Volume 21 - Issue 1 - January, 2009
The Role of Out-of-Hospital Cardiac Arrest in Predicting Hospital Mortality
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For Percutaneous Coronary Interventions in the Clinical Outcomes Assessment Program
ABSTRACT: Published mortality models for percutaneous coronary intervention (PCI), including the Clinical Outcomes Assessment Program (COAP) model, have not considered the effect of out-of-hospital cardiac arrest. The primary objective of this study was to determine if the inclusion of out-of-hospital cardiac arrest altered the COAP mortality model for PCI. The COAP PCI database contains extensive demographic, clinical, procedural and outcome information, including out-of-hospital cardiac arrest, wh
Analysis of Particulate Debris after Superficial Femoral Artery Atherectomy
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ABSTRACT: Purpose. To evaluate the occurrence, size and composition of embolized debris captured during routine directional atherectomy using the SilverHawk device. Methods. 15 consecutive eligible patients with a nonocclusive superficial femoral artery (SFA) were enrolled. Patients were included if they were > 18 years of age and had ≥ 70% stenosis in the SFA. All lesions underwent plaque excision with the SilverHawk atherectomy device. A FilterWire EZ was used for distal protection and retrieval of embolized material. Specimens were collected separately from the filter basket and the Silve
Plaque Excision with Distal Protection: A Logical Next Step for Superficial Femoral Artery SilverHawk Atherectomy
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J INVASIVE CARDIOL 2009; 21:11-12
Endovascular treatment for peripheral vascular disease continues to evolve.1,2 Among the many devices available for endovascular intervention, atherectomy offers several potential advantages. SilverHawk atherectomy (ev3, Inc., Plymouth, Minnesota) allows plaque excision, a gradual and progressive increase in lumen size and, in many patients, can be used as standalone therapy obviating the need for balloon angioplasty and/or stent placement. As the SilverHawk atherectomy device is advanced through the lesion, plaque is excised and then captured within the
Level of Complement Activity Predicts Cardiac Dysfunction after Acute Myocardial Infarction
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Treated with Primary Percutaneous Coronary Intervention
ABSTRACT: Background. The positive effect of reperfusion after ST-elevation myocardial infarction (STEMI) can be reduced by ischemic/reperfusion (I/R) injury. Mannose-binding-lectin (MBL) and soluble C5b-9 (membrane-attack-complex) are involved in complement-driven cell lysis and may play a role in human myocardial I/R injury. We evaluated the potential association between MBL and sC5b-9 in plasma and subsequent cardiac dysfunction in patients with STEMI treated with primary percutaneous coronary intervention (pPCI). Methods
Impact of Body Mass Index on Long-Term All-Cause Mortality after Percutaneous Coronary Intervention in African-Americans
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ABSTRACT: Background. Studies on body mass index (BMI) and post-percutaneous coronary intervention (PCI) outcomes have suggested an “obesity paradox” (lower post-PCI mortality rates in obese patients compared to patients of normal weight). Hypothesis. We assessed the hypothesis that BMI is an independent predictor of post-PCI long-term mortality in African-Americans. Methods. We evaluated 777 patients (146 with normal BMI [BMI >18.5 to < 25 kg/m2], 261 overweight patients [BMI ≥ 25 to < 30 kg/m2], and 370 obese patients [BMI ≥ 30 kg/m2]) who underwent PCI during January 2003 to August
Hyperperfusion Syndrome following Carotid Artery Stenting: The Largest Single-Operator Series to Date
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ABSTRACT: Background. Cerebral hyperperfusion syndrome (HPS) results from autoregulatory failure of cerebral blood flow following carotid endarterectomy (CEA) or carotid artery stenting (CAS) and encompasses a range of neurological findings including headache, seizure, intracranial hemorrhage (ICH), altered mental status and focal neurological changes. This report is the largest single-operator series evaluating the incidence and predictors of HPS following CAS. Methods. A retrospective review was conducted on 482 consecutive patients who underwent CAS between August 1999 and December 2007 at
Intravascular Ultrasound Evaluation of a Stenotic Modified Blalock-Taussig
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Case Presentation. A 33-year-old female with Down syndrome and complex congenital heart disease was admitted to the hospital with progressive cyanosis and fatigue. She had a history of a complete atrioventricular canal defect with a double-outlet right ventricle and severe pulmonary stenosis. A Waterston-Cooley and a modified Blalock-Taussig (BT) with a 6 mm PTFE graft shunt procedures were performed at 16 months and 10 years, respectively. She had presented with a stroke with residual right hemiparesis 2 weeks previously.
Angiography showed an eccentric and severe stenosis at the mi
Editor's Message
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Dear Readers,
The January 2009 issue of the Journal of Invasive Cardiology commences a new and exciting year that will undoubtedly usher in significant challenges as well as new developments in the field of invasive cardiology.
The original research articles contained in this issue of the journal cover a variety of clinical topics. Dr. Charles Maynard and collaborators from the Department of Health Services and Department of Medicine at the University of Washington, the Department of Veterans Affairs Health Services Research and Development in Seattle, Washington, Duke Clinical Resear
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