Cost and therapeutic modification of intracoronary ultrasound-assisted coronary angioplasty

Talley, J. David; Mauldin, Patrick D.; Becker, Edmund R.; Stikovac, Miodrag; Leesar, Massoud A.

doi:10.1016/s0002-9149(96)00192-0

Cited by 9 publications

(2 citation statements)

References 8 publications

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“…Three-year period Shook et al [22] US$ 7977 (high-volume operators) Hospitalisation receiving a PCI US$ 8278 (low-volume operators) Talley et al [23] US$ 5326 PCI procedure only Weintraub et al [24] US$ 12654 Hospitalisation receiving a PCI Note: The descriptions of the study estimate were not very detailed. As a consequence, whether or not the American studies included physician labour cost could not be determined.…”

Section: Appendix Bmentioning

confidence: 99%

Comparing systems for costing hospital treatments

Larsen¹,

Skjoldborg²

2004

Health Policy

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Section: Appendix Bmentioning

confidence: 99%

Comparing systems for costing hospital treatments

Larsen¹,

Skjoldborg²

2004

Health Policy

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“…Every interventionalist is confronted with the phenomenon of reduced flow after angioplasty or the ªscratchingº catheter, without recognising a clear equivalence on the DSA images. In these cases IVUS seems to be mandatory [13,14,15]. Another easy-tohandle device is intravascular Doppler.…”

Section: Discussionmentioning

confidence: 99%

Intra-arterial Doppler flowmetry in the superficial femoral artery following angioplasty

et al. 2000

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The aim of the study was to assess the diagnostic value of an intravascular Doppler guidewire in patients with peripheral percutaneous angioplasty (PTA). The prognostic value was also evaluated. Measurements were done prior and following angioplasty in 22 patients with peripheral arterial occlusive disease. As additional therapy, stent insertion and peripheral (Aa. poplitea Tll/tibial) angioplasty was performed (4 patients per group). For stress testing, adenosinetriphosphate (ATP) was given intra-arterially. Follow-up was performed by angiography, colour-coded duplex ultrasound or judged by unequivocal clinical stage at follow-up to 13 months. Average (APV) and maximal peak velocity (MPV) increased following PTA, after additional treatment (peripheral PTA or stent), and after intra-arterial application of a vasodilator. Patients with peripheral lesions had markedly lower velocities prior treatment and following PTA after vasodilatation. Following peripheral PTA, the values were similar to the patients with PTA alone. Velocities after stenting were markedly increased in the stress condition. Of the 22 patients, 7 had a recurrent disease. The latter patients had higher velocities at rest prior to and following PTA. In stented lesions higher velocities seem to be linked with a worse outcome. The ratio between velocity prior to and after the application of the vasodilator seems to be of diagnostic importance. A ratio of 1.9 or more was of positive prognostic value. The Doppler guidewire is a practical and valuable tool in assessing technical success after angioplasty of peripheral lesions, critical or morphologically worse lesions. In our study the decision for stent application was made on the morphological image; however, increased velocity and changes in phasicity substantiated our decisions. Increased ratios prior to and after vasodilation (flow reserve) are of prognostic value and therefore suitable as indication for stent placement or tibial angioplasty.

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