In human PTCA models, a PC effect is observed in 180 s ischemia, but not in 60 s ischemia. A pharmacological PC effect is induced by NC, a KATP channel opener with a nitrate-like effect but not ISDN. This suggests that the opening of KATP channels plays an important role in the protecting effect of NC.
Patients with abdominal aortic aneurysm appear to have an approximately 3-fold increased risk for both inguinal and postoperative incision hernia compared to patients with aortoiliac occlusive disease. A large multi-centre prospective study is needed to confirm the results of this review.
Intercostal artery pseudoaneurysm is extremely rare, and only six cases have been reported in the English literature. We describe a case of intercostal artery pseudoaneurysm due to a stab wound, review the literature, and discuss therapeutic modalities. Intercostal artery pseudoaneurysm is at risk for early rupture, and diagnosis before rupture is mandatory. Although embolization is considered to be a feasible therapeutic method, we would emphasize the significance of the anatomic features of the intercostal arteries: multiple blood supplies into the pseudoaneurysm, such as the anterior and posterior intercostal arteries, and musculophrenic artery.
Background-Collateral fractional flow reserve (FFR coll ) is an index to quantify collateral blood flow, derived from coronary pressure measurements. Although well defined theoretically, its direct validation by myocardial perfusion imaging has not been established so far. Validating this index by myocardial perfusion imaging is the main aim of this study. Methods and Results-Twenty-four consecutive patients with stable angina and single left anterior descending artery stenosis underwent simultaneous measurement of aortic pressure (P a ), coronary wedge pressure (P w ), and central venous pressure (P v ) during balloon inflation. FFR coll was calculated and compared with the extent and severity of the defect during coronary occlusion using 99m Tc-sestamibi imaging at balloon inflation of the respective coronary artery. Although the pressure-derived collateral indexes (P w , P w /P a , and FFR coll ) ranged widely, they were closely correlated with extent and severity scores of the nuclear occlusion images and superior to the ECG for that purpose. Of all parameters, FFR coll correlated best with the severity score at imaging (rϭϪ0.88), followed by the P w /P a ratio (rϭϪ0.74) or P w alone (rϭϪ0.69). Conclusions-FFR coll , calculated from coronary pressure during balloon occlusion, is highly correlated with the extent and severity of the defect at myocardial perfusion of the territory of the occluded artery and can be used for quantitative assessment of collateral blood flow in conscious humans.
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