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Heart attack treatment may involve primary percutaneous transluminal coronary angioplasty (PTCA). Heart attack treatment information developed by physicians.
TY - JOUR. T1 - Survival of patients undergoing rescue percutaneous coronary intervention. AU - Burjonroppa, Sukesh C.. AU - Varosy, Paul D.. AU - Rao, Sunil V.. AU - Ou, Fang Shu. AU - Roe, Matthew. AU - Peterson, Eric. AU - Singh, Mandeep. AU - Shunk, Kendrick A.. PY - 2011/1. Y1 - 2011/1. N2 - Objectives This study sought to develop a tool for predicting an individuals risk of mortality following rescue percutaneous coronary intervention (PCI). Background Although fibrinolytic therapy is appropriate and improves survival for certain ST-segment elevation myocardial infarction patients, a substantial proportion suffer ongoing myocardial ischemia, a class I indication for emergent percutaneous coronary intervention (rescue PCI). Methods Using the National Cardiovascular Data Registry (NCDR), rescue PCI was defined as nonelective PCI following failed fibrinolysis in patients with continuing or recurrent myocardial ischemia. Multivariable logistic regression was used to determine mortality ...
Successful percutaneous transluminal coronary angioplasty (PTCA) was performed on a 37-year-old white man with an isolated 95% right coronary artery stenosis who initially presented with type II unstable angina. Submaximal treadmill stress testing was not carried out before PTCA, but testing 3 days after PTCA was strongly positive without accompanying symptoms of myocardial ischaemia. Some 30 minutes after this test the patient experienced severe precordial pain with features of a hyperacute transmural inferior myocardial infarction. Immediate coronary arteriography delineated fresh thrombus related to the previous PTCA site. Intracoronary thrombolysis with streptokinase was successful, revealing an underlying severe stenosis at the PTCA site. PTCA was not repeated, nor was emergency coronary artery bypass grafting (CABG) performed. This is the second such case documented in the literature; the first patient failed to respond to intracoronary thrombolysis with streptokinase and was submitted to ...
TY - JOUR. T1 - Employment and recreation patterns in patients treated by percutaneous transluminal coronary angioplasty. T2 - A multicenter study. AU - Holmes, David. AU - Vlietstra, Ronald E.. AU - Mock, Michael B.. AU - Smith, Hugh C.. AU - Dorros, Gerald. AU - Cowley, Michael J.. AU - Kent, Kenneth M.. AU - Hammes, La Von N.. AU - Janke, Lynne. AU - Elveback, Lila R.. AU - Vetrovec, George W.. PY - 1983/10/1. Y1 - 1983/10/1. N2 - Employment and recreational patterns were analyzed in 279 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) for treatment of symptomatic coronary artery disease. PTCA was successful in 180 patients (65%). When it was unsuccessful, coronary artery bypass graft surgery was usually performed (80%). Return-to-work rates were high irrespective of the outcome of PTCA. Of patients employed full-time or part-time before treatment, 98.5% of those who had successful PTCA alone and 97% of those whose PTCA was unsuccessful but who underwent ...
BACKGROUND: This study is the third in a series of investigations on the requisite length of time that patients should be restricted to bed after coronary arteriography or percutaneous transluminal coronary angioplasty using a femoral artery approach. METHODS: A prospective, experimental-control group design with randomization was used initially to compare the incidence of bleeding between patients who remained in bed for 4 hours and patients who remained in bed for 6 hours after sheath removal following percutaneous transluminal coronary angioplasty. RESULTS: Rapid changes in the healthcare environment led to nurses collecting complete data sets for the experimental group only. The experimental group (n = 51) was 73% male and 27% female; mean age was 57 years (SD = 11.4 years). Mean time in bed was 4.1 hours (SD = 0.27 hours). Most patients (98%) did not bleed from the femoral artery access site after remaining in bed for 4 hours following sheath removal. Ninety-two percent of patients required ...
Coronary dissection and total coronary occlusion leading to emergency coronary surgery are the most frequent complications of percutaneous transluminal coronary angioplasty (PTCA) and their occurrence usually is unpredictable. To identify angiographic characteristics of coronary stenoses that may affect the incidence of these complications, the diagnostic pre-PTCA coronary angiograms of 38 consecutive patients (group I) undergoing emergency coronary surgery for dissection or occlusion were reviewed and compared with the angiograms of a random sample of 38 patients (stratified for left anterior descending and right coronary arteries) from a group of 1151 who did not need emergency coronary surgery (group II). Stenosis morphology before angioplasty was considered complicated if at least one of the following criteria was present: irregular borders, intraluminal lucency, and localization of stenosis in curve or at bifurcation. Baseline characteristics, maximum inflation pressures, types of balloon ...
To evaluate the long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA) and alternative angioplasty devices in patients with coronary heart disease. There are four registries. The first registry followed 3,079 patients who received PTCA between 1977 and 1982. The second registry followed 1,500 patients from the first registry for a minimum of five years and followed 2,000 newly entered patients who received PTCA in 1985 and 1986 so that the second cohort would also be followed for five years. The third registry, the New Approaches to Coronary Intervention (NACI), followed approximately 4,424 patients between November 1990 and February 1997. The dynamic evaluation study will follow a total of 6,000 procedures ...
