Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Dec 2006
Case ReportsIntravascular ultrasound identification of intraluminal embolic plaque material during carotid angioplasty with stenting.
Carotid angioplasty with stenting (CAS) has evolved as a viable method for treating patients at high risk for carotid endarterectomy. Strokes complicating CAS are most commonly caused by the liberation and distal embolization of embolic material from plaque during the procedure. ⋯ IVUS can identify intraluminal plaque material, which may be a precursor for embolism and delayed ischemic events after CAS. IVUS may allow for treatment before distal embolization of plaque material. Virtual histology IVUS software may help to identify carotid lesions at higher risk for significant embolization during CAS.
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Catheter Cardiovasc Interv · Dec 2006
Trends in percutaneous versus surgical revascularization of unprotected left main coronary stenosis in the drug-eluting stent era: a report from the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR).
We sought to determine how practice patterns for unprotected left main stenosis have changed with the advent of drug-eluting stents (DES). ⋯ In the era of DES, the rate of PCI for unprotected left main stenosis has risen, while CABG has declined. These findings are seen across varying clinical situations, including elective procedures. DES have rapidly and largely replaced bare metal stents for PCI of unprotected left mains. However, PCI is still chosen less frequently than CABG for unprotected left main revascularization.
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Catheter Cardiovasc Interv · Dec 2006
Cardiac catheterization in infants weighing less than 1,500 grams.
The improved survival of very low-birth-weight (<1,500 g) infants justifies more aggressive attempts to treat underlying congenital heart disease than in the past. ⋯ Cardiac catheterization in neonates <1,500 g is more likely to include percutaneous intervention, especially on the left side, but is generally successful with a complication rate similar to procedures performed in larger infants. Although these procedures are rare, improved miniaturization of equipment would facilitate safer interventions.
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Catheter Cardiovasc Interv · Nov 2006
Randomized Controlled Trial Multicenter StudyThe safety and efficacy of the StarClose Vascular Closure System: the ultrasound substudy of the CLIP study.
The StarClose Vascular Closure System (Abbott Vascular, Redwood City, CA) features a nitinol clip that is designed to achieve closure of the femoral arteriotomy access site. The CLIP Study was performed to assess the safety and efficacy of StarClose when compared with standard manual compression following 5-6 French diagnostic or interventional percutaneous procedures. A substudy of this trial was designed to assess the utility of duplex ultrasonography to assess patency of the femoral artery and to determine access site complications (pseudoaneurysm, arteriovenous fistula, hematoma, deep vein thrombosis) in a multicenter prospective trial. This is the report of the duplex ultrasound (DUS) substudy of the CLIP trial. ⋯ DUS, a safe and reliable method for determining the safety and efficacy of access site closure devices, is a reliable, safe, inexpensive and accurate method of assessing vascular access site complications in multicenter trials. In this substudy of the CLIP study, DUS found no statistical difference in access site complications between the StarClose and manual compression groups. Both groups maintained vessel patency without stenosis, thrombosis, hematoma, pseudoaneurysm, or AV fistula.
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Catheter Cardiovasc Interv · Nov 2006
Comparative StudyTranscatheter closure versus medical therapy of patent foramen ovale and cryptogenic stroke.
The purpose of this study was to evaluate the efficacy and safety of device closure of patent foramen ovale (PFO) versus antiplatelet therapy in patients with cryptogenic stroke (CS). ⋯ PFO closure using the APFOO is a rational alternative to medical treatment in patients with CS. Larger randomized clinical trials are required to support the use of this device over the other PFO occluders and medical therapy.