Is Stenting or Coronary Artery By-pass Grafting the Better Treatment for This Patient?

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Is Stenting or Coronary Artery By-pass Grafting the Better Treatment for This Patient?"

Transcription

1 Is Stenting or Coronary Artery By-pass Grafting the Better Treatment for This Patient? --- NIRS-IVUS TVC Imaging Adds Additional Information for the Heart Team Dr. Luis Tami Memorial Regional Hospital Hollywood, FL

2 Patient History 64 year old female with unstable angina. Severe COPD requiring home oxygen for 2 years, obesity, hypertension, peripheral vascular disease, dyslipidemia and diabetes.

3 Angiographic Findings Total occlusion of the RCA with L to L collaterals filling PDA. An anomalous LCX is occluded and fills with L to L collaterals. Moderate stenosis by angiography is present in the left main. Ventriculogram shows inferior hypokinesis with EF 25%.

4 IVUS Imaging Results The L Main lesion observed on angiogram is shown by IVUS to cause significant narrowing with a minimal lumen area of 3.9 mm 2. Hence, this unstable angina patient has critical L main stenosis, plus an occluded RCA and LCX. The stenotic L main provides the almost all flow to the heart. Revascularization with CABG or stenting is required.

5 What is the Best Mode of Revascularization for this Patient? For CABG: Very high Syntax score, indicating high risk PCI. Good distal vessels for surgical bypass. Prevention of future coronary events by distal bypass insertion. Diabetic The risk of L Main PCI is increased by occluded RCA. Stenting L main only will not provide complete revascularization. For PCI: A L main stent could provide immediate relief for unstable angina and protect essential coronary flow. Very high STS score due to COPD requiring home oxygen, PVD, obesity, indicating high surgical risk. Recovery from PCI more rapid than recovery from CABG. Patient, family and cardiac surgeons prefer the stenting option.

6 The Potential Benefit of Determining the Amount of Coronary Lipid in a Patient with Extensive Disease Visible on Angiography Disparity Between Angiographic Coronary Lesion Complexity and Lipid Core Plaques Assessed by Near-Infrared Spectroscopy Zynda,Thompson, Khiet, Hoang, Seto, Glovaci, Wong, Patel, and Kern,CCI, 2013 In 78 patients, Lipid Core Burden Index was only weakly correlated with angiographic Syntax score. In the present case could there be extensive lipid that might complicate stenting and elevate risk beyond that indicated by the Syntax score which is based on angiographic findings?

7 NIRS Imaging Provides Additional Information The stenotic lesion in the L main also contains a large, circumferential LCP which extends into the ostium of the LAD. MaxLCBI4mm: 705 MLA: 3.9mm2 PB: 65% Left Main

8 The L Main Lipid Also Extends into the LAD, thus Involving the Bifurcation with the LCX LCX LAD

9 Extensive Lipid-rich Plaque (LRP) has Been Shown to Increased Short and Long-term Complications of Stenting While the risk/benefit ratio for stenting flow-limiting lesions is generally positive, stenting a site with increased LRP is associated with -- No-reflow and peri-stenting MI Goldstein et al., Circ Cardiovascular Interventions 2011 Brilakis et al, CCI, 2012 Stone et al, CANARY, TCT 2014 Early stent thrombosis. Sakhuja et al, Circulation 2010 Plaque shift into side branches. Husaini et al, CCI B-070, 2014 Stent failure post PCI. Dohi et al, JACC TCT-583, 2013

10 Stent Failure Post Placement Over a Stenotic Lesion with Elevated Max LCBI 4mm Similar to that of the Present Case Pre Stenting Index PCI Post Stenting In-stent Restenosis after 8 months Stent Segment DES 3.0x15mm Pre PCI NIRS findings MaxLCBI4mm in stent segment: 936 Dohi et al, JACC TCT-583, 2013

11 Excellent Outcome in a Prior Case in Which a Stent was Placed for a Stenotic Lesion with Minimal LRP Pre Stenting Post Stenting Stent segment Xience 2.5x23mm Xience 2.5x23mm Xience 2.5x15mm Pre PCI NIRS findings MaxLCBI4mm in stent segment: 157 Dohi et al, JACC TCT-583, 2013

12 Increased maxlcbi 4mm in the Stented Segment Grouped by Occurrence of Stent Failure 478 stented patients with a DES - mean FU = 392 days. 13 cases of stent failure MaxLCBI 4mm Current Case = 705 P=0.043 The Max LCBI 4mm at baseline was significantly greater in those with stent failure. DES failure was not seen if Max LCBI <100. MaxLCBI 4mm The current case has extensive LRP at the potential stenting site. 0 Stent Failure Non-Stent Failure N = 13 N = 30 Dohi et al, JACC TCT-583, 2013

13 In the Current Case the Max 4mm LCBI in the Target Lesion in the L Main was 705

14 Clinical Plan, and Outcome The NIRS finding of lipid in the L main was an additional piece of data in favor of CABG. A NIRS finding that the L main did not contain lipid would have been data in favor of PCI. Assessing the balance of findings for PCI or CABG, the interventional cardiologist recommended CABG. The recommendation for CABG and the supporting evidence, including the chemogram, were presented to the patient, family and surgeons. CABG was selected by consensus. A LIMA was placed to the LAD, SV to PDA and SV to the anomalous LCX. The ejection fraction increased from 25 to 35% and the patient is doing well 1 month post surgery. NIRS IVUS TVC imaging provided useful information for the heart team in deciding between PCI and CABG.