The main purpose of this study is to observe the incidence of major adverse cardiac and cerebrovascular events (MACCE), target vessel failure (TVF), target vessel revascularization (TVR) and stent thrombosis out to 5 years after the procedure in patients who underwent percutaneous coronary intervention (PCI) with everolimus-eluting stents for unprotected left main coronary artery (ULMCA) disease and lesions involving the ULMCA in Japan. The investigators will also establish a method of adjustment to the Japanese version of the SYNTAX score by conducting an assessment using the SYNTAX score recently reported in the US and Europe as well as the EuroSCORE, and by clarifying the differences of PCI procedures and treatment results in Japan with those reported in the US and Europe ...
|i|Background|/i|. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. |i|Aim|/i|. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. |i|Methods|/i|. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. |i|Results|/i|. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6&
TY - JOUR. T1 - Time and cardiac risk of surgery after bare-metal stent percutaneous coronary intervention. AU - Nuttall, Gregory A.. AU - Brown, Michael J.. AU - Stombaugh, John W.. AU - Michon, Peter B.. AU - Hathaway, Matthew F.. AU - Lindeen, Kevin C.. AU - Hanson, Andrew C.. AU - Schroeder, Darrell R.. AU - Oliver, William C.. AU - Holmes, David R.. AU - Rihal, Charanjit S.. PY - 2008/10. Y1 - 2008/10. N2 - Background: The duration of time that elective noncardiac surgery (NCS) should be delayed after percutaneous coronary intervention (PCI) with bare metal stents (BMSs) is unknown. Methods: This large, single-center, retrospective study examined the relation between complication rate in patients with BMSs undergoing NCS and the duration of time between PCI and NCS. Primary endpoints included in-hospital major adverse cardiac events (death, myocardial infarction, stent thrombosis, or repeat revascularization with either coronary artery bypass grafting or PCI of the target vessel) and ...
Summary Circulating procoagulant microparticles (MP) were measured as markers of vascular damage and prothrombotic risk in patients undergoing ST-segment myocardial infarction (STEMI) treated by primary percutaneous transluminal coronary angioplasty (PTCA) and additional GPIIb-IIIa antagonists. Cel...
Early RHs carry a significant economic burden,12 and reducing the number of RHs by improving quality of care specifically in patients at high risk could lend to a better utilization of resources. Notwithstanding, such an undertaking may turn out complex. For instance, early physician follow‐up have not been associated with lower 30‐day RH rates in patients discharged after non‐STEMI.22. Baseline and procedural characteristics associated with unplanned RHs vary based on whether the cause of RH is cardiac or noncardiac. Interestingly, comorbidities, such as hypertension, previous stroke or transient ischemic attack, history of malignancy, and anemia, were associated only with unplanned noncardiac RHs, whereas lower left ventricular systolic function and higher MI Syntax score were associated only with unplanned cardiac RHs. A common characteristic of patients being readmitted for both cardiac and noncardiac reason was a significantly lower LDL level measured before initialization of statin ...
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Percutaneous transluminal coronary angioplasty (PTCA) is a minimally invasive procedure to open up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. Market Analysis and Insights: Global Percutaneous Translumi
JA Allen, LA Throm; Percutaneous transluminal coronary angioplasty: a new alternative for ischemic heart disease. Crit Care Nurse 1 January 1982; 2 (1): 24-29. doi: https://doi.org/10.4037/ccn1982.2.1.24. Download citation file:. ...
Background: Angiographic outcomes after percutaneous coronary intervention (PCI) for stent thrombosis (ST) have not been reported. In this study, we compared angiographic outcomes after PCI for ST between the timing of ST occurrence and between additional stenting and balloon angioplasty.. Methods: From January 2001 to October 2011, 152 patients (161 lesions) underwent PCI for definite ST. Of these patients, 134 patients (139 lesions) have survived to discharge, and we compared angiographic results between early, late, and very late ST and between addional stenting and balloon angioplasty. Angiographic follow-up was scheduled from 6 to 8 months after PCI by coronary angiography, but was performed earlier if ischemia was indicated clinically. Target lesion revascularization (TLR) was evaluated at 1 year after PCI for ST.. Results: Angiographic follow-up was performed in 113 lesions (81.3%). Serial quantitative coronary angiographic results are shown in the table. Very late ST had significantly ...
OBJECTIVE: To evaluate the effect of the waiting time for elective percutaneous transluminal coronary angioplasty (PTCA) on the primary success rate. SETTING: University hospital in The Netherlands. PATIENTS: A cohort of 817 consecutive patients awaiting elective PTCA. Scheduled PTCA was performed in all 817 patients, involving 1237 coronary lesions. MAIN OUTCOME MEASURES: The relation between procedural success and the duration of the waiting time was evaluated. Major cardiac events, that is, death and myocardial infarction while awaiting PTCA, were documented. Alterations in lesion characteristics during the waiting time were assessed in unsuccessful procedures. RESULTS: Elective PTCA was performed within one to six weeks after acceptance in 388 patients (587 lesions; 47.5%), between six and 12 weeks in 203 patients (308 lesions; 25%), and after more than 12 weeks in 226 patients (342 lesions; 27.5%). The procedural success rates in the defined time intervals were 97%, 99%, and 97% in ACC/AHA ...
