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coronary bifurcation

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https://www.readbyqxmd.com/read/28541601/the-approach-to-coronary-bifurcation-treatment-and-its-outcomes-in-poland-the-single-center-experience
#1
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Rakesh Jalali, Jerzy Górny, Jacek Bil
BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland. METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®)...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28516090/lower-aorto-iliac-bifurcation-position-and-incident-cardiovascular-disease-a-multi-ethnic-study-of-atherosclerosis-mesa
#2
Nketi I Forbang, Matthew A Allison, Michael H Criqui
BACKGROUND: With increasing age, a downward shift of the aorto-iliac bifurcation relative to the lumbar spine occurs. A lower bifurcation position is an independent marker for adverse vascular aging and is associated with increased burden of cardiovascular disease (CVD) risk factors; however, the associations between lower bifurcation position and CVD events remain unknown. METHODS: Abdominal computed tomography scans were used to measure the aorto-iliac bifurcation distance (AIBD, distance from the aorto-iliac bifurcation to the L5/S1 disc space)...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28515858/three-dimensional-optical-coherence-tomography-reconstruction-of-bifurcation-stenting-using-the-szabo-anchor-wire-technique
#3
Katherine Yu, Harkawal Hundal, Todd Zynda, Arnold Seto
Ostial lesions present unique challenges for percutaneous coronary intervention (PCI). These lesions are often more calcified, fibrotic, rigid, and more prone to elastic recoil. Intervention on these lesions is associated with higher procedural complications and higher rates of restenosis. Ostial lesions require precise stent placement in the ostium with the absence of side branch compromise. Accurate stent placement in the ostium without side branch compromise is difficult to accomplish with angiography alone...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28511718/simultaneous-development-of-kawasaki-disease-following-acute-human-adenovirus-infection-in-monozygotic-twins-a-case-report
#4
Sayaka Fukuda, Shuichi Ito, Maya Fujiwara, Jun Abe, Nozomu Hanaoka, Tsuguto Fujimoto, Hiroshi Katsumori
BACKGROUND: The etiology of Kawasaki disease (KD) remains unknown. However, many studies have suggested that specific genetic factors and/or some infectious agents underlie the onset of KD. Previous studies have suggested that human adenovirus (HAdV) is one of the triggering pathogens of KD. Here, we report monozygotic twin boys who sequentially developed KD in conjunction with acute HAdV type 3 (HAdV-3) infection. CASE PRESENTATION: The patients were four-year-old monozygotic twin boys...
May 16, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28508393/reversed-single-string-technique-for-coronary-bifurcation-stenting-first-report-of-case-demonstrations-in-vitro
#5
Julien Adjedj, Gabor G Toth, Mariano Pellicano, William Wijns
OBJECTIVES: This work reports the concept and the practical feasibility of Reversed Single String bifurcation stenting technique by demonstrating three in vitro cases. BACKGROUND: Provisional T stenting is the most used interventional technique to treat coronary bifurcation lesions. However, after main branch (MB) stenting, treatment of the side branch (SB) may become indicated to provide a good final result. Currently applied methods all have their structural limitations with respect to wall coverage, multiple strut layers, poor apposition rate...
May 16, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28500478/effect-of-stenosis-eccentricity-on-the-functionality-of-coronary-bifurcation-lesions-a-numerical-study
#6
Catherine Pagiatakis, Jean-Claude Tardif, Philippe L L'Allier, Rosaire Mongrain
Interventional cardiologists still rely heavily on angiography for the evaluation of coronary lesion severity, despite its poor correlation with the presence of ischemia. In order to improve the accuracy of the current diagnostic procedures, an understanding of the relative influence of geometric characteristics on the induction of ischemia is required. This idea is especially important for coronary bifurcation lesions (CBLs), whose treatment is complex and is associated with high rates of peri- and post-procedural clinical events...
