy; Piquet, Philippe; Bartoli, Jean-Michel

    2003-02-15

    Purpose: To evaluate the therapeutic effects of local molsidomine delivery via a hydrogel-coated angioplasty balloon catheter during overstretch angioplasty in atheroscleroticswine iliac vessels. Molsidomine is retained in the arterial wall after local delivery for more than 72 hr and is slowly metabolized intolinsidomine, releasing nitric oxide (NO). Methods: A hydrogel-coated angioplasty balloon catheter was used to both deliver drug locally (150 mg molsidomine or placebo in the contralateral vessel) and dilate iliac vessels in nine Pietrin pigs that had been on an atherogenic diet for 5 months. Animals were killed at 3 hr(n = 2), 24 hr (n = 3) and 3 months(n = 3) after treatment. Iliac arteries were examined for wall pulsatility, histomorphometry, cell proliferation and platelet aggregation. Results: No significant therapeutic effects were detected 3 hr after treatment. At 24 hr, wall pulsatility,thrombo resistance and vascular cell homeostasis were significantly restored in the molsidomine-treated versus placebo group. At 3 months,molsidomine inhibited restenotic lesion development, except in scarred areas of histologically detectable adventitial/medial dissection. Conclusion: Local delivery of concentrated molsidomine from a hydrogel-coated angioplasty balloon catheter resulted in early NO-dependent vasodilation/stress normalization and antithrombotic and antiproliferative effects. In the medium term, molsidomine inhibited restenosis in the absence of vessel dissection.

  14. [Evidenzbasierte Leitlinien, Anspruch und Wirklichkeit].

    PubMed

    Gutsch, Johannes; Reif, Marcus; Müller-Hübenthal, Boris; Matthiessen, Peter F

    2016-01-01

    Mit der Konzeption der «Evidenzbasierten Medizin» und den «Evidenzbasierten Leitlinien» soll mithilfe von Formalisierungsprozeduren die ärztliche Irrtumsanfälligkeit kalkulierbar gemacht werden. Quantifizierte objektive Aussagen über die therapeutische Wirksamkeit einer Behandlung sollen die individuelle ärztliche Beurteilung der therapeutischen Wirksamkeit überflüssig machen. Damit kommt der Befolgung von formalen Regeln die entscheidende Rolle bei der Beantwortung der Frage nach dem Wahrheitsgehalt und dem Wirklichkeitsbezug zu. Im Rahmen evidenzbasierter Leitlinien werden vorrangig die Ergebnisse randomisierter kontrollierter Studien (RCT) oder Meta-Analysen solcher Studien herangezogen. Am Beispiel der S3-Leitlinie «Malignes Melanom» wird hier eine evidenzbasierte Urteilsbildung zur Wirksamkeit einer unkonventionellen Therapie - hier mit einem Mistelpräparat - analytisch nachvollzogen. Die für die Beurteilung dieser unkonventionellen Therapie herangezogene randomisierte Studie wird genauer methodisch analysiert. Obwohl sie keine statistisch basierte Aussage zulässt, wurde eine Leitlinienempfehlung auf Basis dieser Studie abgeleitet. Es wird gezeigt, dass 1) allein die Existenz einer einzigen RCT mit hoher Evidenz gleichgesetzt wird, 2) die Ergebnisse trotz beträchtlicher Fehlinterpretationen in eine S3-Leitlinie einfließen und 3) Meinungen anstelle kritischer wissenschaftlicher Analysen verarbeitet werden. Unsere Untersuchung zeigt, dass noch so ausgefeilte epistemologische und methodologische Formalien den Arzt nicht von der Pflicht entbinden, auf Basis seiner ärztlichen Erfahrung und professionellen Kompetenz den Realitätswert der ihm zur Verfügung stehenden Information zu beurteilen. PMID:27161555

  15. Percutaneous Transluminal Angioplasty and Enclosed Thrombolysis Versus Percutaneous Transluminal Angioplasty in the Treatment of Femoropopliteal Occlusions: Results of a Prospective Randomized Trial

    SciTech Connect

    Nicholson, Tony

    1998-11-15

    Purpose: To determine whether percutaneous transluminal angioplasty (PTA) and enclosed thrombolysis (ET) is superior to PTA alone in the treatment of femoropopliteal occlusions. Methods: Twenty-five patients with 5-15-cm-long occlusions in the femoropopliteal segments, with otherwise normal run-in arteries and at least one normal tibioperoneal artery to the foot, were randomized to ET/PTA or PTA alone. Ankle brachial systolic index (ABI) was measured before the procedure and at 24 hr and 12 months after the procedure, when a duplex scan was also carried out. End points in the study were patency at, or repeat intervention before, 12 months. Results: Procedures were successful in 23 of 25 patients. There was one immediate occlusion of tibioperoneal arteries, and one early reocclusion of a reopened segment in the ET/PTA group. There was one early reocclusion in the PTA group. At 12 months patency was 70% and 69.2% in the ET/PTA and PTA groups respectively. Covariant analysis showed no significant difference in ABI between the two groups at any of the three measurement times. Conclusion: This trial demonstrated no difference between ET/PTA and PTA alone in femoropopliteal occlusions associated with normal proximal arteries and at least one normal tibioperoneal artery.

  16. [Vegetarische und vegane Ernährung bei Kindern - Stand der Forschung und Forschungsbedarf].

    PubMed

    Keller, Markus; Müller, Stine

    2016-01-01

    Die Praxis vegetarischer Ernährungsformen ist in Deutschland im letzten Jahrzehnt deutlich angestiegen. Allerdings ist der Anteil vegetarischer und veganer Kinder dabei unbekannt. Studien mit Erwachsenen zeigen das präventive Potenzial, aber auch potenzielle Schwachstellen pflanzenbasierter Kostformen. Die Vorteile und Risiken einer vegetarischen bzw. veganen Ernährung im Kindesalter wurden bisher jedoch relativ selten untersucht. Außerdem lassen das unterschiedliche Alter der Kinder, das heterogene Studiendesign sowie die teilweise geringe Probandenzahl der Studien keine verbindlichen Aussagen zu. In dieser Übersichtsarbeit werden die Ergebnisse der wenigen Studien zu vegetarisch und vegan ernährten Kindern (< 12 Jahren) in Nordamerika und Europa zusammengefasst. Demnach lag die Zufuhr von Nahrungsenergie und Makronährstoffen vegetarischer und veganer Kinder meist näher an den Empfehlungen der Fachgesellschaften als die Ernährung gleichaltriger Mischkostkinder. Ebenso wiesen vegetarisch und vegan ernährte Kinder eine höhere Zufuhr von und bessere Versorgung mit verschiedenen Vitaminen und Mineralstoffen auf. Häufiger zeigten sich jedoch Defizite bei Vitamin B12, Zink, Kalzium, Eisen und Vitamin D. Das Wachstum und die Entwicklung vegetarisch und vegan ernährter Kinder entsprachen weitgehend den Referenzstandards, wobei sie dazu tendierten, leichter, schlanker und (< 5 Jahren) auch kleiner zu sein. Aufgrund der unzureichenden Studienlage besteht erheblicher Forschungsbedarf zu den Auswirkungen einer vegetarischen und veganen Ernährung im Kindesalter. PMID:27160086

  17. Restaurierung von Seen und Renaturierung von Seeufern

    NASA Astrophysics Data System (ADS)

    Grüneberg, Björn; Ostendorp, Wolfgang; Leßmann, Dieter; Wauer, Gerlinde; Nixdorf, Brigitte

    Süßwasserseen haben als ökosysteme und Lebensraum für Pflanzen und Tiere eine herausragende Bedeutung für die Artenvielfalt auf der Erde und prägen als Landschaftselemente unsere natürliche Umwelt. Seen fungieren als natürliche Stoffsenken, vor allem für Kohlenstoff und Nährstoffe, aber auch als Senken für in ihren Einzugsgebieten emittierte gelöste und feste Schadstoffe. Darüber hinaus ist Wasser eine wichtige Naturressource. Süßwasserseen stellen in den meisten Regionen der Erde lebenswichtige Quellen für die Versorgung mit Trinkwasser und tierischem Eiweiß (Fischfang) dar. Sie dienen als Wasserspeicher für die landwirtschaftliche und industrielle Nutzung. Auch für Erholungsaktivitäten des Menschen kommt ihnen eine große Bedeutung zu.

  18. Bewegungsapparat: Postcraniales Skelett und Muskulatur

    NASA Astrophysics Data System (ADS)

    Fischer, Martin S.

    Der Bewegungsapparat bestimmt die Form des Wirbeltierkörpers. So lässt sich z. B. aus der Gestalt eines Fisches auf seine bevorzugt e Schwimmweise schließen (S. 61). Bei den aquatisch en Schädeltieren dominiert die Fortbewegung mit axialem Antrieb; bei den meisten Tetrapoda findet sich eine Kombination aus axialem Antrieb und Bewegung durch Gliedmaßen. Selbst beim höchst spezialisierten Gang, der bipeden Bewegung des Menschen, sind Torsionsbewegungen des Rumpfes noch maßgeblich und bestimmen auch die Grundform des menschlichen Körpers (z. B. die Taille). Obwohl die verschiedenen Antriebsmechanismen eine funktionelle Einheit bilden, werden im Folgenden das Axialskelett sowie der Schulter- und Beckengürtel mit den zugehörigen Extremitäten getrennt besprochen.

  19. Cutting Balloon Angioplasty of Bilateral Renal Artery Stenosis Due to Takayasu Arteritis in a 5-Year-Old Child with Midterm Follow-Up

    SciTech Connect

    Gumus, Burcak Cevik, Halime; Vuran, Can; Omay, Oguz; Kocyigit, Ozgen Ilgaz; Turkoz, Riza

    2010-04-15

    The aim of this report is to demonstrate the successful endovascular treatment of bilateral renal artery stenosis due to Takayasu arteritis by cutting balloon angioplasty in a 5-year-old child with mid-term follow-up.

  20. What practical factors guide the choice of stent and protection device during carotid angioplasty?

    PubMed

    Bosiers, M; Deloose, K; Verbist, J; Peeters, P

    2008-06-01

    The importance of angioplasty and stenting in the treatment of carotid artery disease cannot be underestimated. Successful carotid stenting does not only depend of the operator's skills and experience, but also an adequate selection of cerebral protection devices and carotid stents can help avoiding neurological complications. A broad spectrum of carotid devices is currently on the market and since all have their assets and downsides, it is virtually impossible to acclaim one specific device as being the best. The individual characteristics of each specific protection system or stent may make it an attractive choice in one circumstance, but render it a less desirable option in others situations. The applicability depends primarily on the arterial anatomy and the specific details of the lesion being treated. But certainly, personal preferences and familiarity with a specific device may legitimately influence the decision to choose one over another. PMID:18375153

  1. Iatrogenic Subtotal Stenosis of the Right Subclavian Artery Treated With Percutaneous Transluminal Angioplasty

    SciTech Connect

    Smeenk, Robert M.; Kock, Mark C. J. M.; Elgersma, Otto E. H.; Schnater, Marco J.

    2011-02-15

    This report describes a rare vascular complication of surgical placement of a marking clip and a possible approach to problem solving. A 55-year-old patient presented with loss of sensation in the fingers and loss of peripheral pulsations in the right arm 4 days after right upper lobectomy for a pT2N1 moderately differentiated adenocarcinoma of the lung. Duplex examination and computed tomography were performed the same day and showed a subtotal stenosis of the right subclavian artery, which was caused by the surgical placement of a metal clip to mark the surgical boundary. Selective angiography was subsequently performed. Percutaneous transluminal angioplasty (PTA) successfully dilated the stenosis and pushed the clip off. Flow in the right subclavian artery (RSA) was completely restored as were neurology and peripheral pulses. In conclusion, arterial stenosis by a surgical (marking) clip may be feasibly treated with PTA.

  2. Preliminary results utilizing a new percutaneous transluminal coronary angioplasty balloon catheter.

    PubMed

    Talley, J D; Joseph, A; Kupersmith, J

    1990-06-01

    We report our initial experience with a new percutaneous transluminal coronary angioplasty (PTCA) balloon catheter and compare it to a similar over-the-wire system in a retrospective, nonrandomized fashion. There was no statistical difference in pre-PTCA angiographic indices and post-PTCA angiographic and clinical success rates between the two groups. There was a trend toward a decrease in length of fluoroscopy (P = .08) and a significant decrease in the amount of contrast utilized (P = .007) with the new balloon catheter. Several new construction features of the new catheter account for this improvement and are discussed. The long-term success of this balloon catheter remains to be investigated. PMID:2354509

  3. Usefulness of intraoperative coronary angioplasty in aorto-coronary bypass surgery.

    PubMed

    Ban, T; Sakata, R; Soneda, J; Matsuda, M; Nishimura, K; Hirata, K; Mochizuki, T

    1985-10-01

    Seven patients underwent aorto-coronary bypass grafting combined with intraoperative transluminal coronary angioplasty (OTCA), because of multiple obliteration of the coronary arteries with poor distal run-off. The patients were all males with a mean age of 52.6 years. For OTCA, a SIMPSON-ROBERT vascular dilator system was used. Eight stenoses in seven patients, four in the left anterior descending artery (LAD) and three in the right coronary artery (RCA) were dilated by means of OTCA. In five patients the results were satisfactory but in two patients the procedures resulted in failure. Dilatation failed because of severe calcification of LAD in one case and, in the other, distal RCA was completely obstructed by a compressed atherosclerotic plaque at the bifurcation after the procedure. From these limited experiences we believe that OTCA might be a method of selection to treat the patients with coronary sclerosis with poor distal run-off. PMID:2935652

  4. Transauricular balloon angioplasty in rabbit thoracic aorta: a novel model of experimental restenosis

    PubMed Central

    2014-01-01

    Background The aim of this study was to demonstrate a percutaneous transauricular method of balloon angioplasty in high-cholesterol fed rabbits, as an innovative atherosclerosis model. Methods Twenty male New Zealand rabbits were randomly divided into two groups of ten animals, as follows: atherogenic diet plus balloon angioplasty (group A) and atherogenic diet alone (group B). Balloon angioplasty was performed in the descending thoracic aorta through percutaneous catheterization of the auricular artery. Eight additional animals fed regular diet were served as long term control. At the end of 9 week period, rabbits were euthanized and thoracic aortas were isolated for histological, immunohistochemical and biochemical analysis. Results Atherogenic diet induced severe hypercholesterolemia in both group A and B (2802 ± 188.59 and 4423 ± 493.39 mg/dl respectively) compared to the control animals (55.5 ± 11.82 mg/dl; P < 0.001). Group A atherosclerotic lesions appeared to be more advanced histologically (20% type IV and 80% type V) compared to group B lesions (50% type III and 50% type IV). Group A compared to group B atherosclerotic lesions demonstrated similar percentage of macrophages (79.5 ± 9.56% versus 84 ± 12.2%; P = 0.869), more smooth muscle cells (61 ± 14.10% versus 40.5 ± 17.07; P = 0.027), increased intima/media ratio (1.20 ± 0.50 versus 0.62 ± 0.13; P = 0.015) despite the similar degree of intimal hyperplasia (9768 ± 1826.79 μm2 versus 12205 ± 8789.23 μm2; P = 0.796), and further significant lumen deterioration (23722 ± 4508.11 versus 41967 ± 20344.61 μm2; P = 0.05) and total vessel area reduction (42350 ± 5819.70 versus 73190 ± 38902.79 μm2; P = 0.022). Group A and B animals revealed similar nitrated protein percentage (P = NS), but significantly higher protein nitration compared to control group (P < 0.01; P < 0.01, respectively

  5. [A Case of Vertebral Artery Stenosis Presenting with Progressing Stroke and Treated by Percutaneous Transluminal Angioplasty].

    PubMed

    Hayashi, Kentaro; Matsuo, Yoshitaka; Toyoda, Keisuke; Hayashi, Yukishige; Shirakawa, Kiyoshi; Kaminogo, Makio

    2016-05-01

    A 75-year-old man with a history of diabetes mellitus and hypertension was suffered from dizziness and vomiting and brought to the near-by hospital. MRI showed cerebellar infarction due to right vertebral artery stenosis. Despite best medical treatment, the infarction progressed day by day and he was transferred to our hospital five days later. Neurological examination showed mild disturbance of consciousness and right hemiparesis. Right vertebral angiography revealed high-grade stenosis accompanied with atherosclerosis at the V3-V4 portion. Percutaneous transluminal angioplasty(PTA)was performed with 2.5mm×14mm balloon with 6 atm dilation. Postoperative course was uneventful and no further stroke occurred after the treatment. PTA was effective for vertebral artery stenosis manifested with progressing stroke. The indication of stent placement for the cerebral artery should be prudent. PMID:27166843

  6. Intravascular Ultrasound and Histology in In Vitro Assessment of Iliac Artery Angioplasty

    SciTech Connect

    Lankeren, Winnifred van; Gussenhoven, Elma J.; Qureshi, Akeel; Lugt, Aad van der

    1999-01-15

    Purpose: Intravascular ultrasound (IVUS) was used to assess in vitro the morphologic and quantitative effects of balloon angioplasty (PTA) of the iliac artery. Methods: Forty human iliac arteries ({>=} 30% area stenosis) were studied with IVUS in vitro before and after PTA and the findings were validated with histology. Results: The sensitivity of IVUS for dissection was 74% and for media rupture 59%. The incidence of vascular damage was higher when the whole segment was analyzed rather than the target site alone. Dissections occurred at the thinnest region of the plaque, unrelated to plaque calcification. Following PTA, quantitative changes at the target site were greater compared with the overall data derived from all cross-sections. The increase in lumen area was caused solely by an increase in vessel area. Conclusions: IVUS is sensitive in detecting dissections, which occurred irrespective of calcification at the thinnest region of the plaque. The increase in lumen area after PTA was caused by stretching of the vessel.

  7. Percutaneous pulmonary vein stenosis angioplasty complicated by rupture: successful stenting with a polytetrafluoroethylene-covered stent.

    PubMed

    Matsumoto, Takashi; Zahn, Evan M; Kar, Saibal

    2014-06-01

    A 47-year-old-man with prior pulmonary vein (PV) isolation for atrial fibrillation developed progressive shortness of breath and was found to have total occlusion of the left lower and significant stenosis in left upper PV. A ventilation/perfusion scan showed decreased left lung perfusion. Percutaneous PV stenosis angioplasty was complicated by the rupture of left lower PV with pericardial tamponade; successful stenting with a polytetrafluoroethylene-covered stent was performed. Follow-up studies at nine months showed patency of both veins with a normal ventilation perfusion scan. In this article, we will discuss acquired PV stenosis following PV isolation, percutaneous PV intervention, and the literature supporting the procedure. PMID:24590687

  8. Clinical results and quality of life after percutaneous transluminal coronary angioplasty: a preliminary report.

    PubMed

    McKenna, K T; McEniery, P T; Maas, F; Aroney, C N; Bett, J H; Cameron, J; Garrahy, P; Holt, G; Hossack, K F; Murphy, A L

    1992-10-01

    To evaluate the effect of percutaneous transluminal coronary angioplasty (PTCA) on quality of life, data on symptomatic status, functional capacity, life satisfaction, and psychological wellness were collected on 102 patients at 1 day pre-PTCA and 2 months post-PTCA, and on the first 50 of these patients at 10 months post-PTCA. There were highly significant changes (p < 0.001) in all quality of life measures between pre-PTCA and the 1st follow-up measurements. No further significant changes occurred in these measures between the 1st and 2nd follow-up measurements, indicating that the initial improvement in quality of life was sustained over this period. Data on primary success rate, complications, and pre- and post-PTCA risk factor scores are also reported. PMID:1446341

  9. Stent-Graft for the Management of Hepatic Artery Rupture Subsequent to Transcatheter Thrombolysis and Angioplasty in a Liver Transplant Recipient

    SciTech Connect

    Yamakado, Koichiro Nakatsuka, Atsuhiro; Takaki, Haruyuki; Usui, Masanobu; Sakurai, Hiroyuki; Isaji, Shuji; Uemoto, Shinji; Takeda, Kan

    2008-07-15

    Arterial rupture subsequent to angioplasty occurs in about 5% of cases. Thrombolysis with re-establishment of flow without resolving underlying anatomic defects such as hepatic arterial stenosis leads to re-thrombosis. We present a case of arterial anastomotic rupture after thrombolysis and angioplasty of an underlying anastomotic hepatic arterial stenosis. Both the underlying anatomic defect and the rupture were resolved successfully with placement of a stent-graft, with a resultant patent artery for 1 year after the procedure.

  10. Effect of gradual computerized angioplasty on outcomes of patients undergoing coronary stenting.

    PubMed

    Leibowitz, David; Lotan, Chaim; Katz, Iony; Nassar, Hisham; Boguslavsky, Larissa; Mosseri, Morris; Jabara, Refat; Varshitzsky, Boris; Danenberg, Haim; Weiss, A Teddy

    2009-07-15

    Mechanical trauma caused by percutaneous coronary intervention is a major factor contributing to subsequent cardiac events, restenosis, and the need for target lesion revascularization (TLR). To minimize this trauma, we developed a Computerized Angioplasty Pressure Sensor and Inflator Device (CAPSID) for gradual inflation. The objective of the present prospective randomized study was to examine whether the use of this novel device reduced TLR, as well as cardiac events, in patients undergoing stenting. Patients undergoing coronary stenting were eligible and randomized to receive CAPSID or standard manual percutaneous coronary intervention. In the CAPSID group, slow, gradual balloon inflation was performed using a personal computer. Patients with acute ST-elevation myocardial infarction or the need for percutaneous coronary intervention for total occlusions, left main disease, and vein grafts were excluded. Clinical follow-up for major adverse cardiac events, including death, acute myocardial infarction, and TLR, was performed at 12 months. A total of 310 patients were enrolled in the study. No significant differences were found in the clinical characteristics between the CAPSID and control groups. At 1 year of follow-up, the CAPSID group had had a significantly lower rate of major adverse cardiac events (8% vs 18%, p <0.01) driven by significantly lower rates of acute myocardial infarction (1% vs 7%, p <0.01) and TLR (5% vs 12%, p <0.05). In conclusion, gradual computerized balloon inflation using CAPSID as a platform for angioplasty and stenting significantly reduced TLR and major adverse cardiac events at 1 year in patients undergoing coronary stenting. The use of this novel device may improve outcomes in patients undergoing coronary stenting. PMID:19576351

  11. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    PubMed Central

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long

  12. Critical appraisal of paclitaxel balloon angioplasty for femoral-popliteal arterial disease.

    PubMed

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel -DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long-term impact

  13. Patient Experience, Pain, and Quality of Life after Lower Limb Angioplasty: A Multisite Prospective Cohort Study

    SciTech Connect

    Culverwell, A. D.; Tapping, C. R.; Ettles, D. F.; Kessel, D.

    2012-08-15

    Purpose: To explore the experience of patients undergoing endovascular lower limb angioplasty and evaluate the improvements in quality of life and disease-related symptoms after the procedure. Methods: Patients completed a questionnaire before treatment and three questionnaires after the procedure (immediately after the procedure, and again 4 weeks and 3 months later). Anxiety, patient understanding, procedure-related pain, and disease-related pain were assessed by a visual analog score (VAS). Complications, analgesic requirements, and satisfaction were recorded. Changes to quality of life were assessed by the validated SF36 questionnaire. Results: A total of 88 patients (41%) responded. Overall, disease-related pain decreased over 3 months after the procedure. Smokers had more pain both before and after the procedure (P < 0.05). Explanation was considered better if provided by radiologist (P < 0.05). Sixty-nine percent of patients found the procedures less painful (mean VAS 2.5) than they had anticipated (VAS 5.5). Fifty percent of patients experienced adverse effects related to their puncture site, but this was highest among patients who had undergone the procedure before and smokers. The greatest quality-of-life improvements were in emotional and general health. Higher levels of disease-related pain were associated with worse general, emotional, and physical health (P < 0.05). Conclusion: Lower limb angioplasty provides symptomatic and quality-of-life improvements. Implementation of simple measures could improve patient satisfaction-for example, treatment should be explained by the radiologist in advance. Routine prescription of analgesics with particular attention to smokers and those undergoing repeat interventions is suggested.

  14. Potential Utility of the SYNTAX Score 2 in Patients Undergoing Left Main Angioplasty

    PubMed Central

    Madeira, Sérgio; Raposo, Luís; Brito, João; Rodrigues, Ricardo; Gonçalves, Pedro; Teles, Rui; Gabriel, Henrique; Machado, Francisco; Almeida, Manuel; Mendes, Miguel

    2016-01-01

    Background The revascularization strategy of the left main disease is determinant for clinical outcomes. Objective We sought to 1) validate and compare the performance of the SYNTAX Score 1 and 2 for predicting major cardiovascular events at 4 years in patients who underwent unprotected left main angioplasty and 2) evaluate the long-term outcome according to the SYNTAX score 2-recommended revascularization strategy. Methods We retrospectively studied 132 patients from a single-centre registry who underwent unprotected left main angioplasty between March 1999 and December 2010. Discrimination and calibration of both models were assessed by ROC curve analysis, calibration curves and the Hosmer-Lemeshow test. Results Total event rate was 26.5% at 4 years.The AUC for the SYNTAX Score 1 and SYNTAX Score 2 for percutaneous coronary intervention, was 0.61 (95% CI: 0.49-0.73) and 0.67 (95% CI: 0.57-0.78), respectively. Despite a good overall adjustment for both models, the SYNTAX Score 2 tended to underpredict risk. In the 47 patients (36%) who should have undergone surgery according to the SYNTAX Score 2, event rate was numerically higher (30% vs. 25%; p=0.54), and for those with a higher difference between the two SYNTAX Score 2 scores (Percutaneous coronary intervention vs. Coronary artery by-pass graft risk estimation greater than 5.7%), event rate was almost double (40% vs. 22%; p=0.2). Conclusion The SYNTAX Score 2 may allow a better and individualized risk stratification of patients who need revascularization of an unprotected left main coronary artery. Prospective studies are needed for further validation. PMID:27007223

  15. Characterization of Pebax angioplasty balloon surfaces with AFM, SEM, TEM, and SAXS.

    PubMed

    Warner, Jacob A; Forsyth, Bruce; Zhou, Fang; Myers, Jason; Frethem, Chris; Haugstad, Greg

    2016-04-01

    In the medical device industry, angioplasty balloons have been widely used in the less invasive treatment of heart disease by expanding and relieving clogged structures in various arterial segments. However, new applications using thin coatings on the balloon surface have been explored to enhance therapeutic value in the delivery of pharmaceuticals (drug-elution) or control thermal energy output (RF ablation). In this study, angioplasty balloon materials comprised of poly(ether-block-amide) (Pebax) were investigated via atomic force microscopy (AFM), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and small-angle X-ray scattering (SAXS) to characterize physical properties at the balloon surface that may affect coating adhesion. The soft segment of this Pebax 1074 material is polyethylene oxide (PEO) and the hard segment is nylon-12. The morphology of the hard segments of this block co-polymer are found via AFM stiffness measurements to be (40 ± 20) nm by (300 ± 150) nm and are oriented parallel to the surface of the balloon. SAXS measurements found the lamellar spacing to be (18.5 ± 0.5) nm, and demonstrate a preferential orientation in agreement with TEM and AFM measurements. Fixation of this balloon in resin, followed by cryo-sectioning is shown to provide a novel manner in which to investigate surface characteristics on the balloon such as material or coating thickness as well as uniformity in comparison to the bulk structure. These outputs were deemed critical to improve overall balloon processing such as molding and surface treatment options for robust designs toward better procedural outcomes targeting new therapeutic areas. PMID:25891789

  16. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    PubMed

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  17. Balloon Angioplasty – The Legacy of Andreas Grüntzig, M.D. (1939–1985)

    PubMed Central

    Barton, Matthias; Grüntzig, Johannes; Husmann, Marc; Rösch, Josef

    2014-01-01

    In 1974, at the Medical Policlinic of the University of Zürich, German-born physician-scientist Andreas Grüntzig (1939–1985) for the first time applied a balloon-tipped catheter to re-open a severely stenosed femoral artery, a procedure, which he initially called “percutaneous transluminal dilatation”. Balloon angioplasty as a therapy of atherosclerotic vascular disease, for which Grüntzig and Charles T. Dotter (1920–1985) received a nomination for the Nobel Prize in Physiology or Medicine in 1978, became one of the most successful examples of translational medicine in the twentieth century. Known today as percutaneous transluminal angioplasty (PTA) in peripheral arteries or percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) in coronary arteries, balloon angioplasty has become the method of choice to treat patients with acute myocardial infarction or occluded leg arteries. On the occasion of the 40th anniversary of balloon angioplasty, we summarize Grüntzig’s life and career in Germany, Switzerland, and the United States and also review the developments in vascular medicine from the 1890s to the 1980s, including Dotter’s first accidental angioplasty in 1963. The work of pioneers of catheterization, including Pedro L. Fariñas in Cuba, André F. Cournand in France, Werner Forssmann, Werner Porstmann and Eberhard Zeitler in Germany, António Egas Moniz and Reynaldo dos Santos in Portugal, Sven-Ivar Seldinger in Sweden, and Barney Brooks, Thomas J. Fogarty, Melvin P. Judkins, Richard K. Myler, Dickinson W. Richards, and F. Mason Sones in the United States, is discussed. We also present quotes by Grüntzig and excerpts from his unfinished autobiography, statements of Grüntzig’s former colleagues and contemporary witnesses, and have included hitherto unpublished historic photographs and links to archive recordings and historic materials. This year, on June 25, 2014, Andreas Grüntzig would have celebrated

  18. Comparative Efficacy of Pulse-Spray Thrombolysis and Angioplasty Versus Surgical Salvage Procedures for Treatment of Recurrent Occlusion of PTFE Dialysis Access Grafts

    SciTech Connect

    Polak, Joseph F.; Berger, Markus F.; Pagan-Marin, Heriberto; Aruny, John E.; Meyerovitz, Michael F.

    1998-07-15

    Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone (p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty [0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision.

  19. Lineare und verzweigte Blockcopolymere aus Polypeptiden und synthetischen Polymeren

    NASA Astrophysics Data System (ADS)

    Kukula, Hildegard

    2001-07-01

    Die vorliegende Arbeit beschäftigt sich mit der Synthese und den Eigenschaften von linearen und verzweigten amphiphilen Polypeptid-Blockcopolymeren. Die Frage nach dem Einfluss der Topologie und Konformation der Blockcopolymere auf die supramolekularen und kolloidalen Eigenschaften bildete einen wichtigen Aspekt bei den Untersuchungen. Die Blockcopolymere wurden nach einem mehrstufigen Reaktionsschema durch Kombination von anionischer und ringöffnender Polymerisation von Aminosäuren-N-Carboxyanhydriden (NCA) synthetisiert. Die Untersuchung der Polypeptid-Blockcopolymere hinsichtlich ihres Aggregationsverhaltens in fester Phase sowie in verdünnter wässriger Lösung erfolgte mittels Streumethoden (SAXS, WAXS, DLS) sowie abbildender Methoden (TEM). Durch Einsatz der Blockcopolymere als polymere Stabilisatoren in der Emulsionspolymerisation wurden Oberflächen funktionalisierte Latizes erhalten. Als Beispiel für eine pharmazeutische Anwendung wurden bioverträgliche Polypeptid-Blockcopolymere als Wirkstoff-Trägersysteme in der Krebstherapie eingesetzt. This work describes the synthesis and characterization of linear and branched polypeptide block copolymers having amphiphilic character. The studies focused on the impact of the block copolymers' conformation and architecture on the supramolecular and colloidal properties. The polypeptide block copolymers were prepared in a multi-step process involving the anionic synthesis of (poly)amino-functional polymers (polystyrene and polybutadiene) which where used as macroinitiators for the ring-opening polymerization of N-carboxyanhydrides (NCA) of protected a-aminoacids. Supramolecular structures of the block copolymers in the solid state as well as in diluted aqueous solution were investigated using scattering (SAXS, WAXS, DLS) and microscopic (TEM) methods. Both linear and branched polypeptide block copolymers were used as polymeric stabilizers in the emulsion polymerization of styrene to yield polypeptide

  20. Dynamische Motorvermessung mit verschiedenen Methoden und Modellen

    NASA Astrophysics Data System (ADS)

    Schreiber, Alexander

    Die stark zunehmenden gesetzlichen und wirtschaftlichen Vorgaben zur Senkung von Kraftstoffverbrauch und Abgasemissionen stellen große Anforderungen an die weitere Entwicklung von Benzin- und Dieselmotoren. Hierbei sind grundlegende Fortschritte durch Konstruktion und auslegungsbedingte Maßnahmen im Bereich der Einspritzung, Gemischaufbereitung, Aufladung, Brennverfahren und Abgasnachbehandlung zu erreichen. Ein wesentlicher Teil dieser Verbesserungen wird jedoch durch eine Zunahme von Variabilitäten erreicht wie z.B. verstellbaren Vor-, Haupt- und Nacheinspritzungen, variablem Raildruck, variablen Nockenwellensteuerwinkeln, Ventilhüben, Drall-/Tumbleklappen sowie verstellbaren Abgasturbinen, Abgasrückführströmen und Abgasnachbehandlungssystemen. Dadurch steigt die Zahl der Stellglieder (Aktoren) stark an. Hinzu kommen zusätzliche Sensoren wie z.B. für Luftzahl, NOx, Brennraumdruck, Abgastemperatur und Abgasdruck. Deshalb nimmt der Umfang der Steuerungs-, Regelungs- und Diagnosefunktionen in der Motorelektronik (ECU) stark zu. Bild 7-1 zeigt als Beispiel den Signalfluss für die gesteuerten und geregelten Größen eines Dieselmotors in einer beispielhaften Prüfstandsumgebung.

  1. Holmium:YAG laser coronary angioplasty: quantitative angiography and clinical results in a large experience of a single medical center

    NASA Astrophysics Data System (ADS)

    Topaz, On; Luxenberg, Michael; Schumacher, Audrey

    1994-07-01

    Clinical experience with the mid IR holmium:YAG laser in a single medical center (St. Paul Ramsey Medical Center, University of Minnesota Medical School, St. Paul, MN) includes 112 patients who underwent holmium laser coronary angioplasty. Utilizing a unique lasing technique; `pulse and retreat,' we applied this laser to thrombotic and nonthrombotic lesions in patients presenting with unstable angina, stable angina, and acute myocardial infarction. A very high clinical success and very low complication rates were achieved. Holmium:YAG laser is effective and safe therapy for patients with symptomatic coronary artery disease. Unlike excimer lasers, the clinical success, efficacy and safety of holmium laser angioplasty is not compromised when thrombus is present.

  2. Heme oxygenase-1 alleviates cigarette smoke-induced restenosis after vascular angioplasty by attenuating inflammation in rat model.

    PubMed

    Ni, Leng; Wang, Zhanqi; Yang, Genhuan; Li, Tianjia; Liu, Xinnong; Liu, Changwei

    2016-03-14

    Cigarette smoke is not only a profound independent risk factor of atherosclerosis, but also aggravates restenosis after vascular angioplasty. Heme oxygenase-1 (HO-1) is an endogenous antioxidant and cytoprotective enzyme. In this study, we investigated whether HO-1 upregulating by hemin, a potent HO-1 inducer, can protect against cigarette smoke-induced restenosis in rat's carotid arteries after balloon injury. Results showed that cigarette smoke exposure aggravated stenosis of the lumen, promoted infiltration of inflammatory cells, and induced expression of inflammatory cytokines and adhesion molecules after balloon-induced carotid artery injury. HO-1 upregulating by hemin treatment reduced these effects of cigarette smoke, whereas the beneficial effects were abolished in the presence of Zincprotoporphyrin IX, an HO-1 inhibitor. To conclude, hemin has potential therapeutic applications in the restenosis prevention after the smokers' vascular angioplasty. PMID:26809138

  3. Does the method of transluminal coronary revascularisation influence re-stenosis? Balloon angioplasty, atherectomy and stents compared.

    PubMed

    Foley, D P; Keane, D; Serruys, P W

    1995-01-01

    Luminal renarrowing after successful coronary angioplasty is now recognised as a continuously distributed process which is determined largely by the extent of luminal increase achieved at angioplasty. In this study an alternative analytical approach is applied to determine whether luminal renarrowing following coronary intervention is related to the mechanism of luminal increase (ie by balloon, by atherectomy, by a self-expanding stainless steel mesh stent, or by a balloon-expandable tantalum coil stent). The results confirm the known proportional relationship between luminal renarrowing during follow-up and luminal improvement at intervention, regardless of the device used. However, significant differences were observed between the devices, which may reflect device-specific characteristics of the hyperplastic response to vessel injury and may have clinical implications. PMID:7742199

  4. Angioplasty or Stenting in Adult Coarctation of the Aorta? A Retrospective Single Center Analysis Over a Decade

    SciTech Connect

    Macdonald, Sumaira Thomas, Steven M.; Cleveland, Trevor J.; Gaines, Peter A.

    2003-08-15

    For over 11 years, endovascular treatment by angioplasty (PTA) alone or stenting of adult coarctation at a single center was evaluated. We retrospectively reviewed 28 consecutive patients (31 interventions), median age 25 years, treated between 1991 and 2002, 20 of whom had native coarctation. Thirteen patients had PTA alone (16 procedures) (10 'kissing balloon' angioplasty comprising 12 interventions, and 3 single balloon angioplasty comprising 4 interventions) and 15 patients were stented(15 procedures), including 6 secondary and 9 primary stents. There were no procedural or 30-day complications. For the whole group, the median follow-up was 6.6 years (range 1-10 years). In the PTA group, median follow-up was 9 years (range 3-10) and in the stenting group it was 3 years (range 1-5). There were 9 restenoses in the PTA group (6 after 'kissing balloons' and 3 after single balloon) comprising 56% of the angioplasties (9/16 procedures). There was 1 restenosis in the stenting group diagnosed at computed tomography (CT). The patient was clinically well. For the whole group there were significant reductions in systolic blood pressure (BP) (p 0.0003), diastolic BP (p = 0.004) and number of drugs per patient (p = 0.045) at latest follow-up post-treatment. Five patients discontinued therapy.Analysis of the groups revealed that the reduction of systolic and diastolic BP and number of drugs did not reach statistical significance in the PTA group but were significant in the stent group. The endovascular management of adult coarctation is safe. Stents may be more effective than PTA alone but longer-term follow-up of stents is required.

  5. Below-the-ankle Angioplasty and Stenting for Limb Salvage: Anatomical Considerations and Long-term Outcomes

    SciTech Connect

    Katsanos, Konstantinos Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Siablis, Dimitris

    2013-08-01

    PurposeTo report the long-term angiographic and clinical results in a series of below-the-ankle (BTA) angioplasty procedures and to present some biomechanical issues related to the unique anatomical geometry of the ankle.MethodsWe performed a retrospective analysis of BTA angioplasty procedures. Clinical end points included technical success, patient mortality, salvage of the treated foot, and repeat target lesion revascularization. Imaging end points included primary patency, binary restenosis of the target lesion at the 50 % threshold, and stent integrity (stent fracture, deformation, or collapse). Univariate subgroup analysis was performed.ResultsIn total, 40 limbs in 37 patients (age 73.5 {+-} 8.2 years) with critical limb ischemia were included and 42 inframalleolar lesions (4.2 {+-} 1.4 cm) were analyzed. Technical success was achieved in 95.2 % (40 of 42). Provisional stent placement was performed in 45.2 % (19 of 42). Two patients died, and two major amputations occurred up to 3 years. At 1 year, overall primary vessel patency was 50.4 {+-} 9.1 %, lesion binary restenosis rate was 64.1 {+-} 8.3 %, and repeat intervention-free survival was 93.6 {+-} 4.3 % according to life table analysis of all treated lesions. Pairwise subgroup analysis showed that BTA self-expanding stents were associated with significantly higher restenosis and poorer primary patency compared to plain balloon angioplasty or sirolimus-eluting balloon-expandable stents. Significant deformation and/or fracture of balloon-expandable stents placed BTA were identified in five of 11. Dynamic imaging showed that the dorsalis pedis artery is kinked during foot dorsiflexion, whereas the distal posterior tibial artery is kinked during plantar flexion of the foot.ConclusionBTA angioplasty for critical limb ischemia treatment is safe and feasible with satisfactory long-term results. BTA stent placement must be reserved for bailout indications.

  6. [Intraoperative iliac angioplasty and distal revascularization: is it an efficacious method in the high-risk patient?].

    PubMed

    Adovasio, R; Chiarandini, S; Ziani, B; Pozzi Mucelli, R

    1992-01-01

    The fact that iliac femoro-popliteal areas are both simultaneously interested in some high risk patients, frequently is cause of several problems in the indication of the surgical treatment. So, we have decided to practice an iliac Angioplasty peroperatively as a method of iliac revascularization in association with the surgical repairment of the femoro-popliteal area. Results of 20 patients with 23 surgical procedures during a period of two years is reported. PMID:1285579

  7. Radiotherapy-Related Axillary Artery Occlusive Disease: Percutaneous Transluminal Angioplasty and Stenting. Two Case Reports and Review of the Literature

    SciTech Connect

    Farrugia, M. Gowda, K.M.S.; Cheatle, T.R.; Ashok, T.P.

    2006-12-15

    Radiotherapy-related axillary artery occlusive disease is a relatively rare condition. This complication is usually encountered in patients with breast carcinoma treated by radiotherapy and might be frequently concealed by the presence of lymphoedema. We discuss this rare complication of radiotherapy treatment for breast cancer and present two cases and their successful treatment by a modified percutaneous transluminal angioplasty and stenting technique. A review of literature on the subject is also presented.

  8. Patency of Wallstents Placed at the Venous Anastomosis of Dialysis Grafts for Salvage of Angioplasty-Induced Rupture

    SciTech Connect

    Rajan, Dheeraj K.; Clark, Timothy W.I.

    2003-06-15

    Purpose: To retrospectively evaluate the patency of Wallstents placed at the venous anastomosis of polytetraflouroethylene (PTFE) hemodialysis grafts to preserve function following angioplasty-induced rupture. Methods: The charts of all patients who underwent percutaneous angioplasty of functioning hemodialysis PTFE grafts between September 1997 and September 2001 were retrospectively reviewed. A total of 414 angioplasties were performed. Nine cases of rupture at the venousanastomosis managed with stent placement were identified (7 women, 2 men). Two grafts were loop grafts, seven grafts were straight grafts. All stents placed were Wallstents; six stents were 8 x 40 mm, the remaining three were 8 x 20 mm, 8 x 60 mm and 10 x 42mm. Average follow-up was 13 months. Results: Technical and clinical success of stent placement was 100%. The primary patencyrates ({+-}SE) of stents placed at the venous anastomosis were 88% (12%) at 30 days, 63% (17%) at 90 days, 33% (18%) at 180 days and 17% (15%) at 360 days. The secondary patency rates ({+-}SE) were 89% (11%) at 90 days, 76% (15%) at 180 days and 69% (23%) (6 stentspatent) at 360 days. During follow-up, one graft was removed because of infection, one patient died and another was lost to follow-up. A single minor complication of a puncture site hematoma occurred (11%) with no major complications. Conclusions: This small retrospective series suggests that Wallstent placement following angioplasty-induced venous anastomotic rupture is effective for preserving dialyzable flow in hemodialysis grafts. Patency is comparable to that of stents placed for reasons other than rupture.

  9. Randomized Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions: The SUPER Study

    SciTech Connect

    Chalmers, Nicholas; Walker, Paul T.; Belli, Anna-Maria; Thorpe, Anthony P.; Sidhu, Paul S.; Robinson, Graham; Ransbeeck, Mariella van

    2013-04-15

    To determine whether primary stenting reduces the rate of restenosis compared with balloon angioplasty alone in the endovascular treatment of long superficial femoral artery lesions; and to assess the effect of treatment on quality of life. A total of 150 patients with superior femoral artery occlusion or severe stenosis of 5-22 cm length from 17 UK centers were randomized to either primary stenting with the SMART stent or balloon angioplasty (i.e., percutaneous transluminal angioplasty, PTA). Bailout stent placement was permitted in case of inadequate result from PTA. The primary end point was restenosis measured by duplex ultrasound at 1 year. Quality-of-life assessments were performed by the EuroQol (EQ)-5D questionnaire. Mean lesion length was 123.0 mm in the stent group and 116.8 mm in the PTA group. A total of 140 (93.3 %) of 150 had total occlusions. At 12 months' follow-up, restenosis measured by Duplex ultrasound was not significantly different between the stent and PTA groups by intention-to-treat or as-treated analyses: 47.2 versus 43.5 % (p = 0.84) and 40.8 versus 46.7 % (p = 0.68), respectively. There were fewer target lesion revascularizations in patients randomized to stenting, but this did not reach statistical significance (12.5 vs. 20.8 %, p = 0.26). There was no difference in the rate of amputation. Patients in both groups reported improved quality of life. Primary stenting of long lesions in predominantly occluded superficial femoral arteries does not reduce the rate of binary restenosis compared with balloon angioplasty and bailout stenting. Both treatment strategies conferred a meaningful and sustained improvement to the quality of life of patients with severe superficial femoral artery disease.

  10. Recovery of regional myocardial dysfunction after successful coronary angioplasty early after a non-Q wave myocardial infarction

    SciTech Connect

    Suryapranata, H.; Serruys, P.W.; Beatt, K.; De Feyter, P.J.; van den Brand, M.; Roelandt, J. )

    1990-08-01

    More aggressive therapy has been suggested for patients who have a non-Q wave myocardial infarction (MI) because of the frequency of subsequent unstable angina, recurrent MI, and high mortality rate compared to patients with Q wave MI. The present study was undertaken to investigate the effect of coronary angioplasty on regional myocardial function of the infarct zone in patients with angina early after a non-Q wave MI. The study population consisted of 36 patients undergoing successful coronary angioplasty within 30 days of a non-Q wave MI, in whom sequential left ventricular angiograms of adequate quality were obtained before the initial procedure and at follow-up angiography. The global ejection fraction increased significantly from 60 +/- 9% to 67 +/- 6% (p = 0.0003). This significant increase in the global ejection fraction was primarily due to a significant improvement in the regional myocardial function of the infarct zone. The results of the present study show not only that ischemic attacks early after a non-Q wave MI may lead to prolonged regional myocardial dysfunction but more important that this depressed myocardium has the potential to achieve normal contraction after successful coronary angioplasty.

  11. Clinical efficacy and scintigraphic evaluation of post-coronary bypass patients undergoing percutaneous transluminal coronary angioplasty for recurrent angina pectoris

    SciTech Connect

    Reed, D.C.; Beller, G.A.; Nygaard, T.W.; Tedesco, C.; Watson, D.D.; Burwell, L.R.

    1989-01-01

    The efficacy of percutaneous transluminal angioplasty in improving recurrent anginal symptoms and myocardial perfusion after coronary artery bypass graft surgery was assessed prospectively in 55 patients, of whom 50 had an initial angiographic and clinical success. Although 80% of those successfully dilated were initially free of angina at 23 +/- 11 months of follow-up, one half of these patients had recurrent angina. Although only 48% of the patient cohort had complete relief of angina, 94% had less angina than before dilatation and 86% were able to decrease antianginal medications. Fifteen patients with persistent or recurrent angina had from one to five repeat dilatations. After angioplasty, lung thallium uptake, the extent of abnormal scan segments, and the magnitude of redistribution in dilated lesions were significantly reduced (n = 24 patients). Redistribution defects were seen in 38% of patients on postangioplasty scans. All were associated with subsequent angina. Of various clinical, angiographic, exercise, and thallium-201 scan variables, only the presence of delayed redistribution was an independent predictor of recurrent angina. Restenosis was the most common underlying cause for this exercise-induced perfusion defect. Thus percutaneous coronary angioplasty performed as primary therapy for recurrent angina after bypass surgery is moderately successful in long-term follow-up for the amelioration of symptoms and enhancement of regional myocardial perfusion.

  12. Early intervention in acute myocardial infarction: significance for myocardial salvage of immediate intravenous streptokinase therapy followed by coronary angioplasty

    SciTech Connect

    Miller, H.I.; Almagor, Y.; Keren, G.; Chernilas, J.; Roth, A.; Eschar, Y.; Shapira, I.; Shargorodsky, B.; Berenfeld, D.; Laniado, S.

    1987-03-01

    Sixteen patients with acute myocardial infarction underwent treatment with streptokinase up to 3 hours after the onset of chest pain. Nine patients (group I) received streptokinase within 1 hour of the onset of pain, and seven patients (group II) received it within 2 to 3 hours. All underwent multigated radionuclide ventriculography after streptokinase therapy and 1 week later. Percutaneous transluminal coronary angioplasty of the infarct artery was performed within 24 hours in all patients. An effort-limited treadmill stress test was performed before discharge. There was no mortality or serious complication. Mean peak total creatine kinase was 521 +/- 289 mU/ml in group I, and 1,614 +/- 709 mU/ml in group II (p less than 0.05). The mean initial left ventricular ejection fraction was 47 +/- 11% in group I and 37 +/- 10% in group II. After early angioplasty (within 24 hours) and at 1 week recovery, left ventricular ejection fraction increased to 53 +/- 9% in group I (p less than 0.05) and to 40 +/- 7% in group II (p = NS). Seven of the nine patients in group I had normal radionuclide ventriculograms at discharge compared with none of the seven patients in group II. Thrombolytic therapy administered less than 1 hour after the onset of symptoms of acute myocardial infarction followed by angioplasty of the infarct artery results in preservation of left ventricular function, whereas therapy given after 2 hours has only a limited effect.

  13. [Ultrasound coronary angioplasty: state of the art and new clinical aspects].

    PubMed

    Rosenschein, U; Budde-Schwartzman, B

    1997-12-01

    Therapeutic ultrasound was shown to ablate thrombi and to disrupt atherosclerotic plaques in vitro and recently to recanalize occluded coronary arteries in acute myocardial infarction (AMI). The goal of this article is to update collective experience and to weigh the promising and unresolved aspects of this newly developed technology and its clinical results. As therapeutic ultrasound was for long known a synonym for lithotripsy of calculi diseases, it lastly received high attention as a catheter-based ultrasound method to ablate thrombi and disrupt atherosclerotic plaques in interventional cardiology (Figure 1). The effect of therapeutic ultrasound to ablate selectively pathological tissue depends on its bioselectivity for elastic fibers: After ultrasound sonication, healthy tissue-rich in elastin and collagen-including arterial wall remains intact whereas thrombus and plaque with their minimal elastic support are found to be highly susceptible to ablation. Our catheter for coronary ultrasound thrombolysis (Figure 2) consists of a solid metal probe and is connected to a piezo-electric transducer at its proximal end. The distal part ends in a three-wire flexible segment with a 1.6 mm tip ball to guarantee maximal wire flexibility and optimal transmission of ultrasound energy. The initial in vitro studies resulted in a fundamental understanding of the destructive effect of ultrasound on tissue based on 4 factors: mechanical vibration, thermal effects, microcurrents, and cavitation. The first studies on human peripheral vessels were published in 1991 being performed during femoral bypass surgery on occluded and partially obstructed arteries. The procedure was performed without perforation, no adverse side effects emerged, restenosis rate was 20%. The clinical application of coronary ultrasound angioplasty was initiated in 1991; Siegel published his data on 44 patients. In his study, 30 patients with chronic atherosclerotic occlusive lesions and 14 with unstable or

  14. Cutting-balloon angioplasty before drug-eluting stent implantation for the treatment of severely calcified coronary lesions

    PubMed Central

    Tang, Zhe; Bai, Jing; Su, Shao-Ping; Wang, Yu; Liu, Mo-Han; Bai, Qi-Cai; Tian, Jin-Wen; Xue, Qiao; Gao, Lei; An, Chun-Xiu; Liu, Xiao-Juan

    2014-01-01

    Background Severely calcified coronary lesions respond poorly to balloon angioplasty, resulting in incomplete and asymmetrical stent expansion. Therefore, adequate plaque modification prior to drug-eluting stent (DES) implantation is the key for calcified lesion treatment. This study was to evaluate the safety and efficacy of cutting balloon angioplasty for severely calcified coronary lesions. Methods Ninety-two consecutive patients with severely calcified lesions (defined as calcium arc ≥ 180° calcium length ratio ≥ 0.5) treated with balloon dilatation before DES implantation were randomly divided into two groups based on the balloon type: 45 patients in the conventional balloon angioplasty (BA) group and 47 patients in the cutting balloon angioplasty (CB) group. Seven cases in BA group did not satisfactorily achieve dilatation and were transferred into the CB group. Intravascular ultrasound (IVUS) was performed before balloon dilatation and after stent implantation to obtain qualitative and quantitative lesion characteristics and evaluate the stent, including minimum lumen cross-sectional area (CSA), calcified arc and length, minimum stent CSA, stent apposition, stent symmetry, stent expansion, vessel dissection, and branch vessel jail. In-hospital, 1-month, and 6-month major adverse cardiac events (MACE) were reported. Results There were no statistical differences in clinical characteristics between the two groups, including calcium arc (222.2° ± 22.2° vs. 235.0° ± 22.1°, P = 0.570), calcium length ratio (0.67 ± 0.06 vs. 0.77 ± 0.05, P = 0.130), and minimum lumen CSA before PCI (2.59 ± 0.08 mm2 vs. 2.52 ± 0.08 mm2, P = 0.550). After stent implantation, the final minimum stent CSA (6.26 ± 0.40 mm2 vs. 5.03 ± 0.33 mm2; P = 0.031) and acute lumen gain (3.74 ± 0.38 mm2 vs. 2.44 ± 0.29 mm2, P = 0.015) were significantly larger in the CB group than that of the BA group. There were not statistically differences in stent expansion, stent symmetry

  15. Thermal characteristics of sapphire contact probe delivery systems for laser angioplasty.

    PubMed

    Ashley, S; Brooks, S G; Gehani, A A; Kester, R C; Rees, M R

    1990-01-01

    Contact probes made from synthetic sapphire crystal, designed for general laser surgery, are currently being evaluated for use in laser angioplasty. Their mode of action and safety in the context of arterial recanalisation is unknown, particularly with respect to the degree of probe and catheter heating. Infrared thermal imaging was used to investigate the surface temperature rise of various rounded sapphire probes during emission of continuous wave Nd-YAG (1,064 nm) laser energy. Catheter safety was addressed by analyzing the temperature of the metal interface between the optical fiber and sapphire, as well as the catheter proximal to this junction. Transmission of Nd-YAG energy through each probe was also measured. Five rounded probes of 1.8-3.0 mm diameter (three supplied by Surgical Laser Technologies [SLT], two by Living Technology [LT]), along with their respective optical catheters, were compared. There was a large temperature gradient between the front and rim of the probes. The maximum surface temperature rise of the sapphire (at 20 W, 5-second exposure) was 314-339 degrees C (SLT) and 90-108 degrees C (LT) [P less than 0.001, 3-way ANOVA]. The reason for this difference may be related to "crazing" of the front surface of the SLT sapphires. At all energy levels sapphire temperatures were considerably lower than attained by metal laser thermal angioplasty probes. Forward transmission was slightly higher in the SLT probes (75-85%) than the LT sapphires (54-69%). With fiber perfusion at 2 ml/minute, a minor degree of heating of the metal sapphire holders was recorded (maximum rise 35 degrees C), but heating of the catheter proximal to this was negligible. Therefore, it would appear that the risk of tip detachment or arterial injury due to heating of the connecting metal interface is extremely low. Without perfusion, however, there was a greater degree of interface heating in the LT delivery system suggestive of more laser backscattering by these sapphires

  16. Thermal and optical behavior of sapphire fiber tips for laser angioplasty

    NASA Astrophysics Data System (ADS)

    Ashley, Simon; Brooks, Stephen G.; Gehani, Abdurrazak A.; Kester, Ralph C.; Rees, Michael R.

