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Article ; Online: Perforación del tronco coronario izquierdo tras aterectomía rotacional

Alfonso Jurado-Román / Guillermo Galeote / Santiago Jiménez-Valero / Sandra Ofelia Rosillo / Raúl Moreno / José Luis López-Sendón

REC: Interventional Cardiology, Vol 3, Iss 1, Pp 78-

2021 Volume 79

Abstract: Mujer de 85 años con angina inestable que presentaba lesiones graves y muy calcificadas en las arterias coronaria derecha proximal (figura 1A, asterisco) y descendente anterior proximal-media (figura 1B, asterisco). Figura 1. Se realizó aterectomía ... ...

Abstract	Mujer de 85 años con angina inestable que presentaba lesiones graves y muy calcificadas en las arterias coronaria derecha proximal (figura 1A, asterisco) y descendente anterior proximal-media (figura 1B, asterisco). Figura 1. Se realizó aterectomía rotacional con el sistema RotaPro (Boston Scientific, EE.UU.) en la coronaria derecha (figura 1C) y se implantó un stent farmacoactivo, con buen resultado (figura 1D) confirmado mediante ecografía intracoronaria (figura 1E). Se obtuvo el consentimiento informado de la paciente. Tras sondar el tronco coronario izquierdo (TCI) se cruzó la guía a la descendente anterior. Se avanzó una oliva de 1,5 mm en modo dynaglide hasta el TCI, momento en que el catéter guía se extubó y se produjo una perforación Ellis-III en el TCI (figura 2A, asterisco; vídeo 1 del material adicional); es posible que una deformación inadvertida de la guía dirigiera la oliva hacia la pared del vaso. La paciente presentó taponamiento cardiaco, que fue tratado con pericardiocentesis. Se implantó un stent recubierto PK-Papyrus (Biotronik, Alemania) de 4 × 15 mm en el TCI sin enjaular la bifurcación (figura 2B). Sin embargo, se mantenía una discreta fuga de contraste (figura 2C, asterisco). Tras posdilatar con balón de 4,5 mm, la perforación quedó sellada (figura 2D; vídeo 2.
Keywords	Internal medicine ; RC31-1245
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Exclusión incompleta de aneurisma gigante por acortamiento de stent PK-Papyrus

Ariana Gonzálvez-García / Alfonso Jurado-Román / Santiago Jiménez-Valero / Guillermo Galeote / Raúl Moreno / José Luis López-Sendón

REC: Interventional Cardiology, Vol 3, Iss 4, Pp 328-

2021 Volume 329

Abstract: Se presenta el caso de un varón de 74 años ingresado por síndrome coronario agudo sin elevación del segmento ST. La coronariografía realizada mostró una estenosis de la arteria coronaria derecha con un aneurisma coronario (AC) gigante y alta carga ... ...

Abstract	Se presenta el caso de un varón de 74 años ingresado por síndrome coronario agudo sin elevación del segmento ST. La coronariografía realizada mostró una estenosis de la arteria coronaria derecha con un aneurisma coronario (AC) gigante y alta carga trombótica (figura 1A). Se recomendó doble antiagregación y anticoagulación oral para excluir el AC en un segundo tiempo. Tras confirmar la reducción del trombo (figura 1B), se predilató y se midió la longitud del AC (40 mm) y de la zona de aterrizaje mediante ecografía intravascular (IVUS) (figura 1C). Se implantaron 2 stents coronarios recubiertos PK-Papyrus (SCR) de 5 × 26 mm (Biotronik, Suiza) de proximal a distal. La zona de solapamiento de ambos stents se confirmó mediante StentBoost (Philips Medical Systems, Países Bajos) (figura 1D). El stent se implantó bajo fluoroscopia y en ausencia de movimientos respiratorios. La siguiente angiografía reveló la exclusión incompleta del AC (figura 1E) a pesar de posdilatación con un balón no compliante (BNC) de 5,5 mm. El IVUS confirmó la existencia de un gap entre ambos stents debido al acortamiento de los mismos (E2, figura 1E y vídeo 1 del material adicional). Se implantó otro SCR de 5 × 15 mm y se posdilató.
Keywords	Internal medicine ; RC31-1245
Language	English
Publishing date	2021-11-01T00:00:00Z
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Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Incomplete giant aneurysm exclusion due to PK-Papyrus stent shortening

