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https://www.readbyqxmd.com/read/28654959/cardiovascular-testing-and-clinical-outcomes-in-emergency-department-patients-with-chest-pain
#1
Alexander T Sandhu, Paul A Heidenreich, Jay Bhattacharya, M Kate Bundorf
Importance: Noninvasive testing and coronary angiography are used to evaluate patients who present to the emergency department (ED) with chest pain, but their effects on outcomes are uncertain. Objective: To determine whether cardiovascular testing-noninvasive imaging or coronary angiography-is associated with changes in the rates of coronary revascularization or acute myocardial infarction (AMI) admission in patients who present to the ED with chest pain without initial findings of ischemia...
June 26, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28654542/percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia-a-comprehensive-meta-analysis
#2
Jiarong Wang, Chi Shu, Zhoupeng Wu, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan, Yi Yang, He Bian, Yazhou He, Ziqiang Wang
OBJECTIVE: The aim of our study was to compare percutaneous vascular interventions (PVI) versus bypass surgeries (BSX) in patients with critical limb ischemia (CLI). BACKGROUND: Previous relevant reviews with limited numbers of included studies did not strictly confine the inclusion criteria to CLI, also involving patients with severe claudication, which may introduce bias in the decision-making of CLI revascularization. Current treatment strategies for CLI still remain controversial...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28654050/dii-perfusion-as-a-method-for-vascular-visualization-in-ambystoma-mexicanum
#3
Anna J Saltman, May Barakat, Donald M Bryant, Anastasia Brodovskaya, Jessica L Whited
Perfusion techniques have been used for centuries to visualize the circulation of tissues. Axolotl (Ambystoma mexicanum) is a species of salamander that has emerged as an essential model for regeneration studies. Little is known about how revascularization occurs in the context of regeneration in these animals. Here we report a simple method for visualization of the vasculature in axolotl via perfusion of 1,1'-Dioctadecy-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI). DiI is a lipophilic carbocyanine dye that inserts into the plasma membrane of endothelial cells instantaneously...
June 16, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28652952/fibromuscular-dysplasia-with-spontaneous-coronary-artery-disease-presenting-as-acute-myocardial-infarction
#4
Ali Farooq, Waseem Amjad, Ata Ur Rahim Bajwa, Hassaan Yasin, Rizwan Ali, Muhammad Pervaiz
A 40-year-old female presented to a rural hospital with crushing substernal chest pain. An initial electrocardiogram showed ST elevation in lead II and aVF with elevated troponin I. She was immediately transferred to a tertiary care hospital. An emergent coronary angiogram did not show any significant coronary artery disease. On the second day, the patient experienced recurrence of severe chest pain with ST elevations in leads I, aVL, V5-V6, ST depressions in V1-V3, T-wave inversion over V2-V5. The troponin I level increased to > 40 ng/ml (normal 0...
May 23, 2017: Curēus
https://www.readbyqxmd.com/read/28652386/long-term-cardiovascular-risk-in-heterozygous-familial-hypercholesterolemia-relatives-identified-by-cascade-screening
#5
Kasper Aalbæk Kjærgaard, Morten Krogh Christiansen, Morten Schmidt, Morten Smærup Olsen, Henrik Kjærulf Jensen
BACKGROUND: Heterozygous familial hypercholesterolemia increases the risk of adverse cardiovascular events. Whether affected relatives of probands are at increased risk remains unknown. We aimed to evaluate the long-term cardiovascular risk in heterozygous familial hypercholesterolemia relatives with a low-density lipoprotein receptor (LDLR) mutation who were all recommended statin therapy. METHODS AND RESULTS: Participants were identified by cascade screening at Aarhus University Hospital during 1992-1994...
