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Cardiovascular Revascularization Medicine: Including Molecular Interventions

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https://www.readbyqxmd.com/read/28546035/hybrid-metal-scaffold-jacket-versus-full-metal-jackets-in-left-anterior-descending-coronary-artery-diffuse-disease-differences-in-radiation-exposure-and-fluoroscopic-procedural-times
#1
Gianluca Rigatelli, Marco Zuin, Jacopo Frigato, Fabio Dell'Avvocata, Federico Ronco, Alberto Mazza, Laura Oliva, Dario Adami, Emiliano Bedendo, Panin Stefano
BACKGROUND/PURPOSE: Bioabsorbable vascular scaffolds (BVS) are made from a radiolucent material. Their multiple implantations on a single long diffused segment requires a specific technique with imaging magnification, which could cause an increase in dose delivered during percutaneous coronary intervention (PCI) procedure. We aimed to identify differences in radiation dose, fluoroscopy and procedural times in Hybrid DES+ multiple BVS (Absorb, Abbott Inc., USA) implantation (hybrid metal/scaffold jacket) versus multiple III generation Drug-eluting stents (DES) (full-metal jacket) in patients with long and diffuse coronary artery disease of the left anterior descending (LAD) coronary artery...
May 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28546034/in-stent-restenosis-nine-years-after-initial-placement-of-a-drug-eluting-stent
#2
Dennis A Hopkinson, Vikram Raje, Ion S Jovin
In-stent restenosis after drug-eluting stent implantation is a rare event and the time frame of restenosis occurrence is less well understood for drug-eluting stent. We describe the case of a patient who presented with an acute coronary syndrome and was found to have severe focal in-stent restenosis in a drug-eluting stent that was placed 9 years earlier.
May 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28539211/left-ventricular-perforation-in-a-patient-with-a-left-ventricular-aneurysm-during-noga%C3%A2-catheter-mapping
#3
Gaurav K Sharma, Marie-France Poulin, Gary L Schaer
Endocardial mapping of the left ventricle (LV) using the NOGA® XP Cardiac Navigation System can identify chronically ischemic and viable myocardium in patients with coronary artery disease by generating electromechanical maps. These maps are very useful when targeting myocardial tissue for injection of stem cells. We present the case of a woman who developed a perforation at the site of an LV aneurysm during NOGA mapping prior to the transendocardial injection of stem cells, as part of a multicenter clinical trial...
May 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#4
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529092/correlation-and-prognostic-role-of-neutrophil-to-lymphocyte-ratio-and-syntax-score-in-patients-with-acute-myocardial-infarction-treated-with-percutaneous-coronary-intervention-a-six-year-experience
#5
Marco Zuin, Gianluca Rigatelli, Claudio Picariello, Fabio dell'Avvocata, Lina Marcantoni, Gianni Pastore, Mauro Carraro, Aravinda Nanjundappa, Giuseppe Faggian, Loris Roncon
BACKGROUND/PURPOSE: The neutrophil/lymphocyte ratio (NLR) has been proposed as a prognostic marker in acute myocardial infarction (AMI). The aim of our study is to demonstrates the correlation between SYNTAX score (SXs) and NLR and its association with 1-year cardiovascular (CV) mortality in patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI). METHODS/MATERIALS: Over 6 consecutive years, (1st January 2010 and 1st January 2016) 6560 patients (4841 males and 1719 females, mean age 64...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#6
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529095/understanding-operator-stent-choice-in-the-catheterization-laboratory-using-a-pre-procedure-survey-opportunities-for-quality-improvement
#7
Matthew J Chung, Jonathan D Hansen, Ryan D Schulteis, Joel C Boggan, W Schuyler Jones, Thomas J Povsic, Susan Roberts, Mitchell W Krucoff, Sunil V Rao
OBJECTIVES: We sought to characterize how the perceived risk of early dual antiplatelet therapy (DAPT) discontinuation is incorporated into operator decision-making regarding stent choice, using a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation. BACKGROUND: Understanding which factors influence operator decision-making regarding stent choice during percutaneous coronary intervention (PCI) could help identify areas for quality improvement...
