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Interventional Medicine and Applied Science
Authors: Cesare Baldi, Marco Mirra, Marco di Maio, Tiziana Attisano, Michele Roberto Di Muro, Francesco Vigorito, Rosario Farina, Maria Vincenza Polito, Pietro Giudice and Federico Piscione

access for coronary angiography and percutaneous coronary intervention BMJ 329 443 446 . 3. O

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Abstract

In recent years, post mortem multi-slice computed tomography (MSCT) is increasingly applied for forensic and pathologic examination. However, classical dissection remains dominant in everyday practice. Lack of quantifiable data on the coronary system has become a disadvantageous attribute of traditional autopsy. Therefore, post mortem MSCT angiography was performed in 80 ex corpo hearts with the aim of improving the accuracy and quantitative documentation of pathologic and forensic diagnoses of coronary artery disease (CAD). Hearts were perfused by introducing a new oily or synthetic resin, or using both contrast materials successively. Then the perfused organs were processed for imaging. Detailed angiographic analysis enabled us to localize, map and quantify coronary calcifications, stenoses, and to characterize the types of atherosclerotic plaques. Significant early or late complications of widely used percutaneous coronary interventions (PCI) and coronary bypass surgery (CABS) could be revealed using CT analysis. Furthermore, by using our oily contrast material and CT imaging, we could identify and visualize the clinically important small caliber nodal arteries (diameter 0.4–2.0 mm). The present work suggests that post mortem CT angiography and post-processing of the data may improve the quality of pathologic and forensic diagnosis. Our collection of coronary casts including digital data are available for further analysis.

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Interventional Medicine and Applied Science
Authors: Macit Kalçık, Mahmut Yesin, Ahmet Güner, Emrah Bayam, Mucahit Yetim, Tolga Doğan, Lütfü Bekar, Oğuzhan Çelik and Yusuf Karavelioğlu

Introduction Coronary angiography may reveal normal coronary arteries in a significant proportion (20%–30%) of patients presenting with typical angina pectoris [ 1 ]. Although non-cardiac causes may be responsible for the chest

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arrest survivors with and without ST-segment elevation myocardial infarction: importance of coronary angiography. JACC Cardiovasc Interv. 2015; 8: 1031–1040. 20 Dumas F, Bougouin

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(STEMI) evaluated with emergent transradial coronary angiography. To the best of our knowledge, this is the first reported case of successful use of OA via the transradial approach in the setting of acute STEMI. Case Report A

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Tissue level myocardial perfusion is one of the most important prognostic factors after successful recanalisation of the occluded coronary artery in patients suffering acute ST elevation myocardial infarction (STEMI). The primary objective of the present study was to examine the relationship between videodensitometric myocardial perfusion parameters as assessed on coronary angiograms directly following successful recanalization therapy and magnetic resonance imaging (MRI)-derived myocardial tissue loss late after STEMI. The study comprised 29 STEMI patients. Videodensitometric parameter Gmax/Tmax was calculated to characterize myocardial perfusion, derived from the plateau of grey-level intensity (Gmax), divided by the time-to-peak intensity (Tmax). Myocardial loss index (MLI) was assessed by cardiac MRI following 376 ± 254 days after PCI. Results: Signifcant correlations could be demonstrated between MLI and Gmax (r = 0.36, p = 0.05) and Gmax/Tmax (r = 0.40, p = 0.03) using vessel masking. Using receiver operating characteristic curve analysis, Gmax/Tmax < 2.17 predicted best MLI = 0.3, 0.4, 0.5 and 0.6 with good sensitivity and specifcity data, while Gmax/Tmax < 3.25 proved to have a prognostic role in the prediction of MLI = 0.7. Conclusions: Selective myocardial tissue level perfusion quantitative measurement method is feasible and can serve as a good predictor of myocardial tissue loss following STEMI and revascularization therapy.

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Interventional Medicine and Applied Science
Authors: Yiğit Çanga, Tolga Sinan Güvenç, Mehmet Baran Karataş, Tahir Bezgin, Bariş Güngör, Rengin Çetin and Osman Bolca

Type IV dual left anterior descending artery (LAD) anomaly constitutes a rare subset of coronary anomalies in which the anterior and anterolateral wall of the left ventricle is supplied by a short LAD originating from the left coronary artery along with a long LAD that originates from the right sinus of Valsalva. Albeit rare, the angiographic presentation is challenging since the appearance of the short LAD is similar to a total occlusion beyond first few diagonal or septal branches. Here, we present a series of four cases with type IV dual LAD anomaly with different clinical and angiographic presentations.

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Imaging
Authors: Sabrina Oebel, Alexander Gotschy, Ingo Paetsch, Cosima Jahnke, Sven Plein, Rolf Gebker, Sandra Hamada, Michael Frick, Jochen von Spiczak, Malgorzata Polacin, Frank Enseleit, Nikolaus Marx, Thomas F. Lüscher, Frank Ruschitzka, Sebastian Kozerke, Hatem Alkadhi and Robert Manka

defined by fractional flow reserve (FFR) measurements (<0.8) or significant stenosis on quantitative coronary angiography (QCA)) in patients with depressed LV function (EF ≤50%). We selected individuals who underwent ischemia testing with suspected and

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renal function tests were investigated and estimated glomerular filtration rate (eGFR) was calculated using Cockcroft–Gault’s formula [ 23 ]. Details of coronary angiography of all cases were recorded and analyzed. The 2D echocardiography was done to

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Interventional Medicine and Applied Science
Authors: Erdal Aktürk, Lütfü Aşkın, Hakan Taşolar, Ertuğrul Kurtoğlu, Serdar Türkmen, Okan Tanrıverdi and Kader Eliz Uzel

patients undergoing coronary angiography (CAG) during catheterization at a rate of 18%–52% [ 3 – 5 ]. Multiple reports have demonstrated that CTO revascularization has clinical benefit [ 6 – 10 ]. Over the years, progress has been made for the presentation

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