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Maass A, Lankveld TAR, Gkouskos D, Groenveld HF, De Haan M, Rienstra M, Lipsic E, Vernooy K. Venoplasty can be performed safely and successfully in patients with subtotal and total venous occlusion needing additional transvenous electrodes. Europace 2022. [DOI: 10.1093/europace/euac053.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Lead failure, but also upgrade procedures from pacemaker to implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) can be hampered by venous obstruction occurring in 10-25% of patients with prior transvenous electrodes. A relatively underused technique to overcome venous obstruction are lead percutaneous venous dilation procedures (venoplasty).
Purpose
We aimed to identify the feasibility of venoplasty procedures in two Dutch tertiary referral centers.
Methods
84 consecutive patients where venoplasty was attempted were included in the study and baseline parameters as well as procedural characteristics and complications were recorded. 42% of patients needed replacement of a defective electrode and 58% an upgrade to CRT or from pacemaker to ICD. Venous stenosis was defined as significant (70-90%), subocclusive (90-99%) and occlusive (100%) and the region was divided into three segments: subclavian vein, brachiocephalic vein and junction to the vena cava superior.
Results
The study included 30 pacemaker and 54 ICD patients, 68±12 years old, 80% were male. Body mass index was 26±3, left ventricular ejection fraction 32±12% and eGFR 63±24ml/min/1,73m2. At the time of the procedure, 2,1±0,8 electrodes were present and 1,2±0,2 electrodes were implanted, in 15% atrial, 52% RV and 52% LV electrodes. The procedures took 123±58 minutes and fluoroscopy dose was 5334±5390µGy/m2. There were 79 total occlusions of any segments and in addition, 51 subocclusive lesions needing venoplasty (table). 8 procedures were unsuccessful (9%), mostly due to failure to pass the occlusion. 3 patients (4%) had pocket hematoma not needing reintervention and one patient (1%) needed lead repositioning due to dislocation. There was no damage to any existing lead during the procedures. 89% of patients had a successful procedure without a complication needing reintervention.
Conclusions
Venoplasty is safe in subocclusive and occlusive venous stenosis and can be performed with high success using modern material potentially avoiding lead extraction or contralateral tunneling procedures.
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Affiliation(s)
- A Maass
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - TAR Lankveld
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
| | - D Gkouskos
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - HF Groenveld
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - M De Haan
- Maastricht University Medical Centre (MUMC), Radiology, Maastricht, Netherlands (The)
| | - M Rienstra
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - E Lipsic
- University Medical Center Groningen, Groningen, Netherlands (The)
| | - K Vernooy
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands (The)
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Selvarajah A, Tavenier AH, Bor WL, Houben V, Rasoul S, Kaplan E, Teeuwen K, Hofma SH, Lipsic E, Amoroso G, van Leeuwen MAH, Berg JMT, van 't Hof AWJ, Hermanides RS. Feasibility and safety of cangrelor in patients with suboptimal P2Y 12 inhibition undergoing percutaneous coronary intervention: rationale of the Dutch Cangrelor Registry. BMC Cardiovasc Disord 2021; 21:292. [PMID: 34118880 PMCID: PMC8199523 DOI: 10.1186/s12872-021-02093-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the advances of potent oral P2Y12 inhibitors, their onset of action is delayed, which might have a negative impact on clinical outcome in patients undergoing percutaneous coronary intervention (PCI). Trials conducted in the United States of America have identified cangrelor as a potent and rapid-acting intravenous P2Y12 inhibitor, which has the potential of reducing ischemic events in these patients without an increase in the bleeding. As cangrelor is rarely used in The Netherlands, we conducted a nationwide registry to provide an insight into the use of cangrelor in the management of patients with suboptimal platelet inhibition undergoing (primary) PCI (the Dutch Cangrelor Registry). STUDY DESIGN The Cangrelor Registry is a prospective, observational, multicenter, single-arm registry with cangrelor administered pre-PCI in: (1) P2Y12 naive patients with ad-hoc PCI, (2) patients with STEMI/NSTEMI with suboptimal P2Y12 inhibition including (3) stable resuscitated/defibrillated patients with out-of-hospital cardiac arrest (OHCA) due to acute ischemia and (4) STEMI/NSTEMI patients with a high thrombotic burden. Primary endpoint is 48 h Net Adverse Clinical Events (NACE), which is a composite endpoint of all-cause death, recurrent myocardial infarction (MI), target vessel revascularization (TVR), stroke, stent thrombosis (ST) and BARC 2-3-5 bleeding. The Dutch Cangrelor Registry will assess the feasibility and safety of cangrelor in patients with suboptimal P2Y12 inhibition undergoing (primary) PCI in the setting of acute coronary syndrome (ACS) and stable coronary artery disease (CAD) in the Netherlands.
