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Cardiovascular Revascularization Medicine: Including Molecular Interventions

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https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#1
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28214140/a-review-of-strategies-for-infarct-size-reduction-during-acute-myocardial-infarction
#2
REVIEW
Yasir Parviz, Sethumadhavan Vijayan, Shahar Lavi
Advances in medical and interventional therapy over the last few decades have revolutionized the treatment of acute myocardial infarction. Despite the ability to restore epicardial coronary artery patency promptly through percutaneous coronary intervention, tissue level damage may continue. The reported 30-day mortality after all acute coronary syndromes is 2 to 3%, and around 5% following myocardial infarction. Post-infarct complications such as heart failure continue to be a major contributor to cardiovascular morbidity and mortality...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28216229/trans-ulnar-catheterization-and-coronary-interventions-from-technique-to-outcomes
#3
REVIEW
Sudhakar Sattur, Maninder Singh, Edo Kaluski
The ulnar artery is similar in size to the radial artery, however it is more difficult to palpate and access. For those physicians who mastered trans-ulnar access (TUA) this access site serves as an alternative to trans radial access (TRA) when the radial artery access is rendered suboptimal (by palpation, ultrasound examination or previous procedural records) or when encountering TRA difficulties or failure. The manuscript describes the anatomy, suggested technique, procedural success and complications associated with TUA...
February 1, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28162989/orbital-atherectomy-for-treating-de-novo-severely-calcified-coronary-lesions-3-year-results-of-the-pivotal-orbit-ii-trial
#4
Michael Lee, Philippe Généreux, Richard Shlofmitz, Daniel Phillipson, Bynthia M Anose, Brad J Martinsen, Stevan I Himmelstein, Jeff W Chambers
BACKGROUND/PURPOSE: The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc...
January 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28162988/drug-coated-balloon-angioplasty-for-subclavian-artery-stenosis-a-potential-novel-indication
#5
Derar Albashaireh, Georges Khoueiry, Owen Mogabgab, Qusay Saleh, Michael Foster, Nidal Abi Rafeh
Subclavian artery stenosis is associated with increased cardiovascular disease mortality. It remains an important treatable cause of upper extremity, brain and cardiac ischemia. Endovascular treatment with angioplasty and stenting has become the preferred modality of treatment. Surgical revascularization is reserved for difficult cases with unfavorable anatomy to endovascular approach. Here we describe a case of subclavian artery stenosis causing subclavian steal syndrome with unfavorable anatomy to stenting treated successfully with drug coated balloon angioplasty with maintenance of patency at 6months...
January 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28131744/troponin-i-elevation-and-all-cause-mortality-after-elective-percutaneous-coronary-interventions
#6
Roberto Muniz Ferreira, Nelson Albuquerque de Souza E Silva, Lúcia Helena Alvares Salis, Rafael Ramos Mendes da Silva, Paula Dias Maia, Lucas Felipe Bastos Horta, Eliene Ferreira Salles, Henrique Moraes Pinto Nunes, Joana Beatriz Moutinho de Oliveira, Yasminne Pascoal de Sousa Domingues, Clarissa Castrighini Macedo de Sousa
BACKGROUND/PURPOSE: Although troponin I (TnI) elevation and myocardial injury after percutaneous coronary interventions (PCI) are frequent findings, their prognoses remain controversial. We aimed to determine the association between any or ≥5 times TnI elevation after elective PCI and subsequent one year mortality rates and long term survival. METHODS: Consecutive patients admitted for elective PCI between January 2013 and December 2014 were retrospectively analyzed by chart review in two hospitals in Rio de Janeiro...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28122689/prolonged-left-ventricular-unloading-prior-to-revascularization-in-cardiogenic-shock-associated-with-complete-ventricular-recovery
#7
Praneet Mylavarapu, Ehtisham Mahmud, Mitul P Patel
The use of percutaneous mechanical circulatory support (MCS) in high-risk coronary intervention and cardiogenic shock is associated with improved ability to obtain complete revascularization. However, whether prolonged left ventricular unloading and mechanical circulatory support prior to coronary revascularization in acute myocardial infarct patients improves outcomes is unclear. We report a case in which a patient with acute anterior myocardial infarction and cardiogenic shock received prolonged left ventricular mechanical unloading for 24h prior to revascularization, and ultimately this resulted in a limited myocardial infarct and complete restoration of left ventricular function...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28119045/cardiac-resynchronization-therapy-before-and-after-mitraclip-implantation-an-advantageous-upgrading-to-reduce-mitral-regurgitation
#8
Francesco Versaci, Giampiero Vizzari, Domenico Sergi, Antonio Trivisonno, Giuseppe Andò, Stefano Nardi, Gian Paolo Ussia, Francesco Romeo
