Percutaneous Coronary Intervention Blogs This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Forbidden tips in PTCA : OMG , give me strength to leave this lesion alone !
Confabulation of a confused cardiologist Yes, It has never bothered me to retrogradely cross a delicately dangerous epicardial collateral in complex CTO. Delivering a twin stent in a partial culotte strategy for a bifurc lesion has never tested my talents. Stenting a left main across the LAD, jailing the LCX with OCT support is my favorite time pass. Crushing a calcium infested diffuse long lesion with diamond-tipped ablator appear as breezy as shopping in a mall. Oh …I am terribly upset with this damn thing. What is that? It requires 4 negative forces . . . to bring one big positive Impact! These studies say medic...
Source: Dr.S.Venkatesan MD - November 17, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome acc esc guidelines scai pci ptca stable chd courage bari 2d orbita ischemia trials tips and tricks in ptca Source Type: blogs

60-something with 2 days of intermittent epigastric pain. Why does the cardiologist disagree?
Conclusion An invasive strategy based on coronary stenting with adjunctive use of abciximab reduces infarct size in patients with acute STEMI without persistent symptoms presenting 12 to 48 hours after symptom onset.===================================MY Comment by KEN GRAUER, MD (10/20/2019):===================================I find it difficult to believe that the Cardiologist Attending On Call did not allow for the possibility that the OMI in this case was either acute and/or ongoing.MY Question: Was this the opinion of the Attending Cardiologist — or a Resid...
Source: Dr. Smith's ECG Blog - October 19, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs

A man in his 70s with chest pain during a bike ride
Case written and submitted by Ryan Barnicle MD, with edits by Pendell MeyersWhile vacationing on one of the islands off the northeast coast, a healthy 70ish year old male presented to the island health center for an evaluation of chest pain. The chest pain started about one hour prior to arrival while bike riding. It was a constant ache on the left side of his chest that forced him to stop cycling and call for an ambulance. It was radiating to his bilateral upper arms. It was associated with nausea but he denied dyspnea, dizziness, and headache.He explained that he had the same chest pain the day prior as well, on and off....
Source: Dr. Smith's ECG Blog - September 29, 2019 Category: Cardiology Authors: Pendell Source Type: blogs

Doctors Perform First Minimally Invasive Remote Robotic Cardiac Procedure
Clinicians in India have teamed up to demonstrate the feasibility of having a physician remotely perform percutaneous coronary intervention (PCI) procedures. Using the CorPath GRX, an FDA cleared cath lab robot that lets physicians stay away from the radiation produced by fluoroscopes, the team from the Apex Heart Institute in Ahmedabad positioned the control mechanism in a building 20 miles away from where the patients were to be treated. They were then able to perform five separate procedures, including dilation with angioplasty balloons and positioning stents within the treated area. All of the procedures were c...
Source: Medgadget - September 6, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiology Radiology Source Type: blogs

How does acute left main occlusion present on the ECG?
Post by Smith and MeyersSam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith):" Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR? "Smith and Meyers answer:First, LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded.But if they do present:The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion, though it might be due to subtotal LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. In these ...
Source: Dr. Smith's ECG Blog - August 8, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs

Predictions and Parachutes
By SAURABH JHA, MD What does it take to create a decision rule? In this episode of Radiology Firing Line podcast Saurabh Jha (@RogueRad) has a discussion with Robert W. Yeh MD MBA about the deep thought and complex statistics involved in creating a decision rule to guide therapy which have narrow risk-benefit calculus, specifically a rule for how long patients should continue dual anti-platelet therapy after percutaneous coronary intervention. They also discuss the motivation behind the legendary, and satirical, parachute RCT published in the recent Christmas edition of the BMJ, which delighted satirists all over the wo...
Source: The Health Care Blog - May 31, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Radiology Firing Line Podcasts RogueRad @roguerad decision rule Robert Yeh Saurabh Jha Source Type: blogs

Optical frequency domain imaging (OFDI)
Optical frequency domain imaging (OFDI) is a novel second generation optical coherence tomography (OCT) derived imaging method [1]. It has substantially higher speed of image acquisition compared to first generation time domain OCT. OFDI can allow rapid imaging for detection of coronary strut coverage with a much higher precision compared to intravascular ultrasound. Axial resolution of OFDI is in the range of 10-20 microns. OPINION trial compared optical frequency domain imaging vs. intravascular ultrasound (IVUS) in percutaneous coronary intervention [2]. It was a prospective, multicentre, randomised, active-controlled...
Source: Cardiophile MD - April 20, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Source Type: blogs

