Local administration of abciximab using a ClearWay RX infusion catheter in a patient with acute coronary syndrome caused by late in-stent thrombosis

We present a case of a 43 year-old male with a diagnosis of non-ST-segment elevation acute coronary syndrome related to in-stent thrombosis successfully treated with intralesion administration of abciximab via a local drug delivery catheter and thrombectomy during primary percutaneous coronary intervention

The influence of yield model parameters on the probability of defect occurrence, Journal of Telecommunications and Information Technology, 2007, nr 3

This paper describes the analysis of the influence of yield loss model parameters on the calculation of the probability of arising shorts between conducting paths in IC’s. The characterization of the standard cell in AMS 0.8 μm CMOS technology is presented as well as obtained probability results and estimations of yield loss by changing values of model parameters

Lokalne podanie abciximabu przy użyciu cewnika infuzyjnego ClearWay RX u chorego z ostrym zespołem wieńcowym spowodowanym późną zakrzepicą w stencie

We present a case of a 43 year-old male with a diagnosis of non-ST-segment elevation acute coronary syndrome related to in-stent thrombosis successfully treated with intralesion administration of abciximab via a local drug delivery catheter and thrombectomy during primary percutaneous coronary intervention.We present a case of a 43 year-old male with a diagnosis of non-ST-segment elevation acute coronary syndrome related to in-stent thrombosis successfully treated with intralesion administration of abciximab via a local drug delivery catheter and thrombectomy during primary percutaneous coronary intervention

High level of serum hepcidin in the group of juniors training canoeing - preliminary report

Introduction The results of biological and clinical studies available in the literature indicate a relationship between physical effort and iron deficiency with coexisting microcytic anemia (iron deficiency anemia) or without anemia (IDNA; iron depletion without anemia). Currently, due to unfavourable clinical consequences for athletes, both IDA and IDNA, i.e. reduced endurance and reduced energy efficiency, intensive research is underway to determine the mechanism of these disorders. In the light of recent studies on biological activity of hepcidin, it is believed that hepcidin can play an important role in the pathogenesis of syderopenia in athletes. Therefore, the aim of the study was to assess the hepcidin concentration against the background of iron management parameters in young junior team members training canoeing in high-performance kayaking. Objective The aim of this study was to evaluate the concentration of serum hepcidin and selected blood morphology parameters in the group of junior canoeists. Material and methods The study group consisted of 29 young athletes (20 boys and 9 girls) participating in a training camp at the Central Sports Centre in Wałcz. The average age of participants of both boys and girls was 16.5 ± 0.6 years. Results Results of this study showed that the average hepcidin concentration in the study group was higher than that observed by other authors for healthy peers. In addition, in 8 juniors (including 6 boys and 2 girls), the hepcidin concentration was above the adult reference range. There was no statistically significant difference in hepcidin concentration between boys and girls. However, a wide range of individual hepcidin values was observed in both groups. In addition, ferritin levels were below normal with 8 patients. A positive correlation between hepcidin and ferritin has been shown. Conclusion The results obtained in the study indicate the hepcidin could be a major contributor to poor iron status observed in the athlete trains professionally. Our research suggests it is necessary to monitor the diet of young athletes with respect to iron content and its proper bioavailability

Radial approach expertise and clinical outcomes of percutanous coronary interventions performed using femoral approach

We sought to evaluate the impact of experience and proficiency with radial approach (RA) on clinical outcomes of percutaneous coronary interventions (PCI) performed via femoral approach (FA) in the “real-world” national registry. A total of 539 invasive cardiologists performing PCIs in 151 invasive cardiology centers in Poland between 2014 and 2017 were included. Proficiency threshold was set at >300 PCIs during four consecutive years per individual operator. The majority of operators performed >75% of all PCIs via RA (449 (65.4%)), 143 (20.8%) in 50–75% of cases, 62 (9.0%) in 25–50% and only 33 (4.8%) invasive cardiologists were using RA in <25% of all PCIs. Operators with the highest proficiency in RA were associated with increased risk of periprocedural death, stroke and bleeding complications at access site during angiography via FA. Similarly, higher prevalence of periprocedural mortality during PCI with FA was observed in most experienced radial operators as compared to other groups. The detrimental effect of FA utilization by the most experienced radial operators was observed in both stable angina and acute coronary syndromes. Higher experience and utilization of RA might be linked to worse outcomes of PCIs performed via femoral artery in both stable and acute settings

Wyniki odległe przezskórnych interwencji obwodowych w zakresie tętnic kończyn dolnych u chorych z ostrym zespołem wieńcowym i współistniejącą cukrzycą

