for Journals by Title or ISSN
for Articles by Keywords
help
Followed Journals
Journal you Follow: 0
 
Sign Up to follow journals, search in your chosen journals and, optionally, receive Email Alerts when new issues of your Followed Jurnals are published.
Already have an account? Sign In to see the journals you follow.
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  [2556 journals]   [H-I: 1]
  • 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
       
  • Index
    • Abstract: Publication date: April 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 2




      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
       
  • Index
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1




      PubDate: 2013-11-26T17:13:55Z
       
  • Current Reperfusion Strategies for Acute Stroke
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Panagiotis Papanagiotou , Wolfgang Reith , Andreas Kastrup , Christian Roth

      Teaser Stroke is the most common cause of permanent disability, the second most common cause of dementia, and the third most common cause of death in the Western world. The treatment of affected patients is a challenge because intravenous (IV) thrombolysis is often ineffective. IV thrombolysis on its own leads to a favorable clinical outcome in only 15% to 25% in patients with large-artery occlusion. Current reperfusion therapies enable high recanalization rates, high rate of favorable clinical outcome, and low complication rates. However, to achieve good clinical results, appropriate patient selection and the use of optimized stroke management system are obligate.

      PubDate: 2013-11-26T17:13:55Z
       
  • Percutaneous Treatment of Severe Intracranial Carotid and Middle Cerebral
           Artery Stenosis
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Alex Abou-Chebl

      Teaser Due to the lack of efficacy and durability data from prospective, randomized, multicenter trials, intracranial stenting remains investigational and should be used only in carefully selected patients after thorough evaluation of their clinical and anatomic factors. Stenting should not be performed in chronic total occlusions and asymptomatic lesions and generally should be avoided in very old patients, especially those with underlying dementia and severe calcification of their vessels. Symptomatic patients with angiographically documented greater than 70% stenosis and who have failed medical therapy are appropriate candidates for intracranial angioplasty and stenting and should be enrolled in clinical trials when possible.

      PubDate: 2013-11-26T17:13:55Z
       
  • Common Cervical and Cerebral Vascular Variants
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Peter C. Thurlow , Jason M. Andrus , Mark H. Wholey

      Teaser Successful open and endovascular carotid artery intervention depends on a thorough foundational knowledge of cervical and intracranial vascular anatomy. It is essential for the carotid interventionist to be familiar with the common and rare variants of the cervical and intracranial vasculature, and to understand the implications of these variants for the performance of carotid intervention with protection of the distal circulation. This article provides interventionists with a basic description of the normal and relevant variant vascular anatomy from the aortic arch to the circle of Willis, and outlines the potential difficulties that specific variants may present for endovascular therapy.

      PubDate: 2013-11-26T17:13:55Z
       
  • Percutaneous Treatment of Vertebral Artery Stenosis
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): J. Stephen Jenkins

      Teaser Endovascular treatment of the ostial and proximal portions of the vertebral artery is a safe and effective technique for alleviating symptoms and improving cerebral blood flow to the posterior circulation. Vertebral artery angioplasty can be performed with high technical and clinical success rates, low complication rates, and durable long-term results. Although restenosis rates range from 0% to 48%, the durability of vertebral artery angioplasty is evidenced by low restenosis rates in multiple large series reported in the literature using multiple treatment options, including balloon angioplasty alone, bare metal stents, and drug-coated stents.

      PubDate: 2013-11-26T17:13:55Z
       
  • Complications and Solutions with Carotid Stenting
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Robert D. Safian

      Teaser Complications of carotid stenting can be classified as neurologic, cardiovascular, death, carotid, access site, device malfunctions, and general and late complications. The risk of most complications is related to readily identifiable patient and anatomic factors. Management and outcome of complications require immediate recognition and a team-based approach to patient care.

