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Topic: Revascularization

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	Revascularization - Wikipedia, the free encyclopedia
		Revascularization is the process of restoring the functionality of an affected organ.
		Revascularization involves a thorough analysis and diagnosis and treatment of the existing diseased vasculature of the affected organ, and can be aided by the use of different imaging modalities such as magnetic resonance imaging, pet scan, CT scan, and X ray fluoroscopy.
		The term revascularization is also used in conjunction with other medical terms such as angioplasty, cardiac, and myocardial to denote specific forms of revascularization techniques.
	en.wikipedia.org /wiki/Revascularization (173 words)

	Transmyocardial Revascularization (TMR)
		Transmyocardial revascularization or TMR is a procedure used to relieve severe angina or chest pain in very ill patients who aren't candidates for bypass surgery or angioplasty.
		Transmyocardial revascularization has received FDA approval for use in patients with severe angina who have no other treatment options.
		Transmyocardial revascularization won't replace coronary artery bypass or angioplasty as the most common method of treating coronary artery disease.
	www.americanheart.org /presenter.jhtml?identifier=4782 (353 words)

	p990831b - Cardiogenic Shock - Revascularization
		Revascularization was accomplished by either coronary-artery bypass grafting or angioplasty.
		Ninety-seven percent of the patients assigned to revascularization underwent early coronary angiography, and 87 percent underwent revascularization; only 2.7 percent of the patients assigned to medical therapy crossed over to early revascularization without clinical indication.
		Early revascularization should be strongly considered for patients with acute myocardial infarction complicated by cardiogenic shock.
	www.emory.edu /WHSCL/grady/amreport/litsrch99/p990831b.html (563 words)

	Guidelines for the Reporting of Renal Artery Revascularization in Clinical Trials -- Rundback et al. 106 (12): 1572 -- ...
		for revascularization in the presence of a significant RAS are
		Revascularization for preservation of renal function in patients with atherosclerotic renovascular disease.
		Renal revascularization for recurrent pulmonary edema in patients with poorly controlled hypertension and renal insufficiency: a distinct subgroup of patients with arteriosclerotic renal artery occlusive disease.
	circ.ahajournals.org /cgi/content/full/106/12/1572 (6677 words)

	Arquivos Brasileiros de Cardiologia - Myocardial revascularization with coronary endarterectomy. Stratification of ... *(Site not responding. Last check: 2007-10-21)*
		The objective of this study is to assess the in-hospital evolution of patients undergoing this procedure and to determine the risk factors related to its morbidity and mortality.
		Improvement in the results of myocardial revascularization caused by a larger experience, by the development of methods of myocardial protection, and by the use of the internal thoracic artery has allowed its application in patients with diffuse coronary heart disease, which was earlier considered a surgical contraindication.
		In conclusion, resurgence of coronary endarterectomy as an adjunctive of myocardial revascularization is a strong concept that has gained impetus through the technological development related to cardiac surgery, providing a significant improvement in its results, comparable to those of conventional myocardial revascularization.
	www.scielo.br /scielo.php?script=sci_arttext&pid=S0066-782X2000001000002&lng=pt&nrm=iso (3537 words)

	Coronary-Artery Revascularization before elective vascular surgery does not significantly alter the long-term outcome
		Therefore, the Coronary Artery Revascularization Prophylaxis (CARP) trial assessed the long-term benefit of preoperative coronary-artery revascularization among patients with stable coronary artery disease who are scheduled for elective vascular surgery.
		Among the patients assigned to preoperative coronary-artery revascularization, percutaneous coronary intervention was performed in 59 percent, and bypass surgery was performed in 41 percent.
		At 2.7 years after randomization, mortality in the revascularization group was 22 percent and in the no-revascularization group 23 percent (relative risk, 0.98; 95 percent confidence interval, 0.7 to 1.37; P=0.92).
	www.cardiologyonline.com /journal_articles/Coronary_artery_revasc.htm (391 words)

