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2. Abstracts

Author

Doulaptsis, C, Masci, PG, Goetschalckx, K, Janssens, S, Bogaert, J, Ferreira, VM, Piechnik, SK, DallArmellina, E, Karamitsos, TD, Francis, JM, Ntusi, N, Holloway, C, Choudhury, RP, Kardos, A, Robson, MD, Friedrich, MG, Neubauer, S, Miszalski-Jamka, T, Sokolowska, B, Szczeklik, W, Karwat, K, Miszalski-Jamka, K, Belzak, K, Malek, L, Mazur, W, Kereiakes, DJ, Jazwiec, P, Musial, J, Pedrotti, P, Masciocco, G, DAngelo, L, Milazzo, A, Quattrocchi, G, Zanotti, F, Frigerio, M, Roghi, A, Rimoldi, O, Kaasalainen, T, Kivistö, S, Holmström, M, Pakarinen, S, Hänninen, H, Sipilä, O, Lauerma, K, Banypersad, S.M, Fontana, M, Maestrini, V, Sado, D.M, Pinney, J, Wechalekar, A.D, Gillmore, J.D, Lachmann, H, Hawkins, P.N, Moon, J.C, Barone-Rochette, G, Pierard, S, Seldrum, S, de Ravensteen, CM, Melchior, J, Maes, F, Pouleur, A-C, Vancraeynest, D, Pasquet, A, Vanoverschelde, J-L, L Gerber, B, Captur, G, Muthurangu, V, Flett, AS, Wilson, R, Barison, A, Anderson, S, Cook, C, Sado, DM, McKenna, WJ, Mohun, TJ, Elliott, PM, Moon, JC, Pepe, A, Meloni, A, Gulino, L, Rossi, G, Paci, C, Spasisno, A, keilberg, P, Restaino, G, Resta, MC, Positano, V, lombardi, M, Reiter, U, Reiter, G, Kovacs, G, Schmidt, A, Olschewski, H, Fuchsjäger, M, Macmillan, A, Dabir, D, Rogers, T, Monaghan, M, Nagel, E, Puntmann, V, Semaan, E, Spottiswoode, B, Freed, B, Carr, M, Wasielewski, M, Fortney-Campione, K, Shah, S, Carr, J, Markl, M, Collins, J, Sung, YM, Hinojar, R, Ucar, EA, Dabir, D, Voigt, T, Gaddum, N, Schaeffter, T, Nagel, E, Puntmann, VO, Dabir, D, Rogers, T, Ucar, EA, Kidambi, A, Plein, S, Gebker, R, Schnackenburg, B, Voigt, T, Schaeffter, T, Nagel, E, Puntmann, VO, McAlindon, E, Bucciarelli-Ducci, C, Sado, D, Maestrini, V, Piechnik, S, Porter, J, Yamamura, J, Fischer, R, Moon, J, Symons, R, Doulaptsis, C, Masci, P.G, Goetschalckx, K, Dymarkowski, S, Janssens, S, Bogaert, J, Yalin, K, Golcuk, E, Ozer, CS, Buyukbayrak, H, Yilmaz, R, Dursun, M, Bilge, AK, Adalet, K, Reinstadler, SJ, Klug, G, Feistritzer, HJ, Mayr, A, Harrasser, B, Krauter, L, Mair, J, Schocke, MF, Pachinger, O, Metzler, B, Rigolli, M, To, A, Edwards, C, Ding, P, Christiansen, J, Rodríguez-Palomares, JF, Ortiz, JT, Bucciarelli, C, Lee, D, Wu, E, Bonow, RO, Karwat, K, Tomala, M, Miszalski-Jamka, K, Licholaj, S, Mazur, W, Kereiakes, DJ, Nessler, J, Zmudka, K, Jazwiec, P, Miszalski-Jamka, T, Peltonen, J, Kaasalainen, T, Kivistö, S, Holmström, M, Lauerma, K, Rutz, T, Meierhofer, C, Martinoff, S, Ewert, P, Hess, J, Stern, H, Fratz, S, Groarke, JD, Waller, AH, Blankstein, R, Kwong, RY, Steigner, M, Alizadeh, Z, Alizadeh, A, Khajali, Z, Mohammadzadeh, A, Kaykhavani, A, Heidarali, M, Singh, A, Bekele, S, Gunarathne, A, Khan, J, Nazir, SN, Steadman, CD, Kanagala, P, Horsfield, MA, McCann, GP, Duncan, RF, Dundon, BK, Nelson, AJ, Williams, K, Carbone, A, Worthley, MI, Zaman, A, Worthley, SG, Monney, P, Piccini, D, Rutz, T, Vincenti, G, Koestner, S, Stuber, M, Schwitter, J, Gripari, P, Maffessanti, F, Pontone, G, Andreini, D, Bertella, E, Mushtaq, S, Caiani, EG, Pepi, M, El ghannudi, S, Nghiem, A, Germain, P, Jeung, M-J, Roy, C, Gangi, A, Nucifora, G, Muser, D, Masci, PG, Barison, A, Piccoli, G, Rebellato, L, Puppato, M, Gasparini, D, Lombardi, M, Proclemer, A, Nucifora, G, Muser, D, Masci, PG, Barison, A, Piccoli, G, Rebellato, L, Puppato, M, Gasparini, D, Lombardi, M, Proclemer, A, Pöyhönen, P, Kivistö, S, Holmströn, M, Hänninen, H, Thorning, C, Bickelhaupt, S, Kampmann, C, Wentz, KU, Widmer, U, Juli, CF, Miszalski-Jamka, K, Klys, J, Glowacki, J, Kijas, M, Miszalski-Jamka, T, Adamczyk, T, Kwiecinski, R, Bogucka-Czapska, J, Ozaist, M, Mazur, W, Kluczewska, E, Kalarus, Z, Kukulski, T, Karakus, G, Marzluf, B, Bonderman, D, Tufaro, C, Pfaffenberger, S, Babyev, J, Maurer, G, Mascherbauer, J, Kockova, R, Tintera, J, Kautznerova, D, Cerna, D, Sedlacek, K, Kryze, L, El-Husseini, W, Sikula, V, Segetova, M, Kautzner, J, Vasconcelos, M, Lebreiro, A, Martins, E, Cardoso, JS, Madureira, AJ, Ramos, I, Maciel, MJ, Florian, A, Ludwig, A, Rösch, S, Sechtem, U, Yilmaz, A, Monmeneu, J.V, López-Lereu, M.P, Bonanad, C, Sanchis, J, Chaustre, F, Merlos, P, Valero, E, Bodí, V, Chorro, F.J, Yalin, K, Golcuk, E, Ozer, CS, Buyukbayrak, H, Yilmaz, R, Dursun, M, Bilge, AK, Adalet, K, Klug, G, Reinstadler, SJ, Feistritzer, HJ, Mayr, A, Riegler, N, Schocke, M, Esterhammer, R, Kremser, C, Pachinger, O, Metzler, B, Siddiqi, N, Cameron, D, Neil, C, Jagpal, B, Singh, S, Schwarz, K, Papadopoulou, S, Frenneaux, MP, Dawson, D, Robbers, LFHJ, Eerenberg, ES, Teunissen, PFA, Jansen, MF, Hollander, MR, Horrevoets, AJG, Knaapen, P, Nijveldt, R, Levi, MM, van Rossum, AC, Niessen, HWM, Marcu, CB, Beek, AM, van Royen, N, Everaars, H, Robbers, LFHJ, Nijveldt, R, Beek, AM, Teunissen, PFA, Hirsch, A, van Royen, N, Zijlstra, F, Piek, JJ, van