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Cardiovascular Revascularization Medicine: Including Molecular Interventions

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https://www.readbyqxmd.com/read/29153509/transcatheter-embolization-of-a-giant-coronary-artery-pseudoaneurysm
#1
Pratik Dalal, Divyashree Varma, Ripa Chakravorty, Salil Sethi, Steven Bailey, Anand Prasad
A 53-year-old diabetic male with sternal dehiscence presented with recurrent staphylococcus bacteremia 2years after coronary artery bypass grafting (CABG). He was found to have a giant right coronary artery (RCA) pseudoaneurysm and a coronary cameral fistula on imaging. Due to excessive surgical risk, the patient underwent percutaneous treatment with a 5mm Amplatzer vascular plug 4 (St. Jude Medical, St.Paul, MN). Post-procedure imaging showed successful cessation of flow into the pseudoaneurysm and follow-up CT scan demonstrated significant improvement in the size of the pseudoaneurysm...
November 16, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29146552/cardiogenic-shock-complicating-transcatheter-aortic-valve-replacement-due-to-severe-para-valvular-regurgitation
#2
M Chadi Alraies, Mohamad Soud, Homam Moussa Pacha, Ron Waksman, Itsik Ben-Dor
We describe a challenging case of successful use of Impella CP™ to provide emergent left ventricular support following a circulatory collapse during transcatheter valve-in-valve implantation with a CoreValve Evolut R prosthesis.
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29117920/orbital-atherectomy-treatment-of-severely-calcified-native-coronary-lesions-in-patients-with-prior-coronary-artery-bypass-grafting-acute-and-one-year-outcomes-from-the-orbit-ii-trial
#3
Michael S Lee, Bynthia M Anose, Brad J Martinsen, Arthur C Lee, Richard A Shlofmitz, Jeffrey W Chambers
AIMS: Patients undergoing percutaneous coronary intervention (PCI), with a history of coronary artery bypass grafting (CABG), may be at increased risk for mortality and repeat revascularization, compared with patients without prior CABG. In this post-hoc analysis of the ORBIT II trial, safety and efficacy of coronary orbital atherectomy (OA) to modify severe coronary artery calcium, prior to stent placement, was evaluated in subjects based on history of CABG. METHODS AND RESULTS: Comorbidities: diabetes, dyslipidemia, hypertension, and history of myocardial infarction (MI) were more prevalent in the CABG group...
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29137967/procedural-and-thirty-day-outcomes-following-transfemoral-implantation-of-the-fully-repositionable-and-retrievable-lotus-valve-without-routine-pre-dilatation-in-a-consecutive-patient-cohort-a-single-centre-experience
#4
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND / PURPOSE: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation...
November 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29137966/clinical-outcomes-of-complex-real-world-diabetic-patients-treated-with-amphilimus-sirolimus-eluting-stents-or-zotarolimus-eluting-stents-a-single-center-registry
#5
Rik Rozemeijer, Daniela Benedetto, Adriaan O Kraaijeveld, Michiel Voskuil, Mèra Stein, Leo Timmers, Saskia Z Rittersma, Pierfrancesco Agostoni, Pieter A Doevendans, Pieter R Stella
OBJECTIVE: To assess clinical outcomes of Amphilimus Sirolimus-Eluting Stents (A-SES) as compared to Zotarolimus-Eluting Stents (ZES) in complex real-world diabetic patients. BACKGROUND: Patients with diabetes mellitus represent one of the most challenging scenarios with high rates of restenosis and stent thrombosis in the current era of drug-eluting stents. Hence, we assessed the safety of A-SES versus ZES in complex diabetic patients. METHODS: In this observational study, we analyzed all consecutive patients with diabetes mellitus referred to our center from November 2012 to November 2014...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113865/identifying-strategy-for-ad-hoc-percutaneous-coronary-intervention-in-patients-with-anticipated-unfavorable-radial-access-the-little-women-study
#6
Gregory A Sgueglia, Daniel Todaro, Antonella De Santis, Micaela Conte, Gaetano Gioffrè, Angela Di Giorgio, Fabrizio D'Errico, Fabiana Piccioni, Francesco Summaria, Achille Gaspardone
BACKGROUND: Transradial percutaneous coronary intervention (PCI) offers important advantages over transfemoral PCI, including better outcomes. However, when there is indication to ad hoc PCI, a 6 French workflow is a common default strategy, hence potentially influencing vascular access selection in patients with anticipated small size radial artery. METHODS: A multidimensional evaluation was performed to compare two ad hoc interventional strategies in women <160cm: a full 6 French workflow (namely 6 French introducer sheath, diagnostic catheters and guiding catheter) with a modified workflow consisting in the use of 5 French diagnostic catheters preceded by the placement of a 6 French sheath introducer and followed by a 6 French guiding catheter use for PCI...
