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. 4 Recent literature has reported clinical benefits associated with rescue stenting in the setting of ICAD‐related MT‐refractory strokes.5

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Stents Stent Circulation Strokes 40

DAIC

FEBRUARY 14, 2024

Diseased human arteries are most simply, reliably, and successfully treated with drug-eluting, balloon-expandable stents," said Lewis B. 2 An estimated 10% of patients with PAOD have its most severe form: chronic limb-threatening ischemia (CLTI). Given this dismal outcome, the prognosis of CLTI is worse than most cancers.3,4

Heart attacks 111

Heart attacks Heart Attack Peripheral Arterial Disease Ischemia 111

DAIC

MARCH 20, 2024

The Freesolve BTK RMS is designed for individuals suffering from chronic limb-threatening ischemia (CLTI). Our next generation RMS represents a leap forward over existing resorbable technology, incorporating technical innovations intended to address physicians' needs and optimize outcomes for patients suffering from CLTI.”

Peripheral Arterial Disease 105

Peripheral Arterial Disease Innovation Technology Coronary Artery Disease 105

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

In some cases the ischemia can be seen "through" the flutter waves, whereas in other cases the arrhythmia must be terminated before the ischemia can be clearly distinguished. First , there can simply be diffuse ST depressions (which obligates reciprocal STE in aVR) associated with tachycardia which are not indicative of ischemia.

Ischemia 52

Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Stroke Journal

JANUARY 30, 2025

Background:Patients with atrial fibrillation were excluded from clinical trials evaluating carotid artery stent(CAS) or carotid endarterectomy (CEA).We Background:Patients with atrial fibrillation were excluded from clinical trials evaluating carotid artery stent(CAS) or carotid endarterectomy (CEA).We

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Atrial Fibrillation Stents Stent Outcomes 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Herein, we describe a single‐step approach to deploy Neuroform Atlas stent (Stryker Neurovascular, Fremont, CA) which is a hybrid laser‐cut, nitinol self‐expanding stent without the need for ELW or lesion re‐access using MINI TREK RX (Abbott Vascular, Inc., There was no restriction on time from last known well (TLKW) to MT.

Angioplasty 40

Angioplasty Stents Stent Stroke 40

DAIC

MAY 14, 2024

The benefits of QFR guidance are supported in a recent study that showed that a QFR-guided strategy of lesion selection for PCI improved two-year clinical outcomes, including reduction in myocardial infraction and ischemia-driven revascularization, when compared with standard angiography guidance alone.2 Accessed May 2024.

Coronary Artery Disease 111

Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Stroke Journal

JANUARY 30, 2025

To our knowledge, no studies have directly compared the right and left TRA for carotid artery stenting (CAS). We analyzed patient characteristics, clinical outcomes, and the presence of lesions on postprocedural diffusion-weighted imaging (DWI lesions).Results:A Patients who underwent proximal balloon-protected CAS were excluded.

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Stents Stent Aortic Interventional Cardiology 40

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

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 baseline ECG is basically normal with no ischemia. In my opinion, I think it looks more like subendocardial ischemia.

Chest Pain 82

Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 82

All About Cardiovascular System and Disorders

APRIL 21, 2024

indicates inducible ischemia while an FFR above 0.80 excludes ischemia in 90% of cases. If the FFR normalizes after stenting, the restenosis rates at six months is less than 5%. If the FFR normalizes after stenting, the restenosis rates at six months is less than 5%. Normal FFR is 1.0 and an FFR below 0.75 in the study.

Myocardial Infarction 52

Myocardial Infarction Stents Stent Coronary Artery Disease 52

Dr. Smith's ECG Blog

AUGUST 6, 2024

In any case, the ECG is diagnostic of severe ischemia and probably OMI. So this could be myocarditis but in my opinion needs an angiogram before making that diagnosis. == Dr. Nossen Comment/Interpretation: Evaluation of ischemia on an ECG can be very challenging. Concordant STE of 1 mm in just one lead or 2a.

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Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

JULY 14, 2024

The cath lab was activated, and then not cancelled, and the angiogram showed 99% TIMI 2 flow proximal LAD culprit lesion, stented in less than 90 minutes of arrival. Outcome of case 2? Cath days later showed complete occlusion of the LAD, stented. Normal vitals. This one, too, is a swirl pattern and diagnostic of LAD occlusion.

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AFIB Stents Stent Chest Pain 105

Dr. Smith's ECG Blog

JUNE 23, 2024

This was interpreted by the treating clinicians as not showing any evidence of ischemia. Given the presentation, the cardiologist stented the vessel and the patient returned to the ICU for ongoing critical care. He was intubated in the field and sedated upon arrival at the hospital. Two subsequent troponins were down trending.