Rossum, AC, Goitein, O, Grupper, A, Hamdan, A, Eshet, Y, Beigel, R, Medvedofsky, D, Herscovici, R, Konen, E, Hod, H, Matetzky, S, Cadenas, R, Iniesta, AM, Refoyo, E, Antorrena, I, Guzman, G, Cuesta, E, Salvador, O, López, T, Moreno, M, López-Sendon, JL, Alam, SR, Spath, N, Richards, J, Dweck, M, Shah, A, Lang, N, Semple, S, MacGillivray, T, Mckillop, G, Mirsadraee, S, Pessotto, R, Zamvar, V, Newby, DE, Henriksen, P, Reiter, G, Reiter, U, Kovacs, G, Olschewski, H, Fuchsjäger, M, Ahmad, S, Raza, U, Malik, A, Sun, JP, Eisner, R, Mazur, W, ODonnell, R, Positano, V, Meloni, A, Santarelli, MF, Landini, L, Tassi, C, Grimaldi, S, Gulino, L, De Marchi, D, Chiodi, E, Renne, S, Lombardi, M, Pepe, A, Wu, L, Germans, T, Güçlü, A, Allaart, CP, van Rossum, AC, Kalisz, K, Lehenbauer, K, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, M-P, Freed, B, Shah, S, Markl, M, Flukiger, J, Carr, J, Collins, J, Osiak, A, Tyrankiewicz, U, Jablonska, M, Jasinski, K, Jochym, PT, Chlopicki), S, Skorka, T, Kalisz, K, Semaan, E, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, MP, Freed, B, Flukiger, J, Lee, D, Kansal, P, Shah, S, Markl, M, Carr, J, Collins, J, Groarke, JD, Shah, RV, Waller, AH, Abbasi, SA, Kwong, RY, Blankstein, R, Steigner, M, Chin, CWL, Semple, S, Malley, T, White, A, Prasad, S, Newby, DE, Dweck, M, Pepe, A, Meloni, A, Lai, ME, Vaquer, S, Gulino, L, De Marchi, D, Cuccia, L, Midiri, M, Vallone, A, Positano, V, Lombardi, M, Pedrotti, P, Milazzo, A, Quattrocchi, G, Roghi, A, Rimoldi, O, Barison, A, De Marchi, D, Masci, P, Milanesi, M, Aquaro, GD, Keilberg, P, Positano, V, Lombardi, M, Positano, Vincenzo, Barison, Andrea, Pugliese, Nicola Riccardo, Masci, Piergiorgio, Del Franco, Annamaria, Aquaro, Giovanni Donato, Landini, Luigi, Lombardi, Massimo, Dieringer, MA, Deimling, M, Fuchs, K, Winter, L, Kraus, O, Knobelsdorff-Brenkenhoff, FV, Schulz-Menger, J, Niendorf, T, Hinojar, R, Ucar, EA, DCruz, D, Sangle, S, Dabir, D, Voigt, T, Gaddum, N, Schaeffter, T, Nagel, E, Puntmann, VO, Sung, YM, Pontone, G, Andreini, D, Bertella, E, Mushtaq, S, Gripari, P, Cortinovis, S, Loguercio, M, Baggiano, A, Conte, E, Pepi, M, El ghannudi, S, Hop, O, Germain, P, Jeung, M-J, De Cesare, A, Roy, C, Gangi, A, Barone-Rochette, G, Pierard, S, Seldrum, S, De Meester de Ravensteen, C, Melchior, J, Maes, F, Pouleur, A-C, Vancraeynest, D, Pasquet, A, Vanoverschelde, J-L, L Gerber, B, Bekele, S, Singh, A, Khan, JN, Nazir, SA, Kanagala, P, McCann, GP, Singh, A, Steadman, CD, Bekele, S, Khan, JN, Nazir, SA, Kanagala, P, McCann, GP, Paelinck, BP, Vandendriessche, T, De Bock, D, De Maeyer, C, Parizel, PM, Christiaan, J, Trauzeddel, RF, Gelsinger, C, Butter, C, Barker, A, Markl, M, Schulz-Menger, J, von