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P Farto e Abreu

Publications and source records attributed to P Farto e Abreu.

6 recordsLinked to original sources
PubMed2001

Results of the quantitative coronary angiographic analysis in the angiographic subgroup of the Multi-Link 2.5 Portuguese Registry.

INTRODUCTION: The restenosis rate of stents implanted into small coronary arteries is considered higher than that of stents in arteries > or = 3 mm, but could be influenced by clinical parameters and by the type and length of the stents. OBJECTIVE: To assess the incidence of angiographic restenosis at 6 months after implantation of 2.5 mm ACS RX Multi-Link (ML) stents, 15 and 25 mm length, in de novo coronary stenosis. DESIGN: Angiographic substudy of the Portuguese Multi-Link 2.5 Registry, which included Interventional Cardiology centers with facilities for coronary angiographic recordings allowing quantitative analysis. POPULATION: Between April 7 and November 20 1998 and in the 5 hospitals that agreed to participate, 61 patients were enrolled and 40 selected as having procedural and 6-month angiographies of sufficient quality for quantitative analysis. The only significant differences in the demographic, clinical and angiographic characteristics of the patients relative to those of the Registry were the lower prevalence of unstable angina and smoking in the angiographic substudy. There were 43 lesions and 46 ML stents were implanted. In 37% the lesions were located in the LAD, in 37% in the LCx and 26% in the RCA. 29 stents of 15 mm length and 17 stents of 25 mm were used. METHODS: The morphologic characteristics of the lesions were analyzed subjectively using the AHA/ACC classification. Quantitative coronary analysis (QCA) was performed, in an independent laboratory using the CAAS 2 system, for reference vessel diameter, lesion length, percentage of stenosis, minimum lumen diameter (MLD) and related parameters. Restenosis was defined as > or = 50% lumen obstruction at 6-month angiography. RESULTS: In the subjective analysis, 2 lesions were type B1, 27 type B2 and 14 type C. The overall restenosis rate was 32.6%. Restenosis was 27.7% for 15 mm stents and 36% for 25 mm stents (p = 0.4). For the QCA parameters analyzed, only MLD at the end of stent implantation was a predictor of 6-month restenosis (2.19 +/- 0.30 without vs. 2.03 +/- 0.18 with restenosis, p = 0.048). CONCLUSIONS: The restenosis rate of the Multi-Link 2.5 mm stents, of 15 and 25 mm length, was similar to that described with other types of stents in small coronary arteries. Minimum lumen diameter after stenting was found to be the best predictor of 6-month restenosis.

Coronary Angiography↗
PubMed1994

[Occlusion of the common branch of the left coronary artery. Clinical and angiographic characteristics and review of the literature].

The clinical and angiographic aspects of seven patients with left main stem coronary artery occlusion diagnosed within the first ten thousand coronary angiographies performed at our Hospital, are reported. The prevalence found (0.07%), is similar to that previously described (0.03 to 0.42%). Left main coronary artery occlusion is always an acute phenomenon with potentially very severe consequences. The existence of previously well developed collateral circulation from the right coronary artery, may avoid the occurrence of extensive acute myocardial infarction with cardiogenic shock and death, which otherwise follows the acute occlusion. Once diagnosed, coronary artery bypass surgery is the first choice treatment, although coronary angioplasty can be performed as a bridge for surgery, or as an alternative, if surgery is not available or is not recommended, int he acute setting of myocardial infarction. Three of our patients underwent successful angioplasty, one electively and two as an emergency during acute myocardial infarction with cardiogenic shock, and five had coronary surgery, one after previous angioplasty due to restenosis. There are only three long term survivors. In our small experience, the severe hemodynamic deterioration after left main occlusion is the major risk factor for mortality, which can only be avoided by early angiographic diagnosis.

Adult↗
PubMed1993

[Coronary artery ectasia: clinical and angiographic characteristics and prognosis].

