Practice Of Coronary Angioplasty

After 7 years of clinical use, percutaneous transluminal coronary angio plasty (PTCA) has now found worldwide acceptance, and its basic techniques are well standardized. A growing number of invasive cardi ologists are acquainting themselves with the procedure in order to be in a position to offer new therapeutic options to their patients. However, the transition from the diagnostic to the therapeutic intervention is not always easily accomplished. Certain prerequisites concerning technique, the physician, technical equipment, and program organization are necessary for safe and effective performance. The consequences of unsuccessful coronary angioplasty range from waste of time and money to severe complications for the patient; the decision to perform PTCA needs to be based on sound indications and techniques according to the best current scientific evidence. Techniques and technology for coronary angioplasty continue to evolve. Scientific evidence of its short-and long-term value continues to accumulate, and applications of the procedure are still being extended. This volume is obviously no substitute for well-guided hands-on experience with the procedure; it is intended rather to present current policies of patient selection and patient management; to describe standard techniques (femoral and brachial approaches) and potential applications; to point out problem areas and limitations of the proce dure; and to provide tips that may be useful even for the more experienced angioplasty operator.

Coronary angioplasty is a procedure used to widen blocked or narrowed coronary arteries, the main blood vessels supplying the heart. The term 'angioplasty' means using a balloon to stretch open a narrowed or blocked artery. However, most modern angioplasty procedures also involve inserting a short wire-mesh tube, called a stent, into the artery during the procedure. The stent is left in place permanently to allow blood to flow more freely (NHS Choices). This book is a complete guide to the practice of coronary angioplasty for practising cardiologists and trainees. Beginning with an introduction to the evolution of the technique and the fundamentals of stent design, each of the following chapters provides in depth detail on angioplasty procedures for different disorders. The final sections discuss potential complications, rehabilitation, outcomes, and the future of angioplasty. This comprehensive text is highly illustrated with clinical photographs, diagrams and tables to enhance learning. Key Points Comprehensive guide to coronary angioplasty for clinicians and trainees Describes the complete evolution of the technique, from its beginnings to future developments Covers angioplasty procedures for many different disorders Highly illustrated with clinical photographs, diagrams and tables

This book assembles a distinguished team of international contributors to identify, analyze and collate the research articles that have earned recognition as the defining literature on coronary angioplasty. It is a unique reference, providing not only a single source for reviewing the most important papers in the discipline, but also a critical analysis of the strengths, weaknesses and the impact of each paper on the development of coronary angioplasty.

After 7 years of clinical use, percutaneous transluminal coronary angio plasty (PTCA) has now found worldwide acceptance, and its basic techniques are well standardized. A growing number of invasive cardi ologists are acquainting themselves with the procedure in order to be in a position to offer new therapeutic options to their patients. However, the transition from the diagnostic to the therapeutic intervention is not always easily accomplished. Certain prerequisites concerning technique, the physician, technical equipment, and program organization are necessary for safe and effective performance. The consequences of unsuccessful coronary angioplasty range from waste of time and money to severe complications for the patient; the decision to perform PTCA needs to be based on sound indications and techniques according to the best current scientific evidence. Techniques and technology for coronary angioplasty continue to evolve. Scientific evidence of its short-and long-term value continues to accumulate, and applications of the procedure are still being extended. This volume is obviously no substitute for well-guided hands-on experience with the procedure; it is intended rather to present current policies of patient selection and patient management; to describe standard techniques (femoral and brachial approaches) and potential applications; to point out problem areas and limitations of the proce dure; and to provide tips that may be useful even for the more experienced angioplasty operator.

Quantitative coronary angiography has become an invaluable tool for the interventional cardiologist, providing objective and reproducible measurements of coronary artery dimensions, which can be used to study progression or regression of coronary atherosclerosis, as well as the immediate and long term effects of percutaneous interventions. Until recently, this powerful imaging technology was confined to a small number of so-called high level institutions. Fortunately, with the development of digital cardiac imaging equipment and adaptation of cine-angiographically based computer software for on-line use in the catheterization room, quantitative coronary angiography is now available to all interventionalists. This book is a timely guide for the impending QCA user, providing practical as well as theoretical and scientific information. A comprehensive evaluation of the clinical usefulness of QCA is covered, from the fundamental principles through experimental validation studies, application to clinical trials of a wide range of pharmacological and interventional therapies in the full spectrum of clinical presentation of coronary disease syndromes, evaluation of the therapeutic efficacy of various new devices for coronary intervention, together with extensive presentation of its physiological, functional and anatomical correlations, by comparison with other intracoronary measurement and imaging techniques. In addition, evolving theories and concepts in the ever topical `restenosis phenomenon' after percutaneous intervention, based on serial QCA studies, are presented and discussed and a potentially unifying methodological approach to further study of this ubiquitous problem is offered. This book, thanks to the collaboration of many experts in the field of intracoronary imaging and measurement, provides stimulating, interesting and practical information, both for the academic scientist and practising clinician.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Few advances in cardiovascular medicine have so captured the inter est of physicians and the public alike as has coronary artery bypass surgery. Cardiologists who lived through the era of false hopes and frustrations of previous" operations" for coronary artery disease can fully appreciate what this major advance offers to their patients. The number of papers on this topic presented at national meetings attest to its popularity, but also make it increasingly difficult for anyone to assimilate all the data. Practitioners who must consider coronary artery bypass surgery for their patients may thus have difficulty in coming to some rational decision regarding the indications for the operation and its consequences. Depending on the "authority" that one reads, there is still some controversy as to which patients are candidates for coronary artery surgery. This monograph on the prac tice of coronary artery bypass surgery, therefore, comes as a welcome boon to cardiologists, surgeons, internists, and general practitioners who must consider referring their patients for such surgery. It presents a balanced and reasonable picture of the overall subject, in addition to containing important information on such topics as opera tive technique and economic impact. Dr. Miller has done an outstand ing job in bringing together in one text the important considerations related to the evaluation of patients, the natural history of coronary artery disease and the benefits and problems associated with bypass surgery.