Textbook of Interventional Cardiology

INTERVENTIONAL CARDIOLOGY......Page 2
Copyright......Page 3
Dedication......Page 4
Contributors......Page 5
Preface......Page 11
Patient Comorbidities......Page 12
SYNTAX Trial......Page 14
Clinical Scores......Page 22
New Mayo Clinic Risk Score......Page 23
Value of Age, Creatinine, and Ejection Fraction Score......Page 25
American College of Cardiology/American Heart Association Lesion Classification System......Page 26
Myocardial Jeopardy Scores......Page 27
Combined Risk Scores......Page 28
Society of Thoracic Surgery Score......Page 29
Anatomic SYNTAX Score......Page 30
Functional SYNTAX Score......Page 31
Clinical SYNTAX Score/Logistic Clinical SYNTAX Score......Page 33
Diabetics......Page 34
SYNTAX II Trial......Page 38
Tools for Assessment of Completeness of Revascularization......Page 41
Residual SYNTAX Score......Page 42
Post–Coronary Artery Bypass Grafting SYNTAX Score......Page 43
SYNTAX III Revolution Trial Noninvasive Heart Team Assessment of Multivessel Coronary Disease With Coronary Computed Tomography .........Page 46
Individual Assessment from a Patient’s Perspective......Page 49
Conclusions......Page 51
Changing Paradigms of Coronary Revascularization......Page 60
Myocardial Infarction and High-Risk Unstable Angina......Page 61
Coronary Anatomy......Page 62
Need for Complete Revascularization......Page 63
Multivessel Disease......Page 64
Registries......Page 65
Randomized Studies......Page 66
Special Considerations in Patients With Diabetes Mellitus......Page 68
Studies With Drug-Eluting Stents......Page 69
Left Main Coronary Artery Disease......Page 70
Registries with Drug-Eluting Stents......Page 71
Randomized Studies With Drug-Eluting Stents......Page 72
Percutaneous Coronary Intervention Versus Medical Therapy Alone......Page 75
Pathophysiology of Atherosclerosis in Diabetes......Page 83
Myocardial Ischemia Detection in Diabetic Patients......Page 84
Percutaneous Coronary Intervention......Page 85
Coronary Artery Bypass Surgery......Page 86
Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Stable Diabetic Patients With Multivessel Disease......Page 88
Early Invasive Versus Conservative Strategy......Page 91
Long-Term Antidiabetic Therapy......Page 92
Antithrombotic Therapy in Diabetes......Page 93
Prasugrel and Ticagrelor......Page 94
Multifactorial Intervention......Page 95
Exercise Stress Testing......Page 100
Contrast Perfusion Imaging......Page 101
Stress Scintigraphic Myocardial Perfusion Imaging......Page 103
Exercise Scintigraphic Myocardial Perfusion Imaging......Page 104
Cardiac Magnetic Resonance Imaging......Page 107
Cardiac Magnetic Resonance Vasodilator Perfusion Imaging......Page 108
Dobutamine and Exercise Stress Cardiac Magnetic Resonance......Page 109
Cardiac Computed Tomography......Page 110
Contrast-Enhanced Computed Tomography Coronary Angiography......Page 111
Stress Myocardial Computed Tomography Perfusion Imaging......Page 114
Coronary Computed Tomography Angiography in Acute Chest Pain......Page 115
Radiation Exposure Relative Health Risks......Page 116
Conclusions......Page 118
Coronary Flow and Flow Reserve......Page 124
Intracoronary Pressure Measurements and Fractional Flow Reserve......Page 125
General Setup and Guidewire Manipulation......Page 126
Adenosine......Page 127
Sodium Nitroprusside......Page 129
Fractional Flow Reserve and Angiography......Page 130
Intracoronary Physiologic Measurements, Intravascular Ultrasound, and Optical Coherence Tomography Measurements......Page 131
Deferring Percutaneous Coronary Intervention for Lesions With Nonsignificant Fractional Flow Reserve......Page 132
Fractional Flow Reserve in Daily Clinical Practice......Page 134
Implications for Fractional Flow Reserve in Patients With Multivessel Coronary Artery Disease and Coronary Artery Bypass Graftin.........Page 135
Left Main Coronary Artery Disease......Page 136
Complex Left Main Coronary Artery Lesion Assessment (Left Main Coronary Artery Plus Downstream Lesions) With Fractional Flow Res.........Page 138
Serial (Multiple) Lesions in a Single Vessel......Page 139
Diffuse Coronary Disease......Page 140
Fractional Flow Reserve in Acute Coronary Syndromes......Page 142
Fractional Flow Reserve in ST Elevation Myocardial Infarction Patients......Page 144
Post–Percutaneous Coronary Intervention Fractional Flow Reserve......Page 145
Simultaneous Measurement of Flow Velocity and Transstenotic Pressure Gradient......Page 146
Nonhyperemic Pressure Ratios......Page 148
Conclusion......Page 149
Definition of Contrast-Induced Acute Kidney Injury......Page 155
Epidemiology and Risk Factors for Contrast-Induced Acute Kidney Injury......Page 156
Biomarkers for Risk Prediction and Early Detection of Contrast-Induced Acute Kidney Injury......Page 157
