Dissertations / Theses on the topic 'Angioplasty, Balloon'
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Mattsson, Erney. "On vessel wall responses to balloon dilatation experimental studies in rabbits /." Lund : Dept. of Surgery, Lund University, Malmö General Hospital, 1992. http://catalog.hathitrust.org/api/volumes/oclc/39693815.html.
Full textGarramone, Samantha. "Structure-property relationships in angioplasty balloons." Link to electronic thesis, 2001. http://www.wpi.edu/Pubs/ETD/Available/etd-0430101-122300/.
Full textSmyth, David William. "The haematological determinants of angioplasty restenosis." Thesis, Queen Mary, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244764.
Full textLöfberg, Anne-Marie. "Infrainguinal percutaneous transluminal angioplasty in limbs with severe lower limb ischaemia /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-5079-2/.
Full textLalli, Dominic. "Cycle-to-cycle control of the angioplasty balloon fabrication process." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98984.
Full textWinkler, Bert. "Perkutane transluminale Angioplastie komplexer infrapoplitealer Gefässläsionen bei kritischer chronischer Extremitätenischämie: Restenoserate und klinische Ergebnisse." Doctoral thesis, Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-150025.
Full textGray, Timothy J. "Inhibitory mechanisms by which suramin may attenuate neointimal formation after balloon angioplasty." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0028/MQ33951.pdf.
Full textChen, Yan 1982. "Modeling and cycle-to-cycle control of the angioplasty balloon forming process." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112564.
Full textOlbrich, Tom. "Measurement of mechanical wall properties from percutaneous transluminal coronary angioplasty balloon catheters." Thesis, University of Newcastle Upon Tyne, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248308.
Full textKonneh, Matthew Kwame. "An investigation of the mechanisms in the intimal response to balloon injury." Thesis, Queen Mary, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244030.
Full textShehab, Mostafa El-Said Nasr. "The mechanism of balloon angioplasty : an experimental and clinical study of pressure and volume curves using a computerised angioplasty system." Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268836.
Full textAzarnoush, Hamed. "Modeling and control of angioplasty balloon deployment based on intravascular optical coherence tomography." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=107712.
Full textLes maladies cardiovasculaires sont la principale cause de décès dans les pays industrialisés. L'angioplastie est réalisée sur des millions de patients chaque année. Il est donc essentiel de constamment explorer et étudier de nouvelles approches pour étudier et améliorer les résultats de cette procédure peu invasive. Dans cette thèse, de nouvelles applications de la tomographie par cohérence optique intravasculaire (IVOCT) sont proposées, à savoir, la surveillance, la caractérisation, la simulation et le contrôle du gonflement du ballon.Des images haute résolution IVOCT mènent à une évaluation détaillée des microstructures. En utilisant des techniques d'analyse d'image, la caractérisation de la déformation du ballon est présentée comme une méthode pour valider la performance de ballons. La caractérisation de la déformation des fantômes est proposée comme une méthode pour étudier la réponse des tissus à des tailles différentes de ballons, et diverses stratégies de pliage et de gonflement du ballon. En outre, la caractérisation de la déformation est proposée pour valider les résultats de simulation. Une comparaison est fournie entre les résultats de la simulation par éléments finis et des résultats expérimentaux pour les deux études de cas, qui étudient les effets de la variation des propriétés mécaniques ainsi que le processus de déploiement et de gonflement du ballon. Enfin, dans cette thèse, des méthodes sont proposées pour contrôler le gonflement du ballon. Pendant le gonflement du ballon, le diamètre luminal de l'artère peut être estimé en temps réel et utilisé dans une boucle de rétroaction pour contrôler le gonflement. La pertinence expérimentale de cette méthode est démontrée lorsque le ballon est gonflé dans un fantôme, dans les artères porcines d'un cœur excisé et d'un cœur battant. Les méthodes et les résultats fournis dans cette thèse pourraient bénéficier aux développeurs de dispositifs d'angioplastie, à la recherche cardiovasculaire et aux utilisateurs cliniques.
Zargham, Ramin. "[Alpha]8[beta]1 integrin and vascular injury : role of [alpha]8[beta]1 integrin in restenosis after balloon injury." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111876.
Full textIn this work, a rat model of carotid angioplasty was used to mimic vascular injury in humans. alpha8beta1 integrin was downregulated in the tunica media concomitantly with loss of the contractile phenotype. In vitro study revealed that it is a differentiation marker of VSMCs. To test the functional significance of the association between alpha8 integrin and the VSMC phenotype, short interference RNA was deployed to silence the alpha8 integrin gene. alpha8 integrin gene silencing heightened VSMC migratory activity as well as modulation of the VSMC phenotype in favour of the noncontractile state. In addition, alpha8 integrin overexpression induced re-differentiation of VSMCs and attenuated their migratory activity. It is, therefore, suggested that alpha8 integrin overexpression after vascular injury might control VSMC migration and neointima formation. On the other hand, alpha8 integrin gene silencing led to a reduced growth rate, which indicated a dichotomy between VSMC migration and proliferation.
In the later stages of neointima formation, constrictive remodeling plays a major role in late lumen loss. Our data demonstrated that alpha8 integrin is upregulated in the neointima during constrictive remodeling with concomitant luminal narrowing. The importance of this finding was highlighted by results showing that alpha8 integrin was required for the VSMC contractile phenotype evoked by transforming growth factor-beta (TFG-beta) and TFG-beta-induced myofibroblastic differentiation of Rat1 fibroblasts. Thus, it appears that alpha8 integrin expression blockade might reduce contractile remodeling and late lumen loss. Although the mechanism of alpha8 integrin signaling is not yet clear, our findings demonstrate that the alpha8 integrin-induced contractile phenotype is blocked by RhoA inhibitors. Furthermore, alpha8 integrin and RhoA are co-immunoprecipitated, and alpha8 integrin gene silencing reduces RhoA activity. Hence, it is postulated that alpha8-RhoA signaling might be closely intertwined.
