Maria Lopez-Benito

Timely reperfusion for ST-segment elevation myocardial infarction: Effect of direct transfer to primary angioplasty on time delays and clinical outcomes

Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction (STEMI) when it can be performed expeditiously and by experienced operators. In spite of excellent clinical results this technique is associated with longer delays than thrombolysis and this fact may nullify the benefit of selecting this therapeutic option. Several strategies have been proposed to decrease the temporal delays to deliver PPCI. Among them, prehospital diagnosis and direct transfer to the cath lab, by-passing the emergency department of hospitals, has emerged as an attractive way of diminishing delays. The purpose of this review is to address the effect of direct transfer on time delays and clinical events of patients with STEMI treated by PPCI.

Double Guide Catheter Technique for Sealing an Iatrogenic Coronary Perforation

Introduction: Coronary vessel perforation is one of the most feared complications of coronary angioplasty. The treatment of this complication relies mostly on the implantation of covered stents. However, due to their design, covered stents are difficult to advance in a tortuous or calcified vessel. Case Presentation: We present a case of a grade III coronary perforation in which the double guiding catheter technique helped us to deliver the graft stent. Conclusions: The double-guiding technique is useful in emergency situations to increase the safety and efficacy of sealing a coronary perforation.

Paclitaxel crystals on the surface of a bioresorbable vascular scaffold visualized by optical coherence tomography after drug-eluting balloon angioplasty

A 79-year-old male with history of coronary artery disease with percutaneous revascularization of medium left anterior descending artery with a bare metal stent 2.5 23 mm presented with unstable angina. A significant in-stent restenosis (ISR) was observed (Panel A), and treated by means of an instent bioresorbable vascular scaffold (BVS) (absorb 2.5 28 mm) with excellent angiographic result. Six months later, the patient presented again with unstable angina and significant restenosis intra-scaffold was observed. Optical coherence tomography (OCT) of the BVS was performed showing significant neointimal proliferation (Panel B). Firstly, an angioplasty with a cutting balloon 2.75 6 mm was performed with a remarkable increase in the luminal diameter of the BVS in OCT (Panel C). After that, an angioplasty with a paclitaxel eluting balloon 2.5/30 mm intra-scaffold was performed. Intracoronary imaging by OCT showed the presence of paclitaxel crystals deposited on the surface of the BVS after their release from the angioplasty balloon (Panel D). An evident change in the neointimal layer of the scaffolded coronary artery was appreciated convincingly attributed to paclitaxel crystals. This represented a new and unique finding that did not appear in previous OCT assessment. Intracoronary imaging is important to identify different mechanisms of ISR and to guide specific management in those cases. This case aims to illustrate the utility of OCT to identify the direct result of the intra-scaffold DEB angioplasty by the documentation of paclitaxel crystals remaining on the vessel surface after percutaneous intervention, in extraordinary technical detail.

GLUCAGON-LIKE PEPTIDE-1 RECEPTOR ACTIVATION REDUCES COMPENSATORY HYPERTROPHY AND LEFT VENTRICULAR REMODELING IN A PORCINE MODEL OF ISCHEMIA AND REPERFUSION

Glucagon-like Peptide-1 (GLP-1) is an intestinal hormone important for glucose metabolism. Recent attention has focused on its anti-apoptotic and cytoprotective actions. Exenatide is a GLP-1 mimetic used to treat Type 2 diabetes. Our group has demonstrated that Exenatide-mediated GLP-1receptor (GLP-