BACKGROUND: Adverse cardiac event rates are higher for percutaneous coronary intervention (PCI) of bifurcation lesions. Currently, provisional stenting or a simple stenting strategy is the standard treatment for bifurcated lesions, but its performance remains limited because of a risk of side-branch (SB) closure and a higher rate of target lesion revascularization (TLR). We report a new provisional side-branch stenting strategy to treat coronary bifurcation lesions using a balloon-stent kissing technique (BSKT).. METHODS: From January 2011 to December 2012, a total of 60 patients with 60 bifurcation lesions underwent PCI using BSKT. Baseline and postprocedural quantitative coronary angiography (QCA) analyses were performed. Procedural and immediate clinical outcomes were reviewed.. RESULTS: The majority of patients presented with acute coronary syndrome (98%) and had true bifurcation lesions (98%). TIMI-3 flow was established in 100% of the main branch and SB lesions. QCA revealed preservation ...
The CVIs Cardiac Catherization Laboratory offers elective angioplasty such as stenting as well as around-the-clock availability of primary percutaneous transluminal coronary angioplasty (PTCA), a common procedure to reopen clogged or damaged coronary arteries.
Primary percutaneous coronary intervention (PCI) is currently the preferred revascularization strategy in acute trasmural myocardial infarction (AMI). In this setting, about one half of patients will be diagnosed with concomitant multivessel (MV) coronary artery disease, associated with a multitude of negative prognostic factors but also still an independent predictor of adverse cardiac events and increased long-term mortality. Since additional angiographic lesions found at primary PCI are not directly responsile for the acute presentation, their treatment represents a difficult decision-making problem in cardiology. The article summarizes available clinical data on treatment in this setting and also review our current understanding of short-term progression of atherosclerosis after AMI.. ...
TY - JOUR. T1 - Thermal-perfusion balloon coronary angioplasty. T2 - In vivo evaluation. AU - Buller, Christopher E.. AU - Culp, Stephen C.. AU - Sketch, Michael H.. AU - Phillips, Harry R.. AU - Virmani, Renu. AU - Stack, Richard S.. PY - 1993/1. Y1 - 1993/1. N2 - The goal of this study was to develop and test a new radio frequency thermal balloon system to allow longer balloon inflations at lower temperature levels than have been used with standard (laser) thermal balloon angioplasty. Radio frequency thermal capabilities were combined with perfusion balloon technology, creating a thermal-perfusion balloon catheter system for prolonged thermal inflations. Twenty-five dogs underwent thermal-perfusion angioplasty at 37°, 60°, or 80° C for 1.5, 5, or 15 minutes with angiographic and morphologic assessments at 24 hours (n = 17) or 4-6 weeks later (n = 8). Treated segments and side branches remained patent. No coronary spasm, occlusive thrombus, or ischemic myocardial infarction occurred. ...
In-hospital and late outcome of rescue versus primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction
In the past ten years, primary percutaneous coronary intervention (PCI) has replaced thrombolysis as the revascularisation strategy for many patients presenting with ST-segment elevation myocardial infarction (STEMI). However, delivery of primary PCI
Background/objectives: Endothelial progenitor cells (EPCs) are circulating mononuclear cells that are released from the bone marrow in response to injury and participate in vascular repair. Some previous studies have suggested an early mobilisation of EPCs following percutaneous coronary intervention (PCI) that could modulate the subsequent risk of restenosis or stent thrombosis. However, those studies did not discriminate between vascular injury caused by PCI and any associated myocardial injury. Myocardial injury alone can influence EPC mobilisation in a non-specific manner, and could therefore confound any association with risk. We investigated the effect of local endothelial trauma following PCI on EPC mobilisation in the absence of myocyte necrosis.. Design: We quantified circulating EPCs from 20 patients immediately before, 6 hours and 24 hours following elective PCI in patients without a 24-hour troponin rise. Absolute counts of EPCs expressing combinations of CD45, CD34, CD133 and kinase ...
MODEL RELEASED. Coronary angioplasty. Surgeon performing a coronary angioplasty procedure on a 50-year-old man. This procedure opens blocked or narrowed coronary arteries, helping to prevent a heart attack. A catheter (narrow wire) has been inserted (centre left) into a groin artery. Use of an X-ray machine (upper right) and an injection of contrast medium, highlights the coronary arteries on an X-ray screen (far right). This aids the surgeon as he passes the catheter and a stent (an expandable tube) through the bodys arteries into a narrowed coronary artery in the heart. Inflation of the catheters balloon tip expands the stent to widen and strengthen the artery. Photographed at the American Hospital of Paris, France. - Stock Image M560/0521
Intracoronary epinephrine in the treatment of refractory no-reflow after primary percutaneous coronary intervention: a retrospective study ...
Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowing (stenosis) of the coronary arteries of the heart found in coronary artery disease. After accessing the blood stream through the femoral or radial artery, the procedure uses coronary catheterization to visualise the blood vessels on X-ray imaging. After this, an interventional cardiologist can perform a coronary angioplasty, using a balloon catheter in which a deflated balloon is advanced into the obstructed artery and inflated to relieve the narrowing; certain devices such as stents can be deployed to keep the blood vessel open. Various other procedures can also be performed. Primary PCI is the very urgent use of PCI in people with acute myocardial infarction (heart attack), especially where there is evidence of severe heart damage on the electrocardiogram (ST elevation MI). PCI is also used in people after other forms of myocardial infarction or unstable angina where there is a high risk of further ...