Altogether, these studies indicate that alpha8 integrin is a contractile marker of VSMCs and a negative regulator of VSMC migration. Therefore, forced alpha8 integrin expression may be applied to reduce neointima formation. However, alpha8 integrin upregulation during constrictive remodeling concomitant with late lumen loss suggest that it could be involved in lumen narrowing. It seems likely that in therapeutic strategies to reduce restenosis the timeline of interference might be very important. Therefore, alpha8 integrin gene silencing in the later stages of neointima formation might be beneficial.
Sturge, Justin. "The behaviour of vascular smooth muscle cells under stress." Thesis, Imperial College London, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298368.
Full textBärlocher, Lorenz Simon. "Stent implantation and balloon angioplasty for treatment of branch pulmonary artery stenosis in children /." [S.l.] : [s.n.], 2009. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000281149.
Full textMutchler, Megan Marie. "Ribonucleotide Reductase Inhibitors for Restenosis." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1211423147.
Full textAcampora, Kara Bethany. "Effect of clinically relevant mechanical forces on smooth muscle cell response in model of balloon angioplasty." Connect to this title online, 2008. http://etd.lib.clemson.edu/documents/1239894703/.
Full textGotti, Enrico <1985>. "Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension: experience of four years in a single centre." Doctoral thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amsdottorato.unibo.it/9135/1/gotti_enrico_tesi.pdf.
Full textKiousis, Dimitrios. "Computer Aided Angioplasty : Patient-specific arterial modeling and smooth 3D contact analysis of the stent-balloon-artery interaction." Licentiate thesis, KTH, Solid Mechanics (Div.), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-4263.
Full textPaper A: In this paper, the development and implementation of a contact algorithm based on C2-continuous surface representations is discussed. In 3D contact simulations involving models with arbitrarily curved surfaces (as in the case of vessel walls), the discretization of the contact surfaces by means of facet-based techniques could lead to numerical instabilities and finally loss of quadratic convergence. These instabilities arise mainly due to the sliding of contractor (slave) nodes over the boundaries of target (master) contact facets, where jumps of the normal vector are experienced. The paper addresses successfully this problem, by discretization of the target surfaces by means of C2-continuous parameterization schemes. Initially, the uniform cubic B-spline surfaces are introduced. Next, in an attempt for more accurate representations of the geometric models of the contact surfaces, a new parameterization based on the expression of cubic B-splines is developed. The two approaches are implemented into a finite element framework and more specifically, into the multipurpose finite element analysis program FEAP. The special merits of the developed algorithms and the advantages of the smooth surfaces over facet-based approaches are exhibited through a classical contact mechanics problem, considering incompressibility, finite deformations and large slidings. Next, a simulation of balloon angioplasty with stenting is presented, where the contact between both medical devices (balloon and stent) with the arterial wall is modeled. The arterial wall is modeled in this first approach, as hyperelastic, homogeneous, isotropic, while a cylindrically orthotropic model is developed to capture the nonlinear, anisotropic behavior of the balloon catheter under pressure. Two stents with the same geometry but different strut thickness, are studied. Both are considered elasto-plastic. The performed simulations point out the outcome of the balloon angioplasty and stenting in terms of luminal gain and mechanical strains. Finally, a comparison between the two stent configurations is presented.
Paper B: The second paper makes use of the contact tool developed in Paper A and focuses on the changes of the mechanical environment of the arterial wall due to stenting, as a function of a set of stent design parameters. In particular, Paper B presents a detailed geometric and material model of a postmortem human iliac artery, composed by distinct tissue components, each associated with specific mechanical properties. The constitutive formulation for the artery considers anisotropic, highly nonlinear mechanical characteristics under supraphysiological loadings. The material and structural parameters of the arterial model are obtained through uniaxial tensile tests on stripes extracted from the several arterial tissues that form the stenosis, axially and circumferentially oriented. Through cooperation with a well-established stent manufacturing company, an iliac stent was acquired. The dimensions of the stent are measured under a reflected-light microscope, while it is parameterized in such a way as to enable new designs to be simply generated through variations of its geometric parameters. The 3D balloon-stent-artery interaction is simulated by making use of the smooth contact surfaces with C2-continuity, as previously mentioned. Next, scalar quantities attempt to characterize the arterial wall changes after stenting, in form of contact forces induced by the stent struts, stresses within the individual components and luminal change. These numerically derived quantities allow the determination of the most appropriate stent configuration for an individual stenosis. Therefore, the proposed methodology has the potential to provide a scientific basis for optimizing treatment procedures, stent material and geometries on a patient-specific level.
Megyesi, Josph Frank. "Immediate and long-term effects of transluminal balloon angioplasty in a new canine carotid artery model of vasospasm." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0017/NQ29078.pdf.
Full textMagee, Alan Gordon. "Development of catheter techniques to treat native and acquired stenoses in congenital heart disease." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/23395.
Full textBudhani, Faisal. "The role of thrombospondin-1 in smooth muscle cell proliferation and migration leading to neointima formation following balloon angioplasty /." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97914.
Full textČibiras, Sigitas Vladas. "Methods of interventional pediatric cardiology in treatment of congenital heart diseases: immediate and long-term results." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100204_100248-32962.
