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1.
J Colloid Interface Sci ; 663: 761-774, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38437755

RESUMO

As a noble metal with extremely high economic benefits, the recovery of silver ions has attracted a particular deal of attention. However, it is a challenge to recover silver ions efficiently and selectively from aqueous solutions. In this research, the novel metal-organic frameworks (MOFs) adsorbent (Zr-DPHT) is prepared for the highly efficient and selective recovery of silver ions from wastewater. Experimental findings reveal that Zr-DPHT's adsorption of Ag(I) constitutes an endothermic process, with an optimal pH of 5 and exhibits a maximum adsorption capacity of 268.3 mg·g-1. Isotherm studies show that the adsorption of Ag(I) by Zr-DPHT is mainly monolayer chemical adsorption. Kinetic studies indicate that the internal diffusion of Ag(I) in Zr-DPHT may be the rate-limiting step. The mechanism for Ag(I) adsorption on Zr-DPHT involves electrostatic interactions and chelation. In competitive adsorption, Ag(I) has the largest partition coefficient (9.64 mL·mg-1), indicating a strong interaction between Zr-DPHT and Ag(I). It is proven in the adsorption-desorption cycle experiments that Zr-DPHT has good regeneration performance. The research results indicate that Zr-DPHT can serve as a potential adsorbent for efficiently and selectively capturing Ag(I), providing a new direction for MOFs in the recycling field of precious metals.

2.
Materials (Basel) ; 16(24)2023 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-38138774

RESUMO

The microstructure evolution and variation of impact toughness in the heat-affected zone (HAZ) of X80 pipeline steel with different Nb content under different peak temperatures in the secondary thermal cycle were studied through welding thermal simulation, the Charpy impact test, EBSD analysis, SEM observation, and TEM observation in this study. The results indicate that when the peak temperatures of the second pass were lower than Ac1, both X80 pipeline steels had high impact toughness. For secondary peak temperatures in the range of Ac1 to Ac3, both X80 pipeline steels had the worst impact toughness, mainly due to the formation of massive blocky M-A constituents in chain form on grain boundaries. When the secondary peak temperatures were higher than Ac3, both X80 pipeline steels had excellent impact toughness. Smaller grain size and higher proportions of HAGBs can effectively improve the impact toughness. Meanwhile, high Nb X80 pipeline steel had higher impact absorption energy and smaller dispersion. Adding an appropriate amount of Nb to X80 pipeline steel can ensure the impact toughness of SCCGHAZ and SCGHAZ in welded joints.

3.
IEEE Trans Pattern Anal Mach Intell ; 45(5): 5970-5987, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36129859

RESUMO

In recent years, great progress has been made to incorporate unlabeled data to overcome the inefficiently supervised problem via semi-supervised learning (SSL). Most state-of-the-art models are based on the idea of pursuing consistent model predictions over unlabeled data toward the input noise, which is called consistency regularization. Nonetheless, there is a lack of theoretical insights into the reason behind its success. To bridge the gap between theoretical and practical results, we propose a worst-case consistency regularization technique for SSL in this article. Specifically, we first present a generalization bound for SSL consisting of the empirical loss terms observed on labeled and unlabeled training data separately. Motivated by this bound, we derive an SSL objective that minimizes the largest inconsistency between an original unlabeled sample and its multiple augmented variants. We then provide a simple but effective algorithm to solve the proposed minimax problem, and theoretically prove that it converges to a stationary point. Experiments on five popular benchmark datasets validate the effectiveness of our proposed method.

4.
Front Oncol ; 12: 1024789, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36387147

RESUMO

The tumor immune microenvironment has been a research hot spot in recent years. The cytokines and metabolites in the microenvironment can promote the occurrence and development of tumor in various ways and help tumor cells get rid of the surveillance of the immune system and complete immune escape. Many studies have shown that the existence of tumor microenvironment is an important reason for the failure of immunotherapy. The impact of the tumor microenvironment on tumor is a systematic study. The current research on this aspect may be only the tip of the iceberg, and a relative lack of integrity, may be related to the heterogeneity of tumor. This review mainly discusses the current status of glucose metabolism and lipid metabolism in the tumor microenvironment, including the phenotype of glucose metabolism and lipid metabolism in the microenvironment; the effects of these metabolic methods and their metabolites on three important immune cells Impact: regulatory T cells (Tregs), tumor-associated macrophages (TAM), natural killer cells (NK cells); and the impact of metabolism in the targeted microenvironment on immunotherapy. At the end of this article,the potential relationship between Ferroptosis and the tumor microenvironment in recent years is also briefly described.

