-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate the feasibility and safety of intravascular radiation therapy (IVRT) using Re-188 filled balloon system in patients with in-stent stenosis.
A total of 39 patients with in-stent restenosis were enrolled as the IVRT (22 patients) and control groups (17 patients) of this study after a successful coronary angioplasty. For irradiation the angioplasty balloon was replaced by a noncompliant balloon of the same diameter but 10 mm longer in length with a proximal and distal radio-opaque marker to deliver the dose of 18 Gy at 0.5 mm depth from the surface of the balloon into the vessel wall. Angiographic follow-up was performed after 6 months.
The length of the irradiated segment was between 9.14 and 22 mm and the diameter between 2.5 and 3 mm. In the IVRT group, two patients who did not receive antiplatelet therapy had myocardial infarction. Four patients who presented with stable angina earlier also had angiographically documented in-stent occlusion (two patients) and edge stenosis (two patients) of the target lesion and received angioplasty (18.1%). In the control group, three patients with recurrent angina and four asymptomatic patients had documented in-stent occlusion angiographically at 6 months and these seven patients underwent target lesion revascularization (41.2%). The overall restenosis rate in the IVRT and control groups were 23.91 and 39.86%, respectively (P=0.013). No complications were documented, except anginal pain and ST segment changes.
Our results indicated that the Re-188 liquid-filled balloon is feasible, safe, and effective in patients with in-stent restenosis.
Nuclear Medicine Communications 05/2010; 31(8):746-52. · 1.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate the accuracy of multislice computed tomography in detecting graft stenosis or occlusion after coronary artery bypass grafting, using coronary angiography as the standard. From January 2005 through May 2006, 25 patients (19 men and 6 women; mean age, 54 +/- 11.3 years) underwent diagnostic investigation of their bypass grafts by multislice computed tomography within 1 month of coronary angiography. The mean time elapsed after coronary artery bypass grafting was 6.2 years. In these 25 patients, we examined 65 bypass conduits (24 arterial and 41 venous) and 171 graft segments (the shaft, proximal anastomosis, and distal anastomosis). Compared with coronary angiography, the segment-based sensitivity, specificity, and positive and negative predictive values of multislice computed tomography in the evaluation of stenosis were 89%, 100%, 100%, and 99%, respectively. The patency rate for multislice computed tomography was 85% (55/65: 3 arterial and 7 venous grafts were occluded), with 100% sensitivity and specificity. From these data, we conclude that multislice computed tomography can accurately evaluate the patency and stenosis of bypass grafts during outpatient follow-up.
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 02/2007; 34(3):296-300. · 0.65 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the effect of coronary bypass grafting on left ventricular (LV) function, exercise capacity and symptom profile in patients with LV impairment and retrospectively evaluate the role of the different factors affecting LV.
A total of 45 patients (33 men, 12 women, mean age 63.49 +/- 7.38 years) with LV ejection fraction of less than 0.32 were admitted to the Istanbul University, Cardiology Institute, Istanbul, Turkey between January 2001 to June 2003 for coronary bypass operation. Preoperative and postoperative wall motion, functional class (New York Heart Association) and risk factors were analyzed.
We had one perioperative mortality (2.2%) and 2 early postoperative mortality (4.4%) due to poor cardiac function. There was a significant increase in the mean LV ejection fraction from 26.64 +/- 5.17 to 32.98 +/- 6.38 (p<0.001) postoperatively. In this group the mean New York Heart Association grade improved from 2.07 +/- 0.76 to 1.5 +/- 0.79 (p<0.001). Preoperative functional class, congestive heart failure, arrhythmia, age, pre/postoperative complications were the main predictors of poor outcome following surgical revascularization for ischemic cardiomyopathy.
In patients with severe LV impairment with myocardial hibernation, coronary artery bypass grafting improves both global and regional LV function and symptom profile. We therefore, recommend a coronary artery bypass grafting as an alternative to orthotopic heart transplantation whenever myocardial viability are documented.
Saudi medical journal 02/2007; 28(1):54-9. · 0.52 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: An anomalous origin and course of the coronary arteries can be benign or life threatening. Recently, because of new advances in computed tomography technology, radiologists have begun to interpret the diseases of coronary arteries. We aimed to demonstrate some remarkable anomalies of coronary arteries, some of which were not shown by multidetector computed tomography (MDCT) coronary angiography previously, and to discuss the clinical importance of these anomalies.
