Revista Brasileira de Cardiologia Invasiva最新文献

{"title":"Artéria coronária única com origem no seio de Valsalva direito","authors":"Igor Ribeiro de Castro Bienert ,&nbsp;Lucas Pocebon ,&nbsp;Felipe Xavier ,&nbsp;Vinícius Santos ,&nbsp;Sarah Bortolucci ,&nbsp;Fábio Salerno Rinaldi ,&nbsp;Paulo André da Silva ,&nbsp;Pedro Beraldo de Andrade","doi":"10.1016/j.rbci.2014.11.001","DOIUrl":"10.1016/j.rbci.2014.11.001","url":null,"abstract":"<div><p>Anomalous origin of coronary arteries is a rare congenital disorder, with an estimated incidence of 0.3 to 1.3% of patients referred for coronary angiography. Currently, its discussion still divides opinions, particularly regarding the therapeutic approach. We report the case of a 75 year‐old woman who underwent cardiac catheterization, which showed the left main coronary artery with an anomalous origin next to the right coronary artery in the right coronary sinus and with a retroaortic course.</p></div>","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"Pages 70-72"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbci.2014.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80892987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resposta vascular após implante de stents liberadores de biolimus A9 com polímero bioabsorvível e stents liberadores de everolimus com polímero durável. Resultados da análise de tomografia de coerência óptica do estudo randomizado BIOACTIVE","authors":"Daniel Chamié ,&nbsp;Breno O. Almeida ,&nbsp;Fábio Grandi ,&nbsp;Evandro M. Filho ,&nbsp;J. Ribamar Costa Jr. ,&nbsp;Ricardo Costa ,&nbsp;Rodolfo Staico ,&nbsp;Dimytri Siqueira ,&nbsp;Fausto Feres ,&nbsp;Luiz Fernando Tanajura ,&nbsp;Marinella Centemero ,&nbsp;Áurea J. Chaves ,&nbsp;Andrea Abizaid ,&nbsp;Amanda G.M.R. Sousa ,&nbsp;Alexandre Abizaid","doi":"10.1016/j.rbci.2015.02.001","DOIUrl":"10.1016/j.rbci.2015.02.001","url":null,"abstract":"<div><h3>Background</h3><p>In BIOACTIVE study, we evaluated vascular responses after the implant of biolimus A9‐eluting stent (BES; BioMatrix^TM) and the everolimus‐eluting stent (EES; XIENCE V^TM). In this study, we present the optical coherence tomography analysis (OCT) 6 months post‐intervention.</p></div><div><h3>Methods</h3><p>Patients were randomized to treatment with BES (n = 22) or EES (n = 18). The primary outcome was the frequency of non‐covered, poorly positioned struts by OCT.</p></div><div><h3>Results</h3><p>OCT was performed in 26 patients (BES: n = 15; EES: n = 11) and 749 tomographic images and 7,725 stent struts were analyzed. BES and EES showed similar luminal and stent areas. Neointimal hyperplasia area, neointimal thickness and the percentage of in‐stent obstruction (8.44 ± 5.10% vs. 9.21 ± 6.36%; <em>p</em> = 0.74) were similar. The rates of not covered struts (BES: 2.10 ± 3.60% vs. ESS: 2.46 ± 2.15%, <em>p</em> = 0.77) and poorly positioned struts (BES: 0.48 ± 1.48% vs. EES 0.44 ± 1.05%, <em>p</em> = 0.94) were similarly low. The frequency of frames with signs consistent with peri‐strut inflammatory infiltrate was low and similar between BES (15.53 ± 20.77%) and EES (11.70 ± 27.51%; <em>p</em> = 0.68).</p></div><div><h3>Conclusions</h3><p>The second‐generation drug‐eluting stents BES and EES were equally effective at suppressing the neointimal formation after 6 months, with favorable vascular responses. The frequency of frames with peri‐strut infiltrate signals per patient was low, and lower than that observed historically with first‐generation drug‐eluting stents.</p></div>","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"Pages 28-37"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbci.2015.