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Biomedical subjects

A Grüntzig

Publications and source records attributed to A Grüntzig.

At least 19 recordsLinked to original sources
PubMed1986

The coronary artery bypass surgery-angioplasty interface.

Coronary artery bypass surgery (CABG) and percutaneous coronary angioplasty (PTCA) now offer patients with obstructive coronary disease an unprecedented opportunity for safe and timely myocardial revascularization. PTCA remains the therapy of choice for patients with single-vessel disease, discrete lesions in multiple vessels and recurrent symptoms following CABG. Until randomized trials define the relative roles of PTCA and CABG in patients with diffuse multivessel disease, such patients should be managed surgically. Despite advances in PTCA technology, skilled surgical standby remains essential to the safe practice of PTCA.

Angioplasty, Balloon↗
PubMed1985

Long-term experience in percutaneous transluminal dilatation of renal artery stenosis.

Percutaneous transluminal dilatation was attempted in 65 patients with renovascular hypertension. In five cases (8 percent), percutaneous transluminal dilatation could not be performed for technical reasons. In the remaining 60 patients (35 with atherosclerotic stenosis and 25 with fibromuscular dysplasia), both mean systolic and diastolic pressure fell immediately after percutaneous transluminal dilatation and remained significantly lower for a period of up to five years. Cure rates after a mean control period of 21.6 months were higher in patients with fibromuscular dysplasia (50 percent) than in those with atherosclerotic stenosis (29 percent). Improvement of blood pressure was observed in 32 percent of patients with fibromuscular dysplasia and in 48 percent of patients with atherosclerotic stenosis. Follow-up angiography in 33 cases showed occlusion of the dilated artery in two patients and recurrence of slight renal artery stenosis in nine patients. Successful redilatation could be performed in five of these cases. Furthermore, renal vein renin determinations were only of limited diagnostic or prognostic value. These results document the good long-term effect of percutaneous transluminal dilatation in patients with renal artery stenosis. Percutaneous transluminal dilatation should, therefore, be the favored procedure in patients with renovascular hypertension.

Adult↗
PubMed1985

Percutaneous transluminal coronary angioplasty: morphological findings in 3 patients.

Little morphologic information is available on the status of the major epicardial coronary arteries in patients dying after percutaneous transluminal coronary angioplasty. We studied hearts from 3 men (aged 60, 45 and 47 years) dying 3 days, 1 month and 7 months after balloon--dilatation of obstructed coronary artery segments. Twice the left anterior, once the left main coronary artery have been desobliterated. In one patient the procedure has not been successful and a venous bypass graft had to be implanted. Histologically the site of dilatation is clearly recognisable after 7 months. The characteristic findings are intimal tears in the segment opposite to the obstructing plaque. The intimal gaps are filled after 7 months by a neointima. In the dilated left main coronary we find 1 month after angioplasty an extensive proliferation of smooth muscle cells resulting in restenosis. Two patients died suddenly after an interval without angina. In the third patient--ome hours after bypass grafting--spasm of the non-involved right coronary artery occurred resulting in inferior infarction; this patient died 3 days after dilatation.

Angioplasty, Balloon↗
PubMed1981

[Early results of percutaneous transluminal coronary vessel dilatation in single vessel disease. Comparison with drug treated or surgically treated patients, retrospective for dilatation suited patients].

The shortterm results (mean follow-up 0.9 years) in 61 patients with single vessel disease (1-VD) who had undergone percutaneous transluminal coronary angioplasty (PTCA) were compared with those in 33 patients with 1-VD treated medically and in 36 patients with 1-VD treated by bypass surgery. All medically and surgically treated patients had coronary artery stenoses which were classified in a retrospective analysis as suitable for PTCA. Initially there were no significant differences between the three groups with respect to functional impairment (NYHA class), incidence of prior myocardial infarction, left ventricular ejection fraction and localization of the coronary stenoses. Comparison of follow-up results at the end of the first year showed (1) that the NYHA class was reduced to a similar extent both in patients treated surgically and in those treated by PTCA, (2) that the NYHA class in the medically treated group was significantly greater than in the other two groups, and (3), that there was no difference among the three groups with respect to infarct and mortality rate.

Coronary Artery Bypass↗
PubMed1981

[Cranial and caudal projections for coronary angiography (author's transl)].

Cranial and caudal projections are a simple method for improving the diagnosis of coronary stenoses. In 20 cases out of 100 unselected coronary angiograms, the cranial projection showed stenoses to be more severe than had been demonstrated by the standard projection, or revealed them for the first time.

Coronary Angiography↗
PubMed1981

Relief by intracoronary glyceryl trinitrate of coronary artery spasm resistant to sublingual route of administration.

Inappropriate percutaneous transluminal coronary angioplasty of the anterior descending artery was avoided in a 52-year-old woman when the intracoronary administration of glyceryl trinitrate immediately before the angioplasty disclosed the organic component of the supposedly fixed, critical (80%) stenosis to be less than 50% of the lumen diameter. The spastic component of the stenosis had not been unmasked by the sublingual administration of two 0.4 mg tablets of glyceryl trinitrate during diagnostic angiography two weeks earlier. Intracoronary glyceryl trinitrate is indicated when suspected coronary spasm persists after the sublingual administration of this drug in potential candidates for percutaneous transluminal coronary angioplasty or coronary bypass surgery.

Coronary Angiography↗