5.
IEEE Trans Image Process ; 31: 6487-6501, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36223353

RESUMO

Transferable adversarial attacks against Deep neural networks (DNNs) have received broad attention in recent years. An adversarial example can be crafted by a surrogate model and then attack the unknown target model successfully, which brings a severe threat to DNNs. The exact underlying reasons for the transferability are still not completely understood. Previous work mostly explores the causes from the model perspective, e.g., decision boundary, model architecture, and model capacity. Here, we investigate the transferability from the data distribution perspective and hypothesize that pushing the image away from its original distribution can enhance the adversarial transferability. To be specific, moving the image out of its original distribution makes different models hardly classify the image correctly, which benefits the untargeted attack, and dragging the image into the target distribution misleads the models to classify the image as the target class, which benefits the targeted attack. Towards this end, we propose a novel method that crafts adversarial examples by manipulating the distribution of the image. We conduct comprehensive transferable attacks against multiple DNNs to demonstrate the effectiveness of the proposed method. Our method can significantly improve the transferability of the crafted attacks and achieves state-of-the-art performance in both untargeted and targeted scenarios, surpassing the previous best method by up to 40% in some cases. In summary, our work provides new insight into studying adversarial transferability and provides a strong counterpart for future research on adversarial defense.


Assuntos
Redes Neurais de Computação
6.
Allergol Immunopathol (Madr) ; 50(5): 39-46, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36086962

RESUMO

Sepsis induces multiple organ dysfunction syndromes, such as acute kidney, liver, or lung injury. Septic lung injury is associated with excessive apoptosis and inflammatory responses in hepatocytes. Deoxyelephantopin is a sesquiterpene lactone found in Elephantopus scaber L, and has immunomodulatory, antibacterial, anti-inflammatory, and antifungal properties. The role of deoxyelephantopin in sepsis-associated lung injury was investigated. First, human bronchial epithelial cells (BEAS-2B) and human pulmonary artery endothelial cells (HPAEC) were treated with lipopolysaccharide to induce cytotoxicity. Treatment with lipopolysaccharide reduced cell viability of BEAS-2B and HPAEC, and promoted cell apoptosis through down-regulation of poly (ADP-ribose) polymerase (PARP) and B-cell lymphoma 2 (Bcl-2), and up-regulation of cleaved PARP and B-cell lymphoma-associated X protein (Bax). Second, lipopolysaccharide-treated BEAS-2B and HPAEC were incubated with increasing concentrations of deoxyelephantopin, that is, 1, 5, or 10 µM. Deoxyelephantopin enhanced cell viability and reduced cell apoptosis of lipopolysaccharide-treated BEAS-2B and HPAEC. Third, deoxyelephantopin attenuated lipopolysaccharide-induced decrease of superoxide dismutase and glutathione, and increase of malondialdehyde and myeloperoxidase in BEAS-2B and HPAEC. Moreover, deoxyelephantopin also weakened lipopolysaccharide-induced increase of tumor necrosis factor-α, interleukin (IL)-1ß, and IL-6. Finally, deoxyelephantopin decreased protein expression of p-p65 and p-signal transducer and activator of transcription 3 (STAT3) in lipopolysaccharide-treated BEAS-2B and HPAEC. In conclusion, deoxyelephantopin exhibited anti-oxidative and anti-inflammatory effects against lipopolysaccharide-treated BEAS-2B and HPAEC through inactivation of nuclear factor kappa B/STAT3 signaling.


