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Journal of Cardiovascular Surgery

Erik Debing, Dimitri Aerden, Alain Vanhulle, Sarah Gallala, Karl von Kemp
BACKGROUND: Several trials have shown that drug coated balloon (DCB) angioplasty reduce the rates of restenosis in the femoropopliteal artery. This controlled, prospective, multicenter study was designed to demonstrate the efficacy of DCB to inhibit restenosis of the infra- inguinal arteries in an exclusive diabetic population. METHODS: Between 2012 and 2014, 106 diabetic patients with symptomatic peripheral arterial disease (PAD) were enrolled at 11 sites in Belgium, 54 treated with DCB angioplasty and 52 treated with plain old balloon angioplasty (POBA)...
October 11, 2016: Journal of Cardiovascular Surgery
Nicola Troisi, Alberto Farina, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Clara Pigozzi, Azzurra Guidotti, Stefano Michelagnoli
BACKGROUND: Previous studies demonstrated that early recoil is frequently observed in patients undergoing balloon angioplasty. The aim of this study was to evaluate the impact of intra-arterial administration of iloprost (Endoprost®, Italfarmaco S.p.A., Milan, Italy) on early elastic recoil after balloon angioplasty of below-the-knee (BTK) vessels in patients with critical limb ischemia (CLI). METHODS: Between January 2015 and December 2015 32 patients with CLI underwent balloon angioplasty of at least one BTK vessel followed by intra-arterial administration of iloprost...
October 4, 2016: Journal of Cardiovascular Surgery
Claudia Fiorina, Giuseppe Bruschi, Luca Testa, Marco De Carlo, Federico De Marco, Giuseppe Coletti, Stefano Bonardelli, Marianna Adamo, Salvatore Curello, Giovanni Scioti, Paolo Panisi, Francesco Bedogni, Anna S Petronio, Federica Ettori
BACKGROUND: About one-third of candidates for transcatheter aortic valve implantation (TAVI) suffer from severe peripheral artery disease, making the routine femoral approach difficult or impossible. Aim was to compare the trans-axillary (TAx) and the trans-aortic (TAo) route for TAVI with Medtronic CoreValve Revalving System (CRS). METHODS: 242 (23%) out of 1049 consecutive TAVI with 18F CRS were treated in 4 high-volume Italian Centre through TAx (61%) and TAo (39%)...
October 4, 2016: Journal of Cardiovascular Surgery
Kristina Wachter, Christian J Rustenbach, Stephan Hill, Philipp Nikolai, Tim Schäufele, Ulrich F Franke, Hardy Baumbach
No abstract text is available yet for this article.
September 22, 2016: Journal of Cardiovascular Surgery
Ana Redondo Palacios, José López Menéndez, Javier Miguelena Hycka, Miren Martín García, Laura Varela Barca, Andrea Ferreiro Marzal, Rafael Muñoz Pérez, Enrique Oliva De Anquín, Ignacio García Andrade, Tomasa Centella Hernández, Daniel Celemín Canorea, Jorge Rodríguez-Roda Stuart
BACKGROUND: Nowadays, Tricuspid valve replacement (TVR) is much less common than aortic or mitral valve replacement, since repair is almost always preferable. Prosthetic tricuspid valves are associated with high mortality and morbidity, mostly due to thrombotic or hemorrhagic events. Nevertheless, there is lack of evidence of which is the optimal type of valve (biological versus mechanical) in tricuspid position. METHODS: We analysed all the patients who underwent TVR in our Institution, from 2005 to 2015...
September 16, 2016: Journal of Cardiovascular Surgery
Pasqualino Sirignano, Francesco Speziale, Laura Capoccia, Danilo Menna, Wassim Mansour, Nunzio Montelione, Francesco Setacci, Giuseppe Galzerano, Carlo Setacci
BACKGROUND: To evaluate the impact of iliac artery's diameters, tortuosity, and peripheral vascular patency on outcome of elective endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) in 2 high volume vascular centers' experience. METHODS: A retrospective study was conducted on a prospectively collected database between 2010 and 2012. Anatomical features at pre-operative computed tomography (CTA) considered as potentially influencing outcomes were: iliac diameters, tortuosity (expressed as a ratio), and calcifications, bilateral internal iliac artery (IIA) patency, and presence of Trans-Atlantic Inter-Societies Consensus (TASC) II C/D femoro-popliteal occlusive disease (PAD)...
