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MRI and coronary stent

Foeke J H Nauta, Arnoud V Kamman, El-Sayed H Ibrahim, Prachi P Agarwal, Bo Yang, Karen Kim, David M Williams, Joost A van Herwaarden, Frans L Moll, Kim A Eagle, Santi Trimarchi, Himanshu J Patel, C Alberto Figueroa
INTRODUCTION: Thoracic aortic stent grafts are orders of magnitude stiffer than the native aorta. These devices have been associated with acute hypertension, elevated pulse pressure, cardiac remodelling and reduced coronary perfusion. However, a systematic assessment of such cardiovascular effects of thoracic endovascular aortic repair (TEVAR) is missing. The CardiOvascular Remodelling following Endovascular aortic repair (CORE) study aims to (1) quantify cardiovascular remodelling following TEVAR and compare echocardiography against MRI, the reference method; (2) validate computational modelling of cardiovascular haemodynamics following TEVAR using clinical measurements, and virtually assess the impact of more compliant stent grafts on cardiovascular haemodynamics; and (3) investigate diagnostic accuracy of ECG and serum biomarkers for cardiac remodelling compared to MRI...
November 17, 2016: BMJ Open
Sebastian Peter Haen, Rebekka Mannal, Martin Steeg, Peter Seizer, Michaela Rockenstiehl, Susanne Mackensen-Haen, Marius Horger, Lothar Kanz, Wichard Vogel
HISTORY AND ADMISSION FINDINGS: We report the case of a 59-year-old male who was admitted to hospital with acute chest pain. Coronary heart disease was known from the medical history. The patient reported recurrent ostealgia and susceptibility for infection during the last months before admission. INVESTIGATIONS: A 75% stenosis of the circumflex branch was treated with a drug eluting stent. Platelet aggregation was inhibited with acetylsalicylic acid and clopidogrel...
April 2016: Deutsche Medizinische Wochenschrift
Tuncay Yetgin, Matthijs van Kranenburg, Tim Ten Cate, Dirk J Duncker, Menko-Jan de Boer, Roberto Diletti, Robert-Jan M van Geuns, Felix Zijlstra, Olivier C Manintveld
BACKGROUND: Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established. STUDY DESIGN: The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI...
October 2016: Catheterization and Cardiovascular Interventions
Tilman Hickethier, Jan Robert Kröger, Jochen Von Spiczak, Bettina Baessler, Roman Pfister, David Maintz, Alexander C Bunck, Guido Michels
BACKGROUND: Accurate assessment of coronary stents after PCI using non-invasive imaging remains challenging despite technological improvements. New bioresorbable vascular scaffolds (BVS) have recently become available promising improved non-invasive imaging properties, which however have not be examined specifically yet. Therefore we investigated CT and MRI visualization properties of the only two CE-marked coronary BVSs. METHODS: The Abbott Absorb and the Elixir DESolve BVS were placed in plastic tubes filled with contrast agent and scanned with a latest generation CT respectively MR system...
March 1, 2016: International Journal of Cardiology
Hongchao Yang, Youxiang Li, Yuhua Jiang
OBJECT Insufficient platelet inhibition has been associated with an increased incidence of thromboembolic complications in cardiology patients undergoing percutaneous coronary intervention. Data regarding the relationship between insufficient platelet inhibition and thromboembolic complications in patients undergoing neurovascular procedures remain controversial. The purpose of this study was to assess the relationship of insufficient platelet inhibition and thromboembolic complications in patients with intracranial aneurysm undergoing stent treatment...
August 2016: Journal of Neurosurgery
Lukas Winter, Eva Oberacker, Celal Özerdem, Yiyi Ji, Florian von Knobelsdorff-Brenkenhoff, Gerd Weidemann, Bernd Ittermann, Frank Seifert, Thoralf Niendorf
PURPOSE: Examine radiofrequency (RF) induced heating of coronary stents at 7.0 Tesla (T) to derive an analytical approach which supports RF heating assessment of arbitrary stent geometries and RF coils. METHODS: Simulations are performed to detail electromagnetic fields (EMF), local specific absorption rates (SAR) and temperature changes. For validation E-field measurements and RF heating experiments are conducted. To progress to clinical setups RF coils tailored for cardiac MRI at 7...
