Key Points Arterial disease in one vascular bed is a harbinger of disease in other vascular beds. The differential diagnosis of diseases involving the upper extremity (UE) and aortic arch branch vessels is vast and requires extensive knowledge and a…
Key points Individuals at risk for lower extremity peripheral artery disease (PAD) should undergo a vascular review of symptoms to assess walking impairment, claudication, ischemic rest pain, and the presence of nonhealing wounds. Despite recent advances in noninvasive evaluation of…
Key Points Vascular physiology is grounded in the following basic equation: CO (flow) equals the pressure difference (Δ P ) divided by the resistance ( R ). Resultantly, coronary blood flow (CBF) is largely driven by supply/demand mismatches in myocardial…
Key Points Current clinical practice guidelines for the care of patients who present with ST-segment elevation myocardial infarction (STEMI) provide a class I recommendation that “all communities should create and maintain a regional system of STEMI care that includes assessment…
Key Points Clinical characteristics of the elective high-risk patient include older age, history of myocardial infarction (MI), low ejection fraction, congestive heart failure (CHF), recent hemodynamic instability, renal insufficiency, and peripheral vascular disease. High-risk angiographic characteristics for the elective patient…
Key Points Rotational and orbital atherectomy facilitate stent implantation in undilatable, rigid, or heavily calcified lesions. Cutting or scoring balloons slip less often than conventional balloons and may be useful for treating restenotic or ostial lesions. Laser angioplasty uses a…
Key Points Restenosis is a pathologic response to injury that leads to narrowing of the vessel segment as a result of negative vascular remodeling and neointimal proliferation of vascular smooth muscle cells. Clinical and angiographic predictors of stent restenosis include…
Key Points The role of the cardiac surgeon in the catheterization laboratory has traditionally been surgical backup for the interventional cardiologist. Such service is losing necessity as the development and mastery of new interventional procedures progress and correlate with the…
Key Points Access-site and nonaccess-site bleeding complications after percutaneous coronary intervention (PCI) are associated with poor outcome, including mortality. A transradial approach (TRA) for diagnostic angiography and PCI is associated with virtually no major access-site bleeding, early ambulation, and subsequent…
Key Points Access-site complications continue to be the most common adverse events after cardiovascular interventions, extending the patient’s hospital stay and increasing the associated procedural costs. Selection of the appropriate access site is frequently a key issue for the successful…