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https://www.readbyqxmd.com/read/28425755/thrombus-aspiration-in-acute-coronary-syndromes-prevalence-procedural-success-change-in-serial-troponin-t-levels-and-clinical-outcomes-in-a-contemporary-swiss-cohort
#1
Soheila Aghlmandi, Nadine Schärer, Dik Heg, Lorenz Räber, Marcel Zwahlen, Baris Gencer, David Nanchen, David Carballo, Sebastian Carballo, Peter Jüni, Arnold von Eckardstein, Ulf Landmesser, Nicolas Rodondi, François Mach, Stephan Windecker, Christian M Matter, Thomas F Lüscher, Roland Klingenberg
BACKGROUND: Randomised controlled trials have provided conflicting results regarding procedural and clinical outcomes of thrombus aspiration combined with percutaneous coronary intervention, when compared with primary percutaneous coronary intervention alone in patients with acute coronary syndromes. METHODS: Acute coronary syndrome patients referred for coronary angiography to four Swiss university hospitals between 2009 and 2012 were enrolled in the SPUM-ACS cohort...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28423440/-results-after-distal-digital-replantation-is-it-worth-the-effort
#2
David Braig, Jan R Thiele, Vincenzo Penna, G Björn Stark, Steffen U Eisenhardt
There are only relative indications for distal digital replantation in zones 1 and 2 according to Tamai. In contrast to primary closure for fingertip amputations, replantation is a complex procedure that requires skills in supermicrosurgical techniques, as vessels with diameters between 0.3-0.8 mm are connected. In addition the time spent in hospital and the time off from work are longer. Distal digital replantation is thus only indicated, if the expected functional and aesthetic benefits surmount those of primary closure...
February 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28417852/nuclear-medicine-in-pediatric-nephro-urology-an-overview
#3
REVIEW
Iosif Mendichovszky, Bernardita Troncoso Solar, Naima Smeulders, Marina Easty, Lorenzo Biassoni
In the context of ante-natally diagnosed hydronephrosis, the vast majority of children with a dilated renal pelvis do not need any surgical treatment, as the dilatation resolves spontaneously with time. Slow drainage demonstrated at Tc-99m-mercaptoacetyltriglycine (MAG3) renography does not necessarily mean obstruction. Obstruction is defined as resistance to urinary outflow with urinary stasis at the level of the pelvic-ureteric junction (PUJ) which, if left untreated, will damage the kidney. Unfortunately this definition is retrospective and not clinically helpful...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28417613/combination-therapy-for-complex-peripheral-artery-disease-the-evidence-for-combining-mechanical-revascularisation-with-anti-restenotic-drug-delivery-systems
#4
Ramon L Varcoe
The management of complex, lower-extremity peripheral artery disease remains a difficult challenge, with ample room for improvement in the results seen with current generation devices. Therapies which use a combination of multiple devices for their mechanical and anti-restenotic properties may be advantageous, and offer an opportunity to improve the durability of revascularization through optimizing and individualizing care. Combination therapy typically utilizes drug delivery devices in addition to stents and atherectomy to achieve improved results...
April 14, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28409009/prognosis-of-complete-versus-incomplete-revascularisation-of-patients-with-stemi-with-multivessel-coronary-artery-disease-an-observational-study
#5
Aukelien C Dimitriu-Leen, Maaike P J Hermans, Caroline E Veltman, Bas L van der Hoeven, Alexander R van Rosendael, Erik W van Zwet, Martin J Schalij, Victoria Delgado, Jeroen J Bax, Arthur J H A Scholte
OBJECTIVE: The best strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease (CAD) regarding completeness of revascularisation of the non-culprit lesion(s) is still unclear. To establish which strategy should be followed, survival rates over a longer period should be evaluated. The aim of this study was to investigate whether complete revascularisation, compared with incomplete revascularisation, is associated with reduced short-term and long-term all-cause mortality in patients with first STEMI and multivessel CAD...
2017: Open Heart
https://www.readbyqxmd.com/read/28409008/two-year-outcome-after-early-or-late-intervention-in-non-st-elevation-acute-coronary-syndrome
#6
Erik A Badings, Wouter S Remkes, Salem H K The, Jan-Henk E Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R Timmer, Marloes L J van der Wielen, Dirk J A Lok, Renicus S Hermanides, Jan Van Wijngaarden, Harry Suryapranata, Arnoud W J van 't Hof
OBJECTIVE: To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate <12 hours) or a delayed invasive strategy (>48 hours after randomisation)...
