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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Stent Stents Circulation Stroke 40

Dr. Smith's ECG Blog

NOVEMBER 17, 2024

The operator performed intravascular ultrasound and visualized acute plaque rupture with thrombus formation and placed a stent. There was reperfusion ischemia superimposed on benign T-wave inversion. He is very lucky that he spontaneously reperfused and was stented before he had the chance to re-occlude.

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Chest Pain Ischemia Stents Stent 91

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Of note, patient had a with left cavernous‐ICA stent placement a month before the presentation and was noncompliant to antiplatelets. We described a left intracranial ICA flow diversion occlusion without anterior circulation ischemia and left PCA ischemia demonstrated. In the emergency department (ED), her NIHSS was 28.

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Stents Stent Ischemia Embolism 40

Journal of the American Heart Association

JANUARY 31, 2024

BackgroundThe rapid evolution of artificial intelligence (AI) in conjunction with recent updates in dual antiplatelet therapy (DAPT) management guidelines emphasizes the necessity for innovative models to predict ischemic or bleeding events after drug‐eluting stent implantation.

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Stents Stent Innovation Ischemia 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.

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Angioplasty Stents Stent Stroke 40

Stroke Journal

FEBRUARY 1, 2024

Objective:To compare the 1-month stroke, myocardial infarction (MI), and/or death rates among symptomatic patients undergoing either CAS or CEA according to the timing of the procedure in Carotid Revascularization Endarterectomy versus Stenting Trial (CREST).Methods:We

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Stent Stents Stenosis Myocardial Infarction 40

Med Page Today

APRIL 30, 2024

(MedPage Today) -- For patients with peripheral artery disease (PAD) and chronic limb-threatening ischemia, drug-eluting stents and drug-coated balloons did not improve amputation-free survival compared with balloon angioplasty alone in the BASIL.

Peripheral Arterial Disease 64

Peripheral Arterial Disease Angioplasty Heart Disease Cancer 64

Frontiers in Cardiovascular Medicine

JANUARY 10, 2024

Coronary heart disease is a narrowing or obstruction of the vascular cavity caused by atherosclerosis of the coronary arteries, which leads to myocardial ischemia and hypoxia. At present, percutaneous coronary intervention (PCI) is an effective treatment for coronary atherosclerotic heart disease.

Heart Disease 59

Heart Disease Stents Stent Atherosclerosis 59

All About Cardiovascular System and Disorders

APRIL 10, 2024

IVUS Measurements Measurements include the measurement of lumen, plaque, calcium, remodeling, stent length and volumetric measurements. It can also give guidance for stenting in terms of assessment of stent apposition and good expansion. Incomplete stent apposition can be detected by intravascular ultrasound.

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Ultrasound Plaque Stents Stent 52

Circulation

FEBRUARY 12, 2024

The secondary outcomes included ischemia-driven target lesion revascularization, target vessel myocardial infarction, death, cardiac death, target vessel revascularization, stent thrombosis, and major adverse cardiac events. OCT was associated with a significant reduction of stent thrombosis compared with ICA (OR, 0.49 [95% CI, 0.26–0.92])

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Ultrasound Myocardial Infarction Thrombosis Stents 67

DAIC

APRIL 11, 2024

PCI is commonly used to open blocked arteries to treat significant myocardial ischemia , which occurs when the heart muscle does not get enough oxygenated blood. During PCI, an operator inserts a stent into a blocked artery through a catheter in the groin or arm.

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Plaque Heart Attack Heart attacks Coronary Artery Disease 111

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 Coronary Artery Disease Stents Stent 52

Dr. Smith's ECG Blog

APRIL 14, 2024

No ischemia. This is a conundrum, because it is clear that the patient is having an acute MI, the ECG is dynamic, but the pain is very mild and there is no ECG evidence of active transmural ischemia. We already know that the ischemia is ongoing, though mild (because of the persistent pain). The culprit was opened and stented.

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Chest Pain Ischemia Myocardial Infarction Ultrasound 108

DAIC

MARCH 20, 2024

The Freesolve BTK RMS is designed for individuals suffering from chronic limb-threatening ischemia (CLTI). Updated estimates for the burden of chronic limb-threatening ischemia in the Medicare population, Journal of Vascular Surgery, Volume 77, Issue 6, 2023, 1760-1775 2 Seguchi M., 2,3 It has shown 99.6%

Peripheral Arterial Disease 105

Peripheral Arterial Disease Innovation Technology Coronary Artery Disease 105

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 the TAAR group, 12 patients (92.31%) were successfully revascularized and 1 patient died in the perioperative period.

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Aortic Quality of Life Stents Stent 49

Coronary Artery Disease Journal

MARCH 7, 2024

Background Untreated multivessel disease (MVD) in acute myocardial infarction (AMI) has been linked to a higher risk of recurrent ischemia and death within one year. The immediate non-IRA PCI is associated with a significantly lower occurrence of unplanned ischemia-driven PCI (OR 0.60; confidence interval [CI] 0.44–0.83)

Myocardial Infarction 40

Myocardial Infarction Ischemia Thrombosis Article 40

Dr. Smith's ECG Blog

JULY 30, 2023

The STD maximal in V1-V4 is diagnostic of acute transmural posterior wall ischemia, most likely due to posterior OMI. Subendocardial ischemia does not localize, and subendocardial ischemia presents with STD maximal in V5-6, II, and STE in aVR. Subendocardial ischemia does not localize. Finally the OMI was realized.