Full textDisertacijos objektas yra nustatyti intervencinės pediatrinės kardiologijos galimybes ir ypatumus, gydant įgimtas širdies ydas (ĮŠY), įvertinti gydomųjų perkateterinių procedūrų efektingumą, remiantis ankstyvųjų ir vėlyvųjų rezultatų analize. Tai retrospektyvus tyrimas. Analizuoti 422 ligonių duomenys, kuriems 1971 - 2007 m. buvo atliekamos 467 įgimtų širdies ydų paliatyvinės - gydomosios procedūros. Nustatyta, kad po balioninės tarpprieširdinės pertvaros septostomijos, statistiškai reikšmingai padidėja prieširdžių pertvaros defektas, didėja arterinio kraujo įsotinimas deguonimi ir mažėja spaudimų skirtumas (SS) tarp prieširdžių. Balioninė plaučių arterijos valvuloplastika (BPV) yra viena iš dažniausiai taikomų gydomųjų procedūrų, jos efektas – ryškus SS tarp dešiniojo skilvelio ir plaučių arterijos (PA) sumažėjimas, o pagrindinė komplikacija – PA vožtuvo nesandarumo vystymasis. BPV vėlyvieji rezultatai blogesni, kai yra didelis SS prieš procedūrą, o po procedūros liekamasis SS ≥ 36mmHg. Nustatyta, kad mažų iki 3mm AAL kimšimas Cook spiralėmis gali sėkmingai konkuruoti su operaciniu gydymu. Rasta, kad aortos, tuščiųjų venų ir plaučių arterijos šakų balioninės plastikos efektas trumpalaikis, o gydymas stentais daug sėkmingesnis. Nustatyta, kad anomalinių įgimtų ir pooperacinių kraujagyslinių jungčių užkimšimas spiralėmis yra saugus ir efektyvus gydymo metodas.
Jeddy, T. A. "Changes following balloon angioplasty of the superficial femoral artery and the effect of low molecular weight heparin : assessment using colourflow doppler ultrasound." Thesis, University of Newcastle Upon Tyne, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246086.
Full textAlejos, Andrea Oriette Ruiz, and Huamán Laura María Navarro. "Mortalidad intrahospitalaria por infarto agudo de miocardio ST elevado en pacientes sometidos a revascularización según tiempo de isquemia y otros factores asociados." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2015. http://hdl.handle.net/10757/621628.
Full textIntroduction: Primary percutaneous coronary intervention reduces mortality in patients with ST elevated myocardial infarction (STE MI). The objective was to evaluate the 30 days in-hospital mortality according to door-to-balloon time and total ischemic time in patients treated with primary PCI. Methods: A retrospective cohort study was performed including patients with STE MI who underwent primary PCI at a national reference hospital in Lima, Peru. A Cox Regression analysis was performed for door-to-balloon time less than 90 minutes and total ischemic time less than 12 hours as predictors and in-hospital mortality as outcome. Results: During 2010’2014, 296 STE MI patients underewent PCI. From them, 82,4% were male. The mean age was 66,5 ±11,8 years. The 30-day mortality was 8,11%. The proportion of patients with total ischemic time less than 12 hours and door-to-balloon time was 82,43% and 33,11% respectively. No association between these intervals and 30-day mortality was found. Cardiac arrest (HR: 2,9 95%CI 1,09-7,72), cardiogenic shock at the admission (HR: 7,06; 95%CI: 2,84- 17,59) and TIMI flow less than 3 after primary PCI (HR: 4,21; 95%CI: 1,73-10,19) were associated with higher 30-day mortality.. Conclusion: No association between mortality and lower total ischemia time or door to ballon time mortality was found. A significant delay was observed in hospital arrival and performing revascularization.
Schwemer, Dorothea. "Balloon angioplasty for native coarctation of the aorta in adolescent and adults with or without stent implantation : acute, midterm and long-term results /." Frankfurt a.M, 2007. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=017381876&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
Full textWahlgren, Carl Magnus. "Mechanisms of thrombosis and restenosis after vascular injury /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-260-8/.
Full textYabuta, Minoru. "Long-term Outcome of Percutaneous Interventions for Hepatic Venous Outflow Obstruction after Pediatric Living Donor Liver Transplantation: Experience from a Single Institute." Kyoto University, 2015. http://hdl.handle.net/2433/199187.
Full textNETO, JOAQUIM DAVID CARNEIRO. "Nefropatia induzida por contraste em pacientes submetidos a angioplastia primÃria no infarto agudo do miocÃrdio." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17185.
Full textIntroduction: The prevention of contrast-induced nephropathy (CIN) is difficult in emergency situations, making it essential to study CIN in patients submitted to urgent angioplasty. Objective: To determine the incidence and associated factors to CIN in patients with myocardial infarction (MI) submitted to primary angioplasty in the first 12 hours after onset of symptoms. Methods: We studied 201 consecutive cases of MI with ST-segment elevation with less than 12 hours of evolution. All patients were submitted to the same angioplasty protocol. CIN was defined as an absolute increase of creatinine of at least 0.5 mg/dL and/or a relative increase of creatinine of 25% in relation to baseline in a period between 48 and 72 hours after contrast administration. The variables that differed between patients with and without CIN in univariate analysis were analyzed by logistic regression. Results: The sample was formed by 135 (67.2%) men and 66 (32.8%) women, with mean age of 66.6  11.7 years. The incidence of CIN was 23.8%. In univariate analysis the patients with CIN were older and had higher frequency of left ventricular ejection fraction ≤ 40% and Killip classification ≥ 2. In multivariate analysis, we did not find independent predictors of CIN. Conclusion: CIN occurred in  of the patients with MI submitted to angioplasty without predictor variables. This finding highlights the need for CIN preventive measures after contrast use in emergency angioplasty.
