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TABLE OF CONTENTS
Series Introduction (Samuel Z. Goldhaber) III
Preface V
Contributors XIII
I
Advanced Diagnostic Methods
1 Intravascular Ultrasound Imaging 1
Peter J. Fitzgerald, Guy F. Friedrich, Dirk Hausmann,
and Paul G. Yock
I. Introduction 1
II. Catheter Design 1
III. Image Interpretation 3
IV. Ultrasound Versus Angiography 7
V. Intravascular Ultrasound and Interventions 8
VI. Tissue Characterization 16
VII. Conclusions 19
References 20
2 Percutaneous Coronary Angioscopy 25
Christopher J. White
I. Introduction 25
II. Angioscopy Equipment 26
III. Angioscopy Technique 27
IV. Clinical Studies 27
V. Potential Clinical Utility 33
VI. Conclusions 34
References 35
3 Clinical Applications of Intracoronary Coronary
Doppler Flow Velocity in Interventional Cardiology 39
Morton J. Kern and Michael S. Flynn
I. Introduction 39
II. Coronary Flow Velocity Techniques 40
III. Important Features in Measuring Doppler Flow Velocity 45
IV. Clinical and Research Applications for Doppler
Flow Velocity 49
V. Thallium Scintigraphic Correlations with
Flow Velocity Findings 72
VI. Conclusions 73
References 74
4 The Practical Application of Quantitative Angiographic
Methods for Investigating Newer Coronary Interventions
and Balloon Angioplasty 79
Jeffrey J. Popma and Richard E. Kuntz
I. Introduction 79
II. Qualitative and Quantitative Methods of Assessing
Lesion Severity 80
III. Quantitative Angiographic Outcome After
Coronary Angioplasty 92
IV. Developing a Conceptual Framework for the
Quantitative Evaluation of Balloon and New
Device Technology 99
V. Conclusions 102
References 102
5 Assessment of Myocardial Viability 113
Jorge Cheirif
I. Introduction 113
II. Clinical Importance of Establishing Myocardial
Viability 115
III. Methods Used to Assess Myocardial Viability 117
IV. Limitations to the Clinical Assessment of
Myocardial Viability 126
V. Treatment of Myocardial Hibernation and Stunning 127
VI. Summary 127
References 128
II
New Therapeutic Technologies
6 Coronary Laser Angioplasty 135
Lawrence Deckelbaum
I. Introduction 135
II. Methods 138
III. Results 144
IV. Discussion 150
V. Conclusions 152
References 152
7 Coronary and Saphenous Vein Graft Stents 157
Christopher J. White and Stephen R. Ramee
I. Introduction 157
II. Coronary Stents 158
III. Biliary Stents for Saphenous Vein Graft Stenoses 167
IV. Conclusions 171
References 173
8 Coronary Atherectomy: Directional, Rotational,
and Extraction Catheters 175
Alaa E. Abdelmeguid and Patrick L. Whitlow
I. Introduction 175
II. Directional Coronary Atherectomy (DCA) 176
III. Rotational Atherectomy 186
IV. Transluminal Extraction Catheter (TEC) Atherectomy 193
V. Conclusions 197
References 198
III
Advanced Therapeutic Strategies
9 Thrombolysis of Occluded Vein Grafts 201
Joseph R. Hartmann
I. Introduction 201
II. Recanalization of Chronically Occluded
Aorto-Coronary Vein Grafts: Thrombolysis
and Angioplasty 208
Recanalization of Chronically Occluded
Aorto-Coronary
III. ROBUST 214
IV. Summary 220
Appendix I: Procedural Steps 221
Appendix II: Equipment Specifications
(Partial Listing) 223
Appendix III: Sample Standing Orders 223
References 225
10 Adjunctive Thrombolysis in Angioplasty 227
Tyrone J. Collins
I. Introduction 227
II. Indications 228
III. Methods 229
IV. Clinical Results 235
V. Summary 238
References 238
11 Supported Coronary Angioplasty 243
John S. Wilson and E. Magnus Ohman
I. Introduction 243
II. Indications for Percutaneous Intervention 243
III. Systemic Support Techniques and Applications 245
IV. Conclusions 264
References 265
12 Reducing Coronary Restenosis After Angioplasty 273
Robert S. Schwartz and David R. Holmes, Jr.
I. Introduction 273
II. Restenosis: Animal Models 274
III. Clinical Results 284
IV. Discussion and Conclusion 288
References 289
13 Saphenous Vein Bypass Graft Angioplasty 299
Stephen R. Ramee and Christopher J. White
I. Introduction 299
II. Balloon Angioplasty 300
III. New Devices 306
IV. Summary 312
References 312
14 Salvaging Failed Coronary Angioplasty 317
John R. Laird and Dale C. Worth am
I. Introduction 317
II. Prolonged Balloon Inflations 320
III. Intracoronary Stents 325
IV. Directional Coronary Atherectomy 329
V. Thrombolysis 333
VI. Other Modalities 336
VII. Summary 336
References 337
Index 343