September 16, 2016: Journal of Cardiovascular Surgery
Laura Pasin, Massimiliano M Marrocco Trischitta, Giovanni Landoni, Desiderio Piras, Pasquale Nardelli, Guglielmo Cornero, Roberto Chiesa, Alberto Zangrillo
BACKGROUND: Carotid endarterectomy remains the most effective surgical treatment for reducing the risk of stroke in patients with significant carotid stenosis. In fact, endovascular approach is associated with a higher incidence of perioperative and long-term minor stroke when compared to carotid endarterectomy although long-term functional outcome and risk of major stroke are similar. However, advanced age resulted to be associated with an increased risk of complications after carotid endarterectomy...
September 13, 2016: Journal of Cardiovascular Surgery
Abdullah Al Otaibi, Saurabh Gupta, Emilie P Belley-Cote, Ali Alsagheir, Jessica Spence, Dominic Parry, Richard P Whitlock
BACKGROUND: Minimal access mitral valve surgery (mini-MVS) approaches are becoming increasingly common. They are thought to be associated with less perioperative bleeding and postoperative pain, resulting in shorter hospital length-of- stay (LOS) and faster return to daily activities. However, there are concerns that this approach may have inferior surgical results - with resultant increases in morbidity and mortality - when compared to conventional mitral valve surgery. To address this gap in the literature, we undertook a systematic review and meta-analysis, comparing right thoracotomy mini-MVS (MT-MVS) to conventional mitral valve surgery using a median sternotomy (sternotomy-MVS) approach...
September 2, 2016: Journal of Cardiovascular Surgery
Michel J Bosiers, Koen Deloose, Patrick Peeters, Giovanni Torsello, Thomas Zeller, Dierk Scheinert, Andrej Schmidt, Lieven Maene, Koen Keirse, Ramon Varcoe, Marc Bosiers
BACKGROUND: The superiority of drug eluting stents versus bare metal stents or balloon angioplasty in the treatment of patients with critical limb ischemia and infrapopliteal lesions has been established. However, only shorter lesions were evaluated. This study was designed to evaluate the immediate and long-term (up to 12 months) outcome of the XIENCE PRIME Everolimus-Eluting Coronary Stent System (Abbott Vascular) in a controlled, prospective, multi center investigation for long lesions up to 10 cm...
July 26, 2016: Journal of Cardiovascular Surgery
Kiattisak Hongku, Nuno V Dias, Björn Sonesson, Timothy A Resch
Endovascular repair has an established role in aortic treatment and has with evolving technologies expanded its applicability to the whole aorta. Whereas open repair is still the standard treatment for aortic arch and ascending aortic pathology, in high-risk patients, endovascular treatment has gained an increasing role. Endovascular options range from hybrid procedures to total endovascular repair using chimney grafts, branched and fenestrated stent grafts. Thoracic endovascular repair (TEVAR) for descending aortic pathologies including aneurysms, traumatic aortic transection, and complicated type B aortic dissection (TBAD) have also been firmly established and in many cases shown superior to open alternatives...
December 2016: Journal of Cardiovascular Surgery
Carlo Setacci, Giuseppe Galzerano, Francesco Setacci, Mariagnese Mele, Susanna Guerrini, Gianmarco De Donato
No abstract text is available yet for this article.
December 2016: Journal of Cardiovascular Surgery
Jos C VAN DEN Berg
The endovascular treatment of atherosclerotic disease of the infra-inguinal arteries has changed significantly since the introduction of drug-eluting balloon technology. The role of angioplasty using drug-eluting balloons for lesions of the superficial femoral and popliteal artery is now well established. The positive results of the use of drug-eluting balloons in the above knee segment could not be achieved in the below-the-knee segment. This paper will give an overview of the current status of drug-eluting balloon angioplasty for below-the-knee lesions, and will present a review of 2 single center registry, 5 randomized trials and a meta-analysis...
December 2016: Journal of Cardiovascular Surgery
Leonardo Rangel-Castilla, Gary B Rajah, Hakeem J Shakir, Jason M Davies, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy, L Nelson Hopkins
Acute ischemic stroke is a leading cause of death and disability in the United States, responsible for 1 of every 20 deaths. The efficacy of intravenous tissue plasminogen activator (tPA) alone for recanalization of large-vessel occlusion (LVO) is low. Several randomized trials have now established endovascular treatment of LVO as a standard of care. Endovascular techniques continue to evolve at a rapid pace. This review seeks to report recent advances in endovascular technology, discuss the correlation between speed of reperfusion and patient outcomes, and present mobile stroke care, shortcoming of the recent technology (such as clot fragmentation), and potential solutions to overcome these drawbacks, as well as anesthetic considerations and cost-effectiveness...
