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https://www.readbyqxmd.com/read/29240736/management-of-coronary-artery-disease-in-patients-on-dialysis
#1
Helen Pilmore, Mark Webster, Karishma Sidhu, Gajan Srikumar
AIMS: Coronary artery disease is common in patients with end-stage renal failure (ESRF). However, there is little evidence that revascularisation improves outcomes, compared with medical management. This study assessed survival and cardiovascular outcomes in patients with ESRF undergoing coronary angiography and then having coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI) or medical management. METHODS: Survival and major adverse cardiac events (MACE) were examined in all patients with ESRF who underwent coronary angiography at Auckland City Hospital between 2003 and 2012...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29240566/a-practical-clinical-approach-to-utilize-cardiopulmonary-exercise-testing-in-the-evaluation-and-management-of-coronary-artery-disease-a-primer-for-cardiologists
#2
Sundeep Chaudhry, Ross Arena, Deepak L Bhatt, Subodh Verma, Naresh Kumar
PURPOSE OF REVIEW: There is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care. RECENT FINDINGS: CPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD)...
December 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29238621/burkholderia-aortic-aneurysm-a-case-report-and-review-of-the-literature
#3
Sreelakshmi Panginikkod, Aishwarya Ramachandran, Pratyusha Bollimunta, Roshanak Habibi, Roshan Kumar Arjal, Venu Gopalakrishnan
Melioidosis is a frequently fatal infection caused by the Gram-negative bacillus Burkholderia pseudomallei endemic to Southeast Asia and Northern Australia. It is a rare imported pathogen in the United States and is a potential bioterror agent. We report the case of an 82-year-old previously healthy man who presented with 2 weeks of fever and epigastric pain after he returned from the Philippines. A diagnosis of nondissecting mycotic aneurysm in the descending thoracic aorta was made with the help of CT angiogram and positive blood cultures...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29238112/crevice-sign-as-an-indicator-of-plaque-laceration-associated-with-postoperative-severe-thromboembolism-after-carotid-artery-stenting-a-case-report
#4
Tomotaka Ohshima, Taiki Yamamoto, Shunsaku Goto, Kojiro Ishikawa, Toshihisa Nishizawa, Shinji Shimato
Carotid artery stenting (CAS) is increasingly utilized in patients with carotid artery stenosis. Various intraprocedural and postprocedural complications have been reported in the literature. We present a case of symptomatic major thromboembolism after CAS. The intraprocedural angiogram showed extraordinary slow filling of the contrast medium into the plaque, which we named as "crevice sign." An 83-year-old man presented repeat right amaurosis fugax for 6 months. The radiological examinations revealed 85% stenosis of the origin of the right internal carotid artery...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29234734/endovascular-aneurysm-sealing-for-management-of-aortic-occlusive-disease
#5
Ahmed Elbasty, Michael Crawford, Darren Morrow
Introduction: Endovascular management of aortic occlusive disease is an alternative to open surgery. This case describes the use of a Nellix graft to treat infrarenal aortic stenosis, outwith the graft indication for use. Case report: A 71 year old man with multiple comorbidities, presented with bilateral buttock claudication. A computed tomography angiogram (CTA) showed significant infrarenal aortic stenosis. Under local anaesthetic, using a percutaneous approach, Nellix grafts were inserted...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29234730/spontaneous-superior-mesenteric-artery-branch-pseudoaneurysm-a-rare-case-report
#6
Mina Guirgis, Jema Hua Xu, Alar Kaard, Bibombe P Mwipatayi
Background: Visceral arterial pseudoaneurysms (VAPAs) are rare vascular entities with serious consequences. Traditionally, they are associated with trauma, infection, and inflammatory disease, or they can arise as a post-operative complication. Report: An 87 year old man presented with abdominal pain and was found to have a spontaneous VAPA on a computed tomography angiogram. Serial imaging 4 months previously had demonstrated no aneurysm. Between scans, warfarin was changed to apixaban for aortic valve replacement, but he had no other changes to any other medications...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29230497/triple-in-situ-antegrade-laser-fenestration-of-aortic-stent-graft-extension-using-fusion-imaging-for-urgent-treatment-of-symptomatic-abdominal-aneurysm-with-type-1-endoleak
#7
Joseph Touma, Hicham Kobeiter, Marek Majewski, Vania Tacher, Pascal Desgranges
The present report describes the management of massive proximal type 1 endoleak with an enlarged symptomatic aneurysmal sac. Urgent treatment was performed using in situ laser fenestration of an aortic proximal extension facing renovisceral ostia. Image fusion was obtained intraoperatively. For each target vessel (superior mesenteric and two renal arteries), an Aptus HeliFX steerable sheath (Medtronic) inserted through femoral access was curved to face the vessel's ostium marker. A laser catheter (Spectranetics) was used to traverse the stent-graft and insert a 0...
