Giuseppe Uccello’s Post

Numerically ⬇️ lower rates of all-cause death in #OCT-guided PCI group versus #FFR-guided group for angiographically intermediate #coronary lesions. 5-year #clinicaloutcome Study Pop: 350 patients from the FORZA (#FractionalFlowReserve vs. #OpticalCoherenceTomography to Guide Revascularization of Intermediate Coronary Stenoses) trial 🥇1st to compare FFR and OCT #PCI guidance #coronaryarterydisease

Did you know the "Bonapace's branch?" A 79-year-old man with arterial hypertension and hypercholesterolemia underwent coronary angiography due to effort angina, repolarization abnormalities on EKG, and occlusion of three coronary vessels on CCTA. A septal coronary branch that originates from the right coronary artery (RCA) or the right coronary sinus, known as the descending septal artery (DSA) or Bonapace’s branch, is an uncommon finding during coronary angiography but can be important in specific cases. Their incidence in post-mortem studies ranges from 12% to 85%. In the presence of coronary artery disease, the DSA is recognized for its role in providing collateral circulation. These anastomoses mainly connect with other septal branches. The patient underwent a Heart Team discussion, and surgical revascularization was chosen. #ptv #policlinicotorvergata #rome #interventionalcardiology #cathlab

Beta-blockers are the mainstay of secondary prevention after Acute Myocardial Infarction. However, their role is under scrutiny in patients who underwent successful revascularization and had excellent post-PCI cardiac function (EF> 50%). This new open-label study from Sweden studied more than 5,000 patients with preserved EF for more than three and a half years and found no added benefits regarding the end point of death from beta-blockers. So, is it time to discontinue this class of drug from post-MI patients with excellent heart function? There is still not enough data and, there is no commentary on the morbidities like arrhythmias, etc in this study. We need to study more about this before concluding anything. You can read more about this study here: #NEJM #BetaBlockers #Opinion

”Significant coronary artery disease (CAD) and severe aortic stenosis (AS) are frequent findings in patients who undergo transcatheter aortic valve implantation (TAVI). With the extension of TAVI in patients who have intermediate and even low surgical risk, the optimal evaluation and management of concomitant CAD needs to be determined. Both pre-TAVI evaluation of CAD and indications for revascularization remain a matter of debate. In this review, we provide an updated overview of the prevailing landscape of CAD in patients undergoing TAVI with a focus on its prognostic impact, diagnostic evaluation pre-procedure, indications for revascularization, optimal timing of revascularization, and future directions.“ Authors: Maharshi Raval, Paul C. Gordon Read more: https://lnkd.in/gCqQw2gs

#RCM Selected paper share --  Volume 25 / Issue 1 -- Reviews in Cardiovascular Medicine 📖 Patient Characteristics and Outcomes Associated with Sentinel Protection Device Use in Patients with Aortic Valve Disease Undergoing TAVR in a “Real-World” Setting ✍ Juan B. Grau, et al 🔗 https://lnkd.in/gg5D3_gt #AorticValveDisease #TAVR #sentinelcerebralprotectionsystem(CPS)

In the group with lumen <2 mm, 3 perioperative major events (10.7%) occurred (1 ischemic stroke, 1 hemorrhagic stroke, 1 myocardial infarction) and 2 (7.1%) at follow-up (average 11 ± 14.5 months; 1 asymptomatic carotid occlusion, 1 hemodynamic restenosis treated with stenting). No event was recorded in the group with lumen >2 mm. According to our results CNO patients show different complication risk according to the presence or not of distal lumen collapse. The later seems to play a significant role in perioperative and follow-up complication rate. These results therefore support a surgical treatment only in patients with CNO without lumen full collapse.

Successful #ECPR despite known total occlusion of infrarenal aorta in a patient with severe coronary artery disease in refractory VFib: 🩸#ECMO successfully initiated via surgical bifemoral-axillary graft, establishing systemic blood flow through axillary artery in peripheral configuration + limb perfusion via femoro-femoral graft 🧠 patient discharged home neurologically intact Open access #FOAMcc #FOAMecmo on ASAIO Journal 🔓 https://bit.ly/3M1XZRy

WHEN THE PROBLEM IS CLOT BURDEN DISCOVER #enVast from Vesalio The 1st & only CE approved stent retriever for temporary endovascular use to restore blood flow in patients experiencing thrombosis symptoms in the coronary vasculature. NO TIME TO WASTE #STEMI STEMI heart attack patients are two times more likely to die than other heart attack victims. Survivors have a 2 to 4 times higher risk of experiencing major, life-altering adverse events. Reopening the artery and restoring blood flow as soon as possible is essential for preventing permanent damage or death. Treatment Window is Short: - Less than 3 hours from the onset, the patient has a chance of full recovery - Greater than 3 hours from the onset, the patient will likely have some permanent damage - Greater than 12 hours, patient outcome is poor 85% IMMEDIATE REPERFUSION Equipped withDrop Zone technology, the enVast coronary thrombectomy system has been proven to remove large thrombus burden (LTB) and create immediate reperfusion in 85% of cases. Drop Zone technology captures the thrombus inside the device, and the closed distal tip keeps it from escaping during removal. To maximise your patients success outcomes and minimise failure choose enVast. Contact #DeltaSurgical 01782 637009 or click https://lnkd.in/ehpMYBXd for more details  @edenmoe

Can D-dimer levels at ER predict first pass effect (recanalization after one pass thrombectomy) in stroke patients with large vessel occlusion? https://lnkd.in/dGHaUc5g Yes...a lower D-dimer level is independently associated with first pass recanalization.

Differentiation between atelectasis and pneumonia in critically-ill patients can be challenging on regular CT. This image highlights the additional value of a [18F]FDG PET/CT scan to differentiate between infectious and inflammatory pulmonary abnormalities in critically ill patients. https://lnkd.in/estT75H7