98 results on '"Vandormael M"'
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2. Assessing the cardiology community position on transradial intervention and the use of bivalirudin in patients with acute coronary syndrome undergoing invasive management: results of an EAPCI survey
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Adamo, Marianna, Byrne, Robert A., Baumbach, Andreas, Haude, Michael, Windecker, Stephan, Valgimigli, Marco, Aaroe, J., Abdeltawab, A. A., Accardi, R., Addad, F., Agostoni, P., Alajab, A., Alcázar, E., Alhabil, B., Altug Cakmak, H., Amico, F., Amoroso, G., Anderson, R., Andò, G., Andreou, A. Y., Antoniadis, D., Aquilina, M., Aramberry, L., Auer, J., Auffret, V., Ausiello, A., Austin, D., Avram, A., Ayman, E., Babunashvili, V., Bagur, R., Bakotic, Z., Balducelli, M., Ballesteros, S. M., Baptista, S., Baranauskas, A., Barbeau, G., Bax, M., Benchimol, C., Berroth, R., Biasco, L., Bilal, A., Binias, K., Blanco Mata, R., Boccuzzi, G., Bolognese, L., Boskovic, S., Bourboulis, N., Briguori, C., Bunc, M., Buysschaert, I., Calabro’, P., Campo, G., Candiello, A., Caprotta, U. F., Cardenas, M., Carrilho-Ferreira, P., Carrizo, S., Caruso, M., Cassar, A., Cernigliaro, C., Chacko, G., Chamie, D., Clapp, B., Coceani, M., Colangelo, S., Colombo, A., Comeglio, M., Connaughton, M., Conway, D., Cortese, B., Cosgrave, J., Costa, F., Couvoussis, E., Crimi, G., Crook, R., Cruz-Alvarado, J. E., Curello, S., D’Ascenzo, F., D’Urbano, M., Dana, A., De Backer, O., De Carlo, M., De Cesare, N., De Iaco, G., De La Torre, H. J. M., De Oliveira Netoj, B., Devlin, G. P., Di Lorenzo, E., Díaz, A., Dina, C., Dorsel, T. H., Eberli, F. R., Echeverría, R., Eftychiou, C., Elguindy, A., Ercilla, J., Ernst, A., Esposito, G., Ettori, F., Eufracino, Null, Ezquerra Aguilera, W., Falcone, C., Falu, R. M., Feres, F., Ferlini, M., Fernández, G., Fernández-Rodríguez, D., Fileti, L., Fischetti, D., Florescu, N., Formigli, D., Fouladvand, F., Franco, N., Fresco, C., Frigoli, E., Furmaniuk, J., Gabaldo, K., Galli, M., Galli, S., Garbo, R., Garducci, S., Garg, S., Gavrielatos, G., Gensch, J., Giacchi, G., Giunio, L., Giustino, G., Goldberg, L., Goldsmit, R., Gommeaux, A., González Godínez, H., Gosselin, G., Govorov, A., Grimfjard, P., Gross, E., Grosz, C., Guagliumi, G., Hadad, W., Hadadi, L., Hansen, P. R., Harb, S., Hatrick, R., Hayrapetyan, H. G., Hernández-Enríquez, M., Ho Heo, J., Horvath, I. G., Huan Loh, P., Ibrahim, A. M., Ierna, S., Ilic, I., Imperadore, F., Ionescu-Silva, E., Jacksch, R., James, S., Janiak, B., Jensen, S. E., Jeroen, S., Jugessur, R. K., Kala, P., Kambis, M., Kanakakis, J., Karamasis, G., Karchevsky, D., Karpovskiy, A., Kayaert, P., Kedev, S., Kemala, E., Ketteler, T., Khan, S. Q., Kharlamov, A., Kiernan, T., Kiviniem, T., Koltowski, L., Koskinas, K. C., Kouloumpinis, A., Kraaijeveld, A. O., Krizanic, F., Krötz, B., Kuczmik, W., Kukreja, N., Kuksa, D., Yav, K., Kyriakos, D., Labrunie, A., Laine, M., Lapin, O., Larosa, C., Latib, A., Lattuca, B., Lauer, B., Lefèvre, T., Legrand, V., Lehto, P., Leiva-Pons, J. L., Leone, A. M., Lev, G., Lim, R., Limbruno, U., Linares Vicente, J. A., Lindsay, S., Linnartz, C., Liso, A., Lluberas, R., Locuratolo, N., Lokshyn, S., Lunde, K., Lupi, A., Magnavacchi, P., Maia, F., Mainar, V., Mancone, M., Manolios, M. G., Mansour, S., Mariano, E., Marques, K., Martins, H., Mckenzie, D., Meco, S., Meemook, K., Mehmed, K., Melikyan, A., Mellwig, K. P., Mendiz, O. A., Merkulov, E., Mesquita, H. G., Mezzapelle, G., Miloradovic, V., Mohamed, S., Mohammed, B., Mohammed, F., Mohammed, K., Mohanad, A., Morawiec, B., More, R., Moreno-Martínez, F. L., Mrevlje, B., Muhammad, F., Näveri, H., Nazzaro, M. S., Neary, P., Negus, B. H., Nelson Durval, F. G., Nick, H., Nilva, E., Oldroyd, K. G., Olivares Asencio, C., Omerovic, E., Ortiz, M. A., Ota, H., Otasevic, P., Otieno, H. A., Paizis, I., Papp, E., Pasquetto, G., Patsourakos, N. G., Peels, J., Pelliccia, F., Pennacchi, M., Penzo, C., Perez, P., Perkan, A., Petrou, E., Phipathananunth, W., Pierri, A., Pinheiro, L. F., Pipa, J. L., Piva, T., Polad, J., Porto, I., Poveda, J., Predescu, L., Prog, R., Puri, R., Raco, D. L., Ramazan, O., Ramazzotti, V., Rao, S. V., Raungaard, B., Reczuch, K., Rekik, S., Rhouati, A., Rigattieri, S., Rodríguez-Olivares, R., Roik, M., Romagnoli, E., Román, A. J., Routledge, H., Rubartelli, P., Rubboli, A., Ruiz-García, J., Russo, F., Ruzsa, Z., Ryding, A., Saad, Aly, Sabate, M., Sabouret, P., Sadowski, M., Saia, F., Sanchez Perez, I., Santoro, G. M., Sarenac, D., Saririan, M., Sarma, J., Schuetz, T., Sciahbasi, A., Sebastian, M., Sebik, R., Sesana, M., Hur, Seung-Ho, Sganzerla, P., Shalva, R., Sharma, S., Sheiban, I., Shein, K. K., Shiekh, I. A., Sinha, M., Slhessarenko, J., Smith, D., Smyth, D. W., Sönmez, K., Sood, N., Sourgounis, A., Srdanovic, I., Stables, R. H., Stefanini, G. G., Stewart, J., Stoyanov, N., Suliman, A. A., Suryadevara, R., Suwannasom, P., Tange Veien, K., Tauchert, S., Tebet, M., Testa, L., Thury, A., Tilsted, H. H., Tiroch, K., Torres, A., Tosi, P., Traboulsi, M., Trani, C., Tresoldi, S., Tsigkas, G., Tueller, D., Turri, M., Udovichenko, A. E., Uretsky, B., Van Der Harst, P., Van Houwelingen, K. G., Vandoni, P., Vandormael, M., Varbella, F., Venkitachalam, C. G., Vercellino, M., Vidal-Perez, R., Vigna, C., Vignali, L., Vogt, F., Voudris, V., Vranckx, P., Vrolix, M., Vydt, T., Webster, M., Wijns, W., Woody, W., Wykrzykowska, J., Yazdani, S., Yildiz, A., Yurlevich, D., Zauith, R., Zekanovic, D., Zhao, M., Zimarino, M., Zingarelli, A., Abdelsamad, A. Y., Abo Shaera, E. S., Afshar, M. S., Agatiello, C., Aguiar, P., Ahmad, A. M., Akin, I., Alameda, M., Alegría-Barrero, E., Alejos, R., Alkhashab, K., Alkutshan, R. S. A., Almorraweh, A., Altnji, I., Alvarez Iorio, C., Anchidin, O., Angel, J., Antonopoulos, A., Apshilava, G., Arana, C., Ashikaga, T., Assomull, R., Atef, S. Z., Azmus, A. D., Azzalini, L., Azzouz, A., Baglioni, P., Bampas, G., Basil, M. P., Baumbach, A., Besh, D., Bhushan Sharm, A., Bien Hsien, H., Bihui, L., Bing-Chen, L., Biryukov, S., Blatt, A., Bocchi, E., Boghdady, A., Bonarjee, V. V. S., Bosnjak, I., Bravo Baptista, S., Brinckman, S. L., Buchter, B., Burzotta, F., Cacucci, M., Cagliyan, C. E., Calabrò, P., Cernetti, C., Chávez Mizraym, R., Choo, W. S., Choudhury, R., Cicco, N., Cisneros Clavijo, P., Çitaku, H., Collet, J. P., Consuegra-Sánchez, L., Conte, M., Corral, J. M., Damonte, A., Dangoisse, V., Dastani, M., Della Rosa, F., Deora, S., Devadathan, S., Dharma, S., Di Giorgio, A., Diez, J. L., Dinesha, B., Duplančić, D., El Behwashi, M. F., Elghawaby, H., Elshahawy, O., Eskola, M. J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gössl, M., Götberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. D., Kaul, U., Khan, A., Kiemeneij, E., Kiviniemi, T., Kleiban, A., Komiyama, N., Konteva, M., Koshy, G., Krepsky, A. M., Kuljit, S., Kulkarni, P., Kumar, V., Kuznetsov, I., Lai, G., Lateef, M. A., Lawand, S., Le Hong, T., Lettieri, C., Levy, G., Lindvall, P., Maitra, A., Makowski, M., Mamas, M. A., Mandal, S. C., Mangalanandan, P., Marin, R., Mashhadi, M., Matsukage, T., Meier, B., Milosavljevic, B., Miro, S. S., Mitov, A., Moeriel, M., Moguel, R., Mohanty, A., Montalescot, G., Mörsdorf, W., Moscato, F., Muniz, A., Muraglia, S., Myć, J., Nada, A., Nair, P., Namazi, M. H., Naraghipour, F., Nguyen, Q. N., Nicosia, A., Nikas, D., Ober, M., Ocaranza-Sánchez, R., Olivecrona, G., Pahlajani, D., Pandey, B. P., Parma, A., Parma, R., Patsilinakos, S. P., Pattam, J., Peddi, S., Perez, P. R., Peruga, J. Z., Pescoller, F., Petrov, I., Piatti, L., Pico-Aracil, F., Pina, J., Piroth, Z., Popa, V., Pourbehi, M. R., Pradhan, A. K., Prida, X. E., Purohit, B. V., Pyun, W. B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodríguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schühlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Şimşek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stefanini, G., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Türkoğlu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. G., Vishwanath, R., Vlachojannis, G. J., Vlachojannis, M., Vlad, V., Von Birgelen, C., Vukcevic, V., Wahab, A., Waksman, R., Wei-Wen, L., Weisz, G., Whittaker, A., Yadav, A., Yokoi, Y., Zacharoulis, A., Zahran, M., Zamani, J., Ziakas, A., Zimmermann, J. P., Adamo, M., Byrne, R. A., Baumbach, A., Haude, M., Windecker, S., Valgimigli, M., Aaroe, J., Abdeltawab, A. A., Accardi, R., Addad, F., Agostoni, P., Alajab, A., Alcazar, E., Alhabil, B., Altug Cakmak, H., Amico, F., Amoroso, G., Anderson, R., Ando, G., Andreou, A. Y., Antoniadis, D., Aquilina, M., Aramberry, L., Auer, J., Auffret, V., Ausiello, A., Austin, D., Avram, A., Ayman, E., Babunashvili, V., Bagur, R., Bakotic, Z., Balducelli, M., Ballesteros, S. M., Baptista, S., Baranauskas, A., Barbeau, G., Bax, M., Benchimol, C., Berroth, R., Biasco, L., Bilal, A., Binias, K., Blanco Mata, R., Boccuzzi, G., Bolognese, L., Boskovic, S., Bourboulis, N., Briguori, C., Bunc, M., Buysschaert, I., Calabro', P., Campo, G., Candiello, A., Caprotta, U. F., Cardenas, M., Carrilho-Ferreira, P., Carrizo, S., Caruso, M., Cassar, A., Cernigliaro, C., Chacko, G., Chamie, D., Clapp, B., Coceani, M., Colangelo, S., Colombo, A., Comeglio, M., Connaughton, M., Conway, D., Cortese, B., Cosgrave, J., Costa, F., Couvoussis, E., Crimi, G., Crook, R., Cruz-Alvarado, J. E., Curello, S., D'Ascenzo, F., D'Urbano, M., Dana, A., De Backer, O., De Carlo, M., De Cesare, N., De Iaco, G., De La Torre, H. J. M., De Oliveira Netoj, B., Devlin, G. P., Di Lorenzo, E., Diaz, A., Dina, C., Dorsel, T. H., Eberli, F. R., Echeverria, R., Eftychiou, C., Elguindy, A., Ercilla, J., Ernst, A., Esposito, G., Ettori, F., Eufracino, Ezquerra Aguilera, W., Falcone, C., Falu, R. M., Feres, F., Ferlini, M., Fernandez, G., Fernandez-Rodriguez, D., Fileti, L., Fischetti, D., Florescu, N., Formigli, D., Fouladvand, F., Franco, N., Fresco, C., Frigoli, E., Furmaniuk, J., Gabaldo, K., Galli, M., Galli, S., Garbo, R., Garducci, S., Garg, S., Gavrielatos, G., Gensch, J., Giacchi, G., Giunio, L., Giustino, G., Goldberg, L., Goldsmit, R., Gommeaux, A., Gosselin, G., Govorov, A., Gonzalez Godinez, H., Gross, E., Grosz, C., Guagliumi, G., Hadad, W., Hadadi, L., Hansen, P. R., Harb, S., Hatrick, R., Hayrapetyan, H. G., Hernandez-Enriquez, M., Ho Heo, J., Horvath, I. G., Huan Loh, P., Ibrahim, A. M., Ierna, S., Ilic, I., Imperadore, F., Ionescu-Silva, E., Jacksch, R., James, S., Janiak, B., Jensen, S. E., Jeroen, S., Jugessur, R. K., Kala, P., Kambis, M., Kanakakis, J., Karamasis, G., Karchevsky, D., Karpovskiy, A., Kayaert, P., Kedev, S., Kemala, E., Ketteler, T., Khan, S. Q., Kharlamov, A., Kiernan, T., Kiviniem, T., Koltowski, L., Koskinas, K. C., Kouloumpinis, A., Kraaijeveld, A. O., Krizanic, F., Krotz, B., Kuczmik, W., Kukreja, N., Kuksa, D., Yav, K., Kyriakos, D., Labrunie, A., Laine, M., Lapin, O., Larosa, C., Latib, A., Lattuca, B., Lauer, B., Lefevre, T., Legrand, V., Lehto, P., Leiva-Pons, J. L., Leone, A. M., Lev, G., Lim, R., Limbruno, U., Linares