      PubDate: 2013-11-26T17:13:55Z
       
  • Carotid Artery Stenting Operator and Institutional Learning Curves
    • Abstract: Publication date: January 2014
      Source:Interventional Cardiology Clinics, Volume 3, Issue 1
      Author(s): Siddharth A. Wayangankar , Herbert D. Aronow

      Teaser Despite rapid growth in the frequency that carotid artery stenting (CAS) is performed, there remain concerns regarding the steep learning curve associated with this procedure. This article reviews the evidence base supporting operator and institutional CAS learning curves and discusses their implications for the establishment and maintenance of competencies. Attempts are made to delineate minimum volume thresholds to attain these goals and means to enhance procedural safety without compromising patient access.

      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
       
  • Forthcoming Issues
    • Abstract: Publication date: October 2013
      Source:Interventional Cardiology Clinics, Volume 2, Issue 4




      PubDate: 2013-10-06T21:24:58Z
       
  • Contributors
    • Abstract: Publication date: October 2013
      Source:Interventional Cardiology Clinics, Volume 2, Issue 4




      PubDate: 2013-10-06T21:24:58Z
       
  • Contents
    • Abstract: Publication date: October 2013
      Source:Interventional Cardiology Clinics, Volume 2, Issue 4




      PubDate: 2013-10-06T21:24:58Z
       
  • Balance of Ischemia and Bleeding in Selecting an Antithrombotic Regimen
    • Abstract: Publication date: October 2013
      Source:Interventional Cardiology Clinics, Volume 2, Issue 4
      Author(s): Bimmer E. Claessen , George D. Dangas , Roxana Mehran

      Teaser Complications after percutaneous coronary intervention (PCI) are of 2 types: ischemic and bleeding. This article provides strategies to individualize pharmacologic regimens after PCI based on periprocedural risk assessment. A practical method to assess whether a patient is at risk for ischemic or bleeding complications is the use of risk scores. Patients at a low risk of bleeding benefit from aggressive antithrombotic therapy. Patients at a high risk of bleeding benefit from selective use of antithrombotic agents. As a large number of antithrombotic agents are currently available, individualization of the antithrombotic drug regimes should be considered in every patient.

      PubDate: 2013-10-06T21:24:58Z
       
  • 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
       
  • The Optimal Duration of Dual Combination Antiplatelet Therapy After Stent
           Implantation and Perioperative Management Issues
    • Abstract: Publication date: Available online 26 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Nisharahmed Kherada , Roxana Mehran , George Dangas

      Teaser Impending risk of stent Thrombosis (ST) after percutaneous coronary intervention (PCI) has mandated post-PCI use of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor. As the optimal duration of DAPT remains controversial, premature discontinuation of it potentiates the risk of ST, myocardial infarction or death; while use of DAPT itself increases the risk of bleed. Similarly, perioperative DAPT management is still ill defined, where there is higher operative risk of bleed on antiplatelet therapy and higher ST risk during this thrombogenic period if off antiplatelet therapy. Additional clinical investigation is warranted in these fields.

      PubDate: 2013-07-29T16:20:27Z
       
  • Antithrombotic Strategies in Endovascular Interventions Current Status and
           Future Directions
    • Abstract: Publication date: Available online 25 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Mehdi H. Shishehbor , Barry T. Katzen

      Teaser Despite increasing numbers of endovascular interventions to treat arterial and venous disease, scant level 1 evidence is available regarding the role of antithrombotic and antiplatelet therapy in patients undergoing these procedures. The current practice in this regard is heterogeneous and has mainly been driven by data from coronary artery disease and percutaneous coronary intervention. This article discusses the role of antithrombotic and antiplatelet agents for endovascular intervention.

      PubDate: 2013-07-26T16:22:39Z
       
  • Combination Antithrombotic Management for Non–ST Segment Elevation
           Acute Coronary Syndromes
    • Abstract: Publication date: Available online 25 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Jayant Bagai , Subhash Banerjee , Emmanouil S. Brilakis

      Teaser Patients with non–ST segment elevation acute coronary syndromes (NSTEACS) are at high risk for subsequent thrombotic events. Combination antithrombotic management with anticoagulant and antiplatelet medications can improve outcomes in these high-risk patients. If an early invasive strategy is planned, unfractionated heparin or bivalirudin are the anticoagulants of choice, whereas in those in whom an early conservative strategy is planned enoxaparin or fondaparinux may be preferred. All patients with NSTEACS should receive aspirin and continue it indefinitely unless they cannot tolerate it. A second antiplatelet agent should be administered both for an early invasive or early conservative strategy.

