Complication Of Angioplasty Research Articles

Risk Determination After an Acute Myocardial Infarction

The objective of the study was to provide comprehensive information for the clinical nurse specialist (CNS) on commonly used clinical prediction (risk assessment) tools used to estimate risk of a secondary cardiac or noncardiac event and mortality in patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). The evolution and widespread adoption of primary PCI represent major advances in the treatment of acute myocardial infarction, specifically STEMI. The American College of Cardiology and the American Heart Association have recommended early risk stratification for patients presenting with acute coronary syndromes using several clinical risk scores to identify patients' mortality and secondary event risk after PCI. Clinical nurse specialists are integral to any performance improvement strategy. Their knowledge and understandings of clinical prediction tools will be essential in carrying out important assessment, identifying and managing risk in patients who have sustained a STEMI, and enhancing discharge education including counseling on medications and lifestyle changes. Over the past 2 decades, risk scores have been developed from clinical trials to facilitate risk assessment. There are several risk scores that can be used to determine in-hospital and short-term survival. This article critiques the most common tools: the Thrombolytic in Myocardial Infarction risk score, the Global Registry of Acute Coronary Events risk score, and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications risk score. The importance of incorporating risk screening assessment tools (that are important for clinical prediction models) to guide therapeutic management of patients cannot be underestimated. The ability to forecast secondary risk after a STEMI will assist in determining which patients would require the most aggressive level of treatment and monitoring postintervention including outpatient monitoring. With an increased awareness of specialist assessment tools, the CNS can play an important role in risk prevention and ongoing cardiovascular health promotion in patients diagnosed with STEMI. Knowledge of clinical prediction tools to estimate risk for mortality and risk of secondary events after PCI for acute coronary syndromes including STEMI is essential for the CNS in assisting with improving short- and long-term outcomes and for performance improvement strategies. The risk score assessment utilizing a collaborative approach with the multidisciplinary healthcare team provides for the development of a treatment plan including any invasive intervention strategy for the patient.

Comparison of drug-eluting versus bare-metal stents after rotational atherectomy for the treatment of calcified coronary lesions

Calcified coronary lesions are a well-known risk factor for short and long-term failure after both bare metal stent (BMS) [ 1 Tan K. Sulke N. Taub N. Sowton E. Clinical and lesion morphologic determinants of coronary angioplasty success and complications: current experience. J Am Coll Cardiol. 1995; 25: 855-865 Google Scholar , 2 Hoffmann R. Mintz G.S. Popma J.J. et al. Treatment of calcified coronary lesions with Palmaz–Schatz stents. An intravascular ultrasound study. Eur Heart J. 1998; 19: 1224-1231 Google Scholar ] and drug eluting stent (DES) implantation [ 3 Moussa I. Ellis S.G. Jones M. et al. Impact of coronary culprit lesion calcium in patients undergoing paclitaxel-eluting stent implantation (a TAXUS-IV sub study). Am J Cardiol. 2005; 96: 1242-1247 Google Scholar , 4 Berenguer A. Mainar V. Bordes P. Valencia J. Gomez S. Lozano T. Incidence and predictors of restenosis after sirolimus-eluting stent implantation in high-risk patients. Am Heart J. 2005; 150: 536-542 Google Scholar , 5 Migliorini A. Shehu M. Carrabba N. et al. Predictors of outcome after sirolimus-eluting stent implantation for complex in-stent restenosis. Am J Cardiol. 2005; 96: 1110-1112 Google Scholar ]. Rotational atherectomy facilitates the delivery of stents in severely calcified coronary lesions by modifying plaque anatomy and smoothing inner vascular lumen. Recent reports suggest that the use of rotational atherectomy in combination with DES implantation for the treatment of severely calcified lesions might result in high procedural success and acceptable restenosis rate [ 6 Clavijo L.C. Steinberg D.H. Torguson R. et al. Sirolimus-eluting stents and calcified coronary lesions: clinical outcomes of patients treated with and without rotational atherectomy. Catheter Cardiovasc Interv. 2006; 68: 873-878 Google Scholar , 7 Garcia de Lara J. Pinar E. Ramon Gimeno J. et al. Percutaneous coronary intervention in heavily calcified lesions using rotational atherectomy and paclitaxel-eluting stents: outcomes at one year. Rev Esp Cardiol. 2010; 63: 107-110 Google Scholar , 8 Furuichi S. Sangiorgi G.M. Godino C. et al. Rotational atherectomy followed by drug-eluting stent implantation in calcified coronary lesions. EuroIntervention. 2009; 5: 370-374 Google Scholar , 9 Mezilis N. Dardas P. Ninios V. Tsikaderis D. Rotablation in the drug eluting era: immediate and long-term results from a single center experience. J Interv Cardiol. 2010; 23: 249-253 Google Scholar , 10 Benezet J. de la Llera LS Diaz Cubero J.M. Villa M. Fernandez-Quero M. Sanchez-Gonzalez A. Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions: long-term clinical outcomes. J Invasive Cardiol. 2011; 23: 28-32 Google Scholar ]. However, the long-term efficacy and safety of DES compared to BMS, in combination with rotational atherectomy in patients with calcified coronary lesions is limited.

