Revista Brasileira de Cardiologia Invasiva最新文献

英文中文

Artéria coronária única com origem no seio de Valsalva direito 起源于右Valsalva窦的单冠状动脉

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2015-01-01 DOI: 10.1016/j.rbci.2014.11.001

Igor Ribeiro de Castro Bienert , Lucas Pocebon , Felipe Xavier , Vinícius Santos , Sarah Bortolucci , Fábio Salerno Rinaldi , Paulo André da Silva , Pedro Beraldo de Andrade

Anomalous origin of coronary arteries is a rare congenital disorder, with an estimated incidence of 0.3 to 1.3% of patients referred for coronary angiography. Currently, its discussion still divides opinions, particularly regarding the therapeutic approach. We report the case of a 75 year‐old woman who underwent cardiac catheterization, which showed the left main coronary artery with an anomalous origin next to the right coronary artery in the right coronary sinus and with a retroaortic course.

冠状动脉异常起源是一种罕见的先天性疾病，估计发病率为0.3至1.3%的患者转介冠状动脉造影。目前，关于它的讨论仍然存在分歧，特别是关于治疗方法。我们报告了一位75岁的妇女，她接受了心导管插入术，结果显示左冠状动脉主动脉在右冠状动脉窦内与右冠状动脉相邻，并伴有主动脉后走行。

引用次数: 0

Resposta vascular após implante de stents liberadores de biolimus A9 com polímero bioabsorvível e stents liberadores de everolimus com polímero durável. Resultados da análise de tomografia de coerência óptica do estudo randomizado BIOACTIVE 生物可吸收聚合物和耐用聚合物依维莫司释放支架植入后的血管反应。生物活性随机研究光学相干断层扫描分析结果

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2015-01-01 DOI: 10.1016/j.rbci.2015.02.001

Daniel Chamié , Breno O. Almeida , Fábio Grandi , Evandro M. Filho , J. Ribamar Costa Jr. , Ricardo Costa , Rodolfo Staico , Dimytri Siqueira , Fausto Feres , Luiz Fernando Tanajura , Marinella Centemero , Áurea J. Chaves , Andrea Abizaid , Amanda G.M.R. Sousa , Alexandre Abizaid

Background

In BIOACTIVE study, we evaluated vascular responses after the implant of biolimus A9‐eluting stent (BES; BioMatrix^TM) and the everolimus‐eluting stent (EES; XIENCE V^TM). In this study, we present the optical coherence tomography analysis (OCT) 6 months post‐intervention.

Methods

Patients were randomized to treatment with BES (n = 22) or EES (n = 18). The primary outcome was the frequency of non‐covered, poorly positioned struts by OCT.

Results

OCT was performed in 26 patients (BES: n = 15; EES: n = 11) and 749 tomographic images and 7,725 stent struts were analyzed. BES and EES showed similar luminal and stent areas. Neointimal hyperplasia area, neointimal thickness and the percentage of in‐stent obstruction (8.44 ± 5.10% vs. 9.21 ± 6.36%; p = 0.74) were similar. The rates of not covered struts (BES: 2.10 ± 3.60% vs. ESS: 2.46 ± 2.15%, p = 0.77) and poorly positioned struts (BES: 0.48 ± 1.48% vs. EES 0.44 ± 1.05%, p = 0.94) were similarly low. The frequency of frames with signs consistent with peri‐strut inflammatory infiltrate was low and similar between BES (15.53 ± 20.77%) and EES (11.70 ± 27.51%; p = 0.68).

Conclusions

The second‐generation drug‐eluting stents BES and EES were equally effective at suppressing the neointimal formation after 6 months, with favorable vascular responses. The frequency of frames with peri‐strut infiltrate signals per patient was low, and lower than that observed historically with first‐generation drug‐eluting stents.

在BIOACTIVE研究中，我们评估了生物泥A9洗脱支架(BES;BioMatrixTM)和依维莫司洗脱支架(EES;XIENCE VTM)。在这项研究中，我们展示了干预后6个月的光学相干断层扫描分析(OCT)。方法随机分为BES组(22例)和EES组(18例)。主要观察指标为oct检测未覆盖、定位不良支撑物的频率。结果26例患者(BES: n = 15;EES: n = 11)， 749张断层图像和7725支支架进行了分析。BES和EES显示相似的管腔和支架面积。内膜增生面积、内膜厚度和支架内梗阻百分比(8.44±5.10% vs. 9.21±6.36%;P = 0.74)相似。未覆盖支撑物的比例(BES: 2.10±3.60% vs. ESS: 2.46±2.15%，p = 0.77)和支撑物定位不良的比例(BES: 0.48±1.48% vs. EES: 0.44±1.05%，p = 0.94)也同样低。在BES(15.53±20.77%)和EES(11.70±27.51%)之间，伴有支架周围炎症浸润征象的帧的频率较低且相似;P = 0.68)。结论第二代药物洗脱支架BES和EES在6个月后抑制新生内膜形成的效果相同，血管反应良好。每位患者出现支架周围浸润信号的频率较低，低于第一代药物洗脱支架的历史观察值。