May 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#8
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28495117/first-experience-with-the-watchman-flx-occluder-for-percutaneous-left-atrial-appendage-closure
#9
Julia Seeger, Ralf Birkemeyer, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: We aimed to evaluate efficacy and safety of left atrial appendage (LAA) closure with the new Watchman FLX and analyze procedural features in a consecutive series of high risk non-valvular atrial fibrillation patients. METHODS AND RESULTS: Twelve consecutive non-valvular atrial fibrillation patients (age 76.6±7.8years) at high risk for stroke (CHA2DS2-VASc-Score 5.5±0.9) and bleeding (HAS-BLED-Score 3.8±0.9), received LAA closure with the Watchman FLX...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28483589/takotsubo-cardiomyopathy-after-microwave-ablation-for-metastatic-liver-lesions
#10
Mostafa Afennas, Hans Bonnier, Danny Schoors
Takotsubo cardiomyopathy (TCMP) is characterized by transient and reversible left ventricular regional wall motion abnormalities triggered by acute and intense emotional or physical stress. We present a case of a 79 year old woman with a hypertensive crisis after microwave ablation (MWA) for metastatic liver lesions. Initial evaluation suggested an acute coronary syndrome with an ST segment elevation and with elevated serum troponin T. No associated chest pain or dyspnea was present. Further evaluation with ECG, echocardiography, coronarography with left ventricle angiogram and MRI was consistent with an apical ballooning syndrome...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28478992/complex-endovascular-repair-of-bilateral-iliac-artery-stenosis-and-coexisting-aneurysm
#11
Sameer Arora, Amol A Bahekar
Concomitant stenosis and aneurysmal disease in the iliac artery lumen are a rare finding. Surgery has been the modality of choice for this degree of complexity; however, advancement in techniques, evolution of stent grafts and increasing operator experience have made endovascular intervention a feasible option. TransAtlantic InterSociety Classification (TASC) categorizes the presence of iliac stenosis adjacent to iliac aneurysm as the most severe category for aortoiliac lesions or a TASC II D lesion. The 2014 Society of Cardiovascular Angiography and Interventions (SCAI) expert consensus statement advocated endovascular approach for TASC II A, B and C lesions with a trend to favor endovascular approach for TASC II D lesions as well...
April 24, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28476438/controlled-antegrade-intimal-tracking-with-subintimal-balloon-inflation-as-a-novel-bailout-technique-for-chronic-total-occlusion-after-failed-intravascular-ultrasound-guided-parallel-wire-technique
#12
Yuta Imai, Junji Yajima, Fumitaka Hosaka
Failure to cross with a guidewire is the most common reason for failure of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). In cases of CTO PCI with no interventional collaterals, an intravascular ultrasound (IVUS)-guided parallel wire technique is usually the last-resort procedure. Failure of this technique sometimes causes enlarged subintimal space, resulting in procedure failure. We present a successful second attempt at left anterior descending artery CTO PCI with no interventional collaterals...
April 24, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28483588/radiation-safety-in-the-cardiac-catheterization-lab-a-time-series-quality-improvement-initiative
#13
Wael Abuzeid, Joseph Abunassar, Jerome A Leis, Vicky Tang, Brian Wong, Dennis T Ko, Harindra C Wijeysundera
BACKGROUND: Interventional cardiologists have one of the highest annual radiation exposures yet systems of care that promote radiation safety in cardiac catheterization labs are lacking. This study sought to reduce the frequency of radiation exposure, for PCI procedures, above 1.5Gy in labs utilizing a Phillips system at our local institution by 40%, over a 12-month period. METHODS: We performed a time series study to assess the impact of different interventions on the frequency of radiation exposure above 1...
April 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28457807/safety-and-efficacy-of-anti-thrombotic-regimens-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation-a-traditional-and-network-meta-analysis
#14
REVIEW
Safi U Khan, Muhammad A Saleem, Amirahwaty Abdullah, Subash Ghimire, Manidhar Lekkala, Hammad Rahman, Ahmad N Lone, Edo Kaluski
BACKGROUND: Previous reports have been inconsistent in generating a consensus for optimal treatment strategy for patients with percutaneous coronary intervention (PCI) who also require oral anticoagulation (OAC). We conducted a traditional and network meta-analysis to evaluate the safety and efficacy of anti-thrombotic regimens in this subset of patients. METHODS: 30 articles were recovered through preferred reporting items for systematic reviews and meta-analyses (PRISMA) using MEDLINE, EMBASE and Cochrane Central Register of Controlled Clinical Trials (CENTRAL) from inception to December 2016...
