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Journal Cover Interventional Cardiology Clinics
  [SJR: 0.162]   [H-I: 2]   [1 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 2211-7458 - ISSN (Online) 2211-7466
   Published by Elsevier Homepage  [2970 journals]
  • Design Principles of Bioresorbable Polymeric Scaffolds
    • Abstract: Publication date: Available online 19 May 2016
      Source:Interventional Cardiology Clinics
      Author(s): Mary Beth Kossuth, Laura E.L. Perkins, Richard J. Rapoza

      Teaser The concept for a bioresorbable vascular scaffold combines the best features of the first 3 generations of percutaneous coronary intervention (namely), balloon angioplasty, bare metallic stents, and drug-eluting stents, into a single device. The principles of operation of a BRS follow 3 phases of functionality that reflect the different physiologic requirements over time; revascularization, restoration, and resorption. Most BRS designs make use of the continuum of hydrolytic degradation in aliphatic polyesters, such as poly(l-lactide), in which molecular weight, strength, and mass decrease progressively in 3 distinct stages, consistent with the in vivo requirements of each performance phase.

      PubDate: 2016-05-22T08:13:43Z
       
  • Pathology of Endovascular Stents
    • Abstract: Publication date: Available online 19 May 2016
      Source:Interventional Cardiology Clinics
      Author(s): Kenta Nakamura, John H. Keating, Elazer R. Edelman

      Teaser Contemporary endovascular stents are the product of an iterative design and development process that leverages evolving concepts in vascular biology and engineering. This article reviews how insights into vascular pathophysiology, materials science, and design mechanics drive stent design and explain modes of stent failure. Current knowledge of pathologic processes is providing a more complete picture of the factors mediating stent failure. Further evolution of endovascular stents includes bioresorbable platforms tailored to treat plaques acutely and to then disappear after lesion pacification. Ongoing refinement of stent technology will continue to require insights from pathology to understand adverse events, refine clinical protocols, and drive innovation.

      PubDate: 2016-05-22T08:13:43Z
       
  • Copyright
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2




      PubDate: 2016-03-22T23:00:23Z
       
  • Contributors
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2




      PubDate: 2016-03-22T23:00:23Z
       
  • Contents
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2




      PubDate: 2016-03-22T23:00:23Z
       
  • Complex coronary intervention
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2




      PubDate: 2016-03-22T23:00:23Z
       
  • Hemodynamic Support Devices for Complex Percutaneous Coronary Intervention
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2
      Author(s): Basil Alkhatib, Laura Wolfe, Srihari S. Naidu

      Teaser High-risk percutaneous coronary intervention (PCI) encompasses a growing portion of total PCIs performed and typically includes patients with high-risk clinical and anatomic characteristics. Such patients may represent not only a high-risk group for complications but also a group who may derive the most benefit from complete revascularization. Several hemodynamic support devices are available. Trial data, consensus documents, and guidelines currently recommend high-risk PCI aided by hemodynamic support devices, and this article discusses the patient populations who would benefit from such an approach, the available devices and strategies, and expected outcomes.

      PubDate: 2016-03-22T23:00:23Z
       
  • Interventional Cardiology Clinics
    • Abstract: Publication date: April 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 2
      Author(s): Matthew J. Price



      PubDate: 2016-03-22T23:00:23Z
       
  • Antiplatelet Therapy in Percutaneous Coronary Intervention
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Alexander C. Fanaroff, Sunil V. Rao

      Teaser Platelets play a key role in mediating stent thrombosis, which is the major cause of ischemic events immediately after percutaneous coronary intervention (PCI). Antiplatelet therapy is therefore the cornerstone of antithrombotic therapy after PCI. However, the use of antiplatelet agents increases bleeding risk, with more potent antiplatelet agents further increasing bleeding risk. In the past 5 years, potent and fast-acting P2Y12 inhibitors have augmented the antiplatelet armamentarium available to interventional cardiologists. This article reviews the preclinical and clinical data surrounding these new agents, and discusses the significant questions and controversies that still exist regarding the optimal antiplatelet strategy.

      PubDate: 2016-02-16T17:44:56Z
       
  • The New Era of Interventional Cardiology: Tackling Complex Coronary
           Intervention
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Michael S. Lee



      PubDate: 2016-02-16T17:44:56Z
       
  • Percutaneous Coronary Intervention for Bifurcation Lesions
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Björn Redfors, Philippe Généreux

      Teaser This article summarizes treatment alternatives for coronary bifurcation lesions. It also reviews current definitions and classifications pertaining to bifurcation lesions and provides an overview of the impact of bifurcation lesions on clinical outcomes.

