Volume 24 - Issue 1 - January 2012
Embolic Protection Device Use and Outcomes in Patients Receiving Saphenous Vein Graft Interventions — A Single-Center Experience
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Abstract: Background. Percutaneous treatment of saphenous vein graft disease is hampered by high rates of periprocedural myocardial infarction (MI). The use of embolic protection devices (EPD) during these interventions is a class IB recommendation when technically feasible, yet they are used routinely in less than half of all cases. Our aim was to explore whether or not the under-utilization of EPDs led to any untoward cardiovascular events.
Embolic ProtectionDevices in Saphenous Vein Graft Interventions: Is There Still a Role?
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Saphenous vein grafts (SVG) are commonly used conduits for coronary bypass, with a graft failure rate of up to 45% per patient and 29% per graft on angiographic follow-up at 18 months.1 Atherosclerotic plaques in SVGs tend to be bulky, friable, lipid-rich, and less calcified compared to atherosclerosis in native arteries. Percutaneous intervention in SVGs carries an early as well as late increase in the risk of major adverse cardiac events, resulting from distal microembolization, vasospasm of the distal vascular bed, and microvascular plugging.2
Effect of Changes in Contractility on Pressure Drop Coefficient and Fractional Flow Reserve in a Porcine Model
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Abstract: Objectives and Background. Decisions based on invasive functional diagnostic measurements are often made in the setting of fluctuating hemodynamic variables that may alter resting or hyperemic measurements. The purpose of this investigation is to analyze the effect of myocardial contractility (CY) on invasive functional parameters.
Intravascular Ultrasound Assessment of Postprocedural Incomplete Stent Apposition
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Abstract: Background. There has been no detailed intravascular ultrasound (IVUS) analysis to evaluate the degree to which stent underexpansion or reference vessel/stent size mismatch contributes to the occurrence of post-procedural incomplete stent apposition (post-ISA). Methods. We evaluated 238 lesions treated with everolimus-eluting stents (n = 110) or paclitaxel-eluting stents (n = 128).
Incomplete Stent Apposition… Do We Still Need to be Convinced?
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One of the cornerstones of contemporary stent implantation during percutaneous coronary revascularization is the need for adequate stent expansion with apposition of stent struts to the vessel wall. In most cases, this is achieved with high-pressure dilatation using a non-compliant balloon, so called post-dilatation. The value of adequate stent expansion and stent strut apposition is related to both reductions in repeat revascularization from restenosis and in-stent thrombosis.1-5
Significance of the Invasive Strategy After Acute Myocardial Infarction on Prognosis and Secondary Preventive Medication: A Nationwide Study of 6364 Women and 11,915 Men
- Thu, 1/5/12 - 10:52am
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Abstract: Objective. To describe gender-specific long-term outcome and initiation of secondary preventive medication among patients with acute myocardial infarction (AMI). Design. Observational cohort study. Setting. Nationwide registries. Patients. We included 18,279 patients: 6364 women (35%) and 11,915 men (65%), admitted with AMI (median age, 67 years; range, 30-90 years) surviving for at least 2 months.
Practical Considerations of Percutaneous Ventricular Assist Devices
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Abstract: Percutaneous ventricular assist devices are increasingly used today, allowing the scope of left ventricular support to move out of the operating room and into the interventional suite and cardiovascular care unit. This has given patients requiring short-term therapy an opportunity to undergo high-risk procedures and provide a failing left ventricular support until native recovery can occur.
Use of a Novel Adjunctive Kissing-Balloon Technique with the Trellis Device to Successfully Prevent Embolization Across Juxtaposed Kissing Aortoiliac Stents
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Abstract: The Trellis thrombectomy system (Covidien) has been used successfully to perform isolated pharmacomechanical thrombectomy of both venous and arterial thrombi. The device is designed to provide localized treatment while preventing both systemic spread of the thrombolytic agent and also distal embolization. However, when this device is utilized to remove thrombi at bifurcation lesions, embolization into the contralateral vessel can potentially occur.
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