Оглавление
Группа авторов. Interventional Cardiology
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Interventional Cardiology. Principles and Practice
Contributors
Foreword
Preface
Acknowledgments
About the Companion Website
CHAPTER 1. Atherogenesis and Inflammation
Pathogenesis of atherosclerosis. Inception of the plaque
Endothelial dysfunction
Cholesterol
Oxidative stress
Progression of atherosclerotic plaque. Stable plaque
The vulnerable plaque
Vulnerable plaque: a shift towards Th1 pattern
Plaque erosions
Neoatherosclerosis
Insights from coronary imaging
Intravascular imaging (IVUS)
Backscattered radio‐frequency (RF) IVUS
Optical coherence tomography (OCT)
OCT assessment of culprit lesions with ACS. Plaque rupture
Plaque erosion
Calcified nodule
OCT‐derived Vulnerable Plaques. OCT‐ derived TCFA
Macrophage infiltration
Cholesterol crystal (CCs)
Neovascularization
Neoatherosclerosis
Near infrared spectroscopy (NIRS)
Lipid rich plaques
Serum markers correlated to plaque inflammation
Markers of inflammation
Biomechanical stress as a trigger for plaque progression and rupture
Future challenges in the treatment of vulnerable plaques
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 2. The Essentials of Femoral Vascular Access and Closure
Femoral access. Anatomy
Puncture technique
Ultrasound guided femoral access
Micropuncture technique
Femoral access closure. Manual compression
Vascular closure devices
AngioSeal
Perclose
StarClose
Exoseal, Femoseal
Manta
Hemostatic patches
Evidence‐based issues for vascular closure devices
Preclosure for large arterial sheaths
Arterial access management for transcatheter aortic valvular replacement procedures requiring large bore sheaths
Large bore venous sheath management
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 3. Radial Artery, Alternative Arm Access, and Related Techniques
Introduction
Rationale and evidence for transradial access
Pre‐procedural considerations
Radial vs ulnar
Right vs left radial
Proximal vs distal radial approach
Access technique and navigating common problems. Access technique
Navigating common anatomical problems
High radial‐ulnar bifurcation (“high take‐off”)
Radial artery loops
Tortuous Radial Arteries
Other Barriers
Complications and management
Spasm
Hematoma
Compartment syndrome
Radial or brachial artery perforation
Radial artery occlusion (RAO)
Catheter kinking and/or entrapment
Hemostasis techniques
Future directions. Distal radial access
Radial and slender clubs
“Safe femoral” strategy
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 4. Optimal Angiographic Views for Coronary Angioplasty
Catheter selection
Left coronary
Right coronary
Radial approach
Coronary intubation
Diagnostic angiography. Left‐sided views
Right‐sided views
Lesion‐specific approach. Optimal views for each coronary segment
Left main stem
Left anterior descending
Circumflex
Right coronary artery
Vein grafts
Left internal mammary artery grafts
Coronary variants
Ventriculography
Transplanted Heart
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 5. Material Selection
Guide catheter selection. Functional design of modern guide catheters
Size requirements
Shape selection
Shape selection for the left coronary system
Shape selection for the right coronary system
Length
Side holes or not?
Variation in access site
Vein grafts
Left and right internal mammary arteries
Gastroepiploic artery grafts
Support
Guide catheter support
Passive support
Active support
Hybrid support
Wire support
Anchor balloon technique
Adjunctive techniques. Double coaxial guiding catheter technique (also known as mother–child)
Guide catheter extensions
Guidewire selection
Balloon catheters
Anatomy of a balloon catheter
Non‐compliant balloon catheters
Microcatheters
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 6. Statistical Essentials in the Design and Analysis of Clinical Trials
The fundamentals. Significance tests and p‐values
Estimating the magnitude of effect
A 95% confidence interval to express uncertainty
Interpreting p‐values
Link between p‐values and confidence intervals
Time to event data
Quantitative data
Trial design: the fundamentals
Control group
Randomization
Trial size and power calculations
Additional topics in clinical design and analysis. Superiority and non‐inferiority designs
Intention to treat, modified intention to treat, and per‐protocol analyses
Bayesian approach
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 7. Physiologic Assessment and Guidance in the Cardiac Catheterization Laboratory
Why to use physiology
Practical considerations of pressure wire measurement
Pressure recording system
Guiding catheter selection
Guide catheter damping
Pressure wire preparation
Pressure wire normalization or equalization
Essential pharmacology
Performing physiological measurement
Hyperemic agents
Pullback and drift check
Pressure wire assessment after PCI
Catheter laboratory conditions for pressure wire assessment
Performing an optimal pressure wire pullback
Practical tips and tricks of performing the iFR Pullback
Co‐Registration of iFR‐Pullback with Angiographic Data
Commonly missed mistakes in Physiological Assessment
Pressure‐only indices to guide coronary intervention. Fractional Flow Reserve
Consideration of right atrial pressure
Stenosis specific assessment
Thresholds for significance and evidence to support
FFR outside typical scenarios
FFR in Acute Coronary Syndromes
Algorithmically determined FFR
The instantaneous wave‐free ratio (iFR) and other non‐hyperemic pressure ratios (NHPRs)
IFR in Clinical Trials
Novel Non‐Hyperemic Indices
NHPR use scenarios
NHPR‐Pullback
Choosing between NHPR and FFR: when is one better than the other?
Does discrepancy matter?
