Efficacy of Low-Dose Compared With Standard-Dose Radiation for Cardiac Catheterization and Intervention (KAR RAD Study).
Authors: Kar S, Teleb M, Albaghdadi A, Ibrahim A, Mukherjee D Abstract OBJECTIVES: We evaluated the efficacy of low-dose (LD) radiation (≤7.5 frames/second [f/s]) compared with standard-dose (SD) radiation (≥10 f/s) in cardiac catheterization (CC) and percutaneous coronary intervention (PCI). Patients undergoing CC with LD vs SD radiation have not been previously studied. METHODS: We performed an observational study of 452 consecutive patients (61 ± 12 years) who had coronary angiography or PCI from September 2016 to September 2017. Patients were divided into an LD radiation group (n = 136) consist...
Source: The Journal of Invasive Cardiology - March 15, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

The Embryologic Origin of Vieussens' Ring.
Authors: Klein LW, Campos EP Abstract Vieussens' ring is an embryologic remnant that acquires clinical significance as an intercoronary collateral vessel in advanced coronary artery disease. Its origin as a peritruncal structure early in embryologic development, and its association with congenital pulmonary artery fistula, provides a crucial insight into the early stages of the coronary circulation. This review describes the embryologic basis of Vieussens' ring in relation to the formation of the coronary arteries, which explains its location, appearance, and clinical importance. PMID: 30819974 [PubMed - in pro...
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Elective Mechanical Circulatory Support in the Percutaneous Treatment of Patients With Combined Complex Coronary Artery Disease and Severe Aortic Valve Stenosis.
CONCLUSIONS: These preliminary results suggest that elective use of the Impella 2.5 system is safe and effective when performing PCI and BAV in high-risk ACS patients suffering from concomitant severe CAD and AS. PMID: 30819975 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Interim Results of the PROMISE I Trial to Investigate the LimFlow System of Percutaneous Deep Vein Arterialization for the Treatment of Critical Limb Ischemia.
CONCLUSION: pDVA using the LimFlow system is a novel approach for treating patients with no-option CLI and may reduce amputation in this population for whom it would otherwise be considered inevitable. Initial findings from this early feasibility trial are promising and additional study is warranted. PMID: 30819976 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Feasibility and Safety of Adopting Next-Day Discharge as First-Line Option After Transfemoral Transcatheter Aortic Valve Replacement.
This study investigated the feasibility and safety of NDD as a first-line option (the very-early discharge [VED] strategy) compared with the early-discharge (ED) strategy (2-3 days as a first-line option) after TAVR. METHODS: We reviewed 611 consecutive patients who had minimalist TAVR (transfemoral approach under conscious sedation) and no in-hospital mortality; a total of 418 patients underwent ED strategy (since December 2013) and 193 patients underwent VED strategy (as part of a hospital initiative to reduce length of stay, since August 2016). NDD in the VED strategy was performed with heart team consensus in patie...
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Septal Hematoma: A Rare But Potentially Serious Complication of Retrograde CTO-PCI.
We present a case of a rare complication of septal collateral perforation resulting in the formation of septal hematoma that fortunately on this occasion did not result in any significant clinical deterioration, and was managed conservatively with a successful outcome. However, on other occasions, the outcome can be more serious. PMID: 30819978 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Large Epicardial Hematoma After Percutaneous Coronary Intervention: Multimodality Imaging.
Authors: Desai D, Ahmad A, Weiss ES, Trivedi S, Allaqaband SQ, Tajik AJ, Jan MF Abstract Epicardial hematoma can manifest immediately or within a few minutes to hours after coronary intervention. Review of angiogram after the diagnosis of hematoma, in our case, showed deep distal positioning of a non-polymer jacketed wire, which is the most likely cause of the adverse outcome. Multimodality imaging is critical for diagnosis and management of such cases. PMID: 30819979 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Transient Lingual Ischemia Complicating Coronary Angiography.
Authors: Skalidis E, Zacharis E, Hamilos M, Skalidis I, Anastasiou I, Parthenakis F Abstract Arterial embolism is a potential complication of coronary angiography and could theoretically affect the lingual circulation. However, the transient nature of clinical signs and symptoms suggests vasospasm as the most likely underlying mechanism of lingual ischemia in our case. PMID: 30819980 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Modified Sleeve Technique for Calcified Coronary Bifurcations.
