Early Recognition and Management of Flecainide Toxicity: A Case Report and Literature Review.

Flecainide acetate is classified as a class IC antiarrhythmic medication according to the Vaughan-Williams classification, primarily used to manage both ventricular and supraventricular tachycardia. It is commonly employed for pharmacological cardioversion of atrial fibrillation (AF) and is frequently used in the "pill-in-the-pocket" approach for on-demand rhythm control. Despite its efficacy, flecainide is associated with significant adverse effects, including cardiac arrest, dysrhythmias, and heart failure.

Radiation Exposure During Invasive Cardiovascular Procedures: Portable Shielding System Versus Standard Lead Aprons.

Introduction Significant progress in the field of interventional cardiology has led to a rise in percutaneous procedures and an increase in the risk of radiation exposure at the workplace. Staff health has been put at risk due to the limitations of conventional radiation protective techniques. Innovative methods, such as RAMPART, have promising prospects for enhancing radiation safety.

Clinical Characteristics and Outcomes of ST-Elevation Myocardial Infarction in Young Patients: A Single-Center Experience.

Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMI and had primary percutaneous coronary intervention (pPCI).

Single Versus Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting for Unprotected Left-Main Coronary Disease.

Background: The use of dual antiplatelet therapy (DAPT) after coronary revascularization for left-main disease is still debated. The study aimed to characterize patients who received dual versus single antiplatelet therapy (SAPT) after coronary artery bypass grafting (CABG) for unprotected left-main disease and compare the outcomes of those patients.

Results: This multicenter retrospective cohort study included 551 patients who were grouped into 2 groups: patients who received SAPT (n = 150) and those who received DAPT (n = 401).

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting.

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function.

Percutaneous coronary intervention vs. coronary artery bypass grafting in emergency and non-emergency unprotected left-main revascularization.

Background: The optimal revascularization strategy in patients with left main coronary artery (LMCA) disease in the emergency setting is still controversial. Thus, we aimed to compare the outcomes of percutaneous coronary interventions (PCI) vs. coronary artery bypass grafting (CABG) in patients with and without emergent LMCA disease.

Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry.

Introduction: The aim of this study was to evaluate the effects of baseline anemia and anemia following revascularization on outcomes in patients with unprotected left main coronary artery (ULMCA) disease.

Methods: This was a retrospective, multicenter, observational study conducted between January 2015 and December 2019. The data on patients with ULMCA who underwent revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) were stratified by the hemoglobin level at baseline into anemic and non-anemic groups to compare in-hospital events.

Pregnancy-Related Spontaneous Coronary Artery Pseudoaneurysm Healed by Medical Treatment Guided by Optical Coherence Tomography.

Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial ischemia. SCAD complicated by coronary artery aneurysm (CAA) is rare and seldom reported. Coronary angiography is the gold standard for the diagnosis of SCAD.

Real-World Experience with a 60-mm-Long Stent in the Setting of Primary Percutaneous Coronary Intervention.

Introduction: Primary percutaneous coronary intervention (PPCI) represents a timely procedure that requires speedy revascularization. Moreover, PPCI in diffuse coronary lesions remains to be challenging even in the hands of experienced operators as the use of a long stent may increase the difficulty of the procedure in terms of stent delivery, deployment, and optimization. However, the practicability and clinical outcomes of deployment of a 60-mm-long stent in the setting of PPCI remain to be determined.

Polymer Emboli Complicating Transcatheter Aortic Valve Implantation: A Case Report.

Hydrophilic polymers are frequently used as surface coatings in modern intravascular technologies. We hereby present a case of a patient who underwent transcatheter aortic valve implantation that was complicated with foot gangrene and mesenteric ischemia, necessitating emergency enterectomy. Histologic examination revealed hydrophilic polymer emboli as the culprit of these complications.

Myocardial Infarction with Non-Obstructive Coronary Arteries: To Stent or Not to Stent? That is the Question.

Myocardial infarction with nonobstructive coronary arteries (MINOCA) in the context of acute ST elevation myocardial infarction (STEMI) is a challenging situation with no clear guidelines. In the absence of a consensus, optical coherence tomography (OCT) provides a better well-informed decision whether to stent or not. Herein, we report a case of MINOCA that underwent stenting of the proximal left anterior descending artery in the setting of extensive anterior wall STEMI in view of high-risk clinical presentation and OCT features of a ruptured plaque.

Explantation of a fully deployed coronary stent.

Percutaneous extraction of a freshly implanted stent is rarely reported, as it requires high technical expertise and accurate selection of instruments to ensure a safe retrieval process. Herein, we report a case of successful snaring of an erroneously deployed stent in the aorto-ostial position using the coaxial snare technique after successful recanalization of a complex right coronary artery chronic total occlusion. < Loss of stent position during percutaneous coronary intervention is a common occurrence especially in the aorto-ostial position of the coronary vessels.

Case Series and Brief Review Report: Excimer Laser Coronary Atherectomy, Facilitating Daily Complex Interventional Challenges.

The excimer laser has revolutionary impact on lesion preparation and chronic total occlusion outcomes. Furthermore, this technology has made huge progression in modern percutaneous intervention, especially in ones labeled as noncrossable lesions. This device has the advantage of crossing lesions that 0.

Outcomes of Unprotected Left Main Percutaneous Coronary Intervention: A Single-Centre Experience.

Introduction: When the baseline anatomical syntax score-I (SxSI) is more than or equal to 33, percutaneous coronary intervention (PCI) of unprotected left main (UPLM) is discouraged and considered as high-risk of adverse cardiac events. We designed this study to compare the outcomes of UPLM-PCI between the low to intermediate-syntax score (SxSI/.) group (defined as SxSI <33) and the high-syntax score (SxSI) group (defined as SxSI more than or equal 33) with a subanalysis to explore the predictive role of intravascular images (IVI).

Entrapment of a Partially Degloved Stent in the Radial Artery: is there Any Way Out?

Stent loss during percutaneous coronary intervention (PCI) is uncommon but may lead to serious adverse events. Here we describe a challenging case of stent loss in the radial artery during primary PCI. There, a long stent failed to cross the culprit lesion, and an attempt to pull back the undeployed stent into the guiding catheter resulted in eversion of the stent, partially stripping it off the stent balloon and rendering the stent irretrievable.