50 results on '"Homorodean C"'
Search Results
2. Assessment of complicated coronary atherosclerotic plaque during percutaneous coronary interventions: role of optical coherence tomography (OCT): 1.04
- Author
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Olinic, D., Homorodean, C., Ober, M., and Olinic, M.
- Published
- 2015
3. Interventional treatment in diabetics in the era of drug-eluting stents and compliance to the ESC guidelines: lessons learned from the Euro Heart Survey Programme
- Author
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Onuma Y., Kukreja N., Ramcharitar S., Hochadel M., Gitt A., Serruys P., Marco J., Vahanian A., Weidinger F., Wijns W., Zeymer U., Silber S., Seabra-Gomez R., Eberli F., Manini M., Bramley C., Laforest V., Taylor C., Huber K., Backer G. D., Sirakova V., Cerbak R., Thayssen P., Aziz O. A., Tammam K., Lehto S., Delahaye F., Kobulia B., Cokkinos D., Kremastinos D., Karlocai K., Shelley E., Behar S., Maggioni A., Grabauskiene V., Deckers J., Asmussen I., Stepinska J., Goncalves L., Fonseca C., Mareev V., Vasilijevic Z., Riecansky M. I., Kenda M. F., Lopez-Sendon J. L., Rosengren A., Buser P., Okay T., Sychov O., Schofield P., Gitt A. K., Tavazzi L., Gomes R. S., de la Iglesia J. M., Wallentin L., Kearney P., McGregor K., Simoons M. L., Squibb B. -M., Lilly E., Margaryan K., Khachatryan S., Doerler J., Stocker E. -M., Altenberger I. J., Heigert M., Pichler M., Christ S. G., Glogar H., Lang I., Ingerle S., De Wilde P., de Marneffe M., Vrolix B. M., Dens J., Lierde J. V., De Wagter G. X., Carlier G. M., Weyne G. A., Legrand K. V., Doneux P., Gach O., Davin L., Mievis L. E., Massart P. -E., Holvoet N. G., Giunio L., Glavas D., Vukovic I., Markovic B., Duplancic D., Runjic F., Galic S. E., Mirat J., Kala P., Semenka J., Hlinomaz O., Petrikovits E., Widimsky B. P., Tousek P., Varvarovsky P. I., Cappelen H., Helqvist O. S., Kelbaek H., Jorgensen E., Engstrom T., Saunamaki K., Kastrup J., Clemmensen P., Hansen H., Al Abbadi M., Razek H. A., Aboul el Nasr G., Ragi H., Ibrihim B., Zarif B., el Banhawy N., Sorour K., Meguid M. A., Mahrous A., Al Khashab K. A., Ahmed Abd Elmoniem F., El Emry M., El Naggar A., Saad B. A., Laanmets P., Voitk J., Lutter P., Jarvekulg S., Jalakas M., Reinmets J., Marandi T., Peeba M., Serka T., Syvannne M., Kaihovirta E., Korpilahti H. K., Vaittinen M. -A., Bassand J. -P., Espinosa D. P., Cottin B. Y., Lhuillier I., Buffet P., Lorgis L., Machecourt D. J., Bertrand B., Serrano D., Bonnet G. J. -L., Steg M. P. G., Juliard J. -M., Farnoud R., Delarche P. N., Marco P. J., Petit F., Farah B., Carrie D., Galinier M., Puel J., Cahuzac J., Roncalli J., Tauzin S., Elbaz M., Schachinger V., Gitt F. A., am Rhein Ralf Zahn L., Fraiture B., Haetinger S., Klepzig N. H., Girth E., Hauber A., Firschke O. C., Widmaier J., Hofbauer F., Huttl S., Sechtem P. U., Parade U., Linnartz S. G., Andrianidis S., Tsiavou N., Papaioannou G., Deliargyris E., Attikis M., Alexopoulos D., Davlouros P., Tsikaderis D., Dardas P., Mezilis N., Istvan E., Zoltan B., Turgeman Y., Khaled S., Feldman A., Jafari J., Manevich I., Cafri C., Ilia R., Abu-Ful A., Yaroslavslev S., Wainstain J. M., Rosenchtein G., Sheva B., Krakover R., Yakov B., Halon D., Gruberg L., Markiewicz W., Grenadier E., Boulos M., Roguin A., Kerner A., Amikam S., Ben-Tzvi M., Rezmovitz J., Mosseri H. M., Lotan H., Varshizky B., Nassar H., Daninberg H., Rot D., Vais T., Benhorin J., Keren A., Medina A., Huri Z., Brandis J. S., Schoenmann G., Kornowski N. R., Assali A., Fuch S., Hasdai D., Brosh D., Sela O., Teplitski I., Tikva P., Eisenberg O., Banai S., Finkelstein A., Hasin Y., Aboud M., Nahir M., Qarwani D., Diab G., Meloni L., Lai G., Cadeddu M., Pirisi R., Bonechi F., Nassi F., Nieri M., Taiti A., Naldoni A., Calabro F., Achilli F., Maggiolini S., Piatti L., Tiberti G., Addamiano P., Berti S., Ravani M., Palmieri C., Trianni G., Cardullo S., Cioppa A., Rubino P., Ambrosini V., Salemme L., Sorropago G., Tesorio T., Geraci G., Scalise F., Mazzeti S., Auguadro C., Esposito G., Canali G., Caccia M. E., Ruggieri C., Benedetta B., de Cesare N., De Benedictis M., Coco T., Manzotti S., Fraz O. S., Marraccini P., Danesi A., Ricci R., Ferraironi A., Olivieri E., Chiera A., Garducci S., Grasseli D., McFadden E., Cahill N., Quinn M., Crean P., Caroll E., Foley D., O'Connor S., O'Hanlon R., Lynch B., O'Donnell S., Roy J., O'Brien D., Krastina A., Erglis A., Lawand S., Dorniak W., Klaudel J., Pawlowski K., Trenkner W., Janion M., Sadowski M., Janion-Sadowska A., Skorupa I., Bystryk L., Kern A., Janiak B., Szelemej R., Ruzyllo W., Witkowski A., Deptuch T., Maczynska-Mazuruk R., Budaj A., Cegieska K. L., Opolski G., Wilczyska J., Roik M., Kochman J., Martins D., Goncalves I. M. F. J., Pereira H., Faria H., Calisto J., Matos V., Leitao-Marques A., Costa M., Oliveira H., Mota P., Santos W., Brandao V., Caires F. G., Silva B., Teles F. R. C., Almeida M., Goncalves P., Raposo L., Mourao L., Bernardes L., Pedro P. G., Ferreira R., Conduto R., Quininha J., Patricio L., Cacela D., Goncalves J. M., de Sousa L., Adao M., Carvalho L. H. C., Romeira H., Sousa J. P., Garcia J. M. M., Silva J. C., Magalhaes D., Santos P. R., Mendes S. P. G., Pipa J., Nunes L., Ferreira P., Vinereanu D., Udroiu C., Florescu N., Parvu O., Stoicescu C., Dorobantu M., Balanescu S. M., Niculescu R., Calmac L., Marinescu M., Olinic B. D., Ober M., Homorodean C., Budurea C., Hij A., Anton F., Cluj-Napoca, Ortan F., Suciu C., Ursu M., Baba C., Targu-Mures, Dragulescu S. I., Petrescu L., Slovenski M., Gavrilescu D., Dina C., Mut B., Babic R., Colic M., Topic D., Vilarrasa J. B., Pont M. P., Martorell R. M., Rohlfs I., Moreno R. M., Irurita M., Irurita J., de Gran Canaria L. P., Cervantes C. E., Galvan T., Navarro J., Franco D., Rodriguez I. S., Ramirez V. H., Fernandes-Aviles F., Revilla A., Masson N., Dupertuis V., Kachboura S., Iyisoy A., Erol M. K., Ongen Z., Babalik E., Oskan M., Ozdemir N., Oto A., Aytemir K., Yavuz B., Sahin M., Durna K., Aytekin V., Demiroglu C., Gulbaran M., Aytekin S., Catakoglu A. B., Ozme B., Gemici G., Feray H., Schofield P. M., Kahn S., Clarke S., Millington H., Di Mario C., Dempster D., Henderson R. A., Burton J., Falcon-Lang D., Cardiology, Onuma, Y., Kukreja, N., Ramcharitar, S., Hochadel, M., Gitt, A., Serruys, P., Marco, J., Vahanian, A., Weidinger, F., Wijns, W., Zeymer, U., Silber, S., Seabra-Gomez, R., Eberli, F., Manini, M., Bramley, C., Laforest, V., Taylor, C., Huber, K., Backer, G. D., Sirakova, V., Cerbak, R., Thayssen, P., Aziz, O. A., Tammam, K., Lehto, S., Delahaye, F., Kobulia, B., Cokkinos, D., Kremastinos, D., Karlocai, K., Shelley, E., Behar, S., Maggioni, A., Grabauskiene, V., Deckers, J., Asmussen, I., Stepinska, J., Goncalves, L., Fonseca, C., Mareev, V., Vasilijevic, Z., Riecansky, M. I., Kenda, M. F., Lopez-Sendon, J. L., Rosengren, A., Buser, P., Okay, T., Sychov, O., Schofield, P., Gitt, A. K., Tavazzi, L., Gomes, R. S., de la Iglesia, J. M., Wallentin, L., Kearney, P., Mcgregor, K., Simoons, M. L., Squibb, B. -M., Lilly, E., Margaryan, K., Khachatryan, S., Doerler, J., Stocker, E. -M., Altenberger, I. J., Heigert, M., Pichler, M., Christ, S. G., Glogar, H., Lang, I., Ingerle, S., De Wilde, P., de Marneffe, M., Vrolix, B. M., Dens, J., Lierde, J. V., De Wagter, G. X., Carlier, G. M., Weyne, G. A., Legrand, K. V., Doneux, P., Gach, O., Davin, L., Mievis, L. E., Massart, P. -E., Holvoet, N. G., Giunio, L., Glavas, D., Vukovic, I., Markovic, B., Duplancic, D., Runjic, F., Galic, S. E., Mirat, J., Kala, P., Semenka, J., Hlinomaz, O., Petrikovits, E., Widimsky, B. P., Tousek, P., Varvarovsky, P. I., Cappelen, H., Helqvist, O. S., Kelbaek, H., Jorgensen, E., Engstrom, T., Saunamaki, K., Kastrup, J., Clemmensen, P., Hansen, H., Al