Laser balloon angioplasty (LBA) is a technique for improving the post angioplasty result by the radial diffusion of continuous wave Neodymium:YAG laser energy to the arterial wall during the final inflation of percutaneous transluminal coronary angioplasty (PTCA). Potential mechanisms of luminal improvement include sealing of dissections, reduction of arterial recoil, desiccation of thrombus, and reduction of thrombogenicity of tissues at the luminal surface. These effects are helpful in the management of failed PTCA as defined by the presence of a greater than 50% stenosis after conventional PTCA. Preliminary data suggest that LBA may be safe and effective for the treatment of abrupt closure, with a majority of patients successfully avoiding emergency coronary artery bypass surgery. Similarly, a cohort in which the residual post-PTCA luminal diameter was less than 50% of reference diameter (n=13) was subsequently treated with LBA and demonstrated uniform success in improving luminal diameter, ...
Chest pain following successful percutaneous coronary interventions is a common problem. Although the development of chest pain after coronary interventions may be of benign character, it is disturbing to patients, relatives and hospital staff. Such pain may be indicative of acute coronary artery closure, coronary artery spasm or myocardial infarction, but may also simply reflect local coronary artery trauma. The distinction between these causes of chest pain is crucial in selecting optimal care.Management of these patients may involve repeat coronary angiography and additional intervention. Commonly, repeat coronary angiography following percutaneous transluminal coronary angioplasty (PTCA) in patients with chest pain demonstrates widely patent lesion sites suggesting that the pain was due to coronary artery spasm, coronary arterial wall stretching or was of non-cardiac origin. ...
BACKGROUND The aim of this study was to evaluate the role of remote ischemic postconditioning (RIPC) of the upper arm on protection from cardiac ischemia-reperfusion injury following primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). MATERIAL AND METHODS Eighty patients with STEMI were randomized into two groups: primary PCI (N=44) and primary PCI+RIPC (N=36). RIPC consisted of four cycles of 5 minutes of occlusion and five minutes of reperfusion by cuff inflation and deflation of the upper arm, commencing within one minute of the first PCI balloon dilatation ...
AIMS: Primary percutaneous coronary intervention (PPCI) is the optimal treatment for patients presenting with ST-elevation myocardial infarction (STEMI). An elevated index of microcirculatory resistance (IMR) reflects microvascular function and when measured after PPCI, it can predict an adverse clinical outcome. We measured coronary microvascular function in STEMI patients and compared sequential changes before and after stent implantation. METHODS AND RESULTS: In 85 STEMI patients, fractional flow reserve, coronary flow reserve, and IMR were measured using a pressure wire (Certus, St Jude Medical, St Paul, MN, USA) immediately before and after stent implantation. Stenting significantly improved all of the measured parameters of coronary physiology including IMR from 67.7 [interquartile range (IQR): 56.2-95.8] to 36.7 (IQR: 22.7-59.5), P | 0.001. However, after stenting, IMR remained elevated (|40) in 28 (32.9%) patients. In 15 of these patients (17.6% of the cohort), only a partial reduction in IMR
Until recently the assessment of alteration in myocardial metabolism in man early after an abrupt occlusion of a major coronary artery has not been feasible. PTCA however, now provides a unique...
Changes in reimbursement have put pressure on health care facilities to shift more elective percutaneous coronary interventions (PCIs) to
Coronary artery restenosis after balloon angioplasty occurs in 30% to 50% of patients. More than 50 randomized trials have failed to show a successful pharmacologic intervention, and the first 2 trials with directional atherectomy (1, 2) produced equivocal results. In these 2 stent trials, the angiographic results were remarkably similar for both post-procedural and follow-up minimum luminal diameter and percent diameter stenosis. Each showed an absolute 10% reduction in angiographic restenosis with stenting, a significant advance in this field. The clinical outcome results can be interpreted in various ways. A more negative analysis than that presented by the authors can be summarized by tabulating the results for stenting rather than angioplasty in 100 patients. In the Benestent study, 10 patients were spared repeat angioplasty at a cost of 1 extra acute coronary artery closure, 2 more bypass operations, 10 extra bleeding or vascular complications, and 540 additional acute hospital days. The ...
Although coronary-artery bypass grafting (CABG) is the standard choice of revascularization for significant left main coronary artery (LMCA) disease, percutaneous coronary intervention (PCI) for LMCA disease has been widely expanded with adoption of drug-eluting stents (DES). Several small- and moderate-sized trials of CABG and first-generation DES showed that PCI might be a good alternative for selected patients with LMCA disease. However, these early trials were relatively underpowered and comparative results of contemporary DES and CABG were clearly required. Subsequently, two large-sized trials comparing CABG and contemporary DES (EXCEL and NOBLE) were conducted, but these trials showed conflicting results with regards to the effects of PCI and CABG on clinical outcomes, which raises further uncertainty on the optimal revascularization for LMCA disease. This article serves to summarize the key findings of landmark clinical trials, to share our knowledge and experience and to express personal
The aim of this study is to evaluate the effect of pre PCI administration of intracoronary nitroprusside on post procedural myonecrosis. Myonecrosis is a prognostically important complication of PCI. Nitric oxide is a potent vasodilator in the resistance arteriolar circulation, and plays a significant role in the control of coronary blood flow through the microcirculation. nitroprussideis a direct donor of nitric oxide. A total of 62 patients were randomized into the NTP (n= 31) or control (n= 31) group. Patients who were scheduled for non-urgent PCI in de novo native coronary arteries were eligible. All patients were pretreated with statin, aspirin and clopidogrel. Myonecrosis was measured by CK-MB elevation 24 h after PCI. The NTP group received intracoronary NTP befor PCI, whereas the control group did not. All patients in NPT group received NTP for prevention of myonecrosis at a dose of at least 50 μg given intrcoronary through guiding catheter. 22 patients received 50μg,7 patients ...