Authors: Tai Z Abstract Historically, in calcified coronary lesions, rotational atherectomy can result in side-branch occlusion in up to 10% of the cases. This can potentially result in significant ischemia depending on the territory involved. Our modification of the GuideLiner technique avoids the added risk of guide-catheter dissection from two guides in the left main and can also be used in non-left main bifurcations. PMID: 30819981 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Importance of Right Marginal Branch Protection During Primary Angioplasty in Inferior STEMI With Right Ventricular Involvement.
Authors: Świerczewski M, Bobrowski R, Sala Z, Kali Czuk U, Demkow M Abstract We document the high effectiveness of an extra guidewire insertion aimed at mechanical lumen protection of the right marginal branch from displaced thrombus, which frequently occurs during proximal right coronary artery stenting. PMID: 30819982 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Successful Percutaneous Coronary Intervention With Two-Stent Technique for Unprotected True Left Main Bifurcation Lesion Via Left Snuffbox Approach.
Authors: Kim Y, Jeong MH, Kim MC, Sim DS, Hong YJ, Kim JH, Ahn Y Abstract There are few data regarding complex PCIs, such as interventions for unprotected left main coronary artery and two-stent technique for the bifurcation lesion via snuffbox approach. This case illustrates the potential feasibility of complex PCI and benefits of hemostasis via snuffbox approach. PMID: 30819983 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 5, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Upper-Extremity Venous Access for Children and Adults in Pediatric Cardiac Catheterization Laboratory.
CONCLUSION: Upper-extremity venous access is a useful, feasible, and safe modality for cardiac catheterization in the pediatric cardiac catheterization laboratory. PMID: 30765619 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Feasibility of 5 Fr Contralateral Radial Access for Hybrid Chronic Total Occlusion Percutaneous Coronary Intervention: Experience From a Single Tertiary Center in the United Kingdom.
Authors: Vanezis AP, Wilson W, Smith W Abstract Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid algorithm has traditionally been performed femorally using 8 Fr sheaths. Antegrade dissection and re-entry (ADR) has facilitated procedures using 6 and 7 Fr guides via the radial artery. Radial artery dysfunction and occlusion is a recognized complication preventing future radial procedures, but is significantly less common with 5 Fr sheaths. Five Fr contralateral radial access (48% left, 52% right) was used in 33 consecutive patients undergoing elective CTO-PCI in a single United ...
Source: The Journal of Invasive Cardiology - February 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Shockwave Intravascular Lithotripsy for Calcified Coronary Lesions: First Real-World Experience.
We present our early real-world experience with the S-IVL device. METHODS: All patients treated with S-IVL between October 2018 and January 2019 during their percutaneous coronary intervention (PCI) at our center were included. RESULTS: During this period, a total of 26 patients undergoing PCI were treated with S-IVL prior to stent deployment (69% male; age, 72 ± 8 years). Indications for PCI were acute coronary syndromes (ACS) in 14 patients (54%), stable angina in 11 patients (42%), and PCI before transcatheter aortic valve implantation in 1 patient (4%). Seventy-one percent of the ACS cases undergoing PCI...
Source: The Journal of Invasive Cardiology - February 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

The Incidence of Non-Cardiac Surgery in Patients Treated With Drug-Eluting Stents According to Age.
Authors: Lee OH, Hong SJ, Ahn CM, Kim JS, Kim BK, Ko YG, Choi D, Jang Y, Hong MK Abstract OBJECTIVES: The impact of age on the incidence and timing of non-cardiac surgery after coronary stent implantation is unknown. We evaluated the incidence and timing of non-cardiac surgery after drug-eluting stent (DES) implantation according to patient age. METHODS: A total of 37,915 consecutive patients treated by DES implantation between February 2003 and April 2014 were included in this study. The number of patients who underwent non-cardiac surgery were as follows: 4263 (11.2%) within 1 year, 5357 (14.1%) within 2 year...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Prognostic Impact of Permanent Pacemaker Implantation in Patients With Low Left Ventricular Ejection Fraction Following Transcatheter Aortic Valve Replacement.
