Shane Gieowarsingh - Academia.edu (original) (raw)
Papers by Shane Gieowarsingh
CHEST Journal, 2004
... ADMINISTERED DURING BRONCHO-PROVOCATION TESTING DOES NOT IMPROVE SHORT-TERM MILITARY RETENTIO... more ... ADMINISTERED DURING BRONCHO-PROVOCATION TESTING DOES NOT IMPROVE SHORT-TERM MILITARY RETENTION IN A UNITED STATES MARINE CORPS RECRUIT POPULATION Christopher M. Stafford, MD*; Erik J. Storlie, MD; Travis G. Deaton, MD; Rich T ...
Journal of Endovascular Therapy, 2008
To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the pre... more To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the predilation phase of carotid artery stenting (CAS) in highly calcified lesions. From January 2003 to February 2007, 178 consecutive patients (109 men; mean age 73.1+/-7.3 years) with highly calcified carotid lesions underwent CAS with CBA applied as a pre-specified strategy in the predilation phase of the procedure. All steps in the procedure were performed under cerebral filter protection. The cutting balloon ranged in diameter from 3 to 4 mm and was inflated at nominal pressures in the target lesion. Pre-CBA dilation with a low-profile coronary balloon was performed only when the cutting balloon was not able to cross the lesion. Selection of the filters and stents was at the operator's discretion. Primary endpoints were the all stroke and death rates at 30 days and 6 months. Secondary endpoints included cutting balloon success (positioning and full balloon inflation), CAS technical success (residual angiographic stenosis <30%), CAS procedural success (technical success and no complications), and in-hospital major complications. Cutting balloon success was achieved in all 178 patients. In 32 (18.0%), pre-CBA dilation was necessary due to inability to cross the lesion with the cutting balloon initially. CAS technical success was achieved in all patients. One (0.6%) patient suffered transient neurological intolerance due to flow cessation from massive debris in the distal filter; this event was completely resolved after the filter was removed (CAS procedural success 99.4%). One patient suffered a major stroke at day 15 (0.6% 30-day all stroke and death rate). At the 6-month follow-up, 174 (97.7%) patients were evaluated; 1 patient died from myocardial infarction at day 35, and 2 patients died from non-neurological or cardiac causes at days 103 and 158. The cumulative all stroke and death rate was 2.2%. These data suggest that CBA performed during the predilation phase of CAS in highly calcified lesion is a safe and useful method to prepare this lesion subset for stenting.
Background The burden of stroke is truly significant and it is imperative that a change to a more... more Background The burden of stroke is truly significant and it is imperative that a change to a more mature approach to its prevention is pursued further by all concerned. Randomised trials comparing carotid artery stenting (CAS) with carotid endarterectomy (CEA) have been plagued with difficulties and a clear consensus cannot be established. We aimed to determine the success, safety and long-term durability of CAS in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored approach. Methods We selected from the Cotignola CAS registry all procedures with intention-to-treat by stenting under protection with a distal filter or a proximal occlusion device. 1515 procedures were identified spanning the period April 1999 to September 2007. Indications included symptomatic stenoses of 50% or greater (366, 24%) and asymptomatic stenoses of 80% or greater (1149, 76%). Results Mean age was 72 ± 8 years (236 ⩾80 years, 17%); 418 women (30%). Filter devices were used ...
