The effects of intraperitoneal administration of normal saline, dextrose, and amino acids were studied in a rat model for intraperitoneal alimentation. No adverse effects from the use of placement of an intraperitoneal catheter were found. Animals who received amino acids demonstrated a specific metabolic advantage over animals who received isocaloric amounts of carbohydrate. They lost less weight and maintained a higher serum albumin. The intraperitoneal route may provide a relatively simple and efficient method of studying parenteral nutrition in laboratory animals. Conceivably, it may also be of value for humans who are on chronic ambulatory peritoneal dialysis, or even as an alternative for central venous alimentation.
Calcified coronary artery bifurcation lesions (CBL) remain a challenge for the interventional cardiologist. Evidence regarding treatment of CBL is minimal. Optimal plaque modification is the most important step prior to stent deployment. Provisional stenting is the preferred strategy for most bifurcation lesions. However, two‐stent strategy should be considered for BL with compromised large SB (>2.5 mm) supplying a large territory, >70% SB stenosis and lesions more than 5 mm long. In this contemporary review article, we present a simplified approach to treating CBL and demonstrate the approach to specific case examples using our newly developed mobile application, BifurcAID.
Background: Both target vessel calcification and target vessel bifurcation are associated with worse outcomes following percutaneous coronary intervention (PCI).Whether these entities in combination interact to influence outcomes after PCI of complex coronary disease is not known.Objectives: This study evaluated the association of target vessel bifurcation and target vessel calcification, alone and in combination, with adverse events following PCI.Methods: Registry data from 21,165 patients who underwent PCI with drug-eluting stents (DES) between January 2009 and December 2017 were analyzed. Patients were divided into four groups according to the presence or absence of target vessel bifurcation and presence of none/mild or moderate/severe target vessel calcification on angiography. Associations between lesion groups and 1 year major adverse cardiac events (MACE) were examined using Cox regression analysis.Results: At 1 year, unadjusted rates of MACE, death, myocardial infarction (MI), as well as stent thrombosis were highest in the group with both bifurcation lesion and moderate/severe calcification. After adjusting for confounders such as age, renal disease, and smoking, hazard ratios for MACE were 1.14 (95%CI 0.99-1.33) for bifurcation with none/mild calcification, 1.21 (95%CI 1.06-1.38) for no bifurcation and moderate/ severe calcification, and 1.37 (95%CI 1.14-1.64) for bifurcation and moderate severe calcification, compared to patients with no bifurcation and none/mild calcification.
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