	1995 Consensus Conference: (Site not responding. Last check: 2007-10-21)
		Revascularization is inevitably a palliative approach, often providing only temporary relief of the mechanical problem faced by the coronary circulation.
		Where a more complete revascularization strategy is thought to be merited (11-13), surgery usually is preferred, although there is preliminary encouragement that the adjunctive use of stenting is associated with substantial restenosis reductions compared with balloon intervention without stenting.
		Patients are subjected to revascularization for improvement of survival, or for relief of symptoms as an alternative to medical therapy.
	www.ccs.ca /society/conferences/archives/1995/1995conf-01.asp (10566 words)

	Penile Revascularization
		Penile revascularization is the correction of erectile dysfunction using surgical or microsurgical procedures to bypass arterial occlusions or repair venous insufficiencies.
		Penile revascularization is a complicated surgical procedure in which major arteries are accessed to restore penile blood flow.
		Revascularization techniques that supply the corpus cavernosum through the collateral deep dorsal venous network or through a surgical fistula between the arterialized vein and the corpus cavernosum include:
	www.bcbst.com /MPManual/Penile_Arterial_Revascularization.htm (463 words)

	Transmyocardial Laser Revascularization -- CTSNet FAQs
		Transmyocardial laser revascularization (TMR) is a new technique that attempts to improve the blood supply to ischemic myocardium by using a high-powered CO laser to create multiple transmyocardial channels.
		That is, there should be a revascularization outside of the normal coronary channels that have the ischemic myocardium.
		Of importance was the fact that myocardial perfusion, which was determined by spect scanning with computerized sesta-bibi left ventricular maps, was significantly improved in those areas that were lasered in the reversibly ischemic areas of myocardium.
	www.ctsnet.org /doc/96 (1223 words)

	Myocardial revascularization and ...
		The authors studied the relationship between diabetes and survival after revascularization in a large prospective cohort of patients with multivessel coronary artery disease (n = 3220) of whom 24% were diabetic.
		Regardless of the method of myocardial revascularization, comprehensive aggressive management of all atherogenic risk factors is required to reduce coronary and total mortality in patients with diabetes.
		The randomized trials of revascularization in patients with multivessel coronary disease are an important example of this.
	www.medforum.nl /idm/myocardi.htm (1004 words)

	Editor's Note: Optimal Therapeutic Management of Non-Q-Wave Myocardial Infarction (Site not responding. Last check: 2007-10-21)
		Coronary angiography was performed within the first seven days in 96% and revascularization within the first 10 days in 71% of patients in the invasive arm.
		Coronary angiography was performed within the first seven days in 10% and revascularization within the first 10 days in 9% of patients in the noninvasive arm.
		It is highly probable that patients in clinical trials comparing medical with revascularization therapy did not receive the medical therapy that one would recommend in the year 2000.
	www.clinicalcardiology.org /briefs/200001briefs/cc23-001.html (1675 words)

	Transmyocardial Revascularization (TMR) for the Treatment of Coronary Artery Disease (Site not responding. Last check: 2007-10-21)
		Transmyocardial revascularization (TMR), also known as transmyocardial laser revascularization (TMLR) is a technique that is used in an effort to improve blood flow to ischemic heart muscle.
		The second is in a population where usage is as an adjunct to coronary artery bypass grafting in individuals with areas of ischemic myocardium that are not amenable to surgical revascularization.
		The individual has documented areas of the myocardium that are not amenable to surgical revascularization due to unsuitable coronary anatomy (i.e., diffuse vascular disease, and/or distal obstruction).
	www.bcbst.com /MPManual/Transmyocardial_Revascularization_(TMR)_for_the_Treatment_of_Coronary_Artery_Disease.htm (931 words)

	Hybrid Coronary Artery Revascularization – Time To Reactivate The Concept?
		Hybrid coronary artery revascularization is a combination of minimally invasive left internal mammary artery bypass grafting to the left anterior descending artery combined with a catheter based intervention to other coronary arteries.
		By these definitions hybrid coronary artery revascularization is a combination between surgical and catheter based intervention on the diseased coronary arteries.
		As hybrid coronary revascularization includes logistic problems such as the involvement of a surgical and an interventional specialist discussions come up whether a single specialist is necessary who can cover both parts of the procedure.
	www.ctsnet.org /sections/innovation/beatingheart/articles/article-6.html (3104 words)

