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. |
Original Contribution
Initial Experience of Removal of 10-French Sheaths Using the 8-French Angio-Seal Vascular Closure Device
ABSTRACT: Objectives. We studied the use of 8 Fr Angio-Seal in closure of access sites up to 10 Fr. Background. The use of larger French catheters for procedures such as valvuloplasty and percutaneous valve replacement has required the use of better methods for arterial closure. The use of 6 and 8 Fr Angio-Seal hemostatic devices (St. Jude Medical, St. Paul, Minnesota) has been well described and are routinely used for diagnostic and interventional procedures up to 8 Fr in size. However, no data are available for the use of an 8 Fr Angio-Seal device in the closure of access sites up to 10 Fr. Methods. In our center, we evaluate the incidence of vascular complications following the use of an 8 Fr Angio-Seal device with 10 Fr sheaths in patients undergoing aortic valvuloplasty. Results. Of 53 procedures, there was only 1 vascular complication, a ruptured pseudoaneurysm, which required vascular repair. Conclusions.
The Twin-Pass Dual Access Catheter for Assessment of the No-Reflow Phenomenon
ABSTRACT: The absence of antegrade flow in a coronary artery during an intervention is an ominous finding requiring diagnosis of the underlying cause and rapid treatment to limit myocardial necrosis. The Twin-Pass dual access catheter allows for distal coronary contrast injection without loss of wire position. The aim of this analysis was to determine the opacification and flow features of patients with abrupt arrest of antegrade flow to determine the underlying pathology. Methods. Coronary angiograms of patients with abrupt arrest of antegrade flow during an intervention that underwent distal vessel contrast injection with the Twin-Pass catheter were retrospectively analyzed for five features: antegrade flow, retrograde flow, myocardial blush, presence of contrast stasis in the vessel wall and evidence of an intraluminal filling defect. The features were then correlated with the underlying pathological process and treatment. Results.
Restenosis Rates following Vertebral Artery Origin Stenting: Does Stent Type Make a Difference?
ABSTRACT: Objectives. To compare our experience with sirolimus- and paclitaxel-eluting stents (drug-eluting stents [DES]) and non-drug-eluting stents (NDES) for treatment of vertebral artery (VA) origin stenosis and review the literature. Methods. A retrospective review of our prospectively collected database was performed. Clinical and radiologic follow up was obtained by reviewing office records and radiology. Data collected included demographics, comorbidities, presenting symptoms, stenosis severity, contralateral VA stenosis and/or carotid stenosis, type of stent used, angioplasty before or after stenting, post-treatment residual stenosis, clinical and radiological follow up and retreatment. Patients with symptomatic > 60% stenosis or asymptomatic > 70% stenosis and/or a hypoplastic or occluded contralateral VA or significant carotid occlusion were chosen for revascularization. Results.
Evaluation of Balloon Withdrawal Forces (Full Title Below)
Evaluation of Balloon Withdrawal Forces with Bare-Metal Stents, Compared with Taxus™ and Cypher™ Drug-Eluting Coronary Stents: Balloon, Stent and Polymer Interactions
Clinical Utility of B-Type Natriuretic Peptide (Full Title Below)
ABSTRACT: Background. B-type natriuretic peptide (BNP) and echocardiographic tissue Doppler indices (TDI) predict elevated filling pressures, but few data exist comparing these methods while adjusting for clinical variables. We hypothesized that BNP would provide incremental value for estimating left ventricular end-diastolic pressure (LVEDP). Methods. Clinical data, echocardiograms, and BNP levels were obtained in 182 geriatric patients undergoing diagnostic left-heart catheterization. Patients with severe valvular disease or acute myocardial infarction were excluded. LVEDP and standard echocardiographic measurements, including early (E) and late (A) mitral inflow velocities and early (Em) mitral annular velocities by TDI, were measured in blinded fashion. Results. Mean age was 71 years, 51% were female, and 19% were nonwhite.
Right Coronary Artery Anatomical Variants: Where and How?
ABSTRACT: Background. Ectopic origin of the right coronary artery (RCA) occurs in ≈1.0% of studied populations. We investigated the prevalence and location of ectopic RCAs among patients undergoing coronary angiography (CA) and assessed its effects on resource utilization. Methods. Cases of ectopic RCAs were prospectively collected over 21 months among patients undergoing cardiac catheterization at a University Hospital. “Ectopic RCA” was defined as a RCA originating outside the posterior two-thirds of the right coronary sinus. Results. The study population included 2,120 patients, of which 23 (1.1%) had ectopic RCAs. Of these, 15 (65%) originated from the anterior third of the right sinus, while 8 (35%) originated from the anterior half of the left sinus. Mean procedure and fluoroscopy times were 60 ± 33 and 15 ± 12 minutes (min) for the former, and 78 ± 35 and 31 ± 20 min for the latter, while mean contrast volume for CA was 112 ± 62 ml and 192 ± 85 ml, respectively.
Efficacy and Safety of Bivalirudin in Patients with Diabetes Mellitus (Full title below)
Efficacy and Safety of Bivalirudin in Patients with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention in Current Clinical Practice
A Poly-N-acetyl Glucosamine Hemostatic Dressing for Femoral Artery Access Site Hemostasis (Full title below)
A Poly-N-acetyl Glucosamine Hemostatic Dressing for Femoral Artery Access Site Hemostasis after Percutaneous Coronary Intervention: A Pilot Study
Repeat Coronary Revascularization Procedures after Successful Bare-Metal or Drug-Eluting Stent Implantation
ABSTRACT: Background. The goal of this study was to assess the rate and anatomical targets of repeat revascularization procedures in routine clinical practice after either bare-metal stent (BMS) or drug-eluting stent (DES) implantation. Randomized trials provide a reference standard for comparing outcomes after BMS or DES, but the rates of repeat revascularization procedures in clinical trials do not necessarily represent the rates in routine practice. Methods. Baseline and 1-year follow-up angiographic data from a cardiac catheterization laboratory data registry with 31 participating hospitals were analyzed. Results. In 17 hospitals 14,459 eligible patients had a BMS implanted between 1998 and 2003, and in 20 hospitals 9,575 eligible patients had a DES implanted in 2005. DES patients had more multivessel disease and diabetes than BMS patients, but fewer DES patients had all diseased vessels stented.
How Much Alcohol Should We Infuse in the Coronary Artery of Hypertrophic Cardiomyopathy Patients?
ABSTRACT: Background. Although alcohol septal ablation (ASA) is increasingly used in hypertrophic cardiomyopathy (HC) patients who are refractory to medical therapy, the amount of alcohol that is required has not been well studied. This study sought to determine the amount of alcohol that is necessary to achieve clinical benefits of ASA. Methods. Myocardial perfusion imaging was used to determine the size of the myocardial infarction produced by ASA in 54 HC patients. Left ventricular outflow gradients (LVOTg) were determined invasively before and after ASA and by Doppler echocardiography before and at a median of 3 months after ASA. Results. LVOTg decreased at rest and after provocation in response to ASA and this was maintained on follow-up at 3 months. There was no relationship between the amount of alcohol infused and the infarct mass as determined by myocardial perfusion imaging.
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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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