      PubDate: 2013-07-26T16:22:39Z
       
  • Basics of Antithrombotic Therapy for Cardiovascular Disease Pharmacologic
           Targets of Platelet Inhibitors and Anticoagulants
    • Abstract: Publication date: Available online 22 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Piera Capranzano , Dominick J. Angiolillo

      Teaser Arterial thrombus formation is the common pathophysiologic process of cardiovascular disease manifestations, requiring interplay between platelets and coagulation factors. Current platelet inhibitors block the formation of thromboxane A2 and interfer with adenosine diphosphate stimulation mediated by the P2Y12 receptor. Novel antiplatelet agents blocking these and other pathways are under clinical development. Thrombin represents a bridge between platelets and coagulation. Indirect and direct thrombin inhibitors are pivotal in clinical settings. Other key coagulation factors include factors IX and X which are therapeutic targets of current and novel anticoagulants. This article reviews the pathophysiology of arterial thrombosis and current and novel antiplatelet and anticoagulant agents.

      PubDate: 2013-07-23T16:21:53Z
       
  • Role of Parenteral Agents in Percutaneous Coronary Intervention for Stable
           Patients
    • Abstract: Publication date: Available online 20 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): David A. Burke , Duane S. Pinto

      Teaser Numerous agents are available for anticoagulation during percutaneous coronary intervention (PCI), and various antiplatelet agents are also used. With all of the medications available, an assessment must be made regarding the ischemic risk and risk of bleeding for an individual patient during elective PCI when selecting the optimal medical strategy to support PCI. Whether new antiplatelet medications will enhance or reduce complications when paired with various newer anticoagulant agents requires further investigation. This article summarizes existing data examining the benefits and limitations of the various anticoagulant and antiplatelet medications, and summarizes guidelines for their use.

      PubDate: 2013-07-20T16:19:36Z
       
  • Combination Antithrombotic Management of STEMI with Pharmacoinvasive
           Strategy, Primary PCI, or Rescue PCI
    • Abstract: Publication date: Available online 13 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Piera Capranzano , Corrado Tamburino , George Dangas

      Teaser The mainstay of acute ST segment elevation myocardial infarction (STEMI) emergent management consists of reperfusion therapy combined with antithrombotic treatment. Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for STEMI. Rescue PCI consists of urgent transfer for PCI of patients with failed fibrinolysis. The pharmacoinvasive strategy consists of administration of fibrinolysis followed by immediate transfer to a PCI-capable hospital for routine early catheterization. This article provides an overview of data and recommendations on primary PCI, rescue PCI, and pharmacoinvasive strategy as well as of the antithrombotic regimens used to support STEMI reperfusion approaches.

      PubDate: 2013-07-14T16:34:49Z
       
  • Triple Antiplatelet Therapy and Combinations with Oral Anticoagulants
           After Stent Implantation
    • Abstract: Publication date: Available online 13 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Vijay Kunadian , Joseph Robert Dunford , Daniel Swarbrick , Rim Halaby , Ogheneochuko Ajari , Madeleine Cochet , Kristin Feeney , Emily Larkin , Gonzalo Romero Gonzalez , Aditya Govindavarjhulla , Daniel Nethala , Hardik Patel , Raviteja Reddy Guddeti , Farman Khan , Shankar Kumar , Sapan Patel , Prashanth Saddala , Vishnu Vardhan Serla , Marcelo Zacarkim , Divya Yadav , C. Michael Gibson

      Teaser Triple oral anticoagulation or triple antiplatelet therapies may be administered for various reasons. They reduce cardiac complications following percutaneous coronary intervention and stroke or other thromboembolic phenomenon in conditions such as atrial fibrillation. There is an elevated risk of severe bleeding, so it is necessary to balance risk and benefits. Newer oral anticoagulants and antiplatelet drugs may be considered; the number of options is increasing. This article examines triple therapies and the efficacy and safety of combinations of traditional anticoagulant and antiplatelet drugs, and reviews clinical trial data on novel agents. Guidelines to inform clinical decision-making are presented.

