Stroke: Vascular and Interventional Neurology

JANUARY 25, 2024

Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis after multiple mechanical thrombectomy attempts. Most respondents (86%) preferred acute treatment of ICAS‐LVO with rescue stenting (RS)±angioplasty.

Atherosclerosis 40

Atherosclerosis Angioplasty Stenosis Biomarkers 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Recent research has identified venous sinus stenosis as a cause of IIH, a common treatment of which is venous stenting and angioplasty. An adverse event of this procedure is in‐stent stenosis (ISS), due to either neointimal hyperplasia or hypersensitivity to an element in the stent.

Stents 40

Stents Stent Hypertension Stenosis 40

Cardiology Update

MARCH 25, 2024

Trials included were: SYNTAX (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), NOBLE (PCI vs. CABG in the Treatment of Unprotected Left Main Stenosis), and EXCEL [Evaluation (..)

Diabetes 122

Diabetes Coronary Artery Bypass Graft Outcomes Coronary Artery Disease 122

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Treatment of ICAS‐LVO with rescue stenting and/or angioplasty has shown promising outcomes, but diagnosing ICAS‐LVO during MT can be challenging [2, 3]. Most neurointerventionalists (91%) diagnose ICAS‐LVO after a continued or recurrent occlusion or by the presence of fixed focal stenosis (FFS) after multiple MT attempts.

Atherosclerosis 40

Atherosclerosis Angioplasty Biomarkers Stents 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

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

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Stents Stent Circulation Stroke 40

Open Heart

JANUARY 31, 2022

Data were collected from the Swedish Coronary Angiography and Angioplasty Registry and Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registries. Complications and mortality were higher in patients with LMD both during CA and PCI, HR 2.9 (1.1–7.6)

Myocardial Infarction 52

Myocardial Infarction Stenosis Angioplasty Heart Disease 52

Circulation

MARCH 11, 2024

The aim of this study was to investigate outcomes in patients with left main disease with and without diabetes undergoing PCI versus CABG.METHODS:Individual patient data were pooled from 4 trials (SYNTAX [TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries], PRECOMBAT [Bypass Surgery Versus Angioplasty (..)

Coronary Artery Bypass Graft 81

Coronary Artery Bypass Graft Diabetes Coronary Artery Disease Stents 81

Dr. Smith's ECG Blog

APRIL 22, 2024

A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty. Two ECG patterns were described by the original investigators in 1982 as being consistent with a Wellens’ Syndrome prediction of high-grade LAD stenosis. Am Heart J.

Chest Pain 118

Chest Pain Myocardial Infarction Anatomy Angina 118

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Patient underwent emergent mechanical thrombectomy with ADAPT to TICI3 revascularization with future plan for possible angioplasty and stenting of R vertebral stenosis. CT perfusion was without mismatch. Subsequently admitted to neurocritical care unit and treated with dual antiplatelet therapy.

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Angioplasty Stroke Strokes Circulation 40

Dr. Anish Koka

JULY 23, 2023

Dormu performed an aortogram of the bilateral lower extremity with bilateral iliac runoff, which revealed a 90% stenosis of the right superficial femoral artery and 100% occlusion of all three tibial vessels. These studies revealed an 80% stenosis of the left superficial femoral artery and 100% occlusion of all three tibial vessels.

Vascular Care 52

Vascular Care Outpatient Peripheral Arterial Disease Stents 52

Dr. Smith's ECG Blog

SEPTEMBER 7, 2024

Angiogram --LAD is a large-caliber vessel that wraps around the apex --There is a tubular 80% in the ostial LAD that was relatively smooth but did not resolve with repeated doses of IC nitroglycerin --There is a tiny D1, medium D2, and small D3 Lesion on Prox LAD: Ostial 80% stenosis. Pre- procedure TIMI III flow was noted. Am Heart J.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Critical Care 52

DAIC

FEBRUARY 29, 2024

24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m.

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Aortic valve Myocardial Infarction Aortic Blood Pressure 103

Dr. Anish Koka

MAY 16, 2023

Marked differences can be seen in the prevalence of coronary artery stenosis at autopsy by age and gender. In 30-39 year old women the rate of coronary stenosis at autopsy was 5/1,545 (0.3%) while 60-69 year old men had a prevalence of 12%, almost 40 times higher. The results of this dataset by age and gender follow.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52

Dr. Smith's ECG Blog

APRIL 8, 2022

Cath report later that afternoon, around 25 hours since arrival: "There was a 70% proximal LAD stenosis secondary to a spontaneous coronary dissection with narrowing of the proximal LAD to at least 50% stenosis. Severe hypokinesis of the anteroseptal, anterior, inferoseptal, and apical myocardium. Normal RV function.

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

Hypertension Journal

JANUARY 19, 2024

Our findings suggest that targeting cellular mitochondrial respiration could be a novel therapeutic for patients with hypertension undergoing vascular angioplasty. A total of 36 202 cells from carotid arteries with or without balloon injury were included in single-cell RNA-sequencing analysis.

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Hypertension Blood Pressure Angioplasty Aortic 40

Dr. Smith's ECG Blog

MAY 10, 2023

LAD plaque with 0-25 percent stenosis. Given that the patient has had an abnormal elevated troponin, would suggest a Cardiology evaluation. --The LAD has moderate 40% ostial-proximal LAD stenosis and severe 90% mid LAD stenosis involving first diagonal branch. --The Now, with elevated troponins, Wellens' syndrome is likely.

Coronary Angiogram 52

Coronary Angiogram Chest Pain Stenosis Pulmonary 52

Dr. Smith's ECG Blog

JUNE 28, 2018

Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction. Wellens' original Papers : de Zwaan C, Bär FW, Wellens HJ. Am Heart J. 1982 Apr;103(4 Pt 2):730-6. de Zwaan C et al. Am Heart J. 2000 Mar;139(3):430-6.

Chest Pain 52

Chest Pain Myocardial Infarction STEMI Article 52

Dr. Smith's ECG Blog

MARCH 9, 2023

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.

Chest Pain 52

Chest Pain STEMI Myocardial Infarction Blog 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

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%

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Stenosis Angioplasty Circulation Stents 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Preliminary data has also reported the 30‐day outcomes associated with intracranial stent placement for ICAD with RO‐ZES compared to results from the Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial.

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Stents Stent Outcomes Angioplasty 40

Dr. Smith's ECG Blog

APRIL 17, 2023

Cath around 1730: Left main: normal LAD: prox LAD 30% stenosis immediately followed by a "99-100% thrombus filled occlusion" involving the proximal and mid LAD, as well as a large diagonal branch, with TIMI 1 flow pre-procedure. Cardiologist interpretation: "Technically does not meet STEMI criteria but concerning for ischemia."

Chest Pain 52

Chest Pain STEMI Document Ischemia 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

61,62) The interventional community defines occlusive LM disease as >50% by FFR, or ≥75% stenosis,(63) but urgent or emergent intervention on lesions not meeting these thresholds is only imperative if it is a thrombotic lesion and the patient has refractory ischemic symptoms (i.e. Widimsky P et al. TIMI 0/1 flow).(61,62) Knotts et al.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52