Physiology after PCI
FFR after PCI
NHPR after PCI and the DEFINE‐PCI study
Using Physiology to Guide PCI Strategy
The Microcirculation. Ischemia with non‐obstructive coronary arteries (INOCA)
IMR: a clinical tool to assess microvascular function
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 8. Intravascular Ultrasound: Principles, Image Interpretation, and Clinical Applications
Principles of IVUS imaging
Equipment for IVUS examination
Imaging artifacts
Ring‐down
Non‐uniform rotational distortion
Reverberations
Other artifacts
Image acquisition and presentation
Normal artery morphology
Quantitative analysis
Qualitative analysis
Comparison of IVUS and angiography
Coronary artery remodeling
Unstable lesions
Detection of Vunerable Plaque
Role of intravascular imaging for assessment of lesion severity
Other unusual lesion morphology
Spontaneous coronary artery dissection (SCAD)
Guidance for stent implantation. Stent sizing
Stent expansion and malapposition
Clinical outcomes using IVUS for non‐LMCA and LMCA PCI
Clinical outcomes using IVUS for LMCA PCI. Observational Studies
Metanalysis
Special imaging cases
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 9. Optical Coherence Tomography, Near‐Infrared Spectroscopy, and Near‐Infrared Fluorescence Molecular Imaging
Optical coherence tomography
Catheter preparation, calibration, image acquisition and fluoroscopic co‐localization
Artifacts
Normal coronary vessel anatomy
Plaque characterization
Vulnerable plaque assessment
Acute coronary syndromes: identification of the culprit plaque and distinction rupture/erosion
Guidance of percutaneous coronary intervention
Apposition and malapposition
Tissue protrusion
Vascular injury: dissections
Guidance of complex lesion treatment: bifurcations, calcified, CTO, long and distal, ostial lesions
Assessment at follow‐up
In‐stent restenosis and neoatherosclerosis
Bioabsorbable vascular scaffolds
Near‐infrared spectroscopy
System description
Potential clinical uses. Determination of high‐risk plaque
Prevention of peri‐procedural myocardial infarction and optimizing interventions
Guiding the effects of treatment
Ongoing trial
Near‐infrared fluorescence molecular imaging
Clinical translation. NIRF‐OCT imaging system
NIRF molecular imaging agents
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 10. Multislice Computed Tomography (MSCT) and Cardiovascular Magnetic Resonance (CMR) Imaging for Coronary and Structural Heart Disease
Coronary MSCT angiography—technique
Stenosis detection
Bifurcations and ostial lesions
Stents
Chronic total occlusion (CTO)
Coronary artery bypass grafting (CABG)
Trials and current guidelines
CT FFR
TAVR
Pulmonary vein ablation
Cardiovascular magnetic resonance
Applications of CMR. Heart failure
Coronary artery evaluation
Ischemic heart disease (IHD)
Pericardial disease
Congenital heart disease
Valvular heart disease
Vascular disease. Aortic disease
Peripheral, carotid, and renal artery disease
CMR for interventional cardiac procedures. Transcatheter aortic valve replacement (TAVR)
Interventional CMR
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 11. Stable Coronary Artery Disease
Guidelines on the management of stable angina
Indications for coronary angiography
Percutaneous coronary intervention for stable angina
Comparison of percutaneous and surgical revascularization
Comparison of coronary artery bypass surgery with medical therapy for stable angina
Recommendations for revascularization in stable angina
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 12. PCI Strategies in Acute Coronary Syndromes without ST Segment Elevation (NSTE‐ACS)
Emergency department diagnosis and risk stratification
Early invasive versus ischemia‐guided strategy
Revascularization for NSTE‐ACS
Adjunctive pharmacologic treatment
Aspirin
Oral P2Y12 receptor inhibitors
Dual antiplatelet therapy duration
Parenteral antiplatelet therapy
Periprocedural anticoagulation
Conclusions
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 13. Primary and Rescue PCI in STEMI
Introduction
Timing of intervention in STEMI
Procedure technique. Access site selection
Primary PCI strategy
Aspiration thrombectomy
Stent selection
Multivessel disease
Primary PCI in the setting of cardiogenic shock
Pharmacological management. Antiplatelet therapy
Prasugrel
Prasugrel vs Ticagrelor
Duration of DAPT
Cangrelor
Glycoprotein (GP) IIb‐IIIa inhibitors
Antithrombotic therapy
Bivalirudin
Enoxaparin i.v
Fondaparinux
Rescue PCI
Fibrinolytic agents
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 14. The Management of Cardiogenic Shock and Hemodynamic Support Devices and Techniques
Introduction
Definition of Shock
Epidemiology
Management of cardiogenic shock. Impact of coronary revascularization
Left‐ventricular assist devices and the intra‐aortic balloon pump
IABP
Impella
Tandemheart
ECMO
Guideline recommendations for the IABP and left ventricular assist devices
Vasopressors and inotropes
Sympathomimetic agents
Phosphodiesterase inhibitors and calcium sensitizers
Treatment pathways for cardiogenic shock complicating myocardial infarction
Cardiogenic shock due to right ventricular failure
Cardiogenic shock due to pericardial tamponade
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 15. PCI for Unprotected Left Main Disease: Current Evidences and Plenty of Questions
Introduction
Is the issue the LM or the associated triple vessel disease?
Should CABG be the preferred strategy in the presence of diabetes mellitus (DM) or impaired ejection fraction (EF)?
What’s the impact of myocardial infarction (MI) on outcomes? Is it true that left internal mammary (LIMA) protects the left anterior descending (LAD) coronary artery from MIs?
PCI for unprotected left main disease in practice: beyond the rule “as simple as possible” What can you do when angiography is not enough?
Is all LM disease the same?
Is provisional stenting always preferable?
Optimization of “simple” provisional stenting: do we always need final kissing balloon inflation?
Direct two‐stents technique: do we have data to support a specific approach?
Do LM interventions need hemodynamic support?
Does LM require prolonged DAPT after PCI?
Take home messages
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 16. Bifurcation Lesion Stenting
Coronary bifurcation anatomy and function
Clinical relevance of a side branch
Clinical evidence base for bifurcation treatment
One vs two stents
Comparisons of different two‐stent techniques
The role of final kissing balloon inflation
Classification of bifurcation stenting techniques
Stepwise provisional side branch stenting strategy
Main vessel stenting
Side branch treatment
Two‐stent techniques
T and T and Protrusion (TAP) technique
Double Kissing Crush technique
Culotte technique
Dedicated bifurcation stents
Left main stenting
Intracoronary imaging
Final remarks
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 17. Risk Stratification Approach to Multivessel Coronary Artery Disease
Introduction
Box 17.1 High‐risk multivessel coronary artery disease patient subsets
Prognostic implications of MVCD and rationale for revascularization
Current recommendations for clinical practice
Myocardial revascularization strategies
Comparison of percutaneous and surgical approaches
Hybrid strategies
Complete revascularization in MVCD
Complete revascularization in STEMI
Functionally‐guided revascularization in MVCD
Risk scores in MVCD
SYNTAX Score
SYNTAX Score II
Functional SYNTAX score
Residual SYNTAX score
Residual functional SYNTAX score
CABG SYNTAX score
FREEDOM score
Surgical risk scores
Special clinical subsets at higher risk
Diabetes mellitus
Chronic kidney disease
Left ventricular dysfunction
Elderly
Complex PCI
Gender disparities
Role of medical therapy
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 18. Chronic Total Coronary Occlusion
Introduction
Morphology of the occlusion
Indication for treatment
Basic rules of engagement
Guide wire selection and handling
Occlusions with a distinct entry point
Occlusions without any discernible entry point
Occlusions with suspected residual lumen
Advanced antegrade recanalization techniques
Antegrade dissection and reentry
Retrograde approach
Algortihmic approach for intervention of chronic total occlusions
Balloon dilatation
Stent placement
Intravascular ultrasound in CTOs
When to stop a procedure
Complications
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 19. Percutaneous Coronary Intervention of Arterial and Vein Grafts
Introduction
Scope of the problem
Secondary revascularization after CABG surgery: PCI or repeat surgery?