      PubDate: 2016-02-16T17:44:56Z
       
  • Acute Myocardial Infarction/Thrombectomy
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Jonathan Soverow, Manish A. Parikh

      Teaser This article focuses on specialized techniques and devices used in the most challenging cases of acute myocardial infarction. Areas where high-quality evidence is either clear or absent are avoided. Controversies in the use of support or thrombectomy devices, the addition of adjunct pharmacology, and the decision to treat nonculprit lesions are discussed. Recent years have seen a shift in guidelines to downgrading the use of assist devices in cardiogenic shock and aspiration thrombectomy, whereas consideration of nonculprit coronary intervention has been revived. These changes come in the wake of a series of large, practice-changing clinical trials.

      PubDate: 2016-02-16T17:44:56Z
       
  • Update on Coronary Chronic Total Occlusion Percutaneous Coronary
           Intervention
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Emmanouil S. Brilakis, Dimitri Karmpaliotis, Minh N. Vo, Mauro Carlino, Alfredo R. Galassi, Marouane Boukhris, Khaldoon Alaswad, Leszek Bryniarski, William L. Lombardi, Subhash Banerjee

      Teaser Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly evolved during recent years. High success rates are being achieved by experienced centers and operators, but not at less-experienced centers. Use of CTO crossing algorithms can help improve the success and efficiency of these potentially lengthy procedures. There is a paucity of clinical trial data examining clinical outcomes of CTO PCI, which is critical for further adoption and refinement of the procedure. We provide a detailed overview of the clinical evidence and current available crossing strategies, with emphasis on recent developments and techniques.

      PubDate: 2016-02-16T17:44:56Z
       
  • In-stent Restenosis
    • Abstract: Publication date: Available online 13 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Michael S. Lee, Gaurav Banka

      Teaser In-stent restenosis (ISR) is the narrowing of a stented coronary artery lesion. The mean time from percutaneous coronary intervention (PCI) to ISR was 12 months with drug-eluting stents (DES) and 6 months with bare metal stents (BMS). ISR typically presents as recurrent angina. The use of DES has significantly reduced the rate of ISR compared with BMS. Predictors of ISR include patient, lesion, and procedural characteristics. Intravascular ultrasound, optical coherence tomography, and fractional flow reserve are important tools for the anatomic and hemodynamic assessment of ISR. Treatment options for ISR include percutaneous coronary intervention with DES.

      PubDate: 2016-02-16T17:44:56Z
       
  • Atherectomy Devices for the Treatment of Calcified Coronary Lesions
    • Abstract: Publication date: Available online 10 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Jeffrey W. Chambers, Ann N. Behrens, Brad J. Martinsen

      Teaser The presence of moderate and severe coronary artery calcification (CAC) is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with noncalcified lesions. Diabetes mellitus, a risk factor for CAC, is increasing in the United States. Vessel preparation before PCI with atherectomy can facilitate successful stent delivery and expansion that may otherwise not be possible. We review here CAC prevalence, risk factors, and impact on PCI, as well as the currently available coronary atherectomy devices including rotational atherectomy, orbital atherectomy, and laser atherectomy.

      PubDate: 2016-02-12T16:42:03Z
       
  • Antithrombotic Therapy in Percutaneous Coronary Intervention
    • Abstract: Publication date: Available online 12 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Xiaoyu Yang, Joanna Ghobrial, Duane S. Pinto

      Teaser Numerous agents are available for anticoagulation during percutaneous coronary intervention (PCI). These agents have been evaluated in a variety of clinical settings, including elective, urgent, and emergent PCI. Although unfractionated heparin remains a frequent choice, accumulating data support the use of newer agents to mitigate bleeding risk, especially in the setting of femoral access and concomitant use of glycoprotein IIb/IIa receptor inhibition. With several antithrombotic agents available, an assessment must be made regarding the ischemic and bleeding risks. This article summarizes existing data examining the benefits and limitations of the various anticoagulants and guidelines for their use.