October 16, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29153508/patient-characteristics-in-variable-left-ventricular-recovery-from-takotsubo-syndrome
#7
Jae I Kim, Charan Yerasi, Alaa Azzouqa, Edward Koiffman, Gaby Weissman, Zuyue Wang, John Moran, Rebecca Torguson, Lowell F Satler, Augusto D Pichard, Ron Waksman, Joseph Lindsay, Itsik Ben-Dor
BACKGROUND: Takotsubo syndrome (TTS) is a heart failure syndrome which is usually reversible. Factors associated with degree of recovery of left ventricular systolic function in TTS are poorly understood. MATERIALS AND METHODS: We conducted a retrospective analysis of 90 TTS patients treated at our institution from 2006 to 2014. Patients were grouped based on recovery of left ventricular ejection fraction (LVEF) on follow-up transthoracic echocardiogram as left ventricular ejection fraction <50% (partial group) or preserved ejection fraction ≥50% (full group)...
October 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29146551/dual-lumen-microcatheters-for-complex-percutaneous-coronary-interventions
#8
REVIEW
Jacopo A Oreglia, Roberto Garbo, Andrea Gagnor, Gabriele L Gasparini
In some bifurcation anatomies side branch wiring can be difficult particularly when side branch is highly angulated. Furthermore a combination of bifurcations and chronic total occlusion can be a real challenge for interventional cardiologists. New devices have been produced to facilitate complex PCI and recently introduced dual lumen microcatheters can be really helpful in these scenarios. All these devices have both a rapid-exchange and an over-the-wire lumen. The rationale for dual lumen microcatheters is to preserve the highest number of side-branches...
October 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29122526/extracorporeal-myocardial-shockwave-therapy-a-precious-blast-for-refractory-angina-patients
#9
Massimo Slavich, Giuseppe Pizzetti, Anna Maria Vella, Claudia Carlucci, Davide Margonato, Roberto Spoladore, Gabriele Fragasso, Alberto Margonato
INTRODUCTION: Refractory Angina Pectoris (RAP) dramatically affects patients' life quality and medical costs. External Shockwave Myocardial Revascularization (ESMR) improves the cardiac blood flow thanks to its pro-angiogenetic action on ischaemic tissues. We hereby describe our experience of ESMR in RAP patients. MATERIALS AND METHODS: This is a retrospective study encompassing all patients referred to OSR for RAP treatment. Efficacy of ESMR was assessed considering the difference between pre and post therapy data in SAQ score and CCS, stress test performance, 24h ECG monitoring, NT-proBNP and echocardiographic measures...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113864/observations-from-a-real-time-ifr-ffr-hybrid-approach-in-patients-with-severe-aortic-stenosis-and-coronary-artery-disease-undergoing-tavi
#10
Roberto Scarsini, Gabriele Pesarini, Mattia Lunardi, Anna Piccoli, Claudia Zanetti, Rosaria Cantone, Michele Bellamoli, Valeria Ferrero, Leonardo Gottin, Giuseppe Faggian, Flavio Ribichini
BACKGROUND: The complexity of coronary physiology in presence of severe aortic stenosis (AS) raises concerns about the reliability of pressure-derived indexes in this clinical setting. Furthermore, neither fractional flow reserve (FFR) nor instantaneous wave-free period (iFR) has been validated in AS. Combining iFR and FFR in a tailored decision-making strategy may help to increase simplicity, accuracy and safety of physiology-guided revascularization in AS. METHODS: In this prospective observational study iFR and FFR were measured before and after TAVI during the same procedure in patients with severe AS and concomitant coronary artery disease (CAD)...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29126947/transradial-versus-transfemoral-access-in-patients-undergoing-peripheral-artery-angioplasty-stenting-a-meta-analysis
#11
REVIEW
George Galyfos, Fragiska Sigala, Konstantinos Filis
