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Interventional Cardiology Board Review 1400+ Questions and Answers

FOURTH EDITION

Interventional Cardiology Board Review 1400+ Questions and Answers

FOURTH EDITION

Editors

Richard A. Lange, MD, MBA President and Dean Paul L. Foster School of Medicine Texas Tech University Health Sciences Center El Paso El Paso, Texas

Saurav Chatterjee, MD Director, Interventional Services and Cardiac Cath Lab New York Community Hospital Clinical Assistant Professor of Medicine Zucker School of Medicine – Hofstra University Hempstead, New York

Debabrata Mukherjee, MD Chairman and Professor Department of Internal Medicine Paul L. Foster School of Medicine Texas Tech University Health Sciences Center El Paso El Paso, Texas

Acquisitions Editor: James Sherman Senior Development Editor: Ashley Fischer Editorial Coordinator: Erin E. Hernandez Marketing Manager: Kristen Watrud Senior Production Project Manager: Alicia Jackson Manager Graphic Arts & Design: Stephen Druding Manufacturing Coordinator: Lisa Bowling Prepress Vendor: S4Carlisle Publishing Services

Fourth Edition

Copyright © 2019 Wolters Kluwer. Copyright © 2011 Wolters Kluwer Health/Lippincott Williams & Wilkins. Copy right © 2006 Lippincott Williams & Wilkins, a Wolters Kluwer business. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. gov ernment employees are not covered by the above-mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@ lww.com, or via our website at shop.lww.com (products and services).

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Library of Congress Cataloging-in-Publication Data

Identifiers: LCCN 2023054818 (print) | LCCN 2023054819 (ebook) | ISBN 9781975211929 (paperback) | ISBN 9781975211936 (ebook) Subjects: MESH: Cardiovascular Diseases—diagnosis | Cardiovascular Diseases—therapy | Examination Questions Classification: LCC RC667 (print) | LCC RC667 (ebook) | NLM WG 18.2 | DDC 616.10076—dc23/eng/20240202 LC record available at https://lccn.loc.gov/2023054818 LC ebook record available at https://lccn.loc.gov/2023054819

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This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to the patient. The publisher does not provide medi cal advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. Given continuous, rapid advances in medical science and health information, independent professional verifica tion of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work.

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To interventional fellows and colleagues everywhere for their hard work and dedication to patient care; to my parents for their infinite patience, love, and understanding; to my nephew Rohin and to Suchandra, for her unconditional love and support. —D ebabrata M ukherjee To interventional fellows worldwide who will use this text to expand their knowledge and advance our field … and to my parents, wife, and sons who’ve taught me more about issues of the heart than any cardiology text. —R ichard A. L ange To my parents, my wife, and my daughters—who inspire me to keep learning—and to my innumerable mentors over the years who have taught me the importance of guidance. —S aurav C hatterjee

PREFACE

Insightful questions have been used throughout the ages as a metric to assess one’s knowledge, but when coupled with carefully delivered answers, they can become a powerful teaching tool. This book of ques tions and annotated answers covering the field of in terventional cardiology is meant to serve as a helpful resource for individuals preparing for the interven tional cardiovascular medicine board exam, as well as for clinicians who wish to perform an in-depth self-assessment on individual topics or the full spec trum of cardiovascular medicine. The book has many key features, which we believe will make the reader successful in passing the boards and improving clini cal practice. Of foremost importance, the areas covered are relevant not only to the day-to-day practice of inter ventional cardiology but have also been modified to fit the scope and content of the actual board exami nation. The book begins with several chapters dedi cated to the anatomy and physiology associated with interventional cardiology and the pathobiology of atherosclerosis and inflammation. This corresponds to 11% of the board examination, which targets ma terial in the basic sciences. The subsequent chapters focus on the essential interventional pharmaco therapy of antiplatelets, anticoagulants, and other commonly used medications in the catheterization laboratory and outpatient setting for patients with atherosclerosis. These chapters correspond to the next 14% of the boards centering on pharmacology. 7% of the board examination is directed toward imaging; and this book includes specific chapters on radiation safety, catheterization laboratory equipment and technique, contrast agents, and intravascular ul trasound. The two largest areas of the examination, each covering ~ 25% of the content, include case se lection management and procedural techniques. The book also now includes questions on catheter-based management of noncoronary disease with 10% of board questions on this topic. This review book

dedicates several chapters to comprehensively cover these areas as well. Finally, we have included chap ters for the miscellaneous remaining areas covered by the board examination, including peripheral vas cular disease, cerebrovascular and structural heart interventions, ethics, statistics, and epidemiology, as well as a chapter directed at improving test-taking skills. Also essential to the quality and appropriateness of the questions and annotated answers is the ex pertise of the chapter authors. We are fortunate to have assembled the “who’s who” of academic inter ventional cardiology. The contributing authors from leading medical centers around the world have over 10,000 articles cited in PubMed. We are greatly in debted to these authors who are recognized both for their interventional expertise and for their teaching skills. In the end, the true value of this textbook is not only the relevance of the questions and the out standing quality of the authors but also the value of the annotated answers. The text includes more than 1,400 questions and over 400 figures and tables. The corresponding answers have been appropriately detailed to provide relevant facts, information, and up-to-date journal citations. The practice of interventional cardiology is excit ing, rewarding, and a privilege each of us enjoys. Likewise, it has been our privilege to work with the superb contributors, our colleagues in interven tional cardiology, and Ms. Erin E. Hernandez and Ms. Ashley Fischer at Wolters Kluwer for their edi torial assistance. It is our personal hope that you will enjoy this book and that it will be a valuable resource to you in passing the board examination and providing the highest quality care possible to your patients.

