ANGIOPLASTY, VARIOUS TECHNIQUES AND CHALLENGES IN TREATMENT OF CONGENITAL AND ACQUIRED VASCULAR STENOSES Edited by Thomas Forbes ȱ ȱȱ ȱ ȱ ȱ ȱ ȱ ȱ ȱ Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses Edited by Thomas Forbes Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Adriana Pecar Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses, Edited by Thomas Forbes p. cm. ISBN 978-953-51-0084-3 ȱ ȱ Contents ȱ Preface IX Chapter 1 Percutaneous Angioplasty and Stenting for Mesenteric Ischaemia 1 Emily He and Stephen M. Riordan Chapter 2 Cerebral Hyperperfusion Syndrome After Angioplasty 9 D. Canovas, J. Estela, J. Perendreu, J. Branera, A. Rovira, M. Martinez and A. Gimenez-Gaibar Chapter 3 Below the Knee Techniques: Now and Then 41 Daniel Brandão, Joana Ferreira, Armando Mansilha and António Guedes Vaz Chapter 4 Investigation of the Oxidative Stress, the Altered Function of Platelets and Neutrophils, in the Patients with Peripheral Arterial Disease 63 Maria Kurthy, Gabor Jancso, Endre Arato, Laszlo Sinay, Janos Lantos, Zsanett Miklos, Borbala Balatonyi, Szaniszlo Javor, Sandor Ferencz, Eszter Rantzinger, Dora Kovacs, Viktoria Kovacs, Zsofia Verzar, Gyorgy Weber, Balazs Borsiczky and Erzsebet Roth Chapter 5 Antithrombotic Therapy After Peripheral Angioplasty 89 Beniamino Zalunardo, Diego Tonello, Fabio Busato, Laura Zotta, Sandro Irsara and Adriana Visonà Chapter 6 Evidence-Based Invasive Treatments for Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage 105 Geoffrey Appelboom, Adam Jacoby, Matthew Piazza and E. Sander Connolly Chapter 7 Angiography for Peripheral Vascular Intervention 121 Yoshiaki Yokoi Chapter 8 Arterial Angioplasty in Congential Heart Disease 169 Thomas J. Forbes, Srinath Gowda and Daniel R. Turner VI Contents Chapter 9 Carotid Angioplasty 189 Parth Shah and Michael Dahn Chapter 10 Revascularization of Tibial and Foot Arteries: Below the Knee Angioplasty for Limb Salvage 209 Marco Manzi, Luis Mariano Palena and Giacomo Cester ȱȱ ȱ Preface ȱ !To the patients whom we treat, allowing us to slowly convert the !art of medicine9 into the !science of medicine9. !"#$% &'$()*('$&"'+,% /#&0&+'#% 1(,&(*(% $.+$% 2'3)(+% 4)5('$6&78% 9."% -():");(3% $.(% :&)#$%#500(##:5,%0")"'+)/%+'7&"-,+#$/%&'%<=>>%&'%?5)&0.8%@9&$6(),+'38%1(7+'%$.(%()+%":% ,(##%&'*+#&*(%&'$()*('$&"'%-():");(3%*&+%$.(%$)+'#0+$.($()%)"5$(A%%2$%$.+$%$&;(8% &'%.&#% :&)#$%0+#(8%5$&,&6&'7%+%kitchen-built%0+$.($()8%.(%#500(##:5,,/%-():");(3%3&,+$&"'%":%+'%BCD% ,(#&"'%":%+%E%;;%#(0$&"'%":%$.(%,(:$%+'$()&")%3(#0('3&'7%+)$()/A%%F(%-)(#('$(3%.&#%:&)#$% :"5)% 0")"'+)/% +'7&"-,+#$/% 0+#(#% +$% $.(% G<=>>% 2;()&0+'% F(+)$% 2##"0&+$&"'H% ;(($&'7% +'3% $.(% )(#$8% $.(/% #+/8% 9+#% .&#$")/A% % I+#0&'+$&'7,/8% +$%$.(% <CJ/(+)% 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advancements in endovascular therapy, there has been an increase in the use of endovascular revascularisation for treatment of AMI In the US registry study of 5237 patients treated for AMI, the outcomes of patients who were treated with endovascular intervention were compared to those who were treated with 6 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses. .. Huyng TT, Lin PH Clinical outcomes of mesenteric artery stenting versus surgical revascularisation in chronic mesenteric ischemia Int Angio 2009; 28(2):132137 8 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses Laissy JP, Trillaud H, Douek P MR angiography: noninvasive vascular imaging of the abdomen Abdom Imaging 2002; 27:488-506 Landis MS, Rajan... period of 26 months The 30-day mortality rate was 3-5% Clinical series comparing endovascular and surgical revascularisation have shown that long term patency rates and freedom from 4 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses symptoms may be inferior in patients who have had endovascular revascularisation (Kougias et al., 2009; Atkins et... methods, and strategies for prevention and treatment We will also discuss a 10 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses condition that shares the same pathophysiology as CHS, contrast-induced encephalopathy, in which contrast agents crossing the blood-brain barrier have a toxic effect on the brain parenchyma, resulting in signs and symptoms... shows the incidence of CHS and of ICH in the largest series published before 2010, including series of patients undergoing angioplasty of intracranial arteries In order to document the incidence of CHS after CAS and to determine possible predisposing factors, Sfyroeras et al (2009) studied 29 patients with CT, MRI, TCD including assessment of CVR, and SPECT before and after the procedure A total of 5 patients... while CBF, cerebral perfusion pressure, and cerebral 16 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses metabolic rate of oxygen increased rapidly and peaked soon after CAS These results suggest that a large discrepancy between rapidly increased CBF, perfusion pressure, and a small increase in vascular reserve in the acute stage after CAS could cause... physiologic insult to patients who are already critically ill Another important issue is to what extent ischaemia-reperfusion injury of the intestine, leading to microvascular injury and cellular necrosis and apoptosis, contributes to morbidity and mortality in patients in whom arterial revascularisation is attained and whether various recent advances in preventing or limiting this phenomenon described in the... neurological events Two of them developed CHS (6.9%); both had Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses 20 exhausted CVR in the preoperative TCD examination All studies that investigate CVR before treatment have found a relation between impaired CVR and the risk of CHS Brantley et al (2009) studied 482 patients, 7 (1.45%) of whom developed CHS... Table 3 Incidence of hyperperfusion syndrome, and intracranial hemorrhage after CAS in the reviewed series from 2003 to 2010 22 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses Few studies have addressed the subject of simultaneous bilateral CAS Henry et al (2005) reported a series of 17 patients who underwent simultaneous bilateral CAS and 40... immediately after the intervention; ICH was due to hemorrhagic conversion of a prior stroke 24 Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses The incidence of ICH after CEA in the series published ranges between 0.2% and 0.7% (Piepgras et al, 1988; Pomposelli et al, 1988; Solomon et al, 1986; Wilson & Ammar, 2005), whereas the incidence of ICH after . 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