The Journal of invasive cardiology
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Although closure of paravalvular leaks with Amplatzer occluders has been described in patients with increased perioperative risk, beneficial outcomes have not been consistently reported. Recent reports have described real-time three-dimensional transesophageal echocardiography (3D TEE) for facilitated guidance of the closure procedure. ⋯ The improved sizing was an important means to prevent device embolization as well as secure complete defect closure. Surprises with regard to the device size or the ability to anchor the device in a stable position were reduced.
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There are limited data on the long-term safety and efficacy of drug-eluting stents (DES) implantation in patients with stable angina referred for elective percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). We therefore aim to investigate whether DES compared with bare-metal stent (BMS) implantation improves long-term outcomes after successful recanalization of single CTO. ⋯ DES implantation during PCI for single CTO reduces MACE rate at 1-year and long-term follow-up due to the significant reduction of TLR in the DES group. Therefore, DES implantation should be preferred as an optimal treatment strategy of single CTO in stable angina patients.
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Randomized Controlled Trial Comparative Study
Prospective comparison of palpation versus ultrasound-guided radial access for cardiac catheterization.
Radial access is increasingly used for both diagnostic and interventional cardiac procedures. Prospective data comparing ultrasound- versus palpation-guided radial catheterization are largely lacking. ⋯ Ultrasound-guided radial access seems to provide no substantial additional benefit over palpation-guided access alone. Attempting the alternative guiding methods to establish radial access before crossover to femoral access seems to be a reasonable approach.
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The aim of this single-center prospective study is to investigate the silent and clinically apparent cerebral embolic events after transcatheter closure of atrial septal defect (ASD) and patent foramen ovale (PFO). ⋯ With the new-generation ASD and PFO occluder devices, the incidence of clinically silent peri-interventional cerebral embolic lesions after transcatheter closure of ASD and PFO is low. Plasma NSE levels offered no additional benefit for monitoring ischemic events after ASD and PFO transcatheter closure procedures.
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Percutaneous coronary intervention (PCI) during ST-segment elevation myocardial infarction (STEMI) can be challenging due to limited distal vessel visualization. We present a case of challenging antegrade wiring during PCI of an inferior STEMI resulting in inadvertent subintimal wiring and ballooning. Recognition of this scenario prior to stenting allowed vessel rescue using the retrograde chronic total occlusion revascularization technique.