Authors: Maeno Y, Abramowitz Y, Israr S, Yoon SH, Kubo S, Nomura T, Miyasaka M, Kawamori H, Kazuno Y, Takahashi N, Chakravarty T, Nakamura M, Sharma RP, Jilaihawi H, Makkar RR Abstract BACKGROUND: Data are limited regarding the clinical impact of permanent pacemaker implantation (PPI) in patients with low left ventricular ejection fraction (LVEF) after transcatheter aortic valve replacement (TAVR). The aim of this study was to determine the impact of new PPI in patients with baseline low LVEF at 2-year follow-up after TAVR. METHODS: A total of 659 patients undergoing TAVR between January 2013 and December 2015 ...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Outcomes of Hemodynamic Support With Impella for Acute Myocardial Infarction Complicated by Cardiogenic Shock at a Rural Community Hospital Without On-Site Surgical Back-up.
Authors: Wilkins CE, Herrera TL, Nagahiro MK, Weathers LB, Girotra SV, Sandhu F Abstract AIMS: Impella 2.5 and Impella CP (Abiomed) are percutaneous left ventricular assist devices that can be easily deployed in the cardiac catheterization laboratory without need for surgery and provide effective hemodynamic support. The utility of Impella devices for management of acute myocardial infarction complicated by cardiogenic shock (AMI-CS) at a rural community hospital without on-site surgical back-up has not been reported. METHODS: We retrospectively reviewed all consecutive patients who underwent percutaneous coron...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Short-Term and Long-Term Outcomes of Patients Undergoing Urgent Transcatheter Aortic Valve Replacement Under a Minimalist Strategy.
CONCLUSIONS: Urgent minimalist TAVR can be safely performed with favorable in-hospital outcomes, while increased 30-day and 1-year mortality rates suggest the importance of appropriate diagnosis and timely treatment of severe aortic stenosis. PMID: 30700628 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Angio-Guidewire-Ultrasound (AGU) Guidance for Femoral Access in Procedures Requiring Large Sheaths.
We report an original technique for femoral access integrating angiographic, guidewire, and ultrasound (AGU) guidance, working together to obtain the best femoral artery stick according to individual patient's anatomy. This technique is designed to facilitate large-sheath femoral access in procedures requiring ancillary arterial access. PMID: 30700629 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Cardiac Arrest in a 31-Year-Old Man With Noonan Syndrome.
Authors: Grotti S, Dall'Ara G, Tarantino F, Bachetti C, Ottani F, Galvani M Abstract A 31-year-old man with Noonan syndrome who suffered an out-of-hospital cardiac arrest presented at our institution with severe postanoxic coma (Glasgow coma scale 3), but normalized electrocardiogram and stable hemodynamics. Coronary angiography documented a giant right coronary artery supplying collateral flow to the left coronary artery, which presented a left main functional occlusion. PMID: 30700630 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Occlusion of a Multilobed Shallow Left Atrial Appendage Using a Special LAmbre Device After Failed Watchman Implantation.
Authors: So CY, Lam YY, Cheung GS, Kam KK, Chan AK, Lee AP, Yan BP Abstract Although reported failure rates of the Watchman device are low, the ballshaped device is not suitable for shallow and multilobed left atrial appendages (LAAs). The LAmbre device is available in two configurations - standard (cover 4-6 mm larger in diameter than the umbrella) and special (cover 12- 14 mm larger than the umbrella) - which allows the closure of a wide range of LAA anatomies. This case illustrates that the LAmbre device can be used for complex LAA anatomies that are not suitable for the Watchman device. PMID: 30700631 [PubM...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Successful Stent Delivery Through a Slaloming Coronary Path.
Authors: Aznaouridis K, Bonou M, Masoura K, Vaina S, Vlachopoulos C, Tousoulis D Abstract A 66-year-old man with refractory angina was admitted for percutaneous coronary intervention (PCI) through a tortuous saphenous vein graft sequentially anastomosed with a diagonal and a first marginal branch. Our target was a critical stenosis at the retrograde limb of the first marginal proximal to saphenous vein graft anastomosis. Stent delivery to our target lesion mandated tracking through sequential angulations. In this case, we enhanced the support of the guide catheter and delivered a stent on the retrograde limb of the...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Endothelialization of an Amplatzer Septal Occluder Device 6 Months Post Implantation: Is This Enough Time? An In Vivo Angioscopic Assessment.