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Affiliation(s)
- A Selvarajah
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - A H Tavenier
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - W L Bor
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - V Houben
- Department of Cardiology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - S Rasoul
- Department of Cardiology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - E Kaplan
- Department of Cardiology, Venlo VieCuri Medical Center, Venlo, The Netherlands
| | - K Teeuwen
- Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands
| | - S H Hofma
- Department of Cardiology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - E Lipsic
- Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | - G Amoroso
- Department of Cardiology, OLVG Hospital, Amsterdam, The Netherlands
| | | | - J M Ten Berg
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - A W J van 't Hof
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
- Department of Cardiology, Zuyderland Medical Center, Heerlen, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - R S Hermanides
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands.
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Sanders MF, Blankestijn PJ, Voskuil M, Spiering W, Vonken EJ, Rotmans JI, van der Hoeven BL, Daemen J, van den Meiracker AH, Kroon AA, de Haan MW, Das M, Bax M, van der Meer IM, van Overhagen H, van den Born BJH, van Brussel PM, van der Valk PHM, Smak Gregoor PJH, Meuwissen M, Gomes MER, Oude Ophuis T, Troe E, Tonino WAL, Konings CJAM, de Vries PAM, van Balen A, Heeg JE, Smit JJJ, Elvan A, Steggerda R, Niamut SML, Peels JOJ, de Swart JBRM, Wardeh AJ, Groeneveld JHM, van der Linden E, Hemmelder MH, Folkeringa R, Stoel MG, Kant GD, Herrman JPR, van Wissen S, Deinum J, Westra SW, Aengevaeren WRM, Parlevliet KJ, Schramm A, Jessurun GAJ, Rensing BJWM, Winkens MHM, Wierema TKA, Santegoets E, Lipsic E, Houwerzijl E, Kater M, Allaart CP, Nap A, Bots ML. Safety and long-term effects of renal denervation: Rationale and design of the Dutch registry. Neth J Med 2016; 74:5-15. [PMID: 26819356] [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: 06/05/2023]
Abstract
BACKGROUND Percutaneous renal denervation (RDN) has recently been introduced as a treatment for therapy-resistant hypertension. Also, it has been suggested that RDN may be beneficial for other conditions characterised by increased sympathetic nerve activity. There are still many uncertainties with regard to efficacy, safety, predictors for success and long-term effects. To answer these important questions, we initiated a Dutch RDN registry aiming to collect data from all RDN procedures performed in the Netherlands. METHODS The Dutch RDN registry is an ongoing investigator-initiated, prospective, multicentre cohort study. Twenty-six Dutch hospitals agreed to participate in this registry. All patients who undergo RDN, regardless of the clinical indication or device that is used, will be included. Data are currently being collected on eligibility and screening, treatment and follow-up. RESULTS Procedures have been performed since August 2010. At present, data from 306 patients have been entered into the database. The main indication for RDN was hypertension (n = 302, 99%). Patients had a mean office blood pressure of 177/100 (±29/16) mmHg with a median use of three (range 0-8) blood pressure lowering drugs. Mean 24-hour blood pressure before RDN was 157/93 (±18/13) mmHg. RDN was performed with different devices, with the Simplicity™ catheter currently used most frequently. CONCLUSION Here we report on the rationale and design of the Dutch RDN registry. Enrolment in this investigator-initiated study is ongoing. We present baseline characteristics of the first 306 participants.
