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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.
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.
One of the biggest risk factors for patients who need coronary revascularization is diabetes, and a new study in JAMA suggests CABG could be a better option than FFR-guided PCI when it comes to long term outcomes for these patients. Patients with T2D who underwent PCI had a 44% higher MACCE risk than those who underwent CABG.
A 55 years old diabetic male patient who had 12 stents in his heart underwent a successful beating heart bypass surgery under Dr. Prateek Bhatnagar, Director Cardiac Surgery. He received these 12 stents on 5 different occasions at 5 different hospitals of the twin cities. This provides excellent long term benefits and survival.
Patients were categorized by diabetes status. Kaplan-Meier event rates, Cox model hazard ratios, and interactions were assessed.RESULTS:Among 4393 patients, 1104 (25.1%) had diabetes. PintHR=0.87) diabetes. Patients were considered suitable for either approach. and 9.9%) compared with those without (2.1%
Subjects with type 2 diabetes (T2D) have a higher risk of in-stent restenosis and stent thrombosis. The activation of the glucagon-like peptide-1 receptor (GLP-1R) has been suggested to induce several effects.
Introduction The use of contemporary drug-eluting stents (DES) has significantly improved outcomes of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). years, Diabetes mellitus 29%, acute coronary syndrome 67%, chronic total occlusion 9%). Of these, 40.9%
Food and Drug Administration ( FDA ) approval for the AGENT Drug-Coated Balloon (DCB), which is indicated to treat coronary in-stent restenosis (ISR) in patients with coronary artery disease. ISR is the obstruction or narrowing of a stented vessel by plaque or scar tissue. vs. 28.7%; P=0.006).
Introduction:Medical therapy and endovascular therapy for intracranial atherosclerotic disease (ICAD) have evolved over the past two decades with improved medical therapy benchmarks, and improved techniques and patient selection for stenting. vs 7.9%), diabetes (33.6% vs 4.6%), obesity (26.4%
suggest that the drug-coated balloon offers an effective treatment strategy for the management of coronary in-stent restenosis, or blockages recurring within previously placed stents. In particular, patients with multiple prior stents have very poor long-term outcomes.
The cohort included 14 220 patients with type 2 diabetes who underwent carotid revascularization (2669 via carotid endarterectomy and 11 551 via carotid stent insertion). ConclusionsThiazolidinedione treatment following carotid revascularization was associated with favorable cardiovascular outcomes in patients with type 2 diabetes.
IntroductionDrug‐eluting stent (DES) use in symptomatic intracranial atherosclerosis disease (ICAD) has been described in the literature using different guiding and distal access catheters. Decision was made to deploy a drug eluting stent into the stenosed M1 segment. The Phenom intermediate catheter was then removed, and the 2.25
This secondary analysis of the HOST-EXAM randomized clinical trial evaluates clopidogrel vs aspirin for long-term maintenance after percutaneous coronary intervention in patients with diabetes.
The purpose of this report is to use propensity score matching to determine gender-specific differences in clinical outcomes after percutaneous coronary interventions with polymer-free sirolimus-coated stents. vs. 2.0%; P = 0.101), however, accumulated MACE rates were higher in females than in males (5.2% vs. 3.9%; P = 0.020).
Sodium-glucose cotransporter 2 (SGLT2) inhibitor is a new oral glucose-lowering agent used in the treatment of diabetes in recent years. Restenosis is the main limiting factor of the long-term success of PCI, and it is also a difficult problem in the field of intervention.
He then discusses paclitaxel-coated balloon catheters vs uncoated balloon angioplasty for treating coronary in-stent restenosis. Eagle looks at the difference between quantitative coronary angiography versus intervascular ultrasound to guide PCI.
Patient 2 A man in his 50s with history of CAD and prior PCI, diabetes, presented with acute constant chest pain for the past few hours. His disease included 70% prox LAD, 80% distal LAD, 10% in-stent stenosis in the distal LCX, 70% OM1, 70% OM2, and 60% prox RCA. He was discharged home. Described as a dull ache, 6/10 in severity.
We evaluated patients who underwent emergent carotid artery stenting (CAS) of the ICA with mechanical thrombectomy (MT).Methods:We Background:Management of large vessel occlusion with extensive ipsilateral internal carotid artery (ICA) occlusion is unknown.
Abstract: Aim of our systematic review and meta-analysis is to compare shortened (≤3 months) dual antiplatelet therapy (DAPT) with longer DAPT in diabetic patients undergoing percutaneous coronary interventions (PCI). Thus, S-DAPT could be considered as a safe and feasible option in diabetic patients. All rights reserved.
Various risk factors, including hypertension, diabetes, hyperlipidemia, smoking, and advanced age lead to ICAS, which in turn results in stroke through different mechanisms. Herein, we focus on current management strategies for ICAS-large vessel occlusion discussed, including the use of perfusion imaging, endovascular therapy, and stenting.
P = 0.016), and diabetes (18.2% Good functional outcome was observed in 44 patients (40%). Patients with mRS score 0–2 were less likely to have hypertension (61.4% versus 83.3%;P P = 0.01), hyperlipidemia (38.6% versus 62.1%;P versus 36.4%;P P = 0.040). versus 42.2%;P P < 0.001).
IntroductionThere is a higher prevalence of diabetes mellitus type 2 in Hispanics as compared to other ethnic groups in the United States. Diabetes is a risk factor for acute ischemic stroke and also a poor predictor of outcome for many interventional surgeries. vs. 20.5%; p = 0.048) and stenting (28.4% or greater.
