Urgent Interventional Therapies

Copyright

Contents

List of Contributors

Foreword

Preface

List of Abbreviations

About the Companion Website

Part 1 Cardiac Interventions

Section I: Acute Coronary Syndrome

Chapter 1 Acute Coronary Syndrome: Guidelines and Definitions

Introduction

Definitions

Pathophysiology

Therapeutic strategies

Other considerations

References

Chapter 2 Cardiac Biomarkers in Acute Cardiac Care

Introduction

Markers of endothelial dysfunction

Biomarkers of vascular inflammation

Biomarkers of myocardial ischemia

Biomarkers of plaque destabilization

Biomarkers of plaque rupture

Biomarkers of myocardial injury

Biomarkers of myocardial stretch or dysfunction

Summary

References

Chapter 3 Diagnosis of Vulnerable Plaque

Introduction

Coronary angiography

Intravascular ultrasound

Coronary angioscopy

Near-infared spectroscopy

Optical coherence tomography

Intravascular thermography

Interventional treatment of vulnerable plaques

Conclusion

Summary

References

Chapter 4 Management of Thrombotic Disorders: Heparin to Newer Anticoagulants

Introduction and overview

Low molecular weight heparins

Ultra-low molecular weight heparins

Antithrombin agents

Factor Xa inhibitors

Generic antithrombotic drugs

Newer oral anticoagulants versus heparins

Some unanswered questions regarding the new oral anticoagulants

Summary

Future perspectives

References

Chapter 5 Newer Antiplatelet Agents for Interventional Indications

Introduction

Clopidogrel

Prasugrel

Ticagrelor

Conclusion

References

Chapter 6 Genetic Considerations of Antiplatelet Therapy

Introduction

General considerations

Specific genetic considerations

Therapeutic strategies

Practical recommendations

References

Chapter 7 Anticoagulant Management of Heparin-Compromised Patients

Introduction

Heparin

Anticoagulant alternatives to heparin

Summary

References

Chapter 8 Management of Bleeding in Urgent Interventions

Introduction

Incidence of bleeding

Risks associated with increased bleeding

Long-term outcomes

Mechanical and other contributors to bleeding

Measures to reduce the incidence of bleeding

Treatment of bleeding

New potential agents for the reversal of anticoagulation

References

Chapter 9 Role of Newer Anti-Xa and Anti-IIa Agents for Interventions

Introduction

Percutaneous coronary intervention

New anti-IIa and anti-Xa agents

New anticoagulants for cardiac interventional procedures

Conclusion

Summary

References

Chapter 10 Treatment of NSTEMI Patients

Introduction

Presentation and diagnosis

Antiplatelet therapies

Anticoagulation strategies

Invasive versus medical therapy

Conclusion

References

Chapter 11 Treatment of Patients with STEMI

Introduction

Indication

Literature review

Invasive treatment center

Technique of primary PCI

Summary

References

Chapter 12 Mechanical Removal of Thrombus from Culprit Lesions: Current Devices and Future Developments

Introduction

Manual aspiration thrombectomy

Mechanical aspiration devices

Embolic protection devices

Meta-analysis of mechanical strategies

Pharmacological strategy

Future directions

References

Chapter 13 Role of Intravenous Fibrinolytic Therapy

Introduction

Mechanism of fibrinolysis

Indications for fibrinolysis

The risks of fibrinolysis

Follow-up treatment of fibrinolytic therapy

Alternatives to fibrinolytic therapy

Fibrinolytic therapy as facilitation of primary angioplasty

Conclusion

References

Chapter 14 The Transradial Approach in Patients with Acute Coronary Syndromes

Introduction

Background

Technique

Right versus left radial approach

Vascular complications with transradial access

Radial artery angiography and intervention in myocardial infarction and acute coronary syndrome