Knobelsdorff, F, Florian, A, Schäufele, T, Ludwig, A, Rösch, S, Wenzelburger, I, Yilmaz, A, Sechtem, U, López-Lereu, M.P, Bonanad, C, Monmeneu, J.V, Sanchís, J, Estornell, J, Igual, B, Maceira, A, Chorro, F.J, Focardi, M, Cameli, M, Bennati, E, Massoni, A, Solari, M, Carbone, F, Banchi, B, Mondillo, S, Miia, H, Kirsi, L, Helena, H, Tiina, H, Jyri, L, Pauli, P, Sari, K, Schumm, J, Greulich, S, Grün, S, Ong, P, Klingel, K, Kandolf, R, Sechtem, U, Mahrholdt, H, Raimondi, F, Ou, P, Boudjemline, Y, Bajolle, F, Iserin, F, Bonnet, D, Collins, J, Kalisz, K, Benefield, B, Sarnari, R, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, M-P, Freed, B, Flukiger, J, Kansal, P, Lee, D, Shah, S, Markl, M, Carr, J, Sokolowska, B, Miszalski-Jamka, T, Szczeklik, W, Karwat, K, Miszalski-Jamka, K, Belzak, K, Mazur, W, Kereiakes, DJ, Jazwiec, P, Musial, J, Silva, G, Almeida, AG, Resende, C, Marques, JS, Silva, D, David, C, Amaro, C, Costa, P, Silva, JAP, Diogo, AN, Tsokolov, AV, Senchilo, VG, Vertelkin, AV, Hoffmann, P, Mykjåland, G, Wangberg, H, Tønnessen, T, Sjaastad, I, Nordsletten, L, Hjørnholm, U, Løset, A, Rostrup, M, Meloni, A, Gulino, L, Keilberg, P, Palazzi, G, Maddaloni, D, Ascioti, C, Missere, M, Salvatori, C, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Filosa, A, Gulino, L, Pulini, S, Salvatori, C, Chiodi, E, Ascioti, C, Keilberg, P, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Gulino, L, Pietrapertosa, A, Izzi, G, De Marchi, D, Valeri, G, Preziosi, P, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Ruffo, GB, Keilberg, P, Gulino, L, Gerardi, C, Sallustio, G, Tudisca, C, Positano, V, Lombardi, M, Pepe, A, Greulich, S, Backes, M, Schumm, J, Grün, S, Sechtem, U, Mahrholdt, H, Dorniak, K, MSc, AS, Szurowska, E, Fijalkowski, M, Rawicz-Zegrzda, D, Dudziak, M, Raczak, G, Hamdan, A, Baker, FA, Klein, M, Di Segni, E, Goitein, O, Fibisch, G, Konen, E, Müller-Bierl, B, Tanaka, K, Buls, N, Fierens, Y, van Cauteren, T, Willekens, I, van Laere, S, Luypaert, R, de Mey, J, Muzzarelli, S, Faragasso, E, Pedrazzini, G, Sürder, D, Pasotti, E, Moccetti, T, Faletra, F, Qayyum, AA, Hasbak, P, Larsson, HB, Mathiasen, AB, Vejlstrup, NG, Kjaer, A, Kastrup, J, Moschetti, K, Favre, D, Pinget, C, Pilz, G, Petersen, S, Wagner, A, Wasserfallen, JB, Schwitter, J, Ghosh Dastidar, A, Cengarle, M, McAlindon, E, Augustine, D, Nightingale, AK, Bucciarelli-Ducci, C, Dandekar, VK, Ertel, AW, Dickens, C, Gonzalez, RC, Farzaneh-Far, A, Ripley, DP, Higgins, D, McDiarmid, AK, Bainbridge, GJ, Uddin, A, Kidambi, A, Herzog, B, Greenwood, JP, Plein, S, Khanji, M, Newton, T, Westwood, M, Sekhri, N, and Petersen, SE

