Effect of Limb Salvage by Excimer Laser Angioplasty Plus Low-Pressure Balloon Inflation in Chronic Limb-Threatening Ischemia Patients with Infrapopliteal Vessel Disease.

Background: Patients with chronic limb-threatening ischemia (CLTI) often exhibit long, diffuse, totally occluded and heavily calcified infrapopliteal (IP) lesions. This study evaluated limb salvage after peripheral excimer laser atherectomy (PELA) plus low-pressure balloon inflation (LPBI) without stent deployment in CLTI patients with severe IP disease. Methods: We retrospectively evaluated 70 consecutive patients with 109 IP vessels who underwent PELA plus LPBI from 2010 to 2013. Technical success was defined as at least one IP straight-line flow being achieved below the malleolus. Binary logistic regression was performed to identify factors associated with 6-month limb salvage. Results: Of the 109 IP vessels, 100 (91.7%) were totally occluded, and none of the patients received a stent. Of the 70 patients, 20% were octogenarians, and 85.8% had a Rutherford-Becker class 5 and 6. The technical success rate was 87.1% and 6-month limb salvage rate was 78.6%. Rutherford score was negatively correlated with clinical success (adjusted odds ratio 0.24; p = 0.028). No immediate major cardiovascular events were recorded during admission. Conclusions: PELA plus LPBI may be a treatment option for complex IP lesions in patients with CLTI. Higher Rutherford class was correlated with a lower 6-month limb salvage rate. However, a large-scale study with a control group is needed to clarify our results.

Real-World Experience with Idarucizumab to Reverse Anticoagulant Effect in Dabigatran-Treated Patients: Report of 11 Cases from Taiwan.

BACKGROUND: This study aims to observe the effectiveness and safety of idarucizumab in dabigatran-treated patients with severe bleeding or requiring surgery in Taiwan. METHODS AND RESULTS: In Taiwan, 11 dabigatran-treated patients developed severe bleeding, fracture that needed surgery, and acute ischemic stroke requiring thrombolysis. These patients were treated with idarucizumab and obtained adequate hemostasis. Our experiences reconfirmed the efficacy and safety of idarucizumab in Asian patients. CONCLUSIONS: Idarucizumab improves safety in dabigatran-treated patients. Continued education about the availability and appropriate use of idarucizumab is necessary in Asia.

A Pregnant Woman with Acute Massive Pulmonary Embolism.

UNLABELLED: A 30-year-old pregnant woman who suffered from massive pulmonary embolism presented in an unstable hemodynamic status. Angiojet catheter embolectomy and extracorporeal membrane oxygenation (ECMO) were performed, which caused the patient's condition to improve. Use of ECMO was continued during the weaning program, but the patient died of intracranial hemorrhage, a complication of ECMO. KEY WORDS: Angiojet; Extracorporeal membrane oxygenation (ECMO); Pregnancy; Pulmonary embolism; Thromboectomy.

Oral Squamous Cell Carcinoma Metastasizing to the Heart: A Case Report from Taiwan.

Background: The most common sites for metastasis from head and neck cancers are the lungs, bones, and liver. We present a rare case of squamous cell carcinoma of the buccal mucosa that metastasized to the right ventricle, pericardium, and bilateral lungs. Methods: A 61-year-old man with oral squamous cell carcinoma (cT4aN2cM0) exhibited mass-like echogenicity adhering to the right ventricular free wall that was accidentally discovered after concurrent chemoradiotherapy. A biopsy of the mass confirmed the oral origin of the metastasis. Results: The patient received palliative care and died 1 month after being diagnosed with cardiac involvement. Conclusion: Cardiac involvement is often not assessed because of its low prevalence. Cardiac metastasis should be considered in patients with malignancies presenting with nonspecific cardiac symptoms.

A Two-Electrode, Double-Pulsed Sensor Readout Circuit for Cardiac Troponin I Measurement.

This paper presents a pulse-stimulus sensor readout circuit for use in cardiovascular disease examinations. The sensor is based on a gold nanoparticle plate with an antibody post-modification. The proposed system utilizes gated pulses to detect the biomarker Cardiac Troponin I in an ionic solution. The characteristic of the electrostatic double-layer capacitor generated by the analyte is related to the concentration of Cardiac Troponin I in the solvent. After sensing by the transistor, a current-to-frequency converter (I-to-F) and delay-line-based time-to-digital converter (TDC) convert the information into a series of digital codes for further analysis. The design is fabricated in a 0.18-µm standard CMOS process. The chip occupies an area of 0.92 mm2 and consumes 125 µW. In the measurements, the proposed circuit achieved a 1.77 Hz/pg-mL sensitivity and 72.43 dB dynamic range.