Seyed-Ebrahim Kassaian

Seyed-Ebrahim Kassaian
Tehran University of Medical Sciences | TUMS · Department of Cardiology

27.85
Research
Research items (71)
Article
Iliofemoral deep vein thrombosis (IFDVT) is a potentially devastating condition comprising a quarter of all cases of lower extremity DVT. It can lead to serious consequences such as pulmonary embolism, limb malperfusion, and post-thrombotic syndrome (PTS), which is a chronic sequela of IFDVT. We herewith present 18 IFDVT cases managed with catheter...
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Background: Increasing age appears to be a risk factor for adverse outcome in patients undergoing percutaneous coronary intervention (PCI). The goal of this study was to compare procedural success, complications, and 12 months major adverse cardiac events (MACE) based on age using a large angioplasty registry. Methods: This registry included 10,...
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Background: Coronary artery ectasia (CAE) is identified as dilation of one or more segments of coronary arteries that reaches 1.5 times or more, compared with near segments that are normal. Several etiologies like atherosclerosis, autoimmune diseases and congenital anomalies have been proposed for this condition. Vitamin D deficiency activates the...
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Background: We aimed to recognize the predictors of long-term major adverse cardiac events (MACE) in the elderly candidates for elective percutaneous coronary intervention (PCI) at our center. Methods: In this retrospective cohort study, we reviewed the data of the elderly (age ≥65 years) candidates for elective PCI who met our study criteria, a...
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A major diagnostic challenge for cardiologists is to distinguish cardiac syndrome X (CSX) from obstructive coronary artery disease in women with typical angina and a positive exercise tolerance test (ETT). We performed this study to develop a scoring system that more accurately predicts CSX in this patient population. Data on 976 women with typical...
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Aims We investigated the association between Type-2 diabetes mellitus (DM) and the need for revascularization at a 5-year follow-up of young coronary artery disease patients and the role of sex in this regard. Methods among 1121 young (males≤45, and females≤55 years) patients (female: 49.7%) from Tehran Heart Center’s Premature Coronary Atheroscle...
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The pseudoaneurysm of the aorta is rarely due to trauma and infection but usually is a late complication of previous surgical procedures like coronary artery bypass graft surgery. We describe a 65-year-old woman with the pseudoaneurysm of the ascending aorta due to coronary artery bypass graft surgery. It was revealed in coronary artery angiography...
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Objective: Depressed coronary artery disease (CAD) patients may experience a poorer prognosis than non-depressed patients. The aim of this study was to find the associated factors for depressive symptoms in young adults with CAD. Method: This was a cross-sectional study within Tehran Heart Center's Premature Coronary Atherosclerosis Cohort (THC-PAC...
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Objective: The aim of this study is to compare intracoronary (IC) bolus only with IC bolus plus maintenance intravenous (IV) infusion of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors with respect to 1-year major adverse cardiac events including mortality, nonfatal myocardial infarction, revascularization, and bleeding events after primary percuta...
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Background: The biolimus-eluting stent (BES), with a biodegradable polymer, has not been previously compared with the everolimus-eluting stent (EES), as a second-generation drug-eluting stent (DES).We sought to compare the 1-year outcome between the PROMUS™ stent (EES type) and the BioMatrix™ stent (BES type). Methods: From March 2008 to September...
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We compared outcomes of percutaneous coronary intervention patients who received biodegradable-polymer biolimus-eluting stents with those who received durable-polymer everolimus-eluting stents. At Tehran Heart Center, we performed a retrospective analysis of the data from January 2007 through December 2011 on 3,270 consecutive patients with coronar...
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Background: Anxiety may negatively affect the course of coronary artery disease (CAD). The aim of this study was to assess which factors are associated with anxiety in young adults with CAD. A cohort of individuals with premature coronary artery disease was formed between 2004-2011, as the Tehran Heart Center's Premature Coronary Atherosclerosis Co...
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Objectives: New-generation coronary stents including zotarolimus- and everolimus-eluting stents (ZES and EES) have been shown to decrease the risk of restenosis. The purpose of this study was to compare the safety and efficacy of ZES and EES over a 12-month clinical follow up, in routine clinical practice. Methods: This is an observational study...