Abbadi, M., Razek, H. A., Aboul el Nasr, G., Ragi, H., Ibrihim, B., Zarif, B., el Banhawy, N., Sorour, K., Meguid, M. A., Mahrous, A., Al Khashab, K. A., Ahmed Abd Elmoniem, F., El Emry, M., El Naggar, A., Saad, B. A., Laanmets, P., Voitk, J., Lutter, P., Jarvekulg, S., Jalakas, M., Reinmets, J., Marandi, T., Peeba, M., Serka, T., Syvannne, M., Kaihovirta, E., Korpilahti, H. K., Vaittinen, M. -A., Bassand, J. -P., Espinosa, D. P., Cottin, B. Y., Lhuillier, I., Buffet, P., Lorgis, L., Machecourt, D. J., Bertrand, B., Serrano, D., Bonnet, G. J. -L., Steg, M. P. G., Juliard, J. -M., Farnoud, R., Delarche, P. N., Marco, P. J., Petit, F., Farah, B., Carrie, D., Galinier, M., Puel, J., Cahuzac, J., Roncalli, J., Tauzin, S., Elbaz, M., Schachinger, V., Gitt, F. A., am Rhein Ralf Zahn, L., Fraiture, B., Haetinger, S., Klepzig, N. H., Girth, E., Hauber, A., Firschke, O. C., Widmaier, J., Hofbauer, F., Huttl, S., Sechtem, P. U., Parade, U., Linnartz, S. G., Andrianidis, S., Tsiavou, N., Papaioannou, G., Deliargyris, E., Attikis, M., Alexopoulos, D., Davlouros, P., Tsikaderis, D., Dardas, P., Mezilis, N., Istvan, E., Zoltan, B., Turgeman, Y., Khaled, S., Feldman, A., Jafari, J., Manevich, I., Cafri, C., Ilia, R., Abu-Ful, A., Yaroslavslev, S., Wainstain, J. M., Rosenchtein, G., Sheva, B., Krakover, R., Yakov, B., Halon, D., Gruberg, L., Markiewicz, W., Grenadier, E., Boulos, M., Roguin, A., Kerner, A., Amikam, S., Ben-Tzvi, M., Rezmovitz, J., Mosseri, H. M., Lotan, H., Varshizky, B., Nassar, H., Daninberg, H., Rot, D., Vais, T., Benhorin, J., Keren, A., Medina, A., Huri, Z., Brandis, J. S., Schoenmann, G., Kornowski, N. R., Assali, A., Fuch, S., Hasdai, D., Brosh, D., Sela, O., Teplitski, I., Tikva, P., Eisenberg, O., Banai, S., Finkelstein, A., Hasin, Y., Aboud, M., Nahir, M., Qarwani, D., Diab, G., Meloni, L., Lai, G., Cadeddu, M., Pirisi, R., Bonechi, F., Nassi, F., Nieri, M., Taiti, A., Naldoni, A., Calabro, F., Achilli, F., Maggiolini, S., Piatti, L., Tiberti, G., Addamiano, P., Berti, S., Ravani, M., Palmieri, C., Trianni, G., Cardullo, S., Cioppa, A., Rubino, P., Ambrosini, V., Salemme, L., Sorropago, G., Tesorio, T., Geraci, G., Scalise, F., Mazzeti, S., Auguadro, C., Esposito, G., Canali, G., Caccia, M. E., Ruggieri, C., Benedetta, B., de Cesare, N., De Benedictis, M., Coco, T., Manzotti, S., Fraz, O. S., Marraccini, P., Danesi, A., Ricci, R., Ferraironi, A., Olivieri, E., Chiera, A., Garducci, S., Grasseli, D., Mcfadden, E., Cahill, N., Quinn, M., Crean, P., Caroll, E., Foley, D., O'Connor, S., O'Hanlon, R., Lynch, B., O'Donnell, S., Roy, J., O'Brien, D., Krastina, A., Erglis, A., Lawand, S., Dorniak, W., Klaudel, J., Pawlowski, K., Trenkner, W., Janion, M., Sadowski, M., Janion-Sadowska, A., Skorupa, I., Bystryk, L., Kern, A., Janiak, B., Szelemej, R., Ruzyllo, W., Witkowski, A., Deptuch, T., Maczynska-Mazuruk, R., Budaj, A., Cegieska, K. L., Opolski, G., Wilczyska, J., Roik, M., Kochman, J., Martins, D., Goncalves, I. M. F. J., Pereira, H., Faria, H., Calisto, J., Matos, V., Leitao-Marques, A., Costa, M., Oliveira, H., Mota, P., Santos, W., Brandao, V., Caires, F. G., Silva, B., Teles, F. R. C., Almeida, M., Goncalves, P., Raposo, L., Mourao, L., Bernardes, L., Pedro, P. G., Ferreira, R., Conduto, R., Quininha, J., Patricio, L., Cacela, D., Goncalves, J. M., de Sousa, L., Adao, M., Carvalho, L. H. C., Romeira, H., Sousa, J. P., Garcia, J. M. M., Silva, J. C., Magalhaes, D., Santos, P. R., Mendes, S. P. G., Pipa, J., Nunes, L., Ferreira, P., Vinereanu, D., Udroiu, C., Florescu, N., Parvu, O., Stoicescu, C., Dorobantu, M., Balanescu, S. M., Niculescu, R., Calmac, L., Marinescu, M., Olinic, B. D., Ober, M., Homorodean, C., Budurea, C., Hij, A., Anton, F., Cluj-Napoca, Ortan, F., Suciu, C., Ursu, M., Baba, C., Targu-Mures, Dragulescu, S. I., Petrescu, L., Slovenski, M., Gavrilescu, D., Dina, C., Mut, B., Babic, R., Colic, M., Topic, D., Vilarrasa, J. B., Pont, M. P., Martorell, R. M., Rohlfs, I., Moreno, R. M., Irurita, M., Irurita, J., de Gran Canaria, L. P., Cervantes, C. E., Galvan, T., Navarro, J., Franco, D., Rodriguez, I. S., Ramirez, V. H., Fernandes-Aviles, F., Revilla, A., Masson, N., Dupertuis, V., Kachboura, S., Iyisoy, A., Erol, M. K., Ongen, Z., Babalik, E., Oskan, M., Ozdemir, N., Oto, A., Aytemir, K., Yavuz, B., Sahin, M., Durna, K., Aytekin, V., Demiroglu, C., Gulbaran, M., Aytekin, S., Catakoglu, A. B., Ozme, B., Gemici, G., Feray, H., Schofield, P. M., Kahn, S., Clarke, S., Millington, H., Di Mario, C., Dempster, D., Henderson, R. A., Burton, J., and Falcon-Lang, D.
- Subjects
Registrie ,Male ,medicine.medical_treatment ,Angiotensin-Converting Enzyme Inhibitors ,Comorbidity ,Coronary Artery Disease ,Severity of Illness Index ,Cardiovascular Disease ,Hospital Mortality ,Registries ,Angioplasty, Balloon, Coronary ,Drug-Eluting Stents ,Middle Aged ,Clopidogrel ,Europe ,Treatment Outcome ,Drug-eluting stent ,Cardiovascular Diseases ,Practice Guidelines as Topic ,Female ,Guideline Adherence ,Inpatient ,Cardiology and Cardiovascular Medicine ,Human ,medicine.drug ,medicine.medical_specialty ,Diabetic Angiopathie ,Adrenergic beta-Antagonists ,Diabetic ,SDG 3 - Good Health and Well-being ,Internal medicine ,Diabetes mellitus ,Angioplasty ,medicine ,Humans ,Drug eluting stent ,cardiovascular diseases ,Risk factor ,Aged ,European Heart Survey ,Inpatients ,Clinical Audit ,business.industry ,Platelet Aggregation Inhibitor ,Adrenergic beta-Antagonist ,Angiotensin-Converting Enzyme Inhibitor ,Guideline ,medicine.disease ,Surgery ,Health Care Survey ,Health Care Surveys ,Conventional PCI ,Hydroxymethylglutaryl-CoA Reductase Inhibitor ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Diabetic Angiopathies ,Platelet Aggregation Inhibitors - Abstract
Aims: The objective of the study is to determine the demographics and the in-hospital outcome of diabetic and non-diabetic patients treated with percutaneous coronary interventions (PCI) in Europe, to report the type of equipment and technology used for PCI procedures in diabetics and to clarify whether the treatment of diabetic patients complies with current European Society of Cardiology (ESC) guidelines. Methods and results: A total of 14,458 patients treated with PCI were enrolled from 29 member countries of the ESC between June 2005 and January 2006. Data were collected on patient characteristics and treatment, using new Cardiology Audit and Registration Data standards. In total, 3,603 patients (24.9%) were diabetic. Diabetics were older, more often female and had a higher body mass index than non-diabetics. Diabetics had higher rates of hypercholesterolaemia and hypertension, while current smokers were more frequent in the non-diabetics. Diabetics also had significantly higher rates of previous cardiovascular events. Clopidogrel was administered only in 48.1% of diabetic patients before PCI, while IIb/IIIa inhibitors were 22.9% during PCI. At discharge, there was a major adjustment of treatment with increases in the use of Beta-blocker (80.4%), angiotensin converting enzyme inhibitor (ACEI, 71.3%) and statins (89.8%) compared with on admission (Beta-blocker 60.9%, ACEI 55.0%, statin 63.1%). Inhospital mortality was higher in diabetics (1.8% vs 1.2%) although the in-hospital MACCE rate was not significantly different (3.6% vs 3.0%, p=0.09). Conclusions: Diabetic patients treated with PCI were older with more comorbidity. According to ESC guideline, the under-usage of clopidogrel, GP IIb/IIIa inhibitors should be improved. PCI is now taken as a good opportunity to adjust the use of appropriate medication. © Europa Edition. All rights reserved.