Vicente, J. A., Lindsay, S., Linnartz, C., Liso, A., Lluberas, R., Locuratolo, N., Lokshyn, S., Lunde, K., Lupi, A., Magnavacchi, P., Maia, F., Mainar, V., Mancone, M., Manolios, M. G., Mansour, S., Mariano, E., Marques, K., Martins, H., Mckenzie, D., Meco, S., Meemook, K., Mehmed, K., Melikyan, A., Mellwig, K. P., Mendiz, O. A., Merkulov, E., Mesquita, H. G., Mezzapelle, G., Miloradovic, V., Mohamed, S., Mohammed, B., Mohammed, F., Mohammed, K., Mohanad, A., Morawiec, B., More, R., Moreno-Martinez, F. L., Mrevlje, B., Muhammad, F., Naveri, H., Nazzaro, M. S., Neary, P., Negus, B. H., Nelson Durval, F. G., Nick, H., Nilva, E., Oldroyd, K. G., Olivares Asencio, C., Omerovic, E., Ortiz, M. A., Ota, H., Otasevic, P., Otieno, H. A., Paizis, I., Papp, E., Pasquetto, G., Patsourakos, N. G., Peels, J., Pelliccia, F., Pennacchi, M., Penzo, C., Perez, P., Perkan, A., Petrou, E., Phipathananunth, W., Pierri, A., Pinheiro, L. F., Pipa, J. L., Piva, T., Polad, J., Porto, I., Poveda, J., Predescu, L., Prog, R., Puri, R., Raco, D. L., Ramazan, O., Ramazzotti, V., Rao, S. V., Raungaard, B., Reczuch, K., Rekik, S., Rhouati, A., Rigattieri, S., Rodriguez-Olivares, R., Roik, M., Romagnoli, E., Roman, A. J., Routledge, H., Rubartelli, P., Rubboli, A., Ruiz-Garcia, J., Russo, F., Ruzsa, Z., Ryding, A., Saad, A., Sabate, M., Sabouret, P., Sadowski, M., Saia, F., Sanchez Perez, I., Santoro, G. M., Sarenac, D., Saririan, M., Sarma, J., Schuetz, T., Sciahbasi, A., Sebastian, M., Sebik, R., Sesana, M., Hur, S. -H., Sganzerla, P., Shalva, R., Sharma, S., Sheiban, I., Shein, K. K., Shiekh, I. A., Sinha, M., Slhessarenko, J., Smith, D., Smyth, D. W., Sonmez, K., Sood, N., Sourgounis, A., Srdanovic, I., Stables, R. H., Stefanini, G. G., Stewart, J., Stoyanov, N., Suliman, A. A., Suryadevara, R., Suwannasom, P., Tange Veien, K., Tauchert, S., Tebet, M., Testa, L., Thury, A., Tilsted, H. H., Tiroch, K., Torres, A., Tosi, P., Traboulsi, M., Trani, C., Tresoldi, S., Tsigkas, G., Tueller, D., Turri, M., Udovichenko, A. E., Uretsky, B., Van Der Harst, P., Van Houwelingen, K. G., Vandoni, P., Vandormael, M., Varbella, F., Venkitachalam, C. G., Vercellino, M., Vidal-Perez, R., Vigna, C., Vignali, L., Vogt, F., Voudris, V., Vranckx, P., Vrolix, M., Vydt, T., Webster, M., Wijns, W., Woody, W., Wykrzykowska, J., Yazdani, S., Yildiz, A., Yurlevich, D., Zauith, R., Zekanovic, D., Zhao, M., Zimarino, M., Zingarelli, A., Abdelsamad, A. Y., Abo Shaera, E. S., Afshar, M. S., Agatiello, C., Aguiar, P., Ahmad, A. M., Akin, I., Alameda, M., Alegria-Barrero, E., Alejos, R., Alkhashab, K., Alkutshan, R. S. A., Almorraweh, A., Altnji, I., Alvarez Iorio, C., Anchidin, O., Angel, J., Antonopoulos, A., Apshilava, G., Arana, C., Ashikaga, T., Assomull, R., Atef, S. Z., Azmus, A. D., Azzalini, L., Azzouz, A., Baglioni, P., Bampas, G., Basil, M. P., Besh, D., Bhushan Sharm, A., Bien Hsien, H., Bihui, L., Bing-Chen, L., Biryukov, S., Blatt, A., Bocchi, E., Boghdady, A., Bonarjee, V. V. S., Bosnjak, I., Bravo Baptista, S., Brinckman, S. L., Buchter, B., Burzotta, F., Cacucci, M., Cagliyan, C. E., Cernetti, C., Chavez Mizraym, R., Choo, W. S., Choudhury, R., Cicco, N., Cisneros Clavijo, P., Citaku, H., Collet, J. P., Consuegra-Sanchez, L., Conte, M., Corral, J. M., Damonte, A., Dangoisse, V., Dastani, M., Della Rosa, F., Deora, S., Devadathan, S., Dharma, S., Di Giorgio, A., Diez, J. L., Dinesha, B., Duplancic, D., El Behwashi, M. F., Elghawaby, H., Elshahawy, O., Eskola, M. J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gossl, M., Gotberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. D., Kaul, U., Khan, A., Kiemeneij, E., Kiviniemi, T., Kleiban, A., Komiyama, N., Konteva, M., Koshy, G., Krepsky, A. M., Kuljit, S., Kulkarni, P., Kumar, V., Kuznetsov, I., Lai, G., Lateef, M. A., Lawand, S., Le Hong, T., Lettieri, C., Levy, G., Lindvall, P., Maitra, A., Makowski, M., Mamas, M. A., Mandal, S. C., Mangalanandan, P., Marin, R., Mashhadi, M., Matsukage, T., Meier, B., Milosavljevic, B., Miro, S. S., Mitov, A., Moeriel, M., Moguel, R., Mohanty, A., Montalescot, G., Morsdorf, W., Moscato, F., Muniz, A., Muraglia, S., Myc, J., Nada, A., Nair, P., Namazi, M. H., Naraghipour, F., Nguyen, Q. N., Nicosia, A., Nikas, D., Ober, M., Ocaranza-Sanchez, R., Olivecrona, G., Pahlajani, D., Pandey, B. P., Parma, A., Parma, R., Patsilinakos, S. P., Pattam, J., Peddi, S., Perez, P. R., Peruga, J. Z., Pescoller, F., Petrov, I., Piatti, L., Pico-Aracil, F., Pina, J., Piroth, Z., Popa, V., Pourbehi, M. R., Pradhan, A. K., Prida, X. E., Purohit, B. V., Pyun, W. B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodriguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schuhlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Simsek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Turkoglu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. G., Vishwanath, R., Vlachojannis, G. J., Vlachojannis, M., Vlad, V., Von Birgelen, C., Vukcevic, V., Wahab, A., Waksman, R., Wei-Wen, L., Weisz, G., Whittaker, A., Yadav, A., Yokoi, Y., Zacharoulis, A., Zahran, M., Zamani, J., Ziakas, A., Zimmermann, J. P., and Cardiology
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Hirudin ,Percutaneous ,Antithrombin ,medicine.medical_treatment ,Psychological intervention ,030204 cardiovascular system & hematology ,medical ,0302 clinical medicine ,Peptide Fragment ,Surveys and Questionnaires ,Surveys and Questionnaire ,Medicine ,Bivalirudin ,030212 general & internal medicine ,Societies, Medical ,Transradial ,Anticoagulant ,Hirudins ,Middle Aged ,Recombinant Protein ,Recombinant Proteins ,Femoral Artery ,Radial Artery ,Cardiology ,acute coronary syndrome ,bivalirudin ,transradial ,adult ,antithrombins ,cardiology ,femoral artery ,hirudins ,humans ,middle aged ,peptide fragments ,percutaneous coronary intervention ,recombinant proteins ,societies, medical ,surveys and questionnaires ,attitude of health personnel ,radial artery ,Acute coronary syndrome ,Cardiology and Cardiovascular Medicine ,Human ,medicine.drug ,Adult ,medicine.medical_specialty ,Attitude of Health Personnel ,medicine.drug_class ,MEDLINE ,Antithrombins ,03 medical and health sciences ,societies ,Percutaneous Coronary Intervention ,Internal medicine ,Humans ,Acute Coronary Syndrome ,Peptide Fragments ,Management of acute coronary syndrome ,business.industry ,Percutaneous coronary intervention ,medicine.disease ,business - Abstract
AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) collecting the opinion of the cardiology community on the invasive management of acute coronary syndrome (ACS), before and after the MATRIX trial presentation at the American College of Cardiology (ACC) 2015 Scientific Sessions. METHODS AND RESULTS A web-based survey was distributed to all individuals registered on the EuroIntervention mailing list (n=15,200). A total of 572 and 763 physicians responded to the pre- and post-ACC survey, respectively. The radial approach emerged as the preferable access site for ACS patients undergoing invasive management with roughly every other responder interpreting the evidence for mortality benefit as definitive and calling for a guidelines upgrade to class I. The most frequently preferred anticoagulant in ACS patients remains unfractionated heparin (UFH), due to higher costs and greater perceived thrombotic risks associated with bivalirudin. However, more than a quarter of participants declared the use of bivalirudin would increase after MATRIX. CONCLUSIONS The MATRIX trial reinforced the evidence for a causal association between bleeding and mortality and triggered consensus on the superiority of the radial versus femoral approach. The belief that bivalirudin mitigates bleeding risk is common, but UFH still remains the preferred anticoagulant based on lower costs and thrombotic risks.
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- 2016
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3. Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey
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V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. 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F., Acuna-Valerio, J., Adriaenssens, T., Agostoni, P., Aikot, H., Alameda, M., Alcaraz, H., Almendro-Delia, M., Altug Cakmak, H., Amir, A., Arjomand, A., Assomull, R., Atalar, E., Avramides, D., Aytek Simsek, M., Aznaouridis, K., Azpeitia, Y., Barnabas, C., Barsness, G. W., Bartorelli, A. L., Basoglu, A., Benezet, J., Benincasa, S., Berland, J., Berrocal, D. H., Bett, N., Boskovic, S., Brandao, V., Caporale, R., Caprotta, F., Carrabba, N., Cazaux, P., Cheniti, G., Chinchilla Calix, H., Chung, W. Y., Cicco, N. A., Cieza, T., Clapp, B., Commeau, P., Cuellar, C., De Benedictis, M., De La Torre Hernandez, J. M., De Vroey, F., Degertekin, M., Eberli, F. R., Eggebrecht, H., Ekicibasi, E., Elmaraghi, M., Elod, P., Ergene, A. O., Fadlalla, V. F., Farah, M. A., Fernandez Vina, R., Ferro, A., Fischer, D., Flore, V., Foley, D. 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C., Mantyla, P., Mariano, E., Marsit, N., Mcdonough, T. J., Medda, M., Mejia Viana, S., Merigo Azpir, C. A., Mitreski, S., Moreno, R., Moreu, J., Muehler, M., Muir, D., Munoz Molina, R., Musilli, N., Myc, J., Nadra, I., Nagy, C. D., Narayanan, A., Neugebauer, P., Nguyen, M., Nick, H., Nicolino, A., Obradovic, S. D., Paizis, I., Panagiotis, P., Park, S. D., Park, S. J., Pasquetto, G., Patel, D., Paunovic, D., Pedon, L., Pereira Machado, F., Pershukov, H., Petrou, E., Pinton, F. A., Preti, G., Puri, R., Pyxaras, S. A., Quintanilla, J., Rhouati, A., Ribeiro De Oliveira, I., Rivetti, L., Rodriguez, A. E., Rotevatn, S., Rubartelli, P., Sachdeva, R., Sanchez-Perez, H., Sangiorgi, G., Santoro, G. M., Saporito, F., Scappaticci, M., Schmermund, A., Schmidt, J. E., Schmitz, T., Schneider, T. I., Schuchlenz, H., Sepulveda Varela, P., Shaw, E., Silva Marques, J., Skalidis, E., Slhessarenko, J., Spaulding, C., Stankovic, G., Suwannasom, P., Synetos, A., Szuster, E., Taha, S., Tavano, D., Tebet, M., Thury, A., Toutouzas, K., Triantafyllis, A. S., Tsikaderis, D., Tumscitz, C., Tzanogiorgis, I., Udovichenko, A., Ulrike, N., Unikas, R., Valerio, M. G., Van Mieghem, C., Vandendriessche, T., Vavlukis, M., Vigna, C., Vilar, J. V., Vizzari, G., Voudris, V., Wafa, S., Wagner, D. R., Wichter, T., Wiedemann, S., Williams, P. D., Woody, W., Yding, A., Zachow, G., and Webster, M.