Ariana Gonzálvez-García / Alfonso Jurado-Román / Santiago Jiménez-Valero / Guillermo Galeote / Raúl Moreno / José Luis López-Sendón

REC: Interventional Cardiology (English Ed.), Vol 3, Iss 4, Pp 328-

2021 Volume 329

Abstract: Seventy-four-year-old male patient admitted with non-ST-elevation acute myocardial infarction. The coronary angiography performed revealed the presence of right coronary artery stenosis with a giant coronary artery aneurysm (CAA) and high thrombus burden ...

Abstract	Seventy-four-year-old male patient admitted with non-ST-elevation acute myocardial infarction. The coronary angiography performed revealed the presence of right coronary artery stenosis with a giant coronary artery aneurysm (CAA) and high thrombus burden (figure 1A). Dual antiplatelet and anticoagulation therapies were recommended for its exclusion in a staged procedure. After confirmation of thrombus reduction (figure 1B), predilatation was attempted and both the length of the CAA (40 mm) and the landing zone were measured on the intravascular ultrasound (IVUS) (figure 1C). From proximal to distal, two 5 mm x 26 mm-PK-Papyrus covered coronary stents (PCS) (Biotronik, Switzerland) were deployed. The overlapping stent zone was confirmed using the StentBoost imaging modality (Philips Medical Systems, Nederland) (figure 1D) and the stent was deployed under fluoroscopic guidance in the absence of any respiratory movements. The subsequent angiography performed revealed an incomplete CAA exclusion (figure 1E) despite postdilatation with a 5.5 mm noncompliant balloon (NCB). The IVUS confirmed the existence of a gap between both stents due to stent shortening (E2, figure 1E and video 1 of the supplementary data). Another 5 mm × 15 mm PCS was deployed followed by postdilatation with a 5.5 mm NCB. Both the angiography and the IVUS confirmed the.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
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Article ; Online: Left main coronary artery perforation after rotational atherectomy

Alfonso Jurado-Román / Guillermo Galeote / Santiago Jiménez-Valero / Sandra Ofelia Rosillo / Raúl Moreno / José Luis López-Sendón

REC: Interventional Cardiology (English Ed.), Vol 3, Iss 1, Pp 78-

2021 Volume 79

Abstract: Eighty-five-year-old woman with unstable angina with serious and heavily calcified lesions in proximal right coronary arteries (figure 1A, asterisk) and proximal and mid left anterior descending coronary artery (figure 1B, asterisk). Rotational ... ...

Abstract	Eighty-five-year-old woman with unstable angina with serious and heavily calcified lesions in proximal right coronary arteries (figure 1A, asterisk) and proximal and mid left anterior descending coronary artery (figure 1B, asterisk). Rotational atherectomy was performed in the right coronary artery using the RotaPro system (Boston Scientific, United States) (figure 1C) and a drug-eluting stent was implanted with good results (figure 1D) as confirmed by the intracoronary ultrasound (figure 1E). Informed consent was obtained from the patient. Figure 1. After the catheterization of the left main coronary artery (LMCA) the left anterior descending coronary artery was crossed. A 1.5 mm olive-shaped burr was advanced in the DynaGlide mode towards the LMCA, which is when the guide catheter was extubated and an Ellis type III perforation occurred in the LMCA (figure 2A, asterisk; video 1 of the supplementary data); it is possible that an unnoticed deformation of the guidewire moved the burr towards the vessel wall. The patient showed cardiac tamponade that was treated with pericardiocentesis. A 4 × 15 mm PK-Papyrus covered coronary stent (Biotronik, Germany) was implanted in the LMCA without jailing the bifurcation (figure 2B). However, a discrete leak of contrast still occurred (figure 2C, asterisk). After postdilatation with a 4.5 mm.
Keywords	Medicine ; R
Subject code	610
Language	English
Publishing date	2021-02-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Experiencia multicéntrica con prótesis valvular aórtica transcatéter de segunda generación reposicionable y recuperable

