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Updated to include the newest devices and procedures, this practical reference is a clinically oriented guide to interventional cardiology. Chapters by the foremost experts present step-by-step approaches to specific clinical problems and offer guidelines for selecting the most appropriate device and technique. The authors' recommendations are backed by their extensive experience and by evidence-based clinical trials. This Third Edition describes the latest stents and stenting procedures—including local drug delivery with coated stents—and provides state-of-the-art information on local myocyte injection, distal protection devices, peripheral vascular intervention, and new adjunctive therapies. The concluding chapter previews future developments in the field.
Here is expert guidance on one of the most vexing clinical challenges faced by interventional cardiologists. Written by global thought leaders in the area and edited by two internationally-recognized pioneers in interventional cardiology, Bifurcation Stenting covers all techniques, imaging modalities, and devices in current use, including VH-IVUS and OCT. It includes practical tips/tricks from leading experts and a section of challenging cases to further illustrate the material and help readers better understand the treatment of bifurcation lesions.
This book is a fully updated and revised second edition of a highly successful text in which a new concept of knowledge mining, based on explication and transfer of interventional knowledge of experts, has been implemented. The dedicated training program that is set out will serve the needs of all interventional operators, whether cardiologists, vascular surgeons, vascular specialists, or radiologists, enabling them to achieve a consistent expert level across the entire broad spectrum of catheter-based interventions. Operator skills – and in particular decision-making and strategic skills – are the most critical factors for the outcome of catheter-based cardiovascular interventions. Currently, such skills are commonly developed by the empirical trial and error method only. The explicit teaching, training, and learning approach adopted in this book permits the rapid transfer of interventional knowledge and enables individual operators to negotiate steep learning curves and acquire complex skills in a highly efficient manner. It will thereby offer invaluable assistance in meeting successfully the challenges of modern cardiovascular care.
This book is open access under a CC BY 4.0 license. This quick-reference handbook offers a concise and practical review of key aspects of the treatment of ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PPCI). In the context of STEMI, PPCI is the preferred mode of emergency revascularization. Access to PPCI is rapidly increasing and is now routinely practiced in both general and specialist hospitals and there has been a recent emphasis on developing STEMI networks to enhance and expedite the referral pathway. This coupled with concurrent developments to enhance the safety and efficacy of the PPCI procedure has heralded an era where STEMI interventions are increasingly considered an important subspecialty within interventional cardiology. Written by leading cardiologists who have been instrumental in the adoption of PPCI in their respective institutions, the book provides junior and senior cardiologists alike with insightful and thought-provoking tips and tricks to enhance the success of PPCI procedures, which may in turn translate into direct improvements in outcomes. The book is also relevant for healthcare providers and emergency department physicians.
This is the latest book in a series of cardiovascular-related texts from IntechOpen Publishing. The present volume considers general aspects of cardiac disease and is divided into three distinct sections covering cardiac risk, cardiorenal pathology, and novel interventional surgical techniques. The chapters offer insight into the current state of the art with respect to the risks of developing cardiovascular diseases, maintenance of patent vascular access in patients with the cardiorenal syndrome, and a plethora of novel interventional technologies all aimed at salvaging damaged tissue and improving prognosis and reducing mortality. This volume of 18 chapters is intended for general medical and biomedical students at both undergraduate and postgraduate level. It also offers insightful updates on recent advances in the understanding of the pathophysiology of cardiac diseases and the new techniques added to the medical armamentarium to improve the outcomes and prevent mortality and would be of interest to those working in academia and healthcare science.
This is a Ph.D. dissertation. Restenosis occurs in 10-50% of patients after PCI, thus remaining a major challenge. Restenosis after PCI is a complex, multifactorial, overlapping wound healing process involving a cascade of cellular and molecular events including platelet activation, inflammatory cell infiltration, smooth muscle cell proliferation, migration and extracellular matrix production. Recent evidence shows that inflammation, matrix metalloproteinases and free oxygen radicals all play a critical role in the restenosis process. Different approaches to prevent restenosis after PCI were studied in this work. Restenosis has been remarkably reduced in the last decade with the introduction of stents. Stents have been optimized regarding their mechanical features, allowing for scaffolding of the plaque and producing an optimal coronary lumen at the end of the procedure. By their metallic nature however, they cause prolonged and chronic inflammation in the vessel wall. Therefore, the long term efficacy remains a concern. In the first study, the author evaluated the long-term follow-up of patients that underwent bare metal stent implantation. The long-term efficacy of this stent was established, and the major adverse cardiac events (MACE) during the long-term follow-up were mainly caused by progression of lesions in other vessels. This study confirmed that implantation of a bare metal stent in an effective treatment modality of atherosclerotic coronary disease. However, in-stent restenosis still results in a failure of this treatment in about 30% of the patients, mostly occurring within the first 6 months.
