Practical Considerations of Percutaneous Ventricular Assist Devices
- Thu, 1/5/12 - 10:22am
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- 1617 reads
Abstract: Percutaneous ventricular assist devices are increasingly used today, allowing the scope of left ventricular support to move out of the operating room and into the interventional suite and cardiovascular care unit. This has given patients requiring short-term therapy an opportunity to undergo high-risk procedures and provide a failing left ventricular support until native recovery can occur.
Radial Artery Spasm During Transradial Coronary Procedures
- Thu, 12/1/11 - 3:42pm
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- 1686 reads
Abstract: Although transradial access (TRA) for coronary procedures has many advantages over the transfemoral approach, it’s still not the dominant route used in coronary interventions. Radial artery spasm (RAS) is an important limitation of TRA. We performed a search of published literature to estimate the prevalence and possible risk factors of RAS in patients undergoing transradial coronary procedure.
Major Bleeding in Acute Coronary Syndromes
- Tue, 10/25/11 - 3:06pm
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- 1601 reads
Abstract: Treatment of acute coronary syndrome has been based on the prevention of ischemic complications by means of antithrombotic therapy and invasive strategies. The desired reduction reached in the recurrence of ischemic events reveals its price, an increase in the occurrence of major bleeding. Initially tolerated as a benign complication, it is now shown to be an important predictor of mortality. Greater attention dedicated to the prognostic impact of bleeding is recent, motivated by the development of new antithrombotic agents.
The Changing Paradigm of Hemodynamic Support Device Selection for High-Risk Percutaneous Coronary Interventions
- Fri, 9/30/11 - 9:34am
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- 2721 reads
Clinical Vignette
A 59-year-old man has 3 hours of chest pain and is transported to the emergency department. He is confused, combative, hypotensive (80/60), tachypneic, and tachycardic, with bilateral rales, hypoxia. The patient is intubated in the Emergency Department (P02 is 80% after intubation on 100% Fi02) and given fluids, bringing BP to 95/60.
Prophylactic Intragraft Injection of Nicardipine Prior to Saphenous Vein Graft Percutaneous Intervention for the Prevention of No-reflow: A Review and Comparison to Protection Devices
- Fri, 4/29/11 - 9:34am
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- 4630 reads
ABSTRACT: No-reflow is a failure to restore normal coronary flow despite appropriate treatment of coronary obstruction. It is most commonly seen during interventions in saphenous vein grafts and is associated with poor outcome. The cause of no-reflow is complex and multifactorial. Various mechanisms including vasospasm and distal embolization of debris released during the intervention have been explained as the cause of no-reflow.
J INVASIVE CARDIOL 2011;23:202–206
Fluoroscopically-Guided Micropuncture Femoral Artery Access for Large-Caliber Sheath Insertion
- Tue, 3/29/11 - 9:31pm
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- 4947 reads
ABSTRACT: Over the last decade, significant developments have been made in the treatment of structural heart disease. Some of these techniques require placement of large arterial sheaths for device delivery. Optimal vascular access is essential for successful large-vessel sheath insertion as well as to avoid vascular complications. The critical step for ideal percutaneous vessel entry is single anterior wall-only puncture of the common femoral artery in a location above the femoral bifurcation and below the inguinal ligament. We describe a fluoroscopically-guided micropuncture technique for accurate placement of large-caliber arterial sheaths.
Review of Vascular Closure Devices
- Wed, 12/22/10 - 12:11am
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- 19268 reads
ABSTRACT: Background. Vascular access-site complications are an important cause of morbidity following catheterization procedures. Manual compression is the “gold standard” in achieving hemostasis of an arteriotomy site; however, manual compression is limited by the need to interrupt anticoagulation, prolonged bed rest, patient discomfort and time demands for healthcare providers.
Management of Spontaneous Coronary Artery Dissection in the Primary Percutaneous Coronary Intervention Era
- Fri, 10/29/10 - 8:42am
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- 9066 reads
ABSTRACT: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes. The increasing use of early angiography in the primary percutaneous coronary intervention (PPCI) era has led to earlier identification of patients with SCAD and may encourage an increased use of percutaneous revascularization strategies in this population.
Tips and Tricks for Stenting of Bifurcation Coronary Lesions
- Thu, 9/9/10 - 1:42pm
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- 7736 reads
ABSTRACT: Although the provisional stenting technique to treat coronary bifurcation lesions is the preferred method, many bifurcation lesions still require a two-stent technique to optimize the result and clinical outcome. This manuscript summarizes the tips and tricks of bifurcation stenting with cases illustrations. As interventionists are encountering more complex and difficult cases, one may find the tips and tricks in this manuscript helpful in daily practice.
J INVASIVE CARDIOL 2010;22:440–444
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Current Perspectives on Carotid Revascularization Among Patients Who Need Cardiac Surgery
- Fri, 8/6/10 - 1:19pm
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- 7588 reads
ABSTRACT: Carotid stenosis is often present in patients who need cardiac surgery and is predictive of post-operative stroke. A strategy of combined carotid endarterectomy and cardiac surgery had been adopted in the past. Staged carotid artery stenting prior to cardiac surgery is a less invasive alternative and seems to be associated with a lower incidence of stroke and myocardial infarction as compared to the combined surgical approach. This article provides a systemic review of the management of patients with concomitant carotid and cardiac disease requiring cardiac surgical
