Read by QxMD icon Read

Cardiovascular Intervention and Therapeutics

Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Shiro Miura, Takeshi Arita, Takenori Domei, Kyohei Yamaji, Yoshimitsu Soga, Makoto Hyodo, Shinichi Shirai, Kenji Ando
Optimal time to perform percutaneous mitral valvuloplasty (PMV) for patients with significant mitral stenosis (MS) and atrial fibrillation (AF) remains controversial. We sought to identify prognostic factors and evaluate long-term clinical outcomes after PMV of 77 consecutive patients with MS with a mitral valve area (MVA) <1.5 cm(2). According to baseline heart rhythm, these patients were divided into sinus rhythm (SR; n = 24) and AF (n = 53) groups. The study endpoint was defined as a composite of all-cause mortality, admission for heart failure, mitral valve surgery, repeated PMV, and major cerebral vascular accident during follow-up...
October 5, 2016: Cardiovascular Intervention and Therapeutics
Umihiko Kaneko, Yoshifumi Kashima, Daitaro Kanno, Takuro Sugie, Ken Kobayashi, Tsutomu Fujita
Although performing rotational atherectomy (RA) requires guidewire exchange for the dedicated guidewire, RotaWire guidewire (Boston Scientific) exhibits much lower performance than conventional guidewire. Consequently, there are times when RotaWire cannot be advanced past the lesion independently or using a microcatheter exchange technique, rendering RA impossible. We present a case of a heavily calcified, device-uncrossable, and non-expansible chronic total occlusion lesion successfully revascularized with RA over RG3 guidewire (Asahi Intecc), which has a length of 330 cm, hydrophilic coating, and a 0...
September 28, 2016: Cardiovascular Intervention and Therapeutics
Eiji Ichimoto, Sawako Horie, Atsushi Hasegawa, Hirofumi Miyahara, Mizuo Nameki
No abstract text is available yet for this article.
September 27, 2016: Cardiovascular Intervention and Therapeutics
Yoshitoki Takagawa, Tetsuaki Furukawa
A sheathless system that inserts a catheter directly into the artery can reduce puncture site-related complications through a 2-Fr reduction of the outer diameter. However, the gap between the dilator and the guiding catheter of the sheathless system is larger than the gap between the dilator and sheath of the introducer system, resulting in stronger insertion resistance. A twisting method with rapid alternating rotation of a device to the left and right during insertion can reduce the insertion resistance...
September 24, 2016: Cardiovascular Intervention and Therapeutics
Masahiro Natsuaki, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Kenji Ando, Hiroki Shiomi, Toshiaki Toyota, Hirotoshi Watanabe, Koh Ono, Satoshi Shizuta, Takashi Tamura, Moriaki Inoko, Tsukasa Inada, Manabu Shirotani, Mitsuo Matsuda, Takeshi Aoyama, Tomoya Onodera, Satoru Suwa, Teruki Takeda, Katsumi Inoue, Takeshi Kimura
One-month duration of dual antiplatelet therapy (DAPT) has widely been adopted after bare-metal stent (BMS) implantation in the real clinical practice. However, it has not been adequately addressed yet whether DAPT for only 1-month could provide sufficient protection from ischemic events beyond 1-month after BMS implantation. We assessed the effects of short DAPT relative to prolonged DAPT on clinical outcomes with the landmark analysis at 2 month after BMS implantation. Among 13,058 consecutive patients enrolled in the CREDO-Kyoto registry cohort-2, this study population consisted of 4905 patients treated with BMS only in whom the information on the status of antiplatelet therapy was available at 2 month after stent implantation [single-antiplatelet therapy (SAPT) group: N = 2575 (acute myocardial infarction (AMI): N = 1257, and non-AMI: N = 1318), and DAPT group: N = 2330 (AMI: N = 1304, and non-AMI: N = 1026)]...
September 19, 2016: Cardiovascular Intervention and Therapeutics
Yoshimitsu Soga, Kenji Ando
The effect of a scoring balloon has been reported. However, it is difficult to compare the effect of conventional vs. scoring balloons on the same lesion. Therefore, we assessed the scoring effect of the NSE with and without elements. The endpoints of this study were scoring grade in the eccentric agar model and crack incidence in the eccentric plaster model after ballooning. The scoring grade consisted of 5 levels: (1) almost none, (2) only at the surface, (3) cleavage in the depth of less than two-thirds, (4) cleavage in the depth of two-thirds or more, and (5) collapse...
September 14, 2016: Cardiovascular Intervention and Therapeutics
Yu Horiuchi, Mika Izumo, Takayoshi Kusuhara, Motoi Yokozuka, Takeshi Taketani, Kengo Tanabe
This report describes an elderly severe aortic stenosis (AS) patient, who had a history of coronary artery bypass grafting and endovascular repair for an abdominal aortic aneurysm (AAA). Type II endoleak with enlargement of AAA was diagnosed and ligation of inferior mesenteric artery (IMA) was recommended. Because aortic valve replacement (AVR) was high risk, we planned transcatheter aortic valve implantation (TAVI). Considering risks of IMA ligation under dual antiplatelet therapy, increased blood pressure after TAVI, and general anesthesia, we performed combined TAVI and IMA ligation...