      PubDate: 2016-02-12T16:42:03Z
       
  • Saphenous Vein Graft Interventions
    • Abstract: Publication date: Available online 11 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Michael S. Lee, Gopi Manthripragada

      Teaser Saphenous vein graft interventions compose a small but important subset of percutaneous coronary revascularization. Because of their unique biology, percutaneous angioplasty and stenting require tailored patient and lesion selection and modification of intervention technique to optimize outcomes. The use of embolic protection and appropriate adjunctive pharmacology can help minimize periprocedural complications, such as the no-reflow phenomenon. Recommendations for best practice in saphenous vein graft interventions continue to evolve with emerging research and therapy.

      PubDate: 2016-02-12T16:42:03Z
       
  • Management of Complications
    • Abstract: Publication date: Available online 11 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Peter P. Monteleone, Robert W. Yeh

      Teaser Percutaneous coronary intervention (PCI) has matured rapidly to tackle increasingly complex coronary disease. Operators must be aware of the incidence of the basic risks involved with coronary angiography and PCI to appropriately inform patients and obtain procedural consent. Even before a wire enters a coronary artery, specific risks, including vascular access complications, renal injury, allergic reaction, and radiation injury, are constantly present. With initiation of PCI, new risks to the coronary circulation arise. A fundamental knowledge of the presentation of these complications and expert ability to emergently manage them are of the utmost importance to the successful completion of PCI.

      PubDate: 2016-02-12T16:42:03Z
       
  • Risk Stratification for Percutaneous Coronary Intervention
    • Abstract: Publication date: Available online 10 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Davide Capodanno

      Teaser The Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is a semiquantitative angiographic score developed to prospectively characterize the disease complexity of the coronary vasculature. With more than 50 validation studies, the SYNTAX score is the most-studied risk model in the setting of percutaneous coronary intervention. In this article, the evolutionary journey of the SYNTAX score is reviewed, with emphasis on its sequential modifications and adaptations, now culminating in the development and validation of the SYNTAX score II.

      PubDate: 2016-02-12T16:42:03Z
       
  • Left Main Percutaneous Coronary Intervention
    • Abstract: Publication date: Available online 10 February 2016
      Source:Interventional Cardiology Clinics
      Author(s): Neil Ruparelia, Alaide Chieffo

      Teaser Significant unprotected left main stem (ULMS) disease is in approximately 5% to 7% of patients undergoing coronary angiography. Historically, coronary artery bypass grafting has been the gold standard treatment of these patients. With recent advances in stent technology, adjunctive pharmacotherapy, and operator experience, percutaneous coronary intervention (PCI) is increasingly regarded as a viable alternative treatment option, especially in patients with favorable coronary anatomy (low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery) scores). This article aims to discuss the evidence supporting PCI for ULMS disease, current guidelines, and technical aspects.

      PubDate: 2016-02-12T16:42:03Z
       
  • Transcatheter Mitral Valve Replacement
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Ala Al-Lawati, Anson Cheung

      Teaser Mitral valve disease prevalence is on the rise worldwide, affecting an estimated 2% of the general population. Novel transcatheter mitral valve replacement technologies are being developed and may provide a viable and safe option in patients who are deemed otherwise not suitable candidates for conventional mitral valve surgery. This article reviews these devices and describes trials of first in-human use.

      PubDate: 2015-12-25T21:51:46Z
       
  • Transcatheter Mitral Valve-in-Valve Therapy
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Jose F. Condado, Brian Kaebnick, Vasilis Babaliaros

      Teaser Valve-in-valve and valve-in-ring transcatheter mitral valve replacement can be used in for the treatment of inoperable patients with failing mitral surgical bioprosthesis or valve repairs. Preprocedural multi-image evaluation by a heart team must include transthoracic echocardiogram, transesophageal echocardiogram, and cardiac computed tomography angiography (CTA). CTA is used to determine access site (transapical, transseptal, or transatrial), transcatheter valve size, and landing zone. Though complications can occur (ie, valve embolization, bleeding, or vascular complications), this less invasive procedure has a reported success rate of 70% to 100% and is now increasingly used.

      PubDate: 2015-12-25T21:51:46Z
       
  • MitraClip Therapy for Mitral Regurgitation
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Ted Feldman, Arjun Mehta, Mayra Guerrero, Justin P. Levisay, Michael H. Salinger

      Teaser Therapy for mitral regurgitation (MR) has been synonymous with mitral valve surgery. Operative approaches for degenerative MR repair have been associated with excellent results, with durable long term outcomes. Surgery for functional MR has been less successful. MitraClip has shown promise for functional MR, especiall in patinets who are high risk for surgery. The aggregate of nonrandomized global experience with MitraClip in functional MR has been consistent in showing improvements in symptoms and left ventricular remodeling. It remains to be seen how MitraClip therapy will compare with best medical therapy. The COAPT trial will clarify this question.

