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Dissertations / Theses on the topic 'Angioplasty, Balloon'
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1
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.
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Garramone, Samantha. "Structure-property relationships in angioplasty balloons." Link to electronic thesis, 2001. http://www.wpi.edu/Pubs/ETD/Available/etd-0430101-122300/.
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Smyth, 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.
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Löfberg, 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/.
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Lalli, 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.
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The development of a new angioplasty balloon from a new material can be a long and arduous process that may take months. These balloons must meet some very stringent requirements such as high rated burst pressure with minimal wall thickness. The purpose of this thesis is to help reduce the amount of time invested in the experimental development stages of these medical balloons. This can be achieved with the aid of a cycle-to-cycle controller. The controller presented here may be simplistic, but it has shown that with further testing and modeling, it has the potential to completely replace the trial-and-error method of balloon development in use today.
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Winkler, 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.
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Gray, 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.
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Chen, 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.
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The development of a new angioplasty balloon is a time consuming process. This thesis aims at reducing the amount of time and materials spent on the experimental stage of the development of new angioplasty balloons. This can be achieved by building a nonlinear neural network model of the balloon forming process and implementing an off-line cycle-to-cycle controller. The controller can learn from the previous experiments and provide better input parameters for improving the quality of the next balloons formed in the process. It is shown in the experimental test results that the neural network model can provide accurate estimates of the process outputs. The neural network model combined with a cycle-to-cycle control strategy has the potential to replace the trial-and-error approach to balloon development that is commonly applied today.
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Olbrich, 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.
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Konneh, 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.
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Shehab, 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.
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Azarnoush, 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.
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Cardiovascular disease is the leading cause of death in industrialized nations. Angioplasty is performed on millions of patients every year. It is, therefore, essential to constantly explore and investigate new approaches to study and improve the outcomes of this minimally-invasive procedure. In this thesis, novel applications of intravascular optical coherence tomography (IVOCT) are proposed, namely, monitoring, characterization, simulation, and control of balloon inflation.High-resolution IVOCT images lead to a detailed assessment of microstructures. Using image analysis techniques, IVOCT characterization of balloon deformation is presented as a method to validate the performance of balloons. IVOCT characterization of the deformation of artery phantoms is proposed as a method to study the tissue's response to various balloon sizes, various balloon folding strategies and various inflation strategies.In addition, IVOCT characterization of deformation is proposed as a method to validate simulation results. This thesis provides a comparison between finite-element simulation results and experimental results for two case studies, which investigate the effects of variation of mechanical properties as well as balloon unfolding and inflation process.Finally, in this thesis, methods are proposed to control the balloon inflation. During balloon inflation, the luminal diameter of an artery could be estimated in real-time and used in a feedback loop to control the inflation. The experimental relevance of this method is demonstrated when the balloon is inflated in an artery phantom, in an artery of an excised porcine heart and in an artery of a beating porcine heart.The methods and the results, provided in this thesis, could benefit the developers of angioplasty devices, cardiovascular research, and clinical users.<br>Les 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.
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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.
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Restenosis is the major cause of the failure of reconstruction methods to restore the blood flow in atherosclerotic arteries. Restenosis results from neointima formation and consequent constrictive remodelling. Vascular smooth muscle cell (VSMC) migration from the tunica media toward the intima is crucial in neointima genesis. The prerequisite for VSMC migratory activity is the modulation from the differentiated (contractile) to the de-differentiated (noncontractile) phenotype. VSMC phenotype change is associated with the altered expression of integrins. alpha8beta1 integrin is upregulated in cell types with contractile properties, including myofibroblasts and mesangial kidney cells. It is one of the integrins that is intensely expressed in mature VSMCs. alpha8beta1 integrin expression during vascular injury and its role in VSMC function have not been studied so far.<br>In 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.<br>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.<br>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.
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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.
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Bärlocher, 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.
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Mutchler, Megan Marie. "Ribonucleotide Reductase Inhibitors for Restenosis." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1211423147.
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Acampora, 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/.
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Gotti, 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.
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Background: Balloon pulmonary angioplasty (BPA) has recently been developed as an alternative and less- invasive treatment strategy for chronic thromboembolic pulmonary hypertension (CTEPH), but therapeutic efficacy and technical safety of the technique have to be established.
Aim: effects of BPA on patients with inoperable disease or residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA).
