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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.
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. FAME series , though never had an intention to compare PCI vs CABG , now we have used the platform to upend it to take on the CABG in multivessel CAD.
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).
Our Interventional Cardiology Fellowship Program offers a unique opportunity for fellows to immerse themselves in high-volume centers and experience complex procedures such as angioplasties, stent placements, and Chronic Total Occlusion (CTO) interventions.
Drug‐eluting stents have been shown to be superior to bare‐metal stents in patients with HBR, even when patients were given abbreviated periods of dual antiplatelet therapy (DAPT). Short DAPT has not been evaluated with the EluNIR ridaforolimus‐eluting stent. presented with acute coronary syndrome; 33.7%
BACKGROUND:In patients with post-thrombotic syndrome, stent recanalization of iliofemoral veins or the inferior vena cava can restore venous patency and improve functional outcomes. The risk of stent thrombosis is particularly increased during the first 6 months after intervention.
3.30]) and subacute definite or probable stent thrombosis (0.58% and 0.17%; hazard ratio, 3.40 [95% CI, 1.26–9.23]) mg/day) monotherapy or to DAPT with aspirin (81–100 mg/day) and prasugrel (3.75 mg/day) after loading of 20 mg of prasugrel in both groups. years; men, 76.6%; acute coronary syndrome, 75.0%).
Doctors then treat the cause of the heart attack, either inserting a stent, removing a clot or taking other necessary action. The NCSI study involved cardiologists at both community hospitals, where many patients with heart attack first present, and large academic centers.
Bleeding events were defined as any bleeding based on the Valve Academic Research Consortium-2 consensus document at 1 year. Patterns of Non-adherence to Anti-Platelet Regimen in Stented Patients (PARIS) and Coronary Revascularisation Demonstrating Outcome Study in Kyoto (CREDO-Kyoto) integer scoring systems were tested.
The primary efficacy objective was to demonstrate superiority of PPA to reduce the primary efficacy end point of all-cause death, nonfatal myocardial infarction, nonfatal stroke, stent thrombosis (definite), or urgent revascularization (any vessel) within 30 days.
The primary outcome was major adverse cardiac and cerebrovascular event (MACCE), namely a composite of death from cardiovascular causes, myocardial infarction (MI), stroke, stent thrombosis within 12 month. The secondary outcome was Bleeding Academic Research Consortium (BARC) scale bleeding events within 12 months.
Past medical history includes coronary stenting 17 years prior. If you take old people with a history of MI (he had a stent), that percentage goes far higher since there is scar tissue that acts as a nidus for the PVCs that initiate VT. Definitive diagnosis that ECG #1 is in fact VT is more than academic.
Based on these results, Dormu performed a percutaneous transluminal balloon angioplasty and a mechanical atherectomy and stenting of the right superficial femoral artery and stenting of the right superficial femoral artery. Another superficial femoral artery stent was placed as well. All stents were occluded. 4.2.2017.
12.6), the rate of complete occlusion was 75.2% (91/121), ≥50% in-stent stenosis 7% (9/129), and retreatment 0.8% (1/129). Analysis included patients with unruptured wide-necked saccular aneurysms (not previously treated), measuring <12 mm along the ICA segments. Successful implantation was encountered in 99% (128/129) of the cases.
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 reappearance of de Winter's pattern caused by acute stent thrombosis: A case report. Am J Emerg Med. 2014;32:e5–e8. As per Drs.
Only 24 patients received intravenous thrombolytics (5.3%) and 47 had stent placement (10.4%). A total of 3 separate groups, low‐dose ticagrelor (45 mg or 60 mg twice a day), full‐dose ticagrelor (90 mg twice a day) and clopidogrel (75 mg daily) were created. Out of 445 patients, 288 were on aspirin 81 mg at time of discharge.
We recorded an ECG in which V1-V3 were put in the position of V4R-V6R, and V4-6 were placed in V7-9 to (academically) confirm posterior OMI. I say academically because the STD in V2 is diagnostic -- posterior leads are NOT necessary. Angiogram: Culprit Lesion (s): Thrombotic occlusion of the proximal RCA -- stented. What to do?
He was found to have a 100% circumflex lesion for which a bare metal stent was placed. Academic Emergency Medicine 24(1):120-124. It is not subtle any more. Interventional cardiology was consulted and patient was taken to the cath lab. Imagine if this patient had been at a busy triage and they trusted the computer interpretation.
Here is the angiogram after stent placement. Academic Emergency Medicine 27(S1): S220; May 2020. There is so-called contrast "hangup" in the thrombus which remains from a prior injection, such that it is visible even before injection on this particular clip. The thrombus is circled in red below. The patient suffered a large infarct.
He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily. Here is the time-zero 12 Lead ECG.
For a detailed review of deWinter OMI visit this post-- [link] Dr. Stephen Smith provides an academic hypothesis concerning the true underlying physiology of deWinter occlusion here-- [link] The clinical significance of HATW's can be found here-- [link] Crews administered 324 mg of ASA and a total of 0.12
The primary superiority endpoint was clinically relevant bleeding (Bleeding Academic Research Consortium [known as BARC] types 2, 3, or 5). The primary non-inferiority endpoint was MACCE (a composite of cardiac death, MI, ischaemic stroke, stent thrombosis, or target vessel revascularisation).
Academic Emergency Medicine 27(S1): S220. A single DES stent was placed, and the patient did well post-procedure. Association between opioid analgesia and delays to cardiac catheterization of patients with occlusion Myocardial Infarctions. Abstract 556. Most other arteries had scattered 20-30% stenoses.
In their haste to hyperventilate about MINOCA, the authors don’t highlight the high percentage of cardiac interventions that are needed in patients with conventional, common epicardial disease - 80% need a coronary stent and 10% need open heart surgery. But these are words you won’t find in the chest pain guidelines of 2023.
I limit my comments to a number of academic and semantic concepts relating to the arrhythmia in this case: What is an “SVT”? Serial troponin T measurements rose from zero to 2.80 ng/mL over the next 10 hours. Here is the ECG after intervention: Persistent STE in III and aVF, with persistent STD in V2-V5.
In the present study, we investigated clinical and procedural characteristics predictive of MT success and failure.MethodsWe conducted a retrospective analysis of MT patients with LVO presenting to our academic comprehensive stroke center from 2015‐2020. Recanalization failure was defined as TICI 0‐2a and success as TICI 2b‐3.
History of diabetes type II and stent placement in 2018. Here it is: Obvious inferior OMI, and now the STE in V1 is huge, with huge hyperacute T-waves of Right ventricular OMI The cath lab was re-activated: Angiogram: 100% occlusion mid-RCA occlusion (in-stent thrombosis). What do you think? I responded: "Definite inferior OMI.
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.
It is used widely in pre- or post-PCI or even asssit during the implantation of stents. Of course, there were some overuse of OCT as well, as many centers did it for some academic fun, even in some innocuous lesions. Optical coherence tomography (OCT) in secondary revascularisation: stent and graft assessment. Reference 1.
Welcome to 2025 and best wishes for a great academic journey to all readers. Collected from ACC website (Arranged in three heading) These are the creamy academic extract of whatever happened over the last one year. It is asking for stenting all non-flow limiting lesion , if found, to carry high risk plaques by intracoronary Imaging.
He eventually underwent CAG, where a circumflex occlusion was stented. Academic Emergency Medicine 27(S1): S220; May 2020. ECG #3 is easily recognized as OMI and the AI model recommends immediate revascularization The patient in today's case received suboptimal care and suffered a substantial myocardial infarction. Abstract 556.
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