382 results match your criteria Circulation: Cardiovascular Interventions [Journal]


Unmasking Myocardial Bridge-Related Ischemia by Intracoronary Functional Evaluation.

Circ Cardiovasc Interv 2018 Jun;11(6):e006247

From the Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Italy.

Background: Invasive physiological assessment of myocardial bridges (MBs) is largely unsettled. Unlike fractional flow reserve (FFR), instantaneous wave-free ratio (iFR) is a diastole-specific index. As such, its value might not be hampered by systolic pressure overshooting and negative systolic pressure gradient caused by the compression of the tunneled coronary artery. Read More

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: The First 10 Years.

Circ Cardiovasc Interv 2018 Jun;11(6):e006901

From the Department of Medicine, Brigham and Women's Hospital, Boston, MA (D.P.F., J.A.L., D.O.W.).

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Treatment Strategy Change After Routine Pressure Wire Assessment for Coronary Artery Disease: What You See Is "NOT" What You Get.

Authors:
Bon-Kwon Koo

JACC Cardiovasc Interv 2018 02;11(4):366-368

Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea; and the Institute on Aging, Seoul National University, Seoul, Korea. Electronic address:

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February 2018
4 Reads

Impact of Routine Invasive Physiology at Time of Angiography in Patients With Multivessel Coronary Artery Disease on Reclassification of Revascularization Strategy: Results From the DEFINE REAL Study.

JACC Cardiovasc Interv 2018 02;11(4):354-365

Department of Cardiovascular Sciences, Policlinico Umberto I Roma, Rome, Italy. Electronic address:

Objectives: This study sought to prospectively assess the impact of routine invasive physiology at the time of angiography on reclassification of therapeutic management of multivessel disease (MVD) patients, and to assess how implementation of instantaneous wave-free ratio (iFR) alters the process.

Background: Routine invasive physiology in intermediate coronary lesions at the time of diagnostic angiography, primarily in patients with single-vessel disease and using fractional flow reserve (FFR), reclassifies coronary revascularization management in 26% to 44% of patients. The role of invasive physiology in patients with MVD is unclear. Read More

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February 2018
5 Reads

Should We Perform an Immediate Coronary Angiogram in All Patients After Cardiac Arrest?: Insights From a Large French Registry.

JACC Cardiovasc Interv 2018 Feb;11(3):249-256

Paris Cardiovascular Research Center, INSERM Unit 970, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France; Paris Sudden Death Expertise Center, Paris, France; Medical Intensive Care Unit, AP-HP, Cochin Hospital, Paris, France. Electronic address:

Objectives: This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival.

Background: An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases.

Methods: From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France). Read More

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February 2018
9 Reads

Dose-Dependent Cardioprotection of Moderate (32°C) Versus Mild (35°C) Therapeutic Hypothermia in Porcine Acute Myocardial Infarction.

JACC Cardiovasc Interv 2018 Jan;11(2):195-205

Division of Cardiovascular Medicine, Stanford University, Stanford, California; Cardiovascular Institute, Stanford University, Stanford, California.

Objectives: The study investigated whether a dose response exists between myocardial salvage and the depth of therapeutic hypothermia.

Background: Cardiac protection from mild hypothermia during acute myocardial infarction (AMI) has yielded equivocal clinical trial results. Rapid, deeper hypothermia may improve myocardial salvage. Read More

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January 2018
3 Reads

Coronary Embolus: An Underappreciated Cause of Acute Coronary Syndromes.

JACC Cardiovasc Interv 2018 Jan;11(2):172-180

Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address:

Coronary embolism is the underlying cause of 3% of acute coronary syndromes but is often not considered in the differential of acute coronary syndromes. It should be suspected in the case of high thrombus burden despite a relatively normal underlying vessel or recurrent coronary thrombus. Coronary embolism may be direct (from the aortic valve or left atrial appendage), paroxysmal (from the venous circulation through a patent foramen ovale), or iatrogenic (following cardiac intervention). Read More

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January 2018
2 Reads

Collateral Channel Size and Tortuosity Predict Retrograde Percutaneous Coronary Intervention Success for Chronic Total Occlusion.

Circ Cardiovasc Interv 2018 Jan;11(1):e005124

From the Department of Internal Medicine, National Taiwan University Hospital, Taipei (C.-C.H., C.-S.H., Y.-H.C., M.-S.L., C.-F.Y., H.-L.K.); and Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu (C.-K. L., S.-W.M.).

Background: There is little evidence on how to select an interventional collateral channel (CC) in retrograde chronic total occlusion (CTO) percutaneous coronary intervention. We aimed to identify independent angiographic predictors of CC tracking and technical success in retrograde CTO percutaneous coronary intervention.

Methods And Results: From January 2012 to December 2015, a total of 216 consecutive retrograde CTO percutaneous coronary intervention attempts by a high-volume operator in a tertiary university-affiliated hospital were enrolled. Read More

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January 2018
5 Reads

Invasive Assessment of the Coronary Microvasculature: The Index of Microcirculatory Resistance.

Circ Cardiovasc Interv 2017 Dec;10(12)

From the Division of Cardiovascular Medicine, Stanford University, CA.

Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Read More

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December 2017
2 Reads

Influence of Contrast Media Dose and Osmolality on the Diagnostic Performance of Contrast Fractional Flow Reserve.

Circ Cardiovasc Interv 2017 Oct;10(10)

From the Stanford University Medical Center, CA (T.N., Y.K., D.-H.C., W.F.F.); Stanford Cardiovascular Institute, CA (T.N., Y.K., D.-H.C., W.F.F.); University of Texas Medical School and Memorial Hermann Hospital, Houston (N.P.J., K.L.G.); Cardiovascular Center Aalst, Belgium (B.D.B.); West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Clydebank, Scotland (C.B., K.G.O.); British Heart Foundation Glasgow Cardiovascular Research Center, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland (C.B.); Division of Cardiovascular Medicine, Stony Brook University Medical Center, NY (A.J.); Cardiovascular Research Foundation (CFR), New York, NY (A.J.); Catharina Hospital, Eindhoven, the Netherlands (N.H.J.P.); and Eindhoven University of Technology, the Netherlands (N.H.J.P.).

Background: Contrast fractional flow reserve (cFFR) is a method for assessing functional significance of coronary stenoses, which is more accurate than resting indices and does not require adenosine. However, contrast media volume and osmolality may affect the degree of hyperemia and therefore diagnostic performance.

Methods And Results: cFFR, instantaneous wave-free ratio, distal pressure/aortic pressure at rest, and FFR were measured in 763 patients from 12 centers. Read More

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October 2017
7 Reads

Role of Proximal Optimization Technique Guided by Intravascular Ultrasound on Stent Expansion, Stent Symmetry Index, and Side-Branch Hemodynamics in Patients With Coronary Bifurcation Lesions.

Circ Cardiovasc Interv 2017 Oct;10(10)

From the Division of Cardiology, University of Alabama at Birmingham (D.H., A.C., O.A., J.T., A.S., M.A.L.); Suez Canal University, Ismailia, Egypt (D.H.); and Medtech Research Theme, National Heart Centre Singapore and Duke-NUS Medical School (N.F.).

Background: Bench models of coronary bifurcation lesions demonstrated that the proximal optimization technique (POT) expanded the stent and opened the side branch (SB). We investigated the role of POT guided by intravascular ultrasound on the main vessel (MV) stent expansion and SB fractional flow reserve (FFR) in patients with coronary bifurcation lesion.

Methods And Results: In 40 patients with coronary bifurcation lesion, 120 intravascular ultrasound examinations of the MV were performed at baseline, after MV stenting, and POT followed by 95 FFR measurements of the SB. Read More

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October 2017

Effect of Elective Percutaneous Coronary Intervention on Hyperemic Absolute Coronary Blood Flow Volume and Microvascular Resistance.

Circ Cardiovasc Interv 2017 Oct;10(10)

From the Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Japan (Y.K., T.M., T.Y., E.U., M.A., J.M., M.H., M.Y., T.N., M.H., S.I., R.H., Y.K., T.K.) and Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Japan (M.I.).

Background: The hemodynamics involved in the relationship between absolute coronary blood flow (ABF) volume and myocardial resistance (MR) are complex, and the effect of percutaneous coronary intervention (PCI) on their changes remains unclear. The aim of this study was to investigate the differences in hyperemic ABF and MR before and after elective PCI using a thermodilution method.

Methods And Results: We investigated 28 vessels (right coronary artery, 9; left anterior descending coronary artery, 18; left circumflex coronary artery, 1) from 28 patients with stable angina pectoris undergoing elective PCI. Read More

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October 2017
1 Read

Phase 2a Clinical Trial of Mitochondrial Protection (Elamipretide) During Stent Revascularization in Patients With Atherosclerotic Renal Artery Stenosis.

Circ Cardiovasc Interv 2017 Sep;10(9)

From the Division of Nephrology and Hypertension (A.S., S.M.S.H., A.E., C.M.F., L.O.L., S.C.T.) and Department of Radiology (J.F.G., H.B., M.A.M., S.M.), Mayo Clinic, Rochester, MN.

Background: Atherosclerotic renal artery stenosis reduces renal blood flow (RBF) and amplifies stenotic kidney hypoxia. Revascularization with percutaneous transluminal renal angioplasty (PTRA) and stenting often fails to recover renal function, possibly because of ischemia/reperfusion injury developing after PTRA. Elamipretide is a mitochondrial-targeted peptide that binds to cardiolipin and stabilizes mitochondrial function. Read More

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September 2017
7 Reads
6.22 Impact Factor

Validation Study of Image-Based Fractional Flow Reserve During Coronary Angiography.

Circ Cardiovasc Interv 2017 Sep;10(9)

From the Cardiovascular Center Aalst, OLV Hospital, Belgium (M.P., B.D.B., P.X.); Rabin Medical Center, Petach Tikva, Israel (I.L., H.V.-A., A.A., O.V., P.C., R.K.); Department of Advanced Biomedical Sciences, Federico II University of Naples, Italy (M.P.); CathWorks Ltd, Ra'anana, Israel (I.L., O.V., Y.L.); Columbia University Medical Center, New York-Presbyterian Hospital (A.J.K., P.C., M.B.L.); and Shaare Zedek Medical Center, Jerusalem, Israel (G.W., Y.A.).