Assuntos
Lesão Pulmonar , Sepse , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Células Endoteliais/metabolismo , Humanos , Lactonas , Lipopolissacarídeos/farmacologia , NF-kappa B/metabolismo , Inibidores de Poli(ADP-Ribose) Polimerases , Fator de Transcrição STAT3 , Sepse/tratamento farmacológico , Sesquiterpenos
7.
Front Nutr ; 9: 961507, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938128

RESUMO

Polysaccharides have a variety of biological activities, and in the anti-tumor field, they produce tumor suppressive effects by regulating the polarization of tumor-associated macrophages (TAMs). In immunotherapy, it has significant activities in modulating cytokines and antibody production. We reviewed them and selected CD24, an immune target, for meta-analysis with colorectal cancer (CRC) to investigate the correlation between CD24 expression and CRC. Correlation of CD24 positive expression with clinical-pathological features: age, sex, Duke's stage, diameter, depth of invasion, degree of differentiation, and lymph node metastasis. It showed that: CD24 expression in CRC was significantly correlated with advanced nuclear grade of CRC, lymph node metastasis, Duke's stage of CRC and age of CRC patients, while there was no significant correlation with gender, tumor diameter and invasion depth. The aim is to clarify the specific mechanism of polysaccharide immune anti-tumor, combined with targeted site-specific anti-solid tumor.

8.
Comput Math Methods Med ; 2022: 5285244, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35924114

RESUMO

Objective: This analysis was aimed at providing evidence-based medicine basis for systematic evaluation of chondroitin combined with glucosamine in the treatment of knee osteoarthritis. Methods: The randomized controlled trials (RCTs) of chondroitin combined with glucosamine in the treatment of knee osteoarthritis (KOA) were searched in PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network Database (CNKI), China VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM) online database. The retrieval time ranges from the database creation to the present. Two investigators gathered the information individually. The risk of bias was assessed using the criteria of the Cochrane back review group. RevMan5.4 statistical software analyzed the selected data. Results: A total of 6 RCT articles were obtained. Overall, 764 samples were evaluated by meta-analysis. The clinical efficacy of chondroitin combined with glucosamine was significantly better than that of routine treatment by meta-analysis. The confidence interval of 95% was (4.86, 17.08) (Z = 6.89, P < 0.00001). The scores of joint pain, tenderness, swelling, and dysfunction in patients with knee osteoarthritis treated with chondroitin combined with glucosamine were significantly lower than those treated with routine treatment. There was no significant difference in the incidence of adverse reactions between chondroitin combined with glucosamine and single treatment of KOA. Due to the small number of documents included in the analysis, it is not suitable to make a funnel chart, but there may be some publication deviation in the analysis. Conclusion: Chondroitin combined with glucosamine is more effective than chondroitin or glucosamine alone in the treatment of KOA and deserves clinical promotion. However, this conclusion still needs to be supported by multicenter, high-quality, double-blind, large-sample randomized controlled clinical trials due to the limitations of the six trials included.


Assuntos
Condroitina , Osteoartrite do Joelho , China , Condroitina/uso terapêutico , Glucosamina/efeitos adversos , Humanos , Estudos Multicêntricos como Assunto , Osteoartrite do Joelho/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
9.
Catheter Cardiovasc Interv ; 99(2): 418-423, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33491870

RESUMO

OBJECTIVES: Assess the impact on fluoroscopy time and contrast use in patients with tortuous brachiocephalic/thoracic aortas undergoing right transradial coronary angiography (RTCA) and provide strategies to manage. BACKGROUND: Unfavorable anatomy with severe brachiocephalic/thoracic tortuosity, referred to as an "elephant head," remains a significant obstacle for RTCA. METHODS: We reviewed the coronary angiograms of patients who underwent RTCA and had tortuous aortas. Angiography was attempted first using a universal catheter (Tiger) and switched to a left coronary specific catheter (Judkins Left [JL]) if challenging. Fluoroscopy time, contrast volume, and greatest distance from the patient's midline to the catheter in the aorta were recorded. RESULTS: Forty-nine patients (62.6 ± 12.0 years, 69.4% male) were included. Fifteen (30.6%) patients underwent successful angiography with a Tiger catheter; 34 (69.4%) patients required switching to JL catheter. The average distance of Tiger catheters to the midline of the spine was 0.78 ± 0.41 cm versus 1.28 ± 0.44 cm (p = .001) in JL catheters. Tiger catheter use resulted in less fluoroscopy time (6.48 ± 4.73 min) and contrast use (58.87 ± 43.53 ml) than in cases switched to JL (13.26 ± 10.76 min [p = .026]; 86.5 ± 69.95 ml [(p = .017]). CONCLUSIONS: For patients undergoing RTCA with significant brachiocephalic/thoracic aorta tortuosity, "elephant head," a Tiger catheter can be used efficiently for curvatures <1 cm from the middle of the spine. We propose that for curvatures >1 cm, operators should consider immediately switching to a JL catheter.


