22 results on '"Holvoet W"'
Search Results
2. Influence of Individual Personality Traits of the Reader on Visual Assessment of Left Ventricular Ejection Fraction: Another Reason to Abandon Visual Assessment
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Knackstedt, Christian, primary, Ramaekers, Bram, additional, Schummers, Georg, additional, Schreckenberg, Marcus, additional, Faessen, Jelle, additional, Marx, Nikolaus, additional, Becker, Michael, additional, Sanders-van Wijk, Sandra, additional, van Empel, Vanessa, additional, Norra, Christine, additional, Kunert, Hanns Jürgen, additional, Brunner-La Rocca, Hans-Peter, additional, Altiok, E., additional, Becker, M., additional, Bekkers, S.C.A.M., additional, Barandiaran, A., additional, Brandenburg, V.M., additional, Brunner-la Rocca, H.P., additional, Cheriex, E.C., additional, Dettori, R., additional, Dinh, N.H.T., additional, Driessen, R., additional, van Empel, V., additional, Ertmer, J., additional, Eurlings, C., additional, Geyik, Z., additional, Hamada, S., additional, Heymans, S.R.B., additional, Holvoet, W., additional, Ilhan, M., additional, Jaarsma, C., additional, Janssen, R., additional, Kästner, W., additional, Kersten, A., additional, Lencer, N.H.K.M., additional, Luermans, J., additional, Mischke, K., additional, Pisters, R., additional, Poels, E., additional, Pluimen, M., additional, Schalla, S.M., additional, Scheenstra, B., additional, Sanders- van Wijk, S., additional, Schöder, J.W., additional, Skobel, E., additional, Stipdonk, T., additional, Stöhr, R., additional, Streukens, S.A.F., additional, Strik, M., additional, Tchaikovsky, V., additional, Theunissen, R.A.L.J., additional, Ubachs, J., additional, Vainer, J., additional, Vernooy, K., additional, Weijs, B., additional, Winkler, P., additional, and van Workum, S., additional
- Published
- 2023
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3. Influence of Individual Personality Traits of the Reader on Visual Assessment of Left Ventricular Ejection Fraction: Another Reason to Abandon Visual Assessment
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Altiok, E., Becker, M., Bekkers, S.C.A.M., Barandiaran, A., Brandenburg, V.M., Brunner-la Rocca, H.P., Cheriex, E.C., Dettori, R., Dinh, N.H.T., Driessen, R., van Empel, V., Ertmer, J., Eurlings, C., Geyik, Z., Hamada, S., Heymans, S.R.B., Holvoet, W., Ilhan, M., Jaarsma, C., Janssen, R., Kästner, W., Kersten, A., Lencer, N.H.K.M., Luermans, J., Mischke, K., Pisters, R., Poels, E., Pluimen, M., Schalla, S.M., Scheenstra, B., Sanders-van Wijk, S., Schöder, J.W., Skobel, E., Stipdonk, T., Stöhr, R., Streukens, S.A.F., Strik, M., Tchaikovsky, V., Theunissen, R.A.L.J., Ubachs, J., Vainer, J., Vernooy, K., Weijs, B., Winkler, P., van Workum, S., Knackstedt, Christian, Ramaekers, Bram, Schummers, Georg, Schreckenberg, Marcus, Faessen, Jelle, Marx, Nikolaus, Becker, Michael, Sanders-van Wijk, Sandra, van Empel, Vanessa, Norra, Christine, Kunert, Hanns Jürgen, and Brunner-La Rocca, Hans-Peter
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- 2023
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4. The Silverway Guidewire: An Observational Study on Successful Crossing when a Conventional J-tip Wire has failed
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Jo Dens, Van Den Buijs DMF, Poels EM, Ferdinande B, Cottens D, Vrolix M, Holvoet W, and Ameloot K
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Applied Mathematics ,General Mathematics - Abstract
Aim: The aim of this observational study was to evaluate the Silverway guidewire [Asahi Intecc Co.] that is designed to guide catheters during cardiac catheterization towards the aortic valve when the standard J-tip guidewire fails because of anatomical anomalies. Materials and Methods: A total of 50 consecutive patients, in which the Silverway guidewire was used, were analyzed: procedural characteristics, such as anatomical challenges, crossing of the vessel and deliverability of the catheters were prospectively collected. This sample size was considered reasonable to describe the success, because this was the first observational study on the performance of the Silverway guidewire. Results: In the majority of procedures, transradial access was used (47 cases; 94%). The Silverway guidewire was able to cross the vessel in 98% and to deliver catheters in 92% of patients. Most anatomical challenges occurred at the radial artery level (39 cases). No clinical important complications occurred after use of the Silverway guidewire. Conclusion:The Silverway guidewire is highly successful in overcoming anatomical obstacles without vascular complications during cardiac catheterization when the J-tip guidewire fails to cross the vascular anatomy.
