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Catheterization and Cardiovascular Interventions

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https://www.readbyqxmd.com/read/28944620/intracoronary-snaring-of-the-retrograde-guidewire-how-to-overcome-extreme-takeoff-angles-in-chronic-total-occlusion-percutaneous-coronary-intervention
#1
Lorenzo Azzalini, Luciano Candilio, Mauro Carlino, Antonio Colombo
Extreme angulation of coronary artery takeoff represents a challenge for wiring and device advancement in percutaneous coronary intervention (PCI). This anatomic feature is particularly adverse in cases of chronic total occlusion (CTO) of the ostial-proximal segment of the target vessel. In this setting, the retrograde approach can help getting access to the occlusion. However, difficulties might arise at the critical step of wire externalization, due to the need to overcome the extreme ostial angle. Here, we describe a case of successful CTO PCI of the proximal circumflex artery, which presented an extreme angle at its takeoff...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28944613/propensity-score-matched-all-comers-population-treated-with-ultra-thin-strut-bare-metal-and-sirolimus-probucol-coated-drug-eluting-stents-of-identical-stent-architecture
#2
Florian Krackhardt, Mohd Ali Rosli, Matthias Leschke, André Schneider, Christian Sperling, Tay Mok Heang, Maxime Pons, Pedro Jerónimo Sousa, Behrouz Kherad, Matthias Waliszewski
OBJECTIVE: The objective of this study was to compare the safety and efficacy of a polymer-free sirolimus coated, ultrathin strut drug eluting stent (PF-SES) to its uncoated bare-metal stent (BMS) platform of identical stent architecture. BACKGROUND: Recently published randomized trials comparing BMS to DES with a focus on shortened dual-antiplatelet therapy reported incidences of stent thrombosis (ST) and bleeding complications (LEADERS FREE) in favor of drug eluting stents (DES)...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28944588/left-ventricular-perforation-after-impella%C3%A2-placement-in-a-patient-with-cardiogenic-shock
#3
David C Peritz, Lee Linstroth, Craig H Selzman, Edward M Gilbert
Mechanical cardiovascular support devices are now widely used both in the setting of cardiogenic shock as well as during high risk cardiac catheterization procedures. We report a case of a young female patient who presented with presumed myocarditis and rapidly deteriorating decompensated heart failure requiring the implantation of an Impella Circulatory Support System. Upon transfer to our facility it was discovered that during transport, the Impella device had migrated through the left ventricle. She was emergently taken to the operating room where the Impella was surgically removed and biventricular support devices were placed...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28944581/a-new-one-step-procedure-for-pulmonary-valve-implantation-of-the-melody-valve-simultaneous-prestenting-and-valve-implantation
#4
Younes Boudjemline
OBJECTIVES: To describe a new modification, the one-step procedure, that allows interventionists to pre-stent and implant a Melody valve simultaneously. BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is the standard of care for managing patients with dysfunctional right ventricular outflow tract, and the approach is standardized. METHODS: Patients undergoing PPVI using the one-step procedure were identified in our database. Procedural data and radiation exposure were compared to those in a matched group of patients who underwent PPVI using the conventional two-step procedure...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28944572/sizing-of-patent-ductus-arteriosus-in-adults-for-transcatheter-closure-using-the-balloon-pull-through-technique
#5
Nabil A Shafi, Gagan D Singh, Thomas W Smith, Jason H Rogers
OBJECTIVES: To describe a novel balloon sizing technique used during adult transcatheter patent ductus arteriosus (PDA) closure. In addition, to determine the clinical and procedural outcomes in six patients who underwent PDA balloon sizing with subsequent deployment of a PDA occluder device. BACKGROUND: Transcatheter PDA closure in adults has excellent safety and procedural outcomes. However, PDA sizing in adults can be challenging due to variable defect size, high flow state, or anatomical complexity...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28941139/comparative-outcomes-of-transcatheter-aortic-valve-replacement-in-african-american-and-caucasian-patients-with-severe-aortic-stenosis
#6
Fahad Alqahtani, Sami Aljohani, Ahmad Almustafa, Mohammed Alhijji, Oluseun Ali, David R Holmes, Mohamad Alkhouli
BACKGROUND: Racial disparities in cardiovascular care have been extensively investigated. The introduction of transcatheter aortic valve replacement (TAVR) revolutionized the treatment of aortic stenosis (AS) in the last decade. Whether a racial disparity in the utilization and outcome of TAVR exists is unknown. METHODS: We utilized the nationwide inpatient sample (NIS) to compare utilization rates, and in-hospital outcomes of Caucasians and African American (AA) patients who underwent TAVR between August 2011 and December 2014...
