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1. Unexpected Internal Mammary Artery Perforation During Transradial Access for a Neuroendovascular Procedure

Author

Mauricio G. Cohen, Vasu Saini, Dileep R. Yavagal, and Isaac Josh Abecassis

Subjects
0301 basic medicine, medicine.medical_specialty, transradial access, Perforation (oil well), education, Case Report, 030105 genetics & heredity, 03 medical and health sciences, arterial perforation, 0302 clinical medicine, Clinical Case, Medicine, Arterial perforation, medicine.diagnostic_test, business.industry, internal mammary artery perforation, Right internal mammary artery, Mammary artery, TRA, transradial access, cerebral angiography, Radiology, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Cerebral angiography, RIMA, right internal mammary artery
Abstract

During cerebral angiography via transradial access, the guidewire inadvertently entered the right internal mammary artery. This was not recognized because of its downward trajectory, and it was interpreted to be in the ascending aorta. Catheter manipulation perforated the right internal mammary artery, with development of pectoral hematoma. The perforation was sealed with coils and glue. (Level of Difficulty: Advanced.), Central Illustration

Published
2021

2. List of contributors

Author

J. Dawn Abbott, Nidal Abi Rafeh, Mazen Abu Fadel, Pierfrancesco Agostoni, Sukru Akyuz, Khaldoon Alaswad, Dimitrios Alexopoulos, Dominick J. Angiolillo, Herbert D. Aronow, Alexandre Avran, Lorenzo Azzalini, Avtandil M. Babunashvili, Jayant Bagai, Subhash Banerjee, Kenneth Baran, Mir Babar Basir, Nicolas Boudou, Konstantinos Dean Boudoulas, Christos V. Bourantas, Nenad Ž. Božinović, Leszek Bryniarski, Alexander Bufe, M. Nicholas Burke, Heinz Joachim Büttner, Pedro Pinto Cardoso, Mauro Carlino, Jeff Chambers, Konstantinos Charitakis, Yiannis S. Chatzizisis, Ivan J. Chavez, James W. Choi, Evald Høj Christiansen, Mauricio G. Cohen, Francesco Costa, Felix Damas de los Santos, Rustem Dautov, Tony De Martini, Ali E. Denktas, Joseph Dens, Zisis Dimitriadis, Anthony Doing, Mohaned Egred, Basem Elbarouni, Ahmed M. El Guindy, Abdallah El Sabbagh, Panayotis Fasseas, Dmitriy N. Feldman, Sergey Furkalo, Andrea Gagnor, Alfredo R. Galassi, Roberto Garbo, Santiago Garcia, Gabriele L. Gasparini, Anthony H. Gershlick, Mario Goessl, Luca Grancini, Abdul Hakeem, Allison B. Hall, Stefan Harb, Raja Hatem, Jose P.S. Henriques, Yangsoo Jang, Risto Jussila, Artis Kalnins, Arun Kalyanasundaram, Paul Hsien-Li Kao, Judit Karacsonyi, Lampros Karagounis, Antonios Karanasos, Dimitri Karmpaliotis, Houman Khalili, Jaikirshan J. Khatri, Dmitrii Khelimskii, Byeong-Keuk Kim, Louis P. Kohl, Daniel M. Kolansky, Michalis Koutouzis, Oleg Krestyaninov, Faisal Latif, Seung-Whan Lee, Thierry Lefevre, Nicholas J. Lembo, Ehtisham Mahmud, Konstantinos Marmagkiolis, Kambis Mashayekhi, Kreton Mavromatis, Michael Megaly, Owen Mogabgab, Michael R. Mooney, Jeffrey W. Moses, Bilal Murad, Alexander Nap, William Nicholson, Dimitrios N. Nikas, Ilias Nikolakopoulos, Goran Olivecrona, Mohamed A. Omer, Jacopo Andrea Oreglia, Lucio Padilla, Ioannis Paizis, Carmelo Panetta, Mitul Patel, Ashish Pershad, Marin Postu, Srini Potluri, Anil Poulose, Stylianos Pyxaras, Sunil V. Rao, Sudhir Rathore, Amir Ravandi, Nicolaus Reifart, Robert F. Riley, Stephane Rinfret, Gurpreet S. Sandhu, Yader Sandoval, Elias Sanidas, Ricardo Santiago Trinidad, Jeffrey M. Schussler, Arnold Seto, Alok Sharma, Arslan Shaukat, Mehdi H. Shishehbor, Evan Shlofmitz, Richard Shlofmitz, Paul Sorajja, Anthony Spaedy, Peter Tajti, Jacqueline E. Tamis-Holland, Aurel Toma, Konstantinos Toutouzas, Jay H. Traverse, Huu Tam Truong, Sotiris Tsalamandris, Ioannis Tsiafoutis, Imre Ungi, Emmanouil Vavouranakis, Evangelia Vemmou, Minh N. Vo, Vassilis Voudris, Yale Wang, Jarosław Wójcik, Jason Wollmuth, Eugene B. Wu, Iosif Xenogiannis, Masahisa Yamane, and Luiz Fernando Ybarra

