101 research outputs found
Is it Reasonable to Treat All Calcified Stenotic Valves With a Valve Stent? Probably Yes If We Get a Full Stent Expansion
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Intimal hyperplasia and cystic medial necrosis as substrate of acute coronary syndrome in a cocaine abuser: an in vivo/ex vivo pathological correlation.
No full textIdentification of pathological substrate of degenerative remodeling of coronary artery causing acute coronary syndrome in a cocaine abuse
Refractory angina with severe left ventricular dysfunction: a case for percutaneous transseptal ventricular assistance supported revascularization.
No full textA 73-year-old female patient with medical refractory angina, severe multivessel disease and a critically depressed left ventricular function (ejection fraction 30%) was admitted to our hospital. Considered a poor candidate for surgical revascularization, she underwent urgent high-risk revascularization supported by use of a novel percutaneous left ventricular assist system
Detection of coronary artery disease in asymptomatic patients with type 2 diabetes mellitus
No full textWe sought to verify the effectiveness of current American Diabetes Association screening guidelines in identifying asymptomatic patients with coronary artery disease (CAD) in type 2 diabetes mellitus (DM2).
BACKGROUND In DM2 patients, CAD generally is detected in an advanced stage with an extensive atherosclerosis and poor outcome, whereas CAD in an asymptomatic stage is commonly
missed.
METHODS This study included 1,899 asymptomatic DM2 patients (age >60 years). Of these, 1,121 had >2 associated risk factors (RFs), group A, and the remaining 778 had >1 RF, group B, for
CAD. All patients underwent dipyridamole myocardial contrast echocardiography (MCE), and in those with myocardial perfusion defects, the anatomy of coronary vessels was analyzed
by selective coronary angiography.
RESULTS In the two study groups, the prevalence of abnormal MCE (59.4% vs. 60%, p < 0.96) and
of a significant CAD (64.6% vs. 65.5%, p <0.92) was similar, irrespective of RF profile. But coronary anatomy differed: group B had a lower prevalence of three-vessel disease (7.6% vs.
33.3%, p <0.001), of diffuse disease (18.0% vs. 54.9%, p 0.001), and of vessel occlusion (3.8% vs. 31.2%, p <0.001), whereas one-vessel disease was more frequent (70.6% vs. 46.3%, p < 0.001). Coronary anatomy did not allow any revascularization procedure in 45% of group A patients.
CONCLUSIONS An “aggressive” diagnostic approach, requiring coronary angiography in asymptomatic DM2 patients with >1 associated RF for CAD and abnormal MCE, identified patients with a subclinical CAD characterized by a more favorable angiographic anatomy. The criterion of >2 RFs did not help to identify asymptomatic patients with a higher prevalence of CAD and is only related to a more severe CAD with unfavorable coronary anatomy
Effect of renal artery stenting on the progression of renovascular renal failure: a case of intravascular ultrasound-confirmed renovascular disease.
No full textWe report the case of a 71-year-old male, submitted to percutaneous transluminal renal angioplasty (PTA) plus stent implantation following the confirmation, at intravascular ultrasound, of severe unilateral renal artery stenosis in the setting of a single functional kidney and of evidence of renal insufficiency (serum creatinine value 300 mumol/l). At 6 months of follow-up the serum creatinine levels had returned to normal (98 mumol/l). This case shows the role of direct PTA on the overall renal function in a case of global renal ischemia
Adjusting the benefits of primary angioplasty against thrombolytic therapy for acute myocardial infarction: the role of time
No full textImpact of clinical risk and prehospital delay on 1 year outcome in STEMI patients treated with reperfusion therapy in a context of interhospital network
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