September 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940882/safety-and-efficacy-of-the-next-generation-resolute-onyx-zotarolimus-eluting-stent-primary-outcome-of-the-resolute-onyx-core-trial
#7
Matthew J Price, Richard A Shlofmitz, Douglas J Spriggs, Thomas A Haldis, Paul Myers, Alexandra Popma Almonacid, Akiko Maehara, Michelle Dauler, Yun Peng, Roxana Mehran
OBJECTIVES: To assess the safety and efficacy of the novel Resolute (R-) Onyx drug-eluting stent (DES). BACKGROUND: The R-Onyx DES consists of a composite wire with an outer shell of cobalt chromium alloy and a platinum-iridium inner core to enhance radiopacity, with thinner, swaged struts and modified stent geometry compared with the predicate Resolute DES, resulting in a slightly lower total drug load in most sizes. METHODS: This was a prospective, single-arm non-inferiority trial compared with a historical control...
September 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28941149/management-of-left-main-coronary-artery-obstruction-after-transcatheter-aortic-valve-replacement-utilizing-a-periscope-approach
#8
Todd Drexel, Gregory Helmer, Santiago Garcia, Ganesh Raveendran
Coronary obstruction is a rare but potentially fatal complication of transcatheter aortic valve replacement (TAVR). It can result from native leaflet or stent frame obstruction of the coronary ostia. There are reports detailing the difficulty of percutaneous coronary intervention following TAVR, but none that describe a periscope approach to access the left main ostia in the presence of a braided nitinol frame. This report describes an alternative approach to access a coronary artery when the valve stent struts are prohibitive to equipment delivery...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28941127/a-comparison-of-the-fully-repositionable-and-retrievable-boston-lotus-and-direct-flow-medical-valves-for-the-treatment-of-severe-aortic-stenosis-a-single-center-experience
#9
Francesco Giannini, Azeem Latib, Matteo Montorfano, Neil Ruparelia, Vittorio Romano, Matteo Longoni, Luca Ferri, Richard Jabbour, Antonio Mangieri, Damiano Regazzoli, Marco Ancona, Nicola Buzzatti, Lorenzo Azzalini, Akihito Tanaka, Eustachio Agricola, Alaide Chieffo, Ottavio Alfieri, Antonio Colombo
BACKGROUND: Second generation transcatheter aortic valve implantation (TAVI) devices have been designed to reduce the rate of paravalvular leak (PVL) and other complications. An important technological advancement has been the ability to fully reposition devices to facilitate optimal implantation depth and position to reduce the likelihood of PVL. OBJECTIVES: To compare procedural and 30-day outcomes according to the Valve Academic Research Consortium (VARC)-2 criteria following TAVI with the fully repositionable and retrievable Lotus and DFM devices...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28941078/the-effectiveness-and-safety-of-the-impella-ventricular-assist-device-for-high-risk-percutaneous-coronary-interventions-a-systematic-review
#10
Jamal Ait Ichou, Natasha Larivée, Mark J Eisenberg, Karine Suissa, Kristian B Filion
BACKGROUND: Small randomized controlled trials (RCTs) and observational studies have examined the effectiveness and safety of the Impella device, a percutaneous left ventricular assist device, in the setting of high-risk percutaneous coronary intervention (PCI). However, data are sparse and results are conflicting. Our objective was to evaluate the effectiveness and safety of the Impella device in high-risk patients undergoing PCI via a systematic review of the literature. METHODS: We searched Medline, EMBASE, and the Cochrane Library for RCTs and observational studies that evaluated the Impella device in high-risk patients undergoing PCI...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940997/real-time-optical-coherence-tomography-coregistration-with-angiography-in-percutaneous-coronary-intervention-impact-on-physician-decision-making-the-optico-integration-study
