Volume 18 - Issue 7 - July, 2006
Real-Time, Three-Dimensional Localization of a Brockenbrough Needle during Transseptal Catheterization Using a Nonfluoroscopic M
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Interatrial transseptal catheterization is a technique commonly used in the electrophysiology laboratory to access the left atrium. The procedure is being used more commonly as ablation of atrial fibrillation is more widely applied. Traditionally, transseptal catheterization has been done utilizing fluoroscopic markers with hemodynamic monitoring.1,2 Different variations of the technique have been described. Recently, intracardiac echocardiography (ICE) has been used to assist in needle localization during transseptal catheterization.3,4 Left atrial catheter ablation is f
Desensitization for the Management of Clopidogrel Hypersensitivity: Initial Clinical Experience
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Clopidogrel bisulfate is a thienopyridine oral antiplatelet agent that acts via irreversible inhibition of adenosine diphosphate-mediated platelet activation and aggregation.1 It is widely used in the treatment and secondary prevention of a variety of cardiovascular diseases. Clopidogrel has been shown to decrease death and ischemic events in patients with recent myocardial infarction, ischemic stroke or symptomatic peripheral arterial disease,2 patients with non-ST-segment elevation acute coronary syndromes,3 and patients undergoing percutaneous coronary inter
Stenting the Chronic Totally Occluded Superficial Femoral Artery: Endovascular Clinical Benefit
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Peripheral vascular disease (PVD) has been described as underreported, underdiagnosed and undertreated in this country. Clinical and epidemiological studies suggest the prevalence of PVD is higher than previously believed and could be over 20% in the general population.1
Classically, lower extremity claudication involves the superficial femoral artery (SFA). It can be the sole level or be a part of multilevel disease in claudicants or critical limb ischemia respectively.2 Importantly, the SFA remains one of the most uniquely dynamic arteries in the arterial tree, as it
Giant Fistula between the Aorta and the Coronary Sinus
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A 66-year-old male presented with exertional dyspnea and palpitations. The electrocardiogram showed atrial fibrillation and episodes of atrial flutter. Subsequent echocardiography revealed signs of right-sided heart failure with dilatation of the right ventricle and atrium, while left ventricular function was normal.
In order to rule out coronary artery disease, coronary angiography was performed. The left coronary artery had atherosclerotic plaque without significant stenotic lesions, while the right coronary artery was chronically occluded with retrograde filling by collaterals. Attempting
Safety of Beta Radiation Exposure to the Non-Target Segment: An Intravascular Ultrasound Dosimetric Analysis
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Although catheter-based brachytherapy has been demonstrated to effectively treat in-stent restenosis, a technique-dependent issue known as “geographic miss” has evolved as a potential limitation contributing to long-term treatment failures. The mechanism responsible for the unfavorable edge effects may include the combination of low-dose radiation and mechanical injury during the interventional procedure.1,2 To ensure full coverage of radiation over the entire injured segment, longer radioactive seed trains have been recently introduced to interventional laboratories. This strat
Dual Lumen Catheters: More Than Just Aspiration
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To the Editor:
Percutaneous coronary interventions of thrombotic or friable lesions, such as in acute myocardial infarctions, can often result in distal embolization. To circumvent this problem, modern techniques frequently involve pretreatment with thrombectomy devices. The Pronto™ (Vascular Solutions, Inc., Minneapolis, Minnesota) and Export® (Medtronic, Inc., Minneapolis, Minnesota) catheters feature dual-lumen platforms consisting of a central rapid exchange wire lumen as well as an eccentric aspiration lumen. They are designed for rapid, manual syringe aspiration of throm
The Utility of Implantable Loop Recorders for Diagnosing Unexplained Syncope in 100 Consecutive Patients – Five-Year, Single-Cen
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Recurrent unexplained syncope and presyncope comprise approximately 1–6% of emergency room and approximately 1% of hospital admissions.1,2 The estimated incidence of self-reported syncope is 6.2 per 1,000 person years in the Framingham study.3 The overall incidence is approximately 3–6% over 10 years, and in a select group of patients, the prevalence of syncope could reach almost 50%.4 A symptom-rhythm correlation is often difficult to obtain during spontaneous episodes because of the sporadic, infrequent and unpredictable nature of syncope.1 A s
Editor's Letter
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Dear Readers,
This issue of the Journal of Invasive Cardiology includes several interesting articles selected for their importance to the care of cardiac patients.
The first research article, submitted by Dr. Ilias Mylonas and colleagues from Evanston Hospital in Evanston, Illinois, evaluates the use of percutaneous suture-mediated closure for the management of 14 Fr femoral vein access during antegrade aortic valvuloplasty. The device was successful in 96% of the patients, with no bleeding and immediate hemostasis.
In the next original research article, Dr. Spyro
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