Percutaneous transluminal angioplasty(PTA) was first described by Dotter and Jukins in 1964 and subsequently modified by Gruentzig and Hoff in 1974. PTA has proved a safe and effective treatment for focal atherosclerotic disease of the aorta and its major extremity branches. The complications of PTA of the peripheral vessels are less frequent and less serve than those associated with the comparable surgical procedure. Intestinal angina is a clinical syndrome compromising postprandial abdominal pain, nausea, vomiting, diarrhea, weight loss, and eventually fear of eating. The syndrome is thought to be due to visceral ischemia, with stenosis or occlusion of the three visceral arteries being necessary for the syndrome to occur. Although the first report of mesenteric PTA appeared in 1980, the series of PTA with stenting of the visceral arteris reported in the literature have been small or included limited follow-up. We report a case of a intestinal angina due to superior mesenteric arterial stenosis. A 69-year-old male complained of serve postprandial pain, chronic diarrhea for 1 year. PTA with stening in superior mesenteric artery results in recannulation of obstructed artery and relief of symptom.
Abdominal Pain ; Aged ; Angioplasty* ; Aorta ; Arteries ; Chronic Pain ; Constriction, Pathologic ; Diarrhea ; Eating ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Male ; Mesenteric Artery, Superior ; Nausea ; Stents* ; Vomiting ; Weight Loss

Therapeutic ionizing radiation can damage the permanent pacemaker. Reimplantation of pacemaker should be considered when the pacemaker site is included in the radiation field. We report a case of successful repositioning of preexisting pacemaker generator and leads with subcutaneous tunneling method across the sternum instead of insertion of new leads in a female patient with breast cancer who had DDD pacemaker.
Breast Neoplasms ; Dichlorodiphenyldichloroethane ; Female ; Humans ; Radiation, Ionizing ; Replantation ; Sternum

Radiofrequency catheter ablation (RFCA) has been established as an effective and safe treatment modality for atrioventricular nodal reentrant tachycardia and WPW syndrome. Surgical ablation or direct current catheter ablation had been performed to cure focal atrial tachycardia (AT), however, these treatments had limitations such as the need of open thoracotomy or the risk of barotrauma. RFCA could be an effective treatment modality for cure of AT. We performed RFCA for AT in 22 patients (male 13, mean age 38.1+/-15.4 years) among 831 patients who underwent electrophysiologic study between Jul. 1996 and May. 1999. Clinical pattern of tachycardia was paroxysmal (17 patients) or incessant (mean duration of symptoms, 41.1+/-42.3 months). Associated cardiac diseases were tachycardia-mediated cardiomyopathy (3 patients), aortic stenosis (1 patient) and ventricular septal defect with pulmonic stenosis (1 patient). AT was induced by programmed electrical stimulation in 17 patients: AT in the other 5 patients was incessant. The RFCA was successful in 17 patients (77.3%). The mean interval between atrial electrogram of mapping catheter and P wave of surface ECG was -53.5+/-24.9msec in 17 successful sites. Fractionated atrial activities were invariably found in the successful sites. Successful sites of RFCA for right AT were around coronary sinus ostium (5), crista terminalis (4), lower portion of sinus node (1), inferior portion of tricuspid annulus (1), and His area (1), respectively. In left AT, lateral portion near atrioventricular groove (2), inferoposterior portion (2) and near left atrial appendage (1) were successful site. During follow-up (mean 23 months), one patient had recurrence (recurrence rate 5.9%). RFCA for AT is an effective and curative treatment in selected cases.
Aortic Valve Stenosis ; Atrial Appendage ; Barotrauma ; Cardiomyopathies ; Catheter Ablation* ; Catheters ; Coronary Sinus ; Electric Stimulation ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Follow-Up Studies ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Pulmonary Valve Stenosis ; Recurrence ; Sinoatrial Node ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Thoracotomy ; Wolff-Parkinson-White Syndrome