The overall prevalence of arterial hypertension was 33.2%, hyperlipidemia, 26.9%, smoking, 17.8%, and diabetes, 3.9%. SCAD-PCI revascularization frequently required three or more stents and had residual areas of dissection. Results The systematic review included 13 observational studies evaluating 1,801 patients with SCAD.
They also had other risk factors, including having had a previous heart attack, receiving drug treatment for diabetes or being 65 or older. The study enrolled 18,219 patients (median age 65.5 years, 74% men and 84.5%
Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." On the combined basis of angiography and IVUS, this patient received stents to his mid RCA, proximal PDA, and OM. RCA and PDA before and after, arrows indicating stented regions.
Angioplasty and stenting typically require the administration of glycoprotein IIb/IIIa inhibitors and/or dual‐antiplatelets which may increase the risk of hemorrhage in the setting of recent thrombolysis administration.MethodsWe conducted a retrospective analysis of a prospectively maintained patient registry at a comprehensive stroke center.
A 40-something with severe diabetes on dialysis and with known coronary disease presented with acute crushing chest pain. LAD: severe in-stent restenosis in the mid (80%) and distal (90%) segment and diffuse disease distally. Here is his ED ECG: What do you think? There is a flat and downsloping ST segment in V2 and V3.
Intra-procedural data included access route, coronary anatomy, lesion complexity, number of stents deployed, door-to-balloon time for primary PCI, and any intra-procedural complications. and the average number of stents 2.6. Mean age was 60.9 ± 9.4 years, and 459/567 (81.0%) were male. The total number of PCI was 367 (122.3
They also had other risk factors, including having had a previous heart attack, receiving drug treatment for diabetes or being 65 or older. The study enrolled 18,219 patients (median age 65.5 years, 74% men and 84.5%
A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. RAO Caudal View Post PCI This is the RAO Caudal view after thrombectomy and stent placement. The proximal LAD is now widely patent.
Written by Willy Frick A man in his 50s with a history of hypertension, dyslipidemia, type 2 diabetes mellitus, and prior inferior OMI status post DES to his proximal RCA 3 years prior presented to the emergency department at around 3 AM complaining of chest pain onset around 9 PM the evening prior. Peak troponin was 12 ng/mL.
Optimal management is controversial, with options including medical therapy (MT), endovascular stenting (ES), and surgical revascularization (SR). Hypertension (HTN, 85.4%) and diabetes (DM, 18.9%) were prevalent. Background:Vertebrobasilar artery stenosis (VBAS) can cause posterior circulation strokes (PCS). Mean age was 69.45
We offer a wide range of diagnostic and treatment services including: Coronary artery bypass surgery Angioplasty and stenting Heart valve surgery Pacemaker and defibrillator implantation Cardiac rehabilitation We believe every patient deserves personalized care.
The above is what I thought when I saw this, so I went to the chart and found this history: A type I diabetic aged approximately 35 years old presented with chest pain, nausea, vomiting and diffuse abdominal pain. It was stented. The patient was in DKA with an anion gap of 35, a glucose of 1128, and a K of 5.5
Our case describes a patient with right extracranial internal carotid artery (ICA) thrombus secondary to later‐diagnosed CaW on close follow‐up imaging.MethodsWe report a 55‐year‐old African American man with history of hypertension, type 2 diabetes mellitus and hyperlipidemia presented with acute onset slurred speech and left facial droop (FP).
link] A 62 year old man with a history of hypertension, type 2 diabetes mellitus, and carotid artery stenosis called 911 at 9:30 in the morning with complaint of chest pain. The image on the left shows the LAD before intervention, and the red circled portion on the right indicates the stented region.
Pulse was 115, BP 140/65, and afebrile He was found to have cellulitis and to be in diabetic ketoacidosis, with bicarb of 14, pH of 2.27, glucose of 381, anion gap of 18, and lactate of 2.2 Previously placed stents in the LAD (multiple) and mid circumflex and patent Formal echocardiogram: Normal left ventricular size and wall thickness.
This 57 yo diabetic male presented with generalized fatigue, myalgias, and arthralgias , mild subjective fever and chills, and nausea. This 42 yo diabetic male presented with cough and foot pain. An open 90% LAD was stented. Preservation of R-wave may mean and initial Q-wave followed by an R-wave (this is called a QR-wave.
As age advances and depending on risk factors like heredity, smoking, high blood pressure and diabetes, fat build up occurs in these blood vessels. Bypass surgery certainly provides much better long term results than balloon angioplasty and stent insertion. Coronary arteries are blood vessels supplying oxygenated blood to the heart.
February 2024 FDA Approvals: Innovations in Cardiovascular Interventions XACT Carotid Stent System (Approved: 02/07/2024) This approval expands the indications to be used during a Transcarotid Artery Revascularization (TCAR) procedure to prevent future strokes. Until this historic approval, no treatment existed.
Written by Destiny Folk, MD, Adam Engberg, MD, and Vitaliy Belyshev MD A man in his early 60s with a past medical history of hypertension, type 2 diabetes, obesity, and hyperlipidemia presented to the emergency department for evaluation of chest pain. The culprit mid LAD lesion was stented. Chest Pain – Benign Early Repol or OMI?
Blood Sugar Management and Blood Pressure Control – For individuals with diabetes, managing blood sugar levels and blood pressure is essential in preventing complications and managing PAD. Angioplasty and stenting are common interventions to widen narrowed arteries and improve blood flow.
INFINITY-SWEDEHEART Trial: This randomized controlled trial, developed by Elixir Medical, compared the DynamX® Coronary Bioadaptor System with the Resolute Onyx drug-eluting stent.
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