	Penile Revascularization Surgery
		Penile revascularization surgery is similar to a cardiac bypass, but in the penis.
		The most common causes of erectile dysfunction which can be treated by penile revascularization are blunt trauma to the perineum or bike riding.
		Most ideal candidates are young men with a history of perineal or pelvic trauma in whom arteriography reveals a localized common penile artery lesion.
	www.bumc.bu.edu /Dept/Content.aspx?PageID=6933&departmentid=371 (232 words)

	ACC Clinical Trials
		There was a significant difference in the median time from MI to revascularization in the two groups, with PTCA patients undergoing revascularization sooner (19.0 vs. 11.1 hours, p<0.01).
		Comparing all-cause survival, there appeared to be an early penalty in the revascularization group, which showed a greater risk during the first 96 hours, then gaining a survival advantage that extended out to 12 months.
		The type of revascularization (CABG or percutaneous intervention) should depend on the anatomy encountered at catheterization and decisions made on the ability to revascularize as completely as possible.
	www.acc.org /education/online/trials/aha99/shock.htm (679 words)

	Emergency Angioplasty or Bypass Surgery Saves Lives of Heart Attack Patients with Cardiogenic Shock --8/08/99
		The results of the SHOCK (Should we Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial are published in the August 26 issue of The New England Journal of Medicine.
		Of the patients undergoing early revascularization, 64 percent had initial angioplasty and 36 percent had surgery as their first procedure.
		The 30-day death rates were 47 percent for patients who had early revascularization and 56 percent for the initial stabilization group, a finding that was not statistically significant.
	www.nhlbi.nih.gov /new/press/aug25-99.htm (803 words)

	SURVIVAL AFTER CORONARY REVASCULARIZATION IN PATIENTS WITH HEART FAILURE (Site not responding. Last check: 2007-10-21)
		Practice guidelines recommend coronary revascularization for patients with heart failure and coronary artery disease; however, the evidence for efficacy of this practice is weak.
		Propensity-adjusted relative survival at 1 y in those receiving revascularization ranged from 1.9 in those in the lowest quintile of revascularization probability to 2.8 in those in the highest (p<0.05 for all quintiles).
		CONCLUSIONS: This analysis of a large cohort of heart failure patients showed a strong association of revascularization with survival, validating the recommendations from practice guidelines and suggesting that revascularization be considered in all patients with heart failure.
	www.pulsus.com /ccc2004/abs/a388.htm (286 words)

	[No title]
		Coronary revascularization plays an important role in the treatment of clinically severe coronary artery disease.
		Patients were ineligible for the trial if they had, for example, insufficient angina or ischemia, required emergency revascularization, left main stenosis of 50 percent or greater, a noncardiac illness expected to result in limited survival, primary coronary spasm, or a poor quality angiogram.
		Finally, all patients who have evidence of coronary artery disease, with or without a prior PTCA or CABG, should receive an aggressive approach to medical management of known risk factors for coronary artery disease, including smoking cessation for smokers, appropriate control of elevated blood pressure or serum cholesterol, and optimal control of diabetes.
	www.nhlbi.nih.gov /new/press/clinalrt.txt (1236 words)

	FOCUS: CORONARY REVASCULARIZATION
		Revascularization of stenotic coronary artery greatly contributes to the treatment of CAD.
		ACIP compared revascularization with medical therapy in 558 patients with ischemia during exercise or asymptomatic ischemia during ambulatory ECG (patient entry between 1991 and 1993).
		Evidence-based selection of revascularization strategy will be more complicated for multi-vessel disease because intended incomplete revascularization by PTCA or MIDCAB may be a reasonable option in non-diabetics.
	www.hmc.org.qa /hmc/heartviews/issue9/CLINICAL.htm (4328 words)

	VascularWeb: No Long Term Benefit To Revascularization Before Vascular (Site not responding. Last check: 2007-10-21)
		The CARP researchers looked at the benefits of preoperative coronary-artery revascularization among 510 stable CAD patients scheduled for elective vascular surgery who were randomized to coronary-artery revascularization before surgery (percutaneous coronary intervention or bypass surgery) or to no revascularization before surgery (medical therapy alone).
		There were no significant between-group differences in 30-day postoperative outcomes including postoperative MI, which occurred in 12% of subjects in the revascularization group and 14% of subjects in the medical therapy only arm.
		In the current trial, beta-blockers, antiplatelet agents, angiotensin-converting enzyme inhibitors, and statins were optimized in all study subjects, which may have improved the outcomes overall and lessened the differences between the two groups, the investigators theorize.
	www.vascularweb.org /_CONTRIBUTION_PAGES/Medical_News_Reuters/No_Long_Term_Benefit_To_Revascularization_Before_Vascular_Su.html (386 words)