Chronic Kidney Disease in Patients Undergoing Percutaneous Coronary Intervention......Page 158
Prevention Strategies to Minimize the Risk of Contrast-Induced Acute Kidney Injury......Page 160
N-Acetyl Cysteine and Sodium Bicarbonate......Page 161
Transcatheter Aortic Valve Replacement Population......Page 162
Critical View and Future Demands......Page 163
RADIATION RISK......Page 169
RADIATION MANAGEMENT......Page 170
Image Chain Components......Page 171
Factors That Contribute to High Skin Dose......Page 173
Best Practices for Patient Dose Management......Page 174
Occupational Dose Monitoring......Page 176
Personal Protective Equipment......Page 177
Perioperative Myocardial Infarction......Page 182
Indications for Preoperative Coronary Angiography......Page 183
Stable Coronary Artery Disease......Page 184
Stent Placement......Page 185
Unanticipated Surgery After Stenting......Page 186
Antiplatelet Drug Interruption......Page 187
Summary and Recommendations......Page 188
Perioperative Bridging......Page 189
Novel Drug-Eluting Stent Platforms......Page 190
Aortic Stenosis and Noncardiac surgery......Page 191
Characteristics and Outcomes of Women Undergoing Percutaneous Coronary Intervention......Page 198
Sex and Percutaneous Coronary Devices and Adjuvant Therapies......Page 199
Sex Differences in Acute Coronary Syndrome......Page 200
Aspirin......Page 202
P2Y12 Inhibitors......Page 203
Other Adjuvant Pharmacotherapy and Post–Acute Coronary Syndrome Treatments......Page 204
Spontaneous Coronary Artery Dissection......Page 205
Microvascular Angina......Page 206
Characteristics of Racial and Ethnic Minorities Undergoing Intervention......Page 207
Social Aspects of Health Care Disparities......Page 208
Conclusion......Page 209
Basic principles of antiplatelet therapy......Page 213
Mechanism of Action......Page 214
Pharmacokinetics and Pharmacodynamics......Page 215
Ticlopidine......Page 216
Pharmacodynamics......Page 218
Dosing Strategies......Page 219
ABCB1. P-glycoprotein is an adenosine triphosphate (ATP)–dependent efflux pump encoded by the ABCB1 gene. It is expressed in the.........Page 220
Clinical Studies......Page 221
Pharmacology and Metabolism......Page 222
Adverse Effects......Page 223
Adverse Effects. Pooled analysis of patient-level data from the CHAMPION trials demonstrated that cangrelor bolus and infusion d.........Page 224
Vorapaxar......Page 225
Abciximab......Page 226
Pivotal Clinical Trials With Glycoprotein IIb/IIIa Inhibitors......Page 227
Timing of Glycoprotein IIb/IIIa Administration......Page 228
Duration of Oral Dual-Antiplatelet Therapy......Page 229
Prediction Scores......Page 230
Triple-Antithrombotic Therapy: Considerations for the Patient With Atrial Fibrillation Undergoing Percutaneous Coronary Infarcti.........Page 231
ARCTIC......Page 232
Other Studies......Page 233
Switching Antiplatelet Therapy......Page 234
Conclusion......Page 235
The Central Role of Thrombin......Page 241
Adverse Events Following Percutaneous Coronary Intervention......Page 242
Direct Thrombin Inhibitors......Page 244
New Pharmacologic Targets......Page 245
ST-Elevation Myocardial Infarction......Page 246
Non–ST-Elevation Acute Coronary Syndrome......Page 247
Percutaneous Coronary Intervention for Stable Coronary Artery Disease......Page 248
Patients With Renal Impairment......Page 249
Patients With Heparin-Induced Thrombocytopenia......Page 250
Conclusion......Page 251
Thrombolytic Agents......Page 253
Major Historical Comparative Thrombolytic Trials......Page 254
Early Treatment......Page 256
Late Treatment......Page 257
Adjunctive Therapies......Page 258
P2Y12 Receptor Antagonists......Page 259
Heparin......Page 261
Glycoprotein IIb/IIIa Inhibitors......Page 262
Facilitated Percutaneous Coronary Intervention......Page 263
Pharmacoinvasive Strategy......Page 264
International Perspective......Page 267
Unstable Angina Pectoris......Page 272
Percutaneous Coronary Intervention......Page 273
End Points......Page 274
Results......Page 275
Chronic Therapy After Myocardial Infarction......Page 276
Acute Myocardial Infarction......Page 277
The CAMELOT Trial......Page 278
Angiotensin-Converting Enzyme......Page 279
Conclusion......Page 280
Radial Access......Page 283
Femoral Access......Page 284
Guide Catheter Selection......Page 285
Guide Extensions......Page 286
Workhorse and Specialty Crossing Wires......Page 287
Coronary Microcatheters and Over the Wire Balloons......Page 288
Facilitated Stent Delivery......Page 289
Contrast and Radiation Sparing......Page 290
Management of Complications......Page 291
Conclusion......Page 292
Limitations of balloon angioplasty and development of the coronary stent......Page 296
Stent Coatings......Page 298
Drug-Eluting Stents Stent Designs......Page 299
Generational Classification of Drug-Eluting Stents......Page 300
