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Article ; Online: Ruptured mycotic coronary artery aneurysm.

Janus, Scott E / Al-Kindi, Sadeer / Pollock, Graham / Laster, Steven

BMJ case reports

2023 Volume 16, Issue 4

Abstract: Aneurysms complicated by rupture of the coronary arteries are exceedingly rare. Literature regarding management of mycotic aneurysms resulting in rupture is limited. Therefore, we describe a fascinating diagnosis, imaging progression and management of a ... ...

Abstract	Aneurysms complicated by rupture of the coronary arteries are exceedingly rare. Literature regarding management of mycotic aneurysms resulting in rupture is limited. Therefore, we describe a fascinating diagnosis, imaging progression and management of a ruptured mycotic coronary artery aneurysm.
MeSH term(s)	Humans ; Aneurysm, Infected/diagnostic imaging ; Aneurysm, Infected/surgery ; Aneurysm, Infected/complications ; Coronary Vessels/diagnostic imaging ; Diagnostic Imaging ; Aneurysm, Ruptured/complications ; Coronary Aneurysm/diagnostic imaging ; Coronary Aneurysm/surgery ; Coronary Aneurysm/complications
Language	English
Publishing date	2023-04-12
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-254488
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Article ; Online: Images in Vascular Medicine. Rapidly progressive arterial aneurysms in a patient with Ehlers-Danlos syndrome.

Safley, David M / Laster, Steven B / Schmidt, Laura / Davis, J Russell

Vascular medicine (London, England)

2016 Volume 21, Issue 1, Page(s) 71–72

MeSH term(s)	Adult ; Aneurysm, Dissecting/diagnosis ; Aneurysm, Dissecting/etiology ; Aneurysm, Dissecting/surgery ; Blood Vessel Prosthesis Implantation ; Dilatation, Pathologic ; Disease Progression ; Ehlers-Danlos Syndrome/complications ; Ehlers-Danlos Syndrome/diagnosis ; Female ; Femoral Artery/diagnostic imaging ; Femoral Artery/surgery ; Humans ; Iliac Aneurysm/diagnosis ; Iliac Aneurysm/etiology ; Iliac Aneurysm/surgery ; Time Factors ; Tomography, X-Ray Computed
Language	English
Publishing date	2016-02
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1311628-9
ISSN	1477-0377 ; 1358-863X
ISSN (online)	1477-0377
ISSN	1358-863X
DOI	10.1177/1358863X15592965
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Zs.A 4409: Show issues

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Article ; Online: Contrast-Enhanced Echocardiographic Evaluation of a Giant Saphenous Vein Graft Aneurysm.

Omer, Mohamed A / Laster, Steven B / Amin, Amit / Main, Michael L

Echocardiography (Mount Kisco, N.Y.)

2016 Volume 33, Issue 7, Page(s) 1092–1094

Abstract: A 61-year-old man presented with unstable angina 16 years after undergoing coronary artery bypass grafting with a left internal mammary artery graft to the left anterior descending coronary artery and a sequential saphenous vein graft (SVG) to the right ... ...

Abstract	A 61-year-old man presented with unstable angina 16 years after undergoing coronary artery bypass grafting with a left internal mammary artery graft to the left anterior descending coronary artery and a sequential saphenous vein graft (SVG) to the right coronary artery and an obtuse marginal branch. Transthoracic echocardiography (TTE) with a Philips iE33 machine and an S5 transducer revealed a 5.3 cm × 4.6 cm mass with a central echolucent area, surrounded by a peripheral zone of increased echodensity adjacent to, and partially compressing, the right atrium. Contrast echocardiography following an intravenous bolus injection of Definity revealed late appearance of contrast within the mass consistent with a giant SVG aneurysm. Coronary artery bypass graft angiography revealed a giant aneurysm in the SVG proximal to the RCA anastomosis; the distal limb of the graft to the obtuse marginal branch was occluded. Under intravascular ultrasound guidance, a 7-mm spider filter was placed in the distal graft; then, a 6 mm × 10 cm Viabahn self-expanding nitinol polyethylene terephthalate-covered stent was deployed in the SVG with good seal zones proximally and distally. A follow-up contrast-enhanced transthoracic echocardiogram 1 day postprocedure revealed partial thrombosis of the aneurysm cavity. Ultrasound contrast did not appear in the aneurysm following intravenous injection, consistent with complete exclusion from the systemic circulation. This is the first report demonstrating feasibility of contrast-enhanced transthoracic echocardiography for the diagnosis of SVG aneurysm and confirming procedural success by documenting exclusion from the systemic circulation following intervention.
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	843645-9
ISSN	1540-8175 ; 0742-2822
ISSN (online)	1540-8175
ISSN	0742-2822
DOI	10.1111/echo.13215
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Zs.A 2170: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 359: Show issues

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Article: Thrombosis in the Surgically Corrected Anomalous Right Coronary Artery after Reimplantation in Aorta.