Seven hundred twenty-five consequent patients referred to Florence Nightingale Hospital and Atatürk University Hospital for MDCT coronary angiography were included in this study. The patients were between the ages of 33 and 78 years (mean +/- SD, 59 +/- 13.86 years). Four hundred ninety-seven patients (68.6%) were men, and 228 (31.4%) were women. All the examinations were evaluated by both a radiologist and a cardiologist.
The incidence of anomalous anatomical origin and course of the coronaries found in our study group was 5.79% (n = 42). The anomalies found in our study are absence of the right coronary artery (RCA; n = 1, 0.13%), ectopic origin of RCA from the left anterior descending (LAD) artery (n = 1, 0.13%), absence of the left main coronary artery (n = 4, 0.52%), ectopic origin of the left main coronary artery from the right sinus of Valsalva (n = 1, 0.13%), double LAD and ectopic origin of LAD from RCA (n = 1, 0.13%), ectopic origin of the left circumflex artery from the right sinus of Valsalva (n = 3, 0.39%), ectopic origin of the left circumflex artery from RCA (n = 2, 0.26%), and myocardial bridging (n = 29, 4%).
An anomalous origin of the coronary anatomy must be present in the interpretations because of its importance for patients, cardiologists, and surgeons. As a conclusion, our study showed that MDCT, especially volume rendering and maximum intensity projection techniques, may be useful for assessment of complex variations, when the conventional angiography may not be sufficient.
Journal of Computer Assisted Tomography 10/2006; 30(6):939-48. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to evaluate the incidence of myocardial bridging in 626 patients examined with MDCT angiography of the coronary arteries.
Six hundred twenty-six patients who were referred to Florence Nightingale and Atatürk University Hospitals were involved in this study. These patients had atypical chest pain, symptoms suggestive of coronary artery disease, or no significant cardiac complaint. Patients were in sinus rhythm and were premedicated with metoprolol tartrate (5 mg/mL IV bolus) to decrease the heart rate and nitroglycerin (5 mg sublingual 1 min before the examination) to dilate the coronary arteries. MDCT was performed on two different 16-MDCT scanners.
Among the 626 patients, 22 cases (3.5%) of myocardial bridging were detected. Fifteen cases of myocardial bridging (2.4%) were located at the middle third of the left anterior descending coronary artery (LAD), five (0.8%) were at the distal third of the LAD, and two (0.3%) were at the proximal third of the LAD. In these patients, the length of tunneled artery was between 6 and 22 mm, with a mean of 17 mm, and the depth of tunneled artery was between 1.2 and 3.3 mm, with a mean of 2.5 mm.
We found the incidence of myocardial bridging in this patient group to be 3.5%. This result is in agreement with some of the angiographic studies in the literature. Our study showed that MDCT is a reliable and noninvasive tool for diagnosing coronary myocardial bridging. After evaluating resource axial images, it is necessary to also evaluate the sagittal multiplanar reconstruction images for myocardial bridging.
American Journal of Roentgenology 07/2006; 186(6 Suppl 2):S391-4. · 2.78 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In sarcoidosis patients the circulating immune complex levels are raised with the activation of the disease but their diagnostic role is not clear. These circulating immune complexes contain complement and immunoglobulins (Ig). Complement and immunoglobulins are mostly accumulated in active sarcoid lesions and in circulating immune complexes. Thus complement and Ig levels in circulation will be reduced in active sarcoidosis patients due to their higher deposition in sarcoid lesions. We tried to make an estimation about the activity of the disease through measuring the IgG, IgA, and IgM and complement (C3-C4) levels in the serum.
Thirty-two (8 men) sarcoidosis patients (with their symptoms, chest x-ray graphies, bronchioalveolar lavage findings and the other related WASOG criteria) were divided into two groups as active and inactive cases. We measured with the immunodiffusion method the immunoglobulin and complement parameters of these two groups and compared them with each other.
Compared to the active group the IgG and IgA in serum were significantly higher in the inactive group (p < 0.001, p=0.07 ). Although statistically not significant the IgM and C3, C4 levels were higher too in the inactive group.
The IgG, IgA, IgM and the complement levels in serum are higher in the inactive group. We think that these findings might be useful for the follow up of the disorder's activity in sarcoidosis patients. In order to prove these finding studies with larger volume are needed.
The Kobe journal of medical sciences 02/2003; 49(5-6):99-106.