Debabrata Mukherjee, MD Richard A. Lange, MD, MBA Saurav Chatterjee, MD

vii

CONTRIBUTORS

Mohammad H. Abbasi, MD Fellow in Cardiovascular Medicine Department of Cardiovascular Medicine Cardiology Fellow Heart, Vascular and Thoracic Institute Cleveland Clinic Foundation Cleveland, Ohio Deepak Acharya, MD, MSPH Professor of Medicine Division of Cardiovascular Disease University of Arizona College of Medicine Division of Cardiology Banner University Medical Center Tucson, Arizona Shikhar Agarwal, MD, MPH Associate Interventional Cardiology and Structural Interventions

Salman S. Allana, MD Assistant Professor

Division of Cardiology Department of Medicine University of Texas Southwestern Medical Center Interventional Cardiologist Division of Cardiology Department of Medicine William P. Clements Jr. University Hospital Dallas, Texas Mohammad Alqarqaz, MD, FACC Interventional Cardiologist Interventional Cardiology Fellowship Program Director Clinical Assistant Professor Henry Ford Hospital Wayne State University Detroit, Michigan Zahid Amin, MD, MSCAI, FAHA Director Pediatric and Adult Congenital Cardiac Services AdventHealth Orlando Orlando, Florida Anastasia L. Armbruster, PharmD Professor Department of Pharmacy Practice St. Louis College of Pharmacy University of Health Sciences and Pharmacy in St. Louis Cardiology Clinical Pharmacy Specialist Department of Pharmacy Missouri Baptist Medical Center St. Louis, Missouri Herbert D. Aronow, MD, MPH Professor Department of Medicine College of Human Medicine, Michigan State University East Lansing, Michigan Medical Director Heart & Vascular Services Henry Ford Health Detroit, Michigan Shilpkumar Arora, MD, MPH Fellow Cardiology Division Department of Medicine Case Western Reserve University School of Medicine University Hospitals Cleveland Medical Center Cleveland, Ohio

Department of Cardiology Geisinger Medical Center Danville, Pennsylvania Vikas Aggarwal, MD, MPH Senior Staff Interventional Cardiology Henry Ford Hospital Detroit, Michigan

Muhammad Ajmal, MD Adjunct Assistant Professor Department of Cardiology University of Arizona College of Medicine Tucson, Arizona

Interventional Cardiologist Department of Cardiology Great River Health West Burlington, Iowa

Mahboob Alam, MBBS, FACC, FSCAI Associate Professor of Medicine Baylor College of Medicine Houston, Texas Mazen Albaghdadi, MD Medical Director Cardiac Catheterization Laboratory Associate Program Director Cardiology Fellowship NCH Rooney Heart Institute Naples, Florida

Contributors

Jayant Bagai, MD, MMHC, FACC, FSCAI Associate Professor Section of Interventional Cardiology Division of Cardiovascular Medicine Department of Medicine Vanderbilt University Medical Center Nashville, Tennessee Sripal Bangalore, MD, MHA Professor of Medicine Division of Cardiology Department of Medicine NYU Grossman School of Medicine Professor of Medicine Director, Invasive and Interventional Cardiology

Emmanouil S. Brilakis, MD, PhD Director, Center for Complex Coronary Interventions Minneapolis Heart Institute Minneapolis, Minnesota

Abel Casso, MD

Assistant Professor Department of Cardiology Mount Sinai Morningside New York, New York

Director, Complex Coronary Intervention Interventional Director, Adult ECMO and MCS Program Bellevue Hospital Center Director of Research, Cardiac Catheterization Laboratory Director, Cardiovascular Outcomes Group

Joaquin E. Cigarroa, MD, FACC, MSCAI Director, Knight Cardiovascular Institute Division Head of Cardiovascular Medicine Melvin Judkins Professor of Cardiology Professor of Medicine Department of Medicine Oregon Health and Sciences University Portland, Oregon

NYU Langone Health New York, New York

Mir Babar Basir, DO Director, Acute Mechanical Circulatory Support

Antonio Colombo, MD Interventional Cardiologist Department of Cardiology Humanitas Research Hospital Rozzano, Italy

Division of Cardiology Henry Ford Hospital Detroit, Michigan

Craig J. Beavers, PharmD, FACC, FAHA, FCCP, BCCP, BCPS (AQ-Cardiology), CACP Adjunct Associate Professor Department of Pharmacy Practice and Science University of Kentucky College of Pharmacy Cardiovascular Clinical Pharmacist Department of Pharmacy University of Kentucky Healthcare Lexington, Kentucky

Alan Dardik, MD, PhD Professor of Surgery and Cellular and Molecular Physiology Vice Chair, Department of Surgery Surgery and Cellular and Molecular Physiology

Yale School of Medicine New Haven, Connecticut Attending Vascular Surgeon Department of Surgery VA Connecticut Healthcare Systems West Haven, Connecticut

Agastya D. Belur, MD Fellow Division of Cardiovascular Medicine University of Louisville Hospital Louisville, Kentucky

Vishal Dhulipala, MD Fellow in Interventional Cardiology Department of Cardiology Icahn School of Medicine at Mount Sinai Fellow in Interventional Cardiology

Mandeep Bhargava, MD Staff Physician Section of Cardiac Electrophysiology and Pacing Department of Cardiovascular Medicine Cleveland Clinic Foundation Cleveland, Ohio Dario Bongiovanni, MD, PhD Senior Physician Internal Medicine and Cardiology Department of Internal Medicine I and Cardiology University Hospital Augsburg Augsburg, Germany

