myocardial-infarction-percutaneous-embolization-coil-deployment-swine

Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model

Myocardial infarction (MI) is the leading cause of mortality worldwide. Despite the use of evidence-based treatments, including coronary revascularization ...

Germans Trias i Pujol University Hospital

Instituto de Salud Carlos III

En la angioplastia primaria, el intervalo entre el primer contacto m&eacute;dico (FMC) y reperfusi&oacute;n debe ser menos de 120 minutos. El tiempo de reperfusi&oacute;n var&iacute;a dependiendo de donde se establece la FMC. Estudios recientes sugieren tiempos m&aacute;s largos en pacientes que presentan en apagado-horas. El objetivo es evaluar los intervalos de tiempo entre el inicio de los s&iacute;ntomas y la reperfusi&oacute;n seg&uacute;n donde se produce la FMC y el tiempo del d&iacute;a de la presentaci&oacute;n del paciente.

[An&aacute;lisis de retardo de reperfusi&oacute;n en pacientes con infarto agudo de miocardio tratan con angioplastia primaria basada en primer contacto m&eacute;dico y tiempo de presentaci&oacute;n].

&#x521D;&#x7EA7;&#x8840;&#x7BA1;&#x6210;&#x5F62;&#x672F;&#xFF0C;&#x7B2C;&#x4E00;&#x6B21;&#x533B;&#x7597;&#x63A5;&#x89E6; &#xFF08;FMC&#xFF09; &#x548C;&#x518D;&#x704C;&#x6CE8;&#x4E4B;&#x95F4;&#x7684;&#x95F4;&#x9694;&#x5E94;&#x4E0D;&#x5C11;&#x4E8E; 120 &#x5206;&#x949F;&#x3002;&#x5987;&#x8054;&#x5728;&#x90A3;&#x91CC;&#x5EFA;&#x7ACB;&#x5F02;&#x5BF9;&#x518D;&#x704C;&#x6CE8;&#x7684;&#x65F6;&#x95F4;&#x3002;&#x6700;&#x8FD1;&#x7684;&#x7814;&#x7A76;&#x8868;&#x660E;&#x60A3;&#x8005;&#x5448;&#x73B0;&#x5728;&#x975E;&#x5DE5;&#x4F5C;&#x65F6;&#x95F4;&#x66F4;&#x957F;&#x7684;&#x65F6;&#x95F4;&#x3002;&#x76EE;&#x6807;&#x662F;&#x8BC4;&#x4F30;&#x51FA;&#x73B0;&#x75C7;&#x72B6;&#x548C;&#x518D;&#x704C;&#x6CE8;&#x6839;&#x636E; FMC &#x51FA;&#x73B0;&#x7684;&#x4F4D;&#x7F6E;&#x548C;&#x65F6;&#x95F4;&#x7684;&#x8010;&#x5FC3;&#x6F14;&#x793A;&#x6587;&#x7A3F;&#x7684;&#x4E00;&#x5929;&#x4E4B;&#x95F4;&#x7684;&#x65F6;&#x95F4;&#x95F4;&#x9694;&#x3002;

[&#x6025;&#x6027;&#x5FC3;&#x808C;&#x6897;&#x6B7B;&#x60A3;&#x8005;&#x518D;&#x704C;&#x6CE8;&#x5EF6;&#x8FDF;&#x6CBB;&#x7597;&#x5206;&#x6790;&#x521D;&#x7EA7;&#x8840;&#x7BA1;&#x6210;&#x5F62;&#x672F;&#x57FA;&#x4E8E;&#x533B;&#x7597;&#x7684;&#x7B2C;&#x4E00;&#x6B21;&#x63A5;&#x89E6;&#x548C;&#x6F14;&#x793A;&#x6587;&#x7A3F;&#x7684;&#x65F6;&#x95F4;]&#x3002;

In primary angioplasty, the interval between first medical contact (FMC) and reperfusion should be less than 120 minutes. The time to reperfusion varies depending on where FMC is established. Recent studies suggest longer times in patients presenting in off-hours. The objective is to evaluate the time intervals between the onset of symptoms and reperfusion according to where the FMC occurs and time of day of patient presentation.

[Analysis of reperfusion delay in patients with acute myocardial infarction treated with primary angioplasty based on first medical contact and time of presentation].