9 (7.6%) 0 (0.0%) 0 (0.0%) (p<O.0001) PTCA 11 (9.2%) 4 (9.5%) 0 (0.0%) (p<0.0001) n ER% OR ... more 9 (7.6%) 0 (0.0%) 0 (0.0%) (p<O.0001) PTCA 11 (9.2%) 4 (9.5%) 0 (0.0%) (p<0.0001) n ER% OR 95%CI p n ER% OR 95%CI p LR 78 1.3 0.11 0.01-0.83 0.005 52 1.9 0.17 0.02-1.30 0.053 MR 273 6.2 0.55 0.32-0.95 0.03 537 8.4 0.75 0.49-1.10 0.19 HR 649 11.9 2.50 1.41-4.23 0.0001 411 11.9 1.60 1.00-2.40 0.037 ER: event rate, LR: low risk, MR: medium risk, HR: high risk, OR: odds ratio Receiver operating curves were 0.60+0.03 and 0.56+0.32 (p=NS), for the new and old classifications respectively. The new guidelines evidenced higher sensitivity (81% vs 51%), and less specificity (37% vs 60%), with similar positive and negative predictive val- ues: 12% vs 12% and 95% vs 92%, respectively. Conclusions: An important conse- quence of the present guidelines is an increase of the high risk group, with a proportional reduction in the size of the medium risk group. The new guidelines are more sensitive and identified more hard events than the older reccomendations.
Journal of the American College of Cardiology
Interventional Cardiology, 2016
Cardiovascular Revascularization Medicine, 2008
Eurointervention Journal of Europcr in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology, Nov 1, 2009
Aims: We aimed to determine the success, safety and long-term durability of carotid artery stenti... more Aims: We aimed to determine the success, safety and long-term durability of carotid artery stenting (CAS) in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored-approach to intervention. Methods and results: From our CAS registry (beginning July 1997) all procedures up to September 2007 with intention-to-treat by stenting under distal filter or proximal occlusion neuroprotection devices were analysed (N=1523; mean age 72 years [237 ≥80 years, 15.5%]). Indications included symptomatic stenoses ≥50% (366, 24.1%) and asymptomatic stenoses ≥80% (1157, 75.9%). CAS success was 99.6% and the 30-day all-stroke/death rate was 1.5% (minor stroke 11 [0.7%], major stroke 8 [0.5%], death 5 [0.3%]). The risk was 1.2% for asymptomatic patients and 2.7% for symptomatic patients (p=0.042). Regarding octogenarians this risk was 2.1% versus 1.5% for patients ≤79 years (p=0.47). Symptomatic octogenarians had a higher risk than other groups (OR 3.9, 95% CI 1.06 to 14.0): asymptomatic ≤79 1.2%, asymptomatic ≥80 1.2%, symptomatic ≤79 2.3% and symptomatic ≥80 4.5%. The event free survival rates from all strokes or stroke-related deaths at eight years were 96% for asymptomatic and 92% for symptomatic patients. Conclusions: Results from this large cohort show that carotid stenting in a real-world setting is safe and efficacious, and durable in the long-term prevention of stroke.
Eur J Vasc Endovasc Surg, Jan 5, 2009
Although balloon angioplasty (BA) has been extensively reported to treat peripheral artery occlus... more Although balloon angioplasty (BA) has been extensively reported to treat peripheral artery occlusive disease, only little information is available about its use for critical hand ischemia. We report a case of a patient with painful ulcerated ischemic lesions of the right hand digits successfully treated by BA of the radial artery (RA) and its deep palmar branch (DPB). The 6-month angiographic follow-up showed a focal restenosis that was approached by a second BA session. Larger series are encouraged to determine the clinical outcome of percutaneous approach in this arterial district.
Diagnosis, Angioplasty and Stenting, 2011
Diagnosis, Angioplasty and Stenting, 2011
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2009
We aimed to determine the success, safety and long-term durability of carotid artery stenting (CA... more We aimed to determine the success, safety and long-term durability of carotid artery stenting (CAS) in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored-approach to intervention. From our CAS registry (beginning July 1997) all procedures up to September 2007 with intention-to-treat by stenting under distal filter or proximal occlusion neuroprotection devices were analysed (N=1523; mean age 72 years [237 >or=80 years, 15.5%]). Indications included symptomatic stenoses >or=50% (366, 24.1%) and asymptomatic stenoses >or=80% (1157, 75.9%). CAS success was 99.6% and the 30-day all-stroke/death rate was 1.5% (minor stroke 11 [0.7%], major stroke 8 [0.5%], death 5 [0.3%]). The risk was 1.2% for asymptomatic patients and 2.7% for symptomatic patients (p=0.042). Regarding octogenarians this risk was 2.1% versus 1.5% for patients <or=79 years (p=0.47). Symptomatic octogenarians had a higher risk than other groups (OR 3.9, 95% CI 1.06 to 14.0): ...