Department of Cardiology The Mount Sinai Hospital New York, New York

Abhay Ashok Divekar, MBBS, MD, FSCAI, FPICS Professor Department of Pediatrics University of Texas Southwestern Medical Center Congenital Interventional Cardiologist Department of Pediatrics Children’s Medical Center Dallas Dallas, Texas

Contributors

Alok Kumar Dwivedi, PhD Associate Professor

Ashequl M. Islam, MD, MPH, FACC, FSCAI Associate Chief, Division of Cardiology

Director of Strategic Development and Growth Medical Director, Valvular Heart Disease Program Baystate Heart and Vascular Program Program Director, Interventional Cardiology Fellowship Professor of Medicine and Surgery Department of Medicine University of Massachusetts Chan Medical School—Baystate Associate Chief of Cardiology Baystate Health Springfield, Massachusetts

Division of Biostatistics & Epidemiology Department of Molecular and Translational Medicine Paul L. Foster School of Medicine Texas Tech University Health Sciences Center El Paso El Paso, Texas Khady N. Fall, MD, MPH, RDCS Director of Operations, Intravascular Imaging and Physiology Columbia Interventional Cardiovascular Care Program Manager, Intravascular Imaging & Physiology NewYork-Presbyterian Hospital New York, New York

Farouc A. Jaffer, MD, PhD Director Coronary Intervention Associate Professor of Medicine Cardiology Division Department of Medicine Harvard Medical School Massachusetts General Hospital Boston, Massachusetts Ankur Kalra, MD, FACP, FACC, FSCAI Interventional Cardiologist

Michael E. Farkouh, MD, MSc Professor and Vice Chair Department of Medicine

University of Toronto Toronto, ON, Canada

Franciscan Health Lafayette, Indiana Primary Investigator Krannert Cardiovascular Research Center Adjunct Clinical Associate Professor of Medicine Indiana University School of Medicine Indianapolis, Indiana

Sareena George, MD

Endovascular Fellow Interventional Cardiology Department Columbia University Irving Medical Center New York, New York Sachin S. Goel, MD, FACC, FSCAI Assistant Professor Department of Cardiology Houston Methodist Academic Institute Interventional Cardiologist and Medical Director Structural Heart Interventions Houston Methodist DeBakey Heart & Vascular Center Houston Methodist Hospital Houston, Texas Sunny Goel, MD, FACC, FSCAI Assistant Professor Department of Cardiology Icahn School of Medicine at Mount Sinai New York, New York Timothy D. Henry, MD, FACC, MSCAI Medical Director The Carl and Edyth Lindner Center for Research and Education The Carl and Edyth Lindner Family Distinguished Chair in Clinical Research Director of Programmatic and Network Development The Christ Hospital Health Network Cincinnati, Ohio Director, Structural Heart Disease Mount Sinai South Nassau Hospital Oceanside, New York

Sanjay Kaul, MD Attending Cardiologist Division of Cardiology Cedars-Sinai Medical Center Los Angeles, California

Jaikirshan Khatri, MD Associate Professor Department of Medicine Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Director of Complex Coronary Intervention Cardiovascular Medicine Cleveland Clinic Foundation Cleveland, Ohio Sahil Khera, MD, MPH, FACC, FSCAI Interventional Director, Structural Heart Program Department of Medicine (Cardiology) The Mount Sinai Hospital New York, New York Annapoorna S. Kini, MD, MRCP, FACC Zena and Michael A. Wiener Professor of Medicine Department of Cardiology Icahn School of Medicine at Mount Sinai Director, Cardiac Catheterization Lab

Department of Cardiology The Mount Sinai Hospital New York, New York

xii

Contributors

Anoop N. Koshy, MBBS, PhD Interventional & Structural Heart Cardiologist Department of Cardiology Austin Hospital

Francesco Loizzi, MD Physician Attending in Cardiology SS Annunziata Hospital, ASL TA Taranto, Italy

University of Melbourne Melbourne, VIC, Australia

Aaqib H. Malik, MD, MPH Cardiologist

Ashish Kumar, MD Resident

Westchester Medical Center New York Medical College Valhalla, New York

Department of Internal Medicine Cleveland Clinic Akron General Akron, Ohio Amartya Kundu, MD, FACC, FSCAI Interventional Cardiologist UK Gill Heart & Vascular Institute Assistant Professor of Medicine Division of Cardiovascular Medicine University of Kentucky Lexington, Kentucky

Anbukarasi Maran, MD, FSCAI, FACC Associate Professor of Medicine Director of Coronary CTO Program Medical University of South Carolina Ralph H. Johnson VA Medical Center Charleston, South Carolina Verghese Mathew, MD Director, Interventional Cardiology Cardiology/Medicine Swedish Hospital NorthShore University HealthSystem Chicago, Illinois

Antonio Landi, MD Cardiologist

Department of Cardiology Cardiocentro Ticino Institute

Ente Ospedaliero Cantonale (EOC) University of Italian Switzerland (USI) Lugano, Switzerland Richard A. Lange, MD, MBA President and Dean Paul L. Foster School of Medicine Texas Tech University Health Sciences

Roxana Mehran, MD, FACC, FAHA, MSCAI, FESC Professor of Medicine in Cardiology and Population Health Science and Policy Mount Sinai Endowed Professor in Cardiovascular Clinical Research and Outcomes Director of Interventional Cardiovascular Research and Clinical Trials Director of Women’s Heart and Vascular Center at Mount Sinai Fuster Heart Hospital Department of Cardiology Icahn School of Medicine at Mount Sinai The Zena and Michael A. Wiener Cardiovascular Institute New York, New York

Center El Paso El Paso, Texas

Azeem Latib, MD Professor, Medicine (Cardiology) Albert Einstein College of Medicine Section Head (Interventional Cardiology) Montefiore Einstein Center for Heart and Vascular Care Montefiore Medical Center Bronx, New York