Abstract

Background-Aims: Early post-infarction pericardial injury is a common finding but its diagnosis remains elusive. Though C-reactive protein (CRP) is considered a marker of myocardial damage, reflecting myocardial inflammation at the infarcted area, we sought to assess the relationship between CRP and pericardial injury depicted by cardiovascular magnetic resonance (CMR) imaging in patients with ST elevation myocardial infarction (MI). Methods and results: 181 MI patients (84% male) were studied with CMR in the first week and at 4 months post-infarction to assess infarct characteristics, left ventricular volumes/function and pericardial injury. The latter was defined as pericardial fluid >4mm and/or enhancement on late gadolinium enhancement CMR. The CRP-value at day 2 (according to previous literature) was used for correlation with CMR and clinical parameters. Pericardial injury was noted in 87 patients, i.e. effusion (n = 30), inflammation (n = 46), both (n = 11). Patients with pericardial injury had significantly higher peak values of cardiac biomarkers (p<0.001) and higher peak CRP-values than patients with normal pericardium (median 13 vs 43 mg/dl, p<0.001). A strong correlation was found between peak CRP-values and a) left venticular ejection fraction and infarct size both at 1 week and 4 months, b) myocardial hemorrhage, microvascular obstruction (MVO) and pericardial injury at 1 week, c) cardiac biomarkers values and time to PCI. However in a multiple regression model only pericardial injury (p = 0.003) and less importantly time to PCI (p = 0.022) were the independent predictors of CRP values. Conclusion: Pericardial damage described by cardiac MRI occurs often after acute ST elevation MI. CRP-values at the acute phase of MI reflect not only inflammation at the infarcted area but even more the inflammation of the surrounding pericardial tissue. Table 1 Comparison of baseline clinical and biochemical parameters of patients with or without evidence of early post-infarct pericardial damage on CMR Normal Group (n = 94)Pericardial injury group (n = 87)p-valueAgem, years59±1160±120.48Male, n(%)83 (88)69 (79)0.10Diabets, n(%)12 (13)9 (10)0.61Smoker, n(%)52 (55)44 (51)0.52Hyperlipidemia, n(%)56 (60)55 (63)0.62BSA m22.0 ± 0.22.0 ± 0.20.20Time to PCI, min195 (155 − 274)223 (160 − 335)0.20Troponin I, μ/l44 (19 − 92)90 (44 − 149)>0.001CK-MB, U/L128 (77 − 216)250 (143 − 443)>0.001CRP, mg/dL13 (7 − 28)43 (16 − 96)>0.001Day of peak CRP2 (1 − 3)2 (1 − 3)0.39 Table 2 Significant correlations between CRP Values and corresponding CMR measurements, cardic biomarkers and clinical related parameters VariblesSpearmanscorrelations rp-valueCMR parameters 1 weekLV EF−0.28>0,001Infractsize(%ofLV)0.40>0,001Microvasular obstruction0.27>0,001Hemorrhage0.33>0,001Size of area atrisk0.31>0,001Transmurality0.30>0,001Pericaldial damage0.43>0,001CMR parameters 4 monthsLVEF−0.43>0,001Infarctsize(%ofLV)0.46>0,001Cardiac BiomarkersPeak TnI0.34>0,001Peak CK-MB0.32>0,001OtherTime to PCI0,1820,007

Published
2013
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3. Efficacy and Tolerability of Palliative Split-Course Thoracic Chemoradiotherapy for Symptomatic Non-Small Cell Lung Cancer.

Author

Dandekar VK, Young J, Kiel K, Bonomi P, Fidler MJ, Batus M, and Sher DJ

Subjects
Adenocarcinoma complications, Adenocarcinoma pathology, Aged, Carboplatin administration & dosage, Carcinoma, Non-Small-Cell Lung complications, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Squamous Cell complications, Carcinoma, Squamous Cell pathology, Chemoradiotherapy adverse effects, Chest Pain etiology, Chest Pain therapy, Cohort Studies, Cough etiology, Cough therapy, Dyspnea etiology, Dyspnea therapy, Esophagitis etiology, Etoposide administration & dosage, Female, Hemoptysis etiology, Hemoptysis therapy, Humans, Lung Neoplasms complications, Lung Neoplasms pathology, Male, Middle Aged, Paclitaxel administration & dosage, Palliative Care, Pemetrexed administration & dosage, Radiation Injuries etiology, Radiation Pneumonitis etiology, Retrospective Studies, Treatment Outcome, Adenocarcinoma therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Non-Small-Cell Lung therapy, Carcinoma, Squamous Cell therapy, Chemoradiotherapy methods, Lung Neoplasms therapy
Abstract

