Frontiers in Cardiovascular Medicine

MAY 21, 2024

We report a case of TRAD in the early postoperative period, which was successfully managed with intravascular ultrasound-assisted endovascular intervention.Case presentationA 38-year-old man underwent HLA-compatible living kidney transplantation. The transplant renal artery lesion was intervened with a stent.

Transplant 52

Transplant Ultrasound Plaque Atherosclerosis 52

The American Journal of Cardiology

JULY 6, 2024

Publication date: Available online 5 July 2024 Source: The American Journal of Cardiology Author(s): Kazumasa Kurogi, Tatsuya Tokai, Yuichiro Shirahama, Nobuyasu Yamamoto, Takeshi Serikawa, Masanobu Ishii, Kenichi Tsujita

Ultrasound 52

Ultrasound Stent Stents 52

Open Heart

APRIL 18, 2022

Introduction Intravascular ultrasound (IVUS) improves clinical outcome in patients undergoing percutaneous coronary intervention (PCI) but dedicated prospective studies assessing the safety and efficacy of IVUS guidance during primary PCI are lacking. Other endpoints include clinical and procedural outcomes along with post-PCI IVUS findings.

Ultrasound 52

Ultrasound Myocardial Infarction Cardiovascular Imaging Plaque 52

Dr. Smith's ECG Blog

NOVEMBER 17, 2023

It is of an elderly woman who complained of shortness of breath and had a recent stent placed. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema. Also, we know the patient had a stent. A few days before that, she had had an LAD stent for LAD occlusion.

Aneurysm 124

Aneurysm Stent Stents Chest Pain 124

DAIC

JANUARY 9, 2024

During the roundtable, participants highlighted the potential of IVUS in guiding revascularization procedures, such as angioplasty and stenting, to optimize outcomes for patients. It provides detailed information about the vessel wall, plaque composition, and blood flow characteristics, enabling more accurate diagnosis and treatment planning.

Peripheral Arterial Disease 105

Peripheral Arterial Disease Ultrasound Angioplasty Interventional Cardiology 105

Circulation

JANUARY 27, 2025

BACKGROUND:In patients with post-thrombotic syndrome, stent recanalization of iliofemoral veins or the inferior vena cava can restore venous patency and improve functional outcomes. The risk of stent thrombosis is particularly increased during the first 6 months after intervention.

Thrombosis 40

Thrombosis Stent Stents Quality of Life 40

Dr. Smith's ECG Blog

OCTOBER 1, 2023

A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. Gallbladder ultrasound was negative for stones. It is stented with good angiographic result. See it again now, along with our new Queen of Hearts functionality.

Stent 127

Stent Stents STEMI Physiology 127

Dr. Smith's ECG Blog

APRIL 12, 2013

A male in his 40's who had been discharged 6 hours prior after stenting of an inferoposterior STEMI had sudden severe SOB at home 2 hours prior to calling 911. He had diffuse crackles on exam and B-lines on chest ultrasound, and chest x-ray also confirmed pulmonary edema. He had no chest pain.

STEMI 52

STEMI Pulmonary Stent Stents 52

Circulation: Cardiovascular Interventions

JANUARY 15, 2024

Circulation: Cardiovascular Interventions, Volume 17, Issue 1 , Page e013691, January 1, 2024.

Ultrasound 40

Ultrasound Stent Stents Cardiovascular Interventions 40

Dr. Smith's ECG Blog

APRIL 14, 2024

A bedside cardiac ultrasound performed by a true EM expert (Robert Reardon, who wrote the cardiac ultrasound chapter in Ma and Mateer) showed an inferior wall motion abnormality. The culprit was opened and stented. But there are also new Q-waves, stronly suggesting new infarction.

Chest Pain 119

Chest Pain Ischemia Myocardial Infarction Ultrasound 119

The British Journal of Cardiology

NOVEMBER 29, 2023

Successful PPCI was performed via right femoral artery, with access gained under ultrasound guidance. Additional arterial access via left brachial artery was obtained, and a covered stent was deployed successfully in the right femoral artery with satisfactory haemostasis.

STEMI 52

STEMI Cardiac Arrest Myocardial Infarction Ultrasound 52

Circulation: Cardiovascular Interventions

JANUARY 29, 2025

BACKGROUND:Geographic stent-ostium mismatch is an important predictor of target lesion failure after percutaneous coronary intervention of an aorto-ostial right coronary artery lesion. Optimal visualization of the aorto-ostial plane is crucial for precise stent implantation at the level of the ostium.

Stent 40

Stent Stents Laboratory Ultrasound 40

Dr. Smith's ECG Blog

DECEMBER 6, 2010

I performed a bedside cardiac ultrasound and the posterior wall appeared to be contracting and shortening normally. Two stents were placed. A posterior ECG was done and showed no ST elevation, not even 0.5 mm in only one posterior lead is highly sensitive and specific for posterior STEMI). The ECG normalized overnight.