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Objectives To assess contemporary data on characteristics, management and 1-year postdischarge outcomes in Iranian patients hospitalised with acute coronary syndrome (ACS). Setting 11 tertiary care hospitals in 5 major cities in the Islamic Republic of Iran. Participants Patients aged ≥20 and ≤80 years discharged alive with confirmed diagnosis of A...
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Background: We performed this study to evaluate the possible synergism between hypertension and other conventional risk factors of coronary artery disease (CAD) on an angiographic severity of coronary atherosclerosis. Methods: A cross-sectional study was conducted on 10502 consecutive patients who underwent coronary angiography in the cardiac ca...
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Background: Transcatheter aortic valve implantation (TAVI) was known as an alternative technique for treatment of severe aortic stenosis (AS). This technique is controversial in bicuspid aortic valve (BAV). Here, we report TAVI for severe AS in a BAV setting in a patient with serious lung disease. Case report: A 68-year-old woman with a history...
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Data on premature coronary artery disease (CAD) are scarce. The Tehran Heart Center's Premature Coronary Atherosclerosis Cohort Study (THC-PAC) is the first study of its kind in the Middle East to assess major adverse cardiac events (MACE) in young CAD patients. The cohort consists of CAD patients, males ≤ 45 years old and females ≤ 55 years old. T...
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Studies have shown controversial effects of obesity on major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). We sought to investigate the impact of the body mass index (BMI) on the mid-term outcome following successful PCI. Between March 2006 and August 2008, 3948 patients underwent successful elective PCI in Tehran He...
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Background: About 40% of women with typical angina and positive exercise tolerance test (ETT) have normal coronary angiographies. We performed this study to construct a scoring system for better distinguishing patients with cardiac syndrome x (CSX) than those with obstructive coronary artery disease (CAD) among women with typical angina and a posit...
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There have been attempts to find new approaches to the treatment of multivessel coronary artery disease without increasing adverse events. Deployment of drug-eluting stents (DES) for complex lesions and bare-metal stents (BMS) for simpler lesions, although already in wide use, has not been well supported by clinical study. A cohort of 1,658 patient...
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In this case-match study, we evaluated the impact of the CYP2C19*2 polymorphism in the occurrence of in-stent restenosis during a 1-year follow-up period despite adequate dual anti-platelet therapy in Iranian patients having undergone percutaneous coronary intervention (PCI). This study, conducted at a tertiary referral heart center in Tehran, recr...
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Behcet's disease is a rare immune mediated systemic vasculitis which besides it's more frequent involvement of eyes and skin, sometimes present with aortic pseudo aneurysm and more rarely cardiac inflammatory masses.A 51-year-old patient with Behçet's Disease presented with two symptomatic aortic pseudoaneurysms concomitant with a right atrial mass...
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Controversy persists over the potential benefits/harms of opium consumption in coronary heart disease. This study investigated the association between 12 months' major adverse cardiac events (MACE) and pre-procedural opium consumption among patients undergoing percutaneous coronary intervention (PCI). Retrospectively, 1545 consecutive men who under...
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We investigated the overall success rate of percutaneous coronary intervention (PCI) as a treatment for coronary chronic total occlusion and sought to determine the predictive factors of technical success and of one-year major adverse cardiac events (MACE). These factors have not been conclusively defined. Using data from our single-center PCI regi...
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Mitral regurgitation (MR) is a common valvular lesion in the general population with considerable impact on mortality and morbidity. The MitraClip System (Abbot Laboratories, Abbot Park, IL, USA) is a novel percutaneous approach for treating MR which involves mechanical edge-to-edge coaptation of the mitral leaflets. We present our initial experien...
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Before primary percutaneous coronary intervention (PCI) in patients with ST elevation myocardial infarction (STEMI), it is not clear whether a routine early administration of glycoprotein IIb/IIIa inhibitors in the emergency ward is beneficial or their administration in selected cases in the catheterization laboratory. The present randomized clinic...
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There is controversy over the potential benefits/harms of the usage of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) as regards the postoperative mortality of coronary artery bypass grafting (CABG). This study investigates the correlation between the in-hospital mortality of CABG and the preoperative admin...