    1990-07-01

    Atraumatic rounded contact probes made from artificial sapphire crystal were developed for general laser surgery and are currently being evaluated for use in percutaneous laser angioplasty utilising continuous wave (cw) Nd-YAG energy (1064nm). The thermal and optical characteristics of five different types of rounded sapphire probe [Surgical Laser Technologies (SLT) - SMTR (1.8mm), MTh (2.2mm), MTRL (3.0mm); Living Technology - LT (2.2mm), OS (2.2mm)] were investigated and related to efficiency of contact ablation of arterial wall in vitro. The sapphire probes were mounted on catheters containing a 0.6 mm quartz optical fiber, coupled to a cw Nd-YAG laser. All probes produced a similar beam profile but there was some variation in their forward transmission of energy (54-85%).Probe heating occurs due to energy absorption within the sapphire and was measured in air by infrared thermography. There was a high temperature gradient from the front surface of the sapphires to the probe rim. But, at energy settings used clinically (10 J pulses, 10 Watts for 1 second) the SMTR, MTR, and MTRL probes exhibited a higher mean temperature rise (63-74 C) than the OS and LT probes (20 C) [3-way ANOVA p

  17. Identification of patients at high risk for adverse coronary events while awaiting routine coronary angioplasty.

    PubMed Central

    Chester, M.; Chen, L.; Kaski, J. C.

    1995-01-01

    BACKGROUND--Identification of patients at risk for progression of coronary stenosis and adverse clinical events while awaiting coronary angioplasty is desirable. OBJECTIVE--To determine the standard clinical or angiographic variables, or both, present at initial angiography associated with the development of adverse coronary events (unstable angina, myocardial infarction, and angiographic total coronary occlusion) in patients awaiting routine percutaneous transluminal coronary angioplasty (PTCA). PATIENTS AND METHODS--Consecutive male patients on a waiting list for routine PTCA. Routine clinical details were obtained at initial angiography. Stenosis severity was measured using computerised angiography. OUTCOME MEASURES--Development of one or more of myocardial infarction, unstable angina, or angiographic total coronary occlusion while awaiting PTCA were recorded as an adverse event. RESULTS--Some 214 of 219 patients underwent a second angiogram. One had a fatal myocardial infarction and four (2%) were lost to follow up. Fifty patients (23%) developed one or more adverse events (myocardial infarction five, unstable angina 35, total coronary occlusion 23) at a median (range) interval of 8 (3-25) months. Twenty (57%) of the 35 patients with unstable angina developed adverse events compared with 30 (17%) of the 180 with stable angina (P = 0.0001). Plasma triglyceride concentration was 2.6 (1.2) mmol/l in patients with adverse coronary events compared with 2.2 (1.1) mmol/l in those without such events (P < 0.05). Patients with adverse events were younger than those without (54 (9) years v 58 (9) years, P < 0.01). The relative risk of an adverse event in patients with unstable angina and increased plasma triglyceride concentrations was 6.9 compared with those presenting with stable angina and a normal triglyceride concentration (P < 0.02). CONCLUSIONS--The study shows that adverse events are not uncommon in patients awaiting PTCA. Patients at high risk for adverse events

  18. Site-targeted acoustic contrast agent detects molecular expression of tissue factor after balloon angioplasty

    NASA Astrophysics Data System (ADS)

    Hall, Christopher S.; Abendschein, Dana R.; Scherrer, David E.; Scott, Michael J.; Marsh, Jon N.; Wickline, Samuel A.; Lanza, Gregory M.

    2000-04-01

    Complex molecular signaling heralds the early stages of pathologies such as angiogenesis, inflammation, and cellular responses to mechanically damaged coronary arteries after balloon angioplasty. In previous studies, we have demonstrated acoustic enhancement of blood clot morphology with the use of a nongaseous, ligand-targeted acoustic nanoparticle emulsion delivered to areas of thrombosis both in vitro and in vivo. In this paper, we characterize the early expression of tissue factor which contributes to subsequent arterial restenosis. Tissue factor is a 42kd glycoprotein responsible for blood coagulation but also plays a well-described role in cancer metastasis, angiogenesis, and vascular restenosis. This study was designed to determine whether the targeted contrast agent could localize tissue factor expressed within the wall of balloon-injured arteries. Both carotid arteries of five pigs (20 kg) were injured using an 8 X 20 mm angioplasty balloon. The carotids were treated in situ with a perfluorocarbon nanoparticle emulsion covalently complexed to either specific anti-tissue factor polyclonal F(ab) fragments (treatment) or non-specific IgG F(ab) fragments (control). Intravascular ultrasound (30 MHz) images of the arteries were obtained before and after exposure to the emulsions. Tissue- factor targeted ultrasonic contrast agent acoustically enhanced the subintima and media at the site of balloon- induced injury compared with control contrast arteries (p less than 0.05). Immunohistochemical staining confirmed the presence of increased tissue factor at the sites of acoustic enhancement. Binding of the targeted agents was demonstrated in vitro by scanning electron microscope images of cultured smooth muscle cells that constitutively express tissue factor. This study demonstrates the concept of molecular imaging and localization of carotid arteries' tissue factor in vivo using a new, nanoparticulate emulsion. Enhancement of the visualization of the molecular

  19. Radiation exposure to patients and operators during diagnostic catheterization and coronary angioplasty.

    PubMed

    Zorzetto, M; Bernardi, G; Morocutti, G; Fontanelli, A

    1997-04-01

    A detailed monitoring, on the basis of single procedures, was undertaken to assess the patient exposure and the occupational doses received by the operators (cardiologist, technician, and nurse) during diagnostic coronary angiography (CAG) and percutaneous transluminal coronary angioplasty (PTCA). The occupational dose to the staff was measured at the collar level using thermoluminescent dosimeters (TLD) to examine the neck and head exposure. Patient exposure was assessed by the dose-area product (DAP in Gy/cm2) and by the skin dose (mGy) at the level of thyroid. The mean neck dose per procedure for cardiologist was about 0.05 mGy, a reasonable level to comply with the International Commission on Radiological Protection (ICRP) eye lens recommended limit. No significant differences were detected between CAG (39 procedures) and PTCA (19 procedures). Relatively high radiation doses are given to the lung of the patient with a significant ICRP lifetime risk of about 10(-3). The patients' mean DAP was 55.9 Gy/cm2 for CAG (79 procedures) and 91.8 Gy/cm2 for PTCA (31 procedures) (P < 0.01). About 70% in CAG and 48% in PTCA of the total dose resulted from the cine examination; in PTCA the total mean DAP was about 60% higher than in CAG procedures. PMID:9096931

  20. Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.

    PubMed Central

    Prince, M R; Deutsch, T F; Mathews-Roth, M M; Margolis, R; Parrish, J A; Oseroff, A R

    1986-01-01

    Laser angioplasty, the in situ ablation of arterial obstructions with laser radiation, has been demonstrated in animal models and early clinical trials. A problem with this technique, however, is the possibility of thermal damage to adjacent or underlying normal tissues that also absorb the radiation. Using a spectrophotometer with an integrating sphere and a specially constructed tunable-dye laser-based spectrophotometer, we evaluated the transmittance and remittance of human cadaveric atheromas and adjacent normal aorta from 250 to 1,300 nm to identify wavebands where there is preferential light absorption by atheromas. Data were analyzed by both the Kubelka-Munk formalism and a Beer's law model. Both methods indicate that atheromas absorb more than normal aorta between 420 and 530 nm. At 470 nm the average Kubelka-Munk absorption coefficient of atheromas from 10 cadavers was 54 +/- 9 cm-1 compared with 26 +/- 6 cm-1 for normal aortic specimens from seven cadavers. Yellow chromophores responsible for the atheroma absorbance were extractable with xylenes. Thin-layer chromatography and absorption spectra identified the extracted chromophores as predominantly consisting of a mix of carotenoids, which are known constituents of atheromatous lesions. Preferential absorption of blue light by carotenoids in atheromas may permit selective ablation of atheromatous obstructions with appropriate pulses of laser radiation. PMID:3722380

  1. A model for optical and thermal analysis of laser balloon angioplasty.

    PubMed

    Cheong, W F; Welch, A J

    1989-12-01

    Laser balloon angioplasty is modeled using an infinitely long cylinder possessing axisymmetry. The balloon surface is assumed to be uniformly irradiated by diffuse light at 1060 nm delivered from within the inner balloon core. The diffusion approximation to the radiative transport equation is solved for a single layer of homogeneous medium enclosing the transparent fluid-filled balloon. The computed light fluence rate (W.cm-2) just beneath the tissue surface is 4.7 times the primary irradiance, owing to scattering and secondary irradiance from the "integrating cylinder" effect of backscattered light into the inner core. The transient temperature response of the heated tissue is then calculated using an implicit finite difference solution of the heat conduction equation for concentric layers of varying thermal properties. Finally, the extent of damage is analyzed using the Arrhenius rate process model. Changes in optical and thermal properties with temperature and thermal phase transitions have been omitted in all our analyses. Irradiances which decrease with time can produce a "temperature plateau" for a longer time period than a constant irradiance of equal total energy output. This may be clinically important. Flexible boundary conditions at the balloon interface permit simulation of a "hot contact surface," such as a black balloon absorbing all incident laser power. In this situation, the computed surface damage is consistently higher than that obtained by LBA of equivalent energy output. PMID:2532617

  2. Ablation of chronic total occlusions using kilohertz-frequency mechanical vibrations in minimally invasive angioplasty procedures.

    PubMed

    McGuinness, G B; Wylie, M P; Gavin, G P

    2010-01-01

    Certain minimally invasive cardiology procedures, such as balloon angioplasty and stent implantation, critically require that the site of an arterial blockage be crossed by an intraluminal guidewire. Plaques resulting in near or totally occluded arteries are known as chronic total occlusions, and crossing them with conventional guidewires is a significant challenge. Among the most promising proposed solutions is the delivery of high-power, low-frequency ultrasonic vibrations to the occlusion site via an intraluminal wire waveguide. The vibrating distal tip of the ultrasound wire waveguide is used to transmit energy to the surrounding plaques, tissues, and fluids to ablate or weaken atherosclerotic plaque. Potential mechanisms of interaction with the plaque and adjacent fluids identified in the literature include: (i) direct contact with the waveguide distal tip, (ii) subcavitational acoustic fluid pressure fluctuations, (iii) cavitation, and (iv) acoustic streaming. We summarize developments in this area over more than two decades, describing experimental methods for device performance characterization, preclinical tests, early clinical investigations, and, later, full clinical trials. The article also reviews theoretical foundations and numerical models suitable for device design and analysis. Finally, important issues for future research and for the development of this technology will be considered. PMID:21303322

  3. Diabetic foot wounds in haemodialysis patients: 2-year outcome after percutaneous transluminal angioplasty and minor amputation.

    PubMed

    Matsuzaki, Kyoichi; Miyamoto, Akira; Hakamata, Naohiro; Fukuda, Masahiro; Yamauchi, Yasutaka; Akita, Takako; Kuhara, Ryoji; Tezuka, Shingo

    2012-12-01

    Critical limb ischaemia (CLI) is known to be associated with high mortality. In some patients, surgery cannot be performed due to high risk of perioperative death and complications. In other cases, there is only pain at rest but no wound. Therefore, it is difficult to accurately predict the prognosis of individual patients. We examined the prognosis of CLI cases in which therapeutic footwear was made for ambulation after wounds healed. The subjects were 31 haemodialysis patients with diabetic foot wounds, which were treated with percutaneous transluminal angioplasty and minor amputation. The subjects were 22 men and 9 women. Female patients were significantly older than male patients (P = 0.046). Two-year postoperative outcomes were survival in 19 patients and death in 12 patients. Eight of twelve deceased patients had a history of coronary intervention. There were 8 deaths among 13 patients with such history, indicating a marginally significant increase in the mortality rate (P = 0.060). Re-amputation was performed in 6 of 19 patients who survived. Two years postoperatively, 41.9% of patients overall survived without re-amputation. It is important to increase the number of cases for further study to improve the well-being of CLI patients and to examine medical economics. PMID:23095148

  4. [Percutaneous transluminal angioplasty in aortic coarctation. The short- and median-term results].

    PubMed

    Ledesma Velasco, M; Acosta Valdes, J L; Munayer Calderón, J; Salgado Escobar, J L; Arias Monroy, L; Soberanis Torruco, C N

    1991-01-01

    Percutaneous transluminal angioplasty (PTA) was performed in 34 patients with aortic coarctation (Ao Co). One of them with coarctation after surgical correction, the rest were native Ao Co. We used one balloon in 28 patients and two balloons simultaneously in 6. They were separated in three groups according to the degree of aortic arc hypoplasia. Group I (mild to moderate hypoplasia N = 9) the gradient dropped 39% with angiographic improvement of 48% during the follow-up (m = 13.1 months). Three cases with restenosis, 2 were satisfactory dilated and one was sent to surgery. In Group II (severe hypoplasia N = 4) the gradient dropped 31% with angiographic improvement of 30% (follow-up 16.3 months). Two cases with recoarctation were sent to surgery. In Group III (without hypoplasia N = 21) we obtained dropped of gradient of 71% with angiographic improvement of 60% (follow-up 18.5 months). Two cases were redilated successfully. The complications were: cerebral hemorrhage with death due to hypertensive crisis, (1) cerebral embolism, (1) thrombosis in the puncture site 1 and small aneurysm in dilated zone. (1) We think PTA is a good choice to conventional surgery with low rate of morbidity-mortality. The results depend basically on the anatomic type of coarctation and degree of aortic arch hypoplasia. PMID:1828657

  5. Early detection of restenosis after successful percutaneous transluminal coronary angioplasty by exercise-redistribution thallium scintigraphy

    SciTech Connect

    Wijns, W.; Serruys, P.W.; Reiber, J.H.; de Feyter, P.J.; van den Brand, M.; Simoons, M.L.; Hugenholtz, P.G.

    1985-02-01

    The value of exercise testing and thallium scintigraphy in predicting recurrence of angina pectoris and restenosis after a primary successful transluminal coronary angioplasty (PTCA) was prospectively evaluated. In 89 patients, a symptom-limited exercise electrocardiogram (ECG) and thallium scintigraphy were performed 4 weeks after they had undergone successful PTCA. Thereafter, the patients were followed for 6.4 +/- 2.5 months (mean +/- standard deviation) or until recurrence of angina. They all underwent a repeat coronary angiography at 6 months or earlier if symptoms recurred. PTCA was considered successful if the patients had no symptoms and if the stenosis was reduced to less than 50% of the luminal diameter. Restenosis was defined as an increase of the stenosis to more than 50% luminal diameter. The ability of the thallium scintigram (presence of a reversible defect) to predict recurrence of angina was 66%, vs 38% for the exercise ECG (ST-segment depression or angina at peak workload). Restenosis was predicted in 74% of patients by thallium scintigraphy, but only in 50% of patients by the exercise ECG. Thus, thallium scintigraphy was highly predictive but the exercise ECG was not (p less than 0.005). These results suggest that restenosis had occurred to some extent already at 4 weeks after the PTCA in most patients in whom it was going to occur.

  6. Intravascular Ultrasound Imaging of Peripheral Arteries as an Adjunct to Balloon Angioplasty and Atherectomy

    SciTech Connect

    Korogi, Yukunori; Hirai, Toshinori; Takahashi, Mutsumasa

    1996-11-15

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque crossectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures.

  7. Intraarterial Pressure Gradients After Randomized Angioplasty or Stenting of Iliac Artery Lesions

    SciTech Connect

    Tetteroo, Eric; Haaring, Cees; Graaf, Yolanda van der; Schaik, Jan P.J. van; Engelen, A.D. van; Mali, Willem P.T.M.

    1996-11-15

    Purpose: To determine initial technical results of percutaneous transluminal angioplasty (PTA) and stent procedures in the iliac artery, mean intraarterial pressure gradients were recorded before and after each procedure. Methods: We randomly assigned 213 patients with typical intermittent claudication to primary stent placement (n= 107) or primary PTA (n= 106), with subsequent stenting in the case of a residual mean pressure gradient of > 10 mmHg (n= 45). Eligibility criteria included angiographic iliac artery stenosis (> 50% diameter reduction) and/or a peak systolic velocity ratio > 2.5 on duplex examination. Mean intraarterial pressures were simultaneously recorded above and below the lesion, at rest and also during vasodilatation in the case of a resting gradient {<=} 10 mmHg. Results: Pressure gradients in the primary stent group were 14.9 {+-} 10.4 mmHg before and 2.9 {+-} 3.5 mmHg after stenting. Pressure gradients in the primary PTA group were 17.3 {+-} 11.3 mmHg pre-PTA, 4.2 {+-} 5.4 mmHg post-PTA, and 2.5 {+-} 2.8 mmHg after selective stenting. Compared with primary stent placement, PTA plus selective stent placement avoided application of a stent in 63% (86/137) of cases, resulting in a considerable cost saving. Conclusion: Technical results of primary stenting and PTA plus selective stenting are similar in terms of residual pressure gradients.

  8. Intravascular ultrasound imaging of peripheral arteries as an adjunct to balloon angioplasty and atherectomy.

    PubMed

    Korogi, Y; Hirai, T; Takahashi, M

    1996-01-01

    This article reviews many of the applications of intravascular ultrasound (US) imaging for peripheral arterial diseases. In vitro studies demonstrate an excellent correlation between ultrasound measurements of lumen and plaque cross-sectional area compared with histologic sections. In vivo clinical studies reveal the enhanced diagnostic capabilities of this technology compared with angiography. Intravascular US imaging can provide valuable information on the degree, eccentricity, and histologic type of stenosis before intervention, and on the morphological changes in the arterial wall and the extent of excision after intervention. Intravascular US may also serve as a superior index for gauging the diameter of balloon, stent, laser probe, and/or atherectomy catheter appropriate for a proposed intervention. Significant new insights into the mechanisms of balloon angioplasty and atherectomy have been established by intravascular US findings. Intravascular US imaging has been shown to be a more accurate method than angiography for determining the cross-sectional area of the arterial lumen, and for assessing severity of stenosis. Quantitative assessment of the luminal cross-sectional area after the balloon dilatation should be more accurate than angiography as intimal tears or dissections produced by the dilatation may not be accurately evaluated with angiography. At the present time, intravascular US is still a controversial imaging technique. Outcome studies are currently being organized to assess the clinical value and cost effectiveness of intravascular ultrasound in the context of these interventional procedures. PMID:8653738

  9. Role of intracoronary thrombus in acute complications during percutaneous transluminal coronary angioplasty.

    PubMed

    Arora, R R; Platko, W P; Bhadwar, K; Simpfendorfer, C

    1989-04-01

    Coronary angiograms from 2,372 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were retrospectively reviewed for the presence of intracoronary thrombus (ICT) before dilatation. Patients with evolving acute myocardial infarction and those receiving thrombolytic therapy were excluded from analysis. Coronary artery thrombus was present in 126 patients (6%) (group 1). When compared to 2,246 patients (group 2) without ICT, group 1 had a higher incidence of unstable angina, 74% vs. 66% (less than 0.06), previous myocardial infarction, 59% vs. 37% (P less than .0001), and history of a recent myocardial infarction, 28% vs. 9% (P less than .0001). Patients with predilatation intracoronary thrombus had a higher risk for acute occlusion, 6% vs. 2% (P less than .002); however, the incidence of emergency coronary bypass surgery and myocardial infarction was similar in both groups. Therefore, the presence of predilatation intracoronary thrombus heralds an increased risk of acute occlusion, but not myocardial infarction or emergency coronary artery bypass surgery. PMID:2523243

  10. Percutaneous Aspiration Thrombectomy for the Treatment of Arterial Thromboembolic Occlusions Following Percutaneous Transluminal Angioplasty

    SciTech Connect

    Schleder, Stephan; Diekmann, Matthias; Manke, Christoph; Heiss, Peter

    2015-02-15

    PurposeThis study was designed to evaluate the technical success and the early clinical outcome of patients undergoing percutaneous aspiration thrombectomy (PAT) for the treatment of arterial thromboembolism following percutaneous infrainguinal transluminal angioplasty (PTA).MethodsIn this single-center study, during a period of 7 years retrospectively, 47 patients (22 male, 47 %) with a mean age of 73 (range 53–96) years were identified in whom PAT was performed for the treatment of thromboembolic complications of infrainguinal PTA. Primary technical success was defined as residual stenosis of <50 % in diameter after sole PAT, whereas secondary technical success was defined as residual stenosis of <50 % in diameter after PAT and additional PTA and/or stenting. Clinical outcome parameters (e.g., need for further intervention, minor/major amputation) were evaluated for the 30-day postinterventional period.ResultsPrimary technical success was achieved in 64 % of patients (30/47); secondary technical success was obtained in 96 % of patients (45/47). Clinical outcome data were available in 38 patients. In 87 % of patients (33/38), there was no need for further intervention within the 30-day postinterventional period. In three patients, minor amputations were conducted due to preexisting ulcerations (Rutherford Category 5 respectively).ConclusionsPAT enables endovascular treatment of iatrogenic thromboembolic complications after PTA with good technical and early clinical results and minimal morbidity.

  11. Haemodynamic observations during percutaneous transluminal coronary angioplasty in the presence of synchronised diastolic coronary sinus retroperfusion.

    PubMed Central

    Beatt, K J; Serruys, P W; de Feyter, P; van den Brand, M; Verdouw, P D; Hugenholtz, P G

    1988-01-01

    Animal studies have demonstrated that synchronised coronary sinus retroperfusion with arterial blood can provide effective perfusion of ischaemic myocardium. Preliminary clinical studies have shown that the technique can also be used with safety in human beings, and in the present study its effectiveness was assessed in three patients undergoing repeated coronary artery occlusions during percutaneous transluminal coronary angioplasty. Arterial blood was removed via an 8F catheter positioned in the femoral artery and delivered by a retroperfusion pumping system to a 7F retroperfusion balloon catheter positioned in the anterior cardiac vein. Ischaemia-related indices were monitored both before and during coronary sinus retroperfusion. These indices included high fidelity left ventricular pressure recordings and pressure derived indices (including velocities of isovolumic contraction and relaxation), as well as electrocardiographic changes and symptoms. Analysis of these variables showed that the ischaemic changes induced during coronary artery occlusion were not prevented by this type of coronary sinus retroperfusion. There was no major complication in any of the patients. It may be that adaptation of the technique or the use of alternative end points will establish a benefit, but further modifications of the delivery system are necessary for effective clinical use. Images Fig 1 PMID:2963657

  12. Relation of Depression, Anxiety, and Quality of Life with Outcome after Percutaneous Transluminal Coronary Angioplasty

    PubMed Central

    Chaudhury, Suprakash; Srivastava, Kalpana

    2013-01-01

    Background. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. Aim. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. Methods. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. Results. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6%) had significant depression. On the Seattle Angina Questionnaire, physical limitation reduced from 67.9 to 48. Disease perception improved from 21.2 to 37.1. On the EQ5D, the health status improved from 42.7 before PTCA to 78.7 after PTCA. Conclusion. Successful PTCA resulted in significant reduction in anxiety, depression, and physical limitation and improvement in disease perception and health status. PMID:24319368

  13. Clinical, angiographic, hemodynamic, perfusional and functional changes after one-vessel left anterior descending coronary angioplasty

    SciTech Connect

    Okada, R.D.; Lim, Y.L.; Boucher, C.A.; Pohost, G.M.; Chesler, D.A.; Block, P.C.

    1985-02-01

    Percutaneous transluminal coronary angioplasty (PTCA) was successfully performed in 20 patients with 1-vessel left anterior descending (LAD) coronary artery disease. Exercise capacity in terms of peak workload, heart rate and systolic blood pressure all increased significantly 1 week after PTCA. All patients had some decrease in stenosis size and gradient. All patients except 1 had an improvement in functional class. Eight of 12 patients with abnormal exercise electrocardiograms before PTCA had normal electrocardiograms after the procedure. Exercise thallium-201 (TI-201) myocardial perfusion images obtained in all 20 patients before and 1 week after PTCA were analyzed using a new computer method designed to quantitate regional myocardial TI-201 distribution, redistribution and clearance rate. Significant improvement in TI-201 activity was present in the anterior and septal segments of the left ventricle 1 week after PTCA. This increase in TI-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images in the same regions. TI-201 clearance rate in the segments supplied by the dilated vessel also improved significantly. Abnormal TI-201 lung uptake was seen in 17 patients before and in 4 patients after PTCA. Exercise ejection fraction response and septal wall motion also improved after PTCA of the LAD stenosis in all 17 patients who had exercise radionuclide ventriculography.

  14. Laser angioplasty with lensed fibers and a holmium:YAG laser in iliac artery occlusions

    NASA Astrophysics Data System (ADS)

    White, Christopher J.; Ramee, Stephen R.; Mesa, Juan E.; Collins, Tyrone J.; Kotmel, Robert; Godfrey, Maureen A.

    1991-05-01

    Holmium-YAG (2.1 (mu) ) laser recanalization was attempted in 10 totally occluded miniature swine iliac arteries using a lensed fiber delivery system. The iliac artery occlusions were created in a Yucatan miniature swine model of atherosclerosis by means of a high cholesterol diet and balloon endothelial denudation. In order to increase the spot size, a spherical silica lens was attached to the distal end of a 300 micrometers core diameter silica optical fiber. The holmium-YAG laser was operated in the free-running mode with 250 microsecond(s) ec pulses at 4 Hz. The energy delivered was 225 mJ per pulse for the 1.0 mm lensed fiber and 200 mJ per pulse for the 1.3 mm lensed fiber. Laser energy was delivered in 2 to 5 second bursts. Successful recanalization was achieved in all 10 arteries attempted without perforation of the arterial wall. The average length of the occlusions was 5.0 +/- 1.8 cm. Following successful laser recanalization significant stenoses (>50%) remained in all of the arteries as judged by angiography. In conclusion, the lensed fibers coupled to the pulsed holmium-YAG laser were safe and effective in recanalizing these difficult lesions in relatively straight iliac arteries. There is potential clinical utility for this system as an adjunct to balloon angioplasty in patients with lesions which are unable to be crossed with guidewires.

  15. Physik gestern und heute Das Eiskalorimeter

    NASA Astrophysics Data System (ADS)

    Heering, P.

    2003-07-01

    Kalorimetrische Messungen gehören heute zum experimentellen Standardrepertoire im Bereich der Thermodynamik und der physikalischen Chemie. Das erste Gerät für derartige Messungen entwickelten Ende des 18. Jahrhunderts die französischen Wissenschaftler Antoine Laurent Lavoisier und Pierre Simon de Laplace.

  16. Mikro- und Nanokapseln aus Funktionspolymeren, Biopolymeren und Proteinen

    NASA Astrophysics Data System (ADS)

    Schüler, Corinna

    2001-03-01

    In dieser Arbeit wird die Beschichtung von kolloidalen Templaten mit Hilfe der Layer-by-layer Technik beschrieben. Mit ihr ist es möglich, die Oberfläche der Template mit sehr dünnen und gut definierten Filmen zu versehen. Durch Auflösung der Template werden Kapseln hergestellt, die je nach Zusammensetzung der Beschichtung unterschiedliche Eigenschaften aufweisen. In this thesis the coating of colloid templates using the layer-by-layer technique is described. The surface of the templates is modified with thin, well defined films. After dissolving the templates, hollow capsules with different properties are obtained.

  17. Potential roles of osteopontin and αVβ3 integrin in the development of coronary artery restenosis after angioplasty

    PubMed Central

    Panda, Dibyendu; Kundu, Gopal C.; Lee, Benjamin I.; Peri, Alessandro; Fohl, David; Chackalaparampil, Isaac; Mukherjee, Barid B.; Li, Xiao D.; Mukherjee, Diane C.; Seides, Stuart; Rosenberg, Joel; Stark, Karen; Mukherjee, Anil B.

    1997-01-01

    Angioplasty procedures are increasingly used to reestablish blood flow in blocked atherosclerotic coronary arteries. A serious complication of these procedures is reocclusion (restenosis), which occurs in 30–50% of patients. Migration of coronary artery smooth muscle cells (CASMCs) to the site of injury caused by angioplasty and subsequent proliferation are suggested mechanisms of reocclusion. Using both cultured human CASMCs and coronary atherectomy tissues, we studied the roles of osteopontin (OPN) and one of its receptors, αvβ3 integrin, in the pathogenesis of coronary restenosis. We also measured the plasma levels of OPN before and after angioplasty and determined the effect of exogenous OPN on CASMC migration, extracellular matrix invasion, and proliferation. We found that cultured CASMCs during log phase of growth and smooth muscle cell layer of the coronary atherosclerotic tissues of patients express both OPN mRNA and protein at a significantly elevated level compared with controls. Interestingly, whereas the baseline plasma OPN levels in control samples were virtually undetectable, those in patient plasma were remarkably high. We also found that interaction of OPN with αvβ3 integrin, expressed on CASMCs, causes migration, extracellular matrix invasion, and proliferation. These effects were abolished when OPN or αvβ3 integrin gene expression in CASMCs was inhibited by specific antisense S-oligonucleotide treatment or OPN-αvβ3 interaction was blocked by treatment of CASMCs with antibodies against OPN or αvβ3 integrin. Our results demonstrate that OPN and αvβ3 integrin play critical roles in regulating cellular functions deemed essential for restenosis. In addition, these results raise the possibility that transient inhibition of OPN gene expression or blocking of OPN-αvβ3 interaction may provide a therapeutic approach to preventing restenosis. PMID:9256478

  18. Association Between Disruption of Fibrin Sheaths Using Percutaneous Transluminal Angioplasty Balloons and Late Onset of Central Venous Stenosis

    SciTech Connect

    Ni, Nina Mojibian, Hamid; Pollak, Jeffrey; Tal, Michael

    2011-02-15

    To compare the rates of central venous stenosis in patients undergoing hemodialysis who underwent disruption of fibrin sheath with percutaneous transluminal angioplasty balloons and those who underwent over-the-wire catheter exchange. This study is a retrospective review of 209 percutaneous transluminal angioplasty balloon disruption and 1304 over-the-wire catheter exchange procedures performed in 753 patients. Approval from the Human Investigations Committee was obtained for this study. Up to 10-year follow-up was performed. A {chi}{sup 2} test was used to compare the rates of central venous stenosis after balloon disruption versus catheter exchange. A t-test was used to compare time to central venous stenosis development. Of the 753 patients in the study, 127 patients underwent balloon disruption of fibrin sheath and 626 had catheter exchange. Within the balloon disruption group, 18 (14.2%) of 127 patients subsequently developed central venous stenosis, compared with 44 (7.0%) of 626 in the catheter exchange group (P < 0.01, {chi}{sup 2} test). Time to central venous stenosis development was approximately 3 years in both groups and not significantly different (1371 and 1010 days, P = 0.20). A total of 25.2% of patients in the balloon disruption group had four or more subsequent catheter exchanges, versus 12.6% in the catheter exchange group (P < 0.01, {chi}{sup 2} test). In conclusions, there is a possible association between percutaneous transluminal angioplasty balloon disruption of fibrin sheath and late-onset central venous stenosis. Because venography was not routinely performed in catheter exchange patients, future randomized studies are necessary to confirm these findings.

  19. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    SciTech Connect

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-08-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA. (JMT)

  20. Percutaneous transluminal angioplasty in a patient with internal carotid artery stenosis following gamma knife radiosurgery for recurrent pituitary adenoma

    PubMed Central

    Ito, Hidemichi; Onodera, Hidetaka; Sase, Taigen; Uchida, Masashi; Morishima, Hiroyuki; Oshio, Kotaro; Shuto, Takashi; Tanaka, Yuichiro

    2015-01-01

    Background: Intracranial vascular complications following radiosurgery are extremely rare. Case Description: We report a case of stenosis in the internal carotid artery 5 years after gamma knife radiosurgery for a recurrent pituitary adenoma. Percutaneous transluminal angioplasty was performed successfully with anatomical and functional improvement. Conclusion: These results suggested the importance of monitoring for arterial stenosis in the long-term follow-up. Moreover, this is the first case of endovascular treatment as an effective therapy for intracranial arterial stenosis due to radiotherapy. PMID:26069850

  1. Influence of plaque morphology on the mechanism of luminal enlargement after directional coronary atherectomy and balloon angioplasty.

    PubMed Central

    Marsico, F.; Kubica, J.; De Servi, S.; Angoli, L.; Bramucci, E.; Costante, A. M.; Specchia, G.

    1995-01-01

    OBJECTIVE--To relate the mechanism of luminal gain after directional atherectomy and balloon angioplasty to the morphological characteristics of the coronary lesions, assessed by intravascular ultrasound imaging. DESIGN--Intravascular ultrasound imaging was performed before and after the revascularisation procedure to assess the contribution of wall stretching and plaque reduction in luminal gain. SUBJECTS--32 patients undergoing balloon angioplasty and 29 undergoing directional coronary atherectomy. MAIN RESULTS--The main luminal area in vessels treated by balloon angioplasty increased from 1.51 (SD 0.30) to 3.91 (1.09) mm2 (P < 0.0001) with a concomitant increase in total vessel area from 11.44 (2.73) to 13.07 (2.83) mm2 (P < 0.0001). Therefore stretching of the vessel wall accounted for 68% of the luminal gain while plaque reduction accounted for the remaining 32%. This mechanism ranged from 45% in non-calcific plaques to 81% in echogenic plaques. The main luminal area in vessels treated by directional atherectomy increased from 1.49 (0.32) to 4.68 (1.73) mm2 (P < 0.0001), with a concomitant increase of total vessel area from 13.61 (4.67) to 15.2 (4.04) mm2 (P = 0.006). Thus stretching of the vessel wall accounted for 49% of the luminal area gain and plaque reduction for the remaining 51%. The presence of calcium influenced the relative contribution of these two mechanisms to the final luminal gain after directional atherectomy, since in calcific plaques stretching of the vessel wall accounted for only 9% of the luminal gain as compared to 56% in non-calcific plaques. After balloon angioplasty there was greater evidence of coronary dissections (32% v 3% after directional atherectomy, P < 0.01) and plaque fissure (60% v 0%, P < 0.01). Plaque fissure was more frequently seen in echolucent and concentric lesions, whereas dissections prevailed in echogenic and eccentric lesions. CONCLUSIONS--Intravascular ultrasound imaging may allow the assessment of acute changes

  2. Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate cement.

    PubMed

    Kim, Suh Min; Min, Seung-Kee; Jae, Hwan Jun; Min, Sang-Il; Ha, Jongwon; Kim, Sang Joon

    2012-10-01

    Percutaneous vertebroplasty is a widely used treatment for vertebral compression fracture. It is relatively safe, but it can be complicated by pulmonary or cerebral embolism caused by the cement injected during the procedure. Here, we present a case of a 69-year-old male with extensive deep vein thrombosis from the inferior vena cava to the right iliac and left femoral veins, which occurred 10 months after vertebroplasty. He was treated successfully by catheter-directed thrombolysis, angioplasty, and stenting. To the best of our knowledge, this is the first report of the successful treatment of delayed thrombosis caused by migrated cement inside the inferior vena cava. PMID:22572011

  3. Early coronary angioplasty for acute myocardial infarction complicated by cardiogenic shock: have novel therapies led to better results?

    PubMed

    Moreno, R; Garcia, E; Abeytua, M; Soriano, J; Acosta, J; Perez De Isla, L; Lopez De Sa, E; Rubio, R; Lopez-Sendon, J

    2000-12-01

    Patients with acute myocardial infarction (MI) and cardiogenic shock constitute a very high risk subset despite an aggressive management. The objective of this study was to evaluate if the results of early coronary angioplasty in patients with acute myocardial infarction and cardiogenic shock have changed over the last years, and to address which role the recent adjuvant therapies have played in this evolution. From 1991 to April 1999, 94 patients with acute MI and cardiogenic shock were treated with coronary angioplasty within the first 12 hours from the onset of symptoms. Temporal changes of the utilization of adjuvant therapies and operators experience were studied over these years, as well as their impact on the angiographic results and in-hospital outcome. Over the years, a progressive and significant increase on the use of coronary stents and c7E3Fab was observed, as well as an increased number of primary angioplasties performed per month. The proportion of patients treated with intraaortic balloon pump did not changed significantly over the years. An angiographic successful result (< 50% residual stenosis and TIMI flow 2 or 3) and a final TIMI grade 3 flow were obtained in 76 (80.9%) and 61 (64.9%) patients, respectively. The angiographic success rate progressively increased over the years, from 72.3% in patients treated before 1994 to 94.1% in those admitted in 1998Eth 1999 (p for trend 0.0409). The proportion of patients with a final TIMI grade 3 flow also grew progressively over the years: from 36.4% before 1994 to 76.5% after 1997 (p for trend 0. 0209). The overall in-hospital mortality rate was 63.8% (60 patients), and there was no significant change in mortality rate over the years. Therefore, apart from the growing operators experience, we have observed an incremental change in the use of coronary stents and c7E3 Fab (abciximab) in patients with acute myocardial infarction and cardiogenic shock treated with early coronary angioplasty. All these

  4. Revascularization therapy for coronary artery disease. Coronary artery bypass grafting versus percutaneous transluminal coronary angioplasty.

    PubMed Central

    Wilson, J M; Ferguson, J J

    1995-01-01

    Coronary artery bypass surgery relieves the symptoms of myocardial ischemia and prolongs survival of patients with more severe coronary artery disease. Randomized trials of surgical therapy have consistently shown that the benefits of surgical revascularization are proportional to the amount of myocardium affected by, or at risk for, ischemic injury. This risk is inferred from angiographically delineated coronary anatomy, estimates of left ventricular function, and physiologic testing. The population that may see a survival benefit from surgical revascularization has probably been expanded beyond that reported in the VA, CASS, and ECSS trials, due to improved perioperative care, longer graft survival, and the use of internal mammary artery grafts. Percutaneous transluminal coronary angioplasty revascularizes myocardium by dilating a stenotic segment of coronary artery. While successful in relieving the symptoms of myocardial ischemia, PTCA is hindered by the occurrence of abrupt vessel closure and the frequent development of restenosis. Furthermore, firm proof of a survival benefit, outside of emergency therapy for acute myocardial infarction, is not yet available. However, because the risk of procedure-related death or serious complication is lower than that seen with bypass surgery, PTCA provides a useful alternative revascularization method for patients with less extensive disease, in whom the risk of surgery may equal or exceed any beneficial effect. New technology and growing experience are widening the scope of percutaneous revascularization by extending the hope of symptomatic relief and survival benefit even to patients with extensive, severe coronary artery disease. Comparisons between surgical therapy and PTCA in select populations with single- and multivessel coronary artery disease have shown that PTCA is not as effective as surgery for long-term symptomatic control, and that it often requires repeat PTCA or cross-over to bypass surgery; however, long

  5. Dentalwerkstoffe und Dentalimplantate - Teil 2

    NASA Astrophysics Data System (ADS)

    Faltermeier, Andreas

    Wie in allen Bereichen der Medizin findet auch in der Zahnmedizin eine kontinuierliche Weiterentwicklung der verwendeten Werkstoffe statt. Gerade für Zahnersatz werden Werkstoffe gesucht, die zum einen ästhetisch, zum anderen haltbar und darüber hinaus auch körperverträglich sind. Auch steigt immer mehr der Wunsch der Patienten nach ästhetischen und zugleich biokompatiblen Materialien. Wurde früher fast ausschließlich als Füllungsmaterial im Seitenzahngebiet quecksilberhaltiges Amalgam verwendet, hat der Zahnarzt heutzutage eine große Auswahl an verschiedenen zahnfarbenen Materialien: zum einen werden sog. Komposite verwendet, das aus einer Polymermatrix mit eingebetteten Füllstoffen besteht, zum anderen können diverse Dentalkeramiken verwendet werden. Besonders die Verwendung von Hochleistungskeramiken, wie beispielsweise Zirkonoxid, das sich bereits als Bremsscheiben für Sportwägen, Hitzeschilde im Space Shuttle und als Kugelköpfe künstlicher Hüftgelenke bewährt hat, spielt heutzutage eine große Rolle bei der Verdrängung des Metalls aus der Mundhöhle. War es früher nur möglich, einen verloren gegangen Zahn mittels einer Brücke, die ein Beschleifen der Nachbarzähne zur Folge hat, oder durch herausnehmbaren Zahnersatz zu ersetzen, ist es heutzutage mit der modernen Implantologie möglich, Zahnersatz zahnschonend einzugliedern. Auch kann mittels Dentalimplantaten dem Wunsch vieler Patienten nach festem Zahnersatz anstelle eines herausnehmbaren Zahnersatzes entsprochen werden. So kann mit Hilfe neuer biokompatiblen Werkstoffe sowohl der ästhetische Anspruch befriedigt als auch das Selbstwertgefühl vieler Patienten angehoben werden.

  6. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

    PubMed Central

    Vaz, Humberto Andres; Vanz, Ana Paula; Castro, Iran

    2016-01-01

    Background The kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective To evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h), 2 (TnT2h), 5 (TnT5h), and 8 hours (TnT8h) after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance). Results This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h). After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI. PMID:26959404

  7. [Coronary arterial rupture during percutaneous transluminal coronary angioplasty: a case report].

    PubMed

    Hsu, Y S; Tamai, H; Odawara, K; Yamagata, T; Ueda, K; Tomita, T; Koya, M; Motohara, S; Uehata, H

    1990-01-01

    A case who developed rupture in a diagonal branch of the left anterior descending coronary artery (LAD) during percutaneous transluminal coronary angioplasty (PTCA) is reported here. The present case was 80-year-old man with severe focal stenosis of the LAD at its junction with a diagonal branch. PTCA for the LAD lesion was successfully performed, but occlusion of the diagonal branch developed later. A subsequent ECG showed elevation of an ST segment in a VL, and PTCA for the diagonal branch was attempted. A 018 Hi-torque floppy guide wire was introduced into the occluded diagonal branch, and its dilatation was attempted using a 2 mm Simpson-Robert catheter. During a maximal pressure of 120 psi, a deformity was found at the distal end of the balloon. Post-PTCA angiograms showed rupture of the diagonal arterial branch, and mild to moderate pericardial effusion was observed by echocardiography. The patient experienced transient hypotension (60 mmHg at systolic), but his condition gradually stabilized after the administration of only a pressor medication. Neither pericardiocentesis nor emergency surgery was performed. The next day, follow-up angiograms showed diagonal branch occlusion at the proximal portion of the rupture site. His clinical course was satisfactory with spontaneous resolution of pericardial effusion and mild elevation of his cardiac enzymes (CPK = 243IU). In this case, it was concluded that the cause of coronary arterial rupture was the difference in diameters of the coronary artery (1 mm) and the balloon catheter (2 mm). This was the first rupture case experienced among 750 PTCA sites (0.13%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2104423

  8. Reducing Radiation Dose in Coronary Angiography and Angioplasty Using Image Noise Reduction Technology.

    PubMed

    Kastrati, Mirlind; Langenbrink, Lukas; Piatkowski, Michal; Michaelsen, Jochen; Reimann, Doris; Hoffmann, Rainer

    2016-08-01

    This study sought to quantitatively evaluate the reduction of radiation dose in coronary angiography and angioplasty with the use of image noise reduction technology in a routine clinical setting. Radiation dose data from consecutive 605 coronary procedures (397 consecutive coronary angiograms and 208 consecutive coronary interventions) performed from October 2014 to April 2015 on a coronary angiography system with noise reduction technology (Allura Clarity IQ) were collected. For comparison, radiation dose data from consecutive 695 coronary procedures (435 coronary angiograms and 260 coronary interventions) performed on a conventional coronary angiography system from October 2013 to April 2014 were evaluated. Patient radiation dosage was evaluated based on the cumulative dose area product. Operators and operator practice did not change between the 2 evaluated periods. Patient characteristics were collected to evaluate similarity of patient groups. Image quality was evaluated on a 5-grade scale in 30 patients of each group. There were no significant differences between the 2 evaluated groups in gender, age, weight, and fluoroscopy time (6.8 ± 6.1 vs 6.9 ± 6.3 minutes, not significant). The dose area product was reduced from 3195 ± 2359 to 983 ± 972 cGycm(2) (65%, p <0.001) in coronary angiograms and from 7123 ± 4551 to 2431 ± 1788 cGycm(2) (69%, p <0.001) in coronary interventions using the new noise reduction technology. Image quality was graded as similar between the evaluated systems (4.0 ± 0.7 vs 4.2 ± 0.6, not significant). In conclusion, a new x-ray technology with image noise reduction algorithm provides a substantial reduction in radiation exposure without the need to prolong the procedure or fluoroscopy time. PMID:27344273

  9. QT interval dispersion changes according to the vessel involved during percutaneous coronary angioplasty.

    PubMed Central

    Kilic, Harun; Atalar, Enver; Necla, Ozer; Ovunc, Kenan; Aksoyek, Serdar; Ozmen, Ferhan

    2007-01-01

    Increased QT dispersion (QTd) is a noninvasive marker of an electrophysiologic abnormality associated with high mortality in coronary artery disease. The purposes of this study were to measure changes in QTd and ST-segment changes immediately before, during and after intracoronary balloon inflation and to determine whether the coronary artery vessel involved and/or the duration of inflation affect(s) QTd. A total of 45 patients (32 men, 13 women, mean age 58 +/- 11 years) who were referred for elective percutaneous transluminal coronary angioplasty were included. The mean QT interval dispersions for all patients before the inflation, during the balloon inflation at 60 sec and after the balloon deflation at 5 min were 68 +/- 13 ms, 82 +/- 16 ms and 71 +/- 13 ms, respectively. There was no significant difference between baseline and 5 min after deflation. The increase in QTd during the balloon inflation was significant (p<0.01). There was no significant QTd change in patients with left circumflex artery (Cx) lesions during inflation and after deflation compared with baseline. The differences were statistically significant only in patients with left anterior descending (LAD) lesions and right coronary artery (RCA) lesions at 60 sec during balloon inflation (p=0.001 vs. p=0.04). Acute reversible myocardial ischemia induced by balloon inflation causes an increase in QTd limited to the LAD and RCA vessels. Therefore, when using QTd as a marker of myocardial repolarization abnormality due to acute reversible ischemia, the involved coronary artery vessel must be taken into account. PMID:17722670

  10. Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

    PubMed Central

    Dawkes, Susan; Smith, Graeme D; Elliott, Lawrie; Raeside, Robert; Donaldson, Jayne H

    2016-01-01

    Objective To explore how older patients self-manage their coronary heart disease (CHD) after undergoing elective percutaneous transluminal coronary angioplasty (PTCA). Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients (n = 93) approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings informed the purposive sampling for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualitative data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants (n = 47) classified as 65 years of age or older. Results 78.7% (n = 37) of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% (n = 16) thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% (n = 19) would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less (P = 0.02) and smoked less (P = 0.01) than their younger counterparts in the study. Age did not seem to affect PTCA patients' likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption (P = 0.237). Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants' likelihood to alter lifestyle factors. PMID:27594866

  11. Retinal Embolization During Carotid Angioplasty and Stenting: Periprocedural Data and Follow-Up

    SciTech Connect

    Vos, J. A. Werkum, M. H. van; Bistervels, J. H. G. M.; Ackerstaff, R. G. A. Tromp, S. C.; Berg, J. C. van den

    2010-08-15

    The purpose of this study was to prospectively evaluate the incidence of retinal emboli during carotid angioplasty and stenting (CAS) and to correlate emboli with clinical findings and transcranial Doppler (TCD)-detected cerebral embolic load. Between 2001 and 2005, 33 CAS procedures in 32 patients (23 [72%] male, 19 [58%] symptomatic, mean age 72.5 years [range 54.6 to 83.9]) scheduled for CAS were included in this study. Bilateral fundoscopy with retinal photography was performed by an experienced ophthalmologist immediately before, immediately after (fundoscopy only), and 1 day after the procedure and again at long-term follow-up (mean 37 months). Visual field testing was performed before CAS and again at long-term follow-up. TCD-detected cerebral emboli were stratified to five procedural phases: wiring, predilatation, stent placement, postdilatation, and cerebral protection device (CPD) use (if applicable). To establish correlation between TCD data and retinal embolization, Mann-Whitney test was used, and P < 0.05 was considered statistically significant. All procedures were performed successfully. In five of 33 procedures (15%), new retinal emboli were found. Two of the procedures with emboli had small retinal infarcts. Three of five were performed using CPDs versus seven of 28 that had no retinal emboli (P = not significant). Two of four patients (50%) with previous radiation therapy to the neck had new retinal emboli versus three of 29 patients (10%) who had no previous radiation therapy (P = 0.038). None of the other patient characteristics was associated with retinal embolization. In 30 (91%) of patients with an adequate acoustic temporal window for TCD monitoring, there was no statistically significant correlation between TCD data and the incidence of retinal emboli. No visual field defects were found. On long-term follow-up, all retinal emboli and retinal infarcts had resolved. Retinal embolization during CAS is not uncommon, and it occurs in both

  12. The Primary Patency of Percutaneous Transluminal Angioplasty in Hemodialysis Patients With Vascular Access Failure

    PubMed Central

    Kim, Woo Shin; Pyun, Wook Bum

    2011-01-01

    Background and Objectives Dysfunction of arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) contributes significantly to morbidity and hospitalization in the dialysis population. We evaluated the primary patency of AVFs following percutaneous transluminal angioplasty (PTA) in haemodialysis patients. Subjects and Methods We performed 231 interventions in 118 patients with a mean age of 62.1±12.9 years. We performed 122 interventions in 53 AVG patients (44.9%), and 109 interventions in 65 AVF patients (55.1%). If there was thrombosis of the vascular access, urokinase was administered and/or thrombus aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. Results For the 118 patients, the median patency time was 10.45±10.29 months at 92 months of follow-up. The primary patencies for stenotic AVFs at 6, 12, 24, 36, 48, and 60 months were 63.4%, 41.4%, 17.0%, 9.7%, 7.3%, and 2.4%, respectively. The primary patencies for AVGs at 6, 12, 24, and 36 months were 36.9%, 19.5%, 10.8%, 2.1%, respectively, and were obtained by means of the Kaplan-Meier analysis (log rank=6.42, p<0.05). The median patency time was 11.0 months and 4.45 months in the non-thrombus and thrombus groups, respectively. The complication rate was 1.73% (4/231); two cases of pseudoaneurysms and two cases of extravasation were detected. All therapy failures (5/231) occurred in thrombotic lesions of AVGs and were treated surgically. Conclusion PTA is an efficacious method for the correction of stenosis of AVFs for hemodialysis, thus prolonging the patency of the fistulas. PMID:22022326

  13. Early Clinical Results Of Pulsed ND-YAG Laser Angioplasty In Patients

    NASA Astrophysics Data System (ADS)

    Cross, F. W.; Bowker, T. J.