December 2016: Journal of Cardiovascular Surgery
Geert Maleux, Sandra Cornelissen, Lawrence Bonne
Percutaneous, catheter-directed embolotherapy is an established interventional technique for the management of many vascular disorders. For more than three decades, typical embolization devices included macro and microcoils, polyvinyl alcohol microparticles, glue and certain liquids such as absolute alcohol. In the past decade, however, several new embolic devices and refinements of existing embolic devices have arrived on the market and a number of clinical studies have demonstrated their added value. In this review article, these new embolic devices and their typical indications will be discussed, as well as the results of studies involving the embolic devices...
December 2016: Journal of Cardiovascular Surgery
Konstantinos Spanos, George Kouvelos, Christos Karathanos, Sokol Xhepa, Giannoukas Athanasios, Miltiadis Matsagkas
Chronic total occlusions (CTOs) represent a technically demanding subset of lesions, which in most cases require special endovascular methods, advanced operator skills, and utilization of sophisticated assisting devices for successful treatment. CTO crossing devices offer an additional option to interventionists in the treatment of challenging lower extremity peripheral arterial occlusions. These devices may improve crossing rates, allowing delivery of therapeutic devices to the target lesion. Initial technical results seem quite promising, although adequate data on patient and device selection are lacking...
December 2016: Journal of Cardiovascular Surgery
Marc Bosiers, Koen Deloose, Joren Callaert, Patrick Peeters, Michel Bosiers
Endovascular techniques have improved markedly over the past several decades. Plain old balloon angioplasty can only reach patencies around 40% after 1 year. Scaffolding stents have resulted in improved short-term results but encountered limitations for longer-term durability. With the introduction of drug-eluting technologies the process of intimal hyperplasia might be slowed, resulting in improved long-term patency results. At first, limus-eluting technologies were not able to transfer the enthusiasm from the coronaries to the infrainguinal vascular bed...
December 2016: Journal of Cardiovascular Surgery
Gianmarco De Donato, Giulia Mazzitelli, Umberto Ruzzi, Mariagnese Mele, Marco Tadiello, Giovanni Giannace, Francesco Setacci, Giuseppe Galzerano, Carlo Setacci
Data from randomized controlled trials (RCTs) demonstrated significant differences between carotid artery stenting (CAS) and carotid endarterectomy (CEA) in terms of early neurological outcomes (from 0 to 30 days), although mid- and long-term neurological results are indistinguishable. CAS in symptomatic standard risk patients is coupled with a higher risk of any stroke, and death or any stroke at 30 days, while the rates of disabling or major stroke do not vary remarkably between treatments. Since the micro-embolization through the stent struts is the primary suspected cause of suspected early postoperative neurological complications (i...
December 2016: Journal of Cardiovascular Surgery
Sarah B Ongstad, Daniel F Miller, Jean M Panneton
BACKGROUND: The aim of this study was to assess the applicability and outcomes of EndoAnchor use in the endovascular repair of thoracic and thoracoabdominal aortic aneurysms. METHODS: A retrospective review was performed of all thoracic endovascular aortic repairs (TEVARs) performed with the use of EndoAnchors between December 2012 and January 2016. Primary study endpoints included freedom from migration, freedom from aortic- related intervention, and freedom from post-operative type I or type III endoleak...
October 2016: Journal of Cardiovascular Surgery
Nicola Mangialardi, Matteo Orrico, Sonia Ronchey, Barbara Praquin, Vittorio Alberti, Carlo Setacci
Endovascular aneurysm repair (EVAR) is largely the most adopted strategy for aneurysmal disease of the aorta. Nevertheless, the high incidence of reintervention makes it difficult to identify EVAR as a definitive solution; in particular, the most frequent indication of reintervention is endoleak, which is defined as persistent flow into the aneurysmal sac from different sources. Several treatment strategies are described. A contemporary literature search was performed with the intent of describing techniques and outcomes of endovascular and open strategies to type I, II, and III endoleak...
October 2016: Journal of Cardiovascular Surgery
Ralf Langhoff, Andrea Behne, Eva Buschmann
In order to assess the role of drug-coated balloons (DCB) in below-the-knee (BTK) artery interventions, we analyzed randomized trials which compare coated to non-coated balloons and additionally a direct comparison of drug-eluting stents (DES) with DCB. As angioplasty with non-coated balloons is per guideline-recommendation still standard of care for below-the-knee artery endovascular treatment, we focused on the direct comparison of efficacy and clinical outcome data of both treatment modalities. Data from peer reviewed and published trials were consulted...
October 2016: Journal of Cardiovascular Surgery
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