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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.
Smits and a distinguished team of international researchers, the trial compares the performance of SMT's biodegradable-polymer sirolimus-eluting Supraflex Cruz stent with the biodegradable-polymer Ultimaster Tansei * stent in patients with high bleeding risk (HBR) undergoing abbreviated dual antiplatelet therapy (DAPT).
In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished. First , there can simply be diffuse ST depressions (which obligates reciprocal STE in aVR) associated with tachycardia which are not indicative of ischemia.
A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. The baseline ECG is basically normal with no ischemia. In my opinion, I think it looks more like subendocardial ischemia.
I do not think this ECG is by itself diagnostic of OMI (full thickness, subepicardial ischemia ), b ut comparison to a previous might reveal this ECG as diagnostic of OMI. Academic Emergency Medicine 27(S1): S220. A single DES stent was placed, and the patient did well post-procedure. Abstract 556.
The diagnosis typically requires classic clinical features, with no evidence of obstructive coronary disease, and typical findings of ischemia on functional studies. This happens. But its rare! A clinician with any grasp on reality would work up men, on average, more aggressively for coronary disease than women.
It is a strange academic habit among cardiologists, that they have subdivided medical management into optimal and suboptimal. otherwise, if you keep getting even the slightest doubt and anxiety over the hidden blocks, go for a stent immediately at a good Institution. (My Academic lessons from this patient.
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. Abstract 556.
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