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Coronary Artherectomy and Treatment of Calcified Coronaries 冠状动脉切除术和钙化冠状动脉的治疗
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000010
R. Mody
{"title":"Coronary Artherectomy and Treatment of Calcified Coronaries","authors":"R. Mody","doi":"10.37179/rijccm.000010","DOIUrl":"https://doi.org/10.37179/rijccm.000010","url":null,"abstract":"Since the introduction of fi rst balloon angioplasty, the fi eld of interventional cardiology has come a long way and witnessed the development of numerous tools and techniques. However, percutaneous coronary intervention (PCI) of heavily calcifi ed coronary artery lesions has always remained as a challenging scenario as appropriate dilation of these lesions is diffi cult which may lead to inadequate stent deployment and ultimately reduce overall procedural success, increase angiographic complications and subsequent adverse cardiovascular events. Recently, plaque modifi cation using dedicated cutting and scoring balloons and with various atherectomy devices has become progressively more important in the management of severely calcifi ed coronary lesions. It alters the morphology of the lesion and improves the feasibility of PCI in severely calcifi ed coronary lesions with an extremely high success rate and a favorable safety profi le. All available atherectomy devices are characterized with diverse design, diff erent mechanism of plaque modifi cation, and indications. In this review, we will discuss various plaque modifi cation strategies, with a particular focus on current atherectomy devices as they are commonly used for severely calcifi ed coronary lesions.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129985428","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}
引用次数: 0
Provisional Stenting for Left Main Bifurcation Disease under IVUS guidance: A Case Series IVUS指导下左主干分叉疾病的临时支架置入术:一个病例系列
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000009
R. Mody
{"title":"Provisional Stenting for Left Main Bifurcation Disease under IVUS guidance: A Case Series","authors":"R. Mody","doi":"10.37179/rijccm.000009","DOIUrl":"https://doi.org/10.37179/rijccm.000009","url":null,"abstract":"Around 15-20% of coronary lesions include bifurcation, and among which left main (LM) bifurcation lesions are critical and complex to manage. Though the two-stent strategy is the preferred option for complex LM bifurcation lesions, the provisional strategy should be considered if the side branch is disease-free to avoid peri- and post-procedural complications. Thus, precise anatomical and physiological assessment of LM lesion should be made using intravascular imaging techniques for appropriate decision making. Here, we report three cases of successfully managed LM bifurcation lesions using the provisional stenting technique with the guidance of intravascular ultrasound, fractional flow reserve, and heart team. All three patients were doing well and were ischemia-free on stress echocardiography at three months follow-up.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132402390","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}
引用次数: 0
Unraveling the mystique of left main stenting: A bugaboo of coronary intervention 揭开左主干支架置入术的神秘面纱:冠状动脉介入治疗的一大隐忧
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000013
R. Mody
{"title":"Unraveling the mystique of left main stenting: A bugaboo of coronary intervention","authors":"R. Mody","doi":"10.37179/rijccm.000013","DOIUrl":"https://doi.org/10.37179/rijccm.000013","url":null,"abstract":"For many years, CABG has been the gold standard treatment for unprotected Left Main (LM) coronary artery lesions. Because of its high artery size and anatomical accessibility, the LM lesion makes a good PCI candidate. Subset PCI has been broadened by the development of Drug-Eluting Stent (DES) as well as fast advances in procedures, devices, and adjunct pharmacotherapies. PCI and CABG had equivalent results in patients with low or moderate coronary complexity for up to fi ve years, according to current research. Most LM bifurcation lesions may be treated successfully with a single provisional stent rather than the more complex two-stent treatment. The unusual instance of a bifurcation lesion, which requires the use of not one, but two stents from the start, is an exception to the norm. Controlling this unusual species and improving treatment outcomes need an integrated strategy involving specialized procedures, additional physiological and morphologic assessment, and hemodynamic devices.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122261775","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}
引用次数: 0
Provisional stenting for left main bifurcation disease under IVUS guidance: Case series my Cath lab philosophy IVUS指导下左主干分叉疾病的临时支架置入术:病例系列我的Cath实验室理念
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000014
R. Mody
{"title":"Provisional stenting for left main bifurcation disease under IVUS guidance: Case series my Cath lab philosophy","authors":"R. Mody","doi":"10.37179/rijccm.000014","DOIUrl":"https://doi.org/10.37179/rijccm.000014","url":null,"abstract":"Instead of various developments in percutaneous coronary intervention (PCI), management of the bifurcation especially left main bifurcation (LM) is diffi cult and quite challenging. In maximum number of patients who present with the LM bifurcation lesion, the one-stent strategy is the most preferred therapeutic option. However, with the objective to reduce the risk of various peri-procedural complications such as side branch occlusion, physiological and anatomical assessment of the LM lesion should be done by using the intravascular imaging techniques during the procedure. Here, we present the three cases of LM bifurcation which were successfully treated by using the provisional stenting method. All three cases were treated with the guidance of the fractional fl ow reserve (FFR) and Intravascular Ultrasound (IVUS) and heart team considerations. Measurement of the fractional fl ow reserve was done to avoid the risk of unnecessary complex interventions. At the three months follow-up, all patients were identifi ed as ischemia free.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"4604 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115591067","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}
引用次数: 0
Conquering Retrograde Coronary Chronic Total Occlusion Intervention: Review of recent Developments 征服逆行性冠状动脉慢性完全闭塞干预:近期进展综述
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000012
R. Mody
{"title":"Conquering Retrograde Coronary Chronic Total Occlusion Intervention: Review of recent Developments","authors":"R. Mody","doi":"10.37179/rijccm.000012","DOIUrl":"https://doi.org/10.37179/rijccm.000012","url":null,"abstract":"Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Retrograde recanalization is one of the greatest amendments of this technique. At present, it has become an integral complement to the traditional antegrade approach. Despite being most frequently used in complex patients; it has the highest success rate with the lowest incidence of complications. Since its inception, significant iterations have occurred that made this technique safer, faster, and even more successful. In this article, we describe various tips and tricks which can help in increasing the success rate of retrograde CTO PCI. Various complications, their preventions, and treatments, if they occur, have been described.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133089715","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}
引用次数: 0
Tips and Tricks for PCI of Chronic Total Occlusions – A Review 慢性全闭塞PCI治疗的提示和技巧综述
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000011
R. Mody
{"title":"Tips and Tricks for PCI of Chronic Total Occlusions – A Review","authors":"R. Mody","doi":"10.37179/rijccm.000011","DOIUrl":"https://doi.org/10.37179/rijccm.000011","url":null,"abstract":"Chronic total occlusion recanalization still represents the final frontier in percutaneous coronary intervention. Retrograde recanalization is one of the greatest amendments of this technique. At present, it has become an integral complement to the traditional antegrade approach. Despite being most frequently used in complex patients, it has the highest success rate with the lowest incidence of complications. Since its inception, significant iterations have occurred that made this technique safer, faster, and even more successful.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130526223","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}
引用次数: 1
Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal 注射青霉素在尼泊尔风湿性心脏病二级预防中的使用不足
Research International Journal of Cardiology and Cardiovascular Medicine Pub Date : 1900-01-01 DOI: 10.37179/rijccm.000004
L. S.
{"title":"Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal","authors":"L. S.","doi":"10.37179/rijccm.000004","DOIUrl":"https://doi.org/10.37179/rijccm.000004","url":null,"abstract":"Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.","PeriodicalId":356752,"journal":{"name":"Research International Journal of Cardiology and Cardiovascular Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125690142","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}
引用次数: 0
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