Right and left heart catheterization via an antecubital fossa vein and the radial artery--a prospective study.

Right heart catheterization has been described via the arm but previous reports have been retrospective, performed for limited indications, and may not give an accurate assessment of the success rate or safety of this technique. We sought to prospectively examine the feasibility and safety of left and right heart catheterization entirely via the arm using the radial artery and an antecubital fossa vein for a broad range of indications. Fifty-eight consecutive procedures were included.

The resting status of the coronary microcirculation is a predictor of microcirculatory function following elective PCI for stable angina.

Background/objectives: We performed a prospective study to investigate markers of percutaneous coronary intervention (PCI) related microvascular injury.

Methods: Consecutive patients undergoing PCI for stable angina were studied. The index of microvascular resistance (IMR) was measured using a temperature and pressure sensing guidewire (TPSG) before and after single vessel PCI.

Three-year clinical results of the Axxess Biolimus A9 eluting bifurcation stent system: the DIVERGE study.

Aims: To report the three-year clinical outcome of the Axxess™ stent, a nitinol self-expanding Biolimus A9™ eluting stent for treatment of de novo coronary bifurcation lesions. The Axxess stent is a new-generation drug-eluting stent that might offer advantages in terms of improved clinical outcomes and safety profile in bifurcation lesion stenting.

Methods And Results: The DIVERGE study was a multicentre, prospective, single-arm trial.

Renal sympathetic denervation: hypertension therapy and beyond.

Hypertension is one of the most important treatable causes of mortality and morbidity in the world, but despite the wide availability of pharamacological therapy, blood pressure is poorly controlled in many patients. Renal sympathetic denervation (RSD) is a novel therapeutic option whereby the renal sympathetic nerves, which lie within and around the wall of the renal arteries, are ablated using a catheter placed within the arterial lumen. The Symplicity HTN-2 trial has shown that RSD reduces blood pressure to a clinically relevant degree; this finding has resulted in an explosion in interest in the procedure and RSD has the potential to become a standard therapy for many hypertensive patients.

Side-branch wire entrapment during bifurcation PCI: avoidance and management.

An LAD/D1 bifurcation intervention was complicated by side-branch wire entrapment and unravelling requiring goose-neck snare removal. Residual microfilaments were retrieved from the main branch after further balloon inflations with a satisfactory final angiographic result and one-year follow-up. Various methods are available to avoid and deal with this complication.

Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study.

Background: Renal sympathetic hyperactivity is associated with hypertension and its progression, chronic kidney disease, and heart failure. We did a proof-of-principle trial of therapeutic renal sympathetic denervation in patients with resistant hypertension (ie, systolic blood pressure >/=160 mm Hg on three or more antihypertensive medications, including a diuretic) to assess safety and blood-pressure reduction effectiveness.

Methods: We enrolled 50 patients at five Australian and European centres; 5 patients were excluded for anatomical reasons (mainly on the basis of dual renal artery systems).