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Cardiovascular Revascularization Medicine: Including Molecular Interventions

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https://www.readbyqxmd.com/read/29331435/complications-of-chronic-total-occlusion-percutaneous-coronary-intervention-subepicardial-hematoma
#1
Punag Divanji, Kendrick Shunk
A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes...
December 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29331437/influence-of-operator-experience-and-pci-volume-on-transfemoral-access-techniques-a-collaboration-of-international-cardiovascular-societies
#2
Daniel W Nelson, Abdulla A Damluji, Nish Patel, Marco Valgimigli, Stephan Windecker, Robert Byrne, James Nolan, Tejas Patel, Emmanouil Brilakis, Subhash Banerjee, Jorge Mayol, Warren J Cantor, Carlos E Alfonso, Sunil V Rao, Mauro Moscucci, Mauricio G Cohen
INTRODUCTION: Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. METHODS: A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. RESULTS: A total of 988 physicians from 88 countries responded to the survey...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29331436/jetstream-atherectomy-system-treatment-of-femoropopliteal-arteries-results-of-the-post-market-jet-registry
#3
William A Gray, Lawrence A Garcia, Ali Amin, Nicolas W Shammas
OBJECTIVES: To report on procedural, safety, and effectiveness outcomes of real-world practice with the Jetstream rotational atherectomy system for treatment of femoropopliteal artery lesions. BACKGROUND: Safety and effectiveness of treatment with the Jetstream device has been demonstrated in clinical trials, but outcomes during real-world clinical practice have yet to be examined. METHODS: 241 patients (66% male, mean age 67years, 41% diabetes; Rutherford 1-3) with de novo or restenotic (non-stent) femoropopliteal lesions ≥4cm in length were recruited...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29306670/multivessel-disease-in-patients-over-75years-old-with-st-elevated-myocardial-infarction-current-management-strategies-and-related-clinical-outcomes-in-the-estrofa-mi-75-nation-wide-registry
#4
Jose M de La Torre Hernandez, Joan A Gomez Hospital, Jose A Baz, Salvatore Brugaletta, Armando Perez de Prado, Jose A Linares, Ramón Lopez Palop, Belen Cid, Tamara Garcia Camarero, Alejandro Diego, Hipolito Gutierrez, Jose A Fernandez Diaz, Juan Sanchis, Fernando Alfonso, Roberto Blanco, Javier Botas, Javier Navarro Cuartero, Jose Moreu, Francisco Bosa, Jose M Vegas, Jaime Elizaga, Antonio L Arrebola, Felipe Hernandez, Neus Salvatella, Marta Monteagudo, Alfredo Gomez Jaume, Xavier Carrillo, Roberto Martin Reyes, Fernando Lozano, Jose R Rumoroso, Leire Andraka, Antonio J Dominguez
BACKGROUND: In elderly patients with ST elevated myocardial infarction (STEMI) and multivessel disease (MVD the outcomes related with different revascularization strategies are not well known. METHODS: Subgroup-analysis of a nation-wide registry of primary angioplasty in the elderly (ESTROFA MI+75) with 3576 patients over 75years old from 31 centers. Patients with MVD were analyzed to describe treatment approaches and 2years outcomes. RESULTS: Of 1830 (51%) with MVD, 847 (46%) underwent multivessel revascularization either in acute (51%), staged (44%) or both procedures (5%)...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29306669/balloon-assisted-tracking-a-practical-solution-to-avoid-radial-access-failure-due-to-difficult-anatomical-challenges
#5
Ioannis Felekos, Rafaqat Hussain, Sundip J Patel, Antonis N Pavlidis