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79866482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aterectomia rotacional em artérias com calcificação extrema ou falha em dilatação prévia: aspectos técnicos e evolução tardia após intervenção coronária percutânea","authors":"Pedro Henrique Magalhães Craveiro de Melo,&nbsp;Breno de Alencar Araripe Falcão,&nbsp;Cristiano Guedes Bezerra,&nbsp;Fábio Augusto Pinton,&nbsp;Welingson V.N. Guimarães,&nbsp;Rafael Cavalcante Silva,&nbsp;Celso K. Takimura,&nbsp;Marco Antônio Perin,&nbsp;Expedito Eustáquio Ribeiro da Silva,&nbsp;Antonio Esteves‐Filho,&nbsp;José Mariani Jr.,&nbsp;Pedro Alves Lemos Neto","doi":"10.1016/j.rbci.2015.01.003","DOIUrl":"10.1016/j.rbci.2015.01.003","url":null,"abstract":"<div><h3>Background</h3><p>Rotational atherectomy with new ablative strategies have been proposed for the treatment of extremely calcified lesions prior to stent implantation. Nevertheless, few data are available about the adoption of these new strategies in contemporary practice and about late outcomes of patients undergoing this therapy.</p></div><div><h3>Methods</h3><p>From July 2012 to November 2014, a retrospective single center registry was conducted, including all patients undergoing rotational atherectomy as part of the treatment of coronary arteries with heavy calcification or previous failed dilation. We evaluated technical aspects of atherectomy and late outcomes of patients for the occurrence of major adverse cardiovascular events (MACE), defined as death, Q‐wave myocardial infarction or repeat target vessel revascularization.</p></div><div><h3>Results</h3><p>Twenty‐nine patients with a mean age of 69.5 ± 7.6 years, underwent atherectomy. The average burr‐to‐artery ratio was 0.54 ± 0.07, the initial rotational speed was 161.000 ± 13.928 and the rate of cutting balloon utilization after atherectomy was 45.1%. Angiographic success was achieved in all procedures. The median follow‐up time was 13.2 months (IQ: 4.0‐17.4) and there were three events: 1 death of non‐cardiac cause and 2 new target vessel revascularizations. The mean MACE‐free survival time was 29.7 ± 2.1 months.</p></div><div><h3>Conclusions</h3><p>Contemporary rotational atherectomy incorporates less aggressive strategies of ablation with high rates of acute success and low occurrence of major adverse cardiovascular events during late follow‐up.</p></div>","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"Pages 38-41"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbci.2015.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76728581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Razões para Utilização da Via Femoral em Centro que Prioriza Técnica Radial em Procedimentos Cardiovasculares Invasivos","authors":"M. Fossati, M. Arndt","doi":"10.1590/0104-1843000000056","DOIUrl":"https://doi.org/10.1590/0104-1843000000056","url":null,"abstract":"Introducao: A tecnica de acesso arterial radial tem sido incorporada em muitos centros como tecnica de escolha para procedimentos invasivos cardiacos. No entanto, ainda ha resistencias relacionadas principalmente a possibilidade de crossover para via femoral, causadas por dificuldades tecnicas ou alteracoes anatomicas vasculares. O objetivo deste estudo foi identificar as razoes para a utilizacao da via femoral em um centro de medio volume de intervencoes, que recentemente adotou essa tecnica como primeira escolha na realizacao de procedimentos invasivos cardiacos. Metodos: Estudo prospectivo, que incluiu pacientes consecutivos submetidos a cateterismo cardiaco e coronariografia de forma eletiva. O preenchimento de formulario foi realizado com informacoes pre-, per- e pos-procedimento, e foi dada enfase a avaliacao das causas da utilizacao da via femoral (crossover ou por escolha primaria do operador). Resultados: No periodo de novembro de 2013 a agosto de 2014, 1.290 pacientes foram submetidos a procedimento diagnostico eletivo. A via femoral foi utilizada em 10,9% dos pacientes, por escolha do operador em 6,6% ou por crossover em 4,3% dos casos. O crossover ocorreu por puncao inadequada (3,4%), espasmo arterial (0,6%) ou tortuosidade vascular (0,3%). As complicacoes imediatas foram observadas em seis pacientes (0,5%) que desenvolveram hematomas locais (tipos I e II). Conclusoes: Em um centro de moderado volume, a tecnica radial foi incorporada como primeira escolha com seguranca e baixa incidencia de crossover para a via femoral.