Abrupt Pressure Delivery: A Novel Technique to Retrieve a Ruptured Entrapped Stent Balloon.

A 71-year-old man with acute coronary syndrome was found to have multiple severe calcified stenoses in the dominant left circumflex coronary artery. After lesion preparation, the distal lesion was stented. A stent was advanced in the proximal lesion and inflated, but during the deployment inflation, the stent balloon ruptured after expansion of the proximal portion of the stent.

Therapeutic Potential and Mechanisms of Mesenchymal Stem Cells in Coronary Artery Disease: Narrative Review.

Coronary artery disease (CAD) remains a leading cause of global morbidity and mortality despite advances in medical and interventional therapies. Mesenchymal stem cell (MSC) therapy has emerged as a promising regenerative approach for patients with refractory or non-revascularizable CAD. MSCs exhibit unique immunomodulatory, pro-angiogenic, and anti-fibrotic properties, primarily through paracrine mechanisms involving the secretion of cytokines, growth factors, and exosomal microRNAs.

Effect of Ischemia Testing and Coronary Revascularization on Mortality and Ventricular Tachycardia Recurrence in Patients With Monomorphic Ventricular Tachycardia Without Acute Coronary Syndrome: A Meta-Analysis and Systematic Review.

Background: Studies show mixed results regarding the effect of coronary revascularization on mortality benefit and ventricular tachycardia (VT) recurrence in patients with monomorphic VT without acute coronary syndrome (ACS). This meta-analysis aimed to assess the effect of ischemia testing and/or coronary revascularization on mortality and VT recurrence in a pooled data set.

Methods: Databases including PubMed, Google Scholar, and the Cochrane Library were searched from January 2000 to December 2023 for studies reporting event data on mortality and VT recurrence in patients without ACS who presented with monomorphic VT.

Traditional Versus Distal Radial Access for Coronary Diagnostic and Revascularization Procedures: Final Results of the TENDERA Multicenter, Randomized Controlled Study.

Background: Traditional transradial access (TRA) is widely used for coronary and non-coronary interventions with significant improvements in procedural outcomes; however, it is associated with RAO that precludes repeat use of the same artery for possible future TRI and other purposes. Distal radial access (DRA) has been proposed as an effective alternative to decrease RAO rates. Published literature describing the RAO rate after DRA versus TRA from various RCT and clinical registries has shown conflicting results.

Procedural Outcomes With Femoral, Radial, Distal Radial, and Ulnar Access for Coronary Angiography: A Network Meta-Analysis.

Background: Radial artery access for coronary angiography or percutaneous coronary intervention (PCI) reduces the risk of death, bleeding, and vascular complications and is preferred over femoral artery access, leading to a class 1 indication by clinical practice guidelines. However, alternate upper extremity access such as distal radial and ulnar access are not mentioned in the guidelines despite randomized trials. We aimed to evaluate procedural outcomes with femoral, radial, distal radial, and ulnar access sites in patients undergoing coronary angiography or PCI.

Optimal Hemostatic Band Duration After Transradial Angiography or Intervention: Insights From a Mixed Treatment Comparison Meta-Analysis of Randomized Trials.

Background: The optimal duration of hemostatic compression post transradial access is controversial. Longer duration increases the risk of radial artery occlusion (RAO) while shorter duration increases the risk of access site bleeding or hematoma. As such, a target of 2 hours is typically used.

Comparison of radiation exposure associated with transradial and transfemoral access: An updated meta-analysis.

Objectives: To assess differences in radiation exposure between transradial access (TRA) and transfemoral access (TFA) for coronary procedures.

Background: TRA is associated with increased radiation exposure as compared to TFA. We compared radiation exposure between the two access sites.

Distal vs Conventional Radial Access for Coronary Angiography and/or Intervention: A Meta-Analysis of Randomized Trials.

Background: Emerging evidence from randomized clinical trials (RCTs) comparing distal radial access (DRA) with conventional radial access (RA) is available.

Objectives: The aim of this study was to provide a quantitative appraisal of the effects of DRA) vs conventional RA for coronary angiography with or without intervention.

Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.

Learning Curve of Robotic Percutaneous Coronary Intervention: A Single-Center Experience.

Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to provide benefits to operators and patients when compared with traditional percutaneous coronary intervention. Despite being available for 16 years in the United States, utilization of R-PCI remains low. This may be because of an expected learning curve with this technology.

Preserving Radial Patency: Multiple Prior Radial Procedures and Now Large-Bore Access.

6 French percutaneous coronary intervention (PCI), has become widely adopted. We describe a case of successful 8 French transradial access (TRA) coronary intervention using state of the art hemostasis technique with preservation of radial patency after the procedure.

