Prevalence, Presentation and Treatment of ‘Balloon Undilatable’ Chronic Total Occlusions: Insights from a Multicenter US Registry

We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry. ResultsBetween 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%). Mean patient age was 65 ± 10 years and most patients were men (84%). Patients with balloon undilatable CTOs were more likely to be diabetic (67 vs. 41%, P 
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CAD ‐ CORONARY ARTERY DISEASE Source Type: research

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CONCLUSION: Performing radial CAG with uninterrupted DOAC treatment appears to carry no risk of increased early or short-term complications. The simple, uninterrupted DOAC strategy is comfortable, easy, and safe. PMID: 30628896 [PubMed - in process]
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars Source Type: research
Abstract ObjectivesTo evaluate the association of diabetes mellitus (DM) with clinical and angiographic characteristics and outcomes of patients with popliteal and infrapopliteal peripheral arterial disease (PAD) undergoing peripheral vascular intervention (PVI). BackgroundClinical features and outcomes in patients with DM and popliteal or infrapopliteal PAD undergoing PVI are not well described. MethodsUsing the data from the laser in popliteal and infrapopliteal stenosis study, we retrospectively examined the association of diabetes with clinical and angiographic characteristics and risk adjusted short‐ and intermediat...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: PERIPHERAL VASCULAR DISEASE Source Type: research
By ANISH KOKA, MD I’m sitting amidst a number of cardiologists to go over the most recent trials presented at the interventional cardiology conference in Denver.  The cardiology fellow presenting goes quickly through the hors de oeuvres until finally getting to the main course – ORBITA. ORBITA sought to test the very foundations interventional cardiology was built on – the simple idea that opening a stenosed coronary artery was good for patients.  The trial was a double blind randomized control trial of patients with tightly stenosed arteries who either had a stent placed or had a sham procedure...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Anish Koka cardiology Orbita Source Type: blogs
AbstractObjectivesTo assess, whether cardiac catheterization via radial access prevents contrast-induced nephropathy.BackgroundContrast-induced nephropathy (CIN) is a major clinical problem which accounts for more than 10% of acute kidney injury cases in hospitalized patients. Protective measures such as the infusion of isotonic saline solution or acetylcysteine have not consistently been proven to prevent acute kidney injury (AKI). However, there is growing evidence that radial access for coronary angiography and coronary intervention is associated with a lower incidence of AKI compared to femoral access.Methods and resul...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Authors: Gayed M, Yadak N, Qamhia W, Daralammouri Y, Ohlow MA Abstract Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coron...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
ObjectiveTo determine the ability of simple hemodynamic parameters obtained at the time of cardiac catheterization to predict in‐hospital mortality following ST‐elevation myocardial infarction (STEMI). BackgroundHemodynamic parameters measured at the time of primary percutaneous coronary intervention (PPCI) could potentially identify high‐risk patients who would benefit from aggressive hemodynamic support in the Cardiac Catheterization laboratory. MethodsThis is a retrospective single‐center study of 219 consecutive patients with STEMI. Left ventricular end‐diastolic pressure (LVEDP), systolic blood pressure (SBP...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Non ‐Invasive Angiography Source Type: research
Contrast-induced nephropathy (CIN) is an acute worsening of renal function after receiving an intravascular contrast during a procedure. Some of the predisposing factors include underlying diabetes, chronic kidney disease, congestive heart failure, periprocedural hypotension, anemia, contrast volume, and osmolality of contrast; however, it remains unclear if risk varies for CIN with race and ethnicity. There is evidence in the literature showing the link between race/ethnicity and the discrepancies in the utilization of preventive care services and the resources related to cardiovascular and renal health.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Review Source Type: research
There has been considerable advancement in catheters, wires, balloons, stents, and adjunctive strategies for procedures performed in the cardiac catheterization laboratory. Despite these improvements, angiographic procedures remain dependent on the use of water-soluble iodinated contrast that has inherent nephrotoxicity (1). In addition, coronary angiography with percutaneous coronary intervention (PCI) poses additional risks of renal atheroembolism, which may occur on a subclinical basis and contribute to acute kidney injury (AKI). In the settings of acute myocardial infarction and heart failure, there are ...
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research
We present a rare entity of isolated supra-cardiac PAPVC, as right pulmonary vein drains into the superior vena cava (SVC) with intact atrial septum, precipitating RHF. A 55-year-old man with hypertension, diabetes mellitus, coronary artery disease, presenting with syncope. On examination blood pressure was 90/44 mm Hg and heart rate of 44 bpm, lungs were clear on auscultation, jugular venous distension was present, prominent S2 heart sound, and bilateral pitting edema of the lower extremities. Laboratory studies were significant for brain natriuretic peptide (BNP) of 504 pg/mL, troponin I of 0.06 ng/mL...
Source: Journal of Investigative Medicine - Category: Research Authors: Tags: Cardiology/Cardiovascular Disease Source Type: research
This study sought to assess the impact of residual coronary artery disease (CAD), using the residual SYNTAX score (rSS), on in‐hospital outcomes after primary percutaneous intervention (PPCI). The study also aimed to determine independent predictors for high rSS. Residual CAD has been associated with worsened prognosis in patients undergoing PCI for non‐ST acute coronary syndromes. The rSS is a systematic angiographic score that measures the extent and complexity of residual CAD after PCI. Materials and MethodsData from 243 consecutive patients undergoing PPCI for ST‐elevation myocardial infarction (STEMI) were analy...
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Coronary Artery Disease Source Type: research
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