Hans E. Luijten
Erasmus University Rotterdam
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Circulation | 1988
Pw Serruys; Hans E. Luijten; Kevin J. Beatt; R. Geuskens; P. J. De Feyter; M. van den Brand; Johan H. C. Reiber; H. J. Ten Katen; G. A. Van Es; Paul G. Hugenholtz
Data from experimental, clinical, and pathologic studies have suggested that the process of restenosis begins very early after coronary angioplasty. The present study was performed to determine prospectively the incidence of restenosis with use of the four National Heart, Lung, and Blood Institute and the 50% or greater diameter stenosis criteria, as well as a criterion based on a decrease of 0.72 mm or more in minimal luminal diameter. Patients were recatheterized at 30, 60, 90, or 120 days after successful percutaneous transluminal coronary angioplasty (PTCA). After PTCA all patients received 10 mg nifedipine three to six times a day and aspirin once a day until repeat angiography. Of 400 consecutive patients in whom PTCA was successful (less than 50% diameter stenosis), 342 underwent quantitative angiographic follow-up (86%) by use of an automated edge-detection technique. A wide variation in the incidence of restenosis was found dependent on the criterion applied. The incidence of restenosis proved to be progressive to at least the third month for all except NHLBI criterion II. At 4 months a further increase in the incidence of restenosis was observed when defined as a decrease of 0.72 mm or more in minimal luminal diameter, whereas the criteria based on percentage diameter stenosis showed a variable response. The lack of overlap between the different restenosis criteria applied affirms the arbitrary nature of angiographic definitions currently in use. Restenosis should be assessed by repeat angiography, and preferably ascertained according to the change in absolute quantitative measurements of the luminal diameter.
Journal of the American College of Cardiology | 1988
Kevin J. Beatt; Hans E. Luijten; Pim J. de Feyter; Marcel van den Brand; Johan H. C. Reiber; Patrick W. Serruys
To determine the changes in stenotic and nonstenotic segments of a dilated coronary artery, detailed quantitative angiographic measurements were performed in 342 patients (398 lesions) immediately after angioplasty and at a predetermined follow-up time of 30, 60, 90 or 120 days after the dilation. Measurements of the stenotic segments were expressed as minimal luminal diameter, and the adjacent nonstenotic segments were expressed as interpolated reference diameter (both in millimeters). A follow-up rate of 86% was achieved. In the patients followed up at 30 and 60 days, there was no significant change in either the mean minimal luminal diameter or the mean reference diameter. However, at 90 and 120 days, there was significant deterioration in both the mean minimal luminal diameter (-0.37 and -0.42 mm, respectively) and the mean reference diameter (-0.17 and -0.26 mm, respectively), all of the changes being highly significant (p less than 0.00001). The reference diameter is involved in the dilation process and may be subject to the same restenosis process that takes place in initially stenotic segments. Percent diameter stenosis measurements, which are conventionally used to express the change in the severity of a stenosis after angioplasty, will tend to underestimate the change when there is a simultaneous reduction in the reference diameter.
American Heart Journal | 1989
Otto Kamp; Kevin J. Beatt; Pim J. de Feyter; Marcel van den Brand; Harry Suryapranata; Hans E. Luijten; Patrick W. Serruys
The first 840 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) performed in the same institution were retrospectively assessed at an average follow-up period of 25 months after the initial procedure. The study population consisted of 506 patients with stable angina pectoris (group 1) and 334 patients with unstable angina pectoris (group 2). Clinical end points were death, nonfatal myocardial infarction, recurrent angina pectoris necessitating bypass surgery or repeat PTCA, and event-free survival. The two groups were comparable with respect to age, sex, previous myocardial infarction, ejection fraction, and number of diseased vessels. PTCA was successful in 83.0% of group 1 and 87.1% of group 2. Follow-up rates were expressed as events per attempted PTCA in a patient group. No difference in survival was observed between the two groups, the mortality rate being approximately 2.8% at 25 months. In the group with stable angina pectoris there was a lower incidence of nonfatal myocardial infarction within the first 24 hours after angioplasty; 4.3% vs 9.0% (p less than 0.01). During long-term follow-up the increase in the incidence of nonfatal myocardial infarction was similar, resulting in an overall long-term follow-up infarction rate of 8.3% and 14.2%, respectively (p less than 0.01). A higher event-free survival was observed in group 1 within 24 hours after PTCA: 93.7% vs 84.2% (p less than 0.01). During subsequent follow-up the difference in event-free survival between the two groups was no longer significant: 68.5% vs 61.2%.(ABSTRACT TRUNCATED AT 250 WORDS)
International Journal of Cardiac Imaging | 1988
Hans E. Luijten; Kevin J. Beatt; P. J. De Feyter; M. van den Brand; Johan H. C. Reiber; P. W. Serruys
SummaryCurrent evidence with regard to the possible association between clinical expression of coronary disease prior to the time of angioplasty, and the subsequent risk of restenosis following successful dilatation, remains inconclusive.To prospectively compare the incidence of restenosis in stable versus unstable angina pectoris patients, follow-up angiography was performed in 85 percent of patients from a consecutive series with a successful PTCA, irrespective of presence or absence of recurrent ischemic symptoms. Furthermore, changes in lesion severity were assessed quantitatively by an automated edge-detection technique rather than visual analysis. Employing such a study design and follow-up protocol, it was found that the incidence of restenosis in patients with stable coronary artery disease was similar to that of patients with unstable rest angina, irrespective of the type of angiographic definition used.
Archive | 1988
Kevin J. Beatt; Hans E. Luijten; Johan H. C. Reiber; Patrick W. Serruys
In order to determine the changes in stenotic lesions following coronary angioplasty, detailed quantitative angiographie measurements were performed in 254 patients (292 lesions) immediately post-angioplasty and then at one of three predetermined follow-up times, at 30, 60 or 90 days. The absolute changes in mm of the minimal lumen diameter were compared for the three groups, and a relatively high follow-up rate of 88% was achieved. In the groups of patients followed-up at 30 and 60 days, the response was variable with 6% of the lesions showing a significant improvement in both groups and 1% and 12% respectively, showing a deterioration. At 90 days no lesions were seen to improve with 23% deteriorating.
Journal of the American College of Cardiology | 1992
Kevin J. Beatt; Patrick W. Serruys; Hans E. Luijten; Benno J. Rensing; H. Suryapranata; Pim J. de Feyter; Marcel van den Brand; Gert Jan Laarman; Jos R.T.C. Roelandt; Gerrit Anne van Es
Clinical Science | 2002
Jaap J. Remmen; W.R.M. Aengevaeren; Freek W.A. Verheugt; Tjeerd van der Werf; Hans E. Luijten; Anja Bos; René W. M. M. Jansen
Journal of the American College of Cardiology | 1990
GertJan Laarman; Hans E. Luijten; Louis G.P.M. van Zeyl; Kevin J. Beatt; Jan G.P. Tijssen; Patrick W. Serruys; Pim J. de Feyter
European Heart Journal | 1988
P. W. Serruys; Hans E. Luijten; Kevin J. Beatt; C. Di Mario; P. J. De Feyter; Catherina E. Essed; J. R. T. C. Roelandt; M. van den Brand
Journal of the American College of Cardiology | 2002
Marc A. Brouwer; Paul J.P.C. van den Bergh; Peter C. Kievit; Wirn Rm. Aengevaeren; Gerrit Veen; Hans E. Luijten; Don P. Hertzberger; G.J.H. Uijen; Freek W.A. Verheugt