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Reich KM, Gill SS, Eckenhoff R, Berger M, Austin PC, Rochon PA, Nguyen P, Goodarzi Z, Seitz DP. Association between surgery and rate of incident dementia in older adults: A population-based retrospective cohort study. J Am Geriatr Soc 2024; 72:1348-1359. [PMID: 38165146 PMCID: PMC11090718 DOI: 10.1111/jgs.18736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/09/2023] [Accepted: 11/16/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The risk of incident dementia after surgery in older adults is unclear. The study objective was to examine the rate of incident dementia among older adults after elective surgery compared with a matched nonsurgical control group. METHODS We conducted a population-based, propensity-matched retrospective cohort study using data from linked administrative databases in Ontario, Canada. All community-dwelling individuals aged 66 years and older who underwent one of five major elective surgeries between April 1, 2007 and March 31, 2011 were included. Each surgical patient was matched 1:1 on surgical specialty of the surgeon at consultation, age, sex, fiscal year of entry, and propensity score with a patient who attended an outpatient visit with a surgeon of the same surgical specialty but did not undergo surgery. Patients were followed for up to 5 years after cohort entry for the occurrence of a new dementia diagnosis, defined from administrative data. Cause-specific hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the association between surgery and the hazard of incident dementia. Subgroup and sensitivity analyses were performed. RESULTS A total of 27,878 individuals (13,939 matched pairs) were included in the analysis. A total of 640 (4.6%) individuals in the surgical group and 965 (6.9%) individuals in the control group developed dementia over the 5-year follow-up period. Individuals who underwent surgery had a reduced rate of incident dementia compared with their matched nonsurgical controls (HR 0.88; 95% CI 0.80-0.97; p = 0.01). This association was persistent in most subgroups and after sensitivity analyses. CONCLUSIONS Elective surgery did not increase the rate of incident dementia when compared with matched nonsurgical controls. This could be an important consideration for patients and surgeons when elective surgery is considered.
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Affiliation(s)
- Krista M Reich
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sudeep S Gill
- Division of Geriatric Medicine, Department of Medicine, Queen's University, Kingston, Ontario, Canada
- ICES Queen's, Queen's University, Kingston, Ontario, Canada
| | - Roderic Eckenhoff
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Miles Berger
- Department of Anesthesiology, Duke Center for the Study of Aging and Human Development, and the Duke/UNC Alzheimer's Disease Research Center, Duke University Medical Centre, Durham, North Carolina, USA
| | - Peter C Austin
- ICES, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Paula A Rochon
- ICES, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Paul Nguyen
- ICES Queen's, Queen's University, Kingston, Ontario, Canada
| | - Zahra Goodarzi
- Division of Geriatric Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Dallas P Seitz
- ICES Queen's, Queen's University, Kingston, Ontario, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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2
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Iacono G, Bressan M, Turicchia GU. Renal intravascular shockwave lithotripsy in complex mono Ch-EVAR. Vascular 2024; 32:281-285. [PMID: 36355623 DOI: 10.1177/17085381221111020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Our objective is to present the Peripheral Intravascular Lithotripsy (IVL) System in the treatment of calcific renal artery stenosis (RAS) during Chimney Endovascular Aneurysm Repair (Ch-EVAR). The Ch-EVAR technique is a bail out procedure in treating aortic aneurysms with challenging anatomy regarding the proximal sealing zone. RAS typically involves varying degrees of calcification, and final treatment can be fraught with risk of vessel's damages and suboptimal results, particularly when renal angioplasty represents the only feasible course of action in Ch-EVAR. METHOD We present a case of a patient with a complex juxtarenal abdominal aortic aneurysm and a pre-obstructive chalky stenosis of the right renal artery who underwent mono ChEVAR associated to visceral Intravascular Lithotripsy shockwave angioplasty. CONCLUSION IVL is an attractive modality for the treatment of challenging, heavily calcified renal arteries that combines the calcium-disrupting capability of lithotripsy with the familiarity of balloon catheters to facilitate proper stent deployment. RESULT We propose the IVL system as an additional tool in the vascular surgeon's armamentarium not only to obtain large-bore access to enable Transaortic Valve Replacement (TAVR) and EVAR but also to perform angioplasty of severely calcified visceral arteries during Ch-EVAR.
