Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Dec 2008
Comparative StudySingle or multivessel percutaneous coronary intervention in ST-elevation myocardial infarction patients.
To evaluate clinical results of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) in patients with multivessel disease (MVD), in relation to single or multivessel (MV)-PCI and to patients with single vessel disease (SVD). ⋯ STEMI patients with MVD have a worse prognosis than those with SVD. MV-PCI in patients without hemodynamic compromise yields good short-term results, even if performed very early, with a 30-day mortality in between that of SVD patients and that of MVD patients with IRA-only treatment.
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Catheter Cardiovasc Interv · Dec 2008
Comparative StudyRecurrent events following patent foramen ovale closure in patients above 55 years of age with presumed paradoxical embolism.
The aim of this article is to summarize our experience of patent foramen ovale (PFO) closure in patients above the age of 55 years. ⋯ PFO closure in older patients is as efficient and seems comparable to those under the age of 55. Although traditional cardiovascular risk factors may be more frequent in the older age group compared with those younger than 55 years, PFO closure should not be withheld as a possible therapeutic option in this age group.
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Catheter Cardiovasc Interv · Dec 2008
The "art" of medicine and the "smokescreen" of the randomized trial off-label use of vascular devices.
Once a device is approved for sale in the United States by the Food and Drug Administration (FDA), it can legally be used by doctors to treat any condition a physician determines is medically appropriate. Based on postmarket published data and physician procedural experience, this may even become the standard of care when an alternative device either does not exist or is inferior in performance, even before FDA approval. ⋯ The off-label use of medical devices for the treatment of peripheral vascular disease has recently become the latest target by groups with interests that have little to do with patient care. This interference has begun to negatively impact the latitude necessary for physicians to best treat their patients.
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Catheter Cardiovasc Interv · Dec 2008
Percutaneous aortic valve implants under sedation: our initial experience.
We have developed an approach where percutaneous aortic valve (PAVI) procedures are done under remifentanil-based sedation administered by an anesthetist. We report here our initial experience. ⋯ Percutaneous aortic valve implantation can, in the majority of cases, be performed under remifentanil-based sedation. Our initial experience suggests that this should result in a shorter implant procedure time, reduced stay in high dependency areas, and shorter time to hospital discharge.
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Catheter Cardiovasc Interv · Dec 2008
The feasibility and safety of routine thrombus aspiration in patients with non-ST-elevation myocardial infarction.
To investigate the feasibility and safety of manual thrombus aspiration in patients undergoing percutaneous coronary intervention (PCI) for non-ST-elevation myocardial infarction (NSTEMI). ⋯ This study demonstrates that thrombus aspiration in most NSTEMI patients is feasible and safe and is associated with a high rate of retrieval of thrombotic material.