2nd Edition
Primary Angioplasty Mechanical Interventions for Acute Myocardial Infarction, Second Edition
The Second Edition of Primary Angioplasty provides an update on the rationale, techniques, and effectiveness of direct percutaneous mechanical revascularization for acute myocardial infarction. Through the use of "real world" methods, clinical perspectives, and mechanical support, this comprehensive resource guides interventional cardiologists and trainees through the angioplasty process safely and effectively.
Innovative and clearly presented, this text:
- includes coverage of the special needs of diabetic, elderly, and female patients
- explores stenting, thrombectomy, atherectomy, and other techniques
- discusses venous and arterial grafts, multivessel intervention, and aneurysmatic arteries
Preface
Contributors
The Clinical Perspective
Pathophysiology Basics of Acute Myocardial Infarction
Guido Parodi
The Epicardial Vessel
The Microcirculation
The Myocardium
References
Major Subgroups at Presentation
Angela Migliorini, Giampaolo Cerisano, Piergiovanni Buonamici, and Guia Moschi
Electrocardiography
Echocardiography
Angiography
Elderly
Women
Diabetics
Cardiogenic Shock
References
The Technical Perspective
Techniques
Angela Migliorini and Renato Valenti
Introduction
Entry Site
Guide Catheters
Coronary Wires and Angioplasty Balloons
Techniques for the Assessment of the Anatomy of a Target
Vessel Persistently Occluded After Crossing of the Wire
Thrombectomy
Emboli Protection Devices
Stents
Other Techniques
References
Platelet Glycoprotein IIb-IIIa Inhibitors
Renato Valenti, Guido Parodi, and Angela Migliorini
Abciximab
Eptifibatide and Tirofiban
Bivalirudin
Thienopyridines
Prevention and Treatment of Bleeding
References
Mechanical Support
Renato Valenti and Guido Parodi
Intra-Aortic Balloon Pumping
Other Percutaneous Mechanical Circulatory Support Devices
References
The Vessel Perspective
Renato Valenti and Angela Migliorini
Right Coronary Artery (RCA)
Left Anterior Descending Artery (LAD)
Left Circumflex Artery (LCX)
Left Main Trunk (LMT)
Multivessel Coronary Intervention
The Efficacy Perspective
Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction in the "Real World"
Renato Valenti, Emilio Vincenzo Dovellini and Giovanni Maria Santoro
The Effectiveness of Percutaneous Mechanical Intervention for Acute Myocardial Infarction
The Impact of Time to Treatment on Outcome of Patients Treated by PCI for Acute Myocardial Infarction
The Institutional Volume of Primary PCI
Logistic Models and Organizative Scenarios
The Role of Cardiac Surgery Backup
References
Rescue and Facilitated Percutaneous Coronary Interventions
Guido Parodi
Introduction
Rescue Angioplasty
Facilitated Primary Angioplasty
Transfer for Primary Angioplasty/Toward Myocardial
Infarction Center
References
Myocardial Stem Cell After Acute Myocardial Infarction
Nazario Carrabba
Intramyocardial Delivery of Stem Cell
The Risk of Accelerated Atherosclerosis
Final Considerations
References
The Assessment of Myocardial Reperfusion and Its Clinical Significance in Acute Myocardial Infarction
Giovanni Maria Santoro
The No-Reflow Phenomenon
Assessment of Myocardial Reperfusion
Conclusions
References
Index
Case Index (DVD)
Renato Valenti, Angela Migliorini, and Guido Parodi
Anterior AMI. Multilesion LAD PCI.
Inferior AMI and Multivessel Disease.
Inferior AMI. Direct RCA Stenting Complicated by Distal Macroembolization.
Anterior AMI Complicated by Cardiogenic Shock. LM Thrombotic Occlusion and RCA Ostium Stenosis.
Inferior AMI. Primary Multivessel Intervention.
NSTEMI. LM Calcific Lesion and 3-Vessel Disease. Multivessel DES Revascularization.
NSTEMI Complicated by Cardiogenic Shock. Multivessel DES Revascularization of LM Complex Anatomy Trifurcation and 3-Vessel Disease.