{"title":"Resposta vascular após implante de stents liberadores de biolimus A9 com polímero bioabsorvível e stents liberadores de everolimus com polímero durável. Resultados da análise de tomografia de coerência óptica do estudo randomizado BIOACTIVE","authors":"Daniel Chamié , Breno O. Almeida , Fábio Grandi , Evandro M. Filho , J. Ribamar Costa Jr. , Ricardo Costa , Rodolfo Staico , Dimytri Siqueira , Fausto Feres , Luiz Fernando Tanajura , Marinella Centemero , Áurea J. Chaves , Andrea Abizaid , Amanda G.M.R. Sousa , Alexandre Abizaid","doi":"10.1016/j.rbci.2015.02.001","DOIUrl":"10.1016/j.rbci.2015.02.001","url":null,"abstract":"<div><h3>Background</h3><p>In BIOACTIVE study, we evaluated vascular responses after the implant of biolimus A9‐eluting stent (BES; BioMatrix<sup>TM</sup>) and the everolimus‐eluting stent (EES; XIENCE V<sup>TM</sup>). In this study, we present the optical coherence tomography analysis (OCT) 6 months post‐intervention.</p></div><div><h3>Methods</h3><p>Patients were randomized to treatment with BES (n = 22) or EES (n = 18). The primary outcome was the frequency of non‐covered, poorly positioned struts by OCT.</p></div><div><h3>Results</h3><p>OCT was performed in 26 patients (BES: n = 15; EES: n = 11) and 749 tomographic images and 7,725 stent struts were analyzed. BES and EES showed similar luminal and stent areas. Neointimal hyperplasia area, neointimal thickness and the percentage of in‐stent obstruction (8.44 ± 5.10% vs. 9.21 ± 6.36%; <em>p</em> = 0.74) were similar. The rates of not covered struts (BES: 2.10 ± 3.60% vs. ESS: 2.46 ± 2.15%, <em>p</em> = 0.77) and poorly positioned struts (BES: 0.48 ± 1.48% vs. EES 0.44 ± 1.05%, <em>p</em> = 0.94) were similarly low. The frequency of frames with signs consistent with peri‐strut inflammatory infiltrate was low and similar between BES (15.53 ± 20.77%) and EES (11.70 ± 27.51%; <em>p</em> = 0.68).</p></div><div><h3>Conclusions</h3><p>The second‐generation drug‐eluting stents BES and EES were equally effective at suppressing the neointimal formation after 6 months, with favorable vascular responses. The frequency of frames with peri‐strut infiltrate signals per patient was low, and lower than that observed historically with first‐generation drug‐eluting stents.</p></div>","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"Pages 28-37"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbci.2015.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79866482","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}

引用次数: 1

Aterectomia rotacional em artérias com calcificação extrema ou falha em dilatação prévia: aspectos técnicos e evolução tardia após intervenção coronária percutânea 严重钙化或先前扩张失败的动脉旋转动脉粥样硬化:经皮冠状动脉介入治疗后的技术方面和晚期进展

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2015-01-01 DOI: 10.1016/j.rbci.2015.01.003

Pedro Henrique Magalhães Craveiro de Melo, Breno de Alencar Araripe Falcão, Cristiano Guedes Bezerra, Fábio Augusto Pinton, Welingson V.N. Guimarães, Rafael Cavalcante Silva, Celso K. Takimura, Marco Antônio Perin, Expedito Eustáquio Ribeiro da Silva, Antonio Esteves‐Filho, José Mariani Jr., Pedro Alves Lemos Neto

Background

Rotational atherectomy with new ablative strategies have been proposed for the treatment of extremely calcified lesions prior to stent implantation. Nevertheless, few data are available about the adoption of these new strategies in contemporary practice and about late outcomes of patients undergoing this therapy.

Methods

From July 2012 to November 2014, a retrospective single center registry was conducted, including all patients undergoing rotational atherectomy as part of the treatment of coronary arteries with heavy calcification or previous failed dilation. We evaluated technical aspects of atherectomy and late outcomes of patients for the occurrence of major adverse cardiovascular events (MACE), defined as death, Q‐wave myocardial infarction or repeat target vessel revascularization.