Scrubbing in for my first cardiac catheterization case as a first-year fellow was exciting enough, but the added exhilaration realizing it was a left main coronary artery (LMCA) PCI was almost too much to handle! We had been taught in medical school that LMCA disease was treated only by CABG.. However, with significant advancements in the field of interventional cardiology, PCI of left main disease has evolved to have comparable outcomes with CABG in selected patients.. Background. The first LMCA PCI was performed by Andreas Gruentzig, MD, FACC, in 1978 with plain old balloon angioplasty. Subsequently, bare metal stent technology has been used and, in the contemporary era, drug-eluting stents (DES.) Adjunctive tools such as intravascular imaging with IVUS and mechanical cardiovascular support have also emerged as important tools when considering a LMCA PCI strategy.1-5. Prominent Trials Addressing LMCA PCI. SYNTAX was a landmark study comparing LMCA PCI using first-generation DES with CABG.6 The ...
TY - JOUR. T1 - Rescue percutaneous coronary intervention for graft failure immediately after coronary artery bypass grafting. T2 - Case report and review of literature. AU - Levine, Stewart. AU - Mendoza, Cesar E.. AU - Virani, Salim S.. AU - Barquet, Glenn. AU - Purow, Joshua. AU - Katariya, Kushagra. AU - Salerno, Tomas. PY - 2008/11/1. Y1 - 2008/11/1. N2 - Perioperative graft failure remains a significant problem and carries a very high morbidity and mortality in patients undergoing coronary artery bypass grafting (CABG). Different therapeutic options are available for the clinician to manage this complication. These include direct reoperation, balloon angioplasty, angioplasty along with stenting, intra-aortic balloon pumping, and conservative medical management. Immediate percutaneous coronary intervention has been reported to be a viable alternative to emergent redo CABG in these patients. Herein, we report an additional case of early graft failure immediately following CABG and review the ...
TY - JOUR. T1 - Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. AU - MRUSMI Investigators. AU - Mathias, Wilson. AU - Tsutsui, Jeane M.. AU - Tavares, Bruno G.. AU - Fava, Agostina M.. AU - Aguiar, Miguel O.D.. AU - Borges, Bruno C.. AU - Oliveira, Mucio T.. AU - Soeiro, Alexandre. AU - Nicolau, Jose C.. AU - Ribeiro, Henrique B.. AU - Chiang, Hsu Po. AU - Sbano, João C.N.. AU - Morad, Abdulrahman. AU - Goldsweig, Andrew. AU - Rochitte, Carlos E.. AU - Lopes, Bernardo B.C.. AU - Ramirez, José A.F.. AU - Kalil Filho, Roberto. AU - Porter, Thomas R.. PY - 2019/6/11. Y1 - 2019/6/11. N2 - Background: Preclinical studies have demonstrated that high mechanical index (MI)impulses from a diagnostic ultrasound transducer during an intravenous microbubble infusion (sonothrombolysis)can restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). Objectives: This study tested the clinical ...
TY - JOUR. T1 - Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis. AU - Sakuma, Tadamichi. AU - Sklenar, Jiri. AU - Leong-Poi, Howard. AU - Goodman, Norman C.. AU - Glover, David K.. AU - Kaul, Sanjiv. PY - 2004/7/1. Y1 - 2004/7/1. N2 - Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo 99mTc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Methods: Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus ...
Title:Intracoronary Injection of Glycoprotein IIb/IIIa, Abciximab, as Adjuvant Therapy in Primary Coronary Intervention. VOLUME: 11 ISSUE: 2. Author(s):Andrea Rognoni, Alessadro Lupi, Chiara Cavallino, Roberta Rosso, Alessia Veia, Sara Bacchini and Angelo Sante Bongo. Affiliation:Coronary Care Unit and Catheterization Laboratory, Hospital Maggiore della Carita, Corso Mazzini 18, 28100 Novara, Italy.. Keywords:STEMI, Acute coronary syndrome, adjuvant therapy, bleeding, GP IIb/IIIa inhibitors, in - stent restenosis, no - reflow phenomenon, percutaneous coronary intervention, platelet, thrombosis.. Abstract:Acute coronary syndromes and, in paticular, ST - segment elevation myocardial infarction are the principle causes or mortality and morbidity in the industrialized countries. The manadgement of acute myocadial infarction is much debated in the literature; primary percutaneous coronary intervention is the treatment of choice. In the recent years there has been an increasing interest in the ...
According to data from randomized, controlled trials, primary percutaneous coronary intervention (PCI) is the treatment of choice for ST-segment elevation myocardial infarction (MI). In these trials, 1 life was saved and 2 other life-threatening complications, including stroke and reinfarction, were prevented for every 50 patients with ST-segment elevation MI treated with primary PCI rather than thrombolytic therapy. Only 1 major bleeding episode occurred.. How can these superior results be realized outside the context of randomized trials? We anticipate 4 obstacles to instituting primary PCI as the universal treatment of ST-segment elevation MI: 1) lack of timely availability, 2) technical expertise of center and operator, 3) the need to address patient subgroups that are not studied in randomized trials, and 4) comparisons of primary PCI to newer pharmacologic regimens.. We propose 3 strategies to increase the availability of this procedure: 1) perform primary PCI in qualified community ...
article{af90d0aa-e201-4e8a-80ec-fd031ac8fe29, abstract = {BACKGROUND: The study aimed to investigate patient and spouse perception of cognitive functioning 1 to 2 years after coronary artery bypass grafting. METHODS: Seventy-six married patients who had undergone coronary artery bypass grafting were selected and sex- and age-matched with 75 concurrent married patients who had undergone percutaneous transluminal coronary angioplasty. Couples received a letter of explanation and then completed telephone interviews. Forty-seven questions assessed memory, concentration, general health, social functioning, and emotional state. Response choices were: improved, unchanged, or deteriorated function after coronary artery bypass grafting/percutaneous transluminal coronary angioplasty. RESULTS: Patients who had undergone coronary artery bypass grafting did not differ in subjective ratings on any measure from patients who had undergone percutaneous transluminal coronary angioplasty. There were no differences ...
Post-marketing surveillance (PMS) may identify rare serious incidents or adverse events due to the long-term use of a medical device, which was not captured in the pre-market process. Percutaneous transluminal coronary angioplasty (PTCA) is a non-surgical procedure that uses a balloon-tipped catheter to enlarge a narrowed artery. In 2011, 1,942 adverse event reports related to the use of PTCA catheters were submitted to the FDA by the manufacturers, an increase from the 883 reported in 2008. The primary research objective is to conduct a systematic review of the published and grey literature published between 2007 and 2012 for the frequency of incidents, adverse events and malfunctions associated with the use of PTCA catheters in patients with coronary artery disease (CAD). Grey literature has not been commercially published. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and PubMed for medical literature on PMS for PTCA catheters in patients with CAD published between
Successful percutaneous coronary intervention during cardiac arrest with use of an automated chest compression device: a case report Berglind Libungan, Christian Dworeck, Elmir OmerovicDepartment of Cardiology, Sahlgrenska University Hospital, Göteborg, SwedenAbstract: Ventricular tachycardia or fibrillation (VT/VF) in patients with ST-elevation myocardial infarction (STEMI) is associated with poor prognosis. Performing manual chest compressions is a serious obstacle for treatment with percutaneous coronary intervention (PCI). Here we introduce a case with refractory VT/VF where the patient was successfully treated with an automated chest compression device, which made revascularization with PCI possible.Keywords: PCI, LUCAS, STEMI, automatic chest compressions, ventricular fibrillation, mechanical CPR
In the United States, ULMCA PCI is performed primarily in patients with a high burden of comorbidities and frequently in those with high-urgency clinical presentations. In this population, in-hospital mortality was substantially higher in those with ULMCA disease who were treated percutaneously; however, this early risk is driven by those with high-urgency, rather than lower-urgency, presentations.. Among ULMCA patients selected for PCI in the United States, 30-month mortality is high (42.7%), with a predominance of cardiovascular events. These findings are especially notable when compared to the 10% mortality reported at 30 months in the MAIN-COMPARE (Korean Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) study (11), and the 4% mortality reported at 1 year in the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial (12). The increased patient age, burden of comorbidities, and ...
Pre-order Price Guarantee. Details Manual of Percutaneous Coronary Interventions: A Step by Step Approach is a practical, easy to read reference guide on how to perform percutaneous coronary intervention in non-CTO lesions. Written by recognized experts in the field, this reference compiles the necessary steps, lists pitfalls to watch out for, and provides tactics on troubleshooting percutaneous coronary interventions. Written to bring a practical and easy to read approach, this book is perfect for interventional cardiologists, interventional and general cardiology fellows, cardiology researchers, physicians, cardiac catheterization laboratory personnel, technical staff, industry professionals and anyone interested in understanding the cutting-edge and rapidly evolving field of coronary PCI.. ...
BACKGROUND: Incomplete revascularisation is common after percutaneous coronary intervention and is associated with increased mortality and adverse cardiovascular events. We aimed to assess whether adjunctive anti-ischaemic pharmacotherapy with ranolazine would improve the prognosis of patients with incomplete revascularisation after percutaneous coronary intervention.. METHODS: We performed this multicentre, randomised, parallel-group, double-blind, placebo-controlled, event-driven trial at 245 centres in 15 countries in Europe, Israel, Russia, and the USA. Patients (aged ≥18 years) with a history of chronic angina with incomplete revascularisation after percutaneous coronary intervention (defined as one or more lesions with ≥50% diameter stenosis in a coronary artery ≥2 mm diameter) were randomly assigned (1:1), via an interactive web-based block randomisation system (block sizes of ten), to receive either twice-daily oral ranolazine 1000 mg or matching placebo. Randomisation was ...
Background In ST-elevation myocardial infarction, primary percutaneous coronary intervention (PCI) has a superior clinical outcome, but it may increase costs in comparison to thrombolysis. The aim of the study was to compare costs, clinical outcome, and quality-adjusted survival between primary PCI and thrombolysis. Methods Patients with ST-elevation myocardial infarction were randomized to primary PCI with adjunctive enoxaparin and abciximab (n = 101), or to enoxaparin followed by reteplase (n = 104). Data on the use of health care resources, work loss, and health-related quality of life were collected during a 1-year period. Cost-effectiveness was determined by comparing costs and quality-adjusted survival. The joint distribution of incremental costs and quality-adjusted survival was analyzed using a nonparametric bootstrap approach. Results Clinical outcome did not differ significantly between the groups. Compared with the group treated with thrombolysis, the cost of interventions was higher ...
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TY - JOUR. T1 - Two-year outcomes after percutaneous coronary intervention of calcified lesions with drug-eluting stents. AU - Généreux, Philippe. AU - Redfors, Björn. AU - Witzenbichler, Bernhard. AU - Arsenault, Marie Pier. AU - Weisz, Giora. AU - Stuckey, Thomas D.. AU - Rinaldi, Michael J.. AU - Neumann, Franz Josef. AU - Christopher Metzger, D.. AU - Henry, Timothy D.. AU - Cox, David A.. AU - Duffy, Peter L.. AU - Mazzaferri, Ernest L.. AU - Francese, Dominic P.. AU - Marquis-Gravel, Guillaume. AU - Mintz, Gary S.. AU - Kirtane, Ajay J.. AU - Maehara, Akiko. AU - Mehran, Roxana. AU - Stone, Gregg W.. PY - 2017/3/15. Y1 - 2017/3/15. N2 - Background Percutaneous coronary intervention (PCI) of lesions with coronary arterial calcification (CAC) is common and has been historically associated with an increased risk of adverse events. Whether the association between target lesion calcification (CAC) and outcomes differ across drug-eluting stent generation or between patients with high vs. low ...
Background There are conflicting data on the clinical benefit from early administration of abciximab from a large randomized trial and a registry. However, both sources suggest that a benefit may depend on the baseline risk profile of the patients. We evaluated the role of early abciximab administration in patients with ST-segment-elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention stratified by the STEMI Thrombolysis In Myocardial Infarction (TIMI) risk score. Methods A total of 1,650 patients were enrolled into the EUROTRANSFER Registry. One thousand eighty-six patients received abciximab (66%). Abciximab was administered early in 727 patients (EA) and late in 359 patients (LA). We used the TIMI risk score for risk stratification. Patients with scores 3 constituted the high-risk group of 616 patients (56.7%), whereas 470 patients formed the low-risk cohort. Factoring in the timing of the abciximab administration resulted in 4 groups of patients who ...
Background The efficacy and safety of ticagrelor following percutaneous coronary intervention for patients with acute coronary syndrome remains unclear. This study sought to evaluate clinical outcomes of ticagrelor as part of dual-antiplatelet treatment for these patients. Methods PubMed, MEDLINE, Embase, and other Internet sources were searched for eligible citations. The primary end point was major adverse cardiovascular and cerebrovascular events, consisting of cardiovascular death, myocardial infarction, and stroke. The secondary end point was the occurrence of definite/probable stent thrombosis (ST). The risk of bleeding was chosen to be the safety end point. Results Eleven clinical trials - six randomized trials and five observational trials - were finally analyzed. A tendency toward reduction in the risk of major adverse cardiovascular and cerebrovascular events was observed only with respect to ticagrelor (OR 0.83, 95% CI 0.66-1.03; P=0
Percutaneous Coronary Intervention (PCI) can be effective in treating Coronary Artery Disease (CAD) and Angina. Learn about Percutaneous Coronary Intervention (PCI), see related evidence, and find other smart treatments for Coronary Artery Disease (CAD) and Angina at FoundHealth.
Aims: We aimed to investigate whether thrombus aspiration could preserve the index of microcirculatory resistance (IMR) after primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods and re
We performed a meta-analysis of randomized trials that compared percutaneous transluminal coronary angioplasty (PTCA) with coronary artery bypass graft (CABG) surgery in patients with multivessel coronary artery disease. The outcomes of death, combined death, and nonfatal myocardial infarction (MI), …
Patients with symptoms suggestive of an acute myocardial infarction (MI) and having electrocardiographic evidence of an acute MI manifested by ST elevations (>1 mm in two contiguous leads afterto rule out coronary vasospasm) that is considered to rep
Patients with symptoms suggestive of an acute myocardial infarction (MI) and having electrocardiographic evidence of an acute MI manifested by ST elevations (>1 mm in two contiguous leads afterto rule out coronary vasospasm) that is considered to rep
Myocardial infarction (MI) remains the most common cause of heart failure (HF) worldwide. For almost 50 years HF has been recognised as a determinant of adverse prognosis after MI, but efforts to promote myocardial repair have failed to translate into clinical therapies. Primary percutaneous coronary intervention (PPCI) has driven improved early survival after MI, but its impact on the incidence of downstream HF is debated. The effects of PPCI are confounded by the changing epidemiology of MI and HF, with an ageing patient demographic, an increasing proportion of non-ST-elevation myocardial infarction, and the recognition of HF with preserved ejection fraction. Herein we review the mechanisms of HF after MI and discuss contemporary data on its incidence and outcomes. We review current and emerging strategies for early detection of patients at risk of HF after MI, with a view to identification of patient cohorts for novel therapeutic agents.
Background Glycated hemoglobin (HbA1c) predicts clinical cardiovascular disease or cardiovascular mortality. However, the relationship between HbA1c and myocardial injury following elective percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (DM) has not been investigated. Objectives The study sought to assess the relationship between HbA1c and myocardial injury following elective PCI in patients with type 2 DM. Methods We studied a cohort of consecutive 994 diabetic patients with coronary artery disease (CAD) undergoing elective PCI. Periprocedural myocardial injury was evaluated by analysis of troponin I (cTnI). The association between preprocedural HbA1c levels and the peak values of cTnI within 24 hours after PCI was evaluated. Results Peak postprocedural cTnI |1×upper limit of normal (ULN), |3×ULN and |5×ULN were detected in 543 (54.6%), 337 (33.9%) and 245 (24.6%) respectively. In the multivariate model, higher HbA1c levels were associated with less risk of
RRH: Rural and Remote Health. Published article number: 2013 - Thrombolysis for acute ST elevation myocardial infarction: a pilot study comparing results from GP led small rural health emergency departments with results from a physician led sub-regional emergency department
I read with interest the article entitled Comparison of Percutaneous Coronary Intervention With Bare-Metal and Drug-Eluting Stents for Cardiac Allograft Vasculopathy (1). This is an interesting study showing a lower in-stent restenosis rate of patients receiving drug-eluting stents (DES) for allograft vasculopathy. There are 2 major points that need clarification. The authors did not report any statistical analysis in regards to important end points such as death, myocardial infarction, or target vessel revascularization in each group. We have to assume that these very important end points, including re-transplantation, were similar between the groups. Death and re-transplantation occurred in 34% of the entire cohort with follow-up of ,1 year. This suggests poor prognosis of patients with significant allograft vasculopathy, regardless of stent types used. This is an important observation that needs to be emphasized. The second important point concerns a major dilemma that exists between ...
This study assessed long-term clinical outcomes in diabetes mellitus patients following percutaneous coronary intervention with a second-generation drug-eluting
Objective: We hypothesised that, compared with culprit-only primary percutaneous coronary intervention (PCI), additional preventive PCI in selected patients with ST-elevation myocardial infarction with multivessel disease would not be associated with iatrogenic myocardial infarction, and would be associated with reductions in left ventricular (LV) volumes in the longer term. Methods: In the preventive angioplasty in myocardial infarction trial (PRAMI; ISRCTN73028481), cardiac magnetic resonance (CMR) was prespecified in two centres and performed (median, IQR) 3 (1, 5) and 209 (189, 957) days after primary PCI. Results: From 219 enrolled patients in two sites, 84% underwent CMR. 42 (50%) were randomised to culprit-artery-only PCI and 42 (50%) were randomised to preventive PCI. Follow-up CMR scans were available in 72 (86%) patients. There were two (4.8%) cases of procedure-related myocardial infarction in the preventive PCI group. The culprit-artery-only group had a higher proportion of anterior ...
A direct comparison of intravenous enoxaparin with unfractionated heparin in primary percutaneous coronary intervention (from the ATOLL Trial) Academic Article ...
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TY - JOUR. T1 - Comparison of effects of thrombolytic therapy followed by elective coronary intervention and direct coronary intervention in acute myocardial infarction. T2 - Usefulness of dobutamine stress echocardiography. AU - Hasegawa, K.. AU - Iwase, M.. AU - Matsuyama, H.. AU - Kimura, M.. AU - Koie, S.. AU - Kato, C.. AU - Yamamoto, H.. AU - Hatada, A.. AU - Ishii, J.. AU - Nomura, M.. AU - Watanabe, Y.. AU - Hishida, H.. PY - 1997/12/1. Y1 - 1997/12/1. N2 - The effects of intravenous administration of tissue plasminogen activator (t-PA) followed by elective percutaneous transluminal coronary angioplasty (PTCA) were compared to those of direct PTCA (d-PTCA) in patients with acute myocardial infarction using dobutamine stress echocardiography 1 week and 1 month after the acute episode. There were 12 patients in the t-PA group and nine patients in the d-PTCA group. Dobutamine was infused at incremental doses (5 μg/kg/min for each 5 min step). Wall motion changes were classified during ...
Percutaneous coronary intervention (PCI) has traditionally been used as first-line therapy for limited coronary artery disease while coronary artery bypass grafting (CABG) has been the mainstay of therapy for patients with more advanced multivessel and left main disease. With the more frequent use of PCI in patients with advanced and complex disease, there is an increasing number of patients who present for CABG who have had previous PCI. A key factor in this PCI first approach must be that the outcome of CABG is not jeopardized by a prior PCI procedure(s). The question therefore is when a patient who has had a previous PCI presents for CABG, is that patient at higher risk for the surgical procedure and subject to worse long-term outcomes than a similar patient presenting for CABG who has not had previous PCI?. It is the general sense of most practicing cardiac surgeons that many patients with 1 or especially multiple previous PCIs who present for CABG are, in fact, worse candidates than they ...
TY - JOUR. T1 - Comparison of Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusion Using Everolimus- Versus Sirolimus- Versus Paclitaxel-Eluting Stents (from the Korean National Registry of Chronic Total Occlusion Intervention). AU - Lee, Min Ho. AU - Lee, Joo M.. AU - Kang, Si Hyuck. AU - Yoon, Chang Hwan. AU - Jang, Yangsoo. AU - Yu, Cheol W.. AU - Park, Hun S.. AU - Lee, Seung Hwan. AU - Hur, Seung Ho. AU - Kim, Moo H.. AU - Rha, Seung Woon. AU - Gwon, Hyeon Cheol. AU - Chae, In Ho. AU - Kim, Hyo Soo. N1 - Funding Information: This study was supported by the Bio and Medical Technology Development Program of the National Research Foundation funded by the Ministry of Education, Science, and Technology ( 2010-0020258 ), Republic of Korea and by the Basic Science Research Program through the National Research Foundation funded by the Ministry of Education, Science, and Technology ( 2012M3A9C7050140 ), Republic of Korea. Dr. Kim is also a professor of Molecular Medicine ...