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coronary bifurcation

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https://www.readbyqxmd.com/read/29148142/outcomes-of-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-due-to-unprotected-left-main-thrombosis-the-asia-pacific-left-main-st-elevation-registry-aster
#1
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
November 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29146671/predictors-and-long-term-clinical-outcome-of-longitudinal-stent-deformation-insights-from-pooled-analysis-of-korean-multicenter-drug-eluting-stent-cohort
#2
Tae-Min Rhee, Kyung Woo Park, Joo Myung Lee, Michael S Lee, Ki-Hyun Jeon, Hyun-Jae Kang, Bon-Kwon Koo, Jay Young Rhew, Kwang Soo Cha, Jang-Ho Bae, Kyoo-Rok Han, Si-Hoon Park, Woo-Jung Park, Seung-Woon Rha, Seok-Kyu Oh, Hyuck Moon Kwon, Ki-Bae Seung, Taehoon Ahn, Sang-Hyun Kim, Hyo-Soo Kim
BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication. METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute)...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146551/dual-lumen-microcatheters-for-complex-percutaneous-coronary-interventions
#3
REVIEW
Jacopo A Oreglia, Roberto Garbo, Andrea Gagnor, Gabriele L Gasparini
In some bifurcation anatomies side branch wiring can be difficult particularly when side branch is highly angulated. Furthermore a combination of bifurcations and chronic total occlusion can be a real challenge for interventional cardiologists. New devices have been produced to facilitate complex PCI and recently introduced dual lumen microcatheters can be really helpful in these scenarios. All these devices have both a rapid-exchange and an over-the-wire lumen. The rationale for dual lumen microcatheters is to preserve the highest number of side-branches...
October 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29139034/vessel-centerline-reconstruction-from-non-isocentric-and-non-orthogonal-paired-monoplane-angiographic-images
#4
Mie Kunio, Caroline C O'Brien, Augusto C Lopes, Lynn Bailey, Pedro A Lemos, Guillermo J Tearney, Elazer R Edelman
PURPOSE: Three-dimensional reconstruction of a vessel centerline from paired planar coronary angiographic images is critical to reconstruct the complex three-dimensional structure of the coronary artery lumen and the relative positioning of implanted devices. In this study, a new vessel centerline reconstruction method that can utilize non-isocentric and non-orthogonal pairs of angiographic images was developed and tested. METHODS: Our new method was developed in in vitro phantom models of bifurcated coronary artery with and without stent, and then tested in in vivo swine models (twelve coronary arteries)...
November 14, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29131803/bench-testing-and-coronary-artery-bifurcations-a-consensus-document-from-the-european-bifurcation-club
#5
John A Ormiston, Ghassan Kassab, Gerard Finet, Yiannis S Chatzizisis, Nicolas Foin, Timothy J Mickley, Claudio Chiastra, Yoshinobu Murasato, Yukata Hikichi, Jolanda J Wentzel, Olivier Darremont, Kiyotaka Iwasaki, Thierry Lefèvre, Yves Louvard, Susann Beier, Hikmat Hojeibane, Jeffery Wooton, Ashley Netravali, Brett Cowan, Mark W Webster, Goran Stankovic
This is a consensus document from the European Bifurcation Club concerning bench testing in coronary artery bifurcations. It is intended to provide guidelines for bench assessment of stents and other strategies in coronary bifurcation treatment where the United States Food and Drug Administration (FDA) or International Organization for Standardization (ISO) guidelines are limited or absent. These recommendations provide guidelines rather than a step-by-step manual. We provide data on the anatomy of bifurcations and elastic response of coronary arteries to aid model construction...