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Male ,medicine.medical_specialty ,Time Factors ,Percutaneous ,Time Factor ,Psychological intervention ,Alternative medicine ,MEDLINE ,Practice Patterns ,Drug Administration Schedule ,acute coronary syndrome ,Settore MED/11 ,Percutaneous Coronary Intervention ,Pharmacotherapy ,Drug Therapy ,Physicians ,Surveys and Questionnaires ,drug-eluting stent ,Humans ,Surveys and Questionnaire ,Medicine ,Practice Patterns, Physicians' ,health care economics and organizations ,clopidogrel ,dual antiplatelet therapy (DAPT) ,stable coronary artery disease ,Drug Therapy, Combination ,Evidence-Based Medicine ,Health Care Surveys ,Platelet Aggregation Inhibitors ,Practice Guidelines as Topic ,Practice Patterns, Physicians ,Treatment Outcome ,Stents ,business.industry ,Platelet Aggregation Inhibitor ,Coronary stenting ,Evidence-based medicine ,Middle Aged ,Surgery ,Clinical trial ,Health Care Survey ,Combination ,Emergency medicine ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting. METHODS AND RESULTS Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (AHA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after AHA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after AHA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAPT should be implemented in selected patients. After AHA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAPT duration, and 40.0% the need for clinical guidance. CONCLUSIONS This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAPT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies.
- Published
- 2015
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4. Dual antiplatelet therapy duration after coronary stenting in clinical practice: Results of an EAPCI survey
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Valgimigli, M., Costa, F., Byrne, R., Haude, M., Baumbach, A., Windecker, S., Aaroe, J., Aasa, M., Abdel-Salam, A. M., Alaarag, A. F., Accardi, R., Adel, A., Alcazar De La Torre, E., Alejos, R., Alfonso Jimenez, V., Alhashimi, H. M. M., Aljeboury, A., Almeida De Sousa, J., Almusawi, A., Alshaikha, M., Altaf, S., Altahmody, K. E. A., Alvarez Contreras, L. R., Amarasena, N., Amoroso, G., Anderson, R., Ando, G., Andrade, J., Andreou, A. Y., Angulo, J., Antonio, T., Aprigliano, G., Aquilina, M., Arafa, S. E. O., Aramberry, L., Arampatzis, C. A., Araujo, J. J., Asher, E., Ates, I., Athanasias, D., Auer, J., Auffret, V., Ayala, F. J., Baba, C., Baglioni, P., Bagur, R., Balam-Ortiz, E., Balducelli, M., Bam Pas, G., Barbash, I. M., Barbosa, A. H. P., Barbosa, R., Barnay, P., Barroso, L., Basti, A., Bax, M., Bayet, G., Beijk, M. A., Beltran, R., Berenguer Jofresa, A., Berroth, R., Berti, S., Berumen Dominguez, L. E., Bhasin, A., Bhaya, M., Bianco, M., Biasco, L., Bikicki, M., Bonarjee, V. V. S., Bonechi, F., Borges Santos, M., Boshev, M., Bouferrouk, A., Bounartzidi, M., Bousoula, E., Brie, D., Brtko, M., Brugaletta, S., Brull, D. J., Buchter, B., Buendia, R., Burzotta, Francesco, Butz, T., Buzzetti, F., Bychowiec, B., Cadeddu, M., Campanile, A., Carneiro, J. G., Carrilho-Ferreira, P., Carrillo Guevara, J. E., Carter, A. J., Casal-Heredia, H., Castiglioni, B., Castro Fabiano, L., Cavalcante Silva, R., Cavalcanti De Oliveira, D., Cavalcanti, R. C., Cavazza, C., Centemero, M. P., Chabane, H. K., Chamie, D., Chatzis, D., Chaves, A. J., Cheng, S., Chinchilla, H., Ciabatti, N., Cirillo, P., Citaku, H., Claeys, M. J., Clifford, C., Coceani, M., Coggiola, J., Cohen, D. J., Conway, D. S. G., Cornelis, K., Coroleu, S. F., Corral, J. M., Cortese, B., Coskun, U., Costa, R. A., Coste, P., Coufal, Z., Cox, S., Cozma, A., Crean, P., Crenshaw, M. H., Cristian, U., Cruz-Alvarado, J. E., Cuculi, F., Cuenza, L., Cyrne Carvalho, H., D'Ascenzo, F., D'Urbano, M., Damonte, A., Dan Florin, F., Dana, A., Dangoisse, V., De Backer, O., De Cock, D., De Vita, M., Debski, A., Delgado, A., Devadathan, S., Dhamrait, S., Di Lorenzo, E., Di Serafino, D., Diego-Nieto, A., Dievart, F., Diez, J. L., Dimitriadis, K., Dina, C., Doerner, O., Donahue, M., Donis, J., Drieghe, B., Drissi, M. F., Du Fretay, H., Dziewierz, A., Echavarria-Pinto, M., Echeverria Romero, R. G., Economou, F., Eftychiou, C., Egdell, R., El Hosieny, A., El Meguid, K., Elabbassi, W., Elesgerli, S., Elghetany, H., Elizondo, J. C., Elkahlout, A., Elrowiny, R., Elserafy, A. S., Emam, A., Emara, A., Emmanouil, P., Ercilla, J., Erglis, A., Eslam Taha, E., Esmaeil, S., Esposito, G., Ettori, F., Eugenio, N., Everaert, B., Ezquerra Aguilar, W., Falu, R., Farag, E., Farjalla, J., Feldman, L., Feldman, M., Felice, H., Fernandez-Nofrerias, E., Fernandez-Rodriguez, D., Ferranti, F., Ferreira, Q., Ferrone, M., Fleischmann, C., Flessas, D., Formigli, D., Fozilov, H., Fraccaro, C., Freitas, J. O., Fresco, C., Fridrich, V., Furmaniuk, J., Gagnor, A., Galasso, G., Galeazzi, G. L., Galli, S., Galvez Villacorta, V., Gandolfo, C., Garcia, E., Garcia-Blas, S., Garducci, S., Garg, S., Garro, N., Gatto, L., Georgiou, M. G., Ghanem, I., Ghose, T., Giacchi, G., Giang, P. T., Giesler, T., Giovino, M., Girardi, P., Girasis, C., Giunio, L., Giustino, G., Glatthor, C., Glogar, H. D., Golledge, P., Gomez Moreno, J., Gomez Recio, M., Gommeaux, A., Grantalis, G., Greco, F., Grundeken, M. J., Grunert, S., Gudmundsdottir, I., Guenoun, M., Guerios, E., Gupta, R., Gupta, S., Gutierrez, C., Hafeez, I., Halvorsen, S., Hamed Hussein, G. A., Hammoudeh, A., Hansen, P. R., Harb, S., Hawas, J. M., Hayrapetyan, H., Heintzen, M. P., Hengstenberg, C., Herity, N., Hernandez, F., Heyse, A., Hicham, D., Hildick-Smith, D., Hill, J., Hillani, A., Hiltrop, N., Hiramori, A., Hobson, A. R., Homan, D. J., Hooda, A., Ielasi, A., Ierna, S., Iftikhar, A. K., Ilic, I., Imai, Y., Imperadore, F., Indolfi, C., Iorga, V., Ipek, E., Ito, S., Jacksch, R., Jae-Sik, J., James, S., Jamshidi, P., Jerbi, J., Jimenez Quevedo, P., Jimenez-Navarro, M., Jimenez-Santos, M., Jin, Q. H., Joksas, V., Jovic, D., Junejo, S., Kallel, R., Kamal, A., Kamiya, H., Kannan, D., Kantaria, M., Kapetanopoulos, A., Kara Ali, B., Karjalainen, P. P., Karthikeyan, V. 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H., Ojeda, S., Oktay Tureli, H., Olowe, Y., Oluseun, A., Opolski, G., Ornelas, C. E., Otasevic, P., Ozturk, A., Padilla, F., Pagny, J. Y., Paolantonio, D., Papaioannou, G. I., Parodi, G., Patil, S. N., Pavei, A., Pavia, A., Pavlidis, A., Pell, A., Percoco, G. F., Pernasetti, L. V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. D., Sanchez-Gila, J., Sanchez-Perez, I., Santarelli, A., Sardovski, Sarenac, D., Sarma, J., Sarno, G., Savonitto, S., Sayied Abdullah, A., Schafer, A., Scherillo, M., Schneider, H., Schuhlen, H., Sciahbasi, A., Seca, L., Sedlon, P., Semenka, J., Serra, L. A., Sesana, M., Sethi, A., Sgueglia, G. A., Shaheen, S., Shahri, H., Sheiban, I., Shyu, K. G., Silva, C. E. F., Sionis, D., Siqueira, D. A., Siqueira, M. J., Smits, P., Sobhy, M., Sokolov, M., Soliman, S., Somani, A. N., Sridhar, G., Stakos, D., Stasek, J., Stefanini, G., Steigen, T. K., Stewart, Stipal, R., Stochino, M. L., Stoel, M. G., Subla, R. M., Suliman, A., Summaria, F., Stoyanov, N., Syed, A. A., Tanaka, Y., Tashani, A., Tauzin, S., Tawade, N., Tawfik, M., Tayeh, O., Terzic, I., Testa, L., Thevan, B., Thiam, M., Tiecco, F., Tierala, I., Tilea, I., Tilsted, H. H., Tomasik, A. R., Tonev, I., Torres Bosco, A., Tousek, P., Townend, J., Tran Ngoc, T., Triantafyllou, K., Tsigkas, G., Tsioufis, C., Turri, M., Tyligadis, G., Ugo, F., Ultramari, F. T., Urban, P., Uren, N., Uretsky, B. F., Uribe, C. E., Usman, B., Valadez Molina, F., Van Houwelingen, K. G., Vandormael, M., Varvarovsky, I., Vassilis, V., Velasquez, D., Verdoia, M., Vermeersch, P., Vidal-Perez, R., Vinesh, J., Violini, R., Vista, J. H., Vogt, F., Vogt, M., Vokac, D., Vom Dahl, J., Vranckx, P., Wahab, A., Wang, R., Wang, T. D., Wani, S., Weisz, S. H., Werner, G. S., Wilkinson, J. R., Wolf, A., Youssef, A., Yumoto, K., Zaderenko, N., Zaghloul Darwish, A. M., Zahn, R., Zaro, T., Zavalloni, D., Zbinden, R., Zekanovic, D., Zhang, B., Zhang, C., Zhang, Y. J., Zhonghan, N., Zingarelli, A., Zueco, J., Zuhairy, H., Abbate, A., Abdel Hamid, M., Abdelmegid, M. A. F., Acuna-Valerio, J., Adriaenssens, T., Agostoni, P., Aikot, H., Alameda, M., Alcaraz, H., Almendro-Delia, M., Altug Cakmak, H., Amir, A., Arjomand, A., Assomull, R., Atalar, E., Avramides, D., Aytek Simsek, M., Aznaouridis, K., Azpeitia, Y., Barnabas, C., Barsness, G. W., Bartorelli, A. L., Basoglu, A., Benezet, J., Benincasa, S., Berland, J., Berrocal, D. H., Bett, N., Boskovic, S., Brandao, V., Caporale, R., Caprotta, F., Carrabba, N., Cazaux, P., Cheniti, G., Chinchilla Calix, H., Chung, W. Y., Cicco, N. A., Cieza, T., Clapp, B., Commeau, P., Cuellar, C., De Benedictis, M., De La Torre Hernandez, J. M., De Vroey, F., Degertekin, M., Eberli, F. R., Eggebrecht, H., Ekicibasi, E., Elmaraghi, M., Elod, P., Ergene, A. O., Fadlalla, V. F., Farah, M. A., Fernandez Vina, R., Ferro, A., Fischer, D., Flore, V., Foley, D. P., Gafoor, S., Gallo, S., Gaspardone, A., Gavrilescu, D., Gentiletti, A., Gilard, M., Giovannelli, F., Gonzalez Pacheco, I., Gonzalo, N., Grajek, S., Gurgel De Medeiros, J. P., Haine, S., Hakim, D., Hakim Vista, J. J., Hallani, H., Hamid, M., Helft, G., Heppell, R. M., Hernandez-Enriquez, M., Hlinomaz, O., Ho Choo, E., Huqi, A., Hurtado, E. O., Iakovou, I., Iosseliani, D., Janssens, L., Jean, M., Jensen, J. K., Jesudason, P., Jimenez Diaz, V. A., Karchevsky, D., Karpovskii, A., Katsimagklis, G., Kereiakes, D., Kersanova, N. C., Kesavan, S., Khaled, H., Khalil, S. A., Kiatchoosakun, S., Kim, K. S., Kirma, C., Koltowski, L., Konteva, M., Kozinski, L., Kuehn, C. R., Kumar, S., Kyriakakis, C. G., Laanmets, P., Labrunie, A., Ladwiniec, A., Lai, G., Laine, M., Latib, A., Lattuca, B., Lazarevic, A. M., Lee, K. S., Legrand, V., Leiva, G., Lester, N., Levchyshyna, O., Livia, G., Londero, H. F., Luha, O., Lupi, A., Lupkovics, G., Maaliki, S., Maeng, M., Mahr, N. C., Mantyla, P., Mariano, E., Marsit, N., Mcdonough, T. J., Medda, M., Mejia Viana, S., Merigo Azpir, C. A., Mitreski, S., Moreno, R., Moreu, J., Muehler, M., Muir, D., Munoz Molina, R., Musilli, N., Myc, J., Nadra, I., Nagy, C. D., Narayanan, A., Neugebauer, P., Nguyen, M., Nick, H., Nicolino, A., Obradovic, S. D., Paizis, I., Panagiotis, P., Park, S. D., Park, S. J., Pasquetto, G., Patel, D., Paunovic, D., Pedon, L., Pereira Machado, F., Pershukov, H., Petrou, E., Pinton, F. A., Preti, G., Puri, R., Pyxaras, S. A., Quintanilla, J., Rhouati, A., Ribeiro De Oliveira, I., Rivetti, L., Rodriguez, A. E., Rotevatn, S., Rubartelli, P., Sachdeva, R., Sanchez-Perez, H., Sangiorgi, G., Santoro, G. M., Saporito, F., Scappaticci, M., Schmermund, A., Schmidt, J. E., Schmitz, T., Schneider, T. I., Schuchlenz, H., Sepulveda Varela, P., Shaw, E., Silva Marques, J., Skalidis, E., Slhessarenko, J., Spaulding, C., Stankovic, G., Suwannasom, P., Synetos, A., Szuster, E., Taha, S., Tavano, D., Tebet, M., Thury, A., Toutouzas, K., Triantafyllis, A. S., Tsikaderis, D., Tumscitz, C., Tzanogiorgis, I., Udovichenko, A., Ulrike, N., Unikas, R., Valerio, M. G., Van Mieghem, C., Vandendriessche, T., Vavlukis, M., Vigna, C., Vilar, J. V., Vizzari, G., Voudris, V., Wafa, S., Wagner, D. R., Wichter, T., Wiedemann, S., Williams, P. D., Woody, W., Yding, A., Zachow, G., Webster, M., and Burzotta F. (ORCID:0000-0002-6569-9401)
- Abstract
Aims: Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting. Methods and results: Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (AHA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after AHA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after AHA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAPT should be implemented in selected patients. After AHA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAPT duration, and 40.0% the need for clinical guidance. Conclusions: This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAPT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies.