Background: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFR) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFR in patients with stable coronary artery disease. Read More

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September 2017
7 Reads

Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention Through Ipsilateral Collateral Channels: A Multicenter Registry.

JACC Cardiovasc Interv 2017 Aug;10(15):1489-1497

Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.

Objectives: The aim of this study was to describe the procedural aspects and outcomes of retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) through ipsilateral collateral channels (ILCs).

Background: Retrograde CTO PCI via ILCs is rarely performed, usually when no other retrograde options exist, and available evidence derives mostly from case reports.

Methods: A large retrospective multinational registry was compiled, including all consecutive patients undergoing retrograde CTO PCI through ILCs at 6 centers between September 2011 and October 2016. Read More

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August 2017
8 Reads

Prognostic Value of Fractional Flow Reserve Measured Immediately After Drug-Eluting Stent Implantation.

Circ Cardiovasc Interv 2017 Aug;10(8)

From the Hungarian Institute of Cardiology, Budapest, Hungary (Z.P.); University Heart Centre Graz, Medical University Graz, Austria (G.G.T.); Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands (P.A.L.T., N.H.J.P.); Cardiovascular Center Aalst, Belgium (G.G.T., E.B., B.D.B.); Department of Advanced Biomedical Sciences, University of Naples Federico II, Italy (E.B.); Institute of Social and Preventive Medicine, University of Bern, Switzerland (S.A.); Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Switzerland (S.A.); Southampton University Hospital NHS Trust, England (N.C.); Cardiovascular Hospital, Lyon, France (G.R.); Department of Biomedical Engineering, Eindhoven University of Technology, the Netherlands (N.H.J.P.); Division of Cardiovascular Medicine, Stanford University Medical Center, CA (W.F.F.); and St. Michael's Hospital, University of Toronto, Canada (P.J.).

Background: The predictive value of fractional flow reserve (FFR) measured immediately after percutaneous coronary intervention (PCI) with drug-eluting stent placement has not been prospectively investigated. We investigated the potential of post-PCI FFR measurements to predict clinical outcome in patients from FAME 1 and 2 trials (Fractional Flow Reserve or Angiography for Multivessel Evaluation).

Methods And Results: All patients of FAME 1 and FAME 2 who had post-PCI FFR measurement were included. Read More

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August 2017
1 Read

Accuracy of Fractional Flow Reserve Measurements in Clinical Practice: Observations From a Core Laboratory Analysis.

JACC Cardiovasc Interv 2017 Jul;10(14):1392-1401

Cardiovascular Research Foundation, New York, New York; St. Francis Hospital, Roslyn, New York. Electronic address:

Objectives: The aim of this study was to compare site-reported measurements of fractional flow reserve (FFR) with FFR analysis by an independent core laboratory (CL).

Background: FFR is an index of coronary stenosis severity that has been validated in multiple trials and is widely used in clinical practice. However, the incidence of suboptimal FFR measurements is unknown. Read More

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July 2017
7 Reads

Impact of Routine Fractional Flow Reserve on Management Decision and 1-Year Clinical Outcome of Patients With Acute Coronary Syndromes: PRIME-FFR (Insights From the POST-IT [Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease] and R3F [French FFR Registry] Integrated Multicenter Registries - Implementation of FFR [Fractional Flow Reserve] in Routine Practice).

Circ Cardiovasc Interv 2017 Jun;10(6)

From the Department of Cardiology, University Hospital, Lille, France (E.V.B., F.V.); INSERM U1011, Lille-II-University, France (E.V.B., F.V.); Hospital Fernando da Fonseca, Amadora, Portugal (S.-B.B.); Hospital de Santa Cruz - CHLO, Carnaxide, Portugal (L.R.); Statistical Department, St. Jude Medical Inc, St Paul, MN (J.H.); Hôpital Louis Pradel, Lyon, France (G.R.); INSERM 1060 CARMEN, Claude Bernard University Lyon, France (G.R.); Centro Hospitalar Vila Nova de Gaia, Portugal (L.S.); Clinique Sainte Clotilde, Saint Denis de la Réunion, France (C.P.); Hospital Santa Marta - Centro Hospitalar Lisboa Central, Lisboa, Portugal (R.R.); CHU La Timone, Marseille, France (T.C.); Hospital Garcia de Orta, Almada, Portugal (R.C.); CHU Mondor, Créteil, France (E.T.); Centro Hospitalar Universitário Coimbra, Portugal (E.J.); CH d'Annecy, France (L.B.); Hospital Divino Espirito Santo, Ponta Delgada, Portugal (C.M.); C.H.I.T.S. Hôpital Sainte Musse, Toulon, France (D.B.); Hospital Geral dos Covões - Centro Hospitalar Coimbra, Portugal (M.C.); Centre Hospitalier Haguenau, France (M.H.); Hospital Santa Maria - Centro Hospitalar Lisboa Norte, Portugal (E.O.); Hôpital de la Croix-Rousse, Lyon, France (C.B.); Hospital de Braga, Portugal (J.C.); Institut Pasteur de Lille-INSERM, France (J.D.); Hospital São Teotónio, Viseu, Portugal (J.P.); Hôpital Lariboisière, Paris, France (G.S.); Centro Hospitalar Setúbal, Portugal (N.F.); Centre Hospitalier Valence, France (C.B.); Hospital Santo André - Centro Hospitalar Leiria-Pombal, Portugal (J.G.); Hôpital Albert Schweizer, Colmar, France (N.L.); Hospital Dr. Nélio Mendonça, Funchal, Portugal (B.S.); Centre Hospitalier La Durance, Avignon, France (P.B.); Hospital Geral Santo António - Centro Hospitalar do Porto, Portugal (M.-J.S.); Centre Hospitalier Amiens Sud, Amiens, France (L.L.); Centro Hospitalar São João, Porto, Portugal (J.C.S.); Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal (A.R.); Centro Hospitalar Trás-os-Montes e Alto Douro - Unidade Hospitalar Vila Real, Portugal (L.S.); Hospital Espírito Santo, Évora, Portugal (R.F.); and Hopital Privé d'Antony, France (P.D.).

