Volume 17 - Issue 9 - September, 2005
Hemostatic Efficacy of Hysrophilic Wound Dressing after Transradial Catheterization
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Transradial coronary angiography (TRA) has proven to be a feasible, safe, and effective method, and steadily growing in popularity.1,2 Furthermore, TRA carries great advantages in terms of reducing the risk of major entry-site complications, hospital staff workload and cost. Until recently, tourniquets and hemostatic compressive devices (CD) have been used routinely to induce hemostasis at the radial artery access site.3 However, tourniquets and other compressive devices carry serious disadvantages: restriction of wrist movement, necessity for prolonged application of the
Distal Embolic Protection — Don't Cause a Stroke Trying to Prevent One!
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The article published in this issue of the Journal regarding initial experience with the SPIDER™ Embolic Protection Device (ev3 Inc., Plymouth, Minnesota) provides further evidence of the merit of these newer-generation “gizmos” in reducing complication rates of carotid stenting. The earlier generation protection devices such as the PercuSurge device (Medtronic, Inc., Minneapolis, Minnesota), the Angiogard device (Cordis Corporation, Miami, Florida), and the Accunet™ device (Guidant Corporation, Indianapolis, Indiana) all have inherent advantages and disadvantages. Certainly, those of
Electrophysiology: A Novel Radiation Protection Drape Reduces Radiation Exposure during Fluroscopy-Guided Electrophysiology Proc
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Over the past 15 years, there has been an exponential increase in the number of procedures performed in the electrophysiology (EP) laboratory. These procedures can be technically difficult with relatively long fluoroscopy times and high radiation dose exposure to patients, operators and laboratory staff.1,2
During fluoroscopic imaging, diagnostic information is carried in the primary beam. These high intensity X-rays are the chief hazard to the patient. Lower energy scattered radiation deviates in all directions from the patient. Despite typical precautions (i.e., hanging a lead sh
A New Percutaneous Porcine Coronary Model of Chronic Total Occlusion
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Chronic total occlusions (CTO) are present in up to 40% of patients with angiographically documented coronary artery disease and represent at least 10% of the target for coronary angioplasty attempts.1 However, despite improvements in angioplasty equipment — primarily guidewires — and operator skills, the success rate of CTO recanalization has reached the plateau of around 70%.1 Recent studies2,3 suggest that compared with unsuccessful CTO recanalization, those with successful procedures have a much better long-term outcome. In addition, the availability of drug-eluti
Efficacy and Safety of Contrast Injection Beyond Total Occlusions in Acute Cardiac Patients: A Method to Confirm Balloon Positio
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Percutaneous therapy of total coronary occlusions is generally more challenging than the treatment of stenotic lesions. It more frequently entails the risk of irreversibly disrupting a protruding plaque, of advancing the wire through a false route, or rarely, of causing coronary perforation. Furthermore, the length of the occlusion is usually either unknown or can only be vaguely estimated during injection into the contralateral coronary artery as a result of distal opacification by collaterals. The procedural difficulty involved in treating total occlusions and the associated risks are more p
Editor's Message
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Dear Readers,
This issue of The Journal of Invasive Cardiology includes original research articles, a rapid communication article, a case reports, two reviews, and articles from the journal’s special sections Adjunctive Therapy, Intervention in Peripheral Vascular Disease and Electrophysiology Corner.
The Rapid Communication article, submitted by Dr. Woohyuk Song and colleagues from the Weill Cornell Medical College in New York, describes their development of a porcine coronary model for the study of chronic total occlusion. Preliminary results from their model indicate that the majo
Sirolimus- and Taxol-eluting Stents Differ Towards Intimal Hyperplasia and Re-endothelialization
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In-stent restenosis of coronary arteries is the major reason for the recurrence of occlusion after successful percutaneous coronary intervention (PCI) and occurs in 20–50% of patients.1 The development of in-stent restenosis depends on complex cellular interactions within the vessel wall involving endothelial cells (ECs), smooth muscle cells (SMCs), fibroblasts, lymphocytes, and macrophages.2 Vessel injury from balloon angioplasty and stenting cause the release of soluble mediators that initiate cellular activation, migration, proliferation, extracellular matrix product
Emergent Mechanical and Electrical Guidewire Pacing of the Right Ventricle for Asystole in the Cardiac Catheterization Laborator
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Case Report. A 72-year-old female with severe symptomatic mitral stenosis, chronic atrial fibrillation, and left bundle branch block was admitted to the hospital for percutaneous balloon valvuloplasty. Catheterization of the right ventricle was complicated by a complete atrioventricular block with asystole, presumably due to an irritation of the right bundle branch by the 5 French multipurpose catheter (Cordis Corporation, Miami, Florida). Immediate and sufficient hemodynamic stabilization (Figure 1) was achieved by the induction of nonsustained ventricular runs by mechanical stimula
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