Angioplasty, Circulation and Outcomes

Abstract 225: Rescue Stenting for Posterior Circulation Strokes

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionIntracranial atherosclerotic disease (ICAD) is associated with up to 32% of posterior circulation strokes.1 Rescue treatment with stenting, balloon angioplasty, and/or intraarterial thrombolysis or antiplatelets are often required to treat the underlying stenosis.

Stents

Stents Stent Circulation Stroke

Two-Year Clinical Outcomes in Female and Male Patients After Sirolimus-Coated Balloon Angioplasty for Coronary Artery Disease

Circulation: Cardiovascular Interventions

APRIL 2, 2025

Circulation: Cardiovascular Interventions, Ahead of Print.

Coronary Artery Disease

Coronary Artery Disease Angioplasty Cardiovascular Interventions Circulation

Abstract WP179: Clinical Outcomes in Acute Stroke in Patients Undergoing Emergency Intracranial Stenting Receiving IV Thrombolysis

Stroke Journal

FEBRUARY 1, 2024

In cases of stent-retriever thrombectomy failure, rescue stent angioplasty might be the sole option for achieving permanent recanalization. We defined two binary outcomes: (1) functional clinical outcome (modified Rankin Scale 0-2) and (2) early symptomatic intracerebral hemorrhage (sICH). 10.43, p=0.0325).Conclusions:The

Stents

Stents Stent Thrombolysis Angioplasty

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Abstract TMP58: Impact of DWI-ADC Mismatch on Infarct Progression and Endovascular Thrombectomy Outcomes in Acute Stroke

Stroke Journal

JANUARY 30, 2025

We compared demographics, radiological findings, clinical outcomes, and follow-up results between mismatch and no mismatch groups.Results:Among 73 patients, 20 (27.4%) had DWI-ADC mismatch. Follow-up lesion volumes and functional outcomes were similar; however, the mismatch group showed a slower infarct growth rate (3.8 ml/h vs. 7.5

Outcomes

Outcomes Stroke Strokes Angioplasty

Abstract TMP94: Association of Acute Carotid Stenting With Functional Outcome Mediated by Excellent Reperfusion in Tandem Lesions: Analysis of a Multicenter Registry

Stroke Journal

FEBRUARY 1, 2024

Introduction:Current evidence suggests that acute carotid artery stenting (CAS) for cervical lesions is associated with better functional outcomes in patients with acute stroke with tandem lesions (TLs) treated with endovascular treatment (EVT). p=<0.001). p=<0.001).

Stents

Stents Stent Outcomes Angioplasty

Abstract 076: 2023 Fusarium Meningitis Outbreak: Neuroendovascular Outcomes and Observations of the Angioinvasive Disease from South Texas

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

The aneurysms were seen exclusively in the posterior circulation. With regard to vasospasm treatment, 80% had treatment with intra‐arterial verapamil and 40% underwent mechanical angioplasty. We did not perform balloon angioplasty in any case due to concern for rupture of the weakened compromised vessel walls.

Aneurysm

Aneurysm Angioplasty Hemorrhage Outcomes

Abstract 158: Rescue Strategy for Failed Mechanical Thrombectomy in Acute Ischemic Stroke: An Analysis of the SVIN Registry

Stroke Journal

FEBRUARY 1, 2024

We aimed to evaluate the association between RS with functional outcomes compared to medical management (MM) in patients who underwent failed MT.Methods:This is a cross-sectional study using prospectively collected data from the Society of Vascular and Interventional Neurology (SVIN) Registry from 2018 to 2021.

Angioplasty

Angioplasty Stroke Strokes Stent

Abstract 231: Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke:An Analysis of the SVIN Registry

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Rescue strategies options, including balloon angioplasty alone, rescue stenting (RS) alone, or stent with balloon angioplasty, have shown promise in observational studies and meta‐analyses [3, 4]. The primary efficacy outcome was the shift in the degree of disability, as measured by the modified Rankin Scale (mRS), at 90 days.

Stents

Stents Stent Angioplasty Thrombolysis

Abstract 4136687: VTRNA2-1 Promoter Methylation as a Prognostic Biomarker in Peripheral Artery Disease: Implications for Maternal Nutritional Influence

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4136687-A4136687, November 12, 2024. Inclusion criteria included adults over 20 years old, consent to participate, and a requirement for angioplasty. Furthermore, the abundance of methylation of the VTRNA2-1 promoter is associated with glucose metabolism and cell aging. 4.42, p=0.027).