The Bioresorbable Vascular Stent Dr Albert Ko

The Bioresorbable Vascular Stent Dr Albert Ko The Bioresorbable Vascular Stent Dr Albert Ko Dr Albert Ko MB BS, FRACP, FCSANZ Interventional/General Cardiologist Ascot Cardiology Symposium 2013 Treatment Goals for Coronary Artery Disease Relieve of

More information

CORONARY ARTERY BYPASS GRAFTS, STENTS, AND EXTRACORONARY CARDIAC DZ. Charles White MD

CORONARY ARTERY BYPASS GRAFTS, STENTS, AND EXTRACORONARY CARDIAC DZ. Charles White MD CORONARY ARTERY BYPASS GRAFTS, STENTS, AND EXTRACORONARY CARDIAC DZ Charles White MD Director of Thoracic Imaging Department of Radiology University of Maryland CORONARY ARTERY BYPASS GRAFTS First performed

More information

Cilostazol versus Clopidogrel after Coronary Stenting

Cilostazol versus Clopidogrel after Coronary Stenting Cilostazol versus Clopidogrel after Coronary Stenting Seong-Wook Park, MD, PhD, FACC Division of Cardiology, Asan Medical Center University of Ulsan College of Medicine Seoul, Korea AMC, 2004 Background

More information

The Cardiac Society of Australia and New Zealand

The Cardiac Society of Australia and New Zealand The Cardiac Society of Australia and New Zealand Guidelines on Support Facilities for Coronary Angiography and Percutaneous Coronary Intervention (PCI) including Guidelines on the Performance of Procedures

More information

Ostial LAD: Single stent approach is the best. Antonio A. Pocoví, MD, FSCAI, MTSAC, Advisory Council Member, CACI

Ostial LAD: Single stent approach is the best. Antonio A. Pocoví, MD, FSCAI, MTSAC, Advisory Council Member, CACI Ostial LAD: Single stent approach is the best Antonio A. Pocoví, MD, FSCAI, MTSAC, Advisory Council Member, CACI Chair, Interventional Cardiology Sanatorio San Lucas Instituto Alexander Fleming Buenos

More information

LEADERS: 5-Year Follow-up

LEADERS: 5-Year Follow-up LEADERS: -Year Follow-up from a Prospective, Randomized Trial of Biolimus A9-eluting Stents with a Biodegradable Polymer vs. Sirolimus-eluting Stents with a Durable Polymer : Final Report of the LEADERS

More information

PRECOMBAT Trial. Seung-Whan Lee, MD, PhD On behalf of the PRECOMBAT Investigators

PRECOMBAT Trial. Seung-Whan Lee, MD, PhD On behalf of the PRECOMBAT Investigators Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease PRECOMBAT Trial Seung-Whan Lee, MD, PhD On behalf

More information

Listen to your heart: Good Cardiovascular Health for Life

Listen to your heart: Good Cardiovascular Health for Life Listen to your heart: Good Cardiovascular Health for Life Luis R. Castellanos MD, MPH Assistant Clinical Professor of Medicine University of California San Diego School of Medicine Sulpizio Family Cardiovascular

More information

INTRODUCTION. Key Words:

INTRODUCTION. Key Words: Case Report Acta Cardiol Sin 2014;30:485 489 Successful Revascularization of Chronic Total Occlusion in Native Coronary Arteries through an Occluded Saphenous Bypass Vein Graft: A Retrograde Alternative

More information

Coronary Bifurcation Treatment: Update from the European Bifurcation Club. Remo Albiero, MD Ist. Clinico S. Rocco Brescia (Italy)

Coronary Bifurcation Treatment: Update from the European Bifurcation Club. Remo Albiero, MD Ist. Clinico S. Rocco Brescia (Italy) Coronary Bifurcation Treatment: Update from the European Bifurcation Club Remo Albiero, MD Ist. Clinico S. Rocco Brescia (Italy) Disclosure Statement of Financial Interest Within the past 12 months, I

More information

Experience of Direct Coronary Stenting at National Institute of Cardiovascular Diseases

Experience of Direct Coronary Stenting at National Institute of Cardiovascular Diseases Experience of Direct Coronary Stenting at National Institute of Cardiovascular Diseases T. Masood,T. Sagheer,D. Jan,N. Qamar,A.M.A. Faruqui ( National Institute of Cardiovascular Diseases (NICVD), Karachi.

More information

PCI vs. CABG for Left Main Disease

PCI vs. CABG for Left Main Disease The EXCEL Ti Trial Design, Status, t and Timelines Gregg W. Stone, MD Columbia University Medical Center NewYork-Presbyterian Hospital Cardiovascular Research Foundation PCI vs. CABG for Left Main Disease

More information

MEDICAL POLICY No. 91580-R1 DRUG-ELUTING STENTS FOR ISCHEMIC HEART DISEASE

MEDICAL POLICY No. 91580-R1 DRUG-ELUTING STENTS FOR ISCHEMIC HEART DISEASE DRUG-ELUTING STENTS FOR ISCHEMIC HEART DISEASE Effective Date: October 1, 2015 Review Dates: 10/11, 10/12, 10/13, 8/14, 8/15 Date Of Origin: October 12, 2011 Status: Current Summary of Changes Clarifications:

More information

OCT STEMI: OCT guidance during stent implantation

OCT STEMI: OCT guidance during stent implantation OCT STEMI: OCT guidance during stent implantation in primary PCI. A Randomized Multicenter study with 9-month optical coherence tomography follow-up Červinka P 1,2, Kala P 3, Jakl M 2,4, Kaňovský J 3,

More information

Antonio Colombo MD on behalf of the SECURITY Investigators

Antonio Colombo MD on behalf of the SECURITY Investigators Second Generation Drug-Eluting Stents Implantation Followed by Six Versus Twelve-Month - Dual Antiplatelet Therapy - The SECURITY Randomized Clinical Trial Antonio Colombo MD on behalf of the SECURITY

More information

CARDIAC CARE. Giving you every advantage

CARDIAC CARE. Giving you every advantage CARDIAC CARE Giving you every advantage Getting to the heart of the matter The Cardiovascular Program at Northwest Hospital & Medical Center is dedicated to the management of cardiovascular disease. The

More information

What is POT and Why to Do It?