2017: Open Heart
https://www.readbyqxmd.com/read/28404212/potential-of-autogenous-or-fresh-frozen-allogeneic-bone-block-grafts-for-bone-remodelling-a-histological-histometrical-and-immunohistochemical-analysis-in-rabbits
#7
E A Garbin Junior, V N de Lima, G A C Momesso, J M Mello-Neto, N M Érnica, O Magro Filho
Our aim was to compare the wound healing of autogenous bone grafts with that of fresh-frozen allogeneic block bone in rabbits. We used 25 animals. One was killed before the experiment to provide the allogeneic bone, and the remainder were killed at four time points (n=6 in each group). On histometrical analysis there was a significant difference between the two groups only at 45days and between 15 and 45days in the intergroup analysis. However, there was significantly more revascularisation (p<0.05), resorption (p<0...
April 9, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28395788/diagnosis-and-treatment-of-chronic-mesenteric-ischemia-an-update
#8
REVIEW
Jeroen J Kolkman, Robert H Geelkerken
Although the prevalence of mesenteric artery stenoses (MAS) is high, symptomatic chronic mesenteric ischemia (CMI) is rare. The collateral network in the mesenteric circulation, a remnant of the extensive embryonal vascular network, serves to prevent most cases of ischemia. This explains the high incidence of MAS and relative rarity of cases of CMI. The number of affected vessels is the major determinant in CMI development. Most subjects with single vessel mesenteric stenosis do not develop ischemic complaints...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28382371/characteristics-of-dyspnoea-and-associated-clinical-outcomes-in-the-champion-phoenix-study
#9
William A Parker, Deepak L Bhatt, Jayne Prats, Jonathan R S Day, Philippe Gabriel Steg, Gregg W Stone, Christian W Hamm, Kenneth W Mahaffey, Matthew J Price, C Michael Gibson, Harvey D White, Robert F Storey
Dyspnoea may be induced by some reversibly-binding P2Y12 inhibitors, including cangrelor and ticagrelor. Dyspnoea was not associated with any compromise to the efficacy of ticagrelor in the PLATO study. The CHAMPION PHOENIX study (NCT01156571) compared initial treatment with cangrelor versus initial treatment with clopidogrel in patients undergoing PCI. We investigated the incidence, characteristics, and associated clinical outcomes in patients with dyspnoea in CHAMPION PHOENIX. Adverse events (AEs) of dyspnoea to 48 hours were recorded in patients randomised to cangrelor or clopidogrel in CHAMPION PHOENIX...
April 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28381584/predicting-the-risk-of-bleeding-during-dual-antiplatelet-therapy-after-acute-coronary-syndromes
#10
Joakim Alfredsson, Benjamin Neely, Megan L Neely, Deepak L Bhatt, Shaun G Goodman, Pierluigi Tricoci, Kenneth W Mahaffey, Jan H Cornel, Harvey D White, Keith Aa Fox, Dorairaj Prabhakaran, Kenneth J Winters, Paul W Armstrong, E Magnus Ohman, Matthew T Roe
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patient's bleeding risk during DAPT treatment in the post-ACS setting. METHODS: To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14...
April 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28377396/optimal-duration-of-dual-antiplatelet-therapy-following-percutaneous-coronary-intervention-protocol-for-an-umbrella-review
#11
Jesse Elliott, Shannon E Kelly, Zemin Bai, Wenfei Liu, Becky Skidmore, Michel Boucher, Derek Y F So, George A Wells
INTRODUCTION: Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT...
April 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28373095/out-of-hospital-cardiac-arrest-survivors-with-inconclusive-coronary-angiogram-impact-of-cardiovascular-magnetic-resonance-on-clinical-management-and-decision-making
#12
A Baritussio, A Zorzi, A Ghosh Dastidar, A Susana, G Mattesi, J C L Rodrigues, G Biglino, A Scatteia, E De Garate, J Strange, L Cacciavillani, S Iliceto, A Nisbet, G D Angelini, D Corrado, M Perazzolo Marra, C Bucciarelli-Ducci
BACKGROUND: Non-traumatic out of hospital cardiac arrest (OHCA) is the leading cause of death worldwide, mainly due to acute coronary syndromes. Urgent coronary angiography with view to revascularisation is recommended in patients with suspected acute coronary syndrome. Diagnosis and management of patients with inconclusive coronary angiogram (unobstructed coronaries or unidentified culprit lesion) is challenging. We sought to assess the role of Cardiovascular Magnetic Resonance (CMR) in the diagnosis and management of OHCA survivors with an inconclusive coronary angiogram...