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Affiliation(s)
- M F Sanders
- Department of Nephrology & Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
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Wijns W, Steg PG, Mauri L, Kurowski V, Parikh K, Gao R, Bode C, Greenwood JP, Lipsic E, Alamgir F, Rademaker-Havinga T, Boersma E, Radke P, van Leeuwen F, Camenzind E. Endeavour zotarolimus-eluting stent reduces stent thrombosis and improves clinical outcomes compared with cypher sirolimus-eluting stent: 4-year results of the PROTECT randomized trial. Eur Heart J 2014; 35:2812-20. [DOI: 10.1093/eurheartj/ehu318] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Lexis CPH, Wieringa WG, Hiemstra B, Van Deursen VM, Lipsic E, Van Der Harst P, Van Vedlhuisen DJ, Van Der Horst ICC. Metformin is associated with reduced myocardial infarct size in diabetic patients with ST elevation myocardial infarction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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van der Meer P, Lok DJ, Januzzi JL, de la Porte PWBA, Lipsic E, van Wijngaarden J, Voors AA, van Gilst WH, van Veldhuisen DJ. Adequacy of endogenous erythropoietin levels and mortality in anaemic heart failure patients. Eur Heart J 2008; 29:1510-5. [DOI: 10.1093/eurheartj/ehn205] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Xu Y, Henning RH, Lipsic E, van Buiten A, van Gilst WH, Buikema H. Acetylcholine stimulated dilatation and stretch induced myogenic constriction in mesenteric artery of rats with chronic heart failure. Eur J Heart Fail 2006; 9:144-51. [PMID: 16828577 DOI: 10.1016/j.ejheart.2006.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Revised: 01/19/2006] [Accepted: 05/03/2006] [Indexed: 12/18/2022] Open
Abstract
Rats with chronic heart failure (CHF) develop increased myogenic constriction in mesenteric resistance arteries. Here we investigated increased myogenic constriction in relation to alterations in EDHF- and NO-mediated dilatation in CHF-rats. Male Spraque-Dawley rats were subjected to myocardial-infarction or sham-surgery. At 9-10 weeks after surgery, isolated mesenteric artery ring preparations were studied in a wire-myograph. Stretch-induced myogenic constriction was obtained by stepwise increase of the internal circumference diameter (0.5-1.2 L100). Cyclooxygenase- and eNOS-inhibitors were employed to study NO- and EDHF-mediated dilatation in response to acetylcholine. Rats with CHF (n=8), but not sham-rats (n=6), developed significant myogenic constriction. In addition, the contribution of endothelial dilator mediators was significantly altered in CHF-rats, with increased dependency on NO and decreased EDHF-mediated dilatation. Moreover, EDHF-mediated dilatation was inversely correlated with myogenic constriction in individual CHF-rats (r=-0.74, p=0.04). These data demonstrate increased myogenic constriction in mesenteric arteries of rats with CHF post-MI to be correlated to decreased EDHF-mediated dilatation. These findings extend the previous observation that myogenic constriction antagonizes EDHF-mediated dilatation in rat coronary artery under normal conditions, and suggests this relationship also to become functional in mesenteric arteries under pathophysiological conditions of CHF.
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Affiliation(s)
- Y Xu
- Groningen University Institute for Drug Exploration, Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, A.Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Van der Meer P, Lipsic E, Henning RH, Boddeus K, van der Velden J, Voors AA, van Veldhuisen DJ, van Gilst WH, Schoemaker RG. Heart Failure after Myocardial Infarction—Benefit beyond Hemoglobin from Erythropoietin. J Am Soc Nephrol 2005. [DOI: 10.1681/asn.2005101067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Lipsic E, Balazovjech I, Kosmálová V, Makaiová I, Dekrét J, Zanou DF. Epinephrine producing pheochromocytoma. Is the secretory pattern decisive for the clinical manifestation? J Endocrinol Invest 2004; 27:691-4. [PMID: 15505997 DOI: 10.1007/bf03347506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adrenal incidentalomas are becoming a major clinical problem, due to increasingly frequent radiological examinations. We present two cases of patients referred to our department with a finding of an unsuspected adrenal mass. Both of them were normotensive and without symptomatology typical for pheochromocytoma. In one patient we found 20-times higher levels of epinephrine and 3-times higher levels of dopamine in 24-h urine, in the second patient there were 8-times higher levels of epinephrine alone. Norepinephrine in urine, as well as values of all adrenal cortical hormones were normal. The diagnosis of pheochromocytoma was confirmed in both cases by a 123I-metaiodobenzylguanidine (MIBG) scintigraphy. The patients underwent adrenalectomy, which was performed without complications. We conclude that levels of single catecholamines excreted are decisive for the clinical presentation of pheochromocytoma. Epinephrine producing pheochromocytoma is more often oligo- or asymptomatic. We stress the importance of a complete hormonal screening in every case of adrenal incidentaloma, with measuring levels of catecholamines and/or metanephrines.
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Affiliation(s)
- E Lipsic
- 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
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Lipsic E. Epinephrine producing pheochromocytoma. Am J Hypertens 2001. [DOI: 10.1016/s0895-7061(01)01993-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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