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- 2015
5. The ARTS (Arterial Revascularization Therapies Study): Background, goals and methods
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Serruys, PWJC (Patrick), Unger, F, van Hout, BA (Ben), van den Brand, MJBM (Marcel), van Herwerden, LA (Lex), Es, Gerrit-anne, Morèl, MA, Bonnier, H, Colombo, A, Morice, MC, Simon, R, Wijns, W, Kremer, D, Mohr, F, Petterson, G, Santoli, C, Breeman, A, Vandormael, M, Firth, BG, Madonna, O, Marshall, PR, Hugenholtz, PG (Paul), Cardiology, and Cardiothoracic Surgery
- Published
- 1999
6. Study of antirestenosis with the BiodivYsio dexamethasone-eluting stent (STRIDE): A first-in-human multicenter pilot trial
- Author
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UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Liu, XS, Hanet, Claude, Huang, YM, Vandormael, M, Legrand, V, Dens, J, Vandenbossche, JL, Missault, L., Vrints, C, De Scheerder, I, UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Liu, XS, Hanet, Claude, Huang, YM, Vandormael, M, Legrand, V, Dens, J, Vandenbossche, JL, Missault, L., Vrints, C, and De Scheerder, I
- Abstract
The aim of this multicenter pilot study was to evaluate the acute safety and efficacy of the dexamethasone-eluting stent (0.5 mug/mm(2) of stent) implanted in patients with de novo single-vessel disease. This study included 71 patients, 42% of whom had unstable angina pectoris. An appropriately sized BiodivYsio Matrix Lo stent loaded with a total dexamethasone dose of 0.5 mug/mm(2) of stent was used. Technical device success rate was 95%. Six-month MACE occurred in two patients (3.3%). Binary restenosis rate was 13.3%. Late loss was 0.45. Late loss and percent diameter stenosis were lower in the unstable angina pectoris patients compared to the stable patients (0.32 +/- 0.39 vs. 0.60 +/- 0.55 mm, P < 0.07, and 26.86 +/- 14 vs. 38.40 +/- 16%, P < 0.02). This study demonstrated the feasibility and safety of the implantation of a dexamethasone-eluting stent and its effect on in-stent neointimal hyperplasia. (C) 2003 Wiley-Liss, Inc.
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- 2003
7. Intracoronary beta-radiation to reduce restenosis after balloon angioplasty and stenting - The Beta Radiation in Europe (BRIE) study
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UCL - MD/MINT - Département de médecine interne, UCL - (SLuc) Service de pathologie cardiovasculaire, Serruys, P.W., Sianos, G, van der Giessen, W, Bonnier, HJRM, Urban, R, Wijns, W., Benit, E, Vandormael, M, Dorr, R, Disco, C, Debbas, Nadia, Silber, S, UCL - MD/MINT - Département de médecine interne, UCL - (SLuc) Service de pathologie cardiovasculaire, Serruys, P.W., Sianos, G, van der Giessen, W, Bonnier, HJRM, Urban, R, Wijns, W., Benit, E, Vandormael, M, Dorr, R, Disco, C, Debbas, Nadia, and Silber, S
- Abstract
Aims The BRIE trial is a registry evaluating the safety and performance of Sr-90 delivered locally (Beta-Cath TM system of Novoste) to de-novo and restenotic lesions in patients with up to two discrete lesions in different vessels. Methods and Results In total, 149 patients (175 lesions) were enrolled; 62 treated with balloons and 113 with stents. The restenosis rate, the minimal luminal diameter and the late loss were determined in three regions of interest: (a) in a subsegment of 5 turn containing the original minimal luminal diameter pre-intervention termed target segment; (b) the irradiated segment, 28 mm in length, and (c) the entire analysed segment, 42 mm in length, termed the vessel segment. Binary restenosis was 9-9% for the target segment, 28-9% for the irradiated segment, and 33-6% for the vessel segment. These angiographic results include 5-3%,) total occlusions. Excluding total occlusions binary restenosis was 4-9%, 25% and 29-9%, respectively. At 1 year the incidence of major adverse cardiac events placed in a hierarchical ranking were: death 2%, myocardial infarction CABG 2%, and target vessel revascularization 20.1%. The event-free survival rate was 65,8%. Non-appropriate coverage of the injured segment by the radioactive source termed geographical miss affected 67-9% of the vessels, and increased edge restenosis significantly (16-3% vs 4-3%, P=0-004). It accounted for 40% of the treatment failures. Conclusion The results of this registry reflect the learning process of the practitioner. The full therapeutic potential of this new technology is reflected by the restenosis rate at the site of the target segment, It can only be unravelled once the incidence of late vessel occlusion and geographical miss has been eliminated by the prolonged use of thienopyridine, the appropriate training of the operator applying this new treatment for restenosis prevention, and the use of longer sources.
- Published
- 2002
8. Study of anti-restenosis with the blodivysio dexamethasone eluting stent (STRIDE) - a multicenter trial
- Author
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UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Liu, XS, Hanet, Claude, Vandormael, M, Legrand, V, Huang, YM, De Scheerder, I, UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Liu, XS, Hanet, Claude, Vandormael, M, Legrand, V, Huang, YM, and De Scheerder, I
- Published
- 2002
9. Late clinical outcomes of paclitaxel and sirolimus eluting stents in diabetic patients: data from the cardioquest interventional database
- Author
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Matar, F., primary, Ebra, G., additional, Vandormael, M., additional, Sullebarger, J.T., additional, Vanderheuvel, K., additional, Taylor, M., additional, Rossi, P., additional, Mulingtapang, R., additional, Khuu, H., additional, and Guest, D., additional
- Published
- 2007
- Full Text
- View/download PDF
10. Stent implantation in acute myocardial infarction using a heparin-coated stent: a pilot study as a preamble to a randomized trial comparing balloon angioplasty and stenting
- Author
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Serruys, PW, primary, Grines, CL, additional, Stone, GW, additional, Garcia, E, additional, Kiemeney, F, additional, Morice, MC, additional, Sousa, JE, additional, Hamm, C, additional, Costantini, C, additional, Probst, P, additional, Rutsch, W, additional, Penn, I, additional, Fernandez-Aviles, F, additional, Vandormael, M, additional, Bartorelli, A, additional, Bilodeau, L, additional, and Eijgelshoven, MHJ, additional
- Published
- 1998
- Full Text
- View/download PDF
11. Randomized Trial Comparing Two Devices: The Palmaz-Schatz Stent and the Strecker Stent in Bail-Out Situations
- Author
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REIFART, N., primary, HAASE, J., additional, MASSA, Th., additional, PREUSLER, W., additional, SCHWARZ, F., additional, STÖRGER, H., additional, VANDORMAEL, M., additional, and HOFMANN, M., additional
- Published
- 1994
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12. A randomized trial of late reperfusion therapy for acute myocardial infarction. Thrombolysis and Angioplasty in Myocardial Infarction-6 Study Group.
- Author
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Topol, E J, primary, Califf, R M, additional, Vandormael, M, additional, Grines, C L, additional, George, B S, additional, Sanz, M L, additional, Wall, T, additional, O'Brien, M, additional, Schwaiger, M, additional, and Aguirre, F V, additional
- Published
- 1992
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13. Determinants of 2-year outcome after coronary angioplasty in patients with multivessel disease on the basis of comprehensive preprocedural evaluation. Implications for patient selection. The Multivessel Angioplasty Prognosis Study Group.
- Author
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Ellis, S G, primary, Cowley, M J, additional, DiSciascio, G, additional, Deligonul, U, additional, Topol, E J, additional, Bulle, T M, additional, and Vandormael, M G, additional
- Published
- 1991
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14. Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Multivessel Angioplasty Prognosis Study Group.
- Author
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Ellis, S G, primary, Vandormael, M G, additional, Cowley, M J, additional, DiSciascio, G, additional, Deligonul, U, additional, Topol, E J, additional, and Bulle, T M, additional
- Published
- 1990
- Full Text
- View/download PDF
15. Intracoronary β-radiation to reduce restenosis after balloon angioplasty and stenting. The Beta Radiation In Europe (BRIE) study.
- Author
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Serruys, P.W., Sianos, G., van der Giessen, W., Bonnier, H.J.R.M., Urban, P., Wijns, W., Benit, E., Vandormael, M., Dörr, R., Disco, C., Debbas, N., and Silber, S.
- Abstract
Aims The BRIE trial is a registry evaluating the safety and performance of90 Sr delivered locally (Beta-Cath TM system of Novoste) to de-novo and restenotic lesions in patients with up to two discrete lesions in different vessels.Methods and Results In total, 149 patients (175 lesions) were enrolled; 62 treated with balloons and 113 with stents. The restenosis rate, the minimal luminal diameter and the late loss were determined in three regions of interest: (a) in a subsegment of 5mm containing the original minimal luminal diameter pre-intervention termed target segment; (b) the irradiated segment, 28mm in length, and (c) the entire analysed segment, 42mm in length, termed the vessel segment. Binary restenosis was 9·9% for the target segment, 28·9% for the irradiated segment, and 33·6% for the vessel segment. These angiographic results include 5·3% total occlusions. Excluding total occlusions binary restenosis was 4·9%, 25% and 29·9%, respectively. At 1 year the incidence of major adverse cardiac events placed in a hierarchical ranking were: death 2%, myocardial infarction 10·1%, CABG 2%, and target vessel revascularization 20·1%. The event-free survival rate was 65·8%. Non-appropriate coverage of the injured segment by the radioactive source termed geographical miss affected 67·9% of the vessels, and increased edge restenosis significantly (16·3% vs 4·3%, P=0·004). It accounted for 40% of the treatment failures.Conclusion The results of this registry reflect the learning process of the practitioner. The full therapeutic potential of this new technology is reflected by the restenosis rate at the site of the target segment. It can only be unravelled once the incidence of late vessel occlusion and geographical miss has been eliminated by the prolonged use of thienopyridine, the appropriate training of the operator applying this new treatment for restenosis prevention, and the use of longer sources. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved. [ABSTRACT FROM PUBLISHER]
- Published
- 2002
- Full Text
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16. Effects of dobutamine on left ventricular performance and myocardial metabolic demands in patients with ischemic heart disease.
- Author
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Cote, P., Bourassa, M. G., Tubau, J. F., Enjalbert, M., and Vandormael, M.
- Published
- 1984
- Full Text
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17. Comparative haemodynamic effects of intravenous flecainide in patients with and without heart failure and with and without beta-blocker therapy.
- Author
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LEGRAND, V., MATERNE, P., VANDORMAEL, M., COLLIGNON, P., and KULBERTUS, H. E.
- Abstract
The haemodynamic effects of flecainide were compared in three different subsets of patients with documented coronary disease. Ten patients (A) had no heart failure, 5 patients were on beta blockers (B) and 5 patients had overt heart failure (C). Flecainide was associated with negative inotropic effects that were relatively more pronounced in patients with left ventricular dysfunction: pulmonary wedge pressure increased by 27% in A, by 31% in B and by 42% in C; left ventricular stroke volume and stroke work decreased respectively by 10 and 12% in A, 21 and 19% in B, 26 and 28% in C. Ejection fraction decreased by 9% in A, 13% in B and 20% in C, in relation with an increase in end systolic volume ( + 9% in A, +10% in Band + 5%inC). Absolute changes, however, were not significantly different from one group to another except for the increase of systemic vascular resistance which was more pronounced in C as compared with the other groups. The myocardial depression was also confirmed by the fall in dPjdt that was maximal at the end of injection; dP/dt remained depressed 15 min later despite some improvement. Flecainide thus exerts negative inotropic effects that are maximal at the end of infusion and may be of importance in patients with established left ventricular dysfunction. [ABSTRACT FROM PUBLISHER]
- Published
- 1985
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18. Haemodynamic effects of intravenous diltiazem at rest and exercise in patients with coronary artery disease.
- Author
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LEGRAND, V., HASTIR, F., VANDORMAEL, M., COLLIGNON, P., and KULBERTUS, H.E.
