Faculty Bibliography
Searched for:
person:coppoj01
Total Results:
65
IMPROVING PROCEDURAL SUCCESS AND REDUCING COMPLICATIONS IN ENDOVASCULAR TREATMENT OF SUPERFICIAL FEMORAL ARTERY IN-STENT RESTENOSIS IN THE PRESENCE OF OBSTRUCTIVE TIBIAL OUTFLOW DISEASE: RETROGRADE TRANSPEDAL ACCESS APPROACH [Meeting Abstract]
ISI:000397342301529
ISSN: 1558-3597
CID: 2528902
Innovative use of a guideliner catheter to assist in snare retrieval of an entrapped kinked guide catheter during transradial coronary intervention [Case Report]
Rescue techniques that enable removal of severe intravascular catheter kinking are always worthwhile. We herein demonstrate the novel employment of a GuideLiner support catheter to assist in the removal of a kinked and entrapped guide catheter within the radial artery during coronary intervention. (c) 2016 Wiley Periodicals, Inc.
PMID: 27567101
ISSN: 1522-726x
CID: 2221732
Influence of Human Immunodeficiency Virus Seropositive Status on the In-Hospital Management and Outcomes of Patients Presenting With Acute Myocardial Infarction
OBJECTIVES: Human immunodeficiency virus (HIV) seropositive individuals are predisposed to acute myocardial infarction (AMI). We sought to evaluate management strategies and outcomes of AMI in patients with HIV in the contemporary era. METHODS: We analyzed data from the National Inpatient Sample from 2002 to 2011 for patients admitted with AMI with or without HIV. Propensity-score matching was used to identify HIV seropositive AMI patients with similar characteristics who were managed invasively (cardiac catheterization, percutaneous coronary intervention [PCI], or coronary artery bypass graft surgery [CABG]) or conservatively. The primary outcome was in-hospital all-cause mortality. RESULTS: Among 1,363,570 patients admitted with AMI, 3788 (0.28%) were HIV seropositive. The frequency of HIV diagnosis among AMI patients increased over time (0.20% in 2002 to 0.35% in 2011; P for trend <.001). Patients with HIV had lower odds of invasive management (adjusted odds ratio [OR], 0.59; 95% confidence interval [CI], 0.55-0.65) and were less likely to undergo CABG (OR, 0.66; 95% CI, 0.57-0.76) or receive drug-eluting stents (OR, 0.83; 95% CI, 0.76-0.92) than HIV-seronegative patients. Patients with HIV had higher in-hospital mortality (adjusted OR, 1.36; 95% CI, 1.13-1.64) than those without HIV. In a propensity-matched cohort of 1608 patients with HIV treated for AMI with invasive vs conservative management, invasive management was associated with lower in-hospital mortality (3.0% vs 8.2%; P<.001; OR, 0.34; 95% CI, 0.21-0.56). CONCLUSIONS: Disparities exist in management of AMI by HIV status. HIV seropositive patients were less likely to receive invasive management, CABG, and drug-eluting stents, and had higher in-hospital mortality vs patients without HIV.
PMID: 27705890
ISSN: 1557-2501
CID: 2273712
Effect of Left Versus Right Radial Artery Approach for Coronary Angiography on Radiation Parameters in Patients With Predictors of Transradial Access Failure
Left transradial approach (TRA) for coronary angiography is associated with lower radiation parameters than right TRA in an all-comers population. The aim of this study was to determine the effects of left versus right TRA on radiation parameters in patients with predictors of TRA failure. Patients with predictors of TRA failure (>/=3 of 4 following criteria: age >/=70 years, female gender, height
PMCID:4976048
PMID: 27328954
ISSN: 1879-1913
CID: 2159122
HIV Infection and Primary Prevention of Cardiovascular Disease: Lights and Shadows in the HAART Era
With the progressive increase in life-expectancy of human immunodeficiency virus (HIV)-positive patients in the "highly active antiretroviral therapy" (HAART) era, co-morbidities, particularly cardiovascular (CV) diseases (CVD) are emerging as an important concern. The pathophysiology of CVD in this population is complex, due to the interaction of classical CV risk factors, viral infection and the effects of antiretroviral therapy (ARV). The role of ARV drugs in HIV is double edged. While these drugs reduce systemic inflammation, an important factor in CV development, they may at the same time be proatherogenic by inducing dyslipidemia, body fat redistribution and insulin resistance. In these patients primary prevention is challenging, considering the lower median age at which acute coronary syndromes occur. Furthermore prevention is still limited by the lack of robust evidence-based, HIV-specific recommendations. Therefore we performed a comprehensive evaluation of the literature to analyze current knowledge on CVD prevalence in HIV-infected patients, traditional and HIV-specific risk factors and risk stratification, and to summarize the recommendations for primary prevention of CVD in this HIV population.