    1988-06-01

    This paper describes the use of a 100u second pulsed Nd-YAG laser at 1.064 um wavelength in the treatment of critical ischemia of the lower limb in five human subjects. Laser energy was delivered percutaneously to superficial femoral artery occlusions using standard angiography access techniques. The fiber tip was modified by the use of a 2.2mm hemispherical sapphire tip in contact with the tissue and laser energy was delivered at 0.5 Joules per pulse at a repetition rate of 10Hz. Patients were selected because of their unsuitability for standard treatment, either through technical inoperability of poor general health. Their mean age (±SD) was 74 ± 11 years and the mean occlusion length (+SD) in the five patients was 16.3 ± 11.9 cm. Passage of a guidewire across the occlusion was attempted, but failed, in every case. The laser crossed all these occlusions with a mean energy delivery of 129 + 76 Joules. Mean ankle-brachial pressure index (ABPI) in the successful cases doubled from 0.25 to 0.5. Two of the recanalised segments closed within 24 hours due to poor runoff but remained open in the remaining three patients for a followup period of up to one year, averting amputation in one of them. These are poor risk patients with deteriorating critical ischemia and little hope of alternative treatment. Laser angioplasty using a pulsed Nd-YAG laser has been shown to be feasible in femoropopliteal disease and should now be applied in patients with less severe symptoms.

  14. Monitoring plasma cardiac troponin I for the detection of myocardial injury after percutaneous transluminal coronary angioplasty.

    PubMed

    Ricchiuti, V; Shear, W S; Henry, T D; Paulsen, P R; Miller, E A; Apple, F S

    2000-12-01

    The objective of this study was to detect myocardial injury defined by an increase of plasma cardiac troponin I (cTnI) following percutaneous transluminal coronary angioplasty (PTCA) and compare plasma cTnI with the risk of cardiac complications at 30 days. Plasma cTnI, creatine kinase (CK) MB, and total CK were determined in 83 patients before (baseline) and 6, 12 and 24 h after PTCA. Thirty-eight patients underwent conventional PTCA, 39 PTCA-stent and six rotational atherectomy. Patients with acute myocardial infarction (AMI) and increased pre-procedural cTnI >0.8 microg/l were categorized into group 1 (n=23). The remaining 60 patients (pre-procedural cTnI=0.8 microg/l) were categorized as follows: group 2 (n=15) AMI; group 3 (n=20) unstable angina (UA); group 4 (n=25) coronary artery disease (CAD). Twelve hours post-procedure, all three cardiac markers were more frequently increased over baseline in group 2 patients (40-60%) compared to patients in group 3 (5-29%, P<0.03) or group 4 (0.5-5%, P<0.01). This was also true for patients undergoing PTCA-stent compared to conventional PTCA or rotational atherectomy (27-40 vs. 4-14%, P<0.02). cTnI was more sensitive (60%) to detect release of myocardial protein after PTCA compared to total CK (47%) or CKMB (43%). A moderate increase of cTnI (0.8-1.5 microg/l) in groups 2, 3 and 4 was associated with higher risk of complications 30 days post-procedure. PMID:11074073

  15. The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

    SciTech Connect

    Gerbaud, Laurent; Manhes, Geraud; Debourse, Juliette; Gouby, Gerald Glanddier, Phyllis-Yvonne; Vader, John-Paul; Boyer, Louis Deteix, Patrice

    2008-11-15

    Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis ({>=}70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http://www

  16. Efficacy of cardiac rehabilitation after balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

    PubMed Central

    Fukui, Shigefumi; Ogo, Takeshi; Takaki, Hiroshi; Ueda, Jin; Tsuji, Akihiro; Morita, Yoshiaki; Kumasaka, Reon; Arakawa, Tetsuo; Nakanishi, Michio; Fukuda, Tetsuya; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi; Goto, Yoichi

    2016-01-01

    Objective To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2–8 sessions/patient. Methods Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24.7±5.5 mm Hg and who suffered remaining exercise intolerance were prospectively studied. Participants were divided into two groups just after the final BPA (6.8±2.3 days): patients with (CR group, n=17) or without (non-CR group, n=24) participation in a 12-week CR of 1-week inhospital training followed by an 11-week outpatient programme. Cardiopulmonary exercise testing, haemodynamics, and quality of life (QOL) were assessed before and after CR. Results No significant between-group differences were found for any baseline characteristics. At week 12, peak oxygen uptake (VO2), per cent predicted peak VO2 (70.7±9.4% to 78.2±12.8%, p<0.01), peak workload, and oxygen pulse significantly improved in the CR group compared with the non-CR group, with a tendency towards improvement in mental health-related QOL. Quadriceps strength and heart failure (HF) symptoms (WHO functional class, 2.2–1.8, p=0.01) significantly improved within the CR group. During the CR, no patient experienced adverse events or deterioration of right-sided HF or haemodynamics as confirmed via catheterisation. Conclusions The combination of BPA and subsequent CR is a new treatment strategy for inoperable CTEPH to improve exercise capacity to near-normal levels and HF symptoms, with a good safety profile. PMID:27220694

  17. A mathematical evaluation of hemodynamic parameters after carotid eversion and conventional patch angioplasty

    PubMed Central

    Kamenskiy, Alexey V.; Pipinos, Iraklis I.; Dzenis, Yuris A.; Gupta, Prateek K.; Jaffar Kazmi, Syed A.

    2013-01-01

    Carotid endarterectomy has a long history in stroke prevention, yet controversy remains concerning optimal techniques. Two methods frequently used are endarterectomy with patch angioplasty (CEAP) and eversion endarterectomy (CEE). The objective of this study was to compare hemodynamics-related stress and strain distributions between arteries repaired using CEAP and CEE. Mathematical models were based on in vivo three-dimensional arterial geometry, pulsatile velocity profiles, and intraluminal pressure inputs obtained from 16 patients with carotid artery disease. These data were combined with experimentally derived nonlinear, anisotropic carotid artery mechanical properties to create fluid-structure interaction models of CEAP and CEE. These models were then used to calculate hemodynamic parameters thought to promote recurrent disease and restenosis. Combining calculations of stress and strain into a composite risk index, called the integral abnormality factor, allowed for an overall comparison between CEAP and CEE. CEE demonstrated lower mechanical stresses in the arterial wall, whereas CEAP straightened the artery and caused high stress and strain concentrations at the suture-artery interface. CEAP produced a larger continuous region of oscillatory, low-shear, vortical flow in the carotid bulb. There was a more than two-fold difference in the integral abnormality factor, favoring CEE. In conclusion, in a realistically simulated carotid artery, fluid-structure interaction modeling demonstrated CEE to produce less mechanical wall stress and improved flow patterns compared with CEAP. Clinical validation with larger numbers of individual patients will ultimately be required to support modeling approaches to help predict arterial disease progression and comparative effectiveness of reconstruction methods and devices. PMID:23812386

  18. Vascular brachytherapy after percutaneous transluminal angioplasty of superficial femoral arteries--Polish pilot group

    SciTech Connect

    Walichiewicz, Piotr; Piecuch, Jerzy; Bialas, Brygida; Orkisz, Witold; Fijalkowski, Marek; Miszczyk, Leszek

    2002-03-01

    Purpose: The article presents the results of treatment with vascular brachytherapy (VBT) in superficial femoral arteries. This method aims to minimize frequency of restenosis after percutaneous transluminal angioplasty (PTA). Method: Treatment was carried out in 20 cases. The patients with severe stenoses or total occlusions verified in angiography were selected. In the group of 19 patients, two were women (the average age of the patients was 58.7 years). VBT was performed immediately after PTA. A 15-Gy dose, with high dose rate, was applied. The dose was calculated based on individually chosen distance from the internal surface of the artery wall, which varied from 2 to 3 mm. The mean observation time after treatment was 8 months. The shortest time was 1 month and the longest 14 months. At the end of the observation time, the control DSA angiography was performed on every patient. Results: During the first 2 months, in three cases, an acute thrombosis in treated artery was observed. In the third month, one treated artery occluded. In the sixth month of observation, one case of acute thrombosis was observed. The rest of the patients were free of restenoses. Conclusions: (1) In superficial femoral arteries, a low value of ankle brachial pressure index (ABPI; below 0.4) is very probably responsible for acute thrombosis after PTA with or without stent implantation followed by VBT. (2) Diabetes, rest ischaemia before treatment, poor vessel status confirmed in angiography may also be responsible for acute thrombosis after VBT. (3) Anticoagulants or antiplatelet (ticlipidine) treatment must be ordered for 6 months after VBT in patients with implanted stents.

  19. BMI and Health Status in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D)

    PubMed Central

    Chung, Sheng-Chia; Hlatky, Mark A.; Stone, Roslyn A.; Rana, Jamal S.; Escobedo, Jorge; Rogers, William J.; Bromberger, Joyce T.; Kelsey, Sheryl F.; Brooks, Maria Mori

    2011-01-01

    BACKGROUND The longitudinal association between obesity, weight variability and health status outcomes is important for patients with coronary disease and diabetes. METHODS The Bypass Angioplasty Revascularization Investigation 2 Diabetes trial (BARI 2D) was a multi-center randomized clinical trial to evaluate the best treatment strategy for patients with both documented stable ischemic heart disease and type 2 diabetes. We examined BARI 2D participants for four years to study how BMI was associated with health status outcomes. Health status was evaluated by the Duke Activity Status Index (DASI), RAND Energy/fatigue, Health Distress, and Self-rated health. BMI was measured quarterly throughout follow-up years, and health status was assessed at each annual follow-up visit. Variation in BMI measures was separated into between-person and within-person change in longitudinal analysis. RESULTS Higher mean BMI over follow-up years (the between-person BMI) was associated with poorer health status outcomes. Decreasing BMI (the within-person BMI change) was associated with better Self-rated health. The relationships between BMI variability and DASI or Energy appeared to be curvilinear, and differed by baseline obesity status. Decreasing BMI was associated with better outcomes if patients were obese at baseline, but was associated with poorer DASI and Energy outcomes if patients were non-obese at baseline. CONCLUSIONS For patients with stable ischemic heart disease and diabetes, weight gain was associated with poorer health status outcomes, independent of obesity-related comobidities. Weight reduction is associated with better functional capacity and perceived energy for obese patients but not for non-obese patients at baseline. PMID:21742107

  20. Frequency, risk factors, and outcome for bacteremia after percutaneous transluminal coronary angioplasty.

    PubMed

    Samore, M H; Wessolossky, M A; Lewis, S M; Shubrooks, S J; Karchmer, A W

    1997-04-01

    The objectives of this study were to examine bacteremias after percutaneous transluminal coronary angioplasty (PTCA) with respect to incidence, outcome, and risk factors. Patients undergoing PTCA from January 1990 through April 1994 were studied; during this period a total of 4,217 PTCAs were performed in 3,473 patients. With use of predefined clinical and microbiologic criteria, bacteremias were divided into 3 categories according to the relation to the PTCA procedure: PTCA-related, unrelated, and indeterminate. Ninety-one patients with at least 1 positive blood culture during a 7-week period after PTCA were identified. The bacteremia was classified as unrelated to the PTCA procedure in 32 patients, PTCA-related in 27, and indeterminant in the remaining 32 patients. The attack rate of PTCA-related bacteremia during the 52-month period was 0.64%. The most common organisms causing PTCA-related bacteremia were Staphylococcus aureus (14 patients), coagulase-negative staphylococci (9 patients) and group B streptococci (6 patients). Septic complications, which included femoral artery mycotic aneurysm, septic arthritis, and septic thrombosis, occurred in 10 patients (0.24%). Independent risk factors for PTCA-related bacteremia included duration of procedure (odds ratio [OR] 2.9; p = 0.04), number of catheterizations at the same site (OR 4.0; p = 0.015), difficult vascular access (OR 14.9; p = 0.007), arterial sheath in place > 1 day (OR 6.8; p = 0.025), congestive heart failure (OR 43.3; p = 0.002). Thus, PTCA-related bacteremia is an infrequent complication of PTCA but can be associated with significant morbidity, particularly when the infecting organism is S. aureus. Four of the 5 risk factors for PTCA-related bacteremia appear to correlate directly with increased vascular injury or maintenance of the arterial entry for the procedure. PMID:9104897

  1. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure.

    PubMed

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud's disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  2. Angioplasty of forearm arteries as a finger salvage procedure for patient with end-stage renal failure

    PubMed Central

    Law, Yuk; Chan, Yiu Che; Cheng, Stephen Wing-Keung

    2016-01-01

    Due to the relatively low metabolic demand and extensive collaterals of the upper limb, peripheral arterial disease seldom leads to tissue loss, except in patients with end-stage renal failure (ESRF), rheumatologic diseases, Raynaud’s disease, frostbites, or distal emboli. We report a case of a 51-year-old lady with ESRF who presented to our tertiary referral vascular center with infected gangrene of her right ring finger. Duplex ultrasound showed that her forearm arteries were severely diseased. Digital subtraction angiogram showed severe multilevel stenoses/occlusions in her forearm radial and ulnar arteries. These lesions were successfully angioplastized with 2 mm × 25 mm angioplasty balloon. Completion angiogram showed good radiological results with some post-dilatation spasm which improved with intra-arterial glyceryl trinitrate. The sepsis improved after revascularization, and the distal phalanx was allowed to self-demarcate with dressings and autoamputate with good clinical results. Our case illustrated that even in delayed setting, patients could still benefit from specialist vascular care with a combination of expert care and angioplasty of forearm arteries, with successful salvage of her finger. PMID:27143949

  3. Acute and chronic complications of laser angioplasty: vascular wall damage and formation of aneurysms in the atherosclerotic rabbit.

    PubMed

    Lee, G; Ikeda, R M; Theis, J H; Chan, M C; Stobbe, D; Ogata, C; Kumagai, A; Mason, D T

    1984-01-15

    Acute and chronic vascular responses to laser exposure in atherosclerotic rabbits were studied. In 7 rabbits fed an atherogenic diet for 3 to 5 months before the study to induce aortic atherosclerosis, a flexible quartz fiber, 400 micron core diameter, attached to an argon ion laser was passed anterogradely or retrogradely to the atherosclerotic ascending aorta. The laser was turned on using power intensities of 1 to 2 W for 3 seconds. After laser treatment, the aortas were studied acutely in 3 rabbits and chronically in 4 rabbits after recovery for 1 to 14 days. In 2 rabbits studied acutely, the argon laser produced a vaporized crater within the atherosclerotic plaque at the endothelial surface; however, in 1 there was also vascular damage extending deep into the medial layer. In addition, aortic aneurysm with muscular wall damage occurred in 2 of the 4 animals studied chronically. Thus, vascular complications may arise when catheter laser angioplasty is randomly applied without visualizing specific plaque targets or without using safe dose increments of power intensities and durations of exposure. This study suggests caution in the clinical use of intensive phototherapy to cardiovascular lesions and stresses the need for further understanding of laser vascular consequences before application of laser angioplasty in patients. PMID:6695725

  4. Percutaneous Transluminal Angioplasty of Hepatic Artery Stenosis in Patients After Orthotopic Liver Transplantation: Mid-term Results

    SciTech Connect

    Jarmila, Lastovickova Jan, Peregrin

    2011-12-15

    Purpose: This study was designed to present our experience with percutaneous treatment of hepatic artery stenosis in orthotopic liver transplant patients and to evaluate the efficacy, technical outcomes, and mid-term clinical results of the procedure. Methods: Twenty-two percutaneous transluminal angioplasties (PTAs) were performed in 19 liver transplant recipients at our institution between 1998 and 2010. Stents were placed into the hepatic/celiac artery in 16 PTAs, but balloon dilatation alone was performed in 6 because of the anatomical condition of the vessel. PTA/stenting was indicated in 17 patients because of elevated liver enzymes; 2 patients were asymptomatic. The objective of treating stenosis was prevention of long-term complications, including thrombosis. Results: Technical success was achieved in all patients. There was only one complication: dissection of the treated artery without any subsequent adverse effects. In all patients, elevated liver enzyme levels improved after treatment. No restenosis was observed in any patient during a mean follow-up of 2.6 years (1 month to 5.5 years). Conclusions: Percutaneous angioplasty/stent placement is a safe method for the treatment of hepatic artery stenosis after orthotopic liver transplantation, with a high technical success rate and promising mid-term results.

  5. Hochschule fur Film und Fernsehen (Babelsberg).

    ERIC Educational Resources Information Center

    Neumann, Roland

    1992-01-01

    Describes the Hochschule fur Film und Fernsehen, an institution of higher education for the study of film and television production in Babelsberg, Germany (formerly the German Democratic Republic). Discusses the major reorientations in the school caused by Germany's reunification. (SR)

  6. Satellitenbewegung, band III: Natiirliche und gesteuerte bewegung.

    NASA Astrophysics Data System (ADS)

    Jochim, E. F.

    2014-12-01

    Im dritten Band der Satellitenbewegung werden in fortlaufender Nummerierung einige für Untersuchungen der Bewegung der künstlichen Satelliten wichtige Grundlagen der Astrodynamik mit ausführlichen mathematischen Formelsystemen behandelt. Dazu zählen die unterschiedlichen Aspekte der Bewegung der natürlichen Himmelskörper, die Steuerung und Kontrolle von künstlichen Objekten, und insbesondere die für eine Satellitenbahnanalyse wichtigen physikalischen Beeinflussungen einer Satellitenbewegung. Mathematisch entscheidend ist die Wahl geeigneter Bahnparameter, die ein bestimmtes Bewegungsproblem widerspruchsfrei und singularitätenfrei zu behandeln gestatten. Für die Behandlung routinemäßiger Aufgabenstellungen der Satellitenbewegung, in erster Linie einer präzisen Bahnbestimmung und Bahnverbesserung, kann auf eine Fülle von lehrbuchartigen Monographien verwiesen werden, so dass diese Problematik in der vorliegenden Arbeit nur angedeutet werden soll.

  7. Simulation und virtuelle Realität

    NASA Astrophysics Data System (ADS)

    von Estorff, Otto; Markiewicz, Marian; Özkan, Ali; Zaleski, Olgierd; Blumrich, Reinhard; Genuit, Klaus; Fiebig, André

    Mit Hilfe akustischer Berechnungen ist es möglich, aufwendige Messungen an Fahrzeugprototypen deutlich zu reduzieren. Dieses Kapitel gibt einen kurzen Überblick über die wichtigsten derzeit verfügbaren Methoden. Dabei wird zunächst auf Elementverfahren, wie die Finite-Elemente-Methode (FEM) und die Boundary-Elemente-Methode (BEM), näher eingegangen. Während diese vor allem im tieffrequenten Bereich eingesetzt werden, kommen bei höheren Frequenzen vermehrt Verfahren zum Einsatz, die auf Energieformulierungen beruhen. Exemplarisch wird hier die Funktionsweise und der Einsatz der Statistischen-Energie-Analyse (SEA) erläutert. Anhand von repräsentativen Beispielen werden die Einsatzmöglichkeiten und Grenzen der verschiedenen Verfahren aufgezeigt, wobei vor allem auch auf Vergleiche zwischen Rechnung und Messung eingegangen wird.

  8. MR-guided balloon angioplasty of stenosed aorta: in vivo evaluation using near-standard instruments and a passive tracking technique.

    PubMed

    Godart, F; Beregi, J P; Nicol, L; Occelli, B; Vincentelli, A; Daanen, V; Rey, C; Rousseau, J

    2000-10-01

    The purpose of this study was to assess the feasibility of magnetic resonance (MR)-guided balloon angioplasty of a stenosed aorta on an open low-field magnet using a passive tracking technique. Visualization of vessels and position of instruments were realized by using a fast low-angle shot (FLASH) sequence. Catheters and guidewire were prepared for susceptibility-based MR visualization. Standard balloon catheters were inflated with diluted gadolinium, and nitinol guidewires were modified by incorporation of iron oxide markers into their walls. After validation on a flow phantom, balloon angioplasty was performed on an in vivo model of arterial stenosis. Creation of abdominal aorta stenosis was realized in five piglets. MR-guided balloon angioplasty of the aorta was performed with success in all but one. In one of them, stent implantation was achieved in the descending aorta. Balloon angioplasty using a passive tracking technique is a simple concept that can be realized with near-standard instruments and any MR imaging system. This represents an advance toward MR-guided vascular interventions in the future. PMID:11042648

  9. Renal Branch Artery Occlusion in a 13-Year-Old Hypertensive Girl: Initial Treatment and Treatment of Recurrent Stenosis by Balloon Angioplasty

    SciTech Connect

    Konez, Orhan; Burrows, Patricia E.; Harmon, William E.

    2001-09-15

    A 13-year-old girl who recently developed hypertension was diagnosed to have an occluded right renal branch artery and was treated successfully with percutaneous transluminal angioplasty (PTA). To our knowledge, PTA has not been reported as a treatment for totally occluded renal branch arteries, and there is no data available regarding the success rate and possible complications.

  10. Changing Health Behaviors to Improve Health Outcomes after Angioplasty: A Randomized Trial of Net Present Value versus Future Value Risk Communication

    ERIC Educational Resources Information Center

    Charlson, M. E.; Peterson, J. C.; Boutin-Foster, C.; Briggs, W. M.; Ogedegbe, G. G.; McCulloch, C. E.; Hollenberg, J.; Wong, C.; Allegrante, J. P.

    2008-01-01

    Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on "net present value" economic theory, would be more effective in behavioral intervention than the standard "future value approach"…

  11. Clinical impact and risk stratification of balloon angioplasty for femoropopliteal disease in nitinol stenting era: Retrospective multicenter study using propensity score matching analysis

    PubMed Central

    Tsuchiya, Taketsugu; Takamura, Takaaki; Soga, Yoshimitsu; Iida, Osamu; Hirano, Keisuke; Suzuki, Kenji; Yamaoka, Terutoshi; Miyashita, Yusuke; Kitayama, Michihiko; Kajinami, Koji

    2016-01-01

    Objective: Nitinol stenting could bring the better outcome in endovascular therapy for femoropopliteal disease. However, it might be expected that recent marked advances in both device technology and operator technique had led to improved efficacy of balloon angioplasty even in this segment. The aims of this study were to evaluate the clinical impact of balloon angioplasty for femoropopliteal disease and make risk stratification clear by propensity score matching analysis. Methods: Based on the multicenter retrospective data, 2758 patients (balloon angioplasty: 729 patients and nitinol stenting: 2029 patients), those who underwent endovascular therapy for femoropopliteal disease, were analyzed. Results: The propensity score matching procedure extracted a total of 572 cases per group, and the primary patency rate of balloon angioplasty and nitinol stenting groups after matching was significantly the same (77.2% vs 82.7% at 1 year; 62.2% vs 64.3% at 3 years; 47.8% vs 54.3% at 5 years). In multivariate Cox hazard regression analysis, significant predictors for primary patency were diabetes mellitus, regular dialysis, cilostazol use, chronic total occlusion, and intra-vascular ultra-sonography use. The strategy of balloon angioplasty was not evaluated as a significant predictor for the primary patency. After risk stratification using five items (diabetes mellitus, regular dialysis, no use of intra-vascular ultra-sonography, chronic total occlusion, and no use of cilostazol: the DDICC score), the estimated primary patency rates of each group (low, DDICC score 0–2; moderate, DDICC score 3; high risk, DDICC score 4–5) were 88.6%, 78.3%, and 63.5% at 1 year; 75.2%, 60.7%, and 39.8% at 3 years; and 66.0%, 47.1%, and 26.3% at 5 years (p < 0.0001). The primary patency rate of balloon angioplasty and nitinol stenting groups was significantly the same in each risk stratification. Conclusion: This study suggests that balloon angioplasty does not have

  12. Iliofemoral Deep Vein Thrombosis: Conventional Therapy Versus Lysis and Percutaneous Transluminal Angioplasty and Stenting

    PubMed Central

    AbuRahma, Ali F.; Perkins, Samuel E.; Wulu, John T.; Ng, Hong K.

    2001-01-01

    Objective To compare conventional treatment (heparin and warfarin) of iliofemoral venous thrombosis with multimodality treatment (lysis and stenting). Summary Background Data Several studies have reported on conventional therapy for iliofemoral venous thrombosis with disappointing results. However, more recent studies have reported better results with multimodality treatment. Methods Fifty-one consecutive patients with extensive iliofemoral venous thrombosis were treated during a 10-year period. If there were no contraindications, patients were given the option to choose between conventional therapy (group 1) and multimodality therapy (group 2). The multimodality treatment strategy included catheter-directed lysis followed by percutaneous transluminal balloon angioplasty (PTA) and stenting for residual iliac stenoses. All patients underwent routine venous duplex imaging at 30 days, 3 months, 6 months, and every 6 months thereafter. Results There were 33 patients in group 1 and 18 patients in group 2. Demographic and clinical characteristics were comparable for both groups. Initial lysis was achieved in 16 of 18 patients (89%) in group 2. Ten of 18 patients in group 2 had residual stenosis after lysis (8 primary and 2 secondary to malignancy), and they were treated with PTA/stenting with an initial success rate of 90%. Two patients in group 1 (6%) had a symptomatic pulmonary embolism (none in group 2). At 30 days, venous patency and symptom resolution were achieved in 1 of 33 patients (3%) in group 1 versus 15 of 18 (83%) in group 2. Kaplan-Meier analysis showed primary iliofemoral venous patency rates at 1, 3, and 5 years of 24%, 18%, and 18% and 83%, 69%, and 69% for groups 1 and 2, respectively. Long-term symptom resolution was achieved in 10 of 33 patients (30%) in group 1 versus 14 of 18 (78%) in group 2. Kaplan-Meier life table analysis showed similar survival rates at 1, 3, and 5 years of 100%, 93%, and 85% for group 1 and 100%, 93%, and 81% for group 2

  13. Is echocardiography or magnetic resonance imaging superior for precoarctation angioplasty evaluation?

    PubMed

    Mendelsohn, A M; Banerjee, A; Donnelly, L F; Schwartz, D C

    1997-09-01

    We compared the dimensions of the aorta obtained by two-dimensional transthoracic echocardiography (echo) (median, 2.5 mo preangioplasty) and magnetic resonance imaging (MRI) (median, 4.2 mo preangioplasty) to those obtained by angiography (cath) in 13 patients (age, 7.7 +/- 1.6 yr; mean +/- SEM) who underwent evaluation for coarctation balloon angioplasty between April 1993-January 1996. Echo measurements were obtained from the suprasternal and subcostal sagittal planes, MRI measurements from axial and sagittal oblique views, and cath measurements from the straight lateral or oblique views. Measurements of the diameters of the aortic isthmus, coarctation, descending aorta at the diaphragm, and isthmus length were made by all three modalities. Presence of aorto-aortic collaterals was determined, and the coarctation length was delineated. Investigators were blinded to other measurement data prior to statistical analysis. Data analysis by repeated analysis of variance (ANOVA) and Student-Newman-Keuls testing revealed no statistically significant difference between systolic pressure gradient by clinical examination (32.2 +/- 5.9 mm Hg), peak instantaneous Doppler evaluation (37.5 +/- 2.9 mm Hg), or preangioplasty systolic pressure gradient (32.1 +/- 3.3 mm Hg). With the exception of measurements of the descending aorta (echo, 11.7 +/- 0.9 mm vs. MRI, 13.3 +/- 0.8 mm vs. cath, 14.0 +/- 1.3 mm; P = 0.04), there was no statistically significant difference in dimensions of the aortic isthmus (9.2 +/- 0.6 mm vs. 10.5 +/- 0.9 mm vs. 10.8 +/- 0.9 mm), coarctation site diameter (4.8 +/- 0.6 mm vs. 5.6 +/- 0.9 mm vs. 5.3 +/- 0.8 mm), or isthmus length (12.4 +/- 2.1 mm vs. 12.1 +/- 2.2 mm vs. 10.9 +/- 1.7 mm). The correlation coefficients derived from comparisons of MRI vs. cath to echo vs. cath were similar for all dimensions except for isthmus length (P < 0.01). MRI demonstrated aorto-aortic collaterals more frequently than echo, while echocardiography better demonstrated

  14. Stent-Protected Carotid Angioplasty Using a Membrane Stent: A Comparative Cadaver Study

    SciTech Connect

    Mueller-Huelsbeck, Stefan Guehne, Albrecht; Tsokos, Michael; Huesler, Erhard J.; Schaffner, Silvio R.; Paulsen, Friedrich; Hedderich, Juergen; Heller, Martin; Jahnke, Thomas

    2006-08-15

    Purpose. To evaluate the performance of a prototype membrane stent, MembraX, in the prevention of acute and late embolization and to quantify particle embolization during carotid stent placement in human carotid explants in a proof of concept study. Methods. Thirty human carotid cadaveric explants (mild stenoses 0-29%, n = 23; moderate stenoses 30-69%, n = 3; severe stenoses 70-99%, n = 2) that included the common, internal and external carotid arteries were integrated into a pulsatile-flow model. Three groups were formed according to the age of the donors (mean 58.8 years; sample SD 15.99 years) and randomized to three test groups: (I) MembraX, n 9; (II) Xpert bare stent, n = 10; (III) Xpert bare stent with Emboshield protection device, n = 9. Emboli liberated during stent deployment (step A), post-dilatation (step B), and late embolization (step C) were measured in 100 {mu}m effluent filters. When the Emboshield was used, embolus penetration was measured during placement (step D) and retrieval (step E). Late embolization was simulated by compressing the area of the stented vessel five times. Results. Absolute numbers of particles (median; >100 {mu}m) caught in the effluent filter were: (I) MembraX: A = 7, B = 9, C = 3; (II) bare stent: A 6.5, B = 6, C = 4.5; (III) bare stent and Emboshield: A = 7, B = 7, C.=.5, D = 8, E = 10. The data showed no statistical differences according to whether embolic load was analyzed by weight or mean particle size. When summing all procedural steps, the Emboshield caused the greatest load by weight (p 0.011) and the largest number (p = 0.054) of particles. Conclusions. On the basis of these limited data neither a membrane stent nor a protection device showed significant advantages during ex vivo carotid angioplasty. However, the membrane stent seems to have the potential for reducing the emboli responsible for supposed late embolization, whereas more emboli were observed when using a protection device. Further studies are necessary

  15. Hemorheological and oxygen free radical associated alterations during and after percutaneous transluminal coronary angioplasty.

    PubMed

    Késmárky, G; Tóth, K; Vajda, G; Habon, L; Halmosi, R; Róth, E

    2001-01-01

    Percutaneous transluminal coronary angioplasty (PTCA) is a frequently used method in the treatment of coronary artery disease. Coronary stenosis, endothelial injury, and ischemia-reperfusion caused by the balloon inflation and deflation during this procedure can cause several changes in blood flow. In our study 19 patients (mean age: 58 +/- 9 years) undergoing PTCA were examined. For the laboratory measurements several blood samples were taken from the femoral vein and the coronary sinus before and 30 minutes after PTCA, and from the cubital vein 1, 2, 5 days and 1, 6 months after PTCA. Among hemorheologic parameters hematocrit, plasma fibrinogen level, plasma and whole blood viscosities were measured and corrected blood viscosity value was calculated. To characterize the oxidative stress, samples were analyzed for thiobarbituric acid reactive substances (TBARS) of blood as a marker of lipidperoxidation and changes in the antioxidant system were investigated by measuring the activity of superoxide dismutase, catalase and the concentration of glutathione; superoxide generating capacity of isolated leukocytes and platelet aggregation were examined as markers of cellular activation. Plasma fibrinogen concentration increased markedly during the first and second day after PTCA (p < 0.001), which was accompanied by the elevation of plasma viscosity (p < 0.05). Plasma fibrinogen returned to the baseline at the one-month check-up visit, but there was a significant increase in its concentration by the end of the sixth month follow-up. Apparent whole blood viscosity at 90 s (-1) showed gradually increasing values up to the one- and six-month check-up visits (p < 0.01), which can partially be explained by the elevation of hematocrit. Corrected blood viscosity was significantly elevated on the fifth day already (p < 0.01), and one month later also. Superoxide production of leukocytes showed an increasing tendency (p = 0.05), and blood TBARS was elevated after one day (p < 0

  16. Magnetic Particle / Magnetic Resonance Imaging: In-Vitro MPI-Guided Real Time Catheter Tracking and 4D Angioplasty Using a Road Map and Blood Pool Tracer Approach

    PubMed Central

    Jung, Caroline; Kaul, Michael Gerhard; Werner, Franziska; Them, Kolja; Reimer, Rudolph; Nielsen, Peter; vom Scheidt, Annika; Adam, Gerhard; Knopp, Tobias; Ittrich, Harald

    2016-01-01

    Purpose In-vitro evaluation of the feasibility of 4D real time tracking of endovascular devices and stenosis treatment with a magnetic particle imaging (MPI) / magnetic resonance imaging (MRI) road map approach and an MPI-guided approach using a blood pool tracer. Materials and Methods A guide wire and angioplasty-catheter were labeled with a thin layer of magnetic lacquer. For real time MPI a custom made software framework was developed. A stenotic vessel phantom filled with saline or superparamagnetic iron oxide nanoparticles (MM4) was equipped with bimodal fiducial markers for co-registration in preclinical 7T MRI and MPI. In-vitro angioplasty was performed inflating the balloon with saline or MM4. MPI data were acquired using a field of view of 37.3×37.3×18.6 mm3 and a frame rate of 46 volumes/sec. Analysis of the magnetic lacquer-marks on the devices were performed with electron microscopy, atomic absorption spectrometry and micro-computed tomography. Results Magnetic marks allowed for MPI/MRI guidance of interventional devices. Bimodal fiducial markers enable MPI/MRI image fusion for MRI based roadmapping. MRI roadmapping and the blood pool tracer approach facilitate MPI real time monitoring of in-vitro angioplasty. Successful angioplasty was verified with MPI and MRI. Magnetic marks consist of micrometer sized ferromagnetic plates mainly composed of iron and iron oxide. Conclusions 4D real time MP imaging, tracking and guiding of endovascular instruments and in-vitro angioplasty is feasible. In addition to an approach that requires a blood pool tracer, MRI based roadmapping might emerge as a promising tool for radiation free 4D MPI-guided interventions. PMID:27249022

  17. Silent ischemia after coronary angioplasty: Evaluation of restenosis and extent of ischemia in asymptomatic patients by tomographic thallium-201 exercise imaging and comparison with symptomatic patients

    SciTech Connect

    Hecht, H.S.; Shaw, R.E.; Chin, H.L.; Ryan, C.; Stertzer, S.H.; Myler, R.K. )

    1991-03-01

    One hundred sixteen patients were evaluated to determine the ability of single photon emission computed tomographic (SPECT) thallium-201 exercise and redistribution imaging to detect silent ischemia secondary to restenosis in asymptomatic patients after single and multiple vessel percutaneous transluminal coronary angioplasty and the findings were compared with SPECT imaging detection of restenosis in symptomatic patients. The value of exercise electrocardiography (ECG) and the amount of ischemic myocardium in symptomatic and asymptomatic patients were determined. Forty-one patients were asymptomatic after angioplasty; 77% of these had chest pain before angioplasty. Seventy-five patients had chest pain after angioplasty; 99% of these had chest pain before angioplasty. Restenosis occurred in 61% of asymptomatic and 59% of symptomatic patients and in 46% of the vessels in both asymptomatic and symptomatic patients. Sensitivity, specificity and accuracy for detection of restenosis by SPECT in individual patients were 96%, 75% and 88% versus 91%, 77% and 85%, respectively, in the asymptomatic versus symptomatic groups (p = NS). Sensitivity, specificity and accuracy for restenosis detection in individual vessels were 90%, 89% and 89% versus 84%, 77% and 84%, respectively, in the asymptomatic and symptomatic groups (p = NS), with similar results for the three major arteries. Sensitivity and accuracy of exercise ECG were significantly less than those of SPECT imaging for the patients with silent (40% and 44%) and symptomatic (59% and 64%) ischemia (p less than 0.001). Restenosis of vessels in the patients with silent and symptomatic ischemia was associated with an equal amount and degree of severity of ischemic myocardium in the two groups.

  18. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay

    PubMed Central

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25–125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  19. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients: Results with Use of a High Sensitivity Polymerase Chain Reaction Assay.

    PubMed

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik; Holmstrup, Palle; Helqvist, Steffen; Tolker-Nielsen, Tim; Givskov, Michael; Hansen, Peter Riis

    2015-01-01

    Periodontitis is a chronic, bacterially-induced inflammatory disease of the tooth-supporting tissues, which may result in transient bacteremia and a systemic inflammatory response. Periodontitis is associated with coronary artery disease independently of established cardiovascular risk factors, and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected patients with stable angina, unstable angina/non-ST elevation myocardial infarction, and ST-elevation myocardial infarction (n = 15 in each group) were collected and analyzed using a PCR assay with high sensitivity and specificity for 16S rRNA genes of the oral microbiome. Despite elimination of extraction and purification steps, and demonstration of sensitivity levels of 25-125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary angioplasty balloons are unlikely to be useful for detection of bacteria with current PCR techniques in unselected patients with coronary artery disease, more studies are warranted to determine the extent to which bacteria contribute to atherosclerosis and its clinical manifestations and whether the presence of bacteria in the arteries is a transient phenomenon. PMID:26695491

  20. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    PubMed

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  1. Ein mobiler und offener Kernspintomograph: Kernspintomographie für Medizin und Materialforschung

    NASA Astrophysics Data System (ADS)

    Blümich, Bernhard; Kölker, Christian; Casanova, Federico; Perlo, Juan; Felder, Jörg

    2005-09-01

    An der RWTH Aachen wurde der erste offene und mobile Kernspintomograph entwickelt. Anders als die normalerweise riesigen und unbeweglichen Geräte besitzt er keine enge Magnetröhre. So kann er auch in große Untersuchungsobjekte hinein schauen, ohne dass diese zerstört werden müssen. Wie eine Lupe erfasst er dabei ein begrenztes Volumen um den Aufsatzpunkt herum. Neben der Medizin ermöglicht der offene Tomograph viele neue Anwendungsgebiete, vor allem in der Materialprüfung und Qualitätskontrolle. Der Aachener Prototyp kann auch das Fließprofil und die Geschwindigkeitsverteilung strömender Flüssigkeiten sichtbar machen. Sein offenes Prinzip erforderte neue technische Komponenten und modifizierte bildgebende Verfahren. Die Messzeit pro Bild kann heute schon unter einer Viertelstunde liegen.

  2. Effect of Music Therapy on Patients’ Anxiety and Hemodynamic Parameters During Coronary Angioplasty: A Randomized Controlled Trial

    PubMed Central

    Forooghy, Masoumeh; Mottahedian Tabrizi, Elaheh; Hajizadeh, Ebrahim; Pishgoo, Bahram

    2015-01-01

    Background: A cardiac catheterization laboratory can be a frightening environment and music can be a supportive source of environmental sound that stimulates and maintains relaxation. However, the results of studies are conflicting in this regard. Objectives: The aim of this study was to investigate the effect of music therapy on patients’ anxiety and hemodynamic parameters during percutaneous transluminal coronary angioplasty. Patients and Methods: This was a randomized controlled trial, conducted in the Catheterization Laboratory Unit of Baqiyatallah Hospital, in Tehran, Iran. A sample of 64 patients, who were planned to undergo coronary angioplasty, was recruited. Patients were randomly allocated to either the control or the experimental groups. In the experimental group, patients received a 20 to 40-minute music therapy intervention, consisting of light instrumental music albums by Johann Sebastian Bach and Mariko Makino. Patients in the control group received the routine care of the study setting, which consisted of no music therapy intervention. Study data were collected by a demographic questionnaire, the Spielberger’s State Anxiety Inventory, and a data sheet for documenting hemodynamic parameters. Chi-square, independent-samples t tests, paired-samples t-test and repeated measures analysis of variance were used to analyze the data. Results: Before the intervention, the study groups did not differ significantly in terms of anxiety level and hemodynamic parameters. Moreover, the differences between the two groups, regarding hemodynamic parameters, were not significant after the intervention (P > 0.05). However, the level of post-intervention anxiety in the experimental group was significantly lower than the control group (32.06 ± 8.57 and 38.97 ± 12.77, respectively; P = 0.014). Compared with the baseline readings, the level of anxiety in the control group did not change significantly after the study (41.91 ± 9.88 vs. 38.97 ± 12.77; P = 0

  3. Anreicherung von Webinhalten mit Semantik - Microformats und RDFa

    NASA Astrophysics Data System (ADS)

    Hausenblas, Michael

    Semantik in Webinhalten wird heftig diskutiert. Teilweise wird es auch schon praktiziert. Dieser Beitrag geht auf semantisches HTML, Microformats und RDFa näher ein und zeigt anhand von praktischen Beispielen, wie und wo diese verwendet werden können.

  4. Tycho Brahe - Instrumentenbauer und Meister der Beobachtungstechnik

    NASA Astrophysics Data System (ADS)

    Wolfschmidt, Gudrun

    Vor der Erfindung des Fernrohrs war der dänische Astronom Tycho Brahe (1546 - 1601) der bedeutendste beobachtende Astronom. Von seinem Observatorium Uraniborg auf der - damals dänischen - Insel Hven ist heute noch der Grundriß erkennbar, von Stjerneborg sind die Fundamente erhalten, die Kuppeln in den 1950er Jahren ergänzt. In der Astronomie-Ausstellung im Deutschen Museum gibt es ein Modell der Sternwarte Uraniborg und der zugehörigen Instrumente (Maßstab 1:10); das größere Modell wurde dem Technischen Museum in Malmö geschenkt. Die Instrumente, die er in den Observatorien Uraniborg und Stjerneborg benutzte, sind nicht erhalten. Aber es gibt gute Beschreibungen der Instrumente (Halbkreis, Quadranten, Sextanten, Armillarsphären, Triquetrum, Himmelsglobus) in seinem Buch Astronomiae instauratae mechanica (Wandsbek 1598). Eine Nachbildung des großen hölzernen Quadranten kann man im Runden Turm in Kopenhagen sehen. Zwei Sextanten, hergestellt für Tycho um 1600 von Jost Bürgi und Erasmus Habermel, gibt es noch im Nationalmuseum für Technik in Prag. Ähnlichkeiten von Tychos Instrumenten mit Groß-Instrumenten aus dem islamischen Kulturkreis sind auffällig. Tycho Brahes Meßgeräte markieren einen großen Fortschritt in der Entwicklung astronomischer Instrumente und Meßtechniken und bilden die Grundlage für den weiteren Fortschritt der Positionsastronomie und der damit verbundenen Tabellenwerke. Die Nachwirkungen sind bis ins 17. und 18. Jahrhundert nachweisbar.

  5. Angioplastie coronaire percutanée chez la femme: particularités cliniques, procédurales et pronostiques

    PubMed Central

    Abid, Leila; Hadrich, Morched; Sahnoun, Mohamed; Kammoun, Samir

    2011-01-01

    AbstractX Les résultats de l′angioplastie transluminale (ATL) des coronaires chez la femme ont été pendant de nombreuses années controversés et longtemps considérés comme moins favorable que chez l′homme. Le but de notre travail était d’évaluer les caractéristiques de l'angioplastie coronaire chez la femme, ainsi que les résultats immédiats et à moyen terme et de les comparer à ceux chez l'homme. Nous avons comparé 200 patients dont 100 femmes, ayant bénéficié d'une angioplastie coronaire, colligés au service de cardiologie de l'hôpital Hédi Chaker de Sfax entre 2002 et 2007. Les femmes étaient significativement plus âgées que les hommes. La comparaison de la fréquence des facteurs de risque d'athérosclérose chez les deux sexes, a permis de noter une co-morbidité franchement plus importante chez la femme, avec une différence statiquement significative. L'ATL a été plus motivée chez la femme devant un angor stable sévère (p<0,05) et un SCA ST- (p=NS). Les femmes avaient plus d'atteinte polytronculaire (p<0,05), d'atteintes des segments moyens et distaux (p<0,05) et plus des lésions serrées (p=NS), longues et calcifiées (p<0,05). 259 stents ont été déployés, un stenting direct était plus fréquent dans la population féminine (p<0,05). Le diamètre des artères féminines, assimilé à celui du stent et/ou ballon utilisé, a été significativement moins important que celui des hommes. La longueur des stents et/ou ballon utilisés, ainsi que les pressions de larguage des stents ont été plus importantes chez la population féminine (p<0,05). Le succès angiographique global a été obtenu chez 94% de la population générale, sans différence significative entre les deux sexes. Les évènements cardiaques majeurs (MACE) hospitaliers ont été plus fréquents chez la femme (p=0,05). Après un suivi moyen de 31 mois, le taux de MACE global a été significativement plus important chez la femme (39% vs. 28%, p<0

  6. Endovascular Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Recanalisation, Angioplasty and Stent Deployment

    PubMed Central

    Weber, W.; Kis, B.; Esser, J.; Berlit, P.; Kühne, D.

    2003-01-01

    Summary We report the endovascular treatment of a 40-year-old woman with bilaterally thrombosed transverse sinuses and a dural arteriovenous fistula (DAVF) causing cortical venous reflux by recanalization, angioplasty and stent deployment of the occluded sinus segment followed by occlusion of the DAVF by stent deployment in the fistulous segment. By recanalization of the occluded sinus we re-established normal anterograde venous drainage and eliminated the venous hypertension and cortical venous reflux. After the procedure, the patient was treated with aspirin and clopidogrel for three months. A follow-up examination showed total occlusion of the DAVF, patency of the sinus and a complete resolution of the clinical symptoms. PMID:20591305

  7. Post-marketing surveillance in the published medical and grey literature for percutaneous transluminal coronary angioplasty catheters: a systematic review

    PubMed Central

    2013-01-01

    Background Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. Methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between January 2007 and July 2012. We also searched the grey literature. Results This review included 11 studies. The in-hospital adverse events reported were individual cases of myocardial infarction and hematoma. In studies of patients with coronary perforation, more patients with balloon angioplasty were identified compared with patients who required stenting. Conclusions Our systematic review illustrates that the volume and quality of PMS studies associated with the use of PTCA catheters in patients with CAD are low in the published and grey literature, and may not be useful sources of information for decisions on safety. In most studies, the objectives were not to monitor the long-term safety of the use of PTCA catheters in clinical practice. Future studies can explore the strengths and limitations of PMS databases administered by regulatory authorities. PMID:24112460

  8. Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

    PubMed

    Rajan, Dheeraj K; Sidhu, Arshdeep; Noel-Lamy, Maxime; Mahajan, Ashish; Simons, Martin E; Sniderman, Kenneth W; Jaskolka, Jeffrey; Tan, Kong Teng

    2016-06-01

    Purpose To qualify and quantify elastic recoil and determine its effect on access patency. Materials and Methods Research ethics board approval was obtained and all patients signed an informed consent form. This was a prospective, nonrandomized study of mature accesses that underwent balloon percutaneous transluminal angioplasty (PTA) between January 2009 and December 2012. After PTA, completion fistulography was performed at 0-, 5-, 10-, and 15-minute intervals. From Digital Imaging and Communications in Medicine images, percentage of lesion stenosis before and after PTA was measured at each time point. A total of 76 patients (44 men, 32 women; mean age, 59.6 years) were enrolled and underwent 154 PTAs in 56 grafts and 98 fistulas. Venous elastic recoil was defined as recurrent luminal narrowing greater than 50% within 15 minutes after full effacement of the stenosis by the angioplasty balloon. Data collected included sex, age, access type and location, lesion location, length, and time to next intervention. Access patency was estimated by using Kaplan-Meier survival method, association of variables with the risk of loss of patency was assessed by using a Cox proportional hazards model, and a multiple variable model was examined by considering all variables. Results Technical success of PTA with less than 30% residual stenosis was 78%. By 15 minutes, 15.6% (24 of 154) of treated lesions recurrently narrowed by more than 50%, with a majority observed at 5 minutes (15 of 24). Technical failure of PTA was predictive of elastic recoil (P < .001), as was cephalic arch stenosis in fistulas (P = .047) and autogenous fistulas (P = .04). Elastic recoil, when it did occur, did not influence patency. Six-month primary patency was 34.8% in grafts and 47.1% in fistulas. Conclusion Venous elastic recoil after PTA of stenoses in hemodialysis access circuits is common, but its occurrence does not influence access primary patency after PTA. (©) RSNA, 2015. PMID:26694051

  9. The Role of 'Cutting' Balloon Angioplasty for the Treatment of Short Femoral Bifurcation Steno-Obstructive Disease

    SciTech Connect

    Cotroneo, Antonio Raffaele; Iezzi, Roberto

    2010-10-15

    This study was designed to report our experience with 'cutting' balloon angioplasty (CBA) for the treatment of short femoral bifurcation arterial stenosis. Between March 2005 and September 2007, 18 consecutive patients who were high-risk for surgery with critical limb ischemia or severe lifestyle-limiting claudication underwent 'cutting' balloon angioplasty (4-6 mm diameter/15-20-mm length) for the treatment of 27 focal (<3 cm) severe fibro-calcified stenosis of the common femoral artery (n = 14) and/or the proximal part of the superficial femoral artery (n = 6) or profunda femoris (n = 7). Baseline patient demographic data, pre- and post-procedural patient clinical data, and procedural results were recorded. Follow-up consisted of clinical check-up and color duplex ultrasonography (CDU) examination 1, 3, 6, 12, and 18 months after the procedure. All endovascular treatments were successfully performed with clinical success obtained for all patients. No complications occurred during all treatments and no patient required surgical conversion or placement of a stent because of recoil, dissection, or arterial tears. No acute vessel closure was registered. During a mean follow-up of 9.4 (range, 6-18) months, endovascular treatment (CBA) was performed for restenosis/occlusion of seven lesions (25.9%) in four patients, whereas surgical treatment (endarterectomy with patch) for restenosis/occlusion of three lesions (11.1%) was performed in two patients with a consequent reintervention rate of 37%. Primary and secondary patency rates were 84.6 and 88.4% at 6 months and 57.9 and 79.6% at 12 months, respectively. No major limb amputation was performed, with a 12-month limb salvage rate of 88.9%. CBA seems to be a valuable tool for the endovascular treatment of focal femoral bifurcation stenotic lesions for patients who are poor candidates for surgery.

  10. Insertion of Self-Expandable Nitinol Stents Without Previous Balloon Angioplasty Reduces Restenosis Compared with PTA Prior to Stenting

    SciTech Connect

    Harnek, Jan; Zoucas, Evita; Stenram, Unne; Cwikiel, Wojciech

    2002-10-15

    Purpose: To compare the development of intimal hyperplasia after deployment of a self-expanding nitinol stent with and without previous percutaneous transluminal balloon angioplasty (PTA), with the results after PTA alone. Methods: In nine healthy pigs, the iliac arteries were divided into three groups: group 1 (n = 6 arteries) was treated with PTA; group 2 n 6)with insertion of self-expanding stents after PTA; and group 3 (n = 6) with stent insertion without previous PTA. After 8 weeks the vessels were examined with intravascular ultrasonography,histologic examination and morphometric analysis. Results: Although the injury index in group 1 (0.17{+-} 0.57) was lower (p <0.05) than in group 2 (0.26 {+-} 0.06) and group 3 (0.26 {+-} 0.08), PTA-treated arteries showed significantly (p <0.05) reduced mean luminal gain (0.53 {+-} 2.84) compared with arteries treated with PTA prior to stenting (2.58 {+-} 1.38) and compared with stenting alone (4.65 {+-}5.34). Stenting after PTA resulted in a higher (p<0.05) restenosis index (2.63 {+-} 1.06) compared with stenting without PTA (1.35 {+-} 0.59). Group 2 also had a significantly thicker intimap <0.05) and 83% and 74% higher intima/mediaratio (p <0.05) compared with groups 1 and 3, respectively. Conclusion: Insertion of a self-expandable nitinol stent without previous PTA results in less intimalhyperplasia than if PTA is performed prior to stenting, suggesting that direct stenting can be used in angioplasty sessions with a favorable outcome.