Open Aortic Stent Grafting and Prosthetic Bypass in a Child

Pseudoaneurysm is a major complication of percutaneous balloon angioplasty to treat recoarctation and restenosis after an interrupted aortic arch repair. Endovascular stent grafting to manage this complication has rarely been performed in children. We used a combination of open stent grafting and a prosthetic ascending aorta-to-descending aorta bypass to treat a pseudoaneurysm and ascending aorta stenosis in a 7-year-old child.

Follow-up Results and Complications of Balloon Angioplasty in Children with Native Coarctation

Follow-up Results and Complications of Balloon Angioplasty in Children with Native Coarctation

Predictors and Implications of Coronary Infarct Artery Patency at Initial Angiography in Patients With Acute Myocardial Infarction (from the CADILLAC and HORIZONS-AMI Trials)

Pre-percutaneous coronary intervention (PCI) Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow has been identified as a predictor of final TIMI grade 3 flow and better survival. Yet pharmacologic strategies increasing the rates of pre-PCI TIMI grade 3 flow resulted in more bleeding, without a benefit in survival. The aim of this study was to identify the predictors and implications of spontaneous reperfusion before primary PCI in patients with ST-segment elevation myocardial infarction. The Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) and Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trials were combined, and the predictors of core laboratory-determined baseline TIMI grade 3 flow and 1-year outcomes were analyzed according to baseline TIMI flow. Baseline TIMI grade 3 flow was present in 932 of 5,332 patients (17.5%). The independent predictors of baseline TIMI grade 3 flow were diabetes, longer delay to PCI, smoking, and more extensive coronary disease. Patients with compared to those without baseline TIMI grade 3 flow had significantly higher rates of post-PCI TIMI grade 3 flow (99.1% vs 91.4%, p <0.0001) and lower 1-year all-cause mortality (2.7% vs 4.3%, p = 0.02). By multivariate analysis, baseline TIMI grade 3 flow (hazard ratio 1.65, 95% confidence interval 1.01 to 2.71, p = 0.046) and final TIMI grade 3 flow (hazard ratio 3.67, 95% confidence interval 2.45 to 5.48, p <0.001) were significant independent predictors of 1-year survival. In conclusion, TIMI grade 3 flow is present in about 1 in every 6 patients before PCI and paradoxically is more common in patients with higher risk characteristics. TIMI grade 3 flow before as well as after PCI is an independent predictor of greater 1-year survival. These data should inform future trials of ST-segment elevation myocardial infarction with respect to improvement in outcomes.

