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Journal Cover Interventional Cardiology Clinics
   [3 followers]  Follow    
   Full-text available via subscription Subscription journal
     ISSN (Print) 2211-7458 - ISSN (Online) 2211-7466
     Published by Elsevier Homepage  [2563 journals]   [H-I: 1]
  • Index
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3




      PubDate: 2014-08-11T21:04:14Z
       
  • Index
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2




      PubDate: 2014-08-11T21:04:14Z
       
  • Management of Mesenteric Ischemia
    • Abstract: Publication date: Available online 5 August 2014
      Source:Interventional Cardiology Clinics
      Author(s): Anvar Babaev , David W. Lee , Louai Razzouk

      Teaser Acute mesenteric ischemia is associated with a high mortality rate and requires emergent evaluation and surgical management. However, patients with chronic mesenteric ischemia can undergo either surgical or endovascular revascularization. Review of recent medical literature suggests lower rates of mortality and complications after endovascular revascularization, but higher rates of primary patency after surgical revascularization. The decision regarding method of revascularization in patients with chronic mesenteric ischemia should be based on the patient’s vascular anatomy, comorbidities, and life expectancy.

      PubDate: 2014-08-07T20:59:11Z
       
  • Management of Atherosclerotic Aortoiliac Occlusive Disease
    • Abstract: Publication date: Available online 7 August 2014
      Source:Interventional Cardiology Clinics
      Author(s): Marcin Bujak , Jacqueline Gamberdella , Carlos Mena

      Teaser Development of aortoiliac occlusive disease (AIOD) is associated with classic risk factors for atherosclerotic disease such as hyperlipidemia, hypertension, diabetes, or smoking. Risk factor modification, smoking cessation, and prevention of cardiovascular events remain the cornerstones of AIOD management. Symptom improvement and limb loss prevention are considered secondary goals of therapy. Continuous technological advances, new devices, as well as new revascularization techniques are constantly changing the landscape of AIOD management. Surgical interventions, which were considered a gold standard therapy for nearly 50 years, currently give way to newer and less invasive endovascular techniques.

      PubDate: 2014-08-07T20:59:11Z
       
  • Contemporary Management of Femoral Popliteal Revascularization
    • Abstract: Publication date: Available online 5 August 2014
      Source:Interventional Cardiology Clinics
      Author(s): Phillip A. Erwin , Mehdi H. Shishehbor

      Teaser Symptomatic peripheral artery disease of the femoral popliteal segment can be treated by surgical and endovascular revascularization, but the best approach is controversial. Conventional approaches to revascularization have focused on lesion anatomy to decide on bypass versus endovascular treatment, but advances in endovascular therapy make an endovascular-first approach increasingly feasible—either as a single approach or as an adjunct to short-segment bypass (ie, hybrid procedure). In this review, we discuss the medical, endovascular, and surgical treatment of femoral popliteal revascularization with a special emphasis on advances in percutaneous therapy.

      PubDate: 2014-08-07T20:59:11Z
       
  • Management of Renal Arterial Disease
    • Abstract: Publication date: Available online 5 August 2014
      Source:Interventional Cardiology Clinics
      Author(s): Jun Li , Sahil A. Parikh

      Teaser Severe atherosclerotic renal artery stenosis can manifest as treatment-resistant hypertension, ischemic nephropathy and/or cardiac disturbance syndromes of recurrent flash pulmonary edema and refractory angina. Renal artery revascularization can dramatically impact patient outcome. However, patient selection for revascularization can be challenging. Renal artery stenting is most commonly used for renal revascularization and is a safe procedure when performed in carefully selected patients. This review addresses the pathophysiology of renal artery stenosis and the data supporting revascularization in such patients.

      PubDate: 2014-08-07T20:59:11Z
       
  • Renal Complications in Patients Undergoing Peripheral Artery Interventions
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Sachin S. Goel , Mehdi H. Shishehbor

      Teaser Surgical or endovascular revascularization procedures for severe peripheral artery disease (PAD) are typically performed in patients with lifestyle-limiting symptoms or evidence of end-organ ischemia secondary to PAD. The role of endovascular therapy in the treatment of PAD is expanding. Contrast-induced nephropathy is the most important and most frequent renal complication of endovascular interventional procedures. Knowledge about complications and their prevention and management is essential for successful outcomes. This article focuses on renal complications during peripheral artery interventions.