Results

Twenty‐nine patients with a mean age of 69.5 ± 7.6 years, underwent atherectomy. The average burr‐to‐artery ratio was 0.54 ± 0.07, the initial rotational speed was 161.000 ± 13.928 and the rate of cutting balloon utilization after atherectomy was 45.1%. Angiographic success was achieved in all procedures. The median follow‐up time was 13.2 months (IQ: 4.0‐17.4) and there were three events: 1 death of non‐cardiac cause and 2 new target vessel revascularizations. The mean MACE‐free survival time was 29.7 ± 2.1 months.

Conclusions

Contemporary rotational atherectomy incorporates less aggressive strategies of ablation with high rates of acute success and low occurrence of major adverse cardiovascular events during late follow‐up.

背景:在支架植入前，已经提出了旋转动脉粥样硬化切除术和新的消融策略来治疗高度钙化的病变。然而，关于在当代实践中采用这些新策略以及接受这种治疗的患者的晚期结果的数据很少。方法2012年7月至2014年11月，回顾性单中心登记，包括所有接受旋转动脉粥样硬化切除术作为治疗冠状动脉重度钙化或既往扩张失败的一部分的患者。我们评估了动脉粥样硬化切除术的技术方面和患者发生主要不良心血管事件(MACE)的晚期结局，MACE定义为死亡、Q波心肌梗死或重复靶血管重建术。结果29例患者行动脉粥样硬化切除术，平均年龄69.5±7.6岁。平均毛刺与动脉之比为0.54±0.07，初始转速为161.000±13.928，动脉粥样硬化切除术后切割球囊使用率为45.1%。所有手术均取得血管造影成功。中位随访时间为13.2个月(IQ: 4.0 ~ 17.4)，有3个事件:1例非心源性死亡和2例新的靶血管重建术。平均无MACE生存时间为29.7±2.1个月。结论:当代旋转动脉粥样硬化切除术采用较少侵袭性的消融策略，在后期随访中具有较高的急性成功率和较低的主要不良心血管事件发生率。

{"title":"Aterectomia rotacional em artérias com calcificação extrema ou falha em dilatação prévia: aspectos técnicos e evolução tardia após intervenção coronária percutânea","authors":"Pedro Henrique Magalhães Craveiro de Melo, Breno de Alencar Araripe Falcão, Cristiano Guedes Bezerra, Fábio Augusto Pinton, Welingson V.N. Guimarães, Rafael Cavalcante Silva, Celso K. Takimura, Marco Antônio Perin, Expedito Eustáquio Ribeiro da Silva, Antonio Esteves‐Filho, José Mariani Jr., Pedro Alves Lemos Neto","doi":"10.1016/j.rbci.2015.01.003","DOIUrl":"10.1016/j.rbci.2015.01.003","url":null,"abstract":"<div><h3>Background</h3><p>Rotational atherectomy with new ablative strategies have been proposed for the treatment of extremely calcified lesions prior to stent implantation. Nevertheless, few data are available about the adoption of these new strategies in contemporary practice and about late outcomes of patients undergoing this therapy.</p></div><div><h3>Methods</h3><p>From July 2012 to November 2014, a retrospective single center registry was conducted, including all patients undergoing rotational atherectomy as part of the treatment of coronary arteries with heavy calcification or previous failed dilation. We evaluated technical aspects of atherectomy and late outcomes of patients for the occurrence of major adverse cardiovascular events (MACE), defined as death, Q‐wave myocardial infarction or repeat target vessel revascularization.</p></div><div><h3>Results</h3><p>Twenty‐nine patients with a mean age of 69.5 ± 7.6 years, underwent atherectomy. The average burr‐to‐artery ratio was 0.54 ± 0.07, the initial rotational speed was 161.000 ± 13.928 and the rate of cutting balloon utilization after atherectomy was 45.1%. Angiographic success was achieved in all procedures. The median follow‐up time was 13.2 months (IQ: 4.0‐17.4) and there were three events: 1 death of non‐cardiac cause and 2 new target vessel revascularizations. The mean MACE‐free survival time was 29.7 ± 2.1 months.</p></div><div><h3>Conclusions</h3><p>Contemporary rotational atherectomy incorporates less aggressive strategies of ablation with high rates of acute success and low occurrence of major adverse cardiovascular events during late follow‐up.</p></div>","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"23 1","pages":"Pages 38-41"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbci.2015.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76728581","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}