PCI for acute post‐operative graft failure
PCI in degenerated saphenous vein grafts
Access site selection: radial vs femoral PCI
Bare metal stents (BMS) or drug eluting stents (DES) in SVG interventions
Embolic protection devices (EPD) in SVG interventions
The use of vasodilator agents in vein graft PCI
The use of glycoprotein IIb/IIIa inhibitors (GPIs) in vein graft PCI
Other considerations during SVG interventions
Distal anastomosis lesions
Instent restenosis in vein grafts
PCI in arterial conduits
Guiding catheter selection for lima and rima grafts
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 20. Interventional Approach in Small Vessel, Diffuse, and Tortuous Coronary Artery Disease
Introduction
Small vessel disease. Definition and prevalence
Anatomical and physiologic assessment
Intravascular ultrasound (IVUS)
Fractional flow reserve (FFR)/instantaneous wave‐free ratio (IFR)
Optical coherence tomography (OCT)
Technical aspects
Device delivery
Bifurcation lesions
Device size
Clinical outcomes
Key points and summary
Diffuse vessel disease. Definition and prevalence
Anatomical and physiologic assessment
Intravascular ultrasound (IVUS) and optical coherence tomography (OCT)
Fractional flow reserve (FFR)/instantaneous wave‐free ratio (IFR)
Technical aspects
Device delivery
Plain old balloon angioplasty (POBA)
Stent
Clinical outcomes
Key points and summary
Tortuous vessel disease. Definition and prevalence
Anatomical and physiologic assessment
Intravascular ultrasound (IVUS)
Fractional flow reserve (FFR)/Instantaneous free‐wave ratio (iFR)
Technical aspects
Rotational atherectomy
Clinical outcomes
Key points and summary
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 21. In‐Stent Restenosis in the New Generation DES Era
Definition
Incidence
Clinical presentation
Pathophysiologic mechanisms
Early restenosis. Biologic factors
Mechanical factors
Incomplete stent expansion and apposition
Stent fractures
Technical factors
Late restenosis. Neo‐atherosclerosis
Morphologic pattern of DES restenosis
Prognostic implications for morphologic patterns of ISR
Predictors of DES restenosis
Role of coronary imaging
Approach to DES restenosis
Drug‐eluting balloon
Drug‐eluting stent
Alternative strategies in ISR approaches
Atherectomy
Proposed treatment strategies of DES restenosis
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 22. High Risk Percutaneous Coronary Intervention
Introduction
Defining high‐risk PCI
Pathophysiological rationale for mechanical support in HR‐PCI
Intra aortic balloon pump
Impella
TandemHeart/extra corporeal life support
An integrated approach to high‐risk PCI
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 23. Laser, Rotational, Orbital Coronary Atherectomy, and Coronary Intravascular Lithoplasty
Background. Rotational atherectomy
Excimer coronary laser atherectomy
Orbital atherectomy
Coronary intravascular lithoplasty
Rotational atherectomy. Technical considerations
Indications for RA. Calcific lesions
In‐stent restenosis
Contraindications to RA
Avoiding complications
Excimer laser coronary atherectomy. Technical considerations
Saline infusion technique
Indications for ELCA. Chronic total occlusions
Non‐dilatable lesions
Underexpanded stents
Avoiding complications
Orbital atherectomy. Technical Considerations
Indications. De novo severely calcified lesion
Contraindications. In stent restenosis
Aorto‐ostial lesions
Coronary intravascular lithoplasty. Technical considerations
Indication
Heavily calcified lesions
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 24. Thrombus‐containing Lesions
Introduction
How to deal with thrombus‐containing lesions. Access site
Identification of thrombus
Intracoronary imaging
Wiring
Lesion preparation
Proximal and distal protection devices
Thrombectomy
Manual thrombectomy
Mechanical thrombectomy
Excimer laser
Stenting
Case study
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 25. Specialized Balloons in Percutaneous Coronary Intervention: Cutting, Scoring, Gliding, andDrug‐Eluting Balloons
Introduction
Cutting and scoring balloons
Coronary bifurcation sidebranch access
Clearway catheter for intracoronary drug delivery
Flash Ostial dual balloon angioplasty catheter
Drug‐eluting balloons
DEB in in‐stent restenosis lesions
DEB in de novo lesions
Safety of coronary drug‐eluting balloons
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 26. Coronary Artery Dissections, Perforations, and the No‐Reflow Phenomenon
Introduction
Coronary artery dissection. Dissection following PCI
Catheter‐induced dissection
Coronary artery perforation. Incidence
Classification
Risk factors for CAP
Management and treatment of CAP
Devices and materials for CAP. Covered Stents
Coils
Microspheres
Thrombin Injection
Others
Early and late clinical outcome
The no‐reflow phenomenon
Incidence
Pathophysiology
Diagnosis
Prevention
Management of distal embolization. Aspiration thrombectomy
Distal embolic protection devices
Rotational Atherectomy
Intracoronary infusions. Treatment
Box 26.1 Strategy for evaluation and management of no‐reflow
Adenosine
Calcium Channel Blockers
Nitroprusside
Other Phamacological Interventions
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 27. Vascular Access Site Complications
Introduction
Common femoral artery related complications
Access site bleeding
Femoral artery pseudoaneurysm (FAP)
The ultrasound‐guided compression repair (UGCR)
Percutaneous thrombin injection
Percutaneous injection of biodegradable collagen
Covered stent placement
Coil embolization
Use of Angio‐Seal closure device
Retroperitoneal hematoma
Arteriovenous fistula formation
Lower extremity ischemia
Infection
Femoral artery access techniques to prevent vascular complications
Routine femoral head fluoroscopy
Ultrasound guidance
Micropuncture technique
Vascular closure devices for femoral access
Efficacy of vascular closure devices
Vascular closure devices in procedures using large bore sheaths
Complications associated with vascular closure devices
Radial artery related complications
Radial artery spasm
Radial artery occlusion
Bleeding complications
Brachial artery related complications
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 28. Renal Insufficiency and the Impact of Contrast Agents
Contrast‐associated acute kidney injury
Pathophysiology
Diagnosis and biomarkers
Functional biomarkers
Structural kidney damage biomarkers
Iodinated Contrast Media
Prevention of CA‐AKI
Risk scores
Minimize CM
Hydration
Pharmacological and other preventive measures
Renal replacement therapy
Remote ischemic preconditioning (RIPC)
Conclusion
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 29. Radiation Management in Interventional Cardiology
Measurements of radiation
Radiobiology
Patient radiation management
Box 29.1 Example of a radiologic checklist
Pre‐procedure aspect of radiation dose management
Time out
Procedural aspects of radiation management
Post‐procedural aspects of radiation management
Staff radiation safety
Personal dose monitoring
Shielding
Specific radiation safety considerations. Women and fluoroscopic guided procedures
Pediatric patients
Training and education
Radiation quality processes
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 30. Concepts of Cell Therapy and Myocardial Regeneration
Cell‐based and cell‐free approaches for cardiac repair: what works and what does not
Adult tissue specific stem cells‐waning expectations?
