Objective To assess the feasibility of coronary angiography by transradial approach with 4 F catheter.Methods The procedural details, picture quality and local complication of coronary angiography by transradial approach with 4 F catheter in 138 patients were recorded and analyzed. Results The success rate of angiography was 97.7%. Mean fluoroscopy time was 5.05?3.23 minutes with total procedural time was 20.51?3.37 minutes. The incidence of dislodgement and excessive engagement of either coronary artery was 7.8% and 9.4% repectively. The angiographic scores for left anterior descending, circumflex and right coronary arteries were 2.87?0.40, 2.88?0.39, 2.90?0.35, respectively. Vasospasm occurred in 6 cases in the radial artery and in another 2 cases in the coronary artery. There were no occlusion of radial artery found during follow up. Conclusion Four-F catheter could be utilized in selected patients for its nice maneuverability, fine images and less vascular complications during angiography.

Objective To evaluate the changes of QT dispersion (QTd) after successful percutaneous transluminal coronary angioplasty (PTCA) or stent implantation during the recovery period after acute myocardial infarction (AMI).Methods We studied 57 AMI patients who underwent PTCA or stent implantation and 86 normal coronary artery subjects used as control. Maximal and minimal QT interval (QT max and QT min) and QTd (QTd=QT max-QT min) were measured using 12-lead electrocardiography within 1 d before and 1 h after PTCA and stent implantation or coronary angiography.Results QTd and corrected QT dispersion (QTcd) were significantly prolonged in patients with AMI compared with control group. There was no significant difference in QTd and QTcd between anterior AMI and inferior one. QT max, QTc max, QTd and QTcd after PTCA or stent implantation were significantly decreased.Conclusion QTd and QTcd were significantly decreased after successful PTCA or stent implantation which were performed during the recovery period of AMI, which shows it can produce beneficial effects in decreasing the risk of ventricular arrhythmia and reducing mortality in AMI patients.

ObjectiveTo evaluate the clinical results of intracoronary implantation of the phosphorylcholine dexamethasone coated biodivysio small coronary stents. Methods Prospective analyses of long-term results of the phosphorylcholine dexamethasone coated biodivysio coronary stents, and their implantation performed on 82 coronary artery disease patients were conducted. We implanted 106 stents of which 54 were the phosphorylcholine dexamethasone coated biodivysio coronary stents, and 52 the phosphorylcholine coated biodivysio coronary stents. Results The success rate of the implantation of both groups was 100%. The major adverse cardiac events (MACE) of the 3-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group were 9.8%; and in the phosphorylcholine coated biodivysio coronary stents group were 22.0%. The restenosis rate of the 8-month follow-up in the phosphorylcholine dexamethasone coated biodivysio coronary stents group was 4.9%; and in the phosphorylcholine coated biodivysio coronary stents group was 23.0%. Conclusion The implantation of the phosphorylcholine dexamethasone coated biodivysio coronary stents is a safe and efficient interventional procedure with a high success rate and few MACE. It may reduce restenosis rate.

75 yrs), presence of DM etc. (2) In our study, even though the door-to-ballon time was longer than the door-to-needle time, the therapentic outcome of primary PCI was better than that of thrombolysis. (3) There are improving room for guidelines application of reperfusions such as fibrinolytic and primary PCI, aspirin, ACEI, ?-blockers and cholesterol lowering agents in patients with acute ST segment elevation myocardial infarction in China.

