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coronary thrombectomy

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https://www.readbyqxmd.com/read/29114095/direct-mechanical-intervention-versus-bridging-therapy-in-stroke-patients-eligible-for-intravenous-thrombolysis-a-pooled-analysis-of-2-registries
#1
Sebastian Bellwald, Ralph Weber, Tomas Dobrocky, Hannes Nordmeyer, Simon Jung, Jeffrie Hadisurya, Pasquale Mordasini, Marie-Luise Mono, Christian P Stracke, Hakan Sarikaya, Corrado Bernasconi, Klaus Berger, Marcel Arnold, René Chapot, Jan Gralla, Urs Fischer
BACKGROUND AND PURPOSE: Randomized controlled trials have shown that mechanical thrombectomy (MT) plus best medical treatment improves outcome in stroke patients with large-vessel occlusion in the anterior circulation. Whether direct MT is equally effective as bridging thrombolysis (intravenous thrombolysis plus MT) in intravenous thrombolysis eligible patients remains unclear. METHODS: We compared clinical and radiological outcomes at 3 months in 249 bridging patients with 111 patients receiving direct MT for large-vessel occlusion anterior circulation stroke from 2 prospective registries (study period Essen: June 2012 to August 2013, Bern February 2009 to August 2014)...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29113867/clinical-significance-of-intracoronary-thrombus-aspirated-during-primary-percutaneous-intervention-an-immunohistopathological-study
#2
Neeraj Parakh, Basavaraj Utagi, Sudhir Arava, Sunil Verma, Ganesan Karthikeyan, Sandeep Singh, Balram Bhargava, Ruma Ray, Chetan D Patel, Vinay K Bahl
BACKGROUND: Manual thrombus aspiration during primary percutaneous intervention provides us with aspirated thrombus sample, that may contain material from the disrupted plaque. Immunohistopathological analysis of thrombus can yield valuable information about the clinical and cardiovascular outcomes and possible mechanisms of myocardial infarction. MATERIAL AND METHODS: We studied and analysed the immunohistopathological features of coronary thrombus aspirated from patients undergoing primary percutaneous coronary angioplasty...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29103567/-difficulty-in-diagnosis-of-a-cardiogenic-shock-with-thrombotic-and-sub-occluded-lad-a-train-can-hide-another-one
#3
R Cheaito, A Tritar, H Benamer, M Saighi Bouaouina, A Masri, M A Bouzid, M Younes, H Mansour, P Jessen
The pheochromocytome is a localized tumor at the level of the medullosurrenale in 85% of the cases. The clinical presentation is very variable. Severe Heart failure presentation can be the mode of revelation in 2% of the cases. We present the case of a patient admitted for refractory cardiogenic shock correlated to pheochromocytome tumor. The difficulty of this rare clinical presentation was to confirm rapidly and in emergency this diagnosis in the same time when the patient presents a persistante and severe cardiogenic chock after finding a sub-occluded and thrombotic LAD coronary artery and which was treated by thrombectomy and coronary revascularization...
November 2, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29084042/a-comparison-of-intracoronary-treatment-strategies-for-thrombus-burden-removal-during-primary-percutaneous-coronary-intervention-a-coctail-ii-substudy
#4
Laura Gatto, Alessio Di Landro, Enrico Romagnoli, Valeria Marco, Chiara Russo, Tomasz Pawlowski, Francesco Versaci, Ugo Limbruno, Fausto Castriota, Luca Di Vito, Antonio Trivisonno, Francesco Prati
BACKGROUND: Manual thrombus aspiration and local drug delivery of abciximab have been proposed as a strategy to reduce thrombus burden during percutaneous coronary intervention in patients with ST elevation myocardial infarction; however, the effectiveness of these approaches, is uncertain. In this COCTAIL II substudy, we compared the effect of these strategies on prestenting and poststenting thrombus burden assessed by optical coherence tomography. PATIENTS AND METHODS: COCTAIL II trial enrolled patients with ST elevation myocardial infarction randomized to intralesion (IL, by the ClearWay catheter) versus intracoronary (IC, by the guide catheter) abciximab bolus with or without aspiration thrombectomy (AT)...