      PubDate: 2013-07-14T16:34:49Z
       
  • The Role of Platelet Function Testing in Risk Stratification and Clinical
           Decision-Making
    • Abstract: Publication date: Available online 10 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Paul A. Gurbel , Udaya S. Tantry

      Teaser Clopidogrel (a widely used second-generation thienopyridine) therapy is associated with an unpredictable pharmacodynamic response whereby approximately 1 in 3 patients will have a high on-treatment platelet reactivity to adenosine diphosphate. High on-treatment platelet reactivity is an established risk factor for ischemic event occurrence in patients undergoing percutaneous coronary intervention. Platelet function testing may have a role in monitoring therapeutic efficacy when clopidogrel is the chosen agent and in safety when more potent drugs are used, especially in patients with high bleeding risk. At this time, it seems most reasonable to assess platelet function in high-risk clopidogrel-treated patients.

      PubDate: 2013-07-11T16:20:18Z
       
  • Aspirin, Platelet P2Y12 Receptor Inhibitors, and Other Oral Antiplatelets
           Comparative Pharmacology and Role in Elective PCI
    • Abstract: Publication date: Available online 10 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Vijay Kunadian , Hannah Sinclair , Aaron Sutton , George Dangas

      Teaser Angina pectoris accounts for a large burden of disease worldwide. Antiplatelet agents play a crucial role in inhibiting the platelet response to vascular injury after percutaneous coronary intervention (PCI) for the management of coronary artery disease. Antiplatelet agents are also essential in the longer term, because the metallic structure of stents is inherently thrombogenic. This article examines the use of aspirin, P2Y12 inhibitors, and other oral antiplatelets in the setting of elective PCI. Dual antiplatelet therapy in elective PCI is now standard therapy. The clinical use of novel antiplatelet therapy in the setting requires further evaluation.

      PubDate: 2013-07-11T16:20:18Z
       
  • Pharmacogenomics in Interventional Pharmacology Present Status and Future
           Directions
    • Abstract: Publication date: Available online 11 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Paddy M. Barrett , Matthew J. Price

      Teaser Pharmacogenomics offers the possibility of tailoring a drug to a patient’s unique genetic signature, improving the likelihood of clinical efficacy while minimizing risks. Clopidogrel, a platelet P2Y12 receptor inhibitor that forms the cornerstone of dual antiplatelet therapy in patients with unstable coronary artery disease and those undergoing percutaneous coronary intervention, is the first broadly used drug in cardiovascular medicine in which genotyping may help optimize outcomes. This article describes techniques to identify the genetic determinants of drug response, their application (ie, clopidogrel), and the challenges to integration of pharmacogenomics into the practice of interventional cardiology.

      PubDate: 2013-07-11T16:20:18Z
       
  • Interventional Pharmacology
    • Abstract: Publication date: Available online 11 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): George D. Dangas



      PubDate: 2013-07-11T16:20:18Z
       
  • Antithrombotic Strategies in Valvular and Structural Heart Disease
           Interventions Current Status and Future Directions
    • Abstract: Publication date: Available online 11 July 2013
      Source:Interventional Cardiology Clinics
      Author(s): Davide Capodanno , Corrado Tamburino

      Teaser Antithrombotic prophylaxis is the cornerstone of adjunctive pharmacologic therapy in patients undergoing transcatheter intervention for valvular and structural heart disease. However, drugs and doses of antiplatelet and anticoagulant agents are mostly empiric for these indications and typically administered at the operator’s discretion. This article describes the rationale for antithrombotic management of patients undergoing transcatheter aortic valve implantation, percutaneous mitral valve repair with the Mitraclip system, patent foramen ovale, and atrial septal defect closure, as well as common strategies for managing antiplatelet and anticoagulant therapy in patients with valvular and structural heart disease undergoing transcatheter procedures.

      PubDate: 2013-07-11T16:20:18Z
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2014