Objective To sbserve the effect of sirolimus-eluting stent in actual clinical practice. Methods The study included 263 patients who had implanted the cypher stents from December 2002 to May 2004. The incidence of MACE was followed up in all patients 8?2 months after stent implantation by means of telephone or out-patient department visit. Evaluation of the therapeutic effect was also made in the diabetes subgroup and different types of lesions, including left main, bifurcation, chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and just A-type lesions. The rate of restenosis was observed in all of the lesion. Results Among 246 patients, all patients were successfully implanted with the cypher stents, 93.5% patients had been followed up, 10 (3.8%) patients had MACE. 139 (52.6%) patient were revised by angiography. The total rate of restenosis was 10.1%, and among it 12.9% was diabetes mellitus patients, 11.1% with chronic total occlusion, 11.3% with little vessel lesion, 10.0% with diffuse lesion, 22.2% with left main lesion, 18.1% with bifurcation, 11.1 with CTO 9.1% with ostial lesions, and 8.7% with A-type lesion lesion. Conclusion Cypher stent implantion was safe and effective in actual clinical proctice. The incidence rate of MACE was low in lesions such as chronic total occlusion, diffuse disease, in-stent restenosis, littlie vessel, acute occlusion, ostial lesions, and A-type lesion. It may be beneficial for patients who had left main, bifurcation, in-stent restenosis.

Objective To study the difference in fibrinogen and D-dimer between the patients with ST-ele-vation myocardial infarction (STEMI) and those with normal angiography of coronary artery.Methods 100 patients with STEMI who underwent PCI and 100 patients with normal coronary arteriograms as controls from Jan.2005 to Dec.2007 were studied.Plasma concentrations of fibrinogen and D-dimer were compared.Results There was no significant difference in gender, age, history of hypertension and diabetes and smoking between the two groups.Plas-ma concentration of fbfinogen(Fg) was higher in control group [(2.65±0.68 )g/L ] than STEMI group [(2.38±0.91)g/L] (P<0.05).The square root of plasma concentration of D-dimer was higher in STEMI group [(13.23±5.08) μg/L] than control group [(9.40±5.03)μg/L ] (P<0.01).The square root of the rate between D-dimer and fibrinogen was higher in STEMI group (9.11±4.13 ) than control group (5.92±3.35 ) (P<0.01).Conclusion The levels of fibrinogen in patients with STEMI are significantly lower than that of control group, and D-dimer is higher in the former group than in the latter group, suggesting that fresh thrombosis and secondary fibrinolysis exit in STEMI patients at the acute stage.

Objective To investigate the clinic characteristics and treatment methods of coronary ectasia. Methods One hundred and fifty-four cases in Anzhen hospital during the last 10 years, whom with coronary aneurysm diagnosed by coronary artery angiogram and summarized the characteristics of symptom, sign, diagnosis and treatment. Results All patients were proved with coronary angiography. There were 112(72.7%)patients presenting angina, but with no specific manifestation in electrocardiogram, X-ray and echocardiogram.Thrombolysis in emergency were taken to 3 cases with acute myocardial infarction patients. One hundred and fifty-four cases were treated with aspirin or heparinizeation, and with nitroglycerin, Calcium channel blocker to dilate vessel. The followed up of 154 cases about 1-20 years, six cases were suffered with acute myocardial infarction. One of the 6 cases was reinfarction and one case was sudden death. Conclusions Angina is the main clinical manifestation and coronary angiography is the accurate diagnostic method. Long-term application with anticoagulant agent and vasodilator should be done to prevent coronary spasm and myocardial infarction. If acute myocardial infarction occurs, prompt thrombolysis should be used, if it is ineffective, coronary artery bypass grafting should be carried out.

Objective To explore the safety, efficacy and 1-year follow-up outcome of radiofrequency ablation combined with magnetic navigation assistance system in elderly patients with atrioventricular node reentrant tachycardia (AVNRT). Methods Forty cases of patients with AVNRT identified by the electrophysiological test were enrolled in the study. Twenty cases were ablated with magnetic navigation system. The other 20 cases underwent the conventional catheters operation. With the cardiodrive, the 8 Frablation magnetic Helios I (Stereotaxis Inc, USA) was advanced to the Koch triangle area from the inferior caval vein (IVC). With the assistance of magnetic navigation (AXIOM Artis, Siemens, Germany), the direction of tip and the advancement or retraction of the catheters were regulated. The success rate, the time of procedure, the fluoroscopy time and the 1-year follow-up outcome were analyzed, and the complications of procedure were recorded. Results Forty cases with AVNRT underwent radiofrequency ablation successfully. In magnetic navigation group, 19/20 cases underwent magnetic catheter operation. The cases who failed to finish magnetic catheter operation underwent successfully conventional catheter operation. There was no perforation complication and no significant statistic difference in the success rate between two groups. No recurring case was found in the two groups 1 year later. The total of fluoroscopy time in magnetic navigation group was more than that in standard ablation group [(16.4±2.7) min vs. (11.1±1.0)rain, P<0.01], but the decreasing trend of fluoroscopy time in magnetic navigation group was showed. The operator's fluoroscopy time in magnetic navigation group was obviously less than that in standard ablation group [(4.5±0.6) min vs. (11.1±1.0) min, P<0.01]. Conclusions The radiofrequeney ablation combining with magnetic navigation system has the similar safety and efficacy to the conventional ablation in elderly patients with AVNRT, but the operator's fluoroscopy time was significantly decreased.