Published
2021
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3. List of Contributors

Author

Samer Abbas, Shuaib Abdullah, Hasan Ahmad, Gorav Ailawadi, Wail Alkashkari, Osama Alsanjari, Jason H. Anderson, Judah Askew, Luis Asmarats, Ganesh Athappan, Rizwan Attia, Vasilis Babaliaros, Richard Y. Bae, Charles M. Baker, Subhash Banerjee, Vinayak N. Bapat, Colin M. Barker, Itsik Ben-Dor, Stefan Bertog, Phillipe Blanke, Peter Block, Patrick Boehm, Stephen Brecker, Emmanouil S. Brilakis, Marcus Burns, Christian Butter, Allison K. Cabalka, Barry Cabuay, Alex Campbell, John D. Carroll, Anson W. Cheung, Adnan K. Chhatriwalla, Martin Cohen, Mauricio G. Cohen, Frank Corrigan, Cameron Dowling, Tanya Dutta, Mackram Eleid, Robert Saeid Farivar, Ted Feldman, Thomas Flavin, Jessica Forcillo, Jennifer Franke, Sameer Gafoor, Evaldas Girdauskas, Steven L. Goldberg, Mario Gössl, Mayra Guerrero, Alexander Haak, Cameron Hague, Eva Harmel, Ziyad Hijazi, David Hildick-Smith, Ilona Hofmann, Samuel E. Horr, Nay M. Htun, Shaw Hua (Anthony) Kueh, Vladimir Jelnin, Brandon M. Jones, Ravi Joshi, Rami Kahwash, Ankur Kalra, Norihiko Kamioka, Samir R. Kapadia, Ryan K. Kaple, Judit Karacsonyi, Marc R. Katz, John J. Kelly, Samuel Kessel, Ung Kim, Neal S. Kleiman, Thomas Knickelbine, Amar Krishnaswamy, Vibhu Kshettry, Shaw-Hua Kueh, Ivandito Kuntijoro, Shingo Kuwata, Jonathon Leipsic, Stamatios Lerakis, John R. Lesser, Scott M. Lilly, D. Scott Lim, David Lin, Francesco Maisano, Gurdeep Mann, Christopher Meduri, Stephanie Mick, Michael Mooney, Aung Myat, Srihari S. Naidu, Michael Neuss, Fabian Nietlispach, Mickaël Ohana, Ioannis Parastatidis, Tilak K.R. Pasala, Ateet Patel, Paul Pearson, Wesley R. Pedersen, François Philippon, Augusto Pichard, Anil Poulose, Alberto Pozzoli, Matthew J. Price, Vivek Rajagopal, Claire Raphael, Michael J. Reardon, Evelyn Regar, Josep Rodés-Cabau, Jason H. Rogers, Carlos E. Ruiz, Michael Salinger, Muhamed Saric, Lowell Satler, Jacqueline Saw, Lynelle Schneider, Atman P. Shah, Rahul Sharma, Mark Victor Sherrid, Joy S. Shome, Horst Sievert, Gagan D. Singh, Thomas W. Smith, Benjamin Sun, Hussam Suradi, Gilbert H.L. Tang, Maurizio Taramasso, Jay Thakkar, Vinod H. Thourani, Stacey Tonne, Imre Ungi, Laura Vaskelyte, Joseph M. Venturini, Marko Vezmar, Ron Waksman, Zuyue Wang, John Graydon Webb, Dominik M. Wiktor, and Mathew R. Williams