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- 2022
5. A prospective, multi-center, randomised controlled trial for evaluation of the effectiveness of the Blimp scoring balloon in lesions not crossable with a conventional balloon or microcatheter: the BLIMP study
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Dens, J., primary, Holvoet, W., additional, McCutcheon, K., additional, Ungureanu, C., additional, Coussement, P., additional, Haine, S., additional, De Hemptinne, Q., additional, Sonck, J., additional, Eertmans, W., additional, and Bennett, J., additional
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- 2022
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6. A prospective, multi-center, randomised controlled trial for evaluation of the effectiveness of the Blimp scoring balloon in lesions not crossable with a conventional balloon or microcatheter: the BLIMP study.
- Author
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Dens, J., Holvoet, W., McCutcheon, K., Ungureanu, C., Coussement, P., Haine, S., De Hemptinne, Q., Sonck, J., Eertmans, W., and Bennett, J.
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- 2023
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7. Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation
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Nijenhuis, V.J. (V.), Brouwer, J. (Jenny), Delewi, R. (Ronak), Hermanides, R.S. (Renicus), Holvoet, W, Dubois, CLF, Frambach, P, De Bruyne, B, van Houwelingen, GK, Van Der Heyden, JAS, Toušek, P, van der Kley, F., Buysschaert, I. (Ian), Schotborgh, C.E., Ferdinande, B, van der Harst, P, Roosen, J. (Joris), Peper, J, Thielen, F.W. (Frederick), Veenstra, L, Chan Pin Yin, DRPP, Swaans, M.J., Rensing, B.J.W.M., van 't Hof, A, Timmers, L. (L.), Kelder, J.C. (Johannes), Stella, P.R. (Pieter), Baan, J., ten Berg, J, Nijenhuis, V.J. (V.), Brouwer, J. (Jenny), Delewi, R. (Ronak), Hermanides, R.S. (Renicus), Holvoet, W, Dubois, CLF, Frambach, P, De Bruyne, B, van Houwelingen, GK, Van Der Heyden, JAS, Toušek, P, van der Kley, F., Buysschaert, I. (Ian), Schotborgh, C.E., Ferdinande, B, van der Harst, P, Roosen, J. (Joris), Peper, J, Thielen, F.W. (Frederick), Veenstra, L, Chan Pin Yin, DRPP, Swaans, M.J., Rensing, B.J.W.M., van 't Hof, A, Timmers, L. (L.), Kelder, J.C. (Johannes), Stella, P.R. (Pieter), Baan, J., and ten Berg, J
- Abstract
BACKGROUND The roles of anticoagulation alone or with an antiplatelet agent after transcatheter aortic-valve implantation (TAVI) have not been well studied. METHODS We performed a randomized trial of clopidogrel in patients undergoing TAVI who were receiving oral anticoagulation for appropriate
- Published
- 2020
- Full Text
- View/download PDF
8. Aspirin with or without clopidogrel after transcatheter aortic-valve implantation
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Brouwer, J., Nijenhuis, V. J., Delewi, R., Hermanides, R. S., Holvoet, W., Dubois, C. L.F., Frambach, P., de Bruyne, B., van Houwelingen, G. K., van der Heyden, J. A.S., Toušek, P., van der Kley, F., Buysschaert, I., Schotborgh, C. E., Ferdinande, B., van der Harst, P., Roosen, J., Peper, J., Thielen, F. W.F., Veenstra, L., Chan Pin Yin, D. R.P.P., Swaans, M. J., Rensing, B. J.W.M., van't Hof, A. W.J., Timmers, L., Kelder, J. C., Stella, P. R., Baan, J., ten Berg, J. M., Brouwer, J., Nijenhuis, V. J., Delewi, R., Hermanides, R. S., Holvoet, W., Dubois, C. L.F., Frambach, P., de Bruyne, B., van Houwelingen, G. K., van der Heyden, J. A.S., Toušek, P., van der Kley, F., Buysschaert, I., Schotborgh, C. E., Ferdinande, B., van der Harst, P., Roosen, J., Peper, J., Thielen, F. W.F., Veenstra, L., Chan Pin Yin, D. R.P.P., Swaans, M. J., Rensing, B. J.W.M., van't Hof, A. W.J., Timmers, L., Kelder, J. C., Stella, P. R., Baan, J., and ten Berg, J. M.
