The results of percutaneous transluminal angioplasty of renal arteries (PTA) were evaluated in 43 patients followed up for 2-39 months (mean: 14 months). The benefit of PTA was higher (82%) in hypertensives with arterial fibrodysplasia (n = 11) than in atherosclerotic vascular lesions (53%, n = 19). Of 15 patients with reduced renal function before PTA, the glomerular filtration rate rose in seven. A major complication was in one patient arterial dissection and in another one loss of function of the transplanted kidney due to acute tubular necrosis. The results confirm that PTA is an important contribution to the treatment of renovascular hypertension.

• MeSH
• arterioskleróza terapie   MeSH
• balónková angioplastika * MeSH
• dospělí MeSH
• hodnoty glomerulární filtrace MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• renovaskulární hypertenze terapie   MeSH
• senioři MeSH
• stenóza terapie   MeSH
• urografie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To assess the progress of chronic myocardial ischemia after successful percutaneous transluminal coronary angioplasty (PTCA) using body surface potential mapping (BSPM). DESIGN: For BSPM analysis the following kinds of maps were used: isopotential repolarization maps corresponding to 70% of ST-T interval's duration and isointegral maps corresponding to 0% to 20% of ST-T duration. BSPM measurements were taken before the PTCA and usually one to six days after this intervention. In 17 patients BSPM was carried out within two days after PTCA. Eleven to 14 BSPM examinations were usually carried out during six months of follow-up. Control coronary angiography was performed after six months in all but three patients. RESULTS: Substantial focal decrease of positive potential in repolarization caused by myocardial ischemia recovered gradually after successful PTCA. This appeared to be caused by the regression of "hibernating myocardium'. An increase of positive potential was statistically significant (P < 0.01) after the fifth week of PTCA intervention. There was a positive correlation between BSPM findings and chest discomfort of patients after PTCA. Chronic myocardial ischemia could be observed on isopotential and/or isointegral maps examined before the PTCA in 21 of 25 cases (sensitivity 84%).

• MeSH
• angiokardiografie MeSH
• balónková koronární angioplastika * MeSH
• chronická nemoc MeSH
• dospělí MeSH
• infarkt myokardu diagnostické zobrazování   terapie   MeSH
• ischemická choroba srdeční diagnostické zobrazování   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mapování potenciálů tělesného povrchu * MeSH
• syndrom omráčeného myokardu MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AIMS: The aim of our study was to compare the effect of autologous stem cell therapy (SCT) and percutaneous transluminal angioplasty (PTA) on diabetic foot disease (DFD) in patients with critical limb ischemia (CLI). METHODS: Thirty-one patients with DFD and CLI treated by autologous stem cells and 30 patients treated by PTA were included in the study; 23 patients with the same inclusion criteria who could not undergo PTA or SCT formed the control group. Amputation-free survival, transcutaneous oxygen pressure (TcPO2) and wound healing were assessed over 12 months. RESULTS: Amputation-free survival after 6 and 12 months was significantly greater in the SCT and PTA groups compared with controls (P = 0.001 and P = 0.0029, respectively) without significant differences between the active treatment groups. Increase in TcPO2 did not differ between SCT and PTA groups until 12 months (both Ps < 0.05 compared with baseline), whereas TcPO2 in the control group did not change over the follow-up period. More healed ulcers were observed up to 12 months in the SCT group compared with the PTA and control groups (84 versus 57.7 versus 44.4 %; P = 0.042). CONCLUSIONS: Our study showed comparable effects of SCT and PTA on CLI, a major amputation rate that was superior to conservative therapy in patients with diabetic foot and an observable effect of SCT on wound healing. Our results support SCT as a potential promising treatment in patients with CLI and diabetic foot.

• Klíčová slova
• critical limb ischemia, percutaneous transluminal angioplasty, stem cell therapy,
• MeSH
• angioplastika * MeSH
• autologní štěp MeSH
• buněčná a tkáňová terapie MeSH
• diabetická noha patologie   patofyziologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• onemocnění periferních arterií patologie   patofyziologie   chirurgie   MeSH
• senioři MeSH
• transplantace kmenových buněk * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH

The most frequent complication of percutaneous transluminal coronary angioplasty is acute obstruction of the artery to be dilated. The authors present their experience with the solution of this situation. In a group of 154 consecutive patients with chronic stable angina pectoris a sudden occlusion was observed in 7.7%, infarction in 5.8% and the necessity of operation arose in 5.2%. A significant position in the solution if these complications is held by cardiosurgical revascularization. As to pharmacological treatment, it is useful to administer a combination of nitrates, calcium channel antagonists and thrombolytic treatment.

• MeSH
• balónková koronární angioplastika škodlivé účinky   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• přehledy MeSH

Endothelin plays an important role in cardiovascular pathology. As one of the most important endothelium-derived vasoconstrictor substances, endothelin together with endothelium-derived vasodilating factor control vascular tone and contribute to the vasoconstrictory response if the production of endothelium-derived vasodilating factor is impaired. The aim of the study was to assess the changes of the local endothelin level in coronary circulation immediately after percutaneous transluminal coronary angioplasty (PTCA). Plasma endothelin levels were measured in blood samples from the peripheral vein and ostium of the coronary artery before the angioplasty, and from the distal coronary artery just beyond the dilated segment and the peripheral vein immediately after the procedure. The plasma endothelin level was significantly higher in the ostium of the coronary artery already prior to PTCA as compared to the peripheral vein (10.9 +/- 3.4 vs. 7.2 +/- 2.1 pg/ml, p < 0.005). There was no change in the endothelin level in the coronary artery distal to the dilated segment immediately after the procedure as compared to the initial level, although this level was higher than the postangioplasty venous level (9.8 +/- 2.9 vs. 7.7 +/- 2.0 pg/ml, p < 0.005). Individual changes in coronary-artery plasma endothelin levels as a response to coronary angioplasty were disparate. An increase and a decrease in coronary artery plasma endothelin levels by more than 2 pg/ml after coronary angioplasty were observed in 3 and 6 subjects, respectively. In conclusion, increased plasma endothelin levels were found in blood samples drawn from the coronary artery as compared to the peripheral vein. There was no further change in the plasma endothelin level in the coronary artery distal to the dilated segment after angioplasty; however, the individual responses were disparate.

• MeSH
• angina pectoris krev   terapie   MeSH
• balónková koronární angioplastika * MeSH
• dospělí MeSH
• endoteliny krev   MeSH
• koronární cévy * MeSH
• koronární cirkulace fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• radioimunoanalýza MeSH
• vazokonstrikce fyziologie   MeSH
• vény MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• endoteliny MeSH

Background: In patients with vertebral artery origin (VAO) stenosis and concomitant stenoses of other cerebral feeding arteries, data on the risk of percutaneous transluminal angioplasty (PTA) alone and with stent placement (PTAS) for VAO stenosis are limited. We aimed to determine how the presence of polystenotic lesions in other cerebral feeding arteries and concomitant carotid artery stenting (CAS) affect the periprocedural risk and long-term effect of PTA/S for atherosclerotic VAO stenosis. Methods: In a retrospective descriptive study, consecutive patients treated with PTA/S for ≥70% VAO stenosis were divided into groups with isolated VAO stenosis and multiple stenoses. We investigated the rate of periprocedural complications in the first 72 h and the risk of restenosis and ischemic stroke (IS)/transient ischemic attack (TIA) during the follow-up period. Results: In a set of 66 patients aged 66.1 ± 9.1 years, polystenotic lesions were present in 56 (84.8%) patients. 21 (31.8%) patients underwent endovascular treatment for stenosis of one or more other arteries in addition to VAO stenosis (15 underwent CAS). During the periprocedural period, no patient suffered from an IS or died, and, in the polystenotic group with concomitant CAS, there was one case of TIA (1.6%). During a mean follow-up period of 36 months, we identified 8 cases (16.3%) of ≥50% asymptomatic VA restenosis, and, in the polystenotic group, 4 (8.9%) cases of IS. Conclusion: The presence of severe polystenotic lesions or concomitant CAS had no adverse effect on the overall low periprocedural risk of PTA/S of VAO stenosis or the risk of restenosis during the follow-up period.

• Klíčová slova
• atherosclerosis, percutaneous transluminal angioplasty, periprocedural complications, polystenotic lesions, recanalization, vertebral artery origin,
• Publikační typ
• časopisecké články MeSH

Percutaneous transluminal angioplasty (PTA) of the deep femoral artery (DFA) was performed in 21 patients with chronically occluded superficial femoral artery (SFA) and a significant DFA lesion as documented by arteriography. The authors failed to pass the guidewire through the occlusion in two patients. The results do not include another patient who, while the PTA was technically successful, had to have a limb amputated because of skin lesion infection. The remaining 18 patients showed a significant increase in the ankle-arm pressure index, prolongation of the claudication interval and reported subjective improvement immediately after PTA; plethysmography performed in 14 patients revealed a significant increase in maximum foot blood flow. While the claudication intervals were found to have further significantly prolonged 6-12 months following PTA, the ankle-arm pressure index remained unchanged. There were no serious complications during and after the PTA procedure. In patients with both superficial and deep femoral artery involvement, where SFA PTA is not suitable or feasible, PTA of the DFA seems to be the method of choice. Considering its probable clinical benefits, it is appropriate to attempt it even in cases where the chances of technical success are low.

• MeSH
• arteria femoralis * diagnostické zobrazování   MeSH
• arteriální okluzní nemoci diagnostické zobrazování   patofyziologie   terapie   MeSH
• balónková angioplastika * MeSH
• lidé středního věku MeSH
• lidé MeSH
• noha (od hlezna dolů) krevní zásobení   MeSH
• radiografie MeSH
• rychlost toku krve MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Restenosis after percutaneous transluminal coronary angioplasty is a critical factor limiting the usefulness of this procedure. It has been reported to occur in 25% to 50% of patients averaging 33%. In the majority of patients it appears within 6 months after procedure. Some clinical, angiographic and procedural factors can predict higher incidence of restenosis--they are discussed in the article. Main mechanisms which result in restenosis are intimal hyperplasia and smooth muscle cellular proliferation. Exercise thallium-201 scintigraphy and coronary angiography are the best methods in diagnosis of restenosis. The prevention and the therapy of restenosis appear as a difficult problems. Successful pharmacological approach doesn't exist until now. In about 50% of patients with restenosis coronary angioplasty is repeated with the same success and restenosis rate as in the first angioplasty.

