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No reflow during percutaneous coronary intervention (PCI) is a complex issue with serious outcomes. Multiple studies have studied predictors of no-reflow during primary PCI, but data on patients with the late presentation is sparse, which constitutes the majority of patients in peripheral centers. This study aimed to determine predictors of no-reflow during PCI in patients with ST-segment elevation myocardial infarction (STEMI) in 7 days. It was a single-center prospective case-control study performed at a tertiary care center and included 958 patients with STEMI who underwent PCI within 7 days of symptom onset. Baseline and angiographic data of patients undergoing PCI were recorded and patients divided into reflow and no-reflow group. Of 958 who underwent PCI, 182 (18.9%) showed no-reflow by myocardial blush grade (MBG) < 2. No-reflow group had a higher mean age (66.46 ± 10.71 vs. 61.36 ± 9.94 years), lower systolic blood pressure (SBP) on admission (100.61 ± 26.66 vs. 112.23 ± 24.35, P < 0.0001), a higher level of peak Troponin I level (9.37 ± 2.81 vs. 7.66 ± 3.11 ng/dL, P < 0.0001), low left ventricular ejection fraction (36.71 ± 3.89 vs. 39.58 ± 4.28% respectively P < 0.0001). Among angiographic data and procedural features, multivariable logistic regression analysis identified that advanced age, reperfusion time > 6 hours, SBP < 100 mmHg on admission, functional status of Killip class for heart failure ≥ 3, lower EF (≤ 35%), low initial myocardial blush grade (≤ 1) before PCI, long target lesion length, larger reference diameter of vessel (> 3.5 mm) and high thrombus burden on angiography were found to be independent predictors of no-reflow (P < 0.05). No-reflow phenomenon after PCI for STEMI is complex and multifactorial and can be identified by simple clinical, angiographic, and procedural features. Preprocedural characters of the lesion and early perfusion decides the fate of the outcome. [ABSTRACT FROM AUTHOR]

Résumé Introduction Le succès de la chirurgie des lambeaux est fortement dépendant de la vascularisation, selon le principe de vascularisation dermique et sous dermique. Ce principe impose le respect de dimensions compatibles avec la survie du lambeau. L’angiographie au vert d’indocyanine (AVI), technique permettant une évaluation de la vascularisation par fluorescence, s’est développée au cours des deux dernières décennies. Le but de cet article est de réaliser une revue de la littérature sur la technique et d’en évaluer l’intérêt en chirurgie reconstructrice dans la pratique des lambeaux. Méthode Nous avons recherché les articles référencés sur PubMed de 1995 à 2015. Tous les types d’études et de lambeaux étaient acceptés. Les articles qui ne portaient pas sur la chirurgie reconstructrice étaient exclus. Résultats Cent cinquante-cinq articles ont été trouvés et trente-quatre ont été sélectionnés. L’AVI peut être utilisée pour le repérage des vaisseaux perforants, la détermination des contours d’un lambeau, l’évaluation de sa viabilité per- et postopératoire et l’évaluation des anastomoses. Conclusion Cette technique permet un pronostic fiable des zones de nécroses potentielles en temps-réel et de déceler plus précocement d’éventuelles complications par rapport aux techniques classiques. Summary Background The success of flap surgery is highly dependant of vascularisation, according to the principle of dermal and subdermal perfusion. This principle requires compatible dimensions for the survival of the flap. Indocyanine green angiography (ICG), a technique enabling an assessment of vascularization by fluorescence, has received a considerable impetus during the last two decades. The purpose of this article was to conduct a review on this technique and to evaluate its relevance in flap surgery. Method We reviewed all articles referenced on PubMed from 1995 till 2015 using a search combining the terms ‘indocyanine green’, ‘flap’, ‘near-infrared’, ‘fluorescence’, ‘imaging’ OR ‘angiography’. Results One hundred fifty five articles were found and among those thirty-four were selected. ICG is a reliable technique to locate perforants vessels, to determine the outlines of the flat and evaluate its per- and postoperative viability and to appraise anastomoses. Conclusion This technique allows a reliable and real-time assessment of potential necrotic areas and an improvement in the detection of complications compared to conventional techniques. [ABSTRACT FROM AUTHOR]