This report therefore evaluates endothelialization in vivo and demonstrates that 6 months of postimplantation prophylactic therapy may not provide sufficient time for adequate endothelialization. Further investigations are warranted to determine the optimal duration of these treatments after atrial septal defect closure. PMID: 30700633 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Superdominant Circumflex Thrombosis With Occluded LAD and Absent RCA Ostium.
Authors: da Silva Matte B, Lima Marques FP, de Araujo GN, Gonçalves SC Abstract To our knowledge, this is the first report of primary percutaneous coronary intervention in a patient with a superdominant left circumflex artery, in which the entire right coronary artery myocardium territory is provided by the left circumflex. Coronary angiographic images of our 80-year-old male patient illustrate this anomaly. Single coronary arteries are among the most rare anatomic coronary anomalies, and the absence of right coronary artery ostium has been described as the rarest of these anomalies. Coronary events in such ...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Percutaneous Biventricular Mechanical Circulatory Support With Impella CP and Protek Duo Plus TandemHeart.
Authors: Patel NJ, Verma DR, Gopalan R, Heuser RR, Pershad A Abstract This is the first reported case of full biventricular mechanical circulatory support with the combination of Impella and Protek Duo, which is a dual-lumen cannula inserted via the right internal jugular vein, with its proximal inflow lumen positioned in the right atrium and distal lumen positioned in the main pulmonary artery. These lumens are connected with the paracorporeal TandemHeart pump allowing flows up to 5 L/min. The alternative percutaneous option for right ventricular support is the Impella RP (Abiomed), which has to be placed in the f...
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

In-Hospital Outcomes of Rotational Atherectomy in High-Risk Patients With Severely Calcified Left Main Coronary Artery Disease: A Single-Center Experience.
We report our experience with RA for severely calcified LM-CAD. METHODS: From January 2008 to January 2017, all patients who underwent RA-assisted LM-PCI were evaluated. The study population included both protected and unprotected LM-CAD patients. Clinical characteristics and in-hospital outcomes were collected retrospectively. In-hospital outcomes included post-PCI myocardial infarction, stroke, death, emergency coronary artery bypass graft surgery, and urgent repeat PCI. Angiographic success was defined by residual stenosis
Source: The Journal of Invasive Cardiology - January 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Frequency and Outcomes of Ad Hoc Versus Planned Chronic Total Occlusion Percutaneous Coronary Intervention: Multicenter Experience.
Authors: Sandoval Y, Tajti P, Karatasakis A, Burke MN, Danek BA, Karmpaliotis D, Alaswad K, Jaffer FA, Yeh RW, Patel M, Mahmud E, Krestyaninov O, Khelimskii D, Choi JW, Doing AH, Toma C, Wyman RM, Uretsky B, Garcia S, Koutouzis M, Tsiafoutis I, Holper E, Moses JW, Lembo NJ, Parikh M, Kirtane AJ, Ali ZA, Doshi D, Kandzari DE, Karacsonyi J, Rangan BV, Thompson C, Banerjee S, Brilakis ES Abstract BACKGROUND: For patients needing coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI), a planned, staged intervention has been recommended by experts. Ad hoc CTO-PCI, however, occurs in practice. ...
Source: The Journal of Invasive Cardiology - January 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Long-Term Single-Center Registry of 6893 Patients Undergoing Elective Percutaneous Coronary Intervention With the Xience Everolimus-Eluting Stent.
CONCLUSIONS: This large, prospective registry confirms the very long-term safety and efficacy of the EES in unselected real-world and complex coronary lesions. PMID: 30643041 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Clinical Outcomes and Cost Comparisons of Stent and Non-Stent Interventions in Infrainguinal Peripheral Artery Disease: Insights From the Excellence in Peripheral Artery Disease (XLPAD) Registry.