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Background: The aim of the present study was to develop a scoring system for predicting 1-year major adverse cardiac events (MACE), including mortality, target vessel or target lesion revascularization, coronary artery bypass graft surgery, and non-fatal myocardial infarction after percutaneous coronary intervention (PCI). Methods: The data were ex...
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This prospective study aimed to evaluate the detailed outcomes of diabetic patients with critical limb ischemia, six months after percutaneous transluminal angioplasty and appropriate multidisciplinary wound care. Totally, 45 consecutive patients (50 limbs) were enrolled and then divided into two groups according to the healing of ulcers. The endp...
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Isolated bilateral internal iliac artery (IIA) aneurysm is a rare and potentially lethal disease. Endovascular repair of this disorder is a matter of debate. A symptomatic 68-year-old male presented with severe pelvic pains. Computed tomography revealed a leaking 46-mm aneurysm in the right IIA, a 27-mm aneurysm in the left IIA, and ectatic changes...
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Percutaneous coronary intervention for chronic total occlusion remains a challenging field for interventional cardiologists because of inability to advance a wire beyond the occlusion. In case that the wire is not crossed to the distal main vessel but a side branch originated from distal end of the occlusion, we applied "reversed guidewire techniqu...
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Despite major advances in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) remains a therapeutic challenge. We sought to compare the mid-term clinical outcomes after treatment with repeat drug-eluting stent (DES) implantation ("DES sandwich" technique) with DES placement in the bare-metal stent (DES-in-BMS) in a "real world" sett...
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We aimed to compare the outcomes of patients who underwent carotid artery stenting (CAS) followed by coronary artery bypass grafting (CABG) with the outcomes of those who underwent isolated CABG without carotid intervention. In this prospective cohort study, conducted between March 2007 and February 2010, all patients who had significant carotid ar...
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Surgical treatment poses a high risk to patients with concomitant aortic coarctation and dissection, and an interventional approach could be an alternative. We describe the case of a 52-year-old man with a long history of untreated hypertension and aortic coarctation who emergently presented at our institution with an acute Stanford type B dissecti...
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Hand ischemia is a rare complication of diabetes and some other chronic vascular diseases. Critical hand ischemia causes painful limbs and disability and requires urgent revascularization. There have been a few reports of successful trans-brachial percutaneous angioplasty in the upper extremity in the radial or ulnar artery. Herein, we report the r...
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The optimal strategy in percutaneous coronary intervention (PCI) for coronary artery bifurcation lesions has yet to be agreed upon. We compared a strategy for stenting the main vessel to provide a complete perfusion flow in the side branch, namely thrombolysis in myocardial infarction (TIMI) - III, with a strategy for intervention in both the main...
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Diabetes has been shown to be independent predictor of restenosis after percutaneous coronary intervention (PCI). The aim of the present study was to investigate whether a pre- and post-procedural glycaemic control in diabetic patients was related to major advance cardiovascular events (MACE) during follow up. We evaluated 2884 consecutive patients...
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Impact of 12 months' versus 24 months' use of dual antiplatelet therapy on the prevalence of stent thrombosis in patients undergoing percutaneous coronary intervention (PCI) with the drug-eluting stent (DES) is not clear. As a result, duration of dual antiplatelet therapy is still under debate among interventionists. From March 2007 until August 20...
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In this retrospective study, we compared the in-hospital and long-term outcomes of the on-label and off-label uses of drug-eluting stents.From April 2003 through June 2007, 1,538 patients underwent percutaneous coronary intervention with a drug-eluting stent (sirolimus or paclitaxel) at Tehran Heart Center. Off-label implantation of the drug-elutin...
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Immunotherapy is the only specific treatment for scorpion sting. In the present study, protective effects of polyvalent antivenom against hemodynamic disturbances, biomarkers (troponin T, creatinine kinase isoenzyme MB, Lactate dehydrogenase) changes, electrocardiogram abnormalities and histopathological complications in heart and lung induced by M...
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The optimal target for revascularization in patients with history of coronary artery bypass graft surgery (CABG) is unclear. This study was designed to compare the outcome of percutaneous coronary intervention (PCI) on saphenous vein grafts (SVG) and that on native vessels in patients with previous CABG in terms of major adverse cardiac events (MAC...