Introduction: To assess the efficacy and tolerability of palliative split-course concurrent thoracic chemoradiotherapy (CRT) in patients with incurable locally advanced and metastatic non-small cell lung cancer., Methods: All patients with incurable non-small cell lung cancer and symptomatic thoracic disease treated with palliative split-course CRT between March 2006 and February 2013 at a single institution were included in this retrospective study. The primary endpoint was improvement in presenting thoracic symptoms. Secondary endpoints included toxicity, overall survival, and the cumulative incidence of locoregional failure., Results: Fifty-five patients were identified, of whom 89% had distant metastatic disease at the initiation of treatment. The median radiotherapy dose delivered was 40 Gy over 20 fractions. Over 90% of patients were able to complete at least 2 cycles of chemotherapy, and 89% of patients completed the prescribed course of radiotherapy. Forty percent of patients had improvement in all presenting symptoms and 78% experienced improvement in at least 1 symptom. Nine and 2 patients, respectively, experienced grade 1 and 2 esophagitis and 1 patient experienced grade 2 pneumonitis. There were no cases of grade 3 toxicity. With a median follow-up for surviving patients of 4.5 months, the estimated actuarial 6-, 12-, and 24-month overall survival was 56%, 25%, and 13%, respectively. The actuarial 6-, 12-, and 24-month cumulative incidence of locoregional failure was 6%, 14%, and 22%, respectively., Discussion: Split-course CRT allows for early introduction of systemic therapy while providing durable locoregional control with tolerable morbidity and significant improvement in chest symptomatology. This paradigm is a viable model for chest palliation in selected patients with intact performance status.

Published
2015
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4. Assessment of global myocardial perfusion reserve using cardiovascular magnetic resonance of coronary sinus flow at 3 Tesla.

Author

Dandekar VK, Bauml MA, Ertel AW, Dickens C, Gonzalez RC, and Farzaneh-Far A

Subjects
Adenosine A2 Receptor Agonists, Aged, Aminophylline administration & dosage, Blood Flow Velocity, Feasibility Studies, Female, Humans, Male, Middle Aged, Myocardial Ischemia physiopathology, Predictive Value of Tests, Prospective Studies, Purinergic P1 Receptor Antagonists administration & dosage, Purines, Pyrazoles, Regional Blood Flow, Coronary Circulation, Coronary Sinus physiopathology, Magnetic Resonance Imaging, Cine, Myocardial Ischemia diagnosis, Myocardial Perfusion Imaging methods
Abstract

Background: Despite increasing clinical use, there is limited data regarding regadenoson in stress perfusion cardiovascular magnetic resonance (CMR). In particular, given its long half-life the optimal stress protocol remains unclear. Although Myocardial Perfusion Reserve (MPR) may provide additive prognostic information, current techniques for its measurement are cumbersome and challenging for routine clinical practice.The aims of this study were: 1) To determine the feasibility of MPR quantification during regadenoson stress CMR by measurement of Coronary Sinus (CS) flow; and 2) to investigate the role of aminophylline reversal during regadenoson stress-CMR., Methods: 117 consecutive patients with possible myocardial ischemia were prospectively enrolled. Perfusion imaging was performed at 1 minute and 15 minutes after administration of 0.4 mg regadenoson. A subgroup of 41 patients was given aminophylline (100 mg) after stress images were acquired. CS flow was measured using phase-contrast imaging at baseline (pre CS flow), and immediately after the stress (peak CS flow) and rest (post CS flow) perfusion images., Results: CS flow measurements were obtained in 92% of patients with no adverse events. MPR was significantly underestimated when calculated as peak CS flow/post CS flow as compared to peak CS flow/pre CS flow (2.43±0.20 vs. 3.28±0.32, p=0.03). This difference was abolished when aminophylline was administered (3.35±0.44 vs. 3.30±0.52, p=0.95). Impaired MPR (peak CS flow/pre CS flow<2) was associated with advanced age, diabetes, current smoking and higher Framingham risk score., Conclusions: Regadenoson stress CMR with MPR measurement from CS flow can be successfully performed in most patients. This measurement of MPR appears practical to perform in the clinical setting. Residual hyperemia is still present even 15 minutes after regadenoson administration, at the time of resting-perfusion acquisition, and is completely reversed by aminophylline. Our findings suggest routine aminophylline administration may be required when performing stress CMR with regadenoson.