Tetz C. Lee, MD, MPH Resident Physician Department of Internal Medicine BronxCare Health System Bronx, New York Pier Pasquale Leone, MD, MSc Cardiology Fellow Department of Cardiology Humanitas University Milan, Italy Visiting Cardiology Fellow Department of Medicine, Interventional Cardiology Montefiore Medical Center Bronx, New York

Ari J. Mintz, DO

Assistant Professor Department of Medicine Columbia University Vagelos College of Physicians and Surgeons

Attending in Cardiology Department of Medicine Columbia University Irving Medical Center NewYork-Presbyterian Hospital New York, New York Sergio A. Montano, Jr, MD, MA Faculty Department of Cardiology NorthShore University Health System Evanston, Illinois

xiii

Contributors

George V. Moukarbel, MD Professor of Medicine Division of Cardiovascular Medicine Department of Medicine The University of Toledo Medical Center Toledo, Ohio

Timir K. Paul, MD, PhD, MPH, FACC, FSCAI, FAHA Professor of Medicine Program Director, Cardiology Fellowship Clinical Medical Education University of Tennessee Health Sciences Center at Nashville

Interventional Cardiologist Saint Thomas Heart Institute Ascension Saint Thomas Hospital West Nashville, Tennessee

Debabrata Mukherjee, MD Chairman and Professor

Department of Internal Medicine Paul L. Foster School of Medicine Texas Tech University Health Sciences

Ian Persits, DO, MS Resident Internal Medicine Cleveland Clinic Foundation Cleveland, Ohio

Center El Paso El Paso, Texas

Srihari S. Naidu, MD, FACC, FAHA, FSCAI Professor of Medicine

Department of Medicine New York Medical College Director, Cardiac Catheterization Laboratory and Hypertrophic Cardiomyopathy Center

J. R. Exequiel T. Pineda, MD, PhD Clinical Assistant Professor of Medicine Division of Cardiology, Department of Medicine University of Arizona College of Medicine Banner University Medical Center Tucson, Arizona Sonal Pruthi, MD Assistant Professor of Medicine Division of Cardiology, Department of Medicine Columbia University Irving Medical Centre New York, New York Rishi Puri, MD, PhD, FRACP Associate Professor Department of Cardiovascular Medicine Staff Interventional Cardiologist Heart, Vascular & Thoracic Institute Medical Director, Angiographic/IVUS Core Laboratories Cleveland Clinic Lerner College of Case Western Reserve University Cleveland, Ohio

Department of Cardiology Westchester Medical Center Valhalla, New York

Sandeep Nathan, MD, MSc Associate Professor of Medicine Medical Director, Cardiac ICU Co-Director, Cardiac Catheterization Laboratory Section of Cardiology University of Chicago Medicine Chicago, Illinois Eliano P. Navarese, MD, PhD Head, Clinical Experimental Cardiology Associate Professor Clinical Interventional Cardiology Sahil A. Parikh, MD Associate Professor of Medicine Division of Cardiology, Department of Medicine Center for Interventional Vascular Therapy Columbia University Irving Medical Center Director of Endovascular Services Division of Cardiology, Department of Medicine NewYork-Presbyterian Hospital New York, New York University of Sassari Sardinia Island, Italy

Arman Qamar, MD, MPH Interventional Cardiologist

Department of Interventional Cardiology NorthShore University Health System Evanston, Illinois

Louai Razzouk, MD, MPH Professor of Medicine NYU Grossman School of Medicine Program Director, Interventional Cardiology Fellowship Quality Officer, Cardiac Catheterization Lab (Tisch/ Kimmel) Division of Cardiology, Department of Medicine

Nimai J. Patel, MD Cardiovascular Disease Fellow Department of Internal Medicine McGovern Medical School at UTHealth Houston

Cardiovascular Disease Fellow Department of Internal Medicine Memorial Hermann Hospital Houston, Texas

NYU Langone Health New York, New York

xiv

Contributors

Frederic S. Resnic, MD, MSc Professor of Medicine Tufts University School of Medicine Boston, Massachusetts Chairman Cardiovascular Medicine Lahey Hospital and Medical Center Burlington, Massachusetts

Abhishek Sharma, MD, FACC, FSCAI Assistant Professor of Medicine Director, Cardiac Catheterization Laboratory & Interventional Cardiology Program Director of Structural Heart Disease Program Department of Medicine Rutgers New Jersey Medical School Newark, New Jersey

Mark Joseph Ricciardi, MD Director, Interventional Cardiology and Structural Heart Disease

Timothy F. Simpson, MD, PharmD Interventional Cardiologist Legacy Health Portland, Oregon Amitoj Singh, MD Fellow Cardiovascular Medicine Lahey Hospital and Medical Center Burlington, Massachusetts

NorthShore Cardiovascular Institute NorthShore University Health System Evanston, Illinois

Partha Sardar, MD

Assistant Professor Department of Medicine Columbia University Irving Medical Center Assistant Attending Physician of Medicine/Cardiology NewYork-Presbyterian Hospital New York, New York

Daniel J. Snyder, MD Physician Division of Cardiology, Department of Medicine Columbia University Irving Medical Center NewYork-Presbyterian Hospital New York, New York Alessandro Spirito, MD Fellow Department of Cardiology The Zena and Michael A. Wiener Cardiovascular Institute Icahn School of Medicine at Mount Sinai New York, New York Jacqueline Tamis-Holland, MD, FAHA, FACC, FSCAI Institute Director, Acute Cardiac Care Interventional Cardiologist Department of Cardiology Cleveland Clinic, Heart, Vascular and Thoracic Institute Cleveland, Ohio

