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A novel risk model including vascular access site for predicting 30-day mortality after primary PCI: The ALPHA score
The mortality benefit of transradial primary PCI has been shown by several studies. Previous risk models have not considered access site as a candidate predictor and many of them were developed using low risk populations of randomized trials. We conducted a prospective cohort study to construct and validate an admission risk model including access site as candidate variable for predicting 30-day mortality after primary PCI. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - October 13, 2016 Category: Cardiology Authors: Istvan Hizoh, Zalan Gulyas, Dominika Domokos, Gyongyver Banhegyi, Zsuzsanna Majoros, Laszlo Major, Timea Ratkai, Robert Gabor Kiss Source Type: research

The AngelMed Guardian system: Is there a role for implantable devices to detect coronary artery occlusion?
The AngelMed Guardian System is an implantable device similar to a single chamber pacemaker that continuously monitors the intracardiac electrogram for evidence of ST segment shift indicating acute coronary artery occlusion. The system aims to reduce time to presentation by alerting patients to present to a medical facility whether symptoms are present or not. In March 2016, the US Food and Drug Administration (FDA) assembled a meeting of the Circulatory System Devices Panel to review the results of the AngelMed for Early Recognition and Treatment of STEMI (ALERTS) pivotal trial and the accompanying premarket approval (PMA...
Source: Cardiovascular Revascularization Medicine - October 6, 2016 Category: Cardiology Authors: Toby Rogers, Arie Steinvil, Rebecca Torguson, Ron Waksman Source Type: research

The AngelMed Guardian system: is there a role for implantable devices for early detection of coronary artery occlusion?
The AngelMed Guardian System is an implantable device similar to a single chamber pacemaker that continuously monitors the intracardiac electrogram for evidence of ST segment shift indicating acute coronary artery occlusion. The system aims to reduce time to presentation by alerting patients to present to a medical facility whether symptoms are present or not. In March 2016, the US Food and Drug Administration (FDA) assembled a meeting of the Circulatory System Devices Panel to review the results of the AngelMed for Early Recognition and Treatment of STEMI (ALERTS) pivotal trial and the accompanying premarket approval (PMA...
Source: Cardiovascular Revascularization Medicine - October 6, 2016 Category: Cardiology Authors: Toby Rogers, Arik Steinvil, Rebecca Torguson, Ron Waksman Source Type: research

Optical coherence tomography: The next ACE in CTO interventions?
When used to guide percutaneous coronary interventions (PCI), intracoronary imaging is associated with improved clinical outcomes [1 –4]. Intracoronary imaging guidance during PCI reduces in-stent restenosis and repeat revascularization after bare-metal stent placement [1] and has been shown to reduce major adverse cardiac events (MACE), stent thrombosis, target vessel myocardial infarction, and target lesion revascularization after drug-eluting stent (DES) placement [2–4]. These benefits have been attributed to the use of larger diameter stents and more aggressive post-dilation when intracoronary imaging is used to gu...
Source: Cardiovascular Revascularization Medicine - September 30, 2016 Category: Cardiology Authors: Ryan D. Madder Tags: Editorial Source Type: research

Thebesian veins as drainage to the ventricle: a case report
A 64-year old woman was referred to the division of cardiology due to recurrent angina pectoris (CCS III). The patient's symptoms and high cardiovascular risk profile were an indication for coronary angiography. Relevant coronary heart disease was hereby ruled out; however, angiography showed a direct drainage of coronary vessels into the chambers. These Thebesian veins are of venoluminal nature in most cases and have a clinical implication in selected cases only. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 29, 2016 Category: Cardiology Authors: Niklas Frederik Boeder, Holger M. Nef, Timm Bauer Source Type: research

Promus Premier Versus Xience V and Taxus Liberte in Contemporary United States Practice (REWARDS Premier Registry)
Drug-eluting stents (DES) reduce in-stent restenosis and repeat revascularization in comparison to bare metal stents. Individual DES vary, however, in regard to rates of restenosis, stent thrombosis; they also differ in regard to their platform and physical characteristics. The Promus Premier was designed to improve the performance of the Promus Element, with respect to conformability, trackability, and avoidance of longitudinal stent deformation; there is little published data, however, on clinical outcomes with Promus Premier. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 29, 2016 Category: Cardiology Authors: Michael A. Gaglia, Randy Goodroe, Greg Mishkel, Wassim Gharib, Ali Tabrizchi, Tamim Nazif, John Wang, Thomas Scott, Mario Lopez, Daniel Steinberg, Jiaxiang Gai, Rebecca Torguson, Ron Waksman Source Type: research