引用次数: 0

Razões para Utilização da Via Femoral em Centro que Prioriza Técnica Radial em Procedimentos Cardiovasculares Invasivos 在有创心血管手术中，中心股路优先使用放射状技术的原因

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000056

M. Fossati, M. Arndt

Introducao: A tecnica de acesso arterial radial tem sido incorporada em muitos centros como tecnica de escolha para procedimentos invasivos cardiacos. No entanto, ainda ha resistencias relacionadas principalmente a possibilidade de crossover para via femoral, causadas por dificuldades tecnicas ou alteracoes anatomicas vasculares. O objetivo deste estudo foi identificar as razoes para a utilizacao da via femoral em um centro de medio volume de intervencoes, que recentemente adotou essa tecnica como primeira escolha na realizacao de procedimentos invasivos cardiacos. Metodos: Estudo prospectivo, que incluiu pacientes consecutivos submetidos a cateterismo cardiaco e coronariografia de forma eletiva. O preenchimento de formulario foi realizado com informacoes pre-, per- e pos-procedimento, e foi dada enfase a avaliacao das causas da utilizacao da via femoral (crossover ou por escolha primaria do operador). Resultados: No periodo de novembro de 2013 a agosto de 2014, 1.290 pacientes foram submetidos a procedimento diagnostico eletivo. A via femoral foi utilizada em 10,9% dos pacientes, por escolha do operador em 6,6% ou por crossover em 4,3% dos casos. O crossover ocorreu por puncao inadequada (3,4%), espasmo arterial (0,6%) ou tortuosidade vascular (0,3%). As complicacoes imediatas foram observadas em seis pacientes (0,5%) que desenvolveram hematomas locais (tipos I e II). Conclusoes: Em um centro de moderado volume, a tecnica radial foi incorporada como primeira escolha com seguranca e baixa incidencia de crossover para a via femoral.

简介:径向动脉通路技术作为心脏侵入性手术的首选技术已被许多中心纳入。然而，由于技术上的困难或血管解剖上的改变，仍然存在阻力，主要与股骨交叉的可能性有关。本研究的目的是确定在中等体积介入中心使用股路的原因，该中心最近采用该技术作为心脏侵入性手术的首选。方法:前瞻性研究，包括连续接受心导管和冠状动脉造影的患者。填写表格时提供术前、术前和术后信息，重点评估股路使用的原因(交叉或操作者的主要选择)。结果:2013年11月至2014年8月，1290例患者接受选择性诊断。10.9%的患者采用股骨通路，6.6%采用操作者选择，4.3%采用交叉。交叉发生在穿刺不足(3.4%)，动脉痉挛(0.6%)或血管弯曲(0.3%)。6例(0.5%)出现局部血肿(I型和II型)的患者立即出现并发症。结论:在中等容量中心，桡骨技术是首选，安全且股骨路交叉发生率低。

{"title":"Razões para Utilização da Via Femoral em Centro que Prioriza Técnica Radial em Procedimentos Cardiovasculares Invasivos","authors":"M. Fossati, M. Arndt","doi":"10.1590/0104-1843000000056","DOIUrl":"https://doi.org/10.1590/0104-1843000000056","url":null,"abstract":"Introducao: A tecnica de acesso arterial radial tem sido incorporada em muitos centros como tecnica de escolha para procedimentos invasivos cardiacos. No entanto, ainda ha resistencias relacionadas principalmente a possibilidade de crossover para via femoral, causadas por dificuldades tecnicas ou alteracoes anatomicas vasculares. O objetivo deste estudo foi identificar as razoes para a utilizacao da via femoral em um centro de medio volume de intervencoes, que recentemente adotou essa tecnica como primeira escolha na realizacao de procedimentos invasivos cardiacos. Metodos: Estudo prospectivo, que incluiu pacientes consecutivos submetidos a cateterismo cardiaco e coronariografia de forma eletiva. O preenchimento de formulario foi realizado com informacoes pre-, per- e pos-procedimento, e foi dada enfase a avaliacao das causas da utilizacao da via femoral (crossover ou por escolha primaria do operador). Resultados: No periodo de novembro de 2013 a agosto de 2014, 1.290 pacientes foram submetidos a procedimento diagnostico eletivo. A via femoral foi utilizada em 10,9% dos pacientes, por escolha do operador em 6,6% ou por crossover em 4,3% dos casos. O crossover ocorreu por puncao inadequada (3,4%), espasmo arterial (0,6%) ou tortuosidade vascular (0,3%). As complicacoes imediatas foram observadas em seis pacientes (0,5%) que desenvolveram hematomas locais (tipos I e II). Conclusoes: Em um centro de moderado volume, a tecnica radial foi incorporada como primeira escolha com seguranca e baixa incidencia de crossover para a via femoral.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"35 1","pages":"339-342"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77698151","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