Published
2014
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5. Complications of transradial catheterization.

Author

Dandekar VK, Vidovich MI, and Shroff AR

Subjects
Cardiac Catheterization methods, Humans, Arterial Occlusive Diseases etiology, Cardiac Catheterization adverse effects, Radial Artery physiopathology, Spasm etiology
Abstract

Cardiac catheterization via the transradial approach has increased in the United States over the past few years; however, wide-scale adoption still lags in comparison to many international health care systems. Transradial catheterization has a unique set of complications and risks that each operator must appreciate. Radial artery spasm and radial artery occlusion are the most common complications, while bleeding complications such as hematomas and perforations are much less frequent. Each of these issues can be managed successfully with minor changes to one's practice. In this review of the current state of the art, the reader will develop an appreciation for the prevalence of each of the common complications as well as the less common, but potentially highly morbid, events. Throughout this evidence-based review, practical prevention strategies and specific treatment pathways are described for each issue that is covered., (Published by Elsevier Inc.)

Published
2012
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6. Transradial percutaneous coronary intervention in patients requiring circulatory assist devices.

Author

Dandekar VK and Shroff AR

Subjects
Aged, Coronary Angiography, Coronary Stenosis physiopathology, Hemodynamics physiology, Humans, Male, Shock, Cardiogenic prevention & control, Treatment Outcome, Ventricular Dysfunction, Left physiopathology, Angioplasty, Balloon, Coronary methods, Coronary Stenosis therapy, Heart-Assist Devices, Radial Artery, Ventricular Dysfunction, Left therapy
Published
2011

7. Are changes in carotid intima-media thickness related to risk of nonfatal myocardial infarction? A critical review and meta-regression analysis.

Author

Goldberger ZD, Valle JA, Dandekar VK, Chan PS, Ko DT, and Nallamothu BK

Subjects
Humans, Incidence, Myocardial Infarction diagnosis, Prognosis, Randomized Controlled Trials as Topic, Risk Factors, Ultrasonography, Carotid Arteries diagnostic imaging, Myocardial Infarction epidemiology, Tunica Intima diagnostic imaging
Abstract

Background: Carotid intima-media thickness (CIMT) is increasingly being used as a surrogate end point in randomized control trials (RCTs) of novel cardiovascular therapies. However, it remains unclear whether changes in CIMT that result from these therapies correlate with nonfatal myocardial infarction (MI)., Methods: We performed a literature search of RCTs from 1990-2009 that used CIMT. Eligible RCTs (1) included quantitative and sequential assessments in CIMT at least 1 year apart and (2) reported nonfatal MI. Across RCTs, random-effects metaregression was employed to correlate differences in mean change in CIMT between treatment and control groups over time with the log odds ratios of developing nonfatal MI during follow-up., Results: Overall, we identified 28 RCTs with 15,598 patients. Differences in mean change in CIMT over time between treatment and control groups correlated with developing nonfatal MI during follow-up: for each 0.01 mm per year smaller rate of change in CIMT, the odds ratio for MI was 0.82 (95% CI, 0.69 to 0.96; P = .018). Results were similar in subgroups of RCTs with >1 year follow-up (P = .018) and those with at least 50 subjects in the treatment group (P = .019). However, there was no significant relationship between mean change in CIMT and nonfatal MI in RCTs evaluating statin therapy or those with high CIMTs at baseline (P > .20 in both instances)., Conclusions: Less progression in CIMT over time is associated with a lower likelihood of nonfatal MI in selected RCTs; however, these findings were inconsistent at times, suggesting caution in using CIMT as a surrogate end point., (Copyright © 2010 Mosby, Inc. All rights reserved.)

Published
2010
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