- Abstract
The acute effects of intravenous diltiazem on exercise performance were studied in 10 patients with coronary artery disease. Haemodynamic measurements were made at rest and during exercise before and after 0-5 mgkg of diltiazem. Diltiazem prolonged the duration of exercise (+2.85 min, P>0.001) and delayed the onset of ischaemic ST depression or angina in all patients. The highest tolerated heart rate and pressure rate product were increased in all but one patient after diltiazem. At rest diltiazem decreased mean arterial pressure (–10.8%, P>0.005), systemic vascular resistance (SVR) (-11.8%, P>005) and left ventricular stroke work index (SWI) (–14.1%, P>0.005). During exercise under diltiazem therapy, at the level achieved before the drug, the pulmonary capillary wedge pressure (-30%, P>0005) and the SVR (–13.6%, P>0.02) were lowered, the SWI (+13%, P>0.01) was increased: at the end of exercise only the SVR (14%, P>0.05) was reduced. Two patients experienced angina on lying down and one had orthostatic hypotension after exercise with diltiazem. This study indicates that intravenous diltiazem is a potentially useful agent for the treatment of angina by reducing myocardial oxygen demand at rest and by improving left ventricular performances on exercise. [ABSTRACT FROM PUBLISHER]
- Published
- 1984
- Full Text
- View/download PDF
19. Stent implantation in acute myocardial infarction using a heparin-coated stent: a pilot study as a preamble to a randomized trial comparing balloon angioplasty and stenting
- Author
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Serruys, PW, Grines, CL, Stone, GW, Garcia, E., Kiemeney, F., Morice, MC, Sousa, JE, Hamm, C., Costantini, C., Probst, P., Rutsch, W., Penn, I., Fernandez-Aviles, F., Vandormael, M., Bartorelli, A., Bilodeau, L., and Eijgelshoven, MHJ
- Abstract
Preliminary experience with primary stenting in myocardial infarction has suggested a greater benefit in clinical outcome than has been obtained with direct balloon angioplasty. However, subacute thrombosis (SAT) remains a limitation for this new mode of therapy. In the BENESTENT II Pilot and main trials, the incidence of SAT with the heparin-coated Palmaz-Schatz stent was only 0.15%. Therefore, as a preamble to a large randomized trial, the feasibility and safety of the use of the Heparin-Coated Palmaz-Schatz™ Stent in Acute Myocardial Infarction (AMI) was tested in 101 patients enrolled between April and September 1996 in 18 clinical centres. In 101 stent-eligible AMI patients, as dictated by protocol, a heparin-coated stent was implanted. The primary objectives were to determine the in-hospital incidence of major adverse cardiac events (MACE: death, MI, target lesion revascularization) and bleeding complications, while the secondary objectives were the procedural success rate and the MACE, the restenosis and reocclusion rates at 6.5 months. Stent implantation (n 3 129 stents) was successful in 97 patients of the 101 who were included in this trial. During their hospital stay, two patients died and no patient experienced re-infarction, ischaemia prompting re-PTCA or CABG. Four patients suffered a bleeding complication, three major and one minor, of whom three required surgical repair. At 210 days follow-up, 81% of the patients were event free. At 6.5 months restenosis was documented in 18% of the 88 patients who underwent follow-up angiography, including three total occlusions. The results, both with respect to QCA and the occurrence of MACE, compare favourably with studies using elective stenting in both stable and unstable angina patients. As a result of this pilot study, a large randomized trial comparing direct balloon angioplasty with direct stenting in 900 patients with AMI was initiated in December 1996.
- Published
- 1998
- Full Text
- View/download PDF
20. Intracoronary β-radiation to reduce restenosis after balloon angioplasty and stenting. The Beta Radiation In Europe (BRIE) study
- Author
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Serruys, P.W., Sianos, G., van der Giessen, W., Bonnier, H.J.R.M., Urban, P., Wijns, W., Benit, E., Vandormael, M., Dörr, R., Disco, C., Debbas, N., Silber, S., Serruys, P.W., Sianos, G., van der Giessen, W., Bonnier, H.J.R.M., Urban, P., Wijns, W., Benit, E., Vandormael, M., Dörr, R., Disco, C., Debbas, N., and Silber, S.
- Abstract
Aims The BRIE trial is a registry evaluating the safety and performance of90 Sr delivered locally (Beta-Cath TM system of Novoste) to de-novo and restenotic lesions in patients with up to two discrete lesions in different vessels. Methods and Results In total, 149 patients (175 lesions) were enrolled; 62 treated with balloons and 113 with stents. The restenosis rate, the minimal luminal diameter and the late loss were determined in three regions of interest: (a) in a subsegment of 5mm containing the original minimal luminal diameter pre-intervention termed target segment; (b) the irradiated segment, 28mm in length, and (c) the entire analysed segment, 42mm in length, termed the vessel segment. Binary restenosis was 9·9% for the target segment, 28·9% for the irradiated segment, and 33·6% for the vessel segment. These angiographic results include 5·3% total occlusions. Excluding total occlusions binary restenosis was 4·9%, 25% and 29·9%, respectively. At 1 year the incidence of major adverse cardiac events placed in a hierarchical ranking were: death 2%, myocardial infarction 10·1%, CABG 2%, and target vessel revascularization 20·1%. The event-free survival rate was 65·8%. Non-appropriate coverage of the injured segment by the radioactive source termed geographical miss affected 67·9% of the vessels, and increased edge restenosis significantly (16·3% vs 4·3%, P=0·004). It accounted for 40% of the treatment failures. Conclusion The results of this registry reflect the learning process of the practitioner. The full therapeutic potential of this new technology is reflected by the restenosis rate at the site of the target segment. It can only be unravelled once the incidence of late vessel occlusion and geographical miss has been eliminated by the prolonged use of thienopyridine, the appropriate training of the operator applying this new treatment for restenosis prevention, and the use of longer sources. Copyright 2002 The European Society of Cardiology. Published by Else
21. Heparin Delivery at the Site of Angioplasty With a Novel Drug Delivery Sleeve
- Author
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Kaplan, A. V., Vandormael, M., Hofmann, M., Weil, H., Sloeger, H., Krajcar, M., Gallant, P., Simpson, J. B., and Reifart, I.
- Published
- 1996
- Full Text
- View/download PDF
22. Limitations of embolic protection in saphenous vein graft intervention: insights from 202 consecutive patients.
- Author
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Matar FA, Smith K, Rossi P, Vandormael M, Sullebarger JT, Taylor M, Caruncho C, Ali T, and Kerensky R
- Subjects
- Aged, Confidence Intervals, Coronary Angiography, Coronary Thrombosis prevention & control, Coronary Thrombosis surgery, Female, Humans, Male, Multivariate Analysis, Odds Ratio, Prospective Studies, Angioplasty, Balloon, Coronary, Coronary Thrombosis therapy, Saphenous Vein
- Abstract
Between January 2003 and September 2006, a total of 2,541 patients had percutaneous coronary intervention (PCI). Of these, 202 (226 grafts) had at least one saphenous vein graft (SVG) intervention. Adjunctive distal embolic protection (DEP) devices were attempted in 123 SVGs (54.4%). The 30-day major adverse cardiac event (occurrence of death, myocardial infarction, or target vessel revascularization) rate in the overall group was 11.9%. The presence of angiographic thrombus independently predicted DEP use while the presence of in-stent restenosis predicted no DEP use. Although the presence of all angiographic technical feasibility criteria independently predicted DEP use, only 72 (32.4%) and 33 (14.6%) of the SVGs would have been eligible for the occlusive balloon- and filter-based distal embolic criteria, respectively. The most common technical reason for ineligibility was a graft size smaller than 3.0 mm, followed by the lack of a long enough landing zone. In a subset of 21 (9.3%) completely occluded lesions which would have excluded DEP use, angiographic success was 66.7%, and that was predicated on successful debulking with rheolytic thrombectomy in 13 (61.9%) with subsequent DEP in 5 (23.8%). In conclusion, not all grafts can be protected, and even in those that can, such protection may be incomplete. Newer embolic protection devices, such as the Proxis((R)), were recently introduced to expand the applicability to a wider population of vein grafts. However, further design improvements such as device miniaturizations applicable to sub-3.0-mm vessels and better particle removing/filtering mechanisms are needed in order to expand the use of embolic protection to reduce the persistently high complication rates associated with this difficult- to-treat subset of patients.
- Published
- 2009
- Full Text
- View/download PDF
23. Angiographic and clinical outcomes of bivalirudin versus heparin in patients with acute coronary syndrome undergoing percutaneous coronary intervention.
- Author
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Matar F, Donoghue C, Rossi P, Vandormael M, Sullebarger JT, Kerenski R, Jauch W, Gloer K, and Ebra G
- Subjects
- Acute Disease, Aged, Drug Therapy, Combination, Female, Follow-Up Studies, Hirudins, Humans, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Myocardial Infarction therapy, Platelet Aggregation Inhibitors therapeutic use, Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors, Recombinant Proteins therapeutic use, Risk Factors, Syndrome, Treatment Outcome, Angioplasty, Balloon, Coronary methods, Anticoagulants therapeutic use, Coronary Angiography, Coronary Disease diagnostic imaging, Coronary Disease therapy, Heparin therapeutic use, Peptide Fragments therapeutic use
- Abstract
Background: Heparin with adjunctive glycoprotein IIb/IIIa platelet receptor (GP IIb/IIIa) inhibitors has demonstrated its effectiveness in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Bivalirudin, a direct thrombin inhibitor, has recently been shown to be an effective alternative for patients undergoing elective PCI., Objectives: To assess the angiographic and clinical outcomes of adjunctive pharmacological strategies in a high-risk population presenting with ACS., Methods: Of 891 consecutive PCI patients with ACS, 304 received bivalirudin (60.5% male, 68+/-11 years) and were compared with 283 who received heparin (58.7% male, 66+/-12 years). A 30-day major adverse cardiac event was defined as the occurrence of cardiac death, nonfatal myocardial infarction, urgent revascularization or major hemorrhage., Results: Adjunctive GP IIb/IIIa inhibitors were used in 14.1% of the bivalirudin group and in 72.4% of the heparin group (P<0.010). The occurrence of Thrombolysis In Myocardial Infarction (TIMI) flow less than grade 3 was lower and the achievement of angiographic success was higher in the bivalirudin group than in the heparin group (5.2% versus 8.2%, 94.7% versus 89.7%, P=0.039 and P<0.010, respectively). There was no difference between groups in the incidence of bleeding events (bivalirudin 2.0% versus heparin 3.5%, P not significant) and in 30-day major adverse cardiac events (bivalirudin 8.3% versus heparin 5.7%, P=0.223)., Conclusions: In the high-risk cohort undergoing PCI, bivalirudin with provisional GP IIb/IIIa inhibitors achieved better angiographic results. Although not powered to show a difference, and while acknowledging that a selection bias could have affected the data, the present study showed that bivalirudin may be as clinically effective and safe as heparin with adjunctive GP IIb/IIIa inhibitors.
- Published
- 2006
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24. Study of antirestenosis with the BiodivYsio dexamethasone-eluting stent (STRIDE): a first-in-human multicenter pilot trial.
- Author
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Liu X, Huang Y, Hanet C, Vandormael M, Legrand V, Dens J, Vandenbossche JL, Missault L, Vrints C, and De Scheerder I
- Subjects
- Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary, Belgium epidemiology, Blood Vessel Prosthesis Implantation, Coronary Angiography, Coronary Restenosis diagnosis, Coronary Restenosis mortality, Equipment Design, Equipment Safety, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Ischemia diagnosis, Myocardial Ischemia mortality, Myocardial Ischemia therapy, Pilot Projects, Postoperative Complications etiology, Postoperative Complications mortality, Postoperative Complications therapy, Reoperation, Survival Analysis, Time Factors, Treatment Outcome, Anti-Inflammatory Agents therapeutic use, Coated Materials, Biocompatible therapeutic use, Coronary Restenosis therapy, Dexamethasone therapeutic use, Glucocorticoids therapeutic use, Stents
- Abstract
The aim of this multicenter pilot study was to evaluate the acute safety and efficacy of the dexamethasone-eluting stent (0.5 microg/mm(2) of stent) implanted in patients with de novo single-vessel disease. This study included 71 patients, 42% of whom had unstable angina pectoris. An appropriately sized BiodivYsio Matrix Lo stent loaded with a total dexamethasone dose of 0.5 microg/mm(2) of stent was used. Technical device success rate was 95%. Six-month MACE occurred in two patients (3.3%). Binary restenosis rate was 13.3%. Late loss was 0.45. Late loss and percent diameter stenosis were lower in the unstable angina pectoris patients compared to the stable patients (0.32 +/- 0.39 vs. 0.60 +/- 0.55 mm, P < 0.07, and 26.86 +/- 14 vs. 38.40 +/- 16%, P < 0.02). This study demonstrated the feasibility and safety of the implantation of a dexamethasone-eluting stent and its effect on in-stent neointimal hyperplasia., (Copyright 2003 Wiley-Liss, Inc.)
- Published
- 2003
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25. Intracoronary beta-radiation to reduce restenosis after balloon angioplasty and stenting; the Beta Radiation In Europe (BRIE) study.