STEMI 52

STEMI Chest Pain Ultrasound Blood Pressure 52

Circulation: Cardiovascular Interventions

JANUARY 20, 2025

BACKGROUND:Bioresorbable scaffolds (BRS) were developed to overcome limitations related to late stent failures of drug-eluting stents, but lumen reductions over time after implantation of BRS have been reported. Six-month angiographic follow-up with optical coherence tomography and intravascular ultrasound was available in 74 patients.

Stenosis 40

Stenosis Ultrasound Stent Stents 40

Dr. S. Venkatesan MD

FEBRUARY 29, 2024

Meanwhile, over the years, ultrasound moved up from the pelvis, abdomen, right into coronary arteries and heart. Intravascular ultrasound-based interventions are being done in coronary artery, in a few cases to avoid contrast in patients with CKD. (We With zero radiation, MRI came close in the fight with innocuous proton imaging.

Ultrasound 52

Ultrasound Anatomy Stent Stents 52

ADN Center of Excellence

SEPTEMBER 27, 2023

In the rapidly changing field of cardiology, IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography) have seen significant growth. IVUS reveals plaque characteristics, optimal stent usage, and vessel measurements. On the other hand, OCT, with its microscopic accuracy, unveils fine stent positioning and tissue reactions.

Education 52

Education Best Practices Stent Stents 52

Frontiers in Cardiovascular Medicine

JANUARY 30, 2024

We aimed ultrasound-guided punctures in the proximal two-thirds of axillary arteries with diameters ≥2 mm to insert 7 cm/4 Fr short introducers. Overall, 27/36 procedures were interventional, including 6 aortic valvuloplasties, 6 balloon angioplasties, and 15 stenting procedures. We administrated intra-arterial verapamil (1.25 mg)

Pediatrics 49

Pediatrics Congenital Heart Disease Thrombosis Angioplasty 49

Dr. Smith's ECG Blog

JANUARY 5, 2024

On intravascular ultrasound (IVUS), the mid RCA plaque was described as "cratered, inflamed, and bulky," and the OM plaque was described as "bulky with evidence of inflammation and probably ulceration." On the combined basis of angiography and IVUS, this patient received stents to his mid RCA, proximal PDA, and OM.

Angina 121

Angina Plaque Document Stent 121

Circulation

NOVEMBER 11, 2024

Once stabilized, intravascular ultrasound showed significant thrombus and plaque in the LAD. This was treated with a drug-eluting stent, but TIMI 3 flow was not achieved. The patient was placed on an integrilin drip with plans to reevaluate in 24 hours.

Aortic valve 40

Aortic valve TAVR Chest Pain Aortic 40

Dr. Smith's ECG Blog

APRIL 22, 2024

Bedside ultrasound with no apparent wall motion abnormalities, no pericardial effusion, no right heart strain. Here are other very interesting posts: Wellens' syndrome: to stent or not? Course : Aspirin 325mg, chemistry, CBC, troponin panel all ordered. Aorta briefly viewed, appears normal caliber and diameter.

Chest Pain 118

Chest Pain Myocardial Infarction Anatomy Angina 118

Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Past medical history includes coronary stenting 17 years prior. If you take old people with a history of MI (he had a stent), that percentage goes far higher since there is scar tissue that acts as a nidus for the PVCs that initiate VT. Pads were placed with ultrasound guidance, so they were in the correct position.

Tachycardia 139

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 139

Cardiology Update

MAY 14, 2024

Intravascular imaging (IVI), such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), play a crucial role in assessing lesion characteristics and optimizing stent placement during percutaneous coronary intervention (PCI).

Outcomes 52

Outcomes Myocardial Infarction Ultrasound Stent 52

Dr. Smith's ECG Blog

MAY 13, 2024

The Queen of Hearts read this ECG as OMI – Low Confidence Click here to sign up for QoH Access The providers taking care of this patient were concerned regarding his clinical history and initial ECG, so they next performed a bedside cardiac ultrasound. The culprit mid LAD lesion was stented.

Chest Pain 120

Chest Pain STEMI Ultrasound Heart attacks 120

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

Arrival at time 0 ECG 7 min Roomed in hallway at 17 min Moved to room with monitor at 37 min The patient was seen briefly by the physician, who then went to get an ultrasound machine. He has a h/o of 3 vessel disease and stents and his pain has been on and off for days. Then he was placed in a room after 30 minutes.

Chest Pain 135

Chest Pain Defibrillator STEMI Coronary Artery Disease 135

Dr. Smith's ECG Blog

OCTOBER 24, 2013

He underwent coronary stenting (uncertain which artery). An emergency cardiac ultrasound could be very useful. He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. I do not have the post-resuscitation ECG. Could this have been avoided?