  11. Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland. Entwicklungs-, Umsetzungs- und Fortschreibungsprozess der Bund-Länder-Strategie für Städte und Regionen

    NASA Astrophysics Data System (ADS)

    Issaoui, Mariam; Sinz, Manfred

    2010-09-01

    Die Ministerkonferenz für Raumordnung stellte im Mai 2010 fest, dass sich die „Leitbilder und Handlungsstrategien für die Raumentwicklung in Deutschland“ (2006) bewährt haben und bei der Gestaltung der räumlichen Entwicklung umgesetzt werden. Um die Leitbilder den sich verändernden wirtschaftlichen, sozialen und naturräumlichen Rahmenbedingungen anzupassen und die Erkenntnisse aus dem bisherigen Diskussions- und Umsetzungsprozess in Politik und Praxis einzubeziehen, sind sie zu ergänzen und weiterzuentwickeln. Im Mittelpunkt der Fortschreibung werden die Themen „Partnerschaften und Strategien für Stadtregionen und ländliche Räume“, „Mobilität und Logistik“ sowie „Klimaschutz und Energieversorgung“ stehen.

  12. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction.

    PubMed

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-08-01

    Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia-reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI).We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers.Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline.Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  13. High plasma coenzyme Q10 concentration is correlated with good left ventricular performance after primary angioplasty in patients with acute myocardial infarction

    PubMed Central

    Huang, Ching-Hui; Kuo, Chen-Ling; Huang, Ching-Shan; Tseng, Wan-Min; Lian, Ie Bin; Chang, Chia-Chu; Liu, Chin-San

    2016-01-01

    Abstract Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia–reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI). We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography. Echocardiography was performed at baseline and at 6-month follow-up. The control group comprised 54 healthy age- and sex-matched volunteers. Serial circulating CoQ10 concentrations significantly decreased with time in the STEMI group. The LV ejection fraction at 6-month follow-up positively correlated with the 1-month plasma CoQ10 tertile. Higher plasma CoQ10 concentrations at 1 month were associated with favorable LV remodeling and systolic function 6 months after STEMI. Multiple linear regression analysis showed that changes in CoQ10 concentrations at 1-month follow-up were predictive of LV systolic function 6 months after STEMI. Changes in CoQ10 concentrations correlated negatively with baseline oxidized low-density lipoprotein and fibrinogen concentrations and correlated positively with leukocyte mitochondrial copy number at baseline. Patients with STEMI who had higher plasma CoQ10 concentrations 1 month after primary angioplasty had better LV performance at 6-month follow-up. In addition, higher plasma CoQ10 concentration was associated with lower grade inflammatory and oxidative stress status. Therefore, plasma CoQ10 concentration may serve as a novel prognostic biomarker of LV systolic function after revascularization therapy for acute myocardial infarction. PMID:27495100

  14. Volkszählung und Mikrozensus1

    NASA Astrophysics Data System (ADS)

    Grohmann, Heinz

    Die Volkszählung (Zensus) ist seit langem weltweit eine statistische Erhebung über Bevölkerung und Erwerbstätigkeit. In vielen Ländern wird sie heute in etwa 10jährigem Abstand durchgeführt. In Deutschland wurde sie in den 80er Jahren zum Politikum. Datenschutzängste, verbunden mit politischen Vorgängen (Friedensbewegung), erregten die Menschen, und das Bundesverfassungsgericht steckte neue Grenzen ab. Nach kontroversen Auseinandersetzungen, an denen die Deutsche Statistische Gesellschaft (DStatG) konstruktiv beteiligt war, kam es zur Volkszählung 1987. Den nachfolgenden Paradigmenwechsel hin zu einem registergestützten Zensus 2011 hat die DStatG ebenfalls kreativ mitgestaltet. Im Beitrag wird dieser Weg nachgezeichnet. Das neue Konzept wird vorgestellt und kritisch gewürdigt. Betroffen war auch der Mikrozensus als größte Bevölkerungs- und Arbeitsmarktstichprobe zwischen den Zensen. Nicht zuletzt durch das Wirken eines wissenschaftlichen Beirats, dessen Mitglieder von der DStatG vorgeschlagen wurden, blieb diese Erhebung in ihrem Kern für die Zukunft erhalten.

  15. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3

  16. Vom Urknall zum Zerfall. Die Welt zwischen Anfang und Ende.

    NASA Astrophysics Data System (ADS)

    Fritzsch, H.

    Contents: Der Tanz mit dem Ozean. Galaktische Landkarte. Das Maß der Dinge. Der würfelnde Gott der Quantenphysik. Geheimnisvolle Felder. Materie und Antimaterie. Quarks - Urstoff unserer Welt. Zerfallende Protonen und die Einheit der Physik. Der Zauberofen. Das überschaubare Universum. Das explodierende Universum. Nachhall der Schöpfung. Der achtfache Weg der kosmischen Entwicklung. Das Ende der Welt. Einheit in der Vielfalt. Das geistige Universum. Gott und das absurde Universum.

  17. The effectiveness of antioxidant vitamins C and E in reducing myocardial infarct size in patients subjected to percutaneous coronary angioplasty (PREVEC Trial): study protocol for a pilot randomized double-blind controlled trial

    PubMed Central

    2014-01-01

    Background Acute myocardial infarction (AMI) is the leading cause of mortality worldwide. Oxidative stress has been involved in the ischemia-reperfusion injury in AMI. It has been suggested that reperfusion accounts for up to 50% of the final size of a myocardial infarct, a part of the damage likely to be prevented.Therefore, we propose that antioxidant reinforcement through vitamins C and E supplementation should protect against the ischemia-reperfusion damage, thus decreasing infarct size. The PREVEC Trial (Prevention of reperfusion damage associated with percutaneous coronary angioplasty following acute myocardial infarction) seeks to evaluate whether antioxidant vitamins C and E reduce infarct size in patients subjected to percutaneous coronary angioplasty after AMI. Methods/Design This is a randomized, 1:1, double-blind, placebo-controlled clinical trial. The study takes place at two centers in Chile: University of Chile Clinical Hospital and San Borja Arriarán Clinical Hospital. The subjects will be 134 adults with acute myocardial infarction with indication for percutaneous coronary angioplasty. This intervention is being performed as a pilot study, involving high-dose vitamin C infusion plus oral administration of vitamin E (Vitamin-treatment group) or placebo (Control group) during the angioplasty procedure. Afterward, the Vitamin-treatment group receives oral doses of vitamins C and E, and the Control group receives placebo for 84 days after coronary angioplasty. Primary outcome is infarct size, assessed by cardiac magnetic resonance (CMR), measured 6 and 84 days after coronary angioplasty. Secondary outcomes are ejection fraction, measured 6 and 84 days after coronary angioplasty with CMR, and biomarkers for oxidative stress, antioxidant status, heart damage, and inflammation, which will be measured at baseline, at the onset of reperfusion, 6 to 8 hours after revascularization, and at hospital discharge. Discussion The ischemia-reperfusion event

  18. Das menschliche Gehör und Grundlagen der Psychoakustik

    NASA Astrophysics Data System (ADS)

    Genuit, Klaus; Sottek, Roland

    Das menschliche Gehör ist ein äußerst komplexes Empfangs- und Signalverarbeitungssystem. Es ist als Schallanalysator in Leistungsfähigkeit und Vielseitigkeit von technisch-analytischen Verfahren nach wie vor unerreicht. Die Signalverarbeitung läuft auf Grundlage komplexer Prozesse ab, die in ihrer Gesamtheit bislang nicht vollständig erfasst sind. Verschiedene Modelle zur gehörgerechten Zeit- und Frequenzanalyse ahmen jene komplexen Prozesse und Verarbeitungsmechanismen nach, die im menschlichen Gehör vollzogen werden.

  19. Self-Expandable Stent Placement in Infrapopliteal Arteries After Unsuccessful Angioplasty Failure: One-Year Follow-up

    SciTech Connect

    Peregrin, J. H. Smirova, S.; Koznar, B.; Novotny, J.; Kovac, J.; Lastovickova, J.; Skibova, J.

    2008-09-15

    The purpose of this prospective study was to evaluate whether stent placement in infrapopliteal arteries is helpful in failed percutaneous transluminal angioplasty (PTA). Infrapopliteal PTA was performed in 70 arteries of 66 patients with chronic critical lower limb ischemia. The group comprised 55 males and 11 females, with an average age of 63.4 (range, 42-82) years. Diabetes mellitus was present in 92.4% of patients. Only the palpable anterior tibial and posterior tibial arteries were evaluated. Stents (Xpert stent; Abbot Vascular, Redwood City, CA, USA) were placed in 16 arteries where PTA was not successful (the failure was defined as residual stenosis >30% after PTA). In 54 arteries simple PTA was performed and was technically successful. Twenty-four nondilated arteries with no significant stenosis served as a comparison group. The 12-month patency rate was evaluated according to a combination of palpation and Doppler ultrasound. In all cases stent placement restored the flow in the artery immediately after unsuccessful PTA. Twelve-month follow-up showed a patency rate of 82% in the PTA group, 78% in the stent group, and 69% in the comparison group. We conclude that stent placement in the case of unsuccessful infrapopliteal PTA changed technical failure to success and restored flow in the dilated artery. At 12-month follow-up the patency rate of infrapopliteal arteries stented for PTA failure did not differ significantly either from nonstented arteries with an optimal PTA result or from a comparison group of nonintervened arteries.

  20. The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

    SciTech Connect

    Loefberg, Ann-Marie; Loerelius, Lars-Erik; Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David

    1996-09-15

    Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions.

  1. Chronic critical lower-limb ischemia: prospective trial of angioplasty with 1-36 months follow-up.

    PubMed

    Matsi, P J; Manninen, H I; Suhonen, M T; Pirinen, A E; Soimakallio, S

    1993-08-01

    To determine the utility of percutaneous transluminal angioplasty (PTA) in the treatment of chronic critical lower-limb ischemia, a prospective study of 103 consecutive patients (117 limbs) was performed. Patients underwent PTA for a total of 209 lesions in the iliac (n = 4), femoropopliteal (n = 121), and infrapopliteal (n = 84) arteries and were followed up for 1-36 months (mean, 12 months). The primary technical success rate was 92% for stenosis and 80% for occlusion. Survival analysis with the Kaplan-Meier method revealed 1-, 2-, and 3-year limb salvage rates of 56%, 49%, and 49%, respectively. The following factors correlated favorably with limb salvage in Cox multiple regression analyses: a small number of diseased lower-limb vessels (one to five vs six to eight) and treated lesions per limb (one or two vs three to five), achieved peripheral runoff (one to three patent calf vessels vs none), and an occlusion as the successfully treated target lesion (instead of stenosis). PMID:8327682

  2. Laser-driven short-duration heating angioplasty: chronic artery lumen patency and histology in porcine iliac artery

    NASA Astrophysics Data System (ADS)

    Shimazaki, Natsumi; Kunio, Mie; Naruse, Sho; Arai, Tsunenori; Sakurada, Masami

    2012-02-01

    We proposed a short-duration heating balloon angioplasty. We designed a prototype short-duration heating balloon catheter that can heat artery media to 60-70°C within 15-25 s with a combination of laser-driven heat generation and continuous fluid irrigation in the balloon. The purpose of this study was to investigate chronic artery lumen patency as well as histological alteration of artery wall after the short-duration heating balloon dilatation with porcine healthy iliac artery. The short-term heating balloon dilated sites were angiographically patent in acute (1 hour) and in chronic phases (1 and 4 weeks). One week after the dilatation, smooth muscle cells (SMCs) density in the artery media measured from H&E-stained specimens was approx. 20% lower than that in the reference artery. One and four weeks after the dilatations, normal structure of artery adventitia was maintained without any incidence of thermal injury. Normal lamellar structure of the artery media was also maintained. We found that the localized heating restricted to artery media by the short-duration heating could maintain adventitial function and artery normal structure in chronic phase.

  3. Ball-Tip Fibres For Laser Angioplasty: Comparison Of Wavelengths From A Pulsed Neodymium-Yag Laser.

    NASA Astrophysics Data System (ADS)

    Michaels, Jonathan A.; Cross, Frank W.; Bowker, Timothy J.; Bown, Stephen G.

    1989-06-01

    A new ball-tip fibre optic device has been assessed for the purpose of laser angioplasty. A pulsed Neodymium-YAG laser producing 100 p.s pulses at a repetition rate of 10 Hz was used to ablate human cadaver arterial tissue using approximately 500 mJ per pulse at a wavelength of 1064 nm or 300 mJ at a wavelength of 1.3 μm. Both wavelengths are capable of ablating atheroma with little histological evidence of surrounding thermal damage. Crater depths of about 5 μm per Joule were produced using 1064 nm with normal tissue exposed under saline. Crater depth increases by about 50% when exposures are carried out under blood and when diseased arterial tissue is exposed the crater depth is almost doubled. Depth of ablation with a wavelength of 1.3 μm is 3 to 4 times greater than with 1064 nm for the same exposure and a similar increased response is seen for diseased tissue or in the presence of blood. Further experiments at 1064 nm have shown that the ball-tip device has advantages over bare fibre or sapphire tipped devices in the recanalisation of occluded femoral vessels in an artificial circulation.

  4. Comparison of Paclitaxel-Coated Balloon Treatment and Plain Old Balloon Angioplasty for De Novo Coronary Lesions

    PubMed Central

    Her, Ae-Young; Ann, Soe Hee; Singh, Gillian Balbir; Kim, Yong Hoon; Yoo, Sang-Yong; Garg, Scot; Koo, Bon-Kwon

    2016-01-01

    Purpose This study compared the angiographic outcomes of paclitaxel-coated balloon (PCB) versus plain old balloon angioplasty (POBA) treatment for de novo coronary artery lesions. At present, there is no available data comparing the efficacy of PCB versus POBA for the treatment of de novo coronary lesions. Materials and Methods This multicenter retrospective observational study enrolled patients with de novo coronary lesions with a reference vessel diameter between 2.5 mm and 3.0 mm and lesion length ≤24 mm who were successfully treated with PCB or POBA. Angiographic measurements and quantitative coronary analysis were performed before and after the procedure, and at 9 months follow-up. Results A total of 72 patients (49 receiving PCB and 23 receiving POBA) were enrolled in this study. Late luminal loss was -0.12±0.30 mm in the PCB group and 0.25±0.50 mm in the POBA group (p<0.001). There was a higher percentage of binary restenosis (diameter stenosis ≥50%) in POBA, compared to PCB (30.4%, n=7 vs. 4.1%, n=2, p<0.001). Target vessel revascularization was higher in the POBA group (13.0%, n=3 vs. 0%, p=0.033). Conclusion PCB treatment of de novo coronary lesions showed better 9-month angiographic outcomes than POBA treatment alone. PMID:26847284

  5. Superior caval venous syndrome after atrial switch procedure: relief of complete venous obstruction by gradual angioplasty and placement of stents.

    PubMed

    Michel-Behnke, I; Hagel, K J; Bauer, J; Schranz, D

    1998-10-01

    Superior caval venous syndrome is one of the late problems known to occur after Mustard repair of complete transposition. Reoperation may leave residual stenosis, and carries substantial risk for the patient. It is now feasible to use intravascular stents to overcome systemic venous baffle obstructions, and such an approach is probably more effective. The purpose of our study therefore, was to assess immediate and medium term results of inserting stents subsequent to gradual balloon enlargement of acquired atresia of the intraatrial baffle in patients who had undergone an atrial switch operation. We investigated five patients with complete obstruction of the superior caval venous pathway at perforation of the atretic segment was achieved using a guide wire technique. The procedure was successful in all patients. Gradual angioplasty was performed and intravascular stents were implanted. The pressure in the superior caval vein dropped to normal values, symptoms improved, and the patency of the newly created venoatrial communication was proven at mid-term follow-up. Thus critical obstructions at the superior caval venous pathway after the Mustard procedure can be reopened by interventional catheterization. Implantation of balloon-expandable intravascular stents is safe and effective in the acute relief of the obstructions, but careful long-term follow-up is mandatory. PMID:9855097

  6. Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage

    PubMed Central

    Choi, Beom Jin; Lee, Jae Il; Ko, Jun Kyeung; Park, Hwa Seung; Choi, Chang Hwa

    2011-01-01

    Objective Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm. Methods Eleven patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications. Results TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement in all patients except one. Conclusion This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm. PMID:21556235

  7. Inadvertent intracoronary stent extraction 10 months after implantation complicating cutting balloon angioplasty for in-stent restenosis

    SciTech Connect

    Almeda, Francis Q.; Billhardt, Roger A

    2003-09-01

    We report the case of an unusual complication for Cutting Balloon Angioplasty (CBA) during treatment for instent restenosis (ISR), which resulted in inadvertent intracoronary stent extraction 10 months after implantation. In this case report, CBA was utilized to treat an ISR lesion in the distal right coronary artery (RCA). Due to difficulty in withdrawing the cutting balloon into the guide after treatment of the lesion, the entire system (guide, cutting balloon, and guidewire) was removed as a unit from the body. Upon examination of the system, the previously placed stent in the distal RCA was attached to the microtomes of the cutting balloon. Although the precise mechanisms for stent extraction in this case remain speculative, the initial stent used in the distal RCA may have been undersized, and this may have played a major role in this complication. Although there is limited data regarding the optimal strategy to treat the site of the inadvertent stent extraction, we opted to re-stent the area with a properly-sized coronary stent. Following the intervention, there was no residual stenosis with TIMI 3 flow through the vessel. The patient remained asymptomatic and a serum troponin drawn 18 hours after the procedure was normal, and he was discharged the next day. The interventionist must be vigilant about this rare but serious complication when applying CBA in the treatment of ISR, particularly when an undersized or underdeployed stent is suspected.

  8. Is the presence of hyperlipidemia associated with impairment of endothelium-dependent neointimal relaxation after percutaneous transluminal coronary angioplasty?

    PubMed

    Sakai, A; Hirayama, A; Adachi, T; Nanto, S; Hori, M; Inoue, M; Kamada, T; Kodama, K

    1996-01-01

    To determine whether hyperlipidemia affects the endothelium-dependent vasomotor response along the dilated vessel after percutaneous transluminal coronary angioplasty (PTCA), we evaluated 32 patients with one-vessel disease, 3-6 months after successful PTCA without restenosis. Fourteen patients had mild stenotic lesions not subjected to PTCA (non-PTCA sites) in addition to the PTCA sites. Vessel diameter changes at 32 PTCA and 36 non-PTCA sites were assessed by quantitative angiography, before and after intracoronary injection of acetylcholine (20 micrograms to the right and 50 micrograms to the left coronary artery) and of nitroglycerin (0.1-0.3 mg). The acetylcholine response ranged from 46% (dilation) to -100% (constriction). All coronary arteries were dilated in response to nitroglycerin, which suggested preservation of the function of vascular smooth muscle, and the presence of an abnormality in endothelial function in those patients with a constrictor response to acetylcholine. There was a negative correlation between the acetylcholine response and the serum total cholesterol level at PTCA sites (r = -0.37; P = 0.038) and at non-PTCA sites (r = -0.46; P = 0.005). These findings indicate that hyperlipidemia is associated with a loss of endothelium-dependent vasodilation, not only at non-PTCA but also at PTCA sites, at which restoration of endothelial function might have occurred. They also suggest that hyperlipidemia may be related to the functional state of the regenerated endothelium at sites where PTCA had been previously performed. PMID:9129246

  9. Successful balloon pulmonary angioplasty with gadolinium contrast media for a patient with chronic thromboembolic pulmonary hypertension and iodine allergy

    PubMed Central

    Nakamura, Tomohisa; Ogo, Takeshi; Tsuji, Akihiro; Fukui, Shigefumi; Fukuda, Tetsuya; Tahara, Nobuhiro; Fukumoto, Yoshihiro; Yasuda, Satoshi; Ogawa, Hisao; Nakanishi, Norifumi

    2016-01-01

    A 28-year-old male was referred to our hospital with dyspnea. He was diagnosed as having chronic thromboembolic pulmonary hypertension, and a pulmonary endarterectomy (PEA) was performed. However, exertional dyspnea remained because of residual pulmonary hypertension; therefore, the patient was re-admitted to our hospital 1 year after PEA. We performed computed tomography and pulmonary angiography and found web and band lesions in the distal pulmonary artery with a high pulmonary artery pressure. Although further management was complicated because the patient had an anaphylactic shock to iodine-based contrast media, we eventually completed five sessions of balloon pulmonary angioplasty (BPA) using gadolinium contrast medium. His symptoms and hemodynamics dramatically improved after a series of BPA. After 15 months, mean pulmonary arterial pressure reduced from 67 mmHg to 20 mmHg, and subjective symptoms improved from stage Ⅳ to I as per the WHO classification system. BPA is a potential procedure for residual pulmonary hypertension after PEA and could be safely performed using gadolinium contrast medium for patients with iodine allergy. PMID:27141436

  10. Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

    SciTech Connect

    Brodmann, Marianne Rief, Peter; Froehlich, Harald; Dorr, Andreas; Gary, Thomas; Eller, Philipp; Hafner, Franz; Deutschmann, Hannes; Seinost, Gerald; Pilger, Ernst

    2013-02-15

    Due to intimal hyperplasia instent reobstruction in the femoropopliteal arterial segment is still an unsolved problem. Different techniques have been discussed in case of reintervention to guarantee longlasting patency rate. We conducted a randomized, controlled, pilot trial comparing Silverhawk atherectomy with percutaneous transluminal angioplasty (PTA) in patients with a first instent reobstruction in the femoropopliteal arterial segment, to evaluate intima media thickness (IMT) within the treated segment, as a parameter of recurrence of intimal hyperplasia. In a total 19 patients were included: 9 patients in the atherectomy device and 10 patients in the PTA arm. IMT within the treated segment was statistically significantly elevated in all patients treated with the Silverhawk device versus the patients treated with PTA. The obvious differentiation in elevation of IMT in nonfavor for patients treated with the Silverhawk device started at month 2 (max IMT SH 0.178 mm vs. IMT PTA 0.1 mm, p = 0.001) with a spike at month 5 (max IMT SH 0.206 mm vs. IMT PTA 0.145 mm, p = 0.003) and a decline once again at month 6 (max IMT SH 0.177 mm vs. IMT PTA 0.121 mm, p = 0.02). The values for mean IMT performed the same way. Although Silverhawk atherectomy provides good results at first sight, in the midterm follow-up of treatment of first instent restenosis it did not perform better than PTA as it showed elevated reoccurrence of intimal media hyperplasia.

  11. Longitudinal Stent-Shortening during Percutaneous Transluminal Angioplasty with Stenting of Right Superficial Femoral Artery: A Case Report.

    PubMed

    Rahman, A; Pasha, K; Hossain, G M; Islam, M M

    2015-10-01

    Longitudinal stent deformation (LSD) involving coronary arteries during PCI have been reported in several literatures. But, LSD occurring during PTA (Percutaneous Transluminal Angioplasty) involving peripheral arteries is rare. We had such a case who presented with coronary and peripheral artery disease. Longitudinal stent deformation occurred during PTA with stenting of right superficial femoral artery (SFA). For CAD, PCI to RCA and LAD was done beforehand and the peripheral procedure was done 4 days later to avoid increased contrast load. Due to LSD occurring during PTA to Rt. SFA, we had to deploy another stent to cover the lesion over that artery. There was no technical fault or difficulty during negotiating the stent and positioning it covering the lesion. So, we did not find any obvious reason for this complication. Since longitudinal stent deformation is uncommon during PCI of coronary arteries and probably rare during PTA of peripheral arteries and we did not find any literature regarding this, we decided to report this case. PMID:26620030

  12. Supraleitung und Interkontinentalraketen „On-line computing“ zwischen Militär, Industrie und Wissenschaft

    NASA Astrophysics Data System (ADS)

    Knolle, Johannes; Joas, Christian

    Der zweite Weltkrieg und der Kalte Krieg veränderten nicht nur das Verhältnis zwischen Militär, Industrie und Wissenschaft, sondern auch die wissenschaftliche Praxis von Physikern und anderen Wissenschaftlern. In den 1950er Jahren stellte die Entwicklung von Interkontinentalraketen die Auftragnehmer des Militärs in der Industrie vor komplexe Fragestellungen, zu deren Lösung sie auf die Expertise von Wissenschaftlern angewiesen waren. Industrieunternehmen gründeten eigene Forschungseinheiten zur Lösung technischer und wissenschaftlicher Probleme.

  13. Darwin, Engels und die Rolle der Arbeit in der biologischen und kulturellen Evolution des Menschen

    NASA Astrophysics Data System (ADS)

    Reichholf, Josef H.

    Im Jahre 1876, 5 Jahre nach Erscheinen von Darwins Buch über die Evolution des Menschen und die sexuelle Selektion (Darwin 1871), veröffentlichte Friedrich Engels den berühmt gewordenen Essay "Anteil der Arbeit an der Menschwerdung des Affen“ (Engels 1876). Die Kernfrage darin lautet in Kurzform: Warum hat der Mensch eigentlich ein Bedürfnis nach Arbeit? Engels Antwort wird nachfolgend näher betrachtet und vom gegenwärtigen Kenntnisstand aus beurteilt. Wie sich zeigen wird, beantworten seine Überlegungen die Frage nicht wirklich. Sie ist weiterhin offen. Es können lediglich einige zusätzliche Anhaltspunkte zur Diskussion gestellt werden. Angesichts des drängenden Problems millionenfacher Arbeitslosigkeit und der Forderungen nach einem "Grundrecht auf Arbeit“ kommt den Überlegungen zum möglichen Ursprung des Bedürfnisses nach Arbeit mehr als nur akademisches Interesse zu.

  14. Haptische Modellierung und Deformation einer Kugelzelle

    NASA Astrophysics Data System (ADS)

    Schippritt, Darius; Wiemann, Martin; Lipinski, Hans-Gerd

    Haptische Simulationsmodelle dienen in der Medizin in erster Linie dem Training operativer Eingriffe. Sie basieren zumeist auf physikalischen Gewebemodellen, welche eine sehr genaue Simulation der biomechanischen Eigenschaften des betreffenden Gewebes erlauben, aber gleichzeitig sehr rechenintensiv und damit zeitaufwändig in der Ausführung sind. Die menschliche Wahrnehmung kann allerdings auch eine ungenaue haptische Modellierung psychooptisch ausgleichen. Daher kann es sinnvoll sein, haptische Simulationen auch mit nicht vollständig physikalisch definierten Deformationsmodellen durchzuführen. Am Beispiel der haptischer Simulation einer in-vitro Fertilisation wird gezeigt, dass durch die Anwendung eines geometrischen Deformationsmodells eine künstliche Befruchtung unter realistischen experimentellen Bedingungen in Echtzeit haptisch simuliert und damit trainiert werden kann.

  15. Newtons Principia Mathematica Philosophia und Plancks Elementarkonstanten

    NASA Astrophysics Data System (ADS)

    Rompe, R.; Treder, H.-J.

    Die Newtonschen Prinzipien, zusammen mit den Planckschen Elementarkonstanten, erweisen sich als gesichertes Fundament der Physik und der exakten Wissenschaften aller Richtungen.Der Begriffsfundus der Physik ist ausreichend für alle physikalischen aber auch weiterreichenden Probleme anderer Naturwissenschaften und Technik. Es zeigt sich, daß die klassische Physik von vornherein so angelegt wurde, daß sie über die Physik der makroskopischen Körper weit hinaus-greifen kann.Translated AbstractNewton's Principia Mathematica Philosophia and Planck's Elementary ConstantsTogether with Planck's elementary constants Newton's principles prove a guaranteed basis of physics and exact sciences of all directions.The conceptions in physics are competent at all physical problems as well as technology too. Classical physics was founded in such a way to reach far beyond the physics of macroscopic bodies.

  16. Biochips und ihr Einsatz in der Lebensmittelanalytik

    NASA Astrophysics Data System (ADS)

    Huber, Ingrid; Zeltz, Patric

    Mit der Verbreitung des Begriffes "Biochip“ in den biotechnologischen Medien wurde Ende der 1990er-Jahre zunächst der Eindruck erweckt, dass die Computerelektronik in die molekularbiologischen Anwendungen eingestiegen ist [18]. In nur wenigen Jahren hat sich die Biochiptechnologie zu einem Verfahren entwickelt, das aus der molekularbiologischen Grundlagenforschung nicht mehr wegzudenken ist und über eine Vielzahl von Einsatzbereichen verfügt. Die Biochiptechnologie ermöglicht die Miniaturisierung von DNA-, RNA- bzw. Proteinanalytik in hochparallelen Formaten. Dieser hohe Parallelisierungsgrad ist einer der wesentlichen Vorteile dieser Technik gegenüber klassischen molekularbiologischen Methoden. Sie wird heutzutage vor allem in der Genomforschung eingesetzt, für Genexpressionsstudien, zum Screening von single nucleotide polymorphisms (SNPs), in der pharmakogenetischen Forschung sowie in der Erforschung von Erbkrankheiten und in der Krebsforschung [1, 7, 19]. Neben vielen weiteren Bereichen finden Biochips auch spezielle Anwendungen in der Lebensmittelanalytik.

  17. Mol-Gastronomie Vinaigrettes und Benetzung

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas

    2005-03-01

    Dass wir Salatblätter mit einer Vinaigrette übergießen, hat natürlich einen kulinarischen Grund: Die Kombination von Essig und Öl verleiht Salat erheblich an Geschmack. Nicht nur durch deren Eigengeschmack, sondern auch durch die Lösungseigenschaften von Geschmacksstoffen. Allerdings liefern Salatsaucen auch einen physikalischen Grund für ihre Beliebtheit: die Benetzungsfähigkeit der Blätter.

  18. Endovascular treatment with angioplasty or stenting versus endarterectomy in patients with carotid artery stenosis in the Carotid And Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial

    PubMed Central

    Ederle, Jörg; Bonati, Leo H; Dobson, Joanna; Featherstone, Roland L; Gaines, Peter A; Beard, Jonathan D; Venables, Graham S; Markus, Hugh S; Clifton, Andrew; Sandercock, Peter; Brown, Martin M

    2009-01-01

    Summary Background Endovascular treatment (angioplasty with or without stenting) is an alternative to carotid endarterectomy for carotid artery stenosis but there are scarce long-term efficacy data showing that it prevents stroke. We therefore report the long-term results of the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS). Methods Between March, 1992, and July, 1997, patients who presented at a participating centre with a confirmed stenosis of the internal carotid artery that was deemed equally suitable for either carotid endarterectomy or endovascular treatment were randomly assigned to either treatment in equal proportions by telephone or fax from the randomisation service at the Oxford Clinical Trials Unit, UK. Patients were seen by an independent neurologist at 1 and 6 months after treatment and then every year after randomisation for as long as possible, up to a maximum of 11 years. Major outcome events were transient ischaemic attack, non-disabling, disabling, and fatal stroke, myocardial infarction, and death from any other cause. Outcomes were adjudicated on by investigators who were masked to treatment. Analysis was by intention to treat. This study is registered, number ISRCTN 01425573. Findings 504 patients with stenosis of the carotid artery (90% symptomatic) were randomly assigned to endovascular treatment (n=251) or surgery (n=253). Within 30 days of treatment, there were more minor strokes that lasted less than 7 days in the endovascular group (8 vs 1) but the number of other strokes in any territory or death was the same (25 vs 25). There were more cranial nerve palsies (22 vs 0) in the endarterectomy group than in the endovascular group. Median length of follow up in both groups was 5 years (IQR 2–6). By comparing endovascular treatment with endarterectomy after the 30-day post-treatment period, the 8-year incidence and hazard ratio (HR) at the end of follow-up for ipsilateral non-perioperative stroke was 11·3% versus 8

  19. Instandhaltung und Plant Asset Management - zwei Welten?

    NASA Astrophysics Data System (ADS)

    Horch, Alexander

    Der Begriff des Asset Management wird nicht mehr nur in der Finanzwelt gebraucht, sondern seit einigen Jahren auch zunehmend in der produzierenden Industrie, insbesondere in der Prozessindustrie. Die Interessengemeinschaft Automatisierungstechnik der Prozessindustrie, NAMUR, hat bereits im Jahr 2001 eine entsprechende Empfehlung zum Thema anlagennahes Asset Management (Plant Asset Management) vorgelegt. In dieser Empfehlung (NAMUR NE 91) taucht der Begriff 'Instandhaltung' in verschiedener Verwendung 15 Mal auf. Die klassische Instandhaltung ist seit vielen Jahren wohl etabliert und definiert, was die große Anzahl Richtlinien, Beschreibungen und Standards belegt (DIN 31051, VDI 2884, VDI 2888, VDI 2889, VDI 2890). Eine oft geäußerte Kritik dem Plant Asset Management gegenüber ist, dass im Grunde nichts Neues angeboten wird, über die Instandhaltung hinaus. Auf der anderen Seite wird das Plant Asset Management seit über zehn Jahren vermehrt gebraucht und etabliert. Dieser scheinbare Widerspruch soll in diesem Beitrag ausgeräumt werden. Als Motivation sollen drei Beispiele kurz beschrieben werden.

  20. Therapeutisches Management kutaner und genitaler Warzen.

    PubMed

    Ockenfels, Hans Michael

    2016-09-01

    Mindestens 10 % der Bevölkerung erkranken während ihres Lebens an einer Infektion mit humanen Papillomaviren (HPV), welche sich klinisch anhand der Ausbildung kutaner oder genitaler Warzen manifestiert. Obwohl Warzen ubiquitär sind, existieren keine definierten Behandlungen. Warzen zeigen, insbesondere in den ersten sechs Monaten, eine erhöhte Selbstheilungsrate. Dieser Umstand erschwert die Interpretation von Studien, da häufig Patienten mit Neuinfektionen zusammen mit Patienten mit Altinfektionen behandelt werden. Lokalisationen, Größe und Dicke der Warzen sind ebenfalls in den meisten Fällen nicht berücksichtigt. Ziel dieses Übersichtsartikels ist eine Analyse des vorliegenden Studienmaterials, unter der für den klinischen Alltag so wichtigen Berücksichtigung von Subtypen und Lokalisationen. Insbesondere die Abgrenzung zwischen frischen und chronisch-therapieresistenten Verrucae vulgares spiegelt sich in einem Therapiealgorithmus wider. Bei genitalen Warzen wird der Therapiealgorithmus deutlicher durch das Ausmaß der infizierten Fläche als durch das Alter der Warzen bestimmt. Bei immunkompetenten Personen muss es mit den hier aufgezeigten therapeutischen Methoden immer das Ziel sein, eine komplette Abheilung zu erzielen. PMID:27607029

  1. Elektronische Citizen Cards in Deutschland und Europa

    NASA Astrophysics Data System (ADS)

    Kowalski, Bernd

    Meine sehr geehrten Damen und Herren, der Bedarf an elektronischen Identitäten entsteht durch die wachsende Mobilität der Gesellschaft bei einem gleichzeitig steigenden Bedarf an Onlinepräsenz. Diese elektronischen Identitäten machen natürlich auch vor den staatlichen Ausweisen nicht halt, wie zum Beispiel dem Reisepass, aber auch dem Personalausweis und weiteren Ausweisdokumenten. Wobei es bei den staatlich herausgegebenen oder kontrollierten Ausweisen immer um zwei verschiedene Dinge geht: Einmal um die hoheitliche Funktion, wie zum Beispiel beim Reisepass. Hier geht es zum Beispiel darum, in einem Europa mit gefallenen Grenzen und bei freiem Reiseverkehr für alle Personen, die in diesem Raum wohnen, insbesondere auch im Schengener Raum, die Möglichkeit zu schaffen, auch künftig noch Personenkontrollen durchzuführen. Auch der Reiseverkehr über die europäischen Grenzen hinaus ist insofern ein Problem, da die Identitätenprüfung an den Grenzkontrollen immer schwieriger wird. Deswegen braucht man an dieser Stelle Möglichkeiten, um eine Personenüberprüfung durchzuführen, um feststellen zu können, dass diese Person auch zum Dokument gehört.

  2. Herstellung von Chitosan und einige Anwendungen

    NASA Astrophysics Data System (ADS)

    Struszczyk, Marcin Henryk

    2001-05-01

    1. Die Deacetylierung von crabshell - Chitosan führte gleichzeitig zu einem drastischen Abfall der mittleren viscosimetrischen Molmasse ( Mv), insbesondere wenn die Temperatur und die Konzentration an NaOH erhöht werden. Diese Parameter beeinflussten jedoch nicht den Grad der Deacetylierung (DD). Wichtig ist jedoch die Quelle des Ausgangsmaterials: Chitin aus Pandalus borealis ist ein guter Rohstoff für die Herstellung von Chitosan mit niedrigem DD und gleichzeitig hoher mittlerer Mv, während Krill-Chitin (Euphausia superba) ein gutes Ausgangsmaterial zur Herstellung von Chitosan mit hohem DD und niedrigem Mv ist. Chitosan, das aus Insekten (Calliphora erythrocephala), unter milden Bedingungen (Temperatur: 100°C, NaOH-Konzentration: 40 %, Zeit: 1-2h ) hergestellt wurde, hatte die gleichen Eigenschaften hinsichtlich DD und Mv wie das aus Krill hergestellte Chitosan. Der Bedarf an Zeit, Energie und NaOH ist für die Herstellung von Insekten-Chitosan geringer als für crabshell-Chitosan vergleichbare Resultaten für DD und Mv. 2. Chitosan wurde durch den Schimmelpilz Aspergillus fumigatus zu Chitooligomeren fermentiert. Die Ausbeute beträgt 25%. Die Chitooligomere wurden mit Hilfe von HPLC und MALDI-TOF-Massenspektrmetrie identifiziert. Die Fermentationsmischung fördert die Immunität von Pflanzen gegen Bakterien und Virusinfektion. Die Zunahme der Immunität schwankt jedoch je nach System Pflanze-Pathogen. Die Fermentation von Chitosan durch Aspergillus fumigatus könnte eine schnelle und billige Methode zur Herstellung von Chitooligomeren mit guter Reinheit und Ausbeute sein. Eine partiell aufgereinigte Fermentationsmischung dieser Art könnte in der Landwirtschaft als Pathogeninhibitor genutzt werden. Durch kontrollierte Fermentation, die Chitooligomere in definierter Zusammensetzung (d.h. definierter Verteilung des Depolymerisationsgrades) liefert, könnte man zu Mischungen kommen, die für die jeweilige Anwendung eine optimale Bioaktivität besitzen. 3

  3. Effects of time required for reperfusion (thrombolysis or angioplasty, or both) and location of acute myocardial infarction on left ventricular functional reserve capacity several months later

    SciTech Connect

    Little, T.; Crenshaw, M.; Liberman, H.A.; Battey, L.L.; Warner, R.; Churchwell, A.L.; Eisner, R.L.; Morris, D.C.; Patterson, R.E. )

    1991-04-15

    The purpose of this study was to determine whether reperfusion of acute myocardial infarction (AMI) by recombinant tissue-type plasminogen activator (rt-PA) or percutaneous transluminal coronary angioplasty, or both, would improve left ventricular (LV) function when it is measured several months later at rest or maximal bicycle exercise, or both. Radionuclide angiography was performed in 44 patients 5 months (range 6 weeks to 9 months) after AMI to assess function, and tomographic myocardial thallium-201 imaging was performed at maximal exercise and delayed rest to determine whether there was any evidence of myocardial ischemia. As expected, no patient had chest pain or redistribution of a thallium defect during the exercise test, because patients had undergone angioplasty (n = 28) or coronary bypass graft surgery (n = 5) where clinically indicated for revascularization. The LV ejection fraction was plotted as a function of the time elapsed between the onset of chest pain and the time when coronary angiography confirmed patency of the infarct-related artery (achieved in 91% of 44 patients by rt-PA (n = 31) or percutaneous transluminal coronary angioplasty (n = 9) ). Functional responses differed markedly between patients with anterior (n = 20) versus inferior (n = 24) wall AMI. LV ejection fraction during exercise correlated with time to reperfusion in patients with an anterior wall AMI (r = -0.58; standard error of the estimate = 11.9%; p less than 0.02) but not in patients with an inferior AMI (r = 0.10; standard error of the estimate = 13.1%); difference not significant.

  4. Detection of restenosis after successful coronary angioplasty: Improved clinical decision making with use of a logistic model combining procedural and follow-up variables

    SciTech Connect

    Renkin, J.; Melin, J.; Robert, A.; Richelle, F.; Bachy, J.L.; Col, J.; Detry, J.M.; Wijns, W. )

    1990-11-01

    A prospective study of 111 patients who underwent repeat coronary angiography and exercise thallium-201 scintigraphy 6 +/- 2 months after complete revascularization by percutaneous transluminal coronary angioplasty was performed to assess whether clinical, procedure-related and postangioplasty exercise variables yield independent information for the prediction of angiographic restenosis after angioplasty. Complete revascularization was defined as successful angioplasty of one or more vessels that resulted in no residual coronary lesion with greater than 50% diameter stenosis. Restenosis was defined as a residual stenosis at the time of repeat angiography of greater than 50% of luminal diameter. Restenosis occurred in 40% of the patients. The 111 patients were randomly subdivided into a learning group (n = 84) and a testing group (n = 27). A logistic discriminant analysis was performed in the learning group and the logistic model was used to estimate a logistic probability of restenosis. This probability of restenosis was validated in the testing group. In the learning group of 84 patients univariate analysis of 39 factors revealed 8 factors related to restenosis: recurrence of angina (p less than 0.0001), postangioplasty abnormal finding on exercise thallium-201 scintigram (p less than 0.0001), exercise thallium-201 scintigram score (p less than 0.0001), difference between exercise and rest ST segment depression (p less than 0.001), postangioplasty exercise ST segment depression (p less than 0.001), absolute postangioplasty stenosis diameter (p less than 0.003), postangioplasty exercise work load (p less than 0.03) and postangioplasty exercise heart rate (p less than 0.05).

  5. Mol-Gastronomie Granulare Fleischgerichte und molekulares Kleben

    NASA Astrophysics Data System (ADS)

    Vilgis, Thomas A.

    2005-09-01

    Buletten, Fleischküchle oder Kebabs, Köstlichkeiten aus gehacktem Fleisch bestimmter Körnung, finden sich in allen Kulturen. Physikalisch ein großes Problem, denn zu Tisch dürfen diese Gebilde nicht auseinander brechen und zerfallen. Für ausreichend Bindung und Klebung muss also gesorgt werden.

  6. Der neue Kosmos. Einführung in die Astronomie und Astrophysik

    NASA Astrophysics Data System (ADS)

    Unsöld, Albrecht; Baschek, Bodo

    Der neue Kosmos bietet in überschaubarem Umfang eine zusammenhängende Einführung in das Gesamtgebiet der Astronomie und Astrophysik. Aus den Bereichen: Klassische Astronomie und Planetensystem, Instrumente und Beobachtungsverfahren, Sonne und Sterne, Milchstraße und Galaxien, Kosmologie, Entstehung des Planetensystems, Entwicklung der Erde und des Lebens werden die Beobachtungsmethoden und die Ergebnisse astronomischer Forschung sowie deren theoretische Grundlagen und wechselseitigen Zusammenhänge vermittelt. Die aktualisierte 7. Auflage berücksichtigt den raschen Fortschritt astronomischer Forschung der letzten drei Jahre von unserem Planetensystem und den Entdeckungen zahlreicher Planeten bei anderen Sternen, über die fernsten Galaxien und Quasare bis zur Entwicklung der modernen Kosmologie.

  7. Common Iliac Artery Thrombosis following Pelvic Surgery Resulting in Kidney Allograft Failure Successfully Treated by Percutaneous Transluminal Angioplasty with Balloon-Expandable Covered Stent

    PubMed Central

    Golla, Maheswara S.; Acharjee, Subasit; Jaber, Bertrand L.; Garcia, Lawrence A.

    2015-01-01

    We report the case of a 66-year-old woman who developed acute kidney allograft failure due to thrombotic occlusion of the common iliac artery after hysterectomy requiring emergent allograft rescue. She underwent percutaneous transluminal angioplasty with endovascular balloon expandable covered stent graft placement in the right common iliac artery. Although there are a handful of case reports of acute limb ischemia secondary to acute common iliac artery thrombosis, this is the first case reported in the literature resulting in successful kidney allograft rescue following pelvic surgery. PMID:26355669

  8. Renaturierung von subalpinen und alpinen Ökosystemen

    NASA Astrophysics Data System (ADS)

    Krautzer, B.; Klug, Brigitte

    Die große Vielfalt an alpinen und subalpinen Ökosystemen auf waldfreien Standorten stellt besonders hohe Anforderungen an Planung und Durchführung von Renaturierungsmaßnahmen. Zunehmende Meereshöhe, starke Hangneigungen und extreme klimatische Verhältnisse im Gebirge bedingen zudem seit jeher natürliche Erosionsprozesse. Die zahllosen menschlichen Aktivitäten der letzten Jahrzehnte, gepaart mit unzureichenden Begrünungsmaßnahmen, erhöhen dieses Risiko noch um ein Vielfaches: Geländekorrekturen im Zuge von Skipistenbauten, Almrevitalisierungen, Forst- und Almwegebauten, Maßnahmen zur Verbesserung der touristischen Infrastruktur oder Wildbach- und Lawinenverbauungen. Nur durch Verwendung von hochwertigem, dem Standort angepasstem Pflanzen-oder Saatgutmaterial in Kombination mit der passenden Begrünungstechnik kann dieser Bedrohung dauerhaft entgegengewirkt werden. Dabei sind folgende limitierende Faktoren besonders zu beachten.

  9. Intelligent produzieren - Prozesse verstehen und mit innovativen Werkzeugen verbessern

    NASA Astrophysics Data System (ADS)

    Kress, Dieter

    Im Umfeld der stetig fortschreitenden Globalisierung und der damit verbundenen Verlagerung von Produktionsstätten und dem Transfer bekannter Technologien ist eine stetige Weiterentwicklung der Fertigungstechnik unumgänglich, um auch zukünftig am Standort Deutschland einen Technologievorsprung zu halten und Produkte zu fertigen, die weltweit konkurrenzfähig sind. Die Notwendigkeit zur permanenten Innovation ist unbestritten. Das Ziel muss es dabei sein, die Produktivität zu erhöhen, die Qualität der Produkte auf stets hohem Niveau zu halten bzw. die Qualität noch weiter zu steigern und gleichzeitig die Kosten stetig zu senken. Dies erfordert intelligente und innovative Werkzeugkonzepte für die Hochleistungsfertigung.

  10. Biokompatible Implantate und Neuentwicklungen in der Gynäkologie

    NASA Astrophysics Data System (ADS)

    Jacobs, Volker R.; Kiechle, Marion

    Für den Einsatz in der Gynäkologie stehen heute eine Vielzahl unterschiedlicher, biokompatibler Materialien und Implantate zur Verfügung. Auf eine Auswahl soll hier näher eingegangen werden, die die verschiedenen Materialien und Bauweisen repräsentieren. So sind Brustimplantate seit fast vier Jahrzehnten im Gebrauch für die Brustvergrösserung und den Brustwiederaufbau. Material, Bauweisen und medizinische Aspekte einschliesslich der kontroversen Diskussion um Silikon werden im folgenden erläutert. Neuere Entwicklungen von Verhütungstechniken für permanente Sterilisation wie den Filshie ClipTM für transabdominalen und den STOPTM für intraluminalen Verschluss der Eileiter oder die intrauterin plazierte Hormonspirale MirenaTM für zeitlich begrenzte Verhütung werden beschrieben. Eine neue Perspektive zur Verhinderung postoperativer intraabdominaler Adhäsionen stellt Spray-GelTM, ein Zweikomponenten Hydrogel aus Polyethylenglykol, dar.

  11. Drug-Coated Balloon Versus Standard Percutaneous Transluminal Angioplasty for the Treatment of Superficial Femoral and Popliteal Peripheral Artery Disease

    PubMed Central

    Tepe, Gunnar; Schneider, Peter; Brodmann, Marianne; Krishnan, Prakash; Micari, Antonio; Metzger, Christopher; Scheinert, Dierk; Zeller, Thomas; Cohen, David J.; Snead, David B.; Alexander, Beaux; Landini, Mario; Jaff, Michael R.

    2015-01-01

    Background— Drug-coated balloons (DCBs) have shown promise in improving the outcomes for patients with peripheral artery disease. We compared a paclitaxel-coated balloon with percutaneous transluminal angioplasty (PTA) for the treatment of symptomatic superficial femoral and popliteal artery disease. Methods and Results— The IN.PACT SFA Trial is a prospective, multicenter, single-blinded, randomized trial in which 331 patients with intermittent claudication or ischemic rest pain attributable to superficial femoral and popliteal peripheral artery disease were randomly assigned in a 2:1 ratio to treatment with DCB or PTA. The primary efficacy end point was primary patency, defined as freedom from restenosis or clinically driven target lesion revascularization at 12 months. Baseline characteristics were similar between the 2 groups. Mean lesion length and the percentage of total occlusions for the DCB and PTA arms were 8.94±4.89 and 8.81±5.12 cm (P=0.82) and 25.8% and 19.5% (P=0.22), respectively. DCB resulted in higher primary patency versus PTA (82.2% versus 52.4%; P<0.001). The rate of clinically driven target lesion revascularization was 2.4% in the DCB arm in comparison with 20.6% in the PTA arm (P<0.001). There was a low rate of vessel thrombosis in both arms (1.4% after DCB and 3.7% after PTA [P=0.10]). There were no device- or procedure-related deaths and no major amputations. Conclusions— In this prospective, multicenter, randomized trial, DCB was superior to PTA and had a favorable safety profile for the treatment of patients with symptomatic femoropopliteal peripheral artery disease. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique Identifiers: NCT01175850 and NCT01566461. PMID:25472980

  12. Influence of Total Coronary Occlusion on Clinical Outcomes (from the Bypass Angioplasty Revascularization Investigation 2 DiabetesTrial).

    PubMed

    Damluji, Abdulla A; Pomenti, Sydney F; Ramireddy, Archana; Al-Damluji, Mohammed S; Alfonso, Carlos E; Schob, Alan H; Marso, Steven P; Gilchrist, Ian C; Moscucci, Mauro; Kandzari, David E; Cohen, Mauricio G

    2016-04-01

    Our aim was to evaluate the influence of chronic total occlusions (CTOs) on long-term clinical outcomes of patients with coronary heart disease and diabetes mellitus. We evaluated patients with coronary heart disease and diabetes mellitus enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes, who underwent either prompt revascularization (PR) with intensive medical therapy (IMT) or IMT alone according to the presence or absence of CTO. Of 2,368 patients enrolled in the trial, 972 patients (41%) had CTO of coronary arteries. Of those, 482 (41%) and 490 (41%) were in the PR with IMT versus IMT only groups, respectively. In the PR group, patients with CTO were more likely to be selected for the coronary artery bypass grafting stratum (coronary artery bypass grafting 62% vs percutaneous coronary intervention 31%, p <0.001). Compared to the non-CTO group, patients with CTO had more abnormal Q wave, abnormal ST depression, and abnormal T waves. The myocardial jeopardy score was higher in the CTO versus non-CTO group (52 [36 to 69] vs 37 [21 to 53], p <0.001). After adjustment, 5-year mortality rate was significantly higher in the CTO group in the entire cohort (hazard ratio [HR] 1.35, p = 0.013) and in patients with CTO managed with IMT (HR 1.46, p = 0.031). However, the adjusted risk of death was not increased in patients managed with PR (HR 1.26, p = 0.180). In conclusion, CTO of coronary arteries is associated with increased mortality in patients treated medically. However, the presence of a CTO may not increase mortality in patients treated with revascularization. Larger randomized trials are needed to evaluate the effects of revascularization on long-term survival in patients with CTO. PMID:26853953

  13. Transcutaneous oxygen tension measurements following peripheral transluminal angioplasty procedure has more specificity and sensitivity than ankle brachial index

    PubMed Central

    Pardo, M; Bernal, F L; Felices, J M; Achel, G D; Canteras, M

    2015-01-01

    Objective: To evaluate the superiority of transcutaneous oxygen pressure (TcPO2) before, during and after peripheral transluminal angioplasty (PTA) in comparison with ankle brachial index (ABI) in patients with diabetes. Methods: 40 consecutive patients with diabetes treated by PTA where included. This study shows results before, during and after PTA and their progression for 8 weeks. Results: The TcPO2 increased from 28.11 ± 8.1 to 48.03 ± 8.4 mmHg, 8 weeks after PTA (p < 0.001). The ABI increased from 0.48 ± 0.38 to 0.77 ± 0.39 after PTA (p < 0.001). After PTA, the stenosis of the vessel decreased from 58.33 ± 20.07% to 21.87 ± 13.57% (p < 0.001). TcPO2 was determined in all the patients, but ABI could not be determined in all patients. Furthermore, we determined patients with “false negatives” with an improvement in ABI and “false positives” in 12.5% of patients. Additionally, in this study, we monitored TcPO2 while performing PTA, revealing variations in each phase of the radiological procedure. Conclusion: The increase in TcPO2 measurements following PTA procedure has more specificity and sensitivity than does ABI. The use of TcPO2 may represent a more accurate alternative than traditional methods (ABI) used in assessing PTA results. The TcPO2 also allows the radiologist to assess changes in tissue oxygenation during PTA, allowing changes to the procedure and subsequent treatment. Advances in knowledge: This is the first time that a graph is shown with TcPO2 results during PTA performance in many patients. PMID:25431933

  14. Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial

    PubMed Central

    Spreen, Marlon I.; Martens, Jasper M.; Hansen, Bettina E.; Knippenberg, Bob; Verhey, Elke; van Dijk, Lukas C.; de Vries, Jean-Paul P.M.; Vos, Jan-Albert; de Borst, Gert Jan; Vonken, Evert-Jan P.A.; Wever, Jan J.; Statius van Eps, Randolph G.; Mali, Willem P.Th.M.

