Biomedical subjects

Peter Pattynama

Publications and source records attributed to Peter Pattynama.

5 recordsLinked to original sources

PubMed2005

Low-profile stent system for treatment of atherosclerotic renal artery stenosis: the GREAT trial.

PURPOSE: The Palmaz Genesis Peripheral Stainless Steel Balloon Expandable Stent in Renal Artery Treatment (GREAT) Trial was designed to assess the safety and performance of a low-profile stent for the treatment of obstructive renal artery disease by looking at 6-month renal artery patency uniformly analyzed by a Core Lab. MATERIALS AND METHODS: Fifty-two consecutive patients (mean age, 63.7 years) were successfully treated with the Palmaz Genesis Peripheral Stent (Cordis, Miami, FL) on the Slalom 0.018-inch Delivery System (Cordis Europe N.V., Oosteinde 8, NLO-9301 LJ Roden, The Netherlands) at 11 investigational centers. Patients with severe renal failure and > 8-mm renal artery were excluded. Primary endpoint was angiographic determination of in-stent percent diameter stenosis at 6 months. Fifty-one patients were treated with one stent, one patient was treated with two stents to cover the complete lesion. RESULTS: Mean percentage diameter stenosis before renal angioplasty was 68.2% +/- 12.0%. No stent implantation failure, displacement, need for additional stent implantation, or procedural complication was observed. Six-month angiography was performed in 41 of 52 patients (79%) resulting in a mean in-stent percent diameter stenosis or Quantitative Vessel analysis (QVA) at 6 months of 23.9%. The in-stent binary (percent diameter stenosis > 50%) restenosis rate at 6 months was 14.3%. No fatal events occurred up to 6 months after implantation. Major adverse events occurred in five patients: four patients (7.7%) required a revascularization and one patient (1.9%) experienced a cerebrovascular event, which regressed spontaneously. CONCLUSIONS: The Palmaz Genesis stent (Cordis) provides good results for renal artery stent placement, with an in-stent binary restenosis rate (percent diameter stenosis > 50%) at 6 months of 14.3% as determined with angiography.

Aged↗

PubMed2003

Noninvasive angiographic evaluation of coronary stents with multi-slice spiral computed tomography.

BACKGROUND: The number of patients with obstructive coronary artery disease, who undergo coronary angioplasty with implantation of stents, is ever increasing. As an alternative to catheter-based angiography, ECG-gated multi-slice spiral computed tomography (MSCT) allows noninvasive imaging of the coronary arteries. However, coronary stents have been notoriously difficult to assess by CT. METHODS AND RESULTS: In vitro experiments were performed, using varying detector collimations, contrast concentrations, stent positions and stent diameters, to evaluate the feasibility and image characteristics of stents. The stent-related high-density artifacts expand the apparent size of the stent struts. This blooming effect is a fairly constant phenomenon, and therefore relatively less evident in larger-diameter stents. The in vivo images show the same artifacts, but assessment is further complicated by motion, lower contrast-to-noise, and vessel wall calcifications. CONCLUSIONS: The clinical value of CT after percutaneous coronary intervention currently remains largely limited to the detection of stent occlusion, and the progression of coronary artery disease in the remaining nonstented segments. Subtle in-stent abnormalities cannot be reliably imaged. Some relief will be offered by improvements in scanner technology, but the use of less radiopaque stent material would be more effective.

Angioplasty, Balloon, Coronary↗

PubMed2003

MS-CT coronary imaging.

Magnetic resonance imaging and computed tomography (CT) have recently emerged as two techniques that can noninvasively visualize the coronary arteries. The latest generation 16-row detector multislice CT scanner is now considered the most reliable technique to visualize the coronaries. The sensitivity and specificity to detect a significant (>50% diameter stenosis) coronary stenosis is +/-94% and +/-90%, respectively. Further technical improvements are necessary to make CT a clinically reliable diagnostic tool.

Cardiomyopathies↗

PubMed2002

Three-dimensional coronary anatomy in contrast-enhanced multislice computed tomography.

A number of three-dimensional imaging modalities, such as magnetic resonance imaging, electron beam computed tomography, ultrasonography, and multislice computed tomography have been introduced in cardiovascular medicine. One of the most recently developed techniques, multislice computed tomographic coronary angiography, allows assessment of the small coronary vessels. The entire heart is scanned within a single breathhold and contrast-enhanced images are reconstructed through retrospective electrocardiographic gating. Instead of the conventional two-dimensional projection images, multislice computed tomographic data can be displayed in a three-dimensional, volume-rendered manner. This paper presents an overview of the cardiac and coronary morphology as it is imaged with contrast-enhanced multislice computed tomography. Further imaging characteristics of computed tomographic angiography are discussed.

Contrast Media↗

PubMedDate not supplied

Noninvasive visualisation of coronary atherosclerosis with multislice computed tomography.

Computed Tomography (Electron Beam Tomography: EBCT and multislice computed tomography: MSCT) have recently emerged as non-invasive diagnostic modalities that can quantify coronary calcium which is not only as indicator of coronary risk, but also permits assessment of the coronary lumen. The 16-slice MS-CT, the most recent CT-scanner has a very high resolution, which allows non-invasive assessment of coronary plaques. This has led to a stimulus for further research to assess the role of MSCT coronary plaque imaging in the identification of high-risk coronary plaques.

Age Distribution↗