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    ABSTRACT: The aim of this study is to evaluate the feasibility and safety of the Glidesheath Slender in routine transradial (TR) coronary angiography and intervention. In recent years, The TR approach has gained in popularity because of several advantages such as reduced vascular access site complications and immediate patient mobilization. Procedural success has been further improved through technological innovations and the development of less invasive devices. The Glidesheath Slender (Terumo, Tokyo, Japan) is a new dedicated radial sheath with a thinner wall and hydrophilic coating. It combines an inner diameter compatible with 6Fr guiding catheter with an outer diameter close to current 5Fr sheaths. Its use has the potential to decrease invasiveness and access site complications during TR procedures. A total of 114 consecutive patients undergoing TR coronary angiography and/or PCI using the Gidesheath Slender were included in a prospective single-center feasibility and safety study. Procedural success was 99.1% with only one case requiring conversion to femoral access. There were six minor hematomas but none of the patients experienced major vascular complications. The rate of symptomatic radial spasm was 4.4%. No case of major sheath kinking was noted. Doppler ultrasound examination of the radial artery at 1 month follow-up was available in 113/114 patients with only one case of radial artery occlusion (RAO) (0.88%). Routine use of the Glidesheath Slender for TR coronary angiography and interventions is safe and feasible with a high rate of procedural success and a low rate of RAO. © 2013 Wiley Periodicals, Inc.
    No preview · Article · Sep 2014 · Catheterization and Cardiovascular Interventions
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    ABSTRACT: Patients undergoing kidney transplantation are sometimes being treated with antiplatelet agents such as ticlopidine or clopidogrel. Some teams refuse to wait-list these patients for fear of bleeding during transplant surgery. We retrospectively reviewed the records of 702 adult patients with a kidney transplant alone between 2000 and 2010. Nineteen (2.7%) patients were taking clopidogrel or ticlopidine when called in for transplantation. Furthermore, 10 of these 19 patients were also taking low-dose aspirin (ASA). We compared the risk of bleeding peri- and postoperatively, and the occurrence of cardiovascular complications within 30 days after renal transplantation between 19 cases and 39 controls randomly selected within the cohort. Platelets were administered to 7 cases (37%) versus 0 controls (P < 0.001). A single case (5.3%) presented with significant bleeding during surgery following an implantation biopsy, and required 4 red bood cell (RBC) units. During the first day, 3 of the 19 cases (16%) and 1 of the 39 controls required RBC (P = 0.1). No reoperation was performed for bleeding. After the transplant, clopidogrel or ticlopidine was resumed in only two patients. The platelet count and haemoglobin were similar between cases and controls at Day 30. No cardiovascular event occurred in cases or controls during the first month post-transplantation. At 5 years, graft and patient survival was similar in cases and controls. Clopidogrel and ticlopidine, sometimes in combination with ASA, are associated with a low risk of bleeding during renal transplantation and does not seem to be a contraindication for renal transplant surgery.
    No preview · Article · Nov 2013 · Nephrology Dialysis Transplantation
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    ABSTRACT: Our current activated partial thromboplastin time (APTT) reagent (PTT-A) is often prolonged for unexplained reasons. We decided to compare this reagent with an alternative reagent (Cephascreen) and with our second line APTT (Actin FS) in terms of cut-off values, sensitivity to in-vitro coagulation factor deficiencies, sensitivity to lupus anticoagulant (LA), and in vivo sensitivity to unfractionated heparin (UFH). Actin FS, PTT-A, and Cephascreen were prolonged for FVIII level at 60%, 40%, and 40% respectively, FIX at 50%, 25%, and 35%, and FXI at 60%, 20%, and 50%. PTT-A showed the same sensitivity and specificity as Cephascreen to LA. Actin FS and PTT-A appeared less suitable to monitor UFH regarding the CLSI criteria. Cephascreen fulfilled the CLSI performance criteria, with a good compromise in terms of sensitivity to factor deficiency and with a substantial reduction of complementary analysis in our routine practice.
    No preview · Article · Oct 2013 · Clinical laboratory


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Top publications last week by reads

Transfusion Alternatives in Transfusion Medicine 10/2007; 9(3):143 - 149. DOI:10.1111/j.1778-428X.2007.00072.x
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Endoscopy 03/2012; 44(3):277-98. DOI:10.1055/s-0031-1291633
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