May 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28496086/-surgical-treatment-of-left-main-trunk-coronary-artery-aneurysm-with-asymptomatic-myocardial-ischemia-report-of-a-case
#7
Satoshi Okugi, Hiroyuki Saito, Etsuji Umeda, Yoji Takiguchi
Coronary artery aneurysm is rare, and there is no established protocol for surgical indication. On preoperative examination of orthopedic surgery, a 76-year-old male was found with asymptomatic myocardial ischemia. Radiological examinations revealed triple vessel disease and a coronary artery aneurysm, 10 mm in size, at the bifurcation of the left main trunk. Combined with quintuple coronary artery bypass grafting, surgical repair of the aneurysm was peformed under cardiopulmonary bypass on beating heart. Epicardial echocardiography was used to detect the site and the blood flow on the aneurysm...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28485275/influence-of-platform-design-of-six-different-drug-eluting-stents-in-provisional-coronary-bifurcation-stenting-by-repot-sequence-a-comparative-bench-analysis
#8
Francois Derimay, Geraud Souteyrand, Pascal Motreff, Gilles Rioufol, Gerard Finet
AIMS: The rePOT (proximal optimizing technique) sequence proved significantly more effective than final kissing balloon (FKB) with two drug-eluting stents (DES) in a bench test. We sought to experimentally validate efficacy in a large range of latest-generation DESs. METHODS AND RESULTS: On left main fractal coronary bifurcation bench models, 5 samples of each of the 6 main latest-generation DESs (Coroflex Isar™, Orsiro™, Promus Premier™, Resolute Integrity™, Ultimaster™, Xience Xpedition™) were implanted on rePOT (initial POT, side-branch inflation, final POT)...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28473705/comparison-of-the-left-main-coronary-bifurcating-angle-among-patients-with-normal-non-significantly-and-significantly-stenosed-left-coronary-arteries
#9
Yu-Hsiang Juan, Pei-Kwei Tsay, Wei-Chih Shen, Chih-Seng Yeh, Ming-Shien Wen, Yung-Liang Wan
We evaluated the correlation of the left main coronary bifurcating angle (LCBA) with the severity of coronary atherosclerosis, risk factors of coronary artery disease (CAD) and the feasibility of measuring the LBCA using the axial plane. Coronary Computed tomography angiographies (CTAs) of 313 patients between Nov. 2006 and Oct. 2013 were reviewed and separated into three groups. Group I (211 patients) had significant stenosis (≥50%) of the left anterior descending coronary artery (LAD) and/or left circumflex coronary artery (LCX)...
May 4, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#10
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28464724/abluminal-coated-drug-eluting-bifurcation-dedicated-stent-for-the-treatment-of-tibioperoneal-bifurcation
#11
Tullio Niglio, Plinio Cirillo, Giuseppe Giugliano, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
Endovascular treatment of below-the-knee region disease is often challenging because of the involvement of arterial bifurcations. Several cases have been reported on the use of coronary stents for the treatment of these patients, but limited evidence is available on the use of dedicated coronary bifurcation devices. We here report the endovascular treatment of a symptomatic bifurcation lesion in below-the-knee region, using a self-expanding Biolimus A9-eluting stent in combination with a "conventional" coronary drug-eluting stent...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28462902/two-stent-techniques-for-coronary-bifurcation-lesions-main-vessel-first-versus-side-branch-first-results-from-the-cobis-coronary-bifurcation-stenting-ii-registry
#12
Taek Kyu Park, Young Bin Song, Jeong Hoon Yang, Joo Myung Lee, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Ju Hyeon Oh, Cheol Woong Yu, Jin-Ok Jeong, Hyeon-Cheol Gwon
AIMS: It has not been known which 2-stent technique is best for treating bifurcation lesions. We compared the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring 2-stent approach. METHODS AND RESULTS: A total of 673 patients with bifurcation lesions were treated with 2- stent techniques-MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularization (TLR) was similar in the 2 groups (SB first versus MV first, 15...
May 2, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28462716/treatment-of-bifurcation-lesions-by-bail-out-tap-or-culotte-lost-in-translation
#13
Francesco Burzotta, Thierry Lefèvre, Jens Flensted Lassen, Niels Ramsing Holm, Goran Stankovic
BACKGROUND: Coronary bifurcated lesions (CBL) represent a hot topic of interventional cardiology. Provisional stenting, i.e. implantation of a drug-eluting (DES) in the main branch followed by side-branch (SB) intervention in case of suboptimal SB result, represents the gold standard to treat the vast majority of CBL undergoing percutaneous coronary interventions (PCI). The best technique for bail-out SB stenting has not been established. Prospective randomized trials comparing different stenting techniques may help provide important insights regarding the best way to conduct PCI in patients with CBL...
