ABSTRACT
Introduction: Drug-eluting (DRUG) peripheral vascular interventions (PVIs) are associated with higher patency rates than nondrug (NONDRUG) PVIs. Recent data raised safety concerns with using DRUG devices in PVIs. Material and methods: The study population was extracted from the 2016 Nationwide Readmissions Database using the International Classification of Diseases, tenth edition, clinical modifications/procedure coding system codes for PVI, DRUG and NONDRUG devices, and in-hospital procedural complications. Study endpoints included in-hospital all-cause mortality, length of index hospitalization, acute kidney injury (AKI), amputation, compartment syndrome, vascular complications, bleeding, and blood transfusion. Propensity matching was used to adjust for baseline characteristics. Results: 49,883 discharged patients who underwent lower extremity arterial PVI were identified, 25.3% DRUG and 74.7% NONDRUG PVI. Mean age was 68.3 years and 40.6% were female. Critical limb ischemia was reported in 33.2%, claudication in 7.6%, and acute limb ischemia in 0.1%. In comparison to the NONDRUG group, the DRUG group was associated with lower in-hospital all-cause mortality (2.2 vs. 2.9%, p < 0.001), shorter length of index hospitalization (8.3 vs. 8.6 days, p = 0.001), bleeding (12.0% vs. 13.5%, p < 0.001), and need for blood transfusion (10.1% vs. 11.0%, p = 0.004). There was no significant difference in terms of AKI (17.3% vs. 18.0%, p = 0.10), amputation (15.3% vs. 15.4%, p = 0.63), compartment syndrome (0.5% vs. 0.6%, p = 0.07), or vascular complications (0.8% vs. 0.8%, p = 0.50). After propensity matching, the mortality benefit was no longer present. Conclusions: DRUG PVI was associated with lower in-hospital all-cause mortality, bleeding events and shorter length of index hospitalization and comparable vascular-related complications. However, this mortality benefit was no longer present after propensity matching.
ABSTRACT
Due to varied presentation, a high index of suspicion is needed for diagnosis of cardiac lipoma. Treatment should only be reserved for symptomatic patients. This case acknowledges the importance of cardiac MRI in making the diagnosis of cardiac lipoma and further delineating the management options available.
Subject(s)
Haemophilus Infections/diagnosis , Haemophilus parainfluenzae/isolation & purification , Pacemaker, Artificial/microbiology , Pneumonia/etiology , Shock, Septic/etiology , Subarachnoid Hemorrhage/microbiology , Anti-Bacterial Agents/therapeutic use , Disease Management , Dyspnea/etiology , Endocarditis/diagnosis , Haemophilus Infections/drug therapy , Humans , Lethargy/etiology , Male , Middle Aged , Pneumonia/drug therapy , Shock, Septic/drug therapy , Subarachnoid Hemorrhage/drug therapyABSTRACT
Photobiomodulation (PB) is a utilization of low-level laser therapy (LLLT) in the far red (R) to near infrared (NIR) spectrum (600-1000 nm) to wield its therapeutic effects. To explore the therapeutic potential of biomodulation of different tissues, LLLT has been extensively researched, especially in the light of its very low side effect profile. We believe there is an opportunity to unearth its dynamic effects on the coronaries which can be promising for the patients with chronic stable angina. NIR treatment of the heart may be protective on patients after acute myocardial infarction or on ischemic heart conditions that are not accessible to current revascularization procedures.