      PubDate: 2014-07-27T10:46:30Z
       
  • Renal Complications in Patients Undergoing Transcatheter Aortic Valve
           Replacement
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Justin M. Dunn , E. Murat Tuzcu , Samir R. Kapadia

      Teaser Acute kidney injury in hospitalized patients is associated with significantly increased mortality across a broad spectrum of conditions. According to the Society of Thoracic Surgeons database, patients with chronic kidney disease undergoing surgical aortic valve replacement with or without coronary artery bypass grafting had a more than 50% reduction in observed 8-year survival compared with those without chronic kidney disease. Transcatheter aortic valve replacement is an exciting new approach for the treatment of aortic stenosis in high-risk or inoperable patients with severe aortic stenosis. This article discusses the incidence, predictors, impact, and potential avoidance and management strategies of renal dysfunction associated with transcatheter aortic valve replacement.

      PubDate: 2014-07-27T10:46:30Z
       
  • Device-Based Therapy in the Prevention of Contrast-Induced Nephropathy
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Dion Stub , Stephen J. Duffy , David M. Kaye

      Teaser Contrast-induced nephropathy (CIN) is a common condition that is associated with short- and, likely, long-term adverse outcomes. Although periprocedural intravenous hydration is the simplest and most widely used technique to prevent CIN, the limited ability of this approach to mitigate the CIN risk in high-risk populations has provided an impetus to develop new preventive strategies. A range of potentially useful device-based approaches offers new preventive techniques. Well-designed and adequately powered randomized studies of these device-based therapies are urgently needed to determine the expanding role they will play in future clinical practice.

      PubDate: 2014-07-27T10:46:30Z
       
  • A Practical Approach to Preventing Renal Complications in the
           Catheterization Laboratory
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Michael Howe , Hitinder S. Gurm

      Teaser Kidney injury following cardiac catheterization is an infrequent, though persistent, complication, which in some cases may be preventable. Patients at increased risk for renal complications following catheterization can be identified through individual and procedural risk factors, and several risk-prediction models are readily available. The authors advocate for the development of an easily implemented and standardized protocol, readily accessible to catheterization laboratory staff, for the identification and treatment of those patients who may be at increased risk for renal complications following cardiac catheterization.

      PubDate: 2014-07-27T10:46:30Z
       
  • Pharmacologic Prophylaxis for Contrast-Induced Acute Kidney Injury
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Anna Toso , Mario Leoncini , Mauro Maioli , Francesco Tropeano , Francesco Bellandi

      Teaser In the effort to prevent contrast-induced acute kidney injury (CI-AKI), several pharmacologic agents have been tested for their single or combined nephroprotective properties. To date, however, no drug has been officially approved for this aim. This article focuses on the three agents that have been most extensively studied: statins, N-acetylcysteine, and ascorbic acid. Particular attention is paid to the impact of these drugs on the CI-AKI prevention and improved prognosis.

      PubDate: 2014-07-27T10:46:30Z
       
  • Predicting Contrast-induced Renal Complications in the Catheterization
           Laboratory
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Judith Kooiman , Hitinder S. Gurm

      Teaser Risk scores should undergo 3 analytical phases before they are suitable for adoption in clinical practice, namely, derivation, external validation, and assessment of effect on clinical outcomes of use of the risk score in a so-called impact study. Major risk factors for renal complications after percutaneous coronary intervention are pre-existing chronic kidney disease, diabetes mellitus, use of a high contrast dose, and hemodynamic instability. Unfortunately, only 3 of these 10 risk scores have undergone external validation. As a result, there is a great need for further research on the already designed risk scores.