Methods: From June 2015 to September 2019 we enrolled symptomatic (NYHA ≥ II) inoperable CTEPH patients and patients with residual PH after PEA. At baseline, immediately before the first BPA session and 3-6 months after last BPA session all patients underwent clinical evaluation, six-minute walking distance and right heart catheterization. For comparisons Friedman test (with Bonferroni post-hoc pairwise analysis) was used. Survival curves were done with Kaplan Meier method.
Results: Forty-seven patients [male 45%, median age 68 (51-74) years, 40 inoperable and 7 with residual PH after PEA] were treated for a total of 136 sessions (median number of sessions for each patient: 2); during each session we treated 2 (2-3) vessels; BPA significantly improved symptoms (NYHA III-IV from 85 to 42%), exercise capacity (from 425 to 446 m) and hemodynamic profile (reduction of mean pulmonary arterial pressure from 41 to 35 mmHg and of pulmonary vascular resistance from 7.1 to 4.7 WU). Five pulmonary artery dissection and 2 hemoptysis with clinical impairment were documented; 33 patients had lung injury (radiographic opacity with/without hemoptysis and/or hypoxemia), 7 patients had access site complications. Five patients died during follow-up (none within 30 days from the procedure) because of sepsis (1), heart failure (1), cancer (1), arrhythmic storm (1) and sudden death in a patient with severe coronary atherosclerosis (1).
Conclusions: BPA is a safe and effective treatment able to improve symptoms and hemodynamic profile in inoperable CTEPH patients and in patients with residual PH after PEA.
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Kiousis, 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.
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<p>Paper 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.</p><p>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.</p>
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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.
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Magee, 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.
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Aim: To describe innovative uses of catheter based treatment in a variety of native and post surgical stenoses in children and young adults with congenital heart disease. Background: Cardiac catheterization in man was first described 1929 and since then there has been a drive to develop endovascular techniques to investigate and treat both congenital and acquired heart disease. Many of the advances are being made in congenital heart disease. Methods: A number of congenital cardiac stenotic lesions were studied including baffle obstruction after atrial switch for transposition of the great arteries, aortic stenosis in infants, coarctation of the aorta, peripheral pulmonary artery stenosis and superior vena caval obstruction. The use of angioplasty balloons, cutting balloons, stents and alternative catheter approaches were investigated for these lesions. Results: Following atrial redirection surgery for transposition of the great arteries balloon angioplasty improved baffle haemodynamics. The technique of anterograde balloon dilation of the aortic valve was developed and had superior outcomes in terms of aortic insufficiency compared to a retrograde approach in neonates with severe aortic valve stenosis. In an animal model of peripheral pulmonary arterial stenosis, the application of cutting balloon angioplasty produced effective relief in a controlled fashion. Balloon mounted stents were used in patients with native and post surgical coarctation of the aorta with significant relief of stenosis and relief of hypertension. Finally, a group of patients with superior vena obstruction syndrome after surgical repair of partial anomalous pulmonary venous drainage had successful treatment using balloon mounted stents. Conclusions: Catheter based treatment of congenital and post surgical vascular stenoses of the heart and great arteries using angioplasty balloons, cutting balloons and balloon mounted stents is safe and appears to be effective in the short and medium term. It may represent a useful alternative to surgery and will reduce the number of surgical procedures required over a lifetime. Future directions will include bio-absorbable stents and hybrid techniques involving surgery.
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Budhani, 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.
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Neointima formation is the major limitation to the use of percutaneous transluminal coronary angioplasty in the treatment of coronary artery disease. It is caused by the proliferation and migration of vascular smooth muscle cells (SMCs) from the media into the intima resulting in narrowing of the luminal diameter. The ELN -/- mouse exhibits a similar phenotype in which overproliferation of SMCs into the lumen leads to obstruction of the aorta causing death at post-natal day 2.5. Based on this observation, a DNA microarray analysis of the ELN -/- aorta was conducted to identify candidate genes responsible for SMC proliferation and migration. Through this process thrombospondin-1 (TSP-1), an extracellular matrix glycoprotein implicated in SMC proliferation and migration, was identified as one of the genes upregulated in the ELN -/- aorta. This result was verified through RT-PCR and immunohistochemistry. To determine the role of TSP-1 in neointima formation, a mouse microsurgery model to simulate balloon angioplasty using the femoral artery was established. This procedure was then performed on TSP-1 +/+ and -/- mice. No difference in the extent of neointima formation was observed 28 days following surgery. However, extensive thrombus formation was observed in the TSP-1 -/- vessel, an unexpected finding of the original study. These results suggest that although TSP-1 is not involved in proliferation and migration of SMCs following balloon angioplasty, it is a critical factor in the regulation of thrombus growth following vascular injury.