Practical Carotid Artery Stenting, 2009
ABSTRACT Carotid artery stenting (CAS) is emerging as an alternative therapy to surgical carotid ... more ABSTRACT Carotid artery stenting (CAS) is emerging as an alternative therapy to surgical carotid endarter-ectomy (CEA) for the treatment of extracranial carotid stenosis [1–3]. The common goal of both procedures is the prevention of stroke, and the efficacy of the procedure depends highly on the periprocedural complication rates. Despite the routine application of stents, advanced stenting techniques, and dual antiplatelet therapy, emboli-zation of debris into the cerebral circulation occurs invariably during CAS. Obstructive carotid artery lesions are known to contain friable, ulcerated, and thrombotic material [4] that can embolize during the intervention, as shown in histopathologic analysis in both ex vivo [5] and in vivo [6] studies, and also demonstrated in transcranial Doppler studies. In addition, it has been shown that microemboliza-tion occurs considerably more frequently during CAS than during CEA [7].
Principles and Practice, 2011
Journal of the American College of Cardiology, 2002
Background: There is evidence for a systemic immune response, involving continuous T cell activat... more Background: There is evidence for a systemic immune response, involving continuous T cell activation, in stable coronary artery disease (CAD). So far, the type of this T cell response is not fully understood. In this study we have examined certain phenotypical properties of CO8+ T cells in stable angina patients.
Journal of the American College of Cardiology, 2002
Background: There is evidence for a systemic immune response, involving continuous T cell activat... more Background: There is evidence for a systemic immune response, involving continuous T cell activation, in stable coronary artery disease (CAD). So far, the type of this T cell response is not fully understood. In this study we have examined certain phenotypical properties of CO8+ T cells in stable angina patients.
Journal of Endovascular Therapy, 2008
To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the pre... more To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the predilation phase of carotid artery stenting (CAS) in highly calcified lesions. From January 2003 to February 2007, 178 consecutive patients (109 men; mean age 73.1+/-7.3 years) with highly calcified carotid lesions underwent CAS with CBA applied as a pre-specified strategy in the predilation phase of the procedure. All steps in the procedure were performed under cerebral filter protection. The cutting balloon ranged in diameter from 3 to 4 mm and was inflated at nominal pressures in the target lesion. Pre-CBA dilation with a low-profile coronary balloon was performed only when the cutting balloon was not able to cross the lesion. Selection of the filters and stents was at the operator&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s discretion. Primary endpoints were the all stroke and death rates at 30 days and 6 months. Secondary endpoints included cutting balloon success (positioning and full balloon inflation), CAS technical success (residual angiographic stenosis &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30%), CAS procedural success (technical success and no complications), and in-hospital major complications. Cutting balloon success was achieved in all 178 patients. In 32 (18.0%), pre-CBA dilation was necessary due to inability to cross the lesion with the cutting balloon initially. CAS technical success was achieved in all patients. One (0.6%) patient suffered transient neurological intolerance due to flow cessation from massive debris in the distal filter; this event was completely resolved after the filter was removed (CAS procedural success 99.4%). One patient suffered a major stroke at day 15 (0.6% 30-day all stroke and death rate). At the 6-month follow-up, 174 (97.7%) patients were evaluated; 1 patient died from myocardial infarction at day 35, and 2 patients died from non-neurological or cardiac causes at days 103 and 158. The cumulative all stroke and death rate was 2.2%. These data suggest that CBA performed during the predilation phase of CAS in highly calcified lesion is a safe and useful method to prepare this lesion subset for stenting.
