Relation of distribution of coronary blood flow volume to coronary artery dominance.

Coronary artery dominance influences the amount and anatomic location of myocardium that is perfused by the left or right coronary circulation. However, it is unknown whether coronary artery dominance also influences the distribution of coronary blood flow volume. The aim of this study was to evaluate volumetric coronary blood flow in 1,322 vessels from 496 patients in the Prediction of Progression of Coronary Artery Disease and Clinical Outcomes Using Vascular Profiling of Endothelial Shear Stress and Arterial Wall Morphology (PREDICTION) study.

Membranous diaphragm formation after simultaneous kissing stenting with sirolimus-eluting stents for the left main bifurcation: insight from optical coherence tomography findings.

Two patients who underwent simultaneous kissing stenting with sirolimus-eluting stents in the left main coronary artery were investigated with optical coherence tomography (OCT) at just more than 1 year postoperatively. In both cases, follow-up angiogram indicated complete coverage of the new metal carina with a membranous diaphragm, yet OCT showed varying tissue-coverage patterns transitioning from stent inflow to stent outflow. These patterns included single-strut coverage, bridge-like membrane formation between more than 1 strut, and end-to-end coverage of the carina; no uncovered stent struts were detected.

Thrombus aspiration with microcatheter for distal embolization during primary angioplasty for acute myocardial infarction: technical notes.

We describe a new technique for removing distal emboli that became visible on angiography during percutaneous coronary intervention for acute myocardial infarction. Three patients presented with distal embolization as a filling defect with an abrupt cut-off in 1 of the peripheral coronary vessels of the infarct-related coronary artery. After a failed attempt to retrieve the thrombus with a conventional aspiration catheter, the thrombus was trapped at the tip of a microcatheter by aspiration and was successfully retrieved.

Diagnostic value of nonenhanced multidetector computed tomography for ruling out acute aortic dissection in patients presenting with chest or back pain.

Background: Multidetector computed tomography (MDCT) is widely used for diagnosing acute aortic dissection (AAD). However, the diagnostic value of nonenhanced MDCT for AAD remains unknown. We evaluated the usefulness of nonenhanced 64-slice MDCT for ruling out AAD in patients presenting with chest or back pain.

Extracorporeal life support for cardiogenic shock or cardiac arrest due to acute coronary syndrome.

Background: Few data are available on the clinical outcome of patients with acute coronary syndrome (ACS) complicated by refractory cardiogenic shock or cardiac arrest who receive percutaneous extracorporeal life support (ECLS). We investigated the in-hospital outcome and predictors of mortality in these patients.

Methods: The investigation was a single-center, retrospective cohort study of 98 ACS patients who received ECLS to reverse hemodynamic collapse refractory to conventional treatment.

Buddy-balloon technique for final kissing-balloon dilatation after crush stenting of the left main coronary artery.

Background: Crush stenting mandates a final kissing-balloon technique (KBT) for a better clinical outcome; however, recrossing the 2 overlapping stent struts with the balloon catheter is technically challenging.

Objectives: The efficacy of the buddy-balloon technique for facilitating completion of the final KBT during crush stenting of the left main coronary artery (LMCA) was evaluated.

Methods: The records of 38 consecutive patients who underwent crush stenting for a lesion in the distal LMCA from January 2005 to December 2009 were retrospectively reviewed.

Supported percutaneous coronary intervention using a novel 6-Fr intra-aortic balloon pump catheter via the brachial artery in a nonagenarian patient with an abdominal aortic aneurysm.

Intra-aortic balloon pump (IABP) counterpulsation is a useful hemodynamic assist device during complex percutaneous coronary intervention (PCI) in patients with poor left ventricular function; however, the presence of an abdominal aortic aneurysm poses a problem, because insertion via the femoral artery may cause distal embolism and aneurysm rupture. A 92-year-old man with unstable angina was admitted to our hospital. Coronary angiography revealed chronic total occlusion of the proximal left anterior descending artery and severe stenosis of the left circumflex artery (LCX).

Successful fenestration using a chronic total occlusion-dedicated guidewire in a patient with catheter-induced dissection of the right coronary artery.

Guiding catheter-induced coronary artery dissection is a rare, but hazardous complication of percutaneous coronary intervention (PCI) and is associated with the potential risk of impairment of coronary blood flow. Therefore, occurrence of this complication mandates a prompt revascularization procedure. A 68-year-old female patient with acute myocardial infarction caused by total occlusion of the proximal right coronary artery (RCA) underwent PCI.

Erythropoietin prevention trial of coronary restenosis and cardiac remodeling after ST-elevated acute myocardial infarction (EPOC-AMI): a pilot, randomized, placebo-controlled study.

Background: Erythropoietin (EPO) enhances re-endothelialization and anti-apoptotic action. Larger clinical studies to examine the effects of high-dose EPO are in progress in patients with acute myocardial infarction (AMI).

Methods And Results: The aim of this multi-center pilot study was to investigate the effect of `low-dose EPO' (6,000 IU during percutaneous coronary intervention (PCI), 24 h and 48 h) in 35 patients with a first ST-elevated AMI undergoing PCI who was randomly assigned to EPO or placebo (saline) treatment.