October 27, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29042400/thrombus-aspiration-for-st-segment-elevation-myocardial-infarction-in-modern-era-still-an-issue-of-debate
#5
REVIEW
Junhua Ge, Andreas Schäfer, Georg Ertl, Peter Nordbeck
The role of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) for acute ST-segment-elevation myocardial infarction has been a matter of intense research and debate now. Although recent randomized controlled clinical trials (notably TASTE [Thrombus Aspiration in ST-Elevation Myocardial Infarction in Scandinavia] and TOTAL [Trial of Routine Aspiration Thrombectomy With PCI Versus PCI Alone in Patients With STEMI]) do not supply evidence supporting the routine use of TA in patients with ST-segment-elevation myocardial infarction, manual TA remains a therapeutic option for interventional cardiologists when treating patients with substantial thrombus burden during PPCI...
October 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29026412/the-role-of-manual-thrombectomy-in-cardiovascular-outcome-among-patients-with-total-cutoff-vessel-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#6
Alireza Khosravi, Davoud Rajabi, Masoud Pourmoghaddas, Afzal Roohi, Masoumeh Esmaeili
BACKGROUND: The applicability of manual aspiration thrombectomy in patients with ST-segment elevation myocardial infarction (STEMI) has been a challenging issue. This study aimed to compare the impact of additive manual thrombectomy on patients with myocardial infarction (MI) and total cutoff vessel with standard primary percutaneous coronary intervention (PPCI) with bailout thrombectomy. METHODS: In this case-control study, 181 patients with acute STEMI were enrolled who referred to Chamran Hospital (Isfahan, Iran) between August to December 2014...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29018137/incidence-and-outcomes-of-myocardial-infarction-in-patients-admitted-with-acute-ischemic-stroke
#7
Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli
BACKGROUND AND PURPOSE: Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. METHODS: The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28989934/takotsubo-cardiomyopathy-with-a-rapidly-resolved-left-ventricular-thrombus
#8
Abdel Anabtawi, Paola C Roldan, Carlos A Roldan
This article presents the case of a 53-year-old man who presented with acute right superficial femoral and popliteal arterial thrombosis for which he underwent an emergent uncomplicated thrombectomy. He denied preceding cardiovascular or neurologic symptomatology and had no history of coronary or peripheral arterial disease, trauma, hypercoagulability, or malignancy. However, he reported having several days of intense emotional stress prior to presentation. His cardiac exam was normal, his electrocardiogram showed normal sinus rhythm and nonspecific ST-T wave abnormalities, and his troponin levels were normal...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28919314/24-hour-alberta-stroke-program-early-ct-score-assessment-in-post-stroke-spasticity-development-in-patients-with-a-first-documented-anterior-circulation-ischemic-stroke
#9
Ondrej Volny, Maria Justanova, Petra Cimflova, Linda Kasickova, Ivana Svobodova, Jan Muzik, Martin Bares
BACKGROUND: Neuroanatomic substrates responsible for development of post-stroke spasticity are still poorly understood. The study is focused on identification of brain regions within the territory of the middle cerebral artery associated with spasticity development. METHODS: This is a single-center prospective cohort study of first documented anterior circulation ischemic strokes with a neurologic deficit lasting >7 days (from March 2014 to September 2016, all patients are involved in a registry)...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28867126/early-ventricular-tachycardia-or-fibrillation-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-and-impact-on-mortality-and-stent-thrombosis-from-the-harmonizing-outcomes-with-revascularization-and-stents
#10
RANDOMIZED CONTROLLED TRIAL
Ioanna Kosmidou, Monica Embacher, Thomas McAndrew, José M Dizon, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
The prevalence and impact of early ventricular arrhythmias (ventricular tachycardia [VT]/ventricular fibrillation [VF]) occurring before mechanical revascularization for acute ST segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention are poorly understood. We sought to investigate the association between early VT/VF and long-term clinical outcomes using data from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction trial. Among 3,602 patients with STEMI, 108 patients (3...