What is POT and Why to Do It? San Francisco, TCT 2013, Monday Oct 28, 10:54-11:09 What is POT and Why to Do It? Carlo Di Mario, Alessio Mattesini, Gianni Dall Ara, Nicola Viceconte, Tito Kabir, Gioel Secco, Alistair Lindsay Royal Brompton

More information

Therapeutic Approach in Patients with Diabetes and Coronary Artery Disease

Therapeutic Approach in Patients with Diabetes and Coronary Artery Disease Home SVCC Area: English - Español - Português Therapeutic Approach in Patients with Diabetes and Coronary Artery Disease Martial G. Bourassa, MD Research Center, Montreal Heart Institute, Montreal, Quebec,

More information

Copenhagen University Hospital Rigshospitalet Aarhus University Hospital Skejby Denmark

Copenhagen University Hospital Rigshospitalet Aarhus University Hospital Skejby Denmark Long-term outcome after drug-eluting versus bare-metal stent implantation in patients with ST-elevation myocardial infarction 3 year follow-up of the randomised trial Peter Clemmensen, Henning Kelbæk,

More information

OCT ASSESSMENT OF CUTTING BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS

OCT ASSESSMENT OF CUTTING BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS OCT ASSESSMENT OF CUTTING BALLOON ANGIOPLASTY FOR IN-STENT RESTENOSIS Division of Cardiology, Mount Sinai Hospital, New York, NY, USA Yuliya Vengrenyuk, PhD; and Annapoorna Kini, MD OCT ASSESSMENT OF CUTTING

More information

California Health and Safety Code, Section 1256.01

California Health and Safety Code, Section 1256.01 California Health and Safety Code, Section 1256.01 1256.01. (a) The Elective Percutaneous Coronary Intervention (PCI) Pilot Program is hereby established in the department. The purpose of the pilot program

More information

HA Territory-wide PCI Audit 2003-05

HA Territory-wide PCI Audit 2003-05 HA Territory-wide PCI Audit 23-5 5 PCI Audit Working Group Central Committee (Cardiac Services) HA Convention 26 Percutaneous Coronary Intervention Background HA AP target 2/3, coordinated by PCI Working

More information

Clinical Research Intracoronary Stenting with Crushing in Coronary Artery Bifurcation Lesions: Initial Results and Medium-Term Follow Up

Clinical Research Intracoronary Stenting with Crushing in Coronary Artery Bifurcation Lesions: Initial Results and Medium-Term Follow Up Hellenic J Cardiol 45: 379-383, 2004 Clinical Research Intracoronary Stenting with Crushing in Coronary Artery Bifurcation Lesions: Initial Results and Medium-Term Follow Up PETROS S. DARDAS, DIMITRIS

More information

06 Validation of risk prediction model

06 Validation of risk prediction model HA Territory-wide PCI Audit 2003-06 06 Validation of risk prediction model PCI Audit Working Group Central Committee (Cardiac Services) HA Convention 2007 Background Participants: All HA hospitals via

More information

Provider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469)

Provider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Provider Checklist-Outpatient Imaging Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Medical Review Note: Per InterQual, if any of the following are present,

More information

OPINION OPtical frequency domain imaging vs. INtravascular ultrasound in percutaneous coronary InterventiON

OPINION OPtical frequency domain imaging vs. INtravascular ultrasound in percutaneous coronary InterventiON OPINION OPtical frequency domain imaging vs. INtravascular ultrasound in percutaneous coronary InterventiON - Baseline preliminary results - Takashi Akasaka, MD, PhD, FESC Wakayama Medical University,

More information

12 Lead ECGs: Ischemia, Injury & Infarction Part 2

12 Lead ECGs: Ischemia, Injury & Infarction Part 2 12 Lead ECGs: Ischemia, Injury & Infarction Part 2 McHenry Western Lake County EMS Localization: Left Coronary Artery Right Coronary Artery Right Ventricle Septal Wall Anterior Descending Artery Left Main

More information

Cardiovascular disease has become a dominant cause of

Cardiovascular disease has become a dominant cause of Abstract Immediate and Six-month Clinical Outcome of Percutaneous Coronary Intervention in a Tertiary Hospital in the Sultanate of Oman Panduranga Prashanth, Mohamed Mukhaini, Abdulla A. Riyami, Kadhim

More information

Prognostic impact of uric acid in patients with stable coronary artery disease

Prognostic impact of uric acid in patients with stable coronary artery disease Prognostic impact of uric acid in patients with stable coronary artery disease Gjin Ndrepepa, Siegmund Braun, Martin Hadamitzky, Massimiliano Fusaro, Hans-Ullrich Haase, Kathrin A. Birkmeier, Albert Schomig,

More information

Cardiac Rehabilitation The Best Medicine for Your CAD Patients. James A. Stone

Cardiac Rehabilitation The Best Medicine for Your CAD Patients. James A. Stone James A. Stone BPHE, BA, MSc, MD, PhD, FRCPC, FAACVPR, FACC Clinical Professor of Medicine, University of Calgary Total Cardiology, Calgary Acknowledgements and Disclosures Acknowledgements Jacques Genest

More information

The Minvasys Amazonia Pax & Nile Pax Polymer Free Paclitaxel Eluting Stent Program

The Minvasys Amazonia Pax & Nile Pax Polymer Free Paclitaxel Eluting Stent Program The Minvasys Amazonia Pax & Nile Pax Polymer Free Paclitaxel Eluting Stent Program Jean Fajadet, MD, FESC Clinique Pasteur - Toulouse - France Disclosure statement Nothing to disclose Dedicated Delivery

More information

Perioperative Cardiac Evaluation

Perioperative Cardiac Evaluation Perioperative Cardiac Evaluation Caroline McKillop Advisor: Dr. Tam Psenka 10-3-2007 Importance of Cardiac Guidelines -Used multiple times every day -Patient Safety -Part of Surgical Care Improvement Project

More information

Duration of Dual Antiplatelet Therapy After Coronary Stenting

Duration of Dual Antiplatelet Therapy After Coronary Stenting Duration of Dual Antiplatelet Therapy After Coronary Stenting C. DEAN KATSAMAKIS, DO, FACC, FSCAI INTERVENTIONAL CARDIOLOGIST ADVOCATE LUTHERAN GENERAL HOSPITAL INTRODUCTION Coronary artery stents are

More information

2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation.