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Chest Pain Cardiac Arrest Sudden Cardiac Death Blog 118

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

IntroductionThe optimal endovascular approach for wide‐neck intracranial aneurysms (IAs) during the acute phase of bleeding remains uncertain, and the use of stent‐assisted coiling or flow diversion is controversial due to antiplatelet therapy requirements and potential risks (1, 2). Of the patients, 60.5%

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Aneurysm Outcomes Hemorrhage Stents 40

Stroke: Vascular and Interventional Neurology

FEBRUARY 15, 2024

BACKGROUNDThe optimal endovascular approach for acutely ruptured wide‐neck intracranial aneurysms remains uncertain, and the use of stent‐assisted coiling or flow diversion is controversial due to antiplatelet therapy requirements and potential risks. Stroke: Vascular and Interventional Neurology, Ahead of Print. Of the patients, 60.5%

Aneurysm 40

Aneurysm Outcomes Hemorrhage Stents 40

Stroke Journal

JANUARY 30, 2025

Total endovascular reconstruction (TER) is increasingly feasible but mid-term and long-term outcomes have not been reported.Methods:Data from all patients treated with carotid CTO treated with TER over the past 18years were collected in a database.

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Outcomes Stents Stent Strokes 40

Dr. Smith's ECG Blog

OCTOBER 8, 2023

ECG#1 ECG#2 ECG#3 ECG#4 ECG#5 See outcomes of all 5 below, with the Queen of Hearts AI Bot interpretation. The patient was referred immediately for cath which revealed RCA occlusion that was stented. Remember, in diffuse subendocardial ischemia with widespread ST-depression there may b e ST-E in lead s aVR and V1.

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Ischemia Chest Pain Cardiogenic Shock Cardiac Arrest 122

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. Only 4(12.5%) were treated with hyperacute stenting.

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Stents Stent Angioplasty Aneurysm 40

Frontiers in Cardiovascular Medicine

FEBRUARY 29, 2024

Outcome In the EVAR group, 47 patients (95.92%) were successfully implanted with overlapping stents, and 2 patients died in the perioperative period. In addition, we summarized and analyzed their Computed Tomographic Angiography (CTA) results and perioperative complications.

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Aortic Quality of Life Stents Stent 49

Dr. Smith's ECG Blog

JUNE 12, 2016

Answer : There is very abnormal T-wave inversion in aVL which is typical of subtle transmural/subepicardial (due to occlusion) ischemia to the inferior wall. Similarly, the precordial T-wave inversions in V2-V4 are reciprocal to posterior wall transmural/subepicardial (due to occlusion) ischemia. An 80% thrombotic RCA was stented.

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Chest Pain Ischemia STEMI Stents 52

Dr. Smith's ECG Blog

MARCH 9, 2013

A stent was placed. For those who depend on echocardiogram to confirm the ECG findings of ischemia, this should be sobering. 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. Lessons: 1. Lessons: 1.

Chest Pain 52

Chest Pain Myocardial Infarction Ischemia Angina 52

Dr. Smith's ECG Blog

OCTOBER 28, 2013

STE limited to aVR is due to diffuse subendocardial ischemia, but what of STE in both aVR and V1? The additional ST Elevation in V1 is not usually seen with diffuse subendocardial ischemia, and suggests that something else, like STEMI from LAD occlusion, could be present. Was this: 1) ACS with ischemia and spontaneous reperfusion?

Cardiac Arrest 52

Cardiac Arrest Ischemia Defibrillator Electrocardiogram 52

Dr. Smith's ECG Blog

MARCH 27, 2025

But it was interpreted as no acute ischemia and the patient was referred to cardiology as Non-STEMI. Cardiology: delayed cath = Non-STEMI Heres the interventional cardiology note describing the ECGs, management and outcome: He has had transitory peak T-waves, ST-segment elevation, and biphasic T-waves during recurrences of pain.

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STEMI Chest Pain Pericarditis Ischemia 80

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

Jason asked me if I thought it is due to occlusion (without either of us knowing the outcome), and this was my answer: This is a posterolateral MI. Down-up T-waves in inferior leads are almost always reciprocal to ischemia in the territory underlying aVL. It was opened and stented. This ECG is diagnostic of ischemia.

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Ischemia Chest Pain STEMI Stenosis 40

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

In his four months follow up clinic visit he had no further concerns of recurrent strokes or new symptoms.ResultsCarotid stump syndrome is a rare cause of cerebral and retinal ischemia; however, it must be considered in patients with recurrent ischemic strokes and chronic ipsilateral ICA occlusion.

