1
|
Wawak M, Pieniążek P, Tekieli Ł, Paluszek P, Trystuła M, Przewłocki T, Kabłak-Ziembicka A. Coarctation of the aorta, carotid artery stenosis and aberrant right subclavian artery as a rare cause of cerebral ischemia in a primigravid woman. Quant Imaging Med Surg 2024; 14:1261-1265. [PMID: 38223113 PMCID: PMC10784048 DOI: 10.21037/qims-23-792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/26/2023] [Indexed: 01/16/2024]
Affiliation(s)
- Magdalena Wawak
- Department of Interventional Cardiology, the St. John Paul II Hospital, Kraków, Poland
- Jagiellonian University Medical College, Doctoral School of Medical and Health Sciences, Kraków, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Piotr Pieniążek
- Department of Interventional Cardiology, the St. John Paul II Hospital, Kraków, Poland
- Department of Vascular and Endovascular Surgery, the St. John Paul II Hospital, Kraków, Poland
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Tekieli
- Department of Interventional Cardiology, the St. John Paul II Hospital, Kraków, Poland
| | - Piotr Paluszek
- Department of Vascular and Endovascular Surgery, the St. John Paul II Hospital, Kraków, Poland
| | - Mariusz Trystuła
- Department of Vascular and Endovascular Surgery, the St. John Paul II Hospital, Kraków, Poland
| | - Tadeusz Przewłocki
- Department of Interventional Cardiology, the St. John Paul II Hospital, Kraków, Poland
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Kabłak-Ziembicka
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Noninvasive Cardiovascular Laboratory, The St. John Paul II Hospital, Kraków, Poland
| |
Collapse
|
2
|
Wawak M, Tekieli Ł, Badacz R, Pieniążek P, Maciejewski D, Trystuła M, Przewłocki T, Kabłak-Ziembicka A. Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature. Biomedicines 2023; 11:2207. [PMID: 37626704 PMCID: PMC10452526 DOI: 10.3390/biomedicines11082207] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Non-atherosclerotic aortic arch pathologies (NA-AAPs) and anatomical variants are characterized as rare cardiovascular diseases with a low incidence rate, below 1 case per 2000 population, but enormous heterogeneity in terms of anatomical variants, i.e., Takayasu disease (TAK) and fibromuscular dysplasia (FMD). In specific clinical scenarios, NA-AAPs constitute life-threatening disorders. METHODS In this study, 82 (1.07%) consecutive patients with NA-AAPs (including 38 TAKs, 26 FMDs, and 18 other AAPs) out of 7645 patients who underwent endovascular treatment (EVT) for the aortic arch and its side-branch diseases at a single institution between 2002 and 2022 were retrospectively reviewed. The recorded demographic, biochemical, diagnostic, operative, and postoperative factors were reviewed, and the functional outcomes were determined during follow-up. A systematic review of the literature was also performed. RESULTS The study group comprised 65 (79.3%) female and 17 (21.7%) male subjects with a mean age of 46.1 ± 14.9 years. Overall, 62 (75.6%) patients were diagnosed with either cerebral ischemia symptoms or aortic arch dissection on admission. The EVT was feasible in 59 (72%) patients, whereas 23 (28%) patients were referred for medical treatment. In EVT patients, severe periprocedural complications occurred in two (3.39%) patients, including one periprocedural death and one cerebral hyperperfusion syndrome. During a median follow-up period of 64 months, cardiovascular events occurred in 24 (29.6%) patients (5 deaths, 13 ISs, and 6 myocardial infarctions). Repeated EVT for the index lesion was performed in 21/59 (35.6%) patients, including 19/33 (57.6%) in TAK and 2/13 (15.4%) in FMD. In the AAP group, one patient required additional stent-graft implantation for progressing dissection to the iliac arteries at 12 months. A baseline white blood count (odds ratio [HR]: 1.25, 95% confidence interval [CI]: 1.11-1.39; p < 0.001) was the only independent prognostic factor for recurrent stenosis, while a baseline hemoglobin level (HR: 0.73, 95%CI: 0.59-0.89; p = 0.002) and coronary involvement (HR: 4.11, 95%CI: 1.74-9.71; p = 0.001) were independently associated with a risk of major cardiac and cerebral events according to the multivariate Cox proportional hazards regression analysis. CONCLUSIONS This study showed that AAPs should not be neglected in clinical settings, as it can be a life-threatening condition requiring a multidisciplinary approach. The knowledge of prognostic risk factors for adverse outcomes may improve surveillance in this group of patients.