October 2015: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Yoshitaka Kurosaki, Kazumichi Yoshida, Ryu Fukumitsu, Nobutake Sadamasa, Akira Handa, Masaki Chin, Sen Yamagata
OBJECTIVE: Plaque characteristics and morphology are important indicators of plaque vulnerability. MRI-detected intraplaque hemorrhage has a great effect on plaque vulnerability. Expansive remodeling, which has been considered compensatory enlargement of the arterial wall in the progression of atherosclerosis, is one of the criteria of vulnerable plaque in the coronary circulation. The purpose of this study was risk stratification of carotid artery plaque through the evaluation of quantitative expansive remodeling and MRI plaque signal intensity...
March 2016: Journal of Neurosurgery
Bogdan A Kindzelski, Ming Li, Dumitru Mazilu, Keith A Horvath
BACKGROUND AND AIM OF THE STUDY: Balloon-expandable (BE) and self-expanding (SE) prostheses are both used for transcatheter aortic valve replacement (TAVR), but differences in long-term outcome using these types of device are unknown. The study aim was to monitor the histopathology, echocardiographic findings and structural integrity of BE and SE stents in a preclinical model for up to six months after TAVR. METHODS: Real-time magnetic resonance imaging (rtMRI)-guided TAVR was performed in 22 Yucatan pigs using either a BE (n = 10) or a SE (n = 12) prosthesis...
March 2015: Journal of Heart Valve Disease
Muhammad Zaid Iskandar, Victor Chong, Stuart Hutcheon
A 73-year-old woman presented with acute shortness of breath and exacerbation of chronic back pain. She was diagnosed with pulmonary oedema and a non-ST-elevation myocardial infarction following chest X-ray, ECG and high sensitivity troponin levels. She subsequently underwent coronary angioplasty with deployment of drug-eluting stents to her circumflex and left anterior descending arteries and was started on aspirin and clopidogrel for her dual antiplatelet therapy. Unfortunately, following the procedure, she gradually lost power and sensation in both lower limbs...
2015: BMJ Case Reports
Timothy John Barreiro, Denis D Asiimwe, David Gemmel, Patrick Brine
A 53-year-old man with a history of diabetic foot ulcer, osteomyelitis, coronary artery disease, hypertension and hyperlipidaemia, presented with chest pain of 3 weeks duration. Eleven days earlier, the patient had had a drug-eluting stent (DES) placed in a branch of the right coronary artery (RCA) after similar chest pain, leading to the findings of a positive nuclear stress test. Since discharge, he was not compliant with taking clopidegrel (Plavix), a concern for in-stent thrombosis with recurrent myocardial ischaemia; but work up was negative and medications were restarted...
2015: BMJ Case Reports
Brigitte Luu, Anoosh Esmaeili, Dietmar Schranz, Stephan Fichtlscherer
Coronary stenting is considered a promising treatment option for patients with coronary artery lesions caused by Kawasaki disease (KD). Here, we report the case of an adolescent with KD who successfully underwent implantation of a fully bioresorbable vascular scaffold (BVS) in a Kawasaki-related, highly obstructed coronary artery. Control coronary angiography 6 months later showed a remaining good result without restenosis or development of aneurysm. Cardial MRI and clinical follow-up revealed stable results at 6 and 18 months without any signs of ischemia...
October 2015: Pediatric Cardiology
F Arslan, J Mair, W-M Franz, M Otten, L van Lelyveld
A 64-year-old man suffering from an acute posterior wall myocardial infarction underwent primary percutaneous coronary intervention. After several aspiration attempts, tirofiban infusion and pre- and post-dilatation, a bare-metal stent was successfully implanted in the culprit right coronary artery. While the patient did not show any neurological symptoms before or during the procedure, he exhibited hemiplegia and loss of spontaneous speech. Additional magnetic resonance imaging showed an extensive brain stem infarction...
July 2015: Netherlands Heart Journal
Stephen P Hoole, Catherine Jaworski, Adam J Brown, Liam M McCormick, Bobby Agrawal, Sarah C Clarke, Nick E J West
OBJECTIVE: Utilising a novel study design, we evaluated serial measurements of the index of microcirculatory resistance (IMR) in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) to assess the impact of device therapy on microvascular function, and determine what proportion of microvascular injury is related to the PPCI procedure, and what is an inevitable consequence of STEMI. DESIGN: 41 patients undergoing PPCI for STEMI were randomised to balloon angioplasty (BA, n=20) or manual thrombectomy (MT, n=21) prior to stenting...
2015: Open Heart
Juan F Iglesias, Pierre Monney, Patrizio Pascale, Patrick Yerly, Olivier Muller, Juerg Schwitter, Roger Hullin, Eric Eeckhout, Pierre Vogt
Important clinical trials and therapeutic advances in the field of cardiology have been presented in 2014. New evidences on the management of acute myocardial infarction and the duration of dual antiplatelet therapy after coronary stent implantation have been published. A new class of therapeutic agents seems to offer promising perspectives for patients with heart failure and reduced ejection fraction. The new generation of subcutaneous or MRI-compatible implantable defibrillators is a major technological breakthrough...