September 7, 2016: Cardiovascular Intervention and Therapeutics
Marco Bruno Ancona, Damiano Regazzoli, Antonio Mangieri, Fabrizio Monaco, Michele De Bonis, Azeem Latib
Ventricular septal rupture (VSR) is a complication of myocardial infarction. Surgery is the only treatment; however, mortality is high, especially if it is performed within 7 days from presentation. The improved outcome with delayed intervention could be related to evolution of the infarct, which allows a more effective surgical repair. However, it is also a representation of survival bias, as an early surgery is usually performed on individuals with hemodynamic instability. We present a case of VSR complicated by cardiogenic shock...
September 7, 2016: Cardiovascular Intervention and Therapeutics
Tatsuya Nakama, Hiroshi Ando, Nozomi Watanabe, Kenji Ogata, Tatsuro Takei, Yoshisato Shibata
Patients with critical limbs ischemia received endovascular revascularization for his posterior tibial artery (PTA) to plantar artery long occlusion without proximal stump. Antegrade recanalization seemed impossible, so retrograde access should be considered. However, the conventional retrograde puncture was also not available. Therefore, novel retrograde transplantar access was conducted. The plantar artery was successfully punctured with a 20-G needle. In addition, a guidewire was retrogradely inserted with a sheathless technique...
August 31, 2016: Cardiovascular Intervention and Therapeutics
Shunichi Imamura, Koji Nishida, Kazuya Kawai, Naohisa Hamashige, Hiroaki Kitaoka
A 75-year-old man with a severe calcified atheromatous plaque of the right coronary artery underwent percutaneous coronary intervention using a Rotablator(®). During the procedure, the 1.5-mm burr became entrapped, and the driveshaft fractured. While various techniques for retrieving the burr were attempted, a new technique was created. The entrapped burr was sandwiched between an inflated balloon and the GuideLiner(®), and a strong back-up force was obtained. Finally, the system was pulled back safely, and the entrapped burr was retrieved without complications...
August 31, 2016: Cardiovascular Intervention and Therapeutics
Hiten R Patel, Priyank Shah, Sharad Bajaj, Hartaj Virk, Mahesh Bikkina, Fayez Shamoon
Fractional flow reserve (FFR) is a standardized and well-established method frequently used in clinical practice to evaluate the hemodynamic significance of epicardial coronary stenosis identified by coronary angiography. It is based on the change in the pressure gradient across the stenosis after the achievement of maximal hyperemia of the coronary circulation which is commonly induced by intravenous (IV) or intracoronary (IC) administration of adenosine. Here, we have described three cases of IC adenosine-induced ventricular arrhythmias during FFR measurement from our institution, and after literature review we found that all the cases of ventricular arrhythmias induced by adenosine during FFR measurement were observed where it was administered via IC route...
August 30, 2016: Cardiovascular Intervention and Therapeutics
Taro Nihei, Yoshito Yamamoto, Shun Kudo, Kenichiro Hanawa, Yuhi Hasebe, Yusuke Takagi, Yutaka Minatoya, Masafumi Sugi, Hiroaki Shimokawa
The Rendezvous technique, which requires bidirectional wiring, is one of the useful methods for improving the success rate of recanalization for chronic total occlusion (CTO) in the field of peripheral intervention. Recently, advanced new devices for percutaneous coronary intervention have enabled us to perform the Rendezvous technique for peripheral as well as for coronary CTO lesions. We used the Intracoronary Rendezvous technique to perform angioplasty for coronary CTO. "Intracoronary Rendezvous" means that Rendezvous was achieved within the CTO lesion...
August 30, 2016: Cardiovascular Intervention and Therapeutics
Hashrul N Rashid, Liam M McCormick, Robert P Gooley, Ian T Meredith
A 79-year-old man with stable chronic obstructive pulmonary disease was found to have an abdominal aortic aneurysm and worsening dyspnoea. Echocardiography demonstrated critical aortic stenosis. Simultaneous endovascular aneurysm repair (EVAR) and transcatheter aortic valve replacement (TAVR) was recommended due to high surgical risk. Procedural strategy was to perform balloon valvuloplasty (BAV), followed by EVAR then TAVR. The initial 25 mm Lotus valve adopted a barrel shape suggestive of an undersized valve and was thus replaced with a 27 mm valve...
