Percutaneous intervention for posterior fossa ischemia. A single center experience and review of the literature.

Objectives: The purpose of our study was to evaluate the results of endovascular treatment of symptomatic vertebro-basilar insufficiency (VBI) unresponsive to medical therapy.

Methods: Cardiac patients regularly followed in our cardiology clinic with symptoms suggestive of posterior fossa ischemia diagnosed by the attending cardiologist, had diagnostic or suspicious findings of vertebral artery stenosis on ultrasound evaluation, with reversed vertebral flow on Doppler examination. These patients were referred for selective vertebral and subclavian artery angiography.

Percutaneous vertebral artery intervention: a necessary tool in every interventional cardiologist armamentarium.

Objectives: The purpose of this study was to evaluate the results of endovascular treatment of symptomatic vertebrobasilar insufficiency unresponsive to medical therapy.

Methods: Twenty-eight patients who were regularly followed up in our cardiology clinic with symptoms suggestive of posterior fossa ischemia and with diagnostic or suspicious findings on ultrasound evaluation were evaluated with selective vertebral and subclavian artery angiography. All patients (17 men, 11 women; mean age, 64 years; range, 54-87) had critical lesions (>70% stenosis) in the vertebral or subclavian arteries or both.

The no-flow phenomenon during diagnostic coronary angiography.

Objectives: Slow flow of dye in epicardial coronary arteries is not an infrequent finding in patients during routine coronary angiography. The extreme form of this phenomenon, namely, no flow or Thrombolysis in Myocardial Infarction (TIMI) 0-1, is very uncommon with life-threatening consequences. We consider the present report as the first one, to our knowledge, that describes this angiographic entity and how prompt recognition and adequate management prevent certain death in this population.

Safety of elective--including "high risk"--percutaneous coronary interventions without on-site cardiac surgery.

Background: Current guidelines (American College of Cardiology/American Heart Association) for percutaneous coronary intervention (PCI) limit the performance of elective cases to hospitals with the capability for cardiac surgery. The number of hospitals in the United States with this capability is limited, which restricts availability of this proven technology.

Objective: To determine the safety of performing elective, nonselected PCI in hospitals without cardiac surgery capability.