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.
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.
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.
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.
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.
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.
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.
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.
15th Annual Complex Cardiovascular Catheter Therapeutics (C3): Advanced Endovascular and Coronary Intervention Global Summit
Orlando, Florida / June 23-26, 2019
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.
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.
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.
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.
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.
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.
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
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