Revista Brasileira de Cardiologia Invasiva (English Edition)最新文献

{"title":"Percutaneous aortic valve implantation – an experience with the LotusTM repositionable device","authors":"Vinicius Esteves ,&nbsp;Julio F. Marchini ,&nbsp;Guilherme Bernardi ,&nbsp;Marden A. Tebet ,&nbsp;Fernando Bernardi ,&nbsp;Sérgio Kreimer ,&nbsp;Paulo Prates ,&nbsp;José Mariani Jr. ,&nbsp;Rogério Sarmento-Leite ,&nbsp;Luiz Alberto Mattos ,&nbsp;Eberhard Grube ,&nbsp;Pedro A. Lemos","doi":"10.1016/j.rbciev.2017.02.005","DOIUrl":"https://doi.org/10.1016/j.rbciev.2017.02.005","url":null,"abstract":"<div><h3>Background</h3><p>The second-generation Lotus^TM transcatheter aortic valve was designed to provide the interventional cardiologist with complete control of its release during the procedure. This study presents the initial experience and in-hospital outcomes of patients treated with this prosthesis in Brazil.</p></div><div><h3>Methods</h3><p>This observational and retrospective study included patients with symptomatic severe aortic stenosis considered at high surgical risk, treated in seven centers.</p></div><div><h3>Results</h3><p>The device was used in 31 patients, 61.3% female, aged 82.9 ± 6.9 years, and with STS score of 6.5 ± 4.1%. The aortic valve area was 0.73 ± 0.18<!--> <!-->cm² and the mean gradient was 51.7 ± 13.9<!--> <!-->mmHg. All procedures were performed by the transfemoral access route, and pre-dilation was necessary in 65% of cases. The success rate of the procedure was 96.7%. There were no vascular complications requiring surgical intervention nor cases of stroke. The mean gradient after the procedure was 10.5 ± 5.8<!--> <!-->mmHg; no cases of moderate to severe aortic regurgitation were observed. The rate of permanent pacemaker implantation was 38.7%, and mean in-hospital length of stay was 8.5 ± 4.8 days.</p></div><div><h3>Conclusions</h3><p>In the initial experience with the use of the Lotus^TM aortic valve, in-hospital results demonstrated the safety and efficacy of the device; no cases of significant aortic regurgitation were observed.</p></div><div><h3>Introdução</h3><p>A válvula aórtica transcateter de segunda geração Lotus^TM foi desenhada para proporcionar ao intervencionista o controle completo de sua liberação durante o procedimento. O presente estudo apresenta a experiência inicial e os desfechos hospitalares de pacientes tratados com essa prótese no Brasil.</p></div><div><h3>Métodos</h3><p>Registro observacional, retrospectivo, que incluiu pacientes com estenose aórtica grave sintomáticos, considerados de alto risco cirúrgico, tratados em sete centros.</p></div><div><h3>Resultados</h3><p>Receberam o dispositivo 31 pacientes, sendo 61,3% do sexo feminino, com idade de 82,9 ± 6,9 anos e escore STS de 6,5 ± 4,1%. A área valvar aórtica foi de 0,73 ± 0,18<!--> <!-->cm² e o gradiente médio de 51,7 ± 13,9<!--> <!-->mmHg. Todos os procedimentos foram realizados pela via transfemoral, e a pré-dilatação foi necessária em 65% dos casos. A taxa de sucesso do procedimento foi de 96,7%. Não houve complicação vascular com necessidade de intervenção cirúrgica e nem casos de acidente vascular cerebral. O gradiente médio após o procedimento foi de 10,5 ± 5,8<!--> <!-->mmHg e não foram observadas regurgitações aórticas de graus moderado/importante. A taxa de implante de marca-passo definitivo foi de 38,7%, e a permanência hospitalar de 8,5 ± 4,8 dias.</p></div><div><h3>Conclusões</h3><p>Na experiência inicial com o implante da válvula aórtica Lotus^TM, os resultad","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 238-241"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72236358","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":"Radial artery avulsion - a rare complication of radial access","authors":"Gilberto Guilherme Ajjar Marchiori,&nbsp;George César Ximenes Meireles,&nbsp;Sérgio Kreimer,&nbsp;Micheli Zanoti Galon,&nbsp;Carlos Vinicius Abreu do Espírito Santo","doi":"10.1016/j.rbciev.2017.02.009","DOIUrl":"10.1016/j.rbciev.2017.02.009","url":null,"abstract":"<div><p>The radial access is widely used for cardiac catheterization and angioplasty, with advantages such as decreased risk of bleeding and vascular complications. This case reports on a rare complication during cardiac catheterization by radial access: radial artery endothelial tissue avulsion through the catheter and its embolization to the left anterior descending artery, which was resolved by manual aspiration of the embolized fragment. This complication may be related to the specific anatomical characteristics of the patient's radial artery.