Comparison of Heparin, Bivalirudin, and Different Glycoprotein IIb/IIIa Inhibitor Regimens for Anticoagulation During Percutaneous Coronary Intervention: A Network Meta-Analysis
Numerous GPIs are available for PCI. Although they were tested in randomized controlled trials, a comparison between the different GPI strategies is lacking. Thus, we performed a Bayesian network meta-analysis to compare different glycoprotein IIb/IIIa inhibitors (GPI) strategies with heparin and bivalirudin for percutaneous coronary intervention (PCI). (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 29, 2016 Category: Cardiology Authors: Michael J. Lipinski, Regina C. Lee, Michael A. Gaglia, Rebecca Torguson, Hector M. Garcia-Garcia, Augusto D. Pichard, Lowell F. Satler, Ron Waksman Source Type: research

Technique of Delayed Endovascular Hemostatic Closure for Large Bore Vascular Access Site: A Case Series
Large bore vascular access is becoming increasingly common for a range of interventional cardiovascular procedures. In the vast majority, percutaneous closure is preplanned and successfully achieved. However, for patients with percutaneous closure failure, or those requiring prolonged hemodynamic support, alternatives to percutaneous closure are required. Currently there are no approved vascular closure devices for delayed removal of large bore sheaths and therefore, manual hemostasis or surgical closure remain the only options. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 29, 2016 Category: Cardiology Authors: Ali Pourdjabbar, Ryan R. Reeves, Ehtisham Mahmud, Lawrence Ang, Mitul P Patel Source Type: research

Neoatherosclerosis causing occlusive in-stent restenosis: Impact of intracoronary imaging in the intensity of lipid-lowering therapy
We report a rare case of occlusive neoatherosclerosis presenting beyond one year after a successful drug-eluting stent implantation. The impact of OCT findings in the clinical decision making process is emphasized. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 29, 2016 Category: Cardiology Authors: David Mart í, Edurne López, Salvador Álvarez, Jorge Palazuelos, Ignacio Rada, Fernando Alfonso Source Type: research

Congenital Single Coronary Artery: A Rare Anatomic Variant
A 70 y/o male presented to the cardiac catheterization laboratory for angiography prior to valve surgery. The left main coronary artery divided into the left anterior descending (LAD) artery and circumflex (LCx). The right coronary artery (RCA) arose as an extension of the LCx, tracing the atrio-ventricular groove before terminating at the anterior base. A separate RCA ostium was absent on aortography. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 28, 2016 Category: Cardiology Authors: James W. Hansen, Alaa Ayyoub, Neil Yager, Sergio Waxman Source Type: research

Acute Pulmonary Embolism after post-traumatic spinal epidural hematoma: use of catheter-direct treatment
We report the case of a 35-year-old man who developed a massive pulmonary embolism (PE) after spine surgery. After an accidental axial fall, the patient developed a spinal epidural hematoma (SHE). Because major trauma, recent surgery and known bleeding risk are considered absolute contraindications to systemic thrombolysis, the patient was treated with catheter-directed therapy (CDT). CDT remains a useful treatment in massive PE, especially when systemic thrombolysis is contraindicated or has failed. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 28, 2016 Category: Cardiology Authors: Marco Zuin, Gianluca Rigatelli, Stefano Ferraresi, Pietro Zonzin, Loris Roncon Tags: Case Report Source Type: research

Time to Start Implementing Lean and Six Sigma in the Catheterization Laboratory
To the Editor. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 28, 2016 Category: Cardiology Authors: Chayakrit Krittanawong, Takeshi Kitai, Tao Sun Source Type: research

A Different Kind of Anchor: An Alternative to the Distal Anchoring Technique
We read with interest the case report by Fiocca, et al., on How to perform distal anchoring technique by 6 French radial approach in complex coronary procedures (1). Complex anatomy continues to challenge the interventionist performing percutaneous coronary intervention (PCI). If one cannot deliver stents to the target lesion, procedural success is impossible and failure can result in increased morbidity (2 –4). Techniques to improve stent delivery have included the mother-daughter technique as well as the anchoring balloon technique (5–9). (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 21, 2016 Category: Cardiology Authors: Richard Heuser, Khalid Naqi Source Type: research

5-Fr sheathless transradial cardiac catheterization using conventional catheters and balloon assisted tracking; a new approach to downsizing
We report a feasibility study of a technique that enables both 5Fr diagnostic and PCI cases to be undertaken without an arterial sheath using conventional diagnostic and guide catheters with a modified balloon assisted tracking (BAT) technique. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 17, 2016 Category: Cardiology Authors: Mamas A. Mamas, Sudhakar George, Karim Ratib, Chun Shing Kwok, Abdelnasir Elkhazin, Kully Sandhu, Julie Stubbs, Pamela Luxford, James Nolan Source Type: research

Transpedal Approach for Iliac Artery Stenting: A Pilot Study
To demonstrate the safety and feasibility of the transpedal approach as an alternate arterial access site for iliac artery intervention. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 17, 2016 Category: Cardiology Authors: Jips J. Zachariah, Justin A. Ratcliffe, Michael Ruisi, Joseph Puma, Olivier Bertrand, Tak Kwan Source Type: research