Collapse
Affiliation(s)
- Magdalena Wawak
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Łukasz Tekieli
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Rafał Badacz
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland
| | - Piotr Pieniążek
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland
| | - Damian Maciejewski
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Mariusz Trystuła
- Department of Vascular and Endovascular Surgery, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland;
| | - Tadeusz Przewłocki
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland
| | - Anna Kabłak-Ziembicka
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland
- Noninvasive Cardiovascular Laboratory, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| |
Collapse
|
3
|
Drabik L, Mazurek A, Czyż Ł, Tekieli Ł, Szot W, Kwiecień E, Banys RP, Urbanczyk-Zawadzka M, Borkowska E, Kozynacka A, Skubera M, Brzyszczyk-Marzec M, Kostkiewicz M, Majka M, Podolec P, Musiałek P. Multi-modality imaging in the CIRCULATE-AMI pilot study cohort: a framework for an imaging-based randomized controlled trial of Wharton jelly mesenchymal stem cell use to stimulate myocardial repair/regeneration. Postepy Kardiol Interwencyjnej 2022; 18:496-499. [PMID: 36967846 PMCID: PMC10031681 DOI: 10.5114/aic.2023.124361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/17/2022] [Indexed: 06/18/2023] Open
Affiliation(s)
- Leszek Drabik
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- Department of Pharmacology, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| | - Adam Mazurek
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| | - Łukasz Czyż
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| | - Łukasz Tekieli
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Szot
- John Paul II Hospital, Krakow, Poland
- Nuclear Imaging Laboratory, Krakow, Poland
| | - Ewa Kwiecień
- Department of Cardiology and Internal Medicine, Ludwik Rydygier Memorial Specialized Hospital, Krakow, Poland
| | - Robert P. Banys
- John Paul II Hospital, Krakow, Poland
- Magnetic Resonance Imaging Laboratory, Krakow, Poland
| | | | - Eliza Borkowska
- John Paul II Hospital, Krakow, Poland
- Nuclear Imaging Laboratory, Krakow, Poland
| | - Anna Kozynacka
- John Paul II Hospital, Krakow, Poland
- Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, Krakow, Poland
| | - Maciej Skubera
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| | | | - Magdalena Kostkiewicz
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
- Nuclear Imaging Laboratory, Krakow, Poland
| | - Marcin Majka
- Department of Transplantation, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| | - Piotr Musiałek
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
- John Paul II Hospital, Krakow, Poland
| |
Collapse
|
4
|
Dzierwa K, Knapik M, Tekieli Ł, Mazurek A, Urbańczyk-Zawadzka M, Klecha A, Kowalczyk T, Koźmik T, Wiewiórka Ł, Banyś P, Węglarz E, Stefaniak J, Nizankowski RT, Grunwald IQ, Musiałek P. Clinical Outcomes of Extracranial Carotid Artery-Related Stroke Eligible for Mechanical Reperfusion on Top of Per-Guidelines Thrombolytic Therapy: Analysis from a 6-Month Consecutive Patient Sample in 2 Centers. Med Sci Monit 2022; 28:e938549. [DOI: 10.12659/msm.938549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Karolina Dzierwa
- Cardiovascular Imaging Laboratory, John Paul II Hospital, Crakow, Poland
| | - Magdalena Knapik
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| | - Łukasz Tekieli
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| | - Adam Mazurek
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| | | | - Artur Klecha
- Department of of Cardiology, Podhalanski Multispecialty Regional Hospital, Nowy Targ, Poland
| | - Tomasz Kowalczyk
- Department of of Cardiology, Podhalanski Multispecialty Regional Hospital, Nowy Targ, Poland
| | - Teresa Koźmik
- Department of of Cardiology, Podhalanski Multispecialty Regional Hospital, Nowy Targ, Poland
| | - Łukasz Wiewiórka
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| | - Paweł Banyś
- Department of of Radiology, John Paul II Hospital, Cracow, Poland
| | - Ewa Węglarz
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| | - Justyna Stefaniak
