Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Sep 2013
Observational StudyImpact of contrast-induced acute kidney injury on outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
The purpose of this study was to identify predictors of contrast-induced acute kidney injury (CI-AKI) and the effect of CI-AKI on cardiovascular outcomes after hospital discharge in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). ⋯ The risk of CI-AKI is increased in patients with pre-procedural renal insufficiency, and eGFR is clinically useful in the emergent setting for CI-AKI risk stratification before primary PCI.
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Cardiovasc Revasc Med · Sep 2013
Comparative Study Observational StudyComparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in "Real World" practice.
We aimed to carry out a "real world" comparison of bivalirudin plus unfractionated heparin (UFH) versus abciximab plus UFH in patients undergoing primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI). ⋯ In this "real-world" observational study, there was no significant difference in the clinical outcome of PPCI for patients who had abciximab or bivalirudin after initial pre-treatment with UFH.
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Complex catheter-based interventions and rising case volumes confer occupational risks to interventional cardiologists. Despite advances in technology, modern interventional procedures are performed in a manner remarkably similar to the techniques pioneered decades ago. Percutaneous interventions are associated with operator orthopedic injuries, exposures to blood borne pathogens, and the effects of chronic radiation exposure from fluoroscopy. This review highlights the occupational hazards of interventional procedures and provides a glimpse at the technologies and techniques that may reduce risks to operators in the catheterization laboratory.
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Cardiovasc Revasc Med · Jul 2013
Acute limb ischemia: role of preoperative and postoperative duplex in differentiating acute embolic from thrombotic ischemia.
Acute limb ischemia (ALI) represents an emergency in which delayed intervention results in significant morbidity, and potentially, death. ⋯ A cut off value of 1.41% as percent dilatation or diminution in the diameter of occluded artery is the most important duplex sign for predicting embolic or thrombotic ALI respectively. Postoperative reduction in the diameter of occluded artery after embolectomy confirms this sign.
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Cardiovasc Revasc Med · Mar 2013
Are drug-eluting stents superior to bare metal stents when compared to coronary artery bypass surgery? Show me the data.
Recent randomized trials comparing coronary artery bypass surgery (CABG) versus drug eluting stents (DES) observed better survival, survival free of myocardial infarction (MI) and free from death, MI and stroke in patients with 3-vessel disease and diabetics if they were treated with DES. In the past, when we used bare metal stent (BMS) and meta-analysis of randomized trials with BMS and CABG, patients with 3-vessel disease and those with diabetes at 5 years of follow up had similar incidence of death, MI and stroke with CABG and BMS. ⋯ The author in the article compared these recent results with the above meta-analysis and made an indirect comparison among DES, BMS and CABG. Reasons for these intriguing findings were discussed, and also a search for potential solutions was conducted.