	References
		Transmyocardial laser revascularization: results of a multicenter trial with transmyocardial laser revascularization used as sole therapy for end-stage coronary artery disease.
		Transmyocardial revascularization with a carbon dioxide laser in patients with end-stage coronary artery disease.
		Transmyocardial laser revascularization in the patient with unmanageable unstable angina.
	www.sts.org /doc/8216 (2066 words)

	EVIDENCE BASED STRATEGY OF CORONARY REVASCULARIZATION
		The second randomized Intervention Treatment of Angina (RITA-2) compared PTCA with medical therapy in patients with single-and multi-vessel disease.4 From 1992 to 1996, patients in whom medical therapy and coronary angioplasty were considered as acceptable alternatives were enrolled in the trial.
		Patients in whom early revascularization was considered necessary for symptom relief or for prognostic benefit were not eligible.
		In the last decade, efficacy of aspirin on survival of patients with stable angina was established.26 Beta-blockers, and slow-release or long-acting channel antagonists are effective in relieving anginal symptoms.
	www.hmc.org.qa /hmc/heartviews/issue8/persp7.htm (3454 words)

	Intermittent Claudication: Cost-effectiveness of Revascularization versus Exercise Therapy -- de Vries et al. 222 (1): ...
		Revascularization was assumed to be preceded by angiography.
		Revascularization for femoropopliteal disease: a decision and cost-effectiveness analysis.
		Myocardial revascularization for chronic stable angina: analysis of the role of percutaneous transluminal coronary angioplasty based on data available in 1989.
	radiology.rsnajnls.org /cgi/content/full/222/1/25 (6205 words)

	Quality Improvement Guidelines for Angiography, Angioplasty, and Stent Placement in the Diagnosis and Treatment of ...
		Renal revascularization using percutaneous balloon angioplasty for fibromuscular dysplasia and atherosclerotic disease.
		Revascularization in atherosclerotic renal artery disease (clinical conference).
		Long-term outcome of surgical revascularization in ischemic nephropathy: normalization of average decline in renal function.
	www.jvir.org /cgi/content/full/14/9/S297 (9137 words)

	Rest-Redistribution 201Tl Single-Photon Emission CT Imaging for Determination of Myocardial Viability: Relationship ...
		was 89 ± 10% for patients undergoing surgical revascularization,
		revascularization, as supported by the data from Lee et al.
		Hammermeister, KE, DeRouen, TA, Dodge, HT (1979) Variables predictive of survival in patients with coronary disease: selection by univariate and multivariate analyses from the clinical, electrocardiographic, exercise, arteriographic, and quantitative angiographic evaluations.
	www.chestjournal.org /cgi/content/full/115/6/1621 (2942 words)

	The Society of Thoracic Surgeons practice guideline series: transmyocardial laser revascularization -- Bridges et al. ...
		revascularization as an adjunct to coronary artery bypass graft
		Transmyocardial revascularization with CO laser in patients with refractory angina pectoris.
		Frazier O.H., March R.J., Horvath K.A. Transmyocardial revascularization with a carbon dioxide laser in patients with end-stage coronary artery disease.
	ats.ctsnetjournals.org /cgi/content/full/77/4/1494 (5511 words)

	Monitoring of Cerebral Vasodilatory Capacity With Transcranial Doppler Carbon Dioxide Inhalation in Patients With ...
		That patient was 1 of the 3 whose CVC was abnormal after revascularization.
		Change in CVR before and after revascularization in 14 patients with severe ICA stenosis or complete occlusion.
		Urgent endovascular revascularization for symptomatic intracranial atherosclerotic stenosis
	stroke.ahajournals.org /cgi/content/full/34/4/945 (3435 words)

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