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coronary artery angiography

Udaya Tantry, Rahul Chaudhary, Jacek Kubica, Kevin Bliden, Paul A Gurbel
All oral P2Y12 receptor blockers are associated with some degree of delayed onset and offset of pharmacodynamic (PD) effects in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). Although intravenous glycoprotein IIb/IIIa inhibitors are associated with rapid onset of action, they are also associated with delayed offset and other limitations such as elevated bleeding risk and thrombocytopenia. Areas covered: In this review, the authors focus on cangrelor, an intravenous, reversible P2Y12 receptor blocker with fast onset and offset of effects...
August 13, 2018: Expert Opinion on Pharmacotherapy
Shozo Sueda, Kaori Fujimoto, Yasuhiro Sasaki, Tomoki Sakaue, Hirokazu Habara, Hiroaki Kohno
Objectives The clinical characteristics in patients with catheter-induced spasm in the proximal right coronary artery (RCA) are controversial. We performed a clinical analysis of catheter-induced spasm in the RCA. Methods We retrospectively analyzed 5,352 consecutive patients who underwent diagnostic or follow-up angiography during a 26-year period. During this period, we found 40 patients with catheter-induced spasm in the RCA. We compared the clinical characteristics and procedures of cardiac catheterization in patients with catheter-induced spasm in the RCA with those in patients without such spasm...
August 10, 2018: Internal Medicine
Ryoto Hourai, Satomi Kasashima, Shu-Ichi Fujita, Koichi Sohmiya, Masahiro Daimon, Yoshinobu Hirose, Takahiro Katsumata, Sachiko Kanki, Michishige Ozeki, Nobukazu Ishizaka
A 74-year-old man was admitted for preoperative screening of aortic stenosis. Five months before this admission, he was found to have elevated serum immunoglobulin G4 (IgG4; 2,010 mg/dL). Computed tomography (CT) showed a soft tissue mass surrounding the abdominal aorta, suggestive of IgG4-related periaortitis. CT coronary angiography showed perivascular thickening of the right coronary artery, and subsequent coronary angiography showed a multi-vessel disease. The patient underwent aortic valve replacement and coronary bypass surgery...
August 11, 2018: International Heart Journal
Qin Li, Benjamin P Berman, Tomoe Hagio, Marios A Gavrielides, Rongping Zeng, Berkman Sahiner, Qi Gong, Yuan Fang, Songtao Liu, Nicholas P Petrick
Extracting coronary artery calcium (CAC) scores from contrast-enhanced computed tomography (CT) images using dual-energy (DE) based material decomposition has been shown feasible, mainly through patient studies. However, the quantitative performance of such DE-based CAC scores, particularly per-stenosis, is underexamined due to lack of reference standard and repeated scans. In this work we conducted a comprehensive quantitative comparative analysis of CAC scores obtained with DE and compare to conventional unenhanced single-energy (SE) CT scans through phantom studies...
August 13, 2018: Physics in Medicine and Biology
Axel Dimberg, Ulrica Alström, Mikael Janiec
OBJECTIVES: Re-exploration for bleeding after cardiac surgery increases the risk of other severe postoperative complications and early mortality. Patients re-explored for bleeding after coronary artery bypass grafting are potentially subject to threats to graft patency. Our goal was to assess the effects of re-exploration for bleeding regarding the incidence of coronary angiographies, the need for coronary reintervention and mortality during long-term follow-up. METHODS: Within the SWEDEHEART registry, all isolated coronary artery bypass operations with a single internal mammary artery and saphenous vein graft in patients aged 40-80 between the years 2005 and 2015 were identified...
August 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Scott A Cameron, Joshua D Robinson, Michael R Carr, Angira Patel
Kawasaki disease (KD) is a vasculitis that affects medium-sized arteries and can lead to coronary artery aneurysms. KD should be considered in any infant presenting with prolonged fever. Delaying treatment beyond Day 10 of fever portends a high risk of coronary artery aneurysms. Echocardiography is often necessary to diagnose KD in young infants who frequently present without classic physical examination findings. We report on a case of KD with giant aneurysms in a 2-month-old infant. A combination of transthoracic echocardiography and CT angiography was utilized in the diagnosis as well as in the management of this infant...