Yasar Sattar, MD

Assistant Professor Research Department Texas Tech University Odessa, Texas Interventional Cardiology Fellow Department of Cardiology J.W. Ruby Memorial Hospital Morgantown, West Virginia

Andrea Scotti, MD Fellow Cardiovascular Research Foundation New York, New York Fellow Montefiore Einstein Center for Heart and Vascular Care Montefiore Medical Center Bronx, New York Sanjum S. Sethi, MD, MPH Assistant Professor of Medicine Division of Cardiology, Department of Medicine Columbia University Irving Medical Center Attending Physician

Craig A. Thompson, MD, MMSc System Director, Hartford Healthcare Heart and Vascular Institute

Medicine/Cardiology Hartford Healthcare Hartford, Connecticut Marco Valgimigli, MD, PhD Adjunct Professor

Division of Cardiology Department of Medicine NewYork-Presbyterian Hospital New York, New York Madhan Shanmugasundaram, MD Associate Professor of Medicine Department of Cardiology

Faculty of Biomedical Sciences Università della Svizzera Italiana Lugano, Switzerland Deputy Chief of Cardiology Department of Cardiology Istituto Cardiocentro Ticino Lugano, Switzerland

University of Arizona College of Medicine Director of Cardiac Catheterization Lab Cardiology/Interventional Cardiology Banner University Medical Center Tucson, Arizona

Contributors

Saraschandra Vallabhajosyula, MD, MSc, FACP, FCCP, FCCM, FAHA, FACC, FSCAI Assistant Professor of Medicine Division of Cardiology, Department of Medicine Warren Alpert Medical School of Brown University Interventional and Critical Care Cardiology Lifespan Cardiovascular Institute Providence, Rhode Island

Pedro Villablanca, MD, MSc Interventional/Structural Cardiologist Department of Medicine Henry Ford Hospital Detroit, Michigan Birgit Vogel, MD Assistant Professor of Medicine Department of Cardiology Icahn School of Medicine Assistant Professor of Medicine Department of Cardiology Mount Sinai Fuster Heart Hospital New York, New York Sandra A. Weiss, MD, FACC Attending, Interventional Cardiology Medical Director, Cardiac ICU

Dennis VanLoozen, MD Interventional Pediatric Cardiologist Department of Pediatric Cardiology Cook Children’s Medical Center Fort Worth, Texas

Department of Cardiology Christiana Care Hospital Christiana Care Health System Newark, Delaware

Joseph S. Van Tuyl, PharmD, BCCP Associate Professor Department of Pharmacy Practice St. Louis College of Pharmacy University of Health Sciences and Pharmacy in St. Louis Cardiovascular Pharmacy Specialist Department of Pharmacy SSM Health St. Louis University Hospital St. Louis, Missouri

Christopher J. White, MD, MACC, MSCAI, FAHA, FESC, FACP Professor and Chairman of Medicine and Cardiology

Ochsner Clinical School University of Queensland Brisbane, QLD, Australia Medical Director

Surendranath R. Veeram Reddy, MD Professor Department of Pediatrics

Centers of Excellence and Service Lines Medical Director for Value Based Care System Chair for Cardiovascular Diseases Ochsner Health New Orleans, Louisiana

University of Texas Southwestern Medical Center Director, Cardiac Catheterization and Interventional Laboratory Medical Director, Single Ventricle/Fontan Program Department of Pediatrics—Heart Center Children’s Medical Center Dallas, Texas

Lina Ya’Qoub, MD Fellow Division of Cardiology UCSF School of Medicine San Francisco, California

Dhiran Verghese, MD Chief Cardiology Fellow Division of Cardiology Department of Medicine NCH Rooney Heart Institute Naples, Florida

Laura Young, MD

Clinical Instructor Department of Interventional Cardiology Cleveland Clinic Lerner College of Medicine Associate Staff Physician Department of Interventional Cardiology Cleveland Clinic Foundation Cleveland, Ohio Firas Zahr, MD Director, Interventional Cardiology Lowell Edwards Professor of Cardiology Knight Cardiovascular Institute Oregon Health & Science University Portland, Oregon

Mladen I. Vidovich, MD, FACC, FSCAI Professor of Medicine Division of Cardiology, Department of Medicine University of Illinois at Chicago Chief, Section of Cardiology Jesse Brown VA Medical Center Chicago, Illinois Chair, VA Cardiology Field Advisory Board Associate Editor, JACC Case Reports

xvi

Contributors

Thomas M. Zellers, MD Professor Pediatrics Pediatrics (Cardiology) UT Southwestern Medical School Pediatric Cardiologist ACHD Cardiologist Heart Center Children’s Health Dallas, Texas

Robert S. Zilinyi, MD Fellow Division of Cardiology, Department of Medicine Columbia University Irving Medical Center NewYork-Presbyterian Hospital New York, New York

CONTENTS

14 Primary, Rescue, and Facilitated

Preface vii Contributors ix

Angioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 J. R. Exequiel T. Pineda, Muhammad Ajmal, and Deepak Acharya

1 Vascular Biology and Metabolism ........... 1 Alan Dardik

15 Periprocedural Myocardial Infarction,

Embolic Protection, and Thrombectomy . . . . 171 Timir K. Paul

2 Anatomy and Physiology of Coronary Arteries . . 11 Richard A. Lange and Joaquin E. Cigarroa

3 Radiation Safety, Equipment, and

16 Chronic Total Occlusion . . . . . . . . . . . . . . . . . . 180 Jaikirshan Khatri and Laura Young

Basic Concepts ........................... 24 Jayant Bagai

17 Ostial and Bifurcation Lesions . . . . . . . . . . . . 192 Anbukarasi Maran

4 Inflammation and Arterial Injury ........... 36 Dhiran Verghese, Mazen Albaghdadi, and Farouc A. Jaffer

18 Long Lesions and Diffuse Disease . . . . . . . . . 202 Daniel J. Snyder, Robert S. Zilinyi, Sonal Pruthi, Sareena George, Khady N. Fall, Ari J. Mintz, Sanjum S. Sethi, and Sahil A. Parikh

