Volume 15 - Issue 7 - July, 2003
A Unique Pacemaker Complication of Thrombus Formation in the Right Internal Jugular Vein Due to Unusual Migration of an Atrial Pacemaker Electrode
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ABSTRACT: Our report describes the late migration of an atrial screw-in lead into the right internal jugular vein causing subsequent subclinical thrombus formation at the tip of the electrode. Previously initiated anticoagulation for atrial fibrillation may have prevented complete occlusion of the internal jugular vein. Therefore, prophylactic anticoagulation should be considered for patients in whom permanent pacing leads are dislodged into central veins and cannot be removed.
Management of Iliac Stent Movement Complicating Peripheral Vascular Intervention: A Rescue Technique When Stent Deployment Mal
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Although percutaneous intervention for the treatment of peripheral vascular disease for symptomatic intermittent claudication is now considered a safe and common practice, such interventions may be compromised by stent deployment malfunction or malpositioning. We report a case of common iliac artery stenting complicated by stent migration and describe an approach to the management of this problem.
Case Report: A 56-year-old woman with diabetes, hypertension and coronary artery disease presented with progressive shortness of breath and left lower extremity claudication. On physical
Heparin in Peripheral Vascular Intervention — Time for a Change?
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Throughout the history of interventional procedures, unfractionated heparin has been the standard anticoagulant.1 More recently, in coronary intervention, agents have been found to provide better efficacy and/or safety than sole therapy with unfractionated heparin.2–5 While the need to improve upon the results obtained with unfractionated heparin has been acknowledged in coronary intervention, peripheral intervention has lagged in this regard. In this issue of the Journal, Shammas et al. have elegantly described the incidence of in-hospital complications in patients und
Identifying the Vulnerable Plaque (IAGS Proceedings - Part I of II parts)
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Jim Zidar: We have chosen magnetic resonance imaging as our primary imaging tool at Duke University. A new cardiac magnetic resonance imaging research laboratory is being installed at Duke, with an adjacent clinical laboratory. In our view, magnetic resonance imaging will be an effective tool as it evolves, but there are many unanswered questions at present. The IAGS may be the ideal society to launch collaborative research on a unique topic. I don’t think we have found the optimal technology yet. I talked to Tom Linnemeier about this on several occasions. Tom has received proposals f
The Diagnostic Importance of Angiographic Visualization of the Distal Vessel in Elucidating the Mechanism of Abrupt Vessel Closu
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Acute vessel closure is a serious event, complicating 0.5–9.3% of percutaneous coronary interventions (PCI), and is associated with major clinical adverse events including emergency coronary bypass surgery, acute myocardial infarction and death.1–4 Although coronary dissection, thrombosis and spasm are frequently observed, the pathogenesis remained uncertain in up to 50% of cases.2,3,5–9 Accordingly, a specific therapy may not be adequately provided in a timely appropriate manner. In this report, we describe 3 cases of abrupt coronary vessel closure in which convent
Identifying the Vulnerable Plaque (IAGS Proceedings - Part II of II)
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(IAGS Proceedings - Part II of II)
Nick Hopkins: The preliminary reports on intracranial angioplasty and stenting showed very high morbidity and mortality rates associated with the procedure — particularly in symptomatic patients. As Dr. Myler suggested, it is risky to treat an unstable plaque. Others have reported that if suboptimal angioplasty is performed in these really sick intracranial plaque patients who are symptomatic, the vessel can be opened slightly to improve flow with very low risk if the proper antiplatelet regimen is maintained. We performed suboptimal angiop
The Search for Optimal Combination of Antiplatelet and Anticoagulation Regimens Following PCI
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“The patient is given aspirin (1.0 g per day) for 3 days, starting the day before the procedure. Heparin and low molecular weight dextran are administered during dilatation; warfarin is started after the procedure and is continued until follow-up study 6–9 months later.”
— Gruentzig AR, Senning A, Siegenthaler WE.
N Engl J Med 1979;301:61–68.
Since the introduction of percutaneous coronary angioplasty by Gruentzig in 1977, vast changes have transformed the field of interventional cardiology.1,2 These changes have not only involved the develop
Editor's Message (May 2003)
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Dear Readers,
This issue of the Journal of Invasive Cardiology includes original research articles, case reports, brief reviews, and articles from the Journal special sections “Acute Coronary Syndromes”, “Clinical Decision Making”, and the “Clinical Images” section, and a discussion section from the 7th Biennial Andreas Gruentzig Society Meeting.
The first research article, submitted by Dr Louis Carnendran and associates at Harrisburg Medical Associates in Harrisonburg, Virginia present their evaluation of the safety and efficacy of low-dose enoxaparin and glycoprotein IIb/
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