      PubDate: 2014-07-27T10:46:30Z
       
  • Biomarkers of Contrast-Induced Nephropathy Which Ones and What Is Their
           Clinical Relevance?
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Jolanta Malyszko , Hanna Bachorzewska-Gajewska , Slawomir Dobrzycki

      Teaser Contrast-induced nephropathy, or contrast-induced acute kidney injury (AKI), is an acute impairment of renal function as manifested by an increase in serum creatinine. Different urinary and serum proteins have been intensively investigated as possible biomarkers for the early diagnosis of AKI. Promising candidate biomarkers have the ability to detect an early and graded increase in tubular epithelial cell injury and to distinguish prerenal causes of AKI from acute tubular necrosis. In this article new, emerging biomarkers of contrast-induced AKI are presented and described, of which serum neutrophil gelatinase-associated lipocalin appears to be the most promising.

      PubDate: 2014-07-27T10:46:30Z
       
  • Intravenous and Oral Hydration Approaches, Principles, and Differing
           Regimens
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Igor Rojkovskiy , Richard Solomon

      Teaser Prevention of contrast-induced nephropathy is founded on minimizing the pathophysiologic consequences of contrast media (CM) interacting with a vulnerable kidney. In this article, the rationale for administering fluid (oral or intravenous) is discussed, and the clinical trials exploring different protocols are reviewed. A benefit from administration of fluids before CM exposure, which corrects volume depletion and increases urine output, can be expected. Forced diuresis without adequate volume replacement is deleterious.

      PubDate: 2014-07-27T10:46:30Z
       
  • Contrast-Induced Nephropathy Definitions, Epidemiology, and Implications
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Peter A. McCullough

      Teaser Contrast-induced nephropathy, now termed contrast-induced acute kidney injury (CI-AKI), has been a long-recognized complication of administering intravascular iodinated contrast. This article reviews the newest literature on subclinical CI-AKI detected by novel biomarkers, and clinical CI-AKI recognized by an increase in serum creatinine and a reduction in urine output. Both components of CI-AKI are associated with adverse outcomes, including in-hospital complications, increased length of stay, need for renal replacement therapy, rehospitalization, permanent loss in renal filtration function, and death.

      PubDate: 2014-07-27T10:46:30Z
       
  • Pathophysiology of Contrast-Induced Acute Kidney Injury
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Remy W.F. Geenen , Hylke Jan Kingma , Aart J. van der Molen

      Teaser Contrast-induced acute kidney injury (CI-AKI) refers to acute kidney injury (AKI) after intravenous or intra-arterial administration of contrast media (CM). The 2 key mechanisms related to AKI are acute tubular necrosis and prerenal azotemia. Although the pathophysiology of AKI is complex, modern frameworks show that AKI has 3 major pathways: hemodynamic injury, systemic inflammation, and toxic injury. In the pathophysiology of CI-AKI, 3 major distinct, but potentially interacting pathways are recognized: hemodynamic effects, increase in oxygen free radicals, and direct CM molecule tubular cell toxicity. This article reviews the pathophysiology of CI-AKI by describing and explaining these pathways.

      PubDate: 2014-07-27T10:46:30Z
       
  • Nonrenal Complications of Contrast Media
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Damien Marycz , Khaled M. Ziada

      Teaser Nonrenal complications of contrast media are caused by chemotoxic or anaphylactoid reactions related to the contrast agent used. Chemotoxicity is mainly attributed to ionic concentration and osmolality. Anaphylactoid reactions are typically caused by direct activation of basophils, mast cells, and complement rather than an observable antigen-antibody interaction, and may be acute or delayed. History of an adverse reaction following prior exposure is the strongest predictor of a subsequent adverse reaction to contrast. Premedication regimens of corticosteroids or antihistamines can lower the risk of repeat adverse reactions. Treatment of anaphylactoid reactions depends on the severity of symptoms.

      PubDate: 2014-07-27T10:46:30Z
       
  • Relative Nephrotoxicity of Different Contrast Media
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Iram Aqeel , Amarinder S. Garcha , Michael R. Rudnick

      Teaser Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury among hospitalized patients. High-osmolar contrast agents are associated with increased risk of CIN. Low-osmolar (LOCM) and iso-osmolar (IOCM) agents show no difference in the incidence of CIN, even among high-risk patients. This finding suggests that factors other than osmolality may play a role in the pathogenesis of CIN. The use of either LOCM or IOCM agents is recommended in high-risk patients.