We present data from the ongoing United States multicenter Excellence in Peripheral Artery Disease Registry between 2006-2016 to compare stent vs non-stent treatment outcomes and associated costs in FP interventions. A total of 2910 FP interventions were performed in 2162 patients (mean age, 66 years), comprising 1339 stent based (superficial femoral artery, 93%) in 1007 patients and 1571 non-stent interventions (superficial femoral artery, 85%) in 1155 patients. A growing trend for non-stent based interventions and a declining trend in repeat revascularization rate at 1 year were observed across years of registry enrollme...
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Cancer Paradox: Machine-Learning Backed Propensity-Score Analysis of Coronary Angiography Findings in Cardio-Oncology.
Authors: Balanescu DV, Monlezun DJ, Donisan T, Boone D, Cervoni-Curet F, Palaskas N, Lopez-Mattei J, Kim P, Iliescu C, Balanescu SM Abstract OBJECTIVES: Cancer has been proposed as a cardiovascular risk factor. We aimed to assess the cardiovascular risk profile and coronary angiography (CA) findings of cancer patients and compare them to those of patients without cancer. METHODS: A retrospective case-control analysis was conducted on randomly enrolled cancer and non-cancer patients from a high-volume cardio-oncology center and a tertiary cardiology center, respectively, who underwent CA from April 2008 to June ...
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Impella CP Dislodgment, Swap, or Removal: Current Practices.
Authors: Kaluski E, Khan SU, Sattur S, Sporn D, Singh M Abstract The Impella CP (ICP) catheter (Abiomed) offers hemodynamic superiority over the intra-aortic balloon pump. However, device-specific issues are occasionally encountered, especially when long-term mechanical circulatory support (MCS) is required. These include ICP dislodgment, ICP mechanical failure, and the need to remove the ICP while maintaining arterial access to either insert a new MCS device or to perform suture-based arteriotomy site closure. We offer a case in which ICP-based MCS involved ICP distal dislodgment, kinking of the ICP catheter, and ...
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Challenging Aorto-Coronary Occlusion: Which Solution?
Authors: Lorenzoni G, Merella P, Casu G Abstract Aorto-coronary occlusion is a particularly difficult lesion to treat, especially in an emergent setting. To our knowledge, this is the first description of the use of a microcatheter not to support the guidewire, but to open an aorto-coronary calcific occlusion with anterograde approach in an emergent situation. PMID: 30611125 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Coronary Artery Tenting After Bypass Grafting: A Key Issue During Percutaneous Coronary Intervention of a Chronic Total Occlusion.
Authors: Jurado-Román A, Rumoroso JR, Abellán-Huerta J, López-Lluva MT, Sánchez-Pérez I, Ruíz-Poveda FL Abstract This image series shows how bypass grafts may tent the vessel to which they are anastomosed, potentially changing the expected course of the native coronary vessel. This fact must be taken into account during CTO-PCI, and this case emphasizes the importance of careful analysis of coronary anatomy with several angiographic projections. PMID: 30611126 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Combined Percutaneous Treatment of Severe Triscuspid Regurgitation and Left Atrial Appendage Closure.
Authors: Arellano-Serrano C, Moñivas V, Estévez-Loureiro R Abstract LAA closure and MitraClip implantation in the tricuspid position in the same procedure is a feasible and safe option in patients with a high surgical risk suffering from severe symptomatic tricuspid regurgitation and bleeding complications under anticoagulant therapy. PMID: 30611127 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Optical Coherence Tomography Evaluation of Coronary Dissection and Intramural Hematoma.
Authors: Hayat U, Williams PD, Austin D Abstract Image series shows an extensive intramural hematoma causing luminal compression corresponding to the angiographic stenosis. Although intramural hematomas are identifiable on intravascular ultrasound, OCT offers superior characterization and exclusion of alternate diagnoses, such as plaque erosion. PMID: 30611128 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

"Single Arm-Double Access" for CTO Intervention.
"Single Arm-Double Access" for CTO Intervention. J Invasive Cardiol. 2019 Jan;31(1):E7 Authors: Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Oikonomidis N, Lazaris E Abstract To our knowledge, this is the first reported case of a dual-access approach for CTO intervention using transradial and ipsilateral transulnar access. Although retrograde CTO intervention is a challenging procedure, a single arm-double access approach seems to be a feasible alternative that may be useful in patients with limited access-site availability. PMID: 30611129 [PubMed - in process] (Source: The Jou...