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- 2009
4. Abstracts
- Author
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Barthelemy, O., primary, Silvain, J., additional, Brieger, D., additional, Bellemain-Appaix, A., additional, Cayla, G., additional, Beygui, F., additional, Lancar, R., additional, Collet, J. P., additional, Mercadier, A., additional, Montalescot, G., additional, Cha, K. S., additional, Nam, Y. H., additional, Kim, J. H., additional, Park, S. Y., additional, Park, T. H., additional, Kim, M. H., additional, Kim, Y. D., additional, Lee, H. C., additional, Ahn, M. S., additional, Hong, T. J., additional, Blanco, R., additional, Blanco, F., additional, Szarfer, J., additional, Garcia Escudero, A., additional, Gigena, G., additional, Gagliardi, J., additional, Rodriguez, A., additional, Sarmiento, R., additional, Affatatto, S., additional, Riccitelli, M., additional, Petris, A., additional, Datcu, M. D., additional, Pop, C., additional, Radoi, M., additional, Arsenescu-Georgescu, C., additional, Petrescu, I., additional, Petrescu, L., additional, Serban, L., additional, Nechita, E., additional, Tatu-Chitoiu, G., additional, Dorobantu, M., additional, Benedek, I., additional, Craiu, E., additional, Sinescu, C., additional, Ionescu, D. D., additional, Ginghina, C., additional, Minescu, B., additional, Izzo, A., additional, Mantovani, P., additional, Tomasi, L., additional, Dall'oglio, L., additional, Bonatti, S., additional, Rosiello, R., additional, Romano, M., additional, Agostini, F., additional, Zanini, R., additional, Zhao, Z. Y., additional, Wu, Y. J., additional, Li, J. J., additional, Yany, Y. J., additional, Qian, H. Y., additional, Tang, Y. D., additional, Timoteo, A. T., additional, Toste, A., additional, Lousinha, A., additional, Ramos, R., additional, Oliveira, J. A., additional, Ferreira, M. L., additional, Ferreira, R. C., additional, Cabades, C., additional, Diez Gil, J. L., additional, Aguar, P., additional, Sanmiguel, D., additional, Lopez-March, A., additional, Marmol, R., additional, Guerra, L., additional, Girbes, V., additional, Ferrando, J., additional, Rincon De Arellano, A., additional, Patricio, L., additional, Blondal, M., additional, Ainla, T., additional, Marandi, T., additional, Eha, J., additional, Oliveira, M. M., additional, Silva, M. N., additional, Cunha, P. S., additional, Feliciano, J., additional, Silva, S., additional, Kanovsky, J., additional, Kala, P., additional, Parenica, J., additional, Poloczek, M., additional, Prymusova, K., additional, Kubkova, L., additional, Spinar, J., additional, Olinic, D., additional, Homorodean, C., additional, Ober, M., additional, Olinic, M., additional, Andrioaia, C., additional, Condac, A., additional, Masmoudi, M., additional, Berdaoui, B., additional, Labidi, S., additional, Tapia Ballesteros, C., additional, Hernandez Luis, C., additional, Sandin, M. G., additional, Vegas, J. M., additional, Andion, R., additional, Martinez, N., additional, Gonzalez, I. A., additional, Alvarado, M., additional, Amat, I. J., additional, San Roman, J. A., additional, Garcia Gonzalez, M. J., additional, Arroyo Ucar, E., additional, Hernandez Garcia, C., additional, Dorta Martin, M., additional, Marrero Rodriguez, F., additional, Dragu, R., additional, Kapeliovich, M., additional, Hammerman, H., additional, Silva, D., additional, Cortez-Dias, N., additional, Jorge, C., additional, Silva Marques, J., additional, Carilho Ferreira, P., additional, Robalo Martins, S., additional, Almeida Ribeiro, M., additional, Calisto, C., additional, Fiuza, M., additional, Lopes, M. G., additional, Milicevic, P., additional, Panic, M., additional, Stankovic, I., additional, Milicevic, D., additional, Kalezic, T., additional, Kafedzic, S., additional, Ilic, I., additional, Cerovic, M., additional, Putnikovic, B., additional, Neskovic, A., additional, Rott, D., additional, Leibowitz, D., additional, Monhart, Z., additional, Reissigova, J., additional, Grunfeldova, H., additional, Jansky, P., additional, Valente, B., additional, Villanueva Benito, I., additional, Solla, I., additional, Paredes, E., additional, Diaz Castro, O., additional, Calvo, F., additional, Baz, J. A., additional, Iniguez, A., additional, Aleksova, A., additional, Gerloni, R., additional, Belfiore, R., additional, Carriere, C., additional, Barbati, G., additional, Fabris, E., additional, Possa, F., additional, Nait, D., additional, Milo, M., additional, Sinagra, G., additional, Marques, N., additional, Mimoso, J., additional, Gomes, V., additional, Agra Bermejo, R. M., additional, Emad Abu Assi, E. A. A., additional, Sergio Raposeiras Roubin, S. R. R., additional, Pilar Cabanas Grandio, P. C. G., additional, Carlos Pena Gil, C. P. G., additional, Jose Maria Garcia Acuna, J. M. G. A., additional, Jose Ramon Gonzalez Juanatey, J. R. G. J., additional, Daly, M. J., additional, Scott, P., additional, Owens, C. G., additional, Tomlin, A., additional, Smith, B., additional, Adgey, A. A. J., additional, Alvarez-Contreras, L. R., additional, Juarez, U., additional, Altamirano, A., additional, Arias, A., additional, Alvarez-San Gabriel, A., additional, Gonzalez-Pacheco, H., additional, Martinez-Sanchez, C., additional, Rahnavardi, M., additional, Keshtkar-Jahromi, M., additional, Vakili, H., additional, Gholamin, S., additional, Razavi, S. M., additional, Gilis-Januszewski, T., additional, Mellwig, K.- P., additional, Wiemer, M., additional, Gilis-Januszewski, J., additional, Peterschroeder, A., additional, Koerfer, J., additional, Horstkotte, D., additional, Vrsalovic, M., additional, Getaldic, B., additional, Vrkic, N., additional, Pintaric, H., additional, Khan, S., additional, Wasan, B., additional, Moretti, L., additional, Grossi, P., additional, Silenzi, S., additional, Testa, M., additional, Candelori, L., additional, Clementi, L. N., additional, Forlini, M., additional, Lando, L., additional, Pezzuoli, M. L., additional, Corradetti, P., additional, Leurent, G., additional, Pennec, P. Y., additional, Filippi, E., additional, Moquet, B., additional, Hacot, J. P., additional, Druelles, P., additional, Rialan, A., additional, Rouault, G., additional, Coudert, I., additional, Le Breton, H., additional, Gevaert, S., additional, Tromp, F., additional, Vandecasteele, E., additional, De Somer, F., additional, Van Belleghem, Y., additional, Bouchez, S., additional, Martens, F., additional, Herck, I., additional, De Pauw, M., additional, Ludka, O., additional, Sepsi, M., additional, Miklik, R., additional, Dusek, L., additional, Tomcikova, D., additional, Garcia-Acuna, J. M., additional, Aguiar-Souto, P., additional, Raposeiras Roubin, S., additional, Agra-Bermejo, R., additional, Jacquet, M., additional, Abu-Assi, E., additional, Gonzalez-Juanatey, J. R., additional, Ibatov, A., additional, Labrova, R., additional, Karlik, R., additional, Lokaj, P., additional, She, Q., additional, Deng, S. B., additional, Huang, S. H., additional, Gu, L. J., additional, Rong, J. I. A. N., additional, Wu, Z. 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J., additional, Gomez Salvador, I., additional, San Roman Calvar, J. A., additional, Mamarasulov, T. M., additional, Todorovic, L., additional, Cherneva, Z. C. H., additional, Denchev, S. D., additional, Heltai, K., additional, Boytsov, A., additional, Nikulina, N. N., additional, Zanna, D., additional, Marangelli, V., additional, Caiati, C., additional, Picon Heras, R., additional, Loureiro, M. J., additional, Urazovskaya, I., additional, Vinogradova, D., additional, Vasilieva, E., additional, Shpektor, A., additional, Conti, E., additional, Musumeci, M. B., additional, Lauri, F. 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V., additional, Galkina, J. V., additional, Timofeev, A. V., additional, Vorobyov, R. I., additional, Vorobyova, E. N., additional, Matos, L., additional, Carvalho, A. C. C., additional, Oliveira, W., additional, Cintra, F., additional, Poyares, D., additional, Andersen, M., additional, Martins, R., additional, Tufik, S., additional, Ostadal, P., additional, Brada, J., additional, Horakova, S., additional, Mlcek, M., additional, Hrachovina, V., additional, Kittnar, O., additional, Gorudko, I. V., additional, Buko, I. V., additional, Cherenkevich, S. N., additional, Polonetsky, L. Z., additional, Plotkin, V. Y., additional, Timoshina, M. A., additional, Azanchevskaya, S. V., additional, Chromov-Borisov, N. N., additional, Vorlat, A., additional, Snoep, L., additional, Claeys, M. J., additional, Vrints, C. J., additional, Palazzuoli, A., additional, Caputo, M., additional, Quatrini, I., additional, Calabro, A., additional, Antonelli, G., additional, Campagna, M. S., additional, Franci, B., additional, Nuti, R., additional, Maisel, A., additional, Negrini, M., additional, Minora, T., additional, Marino, P., additional, Seregni, R., additional, Tavlueva, E., additional, Barbarash, O., additional, Barbarash, L., additional, Janota, T., additional, Kudlicka, J., additional, Malik, K., additional, Wichterle, D., additional, Hradec, J., additional, Body, R., additional, Carley, S. D., additional, Mcdowell, G., additional, Nuttall, M., additional, Wibberley, C., additional, France, M., additional, Cruickshank, J. K., additional, Mackway-Jones, K., additional, Leon, M., additional, Cozma, C., additional, Mitu, F., additional, Almeida, D. R., additional, Dias, C. B., additional, Burazor, I., additional, Burazor, M., additional, Krstic, M., additional, Lazovic, M., additional, Vukmanovic, M., additional, Djordjevic, J., additional, Radovanovic, Z., additional, Ilic, D., additional, Bosnjakovic, P., additional, Ferreira, A. C., additional, Mateus, P. S., additional, Fontes, P., additional, Teixeira, T., additional, Conte, G., additional, Menozzi, A., additional, Solinas, E., additional, Bolognesi, M. G., additional, Tadonio, I., additional, Mantovani, F., additional, Cattabiani, A., additional, Vignali, L., additional, Ardissino, D., additional, Tautu, O., additional, Alexandrescu, A., additional, Niculescu, R., additional, Jankovic, R., additional, Bozinovic, N., additional, Santos, C., additional, Costa, F., additional, Cardoso, G., additional, Correia, I., additional, Fountoulaki, K., additional, Kastellanos, S., additional, Voltirakis, E., additional, Kokotos, A., additional, Michalakeas, C., additional, Kontsas, K., additional, Hasioti, K., additional, Iliodromitis, E. T., additional, Sandin Fuentes, M. G., additional, Zatarain Nicolas, E., additional, Martinez Uruena, N., additional, Alvarado Montes De Oca, M., additional, Dytrych, V., additional, Kovarnik, T., additional, Smid, O., additional, Kral, A., additional, Aroutunov, A. G., additional, Intwala, S., additional, Jegere, I., additional, Shaalan, H. S. H., additional, Pagava, Z., additional, Agladze, R., additional, Shakarishvili, R., additional, Sharashidze, N., additional, Gujejiani, L., additional, Saatashvili, G., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Vukotic, S., additional, Rafajlovski, S., additional, Romanovic, R., additional, Antonijevic, N., additional, Gligic, B., additional, Hutyra, M., additional, Skala, T., additional, Horak, D., additional, Vindis, D., additional, Taborsky, M., additional, Contine, A., additional, Del Pinto, M., additional, Angeli, F., additional, Verdecchia, P., additional, Borgognoni, F., additional, Grikstaite, E., additional, Pantano, P., additional, Ambrosio, G., additional, Cavallini, C., additional, Bonanad, C., additional, Sanchis, J., additional, Bodi, V., additional, Nunez, J., additional, Bosch, X., additional, Heras, M., additional, Pellicer, M., additional, Llacer, A., additional, Adao, L., additional, Oliveira, M., additional, Goncalves, H., additional, Primo, J., additional, Gama, V., additional, Lombardi, C., additional, Metra, M., additional, Bugatti, S., additional, Pasotti, E., additional, Quinzani, F., additional, Adamo, M., additional, Villa, C., additional, Rovetta, R., additional, Manerba, A., additional, Mariani, M., additional, Dushpanova, A., additional, Baroni, M., additional, Cerone, E., additional, Nardelli, A., additional, Gianetti, J., additional, Berti, S., additional, Feliciano, F., additional, Soares, R., additional, Santos, S., additional, Kruger, A., additional, Vondrakova, D., additional, Herget, J., additional, Navarro, C., additional, Cromie, N. A., additional, Adgey, J. A. A., additional, Caeiro Pereira, D., additional, Braga, P., additional, Fontes Carvalho, R., additional, Rodrigues, A., additional, Goncalves, M., additional, Simoes, L., additional, and Borisov, K. V., additional
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- 2010
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5. Templates implementation for structured DICOM diagnosis reporting in echocardiography
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Homorodean, C., primary, Olinic, D., additional, Nedevschi, S., additional, and Olinic, N., additional
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- 2005
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6. Structured reporting of echocardiography images in a DICOM environment.