April 26, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28457603/healthy-and-diseased-coronary-bifurcation-geometries-influence-near-wall-and-intravascular-flow-a-computational-exploration-of-the-hemodynamic-risk
#14
Claudio Chiastra, Diego Gallo, Paola Tasso, Francesco Iannaccone, Francesco Migliavacca, Jolanda J Wentzel, Umberto Morbiducci
Local hemodynamics has been identified as one main determinant in the onset and progression of atherosclerotic lesions at coronary bifurcations. Starting from the observation that atherosensitive hemodynamic conditions in arterial bifurcation are majorly determined by the underlying anatomy, the aim of the present study is to investigate how peculiar coronary bifurcation anatomical features influence near-wall and intravascular flow patterns. Different bifurcation angles and cardiac curvatures were varied in population-based, idealized models of both stenosed and unstenosed bifurcations, representing the left anterior descending (LAD) coronary artery with its diagonal branch...
April 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28450550/biomechanical-impact-of-provisional-stenting-and-balloon-dilatation-on-coronary-bifurcation-clinical-implications
#15
Henry Y Chen, Khalid Al-Saadon, Yves Louvard, Ghassan S Kassab
BACKGROUND: In-stent restenosis (ISR) and stent thrombosis remain clinically significant problems for bifurcations. Although the role of wall shear stress (WSS) has been well investigated, the role of circumferential wall stresses (CWS) has not been well studied in provisional stenting with and without final kissing balloon (FKB). METHODS: We hypothesized that the perturbation of CWS at the SB in provisional stenting and balloon dilatation is an important factor in addition to WSS, and hence may affect restenosis rates (i...
April 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28449503/re-crossing-the-distal-cell-in-bifurcation-verified-by-using-an-enhanced-stent-visualization-system-and-optical-coherence-tomography-a-report-of-two-cases
#16
Ruofei Jia, Zening Jin, Hong Li, Jing Han
The coronary guidewire re-crossing position before the final kissing balloon post-dilation is important to reduce the incidence of incomplete stent apposition in bifurcation lesions. Angiography and intravascular ultrasonography are unreliable at detecting the site of wire re-crossing. The high resolution of optical coherence tomography (OCT) offers the advantage of precise assessment of construction in bifurcation. However, the OCT technique still has some limitations, including the requirement for additional contrast and expense...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445003/a-multiscale-approach-for-determining-the-morphology-of-endothelial-cells-at-a-coronary-artery
#17
Hossein Ali Pakravan, Mohammad Said Saidi, Bahar Firoozabadi
The morphology of endothelial cells (ECs) may be an indication for determining the atheroprone sites. Until now, there is not any clinical imaging technique to visualize the morphology of ECs at the arteries. The present study, introduces a computational technique for determining the morphology of ECs. This technique is a multiscale simulation, consisting the artery-scale and the cell-scale. The artery-scale is a FSI simulation. The input for the artery-scale is the geometry of the coronary artery (CA), dynamic curvature of the artery due to the cardiac motion, blood flow, blood pressure, heart rate, and the mechanical properties of the blood and the arterial wall, which these quantities can be obtained for a specific patient...
April 26, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28423237/assessment-of-vascular-response-to-bioss-lim-c-%C3%A2-stents-vs-orsiro-%C3%A2-stents-in-the-porcine-coronary-artery-model
#18
Jacek Bil, Robert J Gil, Tomasz Pawlowski, Krzysztof P Milewski
AIMS: The optimal treatment strategy for coronary bifurcation lesions is still unknown. The aim of the study was to assess applicability of the new cobalt-chromium version of the sirolimus-eluting dedicated bifurcation BiOSS(®) LIM C stent in comparison with regular sirolimus-eluting Orsiro(®)  stent in a porcine coronary model. METHODS: A total of 13 BiOSS(®) LIM C stents and 6 Orsiro(®) stents were implanted in normal non-atherosclerotic porcine straight coronary arteries of six animals using 1...
April 19, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#19
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28401352/randomized-comparison-between-provisional-and-routine-kissing-balloon-technique-after-main-vessel-crossover-stenting-for-coronary-bifurcation-lesions
#20
Masahiro Yamawaki, Masaki Fujita, Shinya Sasaki, Masanori Tsurugida, Mamoru Nanasato, Motoharu Araki, Keisuke Hirano, Yoshiaki Ito, Reiko Tsukahara, Toshiya Muramatsu
We compared the myocardial ischemic burden of provisional and routine final kissing-balloon inflation (FKI) with the 1-stent strategy using a second-generation drug-eluting stent for coronary bifurcation lesions (CBL). There are no established guidelines for side branch (SB) intervention after main vessel stenting. In total, 113 CBL patients were randomized to receive different SB intervention strategies: provisional-FKI group (n = 57; FKI only when SB flow was TIMI <3) and routine-FKI group (n = 56; mandatory FKI with aggressive treatment until SB-residual stenosis <50%)...
April 11, 2017: Heart and Vessels
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