The Taxus Paclitaxel-Eluting Stent......Page 301
Durable Polymer-Based Second-Generation Drug-Eluting Stents......Page 304
Cobalt-Chromium Everolimus-Eluting Stents (Xience)......Page 307
Cobalt-Chromium Everolimus-Eluting Stents Versus Bare-Metal Stents......Page 308
Platinum-Chromium Everolimus-Eluting Stents (Promus Element/Premier)......Page 311
Zotarolimus-Eluting Stent (Endeavor)......Page 312
Re-ZES (Resolute)......Page 315
BP-BES (Biomatrix/NOBORI) and Comparisons with First-Generation Drug-Eluting Stents......Page 316
BP-BES (Biomatrix/NOBORI) and Comparisons with Second-Generation Drug-Eluting Stents......Page 322
Novel BP-BASED Drug-Eluting Stents: Orsiro and Synergy......Page 323
Other BP-Based Drug-Eluting Stents......Page 324
Acute ST-Segment Elevation Myocardial Infarction......Page 327
Stents to Reduce Distal Embolization in STEMI......Page 332
Diabetes Mellitus......Page 333
Left Main and Multivessel Disease......Page 334
Chronic Total Occlusions......Page 337
Bifurcation Lesions......Page 338
Stent Thrombosis......Page 339
Dual Antiplatelet Therapy and Stent Thrombosis......Page 340
Restenosis......Page 343
Treatment of Restenosis......Page 345
Conclusions and Future Directions......Page 346
Introduction......Page 364
Polymers......Page 365
Current Landscape of Clinically Tested Bioresorbable Scaffold......Page 366
Absorb......Page 369
Ideal BioStent......Page 371
NeoVas......Page 372
From Initial Trials and Promises to Current Status and Future Outlook......Page 373
Preclinical Data......Page 378
Coronary In-Stent Restenosis......Page 381
Coronary De Novo Disease......Page 382
Clinical Data From the Peripheral Vascular Application of Drug-Coated Balloons......Page 383
The Future of Drug-Coated-Balloon Technology......Page 384
INTRODUCTION......Page 388
Percutaneous Coronary Revascularization: Efficacy on Symptom Improvement......Page 390
Percutaneous Coronary Revascularization: Effect on Clinical End Points......Page 393
SELECTION OF REVASCULARIZATION STRATEGY......Page 398
Tools for Selection of Therapy......Page 400
Silent Myocardial Ischemia......Page 402
SUMMARY......Page 405
REFERENCES......Page 406
Ischemic Risk Stratification......Page 408
Invasive Versus Ischemia-Guided Strategy......Page 410
Timing of the Intervention: Early Versus Delayed Invasive Strategy......Page 412
Ticagrelor......Page 413
Low Molecular Weight Heparin......Page 414
Abciximab......Page 415
Radial VERSUS Femoral Approach......Page 416
Multivessel Disease......Page 417
Patients with Left Ventricular Dysfunction......Page 420
Single-Sitting Versus Staged Multivessel Percutaneous Coronary Intervention......Page 421
Introduction......Page 427
Primary Percutaneous Coronary Intervention Versus Fibrinolysis as Reperfusion Strategy for ST-Elevation Myocardial Infarction......Page 428
Time-To-Reperfusion and Outcome of Primary Percutaneous Coronary Intervention......Page 430
Primary Percutaneous Coronary Intervention in Late Presenters......Page 435
Interhospital Transfer for Primary Percutaneous Coronary Intervention......Page 436
Facilitated Percutaneous Coronary Intervention......Page 439
Rescue Percutaneous Coronary Intervention......Page 442
Primary Stenting......Page 443
Drug-Eluting Stents......Page 444
Drug-Eluting Balloons......Page 446
Self-Expanding Stents......Page 448
Direct Stenting......Page 449
Multivessel Intervention in Patients with St-Segment Elevation Myocardial Infarction......Page 450
Mechanical and Aspiration Thrombectomy......Page 453
Deferred Stenting......Page 454
Antithrombotic Therapy in Patients with St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.........Page 455
Anticoagulant Therapy in Patients with St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention......Page 458
Glycoprotein IIB/IIIA Inhibitors......Page 460
Out-of-Hospital Cardiac Arrest......Page 466
Cardiogenic Shock......Page 467
Primary Percutaneous Coronary Intervention in Elderly......Page 469
Conclusion......Page 471
Access Site Management......Page 484
Communication to Referring Physician......Page 485
Platelet Function......Page 486
Technological, Pharmacological, and Procedural Advances......Page 487
Patient Selection......Page 488
Elderly......Page 490
Economic Impact of Same-Day Discharge......Page 491
Conclusions......Page 492
Clinical Presentation......Page 495
Clinical Manifestations......Page 496
Inotropes......Page 497
Mechanical Support......Page 498
Percutaneous Coronary Intervention in Cardiogenic Shock......Page 499
Conclusion......Page 500
Contemporary Studies......Page 504
Approach to Treatment of Bifurcation Lesions......Page 508
Difficult Side Branch Access......Page 509
The Role of Final Kissing Balloon Inflation......Page 510
The European Bifurcation Club Approach to Bifurcation Stenting......Page 511