Supersaturated oxygen reduces infarct size in anterior wall infarction
United States Food and Drug Administration (US FDA) has approved SuperSaturated Oxygen (SSO2) Therapy for reducing infarct size in left anterior descending coronary artery territory ST elevation myocardial infarction (STEMI) within 6 hours of onset, after percutaneous coronary intervention. How is supersaturated oxygen delivered? Supersaturated oxygen is delivered using an extracorporeal circuit (TherOx, Inc, Irvine, Calif). Blood is withdrawn from the sidearm of the femoral sheath which is chosen to be 2F larger than the PCI guide or from a 5F sheath in the opposite femoral artery. The blood is oxygenated in a polycar...
Source: Cardiophile MD - April 6, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Coronary Interventions Source Type: blogs

FDA Approves First New Therapy to Treat Heart Attacks in Years
Heart attacks are typically treated by placing stents at the sites of narrowing coronary arteries. This has become a standard of care and advances in cath lab technologies allows interventional cardiologists to accurately place stents in a matter of minutes. Now another option, called SuperSaturated Oxygen (SSO2), is being made available thanks to a brand new approval from the FDA. SSO2 is the first treatment approved by the FDA since percutaneous coronary intervention (PCI, aka stenting) to help reduce the damage that heart attacks cause. The therapy, developed by TherOx, a company based in Irvine, California, involves p...
Source: Medgadget - April 4, 2019 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Critical Care Source Type: blogs

Failing Healthcare ’ s ‘ Free Market ’ Experiment in US: Single Payer to the Rescue?
This article originally appeared on LinkedIn here. (Source: The Health Care Blog)
Source: The Health Care Blog - February 19, 2019 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Politics ACA Health insurance Khurram Nasir Single payer Source Type: blogs

Critical gaps in STEMI knowledge base : What is the relationship between “ Time window ” and “ Age ” of IRA thrombus ?
Cardiologists are grappling with at least half a dozen time windows in the management of STEMI. (It can be combinations of any of the following :Symptom – DAPT Loading – Door – Needle /Balloon-Sheath, wire crossing etc ) Time windows are Important in choosing the right (or no)modality of re-perfusion . Though superiority of primary PCI is thought to be established in academic community , it may not be in real world. Published studies that suggest pPCI is superior to lysis at any time window still lack good evidence. Why is this long drawn confusion ? One of the important determinant of...
Source: Dr.S.Venkatesan MD - February 9, 2019 Category: Cardiology Authors: dr s venkatesan Tags: cath lab tips and tricks PCI PTCA Hardware Primary -PCI STEMI STEMI -Managment STEMI-Primary PCI Thrombolysis how to estimate the age of thrombus in stemi acs soft vs hard thrombus in stemi thrombus hardening time thrombus organising t Source Type: blogs

AF Ablation Update 2019
Most years I write an update on any big developments in AF ablation. This year’s version will be a short one. I have little new to report. But it’s worth reviewing some basic issues. We still do not know the cause of atrial fibrillation (AF). That makes it hard to fix with ablation. Knowledge Deficits: To explain why not knowing the cause of AF impairs our ability to ablate it, it’s useful to compare AF ablation to WPW ablation. Wolfe-Parkinson-White or WPW syndrome causes rapid heart rates because of an extra pathway from the top to the bottom (atria and ventricle) of the heart. You can cure WPW by ablat...
Source: Dr John M - February 8, 2019 Category: Cardiology Authors: Dr John Source Type: blogs

MKSAP: 66-year-old man with ST-elevation myocardial infarction
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 66-year-old man is evaluated in the hospital following ST-elevation myocardial infarction treated with primary percutaneous coronary intervention of the left anterior descending artery 4 days ago. His initial presentation was complicated by the presence of heart failure and pulmonary edema. […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - February 2, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Cardiology Source Type: blogs

Evidence less cardiology : Is “ No-flow ” better than “ No-reflow ” in STEMI ?
Cath labs are propably the best place to practice preventive cardiology . . . Practice of medicine is primarily guided by Infinite Information , plenty of Intuition, little bit of Intelligence and unquantifiable amount of Ignorance.The science of coronary reperfusion is standing example for variable mix of the above.The term no reflow is a jargan used liberally in cath labs right from first year fellow to super consultant without knowing what exactly they mean by it. What really is No-reflow then ? The academic definition :According to Kloner no-reflow is defined as suboptimal myocardial reperfusion through a part of coron...
Source: Dr.S.Venkatesan MD - January 26, 2019 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

The VERDICT Trial
This study is unable to comment on whether patients with STEMI(-) Occlusion MI have benefit from emergent cath, because that is not the population studied and this subgroup is not commented on.This study is just the most recent in a long long line of similar literature. Context is everything for understanding this study. See below for an excerpt from theOMI Manifesto which summarizes the existing literature and provides details on each study:-------------------------------------------------------------------------------------------------------------- Counter-argument:“Haven’t there been RCTs showing no benefit for earl...
Source: Dr. Smith's ECG Blog - January 4, 2019 Category: Cardiology Authors: Pendell Source Type: blogs