Role of Fractional-Flow Reserve in Guiding Percutaneous Revascularization in Stable Coronary Artery Disease
Abstract Optimal medical therapy unarguably forms the cornerstone of management for patients with stable coronary artery disease. There is, however, a significant body of evidence suggesting that reduction of ischemia can be achieved more effectively with revascularization than medical therapy and can confer significant symptomatic and prognostic advantages. Nonetheless, owing to limitations of coronary angiography and conventional non-invasive functional testing for myocardial ischemia, targeting of hemodynamically significant coronary stenoses for revascularization is often difficult. We discuss the role of invasive fractional-flow reserve evaluation in guiding percutaneous revascularization procedures for patients with stable coronary artery disease and its potential impact on outcomes for these patients.
ConclusionsPreangiography levels of injury and repair biomarkers modestly predict the development of MAKE-D and can be used to improve the efficiency of future CA-AKI trials.
Publication date: October 2019Source: Journal of Vascular and Interventional Radiology, Volume 30, Issue 10Author(s): Gabriel Heymann, David S. Shin, Guy E. Johnson
An 11-year-old boy with Klippel-Trenaunay syndrome with right lower extremity and pelvic venous ectasia underwent prophylactic embolization of persistent sciatic vein and markedly ectatic internal iliac vein using 24 coils (20 mm x 20 cm to 12 mm x 14 cm) (Nester; Cook Inc, Bloomington, Indiana) (Fig 1) to reduce risk of pulmonary embolism. He presented to the emergency department 3 days later with mild chest discomfort. Scout image from computed tomography (CT) pulmonary angiogram showed completely displaced coil nest in the chest (Fig 2).
Aortocaval fistula (ACF) is a rare but serious complication of ruptured abdominal aortic aneurysm (AAA). We discuss a 72-year-old man who presented with abdominal pain, acute renal failure, and bilateral leg phlegmasia. Computed tomography (CT) angiography confirmed an 8.5-cm AAA with ACF (Fig 1).
A 91-year-old man presented emergently with anterior neck pain, severe dysphagia, and neck expansion after a fall 1 day earlier. His oxygen saturation level was 88% on 4 L of oxygen. A triple-phase computed tomographic (CT) angiogram of the neck showed a massive prevertebral hematoma from a bleeding pseudoaneurysm (Fig 1). A right vertebral artery angiogram showed the prevertebral pseudoaneurysm to be supplied by a tiny muscular branch that was too small for selective transarterial catheterization (Fig 2).
ConclusionEVT of the true PcomA aneurysm is a safe and feasible procedure but may be associated with recurrence in midterm follow-up, requiring close surveillance and potential retreatment.
The term Ischemic cardiomyopathy(ICM) was originally coined by Dr. Burch from Tulane University, New Orleans, USA in 1970. For many decades there was skepticism regarding the existence of such entity. WHO classification over the years never included this term. ESC working group of 2008 (Elliott P, European Heart 29(2):270–276) decided not to include CAD as a cause for cardiomyopathy. Even the current MOGES system doesn’t invoke CAD as a cause for cardiomyopathy. But, I am sure, most of practicing cardiologists would agree, there is a need for such an entity. Why there is m...
To qualitatively and quantitatively compare gadobutrol with gadopentetate dimeglumine (Gd-DTPA) in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA) and contrast-enhanced magnetic resonance imaging (CE-MRI) during one-stop imaging.
AbstractPurposeTo assess and compare early changes in neuroinflammatory and vascular parameters in diabetic macular edema (DME) with subfoveal neuroretinal detachment (SND) after treatment with intravitreal dexamethasone (DEX-I) and ranibizumab (IVR).MethodsThirty-three eyes (33 patients) with treatment na ïve DME with SND were retrospectively evaluated at baseline and 2 months after DEX-I (15 eyes) and 1 month after 3 monthly IVR injections (18 eyes). Inclusion criteria were: complete eye examination, good quality OCT and OCT-A images. OCT parameters included: central macular thickness (CMT); numb er of hyp...
Condition: Necorsis Intervention: Device: indocyanine green angiography Sponsor: Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University Not yet recruiting