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coronary, bifurcation, Left main

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https://www.readbyqxmd.com/read/29786539/percutaneous-coronary-intervention-in-left-main-coronary-artery-disease-the-13th-consensus-document-from-the-european-bifurcation-club
#1
Francesco Burzotta, Jens Flensted Lassen, Adrian P Banning, Thierry Lefèvre, David Hildick-Smith, Alaide Chieffo, Olivier Darremont, Manuel Pan, Yiannis S Chatzizisis, Remo Albiero, Yves Louvard, Goran Stankovic
The 2017 European Bifurcation Club (EBC) meeting was held in Porto (Portugal) and allowed a multidisciplinary international faculty to review and discuss the latest data collected in the field of coronary bifurcation interventions. In particular, the topic of percutaneous coronary intervention (PCI) on left main coronary artery (LM) disease was highlighted as a contemporary priority. Herein, we summarise the key LM anatomy features, the diagnostic modalities and available data that are relevant for a patient's procedural management...
May 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#2
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#3
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29706477/usefulness-of-the-finet-law-to-guide-stent-size-selection-in-ostial-left-main-stenting-comparison-with-standard-angiographic-estimation
#4
Gianluca Rigatelli, Marco Zuin, Federico Ronco, Francesco Caprioglio, Daniele Cavazzini, Sara Giatti, Gabriele Braggion, Stefano Perilli, Van Tan Nguyen
BACKGROUNDS: Intravascular ultrasound has been suggested to optimize stent diameter and length in Left Main (LM) procedures, but in the real-world ostial LM stenting is often accomplished with angiography only guidance. The Finet law which regulates the fractal geometry of human bifurcation has the potential to increase the accuracy of stent-sizing. To retrospectively evaluating the impact on outcomes of the addition of Finet Law to standard quantitative coronary angiography (QCA) in guiding stent selection of ostial LM stenting compared to standard angiography estimation...
April 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29693768/simultaneous-kissing-stents-to-treat-unprotected-left-main-stem-coronary-artery-bifurcation-disease-stent-expansion-vessel-injury-hemodynamics-tissue-healing-restenosis-and-repeat-revascularization
#5
Paul D Morris, Javaid Iqbal, Claudio Chiastra, Wei Wu, Francesco Migliavacca, Julian P Gunn
OBJECTIVES: To perform detailed analysis of stent expansion, vessel wall stress, hemodynamics, re-endothelialization, restenosis, and repeat PCI in the simultaneous kissing stents (SKS) technique of bifurcation left main stem (LMS) stenting. BACKGROUND: The SKS technique is useful to treat patients with true bifurcation disease of the LMS but remains controversial. METHODS AND RESULTS: Computational structural analysis of SKS expansion demonstrated undistorted and evenly expanded stents...
April 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29688182/intravascular-ultrasound-in-the-evaluation-and-treatment-of-left-main-coronary-artery-disease-a-consensus-statement-from-the-european-bifurcation-club-ebc
#6
Gary S Mintz, Thierry Lefèvre, Jens Lassen, Luca Testa, Manuel Pan, Jag Singh, Goran Stankovic, Adrian P Banning
No abstract text is available yet for this article.
April 24, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29667231/feasibility-and-clinical-outcomes-of-rotational-atherectomy-for-heavily-calcified-side-branches-of-complex-coronary-bifurcation-lesions-in-the-real-world-practice-of-the-drug-eluting-stent-era
#7
Yu-Wei Chen, Chieh-Shou Su, Wei-Chun Chang, Tsun-Jui Liu, Kae-Woei Liang, Chih-Hung Lai, Hong-Xu Liu, Wen-Lieng Lee
OBJECTIVES: To evaluate the outcomes of rotational atherectomy for heavily-calcified side branches of coronary bifurcation lesions. BACKGROUND: Side-branch (SB) preservation is clinically important but technically challenging in heavily-calcified non-left main true bifurcation lesions. SB rotational atherectomy (SB RA) is sometimes mandatory but the clinical outcomes are not well studied. METHODS: We retrospectively studied the outcomes of patients who underwent RA at our institute for heavily calcified, balloon-uncrossable or-undilatable SB lesions over an approximately 5-year period (January 2011 to September 2016)...