Two Stents as Intention-to-Treat......Page 512
Technique Description......Page 514
Flower Petal Stenting......Page 516
Left Main Bifurcation Stenting......Page 517
Controversies in the Technical Approach to Isolated Ostial Left Anterior Descending or Circumflex Lesions......Page 519
Intracoronary Imaging......Page 520
Conclusions......Page 521
Definition of Significant Left Main Coronary Artery Stenosis......Page 526
Provisional One-Stent Strategy......Page 527
Medical Treatment Versus Revascularization......Page 528
In-Stent Restenosis After Left Main Coronary Artery Drug-Eluting Stenting......Page 529
Current Status of Left Main Coronary Artery Percutaneous Coronary Intervention and Selection of Revascularization Strategy......Page 530
Conclusions......Page 531
Multivessel Disease: Prevalence and Prognostic Implications......Page 536
The BEST Trial......Page 537
The FREEDOM Trial......Page 538
Fractional Flow Reserve and the FAME Trial......Page 539
Intravascular Imaging to Guide and Optimize Percutaneous Coronary Intervention Procedures......Page 540
Combining Different Strategies to Improve Percutaneous Coronary Intervention Outcomes of Multivessel Disease: The SYNTAX II Stud.........Page 541
Managing Multivessel Disease in Patients with Stemi......Page 542
Conclusions......Page 543
Prevalence......Page 548
Indications for Revascularization......Page 549
Collateral Circulation......Page 551
Scoring Systems to Stratify Difficulty of Chronic Total Occlusion Percutaneous Coronary Intervention......Page 552
Antegrade Wire Escalation......Page 553
Retrograde Wire Escalation......Page 554
Retrograde Dissection and Reentry Techniques......Page 555
Observational Data......Page 556
Randomized Controlled Trials......Page 557
Conclusion......Page 558
Early Postoperative Period......Page 561
More Than Three Years After Surgery......Page 562
Acute ST-Segment Elevation Myocardial Infarction......Page 563
Technical Strategy......Page 564
Percutaneous Coronary Intervention Versus Reoperation......Page 565
Vein Graft Intervention......Page 566
Bare-Metal Stents Versus Balloon Angioplasty in Vein Grafts......Page 567
Drug-Eluting Stents in Vein Grafts......Page 568
Embolic Protection......Page 569
Adjunctive Pharmacotherapy......Page 571
Internal Mammary Artery Grafts......Page 573
The Future of Bypass Graft Intervention......Page 574
Processes of Thrombus Formation: Histopathology and Types......Page 579
Thrombus Architecture and Related Characteristics......Page 581
The Grading and Classification of Thrombi......Page 583
Targeted Thrombus Revascularization Strategies......Page 586
Adjunctive Thrombectomy......Page 587
Embolic Protection......Page 589
Power-Sourced Thrombectomy......Page 591
Stents for Targeted Thrombus Capture......Page 594
Stent Thrombosis......Page 596
Left Main Coronary Lesions......Page 597
Multiple Thrombi in a Single Vessel......Page 598
Chronic Thrombotic Occlusion......Page 599
Saphenous Vein Graft......Page 601
Mechanisms......Page 610
Treatment......Page 611
Stent Thrombosis......Page 612
Mechanism......Page 614
Management......Page 615
Incidence......Page 618
Treatment......Page 619
Incidence......Page 620
Mechanism......Page 621
Prevention—Pharmacotherapy......Page 622
Incidence and Diagnosis......Page 623
Prognosis......Page 624
Treatment......Page 625
Bleeding......Page 626
Conclusion......Page 628
Embolism Protection Devices......Page 634
The Third Universal Definition of Myocardial Infarction: Definition of Periprocedural Myocardial Infarction......Page 635
Enzyme Elevation and Imaging Evidence of Myonecrosis......Page 636
Distal Embolization and Periprocedural Myocardial Infarction......Page 637
Clinical Characteristics......Page 638
Procedural Complications and Risk of Periprocedural Myocardial Infarction......Page 639
Risk of Periprocedural Myocardial Infarction by Interventional Device......Page 640
Prognostic Implications of Periprocedural Myocardial Infarction......Page 641
Intravenous Glycoprotein IIb/IIIa Platelet Inhibitors......Page 642
P2Y12 Platelet Inhibitors......Page 643
Nonpharmacologic Approaches......Page 645
Conclusions......Page 646
Proximal Occlusion Devices......Page 647
Saphenous Vein Graft Percutaneous Coronary Intervention......Page 648
Percutaneous Coronary Intervention for Acute Myocardial Infarction......Page 650
Distal Embolism Protection Devices in Carotid Stenting......Page 651
Cerebral Embolic Protection Device Use During Transcatheter Aortic Valve Replacement......Page 653
Conclusions......Page 656
Planning Access......Page 662
Traditional Palpatory Method......Page 663
Ultrasound-Guided Femoral Access......Page 664
Puncture Technique for the Brachial Artery......Page 665
Manual and Mechanical Compression......Page 666
