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coronary bifurcation

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https://www.readbyqxmd.com/read/28228303/impact-of-very-high-pressure-stent-deployment-on-angiographic-and-long-term-clinical-outcomes-in-true-coronary-bifurcation-lesions-treated-by-the-mini-crush-stent-technique-a-single-center-experience
#1
Antoine Gerbay, Jeremy Terreaux, Alexis Cerisier, Marco Vola, Karl Isaaz
BACKGROUND: Percutaneous coronary intervention (PCI) for bifurcation lesions (BL) using 2 stents technique is known to be associated with high rates of procedural failure especially on the side branch (SB) mainly due to stent incomplete apposition. Stent deployment at very high pressure (SDHP) may lead to better stent expansion and apposition. However, SDHP may also be at the origin of deeper wall injury resulting into major cardiac adverse events. No data are available on evaluation of SDHP in BL treated by a mini-crush stent technique...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28227430/a-method-for-coronary-bifurcation-centerline-reconstruction-from-angiographic-images-based-on-focalization-optimization
#2
E Montin, S Migliori, C Chiastra, C Credi, R Fedele, C Aurigemma, M Levi, F Burzotta, F Migliavacca, L T Mainardi, E Montin, S Migliori, C Chiastra, C Credi, R Fedele, C Aurigemma, M Levi, F Burzotta, F Migliavacca, L T Mainardi, L T Mainardi, C Chiastra, E Montin, S Migliori, F Burzotta, C Credi, R Fedele, M Levi, C Aurigemma, F Migliavacca
A method for the reconstruction of a vessel centerline from angiographic images is outlined in this work. A typical coronary artery segment with bifurcations was emulated with a 3D printed static phantom and several angiograms were acquired at various angular positions on the C-Arm. The effectiveness of the reconstruction turned out to be largely influenced by the intrinsic parameters of the angiographic system, particularly the homogeneous coordinates system scaling factor λ. Therefore, recourse was made to a heuristic optimization method to estimate the optimal value of λ for each view...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227224/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#3
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
#4
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
#5
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/28209184/arterial-access-site-complications-after-use-of-a-vascular-closure-device-related-to-puncture-height
#6
Benjamin Sartorius, Michael Behnes, Melike Ünsal, Ursula Hoffmann, Siegfried Lang, Kambis Mashayekhi, Martin Borggrefe, Ibrahim Akin
BACKGROUND: To analyze differences of access-site complications related to the height of femoral arterial puncture and the use of a vascular closure device (VCD) following percutaneous coronary intervention (PCI). METHODS: A subgroup of the FERARI study being treated by femoral arterial access and valuable inguinal angiography before implantation of a VCD were included. Inguinal angiographies were systematically reviewed by two independent cardiologists to determine the correct height of femoral arterial puncture...
February 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28205195/is-it-possible-to-further-improve-clinical-results-with-coronary-bifurcation-stenting-or-what-is-more-important-the-technique-or-the-stent
#7
Dobrin Vassilev, Liubomir Dosev, Robert J Gil
No abstract text is available yet for this article.
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28196817/comparison-of-carotid-plaque-score-and-coronary-artery-calcium-score-for-predicting-cardiovascular-disease-events-the-multi-ethnic-study-of-atherosclerosis
#8
Adam D Gepner, Rebekah Young, Joseph A Delaney, Matthew J Budoff, Joseph F Polak, Michael J Blaha, Wendy S Post, Erin D Michos, Joel Kaufman, James H Stein
BACKGROUND: Coronary artery calcium (CAC) predicts coronary heart disease (CHD) events better than carotid wall plaque presence; however, differences in the utility of CAC burden and carotid plaque burden across the spectrum of cardiovascular disease (CVD) events is unknown. METHODS AND RESULTS: CVD, CHD and stroke/transient ischemic attack (TIA) events were evaluated prospectively in a multiethnic cohort without CVD at baseline. Carotid plaque score was determined by the number of ultrasound-detected plaques in the common, bifurcation, and internal carotid artery segments...