August 30, 2016: Cardiovascular Intervention and Therapeutics
Takanari Fujita, Naritatsu Saito, Kenji Minakata, Masao Imai, Kazuhiro Yamazaki, Takeshi Kimura
An 82-year-old woman with severe aortic stenosis was referred. She had previously undergone mitral valve replacement. We planned transcatheter aortic valve implantation (TAVI) with transfemoral approach. We planned to use the Safari-dedicated TAVI guidewire. No studies have reported clinical application of the dedicated TAVI guidewire in a patient with the previous mitral valve replacement. Thus, we conducted a simulation using a three-dimensional heart model to confirm the safety of the procedure. The procedure was successful without any complications...
August 27, 2016: Cardiovascular Intervention and Therapeutics
Masayuki Hyogo, Takahisa Sawada, Jun Shiraishi, Yoshio Kohno
A 62-year-old male underwent three percutaneous coronary interventions involving four bare metal stents and six Cypher sirolimus-eluting stents within 1 month. At the latest coronary angiographic examination, all of the Cypher stents, but none of the bare metal stents, exhibited peri-stent contrast staining. Moreover, these findings had progressively worsened over time, especially for lesions where two stents came into contact or stent fracture had occurred. It is rare for Cypher stent implantation to result in progressive peri-stent contrast staining, but patients who are treated with these stents should be carefully followed-up, including for stent thrombosis...
August 24, 2016: Cardiovascular Intervention and Therapeutics
Shigemitsu Tanaka, Yuji Ikari, Takeshi Ijichi, Gaku Nakazawa
A reduction of low-density lipoprotein cholesterol (LDL-C) is important for the secondary prevention of coronary artery disease. We performed secondary prevention in 632 consecutive patients, including 315 with acute coronary syndrome, who underwent percutaneous coronary intervention according to current treat-to-target lipid-lowering guidelines to achieve LDL-C <100 mg/dL. We retrospectively analyzed 2-year all-cause mortality. The average LDL-C level was reduced from 114 ± 36 mg/dL at baseline to 94 ± 25 mg/dL at follow-up; 61 % of patients achieved the guideline target...
August 18, 2016: Cardiovascular Intervention and Therapeutics
Hamid Reza Sanati, Ali Zahedmehr, Ata Firouzi, Melody Farrashi, Kamyar Amin, Mohammad Mehdi Peighambari, Farshad Shakerian, Reza Kiani
Although aspirin and clopidogrel seem to be quite enough during low risk percutaneous coronary intervention (PCI), the combination may need some reinforcement in complex situations such as primary PCI. By modifying the route and also the duration of administration, glycoprotein IIb/IIIa inhibitors might be a viable option. The aim of this study is to compare the benefits and disadvantages of three different methods of administration of eptifibatide in primary PCI population. Primary PCI candidates were randomized in three groups on which three different methods of administration of eptifibitide were tested: intravenous bolus injection followed by 12-h infusion (IV-IV), intracoronary bolus injection followed by intravenous infusion (IC-IV) and, only intracoronary bolus injection (IC)...
August 17, 2016: Cardiovascular Intervention and Therapeutics
Hideki Wada, Manabu Ogita, Katsumi Miyauchi, Shuta Tsuboi, Hirokazu Konishi, Jun Shitara, Mitsuhiro Kunimoto, Taketo Sonoda, Takashi Iso, Hideki Ebina, Eriko Aoki, Kenichi Kitamura, Hiroshi Tamura, Satoru Suwa, Hiroyuki Daida
Acute coronary syndrome (ACS) is an important cause of mortality and morbidity in the general population. Recent advances in percutaneous coronary intervention (PCI) and optimal medical treatment have helped to improve the prognosis of patients with ACS. The previous reports indicated that women with ACS have a higher risk of adverse outcomes. However, sex differences in clinical outcomes with contemporary coronary revascularization and medical therapy for ACS have not been elucidated. We analyzed data from 676 consecutive patients with ACS (female, n = 166; male, n = 510) who were treated by emergency PCI between 2011 and 2014 at Juntendo Shizuoka Hospital...
August 8, 2016: Cardiovascular Intervention and Therapeutics
Takafumi Ueno, Hiroshi Koiwaya, Ken-Ichiro Sasaki, Yoshio Katsuki, Yousuke Katsuda, Yoshinobu Murasato, Junichiro Shimamatsu, Kyoko Umeji, Yoritaka Otsuka, Tomohiro Kawasaki, Yoshisato Shibata, Yoshihiro Fukumoto
Patients with ischemic heart disease are administered a dual antiplatelet therapy after percutaneous coronary intervention. This consists of aspirin and thienopyridine, which can be switched from prasugrel to clopidogrel. However, the impact of switching is unknown. This study aimed to determine the efficacy and safety of switching from prasugrel to clopidogrel in Japanese patients. One-hundred and thirty-six patients with acute coronary syndrome scheduled to undergo percutaneous coronary intervention and patients with coronary artery disease requiring elective coronary stenting were enrolled...
August 3, 2016: Cardiovascular Intervention and Therapeutics
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"