Transradial (TR) access has been extensively compared to transfemoral (TF) access in patients undergoing percutaneous coronary interventions, with TR method showing a clear benefit over the latter. However, comparative data concerning peripheral artery endovascular interventions has been limited in the literature. Therefore, a systematic review was conducted in order to compare main outcomes between TR and TF access in patients undergoing peripheral artery angioplasty and/or stenting. Main outcomes included technical success, major/minor bleeding risk, access site complications, hospital stay, death, myocardial infarction, neurological events and other procedural parameters...
September 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29122525/iatrogenic-corticosteroids-induced-takotsubo-cardiomyopathy
#12
REVIEW
Luciano Candilio, Thomas Moon, Daniel Sado, Rafal Dworakowski
No abstract text is available yet for this article.
September 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113866/intravascular-ultrasound-enhances-the-safety-of-rotational-atherectomy
#13
REVIEW
Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Yoshimasa Tsurumaki, Shin-Ichi Momomura, Hideo Fujita
Intravascular ultrasound (IVUS) is mainly used in PCI to treat complex lesions, such as left main bifurcation, chronic total occlusion and calcified lesions. Although IVUS yields useful information such as the presence of napkin-ring calcification, the role of IVUS in rotational atherectomy (RA) is not fully appreciated. Recently, since the deliverability and crossability of IVUS catheters have improved, IVUS should be attempted before RA. Even if the IVUS catheter cannot cross the lesion, IVUS provides information just proximal to the target lesion, which would be useful in the selection of the appropriate guidewire and burr size...
September 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29117919/guideliner-extension-catheter-facilitated-side-strut-stenting-technique-for-the-treatment-of-right-coronary-artery-ostial-in-stent-restenosis
#14
REVIEW
George Kassimis, Tushar Raina
Percutaneous coronary intervention (PCI) for the treatment of right coronary artery (RCA) ostial in-stent restenosis (ISR) can be challenging. The technical difficulties are compounded by excessive stent protrusion into the aorta, preventing coaxial engagement of the guiding catheter and wiring through the central stent lumen. Through this review, we aim to highlight the practical challenges encountered during the treatment of ostial RCA ISR through PCI and evaluate the various interventional techniques that have been used...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113867/clinical-significance-of-intracoronary-thrombus-aspirated-during-primary-percutaneous-intervention-an-immunohistopathological-study
#15
Neeraj Parakh, Basavaraj Utagi, Sudhir Arava, Sunil Verma, Ganesan Karthikeyan, Sandeep Singh, Balram Bhargava, Ruma Ray, Chetan D Patel, Vinay K Bahl
BACKGROUND: Manual thrombus aspiration during primary percutaneous intervention provides us with aspirated thrombus sample, that may contain material from the disrupted plaque. Immunohistopathological analysis of thrombus can yield valuable information about the clinical and cardiovascular outcomes and possible mechanisms of myocardial infarction. MATERIAL AND METHODS: We studied and analysed the immunohistopathological features of coronary thrombus aspirated from patients undergoing primary percutaneous coronary angioplasty...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113863/long-term-outcomes-after-carotid-artery-stenting-of-patients-with-prior-neck-irradiation-or-surgery
#16
Ho-Hin K Choy, Damianos G Kokkinidis, Ryan Cotter, Gagan D Singh, R Kevin Rogers, Stephen W Waldo, John R Laird, Ehrin J Armstrong
BACKGROUND: Carotid artery stenting (CAS) is often performed in patients with carotid artery stenosis who have relative contraindications to carotid endarterectomy (CEA), including hostile neck anatomy (e.g., history of neck irradiation or prior surgery). We examined the impact of hostile neck anatomy on long-term outcomes after CAS. METHODS: All carotid artery stent procedures performed at two institutions from 2006 to 2016 were reviewed. Routine duplex carotid ultrasound was used to assess target lesion restenosis at regular intervals...