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Clinical trials of revascularization have routinely under-enrolled elderly subjects. Thus, symptom relief and improved survival might not apply to elderly patients, in whom the risk of mortality and disability from revascularization procedures seems to be high and co-morbidity is more prevalent. The present case control study was performed to draw...
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For all the wealth of research comparing the efficacy of the different types of the drug-eluting stent (DES) such as sirolimus-, paclitaxel-, and zotarolimus-eluting stents, there is still a dearth of data on the different brands of each DES type. We aimed to investigate the one-year clinical outcomes, including major adverse cardiac events (MACE),...
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The management of carotid artery stenosis reduces the risk of stroke and its related deaths. Management options include risk factor modification and medical therapy, carotid endarterectomy (CEA), and carotid artery stenting (CAS). Although several randomized controlled trials (RCTs), mostly conducted in late-1980s and mid-1990s, have proved CEA to...
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we investigated the outcomes of stenting with overlapping drug-eluting stents (DES) versus overlapping stenting with a combination of drug-eluting and bare metal stents (BMS) in very long coronary lesions (≥ 25 mm). fifty-two patients treated with either overlapping DES-DES (n = 22) or DES-BMS (n = 30) were selected from a registry of 588 patients...
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Transcatheter occlusion of the patent ductus arteriosus (PDA) is a minimally invasive treatment. The appropriate device size is chosen based on the angiographic measurement of the PDA. The current study aimed to assess the relationship between the transthoracic echocardiographic (TTE) measurements of the PDA prior to the occlusion procedure and the...
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Given the common concomitance of tricuspid regurgitation (TR) with significant mitral stenosis, we aimed at exploring the relation between TR severity and pulmonary artery hypertension (PAH) in patients who underwent mitral balloon valvotomy (MBV). We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68 ± 12....
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Transcatheter closure of atrial septal defect secundum (ASD-II) has become an alternative method for surgery. We sought to compare the two-dimensional transesophageal echocardiography (TEE) method for measuring atrial septal defect with balloon occlusive diameter (BOD) in transcatheter ASD-II closure. A total of 39 patients (71.1% female, mean age:...
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Sodium bicarbonate has been recently proposed as a prophylactic measure for the prevention of contrast-induced nephropathy (CIN). We aimed to compare the efficacy of the combination of sodium bicarbonate with half saline, and half saline alone in preventing CIN in patients having uncontrolled hypertension, compensated severe heart failure or a hist...
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Drug-eluting stents improved the outcome after percutaneous coronary intervention (PCI), however, there may be significant differences in their safety and efficacy. To compare the in-hospital and mid-term clinical outcomes of stenting with sirolimus-eluting stents (SES) versus paclitaxel-eluting stents (PES) for the treatment of coronary artery les...
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There is controversy about the prophylactic measures proposed for the prevention of contrast-induced nephropathy (CIN). We aim to compare the efficacy of the combination of sodium bicarbonate and isotonic saline and that of isotonic saline alone in preventing CIN. Randomized double-blind controlled trial. 265 consecutive patients 18 years or older...
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Cardiac rehabilitation (CR) programmes play an important role in the management of patients with coronary artery disease. However, a significant proportion of patients do not participate or do not complete CR. To asses the prevalence and predictors of discontinuation of a hospital-based CR programme and to investigate whether or not the completers...
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Direct stenting without balloon dilatation may reduce procedural costs and duration, and hypothetically, the restenosis rate. This study was designed to compare the in-hospital and long-term outcomes of direct stenting (DS) versus stenting after pre-dilatation (PS) in our routine clinical practice. The 1 603 patients treated with stenting for singl...
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This is a case of severely stunned left ventricle which occurred after a non-ST elevation myocardial infarction in a 76-year-old woman who was a known case of three-vessel disease. Her symptoms and cardiac function responded well to revascularization.
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The association between coronary arterial dominance patterns and the coronary artery diameter, length, and valvular heart diseases were previously studied. However, its association with coronary artery disease (CAD) is unclear. We investigated to determine whether the extent and localization of CAD differ in right, left, or codominant coronary arte...
