MULTISLICE THOMOGRAPHY EVALUATION IN CORONARY ARTERY DISEASE

Conventional Coronary Angiography (CCA) is the diagnostic standard for identification and evaluation of coronary stenosis and coronary artery bypass graft (CABG) patency. Limits of this technique (invasivity, undeniable costs, risk of mortality and morbidity) and the large, worldwide, procedure number, whose only one third followed by interventional procedures, because of high percentage of uninjured coronary arteries, suggest the usefulness of a new non-invasive way to visualize the coronaric tree in patients with actual indication to CCA and Percutaneous Coronary Interventions (PCI).Multi-slice computed tomography (MSCT) is a rapidly developing technique and allows reliable evaluation of the coronary arteries and CABG in a non-invasive manner. Despite limitations due to calcium, movement, metallic parts and high radiation dose, MSCT – CA showed a good diagnostic capability in detecting significant coronary artery stenosis in patient with suspected or known significant coronary artery disease

Effects of Essential Hypertension on coronary Microcirculation: Focus on a Population of Hypertensives Affected by Microvascular Angina

A correlation between essential hypertension and the establishmentof myocardial ischemia is nowadays universally accepted. Coronary atherosclerosis is deemed to be the most important process through which the capability of coronary district to supply a blood flow consistent with myocardial needs can be impaired, until the onset of an anginal syndrome. In this study, we verified whether hypertensives’ coronaries, seen by performing an angiographic study, are properly definable as normal, even in presence of an overt exertional angina, or if they should rather be barely defined as “macroscopically unharmed”, through the clues of a microvascular alteratio

Troponina e infarto periprocedurale: filo di Arianna o folle volo di Icaro?

Percutaneous coronary interventions cause frequently an increase in myocardial necrosis markers. Is troponin elevation after percutaneous coronary intervention a predictor of events at follow-up or a consequence of the procedure with no cause-effect relationship with prognosis? The debate is still ope

Clinical Appropriateness of Coronary Angiography

Background: The study evaluates the appropriateness of coronary angiography and the agreement between the used method and the presence of coronary artery disease by the indications proposed from American College of Cardiology/American Heart Association (1999). Method: The guidelines allow us to associate to Class I and IIa the judgment of appropriateness, to the Class IIb of uncertainty; to Class III of inappropriateness. Result: On 761 coronary angiography 76.74% were appropriate, 23.13% unsuitable, 0.13% uncertain. The group with the greater value of appropriateness is that one with unstable angina (97.9% appropriate); that one with the lower value is the group with non-specific symptomatology (26.7% appropriate). Conclusion: Considering the false positives, it is important the rate of the greater sensibility and the lower specificity of the not invasive tests carried before coronary angiography, as well as, the probable presence of microcircle disease. Among the false negatives, we must considered the number of patients with effective coronary artery disease which has “jumped” the intermediate stage of the not invasive diagnostic process, before the coronary angiography, but have obtained the same final benefit

A rare case of Prinzmetal angina 3 days after coronary artery stenting with a second-generation drug-eluting stent.

Non previsto

LEFT MAIN CORONARY BIFURCATION TREATMENT WITH IMPELLA SUPPORT IN COMPLEX AND HIGH RISK PATIENT (CHIP)

Bifurcation lesions, especially around the left main coronary (LMC), are occasionally encountered. More frequent LMC lesion are present in Complex and High risk Patients (CHIP) and this case represent a real challenge for interventional cardiologists. Bifurcation lesions PCI reported to have high overall major adverse cardiovascular events, and require the use of various complex interventional techniques. Here, we report a case of successful percutaneous coronary intervention supported by Impella on an LMC bifurcation treatment with culotte stenting in patient with cardiogenic shock