    2016-01-01

    Background— Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions. Methods and Results— Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA±BMS or DES with paclitaxel. Primary end point was 6-month primary binary patency of treated lesions, defined as ≤50% stenosis on computed tomographic angiography. Stenosis >50%, retreatment, major amputation, and critical limb ischemia–related death were regarded as treatment failure. Severity of failure was assessed with an ordinal score, ranging from vessel stenosis through occlusion to the clinical failures. Seventy-four limbs (73 patients) were treated with DES and 66 limbs (64 patients) received PTA±BMS. Six-month patency rates were 48.0% for DES and 35.1% for PTA±BMS (P=0.096) in the modified-intention-to-treat and 51.9% and 35.1% (P=0.037) in the per-protocol analysis. The ordinal score showed significantly worse treatment failure for PTA±BMS versus DES (P=0.041). The observed major amputation rate remained lower in the DES group until 2 years post-treatment, with a trend toward significance (P=0.066). Less minor amputations occurred after DES until 6 months post-treatment (P=0.03). Conclusions— In patients with critical limb ischemia caused by infrapopliteal lesions, DES provide better 6-month patency rates and less amputations after 6 and 12 months compared with PTA±BMS. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00471289. PMID:26861113

  15. Development of novel short-term heating angioplasty: diameter and elasticity change of vascular wall ex vivo

    NASA Astrophysics Data System (ADS)

    Shimazaki, Natsumi; Kaneko, Kenji; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    In order to investigate the optimum operation parameters on novel short-term heating (<15s, approx. 70 °C) balloon, named Photo-thermo dynamic balloon (PTDB), we studied diameter and elasticity change of vascular wall after dilatation ex vivo. We have been studying to develop the PTDB angioplasty in which we demonstrated sufficient vascular dilatation with lower pressure by heat- induced denaturation of arterial collagen. And we have also demonstrated the suppression of intimal hyperplasia in animal experiments. We need to understand the PTDB dilatation mechanism to determine the optimum operation parameters. The prototype PTDB with diameter of 3mm was used in our experiments. The internal diameters of extracted fresh porcine carotid arteries at pre- and post- PTDB dilatation were measured. Balloon parameters were follows; pressure P=2atm, peak temperature in balloon T=60-80 °C, and heating duration t=4-30s. Morphological change in the media of dilated artery with PTDB were microscopically examined with Weigert staining. Elastic properties were carried out by stress-strain measurements with calculation of young's modulus. We found that PTDB dilatation provided the effect to prevent elastic recoil. We explained that the reason of this effect might be arrangement of micro- structure in the media, i.e., heat-denatured collagen fibers sustained the elastic recoil due to rubbery elastin fibers. The arterial elasticity was not significant different after PTDB dilatation. It was suggested that there could be no compliance mismatch after PTDB dilatation in physiological range. We found that a part of PTDB dilatation mechanism, in which the vascular wall structure played an important role. The optimum operation parameters for PTDB might be determined in consideration of collagen denaturation progress and arterial composition.

  16. Cost-efficacy modeling of functional testing with perfusion imaging to detect asymptomatic restenosis following percutaneous transluminal coronary angioplasty.

    PubMed

    Mak, K H; Eisenberg, M J; Shaw, J

    1999-12-01

    The objective of this study was to perform a theoretical cost-efficacy analysis on the use of routine functional testing with perfusion imaging to identify patients with asymptomatic restenosis following percutaneous transluminal coronary angioplasty (PTCA) procedures. Approximately 50% of patients with restenosis following PTCA are asymptomatic. Routine functional testing is commonly performed at 3 to 6 months to identify these patients. The cost-efficacy associated with this strategy is unknown. Theoretical models were constructed based on assumed costs for functional testing (U.S. $1,300) and coronary angiography (U.S. $3,000). Restenosis rates were assumed to be 40%, and half of patients with restenosis were assumed to be asymptomatic. To provide a range of costs to identify a patient with asymptomatic restenosis, three scenarios were constructed based on the diagnostic test characteristics of functional testing. Sensitivity analyses were performed using a range of costs for functional testing, restenosis rates, and proportion of patients with restenosis who are asymptomatic. Depending on the diagnostic accuracy of functional testing, it costs $8,200 to $22,400 to identify an asymptomatic patient with restenosis following PTCA. The cost to identify a patient with asymptomatic restenosis varies inversely with the rates of restenosis. When restenosis rates are < 20%, the cost to identify a patient with asymptomatic restenosis exceeds $10,000. Similarly, the cost to identify a patient with asymptomatic restenosis increases when the proportion of patients with asymptomatic restenosis decreases. The cost, associated with the use of routine functional testing for the identification of asymptomatic patients with restenosis appears exorbitant. However, a formal study is warranted to determine the cost-efficacy of such a strategy. Cathet. Cardiovasc. Intervent. 48:352-356, 1999. PMID:10559811

  17. Consideration for primary angioplasty: impact on the door-to-drug time in AMI patients ultimately treated with thrombolytic agent.

    PubMed

    Brady, W J; Esterowitz, D; Syverud, S A

    2001-01-01

    The objective of this study was to determine if consideration for percutaneous transluminal coronary angioplasty (PTCA) delays administration of thrombolytic therapy in acute myocardial infarction (AMI) patients. Retrospective medical record review of patients ultimately diagnosed with AMI who presented to the ED with chest pain and ST segment elevation on the electrocardiogram; these patients also received acute reperfusion therapy (PTCA or thrombolytic agent). AMI was diagnosed by abnormal elevations in the creatinine phosphokinase MB fraction. The study period covered 2 years (July 1, 1994 to June 30, 1996) in a university hospital ED with an annual volume of 60,000 patient-visits. The use of reperfusion therapies, time intervals, and times of presentation were recorded. Patients were divided into two groups based on cardiac catheterization laboratory (CATH) availability: (group I, CATH currently in operation, Monday to Friday, 7 am to 7 pm and group II, CATH currently not in-operation, all other times). Fifty-two patients with AMI met entry criteria. Patients were treated with thrombolytic therapy in 25 cases; PTCA in 27 cases. Patients received thrombolytic agents within statistically equivalent time intervals regardless of the period of presentation; time to thrombolytic therapy for group I patients was 38 +/- 16 minutes compared with 36 +/- 26 minutes for group II patients (P =. 891). A trend toward significance was noted in the use of PTCA compared with thrombolytic agent; Group I patients were more often treated with PTCA (19) compared with group II patients (11, P =.067). Patients were more rapidly treated with PTCA during CATH operation; the mean time to PTCA for group I patients was 73.5 minutes compared with PTCA for group II patients with 107.8 minutes (P =.033). The consideration for PTCA did not significantly delay the administration of thrombolytic therapy at the study site institution. PTCA was initiated more rapidly in patients presenting with

  18. Small Dense Low Density Lipoprotein Particles Are Associated with Poor Outcome after Angioplasty in Peripheral Artery Disease

    PubMed Central

    Mosimann, Kathrin; Husmann, Marc; Thalhammer, Christoph; Wilkinson, Ian; Berneis, Kaspar; Amann-Vesti, Beatrice R.

    2014-01-01

    Purpose In patients suffering from symptomatic peripheral artery disease (PAD), percutaneous revascularization is the treatment of choice. However, restenosis may occur in 10 to 60% in the first year depending on a variety of factors. Small dense low density lipoprotein (sdLDL) particles are associated with an increased risk for cardiovascular events, but their role in the process of restenosis is not known. We conducted a prospective study to analyze the association of sdLDL particles with the outcome of balloon angioplasty in PAD. The composite primary endpoint was defined as improved walking distance and absence of restenosis. Methods Patients with angiographically documented PAD of the lower extremities who were scheduled for lower limb revascularization were consecutively recruited for the study. At baseline and at three month follow-up triglyceride, total cholesterol, LDL size and subclasses and HDL cholesterol and ankle-brachial index (ABI) were measured. Three months after the intervention duplex sonography was performed to detect restenosis. Results Sixty-four patients (53% male) with a mean age of 68.6±9.9 years were included. The proportion of small- dense LDL particles (class III and IV) was significantly lower (33.1±11.0% vs. 39.4±12.1%, p = 0.038) in patients who reached the primary end-point compared with those who did not. Patients with improved walking distance and without restenosis had a significantly higher LDL size at baseline (26.6±1.1 nm vs. 26.1±1.1 nm, p = 0.046) and at follow-up (26.7±1.1 nm vs. 26.2±0.9 nm, p = 0.044) than patients without improvement. Conclusions Small-dense LDL particles are associated with worse early outcome in patients undergoing percutaneous revascularization for symptomatic PAD. PMID:25265512

  19. The Role of Postintervention Pullback Pressure Gradient in Percutaneous Transluminal Angioplasty for Central Vein Stenosis in Dialysis Patients

    SciTech Connect

    Lin, Yu-Sheng; Yang, Cheng-Hsu; Chu, Chi-Ming; Fang, Chi-Yung Chen, Chien-Jen; Hsu, Jen-Te Yang, Teng-Yao; Hang, Chi-Ling Wu, Chiung-Jen

    2013-10-15

    Purpose: The severity of residual stenosis (RS) sometimes cannot be accurately measured by angiography during central vein intervention. This study evaluated the role of pullback pressure measurement during central vein stenosis (CVS) intervention. Methods: A retrospective review enrolled 94 consecutive dialysis patients who underwent CVS interventions but not stenting procedures. Patients were classified into 2 groups by either angiography or pressure gradient (PG) criteria, respectively. Groups divided by angiographic result were successful group (RS {<=}30 %) and acceptable group (50 % {>=} RS > 30 %), while groups divided by PG were low PG group (PG {<=}5 mmHg) and high PG group (PG >5 mmHg). Baseline characteristics and 12-month patency rates between the groups were analyzed. Results: The angiography results placed 63 patients in the successful group and 31 patients in the acceptable group. The patency rate at 12 month was not statistically different (P = 0.167). When the patients were reclassified by the postintervention pullback PG, the patency rate at 12 months was significant (P = 0.048). Further analysis in groups redivided by different combinations of RS and PG criteria identified significant differences in the group with both RS {<=}30 % and PG {<=}5 mmHg compared with those with either RS >30 % (P = 0.047) or PG >5 mmHg (P = 0.027). In addition, there was a significant difference between those with both RS {<=}30 % and PG {<=}5 mmHg compared with those with both RS >30 % and PG >5 mmHg (P = 0.027). Conclusion: Postintervention PG can better predict long-term outcomes after angioplasty for CVS in nonstented dialysis patients than angiography.

  20. Assessing risk factors for major adverse cardiovascular and cerebrovascular events during the perioperative period of carotid angioplasty with stenting patients

    PubMed Central

    Liu, Juan; Xu, Zhi-Qiang; Cui, Min; Li, Ling; Cheng, Yong; Zhou, Hua-Dong

    2016-01-01

    Carotid atherosclerotic stenosis is a risk factor for ischemic stroke. The rapid development of neuroimaging techniques had led to carotid angioplasty with stenting (CAS) becoming a useful, effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. The aim of the present study was to identify independent risk factors to predict perioperative major adverse cerebral and cardiovascular events for CAS patients and establish a risk evaluation model. Consecutive patients treated with a standardized CAS procedure were enrolled in the present study. The patients included underwent independent neurological evaluation prior to and after the procedure and at 30 days. The rates of transient ischemic attack, stroke, myocardial infarction and mortality were recorded. A relative regression model was established to evaluate risk factors of perioperative major adverse cardiac and cerebrovascular events (MACCE). In total, 403 subjects treated with CAS were enrolled into the study at a baseline MACCE rate of 8.19%, whereas the overall stroke, myocardial infarction and mortality rate at 30 days was 3.97%. The multiple regression analysis revealed that certain factors significantly predicted the 30-day risk of treatment-related MACCE. These factors included age of ≥70 years, ulcerative plaque, severe carotid stenosis, bilateral carotid artery stenting and hemodynamic depression following CAS. The MACCE risk prediction model and risk score system were subsequently established. In conclusion, factors that significantly predicted the 30-day risk of MACCE of CAS included, age of ≥70 years, ulcerative plaque, severe carotid stenosis, bilateral carotid artery stenting and hemodynamic depression, with hemodynamic depression being a controllable factor. The established risk score system is therefore a potentially useful tool that can be employed in the prediction of MACCE after CAS. PMID:27446318

  1. Clinical outcome of angiosome-oriented infrapopliteal percutaneous transluminal angioplasty for isolated infrapopliteal lesions in patients with critical limb ischemia

    PubMed Central

    Jeon, Eui-Yong; Cho, Young Kwon; Yoon, Dae Young; Kim, Dae Jung; Woo, Jeong Joo

    2016-01-01

    PURPOSE We aimed to evaluate the clinical usefulness and outcome of angiosome-oriented percutaneous transluminal angioplasty (IP-PTA) and its clinical outcome for isolated infrapopliteal lesions in diabetic critical limb ischemia. METHODS We retrospectively reviewed 70 patients (82 limbs) with diabetic critical limb ischemia who had localized disease at the level of the infrapopliteal artery. Patients underwent IP-PTA between January 2011 and December 2013 and were followed up for a mean of 13 months. The primary target arterial lesions were chosen according to the angiosome concept. We evaluated clinical findings, technical success, and patients’ clinical outcome. The angiographic outcome of IP-PTA was assessed using the angiosome score. We analyzed the relationship between the angiosome score and the amputation rate. RESULTS There were 69 anterior tibial artery (ATA) lesions, 70 posterior tibial artery (PTA) lesions, and 58 peroneal artery (PA) lesions. The primary target arteries were the ATA (n=43), PTA (n=26), PA (n=2), and ATA + PTA (n=11). We divided the treated limbs into target (n=63) and nontarget (n=19) groups. The overall initial technical success rate was 91.4%. Successful wound healing rates were 87.3% (55/63) and 47.3% (9/19) in the target and nontarget groups, respectively (P < 0.05). CONCLUSION Angiosome-oriented primary targeted IP-PTA shows a highly effective treatment outcome in diabetic critical limb ischemia. In cases with inadequate angioplastic results of the target artery, IP-PTA of the nontarget artery should be recommended to improve the limb salvage rates. PMID:26573976

  2. Utility of liver biopsy in predicting clinical outcomes after percutaneous angioplasty for hepatic venous obstruction in liver transplant patients

    PubMed Central

    Sarwar, Ammar; Ahn, Edward; Brennan, Ian; Brook, Olga R; Faintuch, Salomao; Malik, Raza; Khwaja, Khalid; Ahmed, Muneeb

    2015-01-01

    AIM: To determine utility of transplant liver biopsy in evaluating efficacy of percutaneous transluminal angioplasty (PTA) for hepatic venous obstruction (HVOO). METHODS: Adult liver transplant patients treated with PTA for HVOO (2003-2013) at a single institution were reviewed for pre/post-PTA imaging findings, manometry (gradient with right atrium), presence of HVOO on pre-PTA and post-PTA early and late biopsy (EB and LB, < or > 60 d after PTA), and clinical outcome, defined as good (no clinical issues, non-HVOO-related death) or poor (surgical correction, recurrent HVOO, or HVOO-related death). RESULTS: Fifteen patients meeting inclusion criteria underwent 21 PTA, 658 ± 1293 d after transplant. In procedures with pre-PTA biopsy (n = 19), no difference was seen between pre-PTA gradient in 13/19 procedures with HVOO on biopsy and 6/19 procedures without HVOO (8 ± 2.4 mmHg vs 6.8 ± 4.3 mmHg; P = 0.35). Post-PTA, 10/21 livers had EB (29 ± 21 d) and 9/21 livers had LB (153 ± 81 d). On clinical follow-up (392 ± 773 d), HVOO on LB resulted in poor outcomes and absence of HVOO on LB resulted good outcomes. Patients with HVOO on EB (3/7 good, 4/7 poor) and no HVOO on EB (2/3 good, 1/3 poor) had mixed outcomes. CONCLUSION: Negative liver biopsy greater than 60 d after PTA accurately identifies patients with good clinical outcomes. PMID:26207170

  3. Increased Expression of Phosphorylated Polo-Like Kinase 1 and Histone in Bypass Vein Graft and Coronary Arteries following Angioplasty

    PubMed Central

    Sur, Swastika; Swier, Vicki J.; Radwan, Mohamed M.; Agrawal, Devendra K.

    2016-01-01

    Interventional procedures, including percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass surgery (CABG) to re-vascularize occluded coronary arteries, injure the vascular wall and cause endothelial denudation and medial vascular smooth muscle cell (VSMCs) metaplasia. Proliferation of the phenotypically altered SMCs is the key event in the pathogenesis of intimal hyperplasia (IH). Several kinases and phosphatases regulate cell cycle in SMC proliferation. It is our hypothesis that increased expression and activity of polo-like kinase-1 (PLK1) in SMCs, following PTCA and CABG, contributes to greater SMC proliferation in the injured than uninjured blood vessels. Using immunofluorescence (IF), we assessed the expression of PLK1 and phosphorylated-PLK1 (pPLK1) in post-PTCA coronary arteries, and superficial epigastric vein grafts (SEV) and compared it with those in the corresponding uninjured vessels. We also compared the expressions of mitotic marker phospho-histone, synthetic-SMC marker, contractile SMC marker, IFN-γ and phosphorylated STAT-3 in the post-PTCA arteries, SEV-grafts, and the uninjured vessels. Immunostaining demonstrated an increase in the number of cells expressing PLK1 and pPLK1 in the neointima of post PTCA-coronary arteries and SEV-grafts compared to their uninjured counterparts. VSMCs in the neointima showed an increased expression of phospho-histone, synthetic and contractile SMC markers, IFN-γ and phosphorylated STAT-3. However, VSMCs of uninjured coronaries and SEV had no significant expression of the aforementioned proteins. These data suggest that PLK1 might play a critical role in VSMC mitosis in hyperplastic intima of the injured vessels. Thus, novel therapies to inhibit PLK1 could be developed to inhibit the mitogenesis of VSMCs and control neointimal hyperplasia. PMID:26820885

  4. Strahlen-und kinetische Waffen: Neue Waffentechniken und Rüstungskontrolle

    NASA Astrophysics Data System (ADS)

    Neuneck, Götz

    Laserstrahlen, Mikrowellen oder elektromagnetische Beschleuniger lassen sich nicht nur für zivile, sondern für militärische Zwecke einsetzen. Die Aufgabe einer vorbeugenden Rüstungskontrolle wäre es, diese wie andere künftige Waffentechnologien auf ihren destabilisierenden Charakter hin zu untersuchen und ihre Stationierung zu beschränken oder zu verhindern.

  5. Surgical treatment of acute myocardial ischaemia related to coronary angioplasty with special reference to use of perfusion balloon catheter and long-term outcome.

    PubMed

    Heikkinen, L; Virtanen, K; Heikkila, J; Verkkala, K; Salo, J; Jarvinen, A

    1997-04-01

    Twenty of 569 consecutive patients (3.5%) undergoing percutaneous transluminal coronary angioplasty required emergency coronary artery bypass grafting for acute closure of the dilated vessel. In seven patients an intracoronary autoperfusion balloon catheter was inserted to ensure antegrade blood flow across the injured zone of the coronary artery. The time needed for completion of the bypass grafts ranged from 100 to 399 minutes (mean 180 minutes). An average of 1.9 coronary artery bypasses was inserted. In total, 11 of the 20 patients (55%) developed new Q waves and had elevated CK-MB levels. However, the myocardial infarction rate was only 14% in those with a perfusion balloon catheter as against 77% in those without one. The insertion of a ball-out catheter permitted greater utilization of the internal mammary artery as a bypass graft. Angiographic follow-up was conducted after a mean of 28 months (19 patients). The patency rate of the bypass grafts placed in the emergency setting was relatively good (91%). Thallium tomography revealed a scar of variable size in all 17 patients studied and a reversible exercise perfusion defect requiring coronary reangioplasty in three patients. In conclusion, the insertion of a perfusion balloon catheter after abrupt coronary occlusion during coronary angioplasty solved the problems of acute myocardial ischemia and markedly lowered the definite myocardial infarction rate. This technique ensures favourable haemodynamic conditions for emergency myocardial revascularization. PMID:9201117

  6. Acute embolic occlusion of the right common iliac artery after revision total hip arthroplasty treated with catheter-directed thrombolysis and balloon angioplasty: A case report

    PubMed Central

    Yang, Hongqi; Chen, Song; Chen, Li; Li, Yuefeng; Chai, Yasheng; Wei, Ping; Xu, Shunchi; Liu, Tangyou; Liu, Feng; Zhang, Zhuo

    2015-01-01

    Methods: A 63-year-old woman with atrial fibrillation presented clinical symptoms and signs of acute ischemia in the right lower extremity on the 17th postoperative day after revision total hip arthroplasty of the left hip for aseptic loosening of femoral component. Aspirin was discontinued 7 days before surgery. Both computed tomography angiography and digital subtraction angiography demonstrated complete occlusion of the right common iliac artery. An emergency catheter-directed thrombolysis with urokinase combined with balloon angioplasty was performed to obtain complete patency of the right common iliac artery. Results: The patient received anticoagulation and antiplatelet therapy postoperatively and was fine at the 2-year follow-up. Conclusions: This case demonstrated that catheter-directed thrombolysis combined with balloon angioplasty could be an efficacious, minimally invasive approach for the treatment of acute embolic occlusion of the common iliac artery. Preoperative anticoagulation for patients undergoing total hip arthroplasty with long-term use of aspirin for atrial fibrillation needs further investigation.

  7. Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

    SciTech Connect

    Kuhan, Ganesh Abisi, Said; Braithwaite, Bruce D.; MacSweeney, Shane T. R.; Whitaker, Simon C.; Habib, Said B.

    2012-10-15

    Purpose: To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods: Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009-2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44-88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan-Meier plots and Cox regression analysis were used to identify significant risk factors. Results: The average length of lesions treated was 25 {+-} 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D (n = 13) and C (n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22-8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82-10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion (p = 0.035). Conclusion: TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.

  8. The Effects of Discharge Plan on Stress, Anxiety and Depression in Patients Undergoing Percutaneous Transluminal Coronary Angioplasty: A Randomized Controlled Trial

    PubMed Central

    Sharif, Farkhondeh; Moshkelgosha, Fariba; Molazem, Zahra; Najafi Kalyani, Majid; Vossughi, Mehrdad

    2014-01-01

    Background: Angioplasty is one of the most common methods for treating coronary artery diseases. However, a large number of those undergoing this treatment face psychological problems that negatively affect the quality of their life and recovery. We aimed to determine the effects of discharge planning on stress, anxiety, and depression in patients undergone percutaneous transluminal coronary angioplasty (PTCA). Methods: In this randomized controlled trial, 80 candidates for PTCA during January to April 2013 were randomly assigned to equal experimental and control groups. The patients in the experimental group participated in two training sessions before and after the procedure and an informative booklet was used for their training. These patients were followed by phone during the two weeks after discharge. The depression anxiety stress scale (DASS-21) was completed by all subjects upon admission, at discharge, and one month after discharge. Data were analyzed using SPSS software, version 18. t test was used as appropriated. Results: The experimental group showed a statistically significant decrease in their stress, anxiety and depression a month after receiving the planned discharge (P<0.001). Although scores of stress (P=0.696), anxiety (P=0.110), depression (P=0.073) of the experimental group did not differ significantly on the day of discharge, the decrease was considerable compared with that of the control group. Conclusion: Using a planned discharge program in patients undergoing PTCA lowered their stress, anxiety, and depression. Trial Registration Number: IRCT201302182812N12 PMID:25349846

  9. Restoration of Failed Renal Graft Function After Successful Angioplasty of Pressure-Resistant Renal Artery Stenosis Using a Cutting Balloon: A Case Report

    SciTech Connect

    Peregrin, J. H.; Buergelova, M.

    2009-05-15

    This study is the report of a 37-year-old male with a transplanted kidney from a 3.5-year-old donor: the graft had two arteries transplanted with an aortic patch to an external iliac artery. Four months after transplantation, the graft function deteriorated, together with the development of hypertension. Stenosis of both graft arteries was detected and the patient was referred for angioplasty. The angiographic result was suboptimal, nevertheless, the graft function improved and was more or less stable (serum creatinine, 160-200 {mu}mol/l) for 4 years, along with persistently difficult-to-control hypertension. Five years after transplantation, the graft function deteriorated again and severe graft artery restenosis was detected. The restenosis did not respond to dilatation, graft function failed, hypertension decompensated, and left ventricular failure developed. The patient required dialysis. A cutting balloon angioplasty opened the artery, and kidney function was restored after a few days: the serum creatinine level dropped to 140-160 {mu}mol/l, and the glomerular filtration rate (creatinine clearance) to 0.65 ml/min/1.73 m{sup 2}. The graft function has now been stable for more than 2 years, however, the hypertension is still difficult to control.

  10. Changing health behaviors to improve health outcomes after angioplasty: a randomized trial of net present value versus future value risk communication

    PubMed Central

    Charlson, M. E.; Peterson, J. C.; Boutin-Foster, C.; Briggs, W. M.; Ogedegbe, G. G.; McCulloch, C. E.; Hollenberg, J.; Wong, C.; Allegrante, J. P.

    2008-01-01

    Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on ‘net present value’ economic theory, would be more effective in behavioral intervention than the standard ‘future value approach’ in reducing cardiovascular morbidity and mortality following angioplasty. At baseline, all patients completed a health assessment, recieved an individualized risk profile and selected risk factors for modification. The intervention randomized patients into two varying methods for illustrating positive effects of behavior change. For the experimental group, each selected risk factor was assigned a numeric biologic age (the net present value) that approximated the relative potential to improve current health status and quality of life when modifying that risk factor. In the control group, risk reduction was framed as the value of preventing future health problems. Ninety-four percent of patients completed 2-year follow-up. There was no difference between the rates of death, stroke, myocardial infarction, Class II–IV angina or severe ischemia (on non-invasive testing) between the net present value group and the future value group. Our results show that a net present risk communication intervention did not result in significant differences in health outcomes. PMID:18025064

  11. Percutaneous Angioplasty and Stenting of left Subclavian Artery Lesions for the Treatment of Patients with Concomitant Vertebral and Coronary Subclavian Steal Syndrome

    SciTech Connect

    Filippo, Ferrara Francesco, Meli; Francesco, Raimondi; Corrado, Amato; Chiara, Mina; Valentina, Cospite; Giuseppina, Novo; Salvatore, Novo

    2006-06-15

    Objective. To evaluate the efficacy of subclavian stenosis percutaneous transfemoral angioplasty (PTA)-treatment in patients with intermittent or complete subclavian steal syndrome (SSS), and coronary-subclavian steal syndrome (C-SSS) after left internal mammary artery-interventricular anterior artery (LIMA-IVA) by pass graft. Methods. We studied 42 patients with coronary subclavian steal syndrome subdivided in two groups; the first group consisted of 15 patients who presented an intermittent vertebral-subclavian steal, while the second group consisted of 27 patients with a complete vertebral-subclavian steal. All patients were treated with angioplasty and stent application and were followed up for a period of 5 years by echocolordoppler examination to evaluate any subclavian restenosis. Results. Subclavian restenosis was significantly increased in patients with a complete subclavian steal syndrome. The restenosis rate was 6.67% in the first group and 40.75% in the second group, These patients had 9.1 fold-increase risk (CI confidence interval 0.95-86.48) in restenosis. Conclusion. Patients with a complete subclavian and coronary steal syndrome present a higher risk of subclavian restenosis.

  12. Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

    NASA Astrophysics Data System (ADS)

    Kaneko, Kenji; Shimazaki, Natsumi; Gotoh, Maya; Nakatani, Eriko; Arai, Tsunenori

    2007-02-01

    Our photo thermal reaction heating architecture balloon realizes less than 10 s short term heating that can soften vessel wall collagen without damaging surrounding tissue thermally. New thermal balloon angioplasty, photo-thermo dynamic balloon angioplasty (PTDBA) has experimentally shown sufficient opening with 2 atm low pressure dilation and prevention of chronic phase restenosis and acute phase thrombus in vivo. Even though PTDBA has high therapeutic potential, the most efficient heating condition is still under study, because relationship of treatment and thermal dose to vessel wall is not clarified yet. To study and set the most efficient heating condition, we have been working on establishment of temperature history estimation method from our previous experimental results. Heating target of PTDBA, collagen, thermally denatures following rate process. Denaturation is able to be quantified with measured collagen birefringence value. To express the denaturation with equation of rate process, the following ex vivo experiments were performed. Porcine extracted carotid artery was soaked in two different temperature saline baths to enforce constant temperature heating. Higher temperature bath was set to 40 to 80 degree Celsius and soaking duration was 5 to 40 s. Samples were observed by a polarizing microscope and a scanning electron microscope. The birefringence was measured by polarizing microscopic system using Brace-Koehler compensator 1/30 wavelength. The measured birefringence showed temperature dependency and quite fit with the rate process equation. We think vessel wall temperature is able to be estimated using the birefringence changes due to thermal denaturation.

  13. Darwinische Kulturtheorie - Evolutionistische und "evolutionistische`` Theorien sozialen Wandels

    NASA Astrophysics Data System (ADS)

    Antweiler, Christoph

    Evolutionistische Argumentationen außerhalb der Biologie sind weit verbreitet. Wenn sie vertreten werden, heißt das mitnichten, dass sie notwendigerweise von darwinischen Argumenten geprägt sind. Wenn man Evolution und Kultur aus explizit darwinischer Perspektive zusammen bringt, bedeutet das noch lange nicht unbedingt Soziobiologie. Und es bedeutet sicherlich nicht Sozialdarwinismus. Dieser Beitrag soll einen Überblick der so genannten evolutionären Ansätze bzw. evolutionistischen Ansätze zu menschlichen Gesellschaften bzw. Kulturen geben. Es soll gezeigt werden, was in den Ansätzen analytisch zu trennen ist und was synthetisch zusammen gehört. Mein Beitrag ist nicht wissenschaftsgeschichtlich angelegt, sondern systematisch ausgerichtet und hat zwei Schwerpunkte (Antweiler 2008; Antweiler 2009b). Zum einen geht es um kausale Zusammenhänge von organischer Evolution und gesellschaftlichem Wandel. Auf der anderen Seite werden Analogien zwischen biotischer und kultureller Evolution erläutert, die als spezifische Ähnlichkeiten dieser beiden als grundsätzlich verschieden gesehenen Prozesse aufgefasst werden. Dadurch wird die Frage aufgeworfen, ob die Evolution von Organismen einerseits und die Transformation von Gesellschaften bzw. Kulturen andererseits, spezielle Fälle eines allgemeinen Modells von Evolution darstellen.

  14. Expertise bewerben und finden im Social Semantic Web

    NASA Astrophysics Data System (ADS)

    Polleres, Axel; Mochol, Malgorzata

    Im vorliegenden Beitrag diskutieren wir Rahmenbedingungen zur Kombination, Wiederverwendung und Erweiterung bestehender RDFVokabulare im Social Semantic Web. Hierbei konzentrieren wir uns auf das Anwendungsszenario des Auffindens und Bewerbens von Experten im Web oder Intranet. Wir präsentieren, wie RDF-Vokabulare einerseits und de facto Standardformate andererseits, die von täglich verwendeten Applikationen benutzt werden (z. B. vCard, iCal oder Dublin Core), kombiniert werden können, um konkrete Anwendungsfälle der Expertensuche und zum Management von Expertise zu lösen. Unser Fokus liegt darauf aufzuzeigen, dass für praktische Anwendungsszenarien nicht notwendigerweise neue Ontologien entwickelt werden müssen, sondern der Schlüssel vielmehr in der Integration von bestehenden, weit verbreiteten und sich ergänzenden Formaten zu einem kohärenten Netzwerk von Ontologien liegt. Dieser Ansatz garantiert sowohl direkte Anwendbarkeit von als auch niedrige Einstiegsbarrieren in Semantic Web-Technologien sowie einfache Integrierbarkeit in bestehende Applikationen. Die im Web verfügbaren und verwendeten RDFFormate decken zwar einen großen Bereich der Aspekte zur Beschreibung von Personen und Expertisen ab, zeigen aber auch signifikante Überlappungen. Bisher gibt es wenig systematische Ansätze, um diese Vokabulare zu verbinden, sei es in Form von allgemeingültigen Praktiken, die definieren, wann welches Format zu benutzen ist, oder in Form von Regeln, die Überlappungen zwischen einzelnen Formaten formalisieren. Der vorliegende Artikel analysiert, wie bestehende Formate zur Beschreibung von Personen, Organisationen und deren Expertise kombiniert und, wo nötig, erweitert werden können. Darüber hinaus diskutieren wir Regelsprachen zur Beschreibung von Formatüberlappungen sowie deren praktische Verwendbarkeit zur Erstellung eines Ontologie-Netzwerks zur Beschreibung von Experten.

  15. Post-Dilatation Intravascular Brachytherapy Trials on Hypercholesterolemic Rabbits Using {sup 32}P-Phosphate Solutions in Angioplasty Balloons

    SciTech Connect

    Walichiewicz, Piotr Wilczek, Krzysztof; Petelenz, Barbara; Jachec, Wojciech; Jochem, Jerzy; Tomasik, Andrzej; Bilski, Pawel; Gaca, Pawel; Banaszczuk, Joanna; Ihnatowicz, Jerzy; Wodniecki, Jan

    2004-01-15

    Response of peripheral arteries to post-dilatation intravascular brachytherapy (IVBT) using {sup 32}P liquid sources was studied in a rabbit model. The applied sources were angioplasty balloons filled with aqueous solutions of Na{sub 2}H{sup 32}PO{sub 4}, NaCl and iodinated contrast. Dose distribution was calibrated by thermoluminescence dosimetry. The uncertainty of in vitro determinations of the activity-dose dependence was {+-} 15-30%. The animal experiments were performed on rabbits with induced hypercholesterolemia. The {sup 32}P sources were introduced into a randomly chosen (left or right) iliac artery, immediately after balloon injury. Due to the low specific activity of the applied sources, the estimated 7-49 Gy doses on the internal artery surface required 30-100 min irradiations. A symmetric, balloon-occluded but non-irradiated artery of the same animal served as control. Radiation effects were evaluated by comparing the thicknesses of various components of irradiated versus untreated artery walls of each animal. The treatment was well tolerated by the animals. The effects of various dose ranges could be distinguished although differences in individual biological reactions were large. Only the 49 Gy dose at 'zero' distance (16 Gy at 1.0 mm from the balloon surface) reduced hypertrophy in every active layer of the artery wall. The cross-sectional intimal thicknesses after 7, 12, 38 and 49 Gy doses were 0.277, 0.219, 0.357 and 0.196 mm{sup 2} respectively, versus 0.114, 0.155, 0.421 and 0.256 mm{sup 2} in controls (p < 0.05). The lowest radiation dose on the intima induced the opposite effect. Edge intimal hyperplasia was not avoided, which agrees with other reports. The edge restenosis and the variability of individual response to identical treatment conditions must be considered as limitations of the post-dilatation IVBT method. Only application of highest irradiation doses was effective. The irradiation dose should be planned and calculated for

  16. China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS): A new, prospective, multicenter, randomized controlled trial in China

    PubMed Central

    Gao, Peng; Zhao, Zhenwei; Wang, Daming; Wu, Jian; Cai, Yiling; Li, Tianxiao; Wu, Wei; Shi, Huaizhang; He, Weiwen; Zhu, Fengshui; Ling, Feng

    2015-01-01

    Background Patients with symptomatic stenosis of intradural arteries are at high risk for subsequent stroke. Since the SAMMPRIS trial, stenting is no longer recommended as primary treatment; however, the results of this trial, its inclusion criteria and its center selection received significant criticism and did not appear to reflect our experience regarding natural history nor treatment complications rate. As intracranial atherosclerosis (ICAS) is the most common cause for stroke in Asian countries, we are hereby proposing a refined prospective, randomized, multicenter study in an Asian population with strictly defined patient and participating center inclusion criteria. Methods The China Angioplasty and Stenting for Symptomatic Intracranial Severe Stenosis (CASSISS) trial is an ongoing, government-funded, prospective, multicenter, randomized trial. It recruits patients with recent TIA or stroke caused by 70%–99% stenosis of a major intracranial artery. Patients with previous stroke related to perforator ischemia will not be included. Only high-volume centers with a proven track record will enroll patients as determined by a lead-in phase. Patients will be randomized (1:1) to best medical therapy alone or medical therapy plus stenting. Primary endpoints are any stroke or death within 30 days after enrollment or after any revascularization procedure of the qualifying lesion during follow-up, or stroke in the territory of the symptomatic intracranial artery beyond 30 days. The CASSISS trial will be conducted in eight sites in China with core imaging lab review at a North American site and aims to have a sample size of 380 participants (stenting, 190; medical therapy, 190). Recruitment is expected to be finished by December 2016. Patients will be followed for at least three years. The trial is scheduled to complete in 2019. Conclusion In the proposed trial, certain shortcomings of SAMMPRIS including patient and participating center selection will be addressed. The

  17. Percutaneous transluminal angioplasty and stenting for symptomatic intracranial arterial stenosis: a systematic review and meta-analysis

    PubMed Central

    Tsivgoulis, Georgios; Katsanos, Aristeidis H.; Magoufis, Georgios; Kargiotis, Odysseas; Papadimitropoulos, Georgios; Vadikolias, Konstantinos; Karapanayiotides, Theodoros; Ellul, John; Alexandrov, Anne W.; Mitsias, Panayiotis D.; Alexandrov, Andrei V.

    2016-01-01

    Objectives: The cumulative safety and efficacy measures of percutaneous transluminal angioplasty and stenting (PTAS) for secondary stroke prevention in patients with symptomatic intracranial arterial stenosis (sICAS) have not previously been evaluated using a meta-analytical approach. Methods: We conducted a systematic review and random effects meta-analysis of all available randomized controlled trials (RCTs) evaluating the safety and efficacy of PTAS (in comparison with medical therapy) for sICAS. Results: Three RCTs (678 total patients) were included in the quantitative analysis. PTAS was associated with a higher risk of recurrent ischemic stroke in the territory of qualifying artery both within 30 days [risk ratio (RR) = 2.21, 95% confidence interval (CI) 1.10–4.43] and 1 year (RR = 1.92, 95% CI 1.10–3.36). PTAS was also related to a higher risk of any ischemic stroke within 30 days from the index event (RR = 2.08, 95% CI 1.17–3.71). The risk for intracranial hemorrhage was found to be higher in PTAS patients both within 30 days (RR = 10.60, 95% CI 1.98–56.62) and 1 year (RR = 8.15, 95% CI 1.50–44.34). The composite outcome of any stroke or death within 1 year (RR = 2.29, 95% CI 1.13–4.66) and 2 years (RR = 1.52, 95% CI 1.04–2.21) was higher in PTAS than in medical therapy. PTAS was associated with a higher risk of any stroke or death within 2 years in the sICAS subgroup located in posterior circulation (RR = 2.37, 95% CI 1.27–4.42). Conclusions: PTAS is associated with adverse early and long-term outcomes and should not be recommended in patients with sICAS. Further research to identify subgroups of patients who could also serve as candidates for future interventional trials along with efforts to reduce procedure-related complications are needed.

  18. Diagnose und Therapie einer Depression im höheren Lebensalter – Einflüsse von Patienten- und Arztmerkmalen

    PubMed Central

    von dem Knesebeck, Olaf; Bönte, Markus; Siegrist, Johannes; Marceau, Lisa; Link, Carol; McKinlay, John

    2013-01-01

    Zusammenfassung Studienergebnissee aus dem englischsprachigen Raum zeigen, dass diagnostische und therapeutische Entscheidungen von Hausärzten bei der Versorgung von depressiven Patienten systematischen Einflüssen unterliegen, und dass sowohl Merkmale des Arztes als auch des Patienten unabhängig vom Krankheitsbild Einfluss auf diese Entscheidungen haben. In der vorliegenden Arbeit werden Ergebnisse einer deutschen Studie präsentiert, in der die Einflüsse von Patienten- und Arztmerkmalen auf diagnostische und therapeutische ärztliche Entscheidungen bei einer Depression untersucht wurden. Unter Anwendung eines faktoriellen Experimentaldesigns spielten professionelle Schauspieler in Videofilmen die Rolle von Patienten, die Symptome für eine depressive Erkrankung äußern. In den Videofilmen, die alle auf einem identischen Skript basieren, wurden systematisch die Patientenmerkmale Alter (55 vs. 75 Jahre), Geschlecht und sozialer Status (Hausmeister vs. Lehrer) variiert. Die randomisierte Ärztestichprobe wurde nach dem Arztgeschlecht und professioneller Erfahrung (< 5 vs. > 15 Jahre) geschichtet. Der Videofilm wurde insgesamt 128 niedergelassenen Ärzten für Allgemeinmedizin und hausärztlich tätigen Internisten in ihrer Praxis vorgespielt. Danach wurden die Ärzte zu unterschiedlichen Aspekten von Diagnose und Therapie befragt. Es wurde erhoben, ob der Arzt dem Patienten über das gezeigte Gespräch hinausgehende Fragen stellen würde, welche Diagnosen er für wahrscheinlich hält, wie sicher er sich mit seiner Diagnose ist, welche diagnostischen Tests er anordnen würde, ob er den Patienten überweisen würde oder ob er Medikamente verordnen oder ihm Empfehlungen zur Änderung seines Lebensstils geben würde. Die Ergebnisse weisen darauf hin, dass sowohl die Diagnose als auch die Therapie einer Depression durch niedergelassene Hausärzte in Deutschland nur geringfügig durch die untersuchten Merkmale der Patienten und der behandelnden Ärzte beeinflusst wird

  19. Methodik und Qualität statistischer Erhebungen

    NASA Astrophysics Data System (ADS)

    Krug, Walter; Schmidt, Jürgen; Wiegert, Rolf

    Kapitel 8 wirft einen Blick hinter die Kulissen statistischer Arbeit und ihrer Methoden, insbesondere auch hinter die der amtlichen Statistik: Wie kommen die Myriaden von Zahlen zustande, die heute aus statistischen Quellenwerken aller Art und aus Datenbanken abgerufen werden können? Dabei wird deutlich, welche Schwierigkeiten bei Erhebungen, insbesondere bei Stichprobenerhebungen, zu überwinden sind, wie man Antwortverweigerer kooperativer stimmt, wie sich auch aus kleinen Stichproben auf intelligente Weise verlässliche Ergebnisse erzielen lassen und wie Großstichproben auf europäischer Ebene harmonisiert werden. Am Beispiel des Zensus 2011 wird gezeigt, wie sich eine Kombination von Stichproben und Registerauswertungen als Ersatz für eine Volkszählung nutzen lässt. Mitglieder der Deutschen Statistischen Gesellschaft waren daran kooperativ beteiligt.

  20. The Women of "Kabale und Liebe": A Teaching Approach

    ERIC Educational Resources Information Center

    Stephan, Naomi I.

    1976-01-01

    The three female characters in Schiller's "Kabale und Liebe" are analyzed. The article questions the value of using this play in a college curriculum because of the oppressive and unenlightened roles of the female characters. (TL)

  1. Einstein. Ein Genie und sein überfordertes Publikum.

    NASA Astrophysics Data System (ADS)

    Fischer, E. P.

    Dieses Buch ist keine herkömmliche Biographie von Albert Einstein - vielmehr untersucht der Autor anhand charakteristischer Stationen in Einsteins Leben, dessen Denken und die Reaktionen seiner Zeitgenossen.

  2. Einstellung und Wissen von Lehramtsstudierenden zur Evolution - ein Vergleich zwischen Deutschland und der Türkei

    NASA Astrophysics Data System (ADS)

    Graf, Dittmar; Soran, Haluk

    Es wird eine Untersuchung vorgestellt, in der Wissen und Überzeugungen von Lehramtsstudierenden aller Fächer zum Thema Evolution an zwei Universitäten in Deutschland und der Türkei erhoben worden sind. Die Befragung wurde in Dortmund und in Ankara durchgeführt. Es stellte sich heraus, dass ausgeprägte Defizite im Verständnis der Evolutionsmechanismen herrschen. Viele Studierende, insbesondere aus der Türkei, sind nicht von der Faktizität der Evolution überzeugt. Dies gilt sowohl für Studierende mit Fach Biologie als auch für Studierende mit anderen Fächern. Näher untersucht worden sind die Faktoren, die die Überzeugungen zur Evolution beeinflussen können, was ja in Anbetracht der hohen Ablehnungsrate der Evolution von besonderem Interesse ist. Das Vertrauen in die Wissenschaft spielt hierbei eine besondere Rolle: Wer der Wissenschaft vertraut, ist auch eher von der Evolution überzeugt, als diejenigen, die skeptisch gegenüber der Wissenschaft sind.

  3. Cryoplasty Versus Conventional Balloon Angioplasty of the Femoropopliteal Artery in Diabetic Patients: Long-Term Results from a Prospective Randomized Single-Center Controlled Trial

    SciTech Connect

    Spiliopoulos, Stavros Katsanos, Konstantinos; Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Kagadis, George C.; Christeas, Nikolaos; Siablis, Dimitris

    2010-10-15

    The purpose of this study was to investigate the immediate and long-term results of cryoplasty versus conventional balloon angioplasty in the femoropopliteal artery of diabetic patients. Fifty diabetic patients (41 men, mean age 68 years) were randomized to cryoplasty (group CRYO; 24 patients with 31 lesions) or conventional balloon angioplasty (group COBA; 26 patients with 34 lesions) of the femoropopliteal artery. Technical success was defined as <30% residual stenosis without any adjunctive stenting. Primary end points included technical success, primary patency, binary in-lesion restenosis (>50%), and freedom from target lesion recanalization. Cox proportional hazards regression analysis was performed to adjust for confounding factors of heterogeneity. In total, 61.3% (19 of 31) in group CRYO and 52.9% (18 of 34) in group COBA were de novo lesions. More than 70% of the lesions were Transatlantic Inter-Society Consensus (TASC) B and C in both groups, and 41.4% of the patients in group CRYO and 38.7% in group COBA suffered from critical limb ischemia. Immediate technical success rate was 58.0% in group CRYO versus 64.0% in group COBA (p = 0.29). According to 3-year Kaplan-Meier estimates, there were no significant differences with regard to patient survival (86.8% in group CRYO vs. 87.0% in group COBA, p = 0.54) and limb salvage (95.8 vs. 92.1% in groups CRYO and COBA, respectively, p = 0.60). There was a nonsignificant trend of increased binary restenosis in group CRYO (hazard ratio [HR] 1.3; 95% CI 0.6-2.6, p = 0.45). Primary patency was significantly lower in group CRYO compared with group COBA (HR 2.2; 95% CI 1.1-4.3, p = 0.02). Significantly more repeat intervention events because of recurrent symptoms were required in group CRYO (HR 2.5; 95% CI 1.2-5.3, p = 0.01). Cryoplasty was associated with lower primary patency and more clinically driven repeat procedures after long-term follow-up compared with conventional balloon angioplasty.

  4. Physik gestern und heute Von der Metallstange zum Hochenergielaser

    NASA Astrophysics Data System (ADS)

    Heering, Peter

    2002-05-01

    Im Mai 1752 wurde in Marly bei Paris auf Anregung des amerikanischen Forschers und Politikers Benjamin Franklin erstmals die elektrische Natur des Blitzes nachgewiesen. Damals beschrieb Franklin auch eine technische Vorrichtung, die als Schutz von Gebäuden vor Blitzschlägen dienen sollte: den Blitzableiter. Diese aus heutiger Sicht scheinbar triviale Vorrichtung wurde aber keineswegs unmittelbar akzeptiert. Und bis heute ist die Forschung zum Schutz von Einrichtungen vor Blitzschlägen nicht abgeschlossen.

  5. Evolution: Treibende Kräfte in Natur und Kultur

    NASA Astrophysics Data System (ADS)

    Wuketits, Franz M.

    Vorbemerkung Der vorliegende Text ist sozusagen die Nachschrift meines im Dezember 2007 in Dresden gehaltenen Vortrags. Ich hielt den Vortrag im Wesentlichen in freier Rede, nur auf der Basis einiger Notizen, und schrieb den vollen Text danach. Dabei habe ich den Vortragsstil beibehalten. Allerdings habe ich nachträglich manches hinzugefügt, den Beitrag mit ein paar Anmerkungen versehen und einiges an zwischenzeitlich erschienener Literatur berücksichtigt.

  6. S1-Leitlinie zur UV-Phototherapie und Photochemotherapie.

    PubMed

    Herzinger, Thomas; Berneburg, Mark; Ghoreschi, Kamran; Gollnick, Harald; Hölzle, Erhard; Hönigsmann, Herbert; Lehmann, Percy; Peters, Thorsten; Röcken, Martin; Scharffetter-Kochanek, Karin; Schwarz, Thomas; Simon, Jan; Tanew, Adrian; Weichenthal, Michael

    2016-08-01

    Die heilsame Wirkung des Sonnenlichts war teilweise schon im Altertum bekannt und fand in der zweiten Hälfte des 19. Jahrhunderts wieder zunehmend Beachtung. Den Beginn der modernen Phototherapien markiert die Entwicklung einer Apparatur zur ultravioletten Bestrahlung der Hauttuberkulose durch Finnsen zu Beginn des zwanzigsten Jahrhunderts. Zur Therapie von Hauterkrankungen finden beinahe ausschließlich die spektralen Bereiche unterhalb des sichtbaren Lichtes (ultraviolett) Anwendung. Seit den 1970er Jahren stehen zunehmend leistungsfähige künstliche Strahlenquellen bereit für die Therapie mit UVB, UVA und die Kombination von UVA mit Photosensibilisatoren (Photochemotherapie). Hohe strukturelle und prozedurale Qualitätsstandards sind unabdingbare Voraussetzung für die Durchführung einer gleichermaßen wirkungsvollen wie auch sicheren Phototherapie. Die Leitlinie formuliert den aktuellen Konsens führender Experten auf dem Gebiet der Phototherapie in Bezug auf die Indikationen für die jeweiligen Therapieverfahren, deren Gegenanzeigen und Nebenwirkungen und insbesondere für die Wahl der korrekten Dosis zu Beginn und im Verlauf einer Therapie sowie das Management von Nebenwirkungen. PMID:27509439

  7. Zahlen und Rechenvorgänge auf unterschiedlichen Abstraktionsniveaus

    NASA Astrophysics Data System (ADS)

    Rödler, Klaus

    "Das Verständnis geht langsam vor sich!" Diesen wichtigen Satz hörte ich bei einem Vortrag von Martin Lowsky. Auf die hier behandelte Fragestellung übertragen heißt das: Was eine Zahl ist und wie ich sie im Rechenvorgang einsetzen und interpretieren kann, das erschließt sich erst allmählich. Die Zahl des Rechenanfängers ist nicht dieselbe wie die des kompetenten Rechners und es ist nicht die Zahl des Lehrers oder der Lehrerin. Die Zahlen sind nur auf der Oberfläche der Worte und Zeichen gleich. Im Innern, im Verständnis, sind sie völlig verschieden! Ich glaube, dass die Missachtung dieser Divergenz dazu führt, dass manche Kinder in für den Lehrer und Lehrerin nicht nachvollziehbaren Routinen stecken bleiben, einfachste Informationen nicht wirklich integrieren. Die auf beiden Seiten wachsende Verunsicherung durch die nicht erkannte und daher nicht kommunizierbare Diskrepanz im inneren Zahlkonzept stört den allmählichen Aufbau strukturierter Zahlvorstellungen.

