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Biomedical subjects

N Pijls

Publications and source records attributed to N Pijls.

5 recordsLinked to original sources
PubMed2000

Randomized comparison of primary stenting and provisional balloon angioplasty guided by flow velocity measurement. Doppler Endpoints Balloon Angioplasty Trial Europe (DEBATE) II Study Group.

BACKGROUND: Coronary stenting improves outcomes compared with balloon angioplasty, but it is costly and may have other disadvantages. Limiting stent use to patients with a suboptimal result after angioplasty (provisional angioplasty) may be as effective and less expensive. METHODS AND RESULTS: To analyze the cost-effectiveness of provisional angioplasty, patients scheduled for single-vessel angioplasty were first randomized to receive primary stenting (97 patients) or balloon angioplasty guided by Doppler flow velocity and angiography (523 patients). Patients in the latter group were further randomized after optimization to either additional stenting or termination of the procedure to further investigate what is "optimal." An optimal result was defined as a flow reserve >2.5 and a diameter stenosis <36%. Bailout stenting was needed in 129 patients (25%) who were randomized to balloon angioplasty, and an optimal result was obtained in 184 of the 523 patients (35%). There was no significant difference in event-free survival at 1 year between primary stenting (86.6%) and provisional angioplasty (85.6%). Costs after 1 year were significantly higher for provisional angioplasty (EUR 6573 versus EUR 5885; P:=0.014). Results after the second randomization showed that stenting was also more effective after optimal balloon angioplasty (1-year event free survival, 93.5% versus 84.1%; P:=0. 066). CONCLUSIONS: After 1 year of follow-up, provisional angioplasty was more expensive and without clinical benefit. The beneficial value of stenting is not limited to patients with a suboptimal result after balloon angioplasty.

Analysis of Variance↗
PubMed1996

Coronary stenting for failed angioplasty in acute myocardial infarction.

UNLABELLED: Intracoronary stents were implanted in 15 patients after unsuccessful PTCA in the setting of acute myocardial infarction (AMI). The stented vessel was the left anterior descending (LAD) in 11 patients, the right coronary artery (RCA) in 3 patients, and a venous bypass graft to the LAD in a single patient. A total of 16 stents were implanted (15 Palmaz Schatz, Johnson and Johnson; and 1 Wiktor, Medtronic). FOLLOW-UP: 1 patient died 10 days after stent implantation as a result of renal failure and cardiogenic shock. Subacute thrombosis occurred in 2 patients, 5 and 15 days after stent implantation; both underwent successful emergency coronary artery bypass grafting (CABG). The remaining 12 patients were free from major ischemic events (death, AMI, and further revascularization) after a mean follow-up of 18.7 +/- 4.1 months. We conclude that the long-term results of intracoronary stenting in AMI after failed PTCA are favourable.

Adult↗
PubMed1993

Experience with U-shaped catheters in angiography and angioplasty of the left coronary artery.

We developed a U-shaped diagnostic and guiding catheter for left coronary angiography and angioplasty. Angiography with a 6 French (F) diagnostic U-shaped catheter was attempted in 101 patients (pts). Primary use in 82 pts; all successful. Secondary use after failure of 6 F left Judkins diagnostic catheters to intubate the left main coronary artery in 19 pts; 17 successful. An 8 F U-shaped guiding catheter was used for percutaneous transluminal coronary angioplasty (PTCA) of left coronary artery branches in 102 pts [left anterior descending (LAD), 48 pts; circumflex (CX), 54 pts]. Stable cannulation of the left coronary artery was achieved in 96 pts (94%), but PTCA was successful in 90 pts (88%). Primary use in 70 pts (LAD, 27 pts; CX, 43 pts). PTCA was successful in 60 pts. Secondary use after failure of left Judkins and Amplatz guiding catheters in 32 pts (LAD, 21 pts; CX, 11 pts). PTCA was successful in 30 pts. No complications were seen. In conclusion, U-shaped diagnostic and guiding catheters increased the success rate of 1) left coronary angiography after failure of left Judkins diagnostic catheters; and 2) PTCA of the left anterior descending and circumflex arteries after failure of left Judkins and Amplatz guiding catheters.

Angioplasty, Balloon, Coronary↗
PubMed1979

Antepartum determination of pre-ejection period of fetal cardiac cycle: its relation to newborn body weight.

Simultaneous recordings of the fetal electrocardiogram and ultrasound Doppler-cardiogram were used for the determination of the pre-ejection period (PEP) of the fetal cardiac cycles. All 50 fetuses selected for the present study experienced uneventful perinatal lives despite maternal antepartum complications which required hospitalization. A significant positive correlation between the PEP and gestational age of the fetuses was again demonstrated. The PEP of the fetus measured within one week prior to delivery was also found to be significantly correlated with the newborn body weights at birth. Statistical analysis demonstrates that fetal body weight was more closely related to the physiologic lengthening of the PEP.

Birth Weight↗