A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right m... more A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right medium cerebral artery during elective coronary angiography. Complete patency was achieved after an intraarterial infusion of r t-PA (60mg/60min) with important functional improvement. Mulher de 56 anos, portadora de angina instavel, apresentou episodio tromboembolico agudo da arteria cerebral media direita, durante cinecoronariografia eletiva. A infusao intra-arterial do rt-PA, na dose de 60mg, durante 60min, promoveu recanalizacao da arteria com recuperacao do deficit neurologico.
To study anatomical limitation of coronary angioplasty, as alternative therapy in patients with m... more To study anatomical limitation of coronary angioplasty, as alternative therapy in patients with multivessel disease and submitted to bypass surgery. In 380 patients with multivessel disease and submitted to previous coronary bypass surgery, age ranged from 41 to 72 (average = 51) years, being 68% males. The following parameters were analyzed in the coronary arteriographies: anatomic aspects of the coronary arteries and distribution of the atherosclerotic stenosis. The patients were arranged in accordance to the criteria: complete revascularization, incomplete and no indication for coronary angioplasty. The patients were arranged in 3 different groups: I-80 (21%) patients included those in whom complete revascularization would be possible; II--55 (14.5%) patients in whom only incomplete revascularization but satisfactory would be possible and III--245 (65.5%) those patients in whom coronary angioplasty would no have indication. The data referind the patients of groups I and II were a...
A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right m... more A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right medium cerebral artery during elective coronary angiography. Complete patency was achieved after an intraarterial infusion of rt-PA (60mg/60min) with important functional improvement.
Congenital coronary arteriovenous fistulae are commonly associated with complications which inclu... more Congenital coronary arteriovenous fistulae are commonly associated with complications which include congestive heart failure, bacterial endocarditis, angina pectoris, secondary to "coronary steal" phenomenon and fistula rupture. Conventional treatment of large coronary arteriovenous fistulae is surgical ligation. In this report we describe the data and therapeutic approach of a patient with a severe coronary stenosis in a large diagonal branch in whom PTCA was successfully conducted, while, in this opportunity no embolization of the fistula was performed.
This case report concerns a 40-year-old patient with an unspecific abdominal pain, diarrhoea, a b... more This case report concerns a 40-year-old patient with an unspecific abdominal pain, diarrhoea, a big axillary mass and a previous pulmonary infection. After biopsy of the axillary mass the diagnosis of lymphoma was excluded based on the presence of cells expressing polyclonal antibodies. Abdominal CT scans and angionuclear magnetic resonance showed an extensive intestinal venous thrombosis. The patient also presented positive results for C and S proteins, lupic anticoagulant factor and antiphospholipid antibodies (anticardiolipin antibodies - IgM and IgG). Treatment started with administration of recombinant tissue plasminogen activator and heparin which decreased the degree of thrombosis. Antibiotics were also administrated to treat pulmonary and abdominal infections. After 25 days, he was discharged with no signs of infection, no abdominal pain and reduction of the thrombosis. He was medicated with warfarin, hydroxichloroquine and clopidogrel. Forty-five days after discharge, abdominal CT scan showed a significant regression of thrombosis.
To evaluate the indications, results and follow-up of patients with 80 years old and over, who ha... more To evaluate the indications, results and follow-up of patients with 80 years old and over, who had undergone percutaneous transluminal coronary angioplasty (PTCA). From July 1987 through July 1990, 36 patients, 80 years of age and over, had PTCA as an alternative method to treat coronary artery disease. Their age ranged from 80 to 85 (mean = 83) years. Twenty five were male. Significative obstruction was considered when 70% or more of the internal diameter was stenosed. Satisfactory results were achieved when reduction of 50% or more of the coronary artery obstruction was obtained. In 34 of 36 patients (94.4%), PTCA was successfully performed. Forty four of 46 coronary arteries were successfully dilated. One patient had acute coronary occlusion with acute myocardial infarction treated clinically. There were no emergency surgeries or early deaths. Clinical follow-up was obtained in 15 of the 34 patients. Four had repeated coronary arteriography (at 1, 3, 6 and 12 months after primary...
Sequential angiographic studies have shown that spontaneous reperfusion occurs in approximately 3... more Sequential angiographic studies have shown that spontaneous reperfusion occurs in approximately 30 to 40% of patients during evolving myocardial infarction. However, it is difficult to establish the effects of spontaneous reperfusion on left ventricular function. We report the case of a 65 year old woman with clinical features of acute myocardial infarction with early spontaneous reperfusion and complete recovery of ventricular function 1 year later.