Long-term clinical outcome following lower limb arterial angioplasty

The aim of this study was to determine the clinical outcome of lower limb arterial angioplasty in a busy district general hospital practice. All angioplasties performed from January 1999 to December 2004 were identified and data collected included cardiovascular risk factors, indications for and complications of angioplasty, limb salvage and patient survival rates, and clinically significant re-stenoses. 471 interventions were performed in 385 patients (231 men, 154 women). The median age was 67.9 years (range: 39-93 years). Indications for angioplasty were critical ischaemia (n=247, 52%) and lifestyle-limiting intermittent claudication (n=224, 48%). Stenotic lesions accounted for 378 (80%) cases and occlusion for 93 (20%). Radiological success was obtained in 417 (88.5%), improving to 93.6% if only those in whom access was achieved were included. Post-angioplasty complications were observed in 42/471 (9.1%) of interventions. The actual patient survival at 1, 2, and 3 years was 87.4%, 85.1% and 83.2% respectively. Indication for angioplasty and the number of lesions present were identified as risk factors for outcome on multivariate analysis. The cumulative post-angioplasty patency rates at 1, 2 and 3 years were 86.0%, 83.1% and 81.6% respectively. The only factor associated with patency was the mode of presentation. Angioplasty for lower limb peripheral vascular disease can be performed safely and efficaciously with a high technical success rate and a low complication rate. The patient survival and post-angioplasty patency data reflect the progressive and multi-site nature of the underlying disease process.

Time Course of Reendothelialization of Stents in a Normal Coronary Swine Model

Late thrombosis of coronary drug-eluting stents is an infrequent but serious complication of percutaneous transluminal coronary angioplasty. The best predictor of this event is the lack of endothelialization of stent struts. The objective of this study is to characterize and quantify the time course of endothelialization of different stents implanted in nonatherosclerotic swine coronary arteries. Thirty-three Carbofilm-coated stents were implanted percutaneously in 11 anesthetized domestic, crossbred pigs (weight 25 ± 3 kg, 2 months old). Each animal received 1 stainless steel stent (SS), 1 cobalt-chromium stent (CCS), and 1 tacrolimus-eluting stent (TES) in each coronary artery. Follow-up periods were 1 day (n = 9 stents), 3 days (n = 9 stents), and 7 days (n = 15 stents). Longitudinal sections of the stented vessels were examined using scanning electron microscopy. At 1 day, there was scarce, patchy endothelialization with areas of fibrin; the endothelialization rate was similar for all the stents (SS, 29% ± 23%; CCS, 29% ± 24%; TES, 31% ± 25%; P = .9). At 3 days, there were more endothelial cells but with immature features and giant cells over fibrin; the endothelialization was greater in SS and CCS than in TES (SS, 79% ± 14%; CCS, 81% ± 17%; TES, 46% ± 9%; P = .007). At 7 days, arteries showed better endothelialization with few giant cells; the endothelialization was greater in SS and CCS than in TES (SS, 95% ± 4%; CCS, 98% ± 4%; TES, 79% ± 9%; P = .01). In conclusion, the described model is useful for the analysis of endothelialization of coronary stents and facilitates measurement of its rate of formation and characterization of the involved cell types.

Cervical carotid pseudoaneurysm: A carotid artery stenting complication

Background:As carotid artery stenting becomes increasingly used, more complications are likely to occur. We present a case of Staphylococcus septicemia and pseudoaneurysm arising in the neck portion of the carotid artery after stenting.Case Description:A 51-year-old man was admitted with mild left hemiparesis. CT and MRI showed right hemisphere ischemia. Duplex Scan and MRA showed bilateral severe stenosis of the carotid arteries in the neck. A percutaneous angioplasty with stenting of the left carotid artery was performed. Two weeks after the procedure, he developed fever and swelling in the right leg and shoulder. An abscess, near where the groin had been punctured for the angioplasty was surgically drained. Blood samples were positive for S. aureus. After treatment the patient complained of a painful bulky pulsatile left cervical mass. Duplex scan and MRA showed a pseudoaneurysm of the left carotid artery. We excised the pseudoaneurysm and rebuilt the carotid artery with a saphenous vein graft. The postoperative period was uneventful, and the MRA revealed a patent saphenous graft.Conclusion:Mycotic pseudoaneurysm of the carotid artery is a rare complication of percutaneous angioplasty and stenting. Surgical treatment with saphenous vein graft is the treatment of choice.

