Wetenschappelijk jaaroverzicht 2012 - Catharina Ziekenhuis

computational flow dynamic modeling, the lesion with the large FFR of the coronary tandem
lesion was indicated as the lesion with the greater degree of simulated diameter stenosis. In
the clinical cohort, 28 patients (53.8%) had only single-lesion treatment, and stent
implantation for 28 lesions (26.9%) was deferred according to the proposed strategy. During
the 9-month follow-up period, only 1 repeat revascularization occurred among the deferred
lesions. In conclusion, for the treatment of coronary tandem lesions, FFR may be a useful
index for prioritizing the treatment sequence and optimizing the stenting procedure. In this
way, unnecessary stent implantation can be avoided, with the achievement of favorable
functional and clinical outcomes.
Impactfactor: 3.368
Rademakers LM
Critical hand ischaemia after transradial cardiac catheterisation: an uncommon
complication of a common procedure
Rademakers LM*, Laarman GJ
Neth Heart J. 2012 Sep;20(9):372-5
We describe a case of critical hand ischaemia after transradial cardiac catheterisation. The
patient presented with hand ischaemia 5 days after transradial coronary angiography.
Urgent angiography demonstrated radial artery occlusion with embolisation to the palmar
arch and digital arteries. The ischaemia was refractory to an extensive thrombolytic regimen,
and subsequently, the patient was referred to the vascular surgeon for urgent
thrombectomy and patch angioplasty. The patient recovered slowly and no amputation was
necessary, but complaints of right hand numbness and paresthesia of all digits remained.
Impactfactor: 1.438
Rademakers LM
Early double stent thrombosis associated with clopidogrel hyporesponsivenesss
Rademakers LM*, Dewilde W*, Kerkhof D van de*
Neth Heart J. 2012 Jan;20(1):38-4. Epub 2011 May 21
A 57-year-old male patient without cardiovascular history suffered an acute myocardial
infarction and underwent drug-eluting stent implantation in the left anterior descending
artery. A few days later, the right coronary artery was also stented (drug-eluting stent).
Three days later, he was re-admitted to our hospital in cardiogenic shock. Emergent
coronary angiography showed total occlusion of both stents.
Platelet function analysis (PFA) showed attenuated platelet inhibition in response to
clopidogrel treatment. The patient was the carrier of a loss-of-function polymorphism in the
CYP2C19 gene, which has been associated with increased incidence of adverse thrombotic
events. Antiplatelet therapy was switched to prasugrel and PFA revealed an adequate
antiplatelet effect.
Impactfactor: 1.438
49