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Nedevschi, S., Rusu, F., Popa, I., Smeu, A., Olinic, D., and Homorodean, C.
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- 2004
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7. A proposal for structured diagnosis reporting in echocardiography, using a DICOM compliant environment.
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Olinic, D., Homorodean, C., Nedevschi, S., Rusu, F., Smeu, A., Popa, I., Vancea, A., and Olinic, N.
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- 2004
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8. DICOM compliant environment for structured reporting in echocardiography.
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Nedevschi, S., Olinic, D., Popovici, R., Rusu, F., Smeu, A., and Homorodean, C.
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- 2003
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9. Ambulatory Blood Pressure Monitoring in Chronic Congestive Heart Failure in Normotensive and in Sinus Rhythm Patients with Ischemic Heart Disease.
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Maria, Olinic, Homorodean, C., and Olinic, D.
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AMBULATORY blood pressure monitoring , *CONGESTIVE heart failure , *SINUSITIS , *CORONARY disease , *BLOOD pressure , *HYPOTENSION , *PATIENTS - Abstract
Objectives: The objective of this study is to analyse the blood pressure behaviour, before and after compensation by medical treatment of decompensated chronic congestive heart failure, in normotensive and in sinus rhythm patients with ischemic heart disease. Its main purpose is to find out whether heart failure compensation is associated with still normal blood pressures or, on the contrary, with the risk of an arterial hypotension. Methods: Data recorded by 24 hours ambulatory blood pressure monitoring, before and after an efficient compensation of heart failure in 16 patients (13 males and 3 females) with decompensated chronic congestive heart disease secondary to ischemic heart disease in functional NYHA classes III (5 patients) or IV (11 patients) were analysed and compared. Results: In the decompensated state, mean systolic blood pressure per 24 h was normal, but well below the superior limit accepted as normal. Significant decreases of all systolic and diastolic blood pressures, per 24 h, diurnal and nocturnal, close to or even in the domain of arterial hypotension, were recorded after the efficient compensatory treatment. None of the patients had clinical symptoms of arterial hypotension. Significant prevalence of the non-dipper state, high in the decompensated state and still present after the efficient heart failure compensation, was found. A significant decrease of the heart rate after heart failure compensation was observed. Decompensated state was associated mainly with heart rates above 70/min, while the compensated state was associated mainly with heart rates below 70/min. Conclusions: Significant asymptomatic decrease of the blood pressure, with a tendency towards arterial hypotension, is revealed by ambulatory blood pressure monitoring, after the efficient treatment of the decompensated chronic congestive heart failure, in normotensive and in sinus rhythm patients with ischemic heart disease. This blood pressure decrease could add a supplementary cardiovascular risk. A high prevalence of the non-dipper state, with its negative significance, was found especially in the decompensated, but also in the compensated state of the chronic congestive heart failure. [ABSTRACT FROM AUTHOR]
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- 2011
10. OCT IMAGING OF A WIDE SPECTRUM OF CULPRIT PLAQUE MORPHOLOGY FEATURES IN ACUTE CORONARY SYNDROMES
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Horea-Laurentiu Onea, Spinu, M., Homorodean, C., Olinic, M., and Olinic, D. -M
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Cardiology and Cardiovascular Medicine
11. Assessment of complicated coronary atherosclerotic plaque during percutaneous coronary interventions: role of optical coherence tomography (OCT)
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Olinic, D., Homorodean, C., Mihai Claudiu Ober, and Olinic, M.
12. Incidence and timing of complications in STEMI patients treated with PPCI: implications for the appropriate use of invasive ICCU facilities
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Olinic, D., Homorodean, C., Mihai Claudiu Ober, Olinic, M., Andrioaia, C., Condac, A., Masmoudi, M., Berdaoui, B., and Labidi, S.
13. Structured reporting of echocardiography images in a DICOM environment
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Nedevschi, S., primary, Rusu, F., additional, Popa, I., additional, Smeu, A., additional, Olinic, D., additional, and Homorodean, C., additional
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14. A proposal for structured diagnosis reporting in echocardiography, using a DICOM compliant environment
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Olinic, D., primary, Homorodean, C., additional, Nedevschi, S., additional, Rusu, F., additional, Smeu, A., additional, Popa, F., additional, Vancea, A., additional, and Olinic, N., additional
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15. Benefits and Challenges of Drug-Coated Balloons in Peripheral Artery Disease: From Molecular Mechanisms to Clinical Practice.
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Tataru DA, Lazar FL, Onea HL, Homorodean C, Ober MC, Olinic M, Spinu M, and Olinic DM
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- Humans, Coated Materials, Biocompatible chemistry, Drug-Eluting Stents, Peripheral Arterial Disease therapy, Angioplasty, Balloon methods
- Abstract
Multiple clinical trials have reported favorable outcomes after drug-coated balloon therapy for peripheral artery disease in above-the-knee and below-the-knee lesions and in both de novo and in-stent restenosis. However, there are still insufficient data to identify and tackle the risk factors associated with a higher risk of restenosis, which is the primary concern for patients who are treated with an endovascular approach. A modern armamentarium, which includes improved lesion preparation techniques such as plaque modification balloons, mechanical atherectomy, intravascular lithotripsy, and imaging, is crucial for obtaining better long-term clinical outcomes. Moreover, a better understanding of the molecular properties of drug-coated balloons has led to improved devices that could tackle the shortcomings of previous generations. This comprehensive review focuses on drug-coated balloon technology as a tool to treat peripheral artery disease and the effects of the molecular mechanisms involved in preventing vascular restenosis.
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- 2024
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16. Ultrasonography for the optimal selection of patients suitable for single session arteriography and endovascular revascularization in severe peripheral artery disease.
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Spinu M, Gligor RI, Olinic M, Homorodean C, Ober MC, Tataru D, Sabiescu B, Onea L, Achim A, Laza L, and Olinic DM
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Aims: Peripheral artery disease (PAD) represents a high burden on the healthcare and social assistance systems. Revascularization reduces symptoms, amputation rate and increases the chances of social reintegration. Our aim was to evaluate the benefits of vascular duplex ultrasonography (DUS) for identifying patients suitable for direct percutaneous transluminal angioplasty (PTA) without the need for a prior angiography., Material and Methods: We included in the study 251 patients with PAD evaluated by DUS. Depending on the DUS findings the patients were split in two groups: group I, 143 patients (57%), in which selective angiography and direct PTA was performed and group 2, 108 patients (43%), in which invasive arteriography was considered necessary prior to a decision for revascularization. Results: The first group had a similar success rate (92.3% vs. 86.1%; p=0.111), but with a reduction in radioscopy time (minutes) (17.2 vs. 20.8; p=0.013), iodine contrast volume (ml) (190 vs. 227.5; p<0.001), days of hospitalization (4 vs. 7; p<0.001) and by 44.75% (p<0.001) of hospitalization costs when compared to the second group., Conclusions: DUS allows the optimal selection of patients who can benefit from direct PTA. This strategy has a high success rate, with a significant decrease in radioscopy exposure time, volume of iodine contrast needed, duration and hospitalization costs, when compared to arteriography and PTA in two different sessions.
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- 2024
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17. A Review Paper on Optical Coherence Tomography Evaluation of Coronary Calcification Pattern: Is It Relevant Today?
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Onea HL, Olinic M, Lazar FL, Homorodean C, Ober MC, Spinu M, Achim A, Tataru DA, and Olinic DM
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The process of coronary calcification represents one of the numerous pathophysiological mechanisms involved in the atherosclerosis continuum. Optical coherence tomography (OCT) represents an ideal imaging modality to assess plaque components, especially calcium. Different calcification patterns have been contemporarily described in both early stages and advanced atherosclerosis. Microcalcifications and spotty calcifications correlate positively with macrophage burden and inflammatory markers and are more frequently found in the superficial layers of ruptured plaques in acute coronary syndrome patients. More compact, extensive calcification may reflect a later stage of the disease and was traditionally associated with plaque stability. Nevertheless, a small number of culprit coronary lesions demonstrates the presence of dense calcified plaques. The purpose of the current paper is to review the most recent OCT data on coronary calcification and the interrelation between calcification pattern and plaque vulnerability. How different calcified plaques influence treatment strategies and associated prognostic implications is of great interest.
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- 2024
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18. Peripheral Artery Disease Ultrasound Assessment in Predicting the Severity of Coronary Artery Disease.
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Olinic M, Lazar FL, Onea HL, Homorodean C, Ober M, Tataru D, Spinu M, Achim A, and Olinic DM
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Atherosclerosis in a progressive disease that is systemic in nature, and hence the simultaneous presentation of coronary artery disease (CAD) and peripheral artery disease (PAD) is not uncommon. As clinically manifested PAD is associated with worse cardiovascular outcomes, the timely identification of subclinical atherosclerosis seems of utmost importance. Ultrasonography (US) is an ideal imaging modality for assessing PAD that is easy to use, accurate, widely available and avoids unnecessary exposure to radiation. Several US parameters have been proposed in the assessment of PAD, with varying prognostic usefulness, depending on disease location. The aim of this review is to summarize the most important evidence available on the association between US-detected atherosclerosis in different vascular sites and the presence and severity of CAD, as well as the impact of the early detection of PAD on the outcomes of patients presenting with CAD.
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- 2024
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19. The role of optical coherence tomography in guiding percutaneous coronary interventions: is left main the final challenge?
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Onea HL, Lazar FL, Olinic DM, Homorodean C, and Cortese B
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- Humans, Tomography, Optical Coherence, Ultrasonography, Interventional methods, Treatment Outcome, Percutaneous Coronary Intervention, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease surgery
- Abstract
Left main (LM) coronary artery disease is a high-risk lesion subset, with important prognostic implications for the patients. Recent advances in the field of interventional cardiology have narrowed the gap between surgical and percutaneous approach of this complex lesion setting. However, the rate of repeat revascularization remains higher in the case of percutaneous coronary intervention (PCI) on long-term follow-up. As such, the need for better stent optimization strategies has led to the development of intravascular imaging techniques, represented mainly by intravascular ultrasound (IVUS) and optical coherence tomography (OCT). These techniques are both able to provide excellent pre- and post-PCI guidance. While IVUS is an established modality in optimizing LM PCI, and is recommended by international revascularization guidelines, data and experience on the use of OCT are still limited. This review paper deeply analyzes the current role of OCT imaging in the setting of LM disease, particularly focusing on its utility in assessing plaque morphology and distribution, vessel dimensions and proper stent sizing, analyzing mechanisms of stent failure such as malapposition and underexpansion, guiding bifurcation stenting, as well as offering a direct comparison with IVUS in this critical clinical scenario, based on the most recent available data.