AIM: The balloon assisted tracking (BAT) technique is utilised to overcome various anatomical difficulties during radial procedures when standard measures such as adequate sedation, pain relief, vasodilators and use of hydrophilic guidewires, fail. The aim of this study was to evaluate the success rates of the BAT technique in overcoming anatomical difficulties during radial coronary interventional procedures. METHODS: We retrospectively reviewed 1100 consecutive patients undergoing coronary procedures from the transradial approach (TRA) between May 2015 and May 2017...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29276176/coronary-aneurysms-in-the-acute-patient-incidence-characterization-and-long-term-management-results
#6
Iván J Núñez-Gil, Belén Terol, Gisela Feltes, Luis Nombela-Franco, Pablo Salinas, Javier Escaned, Pilar Jiménez-Quevedo, Nieves Gonzalo, David Vivas, Daniel Bautista, Carlos Macaya, Antonio Fernández-Ortiz
BACKGROUND: Coronary aneurysms (1.5 times dilation the reference-vessel) are uncommon and have been diagnosed with increasing frequency with coronary angiography. The incidence varies from 1.5% to 5%. Reported complications are multiple: thrombosis, distal embolization, rupture and vasospasm, causing ischemia, heart failure or arrhythmias. However, the natural history and prognosis remains obscure. We aimed to describe the characteristics of acute patients with coronary aneurysms. METHODS: Prospective coronariography registry of patients with the diagnosis of coronary aneurysm between 2002 and 2013...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29276174/routine-use-of-anticoagulation-after-transcatheter-aortic-valve-replacement-initial-safety-outcomes-from-a-single-center-experience
#7
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Demetris Yannopoulos, Santiago Garcia
BACKGROUND: Subclinical leaflet thrombosis (SCLT) can be seen in up to 12% of patients after transcatheter aortic valve replacement (TAVR). Anticoagulation appears to prevent and reverse SCLT but concerns exist about bleeding risk. METHODS: Our program adopted a strategy of routine anticoagulation after TAVR, starting warfarin on post-procedure day 0 and continuing for 3months in 10/2015. We report the initial safety and efficacy outcomes of this approach. Bleeding events were assessed using Valve Academic Research Consortium (VARC) and Bleeding Academic Research Consortium (BARC) definitions...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29292015/postprocedural-high-sensitivity-troponin-t-and-prognosis-in-patients-with-non-st-segment-elevation-myocardial-infarction-treated-with-early-percutaneous-coronary-intervention
#8
Yukinori Harada, Konstantinos C Koskinas, Gjin Ndrepepa, Lorenz Räber, Siegmund Braun, Thomas Zanchin, Sebastian Kufner, Lukas Hunziker, Robert A Byrne, Dik Heg, Adnan Kastrati, Stephan Windecker
BACKGROUND: The association of postprocedural high-sensitivity troponin T (hs-TnT) with prognosis of non-ST-segment elevation myocardial infarction (NSTEMI) patients is incompletely investigated. AIM: To assess the prognostic value of hs-TnT in NSTEMI patients undergoing early percutaneous coronary intervention (PCI). METHODS: This study included 3783 patients with NSTEMI undergoing early PCI. Preprocedural and peak postprocedural hs-TnT was measured...
November 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221957/endovascular-repair-of-complex-juxtarenal-aortic-aneurysm-using-a-combined-fenestrated-endograft-and-chimney-technique
#9
REVIEW
Zaher Fanari, Nilesh J Goswami
Chimney EVAR (CHEVAR) and Fenestrated EVAR (FEVAR) are two options for management of very complex abdominal aortic aneurysm (AAA). While some anatomical factors may favor one strategy over the other, there are some cases where the anatomical challenges may require using a hybrid approach. We are reporting the case of an 84-year-old male with a 6.8×5.7cm infrarenal abdominal aortic aneurysm that arises immediately below the level of the renal arteries and extends down to just above the iliac bifurcation with occluded celiac and inferior mesenteric arteries and severe bilateral renal artery stenosis with caudally oriented right renal and cranially oriented left renal artery...
