Interventional cardiology,radiology

Coronary arterial fistulae are rare, but it is one of the most common coronary artery anomalies. Most of the cases are asymptomatic in younger patients unless it is large and of haemodynamic significance. The incidence of thromboembolic complications usually increases with age. We report a case of a young male in his early 20s presenting with central chest pain. Coronary computed tomographic angiography revealed acute coronary syndrome due to a fistula between right coronary artery and right atrium occluded by thrombus...

The aim of this work was to propose a preliminary local diagnostic reference levels (DRL) for pediatric interventional cardiology (PIC) procedures in Argentina, for different ranges of age and weight. This work has been conducted in the framework of the "Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean" (OPRIPALC) program coordinated by the World Health Organization and the Pan American Health Organization in cooperation with the International Atomic Energy Agency to ensuring that radiation exposures of pediatric patients are the minimum necessary during fluoroscopy-guided interventional procedures...

Endovascular robots have the potential to revolutionize the field of vascular interventions by enhancing procedural efficiency, accuracy, and standardization. They aim to reduce radiation exposure, as well as physical strain on operators and medical staff, while enabling precise navigation of catheters through challenging anatomical structures. However, the widespread adoption of these robots faces barriers, such as real estate constraints, setup time, limited range of compatible tools, and high costs. This paper discusses these barriers and highlights Hansen Medical's Magellan and the Liberty robotic systems as notable examples...

BACKGROUND: The recommendations for the use of and selection of covered stent grafts in patients with aortoiliac occlusive disease are limited. OBJECTIVE: The GORE VBX FORWARD clinical study aims to demonstrate the superiority of the GORE VIABAHN VBX Balloon Expandable Endoprosthesis (VBX device) for primary patency when compared to bare metal stenting (BMS) for the treatment of complex iliac artery occlusive disease. METHODS: A prospective, multicenter, randomized control study in the United States, European Union, United Kingdom, Australia, and New Zealand will enroll patients with symptomatic, complex iliac artery occlusive disease...

BACKGROUND: Cardiovascular calcification, characterized by deposition of calcium phosphate in the arterial wall and heart valves, is associated with cardiovascular morbidity and mortality and is commonly seen in aging, diabetes, and chronic kidney disease. Whether evidence-based interventions could significantly attenuate cardiovascular calcification progression remains uncertain. METHODS AND RESULTS: We conducted a systematic review of randomized controlled trials involving interventions, compared with placebo, another comparator, or standard of care, to attenuate cardiovascular calcification...

Pediatric interventional cardiology procedures are essential in diagnosing and treating congenital heart disease in children; however, they raise concerns about potential radiation exposure. Managing radiation doses and assessing image quality in angiographs becomes imperative for safe and effective interventions. This systematic review aims to comprehensively analyze the current understanding of physical image quality metrics relevant for characterizing X-ray systems used in fluoroscopy-guided pediatric cardiac interventional procedures, considering the main factors reported in the literature that influence this outcome...

BACKGROUND: The COVID-19 pandemic resulted in extensive disruption to the delivery of elective health services. Official figures of NHS waiting lists in England do not account for patients on the hidden waiting list (ie, patients who have symptoms or disease requiring elective procedures who have not been placed on the waiting list due to pandemic-related disruption). The aim of this study was to model the elective procedure backlog in England, including the hidden waiting list. METHODS: We used publicly available activity data from NHS Digital to estimate procedure-level backlogs in England for the pandemic period (from Jan 1, 2020, to Dec 31, 2022) compared with expected population need for elective procedures based on pre-pandemic trends, adjusting for population growth and ageing, as well as patient deaths while on the waiting list...

PURPOSE: Prompt endovascular treatment of patients with stroke due to intracranial Large Vessel Occlusion (LVO) is a major challenge in rural areas because neurointerventionalists are usually not available. As a result, treatment is delayed, and clinical outcomes are worse compared with patients primarily treated in comprehensive stroke centers (CSC). To address this problem, we present a concept in which interdisciplinary, on-site endovascular treatment is performed in a Primary Stroke Center (PSC) by a team of interventional neuroradiologists and cardiologists: the Rendez-Vous approach...

This study describes trends in surgical versus endovascular interventions for treatment of chronic superficial venous disease (SVD) in the Medicare population. Medicare Part B data from 2010-2018 was obtained. Claims for SVD treatment were identified using Healthcare Common Procedure Coding System (HCPCS) codes. Total percent change in utilization rates and market share was determined for each provider group. Utilization of SVD treatments increased by 58%, mostly due to growing utilization of endovascular treatments...

Disease of the aortic arch, descending thoracic, or thoracoabdominal aorta necessitates dedicated expertise across medical, endovascular, and surgical specialties. Cardiologists, cardiac surgeons, vascular surgeons, interventional radiologists, and others have expertise and skills that aid in the management of patients with complex aortic disease. No specialty is uniformly expert in all aspects of required care. Because of this dispersion of expertise across specialties, an aortic team model approach to decision-making and treatment is advocated...

