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https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#1
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
May 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#2
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28504239/sustained-safety-and-clinical-performance-of-a-drug-eluting-absorbable-metal-scaffold-up-to-24-months-pooled-outcomes-of-biosolve-ii-and-biosolve-iii
#3
Michael Haude, Hüseyin Ince, Stephan Kische, Alexandre Abizaid, Ralph Tölg, Pedro Alves Lemos, Nicolas M Van Mieghem, Stefan Verheye, Clemens von Birgelen, Evald Høj Christiansen, William Wijns, Hector M Garcia-Garcia, Ron Waksman
AIMS: We aimed to assess the safety and performance of the DREAMS 2G scaffold up to 24 months post implant. METHODS AND RESULTS: The present study population comprises a total of 184 patients with 189 lesions who were enrolled in the prospective, multicentre BIOSOLVE-II and BIOSOLVE-III trials. Clinical follow-up was scheduled at one, six, 12, 24 and 36 months. The present report includes pooled follow-up data at six months and BIOSOLVE-II data at 24 months. Patients were 65...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504219/one-year-clinical-results-of-the-italian-diffuse-multivessel-disease-absorb-prospective-registry-it-disappears
#4
Luca Testa, Marco De Carlo, Alessandro Petrolini, Claudio Rapetto, Ferdinando Varbella, Bernardo Cortese, Gabriele Gabrielli, Salvatore Geraci, Bruno Loi, Giacomo Boccuzzi, Giuseppe Tarantini, Daniela Fischetti, Paolo Calabria, Fabrizio Tomai, Flavio Ribichini, Corrado Tamburino, Ciro Indolfi, Antonio L Bartorelli, Anna Sonia Petronio, Francesco Bedogni
AIMS: The present multicentre prospective study, IT-DISAPPEARS, was designed with the aim of evaluating early and long-term clinical outcomes of the Absorb BVS in patients with long coronary lesions and/or multivessel coronary artery disease. The aim of this article is to present the one-year clinical results of this study. METHODS AND RESULTS: Between November 2014 and January 2016, we enrolled 1,002 patients undergoing BVS implantation (long lesion [≥ 24 mm] of a single vessel in 80...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504218/first-in-human-evaluation-of-a-novel-poly-l-lactide-based-sirolimus-eluting-bioresorbable-vascular-scaffold-for-the-treatment-of-de-novo-native-coronary-artery-lesions-meres-1-trial
#5
Ashok Seth, Yoshinobu Onuma, Ricardo Costa, Praveen Chandra, Vinay K Bahl, Cholenahally N Manjunath, Ajaykumar U Mahajan, Viveka Kumar, Pravin K Goel, Gurpreet S Wander, Mathew S Kalarickal, Upendra Kaul, V K Ajit Kumar, Pratap C Rath, Vijay Trehan, Gunasekaran Sengottuvelu, Sundeep Mishra, Alexandre Abizaid, Patrick W Serruys
AIMS: The MeRes-1 trial sought to study the safety and effectiveness of a novel sirolimus-eluting bioresorbable vascular scaffold (MeRes100 BRS) in treating de novo native coronary artery lesions by clinical evaluation and using multiple imaging modalities. METHODS AND RESULTS: The MeRes-1 first-in-human trial was a single-arm, prospective, multicentre study, which enrolled 108 patients with de novo coronary artery lesions (116 scaffolds were deployed to treat 116 lesions in 108 patients)...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#6
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28500087/feasibility-of-the-manchester-acute-coronary-syndromes-macs-decision-rule-to-safely-reduce-unnecessary-hospital-admissions-a-pilot-randomised-controlled-trial
#7
Richard Body, Charles Boachie, Alex McConnachie, Simon Carley, Patricia Van Den Berg, Fiona E Lecky
BACKGROUND: Observational studies suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule can effectively 'rule out' and 'rule in' acute coronary syndromes (ACS) following a single blood test. In a pilot randomised controlled trial, we aimed to determine whether a large trial is feasible. METHODS: Patients presenting to two EDs with suspected cardiac chest pain were randomised to receive care guided by the MACS decision rule (intervention group) or standard care (controls)...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28490559/screening-for-coronary-artery-disease-in-patients-with-type-2-diabetes-a-meta-analysis-and-trial-sequential-analysis