2/20/2015. Cardiac Evaluation of Potential Solid Organ Transplant Recipients. Issues Specific to Transplantation. Kidney Transplantation. DISCLOSURES I have no relevant financial relationships to disclose. Cardiac Evaluation of Potential Solid Organ Transplant Recipients Michele Hamilton, MD Director, Heart Failure Program Cedars Sinai Heart

More information

Appropriate Use: Big Brother is Watching. Jason H. Rogers, MD Director, Interventional Cardiology UC Davis Medical Center

Appropriate Use: Big Brother is Watching. Jason H. Rogers, MD Director, Interventional Cardiology UC Davis Medical Center Appropriate Use: Big Brother is Watching Jason H. Rogers, MD Director, Interventional Cardiology UC Davis Medical Center Disclosures Consultant Boston Scientific, Medtronic, Middle Peak Medical, Millipede,

More information

Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg

Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg Cardiac Assessment for Renal Transplantation: Pre-Operative Clearance is Only the Tip of the Iceberg 2 nd Annual Duke Renal Transplant Symposium March 1, 2014 Durham, NC Joseph G. Rogers, M.D. Associate

More information

Drug-Eluting Balloons. Klaus Bonaventura Department of Cardiology and Angiology Heart Thorax Vascular Center, Klinikum Ernst von Bergmann, Potsdam

Drug-Eluting Balloons. Klaus Bonaventura Department of Cardiology and Angiology Heart Thorax Vascular Center, Klinikum Ernst von Bergmann, Potsdam Drug-Eluting Balloons Klaus Bonaventura Department of Cardiology and Angiology Heart Thorax Vascular Center, Klinikum Ernst von Bergmann, Potsdam Potential conflicts of interest Speaker s name: Klaus Bonaventura

More information

Majestic Trial 12 Month Results

Majestic Trial 12 Month Results Majestic Trial 12 Month Results S.Müller-Hülsbeck, MD, EBIR, FCIRSE, FICA ACADEMIC HOSPITALS Flensburg of Kiel University Ev.-Luth. Diakonissenanstalt zu Flensburg Knuthstraße 1, 24939 FLENSBURG Dept.

More information

Coding Updates for 2013: Cardiology

Coding Updates for 2013: Cardiology Coding Updates for 2013: Cardiology Presented by: David Dunn, MD, FACS CIRCC, CPC-H, CCVTC, CCC, CCS, RCC National Coding Standards Sources of information Centers for Medicare and Medicare (CMS) Provider

More information

Heart Center Packages

Heart Center Packages Heart Center Packages For more information and appointments, Please contact The Heart Center of Excellence at the American Hospital Dubai Tel: +971-4-377-6571 Email: heartcenter@ahdubai.com www.ahdubai.com

More information

Health Related Quality of Life and U.S. Economic Outcomes of PCI with Drug-Eluting Stents vs. Bypass Surgery: 1-Year Results from the SYNTAX Trial

Health Related Quality of Life and U.S. Economic Outcomes of PCI with Drug-Eluting Stents vs. Bypass Surgery: 1-Year Results from the SYNTAX Trial Health Related Quality of Life and U.S. Economic Outcomes of PCI with Drug-Eluting Stents vs. Bypass Surgery: 1-Year Results from the SYNTAX Trial David J. Cohen, Tara A. Lavelle, Patrick W. Serruys, Friedrich

More information

Main Effect of Screening for Coronary Artery Disease Using CT

Main Effect of Screening for Coronary Artery Disease Using CT Main Effect of Screening for Coronary Artery Disease Using CT Angiography on Mortality and Cardiac Events in High risk Patients with Diabetes: The FACTOR-64 Randomized Clinical Trial Joseph B. Muhlestein,

More information

Cardiac Rehabilitation: Strategies Approaching 2020

Cardiac Rehabilitation: Strategies Approaching 2020 ACC Banff 2015 Cardiac Rehabilitation: Strategies Approaching 2020 James A. Stone BPHE, BA, MSc, MD, PhD, FRCPC, FAACVPR, FACC Clinical Professor of Medicine, University of Calgary Libin Cardiovascular

More information

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention

2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention J_ID: Z7V Customer A_ID: 2011_PCI_Guideline Cadmus Art: CCD23390 Date: 3-November-11 Stage: Page: 1 ID: kandasamy.d I Black Lining: [ON] I Time: 12:16 I Path: N:/3b2/CCD#/Vol00000/110478/APPFile/JW-CCD#110478

More information

Repeat Coronary Revascularization Procedures after Successful Bare-Metal or Drug-Eluting Stent Implantation

Repeat Coronary Revascularization Procedures after Successful Bare-Metal or Drug-Eluting Stent Implantation Original Contribution Repeat Coronary Revascularization Procedures after Successful Bare-Metal or Drug-Eluting Stent Implantation Cynthia A. Yock, MS, J. Michael Isbill, MS, Spencer B. King III, MD, Mark

More information

The left internal mammary artery (LIMA) is the

The left internal mammary artery (LIMA) is the Case Report 925 Direct Stenting of a Transradial Left Internal Mammary Artery Graft Wei-Chin Hung, MD; Bih-Fang Guo, MD, PhD; Chiung-Jen Wu, MD; Chien-Jen Chen, MD; Chih-Yuan Fang, MD Taking the transfemoral