Trombose Muito Tardia de Stent pela Angiografia. Um Caso de Progressão da Aterosclerose pela OCT 血管造影的晚期支架血栓形成。1例OCT引起的动脉粥样硬化进展

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000067

Antonio de Castro-Filho, Daniel Chamié, Alexandre Abizaid

The progressive nature of coronary atherosclerotic disease is often neglected in patients submitted to percutaneous coronary intervention. Very late (> 1 year) myocardial infarctions affecting the treated myocardial territory are usually attributed to device related complications. We report the case of a patient with acute inferior wall ST-elevation myocardial infarction, who had a thrombotic occlusion of a bare-metal stent implanted 8 years before. Despite the angiographic diagnosis of very late stent thrombosis, optical coherence tomography revealed that the acute myocardial infarction was caused by rupture of an atherosclerotic plaque outside of the previously stented segment.

在接受经皮冠状动脉介入治疗的患者中，冠状动脉粥样硬化疾病的进展性往往被忽视。影响治疗心肌区域的晚期心肌梗死通常归因于器械相关并发症。我们报告一例急性下壁st段抬高型心肌梗死患者，8年前植入裸金属支架后血栓闭塞。尽管血管造影诊断为非常晚期的支架血栓形成，但光学相干断层扫描显示急性心肌梗死是由先前支架段外的动脉粥样硬化斑块破裂引起的。

引用次数: 0

Tratamento Endovascular dos Aneurismas de Artéria Poplítea 腘动脉动脉瘤的血管内治疗

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000063

Marília Granzotto Volpato, Patrick Bastos Metzger, Maria Claudia Folino, Fabio Henrique Rossi, Samuel Martins Moreira, Mohamed Hassan Saleh, Nilo Mitsuru Izukawa, Antonio Massamitsu Kambara

Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen ViabahnTM and two MultilayerTM stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up.

背景:随着近年来血管内技术的进步和更灵活的假体的出现，腘动脉动脉瘤的治疗变得越来越频繁。本研究的目的是评估使用柔性假体治疗腘动脉动脉瘤的短期和中期临床结果。方法:2011年1月至2014年2月在2个地点进行回顾性纵向研究。在平均1年的随访中评估人群特征、手术相关数据和放射学成像。获得了发病率、死亡率、并发症发生率和支架通畅率。结果:共收治15肢腘动脉动脉瘤患者13例，平均年龄66±9岁。径流血管评估显示，大多数患者至少有两条腿部动脉未闭(92.3%)。57.1%的手术在腘动脉中段植入支架，42.9%的手术在腘动脉远端植入支架。所有病例均能实现病灶血管重建，四肢均需两支支架。使用17个ViabahnTM支架和2个MultilayerTM支架。在12个月的随访中，无支架骨折发生。原发性通畅率为53.3%，残肢保留率为100%。结论:中期随访表明血管内治疗腘动脉动脉瘤是有效的。

{"title":"Tratamento Endovascular dos Aneurismas de Artéria Poplítea","authors":"Marília Granzotto Volpato, Patrick Bastos Metzger, Maria Claudia Folino, Fabio Henrique Rossi, Samuel Martins Moreira, Mohamed Hassan Saleh, Nilo Mitsuru Izukawa, Antonio Massamitsu Kambara","doi":"10.1590/0104-1843000000063","DOIUrl":"https://doi.org/10.1590/0104-1843000000063","url":null,"abstract":"Background: With the recent advances in endovascular techniques and the emergence of more flexible endoprosthesis, the treatment of popliteal artery aneurysms has become more frequent. The objective of this study was to evaluate the short and mid-term clinical outcomes of the treatment of popliteal artery aneurysms with the use of a flexible endoprosthesis. Methods: Retrospective longitudinal study conducted in two sites from January of 2011 to February of 2014. Populational characteristics, procedure-related data, and radiologic imaging were evaluated at a mean follow-up of 1 year. Morbidity and mortality rates, complication rates, and stent patency rates were obtained. Results: A total of 13 male patients, mean age 66 ± 9 years, were submitted to popliteal artery aneurysm treatment in 15 limbs. Run-off vessel evaluation showed that most patients had at least two patent arteries in the legs (92.3%). Stents were implanted in the middle segment in 57.1% and in the distal segment of the popliteal artery in 42.9% of the procedures. Target lesion revascularization was achieved in all of the cases and two stents were required in four limbs. Seventeen ViabahnTM and two MultilayerTM stents were used. During the 12-month follow-up there were no stent fractures. The primary patency rate was 53.3% and limb salvage rate was 100%. Conclusions: Endovascular treatment of popliteal artery aneurysm was shown to be effective in the mid-term follow-up.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"90 1","pages":"375-381"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74604473","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: 3