5 Antiplatelet, Antithrombotic, and

Thrombolytic Agents ...................... 47 Birgit Vogel, Alessandro Spirito, and Roxana Mehran

19 Restenosis and Percutaneous Options ..... 216 Abhishek Sharma and Sunny Goel

6 Pharmacogenomics and Drug-Drug

Interactions .............................. 58 Craig J. Beavers

20 Atherectomy, Rotablation, and Laser . . . . . . . 224 Mladen I. Vidovich

7 Antiarrhythmics, Inotropes, Sedatives, and

Lipid-Lowering Agents .................... 66 Anastasia L. Armbruster and Joseph S. Van Tuyl

21 Stents and Stent Thrombosis . . . . . . . . . . . . . . 233 Antonio Landi, Francesco Loizzi, Dario Bongiovanni, and Marco Valgimigli

8 Approach to Chest Pain ................... 78 Richard A. Lange

22 Drug-Eluting Stents and Drug-Coated

Balloons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Pier Pasquale Leone, Antonio Colombo, and Azeem Latib

9 Vasoactive Agents ........................ 86 Sandra A. Weiss and Sandeep Nathan

10 Guiding Catheter Selection for Coronary

23 Saphenous Vein Graft Percutaneous

Interventions ............................. 98 Annapoorna S. Kini and Vishal Dhulipala

Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254 Salman S. Allana and Emmanouil S. Brilakis

11 Intravascular Contrast Agents . . . . . . . . . . . . . 108 Vikas Aggarwal and Nimai J. Patel

24 Vascular Closure Devices ................. 268 Amitoj Singh, George V. Moukarbel, and Frederic S. Resnic

12 Elective Coronary Intervention ............ 114 Tetz C. Lee, Abel Casso Dominguez, and Jacqueline E. Tamis-Holland

25 Management of Intraprocedural and

13 Percutaneous Coronary Intervention

26 Qualitative and Quantitative Angiography . . . 293 Madhan Shanmugasundaram

for Acute Coronary Syndrome . . . . . . . . . . . . . 139 Shilpkumar Arora and Sachin S. Goel

xvii

xviii

Contents

27 Intracoronary Doppler and Pressure

39 Congenital Heart Disease Interventions . . . . 436 Abhay Ashok Divekar, Thomas M. Zellers, and Surendranath R. Veeram Reddy

Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 Yasar Sattar and Mahboob Alam

40 Patent Foramen Ovale and Atrial

28 Intravascular Ultrasound and Optical

Septal Defect Closure .................... 450 Srihari S. Naidu and Aaqib H. Malik

Coherence Tomography . . . . . . . . . . . . . . . . . . 308 Dhiran Verghese, Agastya D. Belur, and Saraschandra Vallabhajosyula

41 Percutaneous Balloon Pericardiotomy

for Pericardial Effusion . . . . . . . . . . . . . . . . . . . 468 Amartya Kundu

29 Approach to Patient With Hemodynamic

Compromise ............................ 324 Lina Ya’Qoub and Mir Babar Basir

42 Percutaneous Alcohol Septal Ablation for Hypertrophic Obstructive

30 Mechanical Circulatory Support . . . . . . . . . . . 335 Ian Persits and Rishi Puri

Cardiomyopathy . . . . . . . . . . . . . . . . . . . . . . . . . 481 Anoop N. Koshy and Sahil Khera

31 Percutaneous Coronary Intervention

in Diabetes and Chronic Kidney Disease . . . 355 Louai Razzouk, Eliano P. Navarese, Verghese Mathew, and Michael E. Farkouh

43 Left Atrial Appendage Closure . . . . . . . . . . . . 494 Mohammad H. Abbasi and Mandeep Bhargava

44 Chronic Ischemic Heart Disease . . . . . . . . . . . 503 Ashequl M. Islam and Shikhar Agarwal

32 Endovascular Interventions for Peripheral

Arterial Disease . . . . . . . . . . . . . . . . . . . . . . . . . 364 Herbert D. Aronow, Mohammad Alqaraz, and Pedro Villablanca

45 Non–ST-Segment Elevation ACS Guidelines . . 516 Craig A. Thompson

33 Cerebrovascular Interventions . . . . . . . . . . . . 380 Christopher J. White

46 ACC/AHA Revascularization Guidelines .... 531 Sripal Bangalore

34 Acute Deep Vein Thrombosis/Pulmonary

47 ST-Elevation Myocardial Infarction:

Embolism Interventions . . . . . . . . . . . . . . . . . . 389 Debabrata Mukherjee

ACC/AHA Guidelines . . . . . . . . . . . . . . . . . . . . . 545 Mehmet Yildiz, James Jollis, and Timothy D. Henry

35 Peripheral Venous Interventions . . . . . . . . . . . 395 Debabrata Mukherjee

48 Ethical Issues and Risks Associated

With Catheterization and Interventional Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559 Ashish Kumar and Ankur Kalra

