Current algorithms for the treatment of chronic coronary total occlusions

Chronic coronary total occlusions (CTOs) represent the most complex group of lesions in interventional cardiology, and technical success in their treatment depends on not only the characteristics of the lesions themselves but also the experience of the operator. Over the past few years, many CTO recanalisation techniques have been proposed, leading to the need for standardisation to achieve a higher success rate. As a result, a number of algorithms that allow the surgeon to choose one or another recanalisation technique depending on the angiographic features of the vessel have been proposed. This article provides an overview of the main algorithms for choosing a CTO recanalisation strategy and considers the clinical and angiographic characteristics that form the basis of the algorithms. The possibility of their use in clinical practice has also been evaluated.Received 7 April 2020. Revised 27 April 2020. Accepted 27 April 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and design: O.V. Krestyaninov, D.A. Khelimskii Drafting the article: O.V. Krestyaninov, D.A. Khelimskii, A.G. Badoian, R.A. Naydenov, R.U. Ibragimov Critical revision of the article: R.A. Naydenov, R.U. Ibragimov Final approval of the version to be published: O.V. Krestyaninov, D.A. Khelimskii, A.G. Badoian, R.A. Naydenov, R.U. Ibragimov

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Neocuspidization of the aortic valve

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-2-11-18 ◽

2021 ◽

Vol 25 (2) ◽

pp. 11

Author(s):

B. K. Kadyraliev ◽

V. B. Arutyunyan ◽

I. I. Chernov ◽

A. H. Umarov ◽

K. Yu. Zhigalov ◽

...

Keyword(s):

Aortic Valve ◽

Conflict Of Interest ◽

Low Cost ◽

Long Term Results ◽

Final Approval ◽

Ideal Approach ◽

Valve Reconstruction ◽

Critical Revision ◽

The Ideal

Aortic valve reconstruction remains the ideal approach to treat aortic valve disease, with an aim to increase durability and prevent anticoagulation. Owing to its availability, handling ease, and low cost, autopericardium has been regularly used since the early days of cardiac surgery. Many of these methods have not been standardized yet and are underutilized. One method with promising long-term results is neocuspidization of the aortic valve, as described by Ozaki using glutaraldehyde-fixed autopericardium. Neocuspidization of the aortic valve includes valve prosthetics with its own pericardium. We performed a literature review on aortic valve neocuspidization.Received 13 October 2020. Revised 6 November 2020. Accepted 11 November 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: B.K. Kadyraliev, V.B. Arutyunyan, I.I. Chernov, A.H. Umarov, K.Yu. Zhigalov, A. Weymann, S.T. Enginoev Drafting the article: B.K. Kadyraliev, V.B. Arutyunyan, S.T. Enginoev Critical revision of the article: V.B. Arutyunyan, A.H. Umarov, S.T. Enginoev Final approval of the version to be published: B.K. Kadyraliev, V.B. Arutyunyan, I.I. Chernov, A.H. Umarov, K.Yu. Zhigalov, A. Weymann, S.T. Enginoev

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Predicting endovascular intervention outcomes in patients with chronic total occlusion of coronary artery. Can we forecast the result?

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2017-1-91-97 ◽

2017 ◽

Vol 21 (1) ◽

pp. 91 ◽

Cited By ~ 2

Author(s):

D. A. Khelimskiy ◽

O. V. Krestyaninov ◽

A. A. Shermuk ◽

R. U. Ibragimov ◽

A. V. Marchenko ◽

...

Keyword(s):

Clinical Practice ◽

Coronary Artery ◽

Conflict Of Interest ◽

Chronic Total Occlusion ◽

Total Occlusion ◽

Advantages And Disadvantages ◽

Data Collection And Analysis ◽

Analytical Review ◽

Potential Benefits ◽

Critical Revision

This article presents an analytical review of the existing scores to predict the outcomes of coronary arteries chronic occlusions recanalization, their advantages and disadvantages. It outlines the potential benefits of introduction of these scales in clinical practice and estimates the possibility of application of such scores in modern conditions.Received 30 September 2016. Accepted 24 January 2017.Financing: The study had no sponsorship.Conflict of interest: Kretov E.I. served as executive editor of “Endovascular surgery” section. All other authors declare no conflict of interest.Author contributionsData collection and analysis: Khelimskiy D.A., Ibragimov R.U., Marchenko A.V., Redkin D.A., Grankin D.S.. Drafting the article: Khelimskiy D.A., Shermuk A.A. Critical revision: Khelimskiy D.A., Shermuk A.A., Krestyaninov O.V., Kretov E.I.