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Novel Approach to Aortoiliac Bifurcation Stenting Using a Single Balloon-Expandable Stent.
Authors: Alomar M, Tayal R, Amponsah M, Cohen M, Wasty N Abstract Contrary to popular wisdom, predominantly unilateral aortoiliac bifurcation disease can be safely treated with a single stent if the contralateral common iliac ostium is protected with matching balloon inflation. Larger studies on this novel approach with a longer clinical follow-up are needed to validate our results. PMID: 30611130 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 7, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

The Spontaneous Coronary Slow-Flow Phenomenon: Reversal by Intracoronary Nicardipine.
Authors: Mehta HH, Morris M, Fischman DL, Finley JJ, Ruggiero N, Walinsky P, McCarey M, Savage MP Abstract OBJECTIVE: An under-recognized cause of chest pain, the coronary slow-flow (CSF) phenomenon is characterized by delayed coronary opacification during diagnostic angiography in the absence of epicardial coronary artery disease (CAD). Given its angiographic resemblance to no-reflow during percutaneous coronary intervention, a condition associated with microvascular spasm responsive to calcium-channel blockers, we hypothesized that spontaneous CSF may similarly be reversed by intracoronary (IC) nicardipine. M...
Source: The Journal of Invasive Cardiology - December 18, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Safety of Calcium-Channel Blockers During Radial Cardiac Catheterization in Patients With Acute Myocardial Infarction or Systolic Heart Failure.
CONCLUSIONS: Patients with STEMI or HF can safely tolerate intra-arterial CCB during radial catheterization. PMID: 30555053 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 18, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Outcomes Among Patients With Heart Failure With Reduced Ejection Fraction Undergoing Transcatheter Aortic Valve Replacement: Minimally Invasive Strategy Versus Conventional Strategy.
Authors: Panhwar MS, Li J, Zidar DA, Clevenger J, Lipinski J, Patel TR, Karim A, Saric P, Patel SM, Kalra A, Attizzani G Abstract OBJECTIVES: To investigate the effect of TAVR technique on in-hospital and 30-day outcomes in patients with aortic stenosis (AS) and reduced ejection fraction (EF). BACKGROUND: Patients with AS and concomitant low EF may be at risk for adverse hemodynamic effects from general anesthesia utilized in transcatheter aortic valve replacement (TAVR) via the conventional strategy (CS). These patients may be better suited for the minimally invasive strategy (MIS), which employs conscious sed...
Source: The Journal of Invasive Cardiology - December 18, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Balloon Valvuloplasty Followed by Transcatheter Aortic Valve Implantation as a Staged Procedure in Patients With Low-Flow Low-Gradient Aortic Stenosis.
Authors: Piayda K, Wimmer AC, Veulemans V, Afzal S, Sievert H, Gafoor S, Erkens R, Polzin A, Quast C, Jung C, Westenfeld R, Kelm M, Hellhammer K, Zeus T Abstract OBJECTIVE: Balloon aortic valvuloplasty (BAV) as a bridge to transcatheter aortic valve implantation (TAVI) is a well-established treatment option in patients who are in a critical state or who suffer from underlying comorbidities that disguise the severity of aortic stenosis (AS). If convalescence is achieved, TAVI can be performed with good results in high-gradient aortic stenosis (HG-AS) patients. Whether this approach is safe and effective in low-flow ...
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Clinical and Angiographic Outcomes Comparison of Patients With Left Main Vs Non-Left Main Bifurcation Lesions Treated With Percutaneous Coronary Intervention With Second-Generation Drug-Eluting Stents.
Authors: Vergara R, Valenti R, Migliorini A, Ciabatti M, Grazia De Gregorio M, Taborchi G, Morini S, Rondine R, Martone R, Antoniucci D Abstract INTRODUCTION: It is not clear if differences exist about treating left main bifurcation (LMB) and non-left main bifurcation (non-LMB) lesions by means of percutaneous coronary intervention (PCI). METHODS: We prospectively analyzed all consecutive patients treated at our center for bifurcation lesions from January 1, 2011 to December 31, 2015, including acute myocardial infarction (MI) and cardiogenic shock, and compared the angiographic and clinical outcomes of patient...
