History, Gruentzig, and Abbott ’s Absorb “Dissolving Stent”
There ’s a lesson for the Absorb BVS in the history of interventional cardiology (an area of particular interest in this 40th anniversary of angioplasty year). Andreas Gruentzig, the inventor of coronary angioplasty had very specific requirements of physicians who were going to start using his balloons, and he also resisted the urge to over-publicize. (Source: Burts Stent Blog : The Voice in the Ear)
Source: Burts Stent Blog : The Voice in the Ear - April 7, 2017 Category: Medical Equipment Source Type: blogs
When do you use a tapering coronary stent ? Which company makes it ?
Coronary artery lumen has unique character . Its well-known LAD diameter is not constant , it tapers in its distal course.(Unlike RCA which is more tubular ) It is estimated LAD looses 15 % of its diameter for every 30mm length.Fortunately LCX has no such long course to make tapering a visible threat. (Though it may still be an Issue !)
Is there a hemodyanmic purpose for this tapering in LAD ?
Should be, God never designs anatomy without a physiological purpose.We have to find it out.(Can it be meant for flow acceleration as the flow is entriely diastolic in LAD while in RCA its both in systole ...
Source: Dr.S.Venkatesan MD - April 2, 2017 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -Technology Cardiology Innovations Cath lab Hardware Uncategorized biomime morph long tapering coronary stent lad coronary diameter tapers rca long stent tapering meril morph overlapping vs tapering stent rate of tapering of cor Source Type: blogs
MKSAP: 81-year-old man after a percutaneous coronary intervention
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
An 81-year-old man is evaluated in the office 3 days following a percutaneous coronary intervention with placement of a bare metal stent in the left anterior descending artery for angina refractory to maximal medical therapy. He indicates that he feels well except for palpitations that were not present before the procedure. Medical history is significant for hypertension and type 2 diabetes mellitus. He has no risk factors for or history of significant bleeding. Medications are aspirin, clopidogrel, lisinopril, ...
Source: Kevin, M.D. - Medical Weblog - March 25, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Heart Source Type: blogs
Strategies for Cardiovascular Regeneration via Cell Therapies
Researchers here review one slice of the cell therapy field, examining the use of mesenchymal stem cells to provoke greater regeneration of heart tissue than normally takes place. While stem cell therapies are generally at least marginally beneficial, with reduction in inflammation the most reliable outcome to date, the research community has so far struggled to consistently produce larger benefits when it comes to heart damage in older people.
The treatment approach for the majority of cardiovascular disease is to administer drugs, and some cases may require surgery such as coronary angioplasty with stent inserti...
Source: Fight Aging! - March 23, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
In (Gasp) Defense of the Coronary Stent
By ANISH KOKA, MD
A kerfuffle ensued recently when an oncologist and expert on evidence based medicine took the field of cardiology to task over the evidence for placement of the ubiquitous coronary stent. What started with a lengthy article in Propublica that included coronary stenting for stable coronary disease as a prime example of a procedure done without evidence to back it up turned into this fiery twitter exchange between Drs. Kirtane (cardiology) and Prasad (oncology).
The crux of the debate revolves around placement of coronary stents in patients with stable coronary artery disease. Stable coronary artery d...
Source: The Health Care Blog - March 6, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Tack Endovascular System Cleared in Europe for Repair of Arterial Dissections Below Knee
Following a balloon angioplasty, an artery can sometimes develop a dissection, a potentially serious complication. The Tack endovascular system from Intact Vascular, a Wayne, Pennsylvania firm, received the CE Mark in Europe to be used to repair arterial dissections such as this in tibial arteries below the knee.
The Tack consists of tiny stent-like implants and a delivery system that places them at arterial dissection sites. The stents can support arteries from 1.5 mm to 4.5 mm in diameter, so there’s not much need for sizing.
Some comments from Intact Vascular regarding what led to the CE Mark clearance:
The CE Ma...
Source: Medgadget - January 24, 2017 Category: Medical Equipment Authors: Editors Tags: Radiology Vascular Surgery Source Type: blogs
Quiz on deep vein thrombosis
Short quiz on DVT
Quiz on DVT
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Question 1Risk factor/s for upper limb venous thrombosis:AVigorous arm exerciseBCentral venous catheter...