      PubDate: 2014-07-27T10:46:30Z
       
  • Contributors
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3




      PubDate: 2014-07-27T10:46:30Z
       
  • Contents
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3




      PubDate: 2014-07-27T10:46:30Z
       
  • Forthcoming Issues
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3




      PubDate: 2014-07-27T10:46:30Z
       
  • Implications of Kidney Disease in the Cardiac Patient
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Roger Rear , Pascal Meier , Robert M. Bell

      Teaser Traditional cardiovascular risk factors, particularly hypertension and diabetes, are common in the disease processes of both renal and cardiac pathology. Unfortunately the coexistence of renal impairment is not an innocent bystander in cardiovascular disease; it disorder not only increases the prevalence and severity of cardiovascular disease, but also negatively affects prognostic outcomes and the safety and efficacy of cardiac interventions. This article discusses the role and impact of kidney disease in the cardiac patient in 3 key common cardiovascular processes: coronary artery disease, arrhythmia, and heart failure.

      PubDate: 2014-07-27T10:46:30Z
       
  • Contrast Media History and Chemical Properties
    • Abstract: Publication date: July 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 3
      Author(s): Michael Buschur , Peter Aspelin

      Teaser Contrast media are essential for cardiac catheterization, and the evolution of these agents has had a significant role in cardiology. Contrast agents are classified as ionic or nonionic based on water solubility and as monomers or dimers based on their chemical structures. Furthermore, these agents are classified on osmolality as high osmolar, low osmolar, or iso-osmolar. The last century has seen a rapid evolution of these agents from their discovery during the search for syphilis treatments to advancements in their chemical properties, making them safer for patients and improving tissue visualization.

      PubDate: 2014-07-27T10:46:30Z
       
  • Renal Complications in the Catheterization Laboratory
    • Abstract: Publication date: Available online 13 May 2014
      Source:Interventional Cardiology Clinics
      Author(s): Hitinder S. Gurm , Judith Kooiman



      PubDate: 2014-05-16T06:04:38Z
       
  • Approaches to Left Atrial Appendage Exclusion
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Randall Lee , Moussa C. Mansour



      PubDate: 2014-04-03T01:29:04Z
       
  • Stroke and Bleeding Risks in Patients with Atrial Fibrillation
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Abhishek Maan , Jeremy N. Ruskin , E. Kevin Heist

      Teaser Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a substantial risk of stroke and mortality. Strokes in patients with AF are associated with a greater disability and poorer outcomes than strokes in patients in sinus rhythm. Patients with AF are at increased risk of bleeding, especially if they use anticoagulant therapy. Recent research in the field of anticoagulation has led to development of new anticoagulants for stroke prevention in addition to antiplatelet agents and warfarin. This review discusses the role of AF as a risk factor for stroke and evaluates the role of various schemes for predicting the risk of stroke and bleeding in patients with AF.

      PubDate: 2014-04-03T01:29:04Z
       
  • Left Atrial Appendage Closure with Transcatheter-Delivered Devices
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Brian Whisenant , Peter Weiss

      Teaser Left atrial appendage (LAA) closure with transcatheter-delivered devices is an evolving story of compelling randomized data and the potential to dramatically reduce the incidence of stroke and improve the quality of life among patients with atrial fibrillation. Oral anticoagulation is the standard of care for stroke prevention in atrial fibrillation but falls short of providing an adequate solution to this common threat when considered from efficacy and safety perspectives. The robust series of Watchman device trials has demonstrated the Watchman device to provide stroke prevention efficacy similar to that of warfarin and by extension provides proof of concept of LAA closure.

      PubDate: 2014-04-03T01:29:04Z
       
  • Clinical Results with Percutaneous Left Atrial Appendage Occlusion
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Zoltan G. Turi

      Teaser Closure of the left atrial appendage (LAA) in patients with non-valvular atrial fibrillation is associated with reduction in embolic events. There is an initial hazard associated with closure methodologies; once successful closure is achieved, the results appear to be superior to those of anticoagulation. The evidence base is largely limited to the safety and efficacy of LAA occlusion in patients who are candidates for anticoagulation as well, and the risk/benefit ratio of competing closure technologies has not been determined. LAA occlusion plus antiplatelet therapy seems to have an acceptable therapeutic and safety profile.