- Author
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Serruys PW, Sianos G, van der Giessen W, Bonnier HJ, Urban P, Wijns W, Benit E, Vandormael M, Dörr R, Disco C, Debbas N, and Silber S
- Subjects
- Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary, Brachytherapy adverse effects, Female, Humans, Male, Middle Aged, Strontium Radioisotopes therapeutic use, Survival Analysis, Treatment Outcome, Yttrium Radioisotopes therapeutic use, Brachytherapy methods, Coronary Artery Disease radiotherapy, Coronary Restenosis prevention & control, Stents
- Abstract
Aims: The BRIE trial is a registry evaluating the safety and performance of (90)Sr delivered locally (Beta-Cath TM system of Novoste) to de-novo and restenotic lesions in patients with up to two discrete lesions in different vessels., Methods and Results: In total, 149 patients (175 lesions) were enrolled; 62 treated with balloons and 113 with stents. The restenosis rate, the minimal luminal diameter and the late loss were determined in three regions of interest: (a) in a subsegment of 5mm containing the original minimal luminal diameter pre-intervention termed target segment; (b) the irradiated segment, 28 mm in length, and (c) the entire analysed segment, 42 mm in length, termed the vessel segment. Binary restenosis was 9.9% for the target segment, 28.9% for the irradiated segment, and 33.6% for the vessel segment. These angiographic results include 5.3% total occlusions. Excluding total occlusions binary restenosis was 4.9%, 25% and 29.9%, respectively. At 1 year the incidence of major adverse cardiac events placed in a hierarchical ranking were: death 2%, myocardial infarction 10.1%, CABG 2%, and target vessel revascularization 20.1%. The event-free survival rate was 65.8%. Non-appropriate coverage of the injured segment by the radioactive source termed geographical miss affected 67.9% of the vessels, and increased edge restenosis significantly (16.3% vs 4.3%, P=0.004). It accounted for 40% of the treatment failures., Conclusion: The results of this registry reflect the learning process of the practitioner. The full therapeutic potential of this new technology is reflected by the restenosis rate at the site of the target segment. It can only be unravelled once the incidence of late vessel occlusion and geographical miss has been eliminated by the prolonged use of thienopyridine, the appropriate training of the operator applying this new treatment for restenosis prevention, and the use of longer sources., (Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.)
- Published
- 2002
- Full Text
- View/download PDF
26. The ARTS study (Arterial Revascularization Therapies Study).
- Author
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Serruys PW, Unger F, van Hout BA, van den Brand MJ, van Herwerden LA, van Es GA, Bonnier JJ, Simon R, Cremer J, Colombo A, Santoli C, Vandormael M, Marshall PR, Madonna O, Firth BG, Breeman A, Morel MA, and Hugenholtz PG
- Subjects
- Coronary Angiography, Coronary Disease diagnostic imaging, Coronary Disease economics, Coronary Disease surgery, Cost-Benefit Analysis, Humans, Multicenter Studies as Topic, Patient Selection, Randomized Controlled Trials as Topic, Research Design, Angioplasty, Balloon, Coronary economics, Coronary Artery Bypass, Coronary Disease therapy, Stents economics
- Abstract
The rising costs of health care have forced policy makers to make choices, and new treatments are increasingly assessed in terms of the balance between additional costs and additional effects. The recent recognition that stenting has a major and long-lasting effect enhancing balloon PTCA procedure has made it imperative to compare in patients with multivessel disease the standard surgical procedure with multiple stenting in a large scale multinational and multicentre approach (19 countries, 68 sites). Selection and inclusion of patients is based on a consensus of the cardiac surgeon and interventional cardiologist on equal 'treatability' of patients by both techniques with analysis of clinical follow-up (event-free survival) on the short (30 day), medium (1 year), and long-term (3 and 5 year) with analysis of cost-effectiveness and quality of life (EuroQol and SF-36). Of the entire trial, the primary null hypothesis which needs to be rejected is that there will be no difference in event-free survival or effectiveness (E), at 1 year and also that the direct and indirect costs (C) per event-free year are not different between surgery or stenting. For this to become significant with a power of 90% one needs 1200 patients. Between April 97 and June 98, 1205 patients have been randomized with a monthly recruitment of 83 patients. Expected costs, effects and cost-effectiveness ratio (CE ratio) are: Stent high costs 2 VDStent high costs 3 VDStent low costs 2 VDStent low costs 3 VDCABG costs (C)$19.297$24.566$16.638$20.456$21.350 effects (E)81%81%81%81%88% CE ratio$23.876$30.397$20.586$25.322$24.348 Clinically, stenting is not expected to be more effective than CABG, but should be cost effective in both the 2- and 3-VD group when using the lower cost estimate and in the 2 VD group when using the higher cost assumptions., (Copyright 1999 Harcourt Publishers Ltd.)
- Published
- 1999
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- View/download PDF
27. Randomized comparison of angioplasty of complex coronary lesions at a single center. Excimer Laser, Rotational Atherectomy, and Balloon Angioplasty Comparison (ERBAC) Study.
- Author
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Reifart N, Vandormael M, Krajcar M, Göhring S, Preusler W, Schwarz F, Störger H, Hofmann M, Klöpper J, Müller S, and Haase J
- Subjects
- Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary, Coronary Angiography, Coronary Disease diagnostic imaging, Female, Follow-Up Studies, Humans, Laser Therapy, Male, Middle Aged, Prospective Studies, Recurrence, Treatment Failure, Angioplasty, Balloon methods, Atherectomy, Coronary methods, Coronary Disease therapy
- Abstract
Background: The purpose of this study was to test whether coronary revascularization with ablation of either excimer laser or rotational atherectomy can improve the initial angiographic and clinical outcomes compared with dilatation (balloon angioplasty) alone., Methods and Results: At a single center, a total of 685 patients with symptomatic coronary disease warranting elective percutaneous revascularization for a complex lesion were randomly assigned to balloon angioplasty (n = 222), excimer laser angioplasty (n = 232), or rotational atherectomy (n = 231). The primary end point was procedural success (diameter stenosis < 50%, absence of death, Q-wave myocardial infarction, or coronary artery bypass surgery). The patients who underwent rotational atherectomy had a higher rate of procedural success than those who underwent excimer laser angioplasty or conventional balloon angioplasty (89% versus 77% and 80%, P = .0019), but no difference was observed in major in-hospital complications (3.2% versus 4.3% versus 3.1%, P = .71). At the 6-month follow-up, revascularization of the original target lesion was performed more frequently in the rotational atherectomy group (42.4%) and the excimer laser group (46.0%) than in the angioplasty group (31.9%, P = .013)., Conclusions: Procedural success of rotational atherectomy is superior to laser angioplasty and balloon angioplasty; however, it does not result in better late outcomes. The role of plaque debulking before balloon dilatation in percutaneous coronary revascularization remains to be fully defined.
- Published
- 1997
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- View/download PDF
28. Prospective case-control comparison of percutaneous transluminal coronary revascularization in patients with multivessel disease treated in 1986-1987 versus 1991: improved in-hospital and 12-month results. Multivessel Angioplasty Prognosis Study (MAPS) Group.
- Author
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Ellis SG, Cowley MJ, Whitlow PL, Vandormael M, Lincoff AM, DiSciascio G, Dean LS, and Topol EJ
- Subjects
- Case-Control Studies, Coronary Angiography, Coronary Disease epidemiology, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Prospective Studies, Registries, Survival Rate, Time Factors, Treatment Outcome, Angioplasty, Balloon, Coronary methods, Angioplasty, Balloon, Coronary statistics & numerical data, Coronary Disease therapy
- Abstract
Objectives: This study sought to ascertain whether early and 12-month clinical outcomes after percutaneous coronary revascularization have improved between 1986-1987 and 1991., Background: Since the mid-1980s, when the results of percutaneous revascularization were considered to be somewhat static, justifying large-scale clinical trials of percutaneous transluminal coronary angioplasty versus other modes of therapy, balloon technology has improved, and several new percutaneous revascularization techniques have become available. The clinical results of the current integrated approach to revascularization compared with those for coronary angioplasty alone in the late 1980s are not known., Methods: In this prospective case-control study, 200 consecutively treated patients with multivessel disease in 1991 were studied prospectively and compared with 400 consecutive patients from the same centers during 1986-1987. Patients from 1991 were matched with earlier patients on the basis of four previously described prognostic determinants (left ventricular ejection fraction, presence of unstable angina, diabetes and target lesion morphology score) and the treating institution and were assessed for treatment outcome (completeness of revascularization, procedural success and event-free survival [freedom from death, myocardial infarction and further revascularization])., Results: The 1991 cohort of patients was older (mean [+/- SD] age 62 +/- 11 vs. 58 +/- 11 years, p < 0.001) and tended to have slightly worse left ventricular function (ejection fraction 56 +/- 10% vs. 58 +/- 11%, p = 0.009) than the 1986-1987 cohort. Overall lesion morphology risk scores were similar. New devices (other than coronary angioplasty) were used in 26% of patients. The 1991 patient cohort had more frequent total revascularization (35% vs. 21%, p = 0.003), fewer emergency bypass operations (1.0% vs. 5.5%, p = 0.006) and an improved overall procedural success rate (90% vs. 84%, p = 0.04). In addition, at 12 months the event-free survival rate was superior in the 1991 cohort (73.3% vs. 63.6%, p = 0.02), although there was no difference in infarct-free survival rate (94.6% vs. 93.2%, p = NS)., Conclusions: Improved results with percutaneous revascularization in 1991 have important implications for patient care and interpretation of ongoing randomized trials enrolling patients in the late 1980s and intending to compare standard coronary angioplasty with other forms of therapy.
- Published
- 1995
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29. Prophylactic versus standby cardiopulmonary support for high risk percutaneous transluminal coronary angioplasty.
- Author
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Teirstein PS, Vogel RA, Dorros G, Stertzer SH, Vandormael MG, Smith SC Jr, Overlie PA, and O'Neill WW
- Subjects
- Adult, Cardiac Catheterization, Female, Hospital Mortality, Humans, Male, Middle Aged, Morbidity, Registries, Risk Factors, Ventricular Function, Left physiology, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary statistics & numerical data, Cardiopulmonary Bypass statistics & numerical data, Coronary Disease therapy
- Abstract
Objectives: Data from a national registry of 23 centers using cardiopulmonary support (CPS) were analyzed to compare the risks and benefits of prophylactic CPS versus standby CPS for patients undergoing high risk coronary angioplasty., Background: Early data from the CPS registry documented a high angioplasty success rate as well as a high procedural morbidity rate. Because of this increased morbidity some high risk patients were placed on standby CPS instead of prophylactic CPS., Methods: Patients in the prophylactic CPS group had 18F or 20F venous and arterial cannulas inserted and cardiopulmonary bypass initiated. Patients in the standby CPS group were prepared for institution of cardiopulmonary bypass, but bypass was not actually initiated unless the patient sustained irreversible hemodynamic compromise., Results: There were 389 patients in the prophylactic CPS group and 180 in the standby CPS group. The groups were comparable with respect to most baseline characteristics, except that left ventricular ejection fraction was lower in the prophylactic CPS group. Thirteen of the 180 patients in the standby CPS group sustained irreversible hemodynamic compromise during the angioplasty procedure. Emergency institution of CPS was successfully initiated in 12 of these 13 patients in < 5 min. Procedural success was 88.7% for the prophylactic and 84.4% for the standby CPS group (p = NS). Major complications did not differ between groups. However, 42% of patients in the prophylactic CPS group sustained femoral access site complications or required blood transfusions, compared with only 11.7% of patients in the standby CPS group (p < 0.01). Among patients with an ejection fraction < or = 20%, procedural morbidity remained significantly higher in the prophylactic CPS group (41% vs. 9.4%, p < 0.01), but procedural mortality was higher in the standby group (4.8% vs. 18.8%, p < 0.05)., Conclusions: Patients in the standby and prophylactic CPS groups had comparable success and major complication rates, but procedural morbidity was higher in the prophylactic group. When required, standby CPS established immediate hemodynamic support during most angioplasty complications. For most patients, standby CPS was preferable to prophylactic CPS during high risk coronary angioplasty. However, patients with extremely depressed left ventricular function (ejection fraction < 20%) may benefit from institution of prophylactic CPS.
- Published
- 1993
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30. Reduction of ischemia with a new flow-adjustable hemoperfusion pump during coronary angioplasty. The Coronary Hemoperfusion Ischemia Prevention Study (CHIPS) Investigators.
- Author
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DiSciascio G, Angelini P, Vandormael MG, Brinker JA, Cowley MJ, Dean LS, and Douglas JS Jr
- Subjects
- Aged, Aged, 80 and over, Angina Pectoris diagnosis, Angina Pectoris etiology, Coronary Artery Disease therapy, Coronary Vessels physiopathology, Electrocardiography, Female, Humans, Male, Middle Aged, Myocardial Reperfusion adverse effects, Prospective Studies, Treatment Outcome, Angina Pectoris prevention & control, Angioplasty, Balloon, Coronary adverse effects, Myocardial Reperfusion instrumentation
- Abstract
A new flow-adjustable pump for coronary hemoperfusion to prevent ischemia during routine coronary angioplasty was evaluated in a multicenter prospective study of 110 patients. The protocol included patients who had angina or ST segment elevation during a control balloon inflation of less than or equal to 3 min. Hemoperfusion was performed by means of a new large lumen angioplasty catheter utilizing the patient's renal vein or femoral artery blood. Vessels perfused were the left anterior descending coronary artery (n = 74), right coronary artery (n = 39), left circumflex artery (n = 9) and coronary vein grafts (n = 15). Mean (+/- SD) perfusion flow was 41 +/- 9 ml/min (range 17 to 70); mean perfusion time was 9.3 +/- 4 min (median 8.5, range 2 to 30). Chest pain score (0 to 4) decreased from 2.9 +/- 1 to 1.4 +/- 1 during hemoperfusion (p less than 0.001); ST segment elevation score (0 to 4) decreased from 2.6 +/- 1 to 0.7 +/- 1 (p less than 0.005) and inflation time increased from 1.3 +/- 0.9 to 7 +/- 4 min, (p less than 0.001). At least a 50% increase in tolerated inflation time was obtained in 104 patients (95%). Free plasma hemoglobin and creatine kinase levels did not increase significantly over baseline values. Angioplasty was successful in 107 patients (97%), with mean stenosis reduced from 87 +/- 11% to 20 +/- 17%; 3 patients had urgent bypass surgery, 2 (1.8%) had a myocardial infarction (1 Q wave, 1 non-Q wave) and 2 (1.8%) died later in the hospital of probable noncoronary causes.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1992
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31. [Intracoronary endoprostheses (stents). Literature review and local experience].
