Emergency percutaneous coronary interventions for unprotected left main stenoses: immediate and long term follow up.
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B J W M Rensing
Publications and source records attributed to B J W M Rensing.
Long term follow up after elective percutaneous coronary intervention for unprotected non-bifurcational left main stenosis: is it time to change the guidelines?
BACKGROUND: According to the American College of Cardiology/American Heart Association guidelines, percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is contraindicated and coronary artery bypass graft surgery (CABG) is preferred. However, PCI of the LMCA is performed under exceptional circumstances. OBJECTIVE: To analyse the data of patients who underwent PCI of the unprotected LMCA in St Antonius Hospital, Nieuwegein, Netherlands. RESULTS: In a database of 17 683 PCI procedures, 71 patients (0.4%) were found with non-bifurcational LMCA stenosis who underwent an elective PCI between 1991 and 2001. Ages ranged from 26.7-86.5 years. Severe concomitant disease was the most frequent argument in favour of PCI instead of CABG. PCI consisted of only balloon angioplasty in 23 cases (32.4%). A stent was used in 46 cases (64.4%). Average follow up was 43 months (range 0-121 months). One patient died one day after the procedure. The total one year survival rate was 98.6% (70/71). Seven patients died during the follow up period, mostly because of non-cardiac reasons. The annual mortality rate was 2.5%. Recurrent elective percutaneous transluminal coronary angioplasty for restenosis of the LMCA was performed in one patient (1.4%) six weeks after the initial procedure. CABG was required in 13 patients (18.3%) throughout the follow up period. CONCLUSION: These results suggest that at highly experienced centres, elective PCI of the non-bifurcational LMCA can be performed safely where the anatomy is suitable.
Adult↗
Noninvasive coronary imaging using electron beam CT: surface rendering versus volume rendering.
OBJECTIVE: Three-dimensional data for noninvasive imaging of the coronary arteries are acquired from electron beam CT, multidetector CT, or MR imaging. Most commonly, surface rendering is used for three-dimensional processing, but recent advances in hardware and software technology have made it possible to use volume rendering. Our objective was to compare volume rendering with surface rendering for the visualization of the coronary artery tree. CONCLUSION: Our experience in the comparison of both techniques shows that because of intrinsic problems associated with surface rendering, volume rendering produces better image quality.
Coronary Angiography↗