Assuntos
Elefantes , Animais , Aorta Torácica/diagnóstico por imagem , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/métodos , Angiografia Coronária/efeitos adversos , Angiografia Coronária/métodos , Feminino , Fluoroscopia , Humanos , Masculino , Artéria Radial/diagnóstico por imagem , Resultado do Tratamento
10.
Am J Cardiol ; 158: 37-44, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34465454

RESUMO

Widespread utilization of mechanical circulatory support (MCS) for high-risk percutaneous coronary intervention (PCI) remains controversial, with a lack of randomized supporting evidence and associated risk of device-related complications. We investigated whether high-risk PCI of native coronary arteries without elective MCS in patients with acute coronary syndrome (ACS) is safe and feasible. We performed a single-center, retrospective analysis for ACS patients meeting American College of Cardiology high-risk criteria: unprotected left main disease, last remaining conduit, ejection fraction <35%, 3-vessel coronary artery disease, severe aortic stenosis, or severe mitral regurgitation. Patients with cardiogenic shock and those undergoing PCI of the bypass grafts were excluded. Major in-hospital and 30-day cardiovascular outcomes were assessed. From 2003 through 2018, 499 patients (847 lesions) with unstable angina pectoris (UAP), 1218 patients (1807 lesions) with non-ST-elevation myocardial infarction (NSTEMI), and 868 patients (1260 lesions) with ST-segment elevation myocardial infarction (STEMI) underwent high-risk PCI. Procedural success was achieved in 97.2% of UAP, 98.3% of NSTEMI, and 96.6% of STEMI patients. In-hospital and 30-day all-cause mortality were as follows: UAP, 2%; NSTEMI, 2.1%; and STEMI 4.7%. Bailout intra-aortic balloon pump was required in 1.6% of UAP, 3.1% of NSTEMI, and 10.3% of STEMI patients. Major complications for UAP, NSTEMI, and STEMI were, respectively: target lesion revascularization (2.3%, 1.4%, and 1.5%), stroke or transient ischemic attack (0.8%, 0.6%, and 1.3%), acute renal failure (8.2%, 7.2%, and 10.2%), major bleeding (1.6%, 3.1%, and 8.5%). In conclusion, our results show that high-risk PCI without elective MCS is safe and feasible in most ACS patients, challenging professional societies' current recommendations. A randomized trial comparing unprotected versus protected high-risk PCI for non-shock ACS patients is warranted.


Assuntos
Angina Instável/cirurgia , Circulação Assistida , Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia , Intervenção Coronária Percutânea/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Idoso , Idoso de 80 Anos ou mais , Angina Instável/mortalidade , Estudos de Viabilidade , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio sem Supradesnível do Segmento ST/mortalidade , Estudos Retrospectivos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Taxa de Sobrevida
11.
Int J Cardiol ; 340: 17-21, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34371029