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Čibiras, 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.
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Objective - to assess possibilities and specific characteristics of pediatric cardiology in treatment of congenital heart diseases (CHD), to evaluate efficacy of curative per-catheter procedures by means of analysis of immediate and long-term results. Retrospective study. The data of 422 patients who underwent 467 CHD palliative-curative procedures during the period since 1971 till 2007 were analyzed. It was postulated that balloon atrial septostomy resulted in statistically significant increase of atrial septal defect, increase of arterial blood oxygen saturation and decrease of interatrial preasure gradient (PG). Balloon pulmonary valvulotomy (BPV) is one of the most common curative procedures; this procedure has an effect of marked decrease of pressure gradient between the right ventricle and right atrium; development of pulmonary artery valve insufficiency is the most common complication of this procedure. The long - term results of BPV are less positive when higher PG prior the procedure is present and residual PG after the procedure is 36mmHg and higher. It was postulated, that closure of small (less than 3 mm) persistent ductus arteriosus using Cook coils may compete with surgical treatment successfully. It was stated, that the efficacy of balloon angioplasties of aorta, caval veins and pulmonary artery branches is transient; treatment using stents is more effective. It was postulated, that closure of congenital and postsurgical anomalies connections using coils is... [to full text]<br>Disertacijos 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.
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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.
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Alejos, 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.
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Introducción: La intervención coronaria percutánea primaria durante las 24 primeras horas de inicio del dolor torácico reduce la mortalidad por infarto de miocardio con ST elevado (IMA STE). El objetivo del estudio fue evaluar la mortalidad intrahospitalaria a 30 días según el tiempo puerta-balón y el tiempo total de isquemia en pacientes con IAM STE sometidos a intervención coronaria percutánea (ICP) primaria en un hospital de referencia.
Métodos: Estudio retrospectivo de cohorte de pacientes con IMA STE sometidos a ICP primaria en un hospital de referencia de Lima, Perú. Analizamos la asociación entre el tiempo total de isquemia menor a 12 horas y tiempo puerta balón menor a 90 minutos con mortalidad a 30 días, mediante Regresión de Cox, ajustado por otros factores.
Resultados: Durante el periodo 2010-2014, 296 sujetos con IMA STE fueron sometidos a ICP primaria. El 82,4% fueron varones y la media de edad fue 66,5 años ±11,8. La mortalidad intrahospitalaria a 30 días fue 8,11%. El 82,43% tuvo un tiempo total de isquemia menor a 12 horas y el 33,11% un tiempo puerta-balón menor a 90 minutos. No se encontró asociación entre ambos tiempos y mortalidad intrahospitalaria. El paro cardiaco (HR: 2,9 IC 95% 1,09-7,72), shock cardiogénico al ingreso (HR: 7,06 IC 95% 2,84-17,59) y un flujo TIMI menor a 3 post ICP (HR: 4,21 IC 95% 1,73-10,19) se asociaban a mayor mortalidad.
Conclusión: No hubo asociación entre los tiempos estudiados con la mortalidad intrahospitalaria. Se sugieren intervenciones para disminuir los tiempos en esta población.<br>Introduction: 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.
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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.
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Wahlgren, Carl Magnus. "Mechanisms of thrombosis and restenosis after vascular injury /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-260-8/.
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Yabuta, 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.
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NETO, 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.
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IntroduÃÃo: A prevenÃÃo da nefropatia induzida por contraste (NIC) à difÃcil nas situaÃÃes de emergÃncia tornando essenciais estudos sobre NIC em pacientes submetidos à angioplastia de urgÃncia.
Objetivo: Determinar a incidÃncia e fatores associados à NIC em pacientes com infarto agudo do miocÃrdio (IAM) submetidos à angioplastia nas primeiras 12 horas apÃs inÃcio dos sintomas.