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To report the utility of a coronary technique to facilitate carotid stenting in patients with difficult arch anatomies. When confronted with challenging arch anatomy that prevents engaging the common carotid artery (CCA) with the guiding sheath using standard techniques, an 8-F left Amplatz guiding catheter (AL1) is placed at the origin of the inno...
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Direct stenting without balloon dilatation may reduce procedural costs and duration, and hypothetically, the restenosis rate. This study was designed to compare the in-hospital and long-term outcomes of direct stenting (DS) versus stenting after predilatation (PS) in our routine clinical practice. One thousand six hundred and three patients treated...
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This study was designed to characterize patients treated with drug-eluting stents (DES) versus those treated with bare metal stents (BMS) and to investigate their clinical outcomes in our routine clinical practice. We studied a consecutive series of 1796 patients, selected from a computerized registry, who underwent stenting for coronary artery les...
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Coronary artery fistulae are rare disorders. Only 2 reports in the medical literature discuss the use of vascular plugs to occlude coronary fistulae, and the same device-the Amplatzer Vascular Plug-was deployed via different techniques to treat those patients. The safety, the feasibility, and the standard approach to deployment have yet to be estab...
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Reduced ejection fraction (EF) has previously been shown to be a risk factor for adverse outcomes in patients undergoing percutaneous coronary intervention (PCI). However, with the advent of stents, procedural complications and restenosis rates have reduced dramatically. The aim of this study was to assess the association between left ventricular (...
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A 32-year-old woman admitted to the emergency department was diagnosed with acute anterior myocardial infarction, treated with thrombolytics and referred for angiography on the basis of her age. The patient was then referred for angioplasty with the diagnosis of an atherosclerotic lesion in the left anterior descending (LAD) coronary artery. Succes...
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Background: Early clinical investigations indicate that an infusion of autologous bone-marrow cells into the infarct-re- lated coronary artery is feasible after acute myocardial infarction. There is increasing evidence that cell transplantation may improve the perfusion and contractile function of the ischemic myocardium. The present study reports...
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Percutaneous coronary angioplasty (PTCA) of a coronary stenosis without documented ischemia at noninvasive stress testing is often performed, but its benefit is unproven. Coronarypressure - derived fractional flow reserve (FFR) is an invasive index of stenosis severity defined as the ratio of maximal blood pressure in a stenotic vessel to the norma...
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Aims: To answer the question whether the delay in coronary artery bypass grafting (CABG) after carotid stenting (CAS) results in adverse events, we describe our experience with planned staged CAS followed by CABG.Methods and results: We retrospectively surveyed our hospital carotid stenting data base, to identify all patients who were scheduled to...
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Previous studies have shown that lesions in proximal left anterior descending coronary artery (LAD) may develop more restenosis after balloon angioplasty than lesions in other coronary segments. However, stenting seems to have reduced this gap. In this study, we compared outcomes of percutaneous coronary intervention (PCI) on proximal LAD versus pr...
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Myocardial free wall rupture is a catastrophic complication of acute myocardial infarction, and prognosis will depend on the prompt diagnosis by echocardiography, extension of infarct size, and prompt surgical treatment. Free wall rupture concomitant with ventricular septal defect (VSD) may be more complicated for management. A case of a 69-year-ol...
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Background: Stenting is currently the standard of care in percutaneous coronary intervention (PCI). Whether young patients remain at increased risk after PCI in the present stent era has not been investigated widely. We evaluated angiographic characteristics and short- and mid-term outcomes in patients younger than 40 years of age who underwent PCI...
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To describe our experience of primary angioplasty in ST-segment elevation myocardial infarction. During a period of 2 years (April 2003 to May 2005), 83 high-risk patients presenting with acute ST-segment elevation myocardial infarction underwent primary angioplasty subject to availability of balloon dilation within 90 min of admission. In total, 7...
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Coronary artery fistulae may be congenital or acquired abnormalities in which blood is shunted into a cardiac chamber, great vessel, or other structure, bypassing the myocardial capillary network. Patients with coronary artery fistulae may present with dyspnea, congestive heart failure, angina, endocarditis, arrhythmias, or myocardial infarction. S...