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- 2024
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20. Correction: Outcomes after stenting of renal artery stenosis in patients with high-risk clinical features.
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Homorodean C, Ober MC, Spinu M, Olinic M, Tataru DA, Onea HL, Achim A, Lazar LF, Homorodean R, Deak B, and Olinic DM
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- 2024
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21. Outcomes after stenting of renal artery stenosis in patients with high-risk clinical features.
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Homorodean C, Ober MC, Spinu M, Olinic M, Tataru DA, Onea HL, Achim A, Lazar LF, Homorodean R, Deak B, and Olinic DM
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Background: In patients with renal artery stenosis, revascularization was seen as a mean to improve outcomes, but large studies failed to show significant benefit in general population. However, data on benefits of renal artery stenting in patients with high-risk features, such as rapidly declining renal function and cardiac destabilization syndromes, are limited, as they were excluded from trials. In this descriptive study, we aimed to evaluate short- and long-term outcomes in high-risk patients with renal artery stenosis, treated by angioplasty and stenting. We have retrospectively interrogated our local databases for renal artery percutaneous interventions; patients at high-risk (rapidly declining renal function; stable chronic renal failure and bilateral renal artery disease; severe hypertensive crisis) were selected for the current analysis., Results: Of 30 patients undergoing renal artery stenting, 18 patients were deemed "high-risk." On short term, good in-hospital control of hypertension and cardiac stabilization were obtained in all patients. Renal function improved significantly only in patients admitted with rapidly declining renal function, with significant creatinine level fall from median 3.98 mg/dL to 2.02 mg/dL, p = 0.023. However, for the whole group, creatinine change was non-significant (- 0.12 mg/dL, p = NS). On the long term, five patients (27.8%) ended-up on chronic hemodialysis and six patients died (33.3%) after a median of 20 months. No death occurred during the first year after the procedure., Conclusions: Percutaneous procedures are feasible and safe in patients with high-risk renal artery stenosis, especially in those with rapidly declining renal function, probably saving some of them from the immediate need for renal replacement therapy, but long-term results are negatively influenced by the precarious general and cardio-vascular status of these patients and by the pre-existing significant renal parenchymal disease, non-related to the renal artery stenosis., (© 2024. The Author(s).)
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- 2024
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22. Correlation between Ultrasound Peak Systolic Velocity and Angiography for Grading Internal Carotid Artery Stenosis.
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Tătaru DA, Olinic M, Homorodean C, Ober MC, Spînu M, Lazăr FL, Onea L, and Olinic DM
- Abstract
(1) Background: The success of carotid revascularization depends on the accurate grading of carotid stenoses. Therefore, it is important for every vascular center to establish its protocols for the same. In this study, we aimed to determine the peak systolic velocity (PSV) thresholds that can predict moderate and severe internal carotid artery (ICA) stenoses. (2) Methods: To achieve this, we enrolled patients who underwent both duplex ultrasound (DUS) and invasive carotid artery digital subtraction angiography (DSA). The degree of ICA stenosis was assessed using the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) protocols. The PSV thresholds were determined using receiver operating characteristic (ROC) curves. (3) Results: Our study included 47 stenoses, and we found that the PSV cut-off for predicting ≥70% NASCET ICA stenoses was 200 cm/s (sensitivity 90.32%, specificity 93.75%). However, PSV did not correlate significantly with ≥50% NASCET ICA stenoses. On the other hand, the optimal PSV threshold for predicting ≥80% ECST ICA stenoses was 180 cm/s (sensitivity 100%, specificity 81.82%). (4) Conclusions: Based on our findings, we concluded that PSV is a good and simple marker for the identification of severe stenoses. We found that PSV values correlate significantly with severe NASCET and ECST stenoses, with 200 cm/s and 180 cm/s PSV thresholds. However, PSV was not reliable with moderate NASCET stenoses. In such cases, complementary imaging should be used.
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- 2024
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23. Superficial Calcified Plates Associated to Plaque Erosions in Acute Coronary Syndromes.
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Onea HL, Spinu M, Homorodean C, Ober MC, Olinic M, Lazar FL, Achim A, Tataru DA, and Olinic DM
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This study investigates the clinical relevance and therapeutic implications of the OCT identification of intracoronary superficial calcified plates (SCPs) in acute coronary syndromes (ACSs). In 70 consecutive ACS patients (pts), we studied the three main underlying ACS mechanisms: plaque erosion (PE), plaque rupture and eruptive calcified nodule (CN). The PE lesions, occurring on an intact fibrous cap overlying a heterogeneous substrate, were identified in 12/70 pts (17.1%). PE on superficial calcified plates (PE-SCP) represented 58.3% of the PE lesions (7/12 pts) and had a 10% overall incidence in the culprit lesions (7/70 pts). PE-SCP lesions occurred mostly on the left anterior descending artery, correlated with white thrombi (85.7%) and had a proximal intraplaque site (71.4%). PE-SCP lesions were treated conservatively, as nonsignificant lesions, in 4/7 pts. Our study emphasizes that the coronary calcium-related ACS risk is not only associated with the spotty calcifications or CN but also with the PE-SCP lesions.
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- 2023
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24. The Role of Ultrasound in Accessing the Distal Radial Artery at the Anatomical Snuffbox for Cardiovascular Interventions.
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Achim A, Péter OÁ, Kákonyi K, Sasi V, Nemes A, Homorodean C, Stanek A, Olinic DM, and Ruzsa Z
- Abstract
In an effort to refine transcatheter vascular interventions, radial artery access has moved more distally at the anatomical snuffbox. Here, more challenges appear as the artery is smaller, more angulated, and more difficult to palpate. Including ultrasound guidance as a mandatory step during puncture may encourage more operators to switch to this approach. In the femoral approach, ultrasound guidance is strongly recommended because of bleeding complications, whereas in the proximal (conventional) radial approach, the role of ultrasound remains optional, and in current practice, almost all cases are performed by palpation of the pulse only. However, in distal radial access, the situation is different because the artery differs in caliber and position, and imaging can help the operator for a clean puncture, especially since repeated punctures are not only painful but also any hematoma formation leads to the complete compression of the artery and failure of access. The aim of this review is to investigate the rationale of vascular ultrasound during distal radial access and to establish some techniques and anatomical landmarks for the ultrasonographic exploration of the dorsal area of the hand.
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- 2022
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25. Distinctive Morphological Patterns of Complicated Coronary Plaques in Acute Coronary Syndromes: Insights from an Optical Coherence Tomography Study.
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Onea HL, Spinu M, Homorodean C, Olinic M, Lazar FL, Ober MC, Stoian D, Itu LM, and Olinic DM
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Optical coherence tomography (OCT) is an ideal imaging technique for assessing culprit coronary plaque anatomy. We investigated the morphological features and mechanisms leading to plaque complication in a single-center observational retrospective study on 70 consecutive patients with an established diagnosis of acute coronary syndrome (ACS) who underwent OCT imaging after coronary angiography. Three prominent morphological entities were identified. Type I or intimal discontinuity, which was found to be the most common mechanism leading to ACS and was seen in 35 patients (50%), was associated with thrombus (68.6%; p = 0.001), mostly affected the proximal plaque segment (60%; p = 0.009), and had no distinctive underlying plaque features. Type II, a significant stenosis with vulnerability features (inflammation in 16 patients, 84.2%; thin-cap fibroatheroma (TCFA) in 10 patients, 52.6%) and a strong association with lipid-rich plaques (94.7%; p = 0.002), was observed in 19 patients (27.1%). Type III, a protrusive calcified nodule, which was found to be the dominant morphological pattern in 16 patients (22.9%), was found in longer plaques (20.8 mm vs. 16.8 mm ID vs. 12.4 mm SS; p = 0.04) and correlated well with TCFA (93.8%; p = 0.02) and inflammation (81.3%). These results emphasize the existence of a wide spectrum of coronary morphological patterns related to ACS.
- Published
- 2022
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26. Interventional Management of a Rare Combination of Nutcracker and Wilkie Syndromes.
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Ober MC, Lazăr FL, Achim A, Tirinescu DC, Leibundgut G, Homorodean C, Olinic M, Onea HL, Spînu M, Tătaru D, Săbiescu B, and Olinic DM
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Nutcracker and Wilkie syndromes are rare mesoaortic compression entities, and their association is even less common. Data on interventional treatment of these pathologies are still scarce, but results from limited case series are encouraging. We report the case of a previously healthy 45-year-old woman diagnosed with nutcracker and Wilkie syndromes who presented with macroscopic hematuria, intermittent pain in the left flank and hypogastric region, postprandial nausea, and unexplained significant weight loss. A successful endovascular approach with stent implantation in the left renal vein was performed, but the stent migrated toward the left kidney, and this acute complication was managed through an interventional strategy as well. At the three-month follow-up, the patient described a marked improvement in all symptoms, except for the macroscopic hematuria. As it was our strong belief that the approach was efficient, we further investigated the "hematuria", which eventually led to the diagnosis of endometrial carcinoma. A hysterectomy and bilateral adnexectomy were planned, and chemoradiotherapy was initiated with the goal of preoperative tumor reduction. To our knowledge, this is the first reported case in which both Wilkie and nutcracker syndromes were effectively treated by stent implantation in the left renal vein, complicated with very early stent migration due to inadequate apposition to the less compliant venous lumen. The treatment of the duodenal compression was indirectly included in the stenting of the left renal vein, as reclaiming the venous lumen widened the aortomesenteric angle. The aim of this review is to discuss our center's transcatheter experience with these rare disorders and explore the literature in order to establish the benefits and limitations of such an approach.
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- 2022
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27. Approaches to Peripheral Artery Disease in Diabetes: Are There Any Differences?
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Achim A, Stanek A, Homorodean C, Spinu M, Onea HL, Lazăr L, Marc M, Ruzsa Z, and Olinic DM
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- Humans, Risk Assessment, Risk Factors, Diabetes Mellitus diagnosis, Diabetes Mellitus epidemiology, Peripheral Arterial Disease epidemiology
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Peripheral artery disease (PAD) increases the risk of diabetes, while diabetes increases the risk of PAD, and certain symptoms in each disease increase the risk of contracting the other. This review aims to shed light on this harmful interplay between the two disorders, with an emphasis on the phenotype of a patient with both diabetes and PAD, and whether treatment should be individualized in this high-risk population. In addition, current guideline recommendations for the treatment of PAD were analyzed, in an attempt to establish the differences and evidence gaps across a population suffering from these two interconnected disorders.
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- 2022
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28. The invasive intracoronary imaging assessment of left main coronary artery disease.