MÃtodos: Foram estudados 201 casos consecutivos de IAM com supradesnivelamento do segmento ST com menos de 12 horas de evoluÃÃo. Todos os pacientes foram submetidos ao mesmo protocolo de angioplastia. A NIC foi definida como elevaÃÃo absoluta da creatinina de pelo menos 0,5 mg/dL e/ou aumento relativo da creatinina de 25% em relaÃÃo ao valor basal no perÃodo entre 48 e 72 horas apÃs a administraÃÃo do contraste. As variÃveis que diferiram entre os pacientes com e sem NIC na anÃlise univariada foram analisadas por regressÃo logÃstica.
Resultados: A amostra foi formada por 135 (67,2%) homens e 66 (32,8%) mulheres com idade mÃdia de 66,6 Â 11,7 anos. A incidÃncia de NIC foi de 23,8%. Na anÃlise univariada os pacientes com NIC eram mais idosos e com maior frequÃncia de fraÃÃo de ejeÃÃo do ventrÃculo esquerdo ≤ 40% e da classificaÃÃo Killip ≥ 2. Na anÃlise multivariada nÃo foram encontrados preditores independentes de NIC.
ConclusÃo: A NIC acomete  dos pacientes com IAM submetidos à angioplastia sem variÃveis preditoras. Esse resultado ressalta a necessidade de medidas preventivas para NIC apÃs uso de contraste em angioplastia de urgÃncia.<br>Introduction: 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 Â 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.
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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.
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Boaventura, 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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Previous issue date: 2015-03-23<br>Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG<br>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.<br>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.
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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.
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Magnetic Resonance Imaging (MRI) provides unique advantages such as superior soft tissue contrast, true multiplanar imaging, variable contrast mechanisms, measurement of temperature changes, perfusion and diffusion, and no ionizing radiation. Despite considerable research efforts in the field of interventional MRI, numerous challenges remain including restricted access to the patient, high acoustic noise and a shortage of MRI-safe devices. Novel methods and devices are presented in this thesis with the primary objective of enabling effective MRI-guided interventions, particularly abdominal needle and common catheter-based endovascular interventions. Firstly, a set of MRI-safe devices (guidewires, micro guidewires, catheters and micro catheters) were developed with passive or inductively coupling resonant markers for MRI visualisation. Secondly, a method was implemented for wireless tracking and dynamic guidance of instruments. Thirdly, a framework of technologies was developed for in-room display, wireless MRI remote control and multi-user communication along with a dedicated user interface and imaging protocol. These implementations were assessed in regards to MRI-safety, performance and usability and evaluated for MRI-guided liver biopsies, balloon angioplasty procedures and also for mechanical thrombolysis. Flow phantoms, Thiel soft-embalmed human cadavers with partially re-established perfusion and a porcine model were used for in vitro, ex vivo and in vivo validation, respectively. The results demonstrate that these interventions are experimentally feasible and practical when using the presented developments: automated device tracking and equipment designed for MRI-guided interventions streamlined procedural workflow. Specifically, it was shown that fast and accurate needle placements along complex trajectories were feasible using a wireless interactive display and control device with a dedicated user interface for interventions. Moreover, safe and efficacious balloon angioplasties of the iliac artery were practical using the described framework of technologies along with a dedicated MRI protocol. Finally, it was demonstrated that these developments could be adapted and applied to MRI-guided endovascular mechanical thrombolysis of the middle cerebral artery. The technologies, described in this thesis have been shown to overcome many of the present limitations and should therefore be useful for enabling MRI-guided interventions while not further constraining the operating physician in an already complex environment. Nevertheless, it is acknowledged that many crucial issues remain to be solved in the field of iMRI and in the context of the presented research. In particular further device optimisations, improvements of the tracking implementation along with further in vivo evaluations are required before moving towards clinical evaluation. This thesis sets the groundwork for moving ahead with the eventual clinical realisation of optimised MRI-guided interventions.
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Decorato, 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.