X-rays are widely used in interventional cardiology (IC). Medical staff is exposed to ionising radiations with difficulties to accurately estimate the absorbed dose, on the other hand, it is well known that eye lens and extremities are the most exposed. In most IC units, radiological monitoring is performed by measuring the personal dose equivalent with a dosemeter worn under the operator's apron. The ambient dose equivalent is, usually, also measured. Furthermore, doses to the lens and extremities are often not measured because of the absence or difficulty of wearing the appropriate dosemeters...

The core content for a medical specialty outlines the scope of the discipline as well as the categories of knowledge considered essential to practice in the field. It provides a template for the development of curricula for medical school, graduate, and postgraduate education, as well as for creating certification standards. Venous and Lymphatic Medicine (VLM) is a specialty that has benefitted from contributions from specialists from several medical disciplines. Optimally, the societies, boards, and residency review committees representing these disciplines would uniformly recognize the scope of VLM to develop education and assessment standards to allow training and identification of qualified practitioners...

Iatrogenic coronary artery dissection is listed among the rare complications of interventional cardiology procedures, such as diagnostic angiography and percutaneous coronary intervention (PCI), which are worldwide routine in clinical practice. Although extremely infrequent, they can lead to severe myocardial injury and even to death. In the following case, we present an iatrogenic left anterior descending coronary artery (LAD) dissection, which led to an ischemic dilated cardiopathy. This case was radiologically and clinically worthy of note for the atypical site of dissection, the lack of symptoms although the ischemic damage and the global management requiring a multidisciplinary approach...

Guiding wire fractures sometimes occur during cardiological interventional procedures or orthopedic operations, but rarely reported guiding wire fractures during interventional radiological sessions. We present a case of right breast cancer with right axillary nodal metastasis and received surgical resection and neoadjuvant chemotherapy and target therapy. An intramuscular abscess at the right gluteal muscle groups was noted in the contrast-enhanced computer tomography (CT) during her follow up clinic visit...

Introduction Angiography is a method for defining the inner vessel wall and demonstrating flow through the lumen by detecting contrast injection into a blood vessel and projecting it onto a sequence of X-rays. This method is used to image the anatomical and architectural aspects of the vascular system. By employing balloon dilatation and the implantation of stents to widen the stenosed arteries, angioplasty is a form of minimally invasive endovascular treatment used to treat cardiovascular diseases and their consequences...

INTRODUCTION: This curriculum was designed to improve access to procedures for our internal medicine residents. METHODS: We created an interdisciplinary procedure course (IDPC) composed of two simulation sessions and a one-week procedural rotation supervised by multiple specialties including nephrology, cardiology, cardiothoracic anesthesiology, general anesthesiology, and interventional radiology. After the course, residents completed two surveys documenting the number of procedures and their level of confidence on a Likert scale (1 = very unconfident to 5 = very confident) prior to and after completing the curriculum...

<b/> Background: The quality of vascular care has significantly improved in part by the expansion of endovascular techniques for the treatment of symptomatic peripheral artery disease (PAD) in recent years. In Germany these are primarily provided by the three disciplines of vascular surgery, angiology, and interventional radiology (IR). However, the relative contribute of angiologists to the total number of cases performed is unknown. Patients and methods: In the present study, we analysed the respective contribution of vascular surgery, angiology, and IR to the delivery of endovascular revascularisations in symptomatic PAD in Germany based on the legally mandatory quality reports representative for the reporting year 2018...

This is a case report of a woman in her 60s with Rutherford class 3 bilateral calf claudication and a resting right Ankle Brachial Index (ABI) 0.49 and left ABI 0.57. The arteriogram of lower extremities demonstrates bilateral persistent sciatic arteries (PSAs). The patient had severe stenosis of left common iliac artery, and thus underwent successful stenting resulting in normalisation of flow and filling of PSA with symptom resolution.

The stressful nature of the medical profession is a known trigger for aggression or abuse among healthcare staff. Interprofessional incivility, defined as low-intensity negative interactions with ambiguous or unclear intent to harm, has recently become an occupational concern in healthcare. While incivility in nursing has been widely investigated, its prevalence among physicians and its impact on patient care are poorly understood. This review summarises current understanding of the effects of interprofessional incivility on medical performance, service and patient care...

BACKGROUND: Achieving the weekly physical activity recommendations of at least 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic exercise is important for reducing cardiometabolic risk, but evidence shows that most people struggle to meet these goals, particularly in the mid to long term. OBJECTIVE: The Messages Improving Resting Heart Health (MIRTH) study aims to determine if (1) sending daily motivational messages through a research app is effective in improving motivation and in promoting adherence to physical activity recommendations in men and women with coronary heart disease randomized to a 12-month intensive lifestyle intervention, and (2) the time of the day when the message is delivered impacts compliance with exercise training...