Published
2019
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5. Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial

Author

Jarosław D. Kasprzak, Arnold I. Levinson, Vic Hasselblad, Warren J. Cantor, Kurt Huber, Michael Aschermann, Jose Lopez-Sendon, Lauren Glenn, P. Gabriel Steg, Paul W. Armstrong, Béla Merkely, Christopher E. Buller, Marco Valgimigli, Rod Stables, Renato D. Lopes, Steven L. Zelenkofske, Toomas Marandi, Peep Laanmets, Mauricio G. Cohen, Peter Sinnaeve, Thomas J. Povsic, Jan H. Cornel, Viliam Fridrich, Marilyn Borgman, João Morais, Mary Ann Sellers, Richard C. Becker, Zhen Huang, Roxana Mehran, John H. Alexander, A. Michael Lincoff, Christoph Bode, and Victor Guetta

Subjects
0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Factor IXa, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, medicine, Bivalirudin, Myocardial infarction, 610 Medicine & health, Intention-to-treat analysis, business.industry, Percutaneous coronary intervention, General Medicine, medicine.disease, Surgery, Clinical trial, 030104 developmental biology, Conventional PCI, Cardiology, business, medicine.drug
Abstract

BACKGROUND REG1 is a novel anticoagulation system consisting of pegnivacogin, an RNA aptamer inhibitor of coagulation factor IXa, and anivamersen, a complementary sequence reversal oligonucleotide. We tested the hypothesis that near complete inhibition of factor IXa with pegnivacogin during percutaneous coronary intervention, followed by partial reversal with anivamersen, would reduce ischaemic events compared with bivalirudin, without increasing bleeding. METHODS We did a randomised, open-label, active-controlled, multicentre, superiority trial to compare REG1 with bivalirudin at 225 hospitals in North America and Europe. We planned to randomly allocate 13,200 patients undergoing percutaneous coronary intervention in a 1:1 ratio to either REG1 (pegnivacogin 1 mg/kg bolus [>99% factor IXa inhibition] followed by 80% reversal with anivamersen after percutaneous coronary intervention) or bivalirudin. Exclusion criteria included ST segment elevation myocardial infarction within 48 h. The primary efficacy endpoint was the composite of all-cause death, myocardial infarction, stroke, and unplanned target lesion revascularisation by day 3 after randomisation. The principal safety endpoint was major bleeding. Analysis was by intention to treat. This trial is registered at ClinicalTrials.gov, identifier NCT01848106. The trial was terminated early after enrolment of 3232 patients due to severe allergic reactions. FINDINGS 1616 patients were allocated REG1 and 1616 were assigned bivalirudin, of whom 1605 and 1601 patients, respectively, received the assigned treatment. Severe allergic reactions were reported in ten (1%) of 1605 patients receiving REG1 versus one (

Published
2016
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6. Acute Coronary Syndrome During the Era of COVID-19: Perspective and Implications Using Google Trends

Author

Juan A. Quintero-Martinez, MD, Joaquin Espinoza, MD, Diego Celli, MD, Carlos Vergara-Sanchez, MD, Jonathan Salter, MD, William Aitken, MD, Igor Palacios, MD, Mauricio G. Cohen, MD, Pablo Rengifo-Moreno, MD, Eduardo de Marchena, MD, Rosario Colombo, MD, Carlos E. Alfonso, MD, and George R. Marzouka, MD