- Abstract
BACKGROUND The effect of single as compared with dual antiplatelet treatment on bleeding and thromboembolic events after transcatheter aortic-valve implantation (TAVI) in patients who do not have an indication for long-term anticoagulation has not been well studied. METHODS In a randomized, controlled trial, we assigned a subgroup of patients who were undergoing TAVI and did not have an indication for long-term anticoagulation, in a 1:1 ratio, to receive aspirin alone or aspirin plus clopidogrel for 3 months. The two primary outcomes were all bleeding (including minor, major, and life-threatening or disabling bleeding) and non-procedure-related bleeding over a period of 12 months. Most bleeding at the TAVI puncture site was counted as non-procedure-related. The two secondary outcomes were a composite of death from cardiovascular causes, non-procedure-related bleeding, stroke, or myocardial infarction (secondary composite 1) and a composite of death from cardiovascular causes, ischemic stroke, or myocardial infarction (secondary composite 2) at 1 year, with both outcomes tested sequentially for noninferiority (noninferiority margin, 7.5 percentage points) and superiority. RESULTS A total of 331 patients were assigned to receive aspirin alone and 334 were assigned to receive aspirin plus clopidogrel. A bleeding event occurred in 50 patients (15.1%) receiving aspirin alone and in 89 (26.6%) receiving aspirin plus clopidogrel (risk ratio, 0.57; 95% confidence interval [CI], 0.42 to 0.77; P=0.001). Non-procedure-related bleeding occurred in 50 patients (15.1%) and 83 patients (24.9%), respectively (risk ratio, 0.61; 95% CI, 0.44 to 0.83; P=0.005). A secondary composite 1 event occurred in 76 patients (23.0%) receiving aspirin alone and in 104 (31.1%) receiving aspirin plus clopidogrel (difference, −8.2 percentage points; 95% CI for noninferiority, −14.9 to −1.5; P<0.001; risk ratio, 0.74; 95% CI for superiority, 0.57 to 0.95; P=0.04). A secondary composite 2 event
- Published
- 2020
9. Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation
- Author
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Nijenhuis, VJ, Brouwer, J, Delewi, R, Hermanides, RS, Holvoet, W, Dubois, CLF, Frambach, P, De Bruyne, B, van Houwelingen, GK, Van Der Heyden, JAS, Toušek, P, van der Kley, F, Buysschaert, I, Schotborgh, CE, Ferdinande, B, van der Harst, P, Roosen, J, Peper, J, Thielen, Frederick, Veenstra, L, Chan Pin Yin, DRPP, Swaans, MJ, Rensing, BJWM, van 't Hof, A, Timmers, L, Kelder, JC, Stella, P, Baan, J, ten Berg, J, Nijenhuis, VJ, Brouwer, J, Delewi, R, Hermanides, RS, Holvoet, W, Dubois, CLF, Frambach, P, De Bruyne, B, van Houwelingen, GK, Van Der Heyden, JAS, Toušek, P, van der Kley, F, Buysschaert, I, Schotborgh, CE, Ferdinande, B, van der Harst, P, Roosen, J, Peper, J, Thielen, Frederick, Veenstra, L, Chan Pin Yin, DRPP, Swaans, MJ, Rensing, BJWM, van 't Hof, A, Timmers, L, Kelder, JC, Stella, P, Baan, J, and ten Berg, J
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- 2020
10. Coronary anomaly: when you think you've seen it all
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Holvoet, W., Mihl, C., Ruiters, A. W., Kietselaer, B. L. J. H., Bekkers, S. C. A. M., Holvoet, W., Mihl, C., Ruiters, A. W., Kietselaer, B. L. J. H., and Bekkers, S. C. A. M.