Additional areas for consideration

Conclusion

References

Chapter 15 Intervention for Failed Grafts

Introduction

Pathophysiology of saphenous vein grafts

Predictors of adverse clinical events

Assessment and treatment of intermediate lesions

Treatment of occluded saphenous vein grafts

Antithrombin and antiplatelet therapy

Stent selection

Saphenous vein graft percutaneous coronary intervention techniques

Pharmacotherapy for slow or no reflow

Treatment of acutely failed saphenous vein grafts

Conclusion

References

Chapter 16 Excimer Laser for Revascularization in AMI

Introduction

Thrombotic lesions in acute myocardial infarction

The role of a dedicated strategy for thrombus removal in acute myocardial infarction

Laser revascularization

Excimer laser interaction with bio-tissue

Technical profile of the excimer laser

Lasing technique

Laser-associated complications

Excimer laser in percutaneous coronary intervention for acute myocardial infarction

Conclusion

References

Chapter 17 Management of Patients Presenting too Late for PTCA

Introduction

Pathophysiological considerations

Challenges and opportunities in mechanical reperfusion of latecomers

Medical therapy in patients not eligible for reperfusion

Conclusion

References

Chapter 18 Is There a Role for Drug-Eluting Balloons in Treatment of Acute Coronary Syndromes?

Introduction

Device

Procedure in the acute setting

Current and future perspectives

Summary

References

Chapter 19 Cardiogenic Shock: Outcomes, Treatment, and Role of Hemodynamic Support

Definition, incidence, and outcomes

Treatment of patients with cardiogenic shock

Thrombolytic therapy in treatment of patients with cardiogenic shock

Other medical management

Hemodynamic support in the management of cardiogenic shock

Conclusion

References

Chapter 20 Management of Patients after Acute Coronary Syndrome

Introduction

Risk factor management and modification

Drug therapy

Risk assessment

Postdischarge follow-up

Cardiac rehabilitation

Return to work

Other activities

Conclusion

Summary

Acknowledgments

References

Chapter 21 Emergency PTCA or CABG for Left Main Disease?

Introduction

Current guidelines and limitations

Outcomes with ACS secondary to ULMCA disease

Coronary artery bypass graft versus percutaneous coronary intervention in ACS

Hemodynamic support

Stent choice (drug-eluting stents versus bare metal stents)

Conclusion

References

Section II: Urgent Electrophysiology

Chapter 22 Management of Reperfusion Arrhythmias

Introduction

Treatment

Conclusion

References

Chapter 23 Ablative Therapies in Arrhythmia Emergencies

Introduction

Methods of emergent ablation of cardiac arrhythmias

Emergent arrhythmia ablative procedures in the pediatric population

Emergent arrhythmia ablative procedures in the adult patient

Alternative emergency therapies

References

Section III: Other Acute Cardiac Conditions

Chapter 24 Principles of Interventions in Acute Structural Heart Disease

Introduction

Chapter 25 Acute Interventional Therapies for Pulmonary Embolism

Introduction

Patient selection

Catheter-based interventions

Inferior vena cava filters

Complications of catheter-based therapies

Conclusion

References

Chapter 26 Transcatheter Aortic Valve Implantation

Introduction

Patient selection and screening

Preprocedural investigations

Procedural details

Aortic valve intervention in the acute setting

Medical management and palliative care

References

Chapter 27 Acute Mitral Interventions

Introduction

Mitral valve stenosis conditions

Mitral valve incompetent conditions

Etiology

Clinical manifestations

Non-invasive testing

Treatment

Interventional procedures for hemodynamic support

Ischemic mitral regurgitation

Rupture of chordae tendineae

Chronic heart disease with acute functional mitral regurgitation

Dysfunctional prosthetic mitral valve

Hypertrophic obstructive cardiomyopathy (HCOM) with MR

Conclusion

References

Chapter 28 Mitral and Aortic Valve Balloon Valvotomy

Balloon mitral valvotomy

Aortic balloon valvotomy

Conclusion

References

Chapter 29 Postinfarction Ventricular Septal Defect

Introduction

Diagnosis

Treatment

Conclusion

References

Chapter 30 Transcatheter VSD Closure

Introduction

Indications

Procedural technique

Outcomes

Summary

References

Chapter 31 Atrial Septostomies

Introduction

Indications for atrial septostomies [1–4]

