Suture-Based Vascular Closure Versus Surgical Closure of Large Bore Arteriotomies: A Real-World Experience.

Introduction: With the introduction of transcatheter aortic valve implantation (TAVI), endovascular abdominal aortic aneurysm repair (EVAR), thoracic endovascular aortic aneurysm repair (TEVAR), and frequent use of left ventricular assist devices in complicated percutaneous coronary interventions, the use of large bore arterial access has become a necessity. In the index study, we compared the percutaneous closure of large arteriotomies with open surgical (OS) closure.

Methods: It was a prospective study in which we compared the technical success and vascular complication rate associated with the use of a suture-based vascular closure device (VCD): Perclose ProGlide (PP) with that of OS closure.

The Safety and Long-Term Efficacy of Carotid Artery Stenting: An All-Comers Registry.

Background Carotid artery stenting (CAS) has emerged as a less invasive alternative to carotid endarterectomy (CEA) for the prevention of future cerebrovascular events in patients with carotid artery stenosis. Despite multiple randomized controlled trials (RCTs) comparing CAS and CEA for carotid disease, real-world data outside the rigorous environment of trials is scarce. Methods The present study is a prospective observational study conducted at a tertiary care center, wherein all patients who underwent CAS between January 2007 and December 2019 were included.

Guiding Principles for the Clinical Use and Selection of Microcatheters in Complex Coronary Interventions.

The use of microcatheters as a coronary interventional tool for a therapeutic approach to complex coronary interventions like bifurcation lesions, ostial location, tortuous anatomy, angled takeoffs, coronary calcification, and chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is growing among cardiologists across the country. During the treatment of such complex lesions, microcatheters play an essential part of the tool kit with both single-lumen and double-lumen microcatheters (DLMs) having their specific niche areas. The selection of microcatheters involves a detailed understanding of the microcatheter specification, lesion anatomy, lesion location, vessel tortuosity and trajectory, and crossing techniques.

Femoral artery access site closure with perclose suture mediated device in coronary interventions.

Objective: To compare the outcome of suture mediated vascular closure device Perclose Proglide (PP) with manual compression (MC) following transfemoral access for coronary interventions (CI).

Methods: It is a retrospective, observational, single centre study from January 2018 to September 2019. Consecutive patients undergoing interventions through transfemoral access were divided into PP and MC groups.

Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial.

Background: Given the shortage of cardiac rehabilitation (CR) programs in India and poor uptake worldwide, there is an urgent need to find alternative models of CR that are inexpensive and may offer choice to subgroups with poor uptake (e.g., women and elderly).

Endovascular management of a case of spontaneous retroperitoneal haematoma complicated with deep vein thrombosis and pulmonary embolism.

Spontaneous retroperitoneal haematoma (SRH) can be a life-threatening emergency presenting with hypovolaemic shock. SRH has been rarely reported with May-Thurner syndrome (MTS) where it occurs due to rupture of the iliac vein or venous collaterals. We report a case of MTS that presented with deep venous thrombosis of the left lower limb complicated by bilateral pulmonary embolism (PE) and a large pelvic haematoma.

Invasive aspergillosis presenting as an intracardiac mass in an immunocompetent host.

Invasive aspergillosis is a severe fungal infection that primarily affects immunocompromised patients. We report a case of invasive aspergillosis presenting as a febrile respiratory infection with a cardiac mass in an immunocompetent patient. Excision of the intracardiac mass followed by histopathological examination confirmed the diagnosis.

Endovascular treatment of a rare cause of secondary hypertension in an elderly woman.

A 70-year-old woman on four antihypertensive drugs including diuretics presented with accelerated hypertension and acute pulmonary oedema. She had a bounding brachial pulse with feeble femoral pulses. A 256 slice CT scan revealed the presence of severe diffuse thoracoabdominal atherosclerosis.

Kissing stenting of aorto-ostial lesions in juxtaposed renal arteries.

Percutaneous angioplasty with or without stenting has become an established procedure for treatment of renal artery stenosis for control of hypertension or progressive renal dysfunction. Anatomic variation of renal arteries is common with dual blood supply of unilateral kidney noted in almost 25% of the general population. Renal angioplasty of these anatomic variants of renal arteries is challenging.

Biventricular thrombosis in a structurally normal heart at high altitude.

We present a rare case of biventricular thrombus in a young patient with a structurally normal heart at high altitude, complicated with pulmonary embolism. Detailed evaluation revealed him to have protein S deficiency. Altered environmental conditions at high altitude associated with protein S deficiency resulted in thrombus formation at an unusual location; the same is discussed in this case report.

Effect of a 6-month intervention with cooking oils containing a high concentration of monounsaturated fatty acids (olive and canola oils) compared with control oil in male Asian Indians with nonalcoholic fatty liver disease.

Objective: We investigated the effects of dietary intervention with canola or olive oil in comparison with commonly used refined oil in Asian Indians with nonalcoholic fatty liver disease (NAFLD).

Subjects And Methods: This was a 6-month intervention study including 93 males with NAFLD, matched for age and body mass index (BMI). Subjects were randomized into three groups to receive olive oil (n=30), canola oil (n=33), and commonly used soyabean/safflower oil (control; n=30) as cooking medium (not exceeding 20 g/day) along with counseling for therapeutic lifestyle changes.

Pulmonary hypertension in a patient with hereditary haemorrhagic telangiectasia.

A young male patient reported for evaluation of progressive easy fatigability, accompanied by a recent history of recurrent haemoptysis. His clinical examination was unremarkable except for evidence of pulmonary arterial hypertension (PAH). Routine investigations (haemogram, coagulogram, serological tests for connective tissue disorders and a sputum Ziehl Neelsen stain for acid-fast bacilli) were normal.

