CLINICAL EVENTS CALENDAR
Non-Accredited Education
 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE On Demand Web ArchiveNon-Accredited Target Audience: Physicians, nurses, and technologists. This activity is supported by an educational grant from Terumo Medical Corporation. |
CASE REPORTS
Percutaneous Arterial Closure for Inadvertent Cannulation of the Subclavian Artery – A Call for Caution
Arterial puncture and sheath placement in the subclavian artery is an infrequent complication of central venous access. The incidence of arterial puncture during subclavian vein access has been estimated at 2.7–4.9%; it is probably higher in critically ill patients and may result in significant morbidity and mortality.1–5 The subclavian artery is particularly prone to inadvertent puncture or laceration during attempted subclavian venipuncture because it is a blind procedure and cannot be guided by arterial palpation. In addition, due to its noncompressible location, sign
Fibromuscular Dysplasia of the Superficial Femoral Artery
Most obstructions in femoral artery are due to atherosclerotic occlusive disease. Fibromuscular dysplasia (FMD) is most prevalent in the renal, carotid, and iliac arteries and its known cause of renal artery stenosis. FMD exists in multiple vascular beds in 28% of affected patients.1 FMD is currently defined as an idiopathic, segmental, noninflammatory and nonatherosclerotic disease of the musculature of arterial walls, leading to stenosis of small- and medium-sized arteries.2 The lesions may become symptomatic as a result of flow reduction, embolic phenomena, dissecti
Long-Term Survival Using Intra-Aortic Balloon Pump and Percutaneous Right Ventricular Assist Device for Biventricular Mechanical
Patients with cardiogenic shock resulting from acute myocardial infarction (MI) experience greater than 50% in-hospital mortality despite aggressive invasive and medical management.1 Right ventricular (RV) ischemia or infarction has been demonstrated in up to 50% of acute inferior-posterior left ventricular (LV) infarctions2 and is clinically manifested as profound hypotension, atrioventricular block, supraventricular tachyarrhythmias and bradycardia.3 Depressed RV function causes decreased LV preload, reduced cardiac output and increased RV size and pericardia
Simultaneous Triple-Balloon Inflation Technique within a 6 Fr Guiding Catheter for a Trifurcation Lesion
Percutaneous coronary intervention of bifurcation lesions is associated with lower procedural success rates and an increased incidence of subsequent major adverse cardiac events and restenosis.1,2 Several reasons may be offered. The implantation of a stent in a main branch may cause severe stenosis or even occlusion at the ostium of the side branch. On the other hand, if the struts of a stent are opened toward the side branch, this may result in subsequent stent deformation at the main branch.3 To protect the side branch, a two-stent strategies such as crush stenting,
A Case of Acute Myocardial Infarction due to Coronary Spasm in the Myocardial Bridge
Coronary arteries are usually located on the surface of the cardiac muscle. Myocardial bridges have been described in a variable number of autopsy cases ranging from 5.4% to 85.7% of cases examined, depending on the population sampled.1,2 In contrast, identification of myocardial bridging during diagnostic angiography was reported to be between 0.5% and 16% of sampled populations.3,4 The majority of such abnormalities were found in the left anterior descending coronary artery, whereas those in the circumflex or the right coronary artery (RCA) were relatively rare.2
Unintentional Extraction of a Coronary Stent Deployed 4 Months Earlier during Cutting-Balloon Angioplasty for In-Stent Restenosi
Coronary stents dislodged or embolized prior to complete expansion in the target vessel may be retrieved with special devices such as snares, baskets and embolization protection devices.1,2 Rare cases of partially expanded or fractured stents extracted by an endovascular snare have been reported.3,4 However, once adequately deployed in the coronary artery with complete stent expansion, removal of the stent appears to be virtually impossible. In the following unique case, the blades of a cutting balloon used to treat in-stent-restenosis of a coronary stent deployed 4 month
Percutaneous Right Ventricular Assist Device as Support for Cardiogenic Shock due to Right Ventricular Infarction
Cardiogenic shock is a devastating complication of acute myocardial infarction (MI) with an in-hospital mortality between 40–76%.1,2 Cardiogenic shock from right ventricular infarction is uncommon, though it has a mortality rate equal to that of left ventricular shock.3,4 The TandemHeart (Cardiac Assist, Inc., Pittsburgh, Pennsylvania) is a peripheral ventricular assist device (PVAD) that can be inserted percutaneously to provide short-term mechanical support, primarily during high-risk percutaneous intervention or cardiogenic shock secondary to left vent
Very Late Sirolimus-Eluting Stent Displaced Fracture in the Mid-Left Anterior Descending Artery
Case Report. A 66-year-old female was admitted in March 2005 with non-ST-segment elevation myocardial infarction (NSTEMI). She had a prior history of hypertension, dyslipidemia and paroxysmal supraventricular tachycardia (SVT). Her coronary angiogram showed severe disease at the mid-left anterior descending artery (LAD) (Figure 1) and first obtuse marginal artery (OM1). The LAD lesion was predilated with 2.5 x 20 mm mercury (Abbott Vascular, Abbott Park, Illinois) balloon. A 3.0 x 33 mm Cypher (Cordis Corp., Miami Lakes, Florida) stent was deployed at the mid-LAD at
Retrograde Recanalization of a Left Anterior Descending Chronic Total Occlusion via an Ipsilateral Intraseptal Collateral
Successful recanalization and percutaneous revascularization of coronary arteries with chronic total occlusions (CTO) is one of the last frontiers in percutaneous coronary interventions (PCI). Successful CTO treatment is associated with reduced angina, improved left ventricular function and, ultimately, improved long-term survival.1 Despite increasing knowledge of CTO recanalization strategies, advances in equipment and operator expertise and published success rates with the standard antegrade techniques appear insufficient.2 A retrograde approach using various collate
Late Complete Heart Block in an Adult Patient undergoing Percutaneous Ventricular Septal Defect Closure
Transcatheter closure of ventricular septal defects has emerged as an attractive therapeutic modality, with excellent procedural and intermediate hemodynamic outcomes. While experience with this technique is relatively limited, longerterm follow up in the pediatric population has demonstrated an incidence of complete heart block both acutely and in late follow up.1,2 Transient disturbances of heart rhythm are common at, or shortly after, the time of device implantation, however, complete heart block remains a late sequela previously documented only in the pediatric population.
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Anytown, California
Press Release
— Bethlehem, Pennsylvania – Invatec received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in October to market its Mo.Ma Ultra Proximal Cerebral Protection Device for use during carotid artery stenting (CAS). The device effectively reduces and captures debris released during the stenting procedure to prevent it from traveling to the brain, where it has the potential to cause a stroke.
CME Showcase
 The Use of Remote Robotic Navigation in Complex Arrhythmias Complimentary Accredited Web Archive This activity is designed for electrophysiologists and EP allied professionals. Diagnosing Coronary Artery Disease: Advanced Cardiovascular Imaging Solutions  New Standards of Care for CRMD Antibiotic Protection Complimentary CME Accredited Webcast Dates: November 18, 2008 Time: 6:00 pm ET November 19, 2008 Time: 3:00 pm ET This activity is sponsored by the North American Center for Continuing Medical Education. |
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