      PubDate: 2015-12-25T21:51:46Z
       
  • Targeted Transseptal Access for MitraClip Percutaneous Mitral Valve Repair
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Gagan D. Singh, Thomas W. Smith, Jason H. Rogers

      Teaser Targeted transseptal puncture remains the most critical initial part of the overall MitraClip procedure. Care and attention must be implemented for patient safety in choosing the optimal puncture site. A consistent and step-by-step methodical approach is recommended. As experienced operators are targeting more complex and nontraditional pathologic conditions, use of adjunctive tools and maneuvers (outlined in this review) are paramount to achieving successful targeted transseptal access and ultimately procedural success.

      PubDate: 2015-12-25T21:51:46Z
       
  • Mitral Paravalvular Leak Closure
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Paul Sorajja

      Teaser For patients with paravalvular mitral prosthetic regurgitation, percutaneous repair is an established therapy for the treatment of symptoms of heart failure or hemolytic anemia. Percutaneous repair of paravalvular mitral regurgitation is a complex procedure with unique technical challenges, even when performed in experienced centers. Herein, the author discusses patient selection, catheter-based techniques for repair, and clinical outcomes of percutaneous repair for paravalvular mitral regurgitation.

      PubDate: 2015-12-25T21:51:46Z
       
  • Anatomy and Function of the Normal and Diseased Mitral Apparatus
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Elizabeth M. Perpetua, Dmitry B. Levin, Mark Reisman

      Teaser Transcatheter mitral valve therapy requires an in-depth understanding of the mitral valve apparatus (annulus, leaflets, chordae tendinae, and papillary muscles) and the impact of various disease states. Adjacent structures (left atrium, left ventricular outflow tract, aortic valve, coronary sinus, and circumflex artery) must also be respected. This article reviews the anatomy and function of the normal and diseased mitral valve apparatus and the implications for catheter-based intervention.

      PubDate: 2015-12-25T21:51:46Z
       
  • Echocardiographic Imaging of the Mitral Valve for Transcatheter
           Edge-to-Edge Repair
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Jeffrey M. Paulsen, Thomas W. Smith

      Teaser Echocardiography continues to be the most effective imaging tool for the diagnosis and follow-up of mitral valve disease. This review addresses the use of transthoracic echocardiography and transesophageal echocardiography in the planning and guidance of transcatheter mitral valve therapies. Many of the echo-imaging guidance techniques are applicable to transcatheter intervention as a whole. However, given that the MitraClip is the only device approved for mitral regurgitation at present, specific attention is paid to this procedure, with additional focus on the guidance of noncentral repair. The imaging techniques discussed will be applicable to future devices.

      PubDate: 2015-12-25T21:51:46Z
       
  • Contents
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1




      PubDate: 2015-12-25T21:51:46Z
       
  • Transcatheter mitral valve intervention
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1




      PubDate: 2015-12-25T21:51:46Z
       
  • A Revolution in Transcatheter Mitral Valve Intervention
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Jason H. Rogers



      PubDate: 2015-12-25T21:51:46Z
       
  • Interventional Cardiology Clinics
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1
      Author(s): Matthew J. Price



      PubDate: 2015-12-25T21:51:46Z
       
  • Copyright
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1




      PubDate: 2015-12-25T21:51:46Z
       
  • Contributors
    • Abstract: Publication date: January 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 1




      PubDate: 2015-12-25T21:51:46Z
       
  • MitraClip Therapy for Mitral Regurgitation
    • Abstract: Publication date: Available online 9 October 2015
      Source:Interventional Cardiology Clinics
      Author(s): G. Athappan, Mohammad Qasim Raza, Samir R. Kapadia

      Teaser Primary mitral regurgitation (MR) owing to degenerative changes in the structural components of the mitral valve is a common acquired valvular pathology in the elderly. Surgical correction with mitral valve repair (MVRe) or replacement (MVR) is the mainstay of therapy. A significant proportion of patients are ineligible for MVRe/MVR owing to prohibitive surgical risk from advanced age, poor ventricular function, or associated comorbidities. Percutaneous mitral valve repair techniques have been developed to fill this void. The edge-to-edge MitraClip has accrued the largest human experience. This paper reviews the available literature on the MitraClip device for treatment of primary MR.