Femoral Closure Devices......Page 667
Plug-Based Sealing Devices......Page 669
Suture-Based Closure Devices......Page 670
Access-Site Complications......Page 671
Pseudoaneurysm......Page 672
Conclusions and Future Trends......Page 673
Feasibility and Security......Page 678
Transradial Versus Transfemoral Approach for Percutaneous Coronary Intervention......Page 679
Transradial Approach in St-Elevation Myocardial Infarction......Page 681
The Allen Test......Page 682
Patient Preparation, Arterial Puncture, and Sheath Insertion......Page 683
Guiding Catheters......Page 685
Difficult Anatomy......Page 686
Conclusions......Page 687
Role of The Surgeon on Surgical Standby......Page 694
Transcatheter and Hybrid Cardiovascular Procedures......Page 695
Transcatheter Aortic Valve Replacement......Page 696
Endovascular Aortic Repair......Page 698
Hybrid Coronary Revascularization......Page 699
Hybrid Cardiac Surgeon......Page 700
Hybrid Suite......Page 701
Cardiac Surgeon in Innovation......Page 702
Training for Future Hybrid Cardiac Surgeon/Interventionalist......Page 703
Inflammation......Page 706
Definitions–Angiographic Restenosis......Page 708
Clinical Restenosis......Page 709
Patterns of Restenosis......Page 710
Predictors of Restenosis......Page 712
Polymer and Elution Kinetics......Page 713
After Percutaneous Transluminal Coronary Angioplasty......Page 714
After Drug-Eluting Stents......Page 715
Debulking and Other Plaque Modifying Modalities......Page 716
Equipment......Page 722
Clinical Results......Page 724
Directional Coronary Atherectomy......Page 725
Mechanism of Action......Page 727
Scoring Balloon Angioplasty......Page 728
Lesion Selection......Page 730
Introduction and Rationale: Identifying the high-risk Patient......Page 737
Approach to the Patient......Page 739
Clinical Trials......Page 740
Insertion Technique......Page 742
Clinical Trials......Page 743
Left Atrial–Femoral Artery Bypass......Page 744
Clinical Trials......Page 745
Insertion Techniques......Page 747
Clinical Trials......Page 748
conclusions......Page 750
INTODUCTION......Page 757
The Case for Regionalized Care......Page 758
Percutaneous Coronary Intervention Centers without on-Site Cardiac Surgery......Page 760
ST-Elevation Myocardial Infarction......Page 762
Non–St-Segment Elevation Acute Coronary Syndromes......Page 764
Models of Regional Systems of Care......Page 765
Limited Medical Resources......Page 767
Future Care of ST-Elevation Myocardial Infarction Patients......Page 768
Initial Workup of Coronary Microvascular Dysfunction......Page 775
Approach......Page 776
Equipment......Page 777
Endothelial-Dependent Microvascular Blood Flow......Page 778
Procedural Safety......Page 779
Nitrates......Page 780
Conclusions......Page 781
Vascular Anatomy of the Lower Extremity......Page 786
Ankle-Brachial Index......Page 787
Pulse Volume Recording......Page 788
Magnetic Resonance Angiography......Page 789
Revascularization Options......Page 790
Clinical Data......Page 791
Superficial Femoral Artery......Page 793
Specific Techniques: Laser, Atherectomy, SilverHawk......Page 794
Clinical Data......Page 795
Specific Techniques......Page 797
Acute Limb Ischemia......Page 798
Critical Leg Ischemia......Page 799
Buerger Disease (Thromboangiitis)......Page 800
Conclusions and Future Directions......Page 801
Normal Anatomy......Page 805
Anatomic Variants......Page 807
History and Physical Examination......Page 809
Catheter-Based Angiography......Page 811
Treatment......Page 812
Thoracic Outlet Syndrome......Page 813
Coronary Steal Syndrome......Page 814
Acknowledgments......Page 815
Diagnosis......Page 817
Treatment......Page 818
Conclusion......Page 820
Epidemiology and Natural History......Page 822
Magnetic Resonance Angiography and Computed Tomography Angiography......Page 823
Functional Assessment of Renal Artery Stenosis......Page 824
CORAL Study......Page 825
Invasive Assessment of Renal Ischemia......Page 826
Renal Artery Stenting......Page 827
Management of In-Stent Restenosis......Page 829
Percutaneous Renal Sympathetic Denervation to Treat Resistant Hypertension......Page 830
Renal Denervation: Science and Clinical Application......Page 836
Surgical Denervation for Hypertension Control......Page 837
Renal Artery Denervation......Page 838
Efficacy......Page 839
Additional Radiofrequency Devices......Page 840
Multielectrode Radiofrequency Ablation......Page 841
Tissue-Directed Pharmacological Ablation......Page 842
Carotid Body and Sinus......Page 843
Mechanical Solutions......Page 845
Matching Patients With Devices—Patient Selection......Page 846
Aortic Dissection......Page 851
Indications for Endovascular Aortic Interventions......Page 853
Stable Acute Type B Aortic Dissection......Page 854
Chronic Type B Aortic Dissection......Page 855
