University of Graz

About: University of Graz is a education organization based out in Graz, Steiermark, Austria. It is known for research contribution in the topics: Population & Context (language use). The organization has 17934 authors who have published 37489 publications receiving 1110980 citations. The organization is also known as: Carolo Franciscea Graecensis & Karl Franzens Universität.

Inhibition of cyclic-3',5'-nucleotide-phosphodiesterase as a possible mode of action of papaverine and similarly acting drugs.

Abstract: The mechan i sm of smooth muscle r e l axa t ion b y "papaverinel ike" drugs is obscure. I n the guinea-pig t aen ia coli the r e l a x a n t effect of adrena l ine was associa ted with an increase in cyclic 3 ' , 5 ' -AMP (Bueding et al., 1966). Moore et al. (1968) r epor t ed t h a t the i soprena l ineinduced re i~xa t ion of the guinea-pig t rachea l chain was mimicked b y d ibu ty ry l 3 ' ,5 ' -AMP, bu t the l a t t e r effect in con t r a s t to t h a t of i soprenal ine was no t b locked b y propranolo l . Ev idence is p resen ted t h a t papave r ine and some other smooth muscle r e l axan t s are ve ry p o t e n t inh ib i tors of phosphodies te rase (PDE) , pa r t i cu l a r l y in co ronary a r te r ia l t issue. The effect of papave r ine on P D E was dose-dependen t and p receded the onset of mechanica l r e l axa t ion in circular s t r ips of co ronary ar ter ies , suggest ing t h a t the r e l a x a n t effect of papaver ine l ike drugs on smooth muscle is due to the i r i nh ib i to ry ac t ion on P D E , and m e d i a t e d by accumula t ed 3 ' ,5 ' -AMP.

Guiding Principles for Chronic Total Occlusion Percutaneous Coronary Intervention: A Global Expert Consensus Document

Abstract: Outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have improved because of advancements in equipment and techniques. With global collaboration and knowledge sharing, we have identified 7 common principles that are widely accepted as best practices for CTO-PCI. 1. Ischemic symptom improvement is the primary indication for CTO-PCI. 2. Dual coronary angiography and in-depth and structured review of the angiogram (and, if available, coronary computed tomography angiography) are key for planning and safely performing CTO-PCI. 3. Use of a microcatheter is essential for optimal guidewire manipulation and exchanges. 4. Antegrade wiring, antegrade dissection and reentry, and the retrograde approach are all complementary and necessary crossing strategies. Antegrade wiring is the most common initial technique, whereas retrograde and antegrade dissection and reentry are often required for more complex CTOs. 5. If the initially selected crossing strategy fails, efficient change to an alternative crossing technique increases the likelihood of eventual PCI success, shortens procedure time, and lowers radiation and contrast use. 6. Specific CTO-PCI expertise and volume and the availability of specialized equipment will increase the likelihood of crossing success and facilitate prevention and management of complications, such as perforation. 7. Meticulous attention to lesion preparation and stenting technique, often requiring intracoronary imaging, is required to ensure optimum stent expansion and minimize the risk of short- and long-term adverse events. These principles have been widely adopted by experienced CTO-PCI operators and centers currently achieving high success and acceptable complication rates. Outcomes are less optimal at less experienced centers, highlighting the need for broader adoption of the aforementioned 7 guiding principles along with the development of additional simple and safe CTO crossing and revascularization strategies through ongoing research, education, and training.