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Dregoesc MI, Iancu AC, and Homorodean C
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- Coronary Vessels diagnostic imaging, Humans, Tomography, Optical Coherence methods, Treatment Outcome, Ultrasonography, Interventional methods, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease pathology, Percutaneous Coronary Intervention methods
- Abstract
Left main coronary artery disease is associated with an unfavorable prognosis. Evidence-based decision making regarding the optimal revascularization strategy in patients with left main disease has become a challenge, in view of the recently published data. An improvement in outcomes following left main percutaneous interventions could be achieved by reducing the rate of repeat target lesion revascularization through stent optimization techniques. In the setting of left main disease, procedural guidance by intravascular ultrasound or optical coherence tomography is essential for good long-term results, in such a way that intravascular imaging has gained more of a therapeutic connotation. Besides stent optimization, intracoronary imaging quantifies lesion severity, guides lesion preparation through morphological data, facilitates stent selection through accurate vessel sizing, identifies the landing zones, diagnoses acute vessel wall complications such as stent-related edge dissection or intramural hematoma, and defines procedural success.This review focuses on the two main intracoronary imaging techniques used for diagnostic evaluation and procedural guidance in left main coronary artery disease: intravascular ultrasound and optical coherence tomography. Based on the most recently published data, the review discusses each technique's advantages and pitfalls, and summarizes their indications.
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- 2022
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29. Safety and Feasibility of Distal Radial Balloon Aortic Valvuloplasty: The DR-BAV Study.
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Achim A, Szűcsborus T, Sasi V, Nagy F, Jambrik Z, Nemes A, Varga A, Homorodean C, Bertrand OF, and Ruzsa Z
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- Feasibility Studies, Humans, Treatment Outcome, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Balloon Valvuloplasty adverse effects, Cardiac Surgical Procedures
- Published
- 2022
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30. High-Sensitivity Troponin: A Review on Characteristics, Assessment, and Clinical Implications.
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Lazar DR, Lazar FL, Homorodean C, Cainap C, Focsan M, Cainap S, and Olinic DM
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- Biomarkers, Chest Pain, Humans, Myocardial Infarction diagnosis, Troponin blood
- Abstract
The use of high-sensitivity cardiac troponin (hs-cTn) assays has become part of the daily practice in most of the laboratories worldwide in the initial evaluation of the typical chest pain. Due to their early surge, the use of hs-cTn may reduce the time needed to recognise myocardial infarctions (MI), which is vital for the patients presenting in the emergency departments for chest pain. The latest European Society of Cardiology Guidelines did not only recognise their central role in the diagnosis algorithm but also recommended their use for rapid rule-in/rule-out of MI. High-sensitivity cardiac troponins are also powerful prognostic markers for long-term events and mortality, not only in a wide spectrum of other cardiovascular diseases (CVD) but also in several non-CVD pathologies. Moreover, these biomarkers became a powerful tool in special populations, such as paediatric patients and, most recently, COVID-19 patients. Although highly investigated, the assessment and interpretation of the hs-cTn changes are still challenging in the patients with basal elevation such as CKD or critically ill patients. Moreover, there are still various analytical characteristics not completely understood, such as circadian or sex variability, with major clinical implications. In this context, the present review focuses on summarizing the most recent research in the current use of hs-cTn, with a main consideration for its role in the diagnosis of MI but also its prognostic value. We have also carefully selected the most important studies regarding the challenges faced by clinicians from different specialties in the correct interpretation of this biomarker. Moreover, future perspectives have been proposed and analysed, as more research and cross-disciplinary collaboration are necessary to improve their performance., Competing Interests: All authors declare that they have no conflict of interest., (Copyright © 2022 Diana Raluca Lazar et al.)
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- 2022
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31. Optical Coherence Tomography-OCT for Characterization of Non-Atherosclerotic Coronary Lesions in Acute Coronary Syndromes.
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Spînu M, Onea LH, Homorodean C, Olinic M, Ober MC, and Olinic DM
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Cardiovascular diseases are the main cause of death worldwide, with coronary artery disease being the predominant underlying etiology. The most prevalent coronary lesions are represented by the atherosclerotic plaques, in more than 85% of cases, but there are several other non-atherosclerotic lesions such as spontaneous coronary artery dissection and/or hematoma and spontaneous recanalization of coronary thrombus, which are less common, approximately 5% of cases, but with similar clinical manifestations as well as complications. There are insufficient data regarding the pathological mechanism, true prevalence and optimal treatment of these kind of coronary lesions. Optical coherence tomography (OCT) is an intracoronary imaging technique, developed in order to overcome the diagnostic limitations of a standard coronary angiography and has an extremely high resolution, similar to that of a usual histological evaluation of a biopsy sample, thus, OCT provides a histological-like information, but in a in vivo environment. The aim of this article is to review the current knowledge regarding non-atherosclerotic coronary lesions, with an emphasis on the importance of OCT for optimal identification, characterization of pathogenic mechanisms and optimal treatment selection.
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- 2022
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32. Intravascular ultrasound insights into the unstable features of the coronary atherosclerotic plaques: A systematic review and meta-analysis.
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Homorodean C, Leucuta DC, Ober M, Homorodean R, Spinu M, Olinic M, Tataru D, and Olinic DM
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- Humans, Coronary Artery Disease diagnostic imaging, Plaque, Atherosclerotic diagnostic imaging, Ultrasonography, Interventional
- Abstract
Background: There is a lack of a comprehensive picture of plaque geometry and composition of unstable atherosclerotic lesions as observed with intravascular ultrasound techniques. We analysed through a systematic review with meta-analysis 39 characteristics of atherosclerotic plaques in three scenarios involving culprit and non-culprit lesions from acute coronary syndromes vs stable angina pectoris patients, and culprit vs non-culprit lesions in acute coronary syndromes patients., Methods: A systematic search of PubMed and EMBASE, from inception to April 2020 was performed. The combined odds ratios or mean differences of all IVUS characteristics were calculated with random-effects models., Results: Twenty-eight studies involving 5434 subjects, and 5618 lesions were included. Culprit lesions in acute coronary syndromes have larger plaque areas and remodeling indexes (MD = 0.13 [0.08; 0.17], p < 0.001) and contained larger necrotic cores (MD = 0.67 (95% CI 0.19;1.15), p = 0.006) that stable angina culprit lesions. In acute patients, culprit plaques were also more remodeled, had larger necrotic cores and had more frequently a Thin-Cap Fibroatheroma morphology (OR = 1.79 (95% CI 1.21; 2.65), p = 0.004) than non-culprit lesions. Non-culprit lesions in acute syndromes were more often ruptured (OR = 2.25 (95% CI:1.05; 4.82), p = 0.037) or Thin-Cap Fibroatheromas than in stable angina., Conclusion: Culprit lesions from acute coronary patients are larger, more positively remodeled and contained more lipids as compared to stable angina lesions or non-culprit in acute patients. Non culprit lesions are also more often complicated or vulnerable in acute than stable patients., (© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2022
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33. Optical Coherence Tomography for In Vivo Identification, Characterization and Optimal Treatment of Spontaneous Recanalization of Coronary Thrombus.
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Spinu M, Homorodean C, Ober MC, Olinic M, Mircea PA, and Olinic DM
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- Adult, Aged, Coronary Artery Disease diagnosis, Coronary Artery Disease diagnostic imaging, Coronary Thrombosis diagnostic imaging, Coronary Vessel Anomalies diagnostic imaging, Female, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Vascular Diseases diagnosis, Vascular Diseases diagnostic imaging, Coronary Angiography methods, Coronary Thrombosis diagnosis, Coronary Vessel Anomalies diagnosis, Tomography, Optical Coherence methods, Vascular Diseases congenital
- Abstract
Background/aim: Spontaneous recanalization of coronary thrombus (SRCT) is a rare in vivo appearance, with a nonspecific angiographic aspect. The aim of this study was to investigate the importance of optical coherence tomography (OCT) use for SRCT identification, characterization of pathogenic mechanisms and optimal treatment., Patients and Methods: We retrospectively analyzed all patients with angiographic suspicion of SRCT who underwent coronary angiography for suspected coronary artery disease and afterward investigated by OCT imaging., Results: We identified 28 cases with angiographic suspicion of SCRT (0.41% of CA) and confirmed it in 4 patients (0.05% of CA). OCT provided insight about the underlying SRCT mechanism: possible complicated atherosclerotic plaques in two cases and, respectively, spontaneous coronary artery dissection in other two cases. OCT provided accurate lesion assessment and offered optimal PCI materials selection., Conclusion: Besides providing the diagnosis, OCT also improved characterization of SRCT pathogenic mechanisms, in the four confirmed SRCT cases, supporting the role of coronary wall in situ complications, namely dissection of an atherosclerotic plaque or spontaneous dissection of a normal coronary wall., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
- Published
- 2020
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34. Unstable Angina Caused by Honeycomb-Like Coronary Lesion Identified with Use of Optical Coherence Tomography.
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Ober MC, Homorodean C, Bindea D, Spinu M, and Olinic DM
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- Aged, Angina, Unstable etiology, Angina, Unstable therapy, Coronary Artery Disease complications, Coronary Artery Disease therapy, Coronary Thrombosis complications, Coronary Thrombosis therapy, Humans, Male, Percutaneous Coronary Intervention instrumentation, Predictive Value of Tests, Stents, Angina, Unstable diagnostic imaging, Coronary Artery Disease diagnostic imaging, Coronary Thrombosis diagnostic imaging, Tomography, Optical Coherence
- Published
- 2020
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35. Acute Limb Ischemia: An Update on Diagnosis and Management.
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Olinic DM, Stanek A, Tătaru DA, Homorodean C, and Olinic M
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This review presents an update on the diagnosis and management of acute limb ischemia (ALI), a severe condition associated with high mortality and amputation rates. A comprehensive spectrum of ALI etiology is presented, with highlights on embolism and in situ thrombosis. The steps for emergency diagnosis are described, emphasizing the role of clinical data and imaging, mainly duplex ultrasound, CT angiography and digital substraction angiography. The different therapeutic techniques are presented, ranging from pharmacological (thrombolysis) to interventional (thromboaspiration, mechanical thrombectomy, and stent implantation) techniques to established surgical revascularization (Fogarty thrombembolectomy, by-pass, endarterectomy, patch angioplasty or combinations) and minor or major amputation of necessity. Postprocedural management, reperfusion injury, compartment syndrome and long-term treatment are also updated.
- Published
- 2019
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36. In ST-segment elevation myocardial infarction, the echocardiographic parameters of microvascular obstruction are not associated with left ventricular remodeling at five years of follow-up.
