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We describe the use of a radiation dose-tracking system (Canon Medical Systems) that can help physicians provide patients with better care after higher radiation exposure dose following lengthy procedures.

Background The Orsiro is a hybrid stent which has passive (amorphous silicon carbide) and active (poly-L-lactic acid, PLLA) coatings. The first layer encapsulates the stent struts, promoting lower local inflammation, whereas the second layer releases sirolimus through a biodegradable matrix. This study's aim was to compare the results of percutaneous coronary interventions (PCI) with Orsiro and Xience™ V stents (everolimus-eluting stent) in daily clinical practice. Methods Observational study in which patients were divided into two groups: those who received only one or more Orsiro stents, and those who received only XienceTM V stents. Early and late outcomes were prospectively collected. Results Between September 2012 and March 2014, this study included 92 and 108 patients treated with Orsiro and Xience™ V stents, respectively. Clinical, angiographic, and procedure characteristics were mostly similar between groups. Rates of procedure success (98.9% vs. 95.4%; p = 0.22), in-hospital mortality (1.1% vs. 0%; p = 0.40) and stent thrombosis (0% vs. 0.9%, p = 0.30) did not differ between groups. Time of follow-up was 434 ± 111 and 477 ± 66 days (p = 0.23), respectively, and differences in mortality (0.9% vs. 0%, p = 0.30), stent thrombosis (0% vs. 0.9%; p = 0.30), or need for repeat revascularization of the target lesion (0% vs. 0.9%; p = 0.30) were not observed. Conclusions Orsiro and Xience™ V stents showed similar performance, with low rates of early and late clinical and angiographic events.

INTRODUÇÃO: Dados observacionais da década de 90 sugerem que pacientes com mais de 70 anos de idade evoluem com maior risco de eventos quando submetidos a intervenção coronariana percutânea (ICP). OBJETIVO: Avaliar os desfechos hospitalares em pacientes com idade superior a 70 anos submetidos a ICP na era contemporânea. MÉTODO: Entre janeiro de 2005 e junho de 2007, pacientes submetidos a ICP foram incluídos consecutivamente em um registro. Informações referentes a fatores de risco, indicação do exame, detalhes técnicos da ICP e desfechos intra-hospitalares foram prospectivamente coletadas. Os pacientes foram divididos em dois grupos: idade < ou > 70 anos. Para comparação, foram utilizados os testes t de Student e qui-quadrado, para variáveis contínuas e categóricas, respectivamente. Valores de p < 0,05 foram considerados diferença estatisticamente significante. RESULTADOS: Foram incluídos na análise 296 pacientes (186 com < 70 anos e 110 com > 70 anos). Não foi observada diferença em relação às características clínico-angiográficas entre os grupos e o sucesso angiográfico foi semelhante (96,6% vs. 97,1%; p = 0,91). Ocorreu tendência a maior mortalidade (1,81% vs. 0,53%; p = 0,06) e a maior incidência de acidente vascular encefálico (1,81% vs. 0%; p = 0,06) no grupo mais idoso. A incidência de cirurgia de urgência e de complicações vasculares não diferiu entre os grupos. Ocorreu maior incidência de nefropatia induzida pelo contraste no grupo > 70 anos (2,7% vs. 0%; p = 0,02). CONCLUSÃO: Pacientes com idade > 70 anos apresentaram incidência aumentada de nefropatia induzida pelo contraste e tendência a maior mortalidade e a maior ocorrência de acidente vascular encefálico. INTRODUCTION: Observational data from the 90's demonstrates that elderly population has an increased risk when treated by percutaneous coronary intervention (PCI). OBJECTIVE: To evaluate in-hospital outcomes in patients aged > 70 years old who underwent PCI in the current era. METHODS: In a single center, from January/2005 to June/2007, a total of 296 patients who underwent PCI were included in this analysis. The presence of risk factors, angiographic characteristics and in-hospital outcomes were recorded and compared among patients < 70-yo (n = 186) and > 70-yo (n = 110) in a dedicated database. For comparison purposes, unpaired t test and chi-square were used for continuous and dichotomous variables respectively. An alpha < 0.05 was considered significant. RESULTS: There was no difference between groups < 70-yo and > 70-yo regarding clinical presentation and the presence of risk factors for cardiovascular disease. Also, there was a homogenous distribution of treated vessels, angiographic pattern, coronary calcification and success rate (96.6% in > 70-yo group x 97.1% < 70-yo, p = 0.91). Regarding complications, there was an increased rate of contrast induced nephropathy in the older group (2.7% x 0%, p = 0.02) that required dialysis. Additionally, we observed a trend in higher mortality (1.81% x 0.53%, p = 0.06) and neurological compromise (1.81% x 0%, p = 0.06) in the elderly population. Vascular complication rates and urgent surgical revascularization were similar in both groups. CONCLUSION: Patients older and younger than 70-yo present similar clinical profile, angiographic characteristics and success rate. However, the incidence of contrast-induced nephropathy requiring dialysis, mortality and neurological compromise are higher in the older group.

Percutaneous coronary intervention (PCI) is a widely performed technique for coronary revascularization. Men and women seem to have different in-hospital outcomes, although results remain unclear. We assessed the gender impact on in-hospital outcomes in men and women undergoing PCI.In a single center, from 1998 to 2002, a total of 413 patients who underwent PCI were included in this analysis. From a dedicated database, the presence of risk factors, angiographic characteristics, left ventricular function and in-hospital outcomes were recorded and compared between men (n=244) and women (n=169). For comparison, unpaired t test and chi-square were used for continuous and dichotomous variables respectively. An alpha0.05 was considered significant.Women were older (65.3+/-10.39 x 60+/-10.68 years, p=0.001), presented better ejection fraction (67.01+/-12.28% x 64.26+/-14.31%, p=0.028) and higher prevalence of stable angina (63.90% x 45.90%, p0.001) than men. There were no differences related to family history for cardiovascular disease, hypertension, diabetes or hyperlipidemia; but there was an observed reduction in tobacco use (17.71% x 32.31%, p0.001) by women. Similar rates of in-hospital successful procedures (94.3% x 94.90%, p=0.93) and death (0.41%x1.18%, p=0.40) were observed in men and women, respectively. Neither vascular complications nor stroke occurred. There was a higher incidence of urgent surgical myocardial revascularization (1.77%x0%, p=0.036) and a trend in the combined outcome of death/surgical myocardial revascularization (2.69% x 0.41%, p=0.06) in the women's group.Women present a higher incidence of urgent surgical myocardial revascularization following percutaneous coronary intervention when compared to men.