332 Predictors and prognostic value of contrast-induced nephropathy in patients undergoing primary angioplasty

Contrast-induced nephropathy (CIN) after coronariography has been associated to increased morbidity and mortality. Patients submitted to primary angioplasty seem to be at higher risk for CIN development, owing in part to hemodynamic status. We sought to determine the prevalence, predictors and prognostic value of CIN occurrence after primary angioplasty. A total of 141 patients consecutively submitted to primary angioplasty and admitted to our coronary unit were reviewed. CIN was defined as impairment of renal function occurring within 48 hours after administration of contrast media and manifested by an absolute increase in the serum creatinine level of at least 0.5 mg/dl or by a relative increase of at least 25% over the baseline value (in the absence of another cause). The primary end points were in-hospital and six-month mortality. CIN developed in 18.4% of the patients (n = 26). Patients with CIN were older (68 ± 13 vs 61 ± 13 years; p < 0.05) and more often had diabetes mellitus (38.5% vs 15.7%; p < 0.05). Although statistical significance was not reached, there was a trend for higher prevalence of hypertension (61.5% vs 42.6%; p = 0.09), female gender (30.8% vs 18.3%; p = 0.18) and Killip class higher than one at admission (26.9% vs 16.3%; p = 0.1) among patients with CIN. Patients with CIN had an higher mean time from symptoms to reperfusion (304 ± 192 vs 397 ± 206 minutes; p < 0.04). By multivariate analysis, independent correlates of CIN were older age (OR = 1.04; 95%CI = 1.01 − 1.08) and diabetes mellitus (OR = 2.99; 95%CI = 1.08 − 8.3). Patients with CIN had higher in-hospital (19.2% vs 0.9%; p < 0.05) and 6-month mortality (28.6% vs 4.9%; p < 0.05). CIN was a frequent complication of primary angioplasty (18.4% of the patients). Independent predictors of CIN after primary angioplasty were older age and diabetes mellitus. Patients with CIN had a worse prognosis, both during in-hospital stay and at 6 months.

Factors Influencing Carotid Stenting Complications

Risk factors for complications of carotid angioplasty with stenting (CAS) remain uncertain. Now, investigators have retrospectively analyzed baseline factors that could alter the combined risk for stroke and death within the first 30 days after attempted CAS in a multicenter, randomized, controlled trial that compared CAS and carotid endarterectomy (CEA) in patients with symptomatic, moderate-to-severe carotid stenosis. Among the 262 patients randomized to CAS, the combined risk for stroke and death was …

When Is Door-to-Balloon Time Critical? Analysis From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) Trials

When Is Door-to-Balloon Time Critical? Analysis From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) Trials

Effects of an Alpha-4 Integrin Inhibitor on Restenosis in a New Porcine Model Combining Endothelial Denudation and Stent Placement

Restenosis remains the main complication of balloon angioplasty and/or stent implantation. Preclinical testing of new pharmacologic agents preventing restenosis largely rely on porcine models, where restenosis is assessed after endothelial abrasion of the arterial wall or stent implantation. We combined endothelial cell denudation and implantation of stents to develop a new clinically relevant porcine model of restenosis, and used this model to determine the effects of an α4 integrin inhibitor, ELN 457946, on restenosis. Balloon-angioplasty endothelial cell denudation and subsequent implantation of bare metal stents in the left anterior descending coronary, iliac, and left common carotid arteries was performed in domestic pigs, treated with vehicle or ELN 457946, once weekly via subcutaneous injections, for four weeks. After 1 month, histopathology and morphometric analyses of the arteries showed complete healing and robust, consistent restenotic response in stented arteries. Treatment with ELN 457946 resulted in a reduction in the neointimal response, with decreases in area percent stenosis between 12% in coronary arteries and 30% in peripheral vessels. This is the first description of a successful pig model combining endothelial cell denudation and bare metal stent implantation. This new double injury model may prove particularly useful to assess pharmacological effects of drug candidates on restenosis, in coronary and/or peripheral arteries. Furthermore, the ELN 457946 α4 integrin inhibitor, administered subcutaneously, reduced inflammation and restenosis in stented coronary and peripheral arteries in pigs, therefore representing a promising systemic therapeutic approach in reducing restenosis in patients undergoing angioplasty and/or stent implantation.

