Volume 21 - Issue 12 - December, 2009

Validation of a Risk Score for Target Vessel Revascularization after Coronary Stent Implantation

aAlexandre S. Quadros, MD, PhD, bFabiane Diemer, RN, bDulce Welter, RN, Thais Modkovski, MD,
aRogério Sarmento-Leite, MD, PhD, aCarlos A.M. Gottschall, MD, PhD, FSCAI, FIAGS

ABSTRACT: Objective. Our aim was to validate a risk score for new target vessel revascularization (TVR) after bare-metal stent (BMS) implantation. Methods. The risk score was developed in a cohort of patients previously treated with BMS at our institution. This risk score ranges from 0 to 5 points, according to the presence of diabetes mellitus (1 point), reference vessel diameter (> 3.5 mm = 0 points; 3–3.5 mm = 1; 20 mm = 2). Patients included in the validation cohort were treated between January and December 2005. Pati...

Very Late Thrombosis of a Sirolimus-Eluting Stent after 57 Months

Anil Paturi, MD,* Mark Rothenberg, MD,* Steven Borzak, MD*§

From the *University of Miami Miller School of Medicine, and Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, Florida, and §Nova Southeastern College of Medicine, Ft. Lauderdale, Florida.

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

Manuscript submitted May 29, 2009, provisional acceptance given June 24, 2009, final version accepted July 7, 2009.

Address for correspondence: Anil Paturi, MD, Internal Medicine Residency Program, JFK Medical Center, 4 South, 5301 S. Congress, Atlantis, FL 33462. E-mail: apaturi@me...

A Novel “In-Situ Tulip-Bud Deployment” Method for Transcatheter Closure of Secundum Atrial Septal Defect

Swee Chye Quek, MD, FRCPCH, Wen Xia Wu, MBBS, Kit Yee Chan, MD, Patrick Ang, MBBS, MRCP,
Ting Fei Ho, MD, FRCP, William Yip, MD, FRCP

ABSTRACT: Objective. We devised a new technique for interventional closure of atrial septal defect (ASD) using the Amplatzer Septal Occluder (ASO), and validated this by comparing it with a cohort using the conventional method. Background. Transcatheter closure of ASD is a widely accepted modality of treatment. Although the outcome is good, there are occasional technical difficulties encountered. Method. In this three-step technique, the device is protruded to form a “tulip bud.” This “tulip bud” is then aligned adjacent to and along the plane of the ASD. The second step involves withd...

Primary Antiphospholipid Syndrome with Recurrent Coronary Thrombosis, Acute Pulmonary Thromboembolism and Intracerebral Hematoma

Panduranga Prashanth, MD and Mohammed Khamis Mukhaini, FRCP(C)

From the Department of Cardiology, Royal Hospital, Muscat, Oman.

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

Manuscript submitted May 21, 2009, provisional acceptance given June 8, 2009, final version accepted June 24, 2009.

Address for correspondence: Dr. Panduranga Prashanth, Department of Cardiology, Royal Hospital, Post Box 1331, Muscat-111, Oman. E-mail: [email protected]

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ABSTRACT: We present a young patient with myocardial infarction who had rec...

Predictors of Distal Embolization in Peripheral Percutaneous Interventions: A Report from a Large Peripheral Vascular Registry

Nicolas W. Shammas, MD, MS, Gail A. Shammas, BS, RN, Eric J. Dippel, MD, Michael Jerin, PhD,
Waheeb J. Shammas

ABSTRACT: Background. Distal embolization (DE) commonly occurs during peripheral percutaneous interventions (PPI) of the lower-extremity arterial vessels. In this study we evaluate the predictors of DE in a large cohort of patients undergoing PPI at our center. Methods. Patients who experienced clinically significant DE (requiring further mechanical or pharmacologic therapy as per operator judgment) were extracted from a peripheral vascular registry that prospectively tracks demographics, clinical, procedural and outcome variables on patients undergoing PPI at our medical center and compared t...

Atheroemboli during Peripheral Arterial Interventions

Subhash Banerjee, MD, Tej Thatthi, BA, Neeraj Badhey, MD, Emmanouil S. Brilakis, MD, PhD

Atheroemboli during percutaneous peripheral arterial interventions (PAI) complicate about 1–2% of procedures, with serious adverse outcomes, although their true incidence is estimated to be much greater.1 In the era of increasing number and complexity of percutaneous peripheral arterial revascularization procedures, it is important to provide operators with guidance regarding the predictors of this rare though serious complication. The rarity and often unpredictability of atheroembolic complications during PAI makes this article by Shammas et al extremely relevant to today’s endovascular s...

Optimizing of Transcoronary Pacing in a Porcine Model

Konstantin M. Heinroth, MD, Justin M. Carter, MD, Michael Buerke, MD, *Dirk Mahnkopf, MD,
Karl Werdan, MD, §Roland Prondzinsky, MD

ABSTRACT: Background. Transcoronary pacing for the treatment of bradycardia during percutaneous coronary intervention (PCI) is not well established, but may be a useful technique in interventional cardiology. We developed a porcine model to examine the feasibility and efficacy of transcoronary pacing during PCI. Methods and Results. Eight pigs under general anesthesia underwent unipolar transcoronary pacing with a standard floppy guidewire in a coronary artery (as the cathode) and a skin patch electrode (as the anode). We examined the effect of skin-patch position (groin vs. anterior or poster...

A Regional System for Delivery of Primary Percutaneous Coronary Intervention (Full title below)

Richard Aplin, MD, Daniel Tiede, MD, Cheryl Lovitz, RN, Mark Gartner, RT(R)(CV), †David Robinson, PhD, †Hui Xu, PhD, Philip Martin, RN, BSN, Bernard Erickson, MD, Wade Schmidt, MD, Jamie Pelzel, MD,
David Wendt, AAS, John Mahowald, MD

A Regional System for Delivery of Primary Percutaneous Coronary Intervention in ST- Elevation Myocardial Infarction: STEMI-St. Cloud

ABSTRACT: Background. Strategies of emergency care in the treatment of ST-segment elevation myocardial infarction (STEMI) have evolved rapidly over the past two decades to include primary percutaneous coronary intervention (PPCI) when possible. Most U.S.-based transfer programs still use complicated protocols that include fibrinolytic therapy often resulting in transfer delays, inappropriately applied therapy (wrong diagnosis) and bleeding and strok...

Primary PCI for STEMI — Pushing the Limits

Robert J. Applegate, MD

The optimal management of patients with ST-elevation myocardial infarction (STEMI) has been the subject of ongoing clinical investigations for the past several decades. When it became apparent that primary angioplasty was not only feasible, but superior, to thrombolytic therapy in randomized clinical trials,1 there was universal adoption of primary percutaneous coronary intervention (PCI) for those centers that perform PCI. The belief that primary PCI was superior to thrombolytic therapy as the initial treatment of STEMI is so strong that many centers that previously administered thrombolytic ...

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