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- 2019
11. Coronary anomaly: when you think you've seen it all
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Holvoet, W., primary, Mihl, C., additional, Ruiters, A. W., additional, Kietselaer, B. L. J. H., additional, and Bekkers, S. C. A. M., additional
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- 2018
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12. Advertising in a digital media environment (ADME): An interdisciplinary approach to a user-centered advertising model for IDTV
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Berte, K, Vanhecke, K, Pelssers, J, Holvoet, W, Pessemiers, T, Jans, Greet, Verbrugge, V, Deryckere, T, Martens, L, Leroux, P, De Turck, F, Demeester, P, De Bens, E, Urban, A, Sapio, B, Turk, T, Urban, A., Sapio, B., and Turk, T.
- Abstract
ispartof: pages:123-131 ispartof: Digital Television Revisited. Linking Users, Markets and Policies. Workshop proceedings, COST Action 298 ‘Participation in the Broadband Society’. pages:123-131 ispartof: COST Action 298 ‘Participation in the Broadband Society’ location:Budapest status: published
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- 2008
13. Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation.
- Author
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Nijenhuis, V. J., Brouwer, J., Delewi, R., Hermanides, R. S., Holvoet, W., F. Dubois, C. L., Frambach, P., De Bruyne, B., van Houwelingen, G. K., Van Der Heyden, J. A. S., Tousek, P., van der Kley, F., Buysschaert, I., Schotborgh, C. E., Ferdinande, B., van der Harst, P., Roosen, J., Peper, J., Thielen, F. W. F., and Veenstra, L.
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CLOPIDOGREL , *MYOCARDIAL infarction , *PLATELET aggregation inhibitors , *HEART valve prosthesis implantation , *RESEARCH & development , *ORGANIZATIONAL research , *RESEARCH , *COMBINATION drug therapy , *ORAL drug administration , *RESEARCH methodology , *ANTICOAGULANTS , *CARDIOVASCULAR diseases , *DISEASE incidence , *EVALUATION research , *MEDICAL cooperation , *COMPARATIVE studies , *RANDOMIZED controlled trials , *PROSTHETIC heart valves , *KAPLAN-Meier estimator , *HEMORRHAGE ,CARDIOVASCULAR disease related mortality - Abstract
Background: The roles of anticoagulation alone or with an antiplatelet agent after transcatheter aortic-valve implantation (TAVI) have not been well studied.Methods: We performed a randomized trial of clopidogrel in patients undergoing TAVI who were receiving oral anticoagulation for appropriate indications. Patients were assigned before TAVI in a 1:1 ratio not to receive clopidogrel or to receive clopidogrel for 3 months. The two primary outcomes were all bleeding and non-procedure-related bleeding over a period of 12 months. Procedure-related bleeding was defined as Bleeding Academic Research Consortium type 4 severe bleeding, and therefore most bleeding at the puncture site was counted as non-procedure-related. The two secondary outcomes were a composite of death from cardiovascular causes, non-procedure-related bleeding, stroke, or myocardial infarction at 12 months (secondary composite 1) and a composite of death from cardiovascular causes, ischemic stroke, or myocardial infarction (secondary composite 2), both tested for noninferiority (noninferiority margin, 7.5 percentage points) and superiority.Results: Bleeding occurred in 34 of the 157 patients (21.7%) receiving oral anticoagulation alone and in 54 of the 156 (34.6%) receiving oral anticoagulation plus clopidogrel (risk ratio, 0.63; 95% confidence interval [CI], 0.43 to 0.90; P = 0.01); most bleeding events were at the TAVI access site. Non-procedure-related bleeding occurred in 34 patients (21.7%) and in 53 (34.0%), respectively (risk ratio, 0.64; 95% CI, 0.44 to 0.92; P = 0.02). Most bleeding occurred in the first month and was minor. A secondary composite 1 event occurred in 49 patients (31.2%) receiving oral anticoagulation alone and in 71 (45.5%) receiving oral anticoagulation plus clopidogrel (difference, -14.3 percentage points; 95% CI for noninferiority, -25.0 to -3.6; risk ratio, 0.69; 95% CI for superiority, 0.51 to 0.92). A secondary composite 2 event occurred in 21 patients (13.4%) and in 27 (17.3%), respectively (difference, -3.9 percentage points; 95% CI for noninferiority, -11.9 to 4.0; risk ratio, 0.77; 95% CI for superiority, 0.46 to 1.31).Conclusions: In patients undergoing TAVI who were receiving oral anticoagulation, the incidence of serious bleeding over a period of 1 month or 1 year was lower with oral anticoagulation alone than with oral anticoagulation plus clopidogrel. (Funded by the Netherlands Organization for Health Research and Development; POPular TAVI EU Clinical Trials Register number, 2013-003125-28; ClinicalTrials.gov number, NCT02247128.). [ABSTRACT FROM AUTHOR]- Published
- 2020
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14. Giant coronary artery aneurysm of the left main treated with a covered stent: a case report.