Bajwa, Ata / Gupta, Bhanu / Ya'qoub, Lina / Laster, Steven B / Thompson, Randall

Case reports in cardiology

2017 Volume 2017, Page(s) 5832692

Abstract: A 32-year-old African American female presented with dyspnea, and after several cardiac diagnostic tests, the diagnosis of an anomalous origin of the RCA from the pulmonary trunk was established by multislice coronary CT angiography. She underwent ... ...

Abstract	A 32-year-old African American female presented with dyspnea, and after several cardiac diagnostic tests, the diagnosis of an anomalous origin of the RCA from the pulmonary trunk was established by multislice coronary CT angiography. She underwent surgical correction with reimplantation of the RCA, from the pulmonary artery to the aortic root. However, 10 days after surgery, she developed frequent episodes of chest pain, and repeat coronary CTA showed a partially occlusive thrombus in the surgically reimplanted RCA. Anticoagulation with warfarin resulted in complete resolution of the patient's symptoms.
Language	English
Publishing date	2017-12-31
Publishing country	United States
Document type	Case Reports
ZDB-ID	2627627-6
ISSN	2090-6412 ; 2090-6404
ISSN (online)	2090-6412
ISSN	2090-6404
DOI	10.1155/2017/5832692
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Article ; Online: Hemolysis induced pancreatitis after orbital atherectomy in a heavily calcified superficial femoral artery.

Mehta, Sameer K / Laster, Steven B

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2008 Volume 72, Issue 7, Page(s) 1009–1011

Abstract: Orbital atherectomy represents a newly developed technology for the endovascular treatment of peripheral artery disease. There is currently limited data with regards to the safety and efficacy of this treatment. Herein, we describe a case where orbital ... ...

Abstract	Orbital atherectomy represents a newly developed technology for the endovascular treatment of peripheral artery disease. There is currently limited data with regards to the safety and efficacy of this treatment. Herein, we describe a case where orbital atherectomy was utilized to treat a heavily calcified superficial femoral artery, and describe a previously unreported side effect of orbital atherectomy, hemolysis induced pancreatitis.
MeSH term(s)	Aged, 80 and over ; Arterial Occlusive Diseases/diagnostic imaging ; Arterial Occlusive Diseases/therapy ; Atherectomy/adverse effects ; Atherectomy/methods ; Calcinosis/diagnostic imaging ; Calcinosis/therapy ; Constriction, Pathologic ; Femoral Artery/diagnostic imaging ; Hemolysis ; Humans ; Male ; Pancreatitis/blood ; Pancreatitis/etiology ; Radiography
Language	English
Publishing date	2008-12-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.21774
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Zs.A 1226: Show issues

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Article ; Online: Spontaneous coronary artery dissection: the management dilemma continues.

Ahmed, Zaheer / Bajwa, Ata / Bhardwaj, Bhaskar / Laster, Steven B / Magalski, Anthony

BMJ case reports

2015 Volume 2015

Abstract: Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of acute coronary syndrome, particularly in women. A 36-year-old Caucasian woman presented to our hospital with sudden onset chest pain and was diagnosed with a non-ST ... ...

