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Few diagnostic methods in Cardiology have heralded such revolutionary developments as the introduction of coronary arteriography. When, in the early 1960's, Dr. F. Mason Sones demonstrated that visualization of the coronary anatomy in living humans was not only feasible but sufficiently safe and reliable to be used as a clinical tool in the evaluation of patients with known or suspected ischemic heart disease, the thus far somewhat neglected area of coronary circulation became the focus of interest. Naturally, for a considerable period of time a great deal of emphasis was placed upon coronary anatomy. Simple relations between narrowing lesions, impediment to flow, and prognosis were assumed ...
In the past few years, the most exciting advances have occured in vascular diagnostics. First of all, well-established techniques like ultrasound have been further refined and developed (intravascular ultrasound). Furthermore, diagnostic investigations could be linked to treatment itself. More and more interventional techniques (the most popular is still percutaneous transluminary angioplasty - PTCA) have been introduced into daily routine. Radiologists and cardiologists are working more and more together, a fact which is reflected by the international group of experts bringing here the knowledge from both fields together for the first time.
This book provides a comprehensive, up-to-date summary of drug-coated balloon (DCB) technology and the role of DCBs in the treatment of coronary and peripheral arterial disease. In addition to clear explanation of how DCBs works, readers will find an enlightening analysis of the mistakes and successes of the past decade and the emergence of the latest delivery systems, which combine a more deliverable device with much improved drug delivery to the vessel wall. The full range of current applications of DCBs are reviewed in detail, drawing on the latest scientific evidence. Due attention is paid to newer devices, with provision of technical insights and documentation of the available clinical data. Ongoing research projects, remaining technical challenges, likely future directions, and reimbursement issues are also carefully considered. This book will be a useful tool for any interventional cardiologist, interventional radiologist, or vascular surgeon who wishes to acquire a deep knowledge of this technology and its application in both coronary and peripheral interventions.
Intravascular ultrasound imaging (IVUS) plays very important roles in clinical cardiology. This book describes the newest advances in vascular ultrasound imaging and the surrounding technologies for high frequency vascular ultrasound imaging. Most important topics of the book are technical applications of IVUS (elasticity imaging, chromaflow...) and the basic data (vibration, acoustic microscopy) that should provide very important information to understand clinical IVUS imaging.
Why a book on contrast echocardiography? Over the past dozen years enough experience has accumulated to warrant a more extensive treatment of this method. Furthermore, there are new developments that suggest increased clinical utility for contrast echocardiography in the future. This book aims to summarize the "state of the art" for those interested in echocardiography - presumably mainly cardiologists, but here and there those of a more technical bent will find useful information as well. We feel that a more basic understanding of microbubble dynamics is necessary to advance research for such applications as transmission through the lungs, videodensitometric quantitation of cardiac output, intracardiac shunts, etc. All of these topics are extensively dealt with. The reader will note that many of the clinical chapters are written by pediatric cardiologists. This is only natural, since shunt detection and analysis of flow relationships are relatively more important in congenital heart diseases, and cur rently represent the most important uses for contrast echo cardiography in day-to day practice.
Following the structure and format of the ESC core syllabus, this text introduces key concepts in the field of cardiovascular medicine.
First Published in 2004. Routledge is an imprint of Taylor & Francis, an informa company.
First Published in 2004. This is Volume I of six of a series on medical imaging systems techniques and applications. This subject area exemplifies a meaningful manifestation of the power of the technologies of the second industrial revolution. The first chapter in this volume on cardiovascular systems emphasizes the importance of accurate measurements of cardiac shape and dynamics as they reflect the scope of cardiac diseases, the major cause of mortality in developed countries today. Cardiac imaging plays an important role in this regard, and almost the only one in this clinical context.
The aim of this work is to give clinicians and interventionalists an overview of the use of cardiac imaging techniques in combination with modern interventional procedures such as thrombolysis, catheter-based coronary revascularization, valvuloplasty and interventions in congenital heart disease.
This book will consider several clinical and interventional topics for which there is uncertainty, continued debate and/or no consensus based on current guidelines. While there are numerous guidelines in cardiology, new and on-going trials that address new drugs treatments and procedures raise many unanswered questions. Furthermore, most practicing cardiologist taking care of the patients are likely unable to digest all of these studies or guidelines and necessarily correctly apply them to their patients. If one considers in the guidelines the frequent use of Level C (consensus), there are many areas or situations where no trial exists. Also, when applying the results of a trial to an individual patient, there can be uncertainty of how this patient should be managed based on the present body of evidence.