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Lean Six Sigma- A powerful strategy to improve efficiency in the modern cardiac catheterization laboratory
We read with interest the brief review by Krittanawong et al., summarizing the data available regarding the implementation of Lean Six Sigma processes in the modern day catheterization laboratories [1]. As pointed out by the authors, these strategies were originally developed in manufacturing industries and aimed to improve process efficiency as well as reduce waste products. As one could easily surmise, Lean and Six Sigma have strongly complementary strengths that could be very useful for a considerable improvement in several healthcare workflow processes. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - November 8, 2016 Category: Cardiology Authors: Shikhar Agarwal, Kanika Khanna Agarwal, Akhil Parashar, Samir Kapadia Source Type: research

Endocarditis after interventional repair of the mitral valve: review of a dilemma
The MitraClip procedure can be an alternative treatment option for patients with high surgical risk for whom surgical treatment is contraindicated. Patients with prosthetic material have an increased risk for infective endocarditis.Hypothesis.Incidence, treatment and outcome of patients with endocarditis after interventional mitral valve repair is not known. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - November 8, 2016 Category: Cardiology Authors: Niklas F. Boeder, Oliver D örr, Johannes Rixe, Kay Weipert, Timm Bauer, Matthias Bayer, Christian W. Hamm, Holger M. Nef Source Type: research

Barriers for transradial coronary angiography and interventions in 2016
Dr. Lucien Campeau reported the first transradial angiography in 1989 followed by Drs. Kiemeneij and Laarman (1992) who performed the first transradial coronary stenting in Amsterdam, The Netherlands. But since then the acceptance rates of TRC has varied considerably and is hugely influenced by the operator and demography of a particular lab - academic training centers have a significantly higher TRC implementation rates compared to community hospitals. In the past few years there has impressive growth of TRC in the US – from less than 3% (2007) to 16% (2012) to current ~36% (2016) of all cardiac catheterization nationwi...
Source: Cardiovascular Revascularization Medicine - November 8, 2016 Category: Cardiology Authors: Sumit Som, Ankitkumar K Patel, Virender Sethi, Haroon Faraz, Irfan Admani, Atish Mathur, Joseph E. Parrillo, Pranaychandra Vaidya Source Type: research

A systematic review on the safety of Prostar XL versus ProGlide after TAVR and EVAR
Endovascular aortic aneurysm repair (EVAR) and transfemoral transcatheter aortic valve replacement (TAVR) are widly spreading minimally invasive procedures performed mainly through the femoral artery. Prostar XL and ProGlide vascular closure devices are used in clinical practice for the hemostasis in these procedures and they have been shown to be safe and effective. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - November 7, 2016 Category: Cardiology Authors: Christos Maniotis, Constantinos Andreou, Ioannis Karalis, Giasemi Koutouzi, Maria Agelaki, Michael Koutouzis Source Type: research

Skirt followed by Trouser stenting technique: true anatomical preservation of coronary Y-shaped bifurcation lesions while using “vanishing” Bioresorbable scaffolds: a report of two cases
We report on two cases in which Y-shaped coronary bifurcations were treated with the use of Bioresorbable scaffolds (Abbott Vascular, Santa Clara, CA, USA). The first case was of a 50years old man, smoker for twenty years with no past chronic illnesses. He presented to emergency department with persistent chest pain. ECG showed T wave inversion in leads I, aVL, V4-V6. Cardiac enzymes where elevated. He was shifted for early coronary intervention, which showed coronary single vessel disease. There was haziness involving a Y-shaped bifurcation of proximal to mid LAD with large diagonal branch (Fig. (Source: Cardiovascular Re...
Source: Cardiovascular Revascularization Medicine - November 1, 2016 Category: Cardiology Authors: Wael Elabbassi, Arif Al Nooryani Source Type: research

Double-Barrel Coronary Artery after Subintimal Stenting for Chronic Total Occlusion
A 70-year-old man with a medical history of hypertension, dyslipidemia, and diabetes was referred to our hospital by his primary care physician for the management of effort angina. Coronary angiography revealed chronic total occlusion (CTO) of the proximal right coronary artery (RCA) that had been collateralized by septal branches from the left anterior descending coronary artery, left circumflex coronary artery, and an antegrade bridge (Fig. 1-A). The lesion was penetrated using subintimal guidewire tracking (Fig. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 29, 2016 Category: Cardiology Authors: Yusuke Watanabe, Yusuke Fujino, Hisaaki Ishiguro, Sunao Nakamura Source Type: research

Clinically Apparent Long-term Electric Disturbances in the Acute and Very Long-Term of Patent Foramen Ovale Device-Based Closure
Incidence of electrical disturbances in patients submitted to transcatheter patent foramen ovale (PFO) closure has not been fully clarified in a large population. Aim of the study is to assess the incidence of atrial fibrillation, supraventricular tachi-arrhythmias, and atrio-ventricular block in the acute and very long-term follow-up. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 28, 2016 Category: Cardiology Authors: Gianluca Rigatelli, Marco Zuin, Luigi Pedon, Roberto Zecchel, Fabio Dell'Avvocata, Antonio Carrozza, Marco Zennaro, Gianni Pastore, Francesco Zanon Source Type: research