Daniele Gemma / Raúl Moreno / Mariano Larman / Rui Campante Teles / Lino Patricio / Eduardo Molina / Vasco Gama Ribeiro / Bruno García Del Blanco / Roque Arana Granado / Santiago Jiménez Valero / Guillermo Galeote / Harold Hernández / Francisco Javier Irazusta Córdoba / Vicenç Serra / José Luis López-Sendón

REC: Interventional Cardiology, Vol 2, Iss 2, Pp 90-

2020 Volume 95

Abstract: RESUMEN Introducción y objetivos: El dispositivo Lotus (Boston Scientific, Estados Unidos) es una prótesis valvular aórtica transcatéter de segunda generación, completamente recuperable y reposicionable. Se presenta la experiencia inicial con la prótesis ...

Abstract	RESUMEN Introducción y objetivos: El dispositivo Lotus (Boston Scientific, Estados Unidos) es una prótesis valvular aórtica transcatéter de segunda generación, completamente recuperable y reposicionable. Se presenta la experiencia inicial con la prótesis Lotus en un registro multicéntrico. Métodos: Estudio observacional que reporta los resultados a corto y largo plazo del implante transfemoral de prótesis Lotus entre marzo de 2014 y abril de 2016 en 8 centros de España y Portugal. Resultados: Se incluyeron 102 pacientes (edad media 80,4 ± 6,1 años, índice STS medio 5,2% ± 3,3%) con estenosis aórtica grave sintomática (área valvular media 0,66 ± 0,17 cm2, gradientes 74,3/45,6 mmHg). Se implantó con éxito el dispositivo en 100 pacientes (98%), con mejoría significativa de los gradientes máximo y medio valvular, y un solo caso de regurgitación periprotésica moderada. No hubo ninguna embolización ni necesidad de implante de una nueva prótesis intravalvular. Hasta el alta hospitalaria, la mortalidad fue del 3,9% y la tasa de ictus fue del 2,9%. En 33 pacientes (32,3%) fue necesario el implante de marcapasos definitivo. Conclusiones: La válvula Lotus es eficaz y segura para el tratamiento de pacientes con estenosis aórtica grave sintomática. Destacan la escasa tasa de insuficiencia periprotésica y la ausencia de complicaciones derivadas del mal posicionamiento o la embolización de la prótesis, a costa de un alta incidencia de implante de marcapasos.
Keywords	Prótesis aórtica transcatéter ; Estenosis aórtica ; Internal medicine ; RC31-1245
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
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Article ; Online: Multicenter experience with a second-generation fully-retrievable and repositionable transcatheter aortic valve

REC: Interventional Cardiology (English Ed.), Vol 2, Iss 2, Pp 90-

2020 Volume 97

Abstract: ABSTRACT Introduction and objectives: The Lotus Valve device (Boston Scientific) is a second-generation fully-retrievable and repositionable transcatheter aortic valve. We report the initial multicenter experience with the Lotus valve in the management ... ...

Abstract	ABSTRACT Introduction and objectives: The Lotus Valve device (Boston Scientific) is a second-generation fully-retrievable and repositionable transcatheter aortic valve. We report the initial multicenter experience with the Lotus valve in the management of patients with severe aortic stenosis. Methods: Observational study that described the short and long-term results of implanting the Lotus valve in 8 Spanish and Portuguese centers from March 2014 through April 2016. Results: The study included 102 patients (mean age 80.4 ± 6.1 years; STS score 5.2% ± 3.3%) with severe symptomatic aortic stenosis (mean aortic valve area 0.66 ± 0.17 cm2, aortic gradients 74.3 / 45.6 mmHg). The valve was successfully implanted in 100 patients (98%), with significant improvement in both the peak and mean aortic valve gradients and with only one patient showing moderate paravalvular regurgitation. Upon hospital discharge, mortality rate was 3.9% while the stroke rate was 2.9%. No cases of valve embolization, ectopic valve deployment or additional valve implantation (valve-in-valve) were seen. Thirty-three patients (32.3%) received a permanent pacemaker. Conclusions: The Lotus Valve System is effective and safe for the management of patients with severe symptomatic aortic stenosis. In particular, considering the low rate of periprosthetic regurgitation and lack of complications like embolization or ectopic valve deployment; however at the expense of a high pacemaker implantation rate.
Keywords	Transcatheter Aortic Valve ; Aortic Stenosis ; Medicine ; R
Subject code	621
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Coronary artery calcium score with cardiac computed tomography to anticipate the need for rotational atherectomy

