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論文(リポジトリ)
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中沢, 聡 ; 氏家, 敏巳 ; 竹久保, 賢 ; 高橋, 善樹 ; 吉谷, 克雄 ; 金沢, 宏 ; 山崎, 芳彦 ; 小池, 哲雄 ; 小田, 弘隆
概要:
A 78-year-old-man was admitted to hospital for transient ischemic attack and angina pectoris. The right carotid angiogra
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m showed severe stenosis of the right internal carotid artery, and two-vessel disease was found in coronary angiography；complete obstruction at ＃6 of the left anterior descending branch, and 90％ stenosis in the left circumflex branch. Hybrid Therapy was performed；First, PTA （perctaneous transluminal angioplasty） with stenting for right internal carotid artery, Next, off-pump CABG （LITA to LAD） and PTCA to the left circumflex branch. The postoperative course was uneventful.
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| 2.
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論文(リポジトリ)
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松岡, 東明
概要:
1) This describes an-inhouse CCU manual addressed to the application for acute myocardial infarctions which was prepared at this department of cardiovascular medi- 2) The PTCA therapy applied to the myocardial infarctions and the PTCA
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technique to be carried out for the ACO, one of the complications of the aforesaid infarctions are presented. 3) This present the protocol practised at our department for the PCPS as a treatment to be conducted before an emergent CABG. 4) A comparision between our therapy policy for VSP, a major complication of acute myocardial infarctions and cardiac rupture and those of other institution is given here. 5) This is an explanation of coronary atherectomy. 6) This is an explanation of coronary stents. 7) Indications, contraindications, and complications of CVIS (IVUS) are given here. 8) This illustrates a graphing of all existing and future therapies presented in the above as of July 1991.
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| 3.
論文(リポジトリ) |
論文(リポジトリ)
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小田, 弘隆 ; 三井田, 努 ; 戸枝, 哲朗 ; 樋熊, 紀雄
概要:
The purpus of this study is to estimate the efficacy of percutaneous transluminal coronary angioplasty (PTCA) for chroni
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c total coronary occlusion. In 41 patients without history of sustained myocardial infarction, overall initial PTCA success rate was 75.6% and was related to duration of occlusion (88.8% success rate for occlusions of less than 3 months, 50.0% after 4 months： p<0.05). Complications were minor： no patient died or requred emergency bypass operation, and 2 patients had small aeras of myocardial infarction. Exercise tolerance improved significantly in successful cases. In 6 patients with left anterior descending artery (LAD) occlusion as single vessl disease, 3 to 5 months after successful PTCA, ejection fraction improved significantly. End-diastolic volume index had no change, but end-systolic volume index decreased significantly, and regional wall motion improved significantly in areas of hyokinesis where LAD supplied. This study shows that initial success rate of PTCA for chronic total occlusion is acceptable with low risk of serious complications, and that exercise capacity and ventricular function improve in successful cases.
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| 4.
論文(リポジトリ) |
論文(リポジトリ)
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大塚, 英明 ; 佐伯, 牧彦 ; 本間, 信生 ; 土谷, 厚
概要:
During the past 7 years (1984～1990) 391 patients with acute myocardial infarction (MI) admitted to our hospital. These p
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atients were divided into the following 3 groups by the therapy which performed within 24 hours of the onset of MI. (1) Conservative therapy group： 239 patients who received neither ICT nor PTCA； 66±11y.o., M/F=2.2 (2) ICT group： 81 patients who received intracoronary thrombolysis (ICT) without rescue PTCA； 61±10y.o., M/F=4.1 (3) PTCA group： 71 patients who received PTCA (56 patients as rescue PTCA after unsuccessful ICT, 15 patients as direct PTCA)； 63±10y.o., M/F=7.9 In patients received ICT, PTCA and conservative therapy, hospital mortality at 4 weeks after the admission was 7.4%, 5.6% and 20.9% respectively. During these admission additional intervention (ICT, PTCA or CABG) were performed in 18 patients (22.2%) of ICT group, 5 patients (7.0%) of PTCA group and in 25 patients (10.5%) of the group who treated conservatively. Therefore, recanalization therapy (both ICT and PTCA) for acute MI appeared to reduce the early mortality (p<0.01). And also PTCA reduce the necessity of the additional intervention as compared with ICT (p<0.01).
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| 5.
論文(リポジトリ) |
論文(リポジトリ)
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樋態, 紀雄 ; 三井田, 努 ; 小田, 弘隆 ; 佐藤, 広則
概要:
From 1985 through the late 1970's essentially all cardiac catheterizations were performed to evaluate individual disease
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states, to guide medical therapy, or to provide a plan for cardiac surgical techniques. Beginning in the 1980's, however, cardiac catheterization has begun to play an increasingly important role in treating as well as diagnosing cardiovascular lesions. Dotter and Judkins noted that it was frequently possible to pass first guide wire and the catheter or dilator through an area of stenosis in the iliac femoral system, thereby enlarging the lumen and improving antegrade blood flow. In 1977, percutaneous balloon angioplasty was extended to stenosis of the epicardial coronary arteries. In our institution, elective angioplasty was performed in 82 cases. Primary success rate for PTCA was 84.2% for the LAD, 90.9% fer the LCx and 84.0% for the RCA. 19.5% （16 cases/82 cases）of patients with an initially successful procedure experienced return of angina owing to angiographically evident renarrowing （restenosis） of dilated segment within 6 months after the procedure. The results of peripheral angioplasty are similar to PTCA. Balloon valvuloplasty was applied to 4 patient with aquired （rheumatic） mitral stenosis, using a transseptal approach. Early （3 to 7 month） follow up studies have demonstrated preservation of improved mitral orifice and physiological improvements. Some of the earlist applications of interventional cardiology were in patients with congenital heart diseases.
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| 6.
論文(リポジトリ) |
論文(リポジトリ)
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高橋, 正 ; 加藤, 秀徳 ; 大塚, 英明 ; 岡部, 正明 ; 松岡, 東明
概要:
Clinical efficacy of percutaneous transluminal coronary angioplasty (PTCA) in elderly patients and evaluation of its safety has not been established. We attempted to perform PTCA in 67 patients aged 70 years or older (mean age 75
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years) out of 302 patients between September 1983 and March 1988. A successful dilatation was achieved in 46/79 cases (58.2%) of elderly patients in comparison with 235/338 cases (69.5%) in patients younger than 70 years. There was no significant difference of the success rate. Mortalities were 3.0% in elderlies and 3.4% in youngers, but these rates decreased 0% and 0.9% of elective PTCA to angina pectoris. PTCA requires shorter hospitalization time and allows more rapid return to social activities. These data suggest that PTCA can be performed relatively safe and efficacious in selected geriatric patients.
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