December 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29229349/surgical-management-of-ruptured-isolated-aneurysm-of-the-artery-of-adamkiewicz-an-interesting-report-and-overview-of-the-literature
#8
Zaid Aljuboori, Mayur Sharma, Jessica Simpson, Thomas Altstadt
BACKGROUND: Spinal subarachnoid hemorrhage (SAH) due to rupture of an isolated spinal aneurysm is extremely rare. Patients usually present with symptoms and signs resulting from spinal cord compression. No standard guidelines are available for the treatment of this condition. CASE ILLUSTRATION: In this report, we present a case of a 78 year old Caucasian male who presented with sudden onset back pain and bilateral lower extremity weakness, spinal angiogram revealed an isolated aneurysm of the artery of Adamkiewicz (AKA)...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29227856/gastroduodenal-artery-aneurysm-post-traumatic-pancreatic-pseudocyst-drainage-an-interesting-case
#9
Mohammad Zarin, Sajid Ali, Abdul Majid, ZakaUllah Jan
BACKGROUND AND AIM: Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreatic surgery and thus prior recognition and prompt treatment is mandatory (Lee et al., 2009 [1]). We report a case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for traumatic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presented with melena one month post operatively...
December 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29226572/nitroglycerin-and-the-enduring-principles-of-coronary-procedures
#10
EDITORIAL
On Topaz
The benefits of nitroglycerin are numerous, from ensuring accurate interpretation of diagnostic angiograms to treatment of coronary spasm and support of PCIs in simple or complex lesion types. The founders of the field were convinced that no coronary arteriography should be considered complete unless a vasodilator is used at some point during the study. This recommendation is valid. The guidelines should change to include administration of intracoronary nitroglycerin.
December 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29226460/ct-pulmonary-angiogram-for-assessing-the-treatment-outcome-of-acute-pulmonary-embolism
#11
Hai-Ting Zhou, Wen-Ying Yan, De-Li Zhao, Hong-Wei Liang, Guo-Kun Wang, Zai-Sheng Ling, Jin-Ling Zhang
OBJECTIVE: To discuss the value of CT pulmonary angiogram (CTPA) for assessing the treatment outcome of acute pulmonary embolism (APE). MATERIALS AND METHODS: CT pulmonary angiogram data and other clinical data were collected for 28 cases diagnosed as APE and analyzed retrospectively. The number and positions of emboli in the pulmonary artery, pulmonary artery obstruction index, right ventricular/left ventricular diameter ratio, main pulmonary artery/ascending aorta diameter ratio and blood oxygen saturation, and pulmonary arterial pressure were compared before and after treatment...
December 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#12
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29223438/-bringing-on-the-light-in-a-complex-clinical-scenario-optical-coherence-tomography-guided-discontinuation-of-antiplatelet-therapy-in-cancer-patients-with-coronary-artery-disease-protect-oct-registry
#13
Cezar A Iliescu, Mehmet Cilingiroglu, Dana E Giza, Oscar Rosales, Jake Lebeau, Israel Guerrero-Mantilla, Juan Lopez-Mattei, Juhee Song, Guillherme Silva, Pranav Loyalka, Andre R M Paixao, Syed Wamique Yusuf, Emerson Perin, Vernon H Anderson, Konstantinos Marmagkiolis
BACKGROUND: Cancer patients with recently placed drug-eluting stents (DESs) often require premature dual antiplatelet therapy (DAPT) discontinuation for cancer-related procedures. Optical coherence tomography (OCT) can identify risk factors for stent thrombosis such as stent malapposition, incomplete strut coverage and in-stent restenosis and may help guide discontinuation of DAPT. METHODS: We conducted a single-center prospective study in cancer patients with recently placed (1-12 months) DES who required premature DAPT discontinuation...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222822/coronary-microvascular-dysfunction-and-myocardial-contractile-reserve-in-women-with-angina-and-no-obstructive-coronary-artery-disease
#14
Marie M Michelsen, Adam Pena, Naja D Mygind, Jan Bech, Ida Gustafsson, Jens Kastrup, Henrik S Hansen, Nis Høst, Peter R Hansen, Eva Prescott
BACKGROUND: Coronary microvascular dysfunction (CMD) is a potential cause of myocardial ischemia and may affect myocardial function at rest and during stress. We investigated whether CMD was associated with left ventricular diastolic and systolic function at rest and during pharmacologically induced hyperemic stress. METHODS: In a prospective cohort study, we included 963 women with angina, left ventricular ejection fraction (LVEF) >45%, and an invasive coronary angiogram without significant stenosis (<50%)...