Angioplastie primaire, l&#39;intervalle entre le premier contact m&eacute;dical (FMC) et de la reperfusion doit &ecirc;tre inf&eacute;rieure &agrave; 120 minutes. Le temps de r&eacute;-perfusion varie en fonction d&#39;o&ugrave; FMC est &eacute;tabli. Des &eacute;tudes r&eacute;centes sugg&egrave;rent plus longs chez les patients pr&eacute;sentant en heures creuses. L&#39;objectif est d&#39;&eacute;valuer les intervalles de temps entre l&#39;apparition des sympt&ocirc;mes et de la reperfusion, selon le cas de la FMC et le moment de la journ&eacute;e de pr&eacute;sentation de patiente.

[Analyse de d&eacute;lai de reperfusion chez les patients avec infarctus aigu du myocarde trait&eacute;s par angioplastie primaire bas&eacute;e sur le premier contact m&eacute;dical et l&#39;heure de pr&eacute;sentation].

In prim&auml;re Angioplastie sollte das Intervall zwischen &auml;rztlichen Erstkontakt (FMC) und Reperfusion weniger als 120 Minuten. Die Zeit zur Reperfusion h&auml;ngt von dem FMC ans&auml;ssig ist. Neuere Studien legen nahe, l&auml;ngere Zeiten bei Patienten, die in Ruhezeiten zu pr&auml;sentieren. Ziel ist es, die Zeitintervalle zwischen dem Auftreten von Symptomen und Reperfusion nach wo die FMC auftritt und Zeit des Tages Patienten Pr&auml;sentation zu bewerten.

[Analyse der Reperfusion Verz&ouml;gerung bei Patienten mit akutem Myokardinfarkt mit prim&auml;rer Angioplastie basierend auf medizinischen Erstkontakt und Zeitpunkt der Pr&auml;sentation behandelt].

L&#39;angioplastica primaria, l&#39;intervallo tra il primo contatto medico (FMC) e riperfusione dovrebbe essere meno di 120 minuti. Il tempo di riperfusione varia a seconda di dove &egrave; stabilito FMC. Studi recenti suggeriscono pi&ugrave; volte in pazienti che presentano in fuori orario. L&#39;obiettivo &egrave; quello di valutare gli intervalli di tempo tra l&#39;insorgenza dei sintomi e riperfusione secondo cui si verifica il FMC e il momento della giornata di presentazione paziente.

[Analisi del ritardo di riperfusione in pazienti con infarto miocardico acuto trattati con angioplastica primaria basato sul tempo di presentazione e di primo contatto medico].

&#x521D;&#x56DE;&#x8840;&#x7BA1;&#x5F62;&#x6210;&#x8853;&#x306E;&#x6700;&#x521D;&#x533B;&#x5B66;&#x306E;&#x63A5;&#x70B9; (FMC) &#x3068;&#x518D;&#x704C;&#x6D41;&#x306E;&#x9593;&#x9694; 120 &#x5206;&#x672A;&#x6E80;&#x3059;&#x308B;&#x5FC5;&#x8981;&#x304C;&#x3042;&#x308A;&#x307E;&#x3059;&#x3002;&#x518D;&#x704C;&#x6D41;&#x3059;&#x308B;&#x6642;&#x9593;&#x306F;&#x3001;FMC &#x304C;&#x78BA;&#x7ACB;&#x3055;&#x308C;&#x308B;&#x5834;&#x6240;&#x306B;&#x5FDC;&#x3058;&#x3066;&#x7570;&#x306A;&#x308A;&#x307E;&#x3059;&#x3002;&#x6700;&#x8FD1;&#x306E;&#x7814;&#x7A76;&#x6642;&#x9593;&#x304C;&#x9577;&#x304F;&#x6642;&#x9593;&#x5916;&#x3067;&#x63D0;&#x793A;&#x3059;&#x308B;&#x60A3;&#x8005;&#x3092;&#x304A;&#x52E7;&#x3081;&#x3057;&#x307E;&#x3059;&#x3002;&#x76EE;&#x7684;&#x306F;&#x3001;&#x75C7;&#x72B6;&#x306E;&#x767A;&#x75C7;&#x3068;&#x518D;&#x704C;&#x6D41; FMC &#x304C;&#x767A;&#x751F;&#x3059;&#x308B;&#x5834;&#x6240;&#x306B;&#x3088;&#x308B;&#x3068;&#x3001;&#x60A3;&#x8005;&#x306E;&#x30D7;&#x30EC;&#x30BC;&#x30F3;&#x30C6;&#x30FC;&#x30B7;&#x30E7;&#x30F3;&#x306E;&#x65E5;&#x306E;&#x6642;&#x9593;&#x306E;&#x9593;&#x306E;&#x6642;&#x9593;&#x9593;&#x9694;&#x3092;&#x8A55;&#x4FA1;&#x3059;&#x308B;&#x305F;&#x3081;&#x306B;&#x3067;&#x3059;&#x3002;