#11
David M Leistner, Matthias Riedel, Lisa Steinbeck, Barbara E Stähli, Georg M Fröhlich, Alexander Lauten, Carsten Skurk, Hans-Christian Mochmann, Laura Lübking, Ursula Rauch-Kröhnert, Renate B Schnabel, Dirk Westermann, Stefan Blankenberg, Ulf Landmesser
AIMS: Intracoronary optical coherence tomography (OCT) imaging allows for high-resolution characterization of coronary lesions. Difficulties in matching cross-sectional OCT-images with angiographic lesion localization may limit optimal clinical utilization. We sought to prospectively assess the impact of a novel system of real-time OCT coregistration with angiography (ACR) on physician decision-making during percutaneous coronary interventions (PCI). METHODS AND RESULTS: Strategy for PCI (stent - length, - diameter, - strategy, landing zone) and PCI-optimization (stent-malappostion, -underexpansion, edge-dissections, geographical mismatch) was prospectively assessed in 50 patients with 58 coronary lesions after (I) angiography, (II) OCT imaging, and (III) ACR...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940991/guidewire-electrosurgery-assisted-trans-septal-puncture
#12
Jaffar M Khan, Toby Rogers, Marvin H Eng, Robert J Lederman, Adam B Greenbaum
OBJECTIVES: Electrifying a coronary guidewire may be a simple escalation strategy when trans-septal needle puncture is unsuccessful. BACKGROUND: Radiofrequency energy to facilitate trans-septal puncture through a dedicated device is costly and directly through a trans-septal needle may be less safe. Our technique overcomes these limitations. METHODS: The technique was used in patients when trans-septal needle penetration failed despite excessive force or tenting of the atrial septum...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940984/a-novel-guidewire-integrated-embolic-protection-filter-device-with-a-handy-folding-system-in-vitro-and-in-vivo-performance-assessment
#13
Hiroki Watanabe, Naritatsu Saito, Yoshimasa Nagata, Erika Yamamoto, Kenji Nakatsuma, Bao Bingyuan, Shin Watanabe, Junichi Tazaki, Takeshi Kimura, Kanji Inoue
OBJECTIVES: We developed a novel guidewire-integrated filter device with a handy-folding system (IFD: Inoue filter device). In vitro and in vivo studies were conducted to evaluate the feasibilityof the IFD. BACKGROUND: Although distal atheromatous and thrombotic embolizations remain unresolved critical issues during catheter interventions, distal protection devices are infrequently used partly because of reduced lower maneuverability. METHODS: In the in vitro experiment, we created an experimental circulation model composed of silicone latex tubes, a reservoir, and a roller pump...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895303/coronary-angiography-with-or-without-percutaneous-coronary-intervention-in-patients-with-hemophilia-systematic-review
#14
Christian Boehnel, Hans Rickli, Lukas Graf, Micha T Maeder
OBJECTIVES: We aimed to summarize the evidence for periprocedural and long-term strategies to both minimize the bleeding risk and ensure sufficient anticoagulation and antiaggregation in hemophilia patients undergoing coronary angiography with or without percutaneous coronary interventions (PCI). BACKGROUND: Hemophilia patients undergoing coronary angiography and PCI are at risk of bleeding due to deficiency of the essential clotting factors VIII or IX combined with the need of peri-interventional anticoagulation and antiaggregation and dual antiplatelet therapy (DAPT) after PCI...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895301/early-leaflet-thrombosis-complicating-transcatheter-implantation-of-a-sapien-3-valve-in-a-native-right-ventricular-outflow-tract
#15
Mounir Riahi, Philipp Blanke, John Webb, Ronald G Carere
