Estimulación ventricular izquierda a través de la guía del implante percutáneo de válvula aórtica / Guidewire-driven left ventricular pacing during transcatheter aortic valve implantation

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SAPIEN 3 embolizada por fuga en el conector en Y / SAPIEN 3 embolization due to a leak in the y connector

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Severe thrombocytopenia induced by iodinated contrast after coronary angiography: The use of gadolinium contrast and intravascular ultrasound as an alternative to guide percutaneous coronary intervention.

Acute contrast-induced thrombocytopenia is a rare event with the use of modern low osmolarity iodinated contrast media. The pathophysiological mechanism that causes platelet counts to drop has not been identified, but an immunological mechanism is suspected due to cytotoxicity after previous exposure to contrast. We report the case of a 47-year-old male patient with acute severe thrombocytopenia due to iodinated contrast media exposure. His platelet count after the procedure with the highest amount of contrast was zero, which is the lowest reported platelet count to date. Percutaneous coronary revascularization under both intravascular ultrasound and gadolinium contrast guidance was performed without complications. The most feared complication after the use of gadolinium is nephrogenic systemic fibrosis, especially in patients on hemodialysis.

Ensayo clínico sobre la compresión radial guiada por la presión arterial media / Clinical trial of radial artery compression guided by mean arterial pressure

Objetivo. Determinar si un método de compresión guiada por la cifra de la presión arterial media del paciente (experimental), es eficaz, seguro y superior a un método de compresión utilizando 15 ml de aire en el dispositivo (estándar) medido en resultados de oclusión de la arteria radial. Método. El estudio fue aleatorizado, unicéntrico e incluía a pacientes a los que se les realizó cateterismo de la arteria radial para diagnóstico o intervencionismo coronario percutáneo, se les retiró el introductor a la finalización del procedimiento y se les comprimió la arteria radial durante 3h, con dispositivo neumático (TR Band™ de Terumo®). Las arterias se valoraron entre las 24 y 72h tras el procedimiento, por curva de pletismografía con test de flujo inverso, y posteriormente con Doppler bidireccional. Resultados. En 351 pacientes estudiados se midió el porcentaje de oclusión arterial, y en el grupo de estudio experimental ocurrió en 2 (1,1%) frente a 21 pacientes (12%) en el grupo estándar (p=0,0001), sin obtener diferencias en el número de complicaciones. Conclusiones. El método de compresión guiado por las cifras de la presión arterial media del paciente, a la finalización del cateterismo de la arteria radial, es eficaz y seguro, y disminuye la oclusión de la arteria frente al método estándar de compresión con el dispositivo neumático(AU)

Objective. To determine whether a compression procedure guided by the patient's mean arterial pressure value (experimental) is safe and effective and superior to a compression procedure using 15 cubic centimeters of air in the device (standard) in patients undergoing radial artery catheterization. Methods. We performed a randomized, single-center study, which included patients undergoing catheterization of the radial artery for diagnosis or percutaneous coronary intervention, in whom the sheath was removed at the end of procedure and the radial artery was compressed for 3h with a pneumatic device (TR Band™ Terumo®). The arteries were evaluated between 24 and 72h after the procedure, using a plethysmography curve with a reverse flow test followed by bidirectional Doppler. Results. The percentage of arterial occlusion was measured in 351 patients. Arterial occlusion was found in two patients (1.1%) in the experimental group compared with 21 patients (12%) in the standard group (p=0.0001). No differences were found in the number of complications. Conclusions. The compression method, guided by the patient's mean arterial pressure value at the end of catheterization of the radial artery, is safe and effective and reduces arterial occlusion compared with the standard compression method using a pneumatic device(AU)

[Clinical trial of radial artery compression guided by mean arterial pressure]. / Ensayo clínico sobre la compresión radial guiada por la presión arterial media.

OBJECTIVE: To determine whether a compression procedure guided by the patient's mean arterial pressure value (experimental) is safe and effective and superior to a compression procedure using 15 cubic centimeters of air in the device (standard) in patients undergoing radial artery catheterization. METHODS: We performed a randomized, single-center study, which included patients undergoing catheterization of the radial artery for diagnosis or percutaneous coronary intervention, in whom the sheath was removed at the end of procedure and the radial artery was compressed for 3 h with a pneumatic device (TR Band Terumo). The arteries were evaluated between 24 and 72 h after the procedure, using a plethysmography curve with a reverse flow test followed by bidirectional Doppler. RESULTS: The percentage of arterial occlusion was measured in 351 patients. Arterial occlusion was found in two patients (1.1%) in the experimental group compared with 21 patients (12%) in the standard group (p = 0.0001). No differences were found in the number of complications. CONCLUSIONS: The compression method, guided by the patient's mean arterial pressure value at the end of catheterization of the radial artery, is safe and effective and reduces arterial occlusion compared with the standard compression method using a pneumatic device.