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Une fistule artérioveineuse (FAV) est un accès vasculaire permanent créé par voie chirurgicale en connectant une veine et une artère chez le patient en hémodialyse. Cet accès vasculaire permet de mettre en place une circulation extracorporelle partielle afin de remplacer les fonctions exocrines des reins. En France, environ 36000 patients sont atteint d'insuffisance rénale chronique en phase terminale, stade de la maladie le plus grave qui nécessite la mise en place d'un traitement de suppléance des reins : l'hémodialyse. La création et présence de la FAV modifient significativement l'hémodynamique dans les vaisseaux sanguins, au niveau local et systémique ainsi qu'à court et à plus long terme. Ces modifications de l'hémodynamiques peuvent induire différents pathologies vasculaires, comme la formation d'anévrysmes et de sténoses. L'objectif de cette étude est de mieux comprendre le comportement mécanique et l'hémodynamique dans les vaisseaux de la FAV. Nous avons étudié numériquement les interactions fluide-structure (IFS) au sein d'une FAV patient-spécifique, dont la géométrie a été reconstruite à partir d'images médicales acquises lors d'un précédent doctorat. Cette FAV a été créée chez le patient en connectant la veine céphalique du patient à l'artère radiale et présente une sténose artérielle réduisant de 80% la lumière du vaisseau. Nous avons imposé le profil de vitesse mesuré sur le patient comme conditions aux limites en entrée et un modèle de Windkessel au niveau des sorties artérielle et veineuse. Nous avons considéré des propriétés mécaniques différentes pour l'artère et la veine et pris en compte le comportement non-Newtonien du sang. Les simulations IFS permettent de calculer l'évolution temporelle des contraintes hémodynamiques et des contraintes internes à la paroi des vaisseaux. Nous nous sommes demandées aussi si des simulations non couplées des équations fluides et solides permettaient d'obtenir des résultats suffisamment précis tout en réduisant significativement le temps de calcul, afin d'envisager son utilisation par les chirurgiens. Dans la deuxième partie de l'étude, nous nous sommes intéressés à l'effet de la présence d'une sténose artérielle sur l'hémodynamique et en particulier à ses traitements endovasculaires. Nous avons dans un premier temps simulé numériquement le traitement de la sténose par angioplastie. En clinique, les sténoses résiduelles après angioplastie sont considérées comme acceptables si elles obstruent moins de 30% de la lumière du vaisseau. Nous avons donc gonflé le ballonnet pour angioplastie avec différentes pressions de manière à obtenir des degrés de sténoses résiduelles compris entre 0 et 30%. Une autre possibilité pour traiter la sténose est de placer un stent après l'angioplastie. Nous avons donc dans un deuxième temps simulé ce traitement numériquement et résolu le problème d'IFS dans la fistule après la pose du stent. Dans ces simulations, la présence du stent a été prise en compte en imposant les propriétés mécaniques équivalentes du vaisseau après la pose du stent à une portion de l'artère. Dans la dernière partie de l'étude nous avons mis en place un dispositif de mesure par PIV (Particle Image Velocimetry). Un moule rigide et transparent de la géométrie a été obtenu par prototypage rapide. Les résultats expérimentaux ont été validés par comparaison avec les résultats des simulations numériques.
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Zeltwanger-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.
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Brandão, 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/.
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Introdução - Os custos para o tratamento da doença arterial coronariana (DAC) são altos em todo o mundo. Foi realizada uma análise post hoc de custo-efetividade de três estratégias terapêuticas para DAC multiarterial. Métodos - De maio de 1995 a maio de 2000, um total de 611 pacientes foram aleatoriamente designados para CRM (n = 203), ICP (n = 205) ou TM (n = 203). Este estudo de análise de custos baseou-se na perspectiva do Sistema Público de Saúde. Os custos iniciais de procedimentos e acompanhamento de medicamentos, exames cardiológicos e hospitalizações por complicações foram calculados após a randomização. Anos de vida e anos de vida ajustados pela qualidade (QALY) foram usados como medidas de eficácia. As razões de custo-efetividade incremental (RCEI) foram obtidas usando métodos de bootstrap não paramétricos com 5.000 replicações. Resultados - Os custos iniciais do procedimento foram menores para o TM. No entanto, os custos acumulados de 5 anos foram menores para a CRM. Em comparação com a linha de base, as 3 opções de tratamento produziram melhorias significativas no QALY. Após 5 anos, a ICP e a CRM tiveram melhores resultados de QALY em comparação com o TM. Os resultados da RCEI favoreceram a CRM e a ICP quando comparadas ao TM, já a ICP em relação à CRM foi mais custo-efetiva em 61% para limiares até 3 PIB per capita por QALY. Por outro lado, a análise de sensibilidade mostrou o TM como a terapia preferida em comparação com a CRM e ICP, na análise considerando custos mais elevados. Conclusão - No seguimento de 5 anos, a ICP e CRM mostraram ser os tratamentos com QALYs cumulativos mais altos entre pacientes com DAC multiarterial quando comparados com TM. Além disso, apesar dos custos iniciais serem mais elevados, a comparação de custo-efetividade após 5 anos de acompanhamento entre os 3 tratamentos mostrou que ambas as intervenções (CRM e ICP) são estratégias custo-efetivas em comparação com a TM<br>Background. 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
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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/.