A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right m... more A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right medium cerebral artery during elective coronary angiography. Complete patency was achieved after an intraarterial infusion of r t-PA (60mg/60min) with important functional improvement. Mulher de 56 anos, portadora de angina instavel, apresentou episodio tromboembolico agudo da arteria cerebral media direita, durante cinecoronariografia eletiva. A infusao intra-arterial do rt-PA, na dose de 60mg, durante 60min, promoveu recanalizacao da arteria com recuperacao do deficit neurologico.
To study anatomical limitation of coronary angioplasty, as alternative therapy in patients with m... more To study anatomical limitation of coronary angioplasty, as alternative therapy in patients with multivessel disease and submitted to bypass surgery. In 380 patients with multivessel disease and submitted to previous coronary bypass surgery, age ranged from 41 to 72 (average = 51) years, being 68% males. The following parameters were analyzed in the coronary arteriographies: anatomic aspects of the coronary arteries and distribution of the atherosclerotic stenosis. The patients were arranged in accordance to the criteria: complete revascularization, incomplete and no indication for coronary angioplasty. The patients were arranged in 3 different groups: I-80 (21%) patients included those in whom complete revascularization would be possible; II--55 (14.5%) patients in whom only incomplete revascularization but satisfactory would be possible and III--245 (65.5%) those patients in whom coronary angioplasty would no have indication. The data referind the patients of groups I and II were a...
A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right m... more A 56-year-old female with unstable angina, presented an acute embolic ischaemic stroke of right medium cerebral artery during elective coronary angiography. Complete patency was achieved after an intraarterial infusion of rt-PA (60mg/60min) with important functional improvement.
Congenital coronary arteriovenous fistulae are commonly associated with complications which inclu... more Congenital coronary arteriovenous fistulae are commonly associated with complications which include congestive heart failure, bacterial endocarditis, angina pectoris, secondary to "coronary steal" phenomenon and fistula rupture. Conventional treatment of large coronary arteriovenous fistulae is surgical ligation. In this report we describe the data and therapeutic approach of a patient with a severe coronary stenosis in a large diagonal branch in whom PTCA was successfully conducted, while, in this opportunity no embolization of the fistula was performed.
This case report concerns a 40-year-old patient with an unspecific abdominal pain, diarrhoea, a b... more This case report concerns a 40-year-old patient with an unspecific abdominal pain, diarrhoea, a big axillary mass and a previous pulmonary infection. After biopsy of the axillary mass the diagnosis of lymphoma was excluded based on the presence of cells expressing polyclonal antibodies. Abdominal CT scans and angionuclear magnetic resonance showed an extensive intestinal venous thrombosis. The patient also presented positive results for C and S proteins, lupic anticoagulant factor and antiphospholipid antibodies (anticardiolipin antibodies - IgM and IgG). Treatment started with administration of recombinant tissue plasminogen activator and heparin which decreased the degree of thrombosis. Antibiotics were also administrated to treat pulmonary and abdominal infections. After 25 days, he was discharged with no signs of infection, no abdominal pain and reduction of the thrombosis. He was medicated with warfarin, hydroxichloroquine and clopidogrel. Forty-five days after discharge, abdominal CT scan showed a significant regression of thrombosis.
To evaluate the indications, results and follow-up of patients with 80 years old and over, who ha... more To evaluate the indications, results and follow-up of patients with 80 years old and over, who had undergone percutaneous transluminal coronary angioplasty (PTCA). From July 1987 through July 1990, 36 patients, 80 years of age and over, had PTCA as an alternative method to treat coronary artery disease. Their age ranged from 80 to 85 (mean = 83) years. Twenty five were male. Significative obstruction was considered when 70% or more of the internal diameter was stenosed. Satisfactory results were achieved when reduction of 50% or more of the coronary artery obstruction was obtained. In 34 of 36 patients (94.4%), PTCA was successfully performed. Forty four of 46 coronary arteries were successfully dilated. One patient had acute coronary occlusion with acute myocardial infarction treated clinically. There were no emergency surgeries or early deaths. Clinical follow-up was obtained in 15 of the 34 patients. Four had repeated coronary arteriography (at 1, 3, 6 and 12 months after primary...
Sequential angiographic studies have shown that spontaneous reperfusion occurs in approximately 3... more Sequential angiographic studies have shown that spontaneous reperfusion occurs in approximately 30 to 40% of patients during evolving myocardial infarction. However, it is difficult to establish the effects of spontaneous reperfusion on left ventricular function. We report the case of a 65 year old woman with clinical features of acute myocardial infarction with early spontaneous reperfusion and complete recovery of ventricular function 1 year later.
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Papers by Elia Ascer