November 2019 Table of Contents

Original Contributions

Coronary Artery Disease

Revascularization Strategies in Patients With STEMI: Culprit-Only vs Multivessel Revascularization Using Percutaneous Coronary Intervention

Noor Alsadat, MD, BSc;  Karice Hyun, PhD;  Mario D’Souza, PhD;  Derek Chew, MBBS, MPH, PhD;  James Weaver, MBBS, PhD;  Craig Juergens, MD;  Leonard Kritharides, MBBS, PhD;  Christopher Hammett, MBChB, MD;  David Brieger, MBBS, PhD, MMed (ClinEpi)

Approximately 50% of patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction have multivessel coronary disease. Evidence on the best PCI approach for these patients is conflicting. The aim of this study is to examine Australian data from the CONCORDANCE registry to describe the practice and outcomes of patients receiving multivessel vs culprit-only PCI. 

J INVASIVE CARDIOL 2019;31(11):314-318. Epub 2019 July 15.

Stroke Prevention 

The IrisFIT Patent Foramen Ovale Closure Device in Patients With History of Cryptogenic Embolization

Marius Hornung, MD;  Stefan C. Bertog, MD;  Sameer Gafoor, MD;  Markus Reinartz, MD;  Laura Vaskelyte, MD;  Ilona Hofmann, MD;  Kolja Sievert, MD;  Predrag Matic, MD;  Iris Grunwald, MD;  Horst Sievert, MD

The aim of this study was to assess safety, efficacy, and clinical outcome of the IrisFIT PFO Closure System (Lifetech Scientific) for transcatheter closure of patent foramen ovale in patients with a history of cryptogenic stroke, transient ischemic attack, or peripheral embolization. 

J INVASIVE CARDIOL 2019;31(11):319-324. Epub 2019 September 15.

Radial Access Technique

Orbital Atherectomy Via Transradial Access: A Multicenter Propensity-Matched Analysis

Rajkumar Doshi, MD, MPH;  Evan Shlofmitz, DO;  Rajiv Jauhar, MD;  Perwaiz Meraj, MD, MPH

The main objective of this study was to assess the safety and feasibility of orbital atherectomy with transradial access compared with more traditional femoral access. A total of 433 patients treated with coronary orbital atherectomy were identified and divided in two groups based on arterial access site. The co-primary outcomes of this study were major bleeding, associated blood transfusion, and safety outcomes.

J INVASIVE CARDIOL 2019;31(11):325-330. Epub 2019 July 15.

Plaque Modification

Initial Experience With GlideAssist to Facilitate Advancement of Orbital Atherectomy Prior to Plaque Modification of Severely Calcified Coronary Artery Lesions 

Michael S. Lee, MD;  Evan Shlofmitz, DO;  Seung-Woon Rha, MD, PhD;  Richard Shlofmitz, MD

Orbital atherectomy is an effective tool to modify calcified plaque prior to stenting. However, advancement of the orbital atherectomy crown may be technically challenging due to complex coronary anatomy. We report our initial experience with GlideAssist (Cardiovascular Systems, Inc) to facilitate advancement of the orbital atherectomy crown. 

J INVASIVE CARDIOL 2019;31(11):331-334.

Radial Access Approach

Radial Versus Femoral Approach in Women Undergoing Coronary Angiography: A Meta-Analysis of Randomized Controlled Trials

Shadi Al Halabi, MD, MPH;  Lucas Burke, MD;  Fizza Hussain, MD;  John Lopez, MD;  Verghese Mathew, MD;  Ivo Bernat, MD, PhD;  Adhir Shroff, MD, MPH

Women undergoing cardiac procedures have increased risk of bleeding and vascular complications, but are under-represented in randomized clinical trials involving coronary angiography. We sought to compare outcomes with radial vs femoral approach in female patients undergoing coronary angiography. 

J INVASIVE CARDIOL 2019;31(11):335-340. Epub 2019 August 15.

Radial Access Approach

Predictors of Universal Catheter Failure in Transradial Coronary Angiography

Rebecca Liebenthal, BS;  Scott Butler, MD;  John Coppola, MD;  Binita Shah, MD, MS

Use of a universal diagnostic catheter may decrease procedural time and catheter-exchange related spasm when compared with a dual-catheter strategy. The aim of this study was to identify preprocedural predictors of failure to complete a coronary angiogram with a universal catheter alone. A total of 782 consecutive patients who underwent a right transradial/transulnar coronary angiogram with a single operator were retrospectively reviewed. 

J INVASIVE CARDIOL 2019;31(11):341-345. Epub 2019 September 15.

Structural Heart Disease

Percutaneous Occlusion of Paravalvular Aortic Leaks: A Single-Center Experience Focused on Intracardiac Echocardiography

Joana Maria Ribeiro, MD, MSc;  Luís Paiva, MD;  Rogério Teixeira, MD, PhD;  Luís Puga, MD, MSc;  João Lopes, MD, MSc;  José Pedro Sousa, MD, MSc;  Diana Campos, MD, MSc;  Carolina Saleiro, MD, MSc; Marco Costa, MD;  Lino Gonçalves, MD, PhD

Percutaneous paravalvular leak (PVL) occlusion has emerged as an alternative to cardiac surgery for patients with symptomatic PVLs. Intracardiac echocardiography is an appealing alternative to transesophageal echocardiography for guidance of percutaneous structural interventions. We describe our initial experience with intracardiac echocardiography for guidance of aortic percutaneous PVL occlusion and assess technical and procedural success rates.