Peripheral Arterial Disease

Peripheral Arterial Disease Biomarkers Angioplasty Atherosclerosis

Abstract TP247: Iatrogenic Cervical Artery Dissections during Endovascular Interventions

Stroke Journal

JANUARY 30, 2025

Due to the rarity of iatrogenic CeAD, existing literature on management and outcomes is limited. 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.

Stents

Stents Stent Angioplasty Aneurysm

Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4140682-A4140682, November 12, 2024. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. Introduction:Dextrocardia is a rare congenital condition where the heart's apex points to the right, with an incidence of about 0.01%.

Coronary Artery Disease

Coronary Artery Disease Angioplasty Anatomy Angina

Abstract 107: Endovascular Therapy for Tandem Vertebral and Basilar Artery Occlusion in a Patient with Low NIHSS

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

1,2 The National Institute of Health Stroke Scale (NIHSS) cutoff for poor outcomes is lower in BAO compared to anterior circulation large vessel occlusions (LVO) due to the scale’s weighted scoring towards cortical signs.3,4 3,4 To bridge this gap, Alemseged et.al 3,4 To bridge this gap, Alemseged et.al

Angioplasty

Angioplasty Stroke Strokes Circulation

A Relatively Narrow Complex Tachycardia at a Rate of 180.

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

There was a good outcome. We believe this represents a form of “toxicomythology” given the millions of doses of beta -blockers administered in the past to patients with hyperadrenergic states, and a paucity of evidence of adverse outcomes (12). This would treat both SVT or sinus tachycardia. Later, he was found to have used cocaine.

Tachycardia

Tachycardia Chest Pain Pharmacology Myocardial Infarction

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

OCTOBER 26, 2011

Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome. Circulation 1999;99(15):1972-7. Circulation 2000;101(2):125-30. Circulation 1998;97(23):2303-6.

STEMI

STEMI Chest Pain Myocardial Infarction Angioplasty

First ED ECG is Wellens' (pain free). What do you think the prehospital ECG showed (with pain)?

Dr. Smith's ECG Blog

MARCH 9, 2013

I have seen cases of Wellens' syndrome that were ignored because of either negative troponins or normal echo or both and the patient did not get an angiogram and had a bad outcome. A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty.

Chest Pain

Chest Pain Myocardial Infarction Ischemia Angina

Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

AUGUST 3, 2017

New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction. Circulation. These patients had worse outcomes than patients with ST depression without occlusion; half of these were circumflex. Neth Heart J. O'Gara et al.

Chest Pain

Chest Pain Myocardial Infarction STEMI Ischemia

A man in his 50s with chest pain

Dr. Smith's ECG Blog

MARCH 9, 2023

Do you think his long term outcome will be as good as if his OMI were recognized appropriately on arrival, 1.5 Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials. Circulation.

Chest Pain

Chest Pain STEMI Myocardial Infarction Blog

Impact of Diabetes on Outcomes in Left Main Coronary Revascularization: PCI vs. CABG

Cardiology Update

MARCH 25, 2024

Left main coronary artery disease (CAD) and diabetes pose significant challenges in cardiovascular care, often leading to adverse outcomes. Preliminary evidence from trials focusing on patients with multivessel disease has hinted at diabetes as a potential modifier of treatment outcomes.

Diabetes

Diabetes Coronary Artery Bypass Graft Outcomes Coronary Artery Disease

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With or Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials

Circulation

MARCH 11, 2024

Circulation, Ahead of Print. BACKGROUND:Diabetes may be associated with differential outcomes in patients undergoing left main coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).

Coronary Artery Bypass Graft

Coronary Artery Bypass Graft Diabetes Coronary Artery Disease Stent

Chest Pain and Right Bundle Branch Block

Dr. Smith's ECG Blog

NOVEMBER 19, 2014

It is highly associated with proximal LAD occlusion and bad outcomes. He could not be resuscitated in the ED but was taken to the cath lab while on LUCAS (mechanical) CPR , underwent successful PCI of a proximal LAD occlusion during chest compression, and after opening the artery, achieved ROSC (return of spontaneous circulation).