#8
Dimitris V Rados, Lana C Pinto, Cristiane B Leitão, Jorge L Gross
OBJECTIVE: To evaluate the efficacy of coronary artery disease screening in asymptomatic patients with type 2 diabetes and assess the statistical reliability of the findings. METHODS: Electronic databases (MEDLINE, EMBASE, Cochrane Library and clinicaltrials.org) were reviewed up to July 2016. Randomised controlled trials evaluating coronary artery disease screening in asymptomatic patients with type 2 diabetes and reporting cardiovascular events and/or mortality were included...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28487063/reverse-left-ventricular-remodelling-in-st-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention-incidence-predictors-and-impact-on-outcome
#9
Jeong Cheon Choe, Kwang Soo Cha, Eun Young Yun, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jeong Su Kim, Jung Hyun Choi, Yong Hyun Park, Han Cheol Lee, June Hong Kim, Kook Jin Chun, Taek Jong Hong, Youngkeun Ahn, Myung Ho Jeong, Shung Chull Chae, Young Jo Kim
BACKGROUD: We investigated reverse left ventricular remodelling (r-LVR), defined as a reduction of >10% in left ventricular end-systolic volume (LVESV) during follow-up, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: STEMI patients (n=1,237) undergoing PPCI with echocardiography at baseline and six-month follow-up were classified into r-LVR (n=466) and no r-LVR groups (n=771). The primary outcome was composite major adverse cardiac events (MACE; all-cause death, myocardial infarction, any revascularisation)...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28483613/the-relationship-between-hospital-or-surgeon-volume-and-outcomes-in-lower-limb-vascular-surgery-in-the-united-kingdom-and-europe
#10
Edward A Goka, Patrick Phillips, Edith Poku, Munira Essat, Helen B Woods, Stephen J Walters, Eva C Kaltenthaler, Phil Shackley, Jonathan Michaels
INTRODUCTION: Peripheral vascular disease is a major cause of death and disability. The extent to which volume influences outcome of lower limb (LL) vascular surgery remains unclear. This review evaluated the relationship between hospital/surgeon volume and outcome in LL surgery. METHODOLOGY: Electronic databases; Medline, Embase, the Cochrane Library Databases, Science Citation Index, and CINAHL, proceedings from conferences, citations, and references of included studies were searched...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479456/contrast-induced-nephropathy-fact-or-fiction-in-lower-limb-revascularisation
#11
Carlos Martínez-Rico, Xavier Martí-Mestre, Antonio Romera-Villegas, Emma Espinar-Garcia, Elena Iborra-Ortega, Ramón Vila-Coll
INTRODUCTION: Contrast-induced nephropathy (CIN) is defined as a increase >25% of serum creatinine from baseline, occurring in 24-48 hours after exposure to contrast, while alternative explanations for renal impairment have been excluded. The volume administered directly relates to risk, increasing by 12% per 100ml of contrast. According to the series, its incidence varies between 3.3-8% in patients without renal damage and 12-50% in patients with chronic kidney disease (CKD) and/or diabetes mellitus (DM)...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28477308/the-contribution-of-individual-exercise-training-components-to-clinical-outcomes-in-randomised-controlled-trials-of-cardiac-rehabilitation-a-systematic-review-and-meta-regression
#12
REVIEW
Bridget Abell, Paul Glasziou, Tammy Hoffmann
BACKGROUND: While the clinical benefits of exercise-based cardiac rehabilitation are well established, there is extensive variation in the interventions used within these trials. It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes. This study aims to systematically examine the relationship between individual components of the exercise intervention in cardiac rehabilitation (such as intensity and frequency) and clinical outcomes for people with coronary heart disease...