- Department of of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Cracow, Poland
| | - Rafał T. Nizankowski
- Accreditation Council, National Centre for Healthcare Quality Assessment, Cracow, Poland
| | - Iris Q. Grunwald
- University of Dundee Chair of Neuroradiology and Department of Radiology, Ninewells Hospital, Dundee, Scotland, United Kingdom
| | - Piotr Musiałek
- Thrombectomy-Capable Stroke Centre, John Paul II Hospital, Cracow, Poland
| |
Collapse
|
5
|
Tekieli Ł, Tomaszewski T, Musiał R, Lipińska-Strasik M, Urbańczyk-Zawadzka M, Banyś RP, Maksoń R, Wiewiórka Ł, Adamczyk-Dylewska J, Grunwald IQ, Musiałek P. Large-vessel occlusion, large thrombus burden acute stroke in acute pulmonary embolism: A single multi-specialty multi-skill team treatment optimization. Kardiol Pol 2021; 79:1382-1384. [PMID: 34643256 DOI: 10.33963/kp.a2021.0126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Łukasz Tekieli
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland. .,John Paul II Hospital, Kraków, Poland. .,Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland. .,Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland.
| | - Tomasz Tomaszewski
- John Paul II Hospital, Kraków, Poland.,Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland.,Department of Neurology, John Paul II Hospital, Kraków, Poland
| | - Robert Musiał
- Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland.,Department of Anesthesiology and Intensive Therapy, John Paul II Hospital, Kraków, Poland
| | - Magdalena Lipińska-Strasik
- Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland.,Department of Anesthesiology and Intensive Therapy, John Paul II Hospital, Kraków, Poland
| | - Małgorzata Urbańczyk-Zawadzka
- Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland.,Department of Radiology, John Paul II Hospital, Kraków, Poland
| | - R Paweł Banyś
- Department of Radiology, John Paul II Hospital, Kraków, Poland
| | | | - Łukasz Wiewiórka
- John Paul II Hospital, Kraków, Poland.,Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.,Department of Radiology, John Paul II Hospital, Kraków, Poland
| | | | - Iris Q Grunwald
- Chair of Neuroradiology, Department of Radiology, University of Dundee, Ninewells Hospital, Dundee, Scotland, United Kingdom
| | - Piotr Musiałek
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.,John Paul II Hospital, Kraków, Poland.,Thrombectomy-Capable Stroke Center, John Paul II Hospital, Kraków, Poland
| |
Collapse
|
6
|
Talarowska P, Dobrowolski P, Klisiewicz A, Kostera-Pruszczyk A, Członkowska A, Kurkowska-Jastrzębska I, Gąsecki D, Warchoł-Celińska E, Światłowski Ł, Florczak E, Januszewicz M, Michałowska I, Józwik-Plebanek K, Szczudlik P, Błażejewska-Hyżorek B, Protasiewicz M, Odrowąż-Pieniążek P, Tekieli Ł, Michel-Rowicka K, Hanus K, Widecka K, Sołtysiak M, Tykarski A, Stryczyński Ł, Szczerbo-Trojanowska M, Hoffman P, Prejbisz A, Januszewicz A. High incidence and clinical characteristics of fibromuscular dysplasia in patients with spontaneous cervical artery dissection: The ARCADIA-POL study. Vasc Med 2019; 24:112-119. [DOI: 10.1177/1358863x18811596] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The association between fibromuscular dysplasia (FMD) and spontaneous cervical artery dissection (SCeAD) has been recognized, but the available evidence on this relationship is scant. Therefore, the main goal of our study was to systematically evaluate FMD frequency, clinical characteristics and vascular bed involvement in patients with SCeAD. Among 230 patients referred to the ARCADIA-POL study, 43 patients (mean age 44.1 ± 8.9 years; 15 men and 28 women) with SCeAD were referred. Also, 135 patients with FMD were compared to patients with and without SCeAD. Patients underwent: ambulatory blood pressure measurements, biochemical evaluation, echocardiographic examination, and whole body computed tomographic angiography. FMD changes were found in 39.5% of patients with SCeAD. There were no differences in clinical characteristics between patients with SCeAD and FMD and those without FMD, except for a tendency towards a higher female ratio in SCeAD patients with FMD. There were no differences in other parameters describing target organ and SCeAD characteristics. Patients with SCeAD and FMD compared to those without SCeAD were characterized by a lower frequency of hypertension and a higher frequency of hyperlipidemia and history of contraceptive hormone use. Our study indicates a high incidence (39.5%) of FMD in subjects with SCeAD. Since there are no distinctive discriminating factors between patients with SCeAD and FMD and those without FMD, FMD should be suspected in all patients with SCeAD.
