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coronary, bifurcation, Left main

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https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#1
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321023/hybrid-strategy-to-treat-life-threatening-giant-coronary-artery-aneurysm-with-severe-in-stent-restenosis
#2
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
Coronary artery aneurysm following drug-eluting stent implantation is rare in the literature. The presentation combined a life-threatening condition with severe in-stent restenosis. How to treat this condition is a complex problem because a surgical approach for a proximal left circumflex lesion is difficult. A hybrid method that is a combination of coronary bypass surgery and coronary stenting for left main bifurcation in-stent restenosis and proximal coronary artery aneurysm is a feasible strategy.
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#3
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28296050/a-heart-within-a-heart
#4
Edward T Carreras, Maya Barghash, Michael M Givertz, Deepak L Bhatt
A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc...
March 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28269012/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#5
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28259665/identification-of-coronary-artery-side-branch-supplying-myocardial-mass-that-may-benefit-from-revascularization
#6
Hyung Yoon Kim, Joon-Hyung Doh, Hong-Seok Lim, Chang-Wook Nam, Eun-Seok Shin, Bon-Kwon Koo, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung Hyuk Choi, Hyeon-Cheol Gwon, Sang-Hoon Lee, Sung Mok Kim, Yeonhyeon Choe, Jin-Ho Choi
OBJECTIVES: The authors sought to identify whether a coronary side branch (SB) is supplying a myocardial mass that may benefit from revascularization. BACKGROUND: The amount of subtending myocardium and physiological stenosis is frequently different between the main vessel (MV) and SB. METHODS: In this multicenter registry, 482 patients who underwent coronary computed tomography angiography and fractional flow reserve (FFR) measurement were enrolled...
February 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28259663/bioresorbable-everolimus-eluting-vascular-scaffold-for-long-coronary-lesions-a-subanalysis-of-the-international-multicenter-ghost-eu%C3%A2-registry
#7
Salvatore Geraci, Hiroyoshi Kawamoto, Giuseppe Caramanno, Neil Ruparelia, Davide Capodanno, Tommaso Gori, Holger Nef, Julinda Mehilli, Maciej Lesiak, Christoph Naber, Carlo Di Mario, Piera Capranzano, Jens Wiebe, Aleksander Araszkiewicz, Stelios Pyxaras, Alessio Mattesini, Thomas Münzel, Corrado Tamburino, Antonio Colombo, Azeem Latib
OBJECTIVES: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND: The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS: The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm...
February 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28227224/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#8
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Takahiro Tsukahara, Yuya Yamada, Yusuke Fujino, Masahiro Motosuke
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226721/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#9
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#10
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#11
Benedikt Schrage, Michael Schwarzl, Christoph Waldeyer, Peter M Becher, Christoph Sinning, Ulrich Schäfer, Moritz Seiffert, Elvin Zengin-Sahm, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Aorto-ostial lesions as well as bifurcation lesions still provide challenges in percutaneous coronary intervention (PCI), as meticulous stent placement is needed. The Szabo-technique, which uses a second wire to anchor the stent at the osmium, may be helpful here. In this article, we will provide detailed information on the technique including video material as well as procedural and long-term follow-up data of a cohort of patients treated with this technique. METHODS AND RESULTS: A retrospective single-centre study was performed in patients undergoing Szabo-PCI from 2014 to 2016 (n=28)...
January 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28145616/bailout-polytetrafluoroethylene-covered-stent-implantation-for-left-main-bifurcation-perforation-using-the-kissing-stent-technique
#12
Noriaki Moriyama, Yutaka Tanaka, Shigeru Saito
Coronary artery perforation during percutaneous coronary intervention is a rare, but potentially lethal complication. Immediate balloon expansion at the perforation site can halt the bleeding. Implantation of a coronary polytetrafluoroethylene (PTFE)-covered stent enables the efficient endovascular repair of a coronary artery perforation. However, if the perforation occurs at a bifurcation, a PTFE-covered stent may jail the side branch. We report a difficult case of blowout coronary perforation (Ellis type III) at a left main coronary artery bifurcation, which was successfully sealed with a PTFE-covered stent without interference with the side branch coronary artery circulation...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#13
REVIEW
Yohei Numasawa, Kenichi Sakakura, Kei Yamamoto, Shingo Yamamoto, Yousuke Taniguchi, Hideo Fujita, Shin-Ichi Momomura
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28108202/evaluation-of-coronary-flow-conditions-in-complex-coronary-artery-bifurcations-stenting-using-computational-fluid-dynamics-impact-of-final-proximal-optimization-technique-on-different-double-stent-techniques
#14
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Nguyen Van Viet Thang, Nicolas Foin
BACKGROUND/PURPOSE: Computational fluid dynamics (CFD) have been recently adopted in many fields of cardiovascular medicine and in interventional cardiology. Using CFD analysis we compared the use of different PCI procedures, with and without the utilization of a proximal optimization technique (POT), on a complex coronary artery bifurcation. METHODS/MATERIALS: For the analysis, we considered a hypothetic model of a left anterior descending artery-diagonal Medina 1,1,1 bifurcation type with a diameter of the proximal main branch (MB) and the side branch (SB) set at 3...