August 12, 2018: Echocardiography
Sergio Barros-Gomes, Abdullah El Sabbagh, Mackram F Eleid, Sunil V Mankad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1-3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse, and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
August 11, 2018: Echo Research and Practice
Hiroya Asou, Naoyuki Imada, Yuichi Nishiyama, Tomoyasu Sato, Katsuhiro Ichikawa
PURPOSE: The aim of the present study was to develop an automated system for determining the cardiac rest period during whole-heart coronary magnetic resonance angiography (CMRA) examination. MATERIALS AND METHODS: Ten healthy male volunteers (25-51 years old, 50-77 beats/min heart rate) were enrolled in this prospective study. A motion area map was generated from a cine image set by extracting high-speed component of cardiac motion, and it was used to specify the rest period in the proposed CMRA...
July 7, 2018: Clinical Imaging
Takeshi Niizeki, Eiichiro Ikeno, Tadateru Iwayama, Masafumi Watanabe
BACKGROUND Recanalized thrombi are usually unrecognized in conventional coronary angiography. However, multiple channels have been observed in recanalized thrombotic lesions. Therefore, the wire apparently crosses the lesion in some difficult cases. We analyzed the cause of difficult wiring of a recanalized thrombotic lesion using optical coherence tomography (OCT). CASE REPORT An 87-year-old man with chest pain was admitted to our hospital. Coronary angiography showed significant stenosis of the proximal right coronary artery with irregular linear filling and haziness...
August 11, 2018: American Journal of Case Reports
Deborah Mueller, Christian Puelacher, Ursina Honegger, Joan E Walter, Patrick Badertscher, Nicolas Schaerli, Ivo Strebel, Raphael Twerenbold, Jasper Boeddinghaus, Thomas Nestelberger, Christina Hollenstein, Jeanne du Fay de Lavallaz, Raban Jeger, Christoph Kaiser, Damian Wild, Katharina Rentsch, Andreas Buser, Michael Zellweger, Tobias Reichlin, Christian Mueller
BCKGROUND: We aimed to directly compare high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the detection of functionally relevant coronary artery disease (fCAD). METHODS: Consecutive patients referred with clinical suspicion of fCAD and no structural heart disease other than coronary artery disease were included. The presence of fCAD was based on rest/stress myocardial perfusion single-photon emission computed tomography/computed tomography and coronary angiography...
August 10, 2018: Clinical Chemistry
Thanh Dinh Nguyen, Gaoke Feng, Xin Yi, Yongnan Lyu, Zhiyuan Lan, Jinggang Xia, Tim Wu, Xuejun Jiang
Objective Using coronary angiography and intravascular ultrasound methods to evaluate the performance of the novel fully bioabsorbable scaffold (NFBS) composed of poly-L-lactic acid/amorphous calcium phosphate (PLLA/ACP) at six-month follow-up by comparing with PLLA scaffolds Methods Twelve PLLA/ACP scaffolds and 12 PLLA scaffolds were implanted into the coronary arteries of 12 miniature pigs. Quantitative coronary angiography (QCA) was used to measure the reference vessel diameter (RVD), mean lumen diameter (MLD) and late lumen loss (LLL)...
August 2018: Journal of Biomaterials Applications
Liyuan Peng, Xincheng Guo, Ya Gao, Qi Guo, Jingjing Zhang, Bangjiang Fang, Bin Yan
This study was conducted to investigate the relationship between right coronary dominance and coronary angiographic characteristics in patients with or without significant coronary artery disease (CAD).A total of 2225 patients undergoing coronary angiography (CAG) between January 2011 and November 2014 were recruited in our study. Based on the CAG results, patients were divided into the left dominance (LD) group, right dominance (RD) group, and co-dominance (CD) group. Multinomial logistic regression was applied to analyze the relationships between coronary dominance and triple-vessel CAD...
August 2018: Medicine (Baltimore)
Wei Fang, Cai-Hong Wang, Yi-Fan Yu, Li-Huan Wang, Dan-Hua Tang, Da-Bo Xu, Zuo-Yun Ding, Wen-Hao Gu
This study aims to evaluate the feasibility of performing coronary computed tomography angiography (CCTA) and abdominal enhanced computed tomography (CT) with 1-time injection of the agent.CCTA images (right coronary artery, left anterior descending coronary artery, and left circumflex coronary artery) were collected from 20 patients who completed a 1-stop combined examination of CCTA and abdominal enhanced CT (group A), 20 patients who only underwent abdominal enhanced CT (group B1), and 20 patients who only underwent CCTA (group B2)...
August 2018: Medicine (Baltimore)
Amir Ahmadi, Dylan Stanger, John Puskas, David Taggart, Y Chandrashekhar, Jagat Narula
The concept of significant lesions has substantially evolved over the last decade. With growing evidence for use of fractional flow reserve (FFR) as a determinant of lesion-specific ischemia and its superiority to angiography-guided revascularization and medical therapy, the field of percutaneous revascularization has shifted to rely exclusively on FFR instead of luminal stenosis alone in guiding revascularization. This transition to physiological assessment has not yet made it to the realm of surgical revascularization...
