Search

Transradial Access (TRA) is the suggested method when performing coronary procedures. TRA has several advantages over the transfemoral approach, but also some restrictions. The present study compared the efficacy and safety of the traditional proximal transradial approach (pTRA) with a newer technique known as the distal transradial approach (dTRA) for performing a coronary angiography (CAG) and percutaneous coronary intervention (PCI). Patients (n = 700) were placed into one of two categories (dTRA or pTRA) based on a random technique. The primary endpoint was RAO at follow-up. The secondary endpoints included the time required for sheath insertion, the rate of successful sheath insertion, rate of successful completion of CAG and PCI, total procedure time, total fluoroscopy time, total radiation dose, total contrast volume used, pain perception (visual analog scale 0–10), and hemostasis duration. dTRA patients had more skin punctures, failed punctures, failed wiring, overlap of access sites, sheath insertion time, and pain evaluation scale, while the pTRA group had more hemostasis time and first-time cannulation. RAO and pseudoaneurysm (PseA) were lower in the dTRA group. In this randomized study, dTRA had lower RAO and PseA than pTRA. However, multicenter, larger-patient trials are needed to provide definitive evidence. [ABSTRACT FROM AUTHOR]

Aim: The transradial technique (TRA) has become widely accepted for coronary catheterization. While TRA offers numerous benefits, certain anatomical challenges can lead to access failure. Balloon-assisted tracking (BAT) has emerged as a valuable technique to overcome these challenges and improve success rates. This study aims to evaluate the feasibility and efficacy of BAT during coronary interventions using TRA. Methods: A retrospective analysis was conducted on patients who underwent diagnostic or percutaneous coronary intervention (PCI) procedures between September 2020 and May 2023. Patient demographics, clinical data, and procedural information were collected for cases where BAT was employed to overcome radial or brachial arterial complexity. Results: A total of 23 patients encountered anatomical difficulties necessitating BAT during the procedure, both elective and acute coronary syndrome (ACS). Radial artery spasm was the most common indication for BAT, with a high proportion of female patients. Successful completion of coronary intervention using BAT, without the need for femoral artery crossover, was achieved in all cases except one. Also, the complexity of anatomy (such as tortuosity, arterial loop, or small artery crossing) was another reason for BAT use. The mean procedural time was 47.9 minutes, and no complications related to the access site were observed. Conclusions: The findings demonstrate that BAT is a safe and effective technique for overcoming complex radial artery anatomical challenges and radial spasm during TRA. The study supports the adoption of BAT in TRA procedures and highlights its potential benefits in both elective and ACS cases. [ABSTRACT FROM AUTHOR]

Aim: Paroxysmal supraventricular tachycardia (PSVT), particularly atrioventricular nodal reentrant tachycardia (AVNRT), is a common arrhythmia with no associated structural heart disease. Inflammation has been implicated in the pathogenesis of arrhythmias. Uric acid to high density lipoprotein (HDL)-cholesterol ratio (UHR) is a novel inflammation marker that has been investigated in various conditions. This study aimed to explore the potential association between UHR and AVNRT. Materials and Methods: A total of 136 patients were included in the study, including 86 patients with AVNRT and 50 controls with normal electrophysiological study. All patients' medical records were reviewed, and data were obtained retrospectively. We recorded baseline features, hematologic and biochemical markers, and determined the UHR value. Results: UHR (p=0.031) and uric acid (p<0.001) levels were significantly higher, while HDL cholesterol (p=0.031) levels were significantly lower in the AVNRT group. Neutrophil leukocyte ratio (NLR) was also higher in the AVNRT group (p=0.034). However, in multivariate analysis, only UHR emerged as an independent predictor for AVNRT (OR: 1.088; 95%CI: 1.022 - 1.159; p=0.008). ROC curve analysis suggested a UHR cut-off > 14.05 for predicting AVNRT with 56% sensitivity and 76% specificity. Conclusion: This study identifies UHR as a promising predictor for AVNRT, shedding light on the potential role of inflammation in the arrhythmia's development. Utilizing UHR as a readily accessible marker in the evaluation of AVNRT patients may have clinical implications. [ABSTRACT FROM AUTHOR]

Copyright of Medical Records is the property of Medical Records 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.)

Infection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality. [ABSTRACT FROM AUTHOR]

Objective: The right ventricle myocardial infarction (RVMI) is one of the leading reasons for right ventricle(RV) dysfunction. RVMI occurs in 20-50% of inferior infarctions. Echocardiography was applied to study RV involvement and proximal right coronary artery (RCA) occlusion in individuals with acute inferior MI. The objective of this study was to investigate if pulmonary annulus motion velocity (PAMVUT) levels in individuals with acute inferior myocardial infarction were linked to proximal RCA lesions. Method: The study comprised 50 people who had been diagnosed with acute inferior myocardial infarction and had culprit lesions in the right coronary artery. The RCA occlusion in Group A was proximal to the right ventricular branch, while the RCA occlusion in Group B was distant to the RV branch. The PAMVUT was tested, as well as other echocardiographic parameters. Results: In terms of metrics indicating right ventricular function, there were substantial disparities between the groups. A favorable association was established in the univariate correlation analysis between PAMVUT and RV TAPSE, with FAC, and with St.PAMVUT was identified as an independent predictor of proximal RCA occlusion in a multivariate logistic regression test. In the ROC analysis, PAMVUT<8,5 cm/s indicated proximal RCA occlusion with 85 percent sensitivity and 69 percent specificity (AUC=0.80, p<0.001). Conclusion: PAMVUT measurements were revealed to be an important predictor of proximal RCA occlusions in this investigation. [ABSTRACT FROM AUTHOR]

Background: One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings., Materials and Methods: Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system. Grouping was carried out on the basis of AMI (n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations., Results: The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001). In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper-thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found., Conclusion: We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD and a significant relationship between survival and QTc in the AMI group., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)