CHEST Journal, 2004
... ADMINISTERED DURING BRONCHO-PROVOCATION TESTING DOES NOT IMPROVE SHORT-TERM MILITARY RETENTIO... more ... ADMINISTERED DURING BRONCHO-PROVOCATION TESTING DOES NOT IMPROVE SHORT-TERM MILITARY RETENTION IN A UNITED STATES MARINE CORPS RECRUIT POPULATION Christopher M. Stafford, MD*; Erik J. Storlie, MD; Travis G. Deaton, MD; Rich T ...
Journal of Endovascular Therapy, 2008
To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the pre... more To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the predilation phase of carotid artery stenting (CAS) in highly calcified lesions. From January 2003 to February 2007, 178 consecutive patients (109 men; mean age 73.1+/-7.3 years) with highly calcified carotid lesions underwent CAS with CBA applied as a pre-specified strategy in the predilation phase of the procedure. All steps in the procedure were performed under cerebral filter protection. The cutting balloon ranged in diameter from 3 to 4 mm and was inflated at nominal pressures in the target lesion. Pre-CBA dilation with a low-profile coronary balloon was performed only when the cutting balloon was not able to cross the lesion. Selection of the filters and stents was at the operator&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s discretion. Primary endpoints were the all stroke and death rates at 30 days and 6 months. Secondary endpoints included cutting balloon success (positioning and full balloon inflation), CAS technical success (residual angiographic stenosis &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30%), CAS procedural success (technical success and no complications), and in-hospital major complications. Cutting balloon success was achieved in all 178 patients. In 32 (18.0%), pre-CBA dilation was necessary due to inability to cross the lesion with the cutting balloon initially. CAS technical success was achieved in all patients. One (0.6%) patient suffered transient neurological intolerance due to flow cessation from massive debris in the distal filter; this event was completely resolved after the filter was removed (CAS procedural success 99.4%). One patient suffered a major stroke at day 15 (0.6% 30-day all stroke and death rate). At the 6-month follow-up, 174 (97.7%) patients were evaluated; 1 patient died from myocardial infarction at day 35, and 2 patients died from non-neurological or cardiac causes at days 103 and 158. The cumulative all stroke and death rate was 2.2%. These data suggest that CBA performed during the predilation phase of CAS in highly calcified lesion is a safe and useful method to prepare this lesion subset for stenting.
Background The burden of stroke is truly significant and it is imperative that a change to a more... more Background The burden of stroke is truly significant and it is imperative that a change to a more mature approach to its prevention is pursued further by all concerned. Randomised trials comparing carotid artery stenting (CAS) with carotid endarterectomy (CEA) have been plagued with difficulties and a clear consensus cannot be established. We aimed to determine the success, safety and long-term durability of CAS in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored approach. Methods We selected from the Cotignola CAS registry all procedures with intention-to-treat by stenting under protection with a distal filter or a proximal occlusion device. 1515 procedures were identified spanning the period April 1999 to September 2007. Indications included symptomatic stenoses of 50% or greater (366, 24%) and asymptomatic stenoses of 80% or greater (1149, 76%). Results Mean age was 72 ± 8 years (236 ⩾80 years, 17%); 418 women (30%). Filter devices were used ...