[&#x533B;&#x7642;&#x306E;&#x6700;&#x521D;&#x306E;&#x63A5;&#x89E6;&#x3068;&#x30D7;&#x30EC;&#x30BC;&#x30F3;&#x30C6;&#x30FC;&#x30B7;&#x30E7;&#x30F3;&#x306E;&#x6642;&#x9593;&#x306B;&#x57FA;&#x3065;&#x3044;&#x3066;&#x30D7;&#x30E9;&#x30A4;&#x30DE;&#x30EA;&#x8840;&#x7BA1;&#x5F62;&#x6210;&#x8853;&#x3067;&#x6CBB;&#x7642;&#x6025;&#x6027;&#x5FC3;&#x7B4B;&#x6897;&#x585E;&#x60A3;&#x8005;&#x306B;&#x304A;&#x3051;&#x308B;&#x518D;&#x704C;&#x6D41;&#x9045;&#x5EF6;&#x306E;&#x89E3;&#x6790;]&#x3002;

&#xAE30;&#xBCF8; &#xD655;&#xC7A5; &#xC220;&#xC5D0; &#xCCAB; &#xC758;&#xB8CC; &#xC811;&#xCD09; (FMC)&#xC640; reperfusion &#xC0AC;&#xC774;&#xC758; &#xAC04;&#xACA9; 120 &#xBD84; &#xBBF8;&#xB9CC; &#xC774;&#xC5B4;&#xC57C; &#xD55C;&#xB2E4;. Reperfusion &#xC2DC;&#xAC04; FMC&#xB97C; &#xC124;&#xB9BD;&#xC5D0; &#xB530;&#xB77C; &#xB2EC;&#xB77C; &#xC9D1;&#xB2C8;&#xB2E4;. &#xCD5C;&#xADFC; &#xC5F0;&#xAD6C; &#xC81C;&#xC548; &#xC2DC;&#xAC04;&#xC5D0;&#xC11C; &#xC81C;&#xC2DC; &#xD558;&#xB294; &#xD658;&#xC790;&#xC5D0;&#xC11C; &#xB354; &#xAE34; &#xC2DC;&#xAC04;. &#xBAA9;&#xD45C; &#xC99D;&#xC0C1; &#xBC1C;&#xBCD1;&#xACFC; reperfusion&#xB294; FMC&#xAC00; &#xBC1C;&#xC0DD; &#xD558;&#xB294; &#xC704;&#xCE58;&#xC5D0; &#xB530;&#xB77C; &#xADF8;&#xB9AC;&#xACE0; &#xD658;&#xC790;&#xC758; &#xD504;&#xB808; &#xC820; &#xD14C;&#xC774; &#xC158;&#xC758; &#xD558;&#xB8E8; &#xC911; &#xC2DC;&#xAC04; &#xC0AC;&#xC774;&#xC758; &#xC2DC;&#xAC04; &#xAC04;&#xACA9;&#xC744; &#xD3C9;&#xAC00; &#xD558;&#xB294; &#xAC83;.

[&#xAE09;&#xC131; &#xC2EC;&#xADFC; &#xACBD;&#xC0C9; &#xD658;&#xC790;&#xC5D0;&#xC11C; reperfusion &#xC9C0;&#xC5F0; &#xBD84;&#xC11D; &#xCCAB; &#xC758;&#xB8CC; &#xC5F0;&#xB77D;&#xCC98; &#xBC0F; &#xD504;&#xB808; &#xC820; &#xD14C;&#xC774; &#xC158;&#xC758; &#xC2DC;&#xAC04;&#xC5D0; &#xB530;&#xB77C; &#xAE30;&#xBCF8; &#xD655;&#xC7A5; &#xC220;&#xC73C;&#xB85C; &#xCE58;&#xB8CC;].

Use of the transradial approach (TRA) in percutaneous coronary intervention (PCI) has increased in recent years. TRA has a lower mortality rate than the transfemoral approach (TFA) in patients with acute coronary syndrome. Comparative studies have systematically excluded patients with cardiogenic shock (CS).

Transradial percutaneous coronary intervention in cardiogenic shock: a single-center experience.