June 26, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28652060/reliability-and-utility-of-the-alberta-stroke-program-early-computed-tomography-score-in-hyperacute-stroke
#6
Jillian Naylor, Leonid Churilov, Neil Rane, Ziyuan Chen, Bruce C V Campbell, Bernard Yan
GOAL: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on non-contrast computed tomography (NCCT) is dependent on the visibility of early ischemic change. The goal of our study was to evaluate whether time from ischemic stroke onset to initial NCCT influences the inter-rater variability and prognostic accuracy of ASPECTS for a 3-month functional outcome. MATERIALS AND METHODS: Ischemic stroke patients treated with intravenous tissue plasminogen activator (IV-tPA) from 2007 to 2014 at the Royal Melbourne Hospital were included...
June 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28651572/efficacy-of-a-seal-wing-paclitaxel-eluting-balloon-catheters-in-the-treatment-of-bare-metal-stent-restenosis
#7
Leos Pleva, Pavel Kukla, Jana Zapletalova, Ota Hlinomaz
BACKGROUND: Our study aimed to compare the efficacy of seal-wing paclitaxel-eluting balloon catheters (PEB) with iopromide-coated PEB and everolimus-eluting stents (EES) for treating bare metal stent restenosis (BMS-ISR). METHODS: We enrolled 64 patients with 69 BMS-ISR. The control group comprised patients from the iopromide-PEB and EES arms of a previous TIS study. The primary end-point was 12-month in-segment late lumen loss (LLL). Secondary end-points included incidence of binary in-stent restenosis and 12-month major adverse cardiac events (MACE)...
June 26, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28650344/the-relationship-between-cardiac-endothelium-and-fibroblasts-it-s-complicated
#8
Ravi Karra, Agoston O Walter, Sean M Wu
Coronary revascularization is an effective means of treating ischemic heart disease; however, current therapeutic revascularization strategies are limited to large caliber vessels. Because the mammalian heart scars following cardiac injury, recent work showing that cardiac fibroblasts can transdifferentiate into new coronary endothelium raises a new and exciting approach to promoting endogenous revascularization following cardiac injury. In this issue of the JCI, He et al. report on their employment of a battery of lineage-tracing tools to address the developmental origins of fibroblasts that give rise to new endothelial cells...
June 26, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28649953/clinical-restenosis-and-its-predictors-after-implantation-of-everolimus-eluting-bioresorbable-vascular-scaffolds-results-from-the-gabi-r-registry
#9
Julinda Mehilli, Stephan Achenbach, Jochen Woehrle, Moritz Baquet, Thomas Riemer, Thomas Muenzel, Holger Nef, Christoph Naber, Gert Richardt, Ralf Zahn, Tommaso Gori, Till Neumann, Johannes Kastner, Axel Schmermund, Christian Hamm
AIMS: To assess clinical restenosis and its predictors after implantation bioresorbable vascular scaffolds (BVS) in everyday practice in the large scale German-Austrian ABSORB Registry (GABI-R). METHODS AND RESULTS: Between November 2013 and January 2016, 3264 patients underwent BVS implantion in 93 centers of GABI-R. At 6-month follow-up, 24 patients experienced clinically-indicated target lesion revascularization (cTLR) unrelated to BVS thrombosis (cumulative incidence 0...
June 27, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#10
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#11
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648324/drug-coated-balloon-angioplasty-for-the-management-of-recurring-infrapopliteal-disease-in-diabetic-patients-with-critical-limb-ischemia
#12
Luis M Palena, Larry J Diaz-Sandoval, Efren Gòmez Jabalera, Olga Peypoch Perez, Enrico Sultato, Cesare Brigato, Enrico Brocco, Marco Manzi
OBJECTIVE: To describe the 1-year outcomes of recurring infrapopliteal disease after endovascular revascularization with the Lutonix drug-coated balloons (LDCB) in diabetic patients with critical limb ischemia (CLI), and to benchmark our findings with previously published objective performance goals (OPG) addressing safety and efficacy of new catheter-based therapies for CLI. METHODS: The present study was a retrospective, single-center, and single-arm trial of symptomatic diabetic patients with CLI, who underwent LDCB-angioplasty for recurring infrapopliteal disease...