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Evolution of carotid endarterectomy: A literature review

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2020-4-22-32 ◽

2020 ◽

Vol 24 (4) ◽

pp. 22

Author(s):

A. N. Kazantsev ◽

G. G. Khubulava ◽

V. N. Kravchuk ◽

A. A. Erofeev ◽

K. P. Chernykh

Keyword(s):

Carotid Endarterectomy ◽

Conflict Of Interest ◽

Internal Carotid ◽

Conflicts Of Interest ◽

State Of The Art ◽

Final Approval ◽

Long Term Follow Up ◽

Critical Revision

This review investigates the various methods used for carotid endarterectomy (CEE). These methods are presented, and allow us to analyse effective revascularisation with extended damage to the internal carotid artery. The data of studies comparing the results of eversion and classical carotid endarterectomy with plasty of the reconstruction zone with a patch made of diepoxy-treated pericardium are presented. Special attention is paid to emergency carotid endarterectomy and carotid endarterectomy in the acute period of ischemic stroke. The important and main aspects of the glomus-saving species of CEE are also demonstrated. The main complications behind operations, and causes of restenosis in long-term follow-up periods are also duly noted. Similarly, suggestions to eliminate these issues are also proposed. This review comprehensively covers the state of the art of carotid endarterectomy and dissects current techniques and methods in the area.Received 16 July 2020. Revised 24 August 2020. Accepted 25 August 2020.Conflict of interest: Authors declare no conflicts of interest.Funding: The study did not have sponsorship.Author contributions Conception and study design: G.G. Khubulava Drafting the article: A.N. Kazantsev Critical revision of the article: A.A. Erofeev, V.N. Kravchuk, K.P. Chernykh Final approval of the version to be published: G.G. Khubulava, A.N. Kazantsev, A.A. Erofeev, V.N. Kravchuk, K.P. Chernykh

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Undifferentiated pleomorphic sarcoma of the right atrium in an infant

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2020-2-119-123 ◽

2020 ◽

Vol 24 (2) ◽

pp. 119

Author(s):

I. S. Murashov ◽

V. E. Kliver ◽

T. A. Ageeva ◽

A. M. Volkov ◽

E. E. Kliver

Keyword(s):

Literature Review ◽

Conflict Of Interest ◽

Malignant Tumour ◽

Final Approval ◽

Therapeutic Approaches ◽

Immunohistochemical Examination ◽

Undifferentiated Pleomorphic Sarcoma ◽

Pleomorphic Sarcoma ◽

Critical Revision ◽

The Right

Undifferentiated pleomorphic sarcoma is a high-grade malignant tumour, accounting for one-third of all primary cardiac sarcomas. This paper describes a case of undifferentiated pleomorphic sarcoma in an infant using detailed morphological characterisation, immunohistochemical examination and a brief literature review. Taken together, these data will be useful not only for practicing pathologists but also for researchers of other biomedical fields for the development of procedures for differential diagnoses, investigation of the pathogenesis and development of therapeutic approaches for undifferentiated pleomorphic sarcoma.Received 4 February 2019. Revised 31 March 2020. Accepted 9 April 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Drafting the article: I.S. Murashov, E.E. Kliver Literature review: V.E. Kliver, T.A. Ageeva Illustrations: V.E. Kliver, A.M. Volkov Critical revision of the article: I.S. Murashov, E.E. Kliver Final approval of the version to be published: I.S. Murashov, V.E. Kliver, T.A. Ageeva, A.M. Volkov, E.E. Kliver

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Markers of myocardial damage after radiofrequency ablation of tachyarrhythmia

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2020-1-9-17 ◽

2020 ◽

Vol 24 (1) ◽

pp. 9

Author(s):

O. L. Zayfrid ◽

K. A. Chueva ◽

E. S. Vasichkina ◽

A. V. Mikhailov ◽

D. S. Lebedev ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Conflict Of Interest ◽

Creatine Phosphokinase ◽

Troponin I ◽

Myocardial Damage ◽

The Past ◽

Damage Indicator ◽

Expression Site ◽

Critical Revision ◽

Indicator Data

This study presents literature data over the past few years on markers of acute myocardial damage after radiofrequency ablation. Information on markers such as troponin I and T, creatine phosphokinase and its fractions, CRP and interleukins and myoglobin is presented in detail. For each potential myocardial damage indicator, data related to their expression site, chemical basis of each marker and correlation between the degree of damage caused by radiofrequency exposure and the levels of various biomarkers of myocardial damage are provided.Received 12 November 2019. Revised 26 February 2020. Accepted 27 February 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and study design: O.L. Zajfrid, R.B. Tatarsky, E.S. Vasichkina Drafting the article: O.L. Zajfrid, K.A. Chueva, A.V. Mikhailov Critical revision of the article: O.L. Zajfrid, R.B. Tatarsky, E.S. Vasichkina, I.L. Nikitina, D.S. Lebedev Final approval of the version to be published: O.L. Zajfrid, K.A. Chueva, E.S. Vasichkina, A.V. Mikhailov, D.S. Lebedev, I.L. Nikitina, R.B. Tatarsky

