Zero contrast optical coherence tomography guided percutaneous coronary intervention for instent restenosis of saphenous vein graft – using non contrast flush medium

We report a 73 year old, stage 3 chronic kidney disease patient (CKD), who underwent coronary artery bypass surgery and saphenous vein graft (SVG) stenting in the past, presented with instent restenosis (ISR) of SVG stent. Zero contrast optical coherence tomography (OCT) guided PCI was successfully performed using low molecular weight dextran-40 (LMWD-40) as the flush medium. Our report suggests the safety and feasibility of LMWD-40 based OCT guided zero contrast PCI in ISR of SVG in a CKD patient, though further prospective studies are needed to evaluate this technique.
Source: Indian Heart Journal - Category: Cardiology Source Type: research

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The number of patients with coronary artery disease (CAD), chronic kidney disease (CKD), and end-stage renal disease requiring dialysis is expected to increase in the next decade. Because of multiple coronary lesions and massive calcifications, coronary revascularization of these subjects is often more difficult and demanding. It is known that long-term survival of patients with CKD is worse than that of patients with normal kidney function after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI).
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Editorial Commentary Source Type: research
ConclusionsAt early follow-up, high-risk subgroups had lower ICERs than the overall cohort when CABG was compared with PCI. A personalised, multidisciplinary approach to treatment of patients may enhance cost containment, as well as improving clinical outcomes following revascularisation strategies.
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research
Coronary artery bypass grafting (CABG) is associated with better survival than percutaneous coronary intervention (PCI) in patients with mild-to-moderate chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, the optimal strategy for coronary artery revascularization in patients with advanced CKD who transition to ESRD is unclear.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Adult Source Type: research
Coronary artery bypass grafting (CABG) is associated with better survival than percutaneous coronary intervention (PCI) in patients with mild-to-moderate chronic kidney disease (CKD) and End-Stage Renal Disease (ESRD). However, the optimal strategy for coronary artery revascularization in advanced CKD patients who transition to ESRD is unclear.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
Authors: Tajti P, Karatasakis A, Danek BA, Alaswad K, Karmpaliotis D, Jaffer FA, Choi JW, Yeh RW, Patel M, Mahmud E, Burke MN, Krestyaninov O, Khelimskii D, Toma C, Doing AH, Uretsky B, Koutouzis M, Tsiafoutis I, Wyman RM, Garcia S, Holper E, Xenogiannis I, Rangan BV, Banerjee S, Ungi I, Brilakis ES Abstract OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures b...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD). Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are frequently performed in patients presenting with a non-ST elevation myocardial infarction (NSTEMI). Utilizing the National Inpatient Sample (NIS) database, we assessed the trends in utilization of coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) in 3,654,586 admissions with NSTEMI from 2001 to 2012.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Publication date: November 2018Source: American Heart Journal, Volume 205Author(s): Sripal Bangalore, David J. Maron, Jerome L. Fleg, Sean M. O’Brien, Charles A. Herzog, Gregg W. Stone, Daniel B. Mark, John A. Spertus, Karen P. Alexander, Mandeep S. Sidhu, Glenn M. Chertow, William E. Boden, Judith S. Hochman, on behalf of the ISCHEMIA-CKD Research GroupBackgroundPatients with chronic kidney disease (CKD) and stable ischemic heart disease are at markedly increased risk of cardiovascular events. Prior trials comparing a strategy of optimal medical therapy (OMT) with or without revascularization have largely excluded p...
Source: American Heart Journal - Category: Cardiology Source Type: research
Publication date: Available online 1 August 2018Source: American Heart JournalAuthor(s): Sripal Bangalore, David J. Maron, Jerome L. Fleg, Sean M. O’Brien, Charles A. Herzog, Gregg W. Stone, Daniel B. Mark, John A. Spertus, Karen P. Alexander, Mandeep S. Sidhu, Glenn M. Chertow, William E. Boden, Judith S. Hochman, on behalf of the ISCHEMIA-CKD Research GroupAbstractBackgroundPatients with chronic kidney disease (CKD) and stable ischemic heart disease (SIHD) are at markedly increased risk of cardiovascular events. Prior trials comparing a strategy of optimal medical therapy (OMT) with or without revascularization hav...
Source: American Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: Women with STEMI are less likely to receive invasive management, revascularisation, or preventive medication at discharge. The reasons for these persistent differences in care require investigation. PMID: 30025513 [PubMed - as supplied by publisher]
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
ConclusionsAt early follow-up, high-risk subgroups had lower ICERs than the overall cohort when CABG was compared with PCI. A personalised, multidisciplinary approach to treatment of patients may enhance cost containment, as well as improving clinical outcomes following revascularisation strategies.
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research
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