0000000000117938
AUTHOR
Dario Buccheri
Coronary artery fistulas as a cause of angina: How to manage these patients?
Abstract Coronary artery fistulas represent the most common hemodynamically significant congenital defect of the coronary arteries and the clinical presentation is mainly dependent on the severity of the left-to-right shunt. We describe a case of a 55-year-old man with history of chest pain and without history of previous significant chest wall trauma or any invasive cardiac procedures. A coronary multislice computed tomography showed two large coronary fistulas arising from the left anterior descending coronary artery and ending in an angiomatous plexus draining into the common pulmonary trunk. Coronary angiography confirmed the CT finding and showed a third fistulous communication arising…
Impact of insulin resistance on cardiac and vascular function.
Background Insulin resistance (IR), constitutes an important cardiovascular risk factor and can cause ischemic heart disease. It can lead to left ventricular dysfunction with a mechanism independent of ischemic heart disease and it is closely associated with impaired vascular function. The aim of our study was to explore the impact of IR on cardiac and vascular function, in patients with cardiovascular risk factors but angiographically undamaged coronary arteries. Methods We studied 32 patients (62.06 ± 11.19 years) with cardiovascular risk factors. All patients underwent coronary angiography, echocardiography, Doppler ultrasound of carotid arteries and laboratory tests. Exclusion criteria …
Coronary artery fistulas: symptoms may not correlate to size. An emblematic case and literature review
<p>Coronary artery fistulas are rare anatomic abnormalities of the coronary arteries present in 0.002% of the general population and represent 14% of all anomalies of coronary arteries. Their clinical relevance focuses mainly on the mechanism of "coronary steal phenomenon”, causing myocardial functional ischemia even in the absence of stenosis, hence common symptoms are angina or dyspnea. Small size fistulas are mostly asymptomatic and have excellent prognosis if managed medically with regular follow-up consisting also in echocardiography every 2-5 years. Big-sized and symptomatic fistulas, on the contrary, should undergo invasive closure, either with a transcatheter approach or with …
Drug-Coated Balloon Versus Drug-Eluting Stent for Small Coronary Vessel Disease
Abstract Objectives This study sought to compare the performance of a novel drug-coated balloon (DCB) (Elutax SV, Aachen Resonance, Germany), with an everolimus-eluting stent (EES) (Abbott Vascular...
Searching the right coronary artery we found a rare anomaly documented by 3-dimensional volume rendering
Coronary artery anomaliesLipton classificationCoronary angiographyComputed tomography angiography (CTA)3-Dimensional volume rendering (VR)Unstable angina (UA)
Renal haemodynamics and coronary atherosclerotic burden are associated in patients with hypertension and mild coronary artery disease
Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30-80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI)…
Drug-coated balloon without stent implantation for chronic total occlusion of coronary arteries: Description of a new strategy with an optical coherence tomography assistance
Acute and spontaneous coronary thrombosis in non-culprit artery during percutaneous coronary intervention in myocardial infarction with ST-segment elevation: A “shocking” case
Bioresorbable vascular scaffold versus everolimus-eluting stents or drug eluting balloon for the treatment of coronary in-stent restenosis: 1-Year follow-up of a propensity score matching comparison (the BIORESOLVE-ISR Study)
Objectives to compare the 1-year outcome between bioresorbable vascular scaffold (BVS), everolimus-eluting stent (EES), and drug-eluting balloon (DEB) for in-stent restenosis (ISR) treatment. Background BVS has been proposed as alternative for ISR treatment. To date a direct comparison between BVS and DES or DEB for ISR treatment is lacking. Methods We retrospectively analyzed all ISR lesions treated with BVS, DEB, and EES from January 2012 to December 2014. A total of 548 lesions (498 patients) were included. By applying two propensity-score matching, 93 lesions treated with BVS were compared with 93 lesions treated with DEB, and 100 lesions treated with BVS were compared to 100 lesions tr…
Multimodality imaging in cardiac echinococcosis for diagnosis and follow-up of an untreatable cyst
TCT-437 Clinical outcome of coronary bifurcation management with a “fully bioresorbable” technique. Results of the multicentre BBS study
Immediate decision making in a case of iatrogenic dissection of left main coronary artery: A successful synergetic treatment
In-Stent Restenosis: Definition, Entity of the Problem, Etiopathogenesis and Treatment Options
In-stent restenosis (ISR) still represents a frequent limitation of percutaneous coronary intervention despite the introduction of latest-generation drug-eluting stents (DES), drastically lowering the overall incidence of ISR. Thus, the treatment of DES ISR remains a real brainteaser for interventional cardiologists.
Characteristics of coronary microcirculatory function in patients with Takotsubo syndrome.
Background: Takotsubo syndrome (TS) is a recently described cardiac syndrome whose pathogenesis is still unclear. We investigated the characteristics of coronary microcirculatory function in patients with TS through the analysis of the TIMI frame count (TFC) compared to normal subjects and with to subjects with microvascular angina (MA). Methods: We enrolled 71 TS patients (F:M =69:2, mean age of 65.27±9.53 years), 70 controls (F:M =34:36, mean age of 56.63±13.5 years) and 71 patients with MA, (F:M =69:2, mean age of 65.9±9.2 years). The assessment of the microcirculation was carried out through the TFC. Results: microcirculation was significantly altered in patients with TS compared with h…