Dissection coronaire extensive compliquant une angioplastie : à propos d’une série de 19 cas consécutifs

Purpose of the study Extensive coronary dissection is a rare complication of intraluminal angioplasty. We report a retrospective study of 19 patients who consulted in a general hospital without cardiac surgery. Patients and methods After consulting our coronarography and angioplasty database, we included the extensive coronary dissections (type D, E and F) in our study. The medical files of the selected patients were analysed. Results Between January 2003 and March 2010, 19 coronary angioplasty (total: 2542) were complicated with extensive dissections (incidence 0,75%). For 62,3% of the patients, the dissection was related to the guiding catheter. Eleven patients had type A and B1 lesions. The dissections affected the right coronary artery for 16 patients, the left anterior descending coronary artery for two patients and the left main coronary artery for one patient. After angioplasty, a final TIMI flow 3 was obtained for only 11 patients. In nine cases, we observed a limited extension to the aorta that did not need a chirurgical intervention and had no influence on the prognosis. The complications were common, such as death ( n = 1), coronary bypass ( n = 2), myocardial infarction ( n = 8), cardiogenic shock ( n = 2) and circulatory assistance ( n = 2). Conclusion Extensive coronary dissection is a rare complication of angioplasty. The right coronary is the most frequent vessel concerned and an extension to aorta is usual. The treatment is usually based on sealing the entry with a coronary stent. The complications are common and serious and we did not find any predicting factors to extensive coronary dissections that are unpredictable.

Impact of Bivalirudin Therapy in High-Risk Patients With Acute Myocardial Infarction: 1-Year Results From the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) Trial

This study sought to assess the relationship between 1-year mortality and baseline patient risk in the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial. The HORIZONS-AMI trial showed that bivalirudin compared with unfractionated heparin (UFH) plus glycoprotein IIb/IIIa inhibitors (GPI) decreased major bleeding and 30-day and 1-year mortality in patients undergoing primary percutaneous intervention for acute myocardial infarction. Patients in the HORIZONS-AMI trial were classified as low, intermediate, and high risk according to the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) risk score based on 7 clinical variables. Among 2,530 CADILLAC-score evaluable HORIZONS-AMI trial patients, 1,522 (60%) were classified as low risk, 531 (21%) as intermediate risk, and 477 (19%) as high risk. The mortality rates in the bivalirudin and UFH plus GPI arms, respectively, were 0.4% and 1.2% (p = 0.09) in the low-risk group, 4.2% and 4.1% (p = 0.99) in the intermediate-risk group, and 8.4% and 15.9% (p = 0.01) in the high-risk group. Among high-risk patients, there was also a decreased rate of recurrent myocardial infarction in patients randomized to bivalirudin as compared to UFH plus GPI (3.6% vs. 7.9%, p = 0.04). In high-risk patients undergoing primary percutaneous coronary intervention for acute myocardial infarction, bivalirudin compared with UFH plus GPI reduces 1-year mortality and recurrent myocardial infarction. (HORIZONS-AMI trial; NCT00433966).

Thrombectomy During Primary Angioplasty: Methods, Devices, and Clinical Trial Data

Distal embolization is a relatively common complication in primary angioplasty and is associated with poor perfusion and higher mortality. The aim of this article is to critically review literature on thrombectomy devices to prevent distal embolization in patients undergoing primary angioplasty. Several manual and mechanical devices have been proposed. Although negative data have been observed with mechanical devices, significant impact on mortality has been observed with routine use of manual thrombectomy devices, due to an improvement in myocardial perfusion and reduction in distal embolization. Therefore, routine adjunctive manual thrombectomy devices should be recommended in the setting of ST-segment elevation myocardial infarction, whereas the use of larger manual thrombectomy devices (7F) or mechanical devices may be considered in patients with large thrombotic burden to provide more guarantees for complete thrombus removal.

