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https://www.readbyqxmd.com/read/29346011/minimally-invasive-management-of-severe-aortoiliac-occlusive-disease
#1
Luigi Pascarella, Maen Aboul Hosn
BACKGROUND: Peripheral arterial disease (PAD) is a complex and highly prevalent pathology. It has been estimated that ∼8.5 million people in the United States are affected by PAD, of which 12%-20% are older than age 60. The TransAtlantic Inter-Society Consensus (TASC) guidelines classified aortoiliac atherosclerotic disease based on morphology and level of lesions. TASC II guidelines recommend bilateral surgical bypass to the femoral arteries for TASC II C and D lesions. The aortobifemoral bypass (ABF) has been considered the gold standard in the treatment of aortoiliac occlusive disease (AIOD)...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#2
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345585/mandatory-reporting-of-coronary-artery-calcifications-incidentally-noted-on-chest-multi-detector-computed-tomography-a-multicentre-experience
#3
Salvatore Cappabianca, Maria Paola Belfiore, Alfonso Reginelli, Raffaella Capasso, Alessandra Del Prete, Mario Petrillo, Paola Mascia, Claudia Rossi, Francesco Romano, Massimo De Filippo, Michele Scialpi, Felice Gragnano, Paolo Calabro, Giuseppe Belfiore, Luca Brunese, Roberto Grassi, Antonio Rotondo
BACKGROUND Coronary artery calcifications (CACs) are associated with coronary atherosclerosis and cardiovascular (CV) events. In "non-cardiovascular" settings, CACs can be easily detected on chest multi-detector computed tomography (MDCT). Their evaluation may help to better stratify CV risk in the general population, especially for primary prevention. AIMS We retrospectively evaluated the relationship between CAC distribution and CV risk, determined by Framingham Risk Score (FRS), in a cohort of patients who underwent chest MDCT performed for several clinical indications...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344756/the-current-state-of-left-main-percutaneous-coronary-intervention
#4
REVIEW
Harshith R Avula, Andrew N Rassi
PURPOSE OF REVIEW: While coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups...
January 17, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29344667/clinical-evaluation-of-covered-stents-in-the-treatment-of-superficial-femoral-artery-pseudoaneurysm-in-drug-abusers
#5
Jian Xu, Zhao Zheng, Yong Yang, Wei Zhang, Hongliang Zhao, Bei E, Minwen Zheng
The present study aimed to investigate the technical feasibility and initial clinical outcomes of a covered stent for the endovascular treatment of superficial femoral artery (SFA) pseudoaneurysm in drug abusers. A total of 29 drug abuse patients with SFA pseudoaneurysm, as confirmed by color Doppler sonography, were enrolled to the present study between January 2012 and May 2014. All patients were treated percutaneously by implantation of a covered stent. Physical examination and lower extremity computed tomography angiography were performed at 1 and 9 months postoperation...
January 15, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29343616/rapamycin-activates-tgf-receptor-independently-of-its-ligand-implications-for-endothelial-dysfunction
#6
Ayumi A Miyakawa, Thais Girao-Silva, Jose E Krieger, Elazer R Edelman
Rapamycin, the macrolide immunosuppressant and active pharmaceutic in drug-eluting stents (DES), has a well-recognized anti-proliferative action that involves inhibition of the mTOR pathway after binding to the cytosolic protein FKBP12. TGF receptor-type I (TGFRI) spontaneous activation is inhibited by the association with FKBP12. We hypothesized that rapamycin, in addition to inhibition of mTOR signaling, activates TGFRI independent of TGFb. Human umbilical vein endothelial cells (HUVEC) were treated with rapamycin (10nmoL/L) and/or TGF-b RI kinase inhibitor (TGFRIi, 100nmoL/L) for 24 hours...