Fusaro, Massimiliano [Verfasser], Adnan [Akademischer Betreuer] Kastrati, and Isabel V. [Akademischer Betreuer] Deisenhofer. "Angiographic and clinical efficacy of Paclitaxel-coated versus Uncoated-Balloon angioplasty for femoro-popliteal revascularization. : A meta-analysis of randomized trials. / Massimiliano Fusaro. Gutachter: Isabel V. Deisenhofer ; Adnan Kastrati. Betreuer: Adnan Kastrati." München : Universitätsbibliothek der TU München, 2012. http://d-nb.info/1031756612/34.
Full textBoaventura, Rafaela Peres. "Desempenho dos indicadores de qualidade da assistência na fase aguda do infarto do miocárdio." Universidade Federal de Goiás, 2015. http://repositorio.bc.ufg.br/tede/handle/tede/5598.
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This study aimed to analyze the pre-hospital course of patients undergoing percutaneous myocardial reperfusion in acute myocardial infarction and evaluate the performance of health care quality indicators of myocardial infarction in these patients. This is a retrospective cohort study with convenience sample. It was analyzed 39 cases of myocardial infarction with ST segment elevation, with Delta T up to 12 hours without previous administration of fibrinolytic agents, admitted for treatment at the General Hospital of Palmas / TO in 2013. Data were collected in the pre-hospital phase in records and interview and in the in-hospital phase through secondary data. For statistical analysis we used the Shapiro-Wilk test, Student's t test and ANOVA with 5% significance level. Most were male (76.9%), with a stable partner (74.4%), with up to nine years of education (64.1%) and at least three cardiovascular risk factors (79.5%). In the pre-hospital delta T phase was high (06h34min ± 03:14) and 10.2% achieved the recommended metric. The delta T was higher among patients that did not previously recognized symptoms of AMI (mean 07h09min ± 03h12min) and lower among those who were treated during the day (mean 03h 25min ± 05h35min). In-hospital phase, 56% were admitted during the day. In 30.8% of cases the Killip Kimball was > I. Among the other infarcted walls prevailed the bottom wall. Five patients (12.8%) died. Time door-ECG and needle holder did not follow international recommendations for all variables. The early recognition of symptoms and time of care are interfering for prehospital delay. There was no statistical correlation-balloon time and door-ECG door to the profile of patients with clinical variables in the hospitalization phase. The metric assessment of infarct treatment quality indicators in the acute phase was unsatisfactory throughout the study period.
Objetivou-se analisar a trajetória pré-hospitalar dos pacientes submetidos à reperfusão miocárdica percutânea na fase aguda do infarto do miocárdio e avaliar o desempenho dos indicadores de qualidade da atenção ao infarto do miocárdio desses pacientes. Trata-se de coorte retrospectiva, com amostra por conveniência. Foram analisados 39 casos de infarto do miocárdio com supradesnível do segmento ST, com Delta T até 12 horas e sem administração prévia de fibrinolíticos, admitidos para tratamento no Hospital Geral de Palmas / TO em 2013. Os dados foram coletados na fase pré-hospitalar por consulta em prontuário e entrevista; na fase intra-hospitalar, por meio de dados secundários. Para a avaliação estatística foram utilizados o teste de Shapiro-Wilk, o teste t de Student e ANOVA, com nível de significância de 5%. A maioria era do sexo masculino (76,9%), com companheiro estável (74,4%), com até nove anos de estudo (64,1%) e com pelo menos três fatores de risco cardiovasculares (79,5%). Na fase pré-hospitalar o Delta T foi elevado (06h34min ± 03h14min) e 10,2% atingiram a métrica recomendada. O Delta T foi maior entre os pacientes que não reconheceram previamente os sintomas de IAM (média 07h09min ± 03h12min) e menor entre aqueles que foram atendidos durante o dia (média 05h35min ± 03h 25min). Na fase intra-hospitalar, 56% foram admitidos durante o dia. Em 30,8% dos casos o Killip Kimball foi > I. Dentre as demais paredes infartadas prevaleceu a parede inferior. Cinco pacientes (12,8%) evoluíram para óbito. Os tempos porta-ECG e porta-agulha não seguiram as recomendações internacionais para todas as variáveis. O reconhecimento prévio dos sintomas e o horário do atendimento estão interferindo para o atraso pré-hospitalar. Não houve correlação estatística do tempo porta-balão e porta-ECG com o perfil dos pacientes e com as variáveis clínicas na fase intra-hospitalar. A avaliação métrica dos indicadores de qualidade do tratamento do infarto na fase aguda foi insatisfatória durante todo o período avaliado.
Rube, Martin. "Novel tools for interventional magnetic resonance imaging." Thesis, University of Dundee, 2014. https://discovery.dundee.ac.uk/en/studentTheses/7e3feb72-0102-431f-982a-b3cdd393994e.
Full textDecorato, Iolanda. "Simulation numérique des interactions fluide-structure dans une fistule artério-veineuse sténosée et des effets de traitements endovasculaires." Phd thesis, Université de Technologie de Compiègne, 2013. http://tel.archives-ouvertes.fr/tel-00832342.
Full textZeltwanger-Trefz, Silke [Verfasser]. "Effekt der Cutting-Balloon Angioplastie auf die Offenheitsdauer von Hämodialyseshunts im Vergleich zur konventionellen perkutanen Angioplastie / Silke Zeltwanger-Trefz." Ulm : Universität Ulm, 2018. http://d-nb.info/1173790977/34.
Full textBrandão, Sara Michelly Gonçalves. "Custo-efetividade e custo-utilidade dos tratamentos clínico, cirúrgico e percutâneo em portadores de doença coronariana multiarterial estável." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-28022019-095319/.