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Holvoet W, van den Buijs D, Bogaerts E, Willems E, Ameloot K, and Dens J
- Abstract
Background: Coronary artery aneurysms (CAAs) of the left main represent a small subset of coronary artery disease and are associated with cardiovascular death. Because of its rare entity, large data are lacking and therefore treatment guidelines are missing., Case Summary: We describe a case of a 56-year-old female with a past medical history of spontaneous dissection of the distal descending left artery (LAD) 6 years before. She presented to our hospital with a non-ST elevation myocardial infarction and a coronary angiogram showed a giant saccular aneurysm of the shaft of the left main coronary artery (LMCA). Given the risk of rupture and distal embolization, the heart team decided to go for a percutaneous approach. Based on a pre-interventional 3D reconstructed CT scan and guided by intravascular ultrasound, the aneurysm was successfully excluded with a 5 mm papyrus-covered stent. At 3-month and 1-year follow-up, the patient is still asymptomatic and repeat angiographies showed full exclusion of the aneurysm and the absence of restenosis in the covered stent., Discussion: We describe the successful percutaneous IVUS-guided treatment of a giant LMCA shaft coronary aneurysm with a papyrus-covered stent with an excellent 1-year angiographic follow-up showing no residual filling of the aneurysm and no stent restenosis., Competing Interests: Conflict of interest: None declared, (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2022
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15. Intracoronary Lithotripsy in Calcified Coronary Lesions: A Multicenter Observational Study.
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El Jattari H, Holvoet W, De Roeck F, Cottens D, Ungureanu C, Bennett J, McCutcheon K, Ghafari C, Carlier S, Zivelonghi C, Segers VFM, and Dens J
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- Humans, Treatment Outcome, Coronary Artery Disease diagnosis, Coronary Artery Disease surgery, Lithotripsy, Percutaneous Coronary Intervention, Vascular Calcification diagnosis, Vascular Calcification surgery
- Abstract
Objectives: The aim of this study was to evaluate the feasibility, effectiveness, and safety of coronary intravascular lithotripsy (IVL; Shockwave Medical) in the treatment of severe coronary artery calcification (CAC) in a real-world setting., Background: Severe CAC can be an arduous obstacle in interventional cardiology, often leading to suboptimal results of percutaneous coronary interventions (PCI). Coronary IVL is a novel technique that modulates severe CAC, thereby facilitating stent implantation., Methods and Results: In this multicenter observational study, data from 134 IVL procedures in 5 Belgian hospitals were prospectively obtained. Successful delivery of the IVL catheter was achieved in all cases but 1 (99.3%). The primary endpoint was final overall procedural success, which was obtained in 88.1% of cases, an aggregate of 92.6% in de novo lesions and 77.5% in stent underexpansion or in-stent restenosis (ISR). IVL therapy effect was considered successful by the operators in 94% of cases, with 68.7% achieving optimal and 25.3% achieving suboptimal results. The 1-month major adverse cardiovascular event rate was 3%, including 2 cardiovascular deaths (1 in-stent thrombosis and 1 coronary artery perforation)., Conclusions: This real-world experience suggests that Shockwave IVL is a feasible, effective, and safe technique for the treatment of heavily calcified coronary lesions.