Integration of a local into a regional primary angioplasty action plan (the Catalan Codi Infart network) reduces time to reperfusion.

Previous trials in elderly patients with ST-elevation myocardial infarction (STEMI) have not shown a definitive benefit of primary percutaneous coronary intervention (PPCI) by transfemoral approach over thrombolysis. The transradial approach (TRA) is associated with a significant decrease in mortality, MACE (Major Adverse Cardiac Event), and serious access site complications compared with the transfemoral approach. We have evaluated clinical outcomes in a cohort of real-life unselected ≥75-year-old patients with STEMI treated by TRA-PPCI. This is a single-center prospective, observational registry of consecutive patients with STEMI who underwent PPCI between February 2007 and February 2013. MACE was defined as death, reinfarction, or stroke. A total of 307 patients were treated by PPCI, 293 (95.1%) with TRA-PPCI (mean age 80 ± 2 years, 42% women). Patients had high co-morbidity levels (cardiogenic shock on admission 8.5%, previous myocardial infarction 11.6%, diabetes 30.4%, previous renal failure 25.6%, previous PCI 9.6%, and peripheral arterial disease 14.3%); IIbIIIa inhibitors were used in 45.1% of patients. Severe bleeding and need for transfusion were recorded for 6.5% and 9.9% of patients, respectively. In-hospital mortality, 1-year mortality, and 1-year MACE were 11.9%, 17.4%, and 22.2%, respectively. Excluding 25 patients with cardiogenic shock on admission, the in-hospital mortality, 1-year mortality, and 1-year MACE were 7.8%, 13.1%, and 17.9%, respectively. In conclusion, TRA-PPCI was feasible in the vast majority of elderly patients with STEMI. In-hospital mortality, 1-year mortality, and 1-year MACE were lower than reported for transfemoral access, suggesting a benefit of the TRA in these patients.

Results of primary percutaneous coronary intervention in patients ≥75 years treated by the transradial approach.

Distal Bioresorbable Vascular Scaffold Strut Embolization Detected at Late Follow-Up: A New BVS-Related Late Complication.

Renal denervation is a percutaneous intervention for the treatment of resistant hypertension. Randomized studies have shown contradictory results on its efficacy. We present the results of a renal denervation registry for the treatment of resistant hypertension in real-life patients in Spain.

Renal denervation for the treatment of resistant hypertension in Spain. The Flex-Spyral Registry.

There is an increasing need for safe and simple techniques for sensing devices and prostheses implanted inside the human body. Microwave wireless inspection may be an appropriate technique for it. The implanted device may have specific characteristics that allow to distinguish it from its environment. A new sensing technique based on the principle of differential resonance is proposed and its basic parameters are discussed. This technique allows to use the implant as a signal scattering device and to detect changes produced in the implant based on the corresponding change in its scattering signature. The technique is first tested with a canonic human phantom and then applied to a real in vivo clinical experiment to detect coronary stents implanted in swine animals.

Resonance-Based Microwave Technique for Body Implant Sensing.

The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak.

Article	Year
[Analysis of reperfusion delay in patients with acute myocardial infarction treated with primary angioplasty based on first medical contact and time of presentation]. Revista espaÃ±ola de cardiologÃa\| PubMed ID: 21570168	2011
Transradial percutaneous coronary intervention in cardiogenic shock: a single-center experience. American heart journal\| PubMed ID: 23453093	2013
Integration of a local into a regional primary angioplasty action plan (the Catalan Codi Infart network) reduces time to reperfusion. International journal of cardiology\| PubMed ID: 23746620	2013
Results of primary percutaneous coronary intervention in patients ≥75 years treated by the transradial approach. The American journal of cardiology\| PubMed ID: 24315363	2014
Distal Bioresorbable Vascular Scaffold Strut Embolization Detected at Late Follow-Up: A New BVS-Related Late Complication. JACC. Cardiovascular interventions\| PubMed ID: 30878472	2019
Renal denervation for the treatment of resistant hypertension in Spain. The Flex-Spyral Registry. Revista espanola de cardiologia (English ed.)\| PubMed ID: 31561981	2020
Resonance-Based Microwave Technique for Body Implant Sensing. Sensors (Basel, Switzerland)\| PubMed ID: 31698742	2019
Impact of COVID-19 on ST-segment elevation myocardial infarction care. The Spanish experience. Revista espanola de cardiologia (English ed.)\| PubMed ID: 32917566	2020

Oriol Rodriguez-Leor

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