  8. Anwendung von Methoden der Logistik und Netzplantechnik zur präzedenz- und ressourcenbeschränkten Ablaufplanung von Echtzeitsystemen

    NASA Astrophysics Data System (ADS)

    Gumzej, Roman; Lipičnik, Martin

    Grundlegende Zusammenhänge zwischen Logistik, Netzplantechnik und Echtzeit sowie den zugehörigen Arten der Ablaufplanung und ihrer Nutzung werden dargestellt. Das Echtzeitprinzip beinhaltet Rechtzeitigkeit von Abläufen, wobei es für eine frühzeitige Beendigung eines Ablaufs keinen Bonus gibt; im Gegensatz zum verspäteten Ablauf, dessen Konsequenzen in der Regel negativ und unabschätzbar sind. Das Just-in-Time-Prinzip gleicht dem der Echtzeit und wird vor allem in der Logistik zur Bezeichnung reibungsloser Abläufe in Beschaffungsketten verwendet. In der Netzplantechnik werden die kritischen Aktivitäten binnen eines Projektes bestimmt, die nicht verzögert werden dürfen, um das Projekt rechtzeitig zu beenden. Außerdem haben die drei Bereiche noch eine Gemeinsamkeit: um realistische Ablaufszenarien darzustellen, müssen in den Analysen auch begrenzte Ressourcen angemessen berücksichtigt werden.

  9. Feasibility of Angioplasty and Stenting for Abdominal Aortic Lesions Adjacent to Previously Stented Visceral Artery Lesions in Patients with Takayasu Arteritis

    SciTech Connect

    Joseph, George George, Paul V.; Pati, Purendra Kumar; Chandy, Sunil Thomas

    2007-04-15

    Two young female patients with Takayasu arteritis presented with symptomatic long-segment abdominal aortic stenosis in the vicinity of previously deployed celiac and renal artery stents that projected markedly into the narrowed aortic lumen. Crushing or distortion of the visceral artery stents during aortic angioplasty was avoided by performing simultaneous or alternating balloon dilatations in the aorta and in the visceral artery stents. Consequently, the visceral artery stents remained patent and shortened longitudinally, allowing unhindered deployment of Wallstents in the adjacent aorta and abolition of a pressure gradient across the aortic lesions. Access to side branches covered by the Wallstent was obtained without difficulty, enabling the performance of balloon dilatation in multiple side branches and ostial stent deployment in a renal artery. These techniques could increase the scope of endovascular therapy in the treatment of patients with Takayasu arteritis.

  10. VDI-Richtlinien - mit Technischen Regeln Wirtschaftlichkeit erhöhen und Standards setzen

    NASA Astrophysics Data System (ADS)

    Mandelartz, Johannes

    Der Verein Deutscher Ingenieure e.V. (VDI) ist ein gemeinnütziger, wirtschaftlich und politisch unabhängiger, technisch-wissenschaftlicher Verein von Ingenieuren und Naturwissenschaftlern. Mit über 137 000 persönlich zugeordneten Mitgliedern ist er eine der größten Ingenieur-Vereinigungen Europas und gilt in Deutschland als führender Sprecher der Technik und der Ingenieure. 1856 gegründet, hat er viele für die Technik wesentliche Entwicklungen in Gang gesetzt, so im Bereich der technischen Überwachung, der technischen Regelsetzung und Normung, der Arbeitsstudien, im gewerblichen Rechtsschutz und im Patentwesen. Seit seiner Gründung sieht es der VDI als seine Aufgabe, "das Zusammenwirken aller geistiger Kräfte der Technik im Bewusstsein ethischer Verantwortung zu fördern“ und die Lebensmöglichkeiten aller Menschen durch Entwicklung und sinnvoller Anwendung technischer Mittel zu verbessern.

  11. Regelungen im Verkehr mit Lebensmitteln und Bedarfsgegenständen in Deutschland

    NASA Astrophysics Data System (ADS)

    Thomas, Gundula; Freund, Astrid; Gründig, Friedrich

    Im Zuge der Globalisierung von Produktion und Handel ändert sich auch der Charakter der Vorschriften im Lebensmittelrecht. Zunehmend treten internationale Rechtsbestimmungen, Abkommen, Standards und andere Normen an die Stelle nationaler Regelungen.

  12. Predicting Factors for Successful Maturation of Autogenous Haemodialysis Fistulas After Salvage Percutaneous Transluminal Angioplasty in Diabetic Nephropathy: A Study on Follow-Up Doppler Ultrasonography

    PubMed Central

    Jeon, Eui-Yong; Cho, Young Kwon; Cho, Sung Bum; Yoon, Dae Young; Suh, Seong O

    2016-01-01

    Background: Maturation failure of autogenous arteriovenous fistula (aAVF) has been increasing after surgical procedures and the salvage percutaneous transluminal angioplasty (sPTA) for immature aAVF has been identified as an effective treatment modality. Objectives: The aim of this study was to identify factors predicting successful aAVF maturation and to determine positive technical aspects of sPTA. Patients and Methods: We retrospectively reviewed medical records and radiological images of 59 patients who had undergone sPTA for non-maturing aAVFs. We analysed images from pre-surgical mapping Doppler ultrasonography, angiography, and angioplasty and follow-up Doppler ultrasonography performed within two weeks after sPTA. We assessed the following factors, for their ability to predict successful aAVF maturation: 1) patient factors (age; sex; co-morbidities; and aAVF age, side and type); 2) vessel factors (cephalic vein diameter and depth, presence of accessory veins, and pre- and postoperative radial artery disease); 3) lesion factors (stenosis number, location and severity); and 4) technical factors (presence of residual stenosis and anatomic success ratio (ASR) on follow-up Doppler ultrasonography). Results: The technical and clinical success rates were both 94.9% (56/59); the mean ASR was 0.84. An ASR of ≥ 0.7 and no significant residual stenosis (< 30%) (both P < 0.001) on two-week follow-up Doppler ultrasonography predicted successful aAVF maturation. Conclusion: For more precise prediction of successful aAVF maturation after sPTA, short-term follow-up Doppler ultrasonography (< 2 weeks) was useful. If the ASR was < 0.7 or if residual stenosis was ≥ 30%, immediate repeat sPTA is recommended. PMID:27127581

  13. Difference between Outcome of Left Circumflex Artery and Right Coronary Artery Related Acute Inferior Wall Myocardial Infarction in Patients Undergoing Adjunctive Angioplasty after Fibrinolysis

    PubMed Central

    Sohrabi, Bahram; Separham, Ahmad; Madadi, Reza; Toufan, Mehrnoush; Mohammadi, Nasibeh; Aslanabadi, Naser; Kazemi, Babak

    2014-01-01

    Introduction: Prognostic differences between anterior and inferior wall Myocardial Infarction (MI) has been extensively investigated, but there is limited information about similar comparison between inferior wall MI caused by right coronary artery (RCA) and left circumflex artery (LCX) occlusion. The aim of present study was to compare prognostic differences between LCX- and RCA-related acute inferior wall ST-segment elevation MI (STEMI) treated by routine adjunctive angioplasty after receiving thrombolytic therapy (TLT). Methods: Between March 2012 and June 2013 one hundred fifty consecutive patients with acute inferior wall STEMI were studied. Patients were divided into two groups according to the infarct related artery (LCX vs. RCA). All patients underwent routine adjunctive angioplasty after TLT during the index hospitalization and clinical characteristics and outcomes were compared. Results: RCA and LCX arteries were occluded in 97 (64.7%) and 53 (35.3%) of patients, respectively. Two groups were similar in baseline characteristics except multiple-vessel disease was more prevalent with LCX occlusion (p= 0.008). There was a higher cardiac enzyme release (p< 0.001), more significant mitral regurgitation (MR) (p= 0.015), and lower left ventricular ejection fraction (LVEF) (p= 0.01) in patients with LCX occlusion. Multivariate analysis showed cTn-I release, occurrence of MR, and lower LVEF as independent factors leading to poor outcome. Conclusions: There were higher cTn-I release, MR occurrence, and lower LVEF in LCX-related acute inferior wall STEMI, all associated with poor outcome. Therefore, patients with ECG finding in favour of LCX occlusion should be considered as high risk and an invasive approach should be planned. PMID:25031825

  14. What Is Coronary Angioplasty?

    MedlinePlus

    ... In many patients a collapsed wire mesh tube (stent), mounted on a special balloon, is moved over ... As the balloon is inflated, it opens the stent against the artery walls. The stent locks in ...

  15. Coronary Angioplasty Stent Placement

    MedlinePlus Videos and Cool Tools

    ... symptoms got worse. He had a nuclear stress test, which was abnormal, and he is has now ... of angina. He had an abnormal nuclear stress test, which is a study performed with chemical induction ...

  16. Nicolaus Copernicus Gesamtausgabe. Band VI/1. Documenta Copernicana: Briefe (Texte und Übersetzungen).

    NASA Astrophysics Data System (ADS)

    Kühne, A.

    Im Auftrage der Kommission für die Copernicus-Gesamtausgabe, herausgegeben von H. M. Nobis und M. Folkerts. Band VI/1 wurde bearbeitet von A. Kühne unter Mitarbeit von F. Boockmann und S. Kirschner und Verwendung der Vorarbeiten von H. M. Nobis.

  17. Ferrofluide - ihre Grundlagen und Anwendungen: Magnetische Flüssigkeiten kontrollieren

    NASA Astrophysics Data System (ADS)

    Odenbach, Stefan

    Strömung und Eigenschaften von Suspensionen kleiner magnetischer Teilchen, so genannten Ferrofluiden, lassen sich durch laborübliche Magnetfelder wesentlich beeinflussen. Dies ergibt neue Möglichkeiten in der Grundlagenforschung und erlaubt die Entwicklung interessanter technischer Anwendungen. So werden Ferrofluide beispielsweise im Dämpfungs- und Dichtungsbereich, in jüngerer Zeit auch im biomedizinischen Bereich eingesetzt.

  18. Isolated acute occlusion of a large right ventricular branch of the right coronary artery following coronary balloon angioplasty. The only true 'model' to study ECG changes in acute, isolated right ventricular infarction.

    PubMed

    van der Bolt, C L; Vermeersch, P H; Plokker, H W

    1996-02-01

    An isolated right ventricular infarction occurs rarely and data on its electrocardiographic appearance and underlying angiographically proven cause are scarce. The electrocardiographic response of acute right ventricular ischaemia is often obscured by the coexisting forces of the ischaemic mass of the inferior wall of the left ventricle when the right coronary artery itself becomes occluded. Percutaneous transluminal coronary angioplasty of the right coronary artery may cause an isolated occlusion of a right ventricular branch. We encountered this phenomenon in nine patients. In all, it led to acute isolated right ventricular ischaemia with ST elevations in the right precordial leads (V1-V3, V3R and V4R) on the electrocardiogram. We conclude that the ECG pattern of pure right ventricular ischaemia can be seen when an isolated occlusion of a large right ventricular branch occurs, for example as a complication of percutaneous transluminal coronary angioplasty. PMID:8732378

  19. Herschel und die Zukunft der Fern-Infrarot-Astronomie

    NASA Astrophysics Data System (ADS)

    Linz, Hendrik

    2015-06-01

    Schon lange ist die beobachtende Astronomie den engen Grenzen des optisch Sichbaren entwachsen und hat fast alle Bereiche des elektromagnetischen Spektrums für sich dienstbar gemacht. Im sogenannten nahen und mittleren Infrarot (Wellenlängen zwischen 1-30 μm) sowie im Millimeter- und Radio-Regime (Wellenlängen zwischen 1 mm und 10 m) ist die Erdatmosphäre relativ gut durchlässig für elektromagnetische Signale oder hat zumindest eine Vielzahl von spektral begrenzten Transmissionsfenstern, die astronomische Beobachtungen zumindest von höheren Bergen aus möglich machen. Allerdings ist das sogenannte Ferne Infrarot (FIR, 30-300 μm Wellenlänge) von der Erde aus fast völlig unzugänglich für astronomische Beobachtungen. Selbst für die besten Beobachtungsplätze der Erde bleibt die atmosphärische Transmission durch die immense Wasserdampf- Absorption auf ein absolutes Minimum beschränkt. Jedoch erlaubt uns das FIR Zugang zu Informationen, die sehr nützlich sind für die astrophysikalische Forschung und komplementär zu anderen Wellenlängen-Bereichen.

  20. Einfluss des Internets auf das Informations-, Einkaufs- und Verkehrsverhalten

    NASA Astrophysics Data System (ADS)

    Nerlich, Mark R.; Schiffner, Felix; Vogt, Walter

    Mit Daten aus eigenen Erhebungen können das einkaufsbezogene Informations- und Einkaufsverhalten im Zusammenhang mit den verkehrlichen Aspekten (Distanzen, Verkehrsmittel, Wegekopplungen) dargestellt werden. Die Differenzierung in die drei Produktkategorien des täglichen, mittelfristigen und des langfristigen Bedarfs berücksichtigt in erster Linie die Wertigkeit eines Gutes, die seine Erwerbshäufigkeit unmittelbar bestimmt. Der Einsatz moderner IKT wie das Internet eröffnet dem Endverbraucher neue Möglichkeiten bei Information und Einkauf. Die verkehrliche Relevanz von Online-Shopping wird deutlich, wenn man berücksichtigt, dass im Mittel rund 17% aller Online-Einkäufe, die die Probanden durchgeführt haben, Einkäufe in Ladengeschäften ersetzen. Dies gilt in verstärktem Maße für Online-Informationen: etwa die Hälfte hätte alternativ im stationären Einzelhandel stattgefunden. Da der Erwerb von Gütern des täglichen Bedarfs häufig nahräumlich und in relevantem Anteil nicht-motorisiert erfolgen kann, sind in diesem Segment - im Gegensatz zum mittel- und langfristigen Bedarf - nur geringe Substitutionseffekte zu beobachten.

  1. Informationsqualität - Definitionen, Dimensionen und Begriffe

    NASA Astrophysics Data System (ADS)

    Rohweder, Jan Philipp; Kasten, Gerhard; Malzahn, Dirk; Piro, Andrea; Schmid, Joachim

    Die Verbesserung und Sicherstellung der Informationsqualität wird in immer mehr Unternehmen als eigenständige Managementaufgabe von großer Wichtigkeit begriffen. IQ-Management ist ein elementarer Baustein in Systemintegrationsprojekten. Aber auch in bestehenden Prozessen mit heterogenen Datenquellen und Informationsnutzern ist eine hohe Informationsqualität die Grundvoraussetzung für funktionierende betriebliche Abläufe. Voraussetzung für ein effektives IQ-Management ist die Bewertung der Informationsqualität [Lee et al. 2006, S. 13 und S. 27]. In vielen Unternehmen ist Informationsqualität nur ein gefühlter Wert. Die meisten Anwender bringen ein gewisses Misstrauen den Daten gegenüber zum Ausdruck, dies jedoch ohne genaue Angabe der Fehlerart und -häufigkeit. Nicht selten werden kostspielige Projekte angestoßen, um die Informationsqualität zu verbessern, ohne sich vor einer IQ-Maßnahme durch eine Analyse ein genaues Bild über die tatsächlichen Probleme zu verschaffen. Nur auf der Basis einer umfassenden Bewertung der Informationsqualität können die notwendigen Ressourcenentscheidungen herbeigeführt, Ziele gesetzt und der Erfolg des IQ-Management beurteilt werden.

  2. IQM-Reifegradmodell für die Bewertung und Verbesserung des Information Lifecycle Management Prozesses

    NASA Astrophysics Data System (ADS)

    Baškarada, Saša; Gebauer, Marcus; Koronios, Andy; Gao, Jing

    Heutige Organisationen produzieren und speichern mehr Informationen als je zuvor. Der resultierende Informationsüberfluss, zusammen mit einem Mangel an Qualitätssicherung für das Information Lifecycle Management, führt zu einem unsicheren Status der Informationsqualität in vielen Organisationen. Weiterhin hat sich herausgestellt, dass das Bewerten, Verbessern und Steuern der Informationsqualität ein offenkundig schwieriges Unterfangen ist. Dieses Kapitel stellt ein Modell zur Bewertung und Verbesserung der Information Quality Management Capability Maturity (IQM-Reifegrad) vor. Es wird ein Satz von Kriterien vorgestellt, der aus Literaturrecherche und Fallstudien abgeleitet wurde. Die Reifegradindikatoren werden validiert und in einem mehrstufigen Reifegradmodell durch eine Delphi-Studie gruppiert. Das abgeleitete IQM-Reifegradmodell hilft Organisationen ihre bestehenden Praktiken im IQM zu bewerten und potentielle Lücken und Verbesserungsstrategien zu ermitteln.

  3. Endoskopie, minimal invasive chirurgische und navigierte Verfahren in der Urologie

    NASA Astrophysics Data System (ADS)

    Grosse, Joachim; von Walter, Matthias; Jakse, Gerhard

    Betrachtet man die letzten 100 Jahre der Urologie in Deutschland seit Gründung ihrer Fachgesellschaft 1906 in Stuttgart, so sind sicherlich die letzten 25 Jahre von umfassenden Entwicklungen mit z. T. vollständigen Umwälzungen bisheriger Therapien und Methoden auf urologischen Fachgebiet gekennzeichnet. In erster Linie handelte es sich dabei um minimal invasive endoskopische Techniken wie perkutane Nierenchirurgie, Ureterorenoskopie, videoendoskopisch unterstütze transurethrale Elektroresektionen der Prostata und von Blasentumore sowie die Laparoskopie. Sie führten zu besseren operativen Ergebnissen und einer deutlichen Senkung der Morbidität der entsprechenden Behandlung urologischer Krankheitsbilder, mit der Konsequenz, dass einige bisher als Standard gültige offene Operationsverfahren abgelöst wurden.

  4. Terror mit Atomwaffen: reale Gefahr? Nukleare und Radiologische Waffen

    NASA Astrophysics Data System (ADS)

    Harigel, Gert G.

    2006-01-01

    Können Terroristen sich nukleare Massenvernichtungswaffen beschaffen? Dazu müssten sie ausreichende Mengen an waffenfähigem, spaltbarem Material stehlen. Selbst der Bau einer primitiven Atombombe erfordert einen hohen technischen Aufwand und Spezialisten. Wahrscheinlicher ist deshalb der Diebstahl einer kleinen taktischen Kernwaffe. Alternativ könnten Terroristen sich radioaktives Material aus zivilen Quellen beschaffen und daraus eine Schmutzige Bombe bauen. Eine solche radiologische Waffe wäre keine echte Massenvernichtungswaffe, doch ihre psychologische Wirkung könnte stark sein. Das macht sie für Terroristen attraktiv, weswegen diese Gefahr ernst genommen werden muss.

  5. Myxomavirus Anti-Inflammatory Chemokine Binding Protein Reduces the Increased Plaque Growth Induced by Chronic Porphyromonas gingivalis Oral Infection after Balloon Angioplasty Aortic Injury in Mice

    PubMed Central

    Lucas, Alexandra R.; Verma, Raj K.; Dai, Erbin; Liu, Liying; Chen, Hao; Kesavalu, Sheela; Rivera, Mercedes; Velsko, Irina; Ambadapadi, Sriram; Chukkapalli, Sasanka; Kesavalu, Lakshmyya

    2014-01-01

    Thrombotic occlusion of inflammatory plaque in coronary arteries causes myocardial infarction. Treatment with emergent balloon angioplasty (BA) and stent implant improves survival, but restenosis (regrowth) can occur. Periodontal bacteremia is closely associated with inflammation and native arterial atherosclerosis, with potential to increase restenosis. Two virus-derived anti-inflammatory proteins, M-T7 and Serp-1, reduce inflammation and plaque growth after BA and transplant in animal models through separate pathways. M-T7 is a broad spectrum C, CC and CXC chemokine-binding protein. Serp-1 is a serine protease inhibitor (serpin) inhibiting thrombotic and thrombolytic pathways. Serp-1 also reduces arterial inflammation and improves survival in a mouse herpes virus (MHV68) model of lethal vasculitis. In addition, Serp-1 demonstrated safety and efficacy in patients with unstable coronary disease and stent implant, reducing markers of myocardial damage. We investigate here the effects of Porphyromonas gingivalis, a periodontal pathogen, on restenosis after BA and the effects of blocking chemokine and protease pathways with M-T7 and Serp-1. ApoE−/− mice had aortic BA and oral P. gingivalis infection. Arterial plaque growth was examined at 24 weeks with and without anti-inflammatory protein treatment. Dental plaques from mice infected with P. gingivalis tested positive for infection. Neither Serp-1 nor M-T7 treatment reduced infection, but IgG antibody levels in mice treated with Serp-1 and M-T7 were reduced. P. gingivalis significantly increased monocyte invasion and arterial plaque growth after BA (P<0.025). Monocyte invasion and plaque growth were blocked by M-T7 treatment (P<0.023), whereas Serp-1 produced only a trend toward reductions. Both proteins modified expression of TLR4 and MyD88. In conclusion, aortic plaque growth in ApoE−/− mice increased after angioplasty in mice with chronic oral P. gingivalis infection. Blockade of chemokines, but not serine

  6. The Impact of Remote Ischemic Pre-Conditioning on Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography and Angioplasty: A Double-Blind Randomized Clinical Trial

    PubMed Central

    Gholoobi, Arash; Sajjadi, Seyyed Masoud; Shabestari, Mahmoud Mohammadzadeh; Eshraghi, Ali; Shamloo, Alireza Sepehri

    2015-01-01

    Background and objective Contrast-induced nephropathy (CIN) is an acute major complication following intravascular administration of iodinated contrast agents; however, the best approach for preventing CIN is not clear. Remote ischemic pre-conditioning (RIPC) is a new, non-pharmacological method that has been considered for the prevention of CIN following coronary angiography. This study assessed the effects of RIPC with four brief episodes of upper limb ischemia and reperfusion in the prevention of contrast-induced nephropathy (CIN) after coronary angiography and/or angioplasty. Methods In this double-blind randomized clinical trial, we enrolled 51 patients with chronic stable angina and non-ST elevation acute coronary syndrome (NSTE.ACS), and they underwent coronary angiography and/or angioplasty. Standard fluid therapy with normal saline was prescribed for all patients before and after the procedure. The patients were divided into two groups, i.e., a study group of patients who had undergone RIPC intervention and a control group of patients who had not undergone RIPC. One hour before the procedure, a sphygmomanometer cuff was placed around one arm and inflated up to 50 mmHg above the systolic pressure for five minutes; then, the cuff was deflated for another five minutes, and this cycle was repeated four times. The patients’ serum creatinine levels were measured at baseline and 48 hours after the procedure, and the incidence of CIN was calculated. Results Twenty-one males and 30 females were studied in two groups, i.e., an RIPC intervention group (n = 25) and a control group (n = 26) that were homogenous considering baseline characteristics. No significant difference was observed in the mean level of serum creatinine between the two groups at a post-intervention time of 48 hours (RICP: 1.74 ± 0.70 mg/dL vs. Control: 1.75 ± 0.87 mg/dL; P = 0.64). However, a lower incidence rate of CIN was observed 48 hours after the administration of the contrast medium in

  7. Historisches Rätsel Physik mit Gewehr und Eiern

    NASA Astrophysics Data System (ADS)

    Loos, Andreas

    2003-11-01

    Es fing schon gut an: Mit zehn Jahren saß der begabte Junge bereits in der Universität, wo ihn kein Geringerer als sein Vater persönlich unterrichtete. Damit schlug dieser zwei Fliegen mit einer Klappe: Sein Sohn lernte etwas Gescheites, und er war zugleich in sicherer Obhut.

  8. Improvement in Claudication After Angioplasty of Distal Ostial Collateral Stenosis in Patients with Long-Segment Occlusion of the Femoral Artery

    SciTech Connect

    Mueller-Buehl, Uwe; Strecker, Ernst-Peter; Goettmann, Dieter; Vetter, Sylvia; Boos, Irene B.L.

    2000-11-15

    Purpose: To evaluate the angiographic and clinical effects of percutaneous transluminal angioplasty (PTA) of distal ostial collateral stenoses in patients with claudication and long-segment occlusion of the superficial femoral artery (SFA).Methods: In ten patients (9 men, 1 woman) with stable intermittent claudication due to chronic long-segment occlusion of the SFA a high-grade stenosis of the distal collateral ostium of the deep femoral artery to the popliteal artery were dilated. PTA was performed using popliteal artery access. Claudication distances on the treadmill and ankle-brachial pressure indices (ABI) at rest were analyzed before, 1 week, and 14 weeks after PTA.Results: Initial technical success was obtained in all patients. There were no significant periprocedural local complications. The initial mean claudication distance on the treadmill increased significantly from 107 {+-} 65 m to 306 {+-} 209 m (p < 0.01), the maximal claudication distance from 203 {+-} 128 m to 392 {+-} 167 m (p < 0.01). The mean ABI changed slightly but significantly (0.61 {+-} 0.08 vs. 0.64 {+-} 0.07; p < 0.05). Early follow-up after 14 weeks revealed no clinical deterioration.Conclusion: This new technique is considered helpful in patients with well-defined claudication and long-segment occlusion of the SFA.

  9. Rescue balloon pulmonary angioplasty under veno-arterial extracorporeal membrane oxygenation in a patient with acute exacerbation of chronic thromboembolic pulmonary hypertension.

    PubMed

    Nakamura, Makiko; Sunagawa, Osahiko; Tsuchiya, Hiroyuki; Miyara, Takafumi; Taba, Yoji; Touma, Takashi; Munakata, Hiroshi; Kugai, Tadao; Okita, Yutaka

    2015-01-01

    We describe a case of a 41-year-old woman with acute exacerbation of chronic thromboembolic pulmonary hypertension (CTEPH) complicated by rapidly progressive respiratory failure and right heart failure with cardiogenic shock. A computed tomography (CT) showed thrombi in the right main pulmonary artery and bilateral peripheral pulmonary arteries, and echocardiography showed right ventricular dilatation and tricuspid regurgitation, with an estimated pressure gradient of 80 mmHg. The patient was initially diagnosed with acute pulmonary thromboembolism, and thrombolytic therapy was administered. Her condition subsequently deteriorated, however, necessitating mechanical ventilation and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We performed emergency catheter-directed thrombectomy and thrombus aspiration. Pulmonary hypertension (PH) temporarily improved, but subsequently worsened, and the patient was diagnosed with CTEPH. Pulmonary endarterectomy (PEA) was performed. After PEA, we were unable to wean the patient off VA-ECMO, and rescue balloon pulmonary angioplasty (BPA) to the middle and inferior lobe branches of the right lung was performed. Five days after BPA, the patient was removed from VA-ECMO and on the 57th day of hospitalization, she was weaned off the ventilator. The patient was discharged after 139 days of hospitalization. Rescue BPA represents a useful intervention for improving PH and weaning off VA-ECMO in a patient with acute exacerbation of CTEPH. PMID:25742948

  10. Selective ablation of WHHLMI rabbit atherosclerotic plaque by quantum cascade laser in the 5.7 μm wavelength range for less-invasive laser angioplasty

    NASA Astrophysics Data System (ADS)

    Hashimura, Keisuke; Ishii, Katsunori; Akikusa, Naota; Edamura, Tadataka; Yoshida, Harumasa; Awazu, Kunio

    2013-06-01

    We investigated the potential of a compact and high-power quantum cascade laser (QCL) in the 5.7 μm wavelength range for less-invasive laser angioplasty. Atherosclerotic plaques consist mainly of cholesteryl esters. Radiation at a wavelength of 5.75 μm is strongly absorbed in C=O stretching vibration mode of cholesteryl esters. Our previous study achieved to make cutting differences between a normal artery and an atherosclerotic lesions using nanosecond pulsed laser by difference-frequency generation (DFG laser) at the wavelength of 5.75 μm. For applying this technique to clinical treatment, a compact laser device is required. In this study, QCL irradiation effects to a porcine normal aorta were compared with DFG laser. Subsequently, QCL irradiation effects on an atherosclerotic aorta of myocardial infarction-prone Watanabe heritable hyperlipidemic rabbit (WHHLMI rabbit) and a normal rabbit aorta were observed. As a result, the QCL could make cutting differences between the rabbit atherosclerotic and normal aortas. On the other hand, the QCL induced more thermal damage to porcine normal aorta than the DFG laser at the irradiation condition of comparable ablation depths. In conclusion, the possibility of less-invasive and selective treatment of atherosclerotic plaques using the QCL in the 5.7 μm wavelength range was revealed, although improvement of QCL was required to prevent the thermal damage of a normal artery.

  11. Comparison of Immediate and 2-Year Outcomes between Excimer Laser-Assisted Angioplasty with Spot Stent and Primary Stenting in Intermediate to Long Femoropopliteal Disease

    PubMed Central

    Chou, Hsin-Hua; Chang, Shang-Hung; Tsai, Yueh-Ju; Hsieh, Chien-An; Cheng, Shih-Tsung; Yeh, Kuan-Hung; Chang, Hern-Jia; Ko, Yu-Lin; Huang, Hsuan-Li

    2013-01-01

    Background. To compare the clinical outcomes between excimer laser-assisted angioplasty (ELA) with spot stent (group A) and primary stenting (group B) in intermediate to long femoropopliteal disease. Methods. Outcomes of 105 patients totaling 119 legs treated with two different strategies were analyzed retrospectively in a prospectively maintained database. Results. Baseline characteristics were similar in both groups. Better angiographic results and lesser increase of serum C-reactive protein levels (0.60 ± 0.72 versus 2.98 ± 0.97 mg/dL, P < 0.001) after the intervention were obtained in Group B. Group A had inferior 1-year outcomes due to higher rate of binary restenosis (67% versus 32%, P = 0.001) and lower rate of primary patency (40% versus 58%, P = 0.039). Rates of amputation-free survival, target vessel revascularization, assisted primary patency, and stent fracture at 24 months were similar in both groups (80% versus 82%, P = 0.979, 65% versus 45%, P = 0.11, 78% versus 80%, P = 0.75 and 6.3% versus 6.8%, P = 0.71, resp.). Conclusion. Greater vascular inflammation after ELA with spot stent resulted in earlier restenosis and inferior 1-year clinical outcomes than primary stenting. This benefit was lost in the primary stenting group at 2 years due to late catch-up restenosis. Active surveillance with prompt intervention was required to maintain the vessel patency. PMID:24381515

  12. Differences in Endothelial Injury After Balloon Angioplasty, Insertion of Balloon-Expanded Stents or Release of Self-Expanding Stents: An Electron Microscopic Experimental Study

    SciTech Connect

    Harnek, Jan; Zoucas, Evita; Carlemalm, Erik; Cwikiel, Wojciech

    1999-01-15

    Purpose: To evaluate which of six different commonly available stents inserted into an artery without percutaneous transluminal angioplasty (PTA) causes the least endothelial damage. To compare the degree of endothelial injury after insertion of such a stent with injury caused by PTA. Methods: Twelve healthy pigs were used in the experiments. In the first part of the study six different types of stents were inserted into the common iliac arteries. In the second part of the study self-expanding stents with large spaces between the wires were used. PTA was performed in the contralateral iliac artery. The pigs were killed immediately after the procedure and resected specimens examined after fixation, using scanning electron microscopy. Results: All procedures but two were accomplished successfully. More endothelium was preserved after insertion of self-expanding stents with large spaces between the wires, compared with stents with small spaces and balloon-expanded stents. After insertion of self-expanding stents with large spaces, 50.1% {+-} 16.4% of the endothelium remained intact, compared with only 5.6% {+-} 7.7% after PTA. The difference was statistically significant (p < 0.001). Conclusion: Self-expanding stents with large spaces between the wires, inserted without PTA, cause less damage to the endothelium than other stents and significantly less damage than PTA.

  13. Budd-Chiari Syndrome Caused by Obstruction of the Hepatic Inferior Vena Cava: Immediate and 2-Year Treatment Results of Transluminal Angioplasty and Metallic Stent Placement

    SciTech Connect

    Xu Ke; He Fangxian; Zhang Hanguo; Zhang Xitong; Han Minjun; Wang Changrong; Kaneko, Masao; Takahashi, Motoichiro; Okawada, Taketoshi

    1996-11-15

    Purpose: To assess the usefulness of percutaneous transluminal angioplasty (PTA) and expandable metallic stent (EMS) placement for treatment of Budd-Chiari syndrome (BCS). Methods: Thirty-two patients with BCS were treated by PTA alone or by PTA and EMS placement. Among the 32 patients, a membranous obstruction was found in 24 and a segmental stenosis or occlusion in 8 patients. The follow-up period for PTA was 38<+>-<+>68 months (mean 52.2 months); for EMS it was 20<+>-<+>36 months (mean 24.3 months). Results: Twenty-one patients underwent PTA as the primary treatment. Of these, one patient died of disseminated intravascular coagulation shortly after the procedure; 20 had good to excellent initial angiographic and clinical results. Of the 20, restenosis or reocclusion developed in 10 patients (48%), all before 27 months; 8 patients (38%) became symptomatic, and 2 remained symptom-free for a total recurrent obstruction rate of 50%. The EMS group of 17 patients included 11 patients who underwent primary stenting and 6 patients with secondary stenting after recurrence following primary PTA; restenosis was demonstrated in only 2 patients (12%). Conclusions: We conclude that PTA alone produces excellent short-term results and about 50% sustained patency after 2 years in patients with BCS; therefore it should remain the procedure of first choice. Stents should be reserved for primary or secondary PTA failures.

  14. Differential effects of Nd-YAG laser on collagen and elastin production by chick embryo aortae in vitro. Relevance to laser angioplasty for removal of atherosclerotic plaques

    SciTech Connect

    Abergel, R.P.; Zaragoza, E.J.; Dwyer, R.M.; Uitto, J.

    1985-08-30

    Aortae from 17-day old chick embryos were subjected to irradiation with a Nd:YAG laser at energy densities varying from 1.2 - 4.7 X 10(3) J/cm2. The aortae were pulse-labeled in vitro with (/sup 3/H)proline or (/sup 14/C)valine, and the synthesis of collagenous polypeptides and soluble elastin was examined by SDS-polyacrylamide gel electrophoresis, followed by fluorography and quantitative scanning densitometry. Irradiation of the aortae with Nd:YAG laser resulted in inhibition of the synthesis of the extracellular matrix proteins. The production of collagen was inhibited to a considerably larger degree than the production of elastin. Thus, the biosynthetic pathway for collagen production appears to be more susceptible to laser inhibition than the corresponding pathway for elastin production. These observations may have relevance to laser angioplasty which has been proposed to be applicable for removal of atherosclerotic plaques in human vessels. Specifically, the results suggest that inhibition of the extracellular matrix production may result in weakening of the vessel wall with subsequent aneurysm formation and rupture.

  15. Fate of side branches after intracoronary implantation of the Gianturco-Roubin flex-stent for acute or threatened closure after percutaneous transluminal coronary angioplasty.

    PubMed

    Mazur, W; Grinstead, W C; Hakim, A H; Dabaghi, S F; Abukhalil, J M; Ali, N M; Joseph, J; French, B A; Raizner, A E

    1994-12-15

    Side branch occlusion may occur in the course of percutaneous transluminal coronary angioplasty (PTCA), particularly if complicated by site dissection. Concern that the additional placement of a stent may further jeopardize side branches is logical. Consequently, this study analyzed pre-PTCA, post-PTCA, poststent, and 6-month follow-up angiograms of 100 consecutive patients in whom 103 Gianturco-Roubin stents were implanted for acute or threatened closure after PTCA. Side branches were defined as major (> 50% of the stented vessel diameter) and minor (< 50%). Minor branches, often < 1 mm in diameter, were assessed only for patency. One hundred eight major branches, of which 33 were diseased (> 50% stenosis), and 129 minor branches were analyzed. Seven major branches (6%), all of which were diseased before PTCA, and 23 minor branches (18%) were lost after PTCA. Immediately after stent insertion, only 1 additional major and 1 minor branch were lost, whereas 2 of 7 major (29%) and 9 of 23 minor (39%) branches reappeared. At follow-up angiography, 7 major branches (6%) were more stenosed and 6 (6%) were improved compared with the angiogram before PTCA. Only 2 major (2%) and 5 minor (4%) branches remained occluded. Additionally, 2 major and 1 minor branch, which were patent after PTCA and stenting, were occluded at follow-up as a result of total occlusion of the stented segment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7977091

  16. Why the United States Center for Medicare and Medicaid Services (CMS) should not extend reimbursement indications for carotid artery angioplasty/stenting

    PubMed Central

    2012-01-01

    In recent years, many important discoveries have been made to challenge current policy, guidelines, and practice regarding how best to prevent stroke associated with atherosclerotic stenosis of the origin of the internal carotid artery. The United States Center for Medicare and Medicaid Services (CMS), for instance, is calling for expert advice as to whether its current policies should be modified. Using a thorough review of literature, 41 leading academic stroke-prevention clinicians from the United States and other countries, have united to advise CMS not to extend current reimbursement indications for carotid angioplasty/stenting (CAS) to patients with asymptomatic carotid stenosis or to patients with symptomatic carotid stenosis considered to be at “low or standard risk from carotid endarterectomy (CEA).” It was concluded that such expansion of reimbursement indications would have disastrous health and economic consequences for the United States and any other country that may follow such inappropriate action. This was an international effort because the experts to best advise CMS are relatively few and scattered around the world. In addition, US health policy, practice, and research have tended to have strong influences on other countries. PMID:22574286

  17. Gestresste Haut? - Aktueller Stand molekularer psychosomatischer Zusammenhänge und ihr Beitrag zu Ursachen und Folgen dermatologischer Erkrankungen.

    PubMed

    Peters, Eva M J

    2016-03-01

    In den 70er Jahren des vergangenen Jahrhunderts wurde zum ersten Mal ein pathogenetisch relevanter Zusammenhang zwischen Stress, im Sinne von psychosozialem Stress, und Krankheit am Beispiel von viralen Erkrankungen der Schleimhäute (wie Rhinovirus-, Coxsackie-Infektion) nachgewiesen. Seither nehmen Publikationen, die diese Zusammenhänge bis auf die molekulare Ebene erforschen, jährlich zu. Dennoch sind die Evidenzen für einen Einfluss von psychosozialer Belastung auf chronisch-entzündliche Hauterkrankungen und auf Hauttumoren wenig bekannt. In diesem Beitrag fassen wir die aktuellen Erkenntnisse aus Epidemiologie, Psychoneuroimmunologie und molekularer Psychosomatik narrativ zusammen. Sie belegen die vielfältigen krankheitsrelevanten Interaktionen zwischen endokrinem System, Nervensystem und Immunsystem. Im Fokus stehen stressinduzierte Verschiebungen in der Immunbalance bei ausgewählten Erkrankungen wie Neurodermitis, Psoriasis oder malignem Melanom. Ziel dieses Beitrages ist die Vermittlung psychosomatischen Grundlagenwissens bei chronischen Dermatosen. Dies reicht von der Ätiologie über die Symptomatik bis zu den therapeutischen Optionen. Besonderes Augenmerk liegt dabei auf den zugrunde liegenden molekularen Zusammenhängen sowohl aus der somatopsychischen als auch aus der psychosomatischen Perspektive. PMID:26972186

  18. Von Ringplaneten und schwarzen Löchern. Die Top-Themen der Astronomie

    NASA Astrophysics Data System (ADS)

    Keller, Hans-Ulrich

    Die spannendsten Monatsthemen der letzten Jahre. Wie alt ist das Universum? Woher kommen die Sterne? Beeinflusst der Mond das irdische Leben? Fast jeder mag sich diese und ähnliche Fragen schon einmal gestellt haben. Kurzweilig berichtet Hans-Ulrich Keller von alten Weisheiten und neuen Erkenntnissen aus der Wissenschaft. Mit vielen farbigen Bildern und Illustrationen sind diese "astronomischen Kurzgeschichten" Lesevergnügen und Informationsquelle zugleich. In über 20 Artikeln erfahren Sie z. B. etwas über: Das feurige Schicksal unseres Sonnensystems. Das Rätsel der dunklen Materie. Die Suche nach außerirdischen Intelligenzen.

  19. Erfassung tribologischer Zusammenhänge und Erkenntnisse in einer Datenbank

    NASA Astrophysics Data System (ADS)

    Gold, Peter Werner; Jacobs, Georg; Loos, J.; Rombach, Volker; Kurutas, Savas; Fröde, Astrid

    Die Datenbank enthält die tribologischen und stofflichen Daten, die innerhalb des Sonderforschungsbereichs 442 ermittelt wurden. Sie wird genutzt, um Informationen über die Eigenschaften von Schmierstoffen und Werkstoffverbunden, sowie über Prüfstände und Versuchsergebnisse zu erhalten. Diese Wissensbasis kann dazu beitragen, ökologisch verträgliche Tribosysteme mit Hilfe der Auswerte-Systeme (Module) auszulegen. Dabei handelt es sich um Berechnungswerkzeuge und Expertenwissen z. B. in Bezug auf die Auswahl von Schichtsystemen. Eine nähere Beschreibung der Auswerte-Systeme kann den folgenden Abschnitten entnommen werden.

  20. The human HDL proteome displays high inter-individual variability and is altered dynamically in response to angioplasty-induced atheroma plaque rupture.

    PubMed

    Jorge, Inmaculada; Burillo, Elena; Mesa, Raquel; Baila-Rueda, Lucía; Moreno, Margoth; Trevisan-Herraz, Marco; Silla-Castro, Juan Carlos; Camafeita, Emilio; Ortega-Muñoz, Mariano; Bonzon-Kulichenko, Elena; Calvo, Isabel; Cenarro, Ana; Civeira, Fernando; Vázquez, Jesús

    2014-06-25

    Recent findings support potential roles for HDL in cardiovascular pathophysiology not related to lipid metabolism. We address whether HDL proteome is dynamically altered in atheroma plaque rupture. We used immunoaffinity purification of HDL samples from coronary artery disease patients before and after percutaneous transluminal coronary angioplasty (PTCA), a model of atheroma plaque disruption. Samples were analyzed by quantitative proteomics using stable isotope labeling and results were subjected to statistical analysis of protein variance using a novel algorithm. We observed high protein variability in HDL composition between individuals, indicating that HDL protein composition is highly patient-specific. However, intra-individual protein variances remained at low levels, confirming the reproducibility of the method used for HDL isolation and protein quantification. A systems biology analysis of HDL protein alterations induced by PTCA revealed an increase in two protein clusters that included several apolipoproteins, fibrinogen-like protein 1 and other intracellular proteins, and a decrease in antithrombin-III, annexin A1 and several immunoglobulins. Our results support the concept of HDL as dynamic platforms that donate and receive a variety of molecules and provide an improved methodology to use HDL proteome for the systematic analysis of differences among individuals and the search for cardiovascular biomarkers. Biological significance The HDL proteome is an interesting model of clinical relevance and has been previously described to be dynamically altered in response to pathophysiological conditions and cardiovascular diseases. Our study suggests that interindividual variability of HDL proteome is higher than previously thought and provided the detection of a set of proteins that changed their abundance in response to plaque rupture, supporting the concept of HDL as dynamic platforms that donate and receive a variety of molecules. PMID:24747125

  1. Relationships of Obesity and Fat Distribution With atherothrombotic Risk Factors: Baseline Results From the Bypass angioplasty Revascularization Investigation 2 Diabetes (BaRI 2D) Trial

    PubMed Central

    Albu, Jeanine B.; Lu, Jiang; Mooradian, Arshag D.; Krone, Ronald J.; Nesto, Richard W.; Porter, Marty H.; Rana, Jamal S.; Rogers, William J.; Sobel, Burton E.; Gottlieb, Sheldon H.

    2015-01-01

    The impact of obesity on cardiovascular disease (CVD) outcomes in patients with type 2 diabetes mellitus (T2DM) and established coronary artery disease (CAD) is controversial; whether BMI and/or waist circumference correlate with atherothrombotic risk factors in such patients is uncertain. We sought to evaluate whether higher BMI or waist circumference are associated with specific risk factors among 2,273 Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) study participants with T2DM and documented CAD (baseline data, mean age 62 years, 66% non-Hispanic white, 71% men). Multiple linear regression models were constructed after adjusting for sex, age, race/ ethnicity, US vs. non-US site, diabetes duration, exercise, smoking, alcohol, and relevant medication use. First-order partial correlations of BMI with risk factors after controlling for waist circumference and of waist circumference with risk factors after controlling for BMI were also evaluated. Ninety percent of the patients were overweight (BMI ≥25 kg/m2); 68% of men and 89% of women had high-risk waist circumference measures (≥102 and ≥88 cm, respectively). BMI and waist circumference, in separate models, explained significant variation in metabolic (insulin, lipids, blood pressure (BP)) and inflammatory/procoagulation (C-reactive protein, PAI-1 activity and antigen, and fibrinogen) risk factors. In partial correlation analyses BMI was independently associated with BP and inflammatory/procoagulation factors, waist circumference with lipids, and both BMI and waist circumference with insulin. We conclude that, in cross-sectional analyses, both BMI and waist circumference, independently, are associated with increased atherothrombotic risk in centrally obese cohorts such as the BARI 2D patients with T2DM and CAD. PMID:19875998

  2. Mortality in primary angioplasty patients starting antiplatelet therapy with prehospital prasugrel or clopidogrel: a 1-year follow-up from the European MULTIPRAC Registry

    PubMed Central

    Goldstein, Patrick; Grieco, Niccolò; Ince, Hüseyin; Danchin, Nicolas; Ramos, Yvonne; Goedicke, Jochen; Clemmensen, Peter

    2016-01-01

    Aim MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. Methods and results MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place. The key outcome was CV death at 1 year. Among 2,036 patients followed-up through 1 year, 49 died (2.4%), 10 during the initial hospitalization and 39 within 1 year after hospital discharge. The primary analysis was based on the P2Y12-inhibitor, used from prehospital loading dose through hospital discharge. Prasugrel (n=824) was more commonly used than clopidogrel (n=425). The observed 1-year rates for CV death were 0.5% with prasugrel and 2.6% with clopidogrel. After adjustment for differences in baseline characteristics, treatment with prasugrel was associated with a significantly lower risk of CV death than treatment with clopidogrel (odds ratio 0.248; 95% confidence interval 0.06–0.89). Conclusion In STEMI patients from routine practice undergoing primary angioplasty, who were able to start oral antiplatelet therapy prehospital, treatment with prasugrel as compared to clopidogrel was associated with a lower risk of CV death at 1-year follow-up. PMID:27143908

  3. Identification of the occluded artery in patients with myocardial ischemia induced by prolonged percutaneous transluminal coronary angioplasty using traditional vs transformed ECG-based indexes.

    PubMed

    García, J; Wagner, G; Sömmo, L; Lander, P; Laguna, P

    1999-10-01

    We have studied the spatial properties of ischemic changes as induced by prolonged angioplasty and how the changes are related to different ECG indexes. Indexes based on measurements at specific points in time (ST level at J + 60 ms point, maximal T wave amplitude and position, QT interval, and QRS duration) and global indexes (based on the Karhunen-Loève transform and applied to the QRS complex, ST-T complex, ST segment, and T wave), considering both repolarization and depolarization information, were analyzed. The changes during the occlusion period of the different indexes were used as variables in a multivariate discriminant analysis to determine which indexes showed the best discrimination of the three major occlusion sites (corresponding to LAD, RCA, and LCX coronary arteries). Occlusions in LCX artery were the most difficult to classify. With three local indexes (ST60 level measured in lead V3, T wave amplitude in I, and ST60 in III) it was possible to correctly classify 76% of patients by the occlusion site, and with three KLT-derived indexes (first-order KLT index for ST-T complex in I and for QRS in leads V3 and I) 83% of correct classification was obtained. Using six indexes for local and KLT-derived indexes the correct classification was increased to 85 and 90% of patients, respectively. The use of different ECG indexes (from different intervals) on quasiorthogonal leads permitted the identification of the occluded artery in patients undergoing PTCA and may be extended to more general use. PMID:10529303

  4. Comparison of transradial and transfemoral artery approach for percutaneous coronary angiography and angioplasty: A retrospective seven-year experience from a north Indian center

    PubMed Central

    Tewari, Satyendra; Sharma, Naveen; Kapoor, Aditya; Syal, Sanjeev Kumar; Kumar, Sudeep; Garg, Naveen; Goel, Pravin K.

    2013-01-01

    Background With the increasing prevalence of coronary artery disease, percutaneous coronary artery procedures have become even more important. Our study has compared transradial to transfemoral artery approach for coronary procedures in Indian population. Aims and objective Comparison of transradial and transfemoral artery approach for percutaneous coronary procedures. Material & methods 26,238 patients, who underwent percutaneous coronary artery procedures, were divided into two groups depending upon transradial and transfemoral artery approach and compared for the various demographic and clinical characteristics, risk factors profile, vascular access and procedural details. Results 26,238 patients underwent percutaneous coronary procedures at our center. 81% were male and 19% were female. 55.65% and 44.35% procedures were done through transfemoral and transradial approach, respectively. 17,417 (66.38%) coronary angiographies were done, out of which 53.92% were transradial and 46.08% were transfemoral procedures. 8821 (33.62%) Percutaneous Transluminal Coronary Angioplasty (PTCA) were done, out of which 25.46% and 74.54% were done through transradial and transfemoral approach, respectively. Mean fluoroscopy time was 4.40 ± 3.55 min for transradial and 3.30 ± 3.66 min for transfemoral CAG (p < 0.001). For PTCA mean fluoroscopy time was 13.53 ± 2.53 min for transradial and 12.61 ± 9.524 min for transfemoral PTCA (p < 0.001). Minor and major procedure related complications and total duration of hospital stay were lower in transradial as compared to transfemoral group. Conclusion The number of percutaneous transradial procedures have increased significantly with reduced complication rates and comparable success rate to transfemoral approach, along with the additional benefits to patient in terms of patient comfort, preference and reduced cost of health delivery. PMID:23992998

  5. The Effect of Short-term Intra-arterial Delivery of Paclitaxel on Neointimal Hyperplasia and the Local Thrombotic Environment after Angioplasty

    SciTech Connect

    Yajun, E; He Nengshu Fan Hailun

    2013-08-01

    PurposeTo evaluate the effects of short-term intra-arterial delivery of paclitaxel on neointimal hyperplasia and the local thrombotic environment after angioplasty.MethodsAn experimental common carotid artery injury model was established in 60 rats, which were divided into experimental groups (40 rats) and controls (20 rats). Local intra-arterial administration of paclitaxel was applied at 2 doses (90 and 180 {mu}g/30 {mu}l), and the effects of short-term delivery of paclitaxel on neointimal hyperplasia and the expression of tissue factor (TF), plasminogen activator inhibitor-1 (PAI-1) and tissue-type plasminogen activator (t-PA) were evaluated at days 15 and 30 by hematoxylin and eosin staining and immunohistochemistry.ResultsAt 15 and 30 days after injury, neointimal thickness and area, the ratio of intimal area to medial area and the stenotic rate were all significantly decreased in the group provided the high concentrations (180 {mu}g/30 {mu}l) of paclitaxel for 2 min or 10 min and in the group provided the low concentration (90 {mu}g/30 {mu}l) of paclitaxel for 10 min (p < 0.05). At 30 days after injury, there were no significant changes in TF expression among all experimental groups. PAI-1 expression increased in the neointima of the high concentration 10 min group (p < 0.05), while t-PA expression decreased in the neointima of the high concentration 2 min group (p < 0.05).ConclusionIn the rat common carotid artery injury model, the short-term delivery of paclitaxel could effectively inhibit neointimal hyperplasia in the long term, with very little influence on the local expression of TF and PAI-1.

  6. An anti-CD11/CD18 monoclonal antibody in patients with acute myocardial infarction having percutaneous transluminal coronary angioplasty (the FESTIVAL study).