Wstęp: Współwystępowanie cukrzycy i ostrych zespołów wieńcowych (OZW) jest częstym zjawiskiem. Obecność cukrzycy jest predyktorem niekorzystnego rokowania chorych po zabiegach przezskórnej angioplastyki tętnic kończyn dolnych (ang. percutaneous transluminal angioplasty, PTA). Cel: Porównanie bezpośrednich wyników leczenia chorych z cukrzycą i bez cukrzycy metodą przezskórnej interwencji wieńcowej (ang. percutaneous coronary intervention, PCI) oraz PTA w czasie tej samej hospitalizacji oraz określenie wyników leczenia w 12-miesięcznej obserwacji. Materiał i metody: Stu szesnastu chorych z OZW bez uniesienia odcinka ST zostało włączonych do prospektywnego rejestru w czasie badania w latach 2003–2009 w jednym centrum akademickim w Krakowie. Wyniki: Analizowano dane chorych, którzy przebyli procedury PCI i PTA w czasie jednego pobytu szpitalnego. Spośród tych chorych 16 (14%) miało rozpoznaną cukrzycę, pozostali nie byli leczeni z tego powodu [100 (86%)]. Obie grupy różniły się istotnie statystycznie ze względu na płeć i wywiad. W ciągu rocznej obserwacji 12,5% osób zmarło w grupie chorych na cukrzycę w przeciwieństwie do 2% zgonów w grupie chorych bez cukrzycy (p = 0,033). Cukrzyca okazała się również silnym czynnikiem konieczności wykonania ponownych interwencji przezskórnych w ciągu 12-miesięcznej obserwacji. Wnioski: Pacjenci z cukrzycą mieli bardziej obciążający wywiad chorobowy z licznymi chorobami towarzyszącymi. Obecność cukrzycy u chorych z OZW leczonych metodą PCI i PTA jest związana z istotnie pogorszonym przeżyciem w 12-miesięcznej obserwacji. Cukrzyca jest ponadto silnym predyktorem konieczności ponownych rewaskularyzacji przezskórnych.Background: Diabetes mellitus is a quite frequent comorbidity among patients with acute coronary syndromes (ACS). The presence of diabetes has also predicted poor outcome after lower limb percutaneous transluminal angioplasty (PTA). Aim: To determine outcomes of patients with and without diabetes mellitus treated with PCI and PTA at index hospital stay during a 12-month follow-up. Material and methods: There were 116 NSTACS (non ST elevation acute coronary syndromes) patients gathered in this prospective registry study in 2003-2009 in one academic center in Krakow, Poland. Results: Data on consecutive patients who underwent PTA and PCI procedure during the same hospital stay were analyzed. Of these, 16 (14%) had diabetes mellitus, the other 100 (86%) had no history of diabetes. Both groups differed significantly with regard to gender and past medical history. During one-year observation 12.5% patients died in diabetes group vs. 2% in non-diabetes group (p = 0.033). Diabetes mellitus has turned out to be a strong predictor of outcome measured by the occurrence of repeated percutaneous peripheral procedure in 12-month observation. Conclusions: Patients with diabetes mellitus have more aggravating past medical history with more frequently coexisting comorbidities. Diabetes mellitus in patients with ACS treated by PCI and PTA is associated with impaired 1-year survival. Diabetes itself is a strong predictor of repeated PTA procedures

Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

Introduction: Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim: To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions: The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications

CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with myocardial infarction

Introduction: The CHA2DS2-VASc and R2-CHA2DS2-VASc scores were initially designed to evaluate the risk of cerebrovascular events in patients with atrial fibrillation. However, these scales consist of parameters which are well known as general risk factors for cardiovascular events. Aim: To assess the role of the CHA2DS2-VASc and R2-CHA2DS2-VASc scores in predicting outcome of patients with myocardial infarction (MI). Material and methods: We enrolled 212 consecutive patients with both ST-elevation and non-ST-elevation MI referred for primary percutaneous coronary intervention (PCI). Patients were divided into two groups depending on the CHA2DS2-VASc score: ≤ 3 (low score) and > 3 points (high score). Results: The group with a CHA2DS2-VASc score > 3 points consisted of 93 (44%) patients. Follow-up was available in 200 (94.3%) patients with median duration of 10 (Q1: 6; Q3: 13) months. During the follow-up all-cause mortality was greater in patients from the high score group (21%) compared to patients with lower scores (8%) (p = 0.009). Recurrent MI was found in 4% of patients from the low score group and in 13% of patients from the high score group (p = 0.024). The combined endpoint of cardiovascular mortality, recurrent non-fatal MI and non-fatal stroke occurred in 13% of lower score patients and in 30% of patients with a score > 3 points (p = 0.002). In a Cox regression model both scores were predictors of all-cause mortality with a hazard ratio of 1.31 per 1 point increase for the CHA2DS2-VASc score (p = 0.004) and 1.36 for the R2-CHA2DS2-VASc score (p < 0.001). Conclusions: The CHA2DS2-VASc and R2-CHA2DS2-VASc scores predict in-hospital and post-discharge outcome in patients with acute MI undergoing primary PCI

Direct Absorb bioresorbable scaffold implantation in acute coronary syndrome

Background: Direct stent implantation is a preferred technique for primary percutaneous coronary intervention (PCI). For the deployment of a bioresorbable vascular scaffold (BVS), the current guidelines recommend aggressive predilatation. Data about direct BVS implantation in patients with acute coronary syndrome (ACS) are scarce. Aim: We sought to assess procedural characteristics and immediate outcomes of direct Absorb BVS implantation in ACS patients. Methods: A total of 91 patients with acute myocardial infarction (MI) requiring urgent coronary revascularisation were enrolled. Among them, 50 patients underwent an attempt of direct Absorb implantation. The control group consisted of 41 patients treated with PCI with BVS deployment after elective predilatation. Results: In the direct group BVS deployment was successful in 91% of lesions, and in the remaining 9% of lesions direct implantation failed. In the control group scaffolds were successfully deployed after predilatation in 98% of lesions. In one case Absorb implantation failed even after balloon angioplasty. Type C lesions with severe tortuosity and angulation &gt; 90° were associated with failure in direct Absorb deployment. Quantitative coronary analysis showed similar final percentages of diameter stenosis in the study and control groups. Flow analyses did not show significant differences between both methods. During hospitalisation no recurrent MI, scaffold thrombosis, or target lesion revascularisation was reported in either group. Conclusions: Direct Absorb implantation in ACS patients may be feasible in a suitable lesion anatomy