Background: Studies show mixed results regarding the effect of coronary revascularization on mortality benefit and ventricular tachycardia (VT) recurrence in patients with monomorphic VT without acute coronary syndrome (ACS). This meta-analysis aimed to assess the effect of ischemia testing and/or coronary revascularization on mortality and VT recurrence in a pooled data set.
Methods: Databases including PubMed, Google Scholar, and the Cochrane Library were searched from January 2000 to December 2023 for studies reporting event data on mortality and VT recurrence in patients without ACS who presented with monomorphic VT.
Background: Traditional transradial access (TRA) is widely used for coronary and non-coronary interventions with significant improvements in procedural outcomes; however, it is associated with RAO that precludes repeat use of the same artery for possible future TRI and other purposes. Distal radial access (DRA) has been proposed as an effective alternative to decrease RAO rates. Published literature describing the RAO rate after DRA versus TRA from various RCT and clinical registries has shown conflicting results.
View Article and Find Full Text PDFBackground: Radial artery access for coronary angiography or percutaneous coronary intervention (PCI) reduces the risk of death, bleeding, and vascular complications and is preferred over femoral artery access, leading to a class 1 indication by clinical practice guidelines. However, alternate upper extremity access such as distal radial and ulnar access are not mentioned in the guidelines despite randomized trials. We aimed to evaluate procedural outcomes with femoral, radial, distal radial, and ulnar access sites in patients undergoing coronary angiography or PCI.
View Article and Find Full Text PDFBackground: The optimal duration of hemostatic compression post transradial access is controversial. Longer duration increases the risk of radial artery occlusion (RAO) while shorter duration increases the risk of access site bleeding or hematoma. As such, a target of 2 hours is typically used.
View Article and Find Full Text PDFObjectives: To assess differences in radiation exposure between transradial access (TRA) and transfemoral access (TFA) for coronary procedures.
Background: TRA is associated with increased radiation exposure as compared to TFA. We compared radiation exposure between the two access sites.
Background: Emerging evidence from randomized clinical trials (RCTs) comparing distal radial access (DRA) with conventional radial access (RA) is available.
Objectives: The aim of this study was to provide a quantitative appraisal of the effects of DRA) vs conventional RA for coronary angiography with or without intervention.
Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.
J Soc Cardiovasc Angiogr Interv
October 2022
Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to provide benefits to operators and patients when compared with traditional percutaneous coronary intervention. Despite being available for 16 years in the United States, utilization of R-PCI remains low. This may be because of an expected learning curve with this technology.
View Article and Find Full Text PDFCardiovasc Revasc Med
August 2023
6 French percutaneous coronary intervention (PCI), has become widely adopted. We describe a case of successful 8 French transradial access (TRA) coronary intervention using state of the art hemostasis technique with preservation of radial patency after the procedure.
View Article and Find Full Text PDFBackground: There is limited insight into the epidemiological characteristics and effect of race and ethnicity on Primary Malignant Cardiac Tumors (PMCTs).
Objectives: Comparison of clinical characteristics and cancer-specific survival outcomes of major races in the United States from the Surveillance, Epidemiology and End-Result (SEER) registry.
Methods: ICD-O-3 codes were used to identify PMCTs for the years 1975 to 2015.
Purpose Of Review: Robotics has been used in multiple areas of procedural medical intervention. Robotic percutaneous coronary intervention (PCI) has been available since 2004. Its adoption has been slow with initial application in simple cases.
View Article and Find Full Text PDFIn selected cases, when STEMI caused by mild or moderate degree lesion with a large concomitant thrombus, additional OCT-guided PCI strategy after thrombus removal allows us to defer stenting with the follow-up natural healing of the vessel wall.
View Article and Find Full Text PDFAlthough echocardiography remains the key tool for evaluation of aortic valve stenosis severity, in a fair minority of patients invasive evaluation is still needed. Dual-lumen catheters allow for simultaneous trans-aortic pressure measurements with single arterial access. We describe a technique where traditional hardware using non-dedicated catheters can be used to obtain simultaneous pressure measurements using a 6 French single arterial access.
View Article and Find Full Text PDFBackground: Lack of health insurance is associated with adverse clinical outcomes; however, the association between health insurance status and in-hospital outcomes after out-of-hospital ventricular fibrillation (OHVFA) arrest is unclear.
Hypothesis: Lack of health insurance is associated with worse in-hospital outcomes after out-of-hospital ventricular fibrillation arrest.
Methods: From January 2003 to December 2014, hospitalizations with a primary diagnosis of OHVFA in patients ≥18 years of age were extracted from the Nationwide Inpatient Sample.
The temporal trends and preprocedural predictors of emergency coronary artery bypass graft surgery (ECABG) after elective percutaneous coronary intervention (PCI) in the contemporary era are largely unknown. From January 2003 to December 2014 elective hospitalizations with PCI as the primary procedure were extracted from the Nationwide Inpatient Sample. ECABG was identified as CABG within 24 hours of elective PCI.
View Article and Find Full Text PDFObjectives: The study evaluated the association between distance from radiation source and radiation exposure.
Background: Radiation exposure during medical procedures is associated with increased risk of cancer and other adverse effects.
Methods: An American National Standards Institute phantom was used to study the relationship between measured entrance surface exposure (MESE) and distance from the X-ray source in postero-anterior, left anterior oblique, and right anterior oblique projections.
Background: Duplex Doppler ultrasonography (USG) remains the gold standard for evaluation of radial artery occlusion (RAO) after transradial access (TRA). The diagnostic accuracy of digital plethysmography, which is cheaper and widely available, for evaluation of RAO after TRA is not known.
Methods: Patients undergoing TRA were prospectively studied.
Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame.
Methods: A total of 996 consecutive patients referred for PCI between December 2017 and March 2019 were studied, of which 310 (31.
Transradial angiography and intervention continues to become increasingly common as an access site for coronary procedures. Since the first "Best Practices" paper in 2013, ongoing trials have shed further light onto the safest and most efficient methods to perform these procedures. Specifically, this document comments on the use of ultrasound to facilitate radial access, the role of ulnar artery access, the utility of non-invasive testing of collateral flow, strategies to prevent radial artery occlusion, radial access for primary PCI and topics that require further study.
View Article and Find Full Text PDFAlthough covered stents have been available for percutaneous treatment of coronary aneurysms, patients with longer aneurysmal segments have been difficult to treat with covered stents. We describe a case of a right coronary artery aneurysm with an angiographically estimated length exceeding 30 mm treated percutaneously using covered stents and conventionally available hardware. ().
View Article and Find Full Text PDFTransradial access (TRA) is increasingly used worldwide for percutaneous interventional procedures and associated with lower bleeding and vascular complications than transfemoral artery access. Radial artery occlusion (RAO) is the most frequent post-procedural complication of TRA, restricting the use of the same radial artery for future procedures and as a conduit for coronary artery bypass graft. The authors review recent advances in the prevention of RAO following percutaneous TRA diagnostic or interventional procedures.
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