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In a recent study published in Circulation , examined how diabetes influences outcomes in left main coronary revascularization procedures, specifically PCI versus CABG, is crucial for tailored treatment strategies. Circulation. Original article: Gaba P et al. 2024;149:00–00.
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.
Background:In stroke patients undergoing EVT, angioplasty and stenting (A&S) has been described as a bailout technique when thrombectomy fails or intracranial stenosis is suspected. Stroke, Volume 55, Issue Suppl_1 , Page AWMP88-AWMP88, February 1, 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).
ml/h, P = 0.04), a higher likelihood of parent artery stenosis (65% vs. 20.8%, P < 0.001), and increased need for angioplasty or stenting (50% vs. 17%, P < 0.001). 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
Circulation, Volume 150, Issue Suppl_1 , Page A4140682-A4140682, November 12, 2024. The left circumflex had 80% proximal stenosis with minimal luminal irregularities in the mid to distal portion. After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed.
Options include initial angioplasty and/or stenting of the cervical lesion followed by intracranial thrombectomy versus Dotter navigation of catheters through the cervical lesion to first target the intracranial LVO. The degree of cervical ICA stenosis following thrombectomy improved from 96.5%
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 CT perfusion was without mismatch.
All of Wellens' cases in his studies (1, 2) had all of: 1) preserved R-waves 2) resolution of pain 3) restored flow to the anterior wall through either a) an open artery or b) collateral circulation. Am Heart J (1989) 117 : pp 657-665. de Zwaan C., Wellens H.J.J., Am Heart J (1982) 103 : pp 730-736. Doevendans P.A., Gorgels A.P., Wehrens X.H.,
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. Knotts et al.
Note that this obvious STEMI does not have 100% stenosis at the time of cath. 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. 2001;104:636–641.
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