Materials and Methods: Institutional review board approval and informed consent from all patients were obtained. Preprocedure color Doppler ultrasonography (US), magnetic resonance (MR) imaging, click here or computed
tomography (CT) were used to evaluate stenosis severity (70% or greater). Clinical findings and combined 30-day complication rates in 400 patients (289 men, 111 women; mean age, 73 years +/- 8 [standard deviation]) who underwent unprotected CAS for asymptomatic (n = 156; 39%) or symptomatic (n = 244, 61%) stenoses were analyzed. Follow-up at 30 days included neurologic evaluation and color Doppler US.
Results: Self-expanding stents were successfully deployed in 397 of 400 (99.25%) patients. Among the 397 patients, nine (2.27%) major complications (all in patients with prior symptoms) had occurred at 30 days, including three (0.76%) major (all
in patients who had stopped antiplatelet prophylaxis) and six (1.5%) minor strokes-three intraprocedural and three delayed. Minor complications included 16 (4%) transient ischemic attacks, four in asymptomatic and 12 in symptomatic patients. The 30-day combined adverse outcomes (transient ischemic attack, ipsilateral stroke, death) were significantly correlated with prior presence of symptoms (symptomatic, 8.6%; asymptomatic, 2.6%; P <.03).
Conclusion: Stent placement without EPD was performed with a high technical success rate. For asymptomatic patients, the combined 30-day adverse-outcomes rate was within the limits
recommended by the American Heart Association for carotid endarterectomy and compared favorably ARN-509 with results reported for CAS with EPD. When a transient ischemic attack is excluded, the 30-day combined death and stroke rate among patients with prior symptoms also compared favorably with published results. (C) RSNA, 2008″
“Background: The aim of this study was to assess the presence of evidence of ventricular mechanical dyssynchrony in patients with isolated left ventricular noncompaction cardiomyopathy (IVNC) and the potential usefulness of cardiac resynchronization therapy (CRT) in those patients.
Methods and Results: We studied 25 patients consecutively diagnosed with IVNC and a control group of 50 patients with dilated cardiomyopathy of different etiologies. Mechanical dyssynchrony was assessed by echocardiography by the presence of a septal flash, the time BMS-345541 manufacturer from peak septal to posterior wall displacement, and the time from septal to lateral wall peak systolic velocity. Among the patients with IVNC, 9 received CRT and were followed at 12 months. Overall, dyssynchrony parameters were significantly more frequent in IVNC, regardless of QRS duration. All 9 IVNC patients treated with CRT showed a septal flash, and a favorable response was observed in 8/9 patients (89%) regardless of QRS width.
Conclusions: The presence of mechanical dyssynchrony, amenable to correction with CRT, is common in patients with IVNC, independently from QRS width.