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Biomedical subjects

E G Manolas

Publications and source records attributed to E G Manolas.

7 recordsLinked to original sources
PubMed1990

Coronary angioplasty for chronic total occlusion reduces the need for subsequent coronary bypass surgery.

Coronary angioplasty was performed in 44 consecutive patients with total occlusion that lasted longer than 1 week. The primary success rate was 59%. Angiographic restudy in 25 of the 26 successful patients (96%) revealed restenosis in 17 patients (65%), which was asymptomatic in seven (44%). Significant correlates of restenosis were mean luminal stenosis at the conclusion of the procedure and symptom recurrence. Clinical follow-up at a mean of 31 +/- 12 months revealed that coronary artery bypass surgery was more frequent in patients who had an unsuccessful initial angioplasty procedure (7/18 vs 3/26; p = 0.04). Nine patients (35%) who had an initially successful procedure required a second angioplasty for symptomatic restenosis. Angioplasty for totally occluded coronary arteries has a high incidence of restenosis that is often asymptomatic. This procedure can, however, lead to a reduction in the need for coronary artery bypass surgery for symptom control.

Angiography↗
PubMed1989

Determinants of restenosis and lack of effect of dietary supplementation with eicosapentaenoic acid on the incidence of coronary artery restenosis after angioplasty.

The effect of an eicosapentaenoic acid-rich encapsulated preparation of fish oil on the incidence of early restenosis after coronary angioplasty was assessed by a randomized double-blind placebo-controlled study. A total of 108 patients received either 10 capsules of fish oil (1.8 g eicosapentaenoic acid, 1.2 g docosahexaenoic acid) or 10 control capsules (50% olive oil, 50% corn oil), commencing the day before angioplasty and continuing for 4 months after angioplasty, in addition to treatment with aspirin and verapamil. In 101 (94%) of the 108 patients, follow-up angiographic or postmortem result was evaluated at a mean (+/- SD) of 100 (+/- 22) days. Angiographic restenosis was observed in 34% of patients (29% of lesions) in the fish oil-treated group and 33% of patients (31% of lesions) in the control group (no significant difference). The overall incidence of angiographic restenosis was significantly higher in patients with 1) recurrent angina pectoris, 2) a positive exercise test at follow-up after angioplasty, 3) residual stenosis greater than 30% immediately after angioplasty, and 4) dilation of the left anterior descending or right coronary artery. Biochemical investigations showed a greater decrease in the serum triglyceride levels in the fish oil-treated group versus the control group (p less than 0.05) but no differences between the two groups in cholesterol levels or platelet counts over the 4 month period. In conclusion, in this study, the administration of fish oil at a dose of 10 capsules/day did not reduce the incidence of early restenosis after coronary angioplasty.

Adult↗
PubMed1988

Long-term clinical and angiographic results following percutaneous transluminal coronary angioplasty.

The long-term results of percutaneous transluminal coronary angioplasty were evaluated in our first 42 patients, who had initial successful angioplasty and no restenosis on angiogram performed four months after angioplasty. Evaluation included repeat follow-up angiogram performed approximately two years after angioplasty in 22 of the 42 patients. All 42 patients had single vessel disease with severe angina pectoris refractory to medical treatment before angioplasty; at a mean follow-up of 28 months after angioplasty, 37 (88%) were asymptomatic. No patient died or underwent coronary artery bypass graft surgery during the follow-up period, although three patients (7%) suffered a myocardial infarction due to occlusion of a nondilated artery. In the 22 cases studied at a mean of 28 months after angioplasty, angiogram showed that successful coronary artery dilatation remained in all cases, with no deterioration of a dilated lesion between the four and 28 month angiograms. Progression of atherosclerosis, however, did occur in five of the 22 patients (23%), with development of either stenosis or occlusion of a non-dilated vessel. This study suggests that the development of restonsis between four and 28 months after percutaneous transluminal coronary angioplasty is unlikely. The results suggest an excellent long-term prognosis after angioplasty, in patients who have no evidence of restenosis at four months after an initially successful dilatation.

Adult↗
PubMed1984

Balloon dilatation of coronary arteries. Four years' experience of coronary angioplasty.

The results of 126 consecutive balloon dilatations of coronary arteries, carried out in 110 patients between 1980 and the end of 1983, are reported. The follow-up periods ranged from one to 47 months. The primary success rate was 74%, and the long-term success rate was 65%. In successful cases, the diameter of stenosis was changed, on average, from an initial 88% to 33%. Acute occlusion of the vessel occurred on 13 occasions (10%). Of these, myocardial infarction occurred in eight (6%), and emergency bypass grafts were performed in nine (7%). One of these 13 patients died (case fatality rate, 0.8%). Occlusion of the dilated vessels did not occur after the patients were discharged from hospital. However, stenosis recurred in 20 of 80 patients with successfully dilated arteries (25%). Dilatation was repeated in 16 of these, and stenosis had not recurred at the three-months' follow-up. There has been a marked improvement in the success rate of this procedure over the years. It is concluded that balloon dilatation is an effective and safe alternative to bypass graft surgery in selected patients with coronary artery disease.

Adult↗
PubMed1980

Effects of quinidine and disopyramide on serum digoxin concentrations.

Although quinidine and digoxin are frequently given together, it has only recently become apparent that serum digoxin concentration may rise during quinidine treatment. A prospective study was performed to compare the effects of quinidine and disopyramide in patients receiving maintenance digoxin therapy. During quinidine administration serum digoxin concentration rose by more than 50% in seven of nine patients (the mean concentration rising from 1.43 +/- 0.20 to 2.61 +/- 0.43 nmol/l, P < 0.005). During the disopyramide treatment a small rise in serum digoxin was noted (mean 1.3 +/- 0.16 to 1.5 +/- 0.19 nmol/l, P < 0.05). We suggest that digoxin doses should be reduced immediately prior to commencing quinidine therapy in patients already receiving adequate maintenance digoxin, and patients should be followed carefully for evidence of digoxin toxicity. Disopyramide appears a suitable alternative anti-arrhythmic drug to quinidine in patients on maintenance digoxin.

Adult↗