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Angiographic Catheter

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Peter R Schofield – One of the best experts on this subject based on the ideXlab platform.

  • coronary flow reserve measurements with a new judkins style doppler Angiographic Catheter
    Angiology, 1993
    Co-Authors: Anoop Chauhan, Paul A. Mullins, Suren Thuraisingham, Michael C. Petch, Gerard W Taylor, Peter R Schofield

    Abstract:

    The authors assessed whether measurements obtained by Judkins-style Dop pler Catheters are comparable to those achieved with the intracoronary Doppler technique in 42 patients with normal coronary arteries on angiography (19 syn drome X and 23 heart transplant patients). Resting coronary flow velocity and response to a hyperemic intracoronary dose of papaverine was measured with a Judkins-style, 8F Doppler-tipped Catheter positioned in the left coronary ostium and a 3.6F intracoronary Doppler Catheter positioned in the proximal left ante rior descending artery. Mean coronary flow velocity at rest was significantly higher with the Judkins Doppler (10.1 ± 4.6 vs 6.3 ± 4.5 cm/sec, p < 0.01). The mean coronary flow velocity at peak hyperemia was also significantly higher with the Judkins Doppler (33.7 ± 14.1 vs 19.7 ± 11.5 cm/sec, p < 0.01). Coro nary flow reserve was 3.57 ± 1.3 with the Judkins Doppler and 3.47 ± 1.2 with the intracoronary Doppler (r = 0.85) . A second study was performed in 14 heart transpl...

  • Validation study of a Doppler-tipped Angiographic Catheter for measurement of coronary flow reserve
    American Journal of Cardiology, 1993
    Co-Authors: Anoop Chauhan, Paul A. Mullins, Suren Thuraisingham, Gerard Taylor, Michael C. Petch, Peter R Schofield

    Abstract:

    Abstract There has been increasing interest in the use of coronary flow reserve measurements to define pathophysiology in various patient groups and to make individual patient management decisions. The concept of coronary flow reserve has provided a method for describing the capacity to conduct maximal hyperemic blood flow. Coronary flow reserve is the ratio of maximal to resting coronary blood flow. The study of coronary circulation in humans has been made possible through the development of several methods.1–6Currently, the most extensively used and validated method is the transluminal, subselective measurement of coronary blood flow velocity and vasodilator reserve.1 The use of intracoronary Doppler Catheters permits rapid and accurate measurements of coronary vasodilator responses to various pharmacologic and physiologic stimuli.7,9 However, the major limitation of this technique is instrumentation of the coronary artery with an angioplasty guide wire and the Doppler Catheter, which requires considerable operator experience and also has the possibility of potential serious vascular complications such as dissection, vasospasm and thrombosis. Systemic heparinization is also required. Recently a new Judkins-style Doppler-tipped Angiographic Catheter has been developed to facilitate a more rapid and safe measurement of coronary flow reserve.6 We assessed whether the coronary flow reserve measurements obtained with these Catheters are comparable to those achieved with the intracoronary Doppler Catheter technique.

Anoop Chauhan – One of the best experts on this subject based on the ideXlab platform.

  • coronary flow reserve measurements with a new judkins style doppler Angiographic Catheter
    Angiology, 1993
    Co-Authors: Anoop Chauhan, Paul A. Mullins, Suren Thuraisingham, Michael C. Petch, Gerard W Taylor, Peter R Schofield

    Abstract:

    The authors assessed whether measurements obtained by Judkins-style Dop pler Catheters are comparable to those achieved with the intracoronary Doppler technique in 42 patients with normal coronary arteries on angiography (19 syn drome X and 23 heart transplant patients). Resting coronary flow velocity and response to a hyperemic intracoronary dose of papaverine was measured with a Judkins-style, 8F Doppler-tipped Catheter positioned in the left coronary ostium and a 3.6F intracoronary Doppler Catheter positioned in the proximal left ante rior descending artery. Mean coronary flow velocity at rest was significantly higher with the Judkins Doppler (10.1 ± 4.6 vs 6.3 ± 4.5 cm/sec, p < 0.01). The mean coronary flow velocity at peak hyperemia was also significantly higher with the Judkins Doppler (33.7 ± 14.1 vs 19.7 ± 11.5 cm/sec, p < 0.01). Coro nary flow reserve was 3.57 ± 1.3 with the Judkins Doppler and 3.47 ± 1.2 with the intracoronary Doppler (r = 0.85) . A second study was performed in 14 heart transpl...