Background: Fractional flow reserve (FFR) is not firmly established as a guide to treatment in patients with acute coronary syndromes (ACS). Primary goals were to evaluate the impact of integrating FFR on management decisions and on clinical outcome of patients with ACS undergoing coronary angiography, as compared with patients with stable coronary artery disease.

Methods And Results: R3F (French FFR Registry) and POST-IT (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease), sharing a common design, were pooled as PRIME-FFR (Insights From the POST-IT and R3F Integrated Multicenter Registries - Implementation of FFR in Routine Practice). Read More

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June 2017
13 Reads

Stimulating Extracardiac Collaterals via Right Internal Mammary Artery Occlusion: Another Step Into an Undiscovered Country.

Circ Cardiovasc Interv 2017 Jun;10(6)

From the Department of Medicine, Veterans Administration Long Beach Health Care System and University of California, Irvine.

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June 2017
6 Reads

Effect of Permanent Right Internal Mammary Artery Closure on Coronary Collateral Function and Myocardial Ischemia.

Circ Cardiovasc Interv 2017 Jun;10(6)

From the Department of Cardiology, Bern University Hospital, Switzerland.

Background: The objective of this study is to test the effect of permanent right internal mammary artery device closure on coronary collateral function and myocardial ischemia.

Methods And Results: This was a prospective, open-label clinical trial in 50 patients with coronary artery disease. The primary study end point was coronary collateral flow index as obtained during a 1-minute proximal right coronary artery (RCA) and left coronary artery balloon occlusion at baseline before and at follow-up examination 6 weeks after distal right internal mammary artery device closure. Read More

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June 2017
9 Reads

Discordance Between Fractional Flow Reserve and Coronary Flow Reserve: Insights From Intracoronary Imaging and Physiological Assessment.

JACC Cardiovasc Interv 2017 May;10(10):999-1007

Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address:

Objectives: The aim of this study was to investigate the epicardial and microvascular substrates associated with discordances between fractional flow reserve (FFR) and coronary flow reserve (CFR) values.

Background: Discordances between FFR and CFR remain poorly characterized.

Methods: FFR, hyperemic stenosis resistance (HSR), and intravascular ultrasound were performed as indexes of epicardial function and CFR and hyperemic microvascular resistance (HMR) as measures of microvascular function in 94 patients with moderate coronary stenosis. Read More

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May 2017
11 Reads

Hemodynamic Measurements for the Selection of Patients With Renal Artery Stenosis: A Systematic Review.

JACC Cardiovasc Interv 2017 May;10(10):973-985

Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. Electronic address:

Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Read More

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May 2017
8 Reads

Outcomes After Decompression of the Right Ventricle in Infants With Pulmonary Atresia With Intact Ventricular Septum Are Associated With Degree of Tricuspid Regurgitation: Results From the Congenital Catheterization Research Collaborative.

Circ Cardiovasc Interv 2017 May;10(5)

From the Department of Pediatrics, Emory University School of Medicine, Atlanta, GA (C.J.P., R.S., G.T.N., C.M., M.K.); Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia (A.C.G., D.J.G.); Department of Pediatrics, Baylor College of Medicine, Houston, TX (A.M.Q., S.A.M., H.J.); Division of Cardiology, Children's Hospital of Philadelphia, PA (N.M.); and The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (W.W., L.S.R., B.H.G.).

Background: Outcomes after right ventricle (RV) decompression in infants with pulmonary atresia with intact ventricular septum vary widely. Descriptions of outcomes are limited to small single-center studies.

Methods And Results: Neonates undergoing RV decompression for pulmonary atresia with intact ventricular septum were included from 4 pediatric centers. Read More

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May 2017
10 Reads

Collateral Circulation in Chronic Total Occlusions: A Marker of Hope or Hype?

JACC Cardiovasc Interv 2017 May;10(9):915-917

PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical, Harvard Medical School, Boston, Massachusetts.

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May 2017
2 Reads

Impact of Collateral Circulation on Survival in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention With a Concomitant Chronic Total Occlusion.