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Affiliation(s)
- G Iacono
- Surgical and Major Trauma Department, AUSL Romagna,Vascular and Endovascular Surgery Unit of Cesena-Forlì, Cesena, Italy
| | - M Bressan
- School of Vascular Surgery, University of Ferrara, Ferrara, Italy
| | - G U Turicchia
- Surgical and Major Trauma Department, AUSL Romagna,Vascular and Endovascular Surgery Unit of Cesena-Forlì, Cesena, Italy
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Gardiner R, Muradagha H, Kiernan TJ. Intravascular lithotripsy during percutaneous coronary intervention: current concepts. Expert Rev Cardiovasc Ther 2022; 20:323-338. [PMID: 35466834 DOI: 10.1080/14779072.2022.2069561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Coronary artery calcification (CAC) is commonly encountered by interventional cardiologists. Severe CAC may impair stent delivery or result in stent underexpansion, stent thrombosis and/or in-stent restenosis (ISR). Multiple tools have been developed to help overcome the challenges associated with CAC and improve outcomes for these patients. Intravascular shockwave lithotripsy (IVL) is a novel therapy that uses acoustic pressure waves for the modification of CAC. AREAS COVERED This review discusses the growing body of evidence to support the safety and efficacy of IVL in the setting of de novo severely calcified coronary arteries prior to stenting. We also discuss international real world experience with the coronary IVL system. This includes the use of IVL in the setting of acute coronary syndrome (ACS), ISR and in combination with other tools for calcium modification. EXPERT OPINION IVL is a safe and effective therapy that results in the fracture of coronary calcium and facilitates optimal stent delivery and expansion. Longer term follow up is essential to shed light on the durability and late outcomes of an IVL strategy. Randomised control trials are warranted to compare IVL to alternative methods of calcium modification and to explore further the use of IVL for ACS.
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Affiliation(s)
- Roisin Gardiner
- Department of Cardiology, University Hospital Limerick, St. Nessan's Rd, Dooradoyle, Limerick, Ireland
| | - Hani Muradagha
- Department of Cardiology, University Hospital Limerick, St. Nessan's Rd, Dooradoyle, Limerick, Ireland
| | - Thomas J Kiernan
- Department of Cardiology, University Hospital Limerick, St. Nessan's Rd, Dooradoyle, Limerick, Ireland.,University of Limerick, Limerick, Ireland
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4
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Wu CH, Peng CK, Chung CH, Chien WC, Tzeng NS. Real-World Evidence for the Association Between Pneumonia-Related Intensive Care Unit Stay and Dementia. Psychiatry Investig 2022; 19:247-258. [PMID: 35500898 PMCID: PMC9058270 DOI: 10.30773/pi.2021.0277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/27/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE There is limited clarity concerning the risk of dementia after pneumonia with intensive care unit (ICU) stay. We conducted a nationwide cohort study, which aimed to investigate the impact of dementia after pneumonia with and without intensive care unit admission. METHODS Data was obtained from Taiwan's National Health Insurance Research Database between 2000 and 2015. A total of 7,473 patients were identified as having pneumonia required ICU stay, along with 22,419 controls matched by sex and age. After adjusting for confounding factors, multivariate Cox regression model analysis was used to compare the risk of developing dementia during the 15-years follow-up period. RESULTS The enrolled pneumonia patients with ICU admission had a dementia rate of 9.89%. Pneumonia patients without ICU admission had a dementia rate of 9.21%. The multivariate Cox regression model analysis revealed that the patients with ICU stay had the higher risk of dementia, with a crude hazard ratio of 3.371 (95% confidence interval, 3.093-3.675; p<0.001). CONCLUSION This study indicated that pneumonia with ICU stay is associated with an increased risk of dementia. A 3-fold risk of dementia was observed in patients admitted to the ICU compared to the control group.