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- 2022
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16. Contemporary Strategies and Outcomes of Dedicated Chronic Total Occlusion Percutaneous Coronary Intervention Programs: A Prospective Multicentre Registry.
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Vanhaverbeke M, Eertmans W, Holvoet W, Hendrickx I, McCutcheon K, Dubois C, Dens J, and Bennett J
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- Chronic Disease, Coronary Angiography, Humans, Prospective Studies, Registries, Risk Factors, Treatment Outcome, Coronary Occlusion surgery, Percutaneous Coronary Intervention
- Abstract
Background: The field of CTO PCI is expanding, but successful and safe percutaneous coronary intervention (PCI) of coronary chronic total occlusions (CTO) requires a substantial resource and experience investment. We aimed to assess temporal trends in strategies and outcomes of 2 dedicated programs for CTO PCI., Methods: Between 2011 and 2020, 920 CTO PCI procedures were prospectively included at 2 referral centres in Belgium. Temporal trends were assessed, and logistic regression models were built to identify predictors of outcome., Results: Despite an increase in lesion complexity (the J-CTO score increased from 1.3 in year 1 to 1.7-2.0 in years 8-9, p < 0.001), technical success improved from 70.0% to 85.6% in year 9 ( p value for trend <0.001). We observed the most significant improvement starting at years 3-4 (OR 2.3 in year 4 versus year 1, p =0.018). Together with an increase in success rates and lesions complexity, there was an increase in the use of dual injections, retrograde approaches, the number of balloons and stents, and the use of microcatheters. Conversely, there was a decrease in large bore access, an increase in radial approach, and a shift towards contemporary dissection/reentry techniques. This strategy resulted in a stable major complication rate of 4.7% ( p value for trend 0.33). The rate of coronary procedure-related myocardial injury was high (71.0%) and was associated with the use of more intracoronary devices., Conclusions: Three to four years after initiation of a dedicated CTO PCI program with 50 CTO PCIs per year, consistent high technical success and low complication rates are achieved using contemporary strategies., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Maarten Vanhaverbeke et al.)
- Published
- 2021
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17. Bail-out extracorporeal membrane oxygenation for hydroxychloroquine intoxication: a warning for COVID-19 health-care givers.
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Holvoet W, van Soest K, Havenith T, Lorusso R, van Mook WNKA, and Delnoij T
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- Antirheumatic Agents poisoning, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid epidemiology, Comorbidity, Female, Humans, Middle Aged, COVID-19 epidemiology, Caregivers, Extracorporeal Membrane Oxygenation methods, Hydroxychloroquine poisoning
- Abstract
This case report describes an intentional intoxication with 18 g of hydroxychloroquine (HCQ) presenting with unconsciousness, ventricular dysrhythmias, cardiogenic shock and pulmonary oedema. Initial treatment consisted of sodium bicarbonate, lipid emulsion, diazepam and norepinephrine. Because of persistent cardiogenic shock veno-arterial extracorporeal membrane oxygenation (V-A ECMO) was successfully used as a bridge to recovery. This case underscores the possible side effects of HCQ and the importance of considering ECMO in cardiogenic shock caused by HCQ intoxication which may occur also in patients with coronavirus disease 2019 (COVID-19) based on the currently frequent use of such a compound.
- Published
- 2021
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18. Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation.