JACC Cardiovasc Interv 2017 May;10(9):906-914

Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Electronic address:

Objectives: This study sought to compare long-term clinical outcome in ST-segment elevation myocardial infarction (STEMI) patients with a concomitant chronic total occlusion (CTO) with well-developed versus poorly developed collaterals toward the CTO.

Background: In STEMI patients, presence of a CTO is associated with increased morbidity and mortality. CTOs are often (partially) perfused by collateral vessels. Read More

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May 2017
3 Reads

Cutoff Value and Long-Term Prediction of Clinical Events by FFR Measured Immediately After Implantation of a Drug-Eluting Stent in Patients With Coronary Artery Disease: 1- to 3-Year Results From the DKCRUSH VII Registry Study.

JACC Cardiovasc Interv 2017 May 26;10(10):986-995. Epub 2017 Apr 26.

Division of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address:

Objectives: This study aimed to investigate the cutoff of post-drug-eluting stent (DES) fractional flow reserve (FFR) for prediction of 1- to 3-year target vessel failure (TVF).

Background: FFR immediately after a DES implantation correlates with clinical events. However, the cutoff of post-DES FFR for predicting long-term clinical events remains understudied. Read More

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May 2017
9 Reads

Fractional Flow Reserve-Guided Complete Revascularization Improves the Prognosis in Patients With ST-Segment-Elevation Myocardial Infarction and Severe Nonculprit Disease: A DANAMI 3-PRIMULTI Substudy (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment of Culprit Lesion Only or Complete Revascularization).

Circ Cardiovasc Interv 2017 Apr;10(4)

From the Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark (J.L., T.E., S.H., L. Kløvgaard, L.H., F.P., E.J., K.S., O.D.B., H.-H.T., L. Køber, D.E.H.); Department of Cardiology, Roskilde Hospital, Denmark (H.K.); Department of Cardiology, Nykoebing Falster Hospital, Denmark (P.C.); and Department of Cardiology, Aalborg University Hospital, Denmark (J.R., A.B.V., J.A., S.E.J., B.R.).

Background: The impact of disease severity on the outcome after complete revascularization in patients with ST-segment-elevation myocardial infarction and multivessel disease is uncertain. The objective of this post hoc study was to evaluate the impact of number of diseased vessel, lesion location, and severity of the noninfarct-related stenosis on the effect of fractional flow reserve-guided complete revascularization.

Methods And Results: In the DANAMI-3-PRIMULTI study (Primary PCI in Patients With ST-Elevation Myocardial Infarction and Multivessel Disease: Treatment of Culprit Lesion Only or Complete Revascularization), we randomized 627 ST-segment-elevation myocardial infarction patients to fractional flow reserve-guided complete revascularization or infarct-related percutaneous coronary intervention only. Read More

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April 2017
19 Reads

Saline-Induced Coronary Hyperemia: Mechanisms and Effects on Left Ventricular Function.

Circ Cardiovasc Interv 2017 Apr;10(4)

From the Cardiovascular Center Aalst, Belgium (B.D.B., J.A., P.X., A.F., Y.M., M. Penicka, V.F., M. Pellicano, E.B.); Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy (M. Pellicano, E.B.); University Heart Centre Graz, Austria (G.T.); Experimental Cardiology, Thoraxcenter, Erasmus University Rotterdam, The Netherlands (D.J.D.); Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (N.H.J.P.); and Department of Biomedical Engineering, Eindhoven University of Technology, The Netherlands (N.H.J.P.).

Background: During thermodilution-based assessment of volumetric coronary blood flow, we observed that intracoronary infusion of saline increased coronary flow. This study aims to quantify the extent and unravel the mechanisms of saline-induced hyperemia.

Methods And Results: Thirty-three patients were studied; in 24 patients, intracoronary Doppler flow velocity measurements were performed at rest, after intracoronary adenosine, and during increasing infusion rates of saline at room temperature through a dedicated catheter with 4 lateral side holes. Read More

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April 2017
9 Reads

Diagnostic Performance of Resting and Hyperemic Invasive Physiological Indices to Define Myocardial Ischemia: Validation With N-Ammonia Positron Emission Tomography.

JACC Cardiovasc Interv 2017 Apr 29;10(8):751-760. Epub 2017 Mar 29.

Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea; Institute of Aging, Seoul National University, Seoul, Korea. Electronic address:

Objectives: The authors sought to compare the diagnostic performance of fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and resting distal coronary artery pressure/aortic pressure (Pd/Pa) using N-ammonia positron emission tomography (PET).

Background: The diagnostic performance of invasive physiological indices was reported to be different according to the reference to define the presence of myocardial ischemia.

Methods: A total of 115 consecutive patients with left anterior descending artery stenosis who underwent both N-ammonia PET and invasive physiological measurement were included. Read More

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April 2017
21 Reads

Effect of Coronary Anatomy and Hydrostatic Pressure on Intracoronary Indices of Stenosis Severity.

JACC Cardiovasc Interv 2017 Apr 29;10(8):764-773. Epub 2017 Mar 29.

Department of Cardiology, Klinikum Oldenburg, European Medical School Oldenburg-Groningen, Carl von Ossietzky University Oldenburg, Germany.

