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A mechanism for stroke complicating thrombus aspiration
We propose a mechanism of how stroke may be caused by thrombus aspiration during primary percutaneous coronary intervention (PPCI), and how it may be technique‐dependent. Two recent meta‐analyses report increased risk of stroke in patients undergoing routine thrombus aspiration during STEMI and the value of this technique has been controversial. The mechanism of stroke has not been fully explained. This case demonstrates 2 mechanisms by which aspiration might cause thrombus embolization. We recommend that if thrombus aspiration is performed during PPCI for STEMI, it should be done selectively and carefully. It is prude...
Source: Catheterization and Cardiovascular Interventions - October 2, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Eddie D. Brown, James C. Blankenship Tags: Coronary Artery Disease Source Type: research

The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation: In‐hospital‐data from the Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study
ConclusionsThe majority of AF patients undergoing PCI‐S are at high stroke risk, and therefore VKA treatment should not be withdrawn and combined anticoagulant and antiplatelet treatment is warranted. Current management appears largely in accordance with current recommendations, whereby accounting for the limited occurrence of in‐hospital adverse ischemic and bleeding events. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 13, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Axel Schlitt, Andrea Rubboli, Gregory H Lip, Heli Lahtela, Josè Valencia, Pasi P. Karjalainen, Michael Weber, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Michael Buerke, K.E. Juhani Airaksinen, Tags: Original Study Source Type: research

The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation
Current recommendations on the management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI‐S) essentially derive from small, single‐center, retrospective datasets. To obtain larger and better quality data, we carried out the prospective, multicenter Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study. Therefore, consecutive patients with history of or ongoing AF undergoing PCI‐S were enrolled, and occurrence of adverse ischemic and bleeding events recorded during 12 months follow‐up. In this article, we report the in‐hospital observations. O...
Source: Catheterization and Cardiovascular Interventions - August 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Axel Schlitt, Andrea Rubboli, Gregory Y.H. Lip, Heli Lahtela, Josè Valencia, Pasi P. Karjalainen, Michael Weber, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Michael Buerke, K.E. Juhani Airaksinen, Tags: Coronary Artery Disease Source Type: research

Efficacy and safety of routine thrombus aspiration in patients with ST‐segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: An updated systematic review and meta‐analysis of randomized controlled trials
ConclusionsCompared with conventional PPCI for STEMI, adjunctive TA reduces the risk of subsequent MACE. However, the benefit in MACE is counterbalanced by an increased risk in stroke. Considering the above potential risks and benefits, TA should be considered in selected patients lesions rather than routinely. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - November 19, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Ioannis Mastoris, Gennaro Giustino, Samantha Sartori, Usman Baber, Roxana Mehran, Annapoorna S. Kini, Samin K. Sharma, George D. Dangas Tags: Coronary Artery Disease Source Type: research

Percutaneous coronary intervention or coronary artery bypass grafting for unprotected left main coronary artery disease
ConclusionsIn patients with unprotected left main coronary disease and low to intermediate SYNTAX score, PCI might be an acceptable alternative to CABG. © 2017 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - March 14, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Ahmed N. Mahmoud, Islam Y. Elgendy, Amgad Mentias, Marwan Saad, Walid Ibrahim, Mohammad K. Mojadidi, Ramez Nairooz, Parham Eshtehardi, R. David Anderson, Habib Samady Tags: Coronary Artery Disease Source Type: research

Meta‐analysis of randomized controlled trials comparing percutaneous coronary intervention with aspiration thrombectomy Vs. Conventional percutaneous coronary intervention during ST‐segment elevation myocardial infarction
ConclusionsUsing the totality of evidence available through 2015, this meta‐analysis failed to show that the routine use of aspiration thrombectomy in patients with ST‐elevation myocardial infarction significantly reduces all‐cause mortality, MACE, recurrent MI, TVR, or stent thrombosis. The role of aspiration thrombectomy in selected patients with angiographic evidence of large thrombus burden requires further clinical investigation. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - December 23, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Abel Casso Dominguez, John A. Bittl, Georges El‐Hayek, Elizabeth Contreras, Jacqueline E. Tamis‐Holland Tags: Coronary Artery Disease Source Type: research