Aortic Stent Graft Placement......Page 857
Endovascular Repair by Stent Grafts......Page 858
Hybrid Procedures for Aortic Arch Pathologies......Page 860
Complications and Outcomes......Page 861
Indications for Treatment......Page 864
Randomized Trial Data and Analysis......Page 865
Vein Valves......Page 871
Chronic Venous Disease......Page 872
Medications......Page 873
Deep Vein Thrombosis Prophylaxis......Page 874
Central Venous Stenosis—Superior Vena Cava Syndrome......Page 875
Anatomy and Symptoms......Page 876
Diagnosis......Page 877
Treatment/Technique......Page 878
Deep Venous Thrombosis—Upper Extremity......Page 879
Treatment Options......Page 880
Surgical Therapy......Page 881
Deep Venous Thrombosis—Lower Extremity......Page 882
Goals of Therapy......Page 883
Catheter-Directed Thrombolysis......Page 884
Percutaneous Mechanical Thrombectomy......Page 887
The Research Gap in Deep Vein Thrombosis Intervention......Page 888
Inferior Vena Cava Filters......Page 889
Carotid Bifurcation Atherosclerosis and Stroke......Page 894
Natural History of Carotid Artery Bifurcation Disease......Page 896
Benefit of Carotid Revascularization......Page 897
Preprocedural Assessment......Page 898
Delivery of Embolic Protection Device......Page 899
Stent Selection and Placement......Page 901
Postdilation......Page 902
Stroke......Page 903
Hyperperfusion Syndrome......Page 904
Restenosis......Page 905
Carotid Artery Stenting in High-Risk Patients......Page 906
Carotid Artery Stenting in Normal-Risk Patients......Page 907
Carotid Artery Stenting—Future Perspective......Page 910
Endovascular Outcomes......Page 911
Intracranial Intervention......Page 912
Clinical Outcomes......Page 914
Conclusions......Page 916
New Imaging Strategies......Page 920
Intravenous Thrombolysis......Page 921
Mechanical Thrombectomy......Page 922
Neuroprotection......Page 923
The Role of Cardiology in a Stroke Program......Page 924
Left Ventriculogram......Page 928
Right Ventriculogram......Page 930
Transesophageal Echocardiography......Page 931
Intracardiac Echocardiography......Page 933
Computed Tomography and “Fusion” Fluoroscopy......Page 935
Transseptal Puncture......Page 937
Patent Foramen Ovale......Page 938
Left Atrial Appendage Occlusion......Page 939
Mitral Valvuloplasty......Page 940
Percutaneous Mitral Valve Repair......Page 941
Percutaneous Aortic Valve Replacement......Page 942
Paravalvular Leak Closure......Page 943
Transcatheter Mitral Valve replacement......Page 944
Transcatheter Tricuspid Valve Repair and Replacement......Page 948
Incidence......Page 953
Cryptogenic Stroke......Page 954
Stroke Recurrence and Risk Identification......Page 955
Percutaneous Treatment......Page 956
Decompression Sickness......Page 958
Indications......Page 959
Preprocedure Considerations......Page 960
Venous Access......Page 961
Atrial Septal Aneurysms......Page 962
Anatomic and Morphologic Considerations......Page 964
Hemodynamics......Page 966
Amplatzer Septal Occluder and Amplatzer Multifenestrated Septal Occluder Cribiform......Page 967
Procedural Details......Page 968
Complications......Page 969
Multifenestrated Atrial Septal Defects......Page 971
Diastolic Left Ventricular Dysfunction and Atrial Septal Defect Closure......Page 972
Conclusions......Page 973
Assessment of Thromboembolic and Bleeding Risk......Page 978
Rationale......Page 980
Surgical Approaches......Page 981
Percutaneous Left Atrial Appendage Transcatheter Occlusion System......Page 982
Implantation Procedure......Page 983
PROTECT-AF......Page 984
PREVAIL......Page 985
Meta-Analysis of Protect-AF and Prevail......Page 987
Clinical Data......Page 988
Clinical Outcomes......Page 989
Patient Selection......Page 992
Conclusions......Page 993
Monitoring the Procedure......Page 1001
Complications......Page 1002
Long-Term Results......Page 1004
Patient Evaluation......Page 1005
Experience of the Medical and Surgical Teams......Page 1006
Future Prospects......Page 1007
Etiology and Mechanism of Mitral Regurgitation......Page 1013
Imaging: Echocardiography......Page 1015
Alternative Imaging Modalities......Page 1016
Isolated Annuloplasty......Page 1017
Isolated Leaflet Repair with Edge-to-Edge Technique......Page 1018
MitraClip for Degenerative Mitral Regurgitation......Page 1019
MitraClip for Functional Mitral Regurgitation......Page 1021
Carillon Mitral Contour System......Page 1022
Edwards Cardioband Annuloplasty System......Page 1023
Basal Annuloplasty of the Cardia Externally......Page 1024
Medtronic Intrepid Valve......Page 1025
Tiara Valve......Page 1026
Surgical Bioprosthetic Valve or Valve Ring Failure......Page 1027
Future Directions......Page 1028
introduction......Page 1032
Retrograde Approach: Equipment and Procedural Steps......Page 1033
Balloon Preparation and Balloon Aortic Valvuloplasty......Page 1034
