Radial haemostasis is facilitated with a potassium ferrate haemostatic patch: the Statseal with TR Band assessment trial (STAT).

Aims: Haemostasis is a limiting factor for discharge after uncomplicated transradial procedures. The purpose of this study was to determine whether a potassium ferrate haemostatic patch (PFHP) could serve as an adjunct to the air-bladder TR Band (TRB) to facilitate implementation of a rapid deflation protocol.

Methods And Results: This was a prospective multicentre randomised controlled trial comparing radial haemostatic protocols.

Ferumoxytol-enhanced MR Angiography for Vascular Access Mapping before Transcatheter Aortic Valve Replacement in Patients with Renal Impairment: A Step Toward Patient-specific Care.

Purpose To assess the technical feasibility of the use of ferumoxytol-enhanced (FE) magnetic resonance (MR) angiography for vascular mapping before transcatheter aortic valve replacement in patients with renal impairment. Materials and Methods This was an institutional review board-approved and HIPAA-compliant study. FE MR angiography was performed at 3.

3-D Electrochemical Impedance Spectroscopy Mapping of Arteries to Detect Metabolically Active but Angiographically Invisible Atherosclerotic Lesions.

We designed a novel 6-point electrochemical impedance spectroscopy (EIS) sensor with 15 combinations of permutations for the 3-D mapping and detection of metabolically active atherosclerotic lesions. Two rows of 3 stretchable electrodes circumferentially separated by 120° were mounted on an inflatable balloon for intravascular deployment and endoluminal interrogation. The configuration and 15 permutations of 2-point EIS electrodes allowed for deep arterial penetration via alternating current (AC) to detect varying degrees of lipid burden with distinct impedance profiles (Ω).

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.

Coronary and bypass graft angiography via the right radial approach using a single catheter.

Transradial cardiac catheterization in patients with previous coronary artery bypass graft surgery can be technically challenging. The presence of a left internal mammary artery (LIMA) graft was previously considered a relative contraindication for a right radial procedure, but there are several reports demonstrating the feasibility and safety of LIMA angiography from a right radial access. This case report demonstrates that transradial coronary and bypass graft angiography including LIMA angiography from the right radial approach is technically feasible with a single catheter.

Acute myocardial infarction caused by multivessel coronary spasm due to calcium channel blocker withdrawal.

Calcium channel blockers are a commonly used class of medications for the management of hypertension, angina, and superventricular tachyarrhythmias. Abrupt withdrawal of these agents can precipitate coronary vasospasm, which may result in myocardial infarction. We present the case of a 47-year-old woman who sustained an acute myocardial infarction mediated by multivessel coronary vasospasm secondary to verapamil withdrawal and the associated interventional management.

Quantification of fractional flow reserve based on angiographic image data.

Coronary angiography provides excellent visualization of coronary arteries, but has limitations in assessing the clinical significance of a coronary stenosis. Fractional flow reserve (FFR) has been shown to be reliable in discerning stenoses responsible for inducible ischemia. The purpose of this study is to validate a technique for FFR quantification using angiographic image data.

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.

Violent hiccups: an infrequent cause of bradyarrhythmias.

A hiccup, or singultus, results from a sudden, simultaneous, vigorous contraction of the diaphragm and inspiratory muscles, accompanied by closure of the glottis. Hiccups can be associated with bradyarrhythmias. The mechanism of this phenomenon is likely hiccup-induced Valsalva maneuver and increased parasympathetic tone.

Transcatheter closure of a traumatic VSD in an adult requiring an ASD occluder device.

Traumatic ventricular septal defects (VSD) can occur after blunt or penetrating chest trauma or cardiac procedures. There are few publications reporting the safety and efficacy of transcatheter closure of traumatic VSDs. We report a case of a large VSD resulting from penetrating chest trauma that was not repaired at the initial surgical procedure on the disrupted right ventricle.

Successful catheter ablation of focal ventricular fibrillation originating from the right ventricle.

Sudden cardiac death from ventricular fibrillation (VF) typically occurs in patients with structural heart disease, but in 5 to 10 percent VF is "idiopathic," occurring in normal hearts. Recently, there has been the description and growing recognition of patients with VF that has a focal origin, the common sites being in the right ventricular outflow tract (RVOT) and sites in the left ventricle. A focus within the right ventricle outside the RVOT is rare.

Addressing the hemodynamic dilemma of combined mitral and aortic stenosis.

Accurate assessment of valvular hemodynamics is essential in the decision-making process when referring a patient for cardiac surgery who has suspected coexistent aortic and mitral valve disease. Often times, one valvular lesion is worse than the other, and the question of "prophylactically" replacing the less severe valve at the time of surgery is controversial. In these situations and because of uncertainty regarding noninvasive assessment, hemodynamic evaluation in the cardiac catheterization laboratory provides critical information in guiding therapy.

Importance of electrocardiography in the assessment and management of heart failure: a case report.

Restoring and maintaining optimal electrical activation of the cardiac chambers as well as atrioventricular synchrony are important aspects of heart failure management. The 12-lead electrocardiogram remains a simple and cost-effective diagnostic tool that can provide important clues in achieving this goal. We report a case where careful interpretation of the 12-lead electrocardiogram led to the diagnosis of pacemaker syndrome.

Utility of cardiac MRI in guiding revascularization therapy in unprotected left main stenosis: a case report.

Decision to select unprotected left main (ULM) stenting versus coronary artery bypass grafting surgery (CABG) depends on a multiplicity of factors, one of the most critical of which is myocardial viability. Delayed enhancement cardiac magnetic resonance (CMR) imaging has emerged as a useful means of comprehensively evaluating viable myocardium in postmyocardial infarct patients who require further revascularization. We present a patient with ULM stenosis in whom CMR imaging assisted in the decision to perform percutaneous coronary intervention over CABG.

Acute lymphoblastic leukemia presenting as acute renal failure.

Background: A 42-year-old previously healthy man presented with acute-onset headache and facial paralysis. He was treated for Bell's palsy with corticosteroids and valaciclovir. One week later, he developed acute renal failure requiring hospitalization.