Manual thrombectomy efficiency in relationship to the area at risk in patients with myocardial infarction with TIMI 0 ‐1 coronary flow: Insights from an all comers registry
ConclusionIn comparison with the group where MT was inefficient, efficient MT may modestly reduce final infarct size without a significant clinical benefit. In comparison with PCI‐only, no difference was found regarding stroke. © 2017 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - February 12, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Andr é Luz, Inês Silveira, Bruno Brochado, Patrícia Rodrigues, Maria João Sousa, Raquel Santos, Maria Trêpa, Mário Santos, João Silveira, Severo Torres, Adelino F. Leite‐Moreira, Henrique Carvalho Tags: Coronary Artery Disease Source Type: research

Volume‐Outcomes relationship in the era of modern coronary intervention ‐ Results from the prospective multicenter German DES.DE registry ‐
Conclusions: In the era of modern coronary intervention technological advances such as DES have not offset the inverse relation between procedural volume and both in‐hospital and 1‐year outcomes after PCI. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - May 15, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ibrahim Akin, Mathias Hochadel, Steffen Schneider, Mohamed Abdel‐Wahab, Ralf Zahn, Jochen Senges, Gert Richardt, Karl‐Heinz Kuck, Christoph A. Nienaber, Tags: Original Study Source Type: research

Procedural success and long‐term outcomes of aspiration thrombectomy for the treatment of stent thrombosis
Conclusions: Aspiration thrombectomy is associated with improved coronary flow and procedural success but is not associated with improved long‐term outcomes among patients undergoing percutaneous intervention for definite ST. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Stephen W. Waldo, Ehrin J. Armstrong, Khung‐Keong Yeo, Mitul Patel, Ryan Reeves, John S. MacGregor, Reginald I. Low, Ehtisham Mahmud, Jason H. Rogers, Kendrick Shunk Tags: Original Studies Source Type: research

Volume–outcomes relationship in the Era of modern coronary intervention—results from the prospective multicenter German DES.DE Registry
ConclusionsIn the era of modern coronary intervention technological advances such as DES have not offset the inverse relation between procedural volume and both in‐hospital and 1‐year outcomes after PCI. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ibrahim Akin, Mathias Hochadel, Steffen Schneider, Mohamed Abdel‐Wahab, Ralf Zahn, Jochen Senges, Gert Richardt, Karl‐Heinz Kuck, Christoph A. Nienaber, Tags: Coronary Artery Disease Source Type: research

Comparison of antithrombotic agents during urgent percutaneous coronary intervention following thrombolytic therapy: A retrospective cohort study
ConclusionIn STEMI patients undergoing PCI within 24 hr after thrombolytic therapy, bivalirudin was associated with a strong trend toward reduced bleeding complications as compared to heparin alone or heparin plus GPI.The optimal antithrombotic regiment for urgent PCI following thrombolytic therapy is currently unknown. Our study demonstrated that use of bivalirudin during PCI following thrombolytic therapy is associated with a trend toward reduced bleeding complications compared to heparin alone or heparin plus GPI. Large randomized trials of adjunctive anticoagulation during PCI in this complex post‐thrombolytic popula...
Source: Catheterization and Cardiovascular Interventions - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Jaya R. Mallidi, Peter Robinson, Paul F. Visintainer, Amir S. Lotfi, Scott Mulvey, Gregory R. Giugliano Tags: Coronary Artery Disease Source Type: research

CYP2C19 pharmacogenetics versus standard of care dosing for selecting antiplatelet therapy in patients with coronary artery disease: A meta ‐analysis of randomized clinical trials
ConclusionIn patients undergoing stent implantation, MACE with genotype ‐guided therapy was not significantly reduced; however, there was a signal towards reduction of MACE in ACS patients, as well as a lower rate of MI, though this will require further confirmation in adequately powered trials.
Source: Catheterization and Cardiovascular Interventions - November 7, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Pranay V. Pandrangi, Adam Chahine, Sahar Ahmed, Khansa Osman, Ghassan Bachuwa, Mustafa Hassan, Deepak L. Bhatt Tags: CORONARY ARTERY DISEASE Source Type: research