</p></div><div><p>A via radial é amplamente utilizada para a realização de cateterismo cardíaco e angioplastia, com vantagens como a diminuição do risco de sangramento e de complicações vasculares. O presente caso relata uma complicação rara durante o cateterismo cardíaco por via radial: a avulsão de tecido endotelial da artéria radial pelo cateter e sua embolização para a artéria descendente anterior, a qual foi resolvida pela aspiração manual do fragmento embolizado. Tal complicação pode ter relação com as características anatômicas específicas da artéria radial do paciente.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 282-284"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"105644519","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":"Comparison of conventional compressive dressings vs. wristband devices after catheterization by radial approach","authors":"Said Assaf Neto ,&nbsp;João Orávio de Freitas Jr. ,&nbsp;Sérgio Luis Berti ,&nbsp;J. Ribamar Costa Jr. ,&nbsp;Jorge Augusto L. Zbeid","doi":"10.1016/j.rbciev.2017.02.014","DOIUrl":"10.1016/j.rbciev.2017.02.014","url":null,"abstract":"<div><h3>Background</h3><p>Wristband devices used in the compression of the radial puncture site add cost to the procedure and have not been adequately compared with conventional compressive dressings. This study evaluated the effectiveness and safety of both forms of hemostasis in patients undergoing coronary angiography and/or percutaneous coronary intervention in daily practice.</p></div><div><h3>Methods</h3><p>A prospective, multicenter, nonrandomized study, which included consecutive patients who underwent procedures through radial access. The type of compression was at the interventionist's discretion and the availability of wristband devices. The main objective was to compare the patency of the radial artery on the 7^th day after the procedure, measured by Doppler. Secondarily, the authors evaluated the occurrence of bleeding/hematoma at the puncture site during compression, after removal of the device and on the 7^th day after the procedure.</p></div><div><h3>Results</h3><p>This study evaluated 528 patients, 416 using conventional compressive dressings and 112 using wristband devices. When the sheath was removed and soon after its removal, a higher incidence of bleeding in the conventional compressive dressings group was observed (13.4% vs. 0%; <em>p</em> &lt; 0.001). All bleeding events were small (type I or type II) and did not require further actions. At 7 days, there were only small hematomas at the puncture site in 7.1% of cases that used the wristband device. There was no difference in the patency rates of the radial artery (3.8% vs. 7.1%; <em>p</em> = 0.20).</p></div><div><h3>Conclusions</h3><p>The use of wristband devices for radial artery hemostasis did not result in higher rates of late arterial patency when compared to conventional compressive dressings.</p></div><div><h3>Introdução</h3><p>Dispositivos dedicados à compressão do sítio de punção radial adicionam custo ao procedimento e não foram adequadamente comparados aos curativos compressivos. Avaliamos a efetividade e a segurança de ambas as formas de hemostasia em pacientes submetidos à cinecoronariografia e/ou intervenção coronária percutânea na prática diária.</p></div><div><h3>Métodos</h3><p>Estudo prospectivo, multicêntrico e não randomizado, que incluiu pacientes consecutivamente submetidos a procedimentos por via radial. A modalidade de compressão ficou a critério do operador e da disponibilidade das pulseiras hemostáticas. O objetivo primário foi a comparação da patência da artéria radial no sétimo dia pós-procedimento, aferida por meio do Doppler. Secundariamente, avaliamos a ocorrência de hemorragia/hematoma no sítio de punção durante a compressão, após a retirada do dispositivo e no sétimo dia pós-procedimento.