January 17, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#7
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29341060/rationale-of-decreasing-low-density-lipoprotein-cholesterol-below-70-mg-dl-in-patients-with-coronary-artery-disease-a-retrospective-virtual-histology-intravascular-ultrasound-study
#8
Young Hoon Seo, Duck-Jun Seo, In Geol Song, Ki-Hong Kim, Taek-Geun Kwon, Jang-Ho Bae
BACKGROUND: The associations between statin and coronary plaque compositional changes were reported according to the use of high dose or not. An evaluation of the impact of low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL by using real world dosages of statin on coronary plaque composition was undertaken. METHODS: The study subjects consisted of 61 patients (mean 59.9 years old, 45 males) who underwent percutaneous coronary intervention, baseline and follow-up (F/U; mean 8...
January 17, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29340741/-platelet-inhibition-in-patients-with-coronary-cerebral-and-peripheral-macroangiopathy-what-when-and-how-long
#9
REVIEW
M Halbach, S Baldus
BACKGROUND: Inhibition of platelet aggregation can reduce the rate of vascular events in patients with coronary artery disease, carotid artery stenosis and symptomatic peripheral arterial disease. The choice of platelet inhibitors in monotherapy and combination therapy as well as the duration of dual platelet inhibition depend on the clinical situation and individual patient characteristics. GOAL: The present review summarizes the latest data from clinical trials and recommendations regarding platelet inhibition in coronary, cerebral and peripheral arterial disease...
January 16, 2018: Der Internist
https://www.readbyqxmd.com/read/29340719/treatment-with-48-mm-everolimus-eluting-stents-procedural-safety-and-12-month-patient-outcome
#10
C K Tan, Z L Tin, M K M Arshad, J K K Loh, F H Jafary, H H Ho, P J L Ong, T Watson
BACKGROUND: Lesion length is a major predictor of adverse outcomes after percutaneous coronary intervention. Long lesions often require multiple stents with variable overlap, which increases the probability of geographical miss and the incidence of mechanical complications, such as side-branch occlusion, restenosis, and stent thrombosis. These pitfalls may be avoided by use of an ultra-long device. METHODS: We retrospectively assessed the performance of the 48-mm Xience Xpedition everolimus-eluting stent (EES) at our institution...
January 16, 2018: Herz
https://www.readbyqxmd.com/read/29339680/case-image-percutaneous-approach-to-giant-coronary-artery-aneurysm-successful-implantation-of-covered-stent-graft
#11
Fatih Yılmaz, Tuğba Aktemur, Aykun Hakgör, Zübeyde Bayram, Cem Doğan
No abstract text is available yet for this article.
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29339323/mechanical-thrombectomy-of-acute-middle-cerebral-artery-occlusion-using-trans-anterior-communicating-artery-approach
#12
Krishna Amuluru, Charles E Romero, Logan Pyle, Mohammad El-Ghanem, Fawaz Al-Mufti
BACKGROUND: A cross-circulation technique involves gaining access to a cerebral vessel through a patent anterior or posterior communicating artery. This technique may be utilized in patients with emergent large vessel occlusions and an unfavorable direct route to the occlusion. While few previous reports have demonstrated successful cross-circulation technique for treatment of emergent large vessel occlusions, we present the first two cases of trans-anterior communicating artery stent-retriever thrombectomy...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29339168/selection-of-p2y12-inhibitor-in-percutaneous-coronary-intervention-and-or-acute-coronary-syndrome
#13
REVIEW
Udaya Tantry, Eliano P Navarese, Aung Myat, Paul Gurbel
The P2Y12 receptor plays a critical role in the amplification of platelet aggregation in response to various agonists and stable thrombus generation at the site of vascular injury leading to deleterious ischemic complications. Therefore, treatment with a P2Y12 receptor blocker is a major effective strategy to prevent ischemic complications in high -risk patients with acute coronary syndrome (ACS) and patients undergoing percutaneous coronary intervention (PCI). The determination of optimal platelet inhibition is based on maximizing antithrombotic properties while minimizing bleeding risk and is critically dependent on individual patient's propensity for thrombotic and bleeding risks...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29339166/anticoagulation-in-acute-coronary-syndrome-state-of-the-art