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Dregoesc MI, Iancu AC, Ober CD, Homorodean C, Bãlãnescu Ş, and Bolboacã S
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- Coronary Thrombosis complications, Coronary Thrombosis physiopathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Wedge Pressure, ST Elevation Myocardial Infarction complications, Coronary Circulation physiology, Coronary Thrombosis diagnostic imaging, Echocardiography, Doppler methods, Microcirculation physiology, ST Elevation Myocardial Infarction physiopathology, Ventricular Remodeling physiology
- Abstract
Objective: The correlation between the echocardiographic Doppler flow parameters of microvascular obstruction (MVO) and coronary wedge pressure (CWP) measured as a marker of severe compressive microvascular dysfunction and a predictor of adverse left ventricular remodeling was evaluated in a group of high-risk acute anterior myocardial infarction survivors., Methods: Twenty-four patients with mechanically reperfused anterior STEMI were divided into two groups based on the 38 mm Hg CWP cutoff for adverse left ventricular remodeling. Diastolic deceleration time (DDT), coronary flow reserve (CFR), systolic retrograde flow, peak systolic and peak diastolic velocities in the infarct-related artery were determined 3-5 days after revascularization. An echocardiographic 20% increase in left ventricular volumes defined adverse remodeling., Results: No significant differences were recorded between groups with regard to the echocardiographic parameters of MVO. No significant correlation was identified between CWP on one side and DDT (P = 0.30) and CFR (P = 0.39) on the other, irrespective of total ischemic time and extracted thrombus length. No difference in 5 years of follow-up left ventricular remodeling was detected in patients with DDT<900 msec as compared to those with DDT≥900 msec. The medium increase in left ventricular end-systolic volume in patients with low CWP was 24.78%, while it reached 127.27% (P = 0.03) in patients with CWP>38 mm Hg., Conclusions: Coronary wedge pressure did not correlate with the surrogate parameters for MVO, but it was a predictor of left ventricular remodeling. None of the echocardiographic MVO parameters was associated with adverse remodeling at 5 years of follow-up., (© 2019 Wiley Periodicals, Inc.)
- Published
- 2019
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37. Renal Failure Impact on the Outcomes of ST-Segment Elevation Myocardial Infarction Patients Due to a Left Main Coronary Culprit Lesion Treated Using a Primary Percutaneous Coronary Intervention.
- Author
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Homorodean C, Iancu AC, Dregoesc IM, Spînu M, Ober MC, Tãtaru D, Leucuţa D, Olinic M, and Olinic DM
- Abstract
Background: Patients with ST-segment elevation myocardial infarction (STEMI) and primary percutaneous coronary intervention (PPCI) on a left main culprit lesion have very high mortality rates. The interaction of chronic kidney disease (CKD) with such a catastrophic acute event on the background of their highly complex atherosclerotic lesions is not well established. Therefore, we sought to evaluate in these patients the influence of the estimated glomerular filtration rate (eGFR) on short- and long-term mortality., Methods: We retrospectively analyzed renal function in 81 patients with STEMI and PPCI on a left main culprit lesion from two tertiary centers., Results: Patients were divided in two groups according to an eGFR cut-off of 60 mL/min/1.73 m
2 : 40 patients with CKD and 41 without CKD. Patients with renal failure were older, had more diabetes, and had experienced more frequent myocardial infarction MIs. CKD patients had a higher baseline-SYNTAX score ( p = 0.015), higher residual-SYNTAX score ( p < 0.001), and lower SYNTAX revascularization index-SRI ( p = 0.003). Mortality at 30-day, 1-year, and 3-year follow-ups were not significantly different between the two groups. However, when analyzed as a continuous variable, eGFR emerged as a predictor of 1-year mortality, both in univariate analysis (OR = 0.97, 95% CI: 0.95-0.99, p = 0.005) and in multivariate analysis, after adjusting for cardiogenic shock and Thrombolysis in Myocardial Infarction TIMI 0/1 flow (OR = 0.975, 95% CI: 0.95-0.99, p = 0.021)., Conclusions: In STEMI with PPCI on a left main culprit lesion, renal failure was associated with more complex coronary lesions and less complete revascularization, and turned out to be an independent predictor of mortality at 1-year follow-up.- Published
- 2019
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38. Real-Life Benefit of OCT Imaging for Optimizing PCI Indications, Strategy, and Results.
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Olinic DM, Spinu M, Homorodean C, Ober MC, and Olinic M
- Abstract
Background: The aim of this study was to evaluate the benefit of standard practice Optical Coherence Tomography (OCT) imaging, as a complement to coronary angiography (CA), for optimizing the indications, strategy, and results of percutaneous coronary interventions (PCI)., Methods: We retrospectively analyzed 182 patients with OCT imaging in a single tertiary center., Results: OCT use had a low prevalence (3.1% of 4256 CAs and 1.7% of 3027 PCIs). OCT was used post-CA in 71.5% and post-PCI in 28.5% of cases, mainly in acute coronary syndromes-95.6%. OCT was performed for borderline lesions in 43.4% of cases; lesion severity was reassessed as severe and led to PCI in 64.5% of them. OCT was performed for nonsignificant lesions in 17% of cases; lesion severity was reassessed as severe and led to PCI in 38.7% of them. OCT provided optimal selection for PCI strategy in 11% of cases. OCT identified suboptimal PCI results in 54% left main PCIs and in 48% bifurcation PCIs with optimal CA; PCI optimization was performed. In the only seven patients with suboptimal PCI, OCT revealed an optimal result in four cases, thus avoiding unneccessary optimization. In 27.3% of patients with post-CA OCT and PCI result "systematic" OCT control, a PCI optimization was indicated., Conclusion: OCT supplied a major benefit in 86.2% of cases, especially by identifying significant coroanry stenosis in CA borderline and nonsignificant lesions; OCT led to PCI indication in two-thirds and, respectively, one-third of these cases. In the post-PCI context, OCT led to an indication of PCI optimization in half of the complex left main and bifurcation lesions, as well as in a quarter of "systematic" post-PCI OCT controls.
- Published
- 2019
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39. New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion.
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Homorodean C, Iancu AC, Leucuţa D, Bãlãnescu Ş, Dregoesc IM, Spînu M, Ober M, Tãtaru D, Olinic M, Bindea D, and Olinic D
- Subjects
- Age Factors, Aged, Female, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Assessment, Romania epidemiology, Shock, Cardiogenic diagnosis, Survival Analysis, Treatment Outcome, Coronary Vessels diagnostic imaging, Coronary Vessels pathology, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods, Percutaneous Coronary Intervention statistics & numerical data, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction mortality, ST Elevation Myocardial Infarction surgery
- Abstract
Objectives: The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA)., Background: Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients., Methods: 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA., Results: Cardiogenic shock (p=0.001), age (p=0.008), baseline SYNTAX Score II (p=0.006), and SYNTAX Revascularization Index (p=0.046) were independent mortality predictors at one-year follow-up. Besides cardiogenic shock (HR 3.28, p<0.001), TIMI 0/1 flow (HR 2.17, p=0.021) and age (HR 1.03, p=0.006), baseline SYNTAX Score II (HR 1.06, p=0.006), residual SYNTAX Score (HR 1.03, p=0.041), and SYNTAX Revascularization Index (HR 0.9, p=0.011) were independent predictors of mortality at three years of follow-up. In patients with TIMI 0/1 flow, the presence of Rentrop collaterals was an independent predictor for long-term survival (HR 0.24; p=0.049)., Conclusions: In this study, the complexity of coronary artery disease and the extent of revascularization represent independent mortality predictors at long-term follow-up., Competing Interests: None of the authors has any conflicts of interest to disclose., (Copyright © 2019 Cãlin Homorodean et al.)
- Published
- 2019
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40. Epidemiology of peripheral artery disease in Europe: VAS Educational Paper.
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Olinic DM, Spinu M, Olinic M, Homorodean C, Tataru DA, Liew A, Schernthaner GH, Stanek A, Fowkes G, and Catalano M
- Subjects
- Age Distribution, Comorbidity, Cost of Illness, Ethnicity, Europe epidemiology, Humans, Incidence, Prognosis, Risk Factors, Sex Distribution, Cardiovascular Diseases mortality, Coronary Artery Disease mortality, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Stroke mortality
- Abstract
This paper reviews the current epidemiological data on peripheral artery disease (PAD) in Europe. Cardiovascular disease (CVD) burden is presented and PAD prevalence is discussed, as compared to coronary (CAD) and cerebrovascular (CeVD) diseases, in European Union (EU) countries and European continent countries. The article reviews PAD clinical manifestations, PAD diagnosis, risk factors for PAD incidence and progression, PAD prognosis and financial implications. CVD mortality is higher in women than in men and in European continent countries, as compared to EU countries. While CAD and CeVD have a lower prevalence in EU countries, as compared to the whole continent, PAD and other CVDs still have a higher prevalence in EU countries. PAD prevalence vary widely between countries, increases sharply with aging and has a relation with ethnicity. CVD comorbidities are high in PAD subjects and particularly high in those with critical limb ischemia. PAD prognosis is related to CAD and CeVD mortality, that are particularly high in critical limb ischemia. This review promotes the need for global awareness on PAD burden, stimulates PAD screening and emphasizes the importance of early diagnosis and treatment of PAD and associated cardiovascular comorbidities.
- Published
- 2018
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41. Antithrombotic treatment in peripheral artery disease.
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Olinic DM, Tataru DA, Homorodean C, Spinu M, and Olinic M
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- Anticoagulants adverse effects, Drug Therapy, Combination, Endovascular Procedures, Fibrinolytic Agents adverse effects, Hemorrhage chemically induced, Humans, Peripheral Arterial Disease blood, Peripheral Arterial Disease diagnosis, Peripheral Arterial Disease epidemiology, Platelet Aggregation Inhibitors adverse effects, Risk Factors, Treatment Outcome, Vascular Surgical Procedures, Anticoagulants therapeutic use, Blood Coagulation drug effects, Fibrinolytic Agents therapeutic use, Peripheral Arterial Disease drug therapy, Platelet Aggregation Inhibitors therapeutic use
- Abstract
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke. In symptomatic PAD, dual antiplatelet therapy (DAPT) with clopidogrel and aspirin does not provide benefit over SAPT with aspirin alone and is associated with increased risk of major bleeding. DAPT with ticagrelor 60 mg b. i. d. and aspirin provides a significant major adverse cardiovascular events reduction in symptomatic PAD patients and may be considered in PAD patients with prior myocardial infarction. The use of a new thrombin receptor antagonist, vorapaxar, on top of SAPT or DAPT with aspirin and/or clopidogrel, reduces the risk of acute limb ischaemia and peripheral artery revascularization in patients with symptomatic PAD, at the cost of an increased risk for bleeding. Rivaroxaban (2.5 mg b. i. d.) plus aspirin (100 mg daily) is the first antithrombotic association that proved significant benefit for PAD patients, in terms of strong endpoints - total mortality and cardiovascular mortality. Therefore, this association shows the strongest evidence for secondary prevention of symptomatic PAD patients. In PAD patients undergoing percutaneous peripheral interventions, at least four weeks of DAPT with aspirin and clopidogrel is recommended after infrainguinal stent implantation. Stenting below-the-knee arteries is often followed by a longer period of DAPT, but no specific evidence is available. Anticoagulation is mandatory to prevent arterial occlusion during radial or brachial invasive procedures. The strategy includes use of unfractioned heparin, bivalirudin or enoxaparin. Vitamin K antagonists may be considered after autologous vein infrainguinal bypass.
- Published
- 2018
- Full Text
- View/download PDF
42. Pre-revascularization coronary wedge pressure as marker of adverse long-term left ventricular remodelling in patients with acute ST-segment elevation myocardial infarction.