      PubDate: 2014-04-03T01:29:04Z
       
  • Role of Transesophageal Echocardiography in Left Atrial Appendage Device
           Closure
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): David M. Dudzinski , Shmuel Schwartzenberg , Gaurav A. Upadhyay , Judy Hung

      Teaser Left atrial appendage (LAA) occlusion or ligation by percutaneously implanted devices is increasingly an alternative management option for atrial fibrillation, particularly for patients who are intolerant or have contraindications for anticoagulation. Echocardiography plays an important part in screening, guidance of implantation, and after-device assessment. Assessment of LAA anatomy suitable for device implantation, thrombus exclusion, guidance of transseptal puncture, localization of catheter, guidance of device deployment, and after-device assessment are all important functions of echocardiography. This article reviews the role of echocardiography in device-based LAA occlusion or ligation.

      PubDate: 2014-04-03T01:29:04Z
       
  • Device- and LAA-Specific Characteristics for Successful LAA Closure Tips
           and Tricks
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Wen-Loong Yeow , Saibal Kar

      Teaser Transcatheter left atrial appendage closure for stroke prevention with nonvalvular atrial fibrillation is an emerging alternative to oral anticoagulation. Several devices and approaches have been developed to achieve optimal closure. This article describes in detail the key procedural steps and the tips and tricks required to succeed in this transcatheter technique. The 4 devices covered are the WATCHMAN, AMPLATZER Cardiac Plug, Coherex WaveCrest generation 1.3, and the LARIAT suture delivery device.

      PubDate: 2014-04-03T01:29:04Z
       
  • Catheter-based Epicardial Closure of the Left Atrial Appendage
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Francesco Santoro , Luigi Di Biase , Pasquale Santangeli , Rong Bai , Stephan Danik , Conor Barrett , Rodney Horton , J. David Burkhardt , Andrea Natale

      Teaser This article reviews novel techniques in stroke prevention based on epicardial closure of the left atrial appendage, illustrating the features of the first endo-epicardial device currently available and those of devices still in development. It also provides further information about early clinical experience with the endo-epicardial device.

      PubDate: 2014-04-03T01:29:04Z
       
  • Managing the Left Atrial Appendage in the Era of Minimally Invasive
           Surgery
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2
      Author(s): Alessandro Montecalvo , Ralph J. Damiano Jr.

      Teaser Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice with greater than 2.2 million people in the United States being affected. Oral anticoagulant therapy has been used to reduce risk of stroke in patients with nonvalvular AF who are at a high risk of thromboembolism. Alternative treatment strategies to prevent thromboembolism have been tested in patients with AF. This article examines the history of left atrial appendage occlusion and the efficacy of the various surgical techniques and provides a brief overview of the minimally invasive surgical strategy adopted to manage the left atrial appendage.

      PubDate: 2014-04-03T01:29:04Z
       
  • Contributors
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2




      PubDate: 2014-04-03T01:29:04Z
       
  • Contents
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2




      PubDate: 2014-04-03T01:29:04Z
       
  • Forthcoming Issues
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2




      PubDate: 2014-04-03T01:29:04Z
       
  • Pericardial Access for Lariat Left Atrial Appendage Closure
    • Abstract: Publication date: Available online 29 January 2014
      Source:Interventional Cardiology Clinics
      Author(s): Miguel Valderrábano

      Teaser Anterior pericardial puncture requires intimate knowledge of the mediastinal anatomy and careful review of the individual anatomic characteristics of each patient. Familiarity with the procedure’s anatomic foundations and with the basic principles of each procedural step are critical, but once this is achieved, the procedure is safe and, in most cases, preferable to a standard inferior puncture. An uncomplicated and properly placed pericardial puncture is the basis of a successful of Lariat procedure. Operators must master the intricacies of the anterior pericardial puncture before embarking on Lariat left atrial appendage ligation.