Abstract	Spontaneous coronary artery dissection (SCAD) is an increasingly recognised cause of acute coronary syndrome, particularly in women. A 36-year-old Caucasian woman presented to our hospital with sudden onset chest pain and was diagnosed with a non-ST elevation myocardial infarction. Coronary angiography revealed mid and distal left anterior descending artery (LAD) dissection with distal LAD occlusion. A short segment of apical LAD filled late with incomplete opacification (Thrombolysis In Myocardial Infarction (TIMI) 1 flow). A decision was made to treat the patient conservatively, with subsequent resolution of dissection over the next 3 months. Our patient made a good clinical recovery with healing of her affected coronary vasculature on subsequent angiogram. The case illustrates that SCAD can be managed conservatively with antiplatelet agents, β-blockers, heparin and statins, if the patient is haemodynamically stable and coronary flow is adequate.
MeSH term(s)	Adenosine/analogs & derivatives ; Adenosine/therapeutic use ; Adult ; Anticholesteremic Agents/therapeutic use ; Antihypertensive Agents/therapeutic use ; Aspirin/therapeutic use ; Atorvastatin/therapeutic use ; Carbazoles/therapeutic use ; Carvedilol ; Coronary Angiography ; Coronary Vessel Anomalies/complications ; Coronary Vessel Anomalies/diagnosis ; Coronary Vessel Anomalies/drug therapy ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Female ; Humans ; Myocardial Infarction/complications ; Myocardial Infarction/drug therapy ; Myocardial Infarction/etiology ; Platelet Aggregation Inhibitors/therapeutic use ; Propanolamines/therapeutic use ; Purinergic P2Y Receptor Antagonists/therapeutic use ; Ticagrelor ; Vascular Diseases/complications ; Vascular Diseases/congenital ; Vascular Diseases/diagnosis ; Vascular Diseases/drug therapy
Chemical Substances	Anticholesteremic Agents ; Antihypertensive Agents ; Carbazoles ; Platelet Aggregation Inhibitors ; Propanolamines ; Purinergic P2Y Receptor Antagonists ; Carvedilol (0K47UL67F2) ; Atorvastatin (A0JWA85V8F) ; Ticagrelor (GLH0314RVC) ; Adenosine (K72T3FS567) ; Aspirin (R16CO5Y76E)
Language	English
Publishing date	2015-08-13
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2015-211061
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Article ; Online: The Descending Thoracic Aorta: Forgotten Vascular Access for Endovascular Device Delivery.

Allen, Keith B / Borkon, A Michael / Aggarwal, Sanjeev / Davis, J Russell / Laster, Steven / Cohen, David J / Chhatriwalla, Adnan K / Hart, Anthony / Baron, Suzanne J

Innovations (Philadelphia, Pa.)

2016 Volume 11, Issue 2, Page(s) 138–141

Abstract: Vascular access for large endovascular devices has evolved as patients have become more complicated and device indications have expanded. As the benefits of catheter-based treatments for aortic aneurysm repair and aortic valve replacement become ... ...

Abstract	Vascular access for large endovascular devices has evolved as patients have become more complicated and device indications have expanded. As the benefits of catheter-based treatments for aortic aneurysm repair and aortic valve replacement become mainstream, there is a need to address difficult vascular access by developing not only smaller-diameter devices but also creative options for vascular access. We describe direct descending thoracic aortic access during endovascular aneurysm repair, transcatheter aortic valve replacement, and redo mesenteric revascularization in three patients who did not have traditional access options.
MeSH term(s)	Aged ; Aged, 80 and over ; Aorta, Thoracic/surgery ; Aortic Aneurysm, Abdominal/surgery ; Aortic Valve Stenosis/surgery ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation ; Blood Vessel Prosthesis Implantation/methods ; Endovascular Procedures/adverse effects ; Endovascular Procedures/instrumentation ; Endovascular Procedures/methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/etiology ; Treatment Outcome
Language	English
Publishing date	2016-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1097/IMI.0000000000000225
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Article ; Online: Tailored endovascular repair of traumatic aortic disruptions with "stacked" abdominal aortic extension cuffs.

Allen, Keith B / Borkon, A Michael / Laster, Steven B / Aggarwal, Sanjeev / Davis, John R / Pak, Alexander F / Stewart, James R / Stuart, R Scott

Innovations (Philadelphia, Pa.)

2012 Volume 7, Issue 5, Page(s) 346–349

Abstract: Objective: The management paradigm for traumatic aortic disruptions has evolved from open to endovascular repair. Thoracic stent grafts designed to treat aneurysmal disease, however, have disadvantages, including size mismatch in younger trauma patients ...

