National Repository of Grey Literature 4 records found  Search took 0.01 seconds. 
Radial approach to coronary catheterizations and interventions
Bernat, Ivo ; Rokyta, Richard (advisor) ; Vojáček, Jan (referee) ; Ošťádal, Petr (referee)
Radial approach in coronary catheterizations and interventions has been only an alternative of the femoral approach. But due to some important advantages radial approach has a chance to become the first choice in majority of catheterized patients. The most important advantage is the reduction of vascular access site bleeding complications. Additonal benefits are patient satisfaction, cost reduction, shorter hospital stay and possibility of the same-day discharge catheterizations and interventions. The aim of our work was to try to answer three open questions: 1. is it possible to catheterize majority of our patients from the left radial artery when 90% of them are right-handed ? 2. what is the optimal care for the radial artery after the procedure in prevention and treatment of radial artery occlusion? 3. is it effective to implement radial approach in primary PCI as a first approach for STEMI patients? The first part relates the left radial approach. After construction of our special variable support for the left arm and forearm we succesfully used this approach in our studies in almost 90% of patients. The second part of this work contains our randomized trial comparing two different doses of unfractionated heparin in prevention of radial artery occlusion after diagnostic cardiac catheterizations....
The Metabolic Determinants of Central Arterial Stiffness
Karnosová, Petra ; Mlíková Seidlerová, Jitka (advisor) ; Bernat, Ivo (referee) ; Petrák, Ondřej (referee)
This dissertation demonstrates not only the classic hemodynamic and metabolic cardiovascular (CV) risk factors affecting arterial rigidity but also the soluble receptor for advanced glycation end-products (sRAGE) was studied. The stiffening of central arteries may precede the onset of manifest atherosclerosis, thus being a potential target for early prevention of cardiovascular disease. The actual guidelines of Czech society for hypertension recommend the measurement of aortic pulse wave velocity (aPWV) in hypertensive patients. The AGEs/RAGE complex participates in various stages of atherosclerosis/arterial stiffening. The soluble form of RAGE probably acts as a decoy for RAGE ligands and it is a naturally occurring inhibitor of toxic impact caused by AGE-RAGE action. It is suggested to be a potential marker of further chronic disease. This dissertation focuses on four publications investigating CV risk factors in two different population cohorts. We studied a random general population sample and offspring of patients with premature coronary heart disease sample compared to controls. In the general population we demonstrated that aPWV increased linearly with the rising numbers of individual metabolic syndrome risk factors (p for trend 0,0001). The levels of sRAGE were significantly positively...
Radial Approach in Therapy of Ischemic Heart Disease
Jirouš, Štěpán ; Bernat, Ivo (advisor) ; Toušek, Petr (referee) ; Hlinomaz, Oto (referee)
Presently, coronary catheterizations and interventions are more often performed by a radial artery approach than by a previously dominant femoral artery approach due to the lower incidence of both local and systemic complications. In addition, based on evidence of lower mortality associated with this approach, the radial approach has received class IA recommendation in the 2015 European Society of Cardiology (ESC) guidelines for interventional treatment of NSTEMI, in the 2017 ESC guidelines for STEMI and lately in the 2018 ESC guidelines for other forms of ischemic heart disease. Although a large number of studies concerning the radial approach have been published, many questions remain unanswered; for example, the evaluation of the radial approach in patients with myocardial infarction complicated with cardiogenic shock. The assessment of radial artery occlusion as the most frequent local complication of this approach has been very heterogeneous so far both in terms of different methods of detection that were used and timing of their application. Thus, there are still possibilities to further reduce the incidence of local complications and to optimize methodology of radial artery occlusion detection. In this dissertation thesis we address the issue of interventional treatment via radial artery access site...
Radial approach to coronary catheterizations and interventions
Bernat, Ivo ; Rokyta, Richard (advisor) ; Vojáček, Jan (referee) ; Ošťádal, Petr (referee)
Radial approach in coronary catheterizations and interventions has been only an alternative of the femoral approach. But due to some important advantages radial approach has a chance to become the first choice in majority of catheterized patients. The most important advantage is the reduction of vascular access site bleeding complications. Additonal benefits are patient satisfaction, cost reduction, shorter hospital stay and possibility of the same-day discharge catheterizations and interventions. The aim of our work was to try to answer three open questions: 1. is it possible to catheterize majority of our patients from the left radial artery when 90% of them are right-handed ? 2. what is the optimal care for the radial artery after the procedure in prevention and treatment of radial artery occlusion? 3. is it effective to implement radial approach in primary PCI as a first approach for STEMI patients? The first part relates the left radial approach. After construction of our special variable support for the left arm and forearm we succesfully used this approach in our studies in almost 90% of patients. The second part of this work contains our randomized trial comparing two different doses of unfractionated heparin in prevention of radial artery occlusion after diagnostic cardiac catheterizations....

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