April 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29661597/clinical-performance-of-a-dedicated-self-apposing-stent-for-the-treatment-of-left-main-stem-disease-results-of-the-left-main-angioplasty-with-a-self-apposing-stent-the-matisse-study
#8
Bernardo Cortese, Antonio Montefusco, Fabrizio D'Ascenzo, Alessio La Manna, Giuseppe Andò, Teodoro Bisceglia, Gioel G Secco, Markus Meyer-Gessner, Wanha Wojciech, Paolo Sganzerla, Massimo Napodano, Gaetano Di Palma, Roberto A Latini, Corrado Tamburino, Pedro Silva Orrego, Andreas Baumbach
BACKGROUND: In the recent years percutaneous treatment of the left main stem (LM) has gained a precise role as a result of consistent scientific evidence vs. coronary artery bypass. A self-apposing stent offers an improved adaptation to the vessel wall, especially in case of tapered vessels; aim of this study was to investigate the role of a novel self-apposing, sirolimus-eluting stent (Stentys, France) for the treatment of LM coronary artery disease. METHODS AND RESULTS: MATISSE is a retrospective, multicenter registry, which enrolled 151 patients treated with the device at 17 international centers...
April 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#9
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29589515/rheolytic-effects-of-left-main-mid-shaft-distal-stenting-a-computational-flow-dynamic-analysis
#10
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Thach Nguyen
Background The aim of this study was to evaluate the rheolytic effects of stenting a mid-shaft/distal left main coronary artery (LMCA) lesion with and without ostial coverage. Stenting of the LMCA has emerged as a valid alternative in place of traditional coronary bypass graft surgery. However, in case of mid-shaft/distal lesion, there is no consensus regarding the extension of the strut coverage up to the ostium or to stent only the culprit lesion. Methods We reconstructed a left main-left descending coronary artery (LM-LCA)-left circumflex (LCX) bifurcation after analysing 100 consecutive patients (mean age 71...
March 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29563393/accelerated-atherogenicity-in-tangier-disease
#11
Jun Muratsu, Masahiro Koseki, Daisaku Masuda, Yuji Yasuga, Satoki Tomoyama, Keiji Ataka, Yoshiki Yagi, Atsushi Nakagawa, Hidehumi Hamada, Shigeki Fujita, Hiroaki Hattori, Tohru Ohama, Makoto Nishida, Hisatoyo Hiraoka, Yuji Matsuzawa, Shizuya Yamashita
We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout childhood. At 46 years old, he experienced effort angina, and coronary angiography demonstrated 75% stenosis in the right coronary artery. Orange-colored tonsils, mild hepatosplenomegaly and very low levels of serum high-density lipoprotein cholesterol (HDL-C) were observed, and the patient was diagnosed with Tangier disease. At 52 years old, effort angina recurred...
March 20, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29553940/benefit-of-a-new-provisional-stenting-strategy-the-re-proximal-optimizing-technique-the-repot-clinical-study
#12
François Dérimay, Gérard Finet, Geraud Souteyrand, Luc Maillard, Adel Aminian, Benoit Lattuca, Guillaume Cayla, Guillaume Cellier, Pascal Motreff, Gilles Rioufol
AIMS: A new coronary bifurcation provisional stenting technique without kissing balloon, rePOT, associating proximal optimizing technique (POT), side-branch inflation and final POT, showed excellent mechanical results in a bench test. The present study sought to use optical coherence tomography (OCT) to quantify the mechanical results of rePOT in vivo in a large patient sample with complex coronary bifurcations. METHODS AND RESULTS: 106 patients with coronary bifurcations were included in a multicenter prospective registry (left main, 40...
March 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29509261/a-volumetric-intracoronary-ultrasonographic-study-of-coronary-bifurcation-lesions
#13
Q-H Li, Q Zhang, X-L Li, J-F Yin, H-G Ji
OBJECTIVE: To evaluate the plaque distribution and composition pattern in the left main coronary artery (LMCA) disease using intracoronary ultrasound. PATIENTS AND METHODS: Intravascular ultrasound data of 50 patients from the January 2010 to December 2015 with significant LMCA bifurcation lesions, with angiographic diameter stenosis >50%, and requiring revascularization, were evaluated. Plaque burden and percentage of necrotic core (% NC) at the minimal lumen area site and maximal % NC site were measured in different segments...
