Volume 15 - Issue 3 - March, 2003

Early and Late Reactions Following the Use of Iopamidol 340, Iomeprol 350 and Iodixanol 320 in Cardiac Catheterization

ABSTRACT: Goal. To investigate the incidence of early (< 24 hours) and late (> 24 hours to 7 days) reactions to 3 contrast agents commonly used in cardiac catheterization. Methods and Results. A total of 2,108 patients undergoing cardiac catheterization in a Regional Cardiothoracic Unit were randomly assigned to receive 1 of 3 commonly used contrast agents in a prospective, double-blind study.

 



A Comparison of Arterial Closure Devices to Manual Compression in Liver Transplantation Candidates Undergoing Coronary Angiograp

Coronary artery disease is common in adult patients with end-stage liver disease who are candidates for orthotopic liver transplantation.1 Patients with end-stage liver disease are predisposed to spontaneous bleeding complications due to thrombocytopenia, reduced synthesis of coagulation factors and increased fibrinolytic activity.2–4 The impaired immunity has been shown to lead to a higher frequency of bacteremia and subsequent increased mortality.5,6 Vascular access site hematomas and infections are well known complications of cardiac catheterization.7 Several trials have reported similar



Contemporary View of the Acute Coronary Syndromes (Part I of II)

Acute coronary syndromes (ACS) represent a clinical spectrum that extends all the way from unstable angina presenting with worsening episodes of chest pain, to non-ST segment elevation myocardial infarction (NSTEMI) with more prolonged chest pain and biochemical evidence of myocardial injury, to ST-segment elevation myocardial infarction (STEMI) with more extensive myocardial damage and usually the formation of Q-waves on the surface electrocardiogram, and finally to sudden cardiac death. Pathophysiologic correlations in ACS include minor plaque ulceration and transient thrombus formation in u



Successful Aspiration of Occlusive Coronary Thrombus with Intracoronary Aspiration Using the Export™ Catheter

Percutaneous transluminal coronary angioplasty (PTCA) for unstable angina relieves symptoms and reduces the likelihood of subsequent acute myocardial infarction. However, initial procedural success rates in patients with unstable angina are lower than in those with stable angina. This is postulated to mainly be due to the higher complication rates associated with PTCA procedures in this setting.1 Procedure-related mortality has been reported to range from 0–5.4%, periprocedural myocardial infarction rates range from 0–12% and the need for emergency surgery ranges from 3–13%.2–8 Complic



Post-Cardiac Catheterization Access Site Complications and Low-Molecular-Weight Heparin Following Cardiac Catheterization

No consensus has emerged on the periprocedural anticoagulation regimen of patients receiving long-term oral anticoagulation.1 Enoxaparin, a low molecular weight heparin (LMWH), is often used following percutaneous invasive procedures in patients on long-term anticoagulation who undergo temporary periprocedural discontinuation of warfarin. From 1993 through 1998, the Food and Drug Administration (FDA) received reports of 43 patients who developed spinal or epidural hematomas following the use of enoxaparin in the setting of neuraxial blockade.2 Many of these patients developed severe neurologic



Long-Term Warfarin and Percutaneous Intervention

Despite improvements in interventional procedural techniques and equipment, vascular and bleeding complications remain a too frequent complication of percutaneous coronary intervention (PCI). In the National Cardiovascular Network database of over 100,000 patients undergoing cardiac catheterization the transfusion rate was 4% and the vascular complication rate was 3.5%.1 Contemporary PCI trials report rates of major bleeding of 1 to 2% and minor bleeding rates of 3–6%.2,3
The optimal peri-procedural strategy for patients requiring ongoing anticoagulation with warfarin is unclear. In the cu



Platelet Glycoprotein IIb/IIIa Inhibition in Unstable Angina and Non-ST Segment Elevation Myocardial Infarction: Application of

Introduction. Over the past decade, appreciable reductions in mortality, reinfarction and length of hospital stay have been reported in large-scale trials of patients with acute coronary syndromes (ACS). Every year, approximately 1.5 million patients are admitted to hospitals in the United States with unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI). In the last few years, there have been many advances in the evaluation and management of this patient population, including effective medical treatments such as antiplatelet, anticoagulant and cholesterol-low



February 2003

Dear Readers,

This issue of the Journal of Invasive Cardiology includes original research articles, case reports, a CME offering, articles from the Journal special sections “Acute Coronary Syndromes” and “Interventional Pediatric Cardiology”, as well as Part VIII of the discussion series from the International Andreas Gruentzig Society 7th Biennial Meeting held in February of 2002.

In the first original research article, Dr. Lee A. MacDonald and colleagues from the Divisions of Cardiology and Hematology in the Department of Medicine at Northwestern University Medical Scho



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