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Evaluation of percutaneous transcatheter embolization for pulmonary arteriovenous malformations

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01448-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

ZhengZhong Wu ◽

JunQing Lin ◽

WeiZhu Yang ◽

Na Jiang ◽

Ning Huang ◽

...

Keyword(s):

New York ◽

Success Rate ◽

Arteriovenous Malformations ◽

Heart Association ◽

Transcatheter Embolization ◽

Pulmonary Arteriovenous Malformations ◽

Technical Success ◽

Arterial Blood Gas ◽

Technical Success Rate ◽

Arterial Blood

Abstract Background The purpose of this study was to assess the safety and efficacy of percutaneous transcatheter embolization (TCE) for the treatment of pulmonary arteriovenous malformations (PAVMs). Methods Forty-three consecutive patients (n = 17 males; n = 26 females) with 72 untreated PAVMs underwent coil and/or plug embolization between January 2010 and February 2018. The mean patient age was 42 ± 14 years (range 19–71 years). The median size of the feeding artery was 7.9 ± 2.9 mm (range 3.5–14.0 mm). The arterial blood gas level and cardiac function of all patients were analysed. The technical success rate, recanalization rate, and complications were evaluated. Computed tomography angiography (CTA) examinations were scheduled for 12 months after treatment and every 2–4 years thereafter. Results Twenty-five PAVMs were treated with coils alone, twenty-one were treated with plugs alone, and twenty-six were treated with both coils and plugs. The technical success rate was 100%. There were no complications during operation. However, one patient (2.3%) had pulmonary thrombosis and embolism post-operation. The patients’ pre-operative and post-operative PaO2 and SaO2 levels were significantly different (p < 0.01). A comparison of the New York Heart Association (NYHA) grade before and after embolization in all patients showed a significant decrease in the post-operative grade (p < 0.01). The 72 PAVMs were divided into three groups (coils only group [n = 25], plugs only group [n = 21], and coils/plugs combined group [n = 26]). After 12 months of follow-up, there were seven reperfusion PAVMs in the coil group, seven reperfusion PAVMs in the plug group, and 1 reperfusion PAVM in the combined group. There were significant differences between the two groups and the combined group. Conclusion Percutaneous TCE is safe and effective for the treatment of PAVMs. A combination of coils and vascular plugs may be useful for preventing recanalization after the embolization of PAVMs.

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Modified percutaneous radiologic gastrostomy technique without endoscopic or nasogastric access

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0086-8 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Reda Tabashy ◽

Amira Darwish ◽

Ashraf Ibrahim ◽

Mohamed Gad El-Mola

Keyword(s):

Esophageal Cancer ◽

Success Rate ◽

Nasogastric Tube ◽

Conventional Technique ◽

Fluoroscopic Guidance ◽

Efficacy And Safety ◽

Technical Success ◽

Technical Success Rate ◽

Major Complications ◽

Percutaneous Radiologic Gastrostomy

Abstract Background The aim of this study is to evaluate the efficacy and safety of a modified percutaneous radiologic gastrostomy (MPRG) technique under ultrasound and fluoroscopic guidance without endoscopic or nasogastric access. Results The study included 24 patients: 10 males and 14 females whose ages ranged from 44 to 80 years old. Ten patients had esophageal cancer and 14 patients had neck cancer. Technical success was achieved in 23 out of the 25 procedures (92%). Two procedures failed (8%) and were converted to the conventional technique by using the nasogastric tube. No major complications were reported. Minor complications were observed in 5 patients (20%): intraperitoneal air and contrast leakage in 4 patients and focal mucosal dissection by the contrast in 1 patient. Conclusion The MPRG has high technical success rate, is safe with no major complications, and is most feasible when endoscopic or nasogastric access cannot be performed.

