Safety of multi-access site venous closure following catheter ablation of atrial fibrillation and flutter.

BACKGROUND: Following catheter ablation, vascular access management involves potential complications and prolonged recovery. Recently, suture-mediated closure (SMC) devices were approved for venous access procedures. The objective of this study is to evaluate the safety of a commercially available SMC for multiple access site venous closure by duplex ultrasound (DUS) in asymptomatic subjects with non-visible complications. METHODS: Thirty-six subjects (63 ± 10.7 years old, 12 female) were enrolled. Following catheter ablation for atrial fibrillation, all subjects had SMC of every venous access site. Subjects underwent DUS of femoral veins and arteries. DUS was performed at discharge, and again at 30 days. Subjects were evaluated for clinically apparent vascular complications. RESULTS: Mean procedure duration was 138.6 min, and the time to hemostasis was 3.1 min/access site and 9.5 min/subject. Median time to ambulation was 193.5 min, and median time to discharge was 5.95 h, with discharge as early as 2.4 h. A median of 2 sheaths/vein and a median of 2 SMC devices/vein were used. There were no major complications and a 16.7% (6/36) minor complication rate at discharge. All complications resolved at 30 days. The complication rate was not higher in patients with 2 SMC per access site as compared to the patients who just received 1 SMC per access site. CONCLUSIONS: This study demonstrates the safety of multi-access closure using SMC, following catheter ablation procedures, for closure of sites that use sheath sizes from ≤ 8F to ≥ 15F and for those that use 2 or more SMCs per access site.

One-year Outcomes of XIENCE Skypoint 48-mm Drug-Eluting Stents in Long Coronary Lesions: The SPIRIT 48 Trial.

Background: Diffuse coronary artery disease may need multiple overlapping stents, associated with less favorable outcomes than those of a single stent. The availability of longer stents can circumvent the need for overlapping stents in long lesions. This prospective, single-arm, SPIRIT 48 trial evaluated the safety and effectiveness of Abbott's next-generation drug-eluting stent, XIENCE Skypoint 48, in patients with coronary artery disease with long de novo native coronary lesions. Methods: SPIRIT 48 enrolled 107 patients at 25 sites in 3 countries. Patients were required to have 1 target lesion treated with XIENCE Skypoint 48 (lesion length of >32.0 mm and ≤44.0 mm). The primary end point was target lesion failure (TLF; composite of cardiac death, target vessel-related myocardial infarction, or clinically indicated target lesion revascularization) at the 1-year compared with a prespecified performance goal of 20%, established through historical control data. This study recently completed its 1-year follow-up. Results: XIENCE Skypoint 48 was implanted in 105 patients with a device success rate of 97.2%. SPIRIT 48 met its primary end point, with a TLF rate of 5.7%, and the upper bound of 95% CI at 9.5% (

Efeitos agudos da aplicação endovenosa do cogumelo-do-sol (Agaricus blazei Murill) sobre a pressão arterial média e a freqüência cardíaca de ratos anestesiados / Acute effects of the endovenous application of the royal mushroom (Agaricus blazei Murill) on mean arterial pressure and heart rate of anesthetized rats

Este trabalho objetivou verificar os efeitos agudos da aplicação endovenosa do extrato aquoso do Agaricus blazei Murill sobre a pressão arterial média (PAM) e a freqüência cardíaca (FC) de ratos anestesiados. Foram usados Rattus novergicus albinus, n = 6, anestesiados com tiopental sódico, traqueostomizados e canulados através da veia jugular e da artéria carótida. Foram injetadas as concentrações de 1,25 mg/kg, 2,50 mg/kg e 5,00 mg/kg do extrato aquoso em volume de 0,2 mL. A PAM foi registrada com um sistema Biopac, modelo MP100, e a FC com um eletrocardiógrafo ECG-4 Funbec. Os resultados foram obtidos no controle e nos tempos 15, 30, 45, 60 e 120s após a aplicação dos extratos. Os valores foram expressos em média ± EPM e analisados estatisticamente pelos testes "t" de Student-Newman-Keuls e Tukey (p<0,05). O extrato aquoso de A. blazei reduziu a PAM de maneira concentração dependente, sendo que a concentração de 1,25 mg/kg não provocou modificações significativas na PAM nem na FC; a de 2,50 mg/kg provocou diminuição da PAM aos 15s (p<0,01) e da FC aos 30s (p<0,001) e a de 5,00 mg/kg diminuiu a PAM aos 15s (p<0,001) e a FC aos 15 e 30s (p<0,001).

The aim of this paper was to verify the acute effects of the endovenous application of the aqueous extract of Agaricus blazei Murill on mean arterial pressure and heart rate of the anesthetized rats. The injected concentrations were: 1.25 mg/kg, 2.50 mg/kg and 5.00 mg/kg, in volume of 0.2 mL. The rats were anesthetized with sodium thiopental and, after tracheotomy, both jugular vein and carotid artery were cannulated. The MAP was recorded with a Biopac System, model MP100. The HR was obtained with an electrocardiograph model ECG-4 (Funbec). The records were made in the control and 15, 30, 45, 60 and 120s after the application of the different concentrations of the extracts. The values were expressed by mean ± SEM and by paired "t"-Student-Newman-Keuls and Tukey tests (p<0.05). The aqueous extract of the A. blazei decreased the MAP of dependent manner. The concentration of 1.25 mg/kg did not provoke effects; 2.50 mg/kg provoked decrease of the PAM at 15s (p<0.01) and of the HR at 30s (p<0.001) and 5.00 mg/kg provoked decrease of the PAM at 15s (p<0.001) and of the HR at 15 and 30s (p<0.001).