Cardiac Arrest 52

Cardiac Arrest Myocardial Infarction Chest Pain Ischemia 52

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

Fortunately, this operator used intravascular ultrasound (IVUS). The operator documented thoughtful consideration of risks and benefits of stent placement. Technically, there was a very narrow landing zone for the stent, and missing this could result in "jailing" the LCx, which is ideally avoided.

Plaque 66

Plaque Stent Stents Chest Pain 66

Dr. Smith's ECG Blog

MAY 20, 2024

This was a presumed culprit and a stent was placed. And angiographers tell me that it is sometimes difficult to say for certain based on angiogram alone, without intravascular ultrasound or, better yet, optical coherence tomography. Assuming that was indeed a culprit, then this was ACS.

Chest Pain 126

Chest Pain Blood Pressure Ischemia STEMI 126

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Under ultrasound guidance, her PT disappeared when the posterior auricular vein collapsed under applied pressure and returned when the pressure was released. Initially, he underwent stent‐assisted coiling of a high‐riding jugular bulb with no change in symptoms. Balloon occlusion test (BOT) of the PCV demonstrated improvement in PT.

Embolism 40

Embolism Stent Stents Stenosis 40

Circulation

NOVEMBER 11, 2024

After guidewire crossing, balloon angioplasty was performed, and a drug-eluting stent was deployed. An intravascular ultrasound was also performed, which was negative for vessel dissection. The left circumflex had 80% proximal stenosis with minimal luminal irregularities in the mid to distal portion.

Coronary Artery Disease 40

Coronary Artery Disease Angioplasty Anatomy Angina 40

Dr. Anish Koka

JULY 23, 2023

A lower extremity arterial ultrasound revealed elevated velocities in the right proximal superficial femoral artery. Based on these results, Dormu performed a percutaneous transluminal balloon angioplasty and a mechanical atherectomy and stenting of the right superficial femoral artery and stenting of the right superficial femoral artery.

Vascular Care 52

Vascular Care Outpatient Peripheral Arterial Disease Stent 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Two thirds of MINOCA cases are due to atherosclerotic causes One way to prove the diagnosis in this case would have been with intravascular imaging such as optical coherence tomography (OCT) or intravascular ultrasound (IVUS). Fortunately, that is exactly what happened. The patient did well afterward without any recurrence of symptoms.

Plaque 127

Plaque Angina Blog Stent 127

Dr. Smith's ECG Blog

MAY 13, 2020

This was a point of care ultrasound, not a bubble contrast echo. One would not expect wall motion to recover so quickly after stenting, so this is good evidence that the POCUS echo was indeed accurate. What do you think the echocardiogram shows? First trop I returns at 1.5.

Echocardiogram 52

Echocardiogram Ischemia Chest Pain Blog 52

Dr. Smith's ECG Blog

FEBRUARY 14, 2009

A bedside ultrasound revealed a possible anterior wall motion abnormality. There was an LAD occlusion that was opened and stented. The patient was treated with Calcium, Insulin, D50, and bicarbonate, with no change in the ECG. The K returned at 2.9 These T waves are NOT typical for hyperK.

Chest Pain 52

Chest Pain Ultrasound STEMI Stent 52

Dr. Smith's ECG Blog

JUNE 11, 2021

Thirty minutes later the first Troponin I came back elevated at 650 ng/L (normal <26), and bedside ultrasound found anteroseptal akinesia. So the RCA was stented. The patient continued to have chest pain after the RCA was reperfused, so the LAD was then stented. The patient still had chest pain and a third ECG was performed.

Chest Pain 52

Chest Pain Cardiac Arrest Ischemia Cardiogenic Shock 52

Dr. Smith's ECG Blog

OCTOBER 2, 2021

After rethinking the case, he remained concerned about ACS and subsequently performed a point-of-care ultrasound in order to evaluate for regional wall motion abnormality. He was successfully treated with one drug eluting stent. A second troponin had been drawn 3 hours after arrival and was again less than 0.30ng/mL.

Chest Pain 52

Chest Pain Ultrasound STEMI Myocardial Infarction 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. A bedside ultrasound was done by the emergency physician, using Speckle Tracking. A male in late middle age with a history of RCA stent 8 years prior complained of chest pain. This is a very common misread. The trick is to find the end of the QRS.

STEMI 40

STEMI Chest Pain Cardiac Arrest Stent 40

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

It was opened and stented. There was an old ECG for comparison: One year prior with no ST segment abnormalities A bedside cardiac ultrasound was done by the emergency physician. Culprit, stented) 3. A stent was placed and the patient became pain free. Later, the patient was taken to the cath lab. The artery was occluded.

Ischemia 40

Ischemia Chest Pain STEMI Stenosis 40