Non-Q-wave infarction and ostial left coronary obstruction due to giant Lambl's excrescences of the aortic valve.
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Aged↗
Biomedical subjects
J R Albanese
Publications and source records attributed to J R Albanese.
A single-step stent delivery, deployment, and expansion system.
Placement of intracoronary stents now comprises a significant number of the percutaneous coronary revascularization procedures being performed in high-volume interventional laboratories in the United States. Stents have become popular because of the reliable acute results, and decreased restenosis. The most common stent currently in use in the United States is the Palmaz-Schatz balloon-expandable stent (PS stent). This stent delivery system (SDS) usually requires predilatation with a balloon and another dilatation, after stent deployment, with a high-pressure balloon in order to adequately expand the stent. We report on a new hybrid stent-delivery system using the PS stent, the sheath from the SDS, and an NC Bandit balloon. This new hybrid system is safe and significantly decreases the procedure time, fluoroscopy time, and need for additional stents due to angiographic dissection resulting from inexact positioning of the high-pressure balloon within the initially deployed stent, and/due to inadequate placement of the first stent. This may be an ideal delivery system for single stent deployment using currently approved FDA equipment.
Angioplasty, Balloon, Coronary↗
Effects of ionic and nonionic contrast media on in vitro and in vivo platelet activation.
An increased incidence of thromboembolic events has been associated with nonionic contrast media. Although it has been demonstrated that nonionic contrast media cause significant platelet activation in vitro, there is no reported evidence of contrast-induced platelet activation in vivo. This study investigated the effect of a nonionic contrast agent, iohexol (Omnipaque), versus an ionic contrast agent, diatrizoate meglumine+diatrizoate sodium (MD-76), on both in vitro and in vivo platelet activity. Blood from normal subjects (n = 12) was incubated in vitro for 15 to 60 seconds with varying proportions of contrast media or saline solution, and analyzed by flow cytometry for markers of platelet degranulation (P-selectin) and platelet GPIIb-IIIa receptor activation (PAC-1). In vivo activation after Omnipaque was measured in patients undergoing cardiac catheterization in peripheral blood before and after contrast (n = 5), and in coronary sinus blood before and after left coronary injections (n = 8). In vitro data showed that Omnipaque incubated for 60 seconds with whole blood at ratios of 1:1 resulted in a greater percentage of platelets expressing P-selectin (median/range) than did MD-76 (68%/38% to 90% vs 17%/1% to 53%, respectively, p < 0.01). Similarly at a contrast: blood ratio of 1:3, Omnipaque caused greater P-selectin expression than did MD-76 (49%/19% to 83% vs 3%/0% to 5%, respectively, p < 0.05). There was no significant increase in platelet degranulation observed with concentrations of contrast more dilute than 1:3. In addition, there was significantly less activation seen even at contrast:blood ratios of 1:1 when exposure time was < 60 seconds (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