RESUMO

BACKGROUND: Percutaneous coronary intervention (PCI) for in-stent restenosis (ISR) remains common. Intravascular imaging allows for the determination of the mechanism of ISR, potentially guiding appropriate therapy. Intravascular ultrasound (IVUS)-guided stent implantation is associated with a reduction in adverse events after PCI, but its impact on treatment of ISR is not clear. METHODS: All patients with 1-year follow-up after ISR treatment from 2003 through 2016 were included and stratified by IVUS use. The primary endpoint was the rate of major adverse cardiac events (MACE) at 1 year, defined as the composite of all-cause mortality, Q-wave myocardial infarction, and target vessel revascularization (TVR). RESULTS: The final analysis included 1522 ISR patients, 65.9% of whom were treated with IVUS guidance. The primary endpoint occurred in 18.0% of patients treated with IVUS guidance vs. 24.5% of patients treated with angiography guidance (p = 0.0014). Post-dilatation was used more often with IVUS (18.6% vs. 14.1%, p < 0.001), with a larger diameter of new stents (3.04 ± 0.35 mm vs. 2.94 ± 0.47 mm, p = 0.001). At 1 year, TVR occurred in 14.5% with IVUS guidance and 19.2% with angiography guidance (p = 0.021). CONCLUSIONS: The use of IVUS is associated with decreased MACE at 1 year following PCI for ISR. These results support routine IVUS for the treatment of ISR lesions.


Assuntos
Doença da Artéria Coronariana , Reestenose Coronária , Stents Farmacológicos , Intervenção Coronária Percutânea , Angiografia Coronária , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção
12.
Cardiovasc Revasc Med ; 33: 62-67, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34247983

RESUMO

Despite contemporary advances in stent technology, in-stent restenosis (ISR) remains a common issue following percutaneous coronary intervention. A novel classification system based on the underlying mechanism of action of restenosis was recently introduced. The Waksman In-Stent Restenosis Classification characterizes different patterns of ISR to best delineate the type of restenosis and help guide treatment. Intravascular imaging with either intravascular ultrasound or optical coherence tomography allows for real-time evaluation of ISR. We herein provide an illustrative review of the Waksman In-Stent Restenosis Classification.


Assuntos
Reestenose Coronária , Stents Farmacológicos , Intervenção Coronária Percutânea , Angiografia Coronária , Reestenose Coronária/diagnóstico por imagem , Reestenose Coronária/etiologia , Reestenose Coronária/terapia , Vasos Coronários , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Stents , Resultado do Tratamento
14.
Am J Cardiol ; 151: 45-50, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34030883

RESUMO

The prognosis of left circumflex (LC) versus non-LC in-stent restenosis (ISR) ostial lesions following treatment has not been assessed. We aimed to assess this prognosis. Anecdotally, treatment of ostial LC ISR has been associated with high recurrence rates. We performed a retrospective analysis of patients from our institution who underwent coronary intervention of an ostial ISR lesion between 2003 and 2018. The primary endpoint was target lesion revascularization (TLR) and major adverse cardiovascular events (MACE). Overall, 563 patients underwent ostial ISR lesion intervention, 144 for an ostial LC ISR lesion. Compared to patients with ostial ISR in non-LC lesions, patients with ostial LC ISR were older, had higher rates of diabetes mellitus and previous coronary bypass surgery. At 1-year follow-up, TLR-MACE rates were 26.6% in the LC group versus 18.4% in the non-LC group (p = 0.036). The TLR rate was also higher in the LC group compared to the non-LC group (p = 0.0498). Univariate and multivariate analyses demonstrated a higher TLR-MACE rate for LC versus non-LC ostial ISR lesions. In conclusion, our study shows increased event rates after treatment of LC versus non-LC ISR lesions. Further studies should be done to assess the optimal treatment approach for ostial LC ISR.


Assuntos
Angioplastia Coronária com Balão , Braquiterapia , Doença da Artéria Coronariana/cirurgia , Reestenose Coronária/terapia , Stents Farmacológicos , Intervenção Coronária Percutânea , Complicações Pós-Operatórias/terapia , Idoso , Aterectomia Coronária , Feminino , Hemorragia/epidemiologia , Mortalidade Hospitalar , Humanos , Masculino , Metais , Infarto do Miocárdio/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Modelos de Riscos Proporcionais , Recidiva , Stents , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento , Ultrassonografia de Intervenção
15.
Catheter Cardiovasc Interv ; 98(3): 572-577, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33539651