    PubMed

    Rusnak, J M; Kopecky, S L; Clements, I P; Gibbons, R J; Holland, A E; Peterman, H S; Martin, J S; Saoud, J B; Feldman, R L; Breisblatt, W M; Simons, M; Gessler, C J; Yu, A S

    2001-09-01

    Maximal benefits of coronary reperfusion after acute myocardial infarction (AMI) with ST-segment elevation may be attenuated by neutrophil-mediated reperfusion injury. Inflammatory mediators released from potentially viable myocytes cause activation of neutrophils, which traverse the endothelium and enter the myocardium. This process involves interaction between the neutrophil-expressed CD11/CD18 and endothelial-expressed intercellular adhesion molecule-1 (ICAM-1). Preclinical studies have shown that monoclonal antibodies (MAb) to CD18 can limit infarct size and preserve left ventricular function. We sought to determine the initial clinical safety and tolerability of Hu23F2G (LeukArrest), a humanized MAb to CD11/CD18, in patients with AMI who underwent percutaneous transluminal coronary angioplasty (PTCA). Sixty patients with AMI were randomized to low- (0.3 mg/kg) or high-dose (1.0 mg/kg) Hu23F2G or to placebo immediately before PTCA. We found no clinically significant differences in vital signs, physical examination, laboratory evaluation, or need for subsequent cardiac interventions. In Hu23F2G treatment groups, serum concentration of Hu23F2G increased rapidly to 3,234 +/- 1,298 microg/L (low-dose group) and 15,558 +/- 4409 microg/L (high-dose group) between 5 and 60 minutes, then declined over 72 hours to near-baseline values. Myocardial single-photon emission computed tomographic imaging 120 to 260 hours after PTCA showed no statistically significant differences in final left ventricular defect size. Hu23F2G was well tolerated, with no increase in adverse events, including infections. Thus, Hu23F2G appears safe and well tolerated in patients undergoing PTCA for AMI. PMID:11524054

  7. Superiority of Transcutaneous Oxygen Tension Measurements in Predicting Limb Salvage After Below-the-Knee Angioplasty: A Prospective Trial in Diabetic Patients With Critical Limb Ischemia

    SciTech Connect

    Redlich, Ulf; Xiong, Yan Y.; Pech, Maciej; Tautenhahn, Joerg; Halloul, Zuhir; Lobmann, Ralf; Adolf, Daniela; Ricke, Jens; Dudeck, Oliver

    2011-04-15

    Purpose: To assess postprocedural angiograms, the ankle-brachial index (ABI), and transcutaneous oxygen tension (TcPO{sub 2}) to predict outcome after infrageniculate angioplasty (PTA) in diabetic patients with critical limb ischemia (CLI) scheduled for amputation. Materials and Methods: PTA was performed in 28 diabetic patients with CLI confined to infrapopliteal vessels. We recorded patency of crural vessels, including the vascular supply of the foot as well as the ABI and TcPO{sub 2} of the foot. Results: Technical success rate was 92.9% (n = 26), and limb-salvage rate at 12 months was 60.7% (n = 17). The number of patent straight vessels above and below the level of the malleoli increased significantly in patients avoiding amputation. Amputation was unnecessary in 88.2% (n = 15) patients when patency of at least one tibial artery was achieved. In 72.7% (n = 8) of patients, patency of the peroneal artery alone was not sufficient for limb salvage. ABI was of no predictive value for limb salvage. TcPO{sub 2} values increased significantly only in patients not requiring amputation (P = 0.015). In patients with only one tibial artery supplying the foot or only a patent peroneal artery in postprocedural angiograms, TcPO{sub 2} was capable of reliably predicting the outcome. Conclusion: Below-the-knee PTA as an isolated part of therapy was effective to prevent major amputation in more than a half of diabetic patients with CLI. TcPO{sub 2} was a valid predictor for limb salvage, even when angiographic outcome criteria failed.

  8. New approach to quantitation of exercise thallium-201 scintigraphy before and after an intervention: application to define the impact of coronary angioplasty on regional myocardial perfusion

    SciTech Connect

    Lim, Y.L.; Okada, R.D.; Chesler, D.A.; Block, P.C.; Boucher, C.A.; Pohost, G.M.

    1984-10-01

    We have developed a new computer method designed to quantitate regional myocardial thallium-201 (TI-201) initial distribution, redistribution, and clearance rate. In addition, this computer method permits the generation of functional images to compare two thallium images in the same projection to one another. These functional images can be used to demonstrate the extent of redistribution and the extent of change in regional perfusion before and after an intervention. To validate and apply this new computer technique, exercise TI-201 myocardial images obtained before and 1 week after percutaneous transluminal coronary angioplasty (PTCA) were analyzed in 20 patients with isolated left anterior descending coronary artery disease. Significant improvement in initial TI-201 activity, expressed as a percentage of maximal myocardial activity, was present in the anterior (71.9 +/- 12.0 to 84.1 +/- 11.5%, p less than 0.001) and septal (66.7 +/- 15.4 to 75.2 +/- 11.0%, p less than 0.05) regions of the left ventricle 1 week after PTCA. This increase in relative anterior wall TI-201 uptake was associated with a significant reduction in the amount of TI-201 redistribution between initial and delayed postexercise images (14.7 +/- 14.6 to 3.0 +/- 13.2%, p less than 0.05) as well as an increase in TI-201 clearance rate (t 1/2 from 8.8 +/- 4.4 to 4.3 +/- 2.5 hours, p less than 0.001). Quantitative analysis of TI-201 scans demonstrated improvement in 14 of 20 patients following PTCA. Computer-derived functional difference images depicted diminution in the extent of ischemia as manifested by redistribution of TI-201.

  9. Comparison of the patient radiation exposure during coronary angiography and angioplasty procedures using trans-radial and trans-femoral access

    PubMed Central

    Tarighatnia, Ali; Mohammad Alian, Amir Hossein; Ghojazadeh, Morteza; Farajollahi, Alir Reza

    2016-01-01

    Introduction: Cardiac catheterization procedure through the trans-radial access (TRA) have shown many clinical advantages over the trans-femoral (TFA), but despite its advantages, there are serious concerns regarding higher possible radiation dose for the patients and operators in TRA. This study was planned to compare the patients’ radiation dose associated with TRA and TFA during coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA). Methods: Of 700 candidates for angiography, 326 patients were entered the study. All the procedures were carried out by one interventional cardiologist employing the same angiography unit in Aalinasab hospital and the patients’ dose area product (DAP), air kerma (AK), fluoroscopy time (FT) and cine film time (CFT) were then determined in both access groups (TRA,TFA) in CA, PTCA and CA+PTCA procedures. Results: The mean FT, CFT and AK values in both TRA & TFA groups were the same in all procedures (P>0.05). The mean DAP in CA+PTCA procedures was 6704.01±3243.23 µGym2 in femoral access compare with 5647.46±2797.74 µGym2 in radial access, which were significantly less than that in TFA with P= 0.02. Conclusion: On the basis of the results obtained in this study, no differences were found in patients’ radiation dose in both access groups, therefore with regard to comparatively more clinical advantages associated with the Trans-radial access technique it might be a good substitute for Trans-femoral access. PMID:27489601

  10. Demographic and Technical Risk Factors of 30-Day Stroke, Myocardial Infarction, and/or Death in Standard- and High-Risk Patients Who Underwent Carotid Angioplasty and Stenting

    PubMed Central

    Borhani Haghighi, Afshin; Yousefi, Samaneh; Bahramali, Ehsan; Kokabi, Safoora; Heydari, Seyed Taghi; Shariat, Abdolhamid; Nikseresht, Alireza; Ashjazadeh, Nahid; Izadi, Sadegh; Petramfar, Peyman; Poursadegh, Maryam; Rahimi Jaberi, Abbas; Emami, Sajjad; Agheli, Hamid; Nemati, Reza; Yaghoubi, Ehsan; Abdi, Mohammad Hosein; Panahandeh, Majid; Heydari, Moslem; Safari, Anahid; Basir, Marziyeh; Cruz-Flores, Salvador; Edgell, Randal

    2015-01-01

    Background Carotid angioplasty and stenting (CAS) is an accepted treatment to prevent stroke in patients with carotid artery stenosis. The purpose of this study is to identify risk factors for major complications after CAS. Materials and Methods This is a prospective study that was conducted at Shiraz University of Medical Sciences in southern Iran from March 2011 to June 2014. Consecutive patients undergoing CAS were enrolled. Both standard- and high-risk patients for endarterectomy were enrolled. Demographic data, atherosclerotic risk factors, site of stenosis, degree of stenosis, and data regarding technical factors were recorded. Thirty-day stroke, myocardial infarction, and/or death were considered as the composite primary outcomes of the study. Results A total of 251 patients were recruited (mean age: 71.1 ± 9.6 years; male: 65.3%). Of these, 178 (70.9%) were symptomatic, 73 (29.1%) were diabetic, 129 (51.4%) were hyperlipidemic, 165 (65.7%) were hypertensive, and 62 (24.7%) patients were smokers. CAS was performed for left internal carotid artery (ICA) in 113 (45.4%) patients. Fourteen (5.6%) patients had sequential bilateral stenting. Mean stenosis of operated ICA was 80.2 ± 13.8%. An embolic protection device was used in 203 (96.2%) patients. Pre- and postdilation were performed in 39 (18.5%) and 182 (86.3%) patients, respectively. Composite outcomes were observed in 3.6% of patients (3.2% stroke, 0% myocardial infarction, and 1.2% death). Left-sided lesions and the presence of diabetes mellitus were significantly associated with poor short-term outcome (p = 0.025 and p = 0.020, respectively). Conclusion There was a higher risk of short-term major complications in diabetic patients and for left carotid artery intervention. PMID:26279663

  11. GLATT Wirbelschichttechnologie zum Coating von Pulvern, Pellets und Mikropellets

    NASA Astrophysics Data System (ADS)

    Grave, Annette; Pöllinger, Norbert

    Wirbelschichtverfahren wurden ursprünglich in der chemischen Verfahrenstechnik angewandt. Ende der 1950er Jahre fand die Wirbelschichttrocknung Eingang in die pharmazeutische Industrie, da eine verbesserte Trocknungseffizienz im Vergleich zu bestehenden Verfahren erzielt werden konnte. Viele Granulationsprozesse wurden durch Feuchtgranulation in einem Zwangsmischer durchgeführt, worauf ein Trocknungsschritt in einem Hordentrockner folgte. Je nach Produktqualität kann eine Hordentrocknung allerdings mehrere Tage dauern. Derart lange Trocknungszeiten können bei Anwendung der Wirbelschichttrocknung häufig auf weniger als eine Stunde verkürzt werden. Die Wirbelschichttrocknung ist eine besonders effektive und schonende Art der Trocknung, da die gesamte Oberfläche der einzelnen Partikel für den Wärme- und Feuchteübergang zur Verfügung steht.

  12. Grundlagen und Vollzug der amtlichen Lebensmittelkontrolle in Deutschland

    NASA Astrophysics Data System (ADS)

    Neuhaus, Annette

    Für Menschen besteht ein täglicher Bedarf an Lebensmitteln, die gesundheitlich unbedenklich, allgemein zum Verzehr geeignet und unverfälscht sein sollen. Lebensmittel sind vergängliche Naturprodukte und bergen in sich Gefahren, die mit dem natürlichen Verderbnisvorgang verbunden sind. Zusätzlich bestehen Risiken durch eine unsachgemäße Herstellung, Behandlung oder Verarbeitung, zum Beispiel durch ungeeignete Zutaten oder technologische Verfahren, falsche Lagertemperaturen oder Verwendung ungeeigneter Behältnisse. So lange wie Lebensmittel zum Zweck der Gewinnerzielung an andere abgegeben werden, besteht darüber hinaus die Versuchung, Kunden durch Verfälschung oder andere Manipulation zu übervorteilen.

  13. Suchmaschinen und Informationsqualität: Status quo, Problemfelder, Entwicklungstendenzen

    NASA Astrophysics Data System (ADS)

    Maaß, Christian; Gräfe, Gernot

    Das Thema Informationsqualität wird in den vorangegangenen Beiträgen umfangreich betrachtet. Die dabei geführte Diskussion zielt vordergründig auf organisatorische Dimensionen der Datenqualität, die strukturierte Datenanalyse oder Datenmanagementprozesse im Unternehmen ab. Dabei liegt ein Gro?teil der zur Unterstützung von Entscheidungsprozessen herangezogenen Informationen in Datenbanksystemen bzw. in einem Data Warehouse vor. Auf Basis verschiedener Analysetools (z. B. Online-Analytical-Processing) lassen sich diese Informationen dann systematisch auswerten. Allerdings können Entscheidungen nicht allein aufgrund der unternehmensintern vorliegenden Informationen getroffen werden. Vielmehr gilt es auch die aus der Unternehmensumwelt relevanten Informationen zu verarbeiten, die zum Teil über das Internet zugänglich sind. Im Gegensatz zu unternehmensinternen Datenbanksystemen handelt es sich beim Internet um ein schwach strukturiertes und offenes Netzwerk, weshalb die im Unternehmenskontext eingesetzten Analysetools kaum weiterhelfen, um Informationen mit hoher Qualität herauszufiltern. In dieser Situation spielen Suchmaschinen eine wichtige Rolle, um Informationen zu identifizieren und anhand verschiedener Kriterien in Form einer Suchergebnisseite zu sortieren. Konservative Schätzungen gehen davon aus, dass über Suchmaschinen zwischen 70 und 85 Prozent aller Informationsrecherchen im Internet erfolgen [Förster & Kreuz 2002, S. 68]. Teilweise beziffert man diesen Wert sogar auf über 90 Prozent [Schulz et al. 2005, S. 20]. Ungeachtet dieser herausragenden Stellung von Suchmaschinen kann konstatiert werden, dass die Qualität der Suchergebnisse oftmals nur gering ist.

  14. Homo sapiens und das 21. Jahrhundert - evolutionsbiologische Betrachtungen

    NASA Astrophysics Data System (ADS)

    Oehler, Jochen

    Was meinen wir, wenn wir vom 21. Jahrhundert sprechen? Es ist ein Zeitraum, der sich durch die Festlegung des Menschen ergibt, die nach Christi Geburt verstrichene Zeit in Jahren zu zählen. Eine kulturelle Leistung, die primär auf der Fähigkeit beruht, das Phänomen Zeit a priori wahrnehmen zu können. Die Antizipation der Zeit ist in der Welt der Organismen ein weit verbreitetes Prinzip. Entsprechend existieren auf zellulären bis zu zentralnervösen Ebenen verschiedenste Mechanismen, die dies ermöglichen. So basiert die Zeitwahrnehmung des Menschen auf zentralnervösen Strukturen und Prozessen phylogenetisch älterer Hirnstrukturen, die ihrerseits die Körperfunktionen von der zellulären bis zur Verhaltensebene steuern und regeln und sie damit an exogene Zeitregime, wie z. B. den Tag-Nacht-Rhythmus (circadianer Rhythmus), anpassen. Die Chronobiologie weist nach, welch große adaptive Bedeutung zeitantizipierende Mechanismen für die Organismen haben, das heißt Fitness fördernd sind (Piechulla 1999; Spork 2004). Die für verschiedene Kulturen des Menschen maßgebliche Zeitrechnung basiert auf der quantitativen Erfassung kosmisch oder irdisch regelmäßig wiederkehrender Ereignisse.

  15. Biegen und Brechen im Supercomputer: Duktile Verformungen und spröde Brüche von Kristallen

    NASA Astrophysics Data System (ADS)

    Buehler, Markus J.; Gao, Huajian

    2004-01-01

    Ob sich ein Material unter Krafteinwirkung duktil verformt oder spröde bricht, hängt davon ab, wie sich in ihm Defekte ausbreiten. Um das zu untersuchen, zerstören wir in Supercomputer-Simulationen Nanokristalle, die bis zu einer Milliarde virtueller Atome enthalten. Die Simulationen zeigen zum Beispiel, wie sich Risse an der Grenzfläche zwischen einem härteren und einem weicheren Material ausbreiten. Sie erlauben auch nie zuvor gesehene Einblicke in die mikroskopischen Prozesse während der duktilen Verformung eines Metalls: Das kollektive Verhalten von vielen tausend Versetzungen führt zu einer Kaltverfestigung des Kristalls. Er wird spröde und bricht.

  16. [COPD und Klangtherapie: Pilotstudie zur Wirksamkeit einer Behandlung mit Körpertambura bei COPD-Patienten].

    PubMed

    Hartwig, Bernhard; Schmidt, Stefan; Hartwig, Isabella

    2016-01-01

    Hintergrund: Erkrankungen der Atemorgane treten mit steigendem Alter öfter auf, nehmen weltweit zu und sind häufige Ursachen für Morbidität und Mortalität. In dieser Pilotstudie wurde der Frage nachgegangen, ob eine einmalige 10-minütige Behandlung mit einer Körpertambura eine signifikante und effektive Verbesserung der Lungenfunktion von Patienten mit chronisch-obstruktiver Lungenerkrankung (COPD; GOLD-Stadium A oder B) erbringen kann. Patienten und Methoden: 54 Probanden konnten je zur Hälfte in eine Behandlungsgruppe (Körpertambura) und eine aktive Kontrollgruppe (Atemtherapie) randomisiert werden. Eine Bestimmung der Lungenfunktionsmessparameter «Einsekundenkapazität» (FEV1) und «inspiratorische Vitalkapazität» (IVC) zu den Zeitpunkten T1 (Baseline), T2 (direkt nach Behandlung) und als Follow-up etwa 3 Wochen nach T1 (T3). Ergebnisse: Die Behandlungsgruppe zeigte sich der Kontrollgruppe in beiden Werten signifikant überlegen. Die Zeit-×-Gruppe-Interaktion (Varianzanalyse) ergab p = 0,001 (FEV1) bzw. p = 0,04 (IVC). Die Behandlungsgruppe zeigte bei beiden Werten eine Verbesserung von klinischer Relevanz. Schlussfolgerung: Diese Ergebnisse zeigen, dass die Klangbehandlung mittels einer Körpertambura - neben den schulmedizinischen, leitliniengerechten Therapien - eine zusätzliche, nebenwirkungsarme, aber durchaus klinisch wirksame Option für die Behandlung von COPD-Patienten darstellen kann, um deren Lebensqualität zu stabilisieren und zu verbessern. PMID:27606616

  17. Gebändigtes Knallgas: Brennstoffzellen im mobilen und stationären Einsatz

    NASA Astrophysics Data System (ADS)

    Waidhas, Manfred; Landes, Harald

    2001-07-01

    Die Brennstoffzelle hat aus technischer Sicht einen hohen Stand erreicht. Die PEMFC konnte ihre Zuverlässigkeit in einer Reihe von Nischenanwendungen, aber auch in Form erster mobiler und dezentraler Prototypen beweisen. Die SOFC und die MCFC konnten bereits in Anlagen von 100 kW und mehr in Erprobung gehen. Um jedoch wirtschaftlich konkur-renzfähig zu den etablierten Technologien der mobilen und dezentralen Energiewandlung zu werden, muss noch eine drastische Kostenreduktion sowohl beim Brennstoffzellen-Stack als auch bei den zu seinem Betrieb notwendigen Hilfsaggregaten erreicht werden. Für Fahrzeugantriebe muss außerdem eine Antwort auf die noch offene Treibstofffrage (Infrastruktur, H2-Erzeugung und H2-Speicherung) gefunden werden.

  18. Umsetzung von CE-Prozessen durch neue Methoden und interaktive 3-D-Modelle

    NASA Astrophysics Data System (ADS)

    Lange, Andrea; Schulz, Torsten; Szymanski, Hans

    Innerhalb der EU gelten einheitliche Anforderungen an die Gestaltung von Maschinen, die in Form von grundlegenden Sicherheits- und Gesundheitsschutzanforderungen in der Maschinenrichtlinie (MaschRL) formuliert sind. Ihre Einhaltung dokumentiert der Hersteller mit der Konformitätserklärung und der Vergabe des CE-Zeichens. Die Maschinenrichtlinie ist ein Element des 1985 von der Europäischen Gemeinschaft (EG) beschriebenen "New Approach“ Rechtsetzungsmodells, das technologische Innovation ermöglicht und die Wettbewerbsfähigkeit der europäischen Industrie regelt. Es wurde erschaffen, um technische Handelshemmnisse im europäischen Binnenmarkt zu beseitigen und ein einheitliches Niveau hinsichtlich der Sicherheit der Produkte und dem Gesundheits- bzw. Verbraucherschutz zu gewährleisten. Alle Produkt-Richtlinien der EG, die später auf Grundlage des New Approach entstanden sind, weisen eine einheitliche Vorgehensweise auf, mit der diese Ziele erreicht werden sollen (VDI Verlag 11/2008).

  19. IN.PACT Amphirion paclitaxel eluting balloon versus standard percutaneous transluminal angioplasty for infrapopliteal revascularization of critical limb ischemia: rationale and protocol for an ongoing randomized controlled trial

    PubMed Central

    2014-01-01

    Background The effectiveness and durability of endovascular revascularization therapies for chronic critical limb ischemia (CLI) are challenged by the extensive burden of infrapopliteal arterial disease and lesion-related characteristics (e.g., severe calcification, chronic total occlusions), which frequently result in poor clinical outcomes. While infrapopliteal vessel patency directly affects pain relief and wound healing, sustained patency and extravascular care both contribute to the ultimate “patient-centric” outcomes of functional limb preservation, mobility and quality of life (QoL). Methods/Design IN.PACT DEEP is a 2:1 randomized controlled trial designed to assess the efficacy and safety of infrapopliteal arterial revascularization between the IN.PACT Amphirion™ paclitaxel drug-eluting balloon (IA-DEB) and standard balloon angioplasty (PTA) in patients with Rutherford Class 4-5-6 CLI. Discussion This multicenter trial has enrolled 358 patients at 13 European centers with independent angiographic core lab adjudication of the primary efficacy endpoint of target lesion late luminal loss (LLL) and clinically driven target lesion revascularization (TLR) in major amputation-free surviving patients through 12-months. An independent wound core lab will evaluate all ischemic wounds to assess the extent of healing and time to healing at 1, 6, and 12 months. A QoL questionnaire including a pain scale will assess changes from baseline scores through 12 months. A Clinical Events Committee and Data Safety Monitoring Board will adjudicate the composite primary safety endpoints of all-cause death, major amputation, and clinically driven TLR at 6 months and other trial endpoints and supervise patient safety throughout the study. All patients will be followed for 5 years. A literature review is presented of the current status of endovascular treatment of CLI with drug-eluting balloon and standard PTA. The rationale and design of the IN.PACT DEEP Trial are

  20. Comparative analysis of the biaxial mechanical behavior of carotid wall tissue and biological and synthetic materials used for carotid patch angioplasty.

    PubMed

    Kamenskiy, Alexey V; Pipinos, Iraklis I; MacTaggart, Jason N; Kazmi, Syed A Jaffar; Dzenis, Yuris A

    2011-11-01

    Patch angioplasty is the most common technique used for the performance of carotid endarterectomy. A large number of patching materials are available for use while new materials are being continuously developed. Surprisingly little is known about the mechanical properties of these materials and how these properties compare with those of the carotid artery wall. Mismatch of the mechanical properties can produce mechanical and hemodynamic effects that may compromise the long-term patency of the endarterectomized arterial segment. The aim of this paper was to systematically evaluate and compare the biaxial mechanical behavior of the most commonly used patching materials. We compared PTFE (n  =  1), Dacron (n  =  2), bovine pericardium (n  =  10), autogenous greater saphenous vein (n  =  10), and autogenous external jugular vein (n  =  9) with the wall of the common carotid artery (n  =  18). All patching materials were found to be significantly stiffer than the carotid wall in both the longitudinal and circumferential directions. Synthetic patches demonstrated the most mismatch in stiffness values and vein patches the least mismatch in stiffness values compared to those of the native carotid artery. All biological materials, including the carotid artery, demonstrated substantial nonlinearity, anisotropy, and variability; however, the behavior of biological and biologically-derived patches was both qualitatively and quantitatively different from the behavior of the carotid wall. The majority of carotid arteries tested were stiffer in the circumferential direction, while the opposite anisotropy was observed for all types of vein patches and bovine pericardium. The rates of increase in the nonlinear stiffness over the physiological stress range were also different for the carotid and patching materials. Several carotid wall samples exhibited reverse anisotropy compared to the average behavior of the carotid tissue. A similar characteristic was

  1. A New Era of Therapeutic Strategies for Chronic Thromboembolic Pulmonary Hypertension by Two Different Interventional Therapies; Pulmonary Endarterectomy and Percutaneous Transluminal Pulmonary Angioplasty

    PubMed Central

    Ando, Motomi; Fukuda, Keiichi; Yoshino, Hideaki; Satoh, Toru

    2014-01-01

    Background Pulmonary endarterectomy (PEA) is established for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Recently, percutaneous transluminal pulmonary angioplasty (PTPA) has been added for peripheral-type CTEPH, whose lesions exist in segmental, subsegmental, and more distal pulmonary arteries. A shift in clinical practice of interventional therapies occurred in 2009 (first mainly PEA, later PTPA). We examined the latest clinical outcomes of patients with CTEPH. Methods and Results This study retrospectively included 136 patients with CTEPH. Twenty-nine were treated only with drug (Drug-group), and the other 107 underwent interventional therapies (Interventions-group) (39 underwent PEA [PEA-group] and 68 underwent PTPA [PTPA-group]). Total 213 PTPA sessions (failures, 0%; mortality rate, 1.47%) was performed in the PTPA-group (complications: reperfusion pulmonary edema, 7.0%; hemosputum or hemoptysis, 5.6%; vessel dissection, 2.3%; wiring perforation, 0.9%). Although baseline hemodynamic parameters were significantly more severe in the Interventions-group, the outcome after the diagnosis was much better in the Interventions-group than in the Drug-group (98% vs. 64% 5-year survival, p<0.0001). Hemodynamic improvement in the PEA-group was a 46% decrease in mean pulmonary arterial pressure (PAP) and a 49% decrease in total pulmonary resistance (TPR) (follow-up period; 74.7±32.3 months), while those in the PTPA-group were a 40% decrease in mean PAP and a 49% decrease in TPR (follow-up period; 17.4±9.3 months). The 2-year survival rate in the Drug-group was 82.0%, and the 2-year survival rate, occurrence of right heart failure, and re-vascularization rate in the PEA-group were 97.4%, 2.6%, and 2.8%, and those in the PTPA-group were 98.5%, 2.9%, and 2.9%, respectively. Conclusion The patients who underwent interventional therapies had better results than those treated only with drugs. The availability of both of these operative and catheter

  2. An empirical comparison of several clustered data approaches under confounding due to cluster effects in the analysis of complications of coronary angioplasty.

    PubMed

    Berlin, J A; Kimmel, S E; Ten Have, T R; Sammel, M D

    1999-06-01

    In the analysis of binary response data from many types of large studies, the data are likely to have arisen from multiple centers, resulting in a within-center correlation for the response. Such correlation, or clustering, occurs when outcomes within centers tend to be more similar to each other than to outcomes in other centers. In studies where there is also variability among centers with respect to the exposure of interest, analysis of the exposure-outcome association may be confounded, even after accounting for within-center correlations. We apply several analytic methods to compare the risk of major complications associated with two strategies, staged and combined procedures, for performing percutaneous transluminal coronary angioplasty (PTCA), a mechanical means of relieving blockage of blood vessels due to atherosclerosis. Combined procedures are used in some centers as a cost-cutting strategy. We performed a number of population-averaged and cluster-specific (conditional) analyses, which (a) make no adjustments for center effects of any kind; (b) make adjustments for the effect of center on only the response; or (c) make adjustments for both the effect of center on the response and the relationship between center and exposure. The method used for this third approach decomposes the procedure type variable into within-center and among-center components, resulting in two odds ratio estimates. The naive analysis, ignoring clusters, gave a highly significant effect of procedure type (OR = 1.6). Population average models gave marginally to very nonsignificant estimates of the OR for treatment type ranging from 1.6 to 1.2 with adjustment only for the effect of centers on response. These results depended on the assumed correlation structure. Conditional (cluster-specific) models and other methods that decomposed the treatment type variable into among- and within-center components all found no within-center effect of procedure type (OR = 1.02, consistently) and a

  3. Wie verstehen Schülerinnen und Schüler den Begriff der Unendlichkeit?

    NASA Astrophysics Data System (ADS)

    Schimmöller, Tabea

    Wie Hilbert bereits feststellte, wirkt die Idee der Unendlichkeit, wie keine andere, schon seit Zeiten sehr anregend und fruchtbar auf den Verstand und bewegt das Gemüt der Menschen. Der Begriff der Unendlichkeit bedarf aber auch, wie kein anderer, der Aufklärung, denn mit ihm eröffnet sich ein weites Feld, welches nicht nur aus vielen verschiedenen Definitionen besteht, sondern auch aus völlig unterschiedlichen Disziplinen. Physiker suchen immer dringender nach einer "Theorie für Alles" oder einer "Weltformel", Kosmologen beschäftigen sich unter anderem mit der Ewigkeit des Universums, Theologen interessiert eher die Unendlichkeit Gottes, Philosophen diskutieren unter anderem Grenzfragen zwischen Naturwissenschaft und Philosophie und die Mathematiker versuchen den Paradoxien des Unendlichen einen Sinn zu geben. Und so wird ersichtlich, dass nichts abstrakter ist als das Unendliche: Obwohl die Unendlichkeit für die unterschiedlichsten Wissenschaften von großer Bedeutung ist, "[ist] in der Wirklichkeit das Unendliche nirgends zu finden, [egal] was für Erfahrungen und Beobachtungen und welcherlei Wissenschaft wir auch heranziehen".

  4. Was leistet ein Sportler? Kraft, Leistung und Energie im Muskel

    NASA Astrophysics Data System (ADS)

    Thaller, Sigrid; Mathelitsch, Leopold

    2006-01-01

    Der Leistungsbegriff ist im Sport weiter gefasst als in der Physik. In beiden Fällen liegt der Fokus jedoch auf einer pro Zeiteinheit erfolgten Energieumsetzung. Allerdings gibt die rein physikalische Leistung nicht immer Auskunft über den Energieumsatz der Muskeln. Die Muskelkraft hängt von der Kontraktionsgeschwindigkeit des Muskels ab. Ein Muskel verhält sich also anders als eine Feder. Für den Hochleistungssport müssen die Energieumsätze der Muskeln durch spezielle Trainings- und Nahrungsprogramme optimiert werden.

  5. Kernschmelze Der nachhaltige Einfluss von Nuklearwaffen auf Politik und Wirtschaft

    NASA Astrophysics Data System (ADS)

    Greiner, Bernd

    "Was sollen wir von einer Kultur halten, der die Ethik stets als wesentliches Element des menschlichen Lebens galt, die aber - außer in fachlicher oder spieltheoretischer Terminologie - nicht in der Lage war, über die Möglichkeit zu sprechen, nahezu alle Menschen zu töten?" Der Fragesteller gehört zu den berühmtesten Physikern des 20. Jahrhunderts und zu den nach wie vor Umstrittensten. über ihn wurde in den 1960er Jahren ein international viel beachtetes Theaterstück geschrieben, vor wenigen Jahren gar eine Oper.

  6. Zu einer inhaltsorientierten Theorie des Lernens und Lehrens der biologischen Evolution

    NASA Astrophysics Data System (ADS)

    Wallin, Anita

    Der Zweck dieser Studie (zwecks Überblick siehe dazu Abb. 9.1) war zu untersuchen, wie die Schüler der Sekundarstufe II ein Verständnis von der Theorie der biologischen Evolution entwickeln. Vom Ausgangspunkt "Vorurteile der Schüler“ ausgehend wurden Unterrichtssequenzen entwickelt und drei verschiedene Lernexperimente in einem zyklischen Prozess durchgeführt. Das Wissen der Schüler wurde vor, während und nach den Unterrichtssequenzen mit Hilfe von schriftlichen Tests, Interviews und Diskussionsrunden in kleinen Gruppen abgefragt. Etwa 80 % der Schüler hatten vor dem Unterricht alternative Vorstellungen von Evolution, und in dem Nachfolgetest erreichten circa 75 % ein wissenschaftliches Niveau. Die Argumentation der Schüler in den verschiedenen Tests wurde sorgfältig unter Rücksichtnahme auf Vorurteile, der konzeptionellen Struktur der Theorie der Evolution und den Zielen des Unterrichts analysiert. Daraus konnten Einsichten in solche Anforderungen an Lehren und Lernen gewonnen werden, die Herausforderungen an Schüler und Lehrer darstellen, wenn sie anfangen, evolutionäre Biologie zu lernen oder zu lehren. Ein wichtiges Ergebnis war, dass das Verständnis existierender Variation in einer Population der Schlüssel zum Verständnis von natürlicher Selektion ist. Die Ergebnisse sind in einer inhaltsorientierten Theorie zusammengefasst, welche aus drei verschiedenen Aspekten besteht: 1) den inhaltsspezifischen Aspekten, die einzigartig für jedes wissenschaftliche Feld sind; 2) den Aspekten, die die Natur der Wissenschaft betreffen; und 3) den allgemeinen Aspekten. Diese Theorie kann in neuen Experimenten getestet und weiter entwickelt werden.

  7. Charakterisierung von Sulfotransferasen im Gastrointestinaltrakt von Mensch und Ratte und Aktivierung von Promutagenen in V79-Zellen, die eine intestinale Form (1B1) des Menschen und der Ratte exprimieren

    NASA Astrophysics Data System (ADS)

    Teubner, Wera

    2001-05-01

    Die Ausstattung der gastrointestinalen Mukosa des Menschen und der Ratte mit Sulfotransferasen wurde mit Hilfe von Immunodetektion und Enzymaktivitätsmessungen untersucht. In Proben aus Colon und Rektum von 39 Personen wurden die Formen h1A1, h1A3 und h1B1 identifiziert, wobei in einer weiteren Probe, die als einzige von einem an Colitis Ulcerosa erkrankten Patienten stammte, keine Sulfotransferasen nachgewiesen werden konnten. Bei der Immunblot-Analyse war das Expressionsmuster der einzelnen Formen in allen Proben ähnlich. In wenigen Proben waren die relativen Signalintensitäten der h1A1 und der h1B1 um die Hälfte erniedrigt. Der Gehalt von SULT an zytosolischem Protein zeigte einen bis zu 8 - 10fachen Unterschied, er betrug jedoch bei zwei Dritteln der Proben zwischen 0,15 und 0,3 (h1A1 und h1A3) bzw. 0,6 und 0,8 Promille (h1B1). Die Variation konnte nicht auf Alter, Geschlecht oder Krankheitsbild der Patienten zurückgeführt werden. Auch der für die allelischen Varianten der h1A1 beschriebene Effekt auf die Enzymaktiviät bzw. Stabilität konnte in der Menge an immunreaktivem Protein nicht in diesem Ausma detektiert werden. Die Allelhäufigkeit von h1A1*R und h1A1*H war gegenüber der gesunden Bevölkerung nicht verändert. In den sieben Proben aus dem Dünndarm (Coecum, viermal Ileum, Jejunum) konnten zusätzlich die Formen h1E1 und h2A1 identifiziert werden. Ein möglicherweise der Form h1C1 entsprechendes Protein wurde im Magen detektiert. Im Vergleich zum Menschen war die Expression in der Ratte stärker auf die Leber konzentriert. Während beim Menschen in allen untersuchten Abschnitten Sulfotransferasen in Mengen detektiert wurden, die in zwei Fällen (h1B1 und h1A3) sogar den Gehalt in der Leber überstiegen, beschränkte sich die Expression in der Ratte auf im Vergleich zur Leber geringe Mengen im Magen und Dickdarm. Nachgewiesen wurden die r1B1, r1A1 sowie eine nicht identifizierte Form von 35kD, bei der es sich vermutlich um die r1C2 handelt. Im

  8. Von Donuts und Zucker: Mit Neutronen biologische Makromoleküle erforschen

    NASA Astrophysics Data System (ADS)

    May, Roland P.

    2003-05-01

    Für die Erforschung von Biomolekülen bieten Neutronen einzigartige Eigenschaften. Vor allem ihre unterschiedliche Wechselwirkung mit dem natürlichen Wasserstoff und seinem schweren Isotop Deuterium ermöglicht tiefe Einblicke in Struktur, Funktion und Dynamik von Proteinen, Nukleinsäuren und Biomembranen. Bei vielen Fragestellungen zur Strukturaufklärung gibt es kaum oder keine Alternative zum Neutron. Das Institut Laue-Langevin trägt Bahnbrechendes zum Erfolg der Neutronen-Methoden in der Biologie bei.

  9. Suchmaschinen und Informationsqualität: Status quo, Problemfelder, Entwicklungstendenzen

    NASA Astrophysics Data System (ADS)

    Maaß, Christian; Gräfe, Gernot

    Das Thema Informationsqualität wird in den vorangegangenen Beiträgen umfangreich betrachtet. Die dabei geführte Diskussion zielt vordergründig auf organisatorische Dimensionen der Datenqualität, die strukturierte Datenanalyse oder Datenmanagementprozesse im Unternehmen ab. Dabei liegt ein Großteil der zur Unterstützung von Entscheidungsprozessen herangezogenen Informationen in Datenbanksystemen bzw. in einem Data Warehouse vor. Auf Basis verschiedener Analysetools (z. B. Online-Analytical-Processing) lassen sich diese Informationen dann systematisch auswerten. Allerdings können Entscheidungen nicht allein aufgrund der unternehmensintern vorliegenden Informationen getroffen werden. Vielmehr gilt es auch die aus der Unternehmensumwelt relevanten Informationen zu verarbeiten, die zum Teil über das Internet zugänglich sind. Im Gegensatz zu unternehmensinternen Datenbanksystemen handelt es sich beim Internet um ein schwach strukturiertes und offenes Netzwerk, weshalb die im Unternehmenskontext eingesetzten Analysetools kaum weiterhelfen, um Informationen mit hoher Qualität herauszufiltern. In dieser Situation spielen Suchmaschinen eine wichtige Rolle, um Informationen zu identifizieren und anhand verschiedener Kriterien in Form einer Suchergebnisseite zu sortieren.

  10. Organization of the und R chromosome region in maize

    SciTech Connect

    Kermicle, J.

    1989-07-01

    Maize is highly polymorphic in pattern of anthocyanin pigmentation. That portion of the total variation which is attributable to one gene is revealed when alleles from various sources are incorporated into a standard line by backcrossing before comparison under uniform environments. The variation associated with such collections of {und R} alleles is discontinuous, suggesting the presence of discrete units of function. Alleles comprising more than one such element constitute an allelic complex or gene family. An objective of the early years of investigation under this grant was to work out the arrangement of genic elements in such allelic complexes. Elements in a complex are identified by independent mutation and separability by recombination, the latter serving also to order them in the chromosome. Alleles having from one to three elements each were represented among five accessions of the colored-seed, colored-plant class ({und R-r}). Nine different genic elements were identified. This line of inquiry has been de-emphasized in recent years in deference to investigating the organization of individual genic elements. We have focused on a set of readily distinguished elements that were identified or produced in the analysis of allelic complexes. 7 refs., 1 tab.

  11. Percutaneous angioplasty used to manage native and recurrent coarctation of the aorta in infants younger than 1 year: immediate and midterm results.

    PubMed

    Adjagba, Philippe Mahouna; Hanna, Baher; Miró, Joaquim; Dancea, Adrian; Poirier, Nancy; Vobecky, Suzanne; Déry, Julie; Lapierre, Chantale; Dahdah, Nagib

    2014-10-01

    Balloon angioplasty (BAP) used to manage native coarctation of the aorta (CoAo) in infants remains controversial. This study aimed to compare short- and midterm results of BAP between native CoAo (NaCo) and postsurgical recoarctations (ReCo) in infants younger than 1 year. This retrospective study compared the clinical, echocardiographic, hemodynamic, and angiographic data for infants who underwent BAP between July 2003 and September 2012. The 12 NaCo and 13 ReCo patients in this study underwent BAP at 4.61 ± 3.69 and 4.88 ± 3.07 months (p = 0.84) and weighed 5.49 ± 2.57 and 6.10 ± 2.11 kg (p = 0.52), respectively. Their respective heights were 60.58 ± 10.58 and 61.15 ± 6.74 cm (p = 0.87). All the ReCo patients had their initial surgery before the age of 3 months. The minimal CoAo diameter was 2.81 ± 0.96 mm in the NaCo group and 2.86 ± 1.0 mm in the ReCo group (p = 0.90). The relative gradient reduction was 62.79 ± 32.43 % in the NaCo group and 73.37 ± 20.78 % in the ReCo group (p = 0.33). The in situ complication rate (pseudoaneurysm) was 8.33 % in the NaCo group and 7.69 % in the ReCo group (p = 0.74). During the early follow-up evaluation, five NaCo patients (41.66 %) presented with recoarctation requiring BAP reintervention within 1.75 ± 1.41 months (all had their initial BAP before 3 months of age) compared with 1 ReCo patient (7.69 %) (p = 0.165). The mean follow-up period was 3.09 ± 2.69 years for the NaCo patients and 3.6 ± 3.18 years for the ReCo patients (p = 0.69), during which the blood pressure gradient was 12.33 ± 9.67 for the NaCo patients and 7.80 ± 8.78 for the ReCo patients (p = 0.17), with corresponding Doppler peak instantaneous gradients of 21.29 ± 11.19 and 16.20 ± 10.23 (p = 0.24). The resultant diameter ratio between the minimal isthmus diameter and the aortic diameter at the diaphragmatic level was 0.81 ± 0.15 in the NaCo group and 0.85 ± 0.12 in the ReCo group (p = 0.53). The immediate and midterm results of BAP for the

  12. Elektrische Phänomene des Körpers und ihre Detektion

    NASA Astrophysics Data System (ADS)

    Bolz, Armin; Kikillus, Nicole; Moor, Claudius

    Im menschlichen Körper verfügen sowohl Nerven- als auch Muskelzellen über die Eigenschaft, intra- und extrazelluläre Ionenkonzentrationen zu verschieben und damit die Potenzialverteilung in ihrer Umgebung zu beeinflussen. Über unterschiedliche Synchronisationsverfahren sind makroskopische Zellverbände zusätzlich in der Lage, koordiniert ihre Felder zu verändern und somit auch signifikante, an der Körperoberfläche messbare elektrische Signale zu erzeugen. Das vorliegende Kapitel beschreibt zunächst die elektrophysiologischen Grundlagen elektrischer Signale des menschlichen Körpers, die Synchronisationsmechanismen und die daraus entstehenden Felder, insbesondere das Elektrokardiogramm (EKG), das Elektroenzephalogramm (EEG) sowie das Elektromyogramm (EMG). Im Anschluss daran werden die wesentlichen Grundlagen der Messtechnik zur Erfassung bioelektrischer Phänomene erläutert. Einige Beispielapplikationen runden diesen Beitrag ab.

  13. Zwischen Commonsense und Wissenschaft Mathematik in der Erziehungsphilosophie A. N. Whiteheads

    NASA Astrophysics Data System (ADS)

    Sölch, Dennis

    Obwohl Whitehead heute wie selbstverständlich als Philosoph rezipiert wird, so hat er seine wissenschaftliche Laufbahn doch als Mathematiker begonnen. Lange Zeit war er gemeinsam mit Bertrand Russell als Autor der Principia Mathematica unter Mathematikern und mathematischen Logikern deutlich besser bekannt als unter Philosophen. Doch selbst von denjenigen, die sich mit Whiteheads Überlegungen zur Metaphysik, zur Wissenschaftsgeschichte und zur Theologie befassen, werden seine Schriften zur Philosophie von Erziehung und Bildung häufig kaum beachtet. So entgeht es leicht, dass Whitehead nicht nur ein auf theoretischem Gebiet brillanter Mathematiker war, sondern sein theoretisches Fachwissen im Hinblick auf pädagogische und didaktische Relevanz fortwährend reflektiert hat.

  14. Jahre Entwicklung der Instandhaltung - von der ausfallorientierten Instandhaltung zum gemeinsamen TPM und RCM

    NASA Astrophysics Data System (ADS)

    Iske, Friedhelm

    Zur Einleitung meines Beitrages möchte ich von einem Gespräch mit einem Mitarbeiter berichten, das ich als junger Vorgesetzter einer Instandhaltungsgruppe 1988 führte. Der engagierte Mitarbeiter feierte damals sein vierzigjähriges Dienstjubiläum und war stolz auf das von ihm Geleistete sowie auf den besonderen Einsatz seiner Altersgruppe, die nach dem Zweiten Weltkrieg das Werk wieder aufgebaut hatte. Auf meine Frage, was denn damals die erste Aufgabe in der Firma war, bekam ich kurz und knapp und mit einer Selbstverständlichkeit die selbstbewusste Antwort: "Unser Pferd füttern und mit dem Pferd die innerbetrieblichen Transporte erledigen“. Als junger, technisch orientierter Vorgesetzter war ich über diese Antwort sehr überrascht. Gedanklich weit entfernt war die Vorstellung, dass in der Vergangenheit Transporte mit einem Pferd erledigt wurden.

  15. Modulare LDAP-Server-, -Protokoll und - Funktionserweiterungen am Beispiel von OpenLDAP

    NASA Astrophysics Data System (ADS)

    Pluta, Daniel

    In diesem Artikel wird ein Standardisierungsvorschlag für eine LDAP-Protokollerweiterung und deren Referenzimplementierung in Form einer modularen Erweiterung für die LDAP-Software-Suite des OpenLDAPProjektes vorgestellt. Nach einer Einführung in und einem Überblick über die wichtigsten OpenLDAP-Komponenten stellen wir unseren Lösungsansatz vor und gehen auf seine technischen Details ein. Ziel dieses Overlays ist die Implementierung einer neuen Funktionalität, die vom LDAP-Protokoll bisher nicht vorgesehen ist: Der Umfang der Suchergebnismenge soll serverseitig, dezentral und in der Granularität ganzer Objekte in Abhängigkeit von der aktuellen Serverzeit (konfigurierbar) eingeschränkt werden.

  16. Kosteneffiziente Honbearbeitung durch intelligente und flexible Verknüpfung von autarken Honzentren

    NASA Astrophysics Data System (ADS)

    Roth, Günther

    Die Planungsabteilungen in der Automobilindustrie werden vor immer größere Herausforderungen gestsellt. Der zur Verfügung stehende Zeitraum zu einer seriensicheren Umsetzung der entwicklungs- und produktionstechnischen Forderungen wird von Projekt zu Projekt kürzer. Aufgrund des hohen Wettbewerbsdrucks und daraus resultierenden erforderlichen Kostenoptimierungen, die schnelleren Timeto-market-und Innovationszyklen und die vermeintlich zur Kundenbindung erforderlichen, kaum mehr überschaubaren Diversifizierungen in den Modellpaletten lassen den Planungshorizont immer kürzer werden. Die zu beschaffenden Fertigungsanlagen sollen aber in den nächsten 8-12 Jahren all die Varianten produzieren können, die heute nur teilweise oder noch gar nicht bekannt sind.

  17. Percutaneous transluminal coronary angioplasty (PTCA)

    MedlinePlus Videos and Cool Tools

    ... minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart ... area and putting a needle into the femoral artery, the blood vessel that runs down the leg. ...

  18. Angioplasty and stent - heart - discharge

    MedlinePlus

    ... of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology ... for the Management of Patients With ST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) ...

  19. How Is Coronary Angioplasty Done?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Percutaneous Coronary Intervention Done? Before you have percutaneous coronary intervention (PCI), ... wall, relieving the blockage and improving blood flow. Percutaneous Coronary Intervention Figure A shows the location of the heart ...

  20. Angioplasty and stent placement - heart

    MedlinePlus

    ... prevent the artery from closing up again. A drug-eluting stent has medicine embedded in it that helps prevent ... may be coated with a drug (called a drug-eluting stent). This type of stent may lower the chance ...

  1. Schönheit und andere Provokationen - Eine neue evolutionsbiologische Theorie der Kunst

    NASA Astrophysics Data System (ADS)

    Junker, Thomas

    Die Evolution hat viele spektakuläre Phänomene hervorgebracht - von der Eleganz des Vogelflugs über die gigantischen Körper der Dinosaurier und die farbenprächtige Vielfalt der Korallenriffe bis hin zu ihrem jüngsten Geniestreich - der menschlichen Kunst. Die schönen Künste - Malerei, Bildhauerei und Architektur, Theater, Tanz, Oper und Filmkunst, Musik und Literatur - Produkte der Evolution? Diese Vorstellung mutet vielen Menschen fremd an, aber wie könnte es anders sein? Denn wenn Charles Darwin recht hat, dann sind nicht nur die körperlichen Merkmale der Menschen als Antworten auf die Erfordernisse des Lebens entstanden, sondern auch ihre geistigen Fähigkeiten und Verhaltensweisen. Im Jahr 1859 hatte er auf den letzten Seiten seines berühmten Buches über die Entstehung der Arten eine kühne Prophezeiung gemacht: Durch die Evolutionstheorie werde es "zu einer bemerkenswerten Revolution in der Naturwissenschaft kommen […]. Die Psychologie wird auf die neue Grundlage gestellt, dass jede geistige Kraft und Fähigkeit notwendigerweise durch graduelle Übergänge erworben wird“ (Darwin 1859, S. 484, 488; Junker 2008).

  2. Strömende Flüssigkeiten und Gase

    NASA Astrophysics Data System (ADS)

    Heintze, Joachim

    Die Bemerkung über die Probleme eines allgemeingültigen Ansatzes, die wir zu Anfang von Kap. 1 machten, gilt in noch höherem Maße für die Mechanik von strömenden Flüssigkeiten; dort erreicht man sogar ziemlich rasch die Grenze der Leistungsfähigkeit der heutigen Mathematik, d. h. wir können zwar - ausgehend von den Newtonschen Gesetzen (Bd. I/3) - eine Differentialgleichung für die Strömung von Flüssigkeiten aufstellen, die sog. Navier-Stokes-Gleichung, es sind aber keine allgemein anwendbaren Lösungsverfahren für diese Gleichung bekannt. Ein Blick in die Natur und auf die vielfältigen Strömungsphänomene zeigt, dass diese Tatsache nicht verwunderlich ist.

  3. Zivilisationsdynamik: Treiber Technik, Folgen und Konsequenzen. Civilisation dynamics: driving force technology, results and consequences

    NASA Astrophysics Data System (ADS)

    Jischa, Michael F.

    2010-11-01

    Die Menschheitsgeschichte ist untrennbar mit der Nutzung von Materie, Energie und Information verbunden. Im Laufe der Geschichte sind Produktivität, Bevölkerung und Ressourcenverbrauch ständig angestiegen, seit dem vergangenen Jahrhundert mit zunehmender Beschleunigung. In den früh industrialisierten Ländern entwickelte sich vor wenigen Jahrzehnten eine Bewusstseinswende, die Segnungen der Technik wurden zunehmend kritisch beurteilt. Das führte zur Formulierung des Leitbildes Nachhaltigkeit und unterschiedlichen Ansätzen, dieses zu operationalisieren, aus Sicht der Ingenieure mit dem Konzept Technikbewertung. Nach den Natur- und den Ingenieurwissenschaften haben die Gesellschaftswissenschaften diese Themen aufgegriffen, was zu einer teilweisen Annäherung der Zwei Kulturen geführt hat. Weiter sind Überlegungen entstanden, Lehr- und Forschungsinhalte zu überdenken, um auf die Weltprobleme (in der Sprache des Club of Rome) angemessen reagieren zu können. In jüngerer Zeit wurden Energieszenarien vorgestellt, deren Kernaussage unmissverständlich lautet: Die Zukunft gehört den erneuerbaren Energien.

  4. Molekulare Methoden zum Nachweis, zur Quantifizierung und zum Monitoring der Mykotoxinbildung lebensmittelrelevanter Pilze

    NASA Astrophysics Data System (ADS)

    Geisen, Rolf

    Schimmelpilze kommen ubiquitär vor und spielen besonders bei pflanzlichen Lebensmitteln und Rohprodukten eine besondere Rolle als Verderbsorganismen. Es wird geschätzt, dass 20-25 % der jährlichen Produktion an pflanzlichen Produkten durch Schimmelpilze verdorben werden (Smith et al., 1994). Viele der lebensmittelrelevanten Schimmelpilze sind zudem in der Lage, Mykotoxine, toxische Sekundärmetabolite, zu bilden, was das Ausmaß des Problems deutlich macht. Die wichtigsten mykotoxinbildenden Spezies gehören zu den Fusarien (Trichothecene, Fumonisine, Zearalenon), Aspergillen (Aflatoxin, Ochratoxin, Cyclopiazonsäure) und Penicillien (Patulin, Ochratoxin). Für viele Mykotoxine, wie die Aflatoxine, Ochratoxin, Fumonisine und Trichothecene sind Grenzwerte erlassen worden, die die Verkehrsfähigkeit betroffener Produkte regeln. Die Einhaltung der Grenzwerte kann sehr genau durch offizielle chemisch-analytische Methoden, wie HPLC, GC-MS etc. kontrolliert werden. Diese analytischen Methoden sind aber für die Anwendung eines HACCP-Ansatzes zur Kontrolle der Mykotoxinbildung nur bedingt geeignet, da sie Endpunktkontrollen darstellen und nur das über eine längere Zeit gebildete Mykotoxin bestimmen. Sie sagen daher nichts über die biologischen Bedingungen zur Zeit der Bildung durch den Pilz aus.

  5. Die Deutsche Statistische Gesellschaft in der Weimarer Republik und während der Nazidiktatur

    NASA Astrophysics Data System (ADS)

    Wilke, Jürgen

    Nach anfänglichen Schwierigkeiten durch den 1. Weltkrieg erlangte die Deutsche Statistische Gesellschaft (DStatG) unter dem renommierten Statistiker und Vorsitzenden der DStatG, Friedrich Zahn, durch eine Vielzahl von Aktivitäten hohes Ansehen. Es gab Bestrebungen, Statistiker aus allen Arbeitsfeldern der Statistik in die DStatG zu integrieren, wobei die "Mathematische Statistik" nur zögerlich akzeptiert wurde (Konjunkturforschung, Zeitreihenanalyse). Nach der Machtübernahme 1933 durch Adolf Hitler geriet die DStatG in das Fahrwasser nationalsozialistischer Ideologie und Politik (Führerprinzip, Gleichschaltung des Vereinswesens). Damit war eine personelle Umstrukturierung in der DStatG verbunden. Politisch Missliebige und rassisch Verfolgte mussten die DStatG verlassen (Bernstein, Freudenberg, Gumbel u.a.). Unter den Statistikern gab es alle Abstufungen im Verhalten zum Regime von Ablehnung und zwangsweiser Anpassung über bereitwilliges Mitläufertum bis zu bewusster Täterschaft. Besonders die Bevölkerungsstatistik wurde durch die NS- Rassenpolitik auf lange Sicht diskreditiert. Im Rahmen von Wirtschaftsplanung und Aufrüstung wurden neue zukunftsträchtige statistische Modelle (Grünig, Bramstedt, Leisse) entwickelt.