Critical Hand Ischemia Treatment via Orbital Atherectomy —A Single Center Observational Retrospective Analysis
Critical hand ischemia (CHI) can be devastating and may result in amputation. Distal vessel calcification has been shown to be a major factor in causing CHI. Atherectomy in the upper extremities is not typically considered due to the small anatomy; however, the Diamondback 360 ° Peripheral Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.) can access treatment areas with a reference vessel diameter of 1.5mm. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 28, 2016 Category: Cardiology Authors: Abdul Bahro, Zsuzsanna Igyarto, Brad Martinsen Source Type: research

Transulnar approach for coronary catheterization in patients with a harvested ipsilatelateral radial artery: a case series
Forearm (radial or ulnar) approach for coronary angiography and intervention is a worldwide growing method. Compared to the transfemoral approach, the forearm approach is associated with less access site bleedings [1], allows patients' earlier ambulation [2,3] and in is associated with better patients' comfort [4] and with mortality reduction in patients with ST elevation myocardial infarction [5]. The main complication of this method is the occlusion of the forearm artery after catheterization, with an incidence of 1 –10% in different trials [6]. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 28, 2016 Category: Cardiology Authors: Michael Koutouzis, Christos Maniotis, Maria Angelaki, Vaios Tzifos, Ioannis Matsoukis, Efstathios Lazaris Source Type: research

Predicting Readmission Risk Following Coronary Artery Bypass Surgery at the Time of Admission
Reducing readmissions following hospitalization is a national priority. Identifying patients at high risk for readmission after coronary artery bypass graft surgery (CABG) early in a hospitalization would enable hospitals to enhance discharge planning. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 28, 2016 Category: Cardiology Authors: Zaher Fanari, Daniel Elliott, Carla A Russo, Paul Kolm, William S. Weintraub Source Type: research

Use of an ePTFE-covered nitinol self-expanding stent graft for the treatment off pre-closure device failure during transcatheter aortic valve replacement
Our aim was to describe our experience with the use of an ePTFE-covered nitinol self-expanding stent graft (GORE ® VIABAHN® Endoprosthesis, Gore Medical, USA) placed in the common femoral artery for the treatment of suture-mediated pre-closure device failure following transcatheter aortic valve replacement (TAVR). (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 20, 2016 Category: Cardiology Authors: Arie Steinvil, Nelson Bernardo, Toby Rogers, Edward Koifman, Kyle Buchanan, M. Chadi Alraies, Christian Shults, Rebecca Torguson, Petros G. Okubagzi, Augusto D. Pichard, Lowell F. Satler, Itsik Ben-Dor, Ron Waksman Source Type: research

A Comparison of Cangrelor, Prasugrel, Ticagrelor, and Clopidogrel in Patients Undergoing Percutaneous Coronary Intervention: A Network Meta-analysis
Newer P2Y12 inhibitors have more rapid onset of platelet inhibition compared with clopidogrel, especially the intravenous P2Y12 inhibitor cangrelor. Direct comparisons between cangrelor and oral P2Y12 inhibitors ticagrelor and prasugrel do not exist. Thus, we performed a network meta-analysis to directly and indirectly compare different P2Y12 inhibitors in patients undergoing percutaneous coronary intervention (PCI). (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 20, 2016 Category: Cardiology Authors: Peter C. Westman, Michael J. Lipinski, Rebecca Torguson, Ron Waksman Source Type: research

Use of an ePTFE-Covered Nitinol Self-Expanding Stent Graft for the Treatment of Pre-Closure Device Failure during Transcatheter Aortic Valve Replacement
Our aim was to describe our experience with the use of an ePTFE-covered nitinol self-expanding stent graft (GORE ® VIABAHN® Endoprosthesis, Gore Medical, USA) placed in the common femoral artery for the treatment of suture-mediated pre-closure device failure following transcatheter aortic valve replacement (TAVR). (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 20, 2016 Category: Cardiology Authors: Arie Steinvil, Nelson Bernardo, Toby Rogers, Edward Koifman, Kyle Buchanan, Chadi M. Alraies, Christian Shults, Rebecca Torguson, Petros G. Okubagzi, Augusto D. Pichard, Lowell F. Satler, Itsik Ben-Dor, Ron Waksman Source Type: research

Successful Treatment of a Nonagenarian Patient with Acute Coronary Syndrome Complicated with Chronic Total Occlusion of the Left Main Coronary Artery
We reported a successfully treated case of a nonagenarian patient with ST-segment elevation myocardial infarction, who had subtotal occlusion of the RCA and total occlusion of the LMCA with Rentrop grade 2 collateral coronary artery supply from the RCA. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 18, 2016 Category: Cardiology Authors: Yukio Mizuguchi, Sho Hashimoto, Hiroki Shibutani, Takeshi Yamada, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata, Akihiko Takahashi Tags: Case Report Source Type: research

Pseudoaneurysm after Transpedal Arterial Access for Evaluation and Treatment of Peripheral Arterial Disease
There has been an increasing use of transpedal arterial access (TPA) for evaluation and treatment of peripheral arterial disease (PAD) over a transfemoral approach (TFA). TPA, it is expected to be associated with better patient comfort, less recovery time and possibly less access site complications compared to standard TFA. Access site complications and pseudoaneurysm (PSA) associated with the TPA have not been previously reported. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 16, 2016 Category: Cardiology Authors: Apurva Patel, Roosha Parikh, Yili Huang, Michael Liou, Justin Ratcliffe, Olivier F. Bertrand, Joseph Puma, Tak W. Kwan Source Type: research