9 (7.6%) 0 (0.0%) 0 (0.0%) (p<O.0001) PTCA 11 (9.2%) 4 (9.5%) 0 (0.0%) (p<0.0001) n ER% OR ... more 9 (7.6%) 0 (0.0%) 0 (0.0%) (p<O.0001) PTCA 11 (9.2%) 4 (9.5%) 0 (0.0%) (p<0.0001) n ER% OR 95%CI p n ER% OR 95%CI p LR 78 1.3 0.11 0.01-0.83 0.005 52 1.9 0.17 0.02-1.30 0.053 MR 273 6.2 0.55 0.32-0.95 0.03 537 8.4 0.75 0.49-1.10 0.19 HR 649 11.9 2.50 1.41-4.23 0.0001 411 11.9 1.60 1.00-2.40 0.037 ER: event rate, LR: low risk, MR: medium risk, HR: high risk, OR: odds ratio Receiver operating curves were 0.60+0.03 and 0.56+0.32 (p=NS), for the new and old classifications respectively. The new guidelines evidenced higher sensitivity (81% vs 51%), and less specificity (37% vs 60%), with similar positive and negative predictive val- ues: 12% vs 12% and 95% vs 92%, respectively. Conclusions: An important conse- quence of the present guidelines is an increase of the high risk group, with a proportional reduction in the size of the medium risk group. The new guidelines are more sensitive and identified more hard events than the older reccomendations.
Journal of the American College of Cardiology
Interventional Cardiology, 2016
Cardiovascular Revascularization Medicine, 2008
Eurointervention Journal of Europcr in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology, Nov 1, 2009
Aims: We aimed to determine the success, safety and long-term durability of carotid artery stenti... more Aims: We aimed to determine the success, safety and long-term durability of carotid artery stenting (CAS) in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored-approach to intervention. Methods and results: From our CAS registry (beginning July 1997) all procedures up to September 2007 with intention-to-treat by stenting under distal filter or proximal occlusion neuroprotection devices were analysed (N=1523; mean age 72 years [237 ≥80 years, 15.5%]). Indications included symptomatic stenoses ≥50% (366, 24.1%) and asymptomatic stenoses ≥80% (1157, 75.9%). CAS success was 99.6% and the 30-day all-stroke/death rate was 1.5% (minor stroke 11 [0.7%], major stroke 8 [0.5%], death 5 [0.3%]). The risk was 1.2% for asymptomatic patients and 2.7% for symptomatic patients (p=0.042). Regarding octogenarians this risk was 2.1% versus 1.5% for patients ≤79 years (p=0.47). Symptomatic octogenarians had a higher risk than other groups (OR 3.9, 95% CI 1.06 to 14.0): asymptomatic ≤79 1.2%, asymptomatic ≥80 1.2%, symptomatic ≤79 2.3% and symptomatic ≥80 4.5%. The event free survival rates from all strokes or stroke-related deaths at eight years were 96% for asymptomatic and 92% for symptomatic patients. Conclusions: Results from this large cohort show that carotid stenting in a real-world setting is safe and efficacious, and durable in the long-term prevention of stroke.
Eur J Vasc Endovasc Surg, Jan 5, 2009
Although balloon angioplasty (BA) has been extensively reported to treat peripheral artery occlus... more Although balloon angioplasty (BA) has been extensively reported to treat peripheral artery occlusive disease, only little information is available about its use for critical hand ischemia. We report a case of a patient with painful ulcerated ischemic lesions of the right hand digits successfully treated by BA of the radial artery (RA) and its deep palmar branch (DPB). The 6-month angiographic follow-up showed a focal restenosis that was approached by a second BA session. Larger series are encouraged to determine the clinical outcome of percutaneous approach in this arterial district.
Diagnosis, Angioplasty and Stenting, 2011
Diagnosis, Angioplasty and Stenting, 2011
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2009
We aimed to determine the success, safety and long-term durability of carotid artery stenting (CA... more We aimed to determine the success, safety and long-term durability of carotid artery stenting (CAS) in stroke prevention for all-comers managed with mandatory neuroprotection and a tailored-approach to intervention. From our CAS registry (beginning July 1997) all procedures up to September 2007 with intention-to-treat by stenting under distal filter or proximal occlusion neuroprotection devices were analysed (N=1523; mean age 72 years [237 >or=80 years, 15.5%]). Indications included symptomatic stenoses >or=50% (366, 24.1%) and asymptomatic stenoses >or=80% (1157, 75.9%). CAS success was 99.6% and the 30-day all-stroke/death rate was 1.5% (minor stroke 11 [0.7%], major stroke 8 [0.5%], death 5 [0.3%]). The risk was 1.2% for asymptomatic patients and 2.7% for symptomatic patients (p=0.042). Regarding octogenarians this risk was 2.1% versus 1.5% for patients <or=79 years (p=0.47). Symptomatic octogenarians had a higher risk than other groups (OR 3.9, 95% CI 1.06 to 14.0): ...