January 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28100341/-comparison-on-the-long-term-outcomes-post-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-bifurcation-lesions-in-unprotected-left-main-coronary-artery
#15
B G Yang, X P Yu, F Chen, S Z Lyu, Q Li, J Q He, F Yuan
Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28099289/orthogonal-views-of-coronary-vessels-a-method-for-imaging-the-delivery-of-blood-cardioplegia-using-transesophageal-echocardiography
#16
Luiz F Maracaja Neto, Raj Modak, Robert B Schonberger
Coronary blood flow can be disrupted during cardiac interventions such as mitral valve surgeries, left atrial appendage ligation, transcatheter aortic valve implantation, and aortic procedures involving reimplantation of coronary buttons. Although difficult to accomplish, coronary imaging using transesophageal echocardiography can be performed by the use of orthogonal imaging with the ability for real-time tilt for angle adjustment. The technique described herein allows imaging of the right coronary artery, left main coronary artery bifurcation, left anterior descending, and circumflex coronary arteries...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28065691/difference-in-vascular-response-between-sirolimus-eluting-and-everolimus-eluting-stents-in-ostial-left-circumflex-artery-after-unprotected-left-main-as-observed-by-optical-coherence-tomography
#17
Yusuke Fujino, Guilherme F Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Kentaro Tanaka, Takahiro Matsumoto, Hiroyoshi Kawamoto, Yuya Yamada, Shinnosuke Amano, Yusuke Watanabe, Takayuki Warisawa, Tomohiko Sato, Satoru Mitomo, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Takahiro Tsukahara, Masahiro Motosuke, Hiram G Bezerra, Shotaro Nakamura, Sunao Nakamura
BACKGROUND: Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT)...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28028693/a-study-of-coronary-bifurcation-shape-in-a-normal-population
#18
Pau Medrano-Gracia, John Ormiston, Mark Webster, Susann Beier, Chris Ellis, Chunliang Wang, Örjan Smedby, Alistair Young, Brett Cowan
During percutaneous coronary intervention, stents are placed in narrowings of the arteries to restore normal blood flow. Despite improvements in stent design, deployment techniques and drug-eluting coatings, restenosis and stent thrombosis remain a significant problem. Population stent design based on statistical shape analysis may improve clinical outcomes. Computed tomographic (CT) coronary angiography scans from 211 patients with a zero calcium score, no stenoses and no intermediate artery, were used to create statistical shape models of 446 major coronary artery bifurcations (left main, first diagonal and obtuse marginal and right coronary crux)...
February 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28012553/comparison-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#19
REVIEW
Syed Yaseen Naqvi, Jordan Klein, Tisa Saha, Daniel J McCormick, Sheldon Goldberg
Coronary artery bypass grafting (CABG) decreases mortality in patients with significant left main (LM) coronary artery disease and for years remained the therapy of choice for patients with this ominous lesion. Advances in percutaneous coronary intervention (PCI) have enabled it to become an alternative to CABG. The results of observational registries and randomized comparisons have shown the safety and efficacy of PCI in appropriately selected patients with low or intermediate angiographic risk scores. Furthermore, the use of physiological measures of flow limitation and the use of intracoronary imaging techniques has added benefit and improved outcomes...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27969747/tct-396-performance-of-drug-coated-balloons-on-in-stent-restenosis-after-two-stent-implantation-for-left-main-coronary-artery-bifurcation-lesions
#20
Akimune Kuwayama, Kazushige Kadota, Katsuya Miura, Masanobu Ohya, Takenobu Shimada, Hidewo Amano, Shunsuke Kubo, Yusuke Hyodo, Suguru Otsuru, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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