      PubDate: 2015-10-10T20:33:54Z
       
  • Percutaneous Mitral Annuloplasty
    • Abstract: Publication date: Available online 9 October 2015
      Source:Interventional Cardiology Clinics
      Author(s): Maurizio Taramasso, Azeem Latib

      Teaser Percutaneous mitral valve therapies are emerging as an alternative option for high-risk patients who are not good candidates for conventional open-heart surgery. Recently, multiple technologies and diversified approaches have been developed and are under clinical study or in preclinical development. This article on transcatheter mitral annuloplasty devices, describes the different technologies, and reports on the initial clinical and preclinical experiences.

      PubDate: 2015-10-10T20:33:54Z
       
  • Use of Computed Tomography to Guide Mitral Interventions
    • Abstract: Publication date: Available online 6 October 2015
      Source:Interventional Cardiology Clinics
      Author(s): Vladimir Jelnin, Chad Kliger, Fabio Zucchetta, Carlos E. Ruiz

      Teaser With increasing utilization of cardiac computed tomographic angiography (CTA) and widespread adoption of fusion imaging technology allowing the merger of pre-procedural CTA with fluoroscopy, the ability of CTA to guide structural heart interventions has evolved significantly. It has opened new possibilities in mitral valve (MV) interventions with improved pre-procedural planning and intra-procedural guidance. Given the lack of fluoroscopic landmarks of the mitral apparatus and continued growth of native MV device technologies, the value of CTA will continue to develop. The goal of this chapter is to detail the role of CTA in MV imaging and support for transcatheter therapies.

      PubDate: 2015-10-10T20:33:54Z
       
  • Coronary Sinus-Based Approach to Mitral Regurgitation
    • Abstract: Publication date: Available online 6 October 2015
      Source:Interventional Cardiology Clinics
      Author(s): Steven L. Goldberg, Christoph Hammerstingl

      Teaser Functional, or secondary, mitral regurgitation (FMR) is clinically important because patient with congestive heart failure with FMR have worse clinical outcomes and associated higher risks than patients without FMR. There is interest in finding repair techniques which may modify the mitral valve dysfunction and reduce the clinical impact. Although several devices have taken advantage of the close anatomical relationship between the coronary sinus and the posterior annulus of the mitral valve, in order to provide a cinching force on the mitral annulus, only the Carillon device is currently in use in humans. A double blind randomized trial is currently being done to evaluate the value of this therapy, building upon the favorable result of three prior safety and efficacy trials, which have led to European approval of the device.

      PubDate: 2015-10-10T20:33:54Z
       
  • Can Resting Indices Obviate the Need for Hyperemia and Promote the Routine
           Use of Physiologically Guided Revascularization'
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Sayan Sen, Ricardo Petraco, Sukhjinder Nijjer, Jamil Mayet, Justin Davies

      Teaser This article assesses the data from contemporary human studies to address some of the common assumptions regarding hyperemic and baseline physiology in the context of the baseline pressure-derived index of instant wave-free ratio and the hyperemic index of fractional flow reserve. The article aims to determine if the available evidence supports the continued investigation, development, and use of baseline indices.

      PubDate: 2015-09-17T10:21:37Z
       
  • Fractional Flow Reserve for the Evaluation of Tandem and Bifurcation
           Lesions, Left Main, and Acute Coronary Syndromes
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Jaya Mallidi, Amir Lotfi

      Teaser Fractional flow reserve (FFR) is a well-established invasive tool to assess the physiologic significance of a coronary stenosis. Several randomized trials proved the safety of deferring revascularization based on FFR in subjects with stable coronary artery disease with single or multivessel disease. Subjects with tandem or bifurcations lesions, left main disease, and acute coronary syndromes were not included in these trials. Unique hemodynamic changes occur in each of these situations, making the measurement and interpretation of FFR challenging. This article reviews the technical aspects of assessing FFR and literature supporting FFR-guided revascularization in each of these situations.