Objectives: The authors sought to analyze height differences within the coronary artery tree in patients in a supine position and to quantify the impact of hydrostatic pressure on intracoronary pressure measurements in vitro.

Background: Although pressure equalization of the pressure sensor and the systemic pressure at the catheter tip is mandatory in intracoronary pressure measurements, subsequent measurements may be influenced by hydrostatic pressure related to the coronary anatomy in the supine position. Outlining and quantifying this phenomenon is important to interpret routine and pullback pressure measurements within the coronary tree. Read More

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April 2017
4 Reads

Programmatic Approach to Management of Tetralogy of Fallot With Major Aortopulmonary Collateral Arteries: A 15-Year Experience With 458 Patients.

Circ Cardiovasc Interv 2017 Apr;10(4)

From the Departments of Pediatrics (H.B.-H., A.B., B.H., M.L., R.A., A.K., C.A.A., S.B.P., A.S., L.F.P., D.B.M.), Anesthesia (L.D., L.W.-F.), and Cardiothoracic Surgery (F.L.H., D.B.M.), Lucile Packard Children's Hospital Heart Center Clinical and Translational Research Program, Stanford University School of Medicine, Palo Alto, CA.

Background: Tetralogy of Fallot with major aortopulmonary collateral arteries is a complex and heterogeneous condition. Our institutional approach to this lesion emphasizes early complete repair with the incorporation of all lung segments and extensive lobar and segmental pulmonary artery reconstruction.

Methods And Results: We reviewed all patients who underwent surgical intervention for tetralogy of Fallot and major aortopulmonary collateral arteries at Lucile Packard Children's Hospital Stanford (LPCHS) since November 2001. Read More

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April 2017
7 Reads

Coronary Collaterals Function and Clinical Outcome Between Patients With Acute and Chronic Total Occlusion.

JACC Cardiovasc Interv 2017 Mar;10(6):585-593

Department of Cardiology, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address:

Objectives: This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs).

Background: The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated.

Methods: The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients. Read More

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March 2017
2 Reads

The Role of Post-Resuscitation Electrocardiogram in Patients With ST-Segment Changes in the Immediate Post-Cardiac Arrest Period.

JACC Cardiovasc Interv 2017 Mar;10(5):451-459

Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address:

Objectives: The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography.

Background: The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial.

Methods: Between January 2010 and December 2014, 1,088 consecutive adult nontraumatic patients with return of spontaneous circulation who visited the emergency department of 3 tertiary care hospitals were enrolled. Read More

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March 2017
6 Reads

Identification of Coronary Artery Side Branch Supplying Myocardial Mass That May Benefit From Revascularization.

JACC Cardiovasc Interv 2017 Mar 1;10(6):571-581. Epub 2017 Mar 1.

Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Emergency Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

Objectives: The authors sought to identify whether a coronary side branch (SB) is supplying a myocardial mass that may benefit from revascularization.

Background: The amount of subtending myocardium and physiological stenosis is frequently different between the main vessel (MV) and SB.

Methods: In this multicenter registry, 482 patients who underwent coronary computed tomography angiography and fractional flow reserve (FFR) measurement were enrolled. Read More

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March 2017
7 Reads

Invasive Assessment of the Coronary Microcirculation in Reperfused ST-Segment-Elevation Myocardial Infarction Patients: Where Do We Stand?

Circ Cardiovasc Interv 2017 Mar;10(3)

From the Hatter Cardiovascular Institute, Institute of Cardiovascular Science, University College London, United Kingdom (H.B., D.J.H.); The National Institute of Health Research, University College London Hospitals, Biomedical Research Centre, United Kingdom (H.B., D.J.H.); Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore (H.B., N.F., D.J.H.); National Heart Research Institute Singapore, National Heart Centre Singapore (H.B., N.F., J.W.T., D.J.H.); National University Heart Centre, Singapore (A.F.L.); Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Çapa, Turkey (M.S.); Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom (D.J.H.); and Yong Loo Lin School of Medicine, National University Singapore (D.J.H.).

For patients presenting with an acute ST-segment-elevation myocardial infarction, the most effective therapy for reducing myocardial infarct size and preserving left ventricular systolic function is primary percutaneous coronary intervention (PPCI). However, mortality and morbidity remain significant. This is partly attributed to the development of microvascular obstruction, which occurs in around 50% of ST-segment-elevation myocardial infarction patients post-PPCI, and it is associated with adverse left ventricular remodeling and worse clinical outcomes. Read More

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March 2017
2 Reads

Management of No-Reflow Phenomenon in the Catheterization Laboratory.

JACC Cardiovasc Interv 2017 Feb;10(3):215-223

Huntington Medical Research Institute, Pasadena, California; Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.

At the conclusion of a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, and after the cardiologist makes certain that there is no residual stenosis following stenting, assessment of coronary flow becomes the top priority. The presence of no-reflow is a serious prognostic sign. No-reflow can result in poor healing of the infarct and adverse left ventricular remodeling, increasing the risk for major adverse cardiac events, including congestive heart failure and death. Read More

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February 2017
2 Reads

Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing.

