JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Jul 2010
Randomized Controlled Trial Multicenter Study Comparative StudyReal-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: FAUST (Femoral Arterial Access With Ultrasound Trial).
The aim of this study was to compare the procedural and clinical outcomes of femoral arterial access with ultrasound (US) guidance with standard fluoroscopic guidance. ⋯ In this multicenter randomized controlled trial, routine real-time US guidance improved CFA cannulation only in patients with high CFA bifurcations but reduced the number of attempts, time to access, risk of venipunctures, and vascular complications in femoral arterial access. (Femoral Arterial Access With Ultrasound Trial [FAUST]; NCT00667381).
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JACC Cardiovasc Interv · Jul 2010
Comparative StudyInsurance type influences the use of drug-eluting stents.
We sought to examine the effect of insurance type upon the likelihood of receiving a drug-eluting stent (DES). ⋯ Insurance status has a significant impact upon the decision to use DES. Efforts to address this disparity should focus on the patient-provider level.
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JACC Cardiovasc Interv · Jul 2010
Comparative StudyPre-hospital triage for primary angioplasty: direct referral to the intervention center versus interhospital transport.
We sought to study the impact of direct referral to an intervention center after pre-hospital diagnosis of ST-segment elevation myocardial infarction (STEMI) on treatment intervals and outcome. ⋯ After ambulance-based diagnosis of STEMI, direct transport to an intervention center with pre-hospital notification of the catheterization laboratory more than triples the proportion of patients treated within the time window of the guidelines. Time to balloon was an independent predictor of post-procedural TIMI flow grade 3, which underscores the need to reduce treatment delays.
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JACC Cardiovasc Interv · Jul 2010
Transcatheter closure of paravalvular defects using a purpose-specific occluder.
This study sought to describe a method of paravalvular leak closure using a purpose-specific occlusion device. ⋯ Closure of mitral and aortic prosthetic paravalvular leaks with the Vascular Plug III using either a transapical (mitral) or a retrograde (aortic) approach appears promising.