Pluripotent and perinatal stem cells for cell replacement therapy‐the niche matters
Overcoming caveats for future cell‐based therapy
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 31. Durable Polymer Everolimus Eluting Stents
Stent platform properties of DP‐EES
Cobalt chromium EES – material properties and stent geometry
Platinum chromium EES – material properties and stent geometry
Polymer biocompatibility of DP‐EES
Drug: Everolimus
Xience CoCr DP‐EES: clinical trials
SPIRIT I–IV
COMPARE I
EXAMINATION
EXCELLENT
EXECUTIVE
TWENTE
Promus PtCr DP‐EES: clinical trials. PLATINUM QCA
PLATINUM
PLATINUM small vessel and long lesions
DUTCH PEERS
HOST‐ASSURE
SCAAR
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 32. Bioresorbable‐polymer Everolimus‐eluting Stents
Introduction
Material properties and biomechanics of the platinum‐chromium alloy
Biocompatibility: surface characteristics and resistance to corrosion
Longitudinal stent deformation and the role of stent architecture
Drugs
Synergy EES. Platform
Polymer
Drug
Clinical trials. EVOLVE I
EVOLVE II
BIO‐RESORT TWENTE
SCAAR
Special groups. Elderly patients
Minority populations
Stent thrombosis
All comer trials
Meta‐analysis
Future perspectives
Evermine 50TM. Platform
Drug
Clinical trials
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 33. Zotarolimus‐Eluting Stents
Technical features
Clinical findings
All‐comers. Endeavor Resolute
Resolute Integrity
Resolute Onyx
High‐bleeding risk patients
STEMI
Challenging scenarios. Left main stem
Small coronary vessels
Chronic total occlusions
Diabetes mellitus
Gender perspective
ZES and dual antiplatelet therapy
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 34. The Biolimus Stent Family
Biolimus. Chemical features and properties
The Biosensor stent family
Clinical evidence
BioMatrix
Randomized studies
AXXESS
BioFreedom
The Nobori stent
Preclinical and pharmacokinetic studies
Clinical evidence (Table 34.3)
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 35. The Biotronik Stent Family
Cobalt chromium platform
Passive coating
PRO‐Kinetic Energy
Clinical evidence
Orsiro
Clinical evidence
BP‐SES Orsiso versus DP‐EES Xience
BP‐SES Orsiso versus DP‐ZES Resolute
BP‐SES Orsiso versus other BP or polymer free drug‐eluting stents
Absorbable metal scaffolds
Magnesium in bioresorbable devices
First‐generation magnesium absorbable vascular scaffold
New magnesium absorbable vascular scaffolds
PK Papyrus stent
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 36. Novel Drug‐Eluting Stent Systems
Metallic platforms. Metallic alloys
Stent and strut design
Delivery systems
Antiproliferative agents
Polymer coatings and alternative drug release technologies
Current durable polymer DES
Biodegradable polymers DES
Non‐polymeric DES (Polymer‐free DES)
Bioabsorbable vascular scaffolds
Future perspectives
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 37. Cardiac Vein Anatomy and Transcoronary Sinus Catheter Interventions in Myocardial Ischemia
Aims of transcoronary sinus interventions
Anatomy of cardiac veins
Pathophysiologic background of transcoronary sinus interventions. Microvasculature and salvage
Resynchronization therapy
Mitral annulus modifications
Regenerative potential of transcoronary sinus interventions
How to access jeopardized myocardium. Expertise necessary to use transcoronary sinus catheter interventions
Current transcoronary sinus catheter interventions in myocardial jeopardy PICSO
Banai stent
Retroinfusion (cells and gene therapy)
Conclusions and future directions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 38. Basics of Antiplatelet and Anticoagulant Therapy for Cardiovascular Disease
Role of platelets and coagulation factors in thrombus formation
Overview of antiplatelet agents for atherosclerotic diseases. Aspirin
P2Y12 ADP receptor antagonists
Glycoprotein IIb/IIIa inhibitors
Phosphodiesterase inhibitors
PAR‐1 antagonists
Other novel antiplatelet agents
Overview of anticoagulant agents for atherosclerotic diseases
Thrombin inhibitors. Indirect thrombin inhibitors
Direct thrombin inhibitors
Factor Xa inhibitors. Indirect factor Xa inhibitors
Direct factor Xa inhibitors
Other anticoagulants under clinical development
Conclusions
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 39. Oral Antiplatelet Agents in Percutaneous Coronary Intervention
Introduction
Platelet activation: pathophysiology and pharmacotherapeutic targets
Oral antiplatelet agents: pharmacology
Oral antiplatelet therapy and PCI
Aspirin (acetylsalicylic acid, ASA)
Thienopyridine P2Y12‐receptor antagonists. Ticlopidine
Clopidogrel
Optimization of clopidogrel therapy
Prasugrel
Non‐thienopyridine P2Y12 receptor antagonists. Ticagrelor
Other oral antiplatelet agents
Duration of dual antiplatelet therapy
Bleeding risk score and antiplatelet therapy
Other considerations
Clinical guidelines: oral antiplatelet therapy in PCI
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 40. Parenteral Anticoagulant Agents in PCI
Heparin. Structure and function
Guidelines recommendation
Dosing recommendation
Reversal
Limitations
Heparin‐induced thrombocytopenia
Low molecular weight heparin. Structure and function
Enoxaparin in PCI for stable coronary artery disease
Enoxaparin in PCI for non‐ST‐elevation acute coronary syndrome
Enoxaparin in primary PCI for ST‐elevation myocardial infarction
Dosing recommendations
Limitations of LMWH
Direct thrombin inhibitors
Bivalirudin in PCI for stable coronary artery disease
Bivalirudin in PCI for non‐ST‐elevation acute coronary syndrome
Bivalirudin in primary PCI for ST‐elevation myocardial infarction
Factor Xa inhibitors
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 41. Vasoactive and Antiarrhythmic Drugs During PCI
Introduction
Vasodilators during percutaneous coronary intervention
Vasodilators in the treatment of no‐reflow
Lesion‐directed delivery of therapeutic agents
Vasodilators in the treatment of arterial spasm
Pharmaceutical agents for coronary spasm provocation tests
Supersaturated and regular oxygen therapy
Antiarrhythmic drugs in percutaneous coronary intervention
Peri‐procedural sedation
Which drugs should be held before percutaneous coronary intervention
Vasopressors and inotropes during PCI
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 42. Triple Antiplatelet Therapy and Combinations with Oral Anticoagulants after Percutaneous Coronary Intervention
Introduction
Platelet activation and the pathophysiology of arterial thrombosis
Mechanisms of antithrombotic pharmacotherapy
Triple antiplatelet therapy (TAPT) following PCI. Phosphodiesterase‐3 (PDE‐3) inhibitors
Oral glycoprotein IIb/IIIa (GPIIb/IIIa) inhibitors
Antiplatelet combinations with oral anticoagulants (OACs) following PCI vitamin K antagonists (VKAs)
Non‐vitamin K antagonist oral anticoagulants (NOACs) Direct thrombin inhibitors
Direct Factor Xa Inhibitors
Achieving improved outcomes following PCI: a role for a third agent?
