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Biomedical subjects

Y Ageishi

Publications and source records attributed to Y Ageishi.

18 recordsLinked to original sources
PubMed1996

Repeat coronary angioplasty as the treatment of choice for restenosis.

A prospective study was performed to determine whether multiple repeat coronary angioplasty can achieve final lesion patency after restenosis. Between 1983 and 1992, 1455 lesions (excluding acute myocardial infarction or total occlusion) were successfully dilated for the first time. Only 941 (68%) of the 1385 lesions followed up showed improved coronary flow (< or = 70% stenosis) after the first procedure. However, 1248 (93%) of 1345 lesions showed improved coronary flow after angioplasty had been repeated as many as three times, and 1268 (94%) of 1345 did so after as many as six procedures. Only 23 (1.6%) lesions required four or more procedures, and 20 of them showed final patency. These findings indicate that repeat angioplasty can be used as a reasonable treatment strategy for restenosis.

Angioplasty, Balloon, Coronary↗
PubMed1995

Long-term angiographic follow-up of lesions patent 6 months after percutaneous coronary angioplasty.

To determine long-term angiographic prognosis after successful angioplasty (< 50% residual stenosis, > or = 20% reduction of stenosis, and no major complications), coronary angiography was performed 2 to 4 years after angioplasty in patients who were < or = 70 years old at the time of treatment and who showed patency (< or = 50% stenosis) 6 months after the initial procedure. Among 407 lesions that were dilated in 333 patients between 1983 and 1989, 298 (73.2%) lesions were reviewed by long-term angiography after 177 +/- 34 weeks. At long-term follow-up, 4 (1.3%) lesions were totally occluded, 3 (1.0%) had severe stenosis (> or = 75% stenosis), 9 (3.0%) had mild stenosis (> 50% to < 75% stenosis), and 282 (94.6%) were patent (< or = 50% stenosis). The percentage of stenosis of patent lesions decreased from 24% +/- 14% at 6 months to 21% +/- 13% at long-term follow-up (p < 0.0001). No specific clinical or angiographic characteristics were identified in patients with severe stenosis at long-term follow-up. These findings indicate that when patency is obtained 6 months after angioplasty, a 95% long-term patency rate with regression of stenosis can be expected.

Adult↗
PubMed1994

Double perfusion system for coronary angioplasty at the origin of the main vessel.

For the treatment of stenosis near the origin of either the left anterior descending artery or the left circumflex artery, one autoperfusion catheter was used to dilate the lesion while another was used to maintain perfusion of the nonstenosed vessel, which would normally suffer from a decrease in blood flow. This technique was applied to nine procedures in six patients. The balloon could be inflated for more than 60 sec in all cases. Satisfactory dilation was achieved without a significant decrease of systemic blood pressure during the procedure.

Angioplasty, Balloon, Coronary↗
PubMed1994

Emphysematous pyelonephritis successfully treated with nephrectomy and granulocyte colony-stimulating factor.

A 58-year-old woman developed diabetic ketoacidosis and emphysematous pyelonephritis caused by Escherichia coli. She was successfully treated with nephrectomy, antibiotics, and recombinant human granulocyte colony-stimulating factor (rhG-CSF). RhG-CSF therapy may be an effective adjunct for diabetic patients with severe infection, even when neutropenia is not present.

Anti-Bacterial Agents↗
PubMed1993

Percutaneous transluminal coronary angioplasty for acute myocardial infarction.

Between 1986 and 1991, direct coronary angioplasty was attempted in 79 patients. The procedure was successful in 76 patients (96%), unsuccessful without complications in 2 patients, and major complications occurred in 1 patient (ventricular fibrillation and cardiogenic shock). Reperfusion was obtained from 1 to 7.5 hours (mean: 3.3 +/- 1.3 hours) after the onset of chest pain. Among the 76 successfully dilated patients, there was one cardiac death and 68 had predischarge angiography (64 patent, 2 stenosed, and 2 occluded). Although only 33 of the 58 patients (57%) angiographically followed after discharge showed persistence of primary patency, 52 of the 57 (91%) followed further obtained final patency when angioplasty was repeated up to 4 times. These results indicate that direct angioplasty in the community hospital setting can achieve a high primary success rate and a low reocclusion rate.