More information

URN: Family name: Given name(s): Address:

URN: Family name: Given name(s): Address: State of Queensland (Queensland Health) 2015 Licensed under: http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Contact: Clinical_Pathways_Program@health.qld.gov.au Facility:... Clinical pathways

More information

2015 European Coronary Stent New Product Innovation Award

2015 European Coronary Stent New Product Innovation Award 2015 European Coronary Stent New Product Innovation Award 2015 Contents Background and Company Performance... 3 Industry Challenges... 3 New Product Attributes and Customer Impact... 3 Conclusion... 4

More information

Endovascular Repair of an Axillary Artery Aneurysm: A Novel Approach

Endovascular Repair of an Axillary Artery Aneurysm: A Novel Approach Endovascular Repair of an Axillary Artery Aneurysm: A Novel Approach Bao- Thuy D. Hoang, MD 1, Jonathan- Hien Vu, MD 2, Jerry Matteo, MD 3 1 Department of Surgery, University of Florida College of Medicine,

More information

Early And Late Outcome For Single Versus Double Stenting For Bifurcational Coronary Artery Lesions

Early And Late Outcome For Single Versus Double Stenting For Bifurcational Coronary Artery Lesions ORIGINAL CONTRBUTION / CLINICAL INVESTIGATION Early And Late Outcome For Single Versus Double Stenting For Bifurcational Coronary Artery Lesions Aram J. Mirza Correspondence: Dr. Aram J.Mirza Interventional

More information

PIHRATE Trial. Polish-Italian-Hungarian Randomized ThrombEctomy Trial. Dariusz Dudek MD, PhD. On behalf PIHRATE investigators

PIHRATE Trial. Polish-Italian-Hungarian Randomized ThrombEctomy Trial. Dariusz Dudek MD, PhD. On behalf PIHRATE investigators Polish-Italian-Hungarian Randomized ThrombEctomy Trial PIHRATE Trial On behalf PIHRATE investigators Dariusz Dudek MD, PhD Institute of Cardiology, Krakow, Poland Impact of distal embolization Distal embolization

More information

INNOVATIONS IN THE ENVIRONMENT: HOW THE HYBRID OPERATING ROOM CAN INFLUENCE CARDIAC SURGERY

INNOVATIONS IN THE ENVIRONMENT: HOW THE HYBRID OPERATING ROOM CAN INFLUENCE CARDIAC SURGERY CLAUDIO GROSSI Cardiac Surgery Ospedale Santa Croce CUNEO (Italy) INNOVATIONS IN THE ENVIRONMENT: HOW THE HYBRID OPERATING ROOM CAN INFLUENCE CARDIAC SURGERY Impossibile visualizzare l'immagine. La memoria

More information

Cardiac Rehab. Home. www.homecareforyou.com. Do you suffer from a cardiac condition that is limiting your independence in household mobility?

Cardiac Rehab. Home. www.homecareforyou.com. Do you suffer from a cardiac condition that is limiting your independence in household mobility? TM Nightingale Home Cardiac Rehab Do you suffer from a cardiac condition that is limiting your independence in household mobility? Such as, 1. A recent heart attack 2. A heart condition coronary artery

More information

R EFERENCES. Summary and conclusions

R EFERENCES. Summary and conclusions R EFERENCES Summary and conclusions 129 S UMMARY AND CONCLUSIONS SUMMARY AND GENERAL DISCUSSION 130 Constant vasodilatation, inhibition of platelet and monocyte adhesion, and local thrombolysis are the

More information

A Patient s Guide to Primary and Secondary Prevention of Cardiovascular Disease Using Blood-Thinning (Anticoagulant) Drugs

A Patient s Guide to Primary and Secondary Prevention of Cardiovascular Disease Using Blood-Thinning (Anticoagulant) Drugs A Patient s Guide to Primary and Secondary Prevention of PATIENT EDUCATION GUIDE What Is Cardiovascular Disease? Cardiovascular disease (CVD) is a broad term that covers any disease of the heart and circulatory

More information

Do método diagnóstico ao terapêutico: a História da Hemodinâmica e da Cardiologia Intervencionista, em 15 minutos. Eulógio E Martinez

Do método diagnóstico ao terapêutico: a História da Hemodinâmica e da Cardiologia Intervencionista, em 15 minutos. Eulógio E Martinez Do método diagnóstico ao terapêutico: a História da Hemodinâmica e da Cardiologia Intervencionista, em 15 minutos Eulógio E Martinez IVUS vs luminologia Positivo Negativo estenose TCE oclusão CD sístole

More information

Abnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging

Abnormal, Autoquant Adenosine Myocardial Perfusion Heart Imaging Background: Reason: preoperative assessment of CAD, Shortness of Breath Symptom: atypical chest pain Risk factors: hypertension Under influence: a beta blocker Medications: digoxin Height: 66 in. Weight:

More information

Déjeuner/Repas Débat ABBOTT «Docteur, je veux un stent qui se dissout» ABSORB,la révolu@on oui, mais chez quel pa@ent? Les dernières données ABSORB

Déjeuner/Repas Débat ABBOTT «Docteur, je veux un stent qui se dissout» ABSORB,la révolu@on oui, mais chez quel pa@ent? Les dernières données ABSORB Déjeuner/Repas Débat ABBOTT «Docteur, je veux un stent qui se dissout» ABSORB,la révolu@on oui, mais chez quel pa@ent? Les dernières données ABSORB Didier Carrié CHU Toulouse APPAC 4 Juin 2014 Aucun conflit

More information

Cardiac Catheterization

Cardiac Catheterization Page 1 Cardiac Catheterization What Other Terms Are Used To Describe Cardiac Catheterization? Heart Cath (catheter) Angiogram What Is Cardiac Catheterization? This procedure is nonsurgical and is performed