Full textBackground. The costs for treating coronary artery disease (CAD) are high worldwide. We performed a post hoc analysis of cost-effectiveness of 3 therapeutic strategies for multivessel CAD. Methods. From May 1995 to May 2000, a total of 611 patients were randomly assigned to CABG (n=203), PCI (n=205), or MT (n=203). This cost analysis study was based on the perspective of the Public Health Care System. Initial procedural and follow-up costs for medications, cardiology examinations, and hospitalizations for complications were calculated after randomization. Life-years and quality-adjusted life years (QALY) were used as effectiveness measures. Incremental cost-effectiveness ratios (ICER) were obtained by using nonparametric bootstrapping methods with 5000 resamples. Results. Initial procedural costs were lower for MT. However, the subsequent 5-year cumulative costs were lower for CABG. Compared with baseline, the 3 treatment options produced significant improvements in QALY. After 5 years, PCI and CABG had better QALY results compared with MT. The ICER results favored CRM and PCI when compared to the TM, since the PCI in relation to the CRM was more costeffective in 61% for the thresholds up to 3 GDP per capita per QALY. On the other hand, sensitivity analysis showed MT as the preferred therapy compared with CABG and PCI, in the analysis considering higher costs. Conclusion. At 5-year follow-up, the 3 treatment options yielded improvements in quality of life, with comparable and acceptable costs. However, despite higher initial costs, the comparison of costeffectiveness after 5 years of follow-up among the 3 treatments showed both interventions (CABG and PCI) to be cost-effective strategies compared with MT
Tanaka, Leonardo Yuji. "Dissulfeto isomerase proteica como via integrativa entre estresse oxidativo e resposta a proteínas mal-enoveladas na reparação à lesão vascular." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-08042014-092611/.
Full textWhole-vessel remodeling is a critical lumen caliber determinant in vascular disease, but underlying mechanisms are poorly understood. We investigated the role of endoplasmic reticulum chaperone Protein Disulfide Isomerase(PDI) and cell-surface PDI(peri/epicellular=pecPDI) pool in vascular caliber and architecture during vascular repair after injury(AI). After rabbit iliac artery balloon injury, there was marked increase in PDI mRNA and protein (25-fold vs. basal at day 14AI), with increase in both intracellular and pecPDI. Silencing PDI by siRNA (organ culture) induced ER stress augmentation and apoptosis, contrarily to pecPDI neutralization with PDI-antibody(PDI Ab). PecPDI neutralization in vivo with PDIAb-containing perivascular gel from days 12-14AI promoted ca.25% decrease in vascular caliber at arteriography and similar decreases in total vessel circumference at optical coherence tomography, without changing neointima, indicating increased constrictive remodeling. PecPDI neutralization promoted marked changes in collagen and cytoskeleton architecture, with inverted fiber orientation and disorganization. Decreased ROS and nitrogen oxide production also occurred. Viscoelastic artery properties assessment showed decreased ductility, evidenced by decreased distance to rupture. Subcellular cytoskeletal disruption by PDI Ab was recapitulated in vascular smooth muscle cell stretch model, with marked decrease in stress fiber buildup. Also, PDI Ab incubation promoted decreased regulation resilience of vascular smooth muscle migration properties. While pecPDI neutralization did not affect global RhoA activity, there was altered RhoA redistribution to the cell surface and association with caveolin-containing clusters, which mislocalized after stretch. In human coronary atheromas, PDI expression inversely correlated with constrictive remodeling. Thus, strongly-expressed PDI after injury reshapes matrix and cytoskeleton architecture to support an anticonstrictive remodeling effect
Dichtel, Laura Elisabeth. "Percutaneous Renal Artery Revascularization in Patients with Atherosclerotic Renal Artery Stenosis and Chronic Kidney Disease." Yale University, 2009. http://ymtdl.med.yale.edu/theses/available/etd-03062009-004834/.
Full textHack, Michael. "Einfluss der systemischen Gabe von hämatopoetischen Zytokinen auf Neointimabildung und vaskuläres Remodeling nach experimenteller Ballon-Angioplastie : Untersuchungen am Carotis-Angioplastie-Modell der erwachsenen Ratte /." Regensburg, 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253200.
Full textKelsch, Bettina [Verfasser]. "Paclitaxel-beschichtete Ballone zur Angioplastie : Beschichtungsoptimierung, Dosisfindung und Pharmakokinetik sowie mögliche neue Anwendungsgebiete / Bettina Kelsch." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2015. http://d-nb.info/1068208600/34.
Full textKherad, Behrouz [Verfasser]. "Angiographische Analyse bei Patienten mit Stent-Implantation in den Hauptstamm der linken Koronararterie und Ballon-Angioplastie des Seitenastes / Behrouz Kherad." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2016. http://d-nb.info/1112133305/34.
Full textDakovic, Igor [Verfasser], and Marcus [Akademischer Betreuer] Treitl. "Outcome der Scoring-Balloon Angioplastie der pAVK der unteren Extremitäten im Vergleich zur herkömmlichen Ballonangioplastie mit besonderem Augenmerk auf Reststenosen und Stentquote / Igor Dakovic ; Betreuer: Marcus Treitl." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2020. http://d-nb.info/1226092403/34.
Full textMagalhães, Cibelle Dias. "Estudo comparativo entre os custos dos tratamentos clínico, cirúrgico e percutãneo em portadores de doença multiarterial coronária estável: 10 anos de seguimento." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-18122017-095256/.
