Primary Angioplasty : Mechanical Interventions for Acute Myocardial Infarction

by Antoniucci; David

• ISBN13: 9781841843421
• ISBN10: 1841843423
• Edition: 1st
• Format: Hardcover
• Copyright: 2004-05-19
• Publisher: CRC Press

Summary

Acute myocardial infarction (AMI) remains a major problem in the Western world. Complete and concise, Primary Angioplasty: Mechanical Interventions for Acute Myocardial Infarction provides an update on the rationale, techniques, and effectiveness of direct percutaneous mechanical revascularization for AMI. It combines a critical review of the key studies that are the foundation of evidence-based medicine with the so-called 'technology of experience.' The book puts the pathophysiologic and clinical aspects of AMI and reperfusion in an interventional perspective, highlighting the rationale for the best interventional approach to the patient with AMI.Sharing insights based on their years of experience, the chapter authors present a comprehensive review of direct angioplasty and stenting supported by a full description of cases representing different angiographic and clinical patient subsets. The innovative format includes four sections based on clinical, technical, procedural, and logistic aspects of mechanical intervention for AMI. The book may be read in a conventional way, from beginning to end, or alternatively, starting from one of the four sections, and then following all possible sequences for the remaining three sections.

Author Biography

David Antoniucci Head, Division of Cardiology, Careggi Hospital, Viale Morgagni, Florence

Table of Contents

Contributors	vii
Preface	ix
Section 1: The Clinical Perspective
Pathophysiological basics of acute myocardial infarction	3	(12)
Guido Parodi
The epicardial vessel
The microcirculation
The myocardium
Major subgroups at presentation	15	(30)
Angela Migliorini
Giampaolo Cerisano
Piergiovanni Buonamici
Guia Moschi
Electrocardiography
Echocardiography
Angiography
Elderly patients
Women
Diabetics
Cardiogenic shock
Section 2: The Technical Perspective
Techniques	45	(14)
Angela Migliorini
Renato Valenti
Entry site
Guiding catheters
Coronary wires and angioplasty balloons
Techniques for assessment of the anatomy of a target vessel persistently occluded after crossing the wire
Thrombectomy
Emboli protection devices
Stents
Other techniques
Platelet glycoproteins IIb/Illa inhibitors	59	(6)
Renato Valenti
Guido Parodi
Angela Migliorini
Abciximab
Eptifibatide and tirofiban
Mechanical support	65	(6)
Renato Valenti
Guido Parodi
Intraaortic balloon pumping
Other percutaneous mechanical circulatory support devices
Section 3: The Vessel Perspective
Right coronary artery (RCA)	71	(46)
Renato Valenti
Angela Migliorini
Left anterior descending artery (LAD)	117	(32)
Renato Valenti
Angela Migliorini
Left circumflex artery (LCX)	149	(14)
Renato Valenti
Angela Migliorini
Left main trunk (LMT)	163	(6)
Renato Valenti
Angela Migliorini
Multivessel coronary intervention	169	(10)
Renato Valenti
Angela Migliorini
Section 4: The Efficacy Perspective
Primary percutaneous coronary intervention for acute myocardial infarction in the `real world'	179	(8)
Renato Valenti
Emilio Vincenzo Dovellini
Giovanni Maria Santoro
Effectiveness of percutaneous mechanical intervention for AMI
Impact of time to treatment on outcome of patients treated by PCI for AMI
Institutional volume of primary PCI
Practice guidelines
Logistic models and organizational scenarios
Role of cardiac surgery backup
Assessment of myocardial reperfusion in acute myocardial infarction	187	(14)
Giovanni Maria Santoro
The no-reflow phenomenon
Assessment of myocardial reperfusion
The concepts of rescue and facilitated percutaneous intervention in perspective	201	(6)
Guido Parodi
Rescue angioplasty
Facilitated primary angioplasty
Transfer for primary angioplasty
Index	207