Volume 16 - Issue 4 - April, 2004
Excimer Laser Revascularization of Saphenous Vein Grafts in Acute Myocardial Infarction
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ABSTRACT: Patients who develop acute myocardial infarction due to occlusion in a saphenous vein graft (SVG) constitute a revascularization challenge. Excimer laser angioplasty may have a potential advantage in the treatment of SVGs, since its 308 nanometer wavelength is avidly absorbed by both atherosclerotic plaque and thrombus. The data presented herein support the notion that excimer laser angioplasty is a technology that has a potential role in achieving adequate revascularization outcomes in this selected, high-risk patient population.
J INVAS CARDIOL 2004;16:177–180
Ke
Use of Corticosteroids in the Treatment of Cholesterol Crystal Embolization after Percutaneous Transluminal Coronary Angioplast
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ABSTRACT: Cholesterol crystal embolization is a rare but recognized complication of cardiac catheterization. While management has traditionally been supportive only, we demonstrate the successful use of corticosteroids in treatment of a patient with cholesterol crystal embolization to the distal extremity.
J INVAS CARDIOL 2004;16:222–223
Key words: atheroembolism, angiography, corticosteroid
Cholesterol crystal embolization (CCE) is a known, albeit uncommon, complication of all angiography, including cardiac catheterization and percutaneous transluminal angioplasty (PTCA). It
Clopidogrel Dosing in Overweight Patients: Does One Size Fit All?
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Finding the “right dose” of a medication for an individual patient remains an illusive challenge for the practicing clinician. As part of the drug approval process, drug developers use randomized controlled trials to determine the general safety and efficacy profiles of a drug using a standard dosing regimen. However, it is clear that pharmacokinetics and dynamics of a drug can vary markedly based on the patient’s age, body size and composition, renal and hepatic function, concomitant medications used and other factors. These issues are particularly relevant with anti-thrombotic or anti-
CME Offering: Vascular Brachytherapy: A New Approach to Renal Artery In-Stent Restenosis
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Learning objectives. At the conclusion of this activity, the participant should be able to: 1) describe conventional approaches to the management of renal artery in-stent restenosis and the justification for using vascular brachytherapy in this setting; 2) compare the advantages and disadvantages of various radiation sources in performing renal vascular brachytherapy; 3) review the major trials of renal vascular brachytherapy; and 4) identify the limitations of existing data.
Activity instructions. Successful completion of this activity entails reading the article, answering the test
Platelet Aggregation According to Body Mass Index in Patients Undergoing Coronary Stenting: Should Clopidogrel Loading-Dose Be
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ABSTRACT: Background. A 300 mg clopidogrel loading-dose (LD) is widely used as an adjunct antithrombotic treatment to reduce the risk of thrombotic events early after coronary stenting (CS). Antithrombotic drugs commonly used during percutaneous coronary interventions, such as heparin and platelet glycoprotein IIb/IIIa inhibitors, but not clopidogrel LD, are weight-adjusted, and few data are available on which is the most effective clopidogrel LD regimen. The aim of this study was to assess whether body mass index (BMI) influenced platelet response to clopidogrel LD in patients undergoing C
Transcatheter Embolization of Recanalized Coronary Artery Fistula with Nit-Occlud Device
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ABSTRACT: Congenital coronary artery fistula is a rare anomaly with varying symptomatology that may be addressed with surgical or interventional closure. Recanalization after complete occlusion of a coronary artery fistula has only been reported after surgical but not after interventional closure. We present a case of coronary artery fistula recanalization after angiographically documented complete transcatheter occlusion with Gianturco coils. The fistula was successfully managed by transcatheter implantation of a Nit-Occlud system, originally designed for interventional closure of patent d
PR-Segment Elevation in Inferior Leads: An Atypical Electrocardiographic Sign of Atrial Infarction
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Atrial infarction (ATI) is detected in about 0.7–42% of autopsy findings of acute myocardial infarction (AMI) depends on whether or not the atria are specifically examined.1–3 Electrocardiography (ECG) is the only means of which antemortem diagnosis of ATI can be made. PR-segment represents the period of atrial repolarization. Significant PR-segment depression in inferior leads with reciprocal PR-segment elevation in lead I is used as one of the diagnostic criteria for ATI.4 However, the sensitivity of these diagnostic criteria is low, in the range of 5.4–6.9% due t
Right-sided Pulsus Alternans in Prosthetic Mitral Valve Thrombosis
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Pulsus alternans is characterized by alternating strong and weak myocardial contractions in the absence of respiratory or cycle length variations, and is commonly associated with advanced left ventricular dysfunction. The alternation may be seen in the systemic circulation, the pulmonic circulation or in both.1 Isolated right-sided pulsus alternans has been described in situations with increased pulmonary resistance, right ventricular dilatation, right-sided congestive heart failure or in diastolic left ventricular dysfunction.2,3
The present case describes a patient w
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