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"35 1","pages":"339-342"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77698151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trombose Muito Tardia de Stent pela Angiografia. Um Caso de Progressão da Aterosclerose pela OCT","authors":"Antonio de Castro-Filho, Daniel Chamié, Alexandre Abizaid","doi":"10.1590/0104-1843000000067","DOIUrl":"https://doi.org/10.1590/0104-1843000000067","url":null,"abstract":"The progressive nature of coronary atherosclerotic disease is often neglected in patients submitted to percutaneous coronary intervention. Very late (> 1 year) myocardial infarctions affecting the treated myocardial territory are usually attributed to device related complications. We report the case of a patient with acute inferior wall ST-elevation myocardial infarction, who had a thrombotic occlusion of a bare-metal stent implanted 8 years before. Despite the angiographic diagnosis of very late stent thrombosis, optical coherence tomography revealed that the acute myocardial infarction was caused by rupture of an atherosclerotic plaque outside of the previously stented segment.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"75 1","pages":"394-400"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83818454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tratamento Endovascular dos Aneurismas de Artéria Poplítea","authors":"Marília Granzotto Volpato, Patrick Bastos Metzger, Maria Claudia Folino, Fabio Henrique Rossi, Samuel Martins Moreira, Mohamed Hassan Saleh, Nilo Mitsuru Izukawa, Antonio Massamitsu Kambara","doi":"10.1590/0104-1843000000063","DOIUrl":"https://doi.org/10.1590/0104-1843000000063","url":null,"abstract":"Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen ViabahnTM and two MultilayerTM stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"90 1","pages":"375-381"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74604473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infarto com Supradesnivelamento do Segmento ST e Trombo Coronariano Extenso em Paciente com Anemia Falciforme","authors":"Fernando Pivatto, A. M. Krepsky, Diogo da Silva Piardi, Márcio Mossmann, M. Gus, M. Wainstein","doi":"10.1590/0104-1843000000066","DOIUrl":"https://doi.org/10.1590/0104-1843000000066","url":null,"abstract":"Myocardial infarction in patients with sickle cell anemia is often underdiagnosed due to confounding factors (e.g., vasoocclusive disease leading to painful crisis). In the majority of reported cases, the coronary arteries were pervious and without stenotic lesions. In this case report, we describe the presence of an extensive coronary thrombus in a patient with sickle cell anemia presenting with ST elevation myocardial infarction, managed satisfactorily with the association of anticoagulants and antiplatelet drugs.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"390-393"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89094769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resultados Angiográficos e do Seguimento Clínico de 5 Anos Após Implante de Stents Farmacológicos com Revestimento Biodegradável em Pacientes com Alto Risco de Reestenose. Análise de Subgrupo do Estudo Randomizado PAINT","authors":"Wilton Francisco Gomes, J. F. Marchini, Bruno Moulin, M. Perin, Ludmilla Oliveira, J. A. Arruda, V. C. Lima, Antônio Augusto Guimarães Lima, P. Caramori, C. R. Medeiros, Mauricio R. Barbosa, F. S. Brito, E. Ribeiro, Pedro A. Lemos","doi":"10.1590/0104-1843000000052","DOIUrl":"https://doi.org/10.1590/0104-1843000000052","url":null,"abstract":"Background: Biodegradable polymers were developed to reduce the hypersensitivity reaction associated to durable polymers found with the first generation drug-eluting stents, while maintaining antiproliferative efficacy and increasing safety. This study evaluated the 9-month angiographic follow-up and long-term clinical outcomes of biodegradable polymer-coated drug-eluting stents compared with identical platform metallic stents in patients with high-risk for restenosis. Methods: Patients with a reference diameter ≤ 2.5 mm, lesion length ≥ 15 mm, diabetes, or a combination of these characteristics were selected from