      PubDate: 2015-09-17T10:21:37Z
       
  • Interventional Cardiology Clinics
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Matthew J. Price



      PubDate: 2015-09-17T10:21:37Z
       
  • Copyright
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4




      PubDate: 2015-09-17T10:21:37Z
       
  • Contributors
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4




      PubDate: 2015-09-17T10:21:37Z
       
  • Limitations and Pitfalls of Fractional Flow Reserve Measurements and
           Adenosine-Induced Hyperemia
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Arnold H. Seto, David Tehrani, Morton J. Kern

      Teaser Coronary hemodynamic measurements provide a critical tool to assess the ischemic potential of coronary stenoses. Fractional flow reserve (FFR) is a reliable method to relate translesional coronary pressures to hyperemic myocardial blood flow. Although a basic understanding in FFR can be quickly achieved, many of the nuances and potential pitfalls require special attention. The authors discuss the practical setup of coronary pressure measurement, the most common pitfalls in technique and ways to avoid them, and the limitations of available pharmacologic hyperemic methods.

      PubDate: 2015-09-17T10:21:37Z
       
  • Landmark Fractional Flow Reserve Trials
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Donald R. Lynch, William F. Fearon

      Teaser Fractional flow reserve (FFR) has become widely used for physiologic assessment of intermediate coronary lesions. The Fractional Flow Reserve to Determine Appropriateness of Angioplasty in Moderate Coronary Stenoses (DEFER) trial established the safety of deferring angioplasty for moderate lesions that are not functionally significant. DEFER and Fractional Flow Reserve versus Angiography for Multivessel Evaluation 1 trials established the feasibility of FFR-guided intervention in stable and unstable patients with moderate coronary lesions, translating to improved clinical outcome and reduced number of unnecessary stents. This article reviews the trials establishing FFR as an important tool for on-the-table functional assessment of coronary lesions.

      PubDate: 2015-09-17T10:21:37Z
       
  • Evaluation of Microvascular Disease and Clinical Outcomes
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Christopher J. Broyd, Mauro Echavarria-Pinto, Enrico Cerrato, Javier Escaned

      Teaser Although coronary microcirculatory dysfunction occurs in numerous cardiac conditions and influences prognosis, it has been largely ignored in clinical practice due to the lack of adequate methods for its assessment. Microcirculatory dysfuntion may result from a variety of causes, including structural remodelling (arterioles or capillaries), dysregulation (paradoxical arteriolar vasoconstriction), hypersensitivity to vasoactive factors or adrenergic drive, and extravascular compression of collapsable elements. Thus, the selection of a method to interrogate coronary microcirculation should be based on the suspected cause of dysfunction. This article reviews such assessment tools and their prognostic information.

      PubDate: 2015-09-17T10:21:37Z
       
  • Contents
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4




      PubDate: 2015-09-17T10:21:37Z
       
  • Forthcoming Issues
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4




      PubDate: 2015-09-17T10:21:37Z
       
  • Coronary Physiology: Basic Concepts and Clinical Applications
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Allen Jeremias



      PubDate: 2015-09-17T10:21:37Z
       
  • History and Development of Coronary Flow Reserve and Fractional Flow
           Reserve for Clinical Applications
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Nils P. Johnson, Richard L. Kirkeeide, K. Lance Gould

      Teaser We discuss the historical development of clinical coronary physiology, emphasizing coronary flow reserve (CFR) and fractional flow reserve (FFR). Our analysis focuses on the clinical motivations and technologic advances that prompted and enabled the application of physiology for patient diagnosis. CFR grew from the general concepts of physiologic and coronary reserve, linking the anatomic severity of a lesion to its impact on hyperemic flow. FFR developed from existing models relating pressure measurements to the potential for flow to increase after removing a stenosis. Because pressure measurements have proved easier and more robust than flow measurements, FFR has become the dominant metric.

      PubDate: 2015-09-17T10:21:37Z
       
  • The Concept of Functional Percutaneous Coronary Intervention
    • Abstract: Publication date: October 2015
      Source:Interventional Cardiology Clinics, Volume 4, Issue 4
      Author(s): Danyaal S. Moin, Allen Jeremias

      Teaser The gold standard for assessing the severity of coronary stenoses has been coronary angiography. However, multicenter randomized clinical trials have demonstrated that treatment decisions based on angiography alone do not guarantee benefit to patients. Fractional flow reserve provides physiologic lesion assessment of coronary stenoses. The use of physiology improves clinical outcomes when used for decision making for coronary revascularization. In the era of increased scrutiny of appropriateness of cardiac catheterization and percutaneous coronary intervention, the use of physiologic assessment of the severity of coronary stenoses should be considered an integral adjunct to the anatomic evaluation provided by the coronary angiogram.

      PubDate: 2015-09-17T10:21:37Z
       
 
 
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