NSTEMI Complicated by Heart Failure. Diffuse Multivessel Disease. Aorto-Iliac Kinking. Multivessel DES Revascularization.
Lateral AMI. Multivessel PCI: Culprit OM Branch and Nonculprit LAD.
Anterior AMI. Three Vessel Simultaneous Thrombosis. Multivessel PCI.
Inferior AMI. Large Thrombus Post-RCA Stenosis. Thrombectomy Aspiration.
Anterolateral AMI Complicated by Heart Failure. Multivessel Disease. Ulcerated Plaque of LAD with Macroembolization. Rheolytic Thrombectomy and Multivessel PCI.
NSTEMI. LAD Ostium Ulcerated Plaque and Sovraimposed Thrombosis. Thrombectomy and Direct Stenting.
Anterior AMI. LAD Occlusion. The Case for Ultraselective Contrast Injection.
Inferior AMI. Thrombotic Occlusion of RCA. Proximal Antiembolic Protection RCA Stenting and Balloon Angioplasty of the Marginal Branch. One-Month Followup and Elective LAD PCI.
Anterior AMI. Thrombotic Occlusion of Distal LAD. Rheolytic Thrombectomy. After Removal of the Thrombus No Evidence of Atherosclerotic Plaque (Erosion).
Inferior AMI. RCA Direct Stenting with Distal Occlusive Antiembolic Device Support. Thrombotic Occlusive Embolization of PDA Treated with Bailout Rheolytic Thrombectomy.
Anterior AMI. LAD Spontaneous Dissection. Complete Spontaneous Healing of the Dissection.
Inferior AMI. Ostial RCA Occlusion. Right Ventricular Cardiogenic Shock.
Anterior AMI. Thrombotic Occlusion of LAD. Rheolytic Thrombectomy.
Inferior AMI. Massive Occlusive Thrombosis of an Aneurysmal RCA. Rheolytic Thrombectomy and Self-Expandable Mesh Stenting.
NSTEMI. Diffuse LM and 3-Vessel Disease. Multivessel Revascularization.
Anterolateral AMI. Tako-Tsubo Cardiomyopathy.
Anterior AMI. Spontaneous LAD Dissection.
Inferior AMI. RCA Occlusion and Severe Multivessel Disease.
Anterior AMI. Spontaneous Diagonal Branch Occlusive Dissection.
Inferior AMI. RCA Occlusion and Proximal LAD Vulnerable Plaque.
Inferior AMI. Long Spontaneous Dissection of PDA Treated with Multiple Stenting.
NSTEMI Complicated by Heart Failure. Multivessel PCI.
Anterior AMI. Direct DES Stenting. Refractory No-Reflow.
Inferior AMI. Massive Subocclusive Thrombosis of RCA. Rheolytic Thrombectomy.
Inferior AMI. Spontaneous Thrombotic Embolization.
Inferior AMI. Distal Occlusive Antiembolic Protection Device.
Anterior AMI. LAD Thrombotic Occlusion.
Anterior AMI Complicated by Cardiogenic Shock.
Anterior AMI. Cardiogenic Shock. Multivessel PCI.
Tako-Tsubo Cardiomyopathy (Ballooning Ventricle).
Anterior AMI. Cardiogenic Shock. Large Proximal LAD Aneurysm. Multidevice Support PCI.
Anterior AMI. Venous Graft Thrombotic Occlusion. Rheolytic Thrombectomy.
Anterior AMI Treated with DES. Recurrence of Angina.
Anterior AMI. Multivessel Ulcerated Lesions with Thrombotic LAD Occlusion. Rheolytic Thrombectomy and Multivessel Stenting.
Inferolateral AMI. Antiembolic Nonocclusive Distal Protection Device (Filter).
Anterior AMI. Cardiogenic Shock. LM Occlusion.
Anterior AMI. Previous Stenting of the Infarct Artery.
Inferior AMI. Rheolytic Thrombectomy.
Inferior AMI. Rheolytic Thrombectomy of a Tortuosus RCA.
Inferolateral AMI. Refractory No-Reflow.
Biography
David Antoniucci