November 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28815091/-spice-synthetic-marijuana-induced-acute-myocardial-infarction-a-case-series
#11
E Ul Haq, A Shafiq, A A Khan, A A Awan, S Ezad, W J Minteer, B Omar
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28804656/pneumomediastinum-and-mediastinal-hematoma-secondary-to-right-brachiocephalic-vein-thrombectomy-mimicking-stemi
#12
Prem Shukla, Prudence Dy, Rishi Raj, Sayee Sundar Alagusundaramoorthy, Noel Nivera
A 50-year-old male with a history of hemodialysis dependent chronic kidney disease presented to our emergency department with acute midsternal crushing chest pain. Patient was diagnosed with acute anterolateral wall Myocardial Infraction due to the presence of corresponding ST segment elevations in EKG and underwent emergent cardiac catheterization which revealed normal patent coronaries without any disease. He continued to have chest pain for which CT of the chest was done which revealed pneumomediastinum with mediastinal hematoma, due to the recent attempted thrombectomy for thrombus in his right brachiocephalic vein...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28797607/trends-and-clinical-outcomes-in-patients-undergoing-primary-percutaneous-revascularisation-for-st-elevation-myocardial-infarction-a-single-centre-experience
#13
Luke P Dawson, Josephine Warren, Juan Mundisugih, Viveka Nainani, William Chan, Dion Stub, Archer Broughton, Andrew J Taylor, Antony Walton, Stephen J Duffy, James A Shaw
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. METHODS: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#14
Gabriel V Fontaine, Shawn M Smith
Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. A 73-year-old man presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin before percutaneous coronary intervention (PCI) for placement of a right coronary artery stent. One hour following PCI, he abruptly developed left hemiparesis and dysphagia...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28685015/hybrid-approach-to-the-management-of-infective-endocarditis-complicated-by-coronary-artery-embolism-a-case-report
#15
Amy G Fiedler, Robert C Schutt, David Greenhouse, James Stone, Thoralf M Sundt, Rahul Sakhuja
Septic coronary embolization in a patient with endocarditis is a rare and can be a devastating complication. The management of this clinical problem in the current era may be best served with a multi-modality approach. We present an interesting case of a patient with septic coronary embolization managed with the combined use of aspiration thrombectomy followed by surgical management of the infected valve.
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28660560/jetstream-atherectomy-and-balloon-angioplasty-with-distal-embolic-protection-for-angio-seal%C3%A2-related-vascular-access-complications
#16
Mihir Barvalia, Mohammad Thawabi, Yassir Nawaz, Nishant Sethi, John Shao, Michael Amponsah, Gautam Visveswaran, Marc Cohen, Najam Wasty
Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases...
June 28, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28606249/-truths-myths-or-lies-who-is-indicated-for-coronary-thrombectomy
#17
Y L Han
No abstract text is available yet for this article.
June 6, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28503386/mechanical-thrombectomy-for-acute-ischemic-stroke-after-cardiac-surgery
#18
Ali S Haider, Prabhat Garg, Ian T Watson, Dean Leonard, Umair Khan, Ahmed Haque, Phu Nguyen, Kennith F Layton
Ischemic stroke is a rare yet devastating complication that may occur following cardiothoracic surgery. Fibrinolytic treatment is contraindicated due to elevated risk for hemorrhage. Mechanical thrombectomy entails a catheterized approach wherein the thrombus is physically removed from the vessel without the use of fibrinolytics, minimizing the possibility of intracranial hemorrhage. Here, we present two original cases of mechanical thrombectomy as treatment for patients experiencing emergent large vessel occlusion following cardiothoracic surgery...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28491085/stenting-versus-non-stenting-treatment-of-intermediate-stenosis-culprit-lesion-in-acute-st-segment-elevation-myocardial-infarction-a-multicenter-randomized-clinical-trial
#19
Jing Dai, Shu-Zheng Lyu, Yun-Dai Chen, Xian-Tao Song, Min Zhang, Wei-Min Li, Yang Zheng, Shang-Yu Wen, Shao-Ping Nie, Yu-Jie Zeng, Hai Gao, Yi-Tong Ma, Shu-Yang Zhang, Li-Jun Guo, Zheng Zhang
BACKGROUND: The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. METHODS AND RESULTS: It was a prospective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate (40%-70%) stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban (15 µg/kg) were enrolled and were randomly assigned (1: 1) to stenting group (n = 201) and non-stenting group (n = 198)...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28468787/inflammatory-differences-in-plaque-erosion-and-rupture-in-patients-with-st-segment-elevation-myocardial-infarction
#20
Sujay Chandran, Johnathan Watkins, Amina Abdul-Aziz, Manar Shafat, Patrick A Calvert, Kristian M Bowles, Marcus D Flather, Stuart A Rushworth, Alisdair D Ryding
BACKGROUND: Plaque erosion causes 30% of ST-segment elevation myocardial infarctions, but the underlying cause is unknown. Inflammatory infiltrates are less abundant in erosion compared with rupture in autopsy studies. We hypothesized that erosion and rupture are associated with significant differences in intracoronary cytokines in vivo. METHODS AND RESULTS: Forty ST-segment elevation myocardial infarction patients with <6 hours of chest pain were classified as ruptured fibrous cap (RFC) or intact fibrous cap (IFC) using optical coherence tomography...
May 3, 2017: Journal of the American Heart Association
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