      PubDate: 2014-02-01T16:59:29Z
       
  • Prevention and Management of Complications of Left Atrial Appendage
           Closure Devices
    • Abstract: Publication date: Available online 21 January 2014
      Source:Interventional Cardiology Clinics
      Author(s): Matthew J. Price

      Teaser Atrial fibrillation is associated with an ongoing risk of thromboembolic stroke and systemic embolism due to stasis and thrombus formation within the left atrial appendage (LAA). Transcatheter occlusion or ligation of the LAA represents a potential paradigm shift in the management of stroke prevention in at-risk patients with atrial fibrillation. This review summarizes the types and rates of procedural complications that have been observed with LAA occlusion and ligation; describes strategies that can be implemented to minimize these complications; and discusses management approaches that may limit the impact of these complications on long-term morbidity.

      PubDate: 2014-01-24T17:21:14Z
       
  • Embryology and Anatomy of the Left Atrial Appendage Why Does Thrombus
           Form'
    • Abstract: Publication date: Available online 22 January 2014
      Source:Interventional Cardiology Clinics
      Author(s): Arun Kanmanthareddy , Yeruva Madhu Reddy , Ajay Vallakati , Matthew Earnest , Jayant Nath , Ryan Ferrell , Buddhadeb Dawn , Dhanunjaya Lakkireddy

      Teaser The left atrial appendage (LAA) is a long tubular structure that opens into the left atrium. In patients with atrial fibrillation, the LAA develops mechanical dysfunction and fibroelastotic changes on the endocardial surface. The complex anatomy of the LAA makes it a good site for relative blood stasis. In addition, systemic factors exacerbate the hypercoagulable state, eventually resulting in endothelial dysfunction, release of tissue factor, and production of inflammatory cytokines and oxidative free radicals, and eventually initiating the coagulation cascade. Thus, the LAA is susceptible for thrombus formation and the most common source of systemic thromboembolism.

      PubDate: 2014-01-24T17:21:14Z
       
  • Rationale for Left Atrial Appendage Exclusion
    • Abstract: Publication date: Available online 10 January 2014
      Source:Interventional Cardiology Clinics
      Author(s): Ted Feldman

      Teaser Left atrial appendage (LAA) is the source of most systemic emboli in patients with atrial fibrillation. Oral anticoagulant therapy reduces stroke risk by two-thirds. New oral agents have advantages over warfarin but are associated with bleeding and drug intolerance. Device therapy for atrial appendage ligation or occlusion is an alternative to drug therapy, without the cumulative incidence of bleeding or the need for anticoagulation. In the more than half century since the early reports of surgical LAA excision, the authors have added considerable detail to our understanding of the rationale for LAA exclusion, which constitutes the subject of this article.

      PubDate: 2014-01-12T12:21:49Z
       
  • Skin to Skin Transfemoral Carotid Angiography and Stenting
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): D. Christopher Metzger

      Teaser Carotid artery stenting (CAS) has emerged as an attractive alternative to carotid endarterectomy (CEA) for the treatment of carotid artery disease. Several recent trials demonstrate excellent and improving results, even at high risk in CEA patients. Randomized North American trials suggest equivalence of CAS to CEA in high-risk and standard-risk patients. However, these improved CAS results apply only to CAS procedures performed by experienced operators at experienced centers. Furthermore, these improved results are due largely to operators’ lessons learned, helping with appropriate case selection.

      PubDate: 2013-11-26T17:13:55Z
       
  • Preface
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Kenneth Rosenfield , Christopher J. White



      PubDate: 2013-11-26T17:13:55Z
       
  • Forthcoming Issues
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1




      PubDate: 2013-11-26T17:13:55Z
       
  • Contents
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1




      PubDate: 2013-11-26T17:13:55Z
       
  • Contributors
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1




      PubDate: 2013-11-26T17:13:55Z
       
  • Surgery Versus Stenting in Symptomatic Patients
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Jun Li , Rahul Sakhuja , Sahil A. Parikh

      Teaser Symptomatic carotid artery stenosis is an important cause of stroke with significant morbidity and mortality. Revascularization with carotid endarterectomy reduces the recurrence of stroke and until recently was considered the gold standard of therapy. Carotid artery stenting has emerged as an alternative method of revascularization in both high-risk and standard-risk patients. This review appraises the role of surgery versus stenting for patients with symptomatic carotid stenosis.