RESUMO

OBJECTIVES: We analyzed post-marketing surveillance data from the United States Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database for suture-based vascular closure devices (VCDs) - Perclose ProGlide (Abbott, Chicago, Illinois) and Prostar XL (Abbott). BACKGROUND: Suture-based VCDs are mostly used for large-bore femoral arterial access-site closure. Real-world, contemporary experience on the most commonly reported complications and modes of failure associated with these devices is limited. METHODS: Post-marketing surveillance data from the FDA MAUDE database, for the ProGlide system and for the Prostar XL system, were analyzed, yielding 827 Perclose ProGlide reports and 175 Prostar XL reports. RESULTS: Of the 827 reports of major complications involving the Perclose ProGlide devices, 404 reports involved injury, and one involved death related to the device. In the Prostar XL analysis, 94 reports involved injury, and one involved death. Bleeding from vessel injury was the most common adverse outcome described with both devices, followed by hematoma and thrombus. Surgical repair was the most commonly used treatment strategy. In terms of device malfunction, suture-related malfunction (212 reports) was most commonly seen in the Perclose ProGlide group, while failed deployment was most commonly seen in the Prostar XL group. CONCLUSIONS: Our analysis of the MAUDE database demonstrates that in real-world practice, suture-based VCDs were found to be associated with complications, including vascular injury, difficulties with the device itself, and even death. Ongoing user education and pre-procedural patient selection are important to minimize risks associated with suture-based vascular closure devices.


Assuntos
Dispositivos de Oclusão Vascular , Artéria Femoral/cirurgia , Humanos , Suturas , Resultado do Tratamento , Estados Unidos , United States Food and Drug Administration
16.
Cardiovasc Revasc Med ; 27: 57-62, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33071196

RESUMO

BACKGROUND/PURPOSE: Coronary artery calcification is a marker of advanced atherosclerosis and a predictor of adverse clinical outcomes. Rotational atherectomy (RA) can effectively modify calcified lesions, optimizing procedural outcomes. We interrogated the most commonly reported adverse events involving rotational atherectomy systems (Rotablator and Rotapro) by analyzing post-marketing surveillance data from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database. METHODS/MATERIALS: We queried MAUDE from September 1, 2016, through December 31, 2019. After excluding duplicate reports, we included 363 reports for Rotablator and 63 reports for Rotapro in the final analysis. RESULTS: Percentages represent the proportion of total submitted MAUDE reports. The most commonly reported complications for Rotablator and Rotapro included dissection (2.7% and 6.3%, respectively) and perforation (4.1% and 19%, respectively). The most commonly reported device-related issues included detachment or structural damage, or both, for Rotablator (39.1%) and entrapment of the device component for Rotapro (47.6%). The most commonly damaged device component was the Rotawire, whereas the most commonly entrapped device component was the Rotaburr for both device configurations. Rotablator and Rotapro device-related complications were most commonly reported for the left anterior descending artery. CONCLUSION: An analysis of the MAUDE database demonstrates that in real-world practice, RA devices are associated with important complications. Ongoing surveillance of safety profiles, patient outcomes, and failure modes of RA devices is warranted. Our analysis provides important insights into the mechanisms of failure of RA devices and associated complications but cannot verify causality.


Assuntos
Aterectomia Coronária , Doença da Artéria Coronariana , Aterectomia Coronária/efeitos adversos , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Bases de Dados Factuais , Humanos , Fatores de Risco , Resultado do Tratamento , Estados Unidos , United States Food and Drug Administration
17.
Cardiovasc Revasc Med ; 23: 119-120, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32952076

RESUMO

Competitive flow from a non-critical native vessel leading to longitudinal narrowing/atresia of the left internal mammary artery (LIMA) is described as "the string phenomenon." We describe spontaneous recanalization of an atretic LIMA following coronary artery bypass grafting for multivessel coronary artery disease.


Assuntos
Doença da Artéria Coronariana , Artéria Torácica Interna , Ponte de Artéria Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Humanos , Anastomose de Artéria Torácica Interna-Coronária/efeitos adversos , Artéria Torácica Interna/diagnóstico por imagem , Artéria Torácica Interna/cirurgia
18.
Case Rep Cardiol ; 2021: 2658094, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35003810

RESUMO

Simultaneous multi-vessel very later stent thrombosis (VLST) is a very rare complication of percutaneous coronary intervention (PCI). We present a case of simultaneous multi-vessel VLST as the cause of acute ST-segment elevation myocardial infarction (STEMI). PCI of the culprit vessel was performed at acute presentation. Resolution of in-stent thrombosis in non-culprit vessels was noted on coronary angiography 2 days later. Our case suggests that PCI for culprit lesion in acute setting may be a reasonable option for simultaneous multi-vessel VLST.

