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Journal of Invasive Cardiology

Peter Tajti, Aris Karatasakis, Barbara A Danek, Khaldoon Alaswad, Dimitri Karmpaliotis, Farouc A Jaffer, James W Choi, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, M Nicholas Burke, Oleg Krestyaninov, Dmitrii Khelimskii, Catalin Toma, Anthony H Doing, Barry Uretsky, Michalis Koutouzis, Ioannis Tsiafoutis, R Michael Wyman, Santiago Garcia, Elizabeth Holper, Iosif Xenogiannis, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². RESULTS: Compared with patients without CKD (n = 1444; 73%), patients with CKD (n = 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity...
September 15, 2018: Journal of Invasive Cardiology
Christopher Reiff, Sergey Gurevich, Stefan Bertog, Paul Sorajja, Rosemary Kelly, Santiago Garcia
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) transcatheter valve therapy (TVT) transcatheter aortic valve replacement (TAVR) score was developed to predict in-hospital mortality in patients undergoing commercial TAVR in the United States. Veterans Affairs (VA) hospitals are not included in the TVT registry. METHODS: The STS/ACC TVT-TAVR score was estimated in 195 veterans undergoing TAVR from 2015-2017. Discrimination was estimated by calculating the area under the receiver operating characteristics curve (AUC) for two outcomes of interest: in-hospital and 30-day mortality...
September 15, 2018: Journal of Invasive Cardiology
Michael Megaly, Michael Rofael, Marwan Saad, Mehdi Shishehbor, Emmanouil S Brilakis
BACKGROUND: Treating coronary bifurcations remains limited by technical difficulties and suboptimal long-term outcomes, often affecting the side branch (SB). Drug-coated balloon (DCB) in SB treatment could reduce neointimal hyperplasia and the risk for restenosis. METHODS: We performed a systematic review of all studies published between January 2000 and February 2018 reporting the outcomes of DCB vs non-coated balloon angioplasty (BA) in the treatment of the SB in coronary bifurcation lesions...
September 15, 2018: Journal of Invasive Cardiology
Michael Schulte-Hermes, Oliver Klein-Wiele, Marc Vorpahl, Melchior Seyfarth
AIMS: Transradial access (TRA) has become a standard approach for cardiac catheterization. However, an obstacle to TRA is the risk of radial artery occlusion (RAO) after radial access in about 5%-10% of patients. We analyzed the safety and efficacy of getting vascular access after RAO by percutaneous transluminal angioplasty in cases of chronic radial occlusion. METHODS AND RESULTS: Chronic RAO was confirmed by Allen test and color Doppler in 8 patients. TRA was achieved by puncture in the distal tabatiere (anatomical snuffbox) using Seldinger's technique followed by insertion of a 5 Fr radial introducer sheath...
August 15, 2018: Journal of Invasive Cardiology
Shuangbo Liu, Mali Worme, Bobby Yanagawa, Naresh Kumar, Christopher E Buller, Asim N Cheema, Akshay Bagai
OBJECTIVE: To evaluate the efficacy of drug-coated balloon (DEB) for the treatment of drug-eluting stent (DES) in-stent restenosis (ISR). METHODS: A comprehensive literature search was performed. The primary outcome was the composite of death, myocardial infarction (MI), and target-lesion revascularization (TLR) at longest available follow-up (range, 12-36 months). Outcomes for DEB vs balloon angioplasty (BA) and DEB vs DES were analyzed separately using a random-effect Mantel-Haenszel model, as per an a priori protocol...
August 15, 2018: Journal of Invasive Cardiology
Wallace W K Chow, Rong Bing, Juliana Kanawati, Jerrett Lau, Javed Sheriff, Mario D'Souza, David Brieger
INTRODUCTION: Radial access for diagnostic coronary angiography (CAG) has gained traction in recent years over the femoral artery approach, but difference in image quality has not been extensively studied. This study aims to compare image quality and diagnostic value in radial vs femoral access in patients undergoing invasive CAG. METHODS: This is a retrospective study of 200 patients (100 radial and 100 femoral) undergoing CAG at an experienced center from 2014 to 2015...
August 15, 2018: Journal of Invasive Cardiology
Giovanni Lorenzoni, Pierluigi Merella, Graziana Viola, Nicola Marziliano, Gavino Casu
Our image shows an impressive "honeycomb" pattern of neoatherosclerosis in the context of very late in-stent restenosis. In this case, OCT excluded the most common mechanisms of late in-stent restenosis, underlying the complexity of this unpredictable disease.
September 2018: Journal of Invasive Cardiology
Khawaja Afzal Ammar, Tanvir Bajwa, Suhail Q Allaqaband, Anthony DeFranco
A case of a 56-year-old woman with normal coronaries displays the side-to-side motion of the unengaged catheter followed by the rhythmic up-and-down, piston-like movements of the catheter tip after engagement.
September 2018: Journal of Invasive Cardiology
Brody D Slostad, Chance M Witt, Thomas A Foley
Coronary artery anomalies are relatively rare (approximately 1% on CTA). We present two exceedingly rare cases, as well as the first reported case of anomalous retro-aortic coronary arteries diagnosed with cardiac CTA and angiography.