36 Mitral Valve Procedures .................. 402 Timothy F. Simpson and Firas Zahr

49 Statistics Related to Interventional

37 Percutaneous Aortic Valve Procedures ..... 409 Sergio A. Montano, Arman Qamar, and Mark Joseph Ricciardi

Cardiology Procedures ................... 562 Alok Kumar Dwivedi and Sanjay Kaul

50 Approach to Interventional Boards

38 Percutaneous Tricuspid and Pulmonary

and Test-Taking Strategies ................ 574 Debabrata Mukherjee

Valve Procedures ........................ 427 Andrea Scotti, Dennis VanLoozen, Zahid Amin, and Azeem Latib

Index 587

ABBREVIATIONS

ALT AMI AMI

three-dimensional

alanine transaminase

AAA ABI

abdominal aortic aneurysm

acute mesenteric ischemia acute myocardial infarction

ankle-brachial index

ABIM ACAS

AMICS

American Board of Internal Medicine Asymptomatic Carotid Atherosclerosis Study American College of Cardiology American College of Cardiology Foundation angiotensin-converting enzyme angiotensin-converting enzyme inhibitor American College of Emergency Physicians Accredited Council for Graduate Medical Education advanced cardiac life support American College of Physicians ACC extended learning

acute myocardial infarction cardiogenic shock Acute Myocardial Infarction Study of Adenosine

AMISTAD-I

ACC

ANA

antinuclear antibody

ACCEL

ANOCA

angina with nonobstructive coronary arteries

ACCF

AoO 2

arterial oxygen content ambulatory phlebectomy

ACE

AP AP

ACEI

anterior-posterior apolipoprotein E

ACEP

ApoE aPTT

activated partial thromboplastin time

ACGME

APV

average peak velocity

Amplatz right

ACLS

ARC

Academic Research Consortium acute renal failure requiring dialysis atorvastatin for reduction of myocardial damage during angioplasty

ACP ACS ACT ACT

ARFD

acute coronary syndrome activated clotting time

ARMYDA

acetylcysteine for contrast-induced nephropathy trial Acute Catheterization and Urgent Intervention Triage Strategy

ARNI

angiotensin receptor neprilysin inhibitors

ACUITY

ARR

absolute risk reduction

ARTIST

Atherectomy for Treatment of Diffuse In-Stent Restenosis Trial

ACVC

acute cardiovascular care

advance directive

aortic stenosis

ADP ADR AEC

adenosine diphosphate

ASA ASA ASC

acetylsalicylic acid

antegrade dissection and reentry automatic exposure control

atrial septal aneurysm agitated saline contrast

atrial fibrillation

ASCVD

atherosclerotic cardiovascular disease

AHA

American Heart Association

ASD AST

atrial septal defect

aortic insufficiency

aspartate aminotransferase

AIVR

accelerated idioventricular rhythm

as-treated

AKI

acute kidney injury

ATHOS-3

Angiotensin II for the Treatment of High-Output Shock

Amplatz left

ALI

ATP

acute limb ischemia

adenosine triphosphate

xix

Abbreviations

AUC AUC

CathPCI

appropriate use criteria area under the ROC curve

catheterization and percutaneous coronary intervention

CBC CCA CCD CCS

complete blood count common carotid artery charge-coupled device

AV AV AV

aortic valve

arterio-venous atrioventricular aortic valve area

Canadian Cardiovascular Society coronary computed tomography angiography

AVA AVF AVM AVP AVR

CCTA

arteriovenous fistula

arteriovenous malformation Amplatzer vascular plus aortic valve replacement Bleeding Academic Research Consortium bypass versus angioplasty revascularization investigation balloon aortic valvuloplasty British Cardiovascular Intervention Society

CCU

coronary care unit

CDPs CDT CEA CEC CES CFA cFFR

clinical decision pathways catheter-directed thrombolysis carotid endarterectomy circulating endothelial cells cholesterol embolization syndrome

BARC

BARI

common femoral artery

BAV BCIS

contrast fractional flow reserve

CFR

coronary flow reserve

cyclic guanosine 3 ′ -5 ′ -monophosphate

cGMP

balloon expandable

CHD

congenital heart disease

BID

twice daily

CHEER

chest pain evaluation in the emergency room

BIMA

bilateral internal mammary artery

BMI BMS BNP

body mass index bare metal stent

CHF

congestive heart failure

CI CI

cardiac index

brain natriuretic peptide

confidence interval

blood pressure

CICU

cardiac intensive care unit contrast-induced nephropathy

BPH bpm

benign prostatic hyperplasia

CIN

beats per minute

CKD

chronic kidney disease creatine kinase-MB

BRAVE-2

Beyond 12 Hours Reperfusion Alternative Evaluation-2

CK-MB

CLIA

Clinical Laboratory Improvement Amendments chronic limb-threatening ischemia coronary microvascular dysfunction continuing medical education cardiovascular magnetic resonance cardiac magnetic resonance imaging Centers for Medicare & Medicaid Services

BRS BSA BUN BVS

bioresorbable stents body surface area blood urea nitrogen

CLTI CMD CME CMR cMRI CMS

bioresorbable vascular scaffold coronary artery bypass graft

CABG

CAC CAD

coronary artery calcium coronary artery disease

CAM-ICU

confusion assessment method for the ICU cyclic adenosine monophosphate Canakinumab Antiinflammatory Thrombosis Outcome Study Coronary Angioplasty and Rotablator Atherectomy Trial controlled antegrade and retrograde tracking

calcific nodule

cAMP

CNS

central nervous system

CANTOS

cardiac output

COACT

Coronary Angiography After Cardiac Arrest Trial

CARAT

COBEST

Covered versus Balloon Expandable Stent Trial

CAS

carotid artery stenting

xxi

Abbreviations

COLCOT

DAEDALUS

Colchicine Cardiovascular Outcomes Trial chronic obstructive pulmonary disease Colchicine for the Prevention of the Postpericardiotomy Syndrome