Collapse
Affiliation(s)
| | - Piotr Dobrowolski
- Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland
| | - Anna Klisiewicz
- Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland
| | | | - Anna Członkowska
- Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Dariusz Gąsecki
- Department of Adult Neurology, Medical University of Gdansk, Gdansk, Poland
| | | | - Łukasz Światłowski
- Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
| | | | - Magdalena Januszewicz
- Department of Hypertension, Institute of Cardiology, Warsaw, Poland
- Second Department of Radiology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Piotr Szczudlik
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Piotr Odrowąż-Pieniążek
- Department of Interventional Cardiology, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Łukasz Tekieli
- Department of Interventional Cardiology, John Paul II Hospital, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | | | - Katarzyna Hanus
- Department of Hypertension, Institute of Cardiology, Warsaw, Poland
| | - Krystyna Widecka
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Marta Sołtysiak
- Department of Hypertension and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Tykarski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Łukasz Stryczyński
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Piotr Hoffman
- Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland
| | | | | |
Collapse
|
7
|
Biernacka-Fiałkowska B, Szuksztul M, Suślik W, Dzierwa K, Tekieli Ł, Kostkiewicz M, Podolec P, Pieniążek P. Intravenous N-acetylcysteine for the PRevention Of Contrast-induced nephropathy - a prospective, single-center, randomized, placebo-controlled trial. The INPROC trial. Postepy Kardiol Interwencyjnej 2018; 14:59-66. [PMID: 29743905 PMCID: PMC5939546 DOI: 10.5114/aic.2018.74356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 11/27/2017] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Contrast-induced nephropathy (CIN) is a common clinical problem that is growing in importance as an increasing number of tests and procedures which utilize contrast media (CM) are performed. AIM To evaluate the efficacy of intravenous N-acetylcysteine (NAC) for prevention of CIN after diagnostic and/or interventional procedures requiring CM administration. MATERIAL AND METHODS In a prospective, single-center, randomized, placebo-controlled trial the preventive effects of N-acetylcysteine were evaluated in 222 patients undergoing elective angiography and/or angioplasty. Patients were randomly assigned to receive either NAC or placebo. All patients received intravenous hydration with normal saline before and after catheterization. Serum creatinine (SCr) and estimated glomerular filtration rate were assessed at baseline, at 48-72 h and 10-15 days after CM administration. Contrast-induced nephropathy was defined as an increase in SCr of at least 44 µmol/l (0.5 mg/dl) or an increase of ≥ 25% of the baseline value 48-72 h after CM administration. RESULTS Contrast-induced nephropathy occurred in 30 of 222 patients (13.5%): 9 of 108 patients in NAC (8.3%) and 21 of 114 patients in the control group (18.4%; p = 0.0281). The multivariate Cox analysis revealed that elevated SCr at 10-15 days (HR = 2.69; p = 0.018) and baseline SCr level (HR = 1.009; p = 0.015) were independent prognostic variables for adverse events during follow-up. CONCLUSIONS Our findings suggest that intravenous NAC along with intravenous hydration may help prevent declining renal function after CM exposure. Elevated SCr level 10-15 days after CM administration was associated with increased risk of adverse events in long-term observation, while elevated SCr within 72 h was not. Measuring SCr at least 10 days after exposure to CM may provide a better outcome measure.