Practical Carotid Artery Stenting, 2009
ABSTRACT Carotid artery stenting (CAS) is emerging as an alternative therapy to surgical carotid ... more ABSTRACT Carotid artery stenting (CAS) is emerging as an alternative therapy to surgical carotid endarter-ectomy (CEA) for the treatment of extracranial carotid stenosis [1–3]. The common goal of both procedures is the prevention of stroke, and the efficacy of the procedure depends highly on the periprocedural complication rates. Despite the routine application of stents, advanced stenting techniques, and dual antiplatelet therapy, emboli-zation of debris into the cerebral circulation occurs invariably during CAS. Obstructive carotid artery lesions are known to contain friable, ulcerated, and thrombotic material [4] that can embolize during the intervention, as shown in histopathologic analysis in both ex vivo [5] and in vivo [6] studies, and also demonstrated in transcranial Doppler studies. In addition, it has been shown that microemboliza-tion occurs considerably more frequently during CAS than during CEA [7].
Principles and Practice, 2011
Journal of the American College of Cardiology, 2002
Background: There is evidence for a systemic immune response, involving continuous T cell activat... more Background: There is evidence for a systemic immune response, involving continuous T cell activation, in stable coronary artery disease (CAD). So far, the type of this T cell response is not fully understood. In this study we have examined certain phenotypical properties of CO8+ T cells in stable angina patients.
Journal of the American College of Cardiology, 2002
Background: There is evidence for a systemic immune response, involving continuous T cell activat... more Background: There is evidence for a systemic immune response, involving continuous T cell activation, in stable coronary artery disease (CAD). So far, the type of this T cell response is not fully understood. In this study we have examined certain phenotypical properties of CO8+ T cells in stable angina patients.
Journal of Endovascular Therapy, 2008
To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the pre... more To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the predilation phase of carotid artery stenting (CAS) in highly calcified lesions. From January 2003 to February 2007, 178 consecutive patients (109 men; mean age 73.1+/-7.3 years) with highly calcified carotid lesions underwent CAS with CBA applied as a pre-specified strategy in the predilation phase of the procedure. All steps in the procedure were performed under cerebral filter protection. The cutting balloon ranged in diameter from 3 to 4 mm and was inflated at nominal pressures in the target lesion. Pre-CBA dilation with a low-profile coronary balloon was performed only when the cutting balloon was not able to cross the lesion. Selection of the filters and stents was at the operator&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s discretion. Primary endpoints were the all stroke and death rates at 30 days and 6 months. Secondary endpoints included cutting balloon success (positioning and full balloon inflation), CAS technical success (residual angiographic stenosis &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;30%), CAS procedural success (technical success and no complications), and in-hospital major complications. Cutting balloon success was achieved in all 178 patients. In 32 (18.0%), pre-CBA dilation was necessary due to inability to cross the lesion with the cutting balloon initially. CAS technical success was achieved in all patients. One (0.6%) patient suffered transient neurological intolerance due to flow cessation from massive debris in the distal filter; this event was completely resolved after the filter was removed (CAS procedural success 99.4%). One patient suffered a major stroke at day 15 (0.6% 30-day all stroke and death rate). At the 6-month follow-up, 174 (97.7%) patients were evaluated; 1 patient died from myocardial infarction at day 35, and 2 patients died from non-neurological or cardiac causes at days 103 and 158. The cumulative all stroke and death rate was 2.2%. These data suggest that CBA performed during the predilation phase of CAS in highly calcified lesion is a safe and useful method to prepare this lesion subset for stenting.