</p></div><div><h3>Resultados</h3><p>Foram avaliados 528 pacientes, 416 que usaram o curativo compressivo e 112 que usaram a pulseira hemostática. Na fase da retirada do introdutor e logo após sua remoção, notou-se uma incidência maior de","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 271-275"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"111215022","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":"Risk factors for vascular access-related complications in patients undergoing early invasive strategy","authors":"Pedro Beraldo de Andrade ,&nbsp;Fábio Salerno Rinaldi ,&nbsp;Igor Ribeiro de Castro Bienert ,&nbsp;Robson Alves Barbosa ,&nbsp;Marcos Henriques Bergonso ,&nbsp;Milena Paiva Brasil de Matos ,&nbsp;Caio Fraga Barreto de Matos Ferreira ,&nbsp;Ederlon Ferreira Nogueira ,&nbsp;André Labrunie ,&nbsp;Sérgio Kreimer ,&nbsp;Vinícius Cardozo Esteves ,&nbsp;Marden André Tebet ,&nbsp;Luiz Alberto Piva e Mattos ,&nbsp;Amanda G.M.R. Sousa","doi":"10.1016/j.rbciev.2017.02.006","DOIUrl":"10.1016/j.rbciev.2017.02.006","url":null,"abstract":"<div><h3>Background</h3><p>The knowledge of risk factors related to vascular access complications in patients undergoing early invasive strategy allows the adoption of methods to minimize them.</p></div><div><h3>Methods</h3><p>We performed a subanalysis of the ARISE study, aiming to identify predictors of vascular complications in patients randomized to the radial or femoral techniques with the use of vascular closure device (VCD).</p></div><div><h3>Results</h3><p>A total of 240 patients with a mean age of 63.0 ± 10.7 years were included, with 30.8% of diabetics. Except for a higher prevalence of women in the radial group, there were no clinical differences between the groups. Percutaneous coronary intervention was performed in 86.7% of the cases. The rate of vascular complications after 30 days was 13.3% in the radial group, due to hematoma &gt; 5<!--> <!-->cm (6.7%) and asymptomatic artery occlusion (5.8%), and 12.5% in femoral group, due to hematoma &gt; 5<!--> <!-->cm, without significant difference. The following were identified as risk factors for vascular access complications: body mass index (BMI), previous stroke, longer duration of the procedure, and VCD failure. At the stratified analysis, female gender and high or very high-risk CRUSADE score were predictors of complications only for the femoral group. In the multivariate model, the factors that remained significant were BMI and VCD failure.</p></div><div><h3>Conclusions</h3><p>The radial and femoral techniques, with the use of VCD, shared variables that were predictors of complications. Risk factors, such as female gender and high-risk CRUSADE score, were attenuated by the use of the radial technique.</p></div><div><h3>Introdução</h3><p>O conhecimento dos fatores de risco relacionados às complicações do acesso vascular em pacientes submetidos à estratégia invasiva precoce permite adotar estratégias capazes de minimizá-las.</p></div><div><h3>Métodos</h3><p>Realizamos subanálise do estudo ARISE, com o objetivo de identificar preditores de complicações vasculares em pacientes randomizados para as técnicas radial ou femoral com emprego de dispositivo de oclusão vascular (DOV).</p></div><div><h3>Resultados</h3><p>Foram incluídos 240 pacientes, com média de idade de 63,0 ± 10,7 anos, sendo 30,8% diabéticos e, exceto pela maior prevalência de mulheres no grupo radial, não foram observadas diferenças clínicas entre os grupos. Intervenção coronária percutânea foi realizada em 86,7% dos casos. A taxa de complicações vasculares aos 30 dias foi de 13,3% no grupo radial, à custa de hematomas &gt; 5<!--> <!-->cm (6,7%) e oclusão arterial assintomática (5,8%), e de 12,5% no grupo femoral, à custa de hematomas &gt; 5<!--> <!