Collapse
Affiliation(s)
| | - Marta Szuksztul
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Suślik
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Karolina Dzierwa
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Tekieli
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kostkiewicz
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Podolec
- Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Pieniążek
- Department of Interventional Cardiology, Jagiellonian University Medical College, Krakow, Poland
| |
Collapse
|
8
|
Musiałek P, Tekieli Ł, Pieniazek P, Undas A, Miszalski-Jamka T, Zajdel W, Klimeczek P, Laskowicz B, Banyś RP, Pasowicz M, Podolec P. How should I treat a very large thrombus burden in the infarct-related artery in a young patient with an unexplained lower GI tract bleeding? EUROINTERVENTION 2012; 7:754-5; discussion 756-63. [PMID: 21986333 DOI: 10.4244/eijv7i6a119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Piotr Musiałek
- Jagiellonian University Institute of Cardiology, Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Pieniążek P, Dzierwa K, Musiałek P, Hlawaty M, Tekieli Ł, Paluszek P, Laskowicz B, Zmudka K, Podolec P. The use of a novel type of distal protection system (FiberNet®) in the percutaneous management of saphenous vein graft disease. Kardiol Pol 2010; 68:1423-1425. [PMID: 21174310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Percutaneous intervention in saphenous vein grafts is associated with a high risk of distal embolisation by plaque material, 'no flow' phenomenon and clinical complications such as myocardial infarction or death. According to randomised trial evidence, intervention in a degenerated vein graft should be performed using an embolic protection device (EPD), since this strategy significantly reduces periprocedural and 30 day adverse event rate. FiberNet® is a novel distal protection system with unique characteristics of a low crossing profile (0.031'' for vessel size 3.5-5 mm), 'cotton wool'-like three dimensional design and a small pore size (40 μm). The FiberNet® does not require a separate delivery sheath and self-achieves its optimal apposition to the vessel wall; the EPD system also contains a dedicated aspiration catheter. We present the use of FiberNet® in a 77 year-old patient who had undergone coronary artery bypass grafting 20 years ago and currently presented with CCS class III angina due to a significant stenosis of the saphenous vein graft to the marginal branch. The procedure involved the use of a novel mesh-covered stent (MGuard®) designed to 'trap' the plaque material between the stent and the vessel wall. It was technically successful and clinically uncomplicated, and the patient remains well six months later.
