Browsing by Subject "Reperfusion therapy"

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    Large-bore aspiration thrombectomy for the treatment of pulmonary embolism in octogenarians
    (Springer, 2025-01-22) Masterson, Reid; Pebror, Travis; Gauger, Andrew; Schmitz, Adam William; Butty, Sabah David; Radiology and Imaging Sciences, School of Medicine
    Purpose: To evaluate outcomes in patients aged ≥ 80 years following large-bore aspiration thrombectomy (LBAT) for the treatment of pulmonary embolism (PE). Materials and methods: All patients ≥ 80 years of age with PE treated via LBAT at a single center were analyzed from September 2019 - August 2024. This included the octogenarian subgroup from a recently published retrospective analysis assessing all PE patients treated with LBAT at our center between September 2019 and January 2023. The following outcomes were evaluated: technical success, change in several hemodynamic measures including pulmonary artery pressure (PAP) and right ventricle to left ventricle ratio (RV to LV ratio), length of hospital and intensive-care-unit (ICU) stay, procedure-related complications, and 7- and 30-day mortality. Results: Forty-eight patients aged ≥ 80 years underwent LBAT procedures for PE. Technical success was achieved in 46 cases (95.8%). The mean reduction in mean PAP was 3.6 mmHg. The mean reduction in RV to LV ratio was -0.42. The mean length of postprocedural hospital and ICU stays were 5.7 ± 3.6 days and 1.0 ± 1.6 days, respectively. There were 2 procedural complications, 1 pulmonary vascular injury involving a pulmonary artery pseudoaneurysm and 1 decompensation involving hypotension requiring vasopressor support. There were no major bleeding complications or cardiac injuries. All-cause mortality was 2.1% (n = 1) at 7 days and 6.3% (n = 3) at 30 days post procedure. PE-related mortality was 2.1% (n = 1) at 30 days. Conclusion: LBAT is a technically feasible procedure for the treatment of PE in octogenarian patients and has a favorable preliminary safety and mortality profile.
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    Reperfused Myocardial Infarction: The Road to CCS Classification of Acute MI and Beyond
    (Elsevier, 2025) Dharmakumar, Rohan; Kloner, Robert A.; Fishbein, Michael; Heusch, Gerd; Vora, Keyur P.; Gropler, Robert; Henry, Timothy; Shing-Chan, Fai; Singh, Dhirendra; Jambunathan, Nithya; Subramanian, Ramesh; Kreutz, Rolf P.; Reed, Grant W.; Kovacs, Richard J.; Fry, Edward; Kalra, Ankur; Kumar, Andreas; Raman, Subha V.; Medicine, School of Medicine
    The Canadian Cardiovascular Society recently put forth a new classification of acute reperfused myocardial infarction (MI) based on stages of myocardial injury. Backed by more than 5 decades of intense investigation in the field, the key message of this new classification is that not all MIs are the same and that the type and extent of myocardial injury should be considered in diagnosing and treating MI. We review the literature with the goal of highlighting the progressive advances that enabled the synthesis of the Canadian Cardiovascular Society classification into 4 distinct stages of tissue injury. We emphasize the major breakthroughs from insights gained from experimental, translational, and clinical studies to date. We also identify current gaps in knowledge and critical research directions that need to be pursued to improve patient care and reduce post-MI complications such as chronic heart failure and malignant arrhythmias, whose risk is linked to stage and extent of myocardial injury.