-->cm, sem diferença significativa. Foram identificados como fatores de risco para complicações do acesso vascular o índice de massa corporal (IMC), o acidente vascular encefálico prévio, a maior duração do procedimento e o insucesso do DOV. Pela análise estratificada, o sexo fem","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 242-246"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"98027939","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":"Extensive spontaneous coronary dissection with favorable evolution maintained under conservative treatment","authors":"Marcos Danillo Peixoto Oliveira,&nbsp;Breno Alencar Falcão,&nbsp;José Mariani Jr.,&nbsp;Carlos M. Campos,&nbsp;Expedito E. Ribeiro,&nbsp;Pedro Alves Lemos","doi":"10.1016/j.rbciev.2017.02.010","DOIUrl":"10.1016/j.rbciev.2017.02.010","url":null,"abstract":"<div><p>Spontaneous coronary dissection is a rare entity and, therefore, its etiology, pathophysiology, and treatment are not yet established. It affects mainly young women without the classic cardiovascular risk factors, commonly during the pregnancy-childbirth cycle. Several factors influence the treatment strategy, such as clinical presentation, hemodynamic status, topography, number of affected arteries, and distal coronary flow. As in the reported case, in stable patients with well-defined dissections and mainly when the coronary flow has been re-established, one can choose a conservative approach, due to the high incidence of spontaneous resolution and low incidence of long-term adverse events.</p></div><div><p>A dissecção coronária espontânea é uma entidade rara e, por conseguinte, de etiologia, fisiopatologia e tratamento ainda não estabelecidos. Acomete, em geral, mulheres jovens, sem os clássicos fatores de risco cardiovascular, comumente ao longo do ciclo gravídico-puerperal. Vários fatores influenciam na estratégia de tratamento, como quadro clínico, status hemodinâmico, topografia da dissecção, número de artérias afetadas e fluxo coronário distal. Como no caso relatado, em pacientes estáveis, com dissecções bem delimitadas e, sobremodo, quando o fluxo coronário é reestabelecido, pode-se optar por uma abordagem conservadora, em razão da alta incidência de resolução espontânea e da baixa incidência de eventos adversos a longo prazo.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 279-281"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"104397414","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":"Identifying patients at risk of vascular access complications","authors":"Pablo Lamelas,&nbsp;Sanjit Jolly","doi":"10.1016/j.rbciev.2017.02.004","DOIUrl":"https://doi.org/10.1016/j.rbciev.2017.02.004","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 236-237"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72204880","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":"Primary coronary angioplasty in patients over 80 years of age","authors":"Alan Castro D’Avila ,&nbsp;Renato Roese Filho ,&nbsp;Marcia Moura Schmidt ,&nbsp;Karina Melleu ,&nbsp;Cristiano de Oliveira Cardoso ,&nbsp;Carlos Antonio Mascia Gottschall ,&nbsp;Alexandre Schann de Quadros ,&nbsp;Alexandre Damiani Azmus","doi":"10.1016/j.rbciev.2017.02.012","DOIUrl":"10.1016/j.rbciev.2017.02.012","url":null,"abstract":"<div><h3>Background</h3><p>The number of elderly patients submitted to primary percutaneous coronary intervention (PCI) is increasingly prevalent. Historically, this population has a worse prognosis when compared to the younger ones. This study aimed to compare the characteristics and 30-day clinical outcomes of patients aged ≥ 80 years to those &lt; 80 years submitted to primary PCI.</p></div><div><h3>Methods</h3><p>Observational, prospective cohort study, extracted from the database of Instituto de Cardiologia do Rio Grande do Sul, between 2009 and 2013.</p></div><div><h3>Results</h3><p>A total of 1,970 patients were included, of whom 122 (6.2%) were aged ≥ 80 years. The elderly showed a predominance of the female gender (50% vs. 29%; <em>p</em> &lt; 0.001), diabetes (34.4% vs. 23.2%; <em>p</em> = 0.004), Killip class 3 or 4 (13.1% vs. 7.4%; <em>p</em> &lt; 0.02), and longer door-to-balloon time (1.4 hour [1.0-1.9 hour] vs. 1.1 hour [0.8-1.5 hour]; <em>p</em> &lt; 0.001). The TIMI 3 post flow did not show any difference between the groups (86% vs. 90.7%; <em>p</em> = 0.08), but the Blush 3 post was lower (59.3% vs. 70.9%; <em>p</em> = 0.01) in the elderly. Angiographic success was obtained in 92.0% vs. 95.6%; <em>p</em> = 0.07. Temporary pacemakers, severe arrhythmias, and aborted sudden death were more frequently observed in patients aged ≥ 80 years. The rates of major adverse cardiovascular events and death at 30 days were higher in the older group (32.2% vs. 11.5% and 29.7% vs. 7.2%; <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>In this contemporary analysis, patients aged ≥ 80 years undergoing primary PCI had a more severe clinical and angiographic profile, longer door-to-balloon time, lower final Blush 3, with higher rates of hospital complications and 30-day mortality when compared with younger patients.