December 8, 2017: Echocardiography
https://www.readbyqxmd.com/read/29222218/fat-embolism-a-rare-cause-of-perioperative-renal-transplant-dysfunction
#15
Jemima Scott, Neil Collin, Richard Baker, Rommel Ravanan
Fat embolism is a recognised complication of bony injury and orthopaedic surgery, commonly involving the long bones and pelvis. We report on the case of a 68-year-old renal transplant recipient who developed acute kidney injury following surgical stabilisation of metastatic carcinoma of the acetabulum and replacement of the proximal femur. A CT renal angiogram demonstrated a large fat embolus in the inferior vena cava (IVC) and left iliac veins below the level of IVC filter, with impaired renal perfusion. The risks of open or endovascular lipothrombectomy were felt to outweigh the potential benefits...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29217515/choroidal-neovascular-membrane-in-paediatric-patients-clinical-characteristics-and-outcomes
#16
Tapas Ranjan Padhi, Bradley J Anderson, Ashkan M Abbey, Yoshihiro Yonekawa, Maxwell Stem, Danish Alam, Rohit Ramesh Modi, Laxmi Prabhavathi Savla, Michael T Trese, Antonio Capone, Kimberly A Drenser, Cagri G Besirli
PURPOSE: To analyse the clinical characteristics and treatment outcomes of choroidal neovascular membranes (CNVM) in paediatric subjects at three paediatric retina referral centres. METHODS: Medical charts of patients aged 18 years or less with a diagnosis of CNVM were retrospectively reviewed. The demographic profile, laterality, presenting complaint, corrected vision, underlying pathology, fundus, fundus fluorescein angiogram and optical coherence tomogram (OCT) were analysed...
December 7, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29217342/cinematic-rendering-of-cardiac-ct-volumetric-data-principles-and-initial-observations
#17
Steven P Rowe, Pamela T Johnson, Elliot K Fishman
BACKGROUND: Cinematic rendering (CR) a new method of 3D computed tomography (CT) volumetric visualization that produces photorealistic images. As with traditional 3D visualization methods, CR may prove to be of value in providing important information when evaluating regions of complex anatomy such as the heart. METHODS: The gated, IV contrast-enhanced chest CT angiogram data from three recent patients were evaluated with CR. Image comparision demonstrates the difference between CR and traditional volume rendering (VR), owing to a more complex lighting model that enhances surface detail and produces realistic shadows to add depth to 3D visualizations...
December 2, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29215411/a-novel-technique-to-measure-the-intensity-of-abnormality-on-gi-bleeding-scans-development-initial-implementation-and-correlation-with-conventional-angiography
#18
Rami Farhat, Derek T Kim, T Dustin French, Dov Bechhofer, Anca-Oana Kranz, Jason C Hoffmann
PURPOSE: Develop a technique to quantify intensity of lower gastrointestinal bleeding (LGIB) on Tc-labeled red blood cell (RBC) scintigraphy, correlate with angiography, and determine the tool's predictive value. MATERIALS AND METHODS: An IRB-approved, single institution database query of GI bleeding scans performed between January 2013 and December 2015. Reports from all studies and imaging from all positive studies were reviewed. A technique was developed for scan analysis, allowing for calculation of percent increase of activity in the region of interest (ROI, area of bleeding) and ROI in the aorta and liver (controls)...
December 5, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29212621/stenotic-lesions-and-the-maximum-diameter-of-coronary-artery-aneurysms-in-kawasaki-disease
#19
Etsuko Tsuda, Nobuyuki Tsujii, Yohsuke Hayama
OBJECTIVES: To determine the prevalence of subsequent stenotic lesions based on the maximum diameter of the largest coronary artery aneurysm in patients with Kawasaki disease and the threshold value of coronary artery diameter associated with risk of developing stenotic lesion. STUDY DESIGN: There were 214 patients (160 males) who had at least 1 aneurysm in a selective coronary angiogram (CAG) done <100 days after the onset of Kawasaki disease were studied. We measured the maximal coronary artery aneurysm diameter in 3 major branches in the initial CAGs...
December 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29204196/delineate-yet-not-dread-anomalous-vertebral-artery-in-pediatric-congenital-atlantoaxial-dislocation-and-basilar-invagination
#20
Pravin Salunke
Introduction: The deformed joints seen in congenital atlantoaxial dislocation (CAAD) are often associated with vascular anomalies. It is important to identify these vascular anomalies and address them appropriately without compromising the manipulation and fusion of C1-C2 joints. The small bones in pediatric age group pose an additional challenge. Materials and Methods: Data of fifty-six children with CAAD operated in the last 4 years was analyzed. A computed tomography angiogram was obtained preoperatively to assess for the course of the third segment of vertebral artery (VA)...
July 2017: Journal of Pediatric Neurosciences
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