Chest Pain

Chest Pain Cardiac Arrest Myocardial Infarction Angioplasty

Five-Year Safety and Effectiveness of Paclitaxel Drug-Coated Balloons Alone or With Provisional Bare Metal Stenting for Real-World Femoropopliteal Lesions: IN.PACT Global Study Subgroup Analysis

Circulation: Cardiovascular Interventions

FEBRUARY 13, 2024

Circulation: Cardiovascular Interventions, Ahead of Print. BACKGROUND:The treatment of complex infra-inguinal disease with drug-coated balloons (DCBs) is associated with a significant number of patients undergoing provisional stenting to treat a suboptimal result. stented versus 45.0% stented versus 19.3% nonstented, log-rankP=0.99).CONCLUSIONS:In

Stents

Stents Stent Angioplasty Cardiovascular Interventions

Abstract 4139207: Supraselective Administration of Very Low-dose Intracoronary Epinephrine as a Rescue and First-line Drug for the Management of No-reflow in Conjunction With the IIB-IIIA Inhibitor Tirofiban.

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4139207-A4139207, November 12, 2024. to 10% of percutaneous coronary interventions (PCI), no-reflow is a complication associated with poor outcomes like myocardial infarction extension and death. Background:Occurring in 0.6% years, and 8 out of 9 patients were male.

Myocardial Infarction

Myocardial Infarction Angioplasty Pulmonary Arrhythmia

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

AUGUST 9, 2019

Below are 6 anecdotal cases of true complete left main occlusion with no collateral circulation: 3 have STE in aVR 1 has no ST shift in aVR 2 have STD in aVR The ECG can have a variety of presentations in LM Occlusion. You'll see that there is collateral circulation from the RCA. Widimsky P et al. Below is the angiogram.

Myocardial Infarction

Myocardial Infarction Ischemia STEMI Cardiogenic Shock

The First 60 Minutes of a Heart Attack: The Golden Hour

Wellnest

JULY 19, 2023

It is imperative to act swiftly when faced with such a medical emergency to ensure the best possible outcome. This indicates that restoring normal blood circulation as quickly as possible will result in less damage. Allow the chest to rise between each compression to ensure proper circulation fully. Perform rescue breaths twice.

Heart Attack

Heart Attack Heart attacks Blood Pressure Myocardial Infarction

Cardiovascular Update

Abstract 225: Rescue Stenting for Posterior Circulation Strokes

Two-Year Clinical Outcomes in Female and Male Patients After Sirolimus-Coated Balloon Angioplasty for Coronary Artery Disease

Abstract WP179: Clinical Outcomes in Acute Stroke in Patients Undergoing Emergency Intracranial Stenting Receiving IV Thrombolysis

Webinars

Abstract TMP58: Impact of DWI-ADC Mismatch on Infarct Progression and Endovascular Thrombectomy Outcomes in Acute Stroke

Abstract TMP94: Association of Acute Carotid Stenting With Functional Outcome Mediated by Excellent Reperfusion in Tandem Lesions: Analysis of a Multicenter Registry

Abstract 076: 2023 Fusarium Meningitis Outbreak: Neuroendovascular Outcomes and Observations of the Angioinvasive Disease from South Texas

Abstract 158: Rescue Strategy for Failed Mechanical Thrombectomy in Acute Ischemic Stroke: An Analysis of the SVIN Registry

Abstract 231: Rescue Stenting for Failed Mechanical Thrombectomy in Acute Ischemic Stroke:An Analysis of the SVIN Registry

Abstract 4136687: VTRNA2-1 Promoter Methylation as a Prognostic Biomarker in Peripheral Artery Disease: Implications for Maternal Nutritional Influence

Abstract TP247: Iatrogenic Cervical Artery Dissections during Endovascular Interventions

Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Abstract 107: Endovascular Therapy for Tandem Vertebral and Basilar Artery Occlusion in a Patient with Low NIHSS

A Relatively Narrow Complex Tachycardia at a Rate of 180.

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

First ED ECG is Wellens' (pain free). What do you think the prehospital ECG showed (with pain)?

Right precordial ST depression in a patient with chest pain

A man in his 50s with chest pain

Impact of Diabetes on Outcomes in Left Main Coronary Revascularization: PCI vs. CABG

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With or Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials

Chest Pain and Right Bundle Branch Block

Five-Year Safety and Effectiveness of Paclitaxel Drug-Coated Balloons Alone or With Provisional Bare Metal Stenting for Real-World Femoropopliteal Lesions: IN.PACT Global Study Subgroup Analysis

Abstract 4139207: Supraselective Administration of Very Low-dose Intracoronary Epinephrine as a Rescue and First-line Drug for the Management of No-reflow in Conjunction With the IIB-IIIA Inhibitor Tirofiban.

How does Acute Total Left Main Coronary occlusion present on the ECG?

The First 60 Minutes of a Heart Attack: The Golden Hour

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