September 2018: Journal of Invasive Cardiology
Chak-Yu So, Kun-Chong Tam, Yat-Yin Lam, Alex Pui-Wai Lee
A 72-year-old woman with severe mitral and tricuspid regurgitation secondary to chronic atrial fibrillation presented with refractory heart failure despite optimal medical treatment. She was considered inoperable, and thus underwent transcatheter edge-to-edge repair of both valves using the MitraClip system as a compassionate use.
September 2018: Journal of Invasive Cardiology
Francisco Ujueta, Jeffrey S Berger, Nathaniel Smilowitz
Each year, more than 300 million patients worldwide undergo non-cardiac surgery. Perioperative myocardial infarction (MI) is a common cardiovascular complication of surgery; thus, we sought to determine coronary artery anatomy in patients referred for coronary angiography for the evaluation of perioperative MI after non-cardiac surgery.
September 2018: Journal of Invasive Cardiology
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No abstract text is available yet for this article.
September 2018: Journal of Invasive Cardiology
Kintur A Sanghvi, Joseph Kusick, Courtney Krathen
OBJECTIVE: We studied the safety and efficacy of tibio-pedal access (TPA) as the sole primary access (ie, the "pedal-first" strategy) for revascularization of peripheral artery disease (PAD). METHODS: We reviewed a prospectively maintained database of patients where TPA was used as a primary access for retrograde diagnostic angiography and intervention. Patients suffering from symptomatic PAD and abnormal non-invasive testing were treated with the intention of using only ipsilateral TPA if there was antegrade flow in one of the three run-off vessels on ultrasound (US)...
September 2018: Journal of Invasive Cardiology
Kazunori Horie, Norio Tada, Tsuyoshi Isawa, Takashi Matsumoto, Masataka Taguri, Shigeaki Kato, Taku Honda, Tatsushi Ootomo, Naoto Inoue
OBJECTIVES: The optimal primary transradial intervention (TRI) technique has not been established in non-ST segment elevation acute coronary syndrome (NSTEACS) patients, because they often, but not always, undergo immediate revascularization after coronary angiography (CAG). Moreover, TRI failure has been reported in 5%-10% of cases. We investigated whether a newly designed strategy of immediate TRI using one sheathless hydrophilic-coated guiding catheter (SH-GC) after diagnostic CAG with one 4...
September 2018: Journal of Invasive Cardiology
Stefan Toggweiler, Alfredo G Cerillo, Won K Kim, Patric Biaggi, Clinton Lloyd, Michael Hilker, Yaron Almagor, Florim Cuculi, Miriam Brinkert, Richard Kobza, Olivier Muller, Andreas Rück, Roberto Corti
OBJECTIVES: We report an international experience of transfemoral transcatheter aortic valve replacement (TAVR) using the self-expanding Acurate neo valve (Boston Scientific) in aortic regurgitation. METHODS: This series comprises 20 patients with pure aortic regurgitation undergoing transfemoral TAVR with the Acurate neo prosthesis at nine centers in Europe and Israel. RESULTS: Mean age was 79 ± 8 years and mean STS score was 8.3 ± 9.3%...
September 2018: Journal of Invasive Cardiology
Benoit Lattuca, David Belardi, Christophe Demattei, Laurent Schmutz, Luc Cornillet, Bertrand Ledermann, Jean-Christophe Macia, Anaïs Iemmi, Richard Gervasoni, François Roubille, Thien Tri Cung, Pierre Robert, Patrick Messner-Pellenc, Florence Leclercq, Guillaume Cayla
OBJECTIVES: Recent studies have challenged systematic pretreatment with a P2Y12 inhibitor before percutaneous coronary intervention (PCI) in elective and non-ST segment elevation myocardial infarction (NSTEMI) patients. The aim of this study was to assess outcomes after performing PCI immediately after coronary angiography with an exclusive "on-the-table" P2Y12 inhibitor loading dose, by evaluating ischemic and bleeding complications in unselected patients. METHODS: Consecutive patients admitted for elective PCI or NSTEMI were included in this two-center, prospective, observational study, and received a P2Y12 inhibitor after coronary angiography when PCI was decided...
September 2018: Journal of Invasive Cardiology
Sandeep Basavarajaiah, Adam Brown, Toru Naganuma, Parag Gajendragadkar, Liam McCormick, Nick West
BACKGROUND: Use of the radial approach for PCI procedures is increasing due to lower rates of access-site complications/bleeding, and patient preference. However, femoral operators switching may be discouraged by the learning curve and by anatomical issues that may complicate the procedure. We aimed to define the frequency of anatomic variants and success rates during transradial access for PCI. METHODS: We retrospectively analyzed 2588 cases of PCI attempted by the radial route; radial/brachial and subclavian angiography was performed when obstructions were encountered...
September 2018: Journal of Invasive Cardiology
Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
September 2018: Journal of Invasive Cardiology
Brody D Slostad, Chance M Witt, Abdallah El Sabbagh, Thomas A Foley
Imaging series highlighting echocardiographic findings associated with the retroaortic anomalous coronary sign and its utility as a non-invasive modality to recognize technically complex and high-risk retroaortic coronary anomalies prior to intervention.
August 2018: Journal of Invasive Cardiology
Rupert Williams, Genevieve Shouls, Sami Firoozi
The importance of selective coronary angiography in patients with severely dilated aortas awaiting surgery is discussed.
August 2018: Journal of Invasive Cardiology
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