January 14, 2015: Revue Médicale Suisse
Graham Nichol, Warren Strickland, David Shavelle, Akiko Maehara, Ori Ben-Yehuda, Philippe Genereux, Ovidiu Dressler, Rupa Parvataneni, Melissa Nichols, John McPherson, Gérald Barbeau, Abhay Laddu, Jo Ann Elrod, Griffeth W Tully, Russell Ivanhoe, Gregg W Stone
BACKGROUND: Systemic hypothermia may reduce infarct size if established before reperfusion. The large surface area of the bowel may facilitate rapid hypothermia. We therefore examined the feasibility, safety, and efficacy of hypothermia induced by an automated peritoneal lavage system in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: Patients with ST-segment-elevation myocardial infarction within 6 hours of symptom onset were randomized to peritoneal hypothermia before and for 3 hours after percutaneous coronary intervention versus control...
March 2015: Circulation. Cardiovascular Interventions
Ivan D Hanson, Shukri W David, Simon R Dixon, D Christopher Metzger, Philippe Généreux, Akiko Maehara, Ke Xu, Gregg W Stone
OBJECTIVES: We sought to evaluate the feasibility and safety of catheter-based supersaturated oxygen (SSO2 ) delivery via the left main coronary artery (LMCA) following primary percutaneous coronary intervention (PCI). BACKGROUND: In the multicenter, randomized AMIHOT-II trial, SSO2 delivered into the proximal or mid left anterior descending (LAD) artery via an indwelling intracoronary infusion catheter in patients with acute anterior ST-segment elevation myocardial infarction (STEMI) following primary PCI significantly reduced infarct size but resulted in a numerically higher incidence of safety events...
October 2015: Catheterization and Cardiovascular Interventions
Keith A Horvath, Dumitru Mazilu, Junfeng Cai, Bogdan Kindzelski, Ming Li
OBJECTIVES: Despite the increasing success and applicability of transcatheter aortic valve replacement, 2 critical issues remain: the durability of the valves, and the ideal imaging to aid implantation. This study was designed to investigate the transapical implantation of a device of known durability using real-time magnetic resonance imaging (MRI) guidance. METHODS: A sutureless aortic valve was used that employs a self-expanding nitinol stent and is amenable to transapical delivery...
April 2015: Journal of Thoracic and Cardiovascular Surgery
Lukas Winter, Eva Oberacker, Celal Özerdem, Yiyi Ji, Florian von Knobelsdorff-Brenkenhoff, Gerd Weidemann, Bernd Ittermann, Frank Seifert, Thoralf Niendorf
PURPOSE: Examine radiofrequency (RF) induced heating of coronary stents at 7.0 Tesla (T) to derive an analytical approach which supports RF heating assessment of arbitrary stent geometries and RF coils. METHODS: Simulations are performed to detail electromagnetic fields (EMF), local specific absorption rates (SAR) and temperature changes. For validation E-field measurements and RF heating experiments are conducted. To progress to clinical setups RF coils tailored for cardiac MRI at 7...
October 2015: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Yoshinori Mano, Kimi Koide, Hiroaki Sukegawa, Masaki Kodaira, Takahiro Ohki
A 62-year-old man was admitted to our emergency department owing to prolonged chest pain that had lasted for 3 h. An electrocardiogram showed ST elevation in leads I, aVL, and V1-6, and the patient's laboratory revealed elevated myocardial necrosis marker levels. Emergency coronary angiography showed total occlusion of the proximal left anterior descending coronary artery. Subsequent percutaneous coronary intervention was performed by balloon angioplasty followed by stent implantation, and the patient showed improvement...
January 2016: Heart and Vessels
Young-Guk Ko, Hoyoun Won, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Jang-Ho Bae, Sahng Lee, Do-Sun Lim, Yangsoo Jang
The purpose of the study was to investigate whether early high-dose potent statin therapy in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention can reduce infarct size compared with conventional low-dose statin therapy. In a randomized placebo-controlled multicenter trial, 185 patients were assigned either to an early high-dose rosuvastatin group (n = 92, rosuvastatin 40 mg before treatment plus maintenance for 7 days) or to a conventional low-dose rosuvastatin group (n = 93, placebo before treatment plus rosuvastatin 10-mg maintenance for 7 days)...
July 1, 2014: American Journal of Cardiology
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