Volume 27 - Issue 3 - March, 2015

A Prospective, Randomized, Pivotal Trial of a Novel Extravascular Collagen-Based Closure Device Compared to Manual Compression in Diagnostic and Interventional Patients

James B. Hermiller, MD1;  Wayne Leimbach, MD2;  Roger Gammon, MD3;  Steven P. Karas, MD4; Robert J. Whitbourn, MD5;  S. Chiu Wong, MD6;  Nilesh Goswami, MD7;  John McCabe, MD8;  Nick G. Cavros, MD9;  Richard Paulus, MD10;  Srihari S. Naidu, MD11;  Zoltan G. Turi, MD12

The RESPECT trial was a multicenter, randomized comparison that evaluates the safety/efficacy of the new Vascade extravascular closure system (Cardiva Medical, Inc) in diagnostic and interventional procedures. Compared to manual compression, Vascade use reduced rates of minor access-site related complications, and significantly shortened time to hemostasis, time to ambulation, and time to discharge eligibility....

Commentary: Where Are We With Vascular Closure Devices After Percutaneous Arteriotomy?

Marc Cohen, MD

A discussion of the RESPECT trial results, and potential issues involved in achieving hemostasis with the new Vascade extravascular closure system (Cardiva Medical, Inc) is provided. While there is no formal economic analysis, Dr. Cohen believes that Vascade device presents a winning proposition in the current medical environment, since it has the potential to optimize resources and reduce length of stay. ...

Adoption of the Hybrid CTO Approach by a Single Non-CTO Operator: Procedural and Clinical Outcomes

Minh N. Vo, MD1;  James M. McCabe, MD2;  William L. Lombardi, MD2;  John Ducas, MD1; Amir Ravandi, MD, PhD1;  Emmanouil S. Brilakis, MD, PhD3

This study tested the feasibility of adopting the “hybrid” approach by a single operator without prior experience in CTO-PCI. The authors conclude that the “hybrid” approach to CTO-PCI can be successfully adopted by a single operator with excellent early procedural success and low complication rates, despite a lack of prior CTO-PCI experience....

Commentary: CTO-PCI: An Emerging New Subspecialty in Interventional Cardiology

Philip Green, MD and Dimitri Karmpaliotis, MD

CTO-PCI has emerged as a new subspecialty of interventional cardiology; modern CTO operators have set a new benchmark for CTO success rates of above 90%. With appropriate training and dissemination of the hybrid approach to new operators in the academic as well as community setting, this goal can be accomplished.  ...

Clinical and Economic Effectiveness of Percutaneous Ventricular Assist Devices for High-Risk Patients Undergoing Percutaneous Coronary Intervention

Atman P. Shah, MD1;  Elizabeth M. Retzer, MD1;  Sandeep Nathan, MD, MSc1;  Jonathan D. Paul, MD1; Janet Friant, MSN1;  Karin E. Dill, MD2;  Joseph L. Thomas, MD3

This study conducted a review of all comparative randomized control trials of the pVADS (Impella and TandemHeart) vs IABP for patients undergoing high-risk percutaneous coronary intervention (PCI)....

Commentary: Intraaortic Balloon Pump Versus Percutaneous Ventricular Assist for the High-Risk Patient: Keep it Simple Except When You Can’t

Mary Shields, MD and Sheldon Goldberg, MD 

In order to put the pVAD analysis of Shah et al into clinical perspective, Drs Shields and Goldberg review the definitions of “high-risk PCI,” the mechanism of action of support devices for PCI patients, and comment on the results of trials comparing these devices....

Topics: 

Safety, Feasibility, and Long-Term Results of Percutaneous Closure of Atrial Septal Defects Using the Amplatzer Septal Occluder Without Periprocedural Echocardiography

Fabien Praz, MD;  Andreas Wahl, MD;  Mathieu Schmutz, MD;  Jean-Pierre Pfammatter, MD;  Mladen Pavlovic, MD; Stéphanie Perruchoud, MD;  Andrea Remondino, MD;  Stephan Windecker, MD;  Bernhard Meier, MD

Percutaneous closure of atrial septal defects (ASDs) is usually performed using simultaneous fluoroscopic and transthoracic, transesophageal, or intracardiac echocardiographic guidance. This study sought to assess the safety and efficacy of percutaneous closure of ASDs under fluoroscopic guidance only, without periprocedural echocardiographic guidance. ...

Ultrasound Guidance for Vascular Access in Patients Undergoing Coronary Angiography Via the Transradial Approach

Anthony C. Camuglia, MD;  Malak Majed, MD;  Shane D. Preston, MD;  Shahar Lavi, MD

In order to assess the value of routine real-time ultrasound (RTUS) guidance, this study enrolled 100 consecutive patients who underwent TRA without the assistance of RTUS followed by 100 consecutive patients who underwent TRA using RTUS guidance....

Comparison of Diabetic and Non-Diabetic Patients Undergoing Endovascular Revascularization for Peripheral Arterial Disease

Michael S. Lee, MD1;  Seung-Woon Rha, MD, PhD2*;  Seung Kyu Han, MD3;  Byoung Geol Choi, BS2;  Se Yeon Choi, BS2;  Jabar Ali, MD2;  Shaopeng Xu, MD2;  Harris Abdullah Ngow, MD2;  Jae Joong Lee, MD2;  Kwang No Lee, MD2;  Ji Bak Kim, MD2;  Sunki Lee, MD2;  Jin Oh Na, MD2;  Cheol Ung Choi, MD2; Hong Euy Lim, MD2;  Jin Won Kim, MD2;  Eung Ju Kim, MD2;  Chang Gyu Park, MD2;  Hong Seog Seo, MD2;  Jeremy Kong, BS¹;  Dong Joo Oh, MD2

This study assessed the clinical outcomes of diabetic versus non-diabetic patients with peripheral arterial disease who underwent peripheral transluminal angioplasty (PTA). Diabetic patients were found to more frequently present with critical limb ischemia compared with non-diabetic patients and they also had higher rates of restenosis and amputation at 2 years following standard PTA. ...

The Extent of Aortic Annulus Calcification is a Predictor of Postprocedural Eccentricity and Paravalvular Regurgitation: A Pre- and Postinterventional Cardiac Computed Tomography Angiography Study

Raffi Bekeredjian, MD1;  Dorothea Bodingbauer, MD1;  Nina P. Hofmann, MD1;  Sebastian Greiner, MD1;  Moritz Schuetz, MD1;  Nicolas A. Geis, MD1;  Hans U. Kauczor, MD2;  Mark Bryant, MD2;  Emmanuel Chorianopoulos1; Sven T. Pleger1;  Derliz Mereles, MD1;  Hugo A. Katus, MD1;  Grigorios Korosoglou, MD1

This study investigates whether the extent of aortic valve calcification is associated with postprocedural prosthesis eccentricity and paravalvular regurgitation in patients undergoing transcatheter aortic valve implantation. ...

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