Defining the common femoral artery: Insights from the femoral arterial access with ultrasound trial.

Objective: We sought to establish the typical location of the common femoral artery (CFA) bifurcation, the origin and most inferior reflection of the inferior epigastric artery (IEA) relative to the femoral head (FH) and whether patient demographics predicted anatomical variations.

Background: In the absence of ultrasound guidance or prior imaging, the precise location of the CFA bifurcation and IEA can only be determined following access site angiography. Fluoroscopic landmarks are commonly used to estimate the location of the CFA bifurcation, but the position of the IEA is less well characterized.

Endovascular repair of traumatic aortic injury: a novel arena in interventional cardiology.

Objective: To assess the feasibility of endovascular repair of traumatic aortic injuries performed by interventional cardiologists in collaboration with cardiothoracic surgeons.

Background: Traumatic aortic injury (TAI) represents a significant cause of mortality in trauma patients. Endovascular techniques have recently come into play for the management of TAI and are usually performed by a multidisciplinary team consisting of a thoracic or vascular surgeon and/or interventional radiology.

Bilateral arm approach for percutaneous coronary intervention of unprotected left main supported by a modified intra-aortic balloon pump.

Patients in whom femoral arterial access is not feasible pose a challenge in terms of hemodynamic support during high-risk percutaneous coronary intervention. Patient's height adds another challenge given the fixed lengths of available intra-aortic balloon pumps, in terms of achieving an adequate infrasubclavian positioning in the descending thoracic aorta. We report a case where a modified intra-aortic balloon pump helped achieve a successful result in a patient undergoing intervention of an unprotected left main using bilateral arm approach.

Liposomal amphotericin B-induced hypotension leading to ST segment elevated myocardial infarction.

We hereby report a short case of 71-year-old gentleman who developed ST segment elevation myocardial infarction shortly after starting the infusion of liposomal amphotericin B for disseminated histoplasmosis. We also discuss the novel pathogenesis of specific liposomal component of amphotericin B that contributed to the acute cardiopulmonary compromise in our patient leading to subsequent myocardial infarction.

Real-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: FAUST (Femoral Arterial Access With Ultrasound Trial).

Objectives: The aim of this study was to compare the procedural and clinical outcomes of femoral arterial access with ultrasound (US) guidance with standard fluoroscopic guidance.

Background: Real-time US guidance reduces time to access, number of attempts, and complications in central venous access but has not been adequately assessed in femoral artery cannulation.

Methods: Patients (n = 1,004) undergoing retrograde femoral arterial access were randomized 1:1 to either fluoroscopic or US guidance.

An acute experimental model demonstrating 2 different forms of sustained atrial tachyarrhythmias.

Background: The objective of this study was to develop an acute experimental model showing both focal and macroreentrant sustained atrial fibrillation (AF).

Methods And Results: In 31 anesthetized dogs, bilateral thoracotomies allowed the attachment of electrode catheters at the right and left superior pulmonary veins, atrial free walls, and atrial appendages. Acetylcholine, 100 mmol/L, was applied topically to either appendage.

Fluoroscopy vs. traditional guided femoral arterial access and the use of closure devices: a randomized controlled trial.

Objective: To compare the effectiveness of accessing the common femoral artery (CFA) using fluoroscopic guidance (FG) versus traditional anatomic landmark guidance (TALG) during cardiac catheterization and to determine the effect of the two modalities on the appropriateness for use of vascular closure devices (VCDs).

Background: Previous studies have shown a consistent relationship between the head of the femur and the CFA, yet there is no prospective data validating the superiority of fluoroscopy-assisted CFA access.

Methods: A total of 972 patients were randomized to either FG or TALG access.

An acute model for atrial fibrillation arising from a peripheral atrial site: evidence for primary and secondary triggers.

Background: We previously demonstrated that acetylcholine (Ach) injected into cardiac ganglionated plexi (GP) causes pulmonary vein (PV) ectopy initiating atrial fibrillation (AF).

Objective: To determine the effects of Ach applied at non-PV sites.

Methods: Overall, 54 dogs were anesthetized with Na-pentobarbital.

Carotid artery stenting: a therapeutic alternative in subtotal internal carotid artery occlusions.

Carotid artery stenting (CAS) is emerging as a less invasive modality for treating atherosclerotic occlusive disease of the internal carotid artery (ICA). Randomized trials like the SAPPHIRE trial have demonstrated that CAS is not inferior to carotid endarterectomy (CEA) in the treatment of carotid artery stenosis, and maybe even superior in high-risk symptomatic patients. However, patients with subtotal ICA occlusions with thrombus are excluded from randomized CAS trials and CAS registries.