Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Nov 2011
ReviewTransradial arterial access for coronary and peripheral procedures: executive summary by the Transradial Committee of the SCAI.
In response to growing U. S. interest, the Society for Coronary Angiography and Interventions recently formed a Transradial Committee whose purpose is to examine the utility, utilization, and training considerations related to transradial access for percutaneous coronary and peripheral procedures. With international partnership, the committee has composed a comprehensive overview of this subject presented here-with.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsAdderall induced inverted-Takotsubo cardiomyopathy.
Takotsubo Cardiomyopathy (TTC), also known as stress-induced cardiomyopathy, was initially described in Japan in 1990. Both illicit and prescription drugs have added to the growing list of insulting stressors. We describe an interesting case of atypical TTC triggered by adderall overdose. ⋯ TTC can be identified as a rapid development of severe and reversible left ventricular dysfunction extending beyond the territory of a single epicardial coronary artery in the absence of coronary artery disease or pheochromocytoma. Clinical presentation can be challenging and very hard to distinguish from acute myocardial infarction. Medication induced-TTC has been reported. In our case, the patient overdosed on Adderall which is a sympathomimetic medication. Cardiac imaging identified wall motion abnormalities consistent with inverted type TTC. Restoration of left ventricular function within days confirms the diagnosis of TTC. In conclusion, this case offers an interesting insight into the pathophysiology of TTC.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsNovel application of Angiojet rheolytic thrombectomy for massive thrombosis of the native aortic valve and Jarvick 2000 ventricular assist device in a patient with end-stage heart failure.
With the diffusion of implantable ventricular assist pumps in heart failure patients refractory to treatments or ineligible to transplantation, acute aortic valve and device thrombosis is an unusual but potentially increasing complication. We report a novel application of Angiojet rheolytic thrombectomy for acute and massive thrombosis of the native aortic valve and of the left ventricular assist device in a heart failure patient. The technical execution and clinical experience with this technique is described.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsImpella assisted transradial coronary intervention in patients with acute coronary syndromes and cardiogenic shock: case series.
Operators may feel apprehension when considering the transradial approach in patients with cardiogenic shock due to concerns of the need for femoral access for mechanical support. There is however potential benefit of transradial approach in this setting by reducing bleeding complications in patients on potent anticoagulant and antiplatelet agents. ⋯ In two cases, the need for mechanical support was not clear at the beginning of the procedure, and in the third there was a clear need to combine femoral and radial access due to pre-existing anatomic issues. Two patients required transfusion of red blood cells but otherwise there were no vascular access complications.
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Catheter Cardiovasc Interv · Nov 2011
Case ReportsMinimally invasive transradial intervention using sheathless standard guiding catheters.
We evaluated a sheathless transradial technique for interventions using standard five and six French nonhydrophilic guiding catheters. ⋯ Sheathless transradial intervention using standard 5 and 6 Fr guiding catheters is a safe and effective method for treatment of coronary and peripheral vascular lesions.