The Journal of invasive cardiology
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Acute aortic dissection extending into the superior mesenteric artery (SMA) following a blunt trauma is an extremely rare complication. We report a case of acute post-traumatic SMA dissection presented with an acute abdominal syndrome. Computed tomographic angiography and arteriography allowed a rapid diagnosis and urgent percutaneous endovascular intervention through transradial route. This approach saved a major surgical intervention and related morbidity.
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Comparative Study
Efficacy and safety of bivalirudin in patients with diabetes mellitus undergoing percutaneous coronary intervention in current clinical practice.
This study sought to evaluate the short- and long-term efficacy and safety of bivalirudin in diabetic patients undergoing percutaneous coronary intervention (PCI) in contemporary clinical practice. ⋯ These findings indicate that in diabetic patients, bivalirudin monotherapy results in similar protection from acute ischemic events and long-term mortality, while lowering the risk of minor bleeding in comparison to UFH plus GP IIb/IIIa inhibition.
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B-type natriuretic peptide (BNP) and echocardiographic tissue Doppler indices (TDI) predict elevated filling pressures, but few data exist comparing these methods while adjusting for clinical variables. We hypothesized that BNP would provide incremental value for estimating left ventricular end-diastolic pressure (LVEDP). ⋯ Standard clinical variables offer only modest utility for predicting LV filling pressures. BNP provides incremental value for estimating LVEDP, and elevated BNP is an independent predictor of increased LVEDP among older patients undergoing diagnostic cardiac catheterization.
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The optimal combination of anticoagulant and antiplatelet therapy following percutaneous coronary intervention with stenting (PCI-S) among patients requiring oral anticoagulation (OAC) is unknown. ⋯ An antiplatelet regimen of aspirin with every-other-day clopidogrel may be as efficacious as daily aspirin and clopidogrel among patients receiving warfarin following PCI-S with DES.