More information

FFR CT : Clinical studies

FFR CT : Clinical studies FFR CT : Clinical studies Bjarne Nørgaard Department Cardiology B Aarhus University Hospital Skejby, Denmark Disclosures: Research grants: Edwards and Siemens Coronary CTA: High diagnostic sensitivity

More information

Endoskopische Venenentnahme der V. saphena in der koronaren Bypasschirurgie - Aktuelle Datenlage - Dr. med. Stefanie Reutter

Endoskopische Venenentnahme der V. saphena in der koronaren Bypasschirurgie - Aktuelle Datenlage - Dr. med. Stefanie Reutter Endoskopische Venenentnahme der V. saphena in der koronaren Bypasschirurgie - Aktuelle Datenlage - Dr. med. Stefanie Reutter Endoskopische Venenentnahme (EVH) - Einführung 1979 Tevaearai und Kollegen haben

More information

Diagnostic and Therapeutic Procedures

Diagnostic and Therapeutic Procedures Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,

More information

Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine

Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics. Yen Tibayan, M.D. Division of Cardiovascular Medicine Is it really so? : Varying Presentations for ACS among Elderly, Women and Diabetics Yen Tibayan, M.D. Division of Cardiovascular Medicine Case Presentation 69 y.o. woman calls 911 with the complaint of

More information

Clinical Programs. Medtronic Coronary Stent Systems. driver BMS

Clinical Programs. Medtronic Coronary Stent Systems. driver BMS Clinical Programs Medtronic Coronary Stent Systems Endeavor DES driver BMS July 2010 Contents Overview of Clinical Programs... 2 Drug-Eluting Stents ENDEAVOR I*... 4 ENDEAVOR II*... 6 ENDEAVOR II Continued

More information

έΰζβν αππ έκυ,νσϊίία κν1γν πλδζέκυνβί1γ π ηία δεόμνκαλ δκζόΰκμ, θν δ υγυθ άμνγνκαλ /εάμ ΚζδθδεάμΝ υλωεζδθδεάμν

έΰζβν αππ έκυ,νσϊίία κν1γν πλδζέκυνβί1γ π ηία δεόμνκαλ δκζόΰκμ, θν δ υγυθ άμνγνκαλ /εάμ ΚζδθδεάμΝ υλωεζδθδεάμν ΝΠθ ζζάθδκνσθϋ λδκν έΰκ μνεδν ιωθκ κεκη δεάμνι λδεάμ έΰζβν έκ,νσϊίί κν1γν λδζέκνβί1γ Α Α φ ; έζ δκμννένσθόμ ηί δεόμνκλ δκζόΰκμ, θν δ γθ άμνγνκλ /εάμ ΚζδθδεάμΝ λωεζδθδεάμν ένivus Scientific Director, Mediolanum

More information

MISSING DATA ANALYSIS AMONG PATIENTS IN THE PINNACLE REGISTRY

MISSING DATA ANALYSIS AMONG PATIENTS IN THE PINNACLE REGISTRY MISSING DATA ANALYSIS AMONG PATIENTS IN THE PINNACLE REGISTRY In order to improve the efficiency of PINNACLE Registry data analytics, a missing data analysis has been conducted on PINNACLE Registry data

More information

GUIDELINES ON MEDICAL DEVICES EVALUATION OF CLINICAL DATA - A GUIDE FOR MANUFACTURERS AND NOTIFIED BODIES -

GUIDELINES ON MEDICAL DEVICES EVALUATION OF CLINICAL DATA - A GUIDE FOR MANUFACTURERS AND NOTIFIED BODIES - EUROPEAN COMMISSION ENTERPRISE AND INDUSTRY DIRECTORATE-GENERAL Consumer goods Cosmetics and Medical Devices MEDDEV 2.7.1 Appendix 1 December 2008 GUIDELINES ON MEDICAL DEVICES EVALUATION OF CLINICAL DATA

More information

Clinical Results of Unprotected Left Main Coronary Stenting

Clinical Results of Unprotected Left Main Coronary Stenting Original Articles IMAJ VOL 11 MARCH 2009 Clinical Results of Unprotected Left Main Coronary Stenting Itsik Ben-Dor MD, Hana Vaknin-Assa MD, Eli Lev MD, David Brosh MD, Shmuel Fuchs MD, Abid Assali MD and

More information

Steven J. Yakubov, MD FACC For the CoreValve US Clinical Investigators

Steven J. Yakubov, MD FACC For the CoreValve US Clinical Investigators Long-Term Outcomes Using a Self- Expanding Bioprosthesis in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery: Two-Year Results From the CoreValve US Pivotal Trial Steven J. Yakubov,

More information

Efficient Evaluation of Chest Pain

Efficient Evaluation of Chest Pain Efficient Evaluation of Chest Pain Vikranth Gongidi, DO FACC FACOI Indian River Medical Center Vero Beach, FL No Disclosures Outline Background Chest pain pathway Indications for stress test Stress test

More information

StentViz Enhanced Stent Visualization

StentViz Enhanced Stent Visualization GE Healthcare StentViz Enhanced Stent Visualization Dr. Morice, Dr. Lefèvre, Dr. Hovasse, Dr. Chevalier, Dr. Louvard Institut Cardiovasculaire Paris Sud, Massy, France Assessing the deployment of stents

More information

Preoperative Cardiac Stents Perioperative Management. Mark A. Taylor, MD Department of Anesthesia

Preoperative Cardiac Stents Perioperative Management. Mark A. Taylor, MD Department of Anesthesia Preoperative Cardiac Stents Perioperative Management Mark A. Taylor, MD Department of Anesthesia Revasc prior to NCS If it offered long term benefit-- --made sense to do it 1-22 vessel CAD by angiogram,