MitraClip therapy has been proposed as therapeutic option in selected patients with degenerative or functional mitral regurgitation (FMR), leading to clinical and prognostic benefits. Previous studies demonstrated the safety and the efficacy of MitraClip therapy on symptoms and left ventricular remodeling in cardiac resynchronization therapy (CRT) non-responder patients. We report a case of a CRT non-responder patient treated with MitraClip implantation followed by a new upgrading of the CRT for persistent FMR at the follow-up...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#9
REVIEW
Yohei Numasawa, Kenichi Sakakura, Kei Yamamoto, Shingo Yamamoto, Yousuke Taniguchi, Hideo Fujita, Shin-Ichi Momomura
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28119043/current-practice-of-transradial-approach-for-coronary-procedures-a-survey-by-the-italian-society-of-interventional-cardiology-sici-gise-and-the-italian-radial-club
#10
Stefano Rigattieri, Orazio Valsecchi, Alessandro Sciahbasi, Francesco Tomassini, Ugo Limbruno, Alfredo Marchese, Alessio La Manna, Ciro Mauro, Ferdinando Varbella, Segio Berti, Fabio F Tarantino, Giuseppe Musumeci
BACKGROUND: Transradial approach (TRA) for percutaneous coronary procedures is associated with improved patient outcome and is being increasingly adopted worldwide. We surveyed Italian interventional cardiologists in order to take a snapshot of the current practice of TRA. METHODS: A web-based questionnaire was emailed to all members of the Italian Society of Interventional Cardiology. RESULTS: The survey was taken by 508 respondents. Cardiogenic shock and chronic total occlusions represented the principal limitations to TRA...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28108202/evaluation-of-coronary-flow-conditions-in-complex-coronary-artery-bifurcations-stenting-using-computational-fluid-dynamics-impact-of-final-proximal-optimization-technique-on-different-double-stent-techniques
#11
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Nguyen Van Viet Thang, Nicolas Foin
BACKGROUND/PURPOSE: Computational fluid dynamics (CFD) have been recently adopted in many fields of cardiovascular medicine and in interventional cardiology. Using CFD analysis we compared the use of different PCI procedures, with and without the utilization of a proximal optimization technique (POT), on a complex coronary artery bifurcation. METHODS/MATERIALS: For the analysis, we considered a hypothetic model of a left anterior descending artery-diagonal Medina 1,1,1 bifurcation type with a diameter of the proximal main branch (MB) and the side branch (SB) set at 3...
January 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089776/predictors-of-same-day-discharge-after-percutaneous-coronary-interventions
#12
Michail Koutouzis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Andreas Tsoulmeleas, Ioannis Matsoukis, Constantinos Andreou, Efstathios Lazaris
OBJECTIVES: The aim of this study is to identify possible predictors for same day discharge (SDD) after percutaneous coronary interventions (PCI). BACKGROUND: Same day discharge after PCI is becoming more and more appealing and patient's selection criteria are being formulated. METHODS: A retrospective analysis was performed in all PCI procedures from January 2013 until December 2015. Patients were discharged the same day (SDD group) or had at least one overnight stay (non-SDD group)...
January 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28110894/endothelial-function-after-st-elevation-myocardial-infarction-in-patients-with-high-levels-of-high-sensitivity-crp-and-lp-pla2-a-substudy-of-the-response-randomized-trial
#13
Jasveen J Kandhai-Ragunath, Bjorn de Wagenaar, Cees Doelman, Jan van Es, Harald T Jørstad, Ron J G Peters, Carine J M Doggen, Clemens von Birgelen
BACKGROUND: The combination of high levels of high-sensitive C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase-A2 (Lp-PLA2) was recently shown to correlate with increased cardiovascular risk. Endothelial dysfunction is also known to be a risk factor for cardiovascular events. AIM: To test among patients with previous ST-elevation myocardial infarction (STEMI) the hypothesis that high levels of both hs-CRP and Lp-PLA2 may be associated with impaired endothelium-dependent vasodilatation...
January 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089777/bioresorbable-vascular-scaffold-to-treat-malignant-in-stent-restenosis-in-a-patient-with-nickel-allergy
#14
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Jesús Piqueras-Flores, Ramón Maseda, Fernando Lozano-Ruíz-Poveda
Nickel is the most frequent allergen in patients with allergic contact dermatitis and nickel allergy has been associated with recurrent in-stent restenosis. However, it is often misdiagnosed because of a low suspicion threshold. It should be discarded in patients with recurrent in-stent restenosis, especially if their medical history reveals prior contact dermatitis. It is also noteworthy and rarely specified that even newer generation stents that use novel metal alloys also contain low amounts of nickel. To avoid the implantation of new stents containing this metal, when percutaneous coronary intervention is indicated, drug eluting balloons or bioresorbable vascular scaffolds associated with small doses of steroids could provide good alternatives of treatment...