the population of the PAINT trial. These patients were previously randomized and allocated for percutaneous coronary intervention with either a sirolimus-eluting biodegradable polymer-coated stent, a paclitaxel-eluting biodegradable polymer-coated stent, or an identical metallic platform stent, at a ratio of 2:2:1. Results: One hundred and seventy-eight patients were treated with biodegradable polymer-coated drug-eluting stents (n = 142) or bare metal stents (n = 36). At the 9-month angiographic follow-up, biodegradable polymercoated drug-eluting stents had lower rates of late loss (0.40 ± 0.42 mm vs. 0.90 ± 0.47 mm; p < 0.01) and binary restenosis (7.4% vs. 25%; p <0.01). In the 5-year clinical follow-up, the group with biodegradable polymer-coated drug-eluting stents had lower rates of the composite endpoint of cardiac death, myocardial infarction, and target vessel revascularization (16.2% vs. 38.0%; p = 0.03), especially due to the reduction of target vessel revascularization (9.9% vs. 36.1%; (p 0.01). Total death, cardiac death and myocardial infarction were not different among groups. 0% (p = 0.30). Conclusions: Paclitaxel or sirolimus-eluting biodegradable polymer-coated stents were effective in reducing angiographic restenosis at 9 months and the need of reintervention for clinical restenosis in 5 years, without increasing the risk of stent thrombosis.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"27 1","pages":"315-319"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83323486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relato Preliminar sobre a Concentração Sanguínea de Níquel Após Oclusão Percutânea de Comunicação Interatrial com a Prótese Cocoon","authors":"André V. Badran, Jorge Luis Haddad, R. B. Pavão, Gustavo Caires Novaes, I. M. Lago, G. L. Figueiredo, Moysés de Oliveira Lima-Filho, M. Romano, J. A. Marin-Neto","doi":"10.1590/0104-1843000000062","DOIUrl":"https://doi.org/10.1590/0104-1843000000062","url":null,"abstract":"Background: The possibility of nickel release to the bloodstream after implantation of latest generation atrial septal defect occlusion devices (Cocoon Septal OccluderTM), whose main component is nitinol (55% nickel and 45% titanium), remains controversial, especially in certain groups of patients such as children and women of childbearing age. Thus, the aim of this study was to evaluate the correlation between the device implantation and serum levels of nickel. Methods: This was a prospective longitudinal observational study conducted at a public hospital. Patients undergoing percutaneous atrial septal defect occlusion were clinically evaluated using transthoracic echocardiography and peripheral vein blood sampling for serum nickel before and after (1 day, 1 and 3 months) implantation. Results: The procedure and subsequent examinations were successfully performed in ten patients, with mean age of 34.4 years (range 5 to 60 years). Serial echocardiography confirmed the maintenance of adequate results of the procedure. Patients did not show manifestations that might suggest a reaction to metal, such as skin rash, dyspnea, thoracic discomfort, palpitations or migraine. Serum nickel levels did not show any significant changes and remained within the normal range for the population, according to the dosing methods within 3 months of the procedure. Conclusions: Preliminary results of this investigation with the Cocoon device have shown that during the initial period of endothelization after the procedure there was no significant nickel release into the bloodstream.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"1 1","pages":"369-374"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89861296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2015: Ano Novo, RBCI Nova!","authors":"Á. Chaves","doi":"10.1590/0104-1843000000051","DOIUrl":"https://doi.org/10.1590/0104-1843000000051","url":null,"abstract":"","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"22 1","pages":"313-313"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75465501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}