Full textIntroduction: The cost-effectiveness analysis in multivessel coronary artery disease treatment have gained importance in clinical trials, since the main treatment options: coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) and medical treatment (MT) have similar efficacy in certain subgroups of patient. Currently, the concernment in economic analysis have grown, since Medical Treatment costs have increased with the constant development of new technologies, but the available budget are finite and should be administered. Objective: prospectively analyze the comparative cost of the three medical treatments for stable multivessel coronary artery disease, during ten years follow-up. Methods: It was calculated the overall therapeutic cost of 611 patients in the clinical trial \"The Second Medicine, Angioplasty, or Surgery Study (MASS II) \", considering the remuneration provided by the health insurance system of the Heart Institute of HC/FMUSP converted to dollar currency. Afterward, the costeffectiveness analysis was conducted by adjusting the cumulative cost obtained at each group for the \"time free of clinical events\" and also for the combination of \"time free of events\" and \"time free of angina\". Results: The MT had a cumulative cost, at the end of ten years, of US$ 6,183.00; PCI had a cost of US$ 14,292.00; and the CABG group had a cumulative cost of US$ 12,316.00. The costs adjusted for \"events-free survival\" were US$ 11,136.00 for MT; US$ 26,912.00 for PCI and US$ 17,883.00 for CABG. There was a statistically significant difference between the 3 groups (p < 0.0001) and paired analysis showed lower cost for the medical treatment group compared with CABG (p < 0.0001) and PCI (p < 0.0001). The CABG compared with PCI also showed lower cost (p < 0.0001). The adjusted costs for \"survival free of clinical events and angina\" were US$25,690.00 for MT; US$45,989.00 for PCI and US$27,920.00 for CABG; with a significant difference between the 3 groups (p < 0.0001). Comparing the groups, it can be seen a lower cost in the medical treatment group, compared with CABG (p < 0.0001), and also in comparison with PCI (p < 0.0001). However, the comparison between the medical treatment group and surgical treatment group showed no significant difference (p=0.5613). Conclusion: The long-term comparative economic analysis revealed that PCI showed up to be the least cost-effective treatment. The medical treatment was the most cost-effective in \"events prevention\", but considering \"events and angina prevention\", it had a cost-effectiveness similar to surgical treatment
Kurre, Corinna [Verfasser], Ralph [Gutachter] Kickuth, Richard [Gutachter] Kellersmann, and Jan Peter [Gutachter] Goltz. "Single-Center Erfahrungen bezüglich des Einsatzes eines „Cutting Balloon Katheters“ (= perkutane transluminale Blade-Angioplastie) bei Patienten mit stenosierten Hämodialyseshunts / Corinna Kurre ; Gutachter: Ralph Kickuth, Richard Kellersmann, Jan Peter Goltz." Würzburg : Universität Würzburg, 2018. http://d-nb.info/1150644737/34.
Full textChen, Ching-Pei, and 陳清埤. "Cost Analysis of Cutting Balloon Angioplasty for Coronary Bifurcation Lesion Compared with Plain old Balloon Angioplasty." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/97927659447955621920.
Full text東海大學
工業工程與經營資訊學系
97
In the plain old balloon angioplasty era, the risk of side branch occlusion was high after percutaneous coronary intervention(PCI). The cutting balloon angioplasty is theoretically able to prevent uncontrolled damage to the vessel wall and pressure injury and plaque shift. This prospective study compared the procedural costs of cutting balloon angioplasty with plain old balloon angioplasty for treatment of coronary bifurcation lesion. From May 2007 to Oct 2008, a total of 30 patients with Institute Cardiovasculaire Paris(ICPS) classification type 1 lesions were randomized to either plain old balloon angioplasty or cutting balloon angioplasty. There was no significant differences in baseline characteristics, vessel size, minimal lumen diameter and severe of stenosis between the two groups. There was a significantly longer procedure time and fluoroscopy time, a higher procedural cost , and a greater volume of contrast used in cutting balloon angioplasty group (NTD$ 136201±51524 vs 72380±49350 p=0.002). The angiographic lesion calcification (p=0.004) and elected procedure (p=0.003) were independent predictors of procedure time. The predictors of procedural costs were elected procedure (p=0.002), angiographic lesion calcification (p=0.004), and left anterior descending artery lesion (p=0.007). In conclusion, for patients with ICPS classification type I and moderately calcified lesion, cutting balloon angioplasty is not the first choice of intervention.
Chang, Shu-Lin, and 張淑玲. "Cutting balloon versus conventional angioplasty for the treatment of in-stent restenosis." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/h4mhdn.
Full text元培科技大學
影像醫學研究所
96
Abstract The object of this study is tracking and analyzing the effect of using plain old balloon angioplasty(POBA)and cutting balloon angioplasty(CBA) for treating in-stent restenosis after coronary artery stents has implanted in a hospital center located in central Taiwan area compared with traditional domestic therapies. Patient data was collected between Jan. 2003 and Dec. 2006 for all patients with coronary artery stents and stents sizes and numbers were analyzed according to the outpatient service situation. Physicians use POBA to treat coronary artery stenosis with small size balloon first as pre-extending operation then choose blade cutting balloon which are 1:1 or 1:1.5 ratio compared to blood vessel to do the following expanding procedure. The re-stenosis ratio of this low pressure and repeated slow progress coronary artery expanding is far smaller than study report compared with traditional POBA after statistic analyzed. Most domestic centers which perform cath therapies usually choose plain old balloon angioplasty at beginning but coronary artery may cause plaque rupture and lead to coronary artery obstruction, at this moment coronary artery stent may support the subside vessel from the inside of vessel. Sometimes it is too serious of the plaque rupture and even coronary artery stent is not working then bypass is needed. This study analyzed and focused on cutting balloon angioplasty as main treaty in which we find out that in stent re-stenosis (14%)and balloon plasty(10%) are quite lower compared with reports from domestic or foreign ( 35% - 50% ) so cutting balloon catheter can give patients the most safe margin and benefit as first chose.