19.
Am J Cardiol ; 142: 44-51, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33285089

RESUMO

Intravascular brachytherapy (VBT) is an effective and safe treatment option for recurrent drug-eluting stent (DES) in-stent restenosis (ISR). However, the optimal therapy for patients with failed VBT is not well-defined. In this study, we sought to evaluate the optimal treatment strategy for patients after a failed VBT. Patients with recurrent ISR after an initial unsuccessful VBT were identified from our percutaneous coronary intervention database. Patients were divided into 2 cohorts (standard treatment with DES or balloon angioplasty versus repeat VBT). Baseline characteristics and clinical outcomes during follow-up were extracted. A total of 279 patients underwent PCI after an initial unsuccessful VBT at our institution. Of those, 215 (77%) patients underwent standard treatment with balloon angioplasty with or without DES, and 64 (33%) underwent balloon angioplasty followed by repeat VBT. The mean age of the cohort was 64±11 years. Overall, 71% were men, 47% had diabetes, and 22% had heart failure. The majority (64%) presented with unstable angina. The groups had similar baseline characteristics. The rate of major adverse cardiovascular events (defined as all-cause mortality, myocardial infarction, or target vessel revascularization) was significantly lower in the repeat VBT group at 1 year (31% vs 14%, p = 0.03), 2 years (51% vs 31%, p = 0.03), and 3 years (57% vs 41%, p = 0.08). Target lesion revascularization and target vessel revascularization were consistently lower in the repeat VBT group at all follow-up intervals than in the standard treatment group. Treatment of recalcitrant ISR following an initial failed VBT is associated with a high MACE rate at 3-year follow-up. Repeat VBT is safe and effective and should be considered as the preferred strategy.


Assuntos
Angioplastia Coronária com Balão/métodos , Braquiterapia/métodos , Reestenose Coronária/terapia , Stents Farmacológicos , Intervenção Coronária Percutânea/métodos , Idoso , Procedimentos Endovasculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Infarto do Miocárdio/epidemiologia , Revascularização Miocárdica/estatística & dados numéricos , Recidiva , Retratamento , Falha de Tratamento
20.
Am J Cardiol ; 135: 32-39, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32866443

RESUMO

Percutaneous coronary intervention (PCI) performed during non-work hours is believed to have inferior outcomes because of operator fatigue, differences in baseline patient characteristics, and fewer on-call catheterization laboratory staff. We aimed to analyze a cohort of patients who underwent PCI (all comers) at our tertiary-care center between January 1, 2006, and December 31, 2018, and compare procedural and in-hospital outcomes between 2 groups defined by whether PCI was performed during normal work hours (7:00 A.M. to 7:00 PM) versus non-work hours (7:01 P.M. to 6:59 A.M. weekdays; all hours weekends and holidays). Finally, we examined temporal changes throughout the 24-hour weekday. Primary outcomes were unadjusted in-hospital adverse outcomes (composite death, recurrent myocardial infarction, emergent coronary artery bypass grafting, and target lesion revascularization). We identified 21,848 patients who underwent PCI at our institution. The proportions of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) were higher during non-work hours. Overall, unadjusted in-hospital adverse outcomes were higher during non-work hours than during normal work hours (8.80% vs 2.00%; p <0.001). These findings were consistent based on the patient's clinical presentation (STEMI, NSTEMI, unstable angina, and stable angina). Despite confounding variables in the patients' presentations preventing definite causal attribution, our analysis demonstrates that in-hospital adverse outcomes were higher for those patients who underwent PCI (all comers) who had their procedures during non-work hours than during normal work hours.


Assuntos
Plantão Médico , Angina Estável/cirurgia , Angina Instável/cirurgia , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Plantão Médico/estatística & dados numéricos , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/métodos , Estudos Retrospectivos , Resultado do Tratamento
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