Abstract	Objective: The management paradigm for traumatic aortic disruptions has evolved from open to endovascular repair. Thoracic stent grafts designed to treat aneurysmal disease, however, have disadvantages, including size mismatch in younger trauma patients and current standard lengths, which may needlessly necessitate coverage of at least 10 cm of thoracic aorta, increasing the risk of spinal cord ischemia. The "off-label" use of abdominal aortic extension cuffs to treat traumatic aortic disruptions may provide an advantage in this regard by better size matching for the younger trauma patient, reduced thoracic aortic coverage, and less cost to the institution. Methods: From 2008 to 2011, a total of 16 traumatic aortic disruptions were evaluated and managed with endovascular techniques. The last six were treated with abdominal aortic extensions cuffs (Excluder Extension Cuffs; W.L. Gore & Associates, Flagstaff, AZ) rather than traditional thoracic stent grafts. In addition to demographics and trauma-related data, additional endpoints evaluated in this retrospective review included operative time, number of cuffs used, stent cost data, procedural complications, and follow-up. Results: All six patients (five men/one woman) with traumatic aortic disruption were successfully treated with complete exclusion of the disruption using abdominal aortic cuffs. There were no complications including death or spinal cord ischemia. The average age was 27 years (range, 18-44 years). The average number of cuffs used to cover the traumatic tear was 2.6 per patient (range, 2-3 cuffs per patient), covering an average of 5.3 cm of thoracic aorta (range, 4-6 cm). Mean procedure time was 70 minutes. Hospital cost for each cuff was $2200 (average total stent cost per patient, $5720). For comparison, a single 10-cm conformable thoracic aortic graft (CTAG) (Gore) costs $14,500. Average follow-up of all six patients for up to 3 years demonstrates no complications or migration of the stent grafts. Conclusions: Traumatic aortic disruptions can be safely and selectively managed with "stacked" abdominal aortic extension cuffs. This tailored therapy may provide advantages over traditional thoracic stents, including improved size match in a younger trauma patient, less aortic coverage, and reduced cost.
MeSH term(s)	Adolescent ; Adult ; Aorta, Thoracic/injuries ; Aorta, Thoracic/surgery ; Blood Vessel Prosthesis ; Endovascular Procedures/methods ; Female ; Humans ; Male ; Prosthesis Design ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2012-09
Publishing country	United States
Document type	Journal Article
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1097/IMI.0b013e31827e7969
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Article ; Online: Nonculprit Lesion Severity and Outcome of Revascularization in Patients With STEMI and Multivessel Coronary Disease.

Sheth, Tej / Pinilla-Echeverri, Natalia / Moreno, Raul / Wang, Jia / Wood, David A / Storey, Robert F / Mehran, Roxana / Bainey, Kevin R / Bossard, Matthias / Bangalore, Sripal / Schwalm, Jon-David / Velianou, James L / Valettas, Nicholas / Sibbald, Matthew / Rodés-Cabau, Josep / Ducas, John / Cohen, Eric A / Bagai, Akshay / Rinfret, Stephane /

Newby, David E / Feldman, Laurent / Laster, Steven B / Lang, Irene M / Mills, Joseph D / Cairns, John A / Mehta, Shamir R

Journal of the American College of Cardiology

2020 Volume 76, Issue 11, Page(s) 1277–1286

Abstract: Background: In the COMPLETE (Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI) trial, angiography-guided percutaneous coronary intervention (PCI) of nonculprit lesions with the aim of complete ... ...