Triple antithrombotic therapy following PCI with prior indications for OAC. Vitamin K antagonists (VKAs)
Non‐vitamin K antagonist oral anticoagulants (NOACs)
Clinical guidelines: DAPT in combination with OAC in AF
Unanswered questions and future perspectives
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 43. Balance of Ischemia and Bleeding in Selecting Intensity and Duration of Antithrombotic Regimens
Introduction
Definitions of common ischemic and bleeding endpoints
Box 43.1 BARC definitions of bleeding
Prognostic impact of ischemic or bleeding events
Risk assessment tools for ischemic and bleeding events
Antithrombotic strategies to reduce ischemic and bleeding complications
Intensity of antithrombotic agents
Duration of dual antiplatelet therapy
Aspirin‐free strategies
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 44. Secondary Prevention of Atherosclerotic Cardiovascular Disease
Introduction
Lipid management
Statins
Non‐statins: Ezetimibe
Non‐statins: omega‐3‐fatty acids
Non‐statins: PCSK‐9 inhibitors
Blood pressure medications: β‐adrenergic blockers
RAAS inhibitors
Lifestyle management. Dietary guidelines
Influenza vaccination
Smoking cessation
Diabetes management
Hemoglobin A1c targets
SGLT2 inhibitors
GLP‐1 agonists & DPP4‐inhibitors
Future therapies
Conclusions
Interactive multiple-choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 45. Peri‐procedural Platelet Function Testing in Risk Stratification and Clinical Decision Making
Initial evidence for HPR to ADP as a risk factor
HPR cut‐off values defined by receiver operating characteristic curve analysis
Randomized trials of platelet function testing
Platelet function testing: bleeding saving focus
Relation between low on‐treatment platelet reactivity and bleeding: the therapeutic window concept
Relation of platelet reactivity to bleeding during surgery
HPR in patients with STEMI during prasugrel and ticagrelor therapy
Conclusions
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 46. Monitoring and Reversal of Anticoagulation and Antiplatelet Agents
Antiplatelet agents. Aspirin
Monitoring
Reversal
P2Y12 receptor blockers
Clopidogrel
Prasugrel
Ticagrelor
Cangrelor
Monitoring during P2Y12 inhibitors
Reversing P2Y12 antagonists
Glycoprotein (GP) IIb/IIIa inhibitors
Monitoring
Reversing GP IIb/IIIa inhibitors
Anticoagulants
Indirect thrombin inhibitors. Unfractionated heparin
Monitoring
Reversal
Low molecular weight heparin (enoxaparin)
Monitoring
Reversal
Pentasaccharides: Fondaparinux
Monitoring
Reversal
Direct thrombin inhibitors: bivalirudin, argatroban, dabigatran
Bivalirudin
Monitoring
Argatroban
Monitoring
Dabigatran
Monitoring
Reversal of direct thrombin inhibitors (bivalirudin, argatroban, dabigatran)
Vitamin K dependent oral anticoagulants
Non‐vitamin K Oral Anticoagulants (NOACs) Factor Xa inhibitors
Rivaroxaban
Apixaban
Edoxaban
Monitoring of NOACs
Reversal
Idarucizumab
Andexanet Alfa
Guidelines
Removal of antithrombotics by filtration
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. Disclosures
References
CHAPTER 47. Right Heart Catheterization and Pulmonary Hemodynamics
Balloon‐tipped pulmonary artery catheter (PAC)
Patient preparation, venous access, and technique
Pulmonary hemodynamics. Normal cardiac and pulmonary hemodynamics
Heart failure and low cardiac output
Left heart failure
Right heart failure
Pulmonary hypertension
Shunt diagnostics
Pharmacologic drug testing
Cardiac tamponade
Constrictive pericarditis
Permanent PA–pressure monitoring
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 48. Treatment of Pulmonary Embolism: Medical, Surgical, and Percutaneous
Risk stratification and patient selection
Therapies for acute PE
Medical therapy. Anticoagulation
Systemic thrombolysis
Surgical embolectomy
Catheter‐based therapies
Catheter‐directed thrombolysis
Ultrasound‐assisted thrombolysis
Suction embolectomy
Right ventricular assist device
Suction thrombectomy
Inari FlowTriever®
Rotatable pigtail catheter
Rheolytic thrombectomy (AngioJet)
Inferior vena cava filters
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 49. Renal Denervation for Resistant Hypertension
Resistant hypertension
Rationale of targeting the renal sympathetic nervous system
Surgical sympathetic denervation
Percutaneous denervation
Anatomy of the renal sympathetic nerves
Ablation catheter technology and the biophysics of ablation
Trial evidence
The procedure. Patient selection
Patient preparation
Vascular access and renal angiogram
Ablation
Complications
The future
Renal denervation beyond hypertension
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 50. Antithrombotic Strategies in Valvular and Structural Heart Disease Interventions
Rationale for antithrombotic therapy post‐TAVR. Cerebrovascular events
Bioprosthetic valve thrombosis
Bleeding post‐TAVR
Anti‐thrombotic strategies in the periprocedural period. Intraprocedural anticoagulation
Summary of guideline recommendations
Antiplatelet strategies
Anticoagulant strategies
Vitamin K antagonists
Non‐Vitamin K oral Anticoagulants (NOACs)
Anti‐thrombotic strategies in transcatheter‐based mitral, tricuspid, and pulmonic valve interventions. Transcatheter mitral valve implantation
Antithrombotic therapy in surgical MVR
Mechanisms of BVT post‐TMVR
Antithrombotic strategies following TMVR
Transcatheter tricuspid and pulmonic valve interventions
Conclusion
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 51. Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy
Introduction
Box 51.1 Common abbreviations for alcohol septal ablation
Selection of patients
Box 51.2 Criteria for selection of patients for alcohol septal ablation
Mechanisms of treatment efficacy
The technique. Assessment of outflow gradient
Placement and testing of the balloon catheter
Alcohol injection
Post‐procedural management
Treatment efficacy
Adverse events
Future directions
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 52. Left Atrial Appendage Exclusion
Indications for LAA exclusion. Endocardial devices
Epicardial devices
Endocardial devices: design and technical details. Watchman LAA occlusion device
Amplatzer cardiac plug
Other devices