Résumé Un homme de 77 ans, porteur de pacemaker, présente un tableau d’insuffisance ventriculaire droite, répondant à un remaniement fibromusculaire obstructif responsable d’une gêne au remplissage ventriculaire droit et résultant du passage transfixiant de la sonde entre l’oreillette et le ventricule. Le diagnostic a reposé sur l’imagerie, en particulier l’angiographie sélective dans l’oreillette droite. Le traitement reste, pour l’instant, strictement médicamenteux. Il s’agit d’une complication inhabituelle de l’implantation d’un pacemaker ventriculaire. Les autres mécanismes décrits dans la littérature en appellent aux végétations, en cas d’endocardite, ou à la sonde du pacemaker elle-même, responsable de perforations, lacérations, ou d’adhérences avec les feuillets valvulaires. Les différents traitements possibles en cas d’échec du traitement médicamenteux sont un remplacement valvulaire chirurgical, une valvuloplastie chirurgicale ou percutanée. Tricuspid stenosis (TS) is an uncommon complication of ventricular pacemaker implantation. Mechanisms described by the literature are ventricular inflow obstruction by tricuspid vegetations (endocarditis) or multiple pacemaker leads and fibrosis secondary to mechanical trauma, accounting for perforation or laceration of the TV leaflets, or adherence between redundant loops and valve tissue. We present the case of iatrogenic tricuspid stenosis, observed in a 77-year-old man. Extrinsic tricuspid valve stenosis was detected by transthoracic echocardiography. Further investigations confirmed the intramyocardial lead position. Tricuspid valve stenosis due to transvenous leads are reported to be treated by surgical replacement, surgical valvuloplasty, or percutaneous balloon valvuloplasty. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To evaluate by intravascular ultrasound (IVUS) the characteristics of the culprit lesion with plaque rupture without significant angiographic stenosis after acute coronary syndromes (ACS). Patients and methods: After ACS, IVUS was performed in 68 patients (46.8 years±11.9) without significant angiographic stenosis (31±15%). Plaque rupture was defined as a cavity within the plaque, communicating with the arterial lumen and having an overlying residual fibrous cap fragment. Qualitative analysis defined the type of plaque, and quantitative analysis evaluated plaque plus media area, plaque volume, plaque burden, and arterial remodeling index. Patients were divided into two groups: Group I with plaque rupture (25 patients) and Group II without plaque rupture (43 patients). Results: All patients with rupture showed soft or mixed plaque but no calcified plaque. In Group I, plaque rupture was associated with a larger plaque burden (49.8±12.3% vs. 39.8±12.1%, P <.0005), a more significant plaque plus media area (7.44±2.9 vs. 5.24±2.4mm2, P <.001), a greater plaque volume (151.9±103.4 vs. 99.2±81.6mm3, P <.007), and a higher ratio of plaque volume over length (8.0±3.8 vs. 5.6±3.7mm3/mm, P <.003). In Group I, positive remodeling was more frequent than intermediate remodeling (P <.03) or negative remodeling (P <.005). In Group II, there was no significant difference between the three types of remodeling. Conclusion: The plaque ruptures responsible for ACS frequently appear on voluminous plaques with a large plaque burden and positive arterial remodeling. [Copyright &y& Elsevier]

Abstract: The transradial approach is the most frequent access used in France for coronarography and percutaneous coronary intervention. This access permits a reduction of local complications in comparison with femoral access. There are very few real contraindications of transradial approach. The use of Allen''s test before coronarography remains controversial in the transradial catheterization community. It remains a standard practice in some institutions, however many centers have stopped using Allen''s test considering that there is no evidence supporting its use. [Copyright &y& Elsevier]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Introduction: The malignant melanoma of the choroid is the most common primary malignant intraocular tumor in adults. There are currently several methods available for the treatment of choroidal melanomas. Among others, hyperthermia represents a therapeutic approach in which infrared radiation is delivered through the dilated pupil, called “transpupillary thermotherapy (TTT)”. The method was initially assumed to cause only a few side effects but gradually more and more complications have been observed. The treatment is associated with a number of vascular responses, for example arterial and venous occlusions. However neovascularizations of the choroid have only been detected twice so far and represent an extreme rarity. Case report: We report on the case of a 70-year-old patient, who developed a choroidal neovascularization (CNV) after we had performed TTT on a subfoveal choroidal melanoma with a prominence of 3.25mm and a base of 7.95mm×7.87mm. Due to insufficient regression of the tumor, the TTT was repeated twice. An indocyanine green (ICG) angiography, performed 8 months after the last TTT, showed a sea fern-shaped CNV, situated subfoveally in the area of treatment. However, leakages or accompanying hemorrhages (common in CNVs found in age-related macular degeneration) were not observed. Conclusion: The development of CNV is known after excessive use of photocoagulation causing damage to the Bruch''s membrane/retinal pigment epithelium complex which implies a risk for the development of CNV. The appearance after TTT seems to be exceptional because TTT uses heat at a level below that required for photocoagulation. Our observation could be a sign of intraocular heat damage as a long-term consequence of TTT. [Copyright &y& Elsevier]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of IRBM is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Sport related myocardial infarctions are rare. They concern a population mainly male, of more than 35 years, with a high prevalence of smoker. The initial clinical presentation is serious, with frequent ventricular fibrillations, the mode of revelation that can be a sudden death. The angiographic data mainly shows a single vessel disease or no significant lesion. These characteristics put down the problem of the validity of preparticipation screening for cardiovascular abnormalities, and in particular the place of exercise stress testing. It is advisable to continue the reflexion to determine a reasonable strategy in the tracking of the subjects at risk. This tracking, the correction of cardiovascular risk factors, the diffusion of elementary rules good sporting practices and the management of sudden death with rapid defibrillation on the sporting sites and complexes are current measurements essential to develop. [Copyright &y& Elsevier]