- Author
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Marc MC, Iancu AC, Ober CD, Homorodean C, Bãlãnescu Ş, Sitar AV, Bolboacã S, and Dregoesc IM
- Subjects
- Biomarkers metabolism, Echocardiography methods, Female, Humans, Hypertrophy, Left Ventricular metabolism, Hypertrophy, Left Ventricular physiopathology, Male, Middle Aged, Myocardial Infarction metabolism, Patient Discharge, Percutaneous Coronary Intervention methods, Prospective Studies, Pulmonary Wedge Pressure physiology, Stroke Volume physiology, Myocardial Infarction physiopathology, Ventricular Function, Left physiology, Ventricular Remodeling physiology
- Abstract
The aim of this study was to investigate the relationship between coronary wedge pressure (CWP), measured as a marker of pre-procedural microvascular obstruction, and left ventricular remodelling in high-risk ST-segment elevation myocardial infarction (STEMI) patients. Pre-revascularization CWP was measured in 25 patients with high-risk anterior STEMI. Left ventricular volumes and ejection fraction were echocardiographically measured at discharge and at follow-up. A 20% increase in left ventricular volumes was used to define remodelling. Patients with CWP ≤ 38 mmHg were characterized by late ventricular remodelling. Patients with CWP > 38 mmHg developed a progressive remodelling process which was associated with a significant 60 months increase in left ventricular volumes (P = 0.01 for end-systolic volume and 0.03 for end-diastolic volume) and a significant decrease in left ventricular ejection fraction (P = 0.05). A significant increase in both left ventricular end-systolic (P = 0.009) and end-diastolic volume (P = 0.02) from baseline to 60 months follow-up was recorded in patients with extracted thrombus length ≥2 mm. Pre-revascularization elevated CWP was associated with increased left ventricular volumes and decreased ejection fraction at long-term follow-up. CWP was a predictor of severe left ventricular enlargement, besides extracted thrombus quantity.
- Published
- 2018
- Full Text
- View/download PDF
43. In vivo imaging of complicated atherosclerotic plaque - role of optical coherence tomography (OCT).
- Author
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Spînu M, Olinic DM, Olinic M, and Homorodean C
- Subjects
- Female, Humans, Male, Plaque, Atherosclerotic pathology, Plaque, Atherosclerotic diagnostic imaging, Tomography, Optical Coherence methods
- Abstract
Cardiovascular diseases are the main cause of death worldwide, with coronary artery disease (CAD) being the predominant underlying etiology. Coronary angiography (CA) is the current invasive method used for CAD diagnosis, as well as for defining the coronary interventional treatment strategy. However, CA offers sometimes-poor accuracy in estimating atherosclerotic plaque volume, morphology and degree of stenosis severity. Optical coherence tomography (OCT) is an intracoronary imaging technique, developed in order to overcome CA limitations and is considered to be an "optical biopsy" that provides in vivo imaging. OCT has an extremely high resolution, similar to that of a usual histological evaluation of a biopsy sample. One of the most important clinical research areas for OCT is represented by the study of the pathophysiology of coronary and carotid atherosclerotic disease, in order to improve diagnosis and optimize therapy. This article reviews OCT basic technical aspects related to its diagnosis efficacy, OCT morphological information offered in coronary artery disease, including acute coronary syndromes and non-atherosclerotic coronary disease, OCT use for morphological percutaneous coronary intervention (PCI) follow-up and stent-failure mechanisms, as well as the new three-dimensional (3D)-OCT approach for atherosclerotic plaque assessment.
- Published
- 2018
44. How should I treat this mini-crush stenting complication?
- Author
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Homorodean C, Ober MC, Iancu AC, Olinic M, Tataru D, Spinu M, Olinic DM, Burzotta F, Trani C, and Erglis A
- Subjects
- Angioplasty, Balloon, Coronary methods, Coronary Angiography methods, Humans, Male, Middle Aged, Postoperative Complications diagnostic imaging, Treatment Outcome, Postoperative Complications surgery, Stents adverse effects
- Published
- 2017
- Full Text
- View/download PDF
45. Endovascular Treatment for Acute Mesenteric Ischaemia in a Young Woman with Polyarterial Disease.
- Author
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Ober MC, Homorodean C, Tataru DA, Macarie AE, Ober CD, and Olinic DM
- Subjects
- Acute Disease, Adult, Angiography methods, Celiac Artery diagnostic imaging, Computed Tomography Angiography methods, Female, Humans, Mesenteric Artery, Superior diagnostic imaging, Mesenteric Ischemia diagnostic imaging, Renal Artery Obstruction diagnostic imaging, Renal Artery Obstruction therapy, Angioplasty methods, Mesenteric Ischemia therapy
- Abstract
Background: Acute mesenteric ischaemia is a condition with a grim prognosis on conservative treatment. Endovascular revascularisation is a promising approach for some of these patients., Case Report: We present the case of a 44-year-old woman with a history of severe arterial hypertension, left leg claudication, and overlooked symptoms of chronic mesenteric ischaemia for one year, who was admitted for severe abdominal pain for one week. Computed tomographic angiography (CTA) showed acute mesenteric ischaemia by occlusion of the coeliac trunk and the superior mesenteric artery (SMA), without bowel perforation. In addition, CTA showed tight left renal stenosis and left external iliac stenosis. We performed angioplasty with a stent of the SMA, followed by revascularisation of the left renal artery. On control injection, the SMA appeared re-occluded, requiring a second stent implantation and a loading dose of dual antiplatelet therapy, with a good final result. Subsequently, the clinical course was uneventful, with no need of surgical exploration; a second procedure was planned, aiming at iliac revascularisation. At one month, the patient was asymptomatic, with normal Doppler flow in the SMA. Angiographic control during iliac revascularisation procedure showed a permeable SMA with a good filling of the coeliac trunk territory. Because of the suspicion of fibro-muscular dysplasia as aetiology, coronary angiography and cerebral CTA were performed, in order to exclude other potential lesions., Conclusions: Endovascular revascularisation in AMI is a promising alternative to the surgical approach in patients presenting without bowel perforation. Nevertheless, its safety and many tactical details remain to be clarified. Existing networks for revascularisation in acute myocardial infarction may be useful for the implementation of this approach.
- Published
- 2017
- Full Text
- View/download PDF
46. Vasa vasorum-induced LAD dissection and haematoma in an anterior STEMI patient with nearly normal angiography: the role of OCT.
- Author
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Olinic DM, Spinu M, Homorodean C, and Olinic M
- Subjects
- Adult, Angiography, Coronary Vessels pathology, Hematoma diagnostic imaging, Humans, Male, Coronary Vessels diagnostic imaging, Hematoma complications, ST Elevation Myocardial Infarction etiology, Vasa Vasorum pathology
- Published
- 2017
- Full Text
- View/download PDF
47. Spontaneous coronary dissection: Optical coherence tomography insights before and after stenting.
- Author
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Homorodean C, Spinu M, Ober MC, Olinic M, and Olinic DM
- Subjects
- Coronary Angiography, Coronary Vessel Anomalies complications, Female, Humans, Inferior Wall Myocardial Infarction diagnostic imaging, Inferior Wall Myocardial Infarction etiology, Middle Aged, Predictive Value of Tests, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Treatment Outcome, Vascular Diseases complications, Vascular Diseases diagnostic imaging, Vascular Diseases therapy, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessel Anomalies therapy, Drug-Eluting Stents, Percutaneous Coronary Intervention instrumentation, Tomography, Optical Coherence, Vascular Diseases congenital
- Published
- 2017
- Full Text
- View/download PDF
48. Takotsubo Cardiomyopathy presenting as ST-elevation myocardial infarction: wide triggering spectrum and specific echocardiographical pattern in a consecutive case series report.
- Author
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Homorodean C, Ober MC, Olinic M, Homorodean R, Hassoune A, Tătaru D, Spînu M, and Olinic DM
- Subjects
- Aged, Aged, 80 and over, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Stress, Psychological diagnosis, Echocardiography methods, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Stress, Psychological complications, Takotsubo Cardiomyopathy diagnostic imaging, Takotsubo Cardiomyopathy etiology
- Abstract
We report a series of six consecutive cases of Takotsubo Cardiomyopathy (TCM) presenting as ST-elevation acute myocardial infarction and consequently addressed to the emergency coronary angiography, inside a time-frame of one year (2015). This series underlines the wide possible triggering spectrum and clinical severity of TCM and recognizes echocardiography as an essential imaging technique in the diagnosis due to its widespread availability and feasibility in the acute care setting.
- Published
- 2016
- Full Text
- View/download PDF
49. How should I treat renal artery in-stent restenosis and stent fracture after endovascular abdominal aortic aneurysm repair?
- Author
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Iancu AC, Bălănescu Ș, Marc M, Homorodean C, Bindea D, Reimers B, Civilini E, Torsello G, Castriota F, Nerla R, Micari A, and Cremonesi A
- Subjects
- Aged, Aortic Aneurysm, Abdominal diagnosis, Blood Vessel Prosthesis adverse effects, Humans, Male, Treatment Outcome, Aortic Aneurysm, Abdominal surgery, Aortic Valve Stenosis therapy, Blood Vessel Prosthesis Implantation methods, Endovascular Procedures methods, Renal Artery surgery, Stents
- Published
- 2016
- Full Text
- View/download PDF
50. Development of a methodology for structured reporting of information in echocardiography.
- Author
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Homorodean C, Olinic M, and Olinic D
- Subjects
- Database Management Systems, Databases, Factual, Documentation methods, Echocardiography methods, Information Storage and Retrieval methods, Radiology Information Systems, User-Computer Interface
- Abstract
Unlabelled: In order to conduct research relying on ultrasound images, it is necessary to access a large number of relevant cases represented by images and their interpretation. DICOM standard defines the structured reporting information object. Templates are tree-like structures which offer structural guidance in report construction., Aims: Laying the foundations of a structured reporting methodology in echocardiography, through the generation of a consistent set of DICOM templates., Material and Methods: We developed an information system with the ability of managing echocardiographic images and structured reports. In order to perform a complete description of the cardiac structures, we used 1900 coded concepts organized into 344 contexts by their semantic meaning in a variety of cardiac diseases., Results: We developed 30 templates, with up to 10 nesting levels. The list of templates has a pyramid-like architecture. Two templates are used for reporting every measurement and description: "EchoMeasurement" and "EchoDescription". Intermediate level templates specify how to report the features of echoDoppler findings: "Spectral Curve", "Color Jet", "Intracardiac mass". Templates for every cardiovascular structure include the previous ones. "Echocardiography Procedure Report" includes all other templates. The templates were tested in reporting echo features of 100 patients by analyzing 500 DICOM images., Conclusions: The benefits of these templates has been proven during the testing process, through the quality of the echocardiography report, the ability to argue and to link every diagnostic feature to a defining image and by opening up opportunities for education, research. In the future, our template-based reporting methodology might be extended to other imaging modalities.
- Published
- 2012
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