PMID: 26943980
ISSN: 1873-1740
CID: 2009512
Superficial Femoral Artery Intervention by Single Transpedal Arterial Access
BACKGROUND: Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting. METHODS: In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation). RESULTS: All patients underwent successful SFA stenting without complication. Procedure time varied from 51 to 72 minutes. The mean contrast amount used was 56 mL; mean fluoroscopy time was 21 minutes; mean radiation dose was 91 mGy. At 1-month follow-up, duplex ultrasonography showed that all pedal arteries had remained patent. CONCLUSIONS: Transpedal artery approach as a primary approach to SFA stenting appears feasible and safe. Comparative trials with standard percutaneous femoral approach are warranted.
PMID: 26524208
ISSN: 1557-2501
CID: 1927682
Predictors of Access Site Crossover in Patients Who Underwent Transradial Coronary Angiography
Despite increasing use of the transradial approach (TRA) for coronary angiography, TRA failure and subsequent access site crossover remain a barrier to TRA adoption. The aim of this study was to elucidate patient and procedural characteristics associated with TRA to transfemoral approach (TFA) crossover and examine TRA to TFA crossover by operator experience over time. This retrospective analysis identified 1,600 patients who underwent coronary angiography with possible percutaneous coronary intervention through TRA by operators with varied TRA experience in an urban tertiary care center from October 2010 to August 2013. Univariate and multivariable logistic regression were used to identify independent predictors of access site crossover, from TRA to TFA, and strength of association is presented as odds ratio (OR, 95% confidence interval [CI]). Access site crossover was noted in 166 patients (10.4%). Multivariable predictors of access site crossover included age >75 years (OR 1.90, 95% CI 1.23 to 2.91, p = 0.004) and operator experience (OR 2.98, 95% CI 1.96 to 4.52, p <0.0001). Less experienced operators (5 years TRA experience) had no significant change in proportion of access site crossover over time (quartile 1: 2.8%, quartile 2: 6.4%, quartile 3: 5.6%, quartile 4: 5.8%, p = 0.54). In conclusion, rate of access site crossover in the contemporary era is relatively low and can be mitigated with operator experience.
PMCID:4499487
PMID: 26026865
ISSN: 1879-1913
CID: 1615162
Utility of Transradial Approach for Peripheral Vascular Interventions
This review demonstrates the feasibility of the transradial approach (TRA) to address different peripheral vascular lesions. The TRA has long been used to address practically all coronary artery lesion subsets. It has shown significant benefits when compared with transfemoral approach (TFA), particularly a reduction in puncture-site related bleeding complications. TRA can be utilized effectively to address peripheral vascular lesions, including the renal, iliac, subclavian, carotid, vertebrobasilar, and superficial femoral systems. Utility of TRA for addressing peripheral vascular lesions using different techniques has been discussed in detail. Advantages and limitations of the TRA are highlighted, and the results of different studies using TRA for peripheral interventions are discussed. The pros and cons of TRA versus TFA for peripheral procedures are also demonstrated. The TRA is an effective alternative for TFA to address most peripheral vascular lesion subsets. However, there is a need for the development of radial-specific hardware to track bulky devices.
PMID: 26028654
ISSN: 1557-2501
CID: 1644712
Transradial Peripheral Arterial Procedures
Increased understanding and increased adoption of transradial catheterization across the world have led to further exploring of radial artery access for transradial endovascular interventions in peripheral artery disease (PAD). This article discusses the advantages and limitations of the transradial approach for endovascular medicine by using case examples, illustrations, and videos. The details about how to use a radial approach for PAD intervention, including and tips tricks, are discussed.
PMID: 28582049
ISSN: 2211-7466
CID: 2590382
Delayed occurrence of radial artery pseudoaneurysm following transradial percutaneous coronary intervention
Radial artery pseudoaneurysm is rare following transradial catheterization procedures. In this article, we report a 5-month delay in the occurrence of this vascular complication following the completion of transradial coronary intervention in a subject without any underlying vasculitis, representing the longest time lag thus far described. <Learning objective: The occurrence of radial artery pseudoaneurysms after transradial coronary intervention is extremely rare, but typically presents clinically within weeks following arterial cannulation. A 5-month time delay for radial artery pseudoaneurysm occurrence in an individual without underlying vasculitis has not been previously reported. It is compulsory that radial operators have full knowledge of the time courses of all potential radial artery complications, so that their timely correction can be instituted.>.
PMCID:6279979
PMID: 30546545
ISSN: 1878-5409
CID: 3556352