OBJECTIVE: To evaluate the incidence of coronary ectasia and its distribution by coronary vessels, natural history and follow-up in coronary artery disease patients. DESIGN: Retrospective study from 1982 to 1985. SETTING: Hemodynamics Cardiology Department of a Central Hospital. PATIENTS: In 1100 patients with coronary artery disease, there were 40 patients, 39 men and 1 woman, with mean age of 53.98 +/- 7.49 years. MATERIAL AND METHODS: Coronary ectasia was defined by CASS criteria as: Diameter of a vessel in the coronarography up to one and half times the diameter of a adjacent normal branch. In the clinical profile, both risk factors and clinical parameters such as angina or myocardial infarction were evaluated. The distribution of coronary ectasia by segments and vessels was also noted. In follow-up we analysed major cardiac events, as well as the need for by-pass surgery. RESULTS: The incidence of coronary ectasia was 3.6%. Smoking was the most frequent risk factor. 42.5% of patients had anti-ischemic therapy and 87.5% has previous angina, 62.5% of whom had myocardial infarction. Angiographic findings showed only one ectatic coronary artery in 25 patients. Right coronary artery was the most frequent ectatic vessel (75%), and there was a higher prevalence of coronary ectasia in the proximal segments (p < 0.001). 33 patients had stenotic lesions associated to coronary ectasia. At a mean follow-up of 63.15 +/- 30.46 months, there were nine major cardiac events (one death, three myocardial infarctions and five new episodes of unstable angina), and eighteen patients underwent coronary by-pass surgery. There were no differences between "pure" ectatic and stenotic coronary associated groups, even in patients who needed bypass surgery. CONCLUSIONS: These results confirmed the usual incidence of coronary ectasia, as well as the predominance of right coronary artery ectasia. Proximal segments were more frequently ectatic. Although "pure" coronary ectasia can be implicated in angina or myocardial infarction, we think that a worse prognosis depends on the association of stenotic coronary artery disease.

Coronary Aneurysm↗
PubMed1992

[Combined infarction: angiography and electrocardiographic diagnosis].

Combined infarction can be defined as the presence of ST segment elevation simultaneously in anterior and inferior leads. Their possible anatomical and physiopathological causes are suggested. Four cases of combined infarction, three of them in previously asymptomatic patients are presented, with their electrocardiographic and angiocoronarography patterns. Acute phase and 24 hours ECG ST changes are analysed and the possibility of an indirect approach to the angiographic diagnosis, is discussed.

Adult↗
PubMed1992

[Contribution of the electrocardiogram to the diagnosis of localization and extension of coronary lesions in patients with acute myocardial infarct].

UNLABELLED: With the purpose of evaluating the contribution of the ECG to the localization and extension of coronary artery lesions, 85 patients with the first acute myocardial infarction treated with thrombolysis, 79 males and 6 females (mean age 53.9 years), were studied, and the ECG changes at 3.5 and 24 hours correlated with the coronary angiographic findings before discharge. Patients were divided in two groups--Group A with anterior infarction (48 pts) and Group B with inferior infarction (37 pts). RESULTS: A) Returning of the ST downslope to baseline in inferior and anterior leads, respectively in anterior and inferior infarction at 24 h ECG, excluded associated LAD or RCA/CX lesions with a sensitivity (S) of 93% and 87% and aspecificity (E) of 60% and 58%, with a positive predictive value (PPV) of 62% and 77% and a negative predictive value of 86% and 85% respectively. All patients with anterior infarction had LAD stenosis. B) ST upslope bigger than 5 mm in V2-V3 or its presence in D-I or aVL associated to any precordial leads, diagnosed proximal LAD lesions with S of 82% and 73% and E of 75% and 73% respectively. The left axis deviation was present in 6 of 7 patients and pointed to proximal lesion. C) In Group B patients, RCA lesion was related to ST downslope in D-I, S = 77%, E = 37.5%, PVV = 80% and NPV = 33.5%, and the proximal localization (ratio between ST downslope in V2 and ST upslope in aVF) inferior to 0.5 mm with S and NPV = 80% and E and PPV = 100%. The presence of an isoelectrical ST in D-I in association with ST upslope in V5-V6 is related to CX with S and NPV = 100%, E = 85% and PPV = 25%. In conclusion, these results suggest that a careful analysis of ECG changes in patients with first acute myocardial infarction, can provide important information regarding the infarct related artery, localization of the stenosis and the presence of associated coronary artery disease, with implications in the risk stratification before hospital discharge.

Adult↗