Current Perspectives of Balloon Aortic Valvuloplasty......Page 1035
Patient Selection for Transcatheter Aortic Valve Implantation......Page 1036
Computed Tomography......Page 1037
Edwards SAPIEN Valve......Page 1038
SAPIEN 3 Valve......Page 1039
Valve Insertion and Deployment......Page 1040
Direct Transaortic Approach......Page 1041
Historical Results......Page 1042
SOURCE and SOURCE XT Registries......Page 1043
PARTNER 2 Trial......Page 1045
Transcatheter Valve Therapy Registry......Page 1046
Stroke......Page 1047
Severe Aortic Insufficiency......Page 1048
Conclusions......Page 1049
CoreValve “Classic”......Page 1055
Procedure Description......Page 1056
CoreValve Extreme Risk Clinical Study......Page 1059
CoreValve High-Risk Clinical Trial......Page 1060
CoreValve Intermediate Risk Clinical Trial......Page 1062
Evolut Low Risk Trial......Page 1063
Alternative Access......Page 1064
Bicuspid Aortic Valve Disease......Page 1065
Transcather Valve Therapies Registry “Real World Outcomes”......Page 1067
Predictors of Mortality......Page 1068
Post–Transcatheter Aortic Valve Replacement Aortic Regurgitation......Page 1069
Vascular Access Complications......Page 1070
Coronary Artery Occlusion......Page 1071
Leaflet Thickening and Thrombosis......Page 1072
Improvements in Quality of Life......Page 1074
Symetis Acurate Neo......Page 1075
Other Valve Prostheses......Page 1076
Sizing......Page 1084
Computed Tomography......Page 1085
Selection of a Transcatheter Heart Valve......Page 1086
Positioning and Deployment of a Transcatheter Heart Valve......Page 1087
Outcomes After Aortic Valve-in-Valve Procedures......Page 1088
Sizing......Page 1089
Thrombosis Risk and Anticoagulation......Page 1090
Background and Clinical Indications......Page 1094
Procedural Technique......Page 1095
Melody Transcatheter Pulmonary Valve......Page 1096
Clinical Criteria......Page 1097
Preprocedural Assessment......Page 1098
Exclusion Criteria......Page 1099
Morphologic Assessment......Page 1101
Prestenting of the Landing Zone. Prior to PPVI, prestenting with bare-metal stents may be helpful. Observational studies have fo.........Page 1102
Immediate Procedural Complications......Page 1103
Nature and Management of Stent Fractures......Page 1105
Functional Outcome......Page 1106
Extended Indications, New Valve Designs, and Future Directions......Page 1107
The Tricuspid Valve Complex......Page 1113
Pathophysiology of Tricuspid Insufficiency......Page 1114
Imaging and Quantification of Tricuspid Insufficiency......Page 1115
Summary of Clinical Evidence......Page 1117
Procedural Approach......Page 1118
Intravalvular Coaptation Device: The FORMA Repair System......Page 1120
Summary of Clinical Evidence......Page 1122
Annuloplasty-Based Devices......Page 1123
IRIS......Page 1124
Caval Valve Implantation......Page 1125
Summary of Clinical Evidence......Page 1126
Valve-in-Valve Procedural Steps Using the Edwards Sapien S3......Page 1127
Conclusion......Page 1129
Natural History of the Disease......Page 1133
Clinical Presentation......Page 1134
Electrocardiography......Page 1135
Magnetic Resonance Imaging......Page 1136
Genetic Overview......Page 1137
Medical Therapy......Page 1138
Dual-Chamber Pacing......Page 1139
Surgery......Page 1140
Septal Ablation......Page 1141
Procedural Technique......Page 1142
Conclusions......Page 1145
Indications......Page 1152
Complications......Page 1153
Postprocedural Management......Page 1154
Technique......Page 1155
Postprocedural Management......Page 1156
Evidence-Based Literature......Page 1157
Adjunctive Diagnostic Approaches......Page 1158
Epicardial Mapping and Ablation......Page 1160
Percutaneous Pericardial Biopsy......Page 1161
Conclusions......Page 1162
Indications for Intervention......Page 1167
Infants......Page 1168
Adults......Page 1169
Long-Term Results......Page 1170
Infants......Page 1171
Acute Results......Page 1172
Long-Term Results......Page 1174
Balloon-Expandable Stenting for Pulmonary Artery Stenosis......Page 1175
Acute and Intermediate Outcomes......Page 1176
Technical Considerations......Page 1178
Clinical Outcomes......Page 1180
Clinical Presentation and Diagnosis......Page 1181
Treatment and Outcome......Page 1182
Introduction......Page 1184
Treatment and Outcome......Page 1185
Coils......Page 1186
Transcatheter Pulmonary Valve Replacement......Page 1187
Clinical Presentation and Diagnosis......Page 1189
Technique......Page 1190
Complications......Page 1191
Conclusion......Page 1192
Approaches to Cell Therapy......Page 1199
Differentiated Cell Transplantation......Page 1200
Bone Marrow-Derived Mononuclear Cells......Page 1201
Mesenchymal Stem Cells and Multipotent Adult Progenitor Cells......Page 1204
Stem Cell–Based Chemokine and Cytokine Strategies......Page 1206
Bench Investigation......Page 1207