November 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221958/a-comparison-of-the-ultrathin-orsiro-hybrid-sirolimus-eluting-stent-with-contemporary-drug-eluting-stents-a-meta-analysis-of-randomized-controlled-trials
#10
Michael J Lipinski, Brian J Forrestal, Micaela Iantorno, Rebecca Torguson, Ron Waksman
BACKGROUND: Recent studies suggest the Orsiro sirolimus-eluting stent (O-SES), which has ultrathin struts with a biodegradable sirolimus-eluting polymer coating, performed better than contemporary drug-eluting stents (DES). We performed a meta-analysis to compare clinical outcomes for all randomized controlled trials (RCTs) of O-SES vs contemporary DES. METHODS/MATERIALS: PubMed, Cochrane CENTRAL, and meeting abstracts were searched for all RCTs comparing O-SES with contemporary DES...
November 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29217340/supera-stent-outcomes-in-above-the-knee-interventions-effects-of-compression-and-elongation-sake-compel-sub-study
#11
Hemal Bhatt, Richard Kovach, Sean Janzer, Jon C George
INTRODUCTION: The interwoven nitinol design of the Supera stent has been shown to have superior radial strength and fracture resistance resulting in higher patency rates at 6 and 12months. A detailed sub-analysis of SUPERB trial showed differences in patency based on stent conformation post deployment. We evaluated the patency of the stent within the SAKE study cohort based on stent deployment conformation. METHODS: We retrospectively evaluated the medical records of 63 patients (77 limbs) with Rutherford class 2-5 symptoms who received Supera stents in the femoro-popliteal artery from March 2010 through May 2011 as part of the SAKE study...
November 16, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29153509/transcatheter-embolization-of-a-giant-coronary-artery-pseudoaneurysm
#12
Pratik Dalal, Divyashree Varma, Ripa Chakravorty, Salil Sethi, Steven Bailey, Anand Prasad
A 53-year-old diabetic male with sternal dehiscence presented with recurrent staphylococcus bacteremia 2years after coronary artery bypass grafting (CABG). He was found to have a giant right coronary artery (RCA) pseudoaneurysm and a coronary cameral fistula on imaging. Due to excessive surgical risk, the patient underwent percutaneous treatment with a 5mm Amplatzer vascular plug 4 (St. Jude Medical, St.Paul, MN). Post-procedure imaging showed successful cessation of flow into the pseudoaneurysm and follow-up CT scan demonstrated significant improvement in the size of the pseudoaneurysm...
November 16, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221960/when-everything-else-fails-high-pressure-balloon-for-undilatable-lesions
#13
REVIEW
Ioannis Felekos, Grigoris V Karamasis, Antonis N Pavlidis
Heavily calcified lesions are encountered with increasing frequency during percutaneous coronary interventions (PCI). This poses a significant problem as it often leads to suboptimal stent expansion, which in turn is a major cause for stent restenosis and thrombosis. Various technologies have been developed to tackle this. The high-pressure balloon (OPN) seems to be a promising adjunct in treating undilatable lesions. In this concise mini review we highlight the use of HPB and we present the current status of technology implemented in complex PCI cases...
November 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29169984/left-main-restenosis-in-the-des-era-a-call-for-action
#14
REVIEW
Gaetano di Palma, Bernardo Cortese
Percutaneous treatment of the unprotected left main trunk (ULM), defined as a vessel without patent bypass graft either to the left circumflex (LCX) or left anterior descending (LAD) artery, has gained a precise role thanks to recent scientific evidence. Although new generation drug-eluting stents have already proven to be safer, there is still a consistent risk of restenosis and late adverse events. The optimal management of a ULM restenosis is still debated. Here we aim at presenting a review of the available data in literature and show our choice for treating it...