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Affiliation(s)
- Chun-Han Wu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Kan Peng
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsian Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
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5
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Cho HJ, Yoo JH, Kim MH, Ko KJ, Jun KW, Han KD, Hwang JK. The risk of dementia in adults with abdominal aortic aneurysm. Sci Rep 2022; 12:1228. [PMID: 35075181 PMCID: PMC8786889 DOI: 10.1038/s41598-022-05191-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/03/2022] [Indexed: 01/06/2023] Open
Abstract
Abdominal aortic aneurysm (AAA) and dementia have similar epidemiological profiles and common pathogenic mechanisms. However, there have been few studies on the link between these two diseases. For this study, information from 2009 to 2015 was extracted from the Korean National Health Insurance system database. A total of 15,251 participants with a new diagnosis of AAA was included. Propensity score matching by age and sex with patients in whom AAA was not diagnosed was used to select the control group of 45,753 participants. The primary endpoint of this study was newly diagnosed dementia (Alzheimer's disease (AD), vascular dementia (VD), or other type of dementia). The incidence of dementia was 23.084 per 1000 person years in the AAA group, which was higher than that of the control group (15.438 per 1000 person years). When divided into AD and VD groups, the incidence of AD was higher than that of VD, but the HR of AAA for occurrence of dementia was higher in VD (1.382 vs. 1.784). Among the various risk factors, there was an interaction of age, hypertension, and history of cardiovascular disease with incidence of dementia (p < 0.05). In the presence of hypertension, the HR for occurrence of dementia was high according to presence or absence of AAA (1.474 vs 1.165). In addition, this study showed higher HR in the younger age group (age < 65) and in the group with no history of cardiovascular disease [1.659 vs. 1.403 (age), 1.521 vs. 1.255 (history of cardiovascular disease)]. AAA was associated with increased risk of dementia regardless of AD or VD, even after adjusting for several comorbidities. These findings indicate that follow-up with AAA patients is necessary for early detection of signs and symptoms of dementia.
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Affiliation(s)
- Hyung-Jin Cho
- Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Korea
| | - Ju-Hwan Yoo
- Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Korea
| | - Mi-Hyeong Kim
- Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Korea
| | - Kyung-Jai Ko
- Department of Surgery, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Kang-Woong Jun
- Division of Vascular and Transplant Surgery, Department of Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Gyeonggi-do, Korea
| | - Kyung-do Han
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul, 06978, Korea.
| | - Jeong-Kye Hwang
- Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021, Tongil-ro, Eunpyeong-gu, Seoul, 03312, Korea.
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Sattar Y, Ullah W, Virk HUH, Doshi R, Rauf H, Desai H, Panchal A, Nasir M, Almas T, Ullah I, Pacha HM, Zaher N, Alraies MC. Coronary intravascular lithotripsy for coronary artery calcifications- systematic review of cases. J Community Hosp Intern Med Perspect 2021; 11:200-205. [PMID: 33889320 PMCID: PMC8043535 DOI: 10.1080/20009666.2021.1883219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: Coronary artery calcification (CAC) is a pathological deposition of calcium in the intimal and medial layer of the arterial wall. A plethora of therapeutic calcium debulking techniques is available for the treatment of CAC, including orbital or rotational atherectomy, excimer lasers, cutting, and scoring balloons, which are associated with a soaring rate of complication and low efficacy. To this end, in 2016, the Food and Drug Administration (FDA) posited that shockwave intravascular lithotripsy (S-IVL) technique can be employed with minimal complication. Methods: A retrospective review of cases received lithotripsy for calcified coronary artery disease was performed by using online data from PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The available search results were downloaded into an Endnote library and analyzed into two phases. Results: Out of 24 participants from case reports and series, Majority were found to be Male. There was no significant difference found in the mortality of patients undergoing IVL for the stenosis of the left main stem, left anterior descending, left circumflex artery, or diagonal branch. The mortality was found to be high among 6 patients with prior comorbidities and underwent more than 3 cycles of IVL (OR 37,95% Cl 1.54–886.04, P 0.02). Out of 24 patients, 2 (8.33%) patients developed complications such as vessel dissection (OR 3.4, 95% Cl 17.87–64.68, P 0.4). Conclusion: Shockwave intravascular lithotripsy (S-IVL) may be used in cases of the calcified disease to gain vessel lumen in order to deploy drug-eluting stents with PCI. The success of the DES implantation of IVL can be 100% with a minimal complication rate.