  • Validation study of a Doppler-tipped Angiographic Catheter for measurement of coronary flow reserve
    American Journal of Cardiology, 1993
    Co-Authors: Anoop Chauhan, Paul A. Mullins, Suren Thuraisingham, Gerard Taylor, Michael C. Petch, Peter R Schofield

    Abstract:

    Abstract There has been increasing interest in the use of coronary flow reserve measurements to define pathophysiology in various patient groups and to make individual patient management decisions. The concept of coronary flow reserve has provided a method for describing the capacity to conduct maximal hyperemic blood flow. Coronary flow reserve is the ratio of maximal to resting coronary blood flow. The study of coronary circulation in humans has been made possible through the development of several methods.1–6Currently, the most extensively used and validated method is the transluminal, subselective measurement of coronary blood flow velocity and vasodilator reserve.1 The use of intracoronary Doppler Catheters permits rapid and accurate measurements of coronary vasodilator responses to various pharmacologic and physiologic stimuli.7,9 However, the major limitation of this technique is instrumentation of the coronary artery with an angioplasty guide wire and the Doppler Catheter, which requires considerable operator experience and also has the possibility of potential serious vascular complications such as dissection, vasospasm and thrombosis. Systemic heparinization is also required. Recently a new Judkins-style Doppler-tipped Angiographic Catheter has been developed to facilitate a more rapid and safe measurement of coronary flow reserve.6 We assessed whether the coronary flow reserve measurements obtained with these Catheters are comparable to those achieved with the intracoronary Doppler Catheter technique.

Y. Takase – One of the best experts on this subject based on the ideXlab platform.

  • eight years of experience with transjugular retrograde obliteration for gastric varices with gastrorenal shunts
    Surgery, 2001
    Co-Authors: F. Chikamori, N. Kuniyoshi, S. Shibuya, Y. Takase

    Abstract:

    Background and objectives. There is no standard treatment for gastric varices. Transjugular retrograde obliteration (TJO) is one way of obliterating gastric varices with gastrorenal shunts, in which blood flow is abundant. Our aim was to examine our experience with TJO during an 8-year period and to determine the long-term effects of this treatment. Methods. We performed TJO procedures in 52 patients to obliterate gastric varices. All the patients had liver cirrhosis. Sixteen had hepatocellular carcinoma (HCC) without vascular invasion. We inserted an Angiographic Catheter with an occlusive balloon through the right internal jugular vein into the gastrorenal shunt or the gastric varices. After controlling the other blood-draining routes with a microcoil or absolute ethanol, or both, we injected 5% ethanolamine oleate with iopamidol into the gastric varices under fluoroscopy. Results. The gastric varices were successfully obliterated by TJO in all cases. The complications were all minor and transient. The mortality rate for TJO was 0%. There was no recurrence and no bleeding of gastric varices at all after TJO. Patient survival differed depending on the presence or absence of HCC (P < .05). The development of HCC in the cirrhotic liver was the most common cause of late death. Gastrointestinal bleeding was not a cause of death. The occurrence rate of esophageal varices after TJO was high, but these varices could be treated easily by endoscopic injection sclerotherapy before they bled. Conclusions. Portal blood flow through the gastrorenal shunt is diverted to the porto-azygos venous system after the gastrorenal shunt is obliterated by TJO. TJO is a safe option that we recommend for treating gastric varices with gastrorenal shunts, provided that the TJO is followed by endoscopic injection sclerotherapy. (Surgery 2001;129:414-20.)

  • Transjugular retrograde obliteration for chronic portosystemic encephalopathy
    Abdominal Imaging, 2000
    Co-Authors: F. Chikamori, N. Kuniyoshi, S. Shibuya, Y. Takase

    Abstract:

    Chronic portosystemic encephalopathy (CPSE) is uncommon, and its management has yet to be determined. We have been able to control five cases of CPSE using transjugular retrograde obliteration (TJO), and we report our clinical results with this technique. All of the five patients were suffering from cirrhosis and had gastric varices and large gastrorenal shunts. According to Sherlock’s classification, the grade of encephalopathy was II in two patients, III in two, and IV in one. According to Child’s classification, one had class B and four had class C cirrhosis. TJO was performed using a 6-F Angiographic Catheter with an occlusive balloon 20 mm in diameter. Absolute ethanol and 5% ethanolamine oleate with iopamidol were used to obliterate the gastrorenal shunt. The gastrorenal shunt was successfully obliterated, and the encephalopathy improved to grade 0 after TJO in all cases. The portal flow volume increased significantly from 542 ± 189 to 992 ± 139 mL/min (p < 0.01). The plasma ammonia levels before and after TJO were 189 ± 40 and 51 ± 23 μg/dL, and the indocyanine green retention rates at 15 min were 44 ± 13% and 27 ± 12%, with both changes being significant (p < 0.01). Minor complications observed were fever of over 38°C and tarry stools due to hemorrhagic gastritis in one patient, which was being controlled conservatively. One patient died of hepatocellular carcinoma 27 months after TJO. The other four patients survived without recurrence of CPSE 17–74 months (44 ± 24 months) after TJO. We conclude that TJO can be adopted as a safe and effective treatment for CPSE. RID="" ID="" Correspondence to: F. Chikamori