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 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE On Demand Web ArchiveNon-Accredited Target Audience: Physicians, nurses, and technologists. This activity is supported by an educational grant from Terumo Medical Corporation. |
Current Issue
- Issue Number:2 (February 2010)Start Page:48End Page:55
ABSTRACT: Objective. To examine the 1-year safety and clinical outcomes associated with the post-marketing early unselected use of sirolimus-eluting stents (SES) in the United States. Background. The safety and effectiveness of SES has been assessed in selected patients enrolled in pivotal randomized trials. This PMS registry was initiated to examine the safety and effectiveness of SES in an unselected population. Methods. Consecutive patients who underwent implantation of ≥1 SES at 38 participating U.S. centers were enrolled in this registry. Results were compared according to “off-” versus “on-label” use of SES. Multivariate regression analyses were carried out in search of predictors of 1-year MACE and stent thrombosis. Results. The mean age of the 2,067 patients (3,367 treated lesions) was 63.7 years. The 12-month follow up was completed by 1,964 patients (95%). SES were implanted for “off-label” indications in 1,173 patients (57%).
DEPARTMENTS
FEATURES
- Should we prescribe Prasugrel and Ticagrelor (not yet approved) routinely over generic clopidogrel?
- In light of recent studies, do you still plan to prescribe PPIs to your patients on Clopidogrel?
Cardiology Blogs
Feature
Increased Vascular Access Complications in Patients with Renal Dysfunction Undergoing Percutaneous Coronary Procedures Using Arteriotomy Closure Devices
Authors: Emad F. Aziz, MB, ChB, DOa, Sandeep Pulimi, MDa, Clinton Coleman, MDb, Calatin Florita, MDc, Dan Musat, MDa, Deborah Tormey, RNa, Ashraf Fawzy, BSa, Steve Lee, BSa, Eyal Herzog, MDa, David L. Coven, MDa, Jacqueline Tamis-Holland, MDa, Mun K. Hong, MDa
ABSTRACT: Background. Arteriotomy closure device (ACD) use has increased following percutaneous transfemoral coronary procedures (PTCP). However, their safety in patients with chronic kidney disease (CKD) is not known. Therefore, we evaluated the complication rates of ACD among patients with CKD. Methods. Six-hundred ten consecutive patients who underwent PTCP and ACD were retrospectively studied. Patients were grouped according to their creatinine clearance (CrCl in ml/min/1.73 m2) calculated by the Cockcroft-Gault formula using the National Kidney Foundation classification system; Stage I (CrCl ≥ 90); Stage II (60–89); Stage III (30–59); Stage IV (15–29); and Stage V (≤ 15). The primary endpoint was the combined incidence of pseudo-aneurysm, retroperitoneal hematoma, femoral artery thrombosis, surgical vascular repair, and groin infection. Results. Among 610 patients 283 (46%) underwent PCI. The primary endpoint was seen in 66 (10.8%) patients. Univariate predictors of primary outcome were lower CrCl (p < 0.001), and presence of peripheral vascular disease (p = 0.03). There was an inverse relationship between CrCl and complication rate. CKD was the strongest independent multivariate predictor for the primary endpoint (OR 1.032; 95% CI 1.019–1.046; p < 0.0001), driven by higher infection (p < 0.0001), thrombosis (p = 0.003) and hematoma (p = 0.007). Conclusions. Renal function appears to be significantly associated with vascular access-site complications. Worsening renal function is associated with higher vascular access site complications, largely driven by an increased infection rate.
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Anytown, California
Press Release
— Bethlehem, Pennsylvania – Invatec received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in October to market its Mo.Ma Ultra Proximal Cerebral Protection Device for use during carotid artery stenting (CAS). The device effectively reduces and captures debris released during the stenting procedure to prevent it from traveling to the brain, where it has the potential to cause a stroke.
CME Showcase
 The Use of Remote Robotic Navigation in Complex Arrhythmias Complimentary Accredited Web Archive This activity is designed for electrophysiologists and EP allied professionals. Diagnosing Coronary Artery Disease: Advanced Cardiovascular Imaging Solutions  New Standards of Care for CRMD Antibiotic Protection Complimentary CME Accredited Webcast Dates: November 18, 2008 Time: 6:00 pm ET November 19, 2008 Time: 3:00 pm ET This activity is sponsored by the North American Center for Continuing Medical Education. |
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