- Author
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Brouwer J, Nijenhuis VJ, Delewi R, Hermanides RS, Holvoet W, Dubois CLF, Frambach P, De Bruyne B, van Houwelingen GK, Van Der Heyden JAS, Toušek P, van der Kley F, Buysschaert I, Schotborgh CE, Ferdinande B, van der Harst P, Roosen J, Peper J, Thielen FWF, Veenstra L, Chan Pin Yin DRPP, Swaans MJ, Rensing BJWM, van 't Hof AWJ, Timmers L, Kelder JC, Stella PR, Baan J, and Ten Berg JM
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- Administration, Oral, Aged, Aged, 80 and over, Aspirin adverse effects, Cardiovascular Diseases epidemiology, Cardiovascular Diseases mortality, Clopidogrel adverse effects, Drug Therapy, Combination, Female, Hemorrhage epidemiology, Humans, Incidence, Male, Platelet Aggregation Inhibitors adverse effects, Postoperative Period, Thrombosis epidemiology, Aspirin therapeutic use, Clopidogrel therapeutic use, Hemorrhage chemically induced, Platelet Aggregation Inhibitors therapeutic use, Thrombosis prevention & control, Transcatheter Aortic Valve Replacement
- Abstract
Background: The effect of single as compared with dual antiplatelet treatment on bleeding and thromboembolic events after transcatheter aortic-valve implantation (TAVI) in patients who do not have an indication for long-term anticoagulation has not been well studied., Methods: In a randomized, controlled trial, we assigned a subgroup of patients who were undergoing TAVI and did not have an indication for long-term anticoagulation, in a 1:1 ratio, to receive aspirin alone or aspirin plus clopidogrel for 3 months. The two primary outcomes were all bleeding (including minor, major, and life-threatening or disabling bleeding) and non-procedure-related bleeding over a period of 12 months. Most bleeding at the TAVI puncture site was counted as non-procedure-related. The two secondary outcomes were a composite of death from cardiovascular causes, non-procedure-related bleeding, stroke, or myocardial infarction (secondary composite 1) and a composite of death from cardiovascular causes, ischemic stroke, or myocardial infarction (secondary composite 2) at 1 year, with both outcomes tested sequentially for noninferiority (noninferiority margin, 7.5 percentage points) and superiority., Results: A total of 331 patients were assigned to receive aspirin alone and 334 were assigned to receive aspirin plus clopidogrel. A bleeding event occurred in 50 patients (15.1%) receiving aspirin alone and in 89 (26.6%) receiving aspirin plus clopidogrel (risk ratio, 0.57; 95% confidence interval [CI], 0.42 to 0.77; P = 0.001). Non-procedure-related bleeding occurred in 50 patients (15.1%) and 83 patients (24.9%), respectively (risk ratio, 0.61; 95% CI, 0.44 to 0.83; P = 0.005). A secondary composite 1 event occurred in 76 patients (23.0%) receiving aspirin alone and in 104 (31.1%) receiving aspirin plus clopidogrel (difference, -8.2 percentage points; 95% CI for noninferiority, -14.9 to -1.5; P<0.001; risk ratio, 0.74; 95% CI for superiority, 0.57 to 0.95; P = 0.04). A secondary composite 2 event occurred in 32 patients (9.7%) and 33 patients (9.9%), respectively (difference, -0.2 percentage points; 95% CI for noninferiority, -4.7 to 4.3; P = 0.004; risk ratio, 0.98; 95% CI for superiority, 0.62 to 1.55; P = 0.93). A total of 44 patients (13.3%) and 32 (9.6%), respectively, received oral anticoagulation during the trial., Conclusions: Among patients undergoing TAVI who did not have an indication for oral anticoagulation, the incidence of bleeding and the composite of bleeding or thromboembolic events at 1 year were significantly less frequent with aspirin than with aspirin plus clopidogrel administered for 3 months. (Funded by the Netherlands Organization for Health Research and Development; POPular TAVI EU Clinical Trials Register number, 2013-003125-28; ClinicalTrials.gov number, NCT02247128.)., (Copyright © 2020 Massachusetts Medical Society.)
- Published
- 2020
- Full Text
- View/download PDF
19. Coronary anomaly: when you think you've seen it all.
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Holvoet W, Mihl C, Ruiters AW, Kietselaer BLJH, and Bekkers SCAM
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- Aged, Humans, Male, Computed Tomography Angiography methods, Coronary Angiography methods, Coronary Vessel Anomalies diagnosis, Coronary Vessels diagnostic imaging, Imaging, Three-Dimensional
- Published
- 2019
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20. Prosthetic valve endocarditis: positron emission tomography/computed tomography as a new golden grail.
