By J. Richard Spears (auth.), Patrick W. Serruys, Bradley H. Strauss, Spencer B. King III (eds.)
From the Foreword via Eric J. Topol some time past 5 years, interventional cardiology has entered a brand new period of comparing percutaneous transcatheter applied sciences to regard coronary artery ailment and forestall restenosis. Cardiologists trying to keep on with this new and fascinating box may perhaps simply be harassed through the expansion and growth of latest units, the technical information proper to every machine and enthusiastic claims of luck. This monograph is a accomplished and goal review of restenosis from the point of view of those new applied sciences together with stenting, atherectomy, rotational abrasion and lasers, written by means of innovators and pioneers.
The foreign breadth of expertise is mirrored within the precis of studies from each side of the Atlantic, from time to time with conflicting observations and effects which in itself is effective, given the various event so far. as well as the lucid summaries of the early and past due result of those new units, vital matters within the method of restenosis examine are addressed, together with barriers of quantitative coronary arteriography in comparing the recent units and critical advances in possible choices to arteriography similar to intravascular imaging. As a complete, this monograph is phenomenally helpful due to its entire, up to date, balanced and visionary components. there isn't any query that the hot coronary machine period has ushered in a few pleasure, and a few depression.
This booklet serves a pivotal objective via weaving such a lot of new innovations jointly, constructing the foundation for additional improvement of mechanical methods to restrict restenosis. I heartily suggest this article to all interventional cardiologists drawn to useful and examine points of restenosis.
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Additional info for Restenosis after Intervention with New Mechanical Devices
European Heart Journal (submitted) Laarman G J, Serruys P W, de Feyter P J (1990) Percutaneous coronary rotational atherecto my (Rotablator). Netherlands J CardioI6:177-183 Gijsbers G H M, Spranger R L H, Keijzer M, de Bakker J M T, van Leeuwen G, Verdaasdonk R M, Borst C, van Gernert M J C (1990) Some laser-tissue interactions in 308 nm excimer laser coronary angioplasty. J lnterven CardioI3:231-241 Kalbfleisch S J, McGillem M J, Simon S B, Deboe S F, Pinto I M F, Mancini G B J (1990) Automated quantitation of indexes of coronary lesion complexity: comparison between patients with stable and unstable angina.
21A,B) . Conversely, the radiopacity of the tantalum Wiktor stent increased the MLCA in these same narrowings by 10-56% depending on the concentration of contrast and specific stenosis (Fig. 21C). , is limited by both methods. Directional Atherectomy Few problems have been encountered in the analysis of patients treated with directional atherectomy . The radiopacity of the device, particularly when the support balloon is inflated, allows the operator excellent visualization of the position of the eccentric cutting apparatus (Fig.
However, a limitation of this procedure is that the guiding catheter may be some distance away from the actual lesion and thus introduce some error into the measurement. 5 . 53 -1 . S-'------~·------~---- PRE ATHERECTOMY POST ATHERECTOMY (Umans et al.. Am J Cardial in press) Figure 23. Agreement between densitometric minimal luminal cross-sectional area (MLCA) and the circular (edge detection) MLCA pre and post directional atherectomy. Despite apparent smooth contours following atherectomy. similar discrepancy exists between analyses performed by edge detection or densitometry as occurs post angioplasty.