Volume 26 - Issue 10 - October, 2014

Recanalization of Infrainguinal Chronic Total Occlusions With the Crosser System: Results of the PATRIOT Trial

John Laird, MD1;  James Joye, DO2;  Naveen Sachdev, MD3;  Paul Huang, MD4;  Ronald Caputo, MD5; Imran Mohiuddin, MD6;  John Runyon, MD7;  Tony Das, MD8

Peripheral artery CTOs are commonly encountered during the evaluation and management of patients with symptomatic peripheral artery disease.  We report the results of a prospective, multicenter trial that evaluated the angiographic and functional outcomes of a recanalization system designed to aid crossing of infrainguinal occlusions....

Serial Intravascular Ultrasound Analysis of Stent Strut Distribution and Fracture: An Integrated Analysis of the Taxus IV, V, and VI Trials

Radoslaw Pracon, MD1;  Maksymilian P. Opolski, MD2;  Gary S. Mintz, MD3;  Jerzy Pregowski, MD4; Mariusz Kruk, MD1;  Jeffrey J. Popma, MD5;  Lazar Mandinov, MD6;  Hong Wang6;  Stephen G. Ellis, MD7; Eberhard Grube, MD8;  Keith D. Dawkins, MD6;  Gregg W. Stone, MD9;  Neil J. Weissman, MD2

Non-uniform distribution of drug-eluting stent struts may cause uneven drug deposition associated with an adverse neointimal response and clinical events. This study assesses circumferential stent strut distribution in bare-metal (BMS, n=117) and paclitaxel-eluting (Taxus, n=125) stents post implantation and at 9-month follow-up, as well as its impact on intimal hyperplasia....

Comparison of the Novel Vasodilator Uridine Triphosphate and Adenosine for the Measurement of Fractional Flow Reserve

Jacob Sivertsen1;  Jan Jensen1,  Søren Galatius1;  Jakob Raunsø1;  Jaya Rosenmeier, MD, PhD2

Our aim was to examine fractional flow reserve responses of intravenous adenosine with increasing doses of intracoronary (IC) adenosine versus IC uridine triphosphate in patients with coronary artery disease. ...

Transcoronary Mapping of Ventricular Asynchrony Due to Left Bundle Branch Block in a Porcine Model

Konstantin M. Heinroth, MD1;  Susanne Unverzagt, PhD1;  Dirk Mahnkopf, MD2;  Alexander Plehn, MD1;  Michael Buerke, MD3;  Karl Werdan, MD1;  Roland Prondzinsky, MD4

Optimal positioning of the left ventricular (LV) lead at the latest activated part of the left ventricle is one of the major challenges in implantation of cardiac resynchronization therapy (CRT) devices with respect to ascertaining an optimal resynchronization effect resulting in a high responder rate. In the present study, we evaluated the feasibility of transcoronary measurement of LV electrical activation by a coated guidewire in a porcine model. ...

Decrease of Vascular and Bleeding Complications After Balloon Aortic Valvuloplasty Performed Without Heparin

Florence Leclercq, MD, PhD1;  Delphine Delseny, MD1;  Erika Nogue, MSc2;   Valérie Macioce, MD2;  Nicolas Nagot, MD, PhD2;  Francois Roubille, MD, PhD1;  Richard Gervasoni, MD1;  Jean C. Macia, MD

The risk of bleeding is of major concern after percutaneous balloon aortic valvuloplasty (BAV) performed in elderly patients. In this registry, we report the effect of heparin use on rate of all severe vascular complications, bleeding, ischemic events, or death at 1-month follow-up (2008 to 2012).  ...

Switching From Transfemoral to Transradial Access for PCI: A Single-Center Learning Curve Over 5 Years

Shantu Bundhoo, MD1;  Ganesh Nallur-Shivu, MD1;  Nicholas Ossei-Gerning, MD1;  Azfar Zaman, MD2;  Tim D. Kinnaird, MD1;  Richard A. Anderson, MD1

We report the learning curve over 5 years in a high-volume interventional center during the crossover from the transfemoral access to transradial access for percutaneous coronary intervention. In particular, we evaluate clinical characteristics, radiation doses, screening times, and subsequent clinical outcomes....

Transcatheter Aortic Valve-In-Valve Implantation: Clinical Outcome as Defined by VARC-2 and Postprocedural Valve Dysfunction According to the Primary Mode of Bioprosthesis Failure

Barbara E. Stähli, MD1*;  Markus Reinthaler, MD2*;  Thi Dan Linh Nguyen-Kim, MD3;  Catherine Gebhard, MD1;  Hanna Tasnady, BSc1;  Jürg Grünenfelder, MD4;   Volkmar Falk, MD4;  Roberto Corti, MD1;  Thomas Frauenfelder, MD3;  Thomas F. Lüscher, MD1;  Willibald Maier, MD1;  Michael J. Mullen, MD2;  Ulf Landmesser, MD1

Surgical aortic valve replacement (SAVR) is considered the standard treatment for symptomatic aortic stenosis (AS) due to its excellent short- and long-term outcomes. The present study reports the University of Zurich and the University College London transcatheter aortic valve-in-valve experience according to the recently revised VARC-2 consensus criteria....

Perioperative Duplex Ultrasound Following Endothermal Ablation of the Saphenous Vein: Is it Worthless?

Randolph Todd C. Jones, MD and Lowell S. Kabnick, MD, RPhS

The standard of care is to obtain a duplex ultrasound to evaluate for the presence of endothermal heat-induced thrombosis within the first 1-2 weeks after endothermic ablation of saphenous veins. We advocate against this routine practice in asymptomatic patients....

Usefulness of Enhanced Stent Visualization Imaging Technique in Simple and Complex PCI Cases

Vivek Mutha, MBBS1,2;  M. Asrar ul Haq, FRACP1,2;  Naveen Sharma, FRACP3;  W.F. den Hartog, MSc4;  William J. van Gaal, MD, FRACP1,2

Enhanced stent visualization is a novel fluoroscopy-based technique that improves visualization of deployed stents in the coronary arteries. We present a case series highlighting the use of this technique in percutaneous coronary intervention. ...

Inappropriate Use of the Appropriate Use Criteria (AUC) as a Guide for Reimbursement

Dmitriy N. Feldman, MD1;  Srihari S. Naidu, MD2;  Peter L. Duffy, MD3

We discuss the difficulty of determining appropriateness of percutaneous coronary intervention in cases wherein clinical decision-making can vary....

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