Procedural aspects for implantation
Imaging
Transeptal access
LAA angiography
Sizing and positioning
Deployment
Confirmation and release
The Lariat system: a combined endocardial–epicardial approach
Post‐implantation consideration and follow‐up. Endocardial devices
Anticoagulation considerations
Other considerations
Epicardial devices (Lariat)
Anticoagulation considerations
Areas for future research
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 53. Cryptogenic Stroke, Patent Foramen Ovale, and ASD Closure
Types of ASD and PFO
Cryptogenic stroke and its relation to PFO
Atrial septal defect. Physiology
Indications for closure
ASD transcatheter closure: patient selection
Closure of ASD and PFO
Contraindications to ASD and PFO closure
Technique
Premedication
Imaging for ASD and PFO closure
Intracardiac echocardiography
ASD and PFO closure procedure
ASD sizing
ASD device selection
PFO device selection
Device delivery. Amplatzer Septal and Amplatzer PFO Occluder
Gore Cardioform Septal Occluer and Cardioform ASD Occluder
Completing the procedure
Adverse events
Aftercare
Future directions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 54. Paravalvular Leak Closure and Ventricular Septal Defect Closure
Transcatheter paravalvular leak closure
Pathophysiology
Clinical features
Diagnostic evaluation. Laboratory findings
Imaging
Localization
Transcatheter paravalvular regurgitation occlusion. Indications
Devices
Techniques. Aortic transcatheter paravalvular regurgitation occlusion
Mitral transcatheter paravalvular regurgitation occlusion
Complications
Follow‐up
Conclusions
Transcatheter VSD closure
Procedural techniques
VSD closure
Hybrid delivery
Complications
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 55. Aortic Valvuloplasty and Large‐Bore Percutaneous Arterial Access
Basic principles and mechanisms of action
Indications and evidence for use
Patient selection and contraindications to BAV
Box 55.1 Adverse prognostic indicators for balloon aortic valvuloplasty
Approach to the procedure
Pre‐access considerations
Large‐bore arterial access
Access planning
Box 55.2 Recommendations for use of CTA in TAVR access planning
Sheath selection
Pre‐closure
Pre‐closure Technique Steps
Contralateral safety wire
Performing balloon aortic valvuloplasty
Anticoagulation during BAV
Crossing the aortic valve
Wires
BAV balloons
Pacing
Procedural conclusion
Arteriotomy closure and troubleshooting
Complications of BAV and their management
Box 55.3 Vascular access site and access‐related complications
Conclusions, recommendations, and future directions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 56. Balloon‐expandable Transcatheter Aortic Valve Replacement
The Edwards Sapien valve system. System description: Frame and leaflet composition and design
Delivery and deployment
Implantation technique
Non‐femoral approaches
Iterations
Outcomes
The MyVal Valve System. System description: Frame and leaflet composition and design
Delivery and deployment
Outcomes
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 57. Self‐Expanding Transcatheter Aortic Valve Replacement and Cerebral Embolic Protection
Introduction
Evolut R/PRO/PRO+
Major trials
Latest valve
Procedural planning
ACURATE neo(2) valve system
Major trials
Latest valve
Procedural planning
Portico valve
Major trials
Latest valve
Procedural planning
JenaValve/J Valve
Cerebral embolic protection
Conclusions
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 58. Leaflet Modification Technologies
KEY POINTS
Introduction
Leaflet modification for aortic valve interventions
Evaluation of risk coronary obstruction during transcatheter aortic valve replacement
Bioprosthetic or native aortic scallop intentional laceration to prevent coronary artery obstruction (BASILICA) intervention
Leaflet modification for transcatheter mitral valve replacement
Evaluation of risk for left ventricular outflow obstruction
Valve‐in‐valve transcatheter mitral valve replacement
Valve‐in‐ring and valve‐in‐MAC transcatheter mitral valve replacement
Leaflet modification in patients with prior MitraClip
Conclusions
Disclosures
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 59. Peri‐procedural Complications of TranscatheterAortic Valve Replacement (TAVR)
Introduction
Paravalvular leak
Preventing paravalvular leak
How to assess paravalvular leak
Management of paravalvular leak
Annular rupture
Management of annular rupture
Minimizing the risk of annular rupture
Aortic and ventricular injuries
Transcatheter valve embolization
How to minimize the risk of transcatheter valve embolization
Management of transcatheter valve embolization
Coronary obstruction
Management of coronary obstruction
Planning for high‐risk coronary obstruction
Stroke
Acute cerebrovascular events: < 24 hours
Late cerebrovascular events: 24 hours – 30 days
Pacemaker implantation
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 60. Intensive Care after Transcatheter Aortic Valve Replacement
Overview of the TAVR patient population
Objectives of intensive care after TAVR
Transition to intensive care: hand‐over
Structure of post‐TAVR care
Acute hemodynamic changes and disorders of blood pressure
Hypotension
Hypertension
Acute anemia and bleeding
Vascular complications
Stroke
Conduction abnormalities
Atrial fibrillation
Acute kidney injury
Hematologic abnormalities
Mobilization and progression of care
Future directions for post‐TAVR intensive care
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 61. New Aortic Valve Technologies
SAPIEN 3 UltraTM
Evolut PROTM
ACURATE neo THV
Portico
Allegra THV
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 62. Principles of Carpentier’s Reconstructive Surgery in Degenerative Mitral Valve Disease
Pathophysiology and functional classification
Application of pathophysiologic triad in patients with degenerative mitral valve disease
Barlow’s disease
Fibroelastic deficiency
Marfan’s disease
Surgical indications
Principles of mitral valve surgery. Perioperative management
Surgical incisions and cardiopulmonary bypass
Mitral valve exposure and intraoperative valve analysis
Fundamentals of mitral valve reconstructive surgery