Infarto com Supradesnivelamento do Segmento ST e Trombo Coronariano Extenso em Paciente com Anemia Falciforme 镰状细胞性贫血患者ST段抬高和广泛冠状动脉血栓的梗死

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000066

Fernando Pivatto, A. M. Krepsky, Diogo da Silva Piardi, Márcio Mossmann, M. Gus, M. Wainstein

Myocardial infarction in patients with sickle cell anemia is often underdiagnosed due to confounding factors (e.g., vasoocclusive disease leading to painful crisis). In the majority of reported cases, the coronary arteries were pervious and without stenotic lesions. In this case report, we describe the presence of an extensive coronary thrombus in a patient with sickle cell anemia presenting with ST elevation myocardial infarction, managed satisfactorily with the association of anticoagulants and antiplatelet drugs.

镰状细胞性贫血患者的心肌梗死常常由于混杂因素(例如，血管闭塞性疾病导致痛苦危象)而被误诊。在大多数报告的病例中，冠状动脉是通透的，没有狭窄的病变。在这个病例报告中，我们描述了镰状细胞性贫血患者广泛冠状动脉血栓的存在，表现为ST段抬高型心肌梗死，通过抗凝血剂和抗血小板药物的联合治疗令人满意。

引用次数: 0

Resultados Angiográficos e do Seguimento Clínico de 5 Anos Após Implante de Stents Farmacológicos com Revestimento Biodegradável em Pacientes com Alto Risco de Reestenose. Análise de Subgrupo do Estudo Randomizado PAINT 高危再狭窄患者生物可降解涂层药物支架植入后5年的血管造影结果和临床随访。油漆随机研究的亚组分析

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000052

Wilton Francisco Gomes, J. F. Marchini, Bruno Moulin, M. Perin, Ludmilla Oliveira, J. A. Arruda, V. C. Lima, Antônio Augusto Guimarães Lima, P. Caramori, C. R. Medeiros, Mauricio R. Barbosa, F. S. Brito, E. Ribeiro, Pedro A. Lemos

Background: Biodegradable polymers were developed to reduce the hypersensitivity reaction associated to durable polymers found with the first generation drug-eluting stents, while maintaining antiproliferative efficacy and increasing safety. This study evaluated the 9-month angiographic follow-up and long-term clinical outcomes of biodegradable polymer-coated drug-eluting stents compared with identical platform metallic stents in patients with high-risk for restenosis. Methods: Patients with a reference diameter ≤ 2.5 mm, lesion length ≥ 15 mm, diabetes, or a combination of these characteristics were selected from the population of the PAINT trial. These patients were previously randomized and allocated for percutaneous coronary intervention with either a sirolimus-eluting biodegradable polymer-coated stent, a paclitaxel-eluting biodegradable polymer-coated stent, or an identical metallic platform stent, at a ratio of 2:2:1. Results: One hundred and seventy-eight patients were treated with biodegradable polymer-coated drug-eluting stents (n = 142) or bare metal stents (n = 36). At the 9-month angiographic follow-up, biodegradable polymercoated drug-eluting stents had lower rates of late loss (0.40 ± 0.42 mm vs. 0.90 ± 0.47 mm; p < 0.01) and binary restenosis (7.4% vs. 25%; p <0.01). In the 5-year clinical follow-up, the group with biodegradable polymer-coated drug-eluting stents had lower rates of the composite endpoint of cardiac death, myocardial infarction, and target vessel revascularization (16.2% vs. 38.0%; p = 0.03), especially due to the reduction of target vessel revascularization (9.9% vs. 36.1%; (p 0.01). Total death, cardiac death and myocardial infarction were not different among groups. 0% (p = 0.30). Conclusions: Paclitaxel or sirolimus-eluting biodegradable polymer-coated stents were effective in reducing angiographic restenosis at 9 months and the need of reintervention for clinical restenosis in 5 years, without increasing the risk of stent thrombosis.