March 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28363994/validating-the-manchester-acute-coronary-syndromes-macs-and-troponin-only-manchester-acute-coronary-syndromes-t-macs-rules-for-the-prediction-of-acute-myocardial-infarction-in-patients-presenting-to-the-emergency-department-with-chest-pain
#13
Jaimi H Greenslade, Robert Nayer, William Parsonage, Shaela Doig, Joanna Young, John W Pickering, Martin Than, Christopher Hammett, Louise Cullen
BACKGROUND: The Manchester Acute Coronary Syndromes (MACS) rule and the Troponin-only MACS (T-MACS) rule risk stratify patients with suspected acute coronary syndrome (ACS). This observational study sought to validate and compare the MACS and T-MACS rules for assessment of acute myocardial infarction (AMI). METHODS: Prospectively collected data from twoEDs in Australia and New Zealand were analysed. Patients were assigned a probability of ACS based on the MACS and T-MACS rules, incorporating high-sensitivity troponin T, heart-type fatty acid-binding protein, ECG results and clinical symptoms...
March 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28344160/pre-operative-predictors-of-poor-outcomes-in-patients-undergoing-surgical-lower-extremity-revascularisation-retrospective-cohort-study
#14
Mohammed Ashrafi, Rohini Salvadi, Philip Foden, Stephanie Thomas, Mohamed Baguneid
BACKGROUND: Surgical lower extremity revascularisation (LER) can lead to poor outcomes that include delayed hospital discharge, in-hospital mortality, major amputations and readmissions. The aim of this study was to identify pre-operative predictors associated with these poor clinical outcomes. MATERIALS AND METHODS: All patients (n = 635; mean age 69; male 67.4%) who underwent surgical LER over a 5 year period in a single tertiary vascular institution were identified...
March 23, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28338117/endovascular-treatment-for-acute-mesenteric-ischaemia-in-a-young-woman-with-polyarterial-disease
#15
Mihai C Ober, Calin Homorodean, Dan A Tataru, Antonia E Macarie, Camelia D Ober, Dan M Olinic
BACKGROUND: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients. CASE REPORT: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation...
March 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28336054/atypical-mesenteric-revascularisation
#16
M Vega De Ceniga, L Estallo Laliena
No abstract text is available yet for this article.
March 20, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28325155/-secondary-prevention-of-coronary-heart-disease-results-of-euroaspire-iv
#17
M Snaterse, S Khatibi, W J M Scholte Op Reimer, R J G Peters, Y Feng, J W Deckers
OBJECTIVE: Secondary prevention is an important part of cardiovascular risk management. Since 1996, an inventory of cardiovascular risk factors and their treatment has been carried out periodically among patients with coronary heart disease within the framework of the European Action on Secondary Prevention by Intervention to Reduce Events (Euroaspire) project. DESIGN: Retrospective investigation of consecutively hospitalised patients with coronary heart disease...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#18
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28318995/a-retrograde-endo-bypass-to-revascularise-an-isolated-internal-iliac-artery
#19
E Girsowicz, N Chakfé
No abstract text is available yet for this article.
March 15, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28317790/clinical-events-beyond-one-year-after-an-acute-coronary-syndrome-insights-from-the-reclose-2-acs-study
#20
Guido Parodi, Benedetta Bellandi, Giuseppe Tarantini, Fernando Scudiero, Renato Valenti, Rossella Marcucci, Angela Migliorini, Niccolò Marchionni, Anna Maria Gori, Chiara Zocchi, David Antoniucci
AIMS: The optimal duration of dual antiplatelet therapy after an acute coronary syndrome (ACS) is still unknown and debated. We sought to assess the incidence of adverse clinical events beyond 12 months after an ACS in patients treated by percutaneous coronary intervention (PCI) and clopidogrel. METHODS AND RESULTS: Among 1,592 consecutive ACS patients treated by PCI enrolled in the RECLOSE 2-ACS study and without event within one year, 1,310 (82%) patients presented at least one risk factor such as age ≥65 years, diabetes, prior myocardial infarction (MI), chronic kidney disease and multivessel coronary disease...
March 20, 2017: EuroIntervention
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