Conclusions......Page 1208
Outcomes......Page 1212
Paraaortic Leaks......Page 1214
Anchor, Single Wire Technique—Sequential Deployment......Page 1215
Complications......Page 1216
Follow-Up......Page 1217
Introduction......Page 1221
Percutaneous Mitral Valve Repair......Page 1222
Percutaneous or Hybrid Ventricular Partitioning or Restoration......Page 1224
Interatrial Shunt Devices......Page 1225
Implantable Hemodynamic Monitors......Page 1226
Conclusions......Page 1227
Qualitative Angiography......Page 1230
SYNTAX Score......Page 1231
Risk Assessment Using Specific Lesion Morphologic Criteria......Page 1232
Thrombus......Page 1233
Bifurcation Lesions......Page 1234
Coronary Dissection......Page 1235
No-Reflow Phenomenon......Page 1236
Stent Thrombosis......Page 1237
Coronary Perfusion......Page 1238
Thrombolysis in Myocardial Infarction Frame Count......Page 1239
Coronary Flow Velocity......Page 1240
Quantitative Coronary Angiography......Page 1241
Biologic Variability......Page 1242
Acquisition Variability......Page 1243
Measurement Variability......Page 1245
Late Lumen Loss......Page 1247
Three-Dimensional Imaging......Page 1248
Mechanically Rotating Single-Transducer System......Page 1254
Imaging Procedures......Page 1255
Image Orientation......Page 1256
Radiofrequency Ultrasound Signal Analysis......Page 1258
Abnormal Lesion Morphology......Page 1260
Gray-Scale Intravascular Ultrasound......Page 1261
Serial Monitoring of Disease Progression or Regression......Page 1262
Intermediate Lesions......Page 1263
Common Stent Problems at Deployment......Page 1265
Restenotic Lesions......Page 1266
Late-Acquired Incomplete Stent Apposition......Page 1267
Impact of Intravascular Ultrasound Guidance on Long-Term Outcomes After Stenting......Page 1268
Bioresorbable Scaffolds......Page 1269
Summary and Future Perspectives......Page 1270
Atherosclerotic Lesion Classification......Page 1276
Resolution of Inflammation......Page 1278
Inflammation as a Promoter of Plaque Neovascularization......Page 1279
Haptoglobin Genotype......Page 1280
Vascular Remodeling and Thin-Cap Fibroatheroma......Page 1281
Clinical Significance of the Thin-Cap Fibroatheroma......Page 1283
Natural History of High-Risk Coronary Atheroma......Page 1284
Intracoronary Imaging......Page 1285
Intravascular Ultrasound......Page 1286
Virtual Histology......Page 1289
Optical Coherence Tomography......Page 1291
Near-Infrared Spectroscopy......Page 1296
Statin and Plaque Regression......Page 1299
Plaque Regression and PCSK9 Inhibitors......Page 1301
Additional Therapies......Page 1302
INTRODUCTION......Page 1312
Image Interpretation and use......Page 1314
Accuracy in Optical Coherence Tomography Measurements......Page 1317
Assessment of Coronary Atherosclerosis......Page 1319
Culprit Plaque Morphology......Page 1320
Culprit Lesion Identification......Page 1321
High-Risk Nonculprit Plaques......Page 1322
Stent Assessment......Page 1324
Strut Apposition......Page 1328
Edge Dissection......Page 1329
Strut Coverage......Page 1331
Stent Thrombosis......Page 1332
Bioresorbable Vascular Scaffolds......Page 1333
Upcoming Technologies......Page 1334
Conclusions......Page 1337
Basic Concepts/Terminology......Page 1343
Evaluation of Procedure and Hospital Cost......Page 1344
Analysis Methods......Page 1345
Time Horizon and Discounting......Page 1346
Cost-Effectiveness Analysis With Patient Level Data......Page 1347
Cost Effectiveness of Medical Therapy Versus Revascularization......Page 1348
Cost Effectiveness of Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Sta.........Page 1349
Medical Economics of Reperfusion in ST-Elevation Myocardial Infarction......Page 1350
Medical Economics of P2Y12 Receptor Antagonists......Page 1351
Medical Economics of Peripheral Vascular Interventions (TABLE 68.5)......Page 1352
Cost Effectiveness of Percutaneous Transluminal Angioplasty Versus Bypass Surgery......Page 1353
Medical Economics of Transcatheter Aortic Valve Replacement......Page 1354
Economic Burden of Interventional Cardiology......Page 1356
Efforts to Improve Quality in U.S. Medicine......Page 1361
Definition......Page 1363
Structure......Page 1364
Outcomes......Page 1365
Clinical Practice Guidelines......Page 1367
Performance Measures......Page 1368
Appropriate Use Criteria......Page 1370
Impact of Guidelines, Performance Measures, and Appropriate Use Criteria......Page 1372
Quality Assurance and Continuous Quality Improvement......Page 1374
Peer Review......Page 1376
Physician Champions......Page 1378
Effects of Reporting on Quality......Page 1379
Potential Unintended Consequences of Public Reporting......Page 1380
Improving Public Reporting......Page 1381
Conclusions......Page 1382
Evidence for a Volume-Outcome Relationship......Page 1387
Conclusions......Page 1391