Adult↗
PubMed1993

[Clinical efficacy of coronary angioplasty for totally occluded lesions in recent transmural myocardial infarction].

Percutaneous coronary angioplasty was used to treat the occlusive lesions responsible for prior myocardial infarction occurring 1-8 weeks previously. Angioplasty was successful in 31 of 33 patients' lesions. Follow-up angiography showed dilated lesions were patent (0-50% diameter stenosis) in 10 patients, mildly stenosed (51-74%) in 3, severely stenosed (75-90%) in 10, subtotally occluded in 2, totally occluded in 5 and one was lost to follow-up. By repeating angioplasty up to two times, the lesions became patent in 23 patients, mildly stenosed in one, totally occluded in 4, and 3 were lost to follow-up. Measuring the left ventricular function in 22 patients with patent lesions and one with mildly stenosed lesion showed the left ventricular ejection fraction was improved from 60 +/- 13.1 to 69 +/- 11.6% (p < 0.00005), and hypokinetic areas (from 18 +/- 15.1% of left ventricular wall to 11 +/- 9.9%, p < 0.05) and an akinetic area (from 11 +/- 12.5% to 4 +/- 7.3%, p < 0.002) were decreased. The findings indicate that angioplasty for totally occluded lesions within 12 weeks of infarction achieves satisfactory lesion patency and functional recovery of the infarcted myocardium.

Angioplasty, Balloon, Coronary↗
PubMed1993

[Ticlopidine may prevent subtotal or total occlusion of dilated lesions after percutaneous coronary angioplasty].

The efficacy of ticlopidine and probucol plus oryzanol for reducing restenosis after dilation was examined in 151 patients with 229 stenotic lesions treated by coronary angioplasty after complete resolution of associated acute myocardial infarction, unstable angina, and variant angina. The stenotic lesions were 90% or less in diameter and less than 10 mm in length, and residual stenosis was 40% or less after treatment. Patients were randomly assigned to receive no medication, ticlopidine (200 mg daily) and/or probucol (1,000 mg daily) plus oryzanol (300 mg daily). One hundred forty-six patients with 220 dilated lesions were examined angiographically to evaluate restenosis. The medications achieved no clear reduction in restenosis, but subtotal or total reocclusion occurred in 6 of 102 patients not receiving ticlopidine, and in none of 118 patients receiving ticlopidine (p < 0.008). Ticlopidine may prevent subtotal or total reocclusion in dilated lesions.

Angioplasty, Balloon, Coronary↗
PubMed1992

Coronary angiography using 4-French preformed catheters--percutaneous brachial approach.

4-French performed catheter systems were developed for coronary angiography. After several new technical features were introduced, these catheters were applied in 384 outpatients between January 1989 and December 1989. Diagnostic coronary angiography was performed in all cases without major complications. In the left coronary artery, 4.0 cm left Judkins catheters were generally used; however, 3.5 cm left Judkins catheters were used if the patient was < or = 164 cm tall and left Amplatz catheters were employed for those > or = 165 cm tall. Although 4.0 cm right Judkins catheters were mainly used for right coronary arteries, there were no predictive factors for subsequent catheter selection. This technique is believed to be suited to meet the increasing demand for coronary angiography.

Adult↗
PubMed1992

Overall clinical effect of percutaneous coronary angioplasty: a critical analysis by follow-up and long-term angiography.

In order to determine the clinical efficacy of coronary angioplasty, the outcome was analyzed in 557 patients who underwent initial angioplasty prior to the end of 1987. Primary success (reduction of stenosis greater than or equal to 20% and residual stenosis less than 50%) was achieved in 492 (88.3%) of the patients. Follow-up angiography showed patency (stenosis less than or equal to 50%) in 295 or 60.0% of the 471 patients and ultimate lesion patency was achieved by repeating angioplasty up to 4 times in 425 (91.4%) of 465 patients followed angiographically. At the 3-year angiography performed in 209 patients with patent lesions, only 2 patients exhibited progression of their disease at dilated sites, while 48 had new lesions. Taking into consideration the 55 patients with unsuccessful primary angioplasty, 10 patients with major complications and 9 patients with mild restenosis, 434 out of 530, or 81.9% of the patients appear to have benefited from angioplasty.

