Publications (38) View all
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Article: An integrated coastal modeling system for analyzing beach processes and beach restoration projects, SMC
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ABSTRACT: A user-friendly system called coastal modeling system (SMC) has been developed by the Spanish Ministry of Environment and the University of Cantabria. The system includes several numerical models specifically developed for the application of the methodology proposed in the Spanish Beach Nourishment and Protection Manual. According to this methodology, the SMC is structured into five-modules: (1) Pre-process module; (2) Short-term module; (3) Long-term module; (4) Coastal terrain module; and (5) Tutorial module. The pre-process module allows the processing of a database of morphodynamic information used as input for the different programs and models of the SMC. Short-, Long-term modules include numerical models to analyze coastal systems on different scales of variability (hours–months–years) and are composed of morphodynamic evolution models in cross-profile 2DV and beach plan 2DH. The coastal terrain module allows the user to modify the working bathymetry and to combine bathymetries from different sources in only one working bathymetry. The tutorial module includes a comprehensive collection of coastal engineering design and analysis software. The SMC has a dynamic design and allows the incorporation of future new databases and morphodynamic models. The SMC system is freely distributed to coastal practitioners and has already been implemented in several countries.Computers & Geosciences. 01/2007; -
Article: [Treatment of acute myocardial infarction with the x-sizer coronary thrombectomy device].
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ABSTRACT: The abundant thrombi present in infarct-related arteries may impair the angiographic result of primary angioplasty in acute myocardial infarction. We describe the utilization of the thrombus-removal device X-Sizer before coronary stenting in 4 patients with acute myocardial infarction treated with primary angioplasty. The procedure was successful in all the cases and the patients were discharged without complications.Revista Espa de Cardiologia 07/2001; 54(6):793-6. · 2.53 Impact Factor -
Article: Long-term outcome of patients with proximal left anterior descending coronary artery in-stent restenosis treated with rotational atherectomy.
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ABSTRACT: Once a first interventional procedure has failed, patients with proximal left anterior descending in-stent restenosis are frequently sent for surgical revascularization. Data on long-term outcome in selected patients with proximal left anterior descending in-stent restenosis treated with RA are lacking. The study's objective was to evaluate the long-term outcome of patients with proximal left anterior descending artery in-stent restenosis treated with rotational atherectomy. The study population is constituted by 42 patients with proximal left anterior descending in-stent restenosis treated with rotational atherectomy. Patients were followed up for 2.1 +/- 0.9 years (range, 6--54). Restenosis length was 16.5 +/- 9.2 mm, and restenosis was diffuse (> 10 mm in length) in 30 (71.4%). The rotational atherectomy procedure was guided by intravascular ultrasound in 18 patients (42.9%). Maximum burr/artery ratio was > 0.7 in 24 (57.1%) patients. One patient suffered a periprocedural non--Q-wave infarction, but no deaths, Q-wave infarction, or new target vessel revascularization occurred during hospitalization. There were no deaths or myocardial infarctions after discharge. Sixteen patients (38.1%) needed a new revascularization, but only five (11.9%) underwent coronary bypass grafting at the end of the follow-up (2.1 +/- 0.9 years). The rate of surgical revascularization at 6 months, 1 year, and 3 years was 4.8%, 7.4%, and 18.4%, respectively. The rate of new target vessel revascularization at 6 months, 1 year, and 3 years was 16.7%, 36.5%, and 40.5%, respectively. Patients with < or = 5 months since stent implantation had a significantly higher rate of new target vessel revascularization. Patients with proximal left anterior descending in-stent restenosis may be safely treated with rotational atherectomy. This strategy is associated with a very good long-term outcome, with few patients undergoing surgical revascularization.Catheterization and Cardiovascular Interventions 04/2001; 52(4):435-42. · 2.29 Impact Factor -
Article: [In-hospital major complications associated with rotational atherectomy: experience with 800 patients at a single center].
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ABSTRACT: Rotational atherectomy is usually performed in patients with angiographically determined high risk coronary lesions. The aim of this study was to evaluate the rate of major adverse cardiac events (death, Q-wave infarction or new revascularization) after rotational atherectomy, as well as to identify the clinical characteristics associated with this incidence. The study population included 800 patients treated with rotational atherectomy from 1993 to 1999: 512 (64%), for de novo lesions, and 288 (36%) for restenosis. Balloon dilation and coronary stenting was performed in 95% and 34% of patients, respectively. During hospitalization, 17 patients (2.1%) died, 16 (2%) had a Q-wave infarction, 30 (3.8%) a non-Q infarction, and new revascularization was performed in 28 (3.5%). The incidence of major adverse cardiac events was 6.5% (n = 52), this incidence being higher in the presence of diabetes (8.9 vs. 4.4%; p = 0.01), unstable angina or acute/recent myocardial infarction (7.6 vs. 3.3%; p = 0.02), multivessel disease (8.6 vs. 3.3%; p < 0.01), treated vessel other than right coronary (7.0 vs. 1.7%; p = 0.01), procedure in > 1 vessel (10.7 vs. 4.7%; p < 0.01), angiographic failure (62.5 vs. 5.5%; p < 0.001), and de novo lesions (8.4 vs. 2.5%; p < 0.01), with diabetes and treatment of de novo lesions being independent predictors of major adverse cardiac events. However, age, previous infarction, and left ventricular dysfunction, were not associated with the rate of events. Some simple variables are associated with a higher incidence of major adverse cardiac events after rotational atherectomy. Advanced age, previous infarction and left ventricular dysfunction, however, do not necessarily imply a poorer prognosis in these patients.Revista Espa de Cardiologia 04/2001; 54(4):460-8. · 2.53 Impact Factor -
Article: Early coronary angioplasty for acute myocardial infarction: predictors of poor outcome in a non-selected population.
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ABSTRACT: The objective of this study was to report the experience in the treatment of acute myocardial infarction (AMI) with early coronary angioplasty (PTCA) in a single European center during one decade, attempting to identify the characteristics associated with a poor prognosis in these patients. Eight hundred patients with AMI were treated with PTCA < 12 hours after symptom onset. Mean age was 64 +/- 13 years, 12% were in cardiogenic shock, AMI location was anterior in 61% and PTCA was performed after failed thrombolysis in 5%. Coronary stents and abciximab were used in 51% and 10%, respectively. An angiographic successful result was obtained in 93%, and final TIMI flow grade 3 was achieved in 83%. The overall in-hospital mortality rate was 12.5% (2.7%, 16.1%, 25.7% and 63.8% in patients in Killip class I, II, III and IV, respectively). Over the years, an improvement in the angiographic results and a reduction in the rates of reinfarction and target vessel revascularization were observed. The independent predictors of death were age > 70 years, absence of hyper-cholesterolemia, anterior location, cardiogenic shock, multi-vessel disease and unsuccessful PTCA. The leading causes of mortality were cardiogenic shock (63%) and ventricular free wall rupture (14%). The rates of non-fatal reinfarction, documented reocclusion and in-hospital repeated revascularization were 2%, 3% and 4%, respectively. In most cases, PTCA performed in a non-selected patient population with AMI results in angiographic success. Mortality especially occurs in patients who are in cardiogenic shock at the beginning of the procedure. We have observed an improvement in the results throughout the course of the decade.The Journal of invasive cardiology 04/2001; 13(3):202-10. · 1.84 Impact Factor