Racial and ethnic characteristics and cancer-specific survival in Primary Malignant Cardiac Tumors.

Background: There is limited insight into the epidemiological characteristics and effect of race and ethnicity on Primary Malignant Cardiac Tumors (PMCTs).

Objectives: Comparison of clinical characteristics and cancer-specific survival outcomes of major races in the United States from the Surveillance, Epidemiology and End-Result (SEER) registry.

Methods: ICD-O-3 codes were used to identify PMCTs for the years 1975 to 2015.

Safety and Efficacy of Robotic-Assisted PCI.

Purpose Of Review: Robotics has been used in multiple areas of procedural medical intervention. Robotic percutaneous coronary intervention (PCI) has been available since 2004. Its adoption has been slow with initial application in simple cases.

Thrombus aspiration without stenting in a patient with anterior STEMI: Regression and healing of an unstable plaque assessed by OCT at 24 months of follow-up.

In selected cases, when STEMI caused by mild or moderate degree lesion with a large concomitant thrombus, additional OCT-guided PCI strategy after thrombus removal allows us to defer stenting with the follow-up natural healing of the vessel wall.

Transradial Access for High-Risk Percutaneous Coronary Intervention: Implications of the Risk-Treatment Paradox.

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Simultaneous Measurement of Left Ventricular and Aortic Pressures Using a Dual-Catheter System With Single Arterial Access.

Although echocardiography remains the key tool for evaluation of aortic valve stenosis severity, in a fair minority of patients invasive evaluation is still needed. Dual-lumen catheters allow for simultaneous trans-aortic pressure measurements with single arterial access. We describe a technique where traditional hardware using non-dedicated catheters can be used to obtain simultaneous pressure measurements using a 6 French single arterial access.

Association between insurance status and in-hospital outcomes in patients with out-of-hospital ventricular fibrillation arrest.

Background: Lack of health insurance is associated with adverse clinical outcomes; however, the association between health insurance status and in-hospital outcomes after out-of-hospital ventricular fibrillation (OHVFA) arrest is unclear.

Hypothesis: Lack of health insurance is associated with worse in-hospital outcomes after out-of-hospital ventricular fibrillation arrest.

Methods: From January 2003 to December 2014, hospitalizations with a primary diagnosis of OHVFA in patients ≥18 years of age were extracted from the Nationwide Inpatient Sample.

Trends, Outcomes, and Predictive Score For Emergency Coronary Artery Bypass Graft Surgery After Elective Percutaneous Coronary Intervention (from a Nationwide Dataset).

The temporal trends and preprocedural predictors of emergency coronary artery bypass graft surgery (ECABG) after elective percutaneous coronary intervention (PCI) in the contemporary era are largely unknown. From January 2003 to December 2014 elective hospitalizations with PCI as the primary procedure were extracted from the Nationwide Inpatient Sample. ECABG was identified as CABG within 24 hours of elective PCI.

Association between distance from the radiation source and radiation exposure: A phantom-based study.

Objectives: The study evaluated the association between distance from radiation source and radiation exposure.

Background: Radiation exposure during medical procedures is associated with increased risk of cancer and other adverse effects.

Methods: An American National Standards Institute phantom was used to study the relationship between measured entrance surface exposure (MESE) and distance from the X-ray source in postero-anterior, left anterior oblique, and right anterior oblique projections.

Comparison of Diagnostic Accuracy of Digital Plethysmography Versus Duplex Ultrasound in Detecting Radial Artery Occlusion After Transradial Access.

Background: Duplex Doppler ultrasonography (USG) remains the gold standard for evaluation of radial artery occlusion (RAO) after transradial access (TRA). The diagnostic accuracy of digital plethysmography, which is cheaper and widely available, for evaluation of RAO after TRA is not known.

Methods: Patients undergoing TRA were prospectively studied.

Comparison of Robotic Percutaneous Coronary Intervention With Traditional Percutaneous Coronary Intervention: A Propensity Score-Matched Analysis of a Large Cohort.

Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame.

Methods: A total of 996 consecutive patients referred for PCI between December 2017 and March 2019 were studied, of which 310 (31.

SCAI expert consensus statement update on best practices for transradial angiography and intervention.

Transradial angiography and intervention continues to become increasingly common as an access site for coronary procedures. Since the first "Best Practices" paper in 2013, ongoing trials have shed further light onto the safest and most efficient methods to perform these procedures. Specifically, this document comments on the use of ultrasound to facilitate radial access, the role of ulnar artery access, the utility of non-invasive testing of collateral flow, strategies to prevent radial artery occlusion, radial access for primary PCI and topics that require further study.