Techniques for atrial septostomies

Summary

References

Chapter 32 Transcatheter Pulmonary Valve Replacement

Introduction

History

Current literature

Available valves

Indications

Procedural technique

Potential complications

Conclusions and future directions

Summary

References

Part 2 Peripheral Interventions

Section IV: Cerebrovascular Disorders

Chapter 33 How to Set Up an Acute Stroke Service

Introduction

Business case

Understanding the crucial steps

Prehospital phase

Acute phase

Posttreatment phase

Conclusion

References

Chapter 34 Acute Stroke Intervention

Introduction

Important anatomical and pathophysiological concepts

Clinical examination

Imaging

Essential laboratory tests

Therapy

Endovascular therapy

Adjunctive therapies

Complications

Conclusion

References

Chapter 35 New Devices for Exclusion of Cerebral Aneurysms

Introduction

New devices

Intraluminal flow diverters

Intrasaccular flow diverters

Summary

References

Section V: Treatment of Critical Leg Ischemia

Chapter 36 Principles of Diagnosis for, and Interventional Treatment of, Critical Leg Ischemia

Background and epidemiology

Principles of diagnosis

Principles of treatment

Conclusion

References

Chapter 37 Iliac and SFA Interventions in Patients with Critical Limb Ischemia

Introduction

Patient assessment

Endovascular treatments: technical aspects

Complications

Conclusion

References

Chapter 38 Role of Atherectomy in Below- the-Knee Vessels in Critical Limb Ischemia

Introduction

Current atherectomy devices

Conclusion

References

Chapter 39 Interventions in Below-the-Knee Lesions in Critical Limb Ischemia

Introduction

Endovascular interventions

Balloon angioplasty

Drug-eluting balloons

Cryoplasty

Bare metal stents

Drug-eluting stents

Excisional atherectomy

Excimer laser-assisted angioplasty

Rotational atherectomy with aspiration

Orbital atherectomy

Conclusion

References

Chapter 40 Management of Diabetic Foot following Percutaneous Transluminal Angioplasty

Introduction

Patient education

Multidisciplinary approach

Wound management

Off-loading

Infection control

Vascular follow-up

Aggressive endovascular reintervention strategy

Conclusion

References

Section VI: Treatment of Acute Aortic Disorders

Chapter 41 Thoracic Aortic Dissections: Perspectives for Endovascular Management

Introduction

Acute type B aortic dissections

Ascending aortic dissections

Aortic arch dissections

Conclusion

References

Chapter 42 Management of Acute Aortic Syndrome

Introduction

Epidemiology

Symptomatology

Aortic dissection

Intramural hematoma

Penetrating aortic ulcer

Initial medical therapy

Treatment of type A dissection

Treatment of type B dissection

Treatment of intramural hemorrhage

Treatment of penetrating aortic ulcer

Long-term management

References

Chapter 43 Urgent Endovascular Renal Intervention

Introduction

Clinical perspectives

Case selection and preparation for urgent intervention

Technical aspects of urgent percutaneous renal intervention

Conclusion

References

Chapter 44 Catheter Interventions in Acute Ischemia of the Upper Extremities

Introduction

Causes of acute arterial ischemia of the upper extremities

Imaging

Treatments

References

Part 3 Urgent Radiology

Chapter 45 Transjugular Intrahepatic Portosystemic Shunt

Introduction

Periprocedural issues

TIPS procedure

Follow-up

Indications

Contraindications

Complications

References

Chapter 46 Chemoembolization of Hepatic Malignancies

Introduction

Indications

Technique

Summary

References

Chapter 47 Pulmonary Arteriovenous Malformations

Introduction

Hereditary hemorrhagic telangiectasia (Osler– Weber–Rendu syndrome)