November 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221959/robotically-assisted-percutaneous-coronary-intervention-reasons-for-partial-manual-assistance-or-manual-conversion
#15
Jonathan Harrison, Lawrence Ang, Jesse Naghi, Omid Behnamfar, Ali Pourdjabbar, Mitul P Patel, Ryan R Reeves, Ehtisham Mahmud
BACKGROUND: Robotically-assisted percutaneous coronary intervention (R-PCI) is feasible for simple coronary lesions. OBJECTIVES: To determine the frequency and reasons for partial manual assistance or manual conversion during R-PCI in clinical practice. METHODS: The CorPath 200 System (Corindus, Waltham, MA) enables the operator to sit in a radiation-shielded cockpit and remotely control intracoronary devices including guidewires, balloons, and stents...
November 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29223499/a-comparison-of-standard-versus-low-dose-heparin-on-access-related-complications-after-coronary-angiography-through-radial-access-a-meta-analysis-of-randomized-controlled-trials
#16
Khagendra Dahal, Sharan Sharma, Adil Yousuf, Juyong Lee, Michael Azrin, Enrique Jimenez, Kalgi Modi, Neeraj Tandon
BACKGROUND: Transradial access (TRA) is preferred for coronary angiography (CA) or percutaneous coronary intervention due to reduced access-related complications, and mortality especially for patients with ST elevation myocardial infarction. Radial artery occlusion (RAO) is a known complication of TRA, and precludes its use as a future access site, conduit for coronary artery bypass grafting or for hemodialysis fistula placement. Although a standard dose (SD) heparin of 5000 Units is used during TRA, the risks of RAO and hematoma compared to lower dose (LD) remain unclear...
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29146552/cardiogenic-shock-complicating-transcatheter-aortic-valve-replacement-due-to-severe-para-valvular-regurgitation
#17
M Chadi Alraies, Mohamad Soud, Homam Moussa Pacha, Ron Waksman, Itsik Ben-Dor
We describe a challenging case of successful use of Impella CP™ to provide emergent left ventricular support following a circulatory collapse during transcatheter valve-in-valve implantation with a CoreValve Evolut R prosthesis.
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29117920/orbital-atherectomy-treatment-of-severely-calcified-native-coronary-lesions-in-patients-with-prior-coronary-artery-bypass-grafting-acute-and-one-year-outcomes-from-the-orbit-ii-trial
#18
Michael S Lee, Bynthia M Anose, Brad J Martinsen, Arthur C Lee, Richard A Shlofmitz, Jeffrey W Chambers
AIMS: Patients undergoing percutaneous coronary intervention (PCI), with a history of coronary artery bypass grafting (CABG), may be at increased risk for mortality and repeat revascularization, compared with patients without prior CABG. In this post-hoc analysis of the ORBIT II trial, safety and efficacy of coronary orbital atherectomy (OA) to modify severe coronary artery calcium, prior to stent placement, was evaluated in subjects based on history of CABG. METHODS AND RESULTS: Comorbidities: diabetes, dyslipidemia, hypertension, and history of myocardial infarction (MI) were more prevalent in the CABG group...
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29137967/procedural-and-thirty-day-outcomes-following-transfemoral-implantation-of-the-fully-repositionable-and-retrievable-lotus-valve-without-routine-pre-dilatation-in-a-consecutive-patient-cohort-a-single-centre-experience
#19
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND / PURPOSE: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation...
November 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221961/prevalence-of-high-on-treatment-aspirin-and-clopidogrel-platelet-reactivity-in-patients-with-critical-limb-ischemia
#20
Leonardo C Clavijo, Noor Al-Asady, Ashwat Dhillon, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVES: The goal of this study is to establish the prevalence of high on-treatment platelet reactivity to aspirin (HPRA) and clopidogrel (HPRC) in patients with critical limb ischemia (CLI). BACKGROUND: CLI is associated with an increased risk of death and cardiovascular events. Unlike other patient populations with atherosclerotic cardiovascular disease, previous studies failed to demonstrate a benefit of antiplatelet therapy in patients with CLI. METHODS: From June 2014 to November 2016, we performed platelet reactivity studies for P2Y12 and thromboxane A2 (TXA2) inhibition in 100 CLI patients receiving daily treatment with aspirin and clopidogrel...
October 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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