June 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28647641/impact-of-left-subclavian-artery-revascularization-prior-to-thoracic-endovascular-aortic-repair-on-post-operative-cerebrovascular-hemodynamics
#13
Arnoud V Kamman, Jonathan L Eliason, David M Williams, Bo Yang, Frans L Moll, Santi Trimarchi, Kim A Eagle, Himanshu J Patel
OBJECTIVES: The impact of left subclavian artery (LSA) revascularization prior to thoracic endovascular aortic repair (TEVAR) on cerebrovascular flow is not well described. We studied bilateral vertebral and carotid artery flow characteristics before and after TEVAR, to evaluate the hemodynamic effects of LSA revascularization. METHODS: Seventy-four patients with mixed etiologies (mean age 70.9±10.5 years) underwent LSA revascularization and TEVAR (2006-2016) and had available pre- and post-operative carotid Duplex study available...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647640/bypass-surgery-after-endovascular-therapy-for-infrapopliteal-lesion-is-not-a-poor-outcome-compared-with-initial-bypass-surgery-by-vascular-surgeons
#14
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS: We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647440/optimal-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-an-updated-large-scale-systematic-review-and-meta-analysis
#15
An Vu Nguyen, Le Van Thanh, Mohamed Gomaa Kamel, Sara Attia Mahmoud Abdelrahman, Mohamed El-Mekawy, Mohamed Ashraf Mokhtar, Aya Ashraf Ali, Nam Nguyen Nho Hoang, Nguyen Lam Vuong, Fatma Abd-Elshahed Abd-Elhay, Omer Abdelbagi Omer, Ahmed Abdou Mohamed, Kenji Hirayama, Nguyen Tien Huy
BACKGROUND: Our study aimed to compare three different percutaneous coronary intervention (PCI) approaches: culprit-only (COR) and complete (CR) revascularization - categorizing into immediate (ICR) or staged (SCR). METHODS: We searched 13 databases for randomized controlled trials. Articles were included if they compared at least two strategies. To have more studies in each analysis, an adjusted analysis was performed using person-years to incorporate follow-up durations and obtain pooled rate ratios (RR), with their corresponding 95% confidence interval...
June 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28647199/influence-of-frailty-on-treatment-outcomes-after-revascularization-in-patients-with-critical-limb-ischemia
#16
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
OBJECTIVE: It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization. METHODS: Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647195/adapting-to-a-total-endovascular-approach-for-complex-aortic-aneurysm-repair-outcomes-after-fenestrated-and-branched-endovascular-aortic-repair
#17
Jacob Budtz-Lilly, Anders Wanhainen, Jacob Eriksson, Kevin Mani
OBJECTIVE: This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies. METHODS: All patients treated endovascular aortic repair (EVAR) for juxta/pararenal AAAs or thoracoabdominal aortic aneurysms (TAAAs), both elective and acute, as well as reoperations, from 2010 to 2015 were included...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647036/supra-aortic-interventions-for-endovascular-exclusion-of-the-entire-aortic-arch
#18
REVIEW
Terézia B Andrási, Marius Grossmann, Dieter Zenker, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVE: Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. METHODS: Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#19
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28646330/-imaging-of-vessels-supplying-the-brain
#20
REVIEW
S M Schellong, N Abolmaali, B Voigts, C Stelzner
Nowadays, several technically validated modalities are available for imaging both the extracranial and intracranial segments of arteries supplying blood to the brain. In the acute stroke setting, computed tomography (CT) angiography is of utmost importance because it provides the key diagnostic criteria indicative for the use of catheter-based recanalization techniques. Ultrasound imaging of extracranial arteries is most suitable for detecting an underlying stenosis of the internal carotid artery (ICA) in patients with stroke, transient ischemic attacks (TIA), retinal vessel occlusion and amaurosis fugax...
June 23, 2017: Der Internist
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