Chen, Yung-Chi, and 陳永麒. "Applications of Finite Element Analysis: Computational Studies of Angioplasty Balloon and Sac." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/76531016503842994034.
Full text國立臺灣大學
機械工程學研究所
104
Cardiovascular disease is now the leading cause of death worldwide. To investigate cardiovascular-related diseases, finite element models were developed in this study. The study is organized as follows: In the first part, a finite element model is established to investigate stent-artery interaction with absence of a realistic balloon. A comparison of previous study is shown that the balloon and the stent expand in a non-uniform end-first manner (the dogbonning effect), and then apply radial force to enlarge the arterial wall. A numerical analysis of novel left ventricular assist device is developed to evaluate the mechanical integrity and pulsatile fatigue resistance of the blood sac in the second part. The results show that the sac thickness is the key factor for safety factor and 0.275 mm is a better choice for resistance of periodic physiologic loading. The length and thickness of lobes are also investigated whether it reduce the stress/strain concentration near the connection region of lobes and sac. The results show that lobe length may affect the stress/strain concentration while tapered lobe thickness causes almost negligible results. In the last part, a bifurcation intervention strategy model of simultaneous kissing stenting technique (SKS) is developed while VDISP user subroutine is used to simulate the interaction behavior between two balloon-expandable stents, balloon and bifurcation lesions. Computational modeling has become a prevalent tool due to its ability to investigate the influence of individual parameters and improve the temporal efficiency of new product development. Finite element models developed in this study could give insights into various aspects of future design optimization for new biomaterials or biomedical devices. It is also feasible to provide a guideline for physicians and medical personnels to achieve the best clinical outcome.
Yuan-Hong, Liu, and 劉芫宏. "Plasma Protein Change After Percutaneous Transluminal Coronary Balloon Angioplasty --- A Pilot Study." Thesis, 2002. http://ndltd.ncl.edu.tw/handle/91240885821250592434.
Full text國立臺灣大學
臨床醫學研究所
90
Summary Background Atherosclerosis is the leading cause of death and disability in the developed world. Coronary artery disease , mostly derived from atherosclerosis, causes angina pectoris, acute myocardial infarction, arrythmias, heart failure, or sudden death. Percutaneous transluminal coronary angioplasty is the major treatment of coronary artery disease. Over 10,000 procedures annually were performed in Taiwan. The Achilles heel of PTCA is the relatively high restenosis rate (around 40%). Restenosis is a complex process associated with elastic recoil of the vessel wall, remodeling of the arterial wall, proliferation of fibrous tissue and smooth muscles of the intima, excess formation of extracellular matrix, residual plaque within the artery, and thrombus formation. Clinical predictors of restenosis include diabetes mellitus, unstable angina, and angiographic predictors. The changes of biological factors after coronary angioplasty are not well known. Changing plasma level of C-reactive protein, serum amyloid A, hemostatic factors endothelin-1, heat shock protein 65, N- terminal proatrial natriuretic peptide, interleukin 6, and macrophage-colony stimulating factors were reported. Some of them are associated with coronary restenosis. However, these findings may explain only parts of human body reaction to coronary balloon angioplasty. Proteomics is the study of the entire protein complement (functional output) of a genome by means of protein separation, identification, and bioinformatics. No one has used this method to analyze the proteins change after coronary balloon angioplasty. Our study is designed to analyze acute phase protein change after PTCA by means of proteomics-based approach, which may characterize overall changes in protein expression before and after percutaneous transluminal coronary angioplasty. Understanding the protein change may help us understand the reaction of our body to PTCA, the potential biologic risk factors for post-angioplasty coronary restenosis. Methods Thirty patients receiving percutaneous transluminal coronary angioplasty with stenting were enrolled. Blood was sampled from the patients before, immediately after, one day after, and 1 week (not all patients) after successful coronary balloon angioplasty. The patients received follow-up at OPD. If the patients had symptoms of angina pectoris or exercise intolerance, he would receive stress test (treadmill test or Thallium-201 myocardial perfusion scan). If the patients have positive results of stress test or if they have acute myocardial infarction/ unstable angina, they would receive coronary angiography to see if coronary restenosis occurs. Two-dimensional gel electrophoresis was performed: (1) Immobilized pH gradient (IPG) as first dimension. (2) SDS-PAGE as second dimension. (3) Silver stain and scanning. Gel images were analyzed with Melanie software to compare multiple gels of the samples from the same patients before and after coronary angioplasty. Comprehensive proteome databases on the internet (ExPaSy Molecular Biology Server) are linked. Proteins of significant change were identified on the basis of isoelectric points and molecular size determined from the two-dimmensional gels. Proteins of significant change were correlated to the possible reaction of our body to coronary angioplasty. Results Blood samples from 7 patients before and after coronary angioplasty were analyzed by two dimensional gel electrophoresis and further protein identification. About 45 significant protein spots change were found. The possible proteins of significant change are haptoglobin, complement C4, transthyretin, immunoglobin light chain and heavy chain mu, and plasma retinol binding protein. Haptoglobin, an acute phase protein, is synthesized by liver. Three polymorphism-- Hp(1-1), Hp(2-1), Hp(2-2) were found. Possession of a particular phenotype has been associated with lipid metabolism and a variety of common disorders (e.g. cardiovascular disease, autoimmune disorders, malignancy).Complement C4 was rarely studied in association with cardiovascular disease. Content of C3 and C4 fractions was reported to decrease in blood of patients with AMI within 1st day of disease.ransthyretin, plasma retinol binding protein, immunoglobulin heavy chain and light chain to cardiovascular diseases so far is not clear. We believe that most of the proteins of significant change are relieved from liver or other tissue, which are stimulated by cytokines from local vascular tissue. The major limitation of this study is its small sample size, and inability of two dimensional gel electrophoresis to detect cytokines level change. The future work is to increase the sample size, to analyze unidentified spots of interest by mass spectrometry and sequencing, to quantify the change of haptoglobin, complement C4, prealbumin before and after coronary angioplasty, and to correlate the plasma protein change with clinical outcomes (e.g. restenosis).