JACC Cardiovasc Interv 2017 Jan;10(2):188-194

Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan.

Objectives: This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing.

Background: Several reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear. Read More

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January 2017
3 Reads

Circulation: Cardiovascular Interventions Editors and Editorial Board.

Authors:

Circ Cardiovasc Interv 2017 Jan;10(1):e000023

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January 2017
6 Reads

INNOVATION Study (Impact of Immediate Stent Implantation Versus Deferred Stent Implantation on Infarct Size and Microvascular Perfusion in Patients With ST-Segment-Elevation Myocardial Infarction).

Circ Cardiovasc Interv 2016 Dec;9(12)

From the Division of Cardiology, Department of Internal Medicine (J.S.K., H.J.L., R.K.C., Y.J.C., J.S.P., T.H.K., H.-J.J., Y.M.R.) and Division of Radiology (Y.M.K.), Sejong General Hospital, Bucheon, Korea; and Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University School of Medicine, Seoul (C.W.Y., S.J.H., J.H.P., H.J.J., S.-A.C., D.-S.L.).

Background: The aim of this study was to assess whether deferred stenting (DS) reduces infarct size and microvascular obstruction (MVO) compared with immediate stenting (IS) in primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction.

Methods And Results: From February 2013 to August 2015, 114 patients (mean age: 69 years) were randomized into the following 2 groups: DS with an intention to stent 3 to 7 days later or IS after primary reperfusion in 2 centers. The primary and secondary end points were infarct size and the incidence of MVO, respectively, assessed by cardiac magnetic resonance imaging at 30 days after primary reperfusion. Read More

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December 2016
16 Reads

The IMPACT Study (Influence of Sensor-Equipped Microcatheters on Coronary Hemodynamics and the Accuracy of Physiological Indices of Functional Stenosis Severity).

Circ Cardiovasc Interv 2016 Dec;9(12)

From the AMC Heart Center, Academic Medical Center, University of Amsterdam, The Netherlands (G.W.M.W., T.P.v.d.H., R.P.K., M.A.B., K.D.S., M.M.V., J.B., K.T.K., J.J.W., J.P.H., R.J.d.W., J.J.P.); and Department of Cardiology, Tergooi Hospital, Blaricum, The Netherlands (T.P.v.d.H., M.I.M.C., S.L.B., J.P.).

Background: The Navvus pressure sensor-equipped microcatheter allows to measure functional stenosis severity over a work-horse guidewire and is used as a more feasible alternative to regular sensor-equipped wires. However, Navvus is larger in diameter than contemporary sensor-equipped guidewires and may, thereby, influence functional measurements. The present study evaluates the hemodynamic influence of the Navvus microcatheter. Read More

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December 2016
7 Reads

Acquired Aseptic Intracardiac Shunts Following Transcatheter Aortic Valve Replacement: A Systematic Review.

JACC Cardiovasc Interv 2016 Dec 23;9(24):2527-2538. Epub 2016 Nov 23.

Institute of Heart Sciences, Hospital Clínico Universitario, Valladolid, Spain.

Objectives: The aim of this study was to describe the incidence, mechanisms, features, and management of aseptic intracardiac shunts (AICS).

Background: AICS following transcatheter aortic valve replacement (TAVR) are an uncommon and barely described complication.

Methods: A systematic review was performed of all published cases of AICS following TAVR, and the incidence, predictors, main features, management, and related outcomes were analyzed. Read More

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December 2016
3 Reads

The Influence of Lesion Location on the Diagnostic Accuracy of Adenosine-Free Coronary Pressure Wire Measurements.

JACC Cardiovasc Interv 2016 Dec 9;9(23):2390-2399. Epub 2016 Nov 9.

Stanford University Medical Center, Stanford, California; Stanford Cardiovascular Institute, Stanford, California. Electronic address:

Objectives: This work compares the diagnostic performance of adenosine-free coronary pressure wire indices based on lesion location.

Background: Several adenosine-free coronary pressure wire indices have been proposed to assess the functional significance of coronary artery lesions; however, there is a theoretical concern that lesion location and the mass of perfused myocardium may affect diagnostic performance.

Methods: A total of 763 patients were prospectively enrolled from 12 institutions. Read More

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December 2016
9 Reads

Importance of Both Early Reperfusion and Therapeutic Hypothermia in Limiting Myocardial Infarct Size Post-Cardiac Arrest in a Porcine Model.

JACC Cardiovasc Interv 2016 Dec 9;9(23):2403-2412. Epub 2016 Nov 9.

University of Arizona Sarver Heart Center, Tucson, Arizona; University of Basel, Basel, Switzerland.

Objectives: The aim of this study was to test the hypothesis that hypothermia and early reperfusion are synergistic for limiting infarct size when an acutely occluded coronary is associated with cardiac arrest.

Background: Cohort studies have shown that 1 in 4 post-cardiac arrest patients without ST-segment elevation has an acutely occluded coronary artery. However, many interventional cardiologists remain unconvinced that immediate coronary angiography is needed in these patients. Read More

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December 2016
5 Reads

Discordance Between Resting and Hyperemic Indices of Coronary Stenosis Severity: The VERIFY 2 Study (A Comparative Study of Resting Coronary Pressure Gradient, Instantaneous Wave-Free Ratio and Fractional Flow Reserve in an Unselected Population Referred for Invasive Angiography).