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Emergency management of the paediatric patient with convulsive status epilepticus

Paediatrics & Child Health ◽

10.1093/pch/pxaa127 ◽

2021 ◽

Vol 26 (1) ◽

pp. 50-57

Author(s):

Kyle C McKenzie ◽

Cecil D Hahn ◽

Jeremy N Friedman

Keyword(s):

Clinical Practice ◽

Status Epilepticus ◽

Emergency Management ◽

Treatment Algorithm ◽

Position Statement ◽

Convulsive Status Epilepticus ◽

Pharmacological Management ◽

The Past ◽

New Treatment ◽

New Evidence

Abstract This guideline addresses the emergency management of convulsive status epilepticus (CSE) in children and infants older than 1 month of age. It replaces a previous position statement from 2011, and includes a new treatment algorithm and table of recommended medications based on new evidence and reflecting the evolution of clinical practice over the past several years. This statement emphasizes the importance of timely pharmacological management of CSE, and includes some guidance for diagnostic approach and supportive care.

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Feasibility and Techniques of Securing 3D-Safety Margin in Superselective Transarterial Chemoembolization to Improve Local Tumor Control for Small Hepatocellular Carcinoma: An Intend-to-Treat Analysis

Liver Cancer ◽

10.1159/000512337 ◽

2021 ◽

Vol 10 (1) ◽

pp. 63-71

Author(s):

Ching Charoenvisal ◽

Toshihiro Tanaka ◽

Hideyuki Nishiofuku ◽

Hiroshi Anai ◽

Takeshi Sato ◽

...

Keyword(s):

Success Rate ◽

Tumor Recurrence ◽

Safety Margin ◽

Small Hepatocellular Carcinoma ◽

Technical Success ◽

Local Tumor ◽

Local Tumor Recurrence ◽

3D Images ◽

Technical Success Rate ◽

Treat Analysis

Introduction: The aim of this study was to investigate the technical success rate of obtaining 3D-safety margin in superselective conventional transarterial chemoembolization (cTACE) using 3D images for small hepatocellular carcinoma (HCC). Methods: Consecutive 48 HCC nodules (diameter, 1–3 cm) in 44 patients were intentionally treated by superselective cTACE in an attempt to achieve 3D-safety margin. Superselective CT during hepatic arteriography (CTHA) was obtained before cTACE. When negative 3D-safety margin was found, branches supplied into the margin area were detected by using a 3D workstation. The technical success rate to obtain 3D-safety margin was investigated by intend-to-treat analysis. Local tumor recurrence rate and adverse events were also evaluated. Result: Nine of 48 tumors (18.8%) had 3D-safety margin in the initial superselective CTHA. After pulling back of the catheter and/or selection of another branch based on 3D images, 3D-safety margin was finally achieved in 45 (93.8%). There were 8 of 46 tumors (17.4%) with local recurrence after 5-year follow-up. Grade 3–4 of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were found in 38.6, 36.4, and 2.3%, respectively. One portal vein thrombus and 3 biliary dilation or biloma were developed. Conclusion: Superselective cTACE obtaining 3D-safety margin in small HCC was feasible with a high success rate by using 3D images, which could be tolerable and prevent local tumor recurrence.

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Noncompaction Cardiomyopathy—History and Current Knowledge for Clinical Practice

Journal of Clinical Medicine ◽

10.3390/jcm10112457 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2457

Author(s):

Birgit J. Gerecke ◽

Rolf Engberding

Keyword(s):

Clinical Practice ◽

Current Knowledge ◽

Clinical Manifestations ◽

Clinical Patient ◽

Noncompaction Cardiomyopathy ◽

The Past ◽

Wide Range ◽

Morphological Variants ◽

A Current ◽

Healthy Persons

Noncompaction cardiomyopathy (NCCM) has gained increasing attention over the past twenty years, but in daily clinical practice NCCM is still rarely considered. So far, there are no generally accepted diagnostic criteria and some groups even refuse to acknowledge it as a distinct cardiomyopathy, and grade it as a variant of dilated cardiomyopathy or a morphological trait of different conditions. A wide range of morphological variants have been observed even in healthy persons, suggesting that pathologic remodeling and physiologic adaptation have to be differentiated in cases where this spongy myocardial pattern is encountered. Recent studies have uncovered numerous new pathogenetic and pathophysiologic aspects of this elusive cardiomyopathy, but a current summary and evaluation of clinical patient management are still lacking, especially to avoid mis- and overdiagnosis. Addressing this issue, this article provides an up to date overview of the current knowledge in classification, pathogenesis, pathophysiology, epidemiology, clinical manifestations and diagnostic evaluation, including genetic testing, treatment and prognosis of NCCM.

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