</p></div><div><h3>Introdução</h3><p>É cada vez mais prevalente o número de idosos submetidos à intervenção coronariana percutânea primária (ICPp). Historicamente, essa população apresenta pior prognóstico quando comparada aos mais jovens. Nosso objetivo foi comparar as características e os desfechos clínicos em 30 dias de pacientes ≥ 80 anos aos &lt; 80 anos submetidos à ICPp.</p></div><div><h3>Métodos</h3><p>Estudo de coorte observacional, prospectivo, extraído do banco de dados do Instituto de Cardiologia do Rio Grande do Sul, entre 2009 e 2013.</p></div><div><h3>Resultados</h3><p>Foram incluídos 1.970 pacientes, sendo 122 (6,2%) com idade ≥ 80 anos. Os mais idosos mostraram predomínio do sexo feminino (50% vs. 29%; <em>p</em> &lt; 0,001), diabetes (34,4% vs. 23,2%; <em>p</em> = 0,004), classe Killip 3 ou 4 (13,1% vs. 7,4%; <em>p</em> = 0,02) e tempo porta-balão superior (1,4 hora [1,0-1,9 hora] vs. 1,1 hora [0,8-1,5 hora]; <em>p</em> &lt; 0,001). O fluxo TIMI 3 pós não mostrou diferença entre os grupos (86% vs. 90,7%; <em>p</em> = 0,08), mas o Blush 3 pós foi menor (59,3% vs. 70,9%; <em>p</em> = 0,01) nos idosos. O suces","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 261-265"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113587206","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":"The repositionable LotusTM valve system","authors":"Seyrani Yücel ,&nbsp;Ulrich Gerckens","doi":"10.1016/j.rbciev.2017.02.003","DOIUrl":"https://doi.org/10.1016/j.rbciev.2017.02.003","url":null,"abstract":"","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 234-235"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72204879","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":"Multivessel rotational atherectomy in left main coronary artery lesion followed by stent implantation","authors":"Isabela Pilar Moraes Alves de Souza,&nbsp;Bruno Macedo Aguiar,&nbsp;Joberto Pinheiro Sena,&nbsp;Paulo José Bastos Barbosa,&nbsp;José Carlos Raimundo Brito","doi":"10.1016/j.rbciev.2017.02.008","DOIUrl":"10.1016/j.rbciev.2017.02.008","url":null,"abstract":"<div><p>A 82-year-old patient with multiple comorbidities and angina, in spite of optimal drug therapy, was submitted to coronary angiography, which showed three-vessel disease with left main coronary artery involvement and severe coronary artery calcification. Coronary artery bypass grafting surgery was contraindicated and the patient was referred for percutaneous coronary intervention, which was carried out in two stages, with a 15-month interval between them. Firstly, the left coronary artery was treated and rotational atherectomy was performed in the left main coronary artery, left anterior descending and left circumflex arteries, with successful implantation of five drug-eluting stents. Subsequently, the right coronary artery was treated with rotational atherectomy, and four drug-eluting stents were also successfully implanted.</p></div><div><p>Paciente com 82 anos, portadora de múltiplas comorbidades, com angina do peito apesar de terapia medicamentosa otimizada. Submetida à coronariografia, que evidenciou doença triarterial com envolvimento do tronco da coronária esquerda e intensa calcificação das artérias coronárias. A cirurgia de revascularização miocárdica foi contraindicada, sendo encaminhada para intervenção coronária percutânea, realizada em dois tempos, com intervalo de 15 meses. Primeiramente, a coronária esquerda foi abordada, realizando-se aterectomia rotacional no tronco da coronária esquerda, artérias descendente anterior e circunflexa, com implante de cinco stents farmacológicos com sucesso. Posteriormente, a coronária direita foi tratada com aterectomia rotacional e implante de quatro stents farmacológicos, também com sucesso.