September 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29102344/clinical-outcomes-of-coronary-occlusion-following-transcatheter-aortic-valve-replacement-a-systematic-review
#17
REVIEW
Oluwaseun A Akinseye, Sunil K Jha, Uzoma N Ibebuogu
BACKGROUND: Coronary occlusion (CO) is a rare but serious complication following transcatheter aortic valve replacement (TAVR) with limited published data. We sought to evaluate the immediate and short-term outcomes of CO complicating TAVR. METHODS: Studies, including case reports, case series and original articles published from 2002 to 2016 describing CO following TAVR were identified with a systematic electronic search using the PRISMA Statement. Only studies reporting data on demographic and procedural characteristics, management and follow up outcomes were analyzed...
September 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29066338/electrocardiographic-changes-after-successful-recanalization-of-a-chronic-total-coronary-occlusion-a-systematic-review-and-meta-analysis
#18
REVIEW
Ivo M van Dongen, Joëlle Elias, Veronique M F Meijborg, Jacques M T De Bakker, Jacqueline Limpens, Chantal E Conrath, José P S Henriques
BACKGROUND: Observational studies suggest that in patients with a CTO successful recanalization is associated with better clinical outcome. This could be related to a reduction in the occurrence of arrhythmias, which may result from modifications of the hibernating myocardium in a CTO region. METHODS AND RESULTS: We aimed to evaluate the effect of CTO PCI on electrophysiological parameters, and conducted a systematic review and meta-analysis according to the PRISMA guidelines...
September 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29066341/full-stent-expansion-of-chronic-total-occlusion-lesions-requires-prolonged-inflation
#19
Srikanth Vallurupalli, Aatish Garg, Mauro Carlino, Abdul Hakeem, Barry F Uretsky
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been associated in some studies with higher target vessel revascularization (TVR) rates than non-CTO PCI. Optimal stent inflation time and its effect on TVR in CTO PCI is unknown. We investigated the time required for stent deployment using the previously described pressure optimized protocol (POP), which uses stent balloon pressure stability rather than an arbitrary inflation time as an end point for balloon deflation. We also compared TVR with CTO PCI vs non-CTO using the POP protocol in both groups...
September 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29037762/evaluation-of-lesion-flow-coefficient-for-the-detection-of-coronary-artery-disease-in-patient-groups-from-two-academic-medical-centers
#20
Srikara V Peelukhana, Rupak K Banerjee, Tim P van de Hoef, Kranthi K Kolli, Mohamed Effat, Tarek Helmy, Massoud Leesar, Hanan Kerr, Jan J Piek, Paul Succop, Lloyd Back, Imran Arif
BACKGROUND: In this study, lesion flow coefficient (LFC: ratio of % area stenosis [%AS] to the square root of the ratio of the pressure drop across the stenosis to the dynamic pressure in the throat region), that combines both the anatomical (%AS) and functional measurements (pressure and flow), was assessed for application in a clinical setting. METHODS AND RESULTS: Pressure, flow, and anatomical values were obtained from patients in 251 vessels from two different centers...
September 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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