This practical handbook is based on an internal working manual developed by staff and fellows at Mount Sinai Heart Cardiovascular Catheterization Laboratory, renowned for its high-volume and low complication complex coronary procedures. The Practical Handbook of Interventional Cardiology captures the knowledge and methodological know-how from leaders in interventional cardiology, it intends to guide users in a stepwise, methodical and practical approach through various cardiac interventional procedures in order to achieve maximum patient safety and improved outcomes. From patient selection, preoperative work-up, setting up equipment to step-by-step illustrations of various procedural details and troubleshooting, this handbook captures all the details necessary to perform the simplest to the most complex cardiac interventions. The book is designed for cardiologists and trainees who desire an efficient way to review the steps of various cardiac interventional procedures and a quick, reliable reference for everyday use.
Debulking in Cardiovascular Interventions and Revascularization Strategies: Between a Rock and the Heart aims to provide a comprehensive overview on the diagnostic and therapeutic aspects of resistant lesions as well as tailored debulking processes in revascularization strategies. Cardiovascular interventionalists and surgeons alike frequently encounter technical challenges and increased risk when attempting to diagnose and treat resistant cardiovascular lesions, bio-tissues and vessels. Calcified plaques, fibrotic or thrombotic lesions, total occlusions, degenerative plaques, complex lesions and vessels impose morphologic obstacles to the safe and effective delivery and deployment of balloons and stents. In such instances, a debulking strategy involving the actual drilling and extraction of the targeted plaque/bio-tissue constitutes a unique option that ensures safe and efficacious subsequent balloon dilatations and stenting. A range of topics is included in the book, from the characteristics and constituents of various resistant targets and bio-tissues, to the corresponding options of debulking methods, and finally the technologic and pharmacologic means available for application. The book also provides an up-to-date description of related management solutions and tools, exploring the medical issues pertaining to the patients with these targets; procedural results and clinical outcomes as related to debulking strategies and associated diagnostic and therapeutic technology and revascularization options. Review and discussion of the pathophysiology of cardiovascular resistant lesions Analysis of the impact on revascularization outcome of cardiovascular lesions/bio-tissues which exhibit resistance to standard revascularization Introduction of the concept of debulking for revascularization of cardiovascular diseases: comprehensive description Presentation of the clinical scenarios associated with resistant cardiovascular lesions and bio-tissue that require debulking Delineation of various state-of-the -art diagnostic imaging modalities for detection and demonstration of the lesions and tissues that require debulking Presentation of the expansive array of mechanical revascularization tools available for debulking Description of surgical debulking approaches to resistant cardiovascular lesions Summary of debulking outcomes
Manual of Chronic Total Occlusion Percutaneous Coronary Interventions: A Step-by-Step Approach, Third Edition is a practical reference for coronary chronic total occlusion (CTO) percutaneous coronary interventions (PCI). Written by recognized national and international experts in the field, this reference compiles the steps necessary to preform, what pitfalls to watch out for, and how to troubleshoot tactics. Written to bring a practical approach, this book is perfect for interventional cardiologists, interventional and general cardiology fellows, cardiology researchers, physicians, cardiac catheterization laboratory personnel, technical staff, industry professionals and everyone else interested in understanding the cutting-edge and rapidly evolving field of CTO PCI. In this new edition, new figures, images and algorithms have been developed to reflect the updates in CTO PCI during the past few years. In addition, this update links to approximately 200 CTO PCI cases that are accessible for free and hosted by the author on YouTube, with monthly updates on new cases. The structure of the book is completely revised to align it with the recently published Manual of Percutaneous Coronary Interventions (published in Oct 2020, also by Dr. Brilakis under the same imprint Academic Press). - Provides step-by-step guidance on every technique used in coronary chronic total occlusion interventions using color figures and diagrams - Presents expert guidance by leaders in the field with both large clinical experience and extensive experience proctoring CTOs in multiple clinical centers - Contains links to approximately 200 YouTube videos that illustrate the concepts and techniques presented in the text - Includes the latest clinical experience, equipment, techniques and publications
A practical and technical handbook providing operators with a step-by-step description of how to perform some of the techniques involved in the procedures, and how to troubleshoot some of the problems along the way. Examples with pictures will be provided, along with live angiographies. At the end of each chapter, the author will be provided with 3 questions to answer. Those questions will be developed by the editor and the contributors. The idea is to provide a quick reference to the most current problems encountered with a specific issue developed in the chapter. Nowadays, the busy clinician is unlikely to exclusively rely on lengthy textbooks to learn specific complex techniques. That is one of the reasons for the popularity of CTO courses, live demonstrations, and conferences and, there are consequently many courses offered around the world to help new operators in the field. CTO PCI has emerged as a very effective procedure to help patients with CTOs, with very high success and low complications rates. It is however a very challenging procedure with multiple pitfalls along the way to success, both in specific cases, but also in the learning process. There are currently no single reference or "one-stop shop" for the operator who wants to learn a given technique that he or she may has seen performed live in a dedicated proctorship event, or in a live demonstration, or to even troubleshoot a problem encountered in daily CTO PCI practice. This will be the first handbook formatted for the busy interventional cardiologist. This book will become a “must have” for operators who are practicing CTO PCI and who want a quick reference. However, it will also provide tips and tricks currently used in the field.