More information

Same-Day PCI: Guidelines & Best Practices for In-N-Out Procedures

Same-Day PCI: Guidelines & Best Practices for In-N-Out Procedures Same-Day PCI: Guidelines & Best Practices for In-N-Out Procedures Michael Guiry, PA-C, MBA AVP, Cardiovascular Services North Shore LIJ Health System New York I, Michael Guiry, DO NOT have a financial

More information

Credentials for Peripheral Angioplasty: Comments on Society of Cardiac Angiography and Intervention Revisions

Credentials for Peripheral Angioplasty: Comments on Society of Cardiac Angiography and Intervention Revisions Credentials for Peripheral Angioplasty: Comments on Society of Cardiac Angiography and Intervention Revisions David Sacks, MD, Gary J. Becker, MD, and Terence A.S. Matalon, MD J Vasc Interv Radiol 2003;

More information

Intracoronary Stenting and. Robert A. Byrne, Julinda Mehilli, Salvatore Cassese, Franz-Josef Neumann, Susanne Pinieck, Tomohisa Tada,

Intracoronary Stenting and. Robert A. Byrne, Julinda Mehilli, Salvatore Cassese, Franz-Josef Neumann, Susanne Pinieck, Tomohisa Tada, Prospective, Randomized Trial of Paclitaxel-Eluting Balloon versus Paclitaxel-Eluting Stent versus Balloon Angioplasty for Treatment of Coronary Restenosis in Limus- Eluting Stents Intracoronary Stenting

More information

Process Representation #1 : The PAD algorithm as a sequential flow thru all sections

Process Representation #1 : The PAD algorithm as a sequential flow thru all sections Process Representation #1 : The PAD algorithm as a sequential flow thru all sections An exploded version of the above scoped section flow is shown below. Notes: The flow presupposes existing services (

More information

NOVOSTE BETA-CATH SYSTEM

NOVOSTE BETA-CATH SYSTEM HOSPITAL INPATIENT AND OUTPATIENT BILLING GUIDE FOR THE NOVOSTE BETA-CATH SYSTEM INTRAVASCULAR BRACHYTHERAPY DEVICE This guide is intended solely for use as a tool to help hospital billing staff resolve

More information

Renal artery stenting: are there any indications left?

Renal artery stenting: are there any indications left? there any indications left? Luís Mendes Pedro, MD. PhD, FEBVS Lisbon Academic Medical Centre (University of Lisbon and Hospital Santa Maria) Instituto Cardiovascular de Lisboa Disclosures Speaker name:

More information

Understanding Coronary Artery Disease, Cardiac Catheterization, and Treatment Options. A Guide for Patients

Understanding Coronary Artery Disease, Cardiac Catheterization, and Treatment Options. A Guide for Patients Understanding Coronary Artery Disease, Cardiac Catheterization, and Treatment Options A Guide for Patients Coronary Artery Disease If you or a member of your family has been diagnosed with coronary artery

More information

Bayfront. Heart Center. www.bayfrontheart.org

Bayfront. Heart Center. www.bayfrontheart.org Bayfront Heart Center www.bayfrontheart.org THE HEART OF THE MATTER At the Bayfront Heart Center, the leading cardiac facility in the area, we are fully equipped to treat all aspects of cardiovascular

More information

Impact of Massachusetts Health Care Reform on Racial, Ethnic and Socioeconomic Disparities in Cardiovascular Care

Impact of Massachusetts Health Care Reform on Racial, Ethnic and Socioeconomic Disparities in Cardiovascular Care Impact of Massachusetts Health Care Reform on Racial, Ethnic and Socioeconomic Disparities in Cardiovascular Care Michelle A. Albert MD MPH Treacy S. Silbaugh B.S, John Z. Ayanian MD MPP, Ann Lovett RN

More information

Abbott Vascular Everolimus-Eluting Bioresorbable Vascular Scaffold Components

Abbott Vascular Everolimus-Eluting Bioresorbable Vascular Scaffold Components Abbott Vascular Everolimus-Eluting Bioresorbable Vascular Scaffold Components Bioresorbabl e Scaffold Bioresorbabl e Coating Everolimus XIENCE V Delivery System *Except for platinum markers All illustrations

More information

CARDIA 288 MONTH FOLLOW-UP SUPPLEMENTAL FORM (FORM B) HOSPITALIZATION CASE #: INTERVIEWER ID FY288BIVID2. Page 1 of 6 FY288BH4CN

CARDIA 288 MONTH FOLLOW-UP SUPPLEMENTAL FORM (FORM B) HOSPITALIZATION CASE #: INTERVIEWER ID FY288BIVID2. Page 1 of 6 FY288BH4CN HOSPITALIZATION CASE #: 2 8 8 0 H FY288BH4CN Has the participant indicated any of the following reasons for being admitted overnight for this case? 1. Suspected or confirmed problems with the heart, circulation,

More information

Clinical Training for Visage 7 Cardiac. Visage 7

Clinical Training for Visage 7 Cardiac. Visage 7 Clinical Training for Visage 7 Cardiac Visage 7 Overview Example Usage 3 Cardiac Workflow Examples 4 Remove Chest Wall 5 Edit Chest Wall Removal 6 Object Display Popup 7 Selecting Optimal Phase 8 Thick

More information

Objectives. Preoperative Cardiac Risk Stratification for Noncardiac Surgery. History

Objectives. Preoperative Cardiac Risk Stratification for Noncardiac Surgery. History Preoperative Cardiac Risk Stratification for Noncardiac Surgery Kimberly Boddicker, MD FACC Essentia Health Heart and Vascular Center 27 th Heart and Vascular Conference May 13, 2011 Objectives Summarize

More information

Now bring the advantages of digital workflow to cardiology

Now bring the advantages of digital workflow to cardiology CARESTREAM Cardiology PACS Now bring the advantages of digital workflow to cardiology The single system advantage Now there s ONE Solution. 2 A large and growing number of health care facilities are benefiting