Abstract	Background: In the COMPLETE (Complete vs Culprit-only Revascularization to Treat Multi-vessel Disease After Early PCI for STEMI) trial, angiography-guided percutaneous coronary intervention (PCI) of nonculprit lesions with the aim of complete revascularization reduced major cardiovascular (CV) events in patients with ST-segment elevation myocardial infarction (MI) and multivessel coronary artery disease. Objectives: The purpose of this study was to determine the effect of nonculprit-lesion stenosis severity measured by quantitative coronary angiography (QCA) on the benefit of complete revascularization. Methods: Among 4,041 patients randomized in the COMPLETE trial, nonculprit lesion stenosis severity was measured using QCA in the angiographic core laboratory in 3,851 patients with 5,355 nonculprit lesions. In pre-specified analyses, the treatment effect in patients with QCA stenosis ≥60% versus <60% on the first coprimary outcome of CV death or new MI and the second co-primary outcome of CV death, new MI, or ischemia-driven revascularization was determined. Results: The first coprimary outcome was reduced with complete revascularization in the 2,479 patients with QCA stenosis ≥60% (2.5%/year vs. 4.2%/year; hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.47 to 0.79), but not in the 1,372 patients with QCA stenosis <60% (3.0%/year vs. 2.9%/year; HR: 1.04; 95% CI: 0.72 to 1.50; interaction p = 0.02). The second coprimary outcome was reduced in patients with QCA stenosis ≥60% (2.9%/year vs. 6.9%/year; HR: 0.43; 95% CI: 0.34 to 0.54) to a greater extent than patients with QCA stenosis <60% (3.3%/year vs. 5.2%/year; HR: 0.65; 95% CI: 0.47 to 0.89; interaction p = 0.04). Conclusions: Among patients with ST-segment elevation MI and multivessel coronary artery disease, complete revascularization reduced major CV outcomes to a greater extent in patients with stenosis severity of ≥60% compared with <60%, as determined by quantitative coronary angiography.
MeSH term(s)	Aged ; Coronary Angiography/methods ; Coronary Angiography/trends ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Revascularization/methods ; Myocardial Revascularization/trends ; Percutaneous Coronary Intervention/methods ; Percutaneous Coronary Intervention/trends ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/surgery ; Severity of Illness Index ; Treatment Outcome
Language	English
Publishing date	2020-09-10
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	605507-2
ISSN	1558-3597 ; 0735-1097
ISSN (online)	1558-3597
ISSN	0735-1097
DOI	10.1016/j.jacc.2020.07.034
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Zs.A 1846: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 196: Show issues

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Article ; Online: Comparison of procedural complications with versus without interventional cardiology fellows-in-training during contemporary percutaneous coronary intervention.

Stolker, Joshua M / Allen, Drew S / Cohen, David J / Kennedy, Kevin F / Laster, Steven B / Frutkin, Andrew D / Mehta, Sameer K / O'Neal, Kelly R / Marso, Steven P

The American journal of cardiology

2014 Volume 113, Issue 1, Page(s) 44–48

Abstract: Despite increasing complexity of contemporary procedures at tertiary care hospitals, the relationship between interventional cardiology fellows-in-training (ICFITs) and complications of percutaneous coronary intervention (PCI) has not been reported. We ... ...

Abstract	Despite increasing complexity of contemporary procedures at tertiary care hospitals, the relationship between interventional cardiology fellows-in-training (ICFITs) and complications of percutaneous coronary intervention (PCI) has not been reported. We compiled logbooks of 6 ICFITs at an academic hospital and evaluated patient and procedural characteristics of PCIs performed with and without presence of an ICFIT. The primary end point was the composite of all in-hospital PCI complications defined by the American College of Cardiology's National Cardiovascular Data Registry: (1) catheterization laboratory events such as no-reflow and dissection/perforation, (2) general clinical events such as stroke or cardiogenic shock, (3) vascular and bleeding complications, and (4) miscellaneous complications such as peak troponin or creatinine levels. Logistic regression adjusted for differences in measured confounders between patients treated with and without presence of an ICFIT. All analyses were repeated after excluding PCI for ST-elevation myocardial infarction. Of 2,605 PCI procedures at the academic hospital between July 2007 and April 2010, an ICFIT was present for 1,638 procedures (63%). Despite having worse clinical and procedural characteristics, patients in the ICFIT group experienced similar rates of the composite end point (12.9% vs 14.5% without ICFIT, p = 0.27). Longer mean fluoroscopy times and greater number of stents were noted in the ICFIT group; however, hospital length of stay was shorter and no individual adverse events were increased in the ICFIT procedures. Presence of an ICFIT remained unrelated to the composite end point after multivariable adjustment (odds ratio 0.92, 95% confidence interval 0.71 to 1.20; p = 0.53), and findings were similar after excluding PCI for ST-elevation myocardial infarction. In conclusion, in contemporary practice at a large academic medical center, PCI complication rates were not adversely affected by the presence of an ICFIT.
MeSH term(s)	Aged ; Cardiology/education ; Clinical Competence ; Education, Medical, Continuing ; Female ; Follow-Up Studies ; Hospitals, Teaching ; Humans ; Incidence ; Male ; Middle Aged ; Missouri/epidemiology ; Myocardial Infarction/surgery ; Percutaneous Coronary Intervention ; Postoperative Complications/epidemiology ; Retrospective Studies
Language	English
Publishing date	2014-01-01
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2013.08.037
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