      PubDate: 2013-11-26T17:13:55Z
       
  • Carotid Artery Stenting Versus Carotid Endarterectomy for Treatment of
           Asymptomatic Carotid Disease
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): R. Kevin Rogers , Sanjay Gandhi , Kenneth Rosenfield

      Teaser In patients with asymptomatic carotid artery stenosis the optimal strategy to reduce the risk for stroke remains controversial. Although carotid endarterectomy was traditionally considered the gold standard for revascularization, emerging data suggest that carotid artery stenting is an appropriate alternative in many asymptomatic patients. This article summarizes the evidence base and related controversies regarding carotid endarterectomy versus carotid artery stenting for the revascularization of carotid disease in asymptomatic patients.

      PubDate: 2013-11-26T17:13:55Z
       
  • Patient, Anatomic, and Procedural Characteristics That Increase the Risk
           of Carotid Interventions
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Christopher J. White

      Teaser Subjective characteristics for increased risk of carotid artery stenting (CAS) have included thrombus-containing lesions, heavily calcified lesions, very tortuous vessels, and near occlusions. More objective high-risk features include contraindications to dual antiplatelet therapy, a history of bleeding complications, and lack of femoral artery vascular access. Variables that increase the risk of CAS complications are attributed to patient characteristics, anatomic features, or procedural factors. Operator and hospital volume affect the risk of complications occurring with CAS. As the complexity and difficulty of CAS patients increases, the need for more highly skilled operators and teams becomes even more necessary to minimize complications.

      PubDate: 2013-11-26T17:13:55Z
       
  • Non-Invasive Carotid Imaging A Comparative Assessment and Practical
           Approach
    • Abstract: Publication date: Available online 29 September 2013
      Source:Interventional Cardiology Clinics
      Author(s): Beau M. Hawkins , Michael R. Jaff

      Teaser Stroke originating from carotid artery disease remains a significant source of morbidity and mortality, and both medical and invasive therapies targeting the carotid artery can improve patient outcomes. Multiple noninvasive imaging methods, including duplex ultrasonography, computerized tomographic angiography, and magnetic resonance angiography, are available to assess the extracranial carotid artery and guide clinical decision making. This article discusses the advantages and limitations of these imaging modalities and provides a practical framework by which clinicians may use imaging to evaluate patients with carotid artery disease.

      PubDate: 2013-09-30T11:20:32Z
       
  • Primary Stroke Prevention Medical Therapy Versus Revascularization
    • Abstract: Publication date: Available online 29 September 2013
      Source:Interventional Cardiology Clinics
      Author(s): Marc P. Bonaca , Joshua A. Beckman

      Teaser Asymptomatic carotid-artery atherosclerotic vascular disease identifies patients at heightened risk of major adverse cardiovascular events including ischemic stroke. Observational and registry analyses demonstrate that this risk extends beyond that attributable to carotid atherosclerosis itself and includes events manifesting in other vascular territories, such as myocardial infarction. However, randomized trials aimed specifically at treating carotid stenosis have shown benefit in terms of reducing ischemic stroke in appropriately selected patients. Therefore, the approach to primary prevention in patients with stable carotid disease must include a comprehensive strategy to reduce cerebrovascular-specific and overall cardiovascular risk through lifestyle changes and intensive medical therapies.

      PubDate: 2013-09-30T11:20:32Z
       
  • Skin to Skin Transradial Carotid Angiography and Stenting
    • Abstract: Publication date: Available online 17 September 2013
      Source:Interventional Cardiology Clinics
      Author(s): Sasko Kedev , Tift Mann

      Teaser Carotid artery stenting (CAS) is a proven alternative to carotid endarterectomy in patients with significant carotid disease. The femoral artery is the conventional access site for CAS procedures. However, this approach may be problematic because of peripheral vascular disease and anatomic variations. Access site complications are the most common adverse event after CAS from the transfemoral approach (TFA) and most technical failures are related to a complex aortic arch. The transradial approach has been evaluated to address the shortcomings of TFA. In cases involving a complex arch, transradial access may be a viable alternative strategy.

      PubDate: 2013-09-19T16:17:06Z
       
 
 
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