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background: Acute coronary syndrome (ACS) hospital admissions decreased during the start of the COVID-19 outbreak. Information is limited on how Google searches were related to patients' behaviour during this time. Methods: We examined de-identified data from 2019 through 2020 regarding the following monthly items: (i) admissions for ACS from the Veterans Affairs Healthcare System; (ii) out-of-hospital cardiac arrest (OHCA) from the National Emergency Medical Services Information System (NEMSIS) public dataset; and (iii) Google searches for “chest pain,” “coronavirus,” “chest pressure,” and “hospital safe” from Google Trends. We analyzed the trends for ACS admissions, OHCA, and Google searches. Results: During the early months of the first COVID-19 outbreak, the following occurred: (i) Veterans Affairs data showed a significant reduction in ACS admissions at a national and regional (Florida) level; (ii) the NEMSIS database showed a marked increase in OHCA at a national level; and (iii) Google Trends showed a significant increase in the before-mentioned Google searches at a national and regional level. Conclusions: ACS hospital admissions decreased during the beginning of the pandemic, likely owing to delayed healthcare utilization secondary to patients fear of acquiring a COVID-19 infection. Concordantly, the volume of Google searches for hospital safety and ACS symptoms increased, along with OHCA events, during the same time. Our results suggest that Google Trends may be a useful tool to predict patients’ behaviour and increase preparedness for future events, but statistical strategies to establish association are needed. Résumé: Contexte: Les admissions à l’hôpital pour un syndrome coronarien aigu (SCA) ont diminué au début de la pandémie de COVID-19. Or, il existe peu de données sur les recherches effectuées par les patients dans Google pendant cette période. Méthodologie: Nous avons examiné des données mensuelles dépersonnalisées de 2019 à 2020 sur les éléments suivants : i) admissions pour un SCA dans le système de santé de Veterans Affairs aux États-Unis; ii) arrêts cardiaques extrahospitaliers (ACEH) de l’ensemble de données publiques du National Emergency Medical Services Information System (NEMSIS); et iii) les recherches dans Google selon Google Trends pour « chest pain » (douleur thoracique), « coronavirus », « chest pressure » (oppression thoracique) et « hospital safe » (sécurité dans les hôpitaux). Nous avons également analysé les tendances relatives aux admissions pour un SCA, aux ACEH et aux recherches dans Google. Résultats: Pour les premiers mois de la première vague de COVID-19, les observations sont les suivantes : i) les données de Veterans Affairs ont montré une réduction significative des admissions pour un SCA à l’échelle nationale et régionale (Floride); ii) la base de données du NEMSIS a montré une augmentation marquée des ACEH à l’échelle nationale; et iii) les tendances observées au moyen de Google Trends indiquent une augmentation significative à l’échelle nationale et régionale des recherches dans Google à l’aide des termes mentionnés précédemment. Conclusions: Les admissions à l’hôpital pour un SCA ont diminué au début de la pandémie, probablement en raison de la crainte des patients de contracter la COVID-19, qui les a amenés à repousser le recours à des soins de santé. Pendant la même période, le volume des recherches dans Google à propos de la sécurité dans les hôpitaux et les symptômes de SCA a augmenté, tout comme le nombre d’ACEH. Nos résultats semblent indiquer que Google Trends pourrait être un outil pratique pour prédire les comportements des patients et mieux se préparer aux événements futurs, mais il convient d’élaborer des stratégies statistiques permettant de mieux caractériser ces liens.

Published
2024
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7. SCAI Expert Consensus Statement on the Management of Patients With STEMI Referred for Primary PCI

Author

Jacqueline E. Tamis-Holland, MD, FSCAI (Chair), J. Dawn Abbott, MD, FSCAI, Karim Al-Azizi, MD, FSCAI, Nitin Barman, MD, Anna E. Bortnick, MD, PhD, MSc, FSCAI, Mauricio G. Cohen, MD, FSCAI, Payam Dehghani, MD, FSCAI, Timothy D. Henry, MD, MSCAI, Faisal Latif, MD, FSCAI, Mohammad Madjid, MD, FSCAI, Celina M. Yong, MD, MBA, MSc, FSCAI, and Yader Sandoval, MD, FSCAI (Co-Chair)

Subjects
intravascular imaging, mechanical circulatory support, microvascular obstruction, no reflow, PCI, STEMI, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

ST-elevation myocardial infarction (STEMI) remains a leading cause of morbidity and mortality in the United States. Timely reperfusion with primary percutaneous coronary intervention is associated with improved outcomes. The Society for Cardiovascular Angiography & Interventions puts forth this expert consensus document regarding best practices for cardiac catheterization laboratory team readiness, arterial access with an algorithm to help determine proper arterial access in STEMI, and diagnostic angiography. This consensus statement highlights the strengths and limitations of various diagnostic and therapeutic interventions to access and treat a patient with STEMI in the catheterization laboratory, reviews different options to manage large thrombus burden during STEMI, and reviews the management of STEMI across the spectrum of various anatomical and clinical circumstances.

Published
2024
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