A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895294/pathology-of-self-expanding-transcatheter-aortic-valves-findings-from-the-corevalve-us-pivotal-trials
#16
Kazuyuki Yahagi, Sho Torii, Elena Ladich, Robert Kutys, Maria E Romero, Hiroyoshi Mori, Frank D Kolodgie, Jeffrey J Popma, Renu Virmani, Aloke V Finn
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has recently become an alternative to surgical aortic valve replacement for patients with severe aortic stenosis. However, paravalvular leaks, possible leaflet thrombosis, and device durability following TAVR remain unresolved issues. METHODS AND RESULTS: We conducted the first systematic microscopic and macroscopic pathologic analysis of self-expanding CoreValve transcatheter aortic valves removed at autopsy or surgically from the U...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895285/complete-filter-based-cerebral-embolic-protection-with-transcatheter-aortic-valve-replacement
#17
Lennart Van Gils, Herbert Kroon, Joost Daemen, Claire Ren, Anne-Marie Maugenest, Marguerite Schipper, Peter P De Jaegere, Nicolas M Van Mieghem
OBJECTIVES: To evaluate the value of left vertebral artery filter protection in addition to the current filter-based embolic protection technology to achieve complete cerebral protection during TAVR. BACKGROUND: The occurrence of cerebrovascular events after transcatheter aortic valve replacement (TAVR) has fueled concern for its potential application in younger patients with longer life expectancy. Transcatheter cerebral embolic protection (TCEP) devices may limit periprocedural cerebrovascular events by preventing macro and micro-embolization to the brain...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895284/usefulness-of-the-syntax-score-ii-to-validate-2-year-outcomes-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-coronary-intervention-a-large-single-center-study
#18
Ying Song, Zhan Gao, Xiaofang Tang, Yuanliang Ma, Ping Jiang, Jingjing Xu, Yi Yao, Xueyan Zhao, Shubin Qiao, Yuejin Yang, Runlin Gao, Bo Xu, Jinqing Yuan
OBJECTIVE: This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice. BACKGROUND: Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI. METHODS: We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895283/right-ventricle-outflow-tract-prestenting-in-vitro-testing-of-rigidity-and-corrosion-properties
#19
Bjorn Cools, Stephen Brown, Martine Wevers, Jan Van Humbeeck, Derize Boshoff, Cis Verdonckt, Marc Gewillig
BACKGROUND: The aim of this study was to assess the resistance to compression (stiffness) of frequently used stents for right ventricular outflow tract prestenting. In addition, to assess the corrosion potential when different types of stent alloys come into contact with each other. METHOD: Different stents were tested in vitro in various combinations at specialized metallurgic laboratories. A bench compression test was used to assess resistance to compression of singular and joined combinations of stents...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895275/incidence-and-outcome-of-infective-endocarditis-following-percutaneous-versus-surgical-pulmonary-valve-replacement
#20
Gentian Lluri, Daniel S Levi, Emily Miller, Abbie Hageman, Sanjay Sinha, Soraya Sadeghi, Brian Reemtsen, Hillel Laks, Reshma Biniwale, Morris Salem, Gregory A Fishbein, Jamil Aboulhosn
OBJECTIVES: To provide a comparison of the outcome of infective endocarditis (IE) in patients undergoing transcatheter pulmonary valve replacement (TPVR) versus surgical pulmonary valve replacement (SPVR). BACKGROUND: Although TPVR is thought to be associated with a higher risk of IE than SPVR, there is paucity of data to support this. METHODS: Patients who underwent TPVR or SPVR at UCLA between October 2010 and September 2016 were included and retrospectively analyzed...
September 12, 2017: Catheterization and Cardiovascular Interventions
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