Posterior leaflet prolapse
Anterior leaflet prolapse
Triangular resection
Chordae transposition
Papillary muscle sliding plasty
Papillary muscle shortening
Commissural prolapse
Remodeling ring annuloplasty
Saline test and post bypass TEE
Results
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 63. Transseptal Puncture
Introduction
Embryology and anatomy of interatrial septum:
Training
Echocardiographic guidance
Box 63.1 Indications for transseptal puncture during interventional procedures
Know your equipment. Sheaths
Puncture needles
Brockenbrough / BRK needle
Radiofrequency needle (Baylis system)
Versacross system (Baylis system)
Wires
For challenging anatomies
Transseptal Puncture procedure:
Transseptal Puncture using fluoroscopy and TEE:
Specificities in transseptal puncture
Subsequent interventional procedures
Complications
Contraindications
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 64.1. Transcatheter Mitral Valve Repair: MitraClip and Emerging Technologies
Introduction
MitraClip system (Abbot, Santa Clara, CA, USA)
Anatomic caveats and eligibility criteria
Mitral valve edge‐to‐edge repair
Complications
Primary (Degenerative) MR
Secondary (Functional) MR
Emerging technologies for the percutaneous treatment mitral valve disease
Edge to edge repair
Coaptation enhancement
Annuloplasty
Chamber remodeling
Chordal replacement
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 64.2 Transcatheter Mitral Valve Replacement
Introduction
General principles and challenges with TMVR
Preprocedural evaluation and imaging‐based procedural guidance
Transcatheter mitral valve‐in‐valve and valve‐in‐ring replacement
Treatment of native mitral valve regurgitation
Evoque
Tendyne
Intrepid
SAPIEN M3
Transcatheter mitral valve‐in‐MAC replacement
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 65. Balloon Mitral Valvuloplasty
Anatomic considerations
Balloon mitral valvuloplasty. Historical aspect
Indications and recommendations for percutaneous balloon mitral valvuloplasty
Class I recommendations
Class IIa recommendations
Class IIb recommendations
Contraindications
Peri‐procedural care. Preprocedural planning
Role of echocardiography in BMV: valve assessment and case selection
Box 65.1 Role of two‐dimensional Doppler echocardiography in the evaluation of patients undergoing balloon mitral valvotomy
Patient preparation
Techniques. Approach
Choice of technique. Double‐balloon technique
Multitrack technique
Metallic commissurotomy
Inoue balloon technique
Vascular access
Transseptal puncture
The procedural technique (see Video 65.1)
Box 65.2 Steps of septal puncture
Dilatation of interatrial septal puncture site
Selection of balloon catheter
Crossing the mitral valve
Box 65.3 Definition of successful balloon mitral valvuloplasty
BMV in difficult scenarios. BMV in LA/LAA clot
BMV in giant left atrium/interatrial septal aneurysm
BMV in severe subvalvular disease
BMV in IVC interruption/IVC anomalies through IJV approach
BMV in juvenile mitral stenosis
BMV in pregnancy
Complications of BMV
Pericardial effusion and tamponade
Acute mitral regurgitation
Stroke and embolism
Residual atrial septal defect
Results of BMV. Immediate results
Long‐term results
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 66. Transcatheter Tricuspid Valve Repair and Replacement
Percutaneous tricuspid valve edge‐to‐edge repair using a clip system
Edge‐to‐edge repair using the Mitraclip™ and TriClip™ device
Edge‐to‐edge repair using the PASCAL™ device
Transcatheter tricuspid annuloplasty. Transcatheter tricuspid ring annuloplasty
Transcatheter tricuspid suture annuloplasty
Transcatheter valve replacement for severe TR
The NaviGate™ valve‐stent system
The EVOQUE Tricuspid Valve Replacement System
The LUX Valve®
Transcatheter tricuspid valve‐in‐ring or valve‐in‐valve replacement
Heterotopic caval valve implantation (CAVI)
Anatomical and clinical patient selection
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 67. Transcatheter Pulmonary Valve Replacement
Introduction
Established approaches. Right ventricular to pulmonary artery conduits
Bioprosthetic valves
Native RVOT
Evolving approaches
Imaging and modeling
Future potentials
Summary
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 68. Imaging for Planning and Guidance for Structural Heart Interventions
Introduction
Transcatheter aortic valve replacement
Percutaneous mitral valve repair
Transcatheter mitral valve replacement
Atrial septal defects/patent foramen ovale closure
Transcatheter tricuspid interventions
Pericardiocentesis
Conclusions
Interactive multiple‐choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 69. Percutaneous Ventricular Assist Devices
Introduction
Left‐sided options
Right‐sided options
Guideline recommendations
Summary
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 70. Implantable Hemodynamic Monitoring Systems
Introduction
Current heart failure monitoring limitations
Implantable remote hemodynamic monitoring. The chronicle right ventricular pressure monitoring system
The CardioMEMS PAP Monitoring System
CardioMEMS Implant Procedure
Other PAP monitoring systems
LAP monitoring systems
Practice guidelines
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 71. Acute Stroke Intervention
Acute stroke therapy: Background and evidence
Clinical exam
Imaging
Laboratory tests
Cerebral angiography
Intervention (Example of an acute middle cerebral artery occlusion intervention illustrated in Videos 71.1–10 and Figure 71.1–7)
What is a successful angiographic result?
The challenge of tandem occlusions
Distal cerebral vessel occlusions
Posterior circulation and basilar artery occlusions
Variations in thrombectomy techniques
Performance of the procedure with or without general anesthesia
Complications
Interventional cardiologists treating acute ischemic strokes with mechanical thrombectomy
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 72. Carotid Artery Angioplasty and Stenting
Introduction
Evolution of carotid angioplasty and stenting
Overview of clinical trials regarding carotid angioplasty and stenting
Current practice guidelines/patient selection
What constitutes high risk?