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Affiliation(s)
- Yasar Sattar
- Department of Internal Medicine at Mount Sinai Elmhurst Hospital, New York, NY, USA
| | - Waqas Ullah
- Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA
| | - Hafeez Ul Hasan Virk
- Department of Interventional Cardiology, University Hospitals/Cleveland Medical Center/Case Western Reserve University, Cleveland, OH, USA
| | - Rajkumar Doshi
- Department of Internal Medicine, University of Nevada Reno School of Medicine, Reno, NV, USA
| | - Hiba Rauf
- Department of Medicine, American Society of Clinical Oncology, Alexandria, VA, USA
| | - Hardik Desai
- Department of Internal Medicine, Gujarat Adani Institute of Medical Sciences, Gujarat, India
| | - Ankur Panchal
- Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Mubarra Nasir
- Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi, Pakistan
| | - Talal Almas
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Ghandara University, Peshawar, Pakistan
| | - Homam Moussa Pacha
- Department of Cardiology, Memorial Hermann Heart and Vascular Institute, University of Texas, Houston, TX, USA
| | - Nathan Zaher
- Department of Internal Medicine, Wayne State University, Detroit Medical Center, DMC Heart Hospital, Detroit, MI, USA
| | - M Chadi Alraies
- Department of Interventional Cardiology, Detroit Medical Center, Detroit, MI, USA
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7
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Chung CH, Chien WC, Yeh HW, Tzeng NS. Psychiatric consultations as a modifiable factor for repeated suicide attempt-related hospitalizations: A nationwide, population-based study. J Affect Disord 2021; 278:157-164. [PMID: 32961411 DOI: 10.1016/j.jad.2020.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/26/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The risk of mortality and morbidity increased in repeated suicide attempts. This study aimed to investigate how psychiatric consultations, a modifiable factor, affects the risk of repeated suicide attempts in patients. METHODS The National Health Insurance Research Database was used in this study. All inpatients aged ≧10 with suicide attempts were recruited in Taiwan from 2000 through 2015. Both the cross-sectional and cohort studies were used to evaluate the risk of repeated suicide attempts associated with psychiatric consultations. RESULTS In the cross-sectional approach, a total of 88,161 suicide attempts and 7,997 with repeated suicide attempts were found. Multivariable logistic regression found that the patients with psychiatric consultations were associated with the decreased risk of repeated suicide attempt-related hospitalization (SARD), as per the adjusted odds ratio of 0.527 (95% confidence interval [CI]=0.416-0.859, p <0.001). In the retrospective cohort approach, the Fine and Gray's survival analysis revealed that the patients with psychiatric consultations were associated with a lower risk of repeated SARD (adjusted subdistribution hazard ratio [SHR] =0.533( 95% CI, 0.332-0.850, p <0.001). CONCLUSIONS Overall, psychiatric consultations for the patients could be a modifiable factor, which were associated with the decreased risk of repeated suicide attempts. The age of clinicians and their experience could be the primary variable above and beyond the mental illness or the performed suicide attempt method.
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Affiliation(s)
- Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Hui-Wen Yeh
- Institute of Bioinformatics and System Biology, National Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan.
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8
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Kassimis G, Didagelos M, De Maria GL, Kontogiannis N, Karamasis GV, Katsikis A, Sularz A, Karvounis H, Kanonidis I, Krokidis M, Ziakas A, Banning AP. Shockwave Intravascular Lithotripsy for the Treatment of Severe Vascular Calcification. Angiology 2020; 71:677-688. [PMID: 32567327 DOI: 10.1177/0003319720932455] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vascular calcification is a highly prevalent pathophenotype that is associated with aging, atherosclerotic cardiovascular disease, diabetes mellitus, and chronic kidney disease. When present, it portends a worse clinical outcome and predicts major adverse cardiovascular events. Heavily calcified coronary and peripheral artery lesions are difficult to dilate appropriately with conventional balloons during percutaneous intervention, and the use of several adjunctive strategies of plaque modification has been suggested. Intravascular lithotripsy (IVL) offers a novel option for lesion preparation of severely calcified plaques in coronary and peripheral vessels. It is unique among all technologies in its ability to modify calcium circumferentially and transmurally, thus modifying transmural conduit compliance. In this article, we summarize the currently available evidence on this technology, and we highlight its best clinical application through appropriate patient and lesion selection, with the main objective of optimizing stent delivery and implantation, and subsequent improved short- and long-term outcomes. We believe that the IVL balloon will transform the market, as it is easy to use, with predictable results. However, cost-effectiveness of such advanced technology will need to be considered.
