1) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Read more 2) Multivessel Disease and Severe Carotid Stenosis: How to Proceed Myocardial revascularization surgery (CABG) is…
PRESERVE: IV Bicarbonate and Oral N-Acetylcysteine Do Not Prevent Contrast-Associated Acute Kidney Injury
Use of IV bicarbonate instead of saline and administration of oral N-acetylcysteine are not effective strategies for preventing contrast-associated acute kidney injury in patients with chronic kidney disease undergoing angiography, according to the randomized PRESERVE trial that was presented at the AHA 2017 Scientific Sessions and published simultaneously in the New England Journal of Medicine…
Study Confirms Lead Shields Protect Cath Lab Staff from Radiation Exposure
The recent publication of several reports on risk of cataract, left sided brain tumors, subclinical atherosclerosis and chromosome damage among interventional cardiologists has raised increasing concerns about radiation exposure in the cath lab. Recognizing these risks has created a demand of these new forms of protection. Unfortunately, these have mainly been focused on the main operator,…
Important Study Detects Radiation-Induced DNA Damage in Operators After an Endovascular Procedure
In recent years, we have seen (both as witnesses and actors) an exponential increase in the number of fluoroscopically-guided cardiovascular interventions carried out by interventional cardiologists, electrophysiologists, and vascular surgeons. Not long ago, most pathologies treated with these procedures were the exclusive domain of open surgery. Now, a large number of patients can be treated…
Effects of Cerebral Radiation on Interventional Cardiologists
In recent years, there has been a growing concern about the occupational hazard for interventional cardiologists who have high and unprecedented levels of ionizing radiation exposure. microRNAs are a class of short and highly conserved non-coding RNA molecules (about 22 nucleotides) that become altered (dysregulated) in many diseases. Read also: “Nearly half of interventional cardiologists may…
Nearly half of interventional cardiologists may have pre-cataract lesions
This statement is based on eye exams conducted during the last SCAI meeting (Society for Cardiovascular Angiography and Interventions), where 47% of evaluated operators had radiation related lesions in their crystalline. In time, these might turn into cataract. Studies on astronauts and Chernobyl survivors have shown a clear association between ionizing radiation and crystalline damage,…
Is it safe to perform percutaneous treatment in acute pulmonary thrombosis?
Courtesy of Dr. Carlos Fava Massive and submassive pulmonary embolism (PE) has traditionally been treated with anticoagulation and catheter direct thrombolysis (CDT), but the safety and efficacy of this treatment has not been yet properly assessed. The study analyzed 137 patients presenting acute PE massive or submassive. All patients received CTD associated to heparin…
Hemodynamic, Functional and Clinical Response to Pulmonary Artery Denervation in Patients with Pulmonary Hypertension
Original Title: Hemodynamic. Functional and Clinical Responses to Pulmonary Artery Denervation with Pulmonary Artery Hypertension of Different Causes. Phase II Results from the Pulmonary Artery Denervation 1 study. Reference: Circ Cardiovasc Interv. 2015;8 Courtesy of Dr. Guillermo Migliaro. Hospital Alemán, Buenos Aires, Argentina. The mechanisms responsible for pulmonary artery hypertension (PAH) are multifactorial. PAH reduces…
Positive result of intraarterial thrombolysis in acute ischemic stroke
Original title: A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. MR CLEAN Investigators. Reference: O.A. Berkhemer et al. N Engl J Med 2015;372:11-20. In patients undergoing acute ischemic stroke caused by a proximal intracranial artery occlusion, intraarterial endovascular treatment is effective; however, there is no evidence of clinical or functional benefits. This study randomized patients undergoing…
The RELID study about radiation related cataracts was the ´Editor Award´ winner of JVIR as the Outstanding Clinical Research Paper for 2013
The development of interventional cardiology has led us to successfully treat injuries and angiographic situations increasingly complex. This goes along that often the length of procedures is increasing automatically leading to increased fluoroscopy time and film images. The result, often unnoticed, is the possibility of the appearance of irradiation injuries in our patients or in…
High doses of radiation also in peripheral procedures
Original title: Patient radiation exposure during percutaneous endovascular revascularization of the lower extremity. Reference: Einat Segal et al. Journal of Vascular Surgery. Article in press. Percutaneous endovascular revascularization is emerging as the first line treatment for peripheral artery disease for both intermittent claudication and chronic critical limb ischemia. Radiation doses for these interventions, usually prolonged, have not been…