James C.S. Spratt

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OBJECTIVE The aim of this study was to determine the reproducibility of pulse wave velocity (PWV) and augmentation index (AIx) measured using pulse wave analysis (PWA), prior to its use in large-scale clinical trials. METHODS Arterial pressure waveforms were recorded and analysed using an established technique (Sphygmocor). Subjects with and without a(More)
BACKGROUND Chronic total occlusion (CTO) is common, being reported in 18% to 30% of patients undergoing coronary angiography. Percutaneous coronary intervention (PCI) is usually performed to relieve anginal symptoms, but data are emerging to suggest that there may also be a mortality benefit. OBJECTIVES This study aimed to compare outcomes of patients(More)
OBJECTIVE To investigate the potential differential effects of selective endothelin (ET) A and dual ET-A/B receptor blockade in patients with chronic heart failure. METHODS Nine patients with chronic heart failure (New York Heart Association class II-III) each received intravenous infusions of BQ-123 alone (selective ET-A blockade) and combined BQ-123 and(More)
Endothelin blocking drugs have vasodilator effects mediated at least in part via the nitric oxide system. Hypercholesterolaemia is associated with vascular dysfunction manifest as impaired nitric oxide-mediated vasodilatation and arterial stiffness. Treatment with HMG CoA reductase inhibitors (statins) has proven mortality benefits in a range of patient(More)
1. The effect on systemic haemodynamics of BQ-123, a selective endothelin A (ETA) receptor antagonist, was investigated in healthy men by giving, on separate occasions, ascending intravenous doses of 100, 300, 1000 and 3000 nmol min(-1) BQ-123, each for 15 min, in a randomized, placebo-controlled, double-blind study. The response of forearm blood flow to(More)
There is substantial evidence that recanalization of a chronic total occlusion is beneficial; nonetheless, it is generally underutilized in clinical practice. We consider the Aesop's fable of the "Fox and the Grapes" as analogous to the current situation in interventional cardiology. The technical challenges in achieving CTO recanalization has led(More)
AIMS Chronic total occlusions (CTO) secondary to in-stent restenosis (ISR) represent challenging lesions with low PCI success rates. The CrossBoss is an over-the-wire blunt catheter which has emerged as a useful tool in occlusive ISR. We aimed to review the utility of this device in the treatment of occlusive ISR within the United Kingdom. METHODS AND(More)
Successful revascularisation of chronic total occlusions (CTOs) remains one of the greatest challenges in the era of contemporary percutaneous coronary intervention (PCI). Such lesions are encountered with increasing frequency in current clinical practice. A predictable increase in the future burden of CTO management can be anticipated given the ageing(More)
The hybrid approach to percutaneous treatment of chronic total occlusion (CTO) of coronary arteries requires both antegrade and retrograde skillsets. In the retrograde approach, wire externalization through the antegrade guide catheter often requires the use of a short donor guide catheter and a long (>150 cm) micro-catheter. Despite this there are(More)