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Strokes Stroke Stents Stent 40

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

The ECG in the chart was read as "no obvious ST changes," (even though no previous ECG was available) and the formal read by the emergency physicians was: "ST deviation and moderated T-wave abnormality, consider lateral ischemia." It was stented. Comment: most T-wave inversion is nonspecific, but not these ones! Gottlieb SO, et al.

Chest Pain 52

Chest Pain Thrombosis Myocardial Infarction STEMI 52

Dr. Smith's ECG Blog

DECEMBER 27, 2023

The pain will resolve and you will think the ischemia is gone when it is only hidden ! Just before 10 AM, the patient received a stent to the culprit OM. We know that today's patient has had prior inferior OMI with stenting of his proximal RCA ~3 years earlier. Peak troponin was 12 ng/mL. Stuckey, T., Zimetbaum, P. Tcheng, J.

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Chest Pain Myocardial Infarction Blog Stents 130

Dr. Smith's ECG Blog

JANUARY 6, 2023

I do not think this ECG is by itself diagnostic of OMI (full thickness, subepicardial ischemia ), b ut comparison to a previous might reveal this ECG as diagnostic of OMI. Smith comment: We have shown that use of opiates is associated with worse outcomes in ACS: Bracey, A. Abstract 556.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction ICU 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" That said, complete LM occlusion would be expected to have subepicardial ischemia (STE) in these myocardial territories: STE vector 1.

Myocardial Infarction 52

Myocardial Infarction Ischemia STEMI Cardiogenic Shock 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. The so-called "ST Elevation" is really the end of the QRS of Right Bundle Branch block. --Is there likely to be fixed coronary stenosis that led to demand ischemia during pneumonia? --Was This is a very common misread. New RBBB + LAFB is a very bad sign.

STEMI 40

STEMI Chest Pain Cardiac Arrest Stents 40

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

The patient’s angiogram should have been expedited, but the EKG change was not recognized as recurrence of transmural ischemia. RAO Caudal View Post PCI This is the RAO Caudal view after thrombectomy and stent placement. The conventional computer algorithm called “ sinus tachycardia, otherwise normal EKG ”.

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Chest Pain Blog Hospital Tachycardia 120

Dr. Smith's ECG Blog

JANUARY 3, 2022

It was a 60yo with a history of stents to the circumflex and right coronary arteries, who presented with 9 hours of fluctuating central chest pain. 2] Here there is no posterior ST elevation, but the anterior ST depression is also less—so it is dynamic, confirming acute ischemia. But it is still STEMI negative.

STEMI 52

STEMI Myocardial Infarction Chest Pain Ischemia 52

Dr. Smith's ECG Blog

OCTOBER 26, 2011

An open 90% LAD was stented. A 51 year old male with h/o stent presented with 30 minutes of chest pain: Obvious anterolateral very acute STEMI with hyperacute T-waves He went for immediate PCI, with successful reperfusion of a 100% occluded proximal LAD, and a door to balloon time of 35 minutes. The LAD has reperfused early.

STEMI 52

STEMI Chest Pain Myocardial Infarction Angioplasty 52

Society of Thoracic Surgeons - Allied Health

FEBRUARY 14, 2023

Leveraging Technology to Improve CABG Outcomes Viviany Taqueti, MD, MPH (Boston, MA, USA) 9:20 a.m. Women and CABG: A Comparison of Graft Conduit Outcomes from the National Adult Cardiac Surgery Audit Database Arnaldo Dimagli, MD (New York, NY, USA) 11:50 a.m. Panel Discussion 8:56 a.m. Panel Discussion 9:55 a.m. – 9:50 a.m.

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Coronary Artery Bypass Graft Atrial Fibrillation Outcomes Stents 52

Dr. Smith's ECG Blog

JULY 31, 2018

Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. The lesion was stented. It they are static, then they are not due to ischemia. This is better evidence for ischemia than any other data point. Again, cath lab was not activated.

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SCAD Chest Pain Myocardial Infarction Ischemia 52

Dr. Smith's ECG Blog

MARCH 11, 2016

It was treated with and dual "kissing balloons" and drug eluting stents. Here is the post stent ECG: There is greater than 50% resolution of ST elevation (all but diagnostic of successful reperfusion) and Terminal T-wave inversion (also highly suggestive of successful reperfusion). TIMI flow is 0. Door to balloon time was 51 minutes.

Myocardial Infarction 52

Myocardial Infarction Pericarditis STEMI Angina 52

Dr. Anish Koka

MAY 16, 2023

Soviet biologist Trofim Lysenko famously rejected the objective reality of Mendelian genetics because it clashed with the Marxist philosophy that the environment, not genetics, was the primary determinant of outcomes. But what should matter is outcomes not diagnoses. Subscribe for free to receive new posts and support my work.

Chest Pain 52

Chest Pain Coronary Artery Disease Cancer Heart Attack 52