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O remodelamento vascular é um determinante fundamental do lúmen em doenças vasculares, porém os mecanismos envolvidos não estão completamente elucidados. Nós investigamos o papel da chaperona redox residente do retículo endoplasmático Dissulfeto Isomerase Proteica (PDI) e sua fração localizada na superfície celular (peri/epicelular=pecPDI) no calibre e arquitetura vascular durante reparação à lesão. Em artérias ilíacas de coelho submetidas à lesão in vivo, houve importante aumento do mRNA e expressão proteica (~25x aumento 14 dias pós-lesão vs. controle) da PDI. O silenciamento da PDI por siRNA (cultura de órgãos) acentuou o estresse do retículo e apoptose, diferentemente da inibição da pecPDI com anticorpo neutralizante (PDI Ab). Bloqueio in vivo da pecPDI por aplicação de gel perivascular contendo PDI Ab no 12° dia após lesão, com análise após 48 h, promoveu ca.25% redução no calibre vascular analisado por arteriografia e diminuição similar na área total do vaso detectada por tomografia de coerência óptica. Neste processo, não ocorreu alteração no tamanho da neoíntima, indicando assim, que PDI Ab acentuou remodelamento constrictivo. Neutralização da pecPDI promoveu importantes alterações na arquitetura da matriz de colágeno e citoesqueleto, resultando em fibras com orientação invertida e desorganizadas. Diminuição na produção de espécies reativas de oxigênio e óxidos de nitrogênio também ocorreu. Análise de propriedades viscoelásticas nas artérias indicou redução na ductilidade vascular, evidenciada pela menor distância para ruptura. As alterações subcelulares no citoesqueleto observadas in vivo após PDI Ab foram recapituladas em um modelo de estiramento cíclico em células musculares lisas vasculares, com importante redução na formação das fibras de estresse. Em modelo de migração randômica de células musculares lisas, a exposição a PDI Ab reduziu a resiliência de regulação da polaridade. Embora a neutralização da pecPDI não tenha afetado a atividade global de RhoA, ela promoveu alterações no padrão de marcação em resposta ao estiramento, na redistribuição de RhoA na superfície celular e na associação com regiões contendo caveolina. Além disso, em aterosclerose nativa em humanos, a expressão da PDI correlacionou-se inversamente com remodelamento constrictivo. Dessa forma, PDI é fortemente expressa após a lesão e sua fração peri/epicelular remodela a arquitetura da matriz e citoesqueleto, promovendo um efeito anti-remodelamento constrictivo<br>Whole-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
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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/.
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The impact of percutaneous renal artery angioplasty and stenting (PTRAS) for treatment of atherosclerotic renal artery stenosis (ARAS) is not fully understood, especially in patients with chronic kidney disease (CKD). We performed a retrospective cohort study of patients with significant ARAS and moderate to severe chronic kidney disease (estimated GFR 15-60 ml/min/1.73m2) who were treated medically or with PTRAS. The primary endpoint of this study was change in renal function over the first year after treatment. Secondary endpoints included hemodynamic outcomes, antihypertensive medication doses, end stage renal disease (ESRD), and death. We reviewed all patients with a diagnosis of significant ARAS and impaired GFR treated between 1997-2007 in the Veterans Affairs Connecticut Healthcare System (VACHS). A total of 118 patients met inclusion criteria (71 medical treatment, 47 PTRAS), with an average follow-up of 34 months. The students t-test was used to compare baseline characteristics, as well as renal and hemodynamic endpoints between the two treatment groups. The cohort had a mean age of 73 ± 9 years and average baseline GFR of 37.2 ± 14.9 ml/min/1.73m2. Demographic, clinical and laboratory characteristics at baseline were similar between the two groups, with the exception of higher diastolic blood pressure in the stent group at baseline (75 versus 70 mmHg, p=0.028). No statistically significant difference was found between the two treatment groups for any renal endpoints. After a steady decline in GFR in both the medical treatment and stent groups during the 12 months preceding diagnosis (-4.2 versus -4.0 ml/min/1.73m2, p=0.911), GFR stabilized in both groups over the year following diagnosis (decline in GFR of -1.6 versus -1.4 ml/min/1.73m2, p=0.938). Multivariate models did not reveal an association between treatment modality and percent change in GFR during follow-up. No difference was found in blood pressure outcomes at 12 months between the medical and stent groups. Antihypertensive therapy, measured in defined daily doses (DDDs), was significantly higher in the medical treatment group at 12 months (4.5 versus 3.5 DDDs, p=0.048), but lost significance thereafter. In addition, the number of deaths was significantly higher in the stented group on univariate analysis, although this did not remain significant on multivariable Cox analysis. No difference was found between treatment groups in the development of ESRD. These data suggest that, among patients with ARAS and CKD, medical therapy and renal artery stenting are comparable in stabilizing renal function.