April 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28546033/long-term-follow-up-of-first-generation-versus-new-generation-drug-eluting-stents-in-three-vessel-coronary-artery-disease
#15
Toru Yoshizaki, Toru Naganuma, Tsuyoshi Kobayashi, Takeo Horikoshi, Hirokazu Onishi, Hiroyoshi Kawamoto, Shotaro Nakamura, Sunao Nakamura
BACKGROUNDS: Few reports have primarily focused on long-term clinical outcomes in three-vessel disease when patients were treated with either first- or new-generation drug-eluting stents (DES). The purpose of this study was to investigate different clinical outcomes after percutaneous coronary intervention (PCI) for three-vessel disease with first- or new-generation DES. METHODS: Between January 2007 and December 2013, a total of 200 patients who received complete revascularization of three-vessel disease with either first-generation DES (n=85) or new-generation DES (n=115) were analyzed in this retrospective study...
April 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28432005/radial-ulnar-angioplasty-in-selected-patients-undergoing-elective-angiography-or-pci-using-complex-forearm-approach
#16
Santiago Jesús Camacho Freire, Antonio Enrique Gómez Menchero, Javier León Jiménez, Jessica Roa Garrido, Rosa Cardenal Piris, José Francisco Díaz Fernández
BACKGROUND: Angioplasty on the radial artery have been performed with good success rates in patients with critical hand ischemia. We sought to assess the feasibility and safety of radial angioplasty on complex radial access in patients undergoing coronary angiography. METHODS/MATERIAL: A prospective series of procedures with complex radial/ulnar access to which radial-ulnar angioplasty (RU-A) was performed. We set goals of efficacy and safety that included the success rate of the procedure (need for ¨Crossover femoral¨) and the existence of radial pulse at one month...
April 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28432004/impact-of-right-ventricular-side-branch-occlusion-during-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-right-ventricular-function
#17
Pepijn A van Diemen, Wynand J Stuijfzand, Stefan P Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Alexander Nap, Albert C van Rossum, Niels van Royen, Robin Nijveldt, Paul Knaapen
OBJECTIVE: To determine the impact of right ventricular side branch (RVB) occlusion, during percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) of the right coronary artery (RCA), on right ventricular (RV) function. BACKGROUND: Developments in PCI techniques have expanded PCI CTO feasibility. However, the utilization of dissection and reentry techniques and extensive stent implantation increases the risk of coronary side branch occlusion...
April 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28455074/management-strategies-and-possible-risk-factors-for-ventricular-septal-defects-after-transcatheter-aortic-valve-replacement-case-series-from-a-single-center-and-review-of-literature
#18
REVIEW
M Rizwan Sardar, Zubair A Khan, Anu Abraham, Wajeeha Saeed, Muhammad Farhan, Dhaval Kolte, Barry Sharaf, Paul Gordon, Frank Sellke, Neel R Sodha, Herbert D Aronow, Afshin Ehsan
Development of membranous ventricular septal defects (VSD) is a rare complication of transcatheter aortic valve replacements (TAVR), and is recognized using intraoperative and postoperative imaging. We present two cases of this rare but serious complication; one was successfully managed conservatively and the other with valve-in-valve therapy. Management strategies for post-TAVR VSDs varies, but should be individualized to the clinical scenario. We performed a literature search and sought to identify various risk factors which may predispose patients to the development of VSD after TAVR...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28432006/stepwise-use-of-circulatory-support-devices-in-a-patient-refractory-to-cardiopulmonary-resuscitation
#19
Marco Spartera, Richard J Jabbour, Mauro Chiarito, Michele De Bonis, Federico Pappalardo
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device)...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28432003/the-effectiveness-of-super-selective-injection-with-anchor-balloon-technique-for-collateral-channel-assessment
#20
Hiroki Shibutani, Yuzo Akita, Yumie Matsui, Masahiro Yoshinaga, Masahiro Karakawa, Etsuo Tsuchikane
The careful assessment of collateral channels is important for a retrograde approach for a chronic total coronary occlusion (CTO). This case report describes a percutaneous coronary intervention for CTO of the distal right coronary artery with good collateral circulation. All visible collateral channels failed by the retrograde approach; however, the procedure was successful using the distal atrial circumflex (AC) channel. Although this distal channel was poorly visualized on standard coronary angiography, it was clearly contrasted retrogradely from the CTO exit using a super-selective injection through the proximal AC channel as the antegrade flow was obstructed by the anchor balloon...
April 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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