Unusual Case of Spontaneous Postcoital Type A Aortic Dissection.

Aortic dissection is a life-threatening condition that may present as severe acute chest or abdominal pain, especially in high-risk patients, and should raise a high index of suspicion for aortic dissection when occurring after moderate-to-high-intensity activities, such as sexual intercourse. Sexual intercourse leads to physiological stress on the body causing an abrupt elevation in blood pressure and shearing force against the vessel wall. This shearing force increases the risk of vessel wall dissection. Below, we discuss a rare case of type A aortic dissection after sexual intercourse and highly recommend physicians to evaluate and educate their high-risk patients regarding aortic dissection with such activities.

Nine-month results of the BIOHELIX-I clinical trial study: Evaluation of the PRO-Kinetic Energy cobalt chromium bare-metal stent system.

OBJECTIVES: To evaluate the safety and efficacy of the PRO-Kinetic Energy (PKE) Cobalt Chromium Coronary Stent System (BIOTRONIK AG, Switzerland). BACKGROUND: Percutaneous coronary intervention is a mainstay treatment for symptomatic coronary artery disease (CAD). While drug-eluting stents constitute a majority of implants, bare-metal stents (BMS) remain important for a subset of patients. Newer generation BMS offer advantages due to stent design improvements. METHODS: The BIOHELIX-I study was a prospective, multicenter, non-randomized, single arm clinical trial designed to evaluate the safety and efficacy of the PKE bare metal stent. Thirty-three study centers (US, Columbia, Europe) enrolled 329 patients for treatment of one target lesion (≤31 mm). Eligible patients received a PKE stent(s), at least one month of dual antiplatelet therapy and were followed for 36-months. The primary endpoint was the 9-month rate of target vessel failure (TVF) compared with a prespecified performance goal of 18.7% derived from prior BMS trials. RESULTS: The mean patient age was 69 years, 28.6% with diabetes. The mean lesion length was 13.7 ± 6.0 mm. The 9-month TVF rate was 9.06% and met the primary endpoint (P < 0.001). The TVF component rates were 0.95% cardiac death, 1.58% myocardial infarction, and 7.26% ischemia-driven target vessel revascularization (TVR). The ischemia-driven target lesion revascularization rate at 9-months was 6.62%. CONCLUSIONS: The 9-month TVF rate of the PKE stent was comparable to other BMS and is a viable option for treating CAD. The low observed rate of ischemia-driven TVR supports the safety and efficacy of the novel BMS design.