Angioplasty Bypass Research Articles

Newer concepts in the treatment of unstable angina pectoris

Unstable angina patients should be hospitalized and treated with antianginal drugs to control their symptoms and with aspirin or heparin to reduce the risk of myocardial infarction. Heparin is probably preferable to aspirin acutely, because it also reduces the risk of refractory angina. However, aspirin therapy should be started before heparin is discontinued, to prevent the rebound in symptoms, and continued long-term. Unless specifically contraindicated, coronary arteriography should be performed to identify patients who might benefit from coronary bypass surgery or angioplasty. Control of risk factors is important for long-term outcome.

Medical Anti-Shock Trousers: Pneumatic Anti-Shock Garment: Does it Work?

The use of the Pneumatic Anti-Shock Garment (PASG) has created much controversy in prehospital care. It is interesting that such an inexpensive device and technique has created so much controversy regarding effectiveness when expensive devices and techniques, such as coronary artery bypass, carotid endarteroectomy, and laser angioplasty have been questioned as to effectiveness, but have not created as much controversy.Where do we stand on the PASG today? One well-done, randomized, prospective study has been reported as several different papers. In reality, these reports originate from only one study (1-5). This is compared to more than 200 other studies, many of which have been randomized, prospective studies in animals using the same quality as the randomized, prospective study done on humans. Such studies have the advantage of having better isolation of the specific condition being studied. It does not seem appropriate to base the clinical use or non-use on just one study. All studies should be reviewed and placed in context when attempting to identify the role the PASG has in patient care.

Management of the post-myocardial infarction patient. Essential considerations.

Management of patients who survive acute myocardial infarction (MI) demands the physician's awareness of certain essential considerations. Risk stratification, a useful prognostic indicator of mortality, should be done early in convalescence. If present, postinfarction angina or postinfarction syndrome warrants appropriate therapy. Low-level exercise testing should be under-taken within three weeks of acute MI, and left ventricular function should be assessed and arrhythmias delineated before the patient's discharge from the hospital. Findings may indicate the need for coronary bypass surgery or angioplasty, antiarrhythmic drug therapy, or permanent pacing. Digitalis should be used for treating congestive heart failure only if deemed absolutely necessary. If there are no contraindications, all postinfarction patients should receive beta blockers for at least two years after MI. Control of coronary risk factors is essential. Aspirin can be used prophylactically in patients at risk for recurrent MI; routine use of anticoagulants is not indicated.

Combined femorotibial bypass and distal intraoperative transluminal angioplasty

Combined femorotibial bypass and distal intraoperative transluminal angioplasty