December 2017: Sports Medicine—Open
https://www.readbyqxmd.com/read/28475445/outcomes-after-foot-surgery-in-people-with-a-diabetic-foot-ulcer-and-a-12-month-follow-up
#13
E Lenselink, S Holloway, D Eefting
OBJECTIVE: The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing. METHOD: Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28470696/complete-versus-culprit-only-revascularisation-in-st-elevation-myocardial-infarction-with-multi-vessel-disease
#14
REVIEW
Claudio A Bravo, Sameer A Hirji, Deepak L Bhatt, Rachna Kataria, David P Faxon, E Magnus Ohman, Kevin L Anderson, Akil I Sidi, Michael H Sketch, Stuart W Zarich, Asishana A Osho, Christian Gluud, Henning Kelbæk, Thomas Engstrøm, Dan Eik Høfsten, James M Brennan
BACKGROUND: Multi-vessel coronary disease in people with ST elevation myocardial infarction (STEMI) is common and is associated with worse prognosis after STEMI. Based on limited evidence, international guidelines recommend intervention on only the culprit vessel during STEMI. This, in turn, leaves other significantly stenosed coronary arteries for medical therapy or revascularisation based on inducible ischaemia on provocative testing. Newer data suggest that intervention on both the culprit and non-culprit stenotic coronary arteries (complete intervention) may yield better results compared with culprit-only intervention...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28452408/psychological-interventions-for-coronary-heart-disease
#15
REVIEW
Suzanne H Richards, Lindsey Anderson, Caroline E Jenkinson, Ben Whalley, Karen Rees, Philippa Davies, Paul Bennett, Zulian Liu, Robert West, David R Thompson, Rod S Taylor
BACKGROUND: Coronary heart disease (CHD) is the most common cause of death globally, although mortality rates are falling. Psychological symptoms are prevalent for people with CHD, and many psychological treatments are offered following cardiac events or procedures with the aim of improving health and outcomes. This is an update of a Cochrane systematic review previously published in 2011. OBJECTIVES: To assess the effectiveness of psychological interventions (alone or with cardiac rehabilitation) compared with usual care (including cardiac rehabilitation where available) for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress; and to explore potential study-level predictors of the effectiveness of psychological interventions in this population...
April 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28452228/medical-treatment-or-revascularisation-as-the-best-approach-for-spontaneous-coronary-artery-dissection-a-systematic-review-and-meta-analysis
#16
José Luís Martins, Vera Afreixo, Luís Santos, Marco Costa, José Santos, Lino Gonçalves
INTRODUCTION: Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. OBJECTIVES: We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. METHODS: We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28450552/one-year-costs-of-bilateral-or-single-internal-mammary-grafts-in-the-arterial-revascularisation-trial
#17
Alastair M Gray, Jacqueline Murphy, Douglas G Altman, Umberto Benedetto, Helen Campbell, Marcus Flather, Stephen Gerry, Belinda Lees, David P Taggart
OBJECTIVE: Coronary artery bypass grafting (CABG) using bilateral internal mammary arteries (BIMA) may improve survival over CABG using single internal mammary arteries (SIMA), but may be surgically more complex (and therefore costly) and associated with impaired sternal wound healing. We report, for the first time, a detailed comparison of healthcare resource use and costs over 12 months, as part of the Arterial Revascularisation (ART) Trial. METHODS: 3102 patients in 28 hospitals in seven countries were randomised to CABG surgery using BIMA (n=1548) or SIMA (n=1554)...
April 27, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28442232/a-genetic-risk-score-predicts-cardiovascular-events-in-patients-with-stable-coronary-artery-disease
#18
Morten Krogh Christiansen, Mette Nyegaard, Sanne Bøjet Larsen, Erik Lerkevang Grove, Morten Würtz, Søs Neergaard-Petersen, Anne-Mette Hvas, Henrik Kjærulf Jensen, Steen Dalby Kristensen
BACKGROUND: Genetic risk scores (GRSs) may predict cardiovascular risk in community-based populations. However, studies investigating the association with recurrent cardiovascular events in patients with established coronary artery disease (CAD) are conflicting. METHODS: We genotyped 879 patients with high-risk stable CAD and created a GRS based on 45 single nucleotide polymorphisms previously reported to be associated with CAD in genome-wide association studies...
April 19, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28437263/a-randomised-trial-to-evaluate-preoperative-oral-carbohydrate-administration-on-insulin-resistance-in-off-pump-coronary-artery-bypass-patients
#19
Bora Lee, Sarah Soh, Jae-Kwang Shim, Ha Y Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. OBJECTIVE: We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28436316/first-in-man-experience-of-self-expanding-nitinol-stents-combined-with-drug-coated-balloon-in-the-treatment-of-femoropopliteal-occlusive-disease
#20
Bibombe Patrice Mwipatayi, Kalpa Perera, Ali Daneshmand, Rhys Daniel, Jackie Wong, Shannon D Thomas, Sally A Burrows
Purpose The present study aimed to determine the safety and efficacy of a drug-coated balloon inflated within a thin-strut self-expanding bare-metal stent in patients with severe and complex femoropopliteal occlusive disease. Methods This prospective study used the Pulsar-self-expanding stent and Passeo-18 Lux drug-coated balloon in patients with severe and complex femoropopliteal occlusive disease. The primary endpoint was the 12-month primary patency, and the secondary endpoints included 24-month primary patency, assisted primary patency, secondary patency, and clinically associated target lesion revascularisation...
January 1, 2017: Vascular
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