Volume 20 - Issue 10 - October, 2008

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

*Jonathan Byrne, MD, §Mark Spence, MD, £Laurent Haegeli, MD, £Eric Fretz, MD, £Anthony Della Siega, MD,
£Malcolm Williams, MD, £David Kinloch, MD, £Richard Mildenberger, MD, ¶Peter Klinke, MD,
¶David Hilton, MD

Author Affiliations:
From the *Division of Cardiology, King’s College Hospital, Denmark Hill, London, United Kingdom, §Belfast Royal Infirmary, Belfast, United Kingdom, £Royal Jubilee Hospital, Victoria, British Columbia, Canada, and ¶Victoria Heart Institute Foundation, Victoria, British Columbia, Canada.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted March 28, 2008, provisional acceptance given May 12, 2008, manuscript accepted June 11, 2008.
Address for correspondence: Jonathan A. Byrne, MD, PhD, Cardiology, King's College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.  E-mail: [email protected]

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

Nobuyoshi Tanaka, MD,  Mitsuyasu Terashima, MD,  Yoshihisa Kinoshita, MD,  Masashi Kimura, MD,
Kenya Nasu, MD,  Mariko Ehara, MD,  Etsuo Tsuchikane, MD,  Tetsuo Matsubara, MD,
Yasushi Asakura,  Osamu Katoh, MD,  Takahiko Suzuki, MD

Author Affiliations:

From the Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted March 25, 2008, provisional acceptance given May 27, 2008, manuscript accepted June 19, 2008.
Address for correspondence; Nobuyoshi Tanaka, MD, Department of Cardiology, Toyohashi Heart Center, 21-1 Gobudori, Oyama-cho, Toyohashi, 441-8530, Japan.  E-mail: [email protected]
 

 

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

Walid Ahmar, BSc(Hons), PhD, MBBS, FRACP, Yuvaraj Malaiapan, MRCP, FRACP,
Ian T. Meredith, BSc(Hons), PhD, MBBS, FRACP

Author Affiliations:
From the Monash Cardiovascular Research Centre, MonashHEART, Southern Health & Department of Medicine, Monash University, Melbourne Australia.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted April 18 and accepted May 2, 2008.
Address for correspondence: Yuvaraj Malaiapan, MonashHeart, Monash Medical Center, Clayton Road, Clayton, Victoria, Australia.  E-mail: [email protected]

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

Walid Ahmar, BSc(Hons), PhD, MBBS, FRACP, Yuvaraj Malaiapan, MRCP, FRACP,
Ian T. Meredith, BSc(Hons), PhD, MBBS, FRACP

Author Affiliations:

From the Monash Cardiovascular Research Centre, MonashHEART, Southern Health & Department of Medicine, Monash University, Melbourne Australia.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted April 18 and accepted May 2, 2008.
Address for correspondence: Yuvaraj Malaiapan, MonashHeart, Monash Medical Center, Clayton Road, Clayton, Victoria, Australia.  E-mail: [email protected]

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

Faizel Osman, MD, MRCP, Nigel Buller, MD, FRCP, Rick Steeds, MA, MD, MRCP

Author Affiliations:
From the Department of Cardiology, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust, Edgbaston, Birmingham.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted January 2, 2008, provisional acceptance given February 8, 2008, and accepted February 18, 2008.
Address for correspondence:  Faizel Osman, MD, MRCP, Department of Cardiology, Queen Elizabeth Hospital, University Hospital Birmingham NHS Trust Edgbaston, Birmingham B15 2TH.  E-mail: [email protected]

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!

Ioannis Stathopoulos, MD, PhD

Author Affiliations:
From the Weill Medical College of Cornell University, New York Hospital Queens, Flushing, New York.
The authors report no conflicts regarding the content hererin.
Manuscript submitted June 19, 2008, provisional acceptance given July 28, 2008, manuscript accepted August 5, 2008.
Address for correspondence: Ioannis Stathopoulos, MD, PhD, Clinical Assistant Professor of Medicine, NYHQ, Catheterization laboratory, 56-45 Main Street, Flushing, New York, NY 11355.  E-mail: [email protected]

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

Mazullah Kamran, MD, Amrit Guptan, MD, Monika Bogal, MD

Author Affiliations:
From the Zena and Michael A. Wiener Cardiovascular Institute at Mt. Sinai Medical Center, New York, New York.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted March 7, 2008, provisional acceptance given March 28, 2008, manuscript accepted May 27, 2008
Address for correspondence: Dr. Mazullah Kamran, Mt. Sinai Medical Center, The Zena and Michael A. Wiener Cardiovascular Institute, The Mt. Sinai Medical Center, Box 1030, One Gustave L. Levy Place, New York, New York 10029. Email: [email protected]

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

*Santhosh K.G Koshy, MD, DM, #Neal S. Kleiman, MD, *Lekha K. George, MD, †Vijay Misra, MD,
†William B. Hillegass, MD, MPH, †Brigitta C. Brott, MD

Author Affiliations:
From the *Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; #Methodist DeBakey Heart Center, Houston, Texas;   and the †Department of Medicine, University of Alabama at Birmingham, Alabama.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted May 27, 2008 and accepted July 10, 2008.
Address for correspondence: Santhosh K.G. Koshy, MD, DM, FACC, FSCAI, Director of Interventional Cardiology, University of Tennessee Health Science Center, 1211 Union Avenue, Suite 340, Memphis, Tennessee 38104. E-mail: [email protected]

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...

Late Presentation of an Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Case Report and Review

Ravi K. Ramana, DO, Peter Varga, MD, Ferdinand Leya, MD

Author Affiliations:
From the Division of Cardiology, Loyola University Medical Center, Maywood, Illinois.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted July 2, 2008, provisional acceptance given July 28, 2008, manuscript accepted August 5, 2008.
Address for correspondence: Ravi K. Ramana, DO, Cardiac Catheterization Laboratory, Division of Cardiology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL  60153.  E-mail: [email protected]

ABSTRACT: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare cause of ischemia, heart failure and/or sudden death. A premortem diagnosis beyond early childhood is exceedingly rare because over 90% of untreated infants die in the first 12 months of life. We present a case of an asymptomatic fourteen-year old male with ALCAPA diagnosed by multidetector computed tomography (MDCT) angiography, who was successfully treated by surgical coronary transfer of the ALCAPA with reimplantation of the LCA to the aortic root.

J...

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