Guillermo Galeote / Harol Hernández / Juan Caro Codón / Raúl Moreno / Antonio Pardo / Gabriela Guzmán / Carlos Álvarez-Ortega / Rafael Peinado / Edurne López Soberón / Santiago Jiménez Valero / Ángel Sánchez-Recalde / Silvia Valbuena / Mar Moreno Yangüela / José Luis López-Sendón

REC: Interventional Cardiology (English Ed.), Vol 1, Iss 3, Pp 167-

2019 Volume 174

Abstract: ABSTRACT Introduction and objectives: This study aims to investigate if the non-invasive assessment of coronary calcium score using multislice cardiac computerized tomography (MSCT) may anticipate the need for elective rotational atherectomy (RA) during ... ...

Abstract	ABSTRACT Introduction and objectives: This study aims to investigate if the non-invasive assessment of coronary calcium score using multislice cardiac computerized tomography (MSCT) may anticipate the need for elective rotational atherectomy (RA) during percutaneous coronary intervention. Methods: Patients were considered eligible for the study after receiving a diagnosis of severe coronary stenosis with moderate or severely calcified plaques during index coronary angiography. Those patients underwent the Agatston coronary artery calcium (CAC) score quantification using the MSCT and then underwent percutaneous intervention. Only those lesions considered non-crossable or non-dilatable according to a pre-specified revascularization protocol were treated with RA. All operators were blinded to the MSCT results. According to the study protocol, clinical, angiographic and Agatston-related variables were included in the statistical analysis. Short and long-term outcomes were investigated in both treatment groups during follow-up. Results: A total of 40 patients were included in the analysis: 20 underwent RA and 20 conventional percutaneous coronary interventions. Most patients were included after suffering from an acute coronary syndrome and had complex coronary anatomy (mean Syntax score, 25 points). The logistic regression analysis showed that creatinine levels and the per-lesion Agatston score were the only predictors of RA. No significant differences were observed regarding in-hospital or long-term procedural outcomes. A novel parameter, the CAC-Cre index, was found to be useful to anticipate the need for RA. Conclusion: Coronary artery calcification analysis using the Agatston score is a simple technique that improves the non-invasive assessment of complex coronary plaques prior to percutaneous coronary intervention. The per-lesion Agatston score, serum creatinine levels, and the CAC-Cre index may become useful parameters to anticipate the need for elective RAs during percutaneous coronary intervention.
Keywords	Rotational atherectomy ; Cardiac computerized tomography ; Agatston ; Calcium score ; Calcified coronary lesions ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Permanyer
Document type	Article ; Online
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Article ; Online: Índice de calcificación coronaria en la tomografía computarizada para predecir la necesidad de aterectomía rotacional

REC: Interventional Cardiology, Vol 1, Iss 3, Pp 167-

2019 Volume 174

Abstract: RESUMEN Introducción y objetivos: El objetivo del estudio fue investigar si la evaluación no invasiva del índice de calcificación coronaria mediante tomografía computarizada cardiaca multidetector (TCMD) puede predecir la necesidad de una aterectomía ... ...