背景:生物可降解聚合物的开发是为了减少与第一代药物洗脱支架中发现的耐用聚合物相关的超敏反应，同时保持抗增殖功效并增加安全性。本研究评估了生物可降解聚合物涂层药物洗脱支架与相同平台金属支架在再狭窄高危患者中9个月的血管造影随访和长期临床结果。方法:从PAINT试验人群中选择参考直径≤2.5 mm，病变长度≥15mm，糖尿病或这些特征的组合的患者。这些患者之前被随机分配到经皮冠状动脉介入治疗，使用西罗莫司洗脱的可生物降解聚合物涂层支架、紫杉醇洗脱的可生物降解聚合物涂层支架或相同的金属平台支架，比例为2:2:1。结果:178例患者使用生物可降解聚合物涂层药物洗脱支架(n = 142)或裸金属支架(n = 36)。在9个月的血管造影随访中，可生物降解聚合物涂层药物洗脱支架的晚期损失率较低(0.40±0.42 mm vs 0.90±0.47 mm;P < 0.01)和二元再狭窄(7.4% vs. 25%;p < 0.01)。在5年的临床随访中，使用可生物降解聚合物涂层药物洗脱支架组心脏死亡、心肌梗死和靶血管重建术的复合终点发生率较低(16.2% vs. 38.0%;P = 0.03)，特别是由于靶血管重建化减少(9.9% vs. 36.1%;(p 0.01)。总死亡、心源性死亡和心肌梗死组间无显著差异。0% (p = 0.30)。结论:紫杉醇或西罗莫司洗脱的可生物降解聚合物涂层支架可有效减少9个月时血管造影再狭窄，5年内临床再狭窄需要再次干预，且不增加支架血栓形成的风险。

{"title":"Resultados Angiográficos e do Seguimento Clínico de 5 Anos Após Implante de Stents Farmacológicos com Revestimento Biodegradável em Pacientes com Alto Risco de Reestenose. Análise de Subgrupo do Estudo Randomizado PAINT","authors":"Wilton Francisco Gomes, J. F. Marchini, Bruno Moulin, M. Perin, Ludmilla Oliveira, J. A. Arruda, V. C. Lima, Antônio Augusto Guimarães Lima, P. Caramori, C. R. Medeiros, Mauricio R. Barbosa, F. S. Brito, E. Ribeiro, Pedro A. Lemos","doi":"10.1590/0104-1843000000052","DOIUrl":"https://doi.org/10.1590/0104-1843000000052","url":null,"abstract":"Background: Biodegradable polymers were developed to reduce the hypersensitivity reaction associated to durable polymers found with the first generation drug-eluting stents, while maintaining antiproliferative efficacy and increasing safety. This study evaluated the 9-month angiographic follow-up and long-term clinical outcomes of biodegradable polymer-coated drug-eluting stents compared with identical platform metallic stents in patients with high-risk for restenosis. Methods: Patients with a reference diameter ≤ 2.5 mm, lesion length ≥ 15 mm, diabetes, or a combination of these characteristics were selected from the population of the PAINT trial. These patients were previously randomized and allocated for percutaneous coronary intervention with either a sirolimus-eluting biodegradable polymer-coated stent, a paclitaxel-eluting biodegradable polymer-coated stent, or an identical metallic platform stent, at a ratio of 2:2:1. Results: One hundred and seventy-eight patients were treated with biodegradable polymer-coated drug-eluting stents (n = 142) or bare metal stents (n = 36). At the 9-month angiographic follow-up, biodegradable polymercoated drug-eluting stents had lower rates of late loss (0.40 ± 0.42 mm vs. 0.90 ± 0.47 mm; p < 0.01) and binary restenosis (7.4% vs. 25%; p <0.01). In the 5-year clinical follow-up, the group with biodegradable polymer-coated drug-eluting stents had lower rates of the composite endpoint of cardiac death, myocardial infarction, and target vessel revascularization (16.2% vs. 38.0%; p = 0.03), especially due to the reduction of target vessel revascularization (9.9% vs. 36.1%; (p 0.01). Total death, cardiac death and myocardial infarction were not different among groups. 0% (p = 0.30). Conclusions: Paclitaxel or sirolimus-eluting biodegradable polymer-coated stents were effective in reducing angiographic restenosis at 9 months and the need of reintervention for clinical restenosis in 5 years, without increasing the risk of stent thrombosis.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"27 1","pages":"315-319"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83323486","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

Relato Preliminar sobre a Concentração Sanguínea de Níquel Após Oclusão Percutânea de Comunicação Interatrial com a Prótese Cocoon 茧假体经皮闭塞房间通讯后血液镍浓度的初步报告

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000062

André V. Badran, Jorge Luis Haddad, R. B. Pavão, Gustavo Caires Novaes, I. M. Lago, G. L. Figueiredo, Moysés de Oliveira Lima-Filho, M. Romano, J. A. Marin-Neto

