Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Apr 2009
Case ReportsPneumopericardial tamponade resulting from a spontaneous gastropericardial fistula.
Pneumopericardium is a rare but serious cause of morbidity and mortality. Untreated, it can lead to cardiac tamponade and thus must be promptly identified to treat the underlying etiology. ⋯ The patient underwent emergent thoracotomy and partial esophagogastrectomy which eventually resulted in a full recovery and discharge on postoperative day 19. Our unique experience with this rare and often fatal disease suggests that early diagnosis combined with an early and aggressive surgical strategy is critical for minimizing morbidity and mortality.
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Catheter Cardiovasc Interv · Mar 2009
Evaluation of intermediate coronary stenosis with intravascular ultrasound and fractional flow reserve: Its use and abuse.
Clinical decision making in patients with intermediate coronary stenosis is still debated. Intravascular ultrasound (IVUS) examination and/or functional assessment of coronary stenosis by fractional flow reserve (FFR) are currently used to define the severity of such lesions. ⋯ There are no randomized, controlled trials to demonstrate the superiority of IVUS versus FFR in providing improved clinical outcomes in comparison with angiography alone. However, the issue of superiority might be irrelevant, because IVUS and FFR could be complementary techniques to be used in the catheterization laboratory to provide critical anatomic and functional data that permit more accurate decisions in the management of the patient.
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Catheter Cardiovasc Interv · Mar 2009
Case ReportsEndovascular balloon occlusion for catheter-induced large artery perforation in the catheterization laboratory.
Vessel perforation is a complication that cannot be completely avoided in the setting of endovascular procedures. When a large noncompressible artery is disrupted, uncontrolled bleeding may lead to hemodynamic collapse. Endovascular occlusion may provide rapid control of hemorrhage and facilitate definitive therapy; yet, occlusion balloons are not commonly utilized in the cardiac catheterization laboratory. ⋯ In most cases of severe catheter-induced bleeding, endovascular balloon occlusion provide a safe, rapid, and effective means of temporary bleeding control.
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Catheter Cardiovasc Interv · Mar 2009
Rheolytic thrombectomy in patients with massive and submassive acute pulmonary embolism.
To appraise the impact of AngioJet rheolytic thrombectomy (RT) on angiographic and clinical endpoints in patients with acute pulmonary embolism (PE). ⋯ In experienced hands AngioJet RT can be operated safely and effectively in most patients with acute PE, either massive or submassive, and substantial involvement of pulmonary vascular bed.