J INVASIVE CARDIOL 2019;31(11):346-351.

Online Exclusive

Original Contribution / Coronary Artery Disease 

Plaque Sealing With Drug-Eluting Stents Versus Medical Therapy for Treating Intermediate Non-Obstructive Saphenous Vein Graft Lesions: A Pooled Analysis of the VELETI and VELETI II Trials

Frédéric Maes, MD, PhD;  Sanjit S. Jolly, MD;  John Cairns, MD;  Robert Delarochellière, MD;  Mélanie Côté, MSc;  Vladimir Dzavik, MD;  Josep Rodés-Cabau, MD

The presence of intermediate “non-obstructive” saphenous vein graft lesions is a strong predictor of cardiac events. Our study aims to assess the efficacy of sealing these saphenous vein graft lesions with drug-eluting stent implantation for reducing major adverse cardiac event rate. 

J INVASIVE CARDIOL 2019;31(11):E308-E315.

Scientific Abstracts 

15th Annual Complex Cardiovascular Catheter Therapeutics (C3): Advanced Endovascular and Coronary Intervention Global Summit

Orlando, Florida / June 23-26, 2019 

J INVASIVE CARDIOL 2019;31(11):E316-E330.

Clinical Images  

Transradial Repair of Type IA Endoleak

Meet Shah, MBChB;  Mitul Patel, DO;  Kintur Sanghvi, MD

An 81-year-old Caucasian male with a known abdominal aortic aneurysm (AAA) was referred to the endovascular clinic. One month after successful endovascular repair, surveillance CTA showed endoleak with presence of contrast within the aneurysmal sac. An elective repair was performed.

J INVASIVE CARDIOL 2019;31(11):E331-E332.

A Case of Single Coronary With Very Late In-Stent Restenosis of Drug-Eluting Stents After 12 Years

Rajesh Vijayvergiya, MD;  Basant Kumar, MD;  Sudhanshu Budhakoty, MD;  Ganesh Kasinadhuni, MD; Kewal Kanabar, MD

We present a rare case of very late in-stent restenosis of Cypher stents 12 years after PCI in a case of a single anomalous coronary.

J INVASIVE CARDIOL 2019;31(11):E333-E334.

The Diagonal Branch to the Accompanying Vein Fistula After Rotational Atherectomy

Guiwen Yi, MD;  Daoqun Jin, MBBS;  Zhenlong Li, MBBS;  Xiaobo Mao, MD

We report a case of rotational-atherectomy induced fistula between the diagonal branch and the accompanying vein. Thus far, the patient has had no relevant symptoms; thus, no intervention has been undertaken. We will closely monitor the patient to determine future treatment.

J INVASIVE CARDIOL 2019;31(11):E335-E336.

Type 3 Coronary Perforation on Optical Coherence Imaging

Viji S. Thomson, MD, DM;  Lijo Varghese, MD, DM;  George Joseph, MD, DM

OCT imaging revealed a 1.5 mm-long transmural breach in a segment of the artery devoid of calcium or eccentric plaque burden. Focal negative remodeling identified on OCT was deemed the reason for this otherwise unexplained cause of coronary rupture.

J INVASIVE CARDIOL 2019;31(11):E337-E338.

Large Right Coronary Artery Aneurysm

Antonio E. Smith, MD;  Said Ashraf, MD;  Tanveer Mir, MD;  Kartik Kumar, MD;  Kendall Bell, MD;  Tomo Ando, MD;  Frank A. Baciewicz, MD

Complications of aneurysm include thrombosis and distal embolization, rupture, and vasospasm. The natural history and prognosis remain obscure. Controversies persist regarding the use of surgical or medical management. 

J INVASIVE CARDIOL 2019;31(11):E339.

Twiddler’s Syndrome Combined With Subclavian Crush Syndrome: A Case of ICD Lead Failure and Potential Challenging Lead Extraction

Levio Quinto, MD;  Martina Testolina, MD;  Francesco Zanon, MD;  Federico Migliore, MD, PhD

Our report demonstrates how Twiddler’s syndrome associated with subclavian crush syndrome may result in a challenging transvenous lead extraction. Thus, it should be performed in centers with experience with the appropriate tools.

J INVASIVE CARDIOL 2019;31(11):E340.

Letter to the Editor

After Action Reviews

Alexander G. Truesdell, MD;  Behnam Tehrani, MD;  Carolyn Rosner, NP;  Ramesh Singh, MD;  Shashank Sinha, MD;  Mehul Desai, MD;  Shashank Desai, MD;  Glenn Druckenbrod, MD; 

Charles Murphy, MD;  Wayne Batchelor, MD;  Christopher O’Connor, MD

J INVASIVE CARDIOL 2019;31(11):E341.

Letter to the Editor

A Need For Long-Term Results of LMCA-CTO-PCI

Pedro Cepas-Guillen, MD;  Sara Vásquez, MD;  Andrea Fernandez-Valledor, MD;  Rodolfo San Antonio, MD;  Eduardo Flores-Umanzor, MD;  Victoria Martin-Yuste, MD, PhD

J INVASIVE CARDIOL 2019;31(11):E342.