More information

Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYNOLDS ecc is sufficient YES NO NEED MORE DATA DISCUSS within Taskforce Your Comments

Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYNOLDS ecc is sufficient YES NO NEED MORE DATA DISCUSS within Taskforce Your Comments Site ID: Q1: Global risk assessment using PROCAM, SCORE, FRAMINGHAM or REYLDS ecc is sufficient Q2: The value of an emerging test is best assessed using C - statistics Q3: Atherosclerosis imaging may be

More information

INTERVENTION IN OSTIAL CORONARY LESIONS:

INTERVENTION IN OSTIAL CORONARY LESIONS: INTERVENTION IN OSTIAL CORONARY LESIONS: Antony (92), le 18 septembre 2013 JEAN MARC PERNES Hopital Privé Antony FRANCE Perfection of Precise Ostial Stent Placement Ostial lesions, including aorta ostial

More information

Presenter: Marco Valgimigli, MD PhD, FESC Erasmus MC, Thoraxcenter Rotterdam The Netherlands

Presenter: Marco Valgimigli, MD PhD, FESC Erasmus MC, Thoraxcenter Rotterdam The Netherlands Comparing zotarolimus-eluting and bare-metal stent efficacy in selected high bleeding risk patients treated with a short dual antiplatelet therapy duration. A pre-specified analysis from the The Zotarolimuseluting

More information

Main Vessel and Side Branch Stenting versus Optional Side Branch Stenting Using Sirolimus-Eluting Stents in Bifurcation Lesions

Main Vessel and Side Branch Stenting versus Optional Side Branch Stenting Using Sirolimus-Eluting Stents in Bifurcation Lesions Main Vessel and Side Branch Stenting versus Optional Side Branch Stenting Using Sirolimus-Eluting Stents in Bifurcation Lesions Terje K. Steigen, Pål Gunnes, Rune Wiseth, Kjell Nikus, Saila Vikman, Jan

More information

SAMPLE. Asia-Pacific Interventional Cardiology Procedures Outlook to 2020. Reference Code: GDMECR0061PDB. Publication Date: May 2014

SAMPLE. Asia-Pacific Interventional Cardiology Procedures Outlook to 2020. Reference Code: GDMECR0061PDB. Publication Date: May 2014 Asia-Pacific Interventional Cardiology Procedures Outlook to 2020 Reference Code: GDMECR0061PDB Publication Date: May 2014 Page 1 1 Table of Contents 1 Table of Contents... 2 1.1 List of Tables... 4 1.2

More information

Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed

Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed Scott Hubbell, MHSc, RRT-NPS, C-NPT, CCT Clinical Education Coordinator/Flight RRT EagleMed Identify the 12-Lead Views Explain the vessels of occlusion Describe the three I s Basic Interpretation of 12-Lead

More information

My Approach to Complex BTK Disease New York 2014

My Approach to Complex BTK Disease New York 2014 My Approach to Complex BTK Disease New York 2014 Raj Dave, MD, FACC, FSCAI Chairman, Division Of Cardiology Director, Catheterization Laboratories Chief Medical Executive, Holy Spirit Cardiovascular Institute

More information

Percutaneous coronary intervention (PCI) continues

Percutaneous coronary intervention (PCI) continues Developing a Same-Day Discharge Program How to identify appropriate patients for safe and efficient discharge. BY CAROLYN A. DICKENS, MSN, APN, AND ADHIR SHROFF, MD, MPH Percutaneous coronary intervention

More information

GENERAL HEART DISEASE KNOW THE FACTS

GENERAL HEART DISEASE KNOW THE FACTS GENERAL HEART DISEASE KNOW THE FACTS WHAT IS Heart disease is a broad term meaning any disease affecting the heart. It is commonly used to refer to coronary heart disease (CHD), a more specific term to

More information

Advances in Stent Technology

Advances in Stent Technology Nurse/Technologist Symposium Advances in Stent Technology Antonietta Tolentino, CCRN, MSN, ANP-C Adult Nurse Practitioner, Cardiac Catheterization Laboratory The Zena and Michael A. Weiner Cardiovascular

More information

Acute Coronary Syndrome. What Every Healthcare Professional Needs To Know

Acute Coronary Syndrome. What Every Healthcare Professional Needs To Know Acute Coronary Syndrome What Every Healthcare Professional Needs To Know Background of ACS Acute Coronary Syndrome (ACS) is an umbrella term used to cover a spectrum of clinical conditions that are caused

More information

CARDIAC RISKS OF NON CARDIAC SURGERY

CARDIAC RISKS OF NON CARDIAC SURGERY CARDIAC RISKS OF NON CARDIAC SURGERY N E W S T U D I E S & N E W G U I D E L I N E S W. B. C A L H O U N, M D, F A C C 2014 ACC/AHA Guideline on perioperative cardiovascular evaluation and management

More information

ST. DAVID S MEDICAL CENTER CARDIOLOGY - Special, Invasive, Diagnostic, or High-Risk Procedure Requirements

ST. DAVID S MEDICAL CENTER CARDIOLOGY - Special, Invasive, Diagnostic, or High-Risk Procedure Requirements ST. DAVID S MEDICAL CENTER CARDIOLOGY - Special, Invasive, Diagnostic, or High-Risk Procedure Requirements Cardiac Catheterization & Peripheral Angiography Completion of a fellowship in Cardiovascular

More information

Overview. Total Joint Replacement in the U.S. KP National Total Joint Registry EMR Tools and Outcome Assessment: A Model for Vascular Surgery?

Overview. Total Joint Replacement in the U.S. KP National Total Joint Registry EMR Tools and Outcome Assessment: A Model for Vascular Surgery? KP National Total Joint Registry EMR Tools and Outcome Assessment: A Model for Vascular Surgery? Liz Paxton Director of Surgical Outcomes and Analysis Overview KP Total Joint Replacement Registry Background

More information