Volume 21 - Issue 5 - May, 2009

Feasibility and Safety of Ad Hoc Percutaneous Coronary Intervention in the Modern Era

Christopher W. Good, DO, James C. Blankenship, MD, Thomas D. Scott, DO, Kimberly A. Skelding, MD, Peter B. Berger, MD, *G. Craig Wood

From the Department of Cardiology, and the *Center for Health Research, Geisinger Medical Center, Danville, Pennsylvania.
The authors report no conflicts of interest regarding the content herein.
Manuscript submitted November 18, 2008, provisional acceptance given December 30, 2008, final version accepted February 9, 2009.
Address for correspondence: James Blankenship, MD, Department of Cardiology 21-60, Geisinger Medical Center, 100 North Academy Drive, Danville, PA 17822. E-mail: [email protected]

ABSTRACT: Background. The frequency of ad hoc percutaneous coronary intervention (PCI) varies among institutions and regions of the country. It is unclear what factors limit use of the ad hoc strategy. Objective. To define factors which limit the use of the ad hoc strategy. Methods. All patients who underwent PCI at our center in 2004 were reviewed. Patients who had emergent PCI for ST-elevation myocardial infarction (n = 188), those who had undergone diagnostic coronary angiography at a referring facility (n = 54), and those who had a repeat PCI after a previous ad hoc PCI (n = 19) were exclu...

Conservative Approach for Perforation and Early Pseudoaneurysm of Left Anterior Descending Artery during Overlapped Stenting

Mohammad Alidoosti, MD, Abbas Soleimani, MD, *Ali Abbasi, MD

From the Department of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran, and the *Department of Epidemiology, University Medical Center Groningen, Groningen, the Netherlands.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted December 5, 2008, provisional acceptance given January 13, 2009, and final version accepted February 9. 2009.

Address for correspondence: Abbas Soleimani, MD, North Kargar Street, Tehran Heart Center, Postal code 1411713138, Tehran, Iran.,Tehran Heart Center...

Preprocedural White Blood Cell Count as a Predictor of Death and Major Adverse Cardiac Events (full title below)

Daniel L. Jurewitz, MD, Antonio Pessegueiro, MD, Raymond Zimmer, MD, Ravi Bhatia, MD, Jonathan Tobis, MD, Michael S. Lee, MD

From the David Geffen School of Medicine at University of California, Los Angeles (Division of Cardiology), Los Angeles, California.
Michael S. Lee is on the speaker’s bureau for Boston Scientific Corporation, Bristol Myer Squibb, and Schering-Plough; Jonathan Tobis is on the speaker’s bureau for Boston Scientific Corporation.
Manuscript submitted December 15, provisional acceptance given February 9, 2009, manuscript accepted February 25, 2009.
Address for correspondence: Michael S. Lee, MD, UCLA Medical Center, Adult Cardiac Catheterization Laboratory, 10833 Le Conte Avenue, Room BL-394 CHS, Los Angeles, CA 90095. E-mail: [email protected]

Preprocedural White Blood Cell Count as a Predictor of Death and Major Adverse Cardiac Events in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

ABSTRACT: Background. Patients with elevated white blood cell (WBC) counts who undergo percutaneous coronary intervention (PCI) are at increased risk for short- and long-term mortality as well as major adverse cardiac events (MACE). We assessed the relationship between elevated WBC counts and clinical events in patients who underwent PCI with drug-eluting stents (DES). Methods. Our retrospecti...

Percutaneous Revascularization of Chronic Total Occlusion of Left Anterior Descending Artery (full title below)

*Akio Kawamura, MD, §Masahiro Jinzaki, MD, §Sachio Kuribayashi, MD

Percutaneous Revascularization of Chronic Total Occlusion of Left Anterior Descending Artery Using Contralateral Injection via
Isolated Conus Artery

From the *Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, and the §Division of Radiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted December 15, 2008, and accepted January 5, 2009.

Address for correspondence: Akio Kawamura, MD, Division of Cardi...

Pre-PCI White Blood Cell Count: Should We Care?

David Lao, MD and Yerem Yeghiazarians, MD

From the University of California San Francisco, Division of Cardiology, San Francisco, California.
Address for correspondence: David Lao, MD, University of California San Francisco, Division of Cardiology, 505 Parnassus Avenue, Box 0103, San Francisco, CA 94143-0103. E-mail: [email protected]

Numerous epidemiologic and clinical studies have shown leukocytosis to be an independent predictor of future cardiovascular events.1 While a causal mechanism has yet to be determined, the relationship remains consistent, temporal and dose-dependent in a wide array of patients, ranging from those free of coronary heart disease to those presenting with acute myocardial infarction (MI).2 In the era of percutaneous coronary intervention (PCI), an elevated preprocedural white blood cell (WBC) count has been associated with worse clinical outcomes in patients undergoing angioplasty with or without b...