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Affiliation(s)
- George Kassimis
- 2nd Cardiology Department, Hippokration Hospital, Aristotle University of Thessaloniki, Greece.,1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Matthaios Didagelos
- 1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | | | - Nestoras Kontogiannis
- Department of Cardiology, Cheltenham General Hospital, Gloucestershire Hospitals NHS, Foundation Trust, Cheltenham, United Kingdom
| | | | - Athanasios Katsikis
- Department of Cardiology, Essex Cardiothoracic Centre, Basildon, United Kingdom
| | - Agata Sularz
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Haralambos Karvounis
- 1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Ioannis Kanonidis
- 2nd Cardiology Department, Hippokration Hospital, Aristotle University of Thessaloniki, Greece
| | - Miltiadis Krokidis
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Antonios Ziakas
- 1st Cardiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki, Greece
| | - Adrian P Banning
- Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom
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9
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Venuti G, Piedimonte G, Castellana C, Ferrarotto L, Guarracini S, Azzalini L, Manna AL. Using the coronary lithotripsy system for coronary artery disease. Future Cardiol 2020; 17:59-71. [PMID: 32530304 DOI: 10.2217/fca-2020-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Severe coronary artery calcification increases percutaneous treatment complexity and the risk of intraprocedural complications, affecting acute and long-term outcomes. Current use of specialty balloons and atherectomy technologies is limited due to the higher risk of complications, degree of technical difficulty and operator experience. Intravascular lithotripsy (IVL) is a novel technology for severe calcified coronary artery disease that facilitates vessel preparation, enhancing vessel compliance. IVL system emits sonic waves that penetrate through vascular layers and disrupt both superficial and deep calcium, leaving the soft tissue unharmed. The purpose of the present review is to provide a summary of the evidence currently available on this therapy, including a practical description of the components and function of the shockwave coronary IVL system.
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Affiliation(s)
- Giuseppe Venuti
- Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania 95123, Italy
| | - Giulio Piedimonte
- Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania 95123, Italy
| | - Carmelo Castellana
- Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania 95123, Italy
| | - Luigi Ferrarotto
- Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania 95123, Italy
| | | | - Lorenzo Azzalini
- The Zena & Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Alessio La Manna
- Division of Cardiology, C.A.S.T., Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania 95123, Italy
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10
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Wang JC, Chien WC, Chung CH, Lin CY, Hsu CW, Lin CS, Tsai SH. Association between surgical repair of aortic aneurysms and the diagnosis of subsequent cardiovascular diseases. J Cardiol 2020; 75:621-627. [DOI: 10.1016/j.jjcc.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 11/25/2019] [Accepted: 12/08/2019] [Indexed: 11/27/2022]
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11
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Cermakova P. Changing utilization of cardiovascular drugs during the course of Alzheimer's disease. Int J Cardiol 2020; 300:226-227. [DOI: 10.1016/j.ijcard.2019.11.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/13/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022]
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12
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Wang JC, Chien WC, Chung CH, Lin CY, Chen YH, Liao MT, Liao WI, Hsu CC, Tsai SH. Association between surgical repair of aortic aneurysms and the diagnosis of intracranial aneurysms. J Vasc Surg 2019; 71:481-489. [PMID: 31204216 DOI: 10.1016/j.jvs.2019.04.466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 04/10/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Aortic aneurysms (AAs) and intracranial aneurysms (IAs) share several clinical risk factors, a genetic predisposition, and molecular signaling pathways. Nonetheless, associations between IAs and AAs remain to be thoroughly validated in large-scale studies. In addition, no effective medical therapies exist for unruptured IAs or AAs. METHODS Data for this nationwide, population-based, retrospective, cohort study described herein were obtained from the National Health Insurance Research Database in Taiwan. The study outcomes assessed were (1) the cumulative incidence of IAs, which was compared between AA and patients without an AA and (2) the cumulative incidence of IAs in patients with AAs during the 13-year follow-up period, which was further compared among those who underwent open surgical repair (OSR), endovascular aneurysm repair or nonsurgical treatment (NST). RESULTS Our analyses included 20,280 patients with an AA and 20,280 propensity score-matched patients without an AA. Compared with the patients without an AA, patients with AA exhibited a significantly increased risk of an IA diagnosis (adjusted hazard ratio [HR], 3.395; P < .001). Furthermore, 6308 patients with AAs were treated with surgical intervention and another 6308 propensity score-matched patients with AAs were not. Patients with an AA who underwent OSR had a significantly lower risk of being diagnosed with an IA than patients with an AA who underwent endovascular aneurysm repair or NST (adjusted HR, 0.491 [P < .001] and adjusted HR, 0.473 [P < .001], respectively). CONCLUSIONS We demonstrated an association between IAs and AAs, even after adjusting for several comorbidities. We also found that OSR was associated with fewer recognized IAs than NST.
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Affiliation(s)
- Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Chih-Yuan Lin
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yuan-Hao Chen
- Department of Neurosurgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Min-Tser Liao
- Department of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Wen-I Liao
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Ching Hsu
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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