Anatomic considerations
Overview of technique
Intervention with distal filter
Intervention with flow reversal (Mo.MA)
Transcarotid Artery Revascularization (TCAR)
Comparison of different methods of embolic protection
Complications after CAS
Neurologic complications
Myocardial infarction
Access site complications
Stent design
Emerging literature
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 73. Cerebral Aneurysms: Diagnosis, Indications, and Strategies for Endovascular Treatment
Introduction
Diagnosis. Ruptured aneurysms
Elective aneurysms
Indications for endovascular treatment. Ruptured aneurysms
Elective aneurysms. Incidental aneurysms <7 mm in the anterior circulation
Incidental aneurysms >7 mm in the anterior and all sizes in the posterior circulation
Coincidental aneurysms
Symptomatic aneurysms
Historical background
General considerations
Tools
Ruptured aneurysms
Elective aneurysms
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 74. Management of Acute Aortic Syndromes
Aortic dissection. Historical background
Epidemiology
Presentation and diagnosis
Classification. Anatomic
Chronicity
Management – Type A aortic dissection
Management – Type B aortic dissection
Determination of acuity of type B aortic dissection. Uncomplicated
High‐risk
Complicated
Intervention
Pre‐operative considerations
Intra‐operative considerations
Complications
Outcomes
Penetrating aortic ulcer
Intramural hematoma
Aortic transection
Case Study
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 75. Thoracic Endovascular Aortic Repair
Introduction
Etiology
Indications for repair. Thoracic aortic aneurysm
Type B aortic dissection
Uncomplicated type B aortic dissections
TEVAR devices
Operative planning. Anatomy
Proximal seal
Access vessels
Aortic arch anatomy
Distal seal zone
Imaging and sizing
Technical considerations. Left subclavian artery revascularization
Spinal cord ischemia
Operative details. Technique
Post operative management and follow up
Evidence to support TEVAR
Future direction
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 76. Endovascular Aortic Aneurysm Repair
Background/history
Measurements
Etiology
Indications
Ruptured AAA
Diagnostic imaging
Ultrasonography
Computed tomography
Magnetic Resonance Imaging
Conventional angiography
Anatomic requirements
Endoleak
Evidence
Case study
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 77. Fenestrated and Branched Endografts
Introduction
Evidence to support use
Imaging and preoperative planning
Devices. Custom‐made fenestrated grafts
Off the shelf
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 78. Acute and Chronic Mesenteric Ischemia
Introduction
Acute mesenteric ischemia
Chronic mesenteric ischemia
Technical considerations
Post‐procedure follow‐up
Complications
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 79. Renal Artery Interventions
Renal artery stenosis
Natural history and clinical outcomes
Indications for screening
Class I indications:
Diagnosis
Duplex ultrasonography
Computed tomographic angiography
Magnetic resonance angiography
Catheter angiography
Translesional pressure gradient, pressure ratio of distal renal artery to aorta, and renal fractional flow reserve
Treatment options for ARAS
Stenting in specific populations with ARAS
Medical therapy of ARAS
Indications for endovascular intervention (revascularization)
Contraindications for endovascular intervention
Technical aspects of renal endovascular intervention for renal artery stenosis
Arterial access
Renal artery angiography
Engagement of guide catheter
Percutaneous renal transluminal angioplasty
Percutaneous renal stenting
Stenting other types of renal artery stenosis
Distal protection devices to prevent atheroembolization
Peri‐interventional care
Complications and management
In‐stent restenosis and management
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 80. Endovascular Interventions for the Pelvis
Introduction
Uterine artery embolization
Uterine arterial anatomy
Traditional standard of care
Endovascular approach: uterine artery embolization
UAE technique
Prostatic artery embolization
Prostate arterial anatomy
Traditional standard of care
Endovascular approach: prostatic artery embolization
PAE technique
Penile revascularization
Penile arterial anatomy
Traditional standard of care
Endovascular approach: penile arterial revascularization
Penile revascularization technique
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 81. Iliac Interventions
Clinical presentation and diagnosis
Percutaneous intervention
Aorto‐iliac stenoses
Chronic totally occlusive lesions
Stent selection: self‐expandable and balloon expandable; covered and uncovered
Bifurcation lesions
Predictive factors
Complications
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 82. Superficial Femoral Artery Interventions
Treatment of patients with PAD
Endovascular treatment. Pharmacology
Access for intervention
Lesion crossing
Contemporary endovascular treatment
Lesion modification/vessel preparation
Orbital atherectomy (OA)
Rotational atherectomy
Directional atherectomy
Peripheral intravascular lithotripsy
Balloon angioplasty, bare metal stent
Drug‐eluting stents/balloons
Excimer laser
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 83. Popliteal Artery Interventions
Interventions for popliteal artery disease
Balloon angioplasty
Stenting
Adjunctive endovascular technologies
Atherectomy
Popliteal artery aneurysms
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 84. Below the Knee Interventions in Critical Limb Ischemia
Background
Box 84.1 Features of critical limb ischemia [3]
Evaluation of the lower extremity arterial system
Box 84.2 Indications and contraindications of endovascular management for below‐the‐knee arterial occlusive disease [7]
Approach to BTK intervention
Box 84.3 Transatlantic Inter‐Society Consensus (TASC) classification of morphologic stratification of below the knee lesions
Box 84.4 Recommendations for critical limb ischemia: endovascular and open surgical treatment for limb salvage [11]
Endovascular management of below the knee critical limb ischemia
Percutaneous transluminal angioplasty
PTA access
Box 84.5 Summary of percutaneous transluminal angioplasty (PTA) access methods
Pedal access technique
Ultrasound guided
Fluoroscopy guided
Access site procedure
Access site hemostasis
Modified angioplasty techniques
Stents
Bare metal stents
Drug‐eluting stents
Drug‐coated balloons
Cryoplasty, peripheral cutting balloon, and AngioSculpt Scoring Balloon
Cryoplasty
Peripheral cutting balloon
AngioSculpt Scoring Balloon
Atherectomy
Excisional atherectomy
Excimer laser‐assisted angioplasty
Rotational atherectomy with aspiration
Orbital atherectomy
Complications of endovascular procedures
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 85. Subclavian, Vertebral, and Upper Extremity Vascular Disease
Subclavian and upper extremity arterial disease. Epidemiology
Causes of subclavian and upper extremity arterial disease. Atherosclerosis
Takayasu’s arteritis and giant cell arteritis
Thoracic outlet syndrome
Radiation
Buerger’s Disease (thromboangiitis obliterans)
Diagnostic evaluation. History and physical examination
Non‐invasive and invasive studies
Maneuvers for the thoracic outlet syndrome
Duplex ultrasonography
Computer tomography and magnetic resonance angiography
Catheter‐based angiography
Treatment. Medical management
Surgical management
Endovascular management
Vertebral artery disease. Epidemiology and clinical presentation
Treatment
Endovascular technique
Vertebral artery trauma and dissection
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 86. Antithrombotic Strategies in Endovascular Interventions: Current Status and Future Directions
Pathophysiology
Aspirin
Ticlopidine
Clopidogrel
Other ADP receptor antagonists
Dipyridamole
Vorapaxar
Low molecular weight heparins
Glycoprotein IIb/IIIa receptor antagonists
Vitamin K antagonist
Cilostazol
Bivalirudin
Direct Oral Anticoagulant Agents (DOACs)
Conclusions
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
CHAPTER 87. Chronic Venous Insufficiency
Introduction
Predisposing factors. Age and gender
Pregnancy
Hereditary
Lifestyle
Body habitus
Pathogenesis
Venous stasis
Venous hypertension
Fibrin cuff
Water hammer effect
Leukocyte trapping
Clinical manifestations
Box 87.1 Advanced CEAP classification
QOL and economic impact
Diagnosis
Physical examination
Duplex imaging
Plethysmography
Computed tomography and magnetic resonance venography
Treatment. Initial treatment: behavioral measures and compression garments
Failure of conservative therapy
Non‐invasive study: venous reflux disease. Superficial venous reflux
Cool‐touch laser
Radiofrequency ablation (RFA) therapy
Endovenous chemical adhesive therapy
Venous sclerotherapy
Ligation and venous phlebectomy
Deep venous reflux. Valve reconstruction surgery and valvuloplasty
Perforator reflux. Subfascial endoscopic perforator surgery
Non‐invasive study: chronic venous flow obstruction. May–Thurner syndrome
Chronic axillary–subclavian vein thrombosis or Paget–Schroetter syndrome
Non‐invasive study: muscle pump dysfunction
Chronic Venous Insufficiency with Venous Ulceration
Interactive multiple choice questions are available for this chapter on www.wiley.com/go/dangas/cardiology. References
Index
WILEY END USER LICENSE AGREEMENT