</p></div>","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 276-278"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"94571027","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":"Independent predictors of multivessel coronary artery disease: results from Angiocardio Registry","authors":"Marcelo José de Carvalho Cantarelli ,&nbsp;Hélio José Castello Jr. ,&nbsp;Rosaly Gonçalves ,&nbsp;Silvio Gioppato ,&nbsp;João Batista de Freitas Guimarães ,&nbsp;Evandro Karlo Pracchia Ribeiro ,&nbsp;Julio Cesar Francisco Vardi ,&nbsp;Danilo Maksud ,&nbsp;Ednelson Cunha Navarro","doi":"10.1016/j.rbciev.2017.02.013","DOIUrl":"10.1016/j.rbciev.2017.02.013","url":null,"abstract":"<div><h3>Background</h3><p>The Angiocardio Registry, which comprises data from five different centers in the state of São Paulo, offers the opportunity to study the association between cardiovascular risk factors and coronary artery disease (CAD) extent, as assessed by coronary angiography. This study aimed to evaluate independent predictors of multivessel CAD in Brazil.</p></div><div><h3>Methods</h3><p>From August 2006 to January 2014, 16,320 patients with CAD were included and divided into the single- and multivessel groups.</p></div><div><h3>Results</h3><p>Patients with multivessel disease (n = 9,512, 58.3%) were on average 3 years older, with a higher prevalence of males (69.4% vs. 65.4%; <em>p</em> &lt; 0.01), arterial hypertension (80.0% vs. 73.5%; <em>p</em> &lt; 0.01), diabetes (40.7% vs. 28.8%; <em>p</em> &lt; 0.01), dyslipidemia (39.6% vs. 34.9%; <em>p</em> &lt; 0.01), family history of CAD (23.0% vs. 21.3%; <em>p</em> &lt; 0.01), chronic renal failure (4.1% vs. 2.6%; <em>p</em> &lt; 0.01), previous stroke (3.8% vs. 2.8%; <em>p</em> &lt; 0.01), peripheral vascular disease (4.0% vs. 3.3%; <em>p</em> = 0.02) and previous myocardial infarction (18.4% vs. 13.9%; <em>p</em> &lt; 0.01), as well as a lower prevalence of smoking (20.0% vs. 24.5%; <em>p</em> &lt; 0.01). At the multivariate analysis, the following were independent predictors of multivessel lesion: age &gt; 40 years (odds ratio - OR = 1.996; 95% CI: 1.52-2.63; <em>p</em> &lt; 0.01), male gender (OR = 1.202; 95% CI: 1.12-1.28; <em>p</em> &lt; 0.01), arterial hypertension (OR = 1.439; 95% CI: 1.34-1.55; <em>p</em> &lt; 0.01), diabetes (OR =1.697; 95% CI: 1.59-1.81; <em>p</em> &lt; 0.01), dyslipidemia (OR = 1.223; 95% CI: 1.15-1.30; <em>p</em> &lt; 0.01), previous acute myocardial infarction (OR = 1.393; 95% CI: 1.28-1.52; <em>p</em> &lt; 0.01), and chronic renal failure (OR = 1.597; 95% CI: 1.33-1.91; <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Multivessel CAD in Brazil is associated with traditional risk factors for atherosclerosis, except for smoking. Age, diabetes, and chronic renal failure were the strongest predictors for multivessel CAD assessed by coronary angiography.</p></div><div><h3>Introdução</h3><p>O Registro Angiocardio, que agrega dados de cinco diferentes centros do Estado de São Paulo, oferece a oportunidade de estudar a associação de fatores de risco cardiovasculares com a extensão da doença arterial coronária (DAC), avaliada pela cinecoronariografia. Este estudo buscou analisar preditores independentes de DAC multiarterial em nosso meio.</p></div><div><h3>Métodos</h3><p>De agosto de 2006 a janeiro de 2014, 16.320 pacientes com DAC foram incluídos e divididos nos grupos uni e multiarterial.</p></div><div><h3>Resultados</h3><p>Pacientes multiarteriais (n = 9.512, 58,3%) apresentaram-se, em média, 3 anos mais idosos, com maior prevalência do sexo masculino (69,4% vs. 65,4%; <em>p</em> &lt; 0,01), hipertensão arterial (80,0% vs. 73,5%; <em>p</em> &lt; ","PeriodicalId":101094,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva (English Edition)","volume":"23 4","pages":"Pages 266-270"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbciev.2017.02.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"106496022","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}