- Author
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Materne P, Vanderperren O, Pourbaix S, Vandormael M, Chevolet C, and Boland J
- Subjects
- Aged, Aged, 80 and over, Humans, Prosthesis Design, Coronary Disease therapy, Coronary Vessels, Stents
- Published
- 1991
32. Predictors of cardiac survival after percutaneous transluminal coronary angioplasty in patients with severe left ventricular dysfunction.
- Author
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Serota H, Deligonul U, Lee WH, Aguirre F, Kern MJ, Taussig SA, and Vandormael MG
- Subjects
- Coronary Disease therapy, Female, Follow-Up Studies, Heart Failure mortality, Humans, Male, Middle Aged, Myocardial Infarction mortality, Odds Ratio, Regression Analysis, Retrospective Studies, Stroke Volume physiology, Survival Analysis, Survival Rate, Angioplasty, Balloon, Coronary mortality, Coronary Disease mortality, Ventricular Function, Left physiology
- Abstract
To assess the outcome of percutaneous transluminal coronary angioplasty (PTCA) in patients with severe left ventricular (LV) dysfunction and to determine the predictors of mortality, 73 patients with LV ejection fraction less than or equal to 40% who underwent initial PTCA were analyzed. The majority of patients had prior (greater than 1 week) myocardial infarction (62 patients, 85%). Congestive heart failure and unstable angina were present in 24 (45%) and 49 (67%) patients, respectively. Multivessel coronary artery disease was present in 60 (83%). The LV ejection fraction ranged from 14 to 40% (mean 34%). Intraaortic balloon pump (15%) and percutaneous cardiopulmonary bypass support (4%) was used infrequently. Angiographic success was obtained in 109 of 128 lesions (85%) attempted. Complete revascularization was obtained in 16 of 60 patients with clinical success. Procedure-related mortality was 5% (4 patients). All patients were followed from greater than or equal to 6 to less than or equal to 71 months (average 26). The estimated survival was 79 +/- 5%, 74 +/- 6%, 66 +/- 7% and 57 +/- 8% at 1, 2, 3 and 4 years, respectively. A Cox regression analysis revealed that the presence of congestive heart failure, a lower LV ejection fraction and a higher myocardial jeopardy score for contractile myocardium were independent predictors of survival after PTCA in patients with LV dysfunction. In conclusion, a high-risk subset can be identified among patients with severe LV dysfunction who undergo PTCA.
- Published
- 1991
- Full Text
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33. Predictors of long-term cardiac survival in patients with multivessel coronary artery disease undergoing percutaneous transluminal coronary angioplasty.
- Author
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Vandormael M, Deligonul U, Taussig S, and Kern MJ
- Subjects
- Age Factors, Coronary Disease therapy, Diabetes Mellitus mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Regression Analysis, Risk Factors, Survival Analysis, Time Factors, Ventricular Function, Left physiology, Angioplasty, Balloon, Coronary mortality, Coronary Disease mortality
- Abstract
The predictors of 5-year cardiac survival in patients with multivessel coronary artery disease (CAD) undergoing percutaneous transluminal coronary angioplasty (PTCA) were analyzed in a series of 637 consecutive patients. The average age was 59 +/- 11 years in 472 men and 165 women. Diabetes mellitus, previous myocardial infarction and unstable angina were present in 119 (19%), 261 (41%) and 305 (47%) patients, respectively. Angiographically, 460 patients had 2-vessel and 177 patients had 3-vessel CAD. The left ventricular contraction score was greater than or equal to 12 in 55 patients. Angiographic success (less than 50% residual stenosis) was achieved in 85% of the 1,343 narrowings and clinical success was obtained in 526 (83%) of the 637 patients. Complete revascularization was obtained in 177 (34%) of 526 successful patients. Procedure-related complications resulted in death in 9 patients (1.4%), in Q-wave myocardial infarction only in 6 patients (0.9%) and in emergency bypass surgery in 44 patients (6.9%) (of whom 10 had Q-wave myocardial infarction). Follow-up for greater than or equal to 1 year and up to 6 years after PTCA was obtained in 608 (95%) of the 637 patients. To determine the predictors of 5-year cardiac survival, 28 clinical, angiographic and procedural variables were analyzed by Cox proportional-hazards regression. The estimated 5-year survival after PTCA was 88 +/- 2% in successful patients and 77 +/- 5% in patients in whom PTCA was unsuccessful (p less than 0.001). When clinical success was forced into the Cox regression, the left ventricular contraction score of greater than or equal to 12, diabetes mellitus and age greater than or equal to 65 years showed additional adverse effects on survival.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1991
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34. Attenuation of pulsus alternans during coronary angiography.
- Author
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Ring ME, Kern MJ, Genovely H, Serota H, and Vandormael M
- Subjects
- Cardiomyopathy, Dilated diagnostic imaging, Cardiomyopathy, Dilated physiopathology, Female, Humans, Middle Aged, Pulmonary Wedge Pressure physiology, Angiography, Coronary Angiography, Iohexol, Pulse
- Abstract
Following coronary angiography in a patient with cardiomyopathy and pulsus alternans, we observed a transient but marked attenuation of the alternation in pulse pressure associated with an elevation in pulmonary artery pressure. Attenuation of pulsus alternans has been rarely reported and may represent further deterioration of ventricular function.
- Published
- 1990
- Full Text
- View/download PDF
35. Intrapericardial "negative" cannon waves during atrioventricular dissociation in large pericardial effusion.
- Author
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Gudipati CV, Deligonul U, Janosik D, Vandormael M, and Kern MJ
- Subjects
- Cardiac Volume physiology, Female, Hemodynamics physiology, Humans, Middle Aged, Pericardial Effusion therapy, Punctures, Suction, Atrioventricular Node physiopathology, Heart Conduction System physiopathology, Pacemaker, Artificial, Pericardial Effusion physiopathology
- Published
- 1990
- Full Text
- View/download PDF
36. Rapid identification of the course of anomalous coronary arteries in adults: the "dot and eye" method.
- Author
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Serota H, Barth CW 3rd, Seuc CA, Vandormael M, Aguirre F, and Kern MJ
- Subjects
- Adult, Aortography, Contrast Media, Humans, Methods, Models, Cardiovascular, Radionuclide Ventriculography, Coronary Vessel Anomalies diagnostic imaging
- Abstract
It is often difficult to delineate the true course of anomalous coronary arteries by angiography because it only provides a 2-dimensional view of a complex 3-dimensional structure. The purpose of this study was to confirm morphologically the radiographic appearance of anomalous coronary arteries and to construct a protocol for rapid determination of their true course. Twenty-one adults who had anomalous origin of coronary arteries without other evidence of congenital heart disease were reviewed. Using an anatomically correct model of the heart, solder wire was placed in the pathologically described anomalous positions and radiographed. With this model the pathologically described courses could be easily recognized and separated radiographically. These courses were confirmed in the operating room in 2 patients and a rare anomaly of posterior origin of a coronary artery was also confirmed by autopsy.
- Published
- 1990
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37. Tissue plasminogen activator followed by percutaneous transluminal coronary angioplasty: one-year TIMI phase II pilot results. TIMI Investigators.
- Author
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Chaitman BR, Thompson BW, Kern MJ, Vandormael MG, Cohen MB, Ruocco NA, Solomon RE, and Braunwald E
- Subjects
- Blood Pressure, Coronary Artery Bypass, Female, Follow-Up Studies, Heart Failure complications, Hospitalization, Humans, Male, Middle Aged, Multicenter Studies as Topic, Myocardial Infarction mortality, Pilot Projects, Prognosis, Recurrence, Regression Analysis, Risk Factors, Time Factors, Angioplasty, Balloon, Coronary, Myocardial Infarction therapy, Tissue Plasminogen Activator therapeutic use
- Abstract
The TIMI phase II pilot study enrolled 288 patients with acute myocardial infarction who were treated with recombinant tissue plasminogen activator (rt-PA) within 4 hours of symptom onset and who were assigned to coronary angioplasty of the infarct-related vessel 18 to 48 hours after rt-PA treatment. The patients were followed to ascertain (1) vital status; (2) whether they suffered a recurrent myocardial infarction; (3) whether they received coronary angioplasty or bypass grafting; and (4) whether they were rehospitalized for a cardiac event. Risk factors for these events or combination of these events were identified and reported. The estimated 6-week, 6-month, and 1-year cumulative event rate of death or myocardial infarction was 9.1 +/- 1.7%, 12.9 +/- 2.0%, and 13.6 +/- 2.0%, respectively. With the exception of repeat hospital admissions, most of the above cardiac events occurred early during the patients' follow-up course. Cox proportional hazard analyses revealed that continuing chest pain after rt-PA administration, history of congestive heart failure, low systolic blood pressure at the time of initial evaluation, and history of hypertension increased the risk of death or recurrent myocardial infarction, while a history of chest discomfort at baseline evaluation and older age was predictive of future hospitalization or a revascularization procedure.
- Published
- 1990
- Full Text
- View/download PDF
38. Relation of silent myocardial ischemia after coronary artery bypass grafting to angiographic completeness of revascularization and long-term prognosis.
- Author
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Kennedy HL, Seiler SM, Sprague MK, Homan SM, Whitlock JA, Kern MJ, Vandormael MG, Barner HB, Codd JE, and Willman VL
- Subjects
- Angiography, Coronary Angiography, Coronary Disease mortality, Electrocardiography, Ambulatory, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications mortality, Prevalence, Prognosis, Coronary Artery Bypass, Coronary Disease diagnosis, Postoperative Complications diagnosis
- Abstract
The prevalence and characteristics of silent myocardial ischemia as detected by 24-hour ambulatory electrocardiography ST-segment depression were prospectively assessed in 94 patients examined early (1 to 3 months) and 184 patients examined late (12 months) after coronary artery bypass grafting (CABG), and followed for a mean of 48 +/- 11 (range 4 to 62) months. The relation of ambulatory electrocardiographic silent ischemia to evidence of completeness of revascularization as defined by cardiac angiography performed 1 and 12 months after CABG, and to prognosis by follow-up of adverse clinical events was analyzed. Silent ischemia was detected early in 20% (19 of 94) and late in 27% (50 of 184) of patients, and showed a mean frequency of episodes ranging from 6 to 10 episodes/24 hours with a mean duration ranging from 15 to 23 minutes. The circadian distribution of episodes disclosed a significant peak of ischemic activity during the period of 6 A.M. to noon and a secondary peak between 6 P.M. and midnight (p less than 0.01 and p less than 0.001, respectively). Silent ischemia was not found by univariate analysis to be associated with graft or anastomotic site occlusions, low graft flow rates, grafted arteries with significant distal residual stenoses or ungrafted stenotic native coronary arteries. Kaplan-Meier analysis of time to cardiac event showed that silent ischemia was not predictive of an adverse clinical event in the early years after CABG. Cox regression analysis of 30 covariates only disclosed age (relative risk 1.06 [95% confidence interval, 1.01 to 2.94]) as having an effect on time to adverse clinical event.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1990
- Full Text
- View/download PDF
39. Initial report of the National Registry of Elective Cardiopulmonary Bypass Supported Coronary Angioplasty.
- Author
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Vogel RA, Shawl F, Tommaso C, O'Neill W, Overlie P, O'Toole J, Vandormael M, Topol E, Tabari KK, and Vogel J
- Subjects
- Angioplasty, Balloon, Coronary mortality, Coronary Disease mortality, Female, Humans, Male, Middle Aged, Multicenter Studies as Topic, Registries, Risk Factors, Stroke Volume, United States, Angioplasty, Balloon, Coronary methods, Cardiopulmonary Bypass, Coronary Disease therapy
- Abstract
Relative contraindications to coronary angioplasty have been large amounts of jeopardized myocardium and poor left ventricular function. To prevent possible hemodynamic collapse after balloon occlusion or acute vessel closure in such high risk patients, a cardiopulmonary bypass system capable of providing up to 6 liters/min output was employed prophylactically. This technique, termed supported angioplasty, results in reductions of preload and afterload and allows prolonged balloon inflations in critical coronary vessels. A National Registry of 14 centers performing elective supported angioplasty was formed to collate the initial experience with high risk patients. Suggested indications were ejection fraction less than 25% or a target vessel supplying more than half the myocardium, or both. During 1988, the data from 105 patients (mean age 62 years) undergoing supported angioplasty were entered into the Registry. This group included 20 patients whose disease was deemed too severe to permit bypass surgery and 30 patients who had dilation of their only patent coronary vessel. Seventeen patients had stenosis of the left main coronary artery and 15 underwent dilation of that vessel. Chest pain and electrocardiographic changes occurred uncommonly despite prolonged balloon inflations. During the trial, there was a progressive change from cutdown insertion to percutaneous insertion of the circulatory support cannulas. The angioplasty success rate was 95% for the 105 patients, who underwent an average of 1.7 dilations per patient. Morbidity was frequent (41 patients), in most cases due to arterial, venous or nerve injury associated with cannula insertion or removal, or both.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1990
- Full Text
- View/download PDF
40. Paradox of acute myocardial ischemia and successful PTCA: a case report of subtle coronary embolus.
- Author
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Presant S, Vandormael M, and Kern MJ
- Subjects
- Acute Disease, Coronary Angiography, Coronary Disease complications, Coronary Disease etiology, Coronary Disease therapy, Coronary Thrombosis complications, Electrocardiography, Humans, Male, Middle Aged, Angioplasty, Balloon adverse effects, Coronary Disease diagnosis, Coronary Thrombosis diagnosis