February 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29475531/associations-between-complex-pci-and-prasugrel-or-clopidogrel-use-in-patients-with-acute-coronary-syndrome-who-undergo-pci-from-the-prometheus-study
#14
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Annapoorna S Kini, Sunil Rao, William Weintraub, Timothy D Henry, Serdar Farhan, Birgit Vogel, Sabato Sorrentino, Zhen Ge, Samir Kapadia, Joseph B Muhlestein, Sandra Weiss, Craig Strauss, Catalin Toma, Anthony DeFranco, Mark B Effron, Stuart Keller, Brian A Baker, Stuart Pocock, George Dangas, Roxana Mehran
BACKGROUND: Potent P2Y12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. METHODS: PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29368394/complex-coronary-bifurcation-treatment-by-a-novel-stenting-technique-bench-test-fluid-dynamic-study-and-clinical-outcomes
#15
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Minh Trí Nhân Nguyễn, Nicolas Foin
OBJECTIVES: We assess the mid-term outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (Nano-Crush) technique in large complex coronary bifurcation. BACKGROUND: Complex bifurcations have been suggested to be better approached by a planned double stent technique. METHODS: Two hundred and five consecutive patients (107 males and 98 females) referred for large complex coronary bifurcation percutaneous coronary interventions were enrolled...
January 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29358042/determinants-of-high-device-cost-in-current-percutaneous-coronary-interventions
#16
Keisuke Hirai, Kenichi Sakakura, Yusuke Watanabe, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
BACKGROUND: Percutaneous coronary interventions (PCI), especially medical devices, consume large amounts of medical resources. It is important to know which type of lesions requires high device costs among current PCI. The purpose of this study was to investigate the association between lesion characteristics and medical device costs in current PCI. METHODS: We identified 593 coronary artery lesions in our PCI database between January 1, 2015 and December 31, 2015...
December 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29336945/current-treatment-of-significant-left-main-coronary-artery-disease-a-review
#17
REVIEW
Mariama Akodad, Marie-Claude Morice
Though infrequent, left main stenosis has a major prognostic impact. The management of left main disease has evolved over the last few decades with the growing evidence of the efficacy and safety of percutaneous interventions, as attested by the most recent trials. However, mastery of the technical aspects of left main bifurcation stenting is essential in ensuring optimal results. This review focuses on recent data concerning left main angioplasty results as well as the current technical approaches.
January 5, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29331437/influence-of-operator-experience-and-pci-volume-on-transfemoral-access-techniques-a-collaboration-of-international-cardiovascular-societies
#18
Daniel W Nelson, Abdulla A Damluji, Nish Patel, Marco Valgimigli, Stephan Windecker, Robert Byrne, James Nolan, Tejas Patel, Emmanouil Brilakis, Subhash Banerjee, Jorge Mayol, Warren J Cantor, Carlos E Alfonso, Sunil V Rao, Mauro Moscucci, Mauricio G Cohen
INTRODUCTION: Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. METHODS: A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. RESULTS: A total of 988 physicians from 88 countries responded to the survey...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29311287/comparison-of-a-simple-angiographic-approach-with-a-synergy-between-percutaneous-coronary-intervention-with-taxus-and-cardiac-surgery-score-based-approach-for-left-main-coronary-artery-stenting-a-pooled-analysis-of-serial-precombat-premier-of-randomized-comparison
#19
Pil Hyung Lee, Jong-Young Lee, Cheol Whan Lee, Seon-Ok Kim, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The applicability of Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores to left main coronary artery disease (CAD) has been questioned. A simplified alternative is needed for guiding decision making. METHODS AND RESULTS: We evaluated the prognostic value of a simplified angiographic classification in comparison with a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score-based approach for patients with left main CAD undergoing drug-eluting stent implantation...
January 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29306470/sex-differences-in-left-main-coronary-artery-stenting-different-characteristics-but-similar-outcomes-for-women-compared-with-men
#20
Eun-Seok Shin, Cheol Whan Lee, Jung-Min Ahn, Pil Hyung Lee, Mineok Chang, Min-Ju Kim, Sung-Han Yoon, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The clinical outcomes for women compared with men undergoing left main PCI were sparse. We compared the characteristics and long-term outcomes in women versus men after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main CAD. METHODS: We identified 2328 patients (545 women; 1783 men) with unprotected left main CAD who received PCI with DES between January 2007 and December 2013 in the Interventional Cardiology Research In-cooperation Society-left MAIN revascularization (IRIS-MAIN) registry...
February 15, 2018: International Journal of Cardiology
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