Adult↗
PubMed1992

[Effect of denopamine on residual left ventricular dysfunction after complete revascularization].

Denopamine (15 mg/day) was administered to 20 patients with residual left ventricular dysfunction after successful percutaneous transluminal coronary angioplasty (75% or more diameter stenosis). Echocardiography was performed before and 6 months after denopamine administration to analyze the left ventricular function. There were significant decreases in both end-diastolic and end-systolic dimensions from 58 +/- 8.3 to 54 +/- 8.4 mm (p = 0.001), and from 44 +/- 10.1 to 40 +/- 10.3 mm (p = 0.005)), respectively, while % fractional shortening remained nearly constant (from 25 +/- 8.3 to 27 +/- 9.6%). Thus, denopamine improved the left ventricular function by decreasing left ventricular size while maintaining wall contractility.

Adrenergic beta-Agonists↗
PubMed1991

Left ventricular function during transient coronary occlusion: digital subtraction left ventriculograms during coronary angioplasty.

The impact of transient myocardial ischemia on left ventricular function was examined by digital subtraction left ventricular angiography. Contrast medium was injected into the right pulmonary artery before, at 60 seconds of balloon inflation, and 10 minutes after balloon deflation. A total of 69 patients completed the study. In 52 patients, the left anterior descending artery (LAD) was involved, and in 17, the right coronary artery (RCA) was the focus. Ejection fraction (EF) declined by balloon inflation and returned to baseline value after deflation of the balloon. There was tendency toward a lower EF and wider akinetic area for LAD dilatation. The linear correlation between resting EF and EF during balloon inflation suggested that the effect of momentary coronary occlusion on left ventricular function appears to be additive to pre-existing left ventricular dysfunction, and resting ejection fraction is an important parameter for estimating the degree of diminished left ventricular function during myocardial ischemia.

Angiography, Digital Subtraction↗
PubMed1991

[Long-term prognosis of coronary angioplasty: angiographic follow-up after three years].

Long-term angiographic follow-up was performed 3 years after percutaneous transluminal coronary angioplasty (PTCA) between 1983 and 1986. Among 294 arteries with initially successful dilatation, in which diameter was reduced by more than 20% and residual stenosis was less than 50%, 192 lesions were angiographically patent (50% or less stenosis) in the 6 month follow-up. Three years later, angiography was again performed for 81 lesions. There was no difference between these 81 cases with angiography and the remaining 111 cases in other clinical manifestations except for a higher frequency of diabetes mellitus observed in the angiography group (33% vs 19%). Progressive deterioration of the disease (more than 50% diameter stenosis) was noted in 5 cases, all of which already had relatively severe stenosis (40% or more) in the 6 month follow-up. It was concluded that dilated coronary artery lesions by PTCA can be expected to have good long-term prognosis once they are proven to be patent in the 6 month follow-up angiography.

Adult↗
PubMed1989

[Undesirable outcome of percutaneous transluminal coronary angioplasty including irreversible damage and re-stenosis of dilated lesions].

To clarify the prognostic implications due to the limitations of coronary angioplasty, 564 newly-dilated lesions were analyzed for the prevalence of irreversible damage (sudden deaths, myocardial infarction, re-stenotic lesions and occlusion unsuitable for or unsuccessful following repeated angioplasty) and re-stenosis after re-dilatation. Re-stenosis occurred in 170 of the 564 newly-dilated lesions, and in 36 of the 135 re-dilated lesions. After repeated angioplasty, up to three times, 449 lesions (89.9%) were eventually patent angiographically, while irreversible damage was observed in 21 lesions. Re-stenosis after re-dilatation was observed more often in variant angina and in lesions exceeding 15 mm in length. Irreversible damage occurred more often in elderly patients and in patients with lesions of the right coronary artery.