Clinical findings and symptomatology

Preoperative imaging

Treatment

Postoperative care and follow-up

Outcomes

Conclusion

References

Chapter 48 Interventional Management of Vascular Malformations

Introduction

Lesion types

Indications for treatment of vascular malformations

Treatment options

Preprocedure preparation

Procedure description

Specific anatomical considerations

Technique

Complications

Conclusion

References

Chapter 49 Interventions for Mesenteric Ischemia

Introduction

Acute mesenteric ischemia

Chronic mesenteric ischemia

Endovascular technique and stent selection

Single vessel versus multiple vessel intervention and recurrent disease

Postprocedure follow-up

Mesenteric duplex

Complications

Conclusion

References

Chapter 50 Acute Gastrointestinal Arterial Bleeding

Introduction

Indications

A brief literature review

Technique

Conclusion

Summary

References

Chapter 51 Vena Cava Filters

Introduction

Indications

Suprarenal inferior vena cava filter placement

Superior vena cava filters

Retrievable versus permanent filters

Contraindications to inferior vena cava filter insertion

Technique

Efficacy

Complications

Summary

References

Chapter 52 Uterine Fibroid Embolization

Introduction

Medical and surgical therapies

Uterine fibroid embolization (UFE)

Uterine fibroid embolization patient selection and preparation

Embolization procedure

Emergent/expectant uterine artery embolization

Postprocedural care

Complications

Outcomes following uterine fibroid embolization

Uterine fibroid embolization versus surgery

Ovarian function and fertility after uterine fibroid embolization

Summary

References

Part 4 Innovative Therapies

Chapter 53 New Stents for Acute Coronary Syndrome

Introduction

Pharmacological therapy

Revascularization therapy

Mechanical interventions

Stenting in acute coronary syndrome

Conclusion

References

Chapter 54 Cell Therapy for Acute Myocardial Infarction

Introduction

Remodeling after infarction

Mechanisms of stem cell action in the diseased heart

Methodological prerequisites for clinical stem cell treatment

Cell delivery to the heart

Clinical results

Cardiogenic shock

Conclusion and clinical perspective

References

Chapter 55 Aqueous Oxygen for Treatment of ST-Segment Elevation Myocardial Infarction

Introduction

Indications

Clinical results

Technique

Conclusion

Summary

References

Chapter 56 Endovascular Hypothermia in Acute Myocardial Infarctions

Introduction

Cardioprotection

Early animal experiments using mild hypothermia for acute myocardial infarction

Early clinical trials of hypothermia for ST-segment elevation myocardial infarction

The RAPID MI-ICE clinical trial

Pooled results of the ICE-IT and RAPID MI-ICE trials

CHILL-MI trial

Ongoing clinical trials

Cooling the conscious patient

Hemodynamic effects of hypothermia

Conclusion

References

Chapter 57 Angiogenesis in the Treatment of Critical Limb Ischemia

Introduction

Neovascularization: angiogenesis, arteriogenesis, and vasculogenesis

Gene therapy

Cell therapy

Conclusion

References

Chapter 58 Catheter-Directed Ultrasound-Accelerated Thrombolysis for the Treatment of Acute Pulmonary Embolism

Introduction

Treatment

Ultrasound-accelerated thrombolysis

Single-center retrospective study

Conclusion

References

Chapter 59 Transcoronary and Left Ventricular Temporary Pacing

Introduction

Transcoronary pacing

Left ventricular pacing

Use of transcoronary pacing

Conclusion

References

Chapter 60 Extracorporeal Shock Wave Therapy for Acute and Chronic Soft Tissue Wounds

Introduction

Basic research

Clinical experience

Conclusion

References

Index

End User License Agreement