Volume 27 - Issue 5 - May, 2015

Correlation Between OCT-Derived Intrastent Dimensions and Fractional Flow Reserve Measurements After Coronary Stent Implantation and Impact on Clinical Outcome

Sebastian Reith, MD1;  Simone Battermann1;  Martin Hellmich, PhD2;  Nikolaus Marx, MD1;  Mathias Burgmaier, MD1

This study investigates the relationship of OCT-derived intrastent lumen dimensions and FFR-derived hemodynamic relevance immediately after stent implantation and evaluates the clinical impact of these parameters at follow-up. Post-stenting FFR and OCT data were compared and related to MACE at follow-up in 66 stable patients with a coronary de novo lesion who had been treated by stent implantation.   ...

Expansion of the Indication of Transcatheter Aortic Valve Implantation — Feasibility and Outcome in “Off-Label” Patients Compared With “On-Label” Patients

Christian Frerker, MD1;  Jury Schewel, MD1;  Dimitry Schewel, MD1;  Peter Wohlmuth2;  Tobias Schmidt, MD1; Felix Kreidel, MD1;  Ralf Bader, MD3;  Karl-Heinz Kuck, MD1;  Ulrich Schäfer, MD1

This study compares both the feasibility and outcomes of “off-label” transcatheter aortic valve replacement (TAVR) patients (n=156) with a standard “on-label” TAVR population (n=435) at a single institution. ...

Sheathless Guide Catheter Coronary Intervention Via Radial Artery: Single-Center Experience With 9658 Procedures

Norio Tada, MD1;  Kaname Takizawa, MD1;  Mitsuru Kahata, MD1;  Masataka Taguri, PhD2; Tatsushi Ootomo, MD1;  Naoto Inoue, MD1 

We conducted a retrospective investigation of all TRIs performed at Sendai Kousei Hospital from January 2004 to December 2013 to evaluate the efficacy and safety of sheathless TRI in a large population (n=9658)....

The Safety and Efficacy of Peripheral Vascular Procedures Performed in the Outpatient Setting

Peyman Mesbah Oskui, MD1,2;  Robert A. Kloner, MD, PhD2,4;  Steven Burstein, MD3,5,8;  Katrine Zhiroff, MD3,8;  Benjamin Richard Kartub6;  Christina Economides, MD3,8;  Jenny Brook, MS7;  Guy S. Mayeda, MD3,5,8

Peripheral vascular interventions have been traditionally performed in the inpatient setting. We evaluate the safety and efficacy of peripheral vascular interventions performed in a private outpatient catheterization laboratory by performing a retrospective chart review of the first 500 consecutive procedures that were performed at our lab from February 2012 through February 2013....

The New Occlutech Duct Occluder: Immediate Results, Procedural Challenges, and Short-Term Follow-Up

Vikram Kudumula, MRCPCH;  Demetris Taliotis, MRCPCH;  Christopher Duke, FRCP

This study assesses immediate and short-term results of transcatheter closure of patent ductus arteriosus using the Occlutech duct occluder, a new self-expanding nitinol device with a body that is wider at the pulmonary artery end than the aortic end....

Left Atrial Appendage Closure With Amplatzer Septal Occluder in Patients With Atrial Fibrillation: CT-Based Morphologic Considerations

Paul T. Vaitkus, MD, MBA1,2;  Dee Dee Wang, MD1;  Mayra Guerrero, MD1;  Adam Greenbaum, MD1;  William O’Neill, MD1

Patients with atrial fibrillation and contraindications to anticoagulation have limited options for left atrial appendage (LAA) closure until approval of dedicated closure devices; off-label use of available cardiac devices represents one option. This study analyzed LAA dimensions measured by computed tomography scan to define optimal selection of Amplatzer septal occluders for LAA closure....

“Tip-In” Technique for Retrograde Chronic Total Occlusion Revascularization

Minh N. Vo, MD1;  Amir Ravandi, MD, PhD1;  Emmanouil S. Brilakis, MD, PhD2

Use of the retrograde approach significantly improves the success rate of chronic total occlusion (CTO) percutaneous coronary intervention. We describe the “tip-in” technique, which involves intubation of the retrograde guidewire with an antegrade microcatheter to allow successful revascularization of a CTO after failure to externalize. ...

Percutaneous Treatment of Stent-Graft (Viabahn) Thrombosis Employing a Second Stent-Graft

Spas Kotev, MD;  Manjusha Anna, MD;  Humayun Iftikhar, MD;  Michelle Lim;  Rajiv Tayal, MD;  Marc Cohen, MD; Najam Wasty, MD

We describe the new Viabahn-in-Viabahn technique for treating acute stent-graft thrombosis by “relining” the thrombosed graft with a second stent-graft. Ten patients were treated with this technique and have been free of any repeat intervention for up to 1 year, showing its feasibility....

Delayed Clopidogrel Transit During Myocardial Infarction Evident on Angiography

Joanna Ghobrial, MD, MS;  C. Michael Gibson, MS, MD;  Duane S. Pinto, MD, MPH

We describe the case of a patient with NSTEMI where oral clopidogrel loading prior to PCI was directly visualized on angiography, implying a very low likelihood of adequate absorption or antiplatelet effect. This observation raises the concern that delayed gastrointestinal transit, apart from other metabolic derangements, may be a factor in achieving optimal platelet inhibition using oral agents....

Allen’s Test: Does it Have Any Significance in Current Practice?

Ashish H. Shah, MD, MD-Research, MRCP1;  Samir Pancholy, MD2;  Sanjay Shah, MD, DM3;  Ashesh N. Buch, MD; FRCP4;  Tejas M. Patel, MD, DM3

Despite demonstrating better patient safety, acceptance of TRA as an access site of choice has remained low, with geographical variations. One of the relative contraindications to performing PCI through TRA is an abnormal Allen’s test (AT), in which case the access site is usually switched to TFA; we present data from the congenital heart and trauma literature that lead us to suggest the AT is an inadequate test to assess the collateral circulation of the hand....

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