Nesler, Donna W. "Perceptions of coronary artery disease and compliance in percutaneous transluminal coronary angioplasty patients." 1988. http://catalog.hathitrust.org/api/volumes/oclc/18904507.html.
Full textWu, Jung-Chou, and 吳榮州. "Cost-Effectiveness Analysis of Balloon Angioplasty Versus Coronary Stenting for Patients with Coronary Artery Disease." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/07311093742885006105.
Full text高雄醫學大學
公共衛生學研究所碩士在職專班
92
OBJECTIVES: The purpose of this study was to compare the cost and effectiveness of coronary stenting (STENT) with those for balloon angioplasty (PTCA) in patients with coronary artery disease. METHODS: We retrospectively studied patients with coronary artery disease treated at a regional teaching hospital between January 2000 and August 2003 who received either coronary stent (n =304) or coronary angioplasty (n =348). Detailed cost data were collected initially and up to Feb 2004 following the procedure. Detailed chart reviewed for collecting clinical related data. Five doctors involve the intervention procedures. RESULTS: Baseline clinical characteristics were similar beween the two treatment groups. The mean in-hospital cost for stent patients were $ 183010 (P<0.001) significantly higher than those receiving coronary angioplasty $ 149117 by 33993 NT dollars. In the following average 2 years follow-up period, the mean cost became no difference between two groups. There was significant difference among the doctors in the following 6 months and 12 months cost. Doctor B had significant higher cost than the others. The revascularization rate of the target vessel at one year was no difference. But the mortality rate was significant higher in the PTCA group at one year (15.5% vs. 10.5%). The major contribution was in the subgroup of acute myocardial infarction(AMI) patients (PTCA 22.2% vs. STENT group 11.7%, P=0.02). There was significant difference among doctors. In patients with acute myocardial infarction and received PTCA, there was higher mortality at one and two years by doctor C. Analyzing the cost-effectiveness at one year, as presenting with ratio between difference of mean cost group and difference of mortality in the two group, the cost to increase one survival patient per year in the PTCA group as compared with STENT group was 917660 NT dollars. Especially in the AMI group, the cost was only 381542 NT dollars. If extended the follow-up period to two years, the cost to increase one survival patient per year in the PTCA group would further decline. CONCLUSION: Although stent is costly, the effect to decrease mortality beyond one year is significant, especially in the AMI patients. From the cost-effectiveness ratio of view, stent should be used more advance especially in the AMI patients.
Lin, Chien-Heng, and 林建亨. "Sleep Deprivation Before and After Balloon Angioplasty Significantly Augments Post-injury Neointimal Proliferation in Carotid Arteries of Rats – Preliminary Study." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/81421101880395901470.
Full text中國醫藥大學
臨床醫學研究所碩士班
96
Background: Coronary artery disease can be treated with percutaneous transluminal coronary angioplasty (PTCA). Although this procedure is efficacious in opening stenotic arteries it may also cause injury and inflammation to the vessel producing neointima formation and subsequently restenosis. Sleep deprivation has major effects on early inflammatory response and may produce numerous untoward effects on cardiovascular disease and wound healing. However, whether sleep deprivation may affect injury-induced neointimal proliferation of the vessel is unknown. This preliminary study is to investigate if sleep deprivation will augment balloon angioplasty induced neointimal proliferation in carotid arteries of rats. Materials and Methods: Rats were randomly assigned to the following four groups: Group C (control group): balloon angioplasty without sleep deprivation. Group A: balloon angioplasty after 24-hours sleep deprivation. Group B: balloon angioplasty before 24-hours sleep deprivation. Group AB: 24-hours sleep deprivation before and after balloon angioplasty. Twenty four hours sleep deprivation was performed by the disc-on-water method for the rats in Group A, Group B and Group AB. Balloon injury was performed with all rats anesthetized and afterwards subjected to an injury of the right carotid artery with a 2F-Fogarty balloon catheter. The untouched left carotid artery was used as another (self) control. Thirteen days after the balloon injury, all of the rats were sacrificed and both carotid arteries were removed. The cross sections were later stained with hematoxylin and eosin (H&E) for morphometric analysis. Results: There were 2 rats in each group. The post injury neointima-to-media area ratio in Group C, Group A, Group B and Group AB were 0.90±0.01, 1.2±0.13, 1.44±0.05 and 1.73±0.02, respectively. There were 31.87%, 58.24%, and 87.91 increase in post-injury neointima-to-media area ratio in Group A, Group B and Group AB, respectively, compared with Group C (p<0.05). In addition, the post injury neointima-to-media area ratios in Group A and Group B were lower than that in Group AB (p<0.05). There were no neointimal proliferations in the left carotid artery for all groups. Conclusion: This preliminary study shows that neointimal proliferation induced by balloon angioplasty is significantly increased whether the 24-hours sleep deprivation was before and/or after balloon angioplasty of rats. In addition, sleep deprivation before and after balloon angioplasty had significantly more neointimal proliferation than sleep deprivation before or after angioplasty alone. We concluded that sleep deprivation significantly augments post-injury neointimal proliferation in carotid artery angioplasty of rats.