July 2018: Annals of Cardiothoracic Surgery
Derrick Y Tam, Saswata Deb, Bao Nguyen, Dennis T Ko, Reena Karkhanis, Fuad Moussa, Jaclyn Fremes, Eric A Cohen, Sam Radhakrishnan, Stephen E Fremes
Background: Studies have demonstrated that female sex is an adverse risk factor in CABG. The primary aim of this study was to determine whether the radial artery (RA) was associated with reduced angiographic occlusion compared to the saphenous vein graft (SVG) stratified by sex in the multi-centered Radial Artery Patency Study (NCT00187356). Methods: Between 1996-2001, 529 patients less than 80 years, with graftable triple-vessel disease underwent isolated CABG across 11 centers with late angiographic and clinical follow-up...
July 2018: Annals of Cardiothoracic Surgery
Rodrigo Modolo, Carlos Collet, Yoshinobu Onuma, Patrick W Serruys
Percutaneous coronary intervention (PCI) has evolved greatly in the last 40 years since its introduction by Andreas Grüntzig in 1977. Since then, we've observed an evolution in balloons, the development of stents, changes in stent structure, development of drug eluting stents, improvements in strut design, thickness and even their polymeric coating. Most recently we saw the rise and "fall" of bioabsorbable scaffolds for PCI. Trials with the most diverse devices for PCI and diagnostic techniques have been conducted...
July 2018: Annals of Cardiothoracic Surgery
Hossam Abubakar, Ahmed S Ahmed, Omeralfaroug Adam, Ahmed S Yassin
A 54-year-old woman presents with a long history exertional chest pain and was found to have left ventricular systolic dysfunction on trans-thoracic echocardiogram. Coronary angiography revealed no evidence of atherosclerotic coronary artery disease and showed multiple micro-fistulae draining from all three major coronary arteries to the left ventricle. This rare abnormality is the result of failure of obliteration of intra-trabecular embryonic sinusoids and may cause myocardial ischemia through the coronary steal mechanism...
August 2018: Oxford Medical Case Reports
Audrey Dionne, Ragui Ibrahim, Catherine Gebhard, Mitchel Benovoy, Mohamed Leye, Julie Déry, Chantale Lapierre, Patrice Girard, Anne Fournier, Nagib Dahdah
BACKGROUND: Coronary artery (CA) aneurysms are a serious complication of Kawasaki disease (KD). Conventional imaging techniques often described segments with regressed aneurysms as normal, whereas studies have shown significant endothelial dysfunction. METHODS: KD patients with aneurysms scheduled for routine coronary angiography underwent optical coherence tomography (OCT) imaging between 2013 and 2016. Microstructural coronary changes were compared between normal CA segments and those with dilation, regressed aneurysms, and persistent aneurysms...
June 1, 2018: Canadian Journal of Cardiology
Michael Green, Edith M Marom, Eli Konen, Nahum Kiryati, Arnaldo Mayer
CCTA has become an important tool for coronary arteries assessment in low and medium risk patients. However, it exposes the patient to significant radiation doses, resulting from high image quality requirements and acquisitions at multiple cardiac phases. For widespread use of CCTA for coronary assessment, significant reduction of radiation exposure with minimal image quality loss is still needed. A neural denoising scheme, relying on a fully convolutional neural network (FCNN) architecture, is developed and applied to noisy CCTA...
July 29, 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Ki Hong Choi, Joo Myung Lee, Il Park, Jihoon Kim, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Dong Seop Jeong, Yang Hyun Cho, Wook Sung Kim, Kiick Sung, Mi Ja Jang, Ji Dong Sung, Jin-Ho Choi, Seung-Hyuk Choi, Bon-Kwon Koo, Young Tak Lee, Eun Kyoung Kim, Sung A Chang, Sung-Ji Park, Jin-Oh Choi, Sang-Chol Lee, Seung Woo Park, Young Seok Cho, Joon Young Choi, Hyeon-Cheol Gwon, Jae K Oh
BACKGROUND: There have been limited and conflicting results regarding the prognostic impact of revascularization treatment on the long-term clinical outcomes of silent ischemia. The current study aimed to determine whether revascularization treatment compared with medical treatment (MT) alone reduces long-term risk of cardiac death of asymptomatic patients with objective evidence of inducible myocardial ischemia. METHODS: A total of 1473 consecutive asymptomatic patients with evidence of inducible myocardial ischemia were selected from a prospective institutional registry...
August 3, 2018: International Journal of Cardiology
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