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Hack, 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.
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Kelsch, 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.
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Kherad, 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.
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Dakovic, 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.
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Magalhães, 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/.
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Introdução: Análise da custo-efetividade no tratamento da doença multiarterial coronária têm ganhado importância nos ensaios clínicos, uma vez que as principais opções terapêuticas: cirurgia de revascularização miocárdica (CRM), intervenção coronária percutânea (ICP) e tratamento medicamentoso (TM) apresentam eficácia similar em determinados subgrupos de pacientes. Atualmente os interesses direcionados à análise econômica têm crescido, uma vez que os gastos na saúde aumentaram com o desenvolvimento de novas tecnologias, porém os recursos disponíveis são finitos e merecem ser administrados. Objetivo: Analisar, prospectivamente, o custo comparativo das três formas terapêuticas da doença multiarterial coronária estável, durante dez anos de seguimento. Métodos: Foi computado o custo terapêutico global de 611 pacientes do ensaio clínico The Second Medicine, Angioplasty, or Surgery Study (MASS II), baseado na remuneração fornecida pelo sistema de saúde suplementar do Instituto do Coração do HC/FMUSP, utilizando valores em dólares. Posteriormente, a análise de custoefetividade foi realizada corrigindo o custo cumulativo obtido em cada grupo para o \"tempo livre de eventos clínicos\" e também para a combinação de \"tempo livre de eventos\" acrescido de \"tempo livre de angina\". Resultados: O TM apresentou um custo cumulativo ao final de dez anos de US$6.183; o ICP apresentou um custo de US$14.292; e o grupo CRM apresentou um custo de US$12.316. Os custos corrigidos para sobrevida livre de eventos foram, US$11.136 para TM; US$26.912 para ICP e US$17.883 para CRM. Houve diferença estatisticamente significativa entre os 3 grupos (p < 0,0001) e a análise pareada, mostrou um menor custo para o grupo tratamento clínico tanto comparado com CRM (p < 0,0001) quanto comparado com ICP (p < 0,0001). O tratamento CRM contra ICP, também mostrou menor custo (p < 0,0001). Os custos corrigidos para sobrevida livre de eventos e angina foram, US$25.690 para TM; US$45.989 para ICP e US$27.920 para CRM; com expressiva diferença entre os 3 grupos (p < 0,0001). Na comparação dos grupos, observou-se um menor custo no grupo tratamento clínico comparado com ICP (p < 0,0001), o grupo angioplastia também teve um maior custo quando comparado com o grupo cirúrgico (p < 0,001). Contudo entre o grupo tratamento medicamentoso e tratamento cirúrgico não houve diferença significativa (p=0,5613). Conclusão: A análise econômica comparativa de longa data, revelou que ICP foi o tratamento menos custo-efetivo. O tratamento medicamentoso foi o mais custo-efetivo na prevenção de eventos, porém na prevenção de eventos e angina, teve custo-efetividade semelhante ao tratamento cirúrgico<br>Introduction: 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
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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.
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Chen, 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 textAbstract:
碩士<br>東海大學<br>工業工程與經營資訊學系<br>97<br>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.
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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.
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碩士<br>元培科技大學<br>影像醫學研究所<br>96<br>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.
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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.
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碩士<br>國立臺灣大學<br>機械工程學研究所<br>104<br>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.
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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.
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碩士<br>國立臺灣大學<br>臨床醫學研究所<br>90<br>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).
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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.
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Wu, 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.
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碩士<br>高雄醫學大學<br>公共衛生學研究所碩士在職專班<br>92<br>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.
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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.
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碩士<br>中國醫藥大學<br>臨床醫學研究所碩士班<br>96<br>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.