Abstract: Purpose: Age-related macular degeneration is the commonest overall cause of irreversible blindness in patients aged 50 or over in the Western world. Current knowledge and key points: Because of the interaction of genetic and environmental origin, the pathogenesis of this affection remains imperfectly elucidated. The disease has been traditionally classified into early and late stages with its dry and wet forms. In association with fluorescein angiography, essential for diagnosis, green indocyanin angiography and optical coherence tomography made it possible to better know the clinical forms of the disease. Patients with age-related maculopathy should consider taking a dietary supplement such as that used in the age-related eye disease study. Exudative age-related macular degeneration is approached depending on the type and localisation of the choroidal new vessels. Laser photocoagulation has only been shown to be beneficial for extra and juxtafoveal classic lesions. Photodynamic therapy with verteporfin is effective in the management of eyes with subfoveal predominantly classic lesions. The encouraging results of new therapeutic with antiangiogenic aiming against vascular endothelial growth factor are a hope to preserve the sight of our patients. Future prospects and projects: In the future, many therapeutics inhibiting neo-vessels will widen our therapeutic options in the treatment of exsudative age-related macular degeneration. [Copyright &y& Elsevier]

Abstract: Objectives: The objective of our work is to study the clinical features and the management of pulmonary embolism in a cardiology department. Material and methods: It is a retrospective study including 43 patients between 1993 and 2003 in the cardiology department of a Tunisian hospital for acute pulmonary embolism. Results: The most common clinical signs were dyspnea, pleural pain and deep venous thrombosis. The most common physical signs were tachypnea and tachycardia. Electrocardiographic abnormalities were found in 38 patients (88.4%). Chest X-ray was abnormal in 25 patients (60.5%). The arterial blood gas found hypoxia and\or hypocapnia in 95% of cases. D-dimer was high in almost totality of patients (96%). US doppler of deep leg veins was positive in more than 40% of patients. Transthoracic echocardiography was normal in more than 40% of the patients. Lung scan noted a high or very high probability in 87% of cases. Pulmonary helical CT was positive in majority of cases. Unfractionated heparin was administered to about 75% of patients and low-molecular-weight-heparin was prescribed at only 40% of patients. Conclusion: Management of pulmonary embolism in our cardiology department is characterized by the frequent use of non invasive techniques on the diagnostic view and appeal to héparine on the therapeutic view. [Copyright &y& Elsevier]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Cardiac resynchronisation therapy, associated with defibrillation therapy or not, has emerged as an effective treatment in heart failure patient.Cardiac resynchronisation technique can be difficult despite improvements in the implantation materials. Knowledge of the anatomy of the coronary venous network, especially the coronary sinus ostium and the distribution of the lateral branches could simplify device implantation. Coronarography with anterograde opacification of the coronary venous system could facilitate pre-selection of appropriate tools for coronary sinus and marginal vein catheterisation. [Copyright &y& Elsevier]

Copyright of EMC-Rhumatologie--Orthopedie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The angiography object of this study concerns the vessels imagery by X-rays. The quality assurance here deals with a quality control protocol (receipt tests), that will constitute the basement of the future constancy tests, for a steady performance of equipment. By being committed in this step, the Lariboisière hospital conforms to regular demands in France (decree Nr 2001-1154 of 05/12/2001; prescription Nr 2001-270 of 28/03/2001). The experiment protocol is composed of tests concerning essentially: the control of acquisition chain, performances depending on quality parameters in angiography, and patient dosimetry. That protocol requiered the utilization of a Barracuda multimeter (RTI), a DSA phantom (Nuclear Associate), and others small equipments. Presented results concern a DSA system GEMS LC ADVANTX set up in 1991. They show that a perfected knowledge of the DSA phantom is necessary for a correct result analysis. One notes then the limits of perceptibility concerning spatial resolution, density and concentration; dosimetry values; etc. All these results must be reproducible in next constancy tests. [Copyright &y& Elsevier]

Abstract: We present the case of a 34-year-old woman who developed, in postpartum period of an uncomplicated pregnancy, a thunderclap headache with visual disturbance associated with a severe arterial hypertension. Both clinical evolution and cerebral imaging including angio-MR confirmed the diagnosis of postpartum reversible vasoconstriction syndrome. One of the leading causes of this syndrome is the use of vasoactive drugs as it was observed in the case of this patient. It is important to consider this syndrome in the differential diagnosis in patients presenting with headache in the postpartum period. [Copyright &y& Elsevier]

A patient suffering from a brachial plexus injury after axillary arteriography is discussed. In the pertinent literature, local complications such as hematomas or pseudoaneurysms have been reported. Herein, rendering this patient, we introduce a new type of a delayed complication after the angiography–compressive injury of the brachial plexus [Copyright &y& Elsevier]

Percutaneous renal biopsy is frequently used in diagnosis of renal dysfunction. Nevertheless, complications, mostly vascular, may occur. Treatment must be minimally invasive with nephron preservation, especially in kidney failure. We present an interesting therapeutic approach with highly selective catheterization under gadolinium and glue embolization, leading to total cure of iatrogenic fistula without renal deterioration. [Copyright &y& Elsevier]