Document 410271

Platelet aggregation in patients treated with clopidogrel
16. Cuisset T, Frere C, Quilici J, Barbou F, Morange PE, Hovasse T, Bonnet JL,
Alessi MC. High post-treatment platelet reactivity identified lowresponders to dual antiplatelet therapy at increased risk of recurrent cardiovascular events after stenting for acute coronary syndrome. J Thromb
Haemost 2006;4:542–549.
17. Kastrati A, von Beckerath N, Joost A, Pogatsa-Murray G, Gorchakova O,
Scho
¨mig A. Loading with 600 mg clopidogrel in patients with coronary
artery disease with without chronic clopidogrel therapy. Circulation
2004;110:1916–1919.
18. Gurbel PA, Bliden KP, Hayes KM, Yoho JA, Herzog WR, Tantry US. The
relation of dosing to clopidogrel responsiveness and the incidence of
high post-treatment platelet aggregation in patients undergoing coronary
stenting. J Am Coll Cardiol 2005;45:1392–1396.
19. Taubert D, Kastrati A, Harlfinger S, Gorchakova O, Lazar A, von Beckerath
N, Scho
¨mig A, Scho
¨mig E. Pharmacokinetics of clopidogrel after administration of a high loading dose. Thromb Haemost 2004;92:311–316.
20. Steinhubl SR, Kereiakes D. Ultegra rapid platelet function analyzer. In:
Michelson AD (ed.), Platelets. Orlando, FL: Academic Press; 2002.
p317–323.
21. von Beckerath N, Pogatsa-Murray G, Wieczorek A, Sibbing D, Scho
¨mig A,
Kastrati A. Correlation of a new point-of-care test with conventional
optical aggregometry for the assessment of clopidogrel responsiveness.
Thromb Haemost 2006;95:910–911.
22. Scho
¨mig A, Neumann FJ, Kastrati A, Schu
¨hlen H, Blasini R, Hadamitzky M,
Walter H, Zitzmann-Roth E, Richardt G, Alt E, Schmitt C, Ulm K. A randomized comparison of antiplatelet and anticoagulant therapy after
the placement of coronary artery stents. N Engl J Med 1996;334:
1084–1089.
1819
23. Steinhubl SR, Charnigo R. Clopidogrel treatment prior to percutaneous
coronary intervention: when enough isn’t enough. JAMA 2006;295:
1581–1582.
24. Mu
¨mig A,
¨ller I, Seyfarth M, Ru
¨diger S, Wolf B, Pogatsa-Murray G, Scho
Gawaz M. Effect of a high loading dose of clopidogrel on platelet function
in patients undergoing coronary stent placement. Heart 2001;85:92–93.
25. von Beckerath N, Taubert D, Pogatsa-Murray G, Scho
¨mig E, Kastrati A,
Scho
¨mig A. Absorption, metabolization, and antiplatelet effects of
300-, 600-, and 900-mg loading doses of clopidogrel: results of the
ISAR-CHOICE (Intracoronary Stenting and Antithrombotic Regimen:
Choose Between 3 High Oral Doses for Immediate Clopidogrel Effect)
Trial. Circulation 2005;112:2946–2950.
26. Kastrati A, Mehilli J, Neumann FJ, Dotzer F, ten Berg J, Bollwein H, Graf I,
Ibrahim M, Pache J, Seyfarth M, Schu
¨hlen H, Dirschinger J, Berger PB,
Scho
¨mig A. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. JAMA 2006;295:1531–1538.
27. Angiolillo DJ. OPTIMUS-1: first report of a randomized trial of different
clopidogrel maintenance doses in patients with diabetes mellitus and
coronary artery disease. Paper presented at Transcatheter Cardiovascular Therapeutics, 2006;Washington DC.
28. Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, Cacoub P,
Cohen EA, Creager MA, Easton JD, Flather MD, Haffner SM, Hamm CW,
Hankey GJ, Johnston SC, Mak KH, Mas JL, Montalescot G, Pearson TA,
Steg PG, Steinhubl SR, Weber MA, Brennan DM, Fabry-Ribaudo L, Booth
J, Topol EJ. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006;354:1706–1717.
doi:10.1093/eurheartj/ehl553
Online publish-ahead-of-print 26 February 2007
Double aortic arch and left superior vena cava persistence visualized by 16-row detector
multi-slice computed tomography
Egidio Traversi1*, Giuseppe Bertoli2, and Gian Carlo Barazzoni2
1
Cardiology Department, Fondazione Salvatore Maugeri, Via Ferrata 4, 27100 Pavia, Italy; 2Radiology Department,
Salvatore Maugeri Foundation, Pavia, Italy
* Corresponding author. Tel:
þ 39 (0)382592611; fax: þ 39 (0)382592099. E-mail address: [email protected]
A 38-year-old woman (F.N.) suffering from dysphagia underwent a
gastroduodenoscopy. An external compression of the middle
portion of the oesophagus was demonstrated. The patient then
underwent a 16-row detector multislice computed tomography
(CT) (Lightspeed 16 pro, G.E. Medical System, Milwakee, WI,
USA) with i.v. administration of iodated non-ionic contrast media
(100 mL) and ECG-gated acquisition of the images. A double
aortic arch was demonstrated (Panel A). The left carotid (LC)
artery and the left subclavian (LS) artery originate from the left
arch, whereas the right carotid (RC) artery and the right subclavian (RS) artery from the right (Panel B). This is clearly demonstrated from the endovascular view of the double arch (Panel C).
Both the subclavian ostia show a diameter slightly greater than
those of the carotid arteries. Along with this malformation, the
persistence of the left superior vena cava draining into the coronary sinus and passing anteriorly to the left pulmonary veins was
demonstrated. In Panel D, using a particular visualization of
the cardiac structures (called ‘transparency’), the relationship
between the superior vena cavae and cardiac structures is well
valuable. Volume rendering multislice CT images seem particularly
useful in complex cardiac and vascular malformations: in this case,
with a single non-invasive examination, the origin of the symptoms
was explained and a complete picture of the anatomical situation
was obtained. This aspect is a further atout of the method when
planning for a surgical approach.
Panel A. Volume rendering posterior view of the heart and the
aorta. AA, ascending aorta.
Panel B. Volume rendering lateral (left) view of the aorta. Abbreviations as given in Panel A; DA, descending aorta.
Panel C. Intravascular view (‘virtual angioscopy’) of the double aortic arch. Abbreviations as given in Panel A.
Panel D. Volume rendering posterior view of the heart. Transparency reconstruction. DA, descending aorta; IVC, inferior vena cava; PV,
pulmonary veins (grey); CS, coronary sinus; LVC, left superior vena cava; RA, right atrium; RVC, right superior vena cava (standard
colourization).
Downloaded from by guest on November 13, 2014
Clinical vignette
`