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Holvoet W, Al Younis I, and Meeder JG
- Subjects
- Aged, 80 and over, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Bioprosthesis microbiology, Endocarditis, Bacterial microbiology, Fatal Outcome, Female, Heart Valve Prosthesis microbiology, Humans, Prosthesis-Related Infections microbiology, Staphylococcal Infections microbiology, Staphylococcus aureus isolation & purification, Bioprosthesis adverse effects, Endocarditis, Bacterial diagnosis, Heart Valve Prosthesis adverse effects, Positron Emission Tomography Computed Tomography methods, Prosthesis-Related Infections diagnosis, Staphylococcal Infections diagnosis
- Abstract
Prosthetic valve endocarditis (PVE) is a serious infection with potentially fatal consequences. Early detection is crucial for successful management and outcome. The diagnosis of PVE is challenging and is based on the Duke criteria (DC) in which echocardiography plays a crucial role. However, transthoracic and transoesophageal echocardiography have less diagnostic value in PVE compared to native valve endocarditis. Combined computed tomography and fluorodeoxyglucose positron emission is a new technique providing improved diagnostic accuracy in PVE. This paper presents a case and reviews on the role of positron emission tomography/computed tomography in PVE.
- Published
- 2018
- Full Text
- View/download PDF
21. Acute cardioversion vs a wait-and-see approach for recent-onset symptomatic atrial fibrillation in the emergency department: Rationale and design of the randomized ACWAS trial.
- Author
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Dudink E, Essers B, Holvoet W, Weijs B, Luermans J, Ramanna H, Liem A, van Opstal J, Dekker L, van Dijk V, Lenderink T, Kamp O, Kulker L, Rienstra M, Kietselaer B, Alings M, Widdershoven J, Meeder J, Prins M, van Gelder I, and Crijns H
- Subjects
- Adult, Anticoagulants therapeutic use, Atrial Fibrillation diagnosis, Atrial Fibrillation drug therapy, Electrocardiography, Emergency Service, Hospital, Female, Humans, Infusions, Intravenous, Male, Metoprolol therapeutic use, Anti-Arrhythmia Agents therapeutic use, Atrial Fibrillation therapy, Electric Countershock, Flecainide therapeutic use, Heart Rate, Watchful Waiting
- Abstract
Background: Current standard of care for patients with recent-onset atrial fibrillation (AF) in the emergency department aims at urgent restoration of sinus rhythm, although paroxysmal AF is a condition that resolves spontaneously within 24 hours in more than 70% of the cases. A wait-and-see approach with rate-control medication only and when needed cardioversion within 48 hours of onset of symptoms is hypothesized to be noninferior, safe, and cost-effective as compared with current standard of care and to lead to a higher quality of life., Design: The ACWAS trial (NCT02248753) is an investigator-initiated, randomized, controlled, 2-arm noninferiority trial that compares a wait-and-see approach to the standard of care. Consenting adults with recent-onset symptomatic AF in the emergency department without urgent need for cardioversion are eligible for participation. A total of 437 patients will be randomized to either standard care (pharmacologic or electrical cardioversion) or the wait-and-see approach, consisting of symptom reduction through rate control medication until spontaneous conversion is achieved, with the possibility of cardioversion within 48 hours after onset of symptoms. Primary end point is the presence of sinus rhythm on 12-lead electrocardiogram at 4 weeks; main secondary outcomes are adverse events, total medical and societal costs, quality of life, and cost-effectiveness for 1 year., Conclusions: The ACWAS trial aims at providing evidence for the use of a wait-and-see approach for patients with recent-onset symptomatic AF in the emergency department., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
22. Deep vein thrombosis: beware what lies beneath.
- Author
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Holvoet W, Schreurs WM, Clarijs R, Weijs B, and Mostard GJ
- Subjects
- Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Breast Neoplasms therapy, Female, Humans, Leiomyosarcoma diagnosis, Leiomyosarcoma drug therapy, Liver Neoplasms diagnosis, Liver Neoplasms drug therapy, Lung Neoplasms secondary, Palliative Care, Treatment Outcome, Leiomyosarcoma complications, Liver Neoplasms complications, Venous Thrombosis diagnosis
- Published
- 2014
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