Adult↗
PubMed1989

[Digital subtraction angiography and Fourier analysis of the left ventriculography: new methods of analyzing left ventricular function].

To evaluate two new methods of analyzing left ventricular function, digital subtraction left ventriculography (DSLV) and Fourier analysis of left ventriculography (FALV) were performed after conventional left ventriculography (LV) in 17 consecutive catheterized cases. Ejection fraction of FALV and LV corresponded closely with the correlation coefficient of 0.906, while segmental wall motion corresponded less with the range of correlation coefficients from 0.56 for the apical segment to 0.94 for the anterior wall. In 10 cases with asynergic segments of the left ventricle, Fourier analysis showed less hypokinesis in four (all had hypokinesis at the septal segment), the same degree in five and more in one case, suggesting the possibility of FALV to evaluate three-dimensional left ventricular function in a single projection.

Angiography, Digital Subtraction↗
PubMed1988

Generalized eruption with severe liver dysfunction associated with occupational exposure to trichloroethylene.

Generalized dermatitis due to trichloroethylene is rare. A 21-year-old printer developed exfoliative dermatitis with mucous membrane involvement, fever and liver dysfunction after a 2-week occupational exposure to trichloroethylene. Positive patch-test reactions to trichloroethylene and to one of its metabolites, trichloroethanol, were observed. This dermatitis is considered to be mediated by a delayed-type hypersensitivity mechanism.

Adult↗
PubMed1988

Percutaneous transluminal coronary angioplasty for elderly patients.

To examine the clinical efficacy of percutaneous transluminal coronary angioplasty in elderly patients, 350 consecutive procedures of coronary angioplasty were reviewed by dividing the patients into two groups: 142 cases of elderly patients whose ages were 65 years or older and 208 cases of younger patients. The primary success rate was satisfactory in both groups (86.6% in the elderly patients and 88.5% in the younger patients) and frequency of complication was acceptable (3.1% vs 2.9%) in both groups. Although restenosis tended to occur more frequently in the elderly patients (36.8% vs 27.1%), most of the lesions were re-dilated. These indicate that coronary angioplasty can be extended to elderly patients. The primary success rate started to decrease with circumflex arteries at age 70 years, and a similar trend was seen with right coronary arteries at age 65 years. Careful selection of the patients for coronary angioplasty as well as detailed analysis of the coronary anatomy and aorta are required to obtain clinical success and to prevent complications.

Aged↗
PubMed1988

[Emergency percutaneous transluminal coronary angioplasty for acute myocardial infarction].

Coronary angioplasty combined with thrombolytic therapy using urokinase (UK-PTCA) was attempted for acute myocardial infarction from September 1983 to December 1985, and without thrombolytic therapy (direct PTCA), thereafter. For UK-PTCA, the lesion was severely stenosed in 13, subtotally occluded in two and totally occluded in 21, and 29 lesions (81%) were successfully dilated. For direct PTCA, the lesion was stenosed in five, subtotally occluded in two and totally occluded in 14, and 19 lesions (90%) were dilated. Only one lesion in UK-PTCA had restenosis during hospitalization, but it was successfully redilated. Follow-up angiography was performed for 26 among 29 UK-PTCA cases and showed patency (diameter stenosis less than 50%) in 13, restenosis (less than 50%) in 12 and occlusion in one. Ten among 12 restenosed lesions were redilated and they were all patent at subsequent angiography. In 15 of 19 dilated lesions with direct PTCA, the lesion was patent in 10, and restenosed in five. Four of them were redilated and remained patent at subsequent angiography. Major complications occurred only in the UK-PTCA group before the judicious use of intra-aortic balloon pumping for hemodynamic instability. These included two deaths due to cardiogenic shock, one coronary dissection, and one sudden reocclusion, possibly due to thrombus formation. PTCA is applicable with or without thrombolytic therapy for acute myocardial infarction with high primary success rate and maintain coronary flow thereafter.

Adult↗