Volume 14 - Issue 4 - April, 2002

Incremental Progress? The Roles of Direct Stenting and Routine Troponin Measurement After Percutaneous Coronary Intervention

Stephen G. Ellis, MD

In this issue of the Journal, Timurkaynak et al. raises some important, but not easily resolvable, issues that deserve thought by practicing interventional cardiologists. In this small, observational study measuring cardiac enzymes after PCI, troponin T was found to be elevated somewhat more frequently in patients undergoing predilatation than those undergoing direct stenting. The authors call for further evaluation of the potential merit of the strategy of direct stenting and also suggest further study of the relevance of troponin elevations after PCI.

See Timurkaynak et al. on pages 167...

Primary Stenting in a Patient with Acute Myocardial Infarction and Primary Antiphospholipid Syndrome

Özer Badak, MD, Sema Güneri, MD, Önder K?r?ml?, MD, Özhan Göldeli, MD,
Özgür Aslan, MD, *Hayri Özsan, MD

Antiphospholipid syndrome (APS) is an uncommon thrombotic disorder characterized by antiphospholipid antibodies (aPL). The syndrome may be associated with arterial or venous thrombosis, thrombocytopenia, recurrent fetal loss, skin lesions, neurological complications and retinal occlusion.1 Premature myocardial infarction may also be seen as a part of APS. In coronary artery bypass graft (CABG) operations and coronary balloon angioplasty (PTCA), APS may lead to complications such as bypass graft closure2 and early failure of PTCA.3,4 Although the patients with APS frequently have positive lupus...

Aqueous Oxygen Hyperbaric Reperfusion in a Porcine Model of Myocardial Infarction

J. Richard Spears, MD, Cassandra Henney, ATC, PhD, Petar Prcevski, DVM, Rui Xu, MD, Li Li, PhD, Giles J. Brereton, PhD, Marcello DiCarli, MD, Ali Spanta, MD, Richard Crilly, PhD, Abdulbaset M. Sulaiman, MD, Samir Hadeed, MD, Steven Lavine, MD, William R. Patterson, PhD, Jeffrey Creech, PhD, Richard Vander Heide, MD, PhD

Hyperbaric oxygen (HBO) administered during reperfusion has been shown experimentally to reduce tissue injury associated with ischemia/reperfusion of a wide variety of tissues,1–8 including myocardium. Potential mechanisms include inhibition of leukocyte adherence; improvement of microvascular flow; reduction of edema; and quenching of lipid peroxide radicals.9 However, implementation of such treatment is not practical for many patients in the acute coronary setting.

We recently developed a new method for delivery of oxygen, based on the infusion of aqueous oxygen (AO) into blood.10,11...

Editor’s Message

Richard E. Shaw, PhD, FACC

Dear Readers,

This issue of the Journal of Invasive Cardiology includes several interesting articles. In the first research article, Dr. J. Richard Spears and collaborators from the Cardiovascular Research Laboratory, Wayne State University, TherOx Inc. in Irvine, California and Michigan State University present their preliminary study of aqueous oxygen hyperbaric reperfusion in a porcine model of myocardial infarction. They demonstrate that with their novel approach to catheter-delivered hyperbaric reperfusion of intracoronary aqueous oxygen, myocardial ischemia and reperfusion injury can ...

Safety and Efficacy of Using 0.052-inch Gianturco Coil for Closure of Large (>= 4 mm) Patent Ductus Arteriosus

Ta-Cheng Huang, MD, Kai-Sheng Hsieh, MD, Cheng-Liang Lee, MD, Chu-Chun Lin, MD

Transcatheter closure of a small patent ductus arteriosus (PDA) is now an established treatment in many pediatric cardiology centers. As for occlusion of large PDA, interventional cardiologists are still looking for a simple, but safe and effective procedure. There are several reports using various devices and novel techniques for occlusion of large PDA.1–5 Although the procedures are effective approaches, some use expensive devices and some require exquisitely complex techniques. The increased costs and technical difficulty prevent their widespread use by interventional cardiologists.

Tr...

Coil Closure of the Large Patent Arterial Duct: Cheap, But How Easy and Effective?

Ziyad M. Hijazi, MD, MPH

Coil occlusion has become an accepted alternative treatment for small to moderate sized patent ductus arteriosus (PDA). Gianturco coils (Cook Cardiology, Inc., Bloomington, Indiana) are small, coiled spring wires with fabric strands woven into the springs. They are available in standard 0.035´´, 0.038´´ and 0.052´´ sizes. The accurate placement of coils in a PDA may be a challenging and frustrating task to the interventionalist, especially in the large ductus (>= 4 mm). Multiple alternative techniques for coil delivery have been devised to improve the success rate of ductus closure. Som...

Laser Angioplasty and Laser-Induced Thrombolysis in Revascularization of Anomalous Coronary Arteries

Rakesh Shah, MD, Robert E. Martin, MD, On Topaz, MD

Anomalous origin of the coronary arteries occurs in only 0.64–1.2% of patients undergoing coronary angiography.1,2 In symptomatic patients with atherosclerotic coronary disease, precise angiographic recognition of the origin and the anatomic course of a target anomalous coronary vessel is important for safe percutaneous revascularization or for coronary bypass surgery. Pulsed excimer laser (308 nm wavelength) is a Food and Drug Administration (FDA)-approved device for debulking and revascularization of complex coronary and peripheral atherosclerotic lesions in symptomatic patients.3–10 Rec...

The Journal of Invasive Cardiology April 2002 issue

Richard E. Shaw, PhD, FACC
Editor in Chief

Dear Readers,

This issue of the Journal of Invasive Cardiology includes several interesting articles. In the first research article, Dr. J. Richard Spears and collaborators from the Cardiovascular Research Laboratory, Wayne State University, TherOx Inc. in Irvine, California and Michigan State University present their preliminary study of aqueous oxygen hyperbaric reperfusion in a porcine model of myocardial infarction. They demonstrate that with their novel approach to catheter-delivered hyperbaric reperfusion of intracoronary aqueous oxygen, myocardial ischemia and reperfusion injury can ...

Extensive Right Coronary Artery Dissection Following Cutting Balloon Treatment of In-Stent Restenosis

Giampaolo Niccoli, MD, William P. Orr, MD, Adrian P. Banning, MD

Case Description. A 44-year-old female was readmitted with chest pain on minimal exertion. She was an ex-smoker and had hypercholesterolemia. Eight months previously, she had experienced an episode of unstable angina and underwent coronary angiography, which demonstrated an essentially normal left coronary artery and a critical stenosis of the proximal right coronary artery. This was stented directly with a 3.5 x 15 mm NIR Royal stent (Boston Scientific/Scimed, Inc., Maple Grove, Minnesota). She was discharged on aspirin and clopidogrel for one month and was well until pain recurred three mont...

Editorial Staff
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    Laurie Gustafson
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    Elizabeth Vasil
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    Jeff Benson
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    Carson McGarrity
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    Amanda Wright
Editorial Correspondence

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