Development of Brugada Syndrome Following Photodynamic Therapy in a Patient with Cholangiocarcinoma

Brugada syndrome can be unmasked by several conditions including a febrile state, marked leukocytosis, and electrolyte disturbances. Herein, we describe a 62-year-old man with cholangiocarcinoma in the first reported case of Brugada syndrome onset following photodynamic therapy

Efficacies of the new Paclitaxel-eluting Coroflex Please™ Stent in percutaneous coronary intervention; comparison of efficacy between Coroflex Please™ and Taxus™ (ECO-PLEASANT) trial: study rationale and design

<p>Abstract</p> <p>Background</p> <p>Previous randomized trials have showed the superiority of Paclitaxel-eluting stent over bare metal stent in angiographic and clinical outcomes. Coroflex Please™ stent is a newly developed drug eluting stent using the Coroflex™ stent platform combined with the drug paclitaxel contained in a polymer coating. PECOPS I trial, one-arm observational study, showed that the clinical and angiographic outcomes of Coroflex Please™ stent were within the range of those of Taxus, the 1^stgeneration paclitaxel-eluting stent (PES). However, there have been no studies directly comparing the Coroflex Please™ stent with the Taxus Liberte™ stent that is the newest version of Taxus. Therefore, prospective, randomized trial is required to demonstrate the non-inferiority of Coroflex Please™ stent compared with Taxus Liberte™ stent in a head-to-head manner.</p> <p>Methods</p> <p>In the comparison of Efficacy between COroflex PLEASe™ ANd Taxus™ stent(ECO-PLEASANT) trial, approximately 900 patients are being prospectively and randomly assigned to the either type of Coroflex Please™ stent and Taxus Liberte™ stent via web-based randomization. The primary endpoint is clinically driven target vessel revascularization at 9 months. The secondary endpoints include major cardiac adverse events, target vessel failure, stent thrombosis and angiographic efficacy endpoints.</p> <p>Discussion</p> <p>The ECO-PLEASANT trial is the study not yet performed to directly compare the efficacy and safety of the Coroflex Please™ versus Taxus Liberte™ stent. On the basis of this trial, we will be able to find out whether the Coroflex Please™ stent is non-inferior to Taxus Liberte™ stent or not.</p> <p>Trial registration</p> <p>ClinicalTrials.gov number, NCT00699543.</p

Prediction of Judkins Left Catheter Size during Left Transradial Coronary Angiography by Simple Chest Radiographic and Echocardiographic Index

Background and Objectives: Appropriate catheter selection when conducting transradial coronary angiography (CAG) helps shorten examination time, preventing vascular complications and lowering medical expense. However, catheter selection is made based on the practitioner’s experience in almost all cases. Therefore, we undertook this study to define radiologic and echocardiographic indices that would enable physicians to anticipate appropriate catheter selection. Materials and Methods: This is a retrospective study of 244 undergoing transradial diagnostic CAG at an established center from February 2006 to April 2014. Patients who successfully underwent angiography with a JL3.5 catheter were defined as the control group, and patients who successfully underwent angiography after the catheter was replaced with a JL4.0 or higher were defined as the switched group. To identify predictors for appropriate catheter selection, radiologic and echocardiographic indices were analyzed. Results: A total of 122 patients in the switched group and 122 patients in the control group were analyzed in this study. Average age was 64.65 ± 8.6 years. In the radiographic index, the switched group exhibited a significantly higher mediastinal-thoracic ratio (0.27 ± 0.05 vs. 0.23 ± 0.03, p &lt; 0.001. Additionally, the mediastinal-cardiac ratio was significantly greater in the switched group (0.50 ± 0.08 vs. 0.45 ± 0.05, p &lt; 0.001). Aortic root diameter, which is used here as the echocardiographic index, was significantly larger in the switched group compared to the control group (34.94 ± 4.18 mm vs. 32.66 ± 3.99 mm, p &lt; 0.001). In the multivariable logistic regression model, mediastinal-cardiac ratio (OR 5.197, 95% CI 2.608–10.355, p &lt; 0.001) and increased aortic root (OR 2.115, 95% CI 1.144–3.912, p = 0.017) were significantly associated with catheter change. Conclusions: Mediastinal-cardiac ratio and aortic root diameter provide helpful and effective indices for appropriate catheter selection during transradial coronary angiography