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Predicting Iliac Vein Compression With Computed Tomography Angiography and Venography: Correlation With Intravascular Ultrasound.
Authors: Shammas NW, Shammas GA, Jones-Miller S, Radaideh Q, Winter AR, Shammas AN, Kovach IZ, Bou Dargham B, Daher GE, Rachwan RJ, Shammas WJ, Omar W, Manazir A, Kasula S Abstract BACKGROUND: Intravascular ultrasound (IVUS) is considered the gold standard in diagnosing common iliac vein (CIV) compression. The presence of>50% surface area reduction by IVUS is considered significant compression by most operators. Thus, we evaluated the role of computed tomography angiography (CTA) and venography in diagnosing CIV compression when compared to IVUS. METHODS: All patients who underwent CTA of the pelvis with ven...
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions: A Single-Center Experience and Review of the Literature.
We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS: . We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017. The electronic medical records and angiograms were individually reviewed. We assessed the in-hospital and mid-term major adverse cardiovascular and cerebrovascular event (MACCE) rates, and reviewed bleeding and vascular complications. RESULTS: Five patients underwent elective high-risk PCI with ECMO support. Mean age was 66.8 ± 8.6 years...
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization.
This study evaluated whether use of different spasmolytic regimens (nitroglycerin or verapamil) administered soon after sheath insertion affects postprocedure radial artery occlusion (RAO) in patients who underwent transradial catheterization. METHODS AND RESULTS: We performed a post hoc analysis of a randomized trial evaluating the use of 500 μg intra-arterial nitroglycerin just before sheath removal in 1706 patients undergoing transradial catheterization. Patients who received 200 μg or 300 μg nitroglycerin after sheath placement (group A; n = 688) were compared with patients who received 5 mg verapamil afte...
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Hybrid Coronary Revascularization vs Complete Coronary Artery Bypass Grafting for Multivessel Coronary Artery Disease: A Systematic Review and Meta-Analysis.
CONCLUSIONS: Our results suggest that compared to CABG, HCR is associated with a lower risk of postoperative blood transfusion and infection, as well as a shorter ICU stay and hospital stay. HCR was also associated with a higher risk of long-term TVR. PMID: 30504516 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Suggesting a New Primary Access Site for Treating Chronic Total Occlusions: Bilateral Distal Transradial Intervention (bdTRI).
Authors: Hadžibegović I, Starčević B Abstract Bilateral distal transradial intervention is a new primary access strategy for chronic total occlusion interventions. We provide a brief review of recent studies and offer the rationale behind this promising approach. PMID: 30504517 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Recanalization of Left Subclavian Vein Total Occlusion Jailed by Superior Vena Cava Stent Using Culotte Stenting Technique With a Dedicated Venous Stent.
Authors: Chi WK, Tam GM, Yan BP Abstract This case demonstrates that the high radial strength of a dedicated nitinol venous stent is able to achieve good acute angiographic results and clinical efficacy. PMID: 30504518 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Thrombolysis-Guided Primary Percutaneous Coronary Intervention.
Authors: Tzanis G, Giannini F, Latib A, Colombo A Abstract A 77-year-old STEMI patient became hemodynamically unstable during attempted PCI, and operators were unable to visualize the right coronary artery ostium despite multiple attempts. Systemic thrombolysis resolved these issues and allowed PCI to proceed. This case highlights that fibrinolysis might still play a key role for some challenging cases in the era of modern PCI. PMID: 30504519 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Snow and Reindeer: Large Tricuspid Valve Mobile Vegetation.
Authors: Olson PC, Agarwal V, Royzman R Abstract A 20-year-old female with history of polysubstance abuse presented with fevers and lightheadness. Blood cultures grew out Streptococcus constellatus, which is known to form purulent infections when introduced in the body. Evaluation with transesophageal echocardiogram showed a definite large, irregular, loosely organized, highly mobile vegetation. PMID: 30504520 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - December 8, 2018 Category: Cardiology Tags: J Invasive Cardiol Source Type: research