Objective To evaluate the acute and long-term results of stenting for left main coronary artery (LMCA) bifurcation lesions. Methods Forty consecutive patients with LMCA bifurcation lesion and normal left ventricular function were included. Sirolimus-eluting stents were performed in all patients. Results (1)The average diameter of LMCA was (0.81?0.48)mm before stenting and increased to (3.53?0.22)mm after stenting.(2)The procedural success rate was 100.0%. In-hospital events including stent thrombosis,Q-wave myocardial infarction,and emergency bypass surgery did not occur in any patients,and non-Q-wave MI in one patient (2.5%).(3)Clinical follow-up was obtained in all patients at (8.43?3.24) months. There were no death and no myocardial infarction during follow-up. The major adverse cardis events rate was 20.0%.(4)The angiographic follow-up rate was 67.5% (27 of the 40 eligible patients),and the restenosis rate was 18.5% (parent vessel only 11.1%,side branch only 3.7%,and both 3.7%).(5)Different type of operation had no influence on restenosis rate during angiographic follow-up. Conclusion Sirolimus-eluting stent implantation for LMCA bifurcation stenosis appears safe and effective with regard to acute and midterm complications.

Objective To evaluate the effect of different regimens of antiplatelet drugs on the major adverse cardiac events (MACEs) in elderly patients undergoing selected percutaneous coronary intervention (PCI) in direction of the adenosine diphosphate (ADP) -induced platelet aggregation index. Methods The 1230 cases aged 60-80 years, mean (67. 2±10. 2) years undergoing selected PCI with the drug eluting stent were enrolled. The 615 cases of the ADP guided group according to the ADP-induced platelet aggregation index. After the first loading dose of clopidogrel (300 mg) , once the decrease of ADP-induced platelet aggregation index was more than 50% as compared with the basic level, the dose of 75 mg each day would be maintained for one year. If the decrease of the index was less than 50%. the another 300 mg of clopidogrel would be given again, until up to 900 mg on the 3th day. If the decrease of the index was still not enough, the combination of clopidogrel 75 mg, cilostazol 100 mg and aspirin 100 mg each day would be suggested. The rest 615 patients in the routine dosage group took the routine dose of clopidogrel (the first loading dosage 300 mg was taken, then 75 mg each day for one year ) . The MACEs, including cardiac death, myocardium infarction, revascularization and stent thrombosis, were observed for 12 months. Results After the first 300 mg of clopidogrel, only 45% of patients reached the standards. Until reaching 900 mg, 67.5% of patients in the ADP guided group were eligible. The tailored clopidogrel loading dose in the ADP guided group yielded a better effect on the inhibition of platelet aggregation (the routine dose vs. the tailored loading dose: 45% vs. 67. 5% , P=0. 028). After one year follow up, the MACEs were less in ADP guided group than in routine dosage group (2. 8% vs. 4. 9% , P = 0. 035). All of patients had no major bleeding, and the minor bleeding and other drug adverse events in two groups had no significant differences. Conclusions The patients undergoing selected PCI should receive ADP -induced platelet aggregation test in order to assess the inhibition effect of clopidogrel on the platelet aggregation. It is safe and effective to modify the antiplatelet drugs regimen during the peri-PCI procedure in direction of ADP-induced platelet aggregation.