Collapse
Affiliation(s)
- Piotr Pieniążek
- Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Collegium Medicum, The John Paul II Hospital, Krakow, Poland
| | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Musiałek P, Tracz W, Kostkiewicz M, Tekieli Ł, Szot W, Klimeczek P, Banyś P, Zebzda A, Majka M, Walter Z, Olszowska M, Pieniazek P, Pasowicz M. [Visualisation of early engraftment of transcoronary applied CD34+ cells in the infarct border zone]. Kardiol Pol 2008; 66:73-77. [PMID: 18266190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Successful delivery of progenitor cells to the injury zone is a prerequisite for any effect of myocardial regeneration therapy. This key issue, however, has received far less attention than, for instance, a potential need for cell type selection or ex-vivo expansion, the optimal timing of cell application or multimodal functional evaluation after cellular transplantation. By combining myocardial perfusion scintigraphy, magnetic resonance imaging and 99Tc-HMPAO-labelled autologous bone marrow-derived CD34+ cells visualisation, we show in a 63-year-old man with a large anterior myocardial infarction that transcoronary applied cells (via the central lumen of an inflated over-the-wire balloon positioned in the stent implanted in primary PCI) graft preferentially to the infarct border zone. This is consistent with the idea that the area of myocardial 'irreversible' injury (i.e. the no-perfusion zone on perfusion scintigraphy or late enhancement zone on magnetic resonance) remains largely inaccessible to transcoronary-applied cells; thus other techniques need to be considered if the cell delivery is aimed at the zone of irreversible injury. The potency of such combined high-resolution visualisation provides grounds for comparing the efficacy of different methods of cell delivery after a recent myocardial infarction in man.
Collapse
Affiliation(s)
- Piotr Musiałek
- Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Kraków.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Tekieli Ł, Pieniazek P, Podolec P, Tomkiewicz-Pajak L, Płazak W, Musiałek P, Leśniak-Sobelga A, Przewłocki T, Biernacka B, Zmudka K, Tracz W. [Percutaneous transluminal septal myocardial ablation: early results and long-term follow-up]. Przegl Lek 2006; 63:628-32. [PMID: 17441371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Percutaneous transluminal septal myocardial ablation (PTSMA) is becoming an alternative to surgical myectomy in the treatment of severe, drug refractory, hypertrophic obstructive cardiomyopathy (HOCM). The aim of our study was to analyze early results, complications and long-term follow-up in patients after PTSMA. METHODS Out of eighteen patients [11 M] initially accepted for PTSMA, the procedure was performed in 12 patients [6 M] age from 22 to 70 y. All the patients underwent clinical evaluation, echocardiography and cardiopulmonary exercise testing (CPX) before the procedure, and after a median of 38 months of observation. In echo-cardiography left ventricle outflow tract gradient (LVOTG) and intraventricular septum diastolic diameter were assessed. The following parameters of CPX were analyzed: exercise duration, anaerobic threshold, peak oxygen consumption, peak exercise heart rate and carbon dioxide ventilating equivalent. RESULTS The procedure was successful in 11 patient. There were 2 acute complications: 3rd degree AV block requiring peacemaker implantation and LVOTG increase with SAM exacerbation requiring urgent cardiosurgical intervention. During long-term follow-up 1 cerebral stroke and 1 death occurred. PTSMA resulted in significant reduction of left ventricle outflow tract gradient (89 +/- 44 vs. 17 +/- 17 mmHg) and intraventricular septum diastolic diameter (24 +/- 4 vs 18 +/- 5 mm) (p < or = 0.01 for both). We also observed improvement of CPX parameters: exercise duration (487 +/- 268 vs. 730 +/- 292 sec), anaerobic threshold (34.3 +/- 8.9 vs. 53.2 +/- 13.4% VO2max predicted), peak oxygen consumption (18.5 +/- 6 vs. 26.8 +/- 10.1 ml/kg/min), peak exercise heart rate (70.3 +/- 8.3 vs. 83.6 +/- 11.7%) and carbon dioxide ventilating equivalent (31 +/- 6.1 vs. 28 +/- 4.8); (p < or = 0.01 for all). CONCLUSIONS PTSMA is an effective method of treatment in patients with severe, drug refractory HOCM. PTSMA is safe and is associated with a low percentage of severe complications.
Collapse
Affiliation(s)
- Łukasz Tekieli
- Klinika Chorób Serca i Naczyń, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Uniwersytet Jagielloński, Collegium Medicum, Kraków.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|