Abstract	RESUMEN Introducción y objetivos: El objetivo del estudio fue investigar si la evaluación no invasiva del índice de calcificación coronaria mediante tomografía computarizada cardiaca multidetector (TCMD) puede predecir la necesidad de una aterectomía rotacional (AR) electiva durante la intervención coronaria percutánea. Métodos: Se incluyeron pacientes diagnosticados de estenosis coronaria grave con placas moderadamente o gravemente calcificadas durante la angiografía coronaria. Esos pacientes se sometieron a la cuantificación del índice de calcificación coronaria con la escala de Agatston utilizando TCMD y posteriormente a intervención percutánea. Solo fueron tratadas con AR las lesiones que se consideraba que no era posible cruzar ni dilatar, según un protocolo de revascularización prediseñado. Ninguno de los operadores conocía de antemano los resultados de la TCMD. Según el protocolo del estudio, en el análisis estadístico se incluyeron variables clínicas, angiográficas y relacionadas con la puntuación Agatston. Durante el seguimiento se estudiaron los resultados a corto y largo plazo en ambos grupos. Resultados: Se analizaron 40 pacientes: 20 que recibieron AR y 20 con intervención coronaria percutánea convencional. La mayoría se incluyó después de un síndrome coronario agudo y tenían una anatomía coronaria compleja (puntuación media de la escala Syntax de 25 puntos). La creatinina y la puntuación de Agatston por lesión fueron los únicos factores predictivos de la AR. No se observaron diferencias significativas en el pronóstico dentro del hospital o a largo plazo. Un nuevo parámetro, el índice CAC-Cre, fue útil para predecir la necesidad de AR. Conclusiones: El análisis de la calcificación de las arterias coronarias mediante la puntuación de Agatston mejora la evaluación no invasiva de las placas coronarias complejas antes de la intervención coronaria percutánea. La puntuación de Agatston por lesión, la creatinina sérica y el índice CAC-Cre son parámetros útiles para predecir la necesidad de una AR electiva ...
Keywords	Aterectomía rotacional ; Tomografía computarizada cardiaca ; Agatston ; Índice de calcificación coronaria ; Lesiones coronarias calcificadas ; Internal medicine ; RC31-1245
Language	English
Publishing date	2019-08-01T00:00:00Z
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Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The impact of an intense religious experience on motor symptoms in Huntington's disease.

Moreno, Jose Luis López-Sendón / de Yebenes, Justo Garcia

Movement disorders : official journal of the Movement Disorder Society

2009 Volume 24, Issue 3, Page(s) 473–474

MeSH term(s)	Adult ; Faith Healing ; Female ; Humans ; Huntington Disease/complications ; Huntington Disease/genetics ; Huntington Disease/psychology ; Psychomotor Disorders/etiology ; Religion
Language	English
Publishing date	2009-02-15
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	607633-6
ISSN	1531-8257 ; 0885-3185
ISSN (online)	1531-8257
ISSN	0885-3185
DOI	10.1002/mds.22405
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Article ; Online: Incobotulinumtoxin A for Sialorrhea in Neurological Disorders

Javier Martínez-Poles / Velina Nedkova-Hristova / José Bernardo Escribano-Paredes / Sebastián García-Madrona / Elena Natera-Villalba / Carlos Estévez-Fraga / José Luis López-Sendón Moreno / Icíar Avilés-Olmos / Gema Sánchez Díaz / Juan Carlos Martínez Castrillo / Araceli Alonso-Canovas

Toxins, Vol 10, Iss 6, p

A Real-Life Experience

2018 Volume 217

Abstract: Botulinum toxin type A is one of the most useful treatments of sialorrhea in neurological disorders. Evidence for the use of incobotulinumtoxin A (inco-A) in the treatment of sialorrhea is limited. Thirty-six patients with sialorrhea were treated with ... ...

Abstract	Botulinum toxin type A is one of the most useful treatments of sialorrhea in neurological disorders. Evidence for the use of incobotulinumtoxin A (inco-A) in the treatment of sialorrhea is limited. Thirty-six patients with sialorrhea were treated with infiltrations of inco-A into both parotid glands. The severity of sialorrhea was evaluated by the Drooling Severity Scale (DSS), and the Drooling Frequency Scale (DFS). Patients’ perceptions of clinical benefit were recorded via the Patient Global Impression of Improvement (PGI-I) scale. Following treatment, there was a significant difference in both the DFS and the DSS (p < 0.001). Clinical benefits on the basis of the PGI-I were present in up to 90% of patients.
Keywords	sialorrhea ; neurological disorders ; Parkinson’s disease ; botulinum toxin type A ; incobotulinumtoxin A ; Medicine ; R
Language	English
Publishing date	2018-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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