Innovative endovascular technique for treatment of rare cause of haemoptysis in young.

A 17-year-old boy reported for evaluation of two episodes of massive haemoptysis. His clinical examination was unremarkable and investigations (haemogram, coagulogram, serological tests for connective tissue disorders) were normal. A 64-slice CT angiography revealed a saccular aneurysm of 3.

Non-alcoholic fatty liver disease is closely associated with sub-clinical inflammation: a case-control study on Asian Indians in North India.

Objectives: Association between sub-clinical inflammation and non-alcoholic fatty liver disease (NAFLD) has not been studied in Asian Indians. In this case-control study, we aimed to analyse association of NAFLD with the sub-clinical inflammation and metabolic profile in Asian Indians in north India.

Methods: Ultrasound diagnosed 120 cases of NAFLD were compared to 152 healthy controls without NAFLD.

Consensus physical activity guidelines for Asian Indians.

India is currently undergoing rapid economic, demographic, and lifestyle transformations. A key feature of the latter transformation has been inappropriate and inadequate diets and decreases in physical activity. Data from various parts of India have shown a steady increase in the prevalence of lifestyle-related diseases such as type 2 diabetes mellitus (T2DM), the metabolic syndrome, hypertension, coronary heart disease (CHD), etc.

Microcoil embolization in post-traumatic high-flow priapism.

An 18-year-old male developed post-traumatic priapism subsequent to a fall causing blunt perineal trauma. Color Doppler ultrasound showed a high-flow arterio-venous fistula with feeders from branches of the left internal iliac artery. Selective arteriography of the left internal pudendal artery demonstrated an arterio-venous fistula.

Consensus dietary guidelines for healthy living and prevention of obesity, the metabolic syndrome, diabetes, and related disorders in Asian Indians.

India is undergoing rapid nutritional transition, resulting in excess consumption of calories, saturated fats, trans fatty acids, simple sugars, salt and low intake of fiber. Such dietary transition and a sedentary lifestyle have led to an increase in obesity and diet-related non-communicable diseases (type 2 diabetes mellitus [T2DM], cardiovascular disease [CVD], etc.) predominantly in urban, but also in rural areas.

Bone mineral density in young males with ankylosing spondylitis.

Objective: To assess bone mineral density (BMD) abnormalities in young Indian males with ankylosing spondylitis (AS) and factors influencing this.

Methods: Eighty AS male subjects were compared with 160 age/sex matched controls for BMD of lumbar spine and proximal femur. AS subjects were evaluated and followed up every 3 months for disease activity.

Abdominal sonography in the medical evaluation of aviation aspirants.

Background: Ultrasonography is increasingly used in elderly individuals for screening of occult malignancy and abdominal aortic aneurysm. Its utility as a screening tool in healthy asymptomatic individuals is not yet established. The current study was undertaken to evaluate the utility of abdominal and pelvic ultrasonographic screening as an adjunct to routine physical examination among young adults undergoing initial medical examination for aviation duties.

Thrombosuction for procedural acute thrombosis during high-risk carotid angioplasty--a case report.

Carotid endarterectomy in the presence of an occluded contralateral artery is associated with a high risk of perioperative stroke. Carotid stenting with neuroprotection devices has emerged as a safe procedure for revascularization in this circumstance. We performed high-risk carotid angioplasty in a patient with a history of recurrent transient ischemic attacks and 90% stenosis of left internal carotid artery with other occluded cerebral vessels.

"Transcollateral" renal angioplasty for a completely occluded renal artery.

Percutaneous transluminal renal angioplasty with stenting has been effective in the control of hypertension, renal function, and pulmonary edema caused by atherosclerotic renal artery stenosis. However, the role of the procedure has not been fully established in the context of chronic total occlusion of renal artery. We report the successful use of this procedure in 57-year-old male patient who reported for evaluation of a recent episode of accelerated hypertension.

Screening coronary angiography prior to surgery in rheumatic valvular heart disease: a study of 2,188 patients.

Background And Aim Of The Study: The role of screening coronary angiography in Asian Indian patients with rheumatic heart disease (RHD) due to undergo valve replacement surgery is unclear. Hence, the study aim was to determine the prevalence of coronary artery disease (CAD), and to monitor its correlation with demographic variables and valvular lesion type, in this patient group.

Methods: A retrospective analysis of 2,188 consecutive patients (1,319 men, 869 women; mean age 48 +/- 7 years) with rheumatic valvular heart disease was conducted.

Impact of obesity on the left ventricular functions and morphology of healthy Asian Indians.

Background: The aim of this study was to determine the impact of obesity on alteration of left ventricular (LV) functions and morphology in nondiabetic, nonhypertensive, and normo-lipidemic obese Asian Indians. A total of 239 consecutive Asian Indians (175 males and 64 females, ages 17-64 years) were divided into obese and nonobese groups based on body mass index (BMI), waist-to-hip circumference ratio (W-HR), and percentage of body fat (%BF).

Methods: Anthropometry (BMI, W-HR), %BF, and two-dimensional echocardiography including tissue Doppler imaging (TDI) were performed for all the subjects.

N-terminal pro-BNP plasma levels before and after percutaneous transvenous mitral commissurotomy for mitral stenosis.

In this study, we investigated the change in N-terminal pro-brain natriuretic peptide (NT-pro-BNP) plasma levels among 44 consecutive patients with mitral stenosis, 10 min before and 24 h after undergoing percutaneous transvenous mitral commissurotomy (PTMC). The procedure was successful in all patients and a significant decline was noted in NT-pro-BNP levels. Reduction of NT-pro-BNP was more marked in patients in sinus rhythm as compared to those with atrial fibrillation.