- Published
- 1986
- Full Text
- View/download PDF
41. The effects of successful PTCA on left ventricular function: assessment by exercise echocardiography.
- Author
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Labovitz AJ, Lewen M, Kern MJ, Vandormael M, Mrosek DG, Byers SL, Pearson AC, and Chaitman BR
- Subjects
- Coronary Disease diagnosis, Coronary Disease therapy, Female, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Prospective Studies, Rest, Systole, Angioplasty, Balloon, Coronary Disease physiopathology, Echocardiography methods, Exercise Test methods, Heart physiopathology, Stroke Volume
- Abstract
To assess the usefulness of exercise echocardiography in the follow-up of patients after percutaneous transluminal coronary angioplasty (PTCA), we studied 56 patients at rest and immediately following exercise with two-dimensional echocardiography. Sixty-nine of 73 stress/echo studies (94%) were suitable for interpretation. Seventeen patients (group I) with significant coronary artery disease (CAD) were studied before and after PTCA. Sixteen patients with coronary disease not undergoing PTCA (group II) and 23 individuals without significant coronary disease (group III) served as age-matched controls. Left ventricular ejection fraction did not change significantly in group I patients prior to PTCA (56 +/- 7 versus 54 +/- 12, p = ns) or in group II patients (52 +/- 10 versus 56 +/- 15, p = ns), rest versus immediate after exercise measurements. Following angioplasty, left ventricular ejection fraction increased in group I patients from 55 +/- 7 to 65 +/- 8, p less than 0.001 from rest to exercise, and to a similar extent in group III individuals (55 +/- 6 to 66 +/- 8, p less than 0.001). Electrocardiographic (ECG) evidence of ischemia (greater than 1 mm ST segment depression) was found in 13 of 17 group I patients prior to PTCA and in 8 of 16 group II patients (CAD). None of the 25 normal patients and four of the group I patients following PTCA had abnormal ECG changes with exercise. New exercise-induced echocardiographic wall motion abnormalities were found in 12 of 17 group I patients prior to PTCA and in none of the group I patients following PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1989
- Full Text
- View/download PDF
42. Percutaneous transluminal coronary angioplasty in patients with intracoronary thrombus.
- Author
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Deligonul U, Gabliani GI, Caralis DG, Kern MJ, and Vandormael MG
- Subjects
- Coronary Disease etiology, Humans, Intraoperative Complications, Thromboembolism etiology, Angioplasty, Balloon adverse effects, Coronary Disease therapy, Coronary Thrombosis therapy
- Published
- 1988
- Full Text
- View/download PDF
43. Emergency coronary artery bypass grafting for failed angioplasty: risk factors and outcome.
- Author
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Naunheim KS, Fiore AC, Fagan DC, McBride LR, Barner HB, Pennington DG, Willman VL, Kern MJ, Deligonul U, and Vandormael MC
- Subjects
- Emergencies, Female, Humans, Male, Middle Aged, Postoperative Complications epidemiology, Retrospective Studies, Risk Factors, Statistics as Topic, Angioplasty, Balloon, Coronary Artery Bypass mortality, Coronary Disease therapy
- Abstract
It has been suggested that coronary artery bypass grafting (CABG) performed in the setting of emergent failure of percutaneous transluminal coronary angioplasty causes minimal increased risk compared with routine CABG. We reviewed the records of 103 patients undergoing emergency CABG for failed percutaneous transluminal coronary angioplasty (group 1) and compared them with an identical number of consecutive CABG patients from 1987 (group 2). Group 1 had a lower risk profile evidenced by lower mean age (p less than 0.01), fewer diseased vessels (p less than 0.0001), better ventricular function (p less than 0.001), fewer left main lesions (p less than 0.0001), and fewer patients with acute ischemia requiring intravenous administration of nitroglycerin (p less than 0.01). Despite these differences, the group 1 patients had a higher mortality rate (11% versus 1%; p less than 0.01) and a higher rate of perioperative infarctions (new Q wave) (22% versus 6%; p less than 0.01). An analysis of risk factors was performed in the group 1 patients using 36 preoperative and operative variables. Multivariate analysis revealed that left ventricular score (p less than 0.0001), preoperative (after percutaneous transluminal coronary angioplasty) need for inotropic support (p less than 0.005), and age (p less than 0.025) were independent predictors of operative mortality. In conclusion, emergency CABG after failed percutaneous transluminal coronary angioplasty carries a significantly greater risk of operative death and perioperative infarction than elective CABG.
- Published
- 1989
- Full Text
- View/download PDF
44. Retrograde transport of coronary thrombus by angioplasty guidewire.
- Author
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Kern MJ, Deligonul U, Vandormael M, and Gabliani G
- Subjects
- Coronary Angiography, Coronary Disease drug therapy, Humans, Male, Middle Aged, Recurrence, Tissue Plasminogen Activator therapeutic use, Angioplasty, Balloon adverse effects, Coronary Disease therapy
- Published
- 1987
- Full Text
- View/download PDF
45. Prognostic value of early exercise stress testing after successful coronary angioplasty: importance of the degree of revascularization.
- Author
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Deligonul U, Vandormael MG, Shah Y, Galan K, Kern MJ, and Chaitman BR
- Subjects
- Angina Pectoris diagnosis, Coronary Disease diagnosis, Female, Humans, Male, Middle Aged, Prognosis, Angioplasty, Balloon, Coronary Circulation, Coronary Disease therapy, Electrocardiography, Exercise Test
- Abstract
The prognostic value of early exercise testing after successful coronary angioplasty was determined in 196 and 225 consecutive patients with single-vessel and multivessel coronary disease, respectively, who underwent a symptom-limited exercise test within 30 days of the procedure. The incidence of exercise-induced ST segment depression greater than or equal to 1 mm was significantly greater in patients with multivessel versus single-vessel disease (27% versus 14%; p less than 0.005) and in patients with multivessel coronary disease who had incomplete versus complete revascularization (36% versus 10%; p less than 0.001). An abnormal exercise ECG result was associated with a significantly increased risk of cardiac events in patients with multivessel disease but not in patients with single-vessel disease. Exercise-induced angina occurred in a small and similar proportion of patients with single and multivessel coronary disease (8% versus 12%). The presence of exercise-induced angina was associated with a higher incidence of follow-up cardiac events in patients with multivessel disease and incomplete revascularization (52% versus 33%; p less than 0.05). Exercise duration was significantly less in patients with multivessel disease who had a subsequent cardiac event compared with that in patients who did not have such an event (458 +/- 168 versus 519 +/- 156 seconds; p = 0.01). Thus an abnormal exercise ECG finding within 1 month of successful coronary angioplasty is predictive of subsequent cardiac events in patients who have multivessel disease. The prognostic content of the test might be further improved if the test were performed several months after the procedure when the risk of restenosis is greatest.
- Published
- 1989
- Full Text
- View/download PDF
46. Multilesion coronary angioplasty: clinical and angiographic follow-up.
- Author
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Vandormael MG, Deligonul U, Kern MJ, Harper M, Presant S, Gibson P, Galan K, and Chaitman BR
- Subjects
- Adult, Aged, Cardiac Catheterization, Coronary Angiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Sex Factors, Angioplasty, Balloon, Coronary Disease therapy
- Abstract
Determination of the restenosis rate after multilesion percutaneous transluminal coronary angioplasty is an important consideration in defining expanded indications for the procedure. Of 209 patients who underwent successful multilesion coronary angioplasty, 55 symptomatic and 74 asymptomatic patients were restudied an average of 7 +/- 4 months after dilation. The restenosis rate was 82% (45 of 55) in the symptomatic patients and 30% (22 of 74) in the asymptomatic patients (p less than 0.001). Only 4% of the asymptomatic patients had restenosis at more than one dilation site. When only patients who developed a restenosis were considered, the restenosis occurred at more than one dilation site in 47% (21 of 45) of the symptomatic group versus 14% (3 of 22) of the asymptomatic group (p less than 0.05). When all recurrent stenoses were examined, the severity of the luminal narrowing was greater than or equal to 70% in 64% (45 of 70) of the stenotic lesions in the symptomatic patients versus 31% (8 of 26) of the stenotic lesions in the asymptomatic patients (p less than 0.05). Proximal left anterior descending coronary artery disease, increased length of the stenotic narrowing, male gender and diabetes were associated with an increased incidence of restenosis by multivariate analysis. Patient-related variables were not predictive of multilesion restenosis. In conclusion, the majority of patients are clinically improved after multilesion coronary angioplasty. Recurrent symptoms after multilesion coronary angioplasty are frequently associated with multilesion restenosis and a more severe degree of restenotic narrowing. Restenosis at more than one dilation site is uncommon in the asymptomatic patient.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1987
- Full Text
- View/download PDF
47. Control of sheath back bleeding: a simplified approach.
- Author
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Gabliani GI, Deligonul U, Kern MJ, and Vandormael M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Cardiac Catheterization instrumentation, Needles
- Published
- 1987
- Full Text
- View/download PDF
48. Paradox of ischemia during successful percutaneous transluminal coronary angioplasty: demonstration of a role for the balloon catheter.
- Author
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Presant S, Kern MJ, Deligonul U, and Vandormael M
- Subjects
- Angina Pectoris therapy, Coronary Circulation, Coronary Disease physiopathology, Humans, Male, Middle Aged, Recurrence, Angioplasty, Balloon adverse effects, Coronary Disease therapy
- Published
- 1987
- Full Text
- View/download PDF
49. Impaired coronary vasodilator reserve in the immediate postcoronary angioplasty period: analysis of coronary artery flow velocity indexes and regional cardiac venous efflux.
- Author
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Kern MJ, Deligonul U, Vandormael M, Labovitz A, Gudipati CV, Gabliani G, Bodet J, Shah Y, and Kennedy HL
- Subjects
- Adult, Aged, Angiography, Blood Flow Velocity, Coronary Angiography, Coronary Disease diagnosis, Female, Humans, Male, Middle Aged, Nitroglycerin, Papaverine, Thermodilution, Ultrasonography, Angioplasty, Balloon, Coronary Circulation, Coronary Disease therapy, Coronary Vessels physiopathology
- Abstract
The ratio of peak hyperemic/basal mean coronary flow velocity, an index of coronary vasodilator reserve, immediately after coronary angioplasty normalizes in less than 50% of patients. To evaluate other indexes of coronary vasodilator capacity, both intracoronary arterial velocity and cardiac venous efflux were measured at rest and during vasodilator-induced coronary hyperemia (intracoronary nitroglycerin and papaverine) before and after angioplasty in 27 patients; 17 patients had measurements of intracoronary velocity alone and 10 had thermodilution measurements of great cardiac vein flow. Coronary flow velocity responses were also measured in 6 angiographically normal segments in patients undergoing angioplasty and in 10 normal left coronary artery segments in patients with normal coronary arteries or isolated right coronary artery disease. Despite significant angiographic (72 +/- 12 to 23 +/- 11% diameter narrowing) and hemodynamic (49 +/- 12 to 19 +/- 12 mm Hg aortocoronary gradient) improvement, coronary vasodilator reserve ratios for both arterial velocity and venous flow after angioplasty were only minimally affected. Angioplasty did not significantly increase rest coronary vein flow or artery flow velocities, but did result in significantly higher papaverine responses after angioplasty. Mean and phasic coronary velocity, diastolic coronary flow velocity integral and measured great cardiac vein flow ratios were significantly lower when compared with those in 16 angiographically normal coronary artery segments. These data indicate that maximal hyperemic coronary flow velocity is increased after angioplasty, but the reserve ratios, calculated by any of several flow velocity indexes, remain minimally improved. Angiographic correlations (percent coronary diameter, absolute diameter or cross-sectional area) with variables of coronary blood flow or velocity suggest that no single variable is useful in assessing angioplasty results. However, postangioplasty arterial mean velocity and diastolic flow velocity integral are nearly normalized in most patients, whereas relative changes remain attenuated. These findings are important in studies assessing coronary vasomotor responses in patients with atherosclerotic coronary disease, especially after angioplasty.
- Published
- 1989
- Full Text
- View/download PDF
50. Effects of pharmacologic coronary hyperemia on echocardiographic left ventricular function in patients with single vessel coronary artery disease.
- Author
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Kern MJ, Pearson AC, Labovitz AJ, Deligonul U, Vandormael M, and Gudipati C
- Subjects
- Angiography, Coronary Circulation, Coronary Disease diagnostic imaging, Heart Ventricles, Hemodynamics, Humans, Hyperemia chemically induced, Papaverine, Vasodilation, Coronary Disease physiopathology, Coronary Vessels, Echocardiography, Heart physiopathology, Hyperemia physiopathology
- Abstract
To assess whether pharmacologic coronary vasodilation could provoke new left ventricular wall motion abnormalities in patients with single vessel coronary artery disease, systemic hemodynamics, coronary blood flow velocity and left ventricular wall motion were measured by two-dimensional echocardiography during administration of 10 mg of intracoronary papaverine in 14 patients before and again immediately after left coronary angioplasty (group 1). As a comparison with an intravenous method, left ventricular wall motion was analyzed after 0.56 mg/kg body weight of intravenous dipyridamole in a separate group of 13 patients with single vessel coronary disease (group 2). Heart rate-blood pressure product increased 3% to 6% in papaverine-treated patients and 14 +/- 11% (p = NS) in dipyridamole-treated patients. No angiographic collateral vessels were present in either group. Although intracoronary mean flow velocity measured in the 14 group 1 patients and in 5 normal control subjects during papaverine treatment increased from 125% to 400% of basal flow velocity, papaverine induced new left ventricular wall motion abnormalities in only 5 of the 14 patients before coronary angioplasty. In three of five patients, left ventricular wall motion abnormalities persisted after successful coronary angioplasty. Four of the 14 patients demonstrated augmentation of left ventricular wall motion with papaverine. After intravenous dipyridamole, only 3 of the 13 group 2 patients developed new left ventricular regional asynergy. These data suggest that selective (papaverine) and, most likely, global (dipyridamole) augmentation of coronary flow alone does not reliably identify potential ischemic left ventricular regions affected by critical single vessel coronary artery disease.
- Published
- 1989
- Full Text
- View/download PDF
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