January 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28109718/lipid-core-burden-response-to-stent-implantation-assessed-with-near-infrared-spectroscopy-and-intravascular-ultrasound-evaluation-in-patients-with-myocardial-infarction
#15
Manijeh Noori, Per Thayssen, Karsten Tange Veien, Anders Junker, Knud Nørregaard Hansen, Henrik Steen Hansen, Lisette Okkels Jensen
INTRODUCTION: Near-infrared spectroscopy (NIRS) is a new method to identify lipid core plaque (LCP). The LCP and vascular response were assessed with NIRS to examine whether LCP was compressed or redistributed during percutaneous coronary intervention with stent implantation. METHODS: In 25 patients with non-ST segment elevation myocardial infarction (NSTEMI) NIRS acquisition was performed after predilation, stent implantation with nominal pressure and high-pressure post-dilation with a non-compliant balloon...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089779/percutaneous-coronary-intervention-of-chronically-occluded-saphenous-vein-grafts-using-excimer-laser-atherectomy-as-an-adjuvant-therapy
#16
Mohsen Mohandes, Sergio Rojas, Mauricio Torres, Cristina Moreno, Francisco Fernández, Jordi Guarinos, Alfredo Bardají
We present two cases with chronic total occlusion of the saphenous vein graft in two patients with a history of previous bypass surgery with unfavorable anatomic features for recanalization of the native coronary artery. In the first case, two dedicated attempts for recanalization of chronic total occlusion of the native artery failed and in the second case there was not an adequate visualization of the native vessel beyond the occlusion point, not even by contralateral injection. Excimer laser atherectomy was used in both cases as an adjuvant therapy during recanalization of the saphenous vein graft in combination with a distal protection device in order to reduce distal embolization...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089778/image-noise-reduction-technology-reduces-radiation-in-a-radial-first-cardiac-catheterization-laboratory
#17
Ateka Gunja, Yagya Pandey, Hui Xie, Beata M Wolska, Adhir R Shroff, Amer K Ardati, Mladen I Vidovich
BACKGROUND: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. METHODS AND RESULTS: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N=200) and a new image noise reduction fluoroscopy system (N=200)...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28063811/mitral-stenosis-due-to-dynamic-clip-leaflet-interaction-during-the-mitraclip-procedure-case-report-and-review-of-current-knowledge
#18
REVIEW
Gagan D Singh, Thomas W Smith, Jason H Rogers
The goal of MitraClip therapy is to achieve mitral regurgitation reduction without iatrogenic creation of clinically significant MS. In some series, up to 35% of patients are left with mild MS. There are many contributors to the final transmitral gradient achieved in patients undergoing MitraClip therapy. Additionally, there are many modalities used for the intraprocedural assessment of MS with no one modality considered to be the benchmark. We herein describe a case which illustrates the dynamic nature of clip-leaflet interaction, and review intraprocedural techniques for invasively and noninvasively assessing MS...
December 22, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28081977/the-combined-use-of-drug-eluting-balloon-and-excimer-laser-for-coronary-artery-restenosis-in-stent-treatment-the-derist-study
#19
Vittorio Ambrosini, Luca Golino, Giampaolo Niccoli, Marco Roberto, Pasquale Lisanti, Roberto Ceravolo, Guglielmo Bernardi, Pietro Armigliato, Gabriele Gabrielli, Giuliano Chizzola, Concetta De Paulis, Filippo Crea, Antonio Colombo
AIM: Stents reduce angiographic restenosis in comparison with balloon angioplasty. The rate of in-stent restenosis (ISR), although less frequent than post-angioplasty restenosis, is becoming increasingly prevalent due to the recent exponential increase in the use of intracoronary stents. The aim of this study is to evaluate angiographic and clinical outcomes of PTCA in combination with the use of excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in treatment of in-stent restenosis (ISR)...
December 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28041858/combining-clinical-and-angiographic-variables-for-estimating-risk-of-target-lesion-revascularization-after-drug-eluting-stent-placement
#20
Joshua M Stolker, David J Cohen, Kevin F Kennedy, Michael J Pencina, Suzanne V Arnold, Neal S Kleiman, John A Spertus
BACKGROUND: Drug-eluting stents (DES) reduce restenosis but require prolonged antiplatelet therapy, when compared with bare metal stents. Ideally, the patient should be involved in this risk:benefit assessment prior to selecting DES, to maximize the benefits and cost-effectiveness of care, and to improve medication adherence. However, accurate estimation of restenosis risk may require angiographic factors identified at cardiac catheterization. METHODS: In a large PCI registry, we used logistic regression to identify clinical and angiographic predictors of clinically-driven target lesion revascularization (TLR) over the first year after stent placement...
December 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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