Volume 20 - Issue 10 - October, 2008

Magnesium Sulphate during Transradial Cardiac Catheterization: A New Use for an Old Drug?

ABSTRACT: Objective. To assess the effect of intra-arterial magnesium on the radial artery during transradial cardiac catheterization. Background. Transradial coronary angiography has become popular in the last decade and offers several advantages over transfemoral angiography. Radial artery spasm is a major limitation of this approach, and a vasodilatory cocktail is usually given. The aim of this study was to examine the effect of magnesium sulphate on the radial artery during cardiac catheterization. Methods. This was a prospective, double-blind, randomized trial of 86 patients undergoing



Unprotected Left Main Coronary Artery Bifurcation Stenosis

 

Impact of Plaque Debulking Prior to Single Sirolimus-Eluting Stent Implantation

ABSTRACT: Background. The impact of plaque debulking with directional coronary atherectomy (DCA) prior to single sirolimus-eluting stent (SES) implantation in an unprotected left main coronary artery (LMCA) involving bifurcation stenosis has not been fully evaluated.  Methods. One hundred and one patients with unprotected LMCA bifurcation lesions treated with single SES implantation (from the LMCA to the left descending coronary artery [LAD] across the left



Transradial Retrieval of a Dislodged Stent from the Left Main Coronary Artery

ABSTRACT: We report a case of successful transradial retrieval of a dislodged and mechanically distorted coronary artery stent from the left main stem in an elderly male. Transradial percutaneous coronary intervention was undertaken to reconstruct a lesion in the left circumflex artery complicated by stent dislodgement. A microsnare was used to successfully retrieve the stent.

J INVASIVE CARDIOL 2008;20:545–547

Coronary stent dislodgement is a rare occurrence in percutaneous intervention and is often associated with significant morbidity.



Transradial Retrieval of a Dislodged Stent from the Left Main Coronary Artery

ABSTRACT: We report a case of successful transradial retrieval of a dislodged and mechanically distorted coronary artery stent from the left main stem in an elderly male. Transradial percutaneous coronary intervention was undertaken to reconstruct a lesion in the left circumflex artery complicated by stent dislodgement. A microsnare was used to successfully retrieve the stent.

J INVASIVE CARDIOL 2008;20:545–547

Coronary stent dislodgement is a rare occurrence in percutaneous intervention and is often associated with significant morbidity.



Use of Intra-Arterial Papaverine for Severe Arterial Spasm during Radial Cardiac Catheterization

ABSTRACT: Coronary angiography and intervention can be performed safely using the radial artery. However, arterial spasm is often encountered and usually amenable to nitrate/verapamil therapy. Rarely, surgical intervention is required to remove catheters and wires. Intra-arterial papavarine can be used to treat severe radial artery spasm and prevent the need for urgent surgical intervention.

J INVASIVE CARDIOL 2008;20:551–552

Case Report. A 46-year-old female presented with a 2-month history of nonexertional left-sided chest pain radiating to



Radial Access — Be Prepared!

ABSTRACT: We present the case of a 46-year-old female patient that experienced recurrent stent thrombosis and underwent attempted primary PCI via the radial artery. Although radial artery cannulation with a 6 Fr sheath and the diagnostic angiography were successfully performed, the PCI could not be achieved because of failure to advance the 6 Fr guide through the radial artery, due to severe angulation of a high take-off radial artery, combined with a proximal radial artery stenosis.

J INVASIVE CARDIOL 2008;20:549–550

Case Report. A 46 year-old



Spontaneous Coronary Artery Dissection: Case Series and Review

ABSTRACT: Spontaneous coronary artery dissection (SCAD) is a rare but important cause of acute coronary syndromes. SCAD can cause unstable angina, acute myocardial infarction, and sudden death. Predisposing factors include atherosclerosis, the peripartum period, and structural and inflammatory conditions affecting the arterial wall. The diagnosis of coronary dissection is usually made by coronary angiography. Prompt diagnosis and treatment of patients with dissection improves survival. Therapeutic options include medical therapy, percutaneous coronary intervention, and surg



Vascular Changes and Black Hole Phenomenon after Coronary Brachytherapy: A Pathologically Distinct Entity

ABSTRACT: Restenosis remains an important issue even after coronary brachytherapy despite its efficacy in the treatment for in-stent restenosis. The acute and chronic changes in vascular wall are unique following brachytherapy. The restenotic tissue post coronary brachytherapy is relatively acellular and appears echolucent in intravascular ultrasound examination. This is dubbed the “black hole” phenomenon. Despite the similarity in the mode of action of brachytherapy and drug eluting stent implantation, the black hole phenomenon seems to be uncommon after drug-e



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