Management of ST-segment-elevation myocardial infarction during the coronavirus disease 2019 (COVID-19) outbreak: Iranian"247" National Committee's position paper on primary percutaneous coronary intervention.

World Health Organization has designated coronavirus disease 2019 (COVID-19) as a pandemic. During the past several weeks, a considerable burden has been imposed on the Iranian's healthcare system. The present document reviewed the latest evidence and expert opinion regarding the management of ST-segment-elevation myocardial infarction during the outbreak of COVID-19 and outlines a practical algorithm for it.

Nursing Assessment of Vascular Complications after Cardiac Catheterization through the Distal Radial Artery.

Background: Distal Radial Artery (DRA) is a new arterial access for coronary catheterization. Assessment of the vascular complications of this new procedure is important in the provision of nursing care to cardiac patients. The aim of this study was the nursing assessment of vascular complications of DRA in angiography and angioplasty. Materials and Methods: This qualitative longitudinal study was conducted on 315 consecutive patients who were candidates for coronary catheterization via DRA from 2017 to 2020 in three hospitals in Tehran, Iran. Patients who had palpable DRA and were capable and willing to consent to inclusion in the study were evaluated. Moreover, patients whose DRA access failed, and those who had previously undergone coronary artery bypass graft were excluded from the study. Vascular complications were assessed on the day of the procedure and about 1 month later. Results: After the procedure, 29 cases of ecchymosis, 8 cases of hematoma, and 1 case of arteriovenous fistula in the DRA were observed. We did not observe any major vascular complications. Conclusions: Nursing assessment of the snuffbox area indicated that this approach is a safe and convenient technique for cardiac catheterization with few minor complications.

Risk factors for major complications due to delay in surgery in staged carotid stenting and coronary bypass graft surgery.

AIMS: To answer the question whether the delay in coronary artery bypass grafting (CABG) after carotid stenting (CAS) results in adverse events, we describe our experience with planned staged CAS followed by CABG. METHODS AND RESULTS: We retrospectively surveyed our hospital carotid stenting data base, to identify all patients who were scheduled to undergo staged carotid stenting followed by CABG. A total of 39 patients who underwent CAS were candidates for staged CABG but only 28 (71.7%) of them referred. In the interval between carotid stenting and CABG, 4 deaths occurred (14.2% of cases), all of them were in the first week after CAS and due to cardiac problems. Also, 2 patients (7.1%) had a minor stroke. Increased number of predictors of type C (most important was stenosis of 95%-99%), age > 75 or significant valvular heart disease were associated with increased rate of complications after CAS. CONCLUSION: Should carotid intervention be performed in the high risk group of patients with > 4 suggested predictors of type C (most importantly is stenosis of 95%-99%), valvular heart disease or age > 75, physicians should closely observe the patients (perhaps in the hospital) during the waiting period before CABG, particularly in the first week after carotid stenting.