Difference in Anti-restenotic Effectiveness of Drug-eluting stent and DCB AngiopLasty for the occUrrence of coronary in-Stent restenosis

COPD

DAP

dose area product

COPPS

DAPT

dual antiplatelet therapy dual antithrombotic therapy directional coronary atherectomy

COR

class of recommendation

DAT DCA DCB DEB

COVADIS

Coronary Vasomotor Disorders International Study

drug-coated balloon drug-eluting balloons

COX

cyclooxygenase

chest pain

DECISION-

Drug-Eluting Stent Implantation versus Optimal Medical Treatment in Patients with Chronic Total Occlusion

CPC

cardiac progenitor cells

CTO

CPIC

Clinical Pharmacogenetics Implementation Consortium

DES

drug-eluting stent

CPO

cardiac power output

DICOM

Digital Imaging and Communication in Medicine

CPOT

critical-care pain observation tool cardiopulmonary resuscitation

CPR CrCl

DK DM

double kissing diabetes mellitus

creatinine clearance

CREDO

clopidogrel for the reduction of events during observation

DNA DNR

deoxyribonucleic acid

do not resuscitate

CREST

Carotid Revascularization Endarterectomy versus Stenting

DOAC

direct oral anticoagulant

DOREMI

Dobutamine Compared with Milrinone diastolic pulmonary artery pressure

CRP

C-reactive protein

dPA dPR

CRT-D

cardiac resynchronization therapy-defibrillator

diastolic pressure ratio

DREAM

Dutch Randomized Endovascular Aneurysm Management

CSA

cross-sectional area

CSO 2

coronary sinus oxygen content

DRT DSA

device-related thrombus

CSS cTn

Clinical Syntax score cardiac troponins computed tomography

digital subtraction angiography digoxin-specific antibody fragment d-transposition of great arteries

DSFab d-TGA dTRA

CTA

computed tomographic angiography chronic thromboembolic pulmonary hypertension

distal transradial access deep vein thrombosis

CTEPH

DVT

EAST

Emory Angioplasty versus Surgery Trial

CTFC

corrected TIMI frame count

EBU ECA ECG

extra back-up

cTn

conventional troponin

external carotid artery

cTnI cTnT CTO CTPA cTRA CVA CVD

cardiac troponin I cardiac troponin T

electrocardiogram

ECMO

extracorporeal membrane oxygenation

chronic total occlusion

computed tomography pulmonary angiography conventional transradial access

ECPR ECST

ECMO-assisted CPR

European Carotid Surgery Trial

emergency department end-diastolic pressure

cerebrovascular accident cardiovascular disease

EDP

Copyright © 2024 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. endothelial-derived relaxing factor EEM external elastic membrane CVP central venous pressure CYP cytochromes P450 EDRF

EEOC

Equal Employment Opportunity Commission

CYP2C19

cytochrome P450 2C19

D2B

door-to-balloon

xxii

Abbreviations

EES

everolimus-eluting stent

French

FT GC

ejection fraction

fluoroscopy time guide catheter

EHIT EKG ELCA

endovenous heat-induced thrombosis

electrocardiogram

GDMT GERD

guideline–directed medical therapy gastroesophageal reflux disease

excimer laser coronary atherectomy enhanced myocardial efficacy and recovery by aspiration of liberated debris emergency medical services endothelial nitric oxide synthase

EMERALD

GFR

glomerular filtration rate

gastrointestinal

GIK

glucose-insulin-potassium glucagon-like peptide-1

EMS

GLP-1

eNOS

glycoprotein

electrophysiologic

GPI

glycoprotein inhibitor

EPC EPD

endothelial progenitor cell embolic protection device

GRACE

Global Registry of Acute Coronary Events

emergency room

gray

ERS ESC ESC

European Respiratory Society

HBR HCM HCTZ

high bleeding risk

embryonic stem cells

hypertrophic cardiomyopathy

European Society of Cardiology

hydrochlorothiazide

ESRD

end-stage renal disease

HDL

high-density lipoprotein

ESSENCE

efficacy and safety of subcutaneous enoxaparin in non–q wave coronary events European Society for Vascular Surgery Examining Use of Ticagrelor in Peripheral Artery Disease

heart failure

HFA

Heart Failure Association

HFpEF

heart failure with preserved ejection fraction heparin-induced thrombocytopenia human immunodeficiency virus

ESVS

EUCLID

HIT HIV HLA

EURO CTO Evaluate the Utilization of Revascularization or Optimal Medical Therapy for the Treatment of Chronic Total Coronary Occlusions EuroSCORE European System for Cardiac Operative Risk Evaluation EVAR endovascular aneurysm repair FAUST Femoral Arterial Access with Ultrasound Trial FDA Food and Drug Administration FFR fractional flow reserve FFR-CT fractional flow reserve computed tomography FIRE FilterWire EX Randomized Evaluation FMC first medical contact FMD fibromuscular dysplasia FOURIER Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk

Human leukocyte antigen

HMG-CoA

hydroxymethylglutaryl coenzyme A

HOCM HOCM

high-osmolar contrast media

hypertrophic obstructive cardiomyopathy HORIZONS Harmonizing Outcomes with

Revascularization and Stents in Acute Myocardial Infarction

HPR HPS

high platelet reactivity Heart Protection Study

HR HR

hazard ratio

heart rate

HRQoL

health-related quality-of-life

hockey stick

hs-cTn

high-sensitivity cardiac troponin

HSR HTN

high surgical risk

hypertension intra-arterial

FOV

field of view

FPS

frames per second

IART iASD

intra-atrial reentry tachycardia

femoral right

iatrogenic ASD

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