Source: Cardiophile MD - December 27, 2016 Category: Cardiology Authors: Johnson Francis Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Coronary artery disease: Primary care and prevention – 2
Previous
Check for differential diagnosis
Some of the important differential diagnosis in the case of acute coronary syndrome are acute pulmonary embolism, aortic dissection, pneumothorax, esophageal disease, perforated peptic ulcer, cholecystitis, gastritis and sometimes even Herpes Zoster of left thoracic region in pre-eruptive phase. A good history, physical findings and sometimes time are needed for an accurate differential diagnosis. Checking for asymmetry of peripheral pulses is often resorted to for excluding aortic dissection, though it may still miss an aortic dissection sparing the branches as in descending thora...
Source: Cardiophile MD - December 18, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Short Quiz on radio contrast (iodinated ‘ dye ’ )
Short quiz on contrast used for angiography.
Quiz on radiocontrast
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Question 1Iodixanol is a —- radiocontrast:AIso-osmolar...
Source: Cardiophile MD - December 9, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Loading dose of Ticagrelor – Cardiology MCQ
Loading dose of Ticagrelor prior to primary angioplasty:
a) 90 mg
b) 180 mg
c) 360 mg
d) None of the above
Correct answer: b) 180 mg
Maintenance dose of Ticagrelor after angioplasty is 90 mg twice daily for at least one year. The ACC / AHA recommended dose of Aspirin along with Ticagrelor is 81 mg daily. (Source: Cardiophile MD)
Source: Cardiophile MD - December 8, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Anticoagulation for primary PCI – Cardiology MCQ
Which of the following should not be used as sole anticoagulant for primary percutaneous coronary angioplasty ?
a) Unfractionated heparin
b) Bivalirudin
c) Fondaparinux
d) None of the above
Correct answer: c) Fondaprinux
If Fondaparinux is used as the sole anticoagulant during primary PCI, there is a higher incidence of catheter thrombosis.
Unfractionated heparin is used in most cases, supplemented if needed, by glycoprotein IIb/IIIa receptor antagonist if needed in case of significant thrombus load. Some prefer Bivalirudin in cases with a higher bleeding risk instead of the above combination. (Source: Cardiophile MD)
Source: Cardiophile MD - December 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
BAG3 as a Target to Reduce Reperfusion Injury in Heart Tissues
There have been a number of life science discoveries of late that might lead to therapies capable of reducing the level of tissue damage caused by structural failures in important blood vessels, the basis for a range of age-related conditions. News of another possible approach arrived recently, and you will find links to the publicity materials and open access paper below. Blood vessel failures cause an interruption of oxygenated blood flow to tissues, and depending on the location in the body and size of the failed vessel, can produce the dramatic symptoms of stroke, heart attack, and so forth. While methods of prevention...
Source: Fight Aging! - November 18, 2016 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Bridging collaterals
are a feature of chronic total coronary occlusions (CTO). They bridge between the proximal and distal parts of a coronary artery which is chronically occluded in between. Presence of bridging collaterals, though physiologically useful for providing distal perfusion, could create problem during attempted percutaneous coronary intervention (PCI). A guidewire passed from the proximal segment, instead of passing into the occluded segment, is likely to take the easy way out into the bridging collaterals.
The coronary angiogram shows bridging collaterals in a post coronary artery bypass right coronary CTO. Sternal wires indica...
Source: Cardiophile MD - November 12, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology Source Type: blogs
Spider view – LAO (left anterior oblique) caudal view
is often the first view taken during diagnostic coronary angiography. It has the advantage of visualizing the proximal left and right coronary arteries along with the left main coronary artery. In this case the left main is not seen well as it is a delayed image. Proximal tight stenosis of the left anterior descending (LAD) coronary artery is seen, as well as significant stenosis of an obtuse marginal (OM) branch of the left circumflex (LCX) coronary artery. This view is not good for visualizing the distal parts of the left system and fore shortens the coronary branches. Yet this view is useful during coronary angioplasty...
Source: Cardiophile MD - November 10, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology Source Type: blogs
Inferolateral myocardial infarction P
ST segment elevation is seen in inferolateral leads (II, III, aVF, V5, V6) indicating inferolateral ST elevation myocardial infarction (STEMI). There is a discordance between the ST segment in aVL and V6 – there is ST segment depression in aVL while the ST segment is minimally elevated in V6. STEMI is an indication immediate angiography and percutaneous coronary intervention (PCI). If that is not feasible, either the patient can be transferred to a PCI capable center or thrombolytic therapy administered if there are no contraindications. Differential diagnosis of this pattern is of course an early repolarization (ERP...
Source: Cardiophile MD - November 5, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology ECG / Electrophysiology ECG Library Source Type: blogs