IVUS-Guided Management of Late Stent Malaposition with Peri-Stent Restenosis with Coronary Artery Aneurysm (full title below)

*Charan P. Lanjewar, MD, DM, *Amit Sharma, MD, DM, §Tej Sheth, MD, FRCPC, FACC

From *Mumbai University, Seth G. S. Medical College and KEM Hospital, Mumbai, India, and §McMaster University, Hamilton Health Sciences, Hamilton General Hospital, Hamilton, Ontario, Canada.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted November 7, 2008, provisional acceptance given February 17, 2009, final version accepted February 20, 2009.

Address for correspondence: Charan Lanjewar, MD, DM, Associate Professor, Cardiology, Seth G.S.Medical College and KEM Hospital, Parel(E), Mumbai, India. E-mail: charanlanjewar@hotmai...

Impact of Thrombus Aspiration Use for the Treatment of Stent Thrombosis on Early Patient Outcomes

Gilles Lemesle, MD, Axel de Labriolle, MD, Laurent Bonello, MD, Tina L. Pinto Slottow, MD, Rebecca Torguson, MPH, Kimberly Kaneshige, BS, Daniel H. Steinberg, MD, Probal Roy, MD, Zhenyi Xue, MS, William O. Suddath, MD, Lowell F. Satler, MD, Kenneth M. Kent, MD, PhD, Joseph Lindsay, MD, Augusto D. Pichard, MD, Ron Waksman, MD

From the Washington Hospital Center, Washington, D.C.
Disclosures: Dr. Waksman has received speaker honoraria from Medtronic, Inc., is a consultant to that company, and has received research grants from the same.
Manuscript submitted November 19, 2008, provisional acceptance given December 30, 2008, final version accepted February 11, 2009.
Address for correspondence: Ron Waksman, MD, Washington Hospital Center, 110 Irving Street, N.W., Suite 4B-1, Washington, D.C. 20010. E-mail: [email protected]

ABSTRACT: Background. Recent data suggest a clinical benefit with the systematic use of thrombus aspiration (TA) for the treatment of ST-elevation myocardial infarction (STEMI). Nevertheless, the impact of TA as a treatment strategy for stent thrombosis (ST) is unknown. This study aimed to analyze the impact of TA use for the treatment of ST on patient outcomes. Methods. From 2003 to 2008, 91 consecutive patients who presented with a definite ST were included in this analysis. We compared procedural success rates and the incidence of the composite criteria death-recurrent MI-recurrent ST at 30...

An Unusual Complication of Transradial Coronary Angiography

Margaret B. McEntegart, PhD, MRCP, Jonathan R. Dalzell, MRCP, M. Mitchell Lindsay, MD, MRCP

From the Department of Cardiology, Western Infirmary, Glasgow, G11 6NT, United Kingdom.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted December 16, 2008, provisional acceptance given February 6, 2009, and final version accepted February 20, 2009.

Address for correspondence: Jonathan R. Dalzell, MRCP, Department of Cardiology, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT, United Kingdom. E-mail: [email protected]

_______________________________________________

ABSTRACT: We report the ...

Stent Thrombosis Aspiration Thrombectomy: Is This Another Glimmer of Hope?

Chrisopher Lawson, MD and Lawrence A. Garcia, MD

From the Section of Interventional Cardiology and the Vascular Medicine Program, St. Elizabeth’s Medical Center, and Tuft’s University School of Medicine, Boston, Massachusetts.
The authors report no conflicts of interest regarding the content herein.
Address for correspondence: Lawrence A. Garcia, MD, FACC, FAHA, Chief, Section Interventional Cardiology, Associate Director, Vascular Medicine Program, St. Elizabeth's Medical Center, Associate Professor of Medicine, Tuft’s University School of Medicine, 736 Cambridge Street, Boston, MA 02135. E-mail: [email protected]

Percutaneous coronary intervention (PCI) has become the default therapy for obstructive coronary artery disease and invariably involves coronary stenting. Currently, stenting with a drug-eluting stent (DES) has become the default method for intervention, with few exceptions.1 The major drawback of this strategy is both acute and subacute stent thrombosis. The DES type, positioning, and lesion complexity may all contribute to stent thrombosis, the mechanisms of which are still under investigation.2 While there may be some debate as to the absolute occurrence of stent thrombosis, the complicatio...

Electrophysiology 2009: Making Practical Decisions in Difficult Economic Times

Guest Editor:
Todd J. Cohen, MD, FACC, FHRS

Electrophysiology continues to make advances. However, we have to place these advances in the context of an economy that has slipped into a deep recession (both in the United States and worldwide). For years, electrophysiology has seen double-digit growth in both the number of devices implanted as well as the number of catheter ablation procedures performed. This growth has been unprecedented and coincided with the growth seen on Wall Street and in technology over the past thirty years. As companies like Microsoft and Intel continued to grow and expand, so did the cardiovascular technology com...

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