#14
REVIEW
Michel Zeitouni, Mathieu Kerneis, Tarek Nafee, Jean-Philippe Collet, Johanne Silvain, Gilles Montalescot
Early intravenous anticoagulation is the corner stone treatment of patients admitted with an acute coronary syndrome: it antagonizes the ongoing coronary thrombosis and facilitates the percutaneous coronary intervention, hence a reduction of mortality and acute stent thrombosis. Unfractionated heparin, enoxaparin, bivalirudin and fondaparinux have been extensively studied in large randomized control trials and meta-analyses with the same objective: reducing the ischemic burden without hiking hemorrhagic events...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#15
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338536/p2y12-receptor-inhibitors-an-evolution-in-drug-design-to-prevent-arterial-thrombosis
#16
Danny Kupka, Dirk Sibbing
P2Y12 inhibitors are a critical component of dual antiplatelet therapy (DAPT) - a combination of a P2Y12 receptor inhibitor and aspirin - which is the superior strategy to prevent arterial thrombosis in patients with acute coronary syndromes (ACS) and undergoing stent implantation. Areas covered: Basic science articles, clinical studies, and reviews from 1992-2017 were searched using Pubmed library to collet impactful literature. After an introduction to the purinergic receptor biology, this review summarizes current knowledge on P2Y12 receptor inhibitors including their specific pharmacodynamic as well as pharmacokinetic and drug interaction features...
January 17, 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29338301/coronary-artery-perforation-complicating-percutaneous-coronary-intervention
#17
Aram J Mirza, Abdulsalam Y Taha, Jaafar S Aldoori, Jawad M Hawas, Kawa W Hassan
Background Coronary artery perforation is a rare but serious complication of percutaneous coronary interventions. We aimed to evaluate the management of coronary artery perforation in Sulaimaniyah, Iraq. Methods A retrospective review of our medical records from 2009 to 2016 identified 24 patients (15 males, 9 females) with coronary artery perforation. Mean age was 60 ± 9.2 years (range 40-74 years). Standard diagnostic angiography or percutaneous interventions were performed. Coronary artery perforation was diagnosed by worsening of symptoms, hypotension, or angiographic evidence of type I (extraluminal crater), II (myocardial or pericardial blushing), or III (contrast streaming or cavity spilling) perforation...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29338298/coronary-and-arch-hybrid-surgery-in-a-patient-with-infrarenal-aortic-occlusion
#18
Teng Kiat Koh, Jocelyn Zi Lin Ting, Bernard Wee, Rustem Khamitov, Kristine Teoh, Julian Wong, Vitaly A Sorokin
A 65-year-old gentleman with claudication underwent contrast-enhanced computed tomography. The scan showed occlusion of the infrarenal abdominal aorta and a 6.0 × 3.7 cm saccular zone-3 arch aneurysm. The left ventricular ejection fraction was 35% and a coronary angiogram revealed triple-vessel disease. In view of the patient's high risk with EuroSCORE II 20.34%, coronary artery surgery was combined with hybrid type I arch aneurysm repair. An endovascular stent was delivered in an antegrade manner. Open heart surgery and a hybrid type I arch intervention can be performed simultaneously through a midline sternotomy approach...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29336945/current-treatment-of-significant-left-main-coronary-artery-disease-a-review
#19
REVIEW
Mariama Akodad, Marie-Claude Morice
Though infrequent, left main stenosis has a major prognostic impact. The management of left main disease has evolved over the last few decades with the growing evidence of the efficacy and safety of percutaneous interventions, as attested by the most recent trials. However, mastery of the technical aspects of left main bifurcation stenting is essential in ensuring optimal results. This review focuses on recent data concerning left main angioplasty results as well as the current technical approaches.
January 5, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29336771/surgical-and-endovascular-management-of-patients-with-chronic-mesenteric-ischemia-a-single-center-experience
#20
Panagiotis Paliogiannis, Giorgio C Ginesu, Alessandro Fancellu, Aldo Pischedda, Mario Maiore, Eleonora Maiore, Antonio Pinna, Michele Barmina, Alberto Porcu
Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years...
December 1, 2017: American Surgeon
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