Background: The possibility of nickel release to the bloodstream after implantation of latest generation atrial septal defect occlusion devices (Cocoon Septal OccluderTM), whose main component is nitinol (55% nickel and 45% titanium), remains controversial, especially in certain groups of patients such as children and women of childbearing age. Thus, the aim of this study was to evaluate the correlation between the device implantation and serum levels of nickel. Methods: This was a prospective longitudinal observational study conducted at a public hospital. Patients undergoing percutaneous atrial septal defect occlusion were clinically evaluated using transthoracic echocardiography and peripheral vein blood sampling for serum nickel before and after (1 day, 1 and 3 months) implantation. Results: The procedure and subsequent examinations were successfully performed in ten patients, with mean age of 34.4 years (range 5 to 60 years). Serial echocardiography confirmed the maintenance of adequate results of the procedure. Patients did not show manifestations that might suggest a reaction to metal, such as skin rash, dyspnea, thoracic discomfort, palpitations or migraine. Serum nickel levels did not show any significant changes and remained within the normal range for the population, according to the dosing methods within 3 months of the procedure. Conclusions: Preliminary results of this investigation with the Cocoon device have shown that during the initial period of endothelization after the procedure there was no significant nickel release into the bloodstream.

背景:以镍钛诺(55%镍和45%钛)为主要成分的最新一代房间隔缺损闭塞器(Cocoon septal OccluderTM)植入后镍释放到血流中的可能性仍存在争议，特别是在某些患者群体中，如儿童和育龄妇女。因此，本研究的目的是评估装置植入与血清镍水平的相关性。方法:这是一项在公立医院进行的前瞻性纵向观察研究。对经皮房间隔缺损封堵术患者在植入前后(1天、1个月和3个月)采用经胸超声心动图和外周静脉采血血清镍进行临床评价。结果:10例患者成功完成手术及后续检查，平均年龄34.4岁(5 ~ 60岁)。连续超声心动图证实该手术维持了足够的结果。患者未出现可能提示金属反应的表现，如皮疹、呼吸困难、胸部不适、心悸或偏头痛。血清镍水平未显示出任何显著变化，并保持在正常范围内的人群，根据给药方法在3个月内的程序。结论:茧装置的初步研究结果表明，在手术后内皮化的初始阶段，镍没有明显释放到血液中。

{"title":"Relato Preliminar sobre a Concentração Sanguínea de Níquel Após Oclusão Percutânea de Comunicação Interatrial com a Prótese Cocoon","authors":"André V. Badran, Jorge Luis Haddad, R. B. Pavão, Gustavo Caires Novaes, I. M. Lago, G. L. Figueiredo, Moysés de Oliveira Lima-Filho, M. Romano, J. A. Marin-Neto","doi":"10.1590/0104-1843000000062","DOIUrl":"https://doi.org/10.1590/0104-1843000000062","url":null,"abstract":"Background: The possibility of nickel release to the bloodstream after implantation of latest generation atrial septal defect occlusion devices (Cocoon Septal OccluderTM), whose main component is nitinol (55% nickel and 45% titanium), remains controversial, especially in certain groups of patients such as children and women of childbearing age. Thus, the aim of this study was to evaluate the correlation between the device implantation and serum levels of nickel. Methods: This was a prospective longitudinal observational study conducted at a public hospital. Patients undergoing percutaneous atrial septal defect occlusion were clinically evaluated using transthoracic echocardiography and peripheral vein blood sampling for serum nickel before and after (1 day, 1 and 3 months) implantation. Results: The procedure and subsequent examinations were successfully performed in ten patients, with mean age of 34.4 years (range 5 to 60 years). Serial echocardiography confirmed the maintenance of adequate results of the procedure. Patients did not show manifestations that might suggest a reaction to metal, such as skin rash, dyspnea, thoracic discomfort, palpitations or migraine. Serum nickel levels did not show any significant changes and remained within the normal range for the population, according to the dosing methods within 3 months of the procedure. Conclusions: Preliminary results of this investigation with the Cocoon device have shown that during the initial period of endothelization after the procedure there was no significant nickel release into the bloodstream.","PeriodicalId":101093,"journal":{"name":"Revista Brasileira de Cardiologia Invasiva","volume":"1 1","pages":"369-374"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89861296","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: 2

2015: Ano Novo, RBCI Nova!

Revista Brasileira de Cardiologia Invasiva

Pub Date : 2014-12-01 DOI: 10.1590/0104-1843000000051

Á. Chaves

引用次数: 1

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Revista Brasileira de Cardiologia Invasiva

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