• MeSH
• balónková koronární angioplastika * MeSH
• koronární nemoc diagnóza   patologie   terapie   MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

CONTEXT AND OBJECTIVE: Peripheral arterial occlusive disease (PAOD) is a prevalent atherosclerotic disorder characterized by limb pain on exertion, limb loss and a high mortality rate. Because of its chronic nature, it often has a negative impact on patients' quality of life (QOL). This study aimed to assess QOL among patients with PAOD that was treated by endovascular intervention using femoral and popliteal percutaneous transluminal balloon angioplasty (PTBA). DESIGN AND SETTING: This study was local, prospective and longitudinal. It was carried at the Second Department of Internal Medicine of Charles University Hospital in Hradec Kralove, Czech Republic. METHODS: Thirty PAOD patients (20 male and 10 female) were treated by endovascular intervention using femoral and popliteal PTBA. The Czech version of the international generic European Quality of Life Questionnaire (EQ-5D) was applied. RESULTS: The statistical evaluation demonstrated that QOL presented highly significant statistical dependence on femoral and popliteal PTBA (p < 0.0001). CONCLUSION: The results showed that femoral and popliteal PTBA had a highly positive effect on the QOL of patients with PAOD.

CONTEXTO E OBJETIVO:: Doença arterial oclusiva periférica (DAOP) é uma desordem aterosclerótica prevalente, caracterizada por dor esforço do membro, perda do membro e alta taxa de mortalidade. Devido à sua natureza crônica, freqüentemente tem impacto negativo na qualidade de vida (QV) dos pacientes. Este estudo objetivou avaliar a QV entre pacientes com DAOP tratada por intervenção endovascular usando angioplastia com balão transluminal femoral e poplítea (ABT). TIPO DE ESTUDO E LOCAL:: Este estudo local, prospectivo e longitudinal foi realizado no Segundo Departamento de Medicina Interna do Charles University Hospital em Hradec Kralove, República Checa. MÉTODOS:: 30 pacientes com DAOP (20 homens) foram tratados por intervenção endovascular usando ABT femoral e poplítea. A versão checa do Questionário Europeu de Qualidade de Vida (EQ-5D) foi aplicada. RESULTADOS:: A avaliação estatística demonstrou que a QV apresentou dependência altamente significativa da ABT femoral e poplítea (p < 0,0001). CONCLUSÃO:: Os resultados mostraram que a ABT femoral e poplítea teve efeito altamente positivo na QV dos pacientes com DAOP.

• MeSH
• arteria femoralis * MeSH
• arteria poplitea * MeSH
• arteriální okluzní nemoci psychologie   terapie   MeSH
• balónková koronární angioplastika psychologie   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• senioři MeSH
• výsledek terapie MeSH
• zdravotní stav MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Aim of this study was to evaluate the possible use of infrared thermography as a supplementary method to the ankle-brachial index used in assessing the treatment effect of percutaneous transluminal angioplasty. The study included 21 patients, mean age was 60.22 years. Healthy control group included 20 persons, mean age was 55.60 years. Patients with symptomatic peripheral arterial disease (Fontaine stages I-III) were admitted for endovascular treatment by percutaneous transluminal angioplasty. Thermal images and ankle-brachial index values were obtained before and after treatment by percutaneous transluminal angioplasty. Median temperature change in the treated limb was 0.4℃, for non-treated limb was -0.5℃. The median value of ankle-brachial index in the treated limb increased by 0.17 from 0.81 after the procedure. The median value of ankle-brachial index in the non-treated limb decreased by 0.03 from the value of 1.01. Significant difference between treated limb and non-treated limb in change of ankle-brachial index was found with p value = .0035. The surface temperature obtained by the infrared thermography correlates with ankle-brachial index. We present data showing that the increase of ankle-brachial index is associated with increase of skin temperature in the case of limbs treated by percutaneous transluminal angioplasty. Our results also suggest potential of the use of infrared thermography for monitoring foot temperature as a means of early detection of onset of foot ischemic disorders.

• Klíčová slova
• Infrared thermography, ankle-brachial index, percutaneous transluminal angioplasty, peripheral arterial disease,
• MeSH
• balónková angioplastika * MeSH
• dolní končetina krevní zásobení   MeSH
• dospělí MeSH
• infračervené záření * MeSH
• lidé středního věku MeSH
• lidé MeSH
• onemocnění periferních arterií diagnóza   patofyziologie   terapie   MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• průchodnost cév MeSH
• regionální krevní průtok MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• teplota kůže * MeSH
• termografie metody   MeSH
• termoregulace MeSH
• tlakový index kotník-paže MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH