2025, Ischemia and Stents - Cardiovascular Update

Abstract WP242: Comparison Between Right and Left Transradial Approach for Carotid Artery Stenting Using a 6-French Simmons Guiding Sheath

Stroke Journal

JANUARY 30, 2025

Stroke, Volume 56, Issue Suppl_1 , Page AWP242-AWP242, February 1, 2025. To our knowledge, no studies have directly compared the right and left TRA for carotid artery stenting (CAS). Typically, the right radial artery is used in neurointerventions. All carotid stenoses were successfully dilated.

Stents

Stents Stent Aortic Interventional Cardiology

Abstract TP247: Iatrogenic Cervical Artery Dissections during Endovascular Interventions

Stroke Journal

JANUARY 30, 2025

Stroke, Volume 56, Issue Suppl_1 , Page ATP247-ATP247, February 1, 2025. Of the 32 patients, 9(28.1%) had dissection with diagnostic angiograms, 6(18.8%) endovascular thrombectomy, 15(46.9%) aneurysm treatment, and 2(6.3%) angioplasty with or without stenting. Only 4(12.5%) were treated with hyperacute stenting.

Stent

Stent Stents Angioplasty Aneurysm

Will this case be flagged for Quality Improvement in the STEMI/NSTEMI Paradigm?

Dr. Smith's ECG Blog

MARCH 27, 2025

But it was interpreted as no acute ischemia and the patient was referred to cardiology as Non-STEMI. The total occlusion was recanalized and stented from 100 to 0%. Clinical: patient alerts for refractory ischemia (refractory chest pain), and empowering nurses to advocate for patients 4. Hyperacute T-waves remain in V3 and V4.

STEMI

STEMI Chest Pain Pericarditis Ischemia

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Intravascular Imaging Can Improve Outcomes for Complex Stenting Procedures

DAIC

APRIL 2, 2025

Stone, MD Mount Sinai Health System tim.hodson Wed, 04/02/2025 - 15:26 March 31, 2025 Using intravascular imaging (IVI) to guide stent implantation during complex stenting procedures is safer and more effective for patients with severely calcified coronary artery disease than conventional angiography, the more commonly used technique.

Stents

Stents Stent Outcomes Coronary Angiogram

Glorifying FAME 3, could end up as academic mischief ! “PCI, in isolation can’t beat CABG, but with FFR it can”

Dr. S. Venkatesan MD

APRIL 8, 2025

The goal was to determine whether using FFR to identify functionally significant stenoses (FFR 0.80) for stenting, rather than relying solely on angiographic appearance. 5 years later in 2025 FAME 3 : 5 year follow up data , released in 2025, tries to confirm the non inferiorty of PCI over CABG in a larger sense. Reference 1.Fearon

Academic

Academic Coronary Artery Bypass Graft Coronary Artery Disease Stents

Abstract DP39: Short-term Outcomes of Atrial Fibrillation Patients Undergoing Carotid Stent Placement or Carotid Endarterectomy in the United States

Stroke Journal

JANUARY 30, 2025

Stroke, Volume 56, Issue Suppl_1 , Page ADP39-ADP39, February 1, 2025. Background:Patients with atrial fibrillation were excluded from clinical trials evaluating carotid artery stent(CAS) or carotid endarterectomy (CEA).We We divided patients based on presence or absence of atrial fibrillation.

Atrial Fibrillation

Atrial Fibrillation Stents Stent Outcomes

Abstract WMP93: Long-term Outcomes of Total endovascular Reconstruction of Symptomatic Internal Carotid Artery Chronic Total Occlusions: An 18-year Experience

Stroke Journal

JANUARY 30, 2025

Stroke, Volume 56, Issue Suppl_1 , Page AWMP93-AWMP93, February 1, 2025. Patients were selected based on the presence of angiographically proven symptomatic carotid occlusion, adequate landing zone and concurrent impairment of cerebrovascular reserve or recurrent ischemia despite maximal medical therapy.

Outcomes

Outcomes Stents Stent Stroke

FDA Approvals (July 2024 – January 2025): Advancements in Cardiorenal and Cardiometabolic Health

Cardiometabolic Health Congress

JANUARY 2, 2025

August 2024 Approvals Minima Stent System (P240003) (Approval Date: August 28, 2024) The Minima Stent System is an expandable cobalt-chromium metal mesh tube to reopen blood vessels in neonates, infants, and children with Coarctation of the Aorta and Pulmonary Artery Stenosis, specifically designed to expand as younger patients grow.

Coronary Artery Disease

Coronary Artery Disease Stents Stent Innovation

"Anterior" ST Depression: Which Lesion is the Culprit?

Dr. Smith's ECG Blog

MARCH 9, 2025

It is not clear by her note what she meant by this (whether or not she recognized this EKG as diagnostic of transmural ischemia, and if so, of what territory) but emergent reperfusion therapy was not pursued. The proximal and mid LAD stenoses were stented and the OM 2 was left alone. Subendocardial ischemia does not localize.

Ischemia

Ischemia Blog STEMI Coronary Angiogram

Carotid web : No longer a new kid in stroke risk

Dr. S. Venkatesan MD

JANUARY 14, 2025

Management The web can create a flow disturbance, potentiating local thrombus formation, which can embolize producing resulting in cerebral ischemia. Current treatment is with anti-thrombotics and/or anticoagulation.Lesser option is to alter the flow disturbance caused by the web (surgery or stent). 2025 Jan;110(Pt A):114-122.

Stroke

Stroke Strokes Ischemia Embolism

Is it possible that this patient with acute chest pain and this ECG does not need emergent intervention?

Dr. Smith's ECG Blog

MARCH 19, 2025

Case submitted by Andrew Grimes, Advanced Care paramedic, with additions from Jesse McLaren and Smith An 84-year-old male with a notable cardiac history (CABG, multiple stents) woke at 0500hrs with pressure in his chest, diaphoresis, and light-headedness. He had a 100% RCA occlusion which was stented.

Chest Pain

Chest Pain STEMI Stents Stent

Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Dr. Smith's ECG Blog

MARCH 25, 2025

There is low voltage in the precordium which always makes reading ischemia harder. In ACS, chest pain is the warning sign of ongoing ischemia. Smith : As Willy says, and as we've said many times before, morphine will resolve pain without resolving ischemia. ECG 1 What do you think? To me, this ECG is not diagnostic.

Chest Pain

Chest Pain Ischemia Plaque Stents

Unresponsive and Acidotic: OMI? Acute, subacute, or reperfused? What is the rhythm? Why RV dysfunction? Can CT scan help?

Dr. Smith's ECG Blog

APRIL 6, 2025

There is Transmural ischemia of Occlusion MI. Spectral CT This spectral CT image really highlights the dense transmural ischemia of the posterior wall. Here you can also see that there is dense ischemia of the RV. But I'm not sure how to explain the RV ischemia based on either ECG or angiogram.

Blood Pressure

Blood Pressure Cardiogenic Shock Ischemia Cardiac Arrest

What happens when you give morphine for chest pain in ACS? And what is pseudo-normalization of T-waves?

Dr. Smith's ECG Blog

MARCH 14, 2025

He eventually underwent CAG, where a circumflex occlusion was stented. This case highlights how T-waves are very important in the assessment of ischemia and dynamic changes in acute coronary syndrome. I have often seen colleagues worry about T-wave inversions as a sign of ongoing ischemia. Clin Cardiol [Internet].

Chest Pain

Chest Pain STEMI Myocardial Infarction Ischemia

Another MUST know ECG, and why its notoriety annoys Dr. Smith

Dr. Smith's ECG Blog

JANUARY 31, 2025

At cath there was a 100% proximal LAD occlusion, which was opened and stented. In this situation, even after the ischemia is relieved and myocardial blood flow is restored myocardial contractile function remains impaired for a variable period of time (usually days to a few weeks). Transient ischemia may lead to "stunning".

STEMI

STEMI Chest Pain Myocardial Infarction Ischemia

Sometimes a patient is fortunate to have a cardiac arrest

Dr. Smith's ECG Blog

FEBRUARY 2, 2025

Total proximal LAD occlusion was found and stented at angiography soon after the ECG above. Long term outcome is not available. == MY Comment, by K EN G RAUER, MD ( 2/1/2025 ): == We need to learn from cases like today's. Here are some images: Next morning ECG: Reperfusion findings are clear.

Cardiac Arrest

Cardiac Arrest STEMI Blog Ischemia

Acute chest pain with LBBB and obvious OMI, worsening on serial ECGs, but repeatedly missed by physicians and Marquette 12SL

Dr. Smith's ECG Blog

JANUARY 23, 2025

His triage EKG is shown below: There is left bundle branch block, so the EKG must be evaluated for ischemia by Smith-modified Sgarbossa criteria. There is evidence of transmural ischemia of the posterior wall as well. Leads V1 to V4 have down-up shaped T waves typical of ischemia and atypical of LBBB.

Chest Pain

Chest Pain Ischemia STEMI Blog

One of those ECGs you need to instantly recognize, which learners may struggle with at first

Dr. Smith's ECG Blog

JANUARY 11, 2025

He had undergone stenting of the LAD several weeks ago (unclear whether elective for stable symptoms, or in response to acute coronary syndrome). Chest Pain and Right Bundle Branch Block == MY Comment , by K EN G RAUER, MD ( 1/9 /2025 ): == As per Dr. Meyers Today's initial ECG represents a "Must Recognize!" That ( as per Dr.

Cardiogenic Shock

Cardiogenic Shock Chest Pain Tachycardia Cardiac Arrest

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Dr. Smith's ECG Blog

MARCH 8, 2025

After stent deployment, we often see improvement in the ST-T within seconds or minutes. Here is the final angiogram following placement of a stent in the ostial RCA. 2:04 PM, post stent deployment You can see that even after complete restoration of flow, the ECG still looks terrible, V most of all. & Dawson, D.

Cardiomyopathy

Cardiomyopathy Myocardial Infarction Defibrillator Bradycardia

Abstract WP242: Comparison Between Right and Left Transradial Approach for Carotid Artery Stenting Using a 6-French Simmons Guiding Sheath

Abstract TP247: Iatrogenic Cervical Artery Dissections during Endovascular Interventions

Will this case be flagged for Quality Improvement in the STEMI/NSTEMI Paradigm?

Webinars

Intravascular Imaging Can Improve Outcomes for Complex Stenting Procedures

Glorifying FAME 3, could end up as academic mischief ! “PCI, in isolation can’t beat CABG, but with FFR it can”

Abstract DP39: Short-term Outcomes of Atrial Fibrillation Patients Undergoing Carotid Stent Placement or Carotid Endarterectomy in the United States

Abstract WMP93: Long-term Outcomes of Total endovascular Reconstruction of Symptomatic Internal Carotid Artery Chronic Total Occlusions: An 18-year Experience

FDA Approvals (July 2024 – January 2025): Advancements in Cardiorenal and Cardiometabolic Health

"Anterior" ST Depression: Which Lesion is the Culprit?

Carotid web : No longer a new kid in stroke risk

Is it possible that this patient with acute chest pain and this ECG does not need emergent intervention?

Can you localize the culprit lesion on angiogram without taking ECG findings into account?

Unresponsive and Acidotic: OMI? Acute, subacute, or reperfused? What is the rhythm? Why RV dysfunction? Can CT scan help?

What happens when you give morphine for chest pain in ACS? And what is pseudo-normalization of T-waves?

Another MUST know ECG, and why its notoriety annoys Dr. Smith

Sometimes a patient is fortunate to have a cardiac arrest

Acute chest pain with LBBB and obvious OMI, worsening on serial ECGs, but repeatedly missed by physicians and Marquette 12SL

One of those ECGs you need to instantly recognize, which learners may struggle with at first

Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

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