Circ Cardiovasc Interv 2016 Nov;9(11)

From the University of Glasgow, United Kingdom (B.H., K.G.O., C.B., P.M., M.B.M., H.E., M.C.P., P.R., R.G., M.M.L., S.H., S.W.); Cardiology Department, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom (B.H., K.G.O., C.B., J.M.); and The Weatherhead PET Imaging Center, Houston, TX (N.J.).

Background: Distal coronary to aortic pressure ratio (Pd/Pa) and instantaneous wave-free ratio (iFR) are indices of functional significance of a coronary stenosis measured without hyperemia. It has been suggested that iFR has superior diagnostic accuracy to Pd/Pa when compared with fractional flow reserve (FFR).We hypothesized that in comparison with FFR, revascularization decisions based on either binary cutoff values for iFR and Pd/Pa or hybrid strategies incorporating iFR or Pd/Pa will result in similar levels of disagreement. Read More

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November 2016
9 Reads

Functional Assessment of Coronary Artery Disease in Patients Undergoing Transcatheter Aortic Valve Implantation: Influence of Pressure Overload on the Evaluation of Lesions Severity.

Circ Cardiovasc Interv 2016 Nov;9(11)

From the Division of Cardiology, Department of Medicine, School of Medicine (G.P., R.S., C.Z., A.P., A.G., A.R., V.F., C.V., F.R.) and Department of Anesthesia and Intensive Care (L.G.), University of Verona, Italy.

Background: Aortic valve stenosis may influence fractional flow reserve (FFR) of concomitant coronary artery disease by causing hypertrophy and reducing the vasodilatory reserve of the coronary circulation. We sought to investigate whether FFR values might change after valve replacement.

Methods And Results: The functional relevance of 133 coronary lesions was assessed by FFR in 54 patients with severe aortic valve stenosis before and after transcatheter aortic valve implantation (TAVI) during the same procedure. Read More

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November 2016
6 Reads

Diagnostic Accuracy of Fast Computational Approaches to Derive Fractional Flow Reserve From Diagnostic Coronary Angiography: The International Multicenter FAVOR Pilot Study.

JACC Cardiovasc Interv 2016 Oct;9(19):2024-2035

Cardiovascular Research Centre, OLV Hospital, Aalst, Belgium; The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway, and Saolta University Healthcare Group, Galway, Ireland.

Objectives: The aim of this prospective multicenter study was to identify the optimal approach for simple and fast fractional flow reserve (FFR) computation from radiographic coronary angiography, called quantitative flow ratio (QFR).

Background: A novel, rapid computation of QFR pullbacks from 3-dimensional quantitative coronary angiography was developed recently.

Methods: QFR was derived from 3 flow models with: 1) fixed empiric hyperemic flow velocity (fixed-flow QFR [fQFR]); 2) modeled hyperemic flow velocity derived from angiography without drug-induced hyperemia (contrast-flow QFR [cQFR]); and 3) measured hyperemic flow velocity derived from angiography during adenosine-induced hyperemia (adenosine-flow QFR [aQFR]). Read More

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October 2016
8 Reads

Does Residual Thrombus After Aspiration Thrombectomy Affect the Outcome of Primary PCI in Patients With ST-Segment Elevation Myocardial Infarction?: An Optical Coherence Tomography Study.

JACC Cardiovasc Interv 2016 Oct;9(19):2002-2011

Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Cardiology, Kyung Hee University, Seoul, Republic of Korea. Electronic address:

Objectives: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI).

Background: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. Read More

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October 2016
5 Reads

Prevention of Radial Artery Occlusion After Transradial Catheterization: The PROPHET-II Randomized Trial.

JACC Cardiovasc Interv 2016 Oct;9(19):1992-1999

Apex Heart Institute, Ahmedabad, India.

Objectives: The study sought to evaluate whether prophylactic ipsilateral ulnar artery compression during radial artery hemostasis could reduce the risk of radial artery occlusion (RAO).

Background: RAO after transradial access (TRA) is a structural complication of TRA. It limits future ipsilateral TRA and may cause transient pain. Read More

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October 2016
3 Reads
7.34 Impact Factor

Elimination of Transcoarctation Pressure Gradients Has No Impact on Left Ventricular Function or Aortic Shear Stress After Intervention in Patients With Mild Coarctation.

JACC Cardiovasc Interv 2016 Sep;9(18):1953-65

Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Objectives: This study sought to investigate the impact of transcatheter intervention on left ventricular function and aortic hemodynamics in patients with mild coarctation of the aorta (COA).

Background: The optimal method and timing of transcatheter intervention for COA remains unclear, especially when the severity of COA is mild (peak-to-peak transcoarctation pressure gradient <20 mm Hg). Debate rages regarding the risk/benefit ratio of intervention versus long-term effects of persistent minimal gradient in this heterogeneous population with differing blood pressures, ventricular function, and peripheral perfusion. Read More

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September 2016
2 Reads