Chest Pain 52

Chest Pain Ischemia STEMI Arrhythmia 52

Dr. Smith's ECG Blog

MARCH 31, 2024

Angiogram reportedly showed acute thrombotic occlusion of the first obtuse marginal which was stented. non-occlusive ischemia) Ongoing ischemic symptoms in NSTEMI is already an indication for emergent cath, regardless of the ECG. Peak troponin was not recorded. The patient survived the hospitalization.

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Chest Pain STEMI Ischemia Myocardial Infarction 92

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.

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Chest Pain Cardiogenic Shock Ischemia Myocardial Infarction 83

Dr. Smith's ECG Blog

MAY 20, 2024

This EKG is diagnostic of transmural ischemia of the inferior wall. If it is angina, lowering the BP with IV Nitroglycerine may completely alleviate the pain and the (unseen) ECG ischemia. Transmural ischemia (as seen with the OMI findings on ECG) is not very common with demand ischemia, but is possible.

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Chest Pain Blood Pressure Ischemia STEMI 123

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). Eur J Vasc Endovasc Surg. 2012;43:55-61. J Am Heart Assoc. DOI: 10.1161/JAHA.118.009724.

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Heart Attack Heart attacks Peripheral Arterial Disease Ischemia 111

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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Stroke Strokes Stents Stent 40

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.

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Ischemia Atrial Flutter Arrhythmia Tachycardia 52

Dr. Smith's ECG Blog

MAY 5, 2024

He interprets here: "This EKG is diagnostic of right bundle branch block and transmural ischemia of the anterior wall, most likely from an occlusion of the proximal LAD. There was a 100% proximal LAD occlusion that was opened and stented. It was recorded at 0530: What do you think? The young ED tech immediately suspected LAD OMI.

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EKG Technician Chest Pain Blog STEMI 114

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

Important point: when there is diffuse subendocardial ischemia but no OMI, a wall motion abnormality will not necessarily be present. They agreed ischemia was likely in the setting of demand given DKA and infection. That this is all demand ischemia is unlikely. Lung exam showed diffuse B lines bilaterally. Aslanger's pattern.

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Chest Pain Ischemia Echocardiogram Myocardial Infarction 103

Dr. Smith's ECG Blog

MAY 13, 2020

Here is the EMS ECG: Obviously massive diffuse subendocardial ischemia, with profound STD and STE in aVR Of course this pattern is most often seen from etoliogies other than ACS. The ECG only tells you there is ischemia, not the etiology of it. Nevertheless, the clinical situation made other etiologies unlikely.

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Echocardiogram Ischemia Chest Pain Blog 52

Dr. Smith's ECG Blog

NOVEMBER 5, 2023

ECG#1 Assessing ischemia on an ECG with wide QRS complexes (AIVR, ventricular pacing, BBB, etc) can be challenging. Many health care providers will simply not attempt to assess ischemia in the presence of a wide QRS. In the ECG above there are several features indicative of ongoing transmural ischemia. What do you think?

Chest Pain 101

Chest Pain Ischemia Pacemaker Stents 101

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

5 ICSS‐ MRI study (International Carotid Stenting Study Magnetic Resonance Imaging Study), indicated that patients with periprocedural hemodynamic depression had decreased cerebral blood flow and increased the risk of new lesions in imaging.6 This is secondary to delayed postoperative cerebral ischemia and infarction caused by vasospasm.7

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Aneurysm Stroke Strokes Ischemia 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

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.

Chest Pain 108

Chest Pain Cardiac Arrest Sudden Cardiac Death Stents 108

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.

Chest Pain 85

Chest Pain Ischemia Pericarditis Tachycardia 85

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. Cath days later showed complete occlusion of the LAD, stented. Ultimately, cardiac cath was done in Case #2, with stenting of the "culprit" LAD lesion.

AFIB 72

AFIB Stents Stent Chest Pain 72

Dr. Smith's ECG Blog

OCTOBER 31, 2024

Here is the circumflex after stenting: Wide open The cardiologist called Dr. Lufkin back and said "Great call!!" Perhaps the highly unusual initial rhythm in today's case was simply the result of SA nodal ischemia that resolved following coronary reperfusion. The patient was transferred to a hospital with PCI capability.

STEMI 104

STEMI Arrhythmia Hospital Stents 104

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).

Aneurysm 40

Aneurysm Outcomes Hemorrhage Stents 40

Dr. S. Venkatesan MD

FEBRUARY 25, 2024

It means either a percutaneous coronary intervention with a stent or CABG. Reference : Apart from the heavily quoted classics of COURAGE, BARI-2D, ISCHEMIA, ORBITA 1 etc. You may be. But I am not.You need to undergo some re-vascularisation procedure. What do you mean by that Doctor ? No we can’t.

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Plaque Chest Pain Stents Stent 59

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

Coronary Artery Disease 111

Coronary Artery Disease Interventional Cardiology Innovation Physiology 111

Dr. Smith's ECG Blog

JANUARY 25, 2024

LAD: severe in-stent restenosis in the mid (80%) and distal (90%) segment and diffuse disease distally. Ramus intermedius: large, severe in-stent restenosis at the distal stent edge (90%) and severe de-novo stenosis at the ostial segment (90%). The pain did not resolve with NTG, and so he went to emergent angiography: 1.

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Chest Pain Stenosis Stents Stent 75