  6. Optische und schwingungsspektroskopische Hochdruckuntersuchungen von Ladungsträgereigenschaften in herkömmlich und nach der Template-Methode synthetisierten leitfähigen Polypyrrolschichten

    NASA Astrophysics Data System (ADS)

    Mikat, Jürgen E. R.

    2001-07-01

    Chemisch dotiertes Polypyrrol gilt als Modellsubstanz für leitfähige Polymere mit nichtdegeneriertem Grundzustand. Das elektrische Transportverhalten in dotiertem Polypyrrol wird durch lokalisierte Ladungsträger, Bipolaronen und Polaronen, bestimmt. Es besteht dabei eine enge gegenseitige Wechselwirkung zwischen der Struktur der Polymerkette und den Eigenschaften der Ladungsträger. Die in dieser Arbeit vorgestellte Kombination von Hochdruckmethodik und optischer Spektroskopie vertieft das Verständnis der Beziehung zwischen der molekularen und supramolekularen Struktur und den elektronischen und optischen Eigenschaften. Durch spezifische Synthesemethoden lassen sich unterschiedliche Strukturen in der polymeren Probe induzieren, die sich durch den Anteil an hochgeordneten Polymerketten unterscheiden. Die gezielte Veränderung dieser Strukturen durch Druckexperimente ermöglicht das Studium des Einflusses der Synthesemethoden auf die Ladungsträgereigenschaften. Für diese Studien wurden herkömmlich synthetisierte Polypyrrol-Filme und Filme, die sich aus Polypyrrol-Nanoröhren zusammensetzen (Synthese in Kernspur-membranen, "Template-Synthese") bei ansonsten gleichen Syntheseparametern untersucht. Raman- und Infrarotspektroskopie sowie UV-Vis-NIR-Absorptionsspektroskopie, die jeweils für die Hochdruckmethodik adaptiert wurden, dienten der Charakterisierung der Proben. Zusätzlich wurden temperatur- und druckabhängige Messungen des elektrischen Widerstands an den Template-Proben durchgeführt. Die Morphologie template-synthetisierter Polypyrrol-Nanoröhren und die filmbildenden Eigenschaften sowie der mögliche Aufbau von Schichtarchitekturen wurden mit transmissions- und rasterelektronenmikroskopischen Techniken untersucht. Die aus den Hochdruckexperimenten gewonnenen Daten werden in der Arbeit im Hinblick auf die Stabilität der Ladungsträger interpretiert. Im Ergebnis bewirkt die Druckerhöhung eine Dissoziation der Bipolaronen in den untersuchten Proben

  7. Isotrope und homogene Materie - Kosmen; On Dynamics and Thermodynamics of Isotropic Matter-Universes

    NASA Astrophysics Data System (ADS)

    Treder, H.-J.

    Die Dynamik und Thermodynamik großer kosmischer Systeme ist fast unabhängig von den besonderen Theorien über die Gravitation. Nur die Feinstruktur der Kosmologie und Kosmonogie reflektiert die speziellen Hypothesen. Diese Neutralität gegenüber den konkreten Gravodynamiken ist die Konsequenz der fundamentalen Eigenschaften der Gravitation: Der Prinzipien der Äquivalenz von Trägheit und Schwere. The dynamics and thermodynamics of great cosmical systems are nearly independent of the theory of gravitation and only the fine-structure of cosmogony and cosmology reflects the special hypotheses.The neutrality against the concret gravodynamics is a consequence of the fundamental properties of gravitation: the principlies of equivalence of gravity and inertia.

  8. Detektion von fahrspuren und kreuzungen auf nichtmarkierten straen zum autonomen führen von fahrzeugen

    NASA Astrophysics Data System (ADS)

    Vacek, Stefan; Bürkle, Cornelius; Schröder, Joachim; Dillmann, Rüdiger

    Das Wissen über Position und Verlauf der Straße ist eine der wichtigsten Informationen, die zum Führen autonomer Straßenfahrzeuge benötigt wird. Die meisten Arbeiten gehen davon aus, dass Markierungen auf der Straße vorhanden sind, die die Erkennung enorm erleichtern. Üblicherweise werden die Fahrbahnränder detektiert und die Fahrspur mit Hilfe eines Kaiman-Filters geschätzt [1]. Andere Arbeiten verwenden zusätzlich die Straßenfarbe und kombinieren die verschiedenen Hinweise in einem Partikel-Filter [2]. Ein allgemeiner Überblick über Verfahren zur Fahrspurdetektion findet sich in [3].

  9. Planeten beobachten. Praktische Anleitung für Amateurbeobachter und solche, die es werden wollen.

    NASA Astrophysics Data System (ADS)

    Roth, G. D.

    Contents: 1. Amateurastronomie und Planetenbeobachtung (H.-J. Mettig, G. D. Roth). 2. Die visuelle Beobachtung (G. D. Roth). 3. Mond- und Planetenphotographie (B. Koch). 4. Die CCD-Bildbearbeitung (R. A. Hillebrecht). 5. Tabellen zur Ermittlung der Belichtungszeiten für Mond- und Planetenaufnahmen (W. Gruschel). 6. Die lichtelektrische Beobachtung (G. D. Roth). 7. Die Objekte in Einzeldarstellungen: Merkur (D. Niechoy); Venus (D. Niechoy); Erdmond (G. D. Roth); Mars (C. M. Schambeck); Kleine Planeten (M. Hoffmann, G. D. Roth, J. Meeus); Jupiter (H.-J. Mettig, R. C. Stoyan, A. Nikolai, C. Kowalec, G. Hahn); Saturn (R. C. Stoyan, G. Hahn, H.-J. Mettig); Uranus (R. C. Stoyan); Neptun (R. C. Stoyan); Pluto (R. C. Stoyan). 8. Adressen, Literaturhinweise, Register.

  10. Technische Systeme für den Herzersatz und die Herzunterstützung

    NASA Astrophysics Data System (ADS)

    Schöb, Reto; Loree, Howard M.

    Herzkrankheiten verursachen allein in den Vereinigten Staaten jährlich mehr als 700’000 Todesfälle. Ungefähr 3 Millionen Patienten in den U.S.A. leiden gemäss der American Heart Association (AHA) und dem National Heart, Lung and Blood Institute (NHLBI) an kongestivem Herzversagen (Congestive Heart Failure, CHF), welches eine chronische, sehr entkräftende und degenerative Krankheit ist: Das Herz ist dabei unfähig, hinreichend Blut zu den Organen des Körpers zu pumpen. Über 400’000 Fälle von CHF werden jedes Jahr diagnostiziert. Ähnliche Zahlen werden für Europa und Japan zusammen geschätzt. Basierend auf Daten vom AHA und NHLBI beträgt die fünfjährige Überlebensrate für CHF-Patienten lediglich etwa 50% [1]. 70’000-120’000 dieser Patienten könnten von einer Herzverpflanzung profitieren. 1999 wurden in den USA aber nur 2185 Herztransplantationen durchgeführt während die Warteliste über 4000 Patienten beträgt [2]. Ein akuter Mangel an Spenderherzen und die enormen Kosten (250’000-400’000 USD pro Patient) sind die begrenzenden Faktoren für Herztransplantationen [3]. Dies bedeutet, dass eine riesige Anzahl von Patienten durch ein zuverlässiges und verschleissfreies, nichtthrombotisches, total implantierbares, künstliches Herz gerettet werden könnten. Bis heute jedoch kein derartiges Implantat kommerziell verfügbar.

  11. Biologie statt Philosophie? Evolutionäre Kulturerklärungen und ihre Grenzen

    NASA Astrophysics Data System (ADS)

    Illies, Christian

    Vor über siebzig Jahren fand man in einer Höhle nahe Hohlenstein-Stadel, im heutigen Baden-Württemberg, eine Frau, die keiner bekannten Spezies und nicht einmal eindeutig den Hominiden zugeordnet werden konnte. Wegen ihres Aussehens wurde sie schon bald als "Löwenfrau“ bekannt (unterdessen wird sie als "Löwenmensch“ bezeichnet, da die in solchen Fragen Klarheit schaffenden Geschlechtsteile bei der Figur fehlen und in Zeiten von gender mainstreaming derartige Festlegungen gerne vermieden werden), denn sie hatte eine menschlich-aufrechte, unbehaarte Gestalt mit weiblichen Rundungen, aber zugleich eine Mähne, sowie Augen, Ohren und Schnauze eines Löwen. Eine sehr weitläufige Verwandte des Minotaurus, so schien es, und doch wesentlich älter als alle Bewohner des Olymps, denn vermutlich wurde die knapp 30 cm große Skulptur bereits in der Altsteinzeit vor etwa 32.000 Jahren aus Mammut-Elfenbein geschnitzt. Wir wissen nicht, ob sie kultischen Zwecken diente oder ein Kind mit ihr spielte, ob sie als Glücksbringer für die Jagd oder als Schamanin mit Löwenmaske verehrt und gefürchtet wurde. Aber die Löwenfrau legt nahe, dass der Mensch schon im Morgendämmern seiner Kultur über die eigene Nähe, aber auch Distanz zum Tier nachgedacht haben muss. Die Frage nach der menschlichen Selbstverortung begegnet uns in dieser Figur, und sie bestimmt viele Zeugnisse menschlichen Nachdenkens, welche uns die Altertumswissenschaften vorlegen. Mit dem Begriff "animal rationale“, wie er unter Bezug auf Aristoteles geprägt wurde, findet sie schließlich ihre klassische, für das Abendland lange Zeit maßgebliche Antwort: Der Mensch als Tier, dessen spezifisches Merkmal die Vernunftbegabtheit ist, die ihn zugleich von allen anderen Tieren abgrenzt und über sie stellt. Aber wo genau verläuft die Grenze? Und wie kann der Mensch beides zugleich sein? Die aristotelische Definition beantwortet diese Fragen nach der Doppelnatur nicht, sondern erhebt das offene R

  12. Entwicklung und Evaluation einer Kalibrierungsmethode für 3D-Ultraschall

    NASA Astrophysics Data System (ADS)

    Bergmeir, Christoph; Seitel, Mathias; Frank, Christian; de Simone, Raffaele; Meinzer, Hans-Peter; Wolf, Ivo

    Wir stellen eine Methode zur Kalibrierung einer 3D-Ultraschallsonde vor. Für Anwendungen in der minimalinvasiven Chirurgie wird die Ultraschallsonde mit einem Trackingsystem verbunden, um dem Aufnahmevolumen eine definierte räumliche Lage zu geben. Die Kalibrierung bringt die Koordinatensysteme des Trackingsystems und des Ultraschallbildes zur Deckung. Hierzu wird ein bekanntes Objekt, das Phantom, aufgenommen und im Ultraschallbild lokalisiert. Die Kalibrierungstransformation wird dann durch ein Verfahren der Hand-Auge-Kalibrierung errechnet. Ein oft übliches Anbringen zusätzlicher Trackingssensoren am Phantom ist damit nicht nötig, was die Kalibrierungsprozedur vereinfacht.

  13. Acute cell death rate of vascular smooth muscle cells during or after short heating up to 20s ranging 50 to 60°C as a basic study of thermal angioplasty

    NASA Astrophysics Data System (ADS)

    Shinozuka, Machiko; Shimazaki, Natsumi; Ogawa, Emiyu; Machida, Naoki; Arai, Tsunenori

    2014-02-01

    We studied the relations between the time history of smooth muscle cells (SMCs) death rate and heating condition in vitro to clarify cell death mechanism in heating angioplasty, in particular under the condition in which intimal hyperplasia growth had been prevented in vivo swine experiment. A flow heating system on the microscope stage was used for the SMCs death rate measurement during or after the heating. The cells were loaded step-heating by heated flow using a heater equipped in a Photo-thermo dynamic balloon. The heating temperature was set to 37, 50-60°C. The SMCs death rate was calculated by a division of PI stained cell number by Hoechst33342 stained cell number. The SMCs death rate increased 5-10% linearly during 20 s with the heating. The SMCs death rate increased with duration up to 15 min after 5 s heating. Because fragmented nuclei were observed from approximately 5 min after the heating, we defined that acute necrosis and late necrosis were corresponded to within 5 min after the heating and over 5 min after the heating, respectively. This late necrosis is probably corresponding to apoptosis. The ratio of necrotic interaction divided the acute necrosis rate by the late necrosis was calculated based on this consideration as 1.3 under the particular condition in which intimal hyperplasia growth was prevented in vivo previous porcine experiment. We think that necrotic interaction rate is larger than expected rate to obtain intimal hyperplasia suppression.

  14. Archivalische Quellen zum Leben und Werk von Franz Xaver von Zach.

    NASA Astrophysics Data System (ADS)

    Wattenberg, D.; Brosche, P.

    Franz Xaver von Zach (1754 - 1832) gehörte um die Wende vom 18. zum 19. Jahrhundert zu den angesehensten und profiliertesten Astronomen. Anliegen dieser Untersuchung ist es, handschriftliche Quellen von Zachs nachzuweisen - auch wenn Vollständigkeit vorläufig nicht erreicht werden kann.

  15. A Look at Graduate Teaching at UND: Faculty Perspectives. Instructional Development Report.

    ERIC Educational Resources Information Center

    Jacobson, Carol R.

    Characteristics of graduate teaching were identified, based on interviews with 18 graduate faculty members at the University of North Dakota (UND). Respondents identified the following essential characteristics of graduate education: the faculty member's knowledge of the subject, objectives of graduate-level programs, the teacher's role, graduate…

  16. Einheit von Forschung und Lehre: Implications for State Funding of Universities

    ERIC Educational Resources Information Center

    Frolich, Nicoline; Coate, Kelly; Mignot-Gerard, Stephanie; Knill, Christoph

    2010-01-01

    The Humboldtian educational ideal is based on the idea of the unity of teaching and research in universities ("Einheit von Forschung und Lehre"). The role of the state, according to Humboldt, was to fund universities in such a way that their autonomy was maintained. Much has changed in the funding mechanisms of higher education systems since the…

  17. Matthias Falter und die frühe Halbleitertechnik in der DDR

    NASA Astrophysics Data System (ADS)

    Dittmann, Frank

    Nach einer ganzen Reihe von Vorarbeiten weltweit1 konnten im Dezember 1947 die amerikanischen Physiker Walter H. Brattain, John Bardeen und William Shockley in den Bell Laboratories den Transistoreffekt demonstrieren. Damit legten sie den Grundstein für die Mikroelektronik als Basistechnologie des Informationszeitalters.

  18. [Naturheilkunde und Komplementärmedizin in medizinischen Leitlinien - können europäische Normen Leitlinien für Naturheilkunde und Komplementärmedizin verdrängen?].

    PubMed

    Jütte, Robert

    2016-01-01

    Leitlinien machen in der Komplementärmedizin, wie das Beispiel der Naturheilkunde zeigt, durchaus Sinn. Sie ergänzen zum Wohle des Patienten und zur besseren Orientierung des Therapeuten die bislang, auch auf europäischer Ebene, bereits bestehenden Leitlinien, die ständig weiterentwickelt werden. Diese Ergänzung ist dringend notwendig, weil die meisten der vorliegenden Leitlinien einzelner Fachgesellschaften die Forschungsergebnisse der Komplementärmedizin, die zum Teil beachtlich und auch evidenzbasiert sind, zum Nachteil des Patienten ignorieren. Es ist bedauerlich, dass einige Richtungen der Komplementärmedizin jedoch meinen, dass eine europäische Norm, wie sie beispielsweise Osteopathen und Homöopathen mithilfe des europäischen Normungsinstituts (CEN) durchzusetzen hoffen, sie in ihrem Kampf um Anerkennung weiterbringen wird. Der Patient, der auf eine individuelle und bestmögliche Behandlung wert legt, wird jedenfalls davon nicht profitieren. PMID:27404104

  19. Long-term risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): long-term follow-up of a randomised trial

    PubMed Central

    Bonati, Leo H; Ederle, Jörg; McCabe, Dominick JH; Dobson, Joanna; Featherstone, Roland L; Gaines, Peter A; Beard, Jonathan D; Venables, Graham S; Markus, Hugh S; Clifton, Andrew; Sandercock, Peter; Brown, Martin M

    2009-01-01

    Summary Background In the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS), early recurrent carotid stenosis was more common in patients assigned to endovascular treatment than it was in patients assigned to endarterectomy (CEA), raising concerns about the long-term effectiveness of endovascular treatment. We aimed to investigate the long-term risks of restenosis in patients included in CAVATAS. Methods 413 patients who were randomly assigned in CAVATAS and completed treatment for carotid stenosis (200 patients had endovascular treatment and 213 patients had endarterectomy) had prospective clinical follow-up at a median of 5 years and carotid duplex ultrasound at a median of 4 years. We investigated the cumulative long-term incidence of carotid restenosis after endovascular treatment and endarterectomy, the effect of the use of stents on restenosis after endovascular treatment, risk factors for the development of restenosis, and the effect of carotid restenosis on the risk of recurrent cerebrovascular events. Analysis was by intention to treat. This study is registered, number ISRCTN01425573. Findings Severe carotid restenosis (≥70%) or occlusion occurred significantly more often in patients in the endovascular arm than in patients in the endarterectomy arm (adjusted hazard ratio [HR] 3·17, 95% CI 1·89–5·32; p<0·0001). The estimated 5-year incidence of restenosis was 30·7% in the endovascular arm and 10·5% in the endarterectomy arm. Patients in the endovascular arm who were treated with a stent (n=50) had a significantly lower risk of developing restenosis of 70% or greater compared with those treated with balloon angioplasty alone (n=145; HR 0·43, 0·19–0·97; p=0·04). Current smoking or a history of smoking was a predictor of restenosis of 70% or more (2·32, 1·19–4·54; p=0·01) and the early finding of moderate stenosis (50–69%) up to 60 days after treatment was associated with the risk of progression to restenosis of 70

  20. A comparison of balloon angioplasty of native coarctation versus surgical repair for short segment coarctation associated with ventricular septal defect—a single-center retrospective review of 92 cases

    PubMed Central

    Zhang, Huifeng; Ye, Ming; Chen, Gang; Liu, Fang; Wu, Lin

    2016-01-01

    Background The hybrid technique combining balloon angioplasty for discrete coarctation (CoA) and surgical repair of a ventricular septal defect (VSD) is a novel treatment for patients with aortic CoA and VSD, but the efficacy of this approach is unknown. Methods We performed a retrospective analysis of 92 patients with short segment CoA and VSD who underwent complete repair between January 2004 and July 2014 in our center. Patients were divided into two groups according to the surgical approach employed: hybrid procedure (group A, n=39) and traditional midline surgical repair (group B, n=53). Baseline, perioperative, and outcome data were compared between the two groups. Results Three early deaths occurred in group B, whereas none occurred in group A. Compared to those in group B, patients in group A experienced a shorter aortic clamp duration (28.1±6.7 vs. 43.2±9.2 minutes, P<0.001), shorter cardiopulmonary bypass (CPB) duration (52.9±10.7 vs. 86.2±23.8 minutes, P<0.001), shorter ventilator time (47.0 vs. 73.7 hours, P=0.002), and shorter intensive care unit stay (6.2 vs. 9.1 days, P=0.019). The risks for aortic re-CoA and re-intervention did not differ significantly between the groups within five years (P=0.40 and 0.65, respectively). Conclusions The hybrid technique was associated with better periprocedural outcomes for patients with short-segment CoA and VSD. The incidences of aortic re-CoA and re-intervention were comparable between the hybrid technique and surgical groups over a mid-term follow-up. PMID:27621858

  1. The efficacy and safety of drug-eluting balloons for the treatment of in-stent restenosis as compared with drug-eluting stents and with conventional balloon angioplasty

    PubMed Central

    Oh, Pyung Chun; Suh, Soon Yong; Kang, Woong Chol; Lee, Kyounghoon; Han, Seung Hwan; Ahn, Taehoon; Shin, Eak Kyun

    2016-01-01

    Background/Aims: Treatment of coronary in-stent restenosis (ISR) is still associated with a high incidence of recurrence. We aimed to compare the efficacy and safety of drug-eluting balloons (DEB) for the treatment of ISR as compared with conventional balloon angioplasty (BA) and drug-eluting stents (DES). Methods: Between January 2006 and May 2012 a total of 177 patients (188 lesions, 64.1 ± 11.7 years old) who underwent percutaneous coronary intervention for ISR were retrospectively enrolled. Clinical outcomes were compared between patients treated with DEB (n = 58, 32.8%), conventional BA (n = 65, 36.7%), or DES (n = 54, 30.5%). The primary end point was a major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization(TLR). Results: Baseline characteristics were not different except for a history of previous MI, which was more frequent in patients treated by conventional BA or DES than in patients treated by DEB (40.0% vs. 48.1% vs. 17.2%, respectively, p = 0.002). The total incidences of MACEs were 10.7%, 7.4%, and 15.4% in patients treated by DEB, DES, or conventional BA, respectively (p > 0.05). TLR was more frequent in patients treated by conventional BA than in patients treated by DEB or DES, but this was not statistically significant (10.8% vs. 6.9% vs. 3.7%, p > 0.05 between all group pairs, respectively). Conclusions: This study showed that percutaneous coronary intervention using DEB might be a feasible alternative to conventional BA or DES implantation for treatment of coronary ISR. Further large-scaled, randomized study assessing long-term clinical and angiographic outcomes will be needed. PMID:26951915

  2. Austauschskräfte zwischen Elementarteilchen und Fermische Theorie des β-Zerfalls als Konsquenzen einer möglichen Feldtheorie der Materie [26

    NASA Astrophysics Data System (ADS)

    Inhalt: Elektron, Neutrino, Proton und Neutron werden als vier verschiedene Quantenzustände einer einzigen Elementpartikel angesehen. Quantensprünge zwischen diesen Zuständen erklären den β-Zerfall (gemäss der Theorie von Fermi) und geben zur HEISENBEBe-MAJOKANA'schen Neutron-Proton-Austauschkraft Anlass. Die Pestsetzung, dass negatives Elektron und positives Proton "Partikel"-Zustände (im Gegensatz zu "Antipartikel") sind, verbietet Zerstrahlungsprozesse der schweren Teilchen. Die umgekehrte Festsetzung (positives Elektron und positives Proton sind Partikel) führt zu Zerstrahlungsprozessen (siehe Zusammenfassung).

  3. „Überholen ohne einzuholen“ Die Entwicklung von Technologien für übermorgen in Kernenergie und Mikroelektronik der DDR

    NASA Astrophysics Data System (ADS)

    Barkleit, Gerhard

    Dem nuklearen Patt zwischen Ostblock und westlichem Staatenbündnis ist es nach weitgehend übereinstimmender Auffassung von Politik und Wissenschaft zu danken, dass der "Kalte Krieg" in der zweiten Hälfte des 20. Jahrhunderts nicht zum weltumfassenden Flächenbrand eskalierte. An der raschen Herstellung dieses Patts waren zwei Dresdner Physiker maßgeblich beteiligt, deren einer im Manhattan-Projekt in den USA gearbeitet hatte und später in England der Spionage für die Sowjetunion und des Verrats des Know-how der Atombombe überführt wurde.

  4. Die Bedeutung der Volumen- und Oberflächeneigenschaften von Biomaterialien für die Adsorption von Proteinen und nachfolgende zelluläre Reaktionen

    NASA Astrophysics Data System (ADS)

    Groth, Thomas

    2003-04-01

    Es ist schon seit längerer Zeit bekannt, dass nach Kontakt des Biomaterials mit der biologischen Umgebung bei Implantation oder extrakorporaler Wechselwirkung zunächst Proteine aus dem umgebenden Milieu adsorbiert werden, wobei die Oberflächeneigenschaften des Materials die Zusammensetzung der Proteinschicht und die Konformation der darin enthaltenden Proteine determinieren. Die nachfolgende Wechselwirkung von Zellen mit dem Material wird deshalb i.d.R. von der Adsorbatschicht vermittelt. Der Einfluss der Oberflächen auf die Zusammensetzung und Konformation der Proteine und die nachfolgende Wechselwirkung mit Zellen ist von besonderem Interesse, da einerseits eine Aussage über die Anwendbarkeit ermöglicht wird, andererseits Erkenntnisse über diese Zusammenhänge für die Entwicklung neuer Materialien mit verbesserter Biokompatibilität genutzt werden können. In der vorliegenden Habilitationsschrift wurde deshalb der Einfluss der Zusammensetzung von Polymeren bzw. von deren Oberflächeneigenschaften auf die Adsorption von Proteinen, den Aktivitätszustand der plasmatischen Gerinnung und die Adhäsion von Zellen untersucht. Dabei wurden auch Möglichkeiten zur Beeinflussung dieser Vorgänge über eine Veränderung der Volumenzusammensetzung oder durch Oberflächenmodifikationen von Biomaterialien vorgestellt. Erkenntnisse aus diesen Arbeiten konnten für die Entwicklung von Membranen für Biohybrid-Organe genutzt werden. The implantation of biomaterials or the contact of blood with extracorporal devices leads to the rapid adsorption of proteins from the surrounding biological fluids. The surface properties of materials determine the composition of the adsorption layer and the conformation of adsorbed proteins. Hence, the subsequent interaction of cells with biomaterials is dependent on the adsorption layer of proteins. The detailed knowledge on the role of surface properties in protein adsorption and cellular interactions is a useful means to learn about the

  5. Unentbehrlich in Natur, Technik und Forschung: Flüssigkristalle im Überblick

    NASA Astrophysics Data System (ADS)

    Mathelitsch, Leopold; Repnik, Robert; Bradac, Zlatko; Vilfan, Mojca; Kralj, Samo

    2003-05-01

    Flüssigkristalle können wie eine Flüssigkeit fließen und zugleich eine innere Ordnung besitzen, die an Festkörper erinnert. Sie begegnen uns im Alltag in vielen technischen Anwendungen, beispielsweise in Displays von elektronischen Geräten. Seit Millionen von Jahren sind sie schon zentrale Bausteine von biologischen Systemen. Dazu zählen zum Beispiel die DNS, viele Proteine und die Membran, die lebende Zellen umschließt. Wegen ihrer besonderen Eigenschaften eignen sich Flüssigkristalle gut als Analogien für andere physikalische Systeme: zum Beispiel die Teilchen-Antiteilchen-Annihilation oder kosmologische Modelle des Universums kurz nach dem Urknall.

  6. Campus Single Sign-On und hochschulübergreifendes Identity Management

    NASA Astrophysics Data System (ADS)

    Hommel, Wolfgang

    Das im Rahmen von IntegraTUM für die TUM geschaffene Identity & Access Management System setzt das Paradigma unified login um, d. h. ein Benutzer kann alle für ihn relevanten Dienste innerhalb der Hochschule mit derselben Loginname-/Passwortkombination nutzen. Dieser Artikel zeigt, wie auf Basis der Software Shibboleth und der deutschlandweiten Hochschulföderation DFN-AAI als weitere Mehrwerte das campusweite web single sign-on und die nahtlose Nutzung zahlreicher externer Web-Anwendungen erreicht werden. Als Beispiel für die Abläufe bei der Erschließung neuer Dienste für die hochschulübergreifende Nutzung wird die Anbindung von Learning Management Systemen auf Basis des DFN-AAI E-Learning-Profils diskutiert. Den umfassenden Vorteilen werden schließlich die aktuellen technischen Grenzen bei der Umsetzung des hochschulübergreifenden Identity Management gegenübergestellt.

  7. Vorausschauend Planen, Gezielt Handeln — Über Die Regelung Und Steuerung Technischer Prozesse

    NASA Astrophysics Data System (ADS)

    Grüne, Lars; Sager, Sebastian; Allgöwer, Frank; Bock, Hans Georg; Diehl, Moritz

    Seit Beginn der industriellen Revolution nimmt die Steuerungs- und Regelungstechnik eine Schlüsselstellung in vielen technischen Bereichen ein. James Watts Fliehkraftregler für Dampfmaschinen ist eines der frühen Beispiele eines extrem erfolgreichen Reglerkonzepts, von dem Ende der 1860er Jahre geschätzte 75000 Exemplare allein in England im Einsatz waren [2, S. 24]. Etwa um diese Zeit begannen Ingenieure, motiviert durch die immer höhere Komplexität der zu regelnden Maschinen, sich systematisch mit theoretischen Grundlagen der Regelung zu beschäftigen. Dies führte unausweichlich zu der Einsicht, dass das dynamische Verhalten der geregelten Systeme nur mit Hilfe der Mathematikverstanden und weiterentwickelt werden konnte, oder wie Werner von Siemens, ein weiterer technischer Pionier in diesem Bereich es formulierte: "Ohne Mathematik tappt man doch immer im Dunkeln.“

  8. Eine Beziehung seit 650 Jahren: Universität Wien und Kloster Melk - Katalog zur Sonderausstellung

    NASA Astrophysics Data System (ADS)

    Bruckmüller, Ernst; Niederkorn-Bruck, Meta; Beck, Paul G.; Deibl, Jakob; Deibl, Johannes; Denk, Ulrike; Ellegast, Burkard; Floßmann, Gerhard; Glaßner, Gottfried; Kalteis, Bernadette; Kowarik, Wilfried; Rotheneder, Martin

    2015-04-01

    University of Vienna was founded in 1365 and celebrates its 650 anniversary in 2015. Due to the university's anniversary, the Benedictine abbey of Melk, Austria presents an exhibition, depicting six and half centuries of university history and collaboration between the university as well as the abbey in all disciplines present at medieval universities. The publication describes the historic frame work as well as case-by-case descriptions of displayed manuscripts, prints and artifacts. Die Universität Wien wurde 1365 gegründet und feiert 2015 ihr 650jähriges Bestehen. Aus Anlass dieses Jubiläums präsentiert das Benediktiner Stift Melk eine Ausstellung, in der sechseinhalb Jahrhunderte Universistaetsgeschichte aufgearbeitet werden, sowie die Zusammenarbeit zwischen Universität und Abtei auf allen Themenbereichen, die an mittelalterlichen Universitäten angeboten wurden. Die Publikation bietet eine historische Zusammenfassung sowie eine Detailbeschreibung der ausgestellten Handschriften, Drucke sowie Gegenstände.

  9. Die Struktur von schlankem Materialfluss mit Lean Production Kanban und Innovationen

    NASA Astrophysics Data System (ADS)

    Scheid, Wolf-Michael

    In der Literatur wird Materialfluss überwiegend in Spezialdisziplinen betrachtet, etwa der Steuerungslogik, der Logistiktechnik oder dem Supply Chain Management. Ein charakterisierendes Merkmal des Materialflusses ist jedoch, dass er sich aus vielfältigen Einzelbausteinen zusammensetzt, die alle harmonisch abgestimmt sein müssen. Die maximal erreichbare Effizienz wird nicht durch Höchstleistungen in dem einen oder anderen Spezialthema bestimmt, sondern durch das schwächste Glied im gesamten komplexen Netzwerk. Den Schnittstellen zwischen den betroffenen Fachbereichen in einem Unternehmen kommt hier eine ganz besondere Bedeutung zu: Erst ein harmonischer Einklang ermöglicht hohe Effektivität. Dies setzt umfassendes Verständnis für interdisziplinäre Notwendigkeiten, ein hohes Maß an Abstimmung mit den operativen Prozessen und letztlich einen einvernehmlichen Umgang und den Respekt vor den Problemstellungen des Anderen voraus.

  10. Charakterisierung von Sulfotransferasen im Gastrointestinaltrakt von Mensch und Ratte und Aktivierung von Promutagenen in V79-Zellen, die eine intestinale Form (1B1) des Menschen und der Ratte exprimieren

    NASA Astrophysics Data System (ADS)

    Teubner, Wera

    2001-05-01

    Die Ausstattung der gastrointestinalen Mukosa des Menschen und der Ratte mit Sulfotransferasen wurde mit Hilfe von Immunodetektion und Enzymaktivitätsmessungen untersucht. In Proben aus Colon und Rektum von 39 Personen wurden die Formen h1A1, h1A3 und h1B1 identifiziert, wobei in einer weiteren Probe, die als einzige von einem an Colitis Ulcerosa erkrankten Patienten stammte, keine Sulfotransferasen nachgewiesen werden konnten. Bei der Immunblot-Analyse war das Expressionsmuster der einzelnen Formen in allen Proben ähnlich. In wenigen Proben waren die relativen Signalintensitäten der h1A1 und der h1B1 um die Hälfte erniedrigt. Der Gehalt von SULT an zytosolischem Protein zeigte einen bis zu 8 - 10fachen Unterschied, er betrug jedoch bei zwei Dritteln der Proben zwischen 0,15 und 0,3 (h1A1 und h1A3) bzw. 0,6 und 0,8 Promille (h1B1). Die Variation konnte nicht auf Alter, Geschlecht oder Krankheitsbild der Patienten zurückgeführt werden. Auch der für die allelischen Varianten der h1A1 beschriebene Effekt auf die Enzymaktiviät bzw. Stabilität konnte in der Menge an immunreaktivem Protein nicht in diesem Ausma detektiert werden. Die Allelhäufigkeit von h1A1*R und h1A1*H war gegenüber der gesunden Bevölkerung nicht verändert. In den sieben Proben aus dem Dünndarm (Coecum, viermal Ileum, Jejunum) konnten zusätzlich die Formen h1E1 und h2A1 identifiziert werden. Ein möglicherweise der Form h1C1 entsprechendes Protein wurde im Magen detektiert. Im Vergleich zum Menschen war die Expression in der Ratte stärker auf die Leber konzentriert. Während beim Menschen in allen untersuchten Abschnitten Sulfotransferasen in Mengen detektiert wurden, die in zwei Fällen (h1B1 und h1A3) sogar den Gehalt in der Leber überstiegen, beschränkte sich die Expression in der Ratte auf im Vergleich zur Leber geringe Mengen im Magen und Dickdarm. Nachgewiesen wurden die r1B1, r1A1 sowie eine nicht identifizierte Form von 35kD, bei der es sich vermutlich um die r1C2 handelt. Im

  11. Bewertung und Verbesserung der Zuverlässigkeit von mikroelektronischen Komponenten in mechatronischen Systemen

    NASA Astrophysics Data System (ADS)

    Wunderlich, Hans-Joachim; Elm, Melanie; Kochte, Michael

    In den letzten Jahrzehnten hat der Anteil der informationsverarbeitenden Komponenten an den Herstellungskosten mechatronischer Systeme rapide zugenommen. In den 70er Jahren machte die Informationsverarbeitung noch ca. 15% des Systems aus. Zu Beginn dieses Jahrtausends sind es bereits über 60% [8.9], wie auch aus Abb. 8.1 hervorgeht. Dieser Zuwachs in den Herstellungskosten ist auf die Zunahme der durch die Informationsverarbeitung realisierten Funktionen zurückzuführen. Sehr deutlich ist diese Zunahme im Automobil zu beobachten. Während das Antiblockiersystem und die digitale Motorsteuerung schon seit Jahren zum Standard gehören, werden nun zunehmend auch Fahrerassistenz- und Infotainmentsysteme ins Kraftfahrzeug integriert. Bei diesen Systemen beginnt die Grenze zwischen klassischer Sicherheits- und Komfortfunktion zu verschwimmen. Die Bandbreite möglichen Fehlverhaltens reicht vom Ausfall des Navigationssystems über Störungen der Zentralverriegelung bis hin zum automatischen Einleiten von Bremsmanövern bei hohen Geschwindigkeiten. Entsprechend ergeben sich hier hohe Anforderungen an die Zuverlässigkeit dieser Systeme.

  12. Vergleich von rekombinanten Vaccinia- und DNA-Vektoren zur Tumorimmuntherapie im C57BL/6-Mausmodell

    NASA Astrophysics Data System (ADS)

    Johnen, Heiko

    2002-10-01

    In der vorliegenden Arbeit wurden Tumorimpfstoffe auf der Basis des Plasmid-Vektors pCI, modified vaccinia virus Ankara (MVA) und MVA-infizierten dendritischen Zellen entwickelt und durch Sequenzierung, Western blotting und durchflußzytometrische Analyse überprüft. Die in vivo Wirksamkeit der Vakzinen wurde in verschiedenen Tumormodellen in C57BL/6 Mäusen verglichen. Die auf dem eukaryotischen Expressionsvektor pCI basierende DNA-Vakzinierung induzierte einen sehr wirksamen, antigenspezifischen und langfristigen Schutz vor Muzin, CEA oder beta-Galactosidase exprimierenden Tumoren. Eine MVA-Vakzinierung bietet in den in dieser Arbeit durchgeführten Tumormodellen keinen signifikanten Schutz vor Muzin oder beta-Galactosidase exprimierenden Tumoren. Sowohl humane, als auch murine in vitro generierte dendritische Zellen lassen sich mit MVA – im Vergleich zu anderen viralen Vektoren – sehr gut infizieren. Die Expressionsrate der eingefügten Gene ist aber gering im Vergleich zur Expression in permissiven Wirtszellen des Virus (embryonale Hühnerfibroblasten). Es konnte gezeigt werden, daß eine MVA-Infektion dendritischer Zellen ähnliche Auswirkungen auf den Reifezustand humaner und muriner dendritischer Zellen hat, wie eine Infektion mit replikationskompetenten Vakzinia-Stämmen, und außerdem die Hochregulation von CD40 während der terminalen Reifung von murinen dendritischen Zellen inhibiert wird. Die während der langfristigen in vitro Kultur auf CEF-Zellen entstandenen Deletionen im MVA Genom führten zu einer starken Attenuierung und dem Verlust einiger Gene, die immunmodulatorische Proteine kodieren, jedoch nicht zu einer Verminderung des zytopathischen Effekts in dendritischen Zellen. Die geringe Expressionsrate und die beobachtete Inhibition der Expression kostimulatorischer Moleküle auf dendritischen Zellen kann für eine wenig effektive Induktion einer Immunantwort in MVA vakzinierten Tieren durch cross priming oder die direkte Infektion

  13. Tanzendes Tier oder exzentrische Positionalität - Philosophische Anthropologie zwischen Darwinismus und Kulturalismus

    NASA Astrophysics Data System (ADS)

    Fischer, Joachim

    Zunächst kurz vorweg zu den Formeln im Titel: "exzentrische Positionalität“ ist der Kategorienvorschlag der Philosophischen Anthropologie (genauer: von Helmuth Plessner) für den Menschen, für seine "Sonderstellung“ unter den Lebewesen - ich werde diesen Begriff erläutern. So viel kann man sagen: Der Terminus ist nicht schwieriger als "Transzendentalität“ oder das "Apriori“ oder "Autopoiesis“, also Begriffe, mit deren Orientierungswert in der intellektuellen Öffentlichkeit bereits gespielt wird, bietet aber möglicherweise mehr Erschließungskraft als die Kunstbegriffe z. B. von Kant, Maturana oder Luhmann. Und "tanzendes Tier“ ist ein glücklicher Anschauungsbegriff, eine Art Übersetzung für "exzentrische Positionalität“ - also ein "verrücktes“ Lebewesen, eine Verrückung im evolutionären Leben, die dieses Lebewesen von Natur aus zu einer bestimmten Art von Lebensführung, nämlich Kultur nötigt. Die Absicht des Beitrages ist es, die Philosophische Anthropologie als eine spezifische Theorietechnik zu präsentieren, um einen adäquaten Begriff des Menschen zu erreichen, und zwar eine Theoriestrategie angesichts des cartesianischen Dualismus - also des Dualismus zwischen Naturalismus und Kulturalismus.

  14. Critical limb ischaemia in a diabetic population from an Asian Centre: angiographic pattern of disease and 3-year limb salvage rate with percutaneous angioplasty as first line of treatment

    PubMed Central

    Tan, M; Pua, U; Wong, DES; Punamiya, SJ; Chua, GC; Teo, N

    2010-01-01

    Purpose: Lower extremity amputation prevention (LEAP) is an ongoing program in our institution aimed at salvaging limbs in patients with critical limb ischemia (CLI). Patients in the LEAP program with reconstructible anatomy on initial Doppler imaging received either bypass surgery or percutaneous transluminal balloon angioplasty (PTA). We present the 3 year limb salvage rate and angiographic disease patterns in 42 consecutive diabetic patients with CLI who received PTA in 2005. Methods and Material: 26 women and 16 men with diabetes between the ages of 45 and 91 years old (mean age, 70.8 years) received PTA in 2005. Presenting symptoms were rest pain (n = 22), pre-existing gangrene (n = 17), non-healing ulcer (n = 16) and cellulitis (n = 2). The aim of the PTA was to achieve straight-line flow from the abdominal aorta down to the patent dorsalis pedis or plantar arch, with limb salvage as the ultimate outcome. Failure of treatment was defined as any amputation above the level of a Syme’s amputation or the need for further surgical bypass. Technical success was achieved in 90% (38 out of 42 patients). Results: Limb salvage rates were 93% at 1 month, 87% at 3 months, 82% at 6 months, 78% at 1 year, 69% at 2 years and 66% at 3 years. Mortality was 17% (n = 7) at 3 years. Of the 13 patients with failed therapy, 3 underwent bypass, 9 had amputations and 1 had bypass followed by amputation. Four of the cases required further intervention due to worsening gangrene and infection, while the remaining was due to persistent rest pain. The rest of the 32 patients had no lower limb related issues at the end of 3 years, with improvement of the presenting symptoms. Patterns of treated segments were aortoiliac occlusions (n = 3), pure infrapopliteal disease (n = 3), femoropopliteal with at least 1 good infrapopliteal run-off vessel (n = 14) and combined femoropopliteal and infrapopliteal disease (n = 25). Conclusion: Involvement of infrapopliteal vessels that needs to be

  15. Efficacy and safety of venous angioplasty of the extracranial veins for multiple sclerosis. Brave dreams study (brain venous drainage exploited against multiple sclerosis): study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with a disabling progressive course. Chronic cerebrospinal venous insufficiency (CCSVI) has recently been described as a vascular condition characterized by restricted venous outflow from the brain, mainly due to blockages of the internal jugular and azygos veins. Despite a wide variability among studies, it has been found to be associated with MS. Data from a few small case series suggest possible improvement of the clinical course and quality of life by performing percutaneous balloon angioplasty (PTA) of the stenotic veins. Study design and methods This is a multicenter, randomized, parallel group, blinded, sham-controlled trial to assess the efficacy and safety of PTA. Participants with relapsing remitting MS or secondary progressive MS and a sonographic diagnosis of CCSVI will be enrolled after providing their informed consent. Each participant will be centrally randomized to receive catheter venography and PTA or catheter venography and sham PTA. Two primary end points with respect to efficacy at 12 months are (1) a combined end point obtained through the integration of five functional indicators, walking, balance, manual dexterity, bladder control, and visual acuity, objectively measured by instruments; and (2) number of new brain lesions measured by T2-weighted MRI sequences. Secondary end points include annual relapse rate, change in Expanded Disability Status Scale score, proportion of patients with zero, one or two, or more than two relapses; fatigue; anxiety and depression; general cognitive state; memory/attention/calculus; impact of bladder incontinence; and adverse events. Six hundred seventy-nine patients will be recruited. The follow-up is scheduled at 12 months. Patients, treating neurologists, trained outcome assessors, and the statistician in charge of data analysis will be masked to the assigned treatment. Discussion The study will

  16. IntegraTUM Teilprojekt E-Mail: Aufbau eines mandantenfähigen Groupware-Services und seine Integration in Identity Management und E-Mail Infrastruktur der Technischen Universität München

    NASA Astrophysics Data System (ADS)

    Diehn, Max

    Die E-Mail-Infrastruktur an der Technischen Universität München (TUM) ist historisch bedingt sehr heterogen und komplex. Viele Einrichtungen müssen wertvolle Arbeitskraft auf die Administration eigener Mailserver verwenden. Auf der anderen Seite wird bei einigen Einrichtungen der Ruf nach Groupware-Funktionalitäten wie z.B. gemeinsame Kalender immer lauter. Das Teilprojekt E-Mail stellt einen zentralen Mail- und Groupware-Service bereit, der den Einrichtungen ermöglichen soll, den Betrieb eigener Server und zugehöriger Systeme (etwa lokaler Benutzerverwaltungen) für diesen Zweck aufzugeben und diese Dienste an das Teilprojekt E-Mail zu migrieren, ohne ihre Verwaltungshoheit oder ihre Maildomains aufgeben zu müssen. Dieser Service versteht sich als eine Ergänzung zur bestehenden Grundversorgung der TUM mit den Maildiensten des myTUM-Mailers, ist mandantenfähig aufgebaut und kann daher künftig neben der TUM auch weiteren Organisationen im Münchner Wissenschaftsnetz zur Verfügung gestellt werden.

  17. Herausforderungen und Best Practices bei der Speicherung von multi-valued Attributen in LDAP-basierten Verzeichnisdiensten

    NASA Astrophysics Data System (ADS)

    Hommel, Wolfgang; Pluta, Daniel

    LDAP-basierte Verzeichnisdienste unterscheiden sich von relationalen Datenbankmanagementsystemen unter anderem stark bezüglich der Datenmodellierung. Dieser Artikel vertieft eingangs die Herausforderungen bei der LDAP-spezifischen Abbildung von Relationen zwischen mehreren multivalued Attributen. Die Diskussion erfolgt vor dem Hintergrund, dass einerseits Verzeichnisdienste generell nur bedingt zur Speicherung von Relationen geeignet sind und dass andererseits multi-valued Attribute ein mächtiges LDAP-Instrument sind, zu dem es in relationalen Datenbanksystemen keine direkte Entsprechung gibt. Anschließend werden Lösungskonzepte vorgestellt und mögliche Weiterentwicklungen des IntegraTUM-LDAP-Schemas zu deren Umsetzung skizziert, eine exemplarische Implementierung präsentiert und die Ergebnisse der bisherigen Entwicklung des IntegraTUM-Schemas gegenübergestellt.

  18. Gesellschaft, Lebensgemeinschaft, Ökosystem - Über die Kongruenz von politischen und ökologischen Theorien der Entwicklung

    NASA Astrophysics Data System (ADS)

    Voigt, Annette

    Im Jahr 1859 veröffentlichte Charles Darwin "On the Origin of Species“. Seine Evolutionstheorie ist das wohl spektakulärste Beispiel einer naturwissenschaftlichen Theorie großer gesellschaftlicher Relevanz. Ihre verschiedenen Facetten wurden in der Öffentlichkeit kontrovers diskutiert, unter anderem auch ihre Anwendung zur Erklärung von Zuständen und Prozessen menschlicher Gesellschaften. Zum Teil wurde die Seiensweise der Natur - scheinbar unabhängig von gesellschaftlichen Interessen - für die Erklärung und Legitimation gesellschaftlicher Zustände oder die Legitimation von politischen Ideologien herangezogen (Sozialdarwinismus). Denn Gesellschaft funktioniere ja so, wie Darwin die Natur erklärt habe: es herrsche z. B. Konkurrenzkampf, Auslese und Arbeitsteilung, Erfolg hätten diejenigen, die sich an die Bedingungen am Besten anpassten.

  19. Mercaptursäure und Nukleosidaddukt im Harn als Biomarker in 1-Hydroxymethylpyren-exponierten Ratten

    NASA Astrophysics Data System (ADS)

    Ma, Lan

    2002-01-01

    1-Methylpyren (MP) ist hepatokanzerogen in neugeborenen männlichen Mäusen. Durch Hydroxylierung an der benzylischen Stelle und anschließende Sulfonierung wird MP zu DNA-reaktivem 1-Sulfooxymethylpyren (SMP) aktiviert. In der Ratte führt die Exposition des benzylischen Alkohols, 1-Hydroxymethylpyren (HMP), zur DNA-Adduktbildung in verschiedenen Geweben. Eventuelle Konsequenz der Toxifizierung ist die Ausscheidung entsprechender Mercaptursäure und Nukleosidaddukt im Harn, welche aufgrund ihrer Herkunft als Biomarker eignen könnten. In dieser Arbeit wird die Ausscheidung der Mercaptursäure und des N2-Desoxyguanosinadduktes in HMP-exponierten Ratten untersucht. Nach der Applikation von HMP bzw. MP wurden weniger als 1 % der Dosis als MPMA über Urin und Faeces ausgeschieden (0 - 48 h). Die Ausscheidung erfolgt hauptsächlich in den ersten 24 h nach der Applikation. MPdG konnte weder in Urin noch in Faeces der HMP-behandelten Tieren identifiziert werden. Nach direkter SMP-Applikation wurde MPdG nur in sehr geringe Menge (weniger als 0,9 ppm in 12 h) im Urin gefunden. Aufgrund der geringen Menge eignet sich MPdG nicht als Biomarker. MPMA dagegen, lässt sich analytisch gut erfassen. Es sollte daher untersucht werden, ob MPMA die Toxifizierung des HMP wiederspiegelt. Die Voraussetzung dafür ist die Kenntnisse über das Metabolismusmuster von HMP. Es wurde daher umfassende Untersuchungen zum Metabolismus des HMP durchgeführt. Die Ergebnisse zeigten, dass mehr als 80 % der Metaboiten in ihrer oxidierten Form (PCS, deren Glucuronsäure-Konjugate sowie phenolische Sulfatester der PCS) ausgeschieden wurden. Demnach spielt die Oxidation des HMP zu PCS eine sehr wichtige Rolle bei der Detoxifizierung und Ausscheidung von HMP. Ferne konnte nachgewiesen werden, dass die Enzyme Alkohol- und Aldehyd-Dehydrogenase an der Oxidation von HMP beteiligt waren. Die Inhibitoren Disulfiram und Ethanol der o. g. Enzyme wurde daher zur Modulation der Detoxifizierung in vivo eingesetzt

  20. Hochenergieröntgenspektren der akkretierenden Röntgenpulsare Vela X-1 und A 0535+26

    NASA Astrophysics Data System (ADS)

    Kretschmar, Peter

    1996-04-01

    In dieser Arbeit wurden Daten aus gemeinsamen, zeitgleichen Beobachtungen der bei- den akkretierenden Röntgenpulsare VelaX-1 und A0535+26 durch die Instrumente HEXE und TTM an Bord der Raumstation Mir ausgewertet. Die Kombination der gemeinsamen Beobachtungen erlaubte zum ersten Mal die Analyse von Lichtkurven, Pulsprofilen und Spektren dieser Quellen im breiten Energieband von 2–200 keV.Obwohl die Systemparameter und Akkretionsmechanismen der beiden Quellen recht verschieden sind, weisen sie im Röntgenbereich einige Ähnlichkeiten auf. So zeigen die Lichtkurven beider Quellen starke Puls-zu-Puls Variationen. Erst bei der Überlagerung hinreichend vieler Pulse ((geq) 10) ergeben sich die recht stabilen mittleren Pulsprofile. Das Spektrum einzelner Pulse kann deutlich vom mittleren Spektrum abweichen, es ergaben sich aber keine Hinweise auf systematische Zusammenhänge mit anderen Größen, wie z.B. dem Gesamtfluß.Die Kontinuumsspektren der beiden Röntgenpulsare werden am besten durch das “Potenzgesetz mit exponentiellem Abfall” beschrieben. “Physikalische” Spektren, die auf stark vereinfachten Modellen beruhen, wie z.B. comptonisierte Spektren, beschreiben das erstmals aus zeitgleichen Beobachtungen bestimmte Breitbandkontinuum systematisch schlechter. In beiden Quellen hängt die Form der Kontinuumsspektren von der Pulsphase ab, allerdings in unterschiedlicher Ausprägung: Für Vela X-1 ergibt sich eine signifikante Variation unterhalb des spektralen Knicks bei ˜20 keV, für A 0535+26 dagegen oberhalb.In den Spektren beider Quellen gibt es deutliche Hinweise auf Zyklotronresonanzlinien, wobei die Stärke und Signifikanz der Strukturen mit der Pulsphase variiert. A 0535+26 zeigt statistisch sehr signifikante Strukturen bei ˜50 und ˜100 keV. Die statistisch etwas weniger signifikanten Strukturen bei ˜23 und ˜45 keV in den Vela X-1 Spektren stimmen gut überein mit Ergebnissen der Ginga -Beobachtungen dieser Quelle (Mihara 1995). Die