When Is Door-to-Balloon Time Critical?: Analysis From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) Trials

Our objective was to evaluate the impact of door-to-balloon time (DBT) on mortality depending on clinical risk and time to presentation. DBT affects the mortality rate in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention, but the impact may vary across subgroups. The CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) and HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trials evaluated stent and antithrombotic therapy in patients undergoing primary percutaneous coronary intervention. We studied the impact of DBT on mortality in 4,548 patients based on time to presentation and clinical risk. The 1-year mortality rate was lower in patients with short versus long DBT (< or = 90 min vs. >90 min, 3.1% vs. 4.3%, p = 0.045). Short DBTs were associated with a lower mortality rate in patients with early presentation (< or = 90 min: 1.9% vs. 3.8%, p = 0.029) but not those with later presentation (>90 min: 4.0% vs. 4.6%, p = 0.47). Short DBTs showed similar trends for a lower mortality rate in high-risk (5.7% vs. 7.4%, p = 0.12) and low-risk (1.1% vs. 1.6%, p = 0.25) patients. Short DBTs had similar relative risk reductions in patients with early presentation in high-risk (3.7% vs. 7.0%, p = 0.08) and low-risk (0.8% vs. 1.5%, p = 0.32) patients, although the absolute benefit was greatest in high-risk patients. Short DBTs (< or = 90 min) are associated with a lower mortality rate in patients with early presentation but have less impact on the mortality rate in patients presenting later. The absolute mortality rate reduction with short DBT is greatest in high-risk patients presenting early. These data may be helpful in designing triage strategies for reperfusion therapy in patients presenting to non-percutaneous coronary intervention hospitals.

Complications of Angioplasty and Stenting of Cervicocerebral Arteries in Iran

Angioplasty and stenting of the cervicocerebral arteries is a novel treatment for atherosclerotic stenosis, which has periprocedural complications. Data were collected prospectively from 2007 to 2009 in a multicenter cohort of patients undergoing interventions for cervicocerebral stenosis. Retrospective assessment of the 2003-2006 archives of the same interventionists and a review of their published work is the second part of this national survey. In 592 extracranial internal carotid artery angioplasty and stenting procedures in 581 patients (73% male; mean age, 63.4 + or - 7 years), transient ischemic attack, stroke, intracerebral hemorrhage, and death occurred in 1.7%, 1.7%, 0.34%, and 1.52%, respectively. In 114 extracranial vertebral artery angioplasty and stenting procedures in 110 patients (68% male; mean age, 65.3 + or - 6 years), transient ischemic attack and stroke each developed in 1 (0.92%) patient, but there was no intracerebral hemorrhage or death. In 70 intracranial angioplasty and stenting procedures in 67 patients (76% male; mean age, 68.5 + or - 8 years), transient ischemic attack, stroke, intracerebral hemorrhage, and death were observed in 1.4%, 8.6%, 1.4%, and 2.9%, respectively. The frequency of periprocedural complications in angioplasty and stenting of cervicocerebral arteries by our neurointerventionists was similar to that in developed countries.

Dissection carotidienne au cours d’une angioplastie pour vasospasme après hémorragie sous-arachnoïdienne. Apport du monitorage cérébral « multimodal »

We report the case of a 54-year-old woman presenting subarachnoid haemorrhage. She experienced multiple vasospasms and treatment included triple-H (hypervolaemia, hypertension, and haemodilution) and endovascular therapies. Right internal carotid dissection complicated angioplasty of the right middle cerebral artery. Combined brain tissue partial pressure of oxygen monitoring and transcranial echo-Doppler could have facilitated early diagnosis. Despite successful revascularization of right internal carotid by stenting, this complication caused acute stroke with refractory intracranial hypertension.

Interventional percutaneous trans-splenic approach in the management of portal venous occlusion after living donor liver transplantation

Interventional percutaneous trans-splenic approach in the management of portal venous occlusion after living donor liver transplantation

Antiphospholipid Syndrome, Microalbuminuria, and Risk of Venous Thromboembolism

nary Events Investigators. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163(19):2345-2353. 3. Halkin A, Singh M, Nikolsky E, et al. Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. J Am Coll Cardiol. 2005;45(9):1397-1405. 4. Mehta RH, O’Neill WW, Harjai KJ, et al; Primary Angioplasty in Myocardial Infarction (PAMI) and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Investigators. Prediction of oneyear mortality among 30-day survivors after primary percutaneous coronary interventions. Am J Cardiol. 2006;97(6):817-822.