February 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28191876/clinical-and-angiographic-predictors-of-hemodynamically-significant-angiographic-lesions-development-and-validation-of-a-risk-score-to-predict-positive-fractional-flow-reserve
#9
Nishtha Sareen, Usman Baber, Safwan Kezbor, Sonny Sayseng, Melissa Aquino, Roxana Mehran, Joseph Sweeny, Nitin Barman, Annapoorna Kini, Samin K Sharma
AIMS: Coronary revascularization based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting hemodynamic stenosis severity by Fractional Flow reserve (FFR) and therefore cannot be used to guide revascularization, particularly in the lesion subset (<70%). Accordingly, we sought to identify independent determinants of angiographic intermediate lesions with hemodynamic significance. METHODS AND RESULTS: We assessed consecutive intermediate lesions for patients from January 2014-April 2015 at our institution...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28191726/risk-stratification-of-periprocedural-myocardial-infarction-after-percutaneous-coronary-intervention-analysis-based-on-the-scai-definition
#10
Dong Zhang, Yiping Li, Dong Yin, Yuan He, Changzhe Chen, Chenxi Song, Ruohua Yan, Chen'gang Zhu, Bo Xu, Kefei Dou
OBJECTIVES: To investigate the predictors of and generate a risk prediction method for periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI) using the new PMI definition proposed by the Society for Cardiovascular Angiography and Interventions (SCAI). BACKGROUND: The SCAI-defined PMI was found to be associated with worse prognosis than the PMI diagnosed by other definitions. However, few large-sample studies have attempted to predict the risk of SCAI-defined PMI...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28176183/improving-the-visual-field-in-coronary-artery-by-with-non-obstructive-angioscopy-dual-infusion-method
#11
Sei Komatsu, Tomoki Ohara, Satoru Takahashi, Mitsuhiko Takewa, Chikao Yutani, Kazuhisa Kodama
Non-obstructive angioscopy (NOA) is used to visualize the surface of the coronary artery, and a clear visual field is obtained by injecting transparent fluid into the gap between the probing catheter and the fiber. This study examines visual field expansion by a dual infusion method, which involves an infusion from the probing and guiding catheters, and the relationships between visual grade and vessel characteristics. Thirty-two patients and thirty patients performed coronary plaque analysis with NOA using the conventional method and the novel dual infusion method, respectively...
February 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#12
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#13
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
#14
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/28122805/clinical-outcome-of-double-kissing-crush-versus-provisional-stenting-of-coronary-artery-bifurcation-lesions-the-5-year-follow-up-results-from-a-randomized-and-multicenter-dkcrush-ii-study-randomized-study-on-double-kissing-crush-technique-versus-provisional
#15
Shao-Liang Chen, Teguh Santoso, Jun-Jie Zhang, Fei Ye, Ya-Wei Xu, Qiang Fu, Jing Kan, Feng-Fu Zhang, Yong Zhou, Du-Jiang Xie, Tak W Kwan
BACKGROUND: Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). METHODS AND RESULTS: A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#16
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/28117242/computed-tomography-angiography-versus-angiography-for-guiding-percutaneous-coronary-interventions-in-bifurcation-lesions-a-prospective-randomized-pilot-study
#17
Rafal Wolny, Jerzy Pregowski, Mariusz Kruk, Cezary Kepka, Gary S Mintz, Gabor G Toth, Artur Debski, Michal Ciszewski, Krzysztof Kukula, Maksymilian P Opolski, Zbigniew Chmielak, Adam Witkowski
BACKGROUND: There is no data on the impact of coronary computed tomography angiography (coronary CTA), as an addition to angiography, on the outcomes of percutaneous coronary interventions (PCI) in bifurcation lesions. METHODS: Patients with stable coronary artery disease scheduled for elective bifurcation PCI were randomized 1:1 to planning the procedure based on coronary CTA and angiography (CTA group) or angiography alone (CA group). The primary efficacy endpoint was the immediate angiographic result...
January 17, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28116778/percutaneous-coronary-intervention-of-complex-calcified-lesions-with-drug-coated-balloon-after-rotational-atherectomy
#18
Tuomas T Rissanen, Sanna Uskela, Antti Siljander, Jussi M Kärkkäinen, Pirjo Mäntylä, Juha Mustonen, Jaakko Eränen
OBJECTIVES: We investigated the safety and efficacy of PCI using drug-coated balloon (DCB) after rotational atherectomy (rotablation) in a retrospective single center study in patients with calcified de novo coronary lesions. The majority of patients had an increased risk for bleeding. BACKGROUND: DCB has been effective in the treatment of in-stent restenosis, small vessels, and bifurcations. DCB enables short one month dual antiplatelet treatment. No published data exist on the use of DCB after rotablation...
January 23, 2017: Journal of Interventional Cardiology
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
#19
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/28105600/approach-to-cto-intervention-overview-of-techniques
#20
REVIEW
Aris Karatasakis, Barbara Anna Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Minh Vo, Mauro Carlino, Mitul P Patel, Stéphane Rinfret, Emmanouil S Brilakis
Successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has been associated with significant clinical benefits, but remains technically demanding. Failure to cross the CTO with a guidewire is the most common cause of CTO PCI failure. CTO crossing can be achieved in the antegrade or retrograde direction and can be accomplished by maintaining true lumen position throughout or via subintimal dissection/reentry techniques. A procedural plan should be created prior to the procedure through careful angiographic review of four key parameters: (a) morphology of the proximal occlusion cap; (b) length of the occlusion; (c) quality of the distal vessel and presence of bifurcation at the distal cap; and (d) suitability of collateral circulation for retrograde crossing...
January 2017: Current Treatment Options in Cardiovascular Medicine
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