No abstract available.
Percutaneous Coronary Intervention

No abstract available.
Korea ; Percutaneous Coronary Intervention

No abstract available.
Percutaneous Coronary Intervention

No abstract available.
Percutaneous Coronary Intervention

Introduction: Though the role of inflammation is reputedly associated with contrast induced nephropathy (CIN), especially in the setting of Acute Coronary Syndrome (ACS), current risk scoring systems do not address inflammatory factors. Neutrophil lymphocyte ratio (NLR), a proportion of two inflammatory markers, is reflective of the balance between innate and adaptive immune responses, and therefore has a strong predictive value. Methods: A cross-sectional analytical study done among adult Filipinos diagnosed with ACS who underwent Percutaneous Coronary Intervention (PCI) from January to December 2018 at Makati Medical Center. Exposure of interest includes baseline NLR count and pre-procedural serum creatinine. Outcome was the incidence of CIN based on serum creatinine 24-48 hours post-procedure. Results and Analysis: A total of 166 ACS patients were analyzed, of which 11 (6.62%) has CIN. Patients with pre-procedural NLR > 4.71 were approximately five times as likely to develop CIN (aOR 1.51 to 17.55, p = 0.009), with sensitivity 63.64%, specificity 80.65%, accuracy 79.52%, Youden’s index 44.29%. On multivariate analysis, NLR and STEMI were associated with increased odds for CIN. STEMI patients had approximately four times the odds of developing CIN (aOR 3.893, 95% CI 1.07 to 14.13, p = 0.039). Conclusion NLR > 4.71 in Filipinos with ACS who underwent PCI is associated with increased risk to develop CIN.
Percutaneous Coronary Intervention

INTRODUCTION

Since earlier days of percutaneous coronary intervention (PCI), there has been improvement in several aspects of PCI including use of transradial approach and third generation drug-eluting stents. Despite data showing its safety, same-day discharge (SDD) PCI has not been widely practiced in our institution and country. At present, there are no published studies from the Philippines showing the safety and outcome of SDD PCI.

The primary objective of this study is to determine and compare the safety and outcomes of SDD versus overnight observation ater PCI in The Medical City from 2018 to 2021.

This was a retrospective cohort study. The primary endpoint was to describe and compare the clinical profile of patients who underwent same-day versus overnight observation after PCI such as age, sex, comorbidities, indication for coronary angiogram, procedure time, total dye used, stent, and drug-eluting stent used. Incidence of major adverse cardiovascular event, mortality, readmission, and access site complications were also determined at 48 hours and 30 days after PCI.

Ninety-three patients were included in the analysis. Reasons for undergoing PCI were a positive noninvasive stress test (45%), stable angina (40%), coronary artery disease (26%), and heart failure (20%). More single-vessel (60%) than multivessel (40%) PCIs were performed. The most frequently affected coronary artery was the LAD (82%), followed by right coronary artery (32%) and left circumflex artery (30%). Compared with patients who stayed longer after PCI, the SDD group had lower mean (±SD) body mass index (25.10 ± 3.12 vs 28.55 ± 4.95 kg/m2), less due to a positive noninvasive test (26% vs 51%), more who underwent a single-vessel PCI (78% vs 54%), lower median amount of injected dye (130 vs 188 mL), shorter median procedural time (74 vs 101.5 minutes), and greater use of sirolimus-eluting stent (22% vs 3%). No adverse outcome of interest was noted in any patient up to 30 days after hospital discharge.

No adverse outcome was noted with SDD PCI. Larger, prospective, randomized comparative studies are needed to ascertain its safety before recommending SDD PCI routinely.

Entrapment of an intravascular ultrasound (IVUS) catheter during coronary intervention is rare, but can cause serious complications. Retrieval of an entrapped catheter can also lead to adverse results for implanted stents. We report a case in which the sheath tip at the guidewire exit port was entrapped and caused stent distortion during a post-stent IVUS procedure with automatic pullback.
Catheters ; Percutaneous Coronary Intervention ; Stents

Guide wire fracture during percutaneous coronary intervention (PCI) is rare. It can cause fatal complications such as thrombus formation, embolization, and perforation. Guide wire fracture could occur during intervention for severely calcified stenotic lesions, and rarely from distal small branches of stenotic lesions. There are several methods for its management depending on the material character, position, length of the remnant, and the patient's condition. If percutaneous retrieval was not achieved, the surgical procedure should be considered for prevention of potential risks, although the remnant guide wire does not usually cause complications. We experienced a patient with a guide wire fracture during PCI, and managed to prevent its complications through surgical removal of the remnant wire. We report this case here.
Humans ; Percutaneous Coronary Intervention* ; Thrombosis

The primary concern in percutaneous coronary intervention for bifurcation lesions is occlusion of a side branch after stenting of a main branch, especially in high-risk patients. We describe a novel technique, consecutive jailed- and kissing-Corsair technique, using a Corsair microcatheter for protection of side branches in bifurcation lesions.
Humans ; Percutaneous Coronary Intervention ; Stents

BACKGROUND AND OBJECTIVES: An anatomic variant of left anterior descending coronary artery (LAD), termed "dual LAD", consists of early bifurcation of the proximal LAD into one early terminating branch (short LAD) which remains in the anterior interventricular sulcus (AIVS) and doesn't reach the apex, and the second (long LAD), which has a variable course outside the AIVS but returns to the distal sulcus and continues to the apex. Its incidence, angiographic features and clinical significance are investigated. MATERIALS AND METHOD: Consecutive 696 coronary angiograms during October 1997 through August 1998 were analyzed. RESULTS: A dual LAD variant was noted in 45 patients (6%) of the 696 patients. Type I, in which the long LAD descends on the left ventricular side of the AIVS before reentering the AIVS, was noted in 24 patients (53%) and type II, in which the long LAD descends on the right ventricular side of the AIVS before reentering the AIVS, in 21(47%). First septal branch was commonly originated from LAD proper in both type (54% vs 52%), but first diagonal branch from LAD proper (63%) in type I, from short LAD (71%) in type II. Presence of dual LAD was recognized before percutaneous coronary intervention (10) or bypass surgery (2) in 12 (63%) of 19 patients. Regional wall motion abnormalities (RWMA) were localized in distal septum or anterolateral wall in 2 patients with short or long LAD obstruction, respectively. CONCLUSION: Recognition of dual LAD is essential to prevent errors of interpretation of the coronary angiogram, to plan optimal strategy for percutaneous coronary intervention or bypass surgery, especially in case of total occlusion, and to understand localized septal or anterolateral RWMA.
Coronary Vessels* ; Humans ; Incidence* ; Percutaneous Coronary Intervention