November 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29128364/one-versus-2-stent-strategy-for-the-treatment-of-bifurcation-lesions-in-the-context-of-a-coronary-chronic-total-occlusion-a-multicenter-registry
#6
Soledad Ojeda, Lorenzo Azzalini, Jorge Chavarría, Antonio Serra, Francisco Hidalgo, Susanna Benincasa, Livia L Gheorghe, Roberto Diletti, Miguel Romero, Barbara Bellini, Alejandro Gutiérrez, Javier Suárez de Lezo, Francisco Mazuelos, José Segura, Mauro Carlino, Antonio Colombo, Manuel Pan
INTRODUCTION AND OBJECTIVES: There is little evidence on the optimal strategy for bifurcation lesions in the context of a coronary chronic total occlusion (CTO). This study compared the procedural and mid-term outcomes of patients with bifurcation lesions in CTO treated with provisional stenting vs 2-stent techniques in a multicenter registry. METHODS: Between January 2012 and June 2016, 922 CTO were recanalized at the 4 participating centers. Of these, 238 (25...
November 8, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29124548/development-of-an-experimental-and-digital-cardiovascular-arterial-model-for-transient-hemodynamic-and-postural-change-studies-a-preliminary-framework-analysis
#7
Rodward L Hewlin, John P Kizito
The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques...
November 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29124384/diagnostic-performance-of-computed-tomography-angiography-in-the-detection-of-coronary-artery-in-stent-restenosis-evidence-from-an-updated-meta-analysis
#8
Tao Dai, Jiang-Rong Wang, Peng-Fei Hu
OBJECTIVES: To evaluate the performance of computed tomography angiography (CTA) ≥64 slices for detecting coronary in-stent restenosis (ISR) and determine the influence of separate characteristics on diagnostic accuracy. METHODS: We searched the PubMed, EMBASE and Cochrane databases for studies of CTA ≥64 slices in diagnosing ISR. We pooled data on bivariate modelling, and subgroup analysis was also performed. RESULTS: A total of 35 studies involving 4131 stents were included...
November 9, 2017: European Radiology
https://www.readbyqxmd.com/read/29116819/double-guide-double-wrist-5f-left-coronary-artery-transradial-percutaneous-coronary-intervention-and-the-x-kiss-technique
#9
Dangoisse Vincent, Schroëder Erwin, Claude Hanet, Antoine Guédès, Pancholy Samir
Percutaneous coronary intervention for bifurcated anatomy, particularly at the proximal left coronary artery site, requires guide catheters (GC) of at least 6 french and preferably larger in diameter. We describe a new trans-radial approach more suitable for small artery size: the simultaneous use of both radial arteries for double cannulation of the LMCA with 5F GC: each GC will target either the LM/LAD or the LM/CX artery (or LM-LAD/LM-LAD-1st diagonal branch) stenoses. The technique successfully was applied to 5 cases...
November 8, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29108400/early-experience-and-favorable-clinical-outcomes-of-everolimus-eluting-bioresorbable-scaffolds-for-coronary-artery-disease-in-korea
#10
Osung Kwon, Jung-Min Ahn, Do-Yoon Kang, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
Background/Aims: Compared with metallic drug-eluting stents (DES), bioresorbable vascular scaffolds (BVS) may further improve long-term outcomes of percutaneous coronary intervention (PCI) in patients with coronary artery disease. We report our early experience with BVS in Korea. Methods: We evaluated 105 consecutive patients with BVS implanted at Asan Medical Center, Korea between October 21, 2015 and June 3, 2016. Angiographic results, and in-hospital and 6-month clinical outcomes were assessed...
November 7, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29106070/transverse-partial-stent-ablation-with-rotational-atherectomy-for-suboptimal-culotte-technique-in-left-main-stem-bifurcation
#11
Giovanni Luigi De Maria, Rajesh Kharbanda, Adrian P Banning
Longitudinal rotational atherectomy of metal struts is well described as bail-out strategy to treat undilatable instent restenosis. Ablation of metal stent struts jailing the ostium of a major side branch in a coronary bifurcation is not described. In the current report, we describe a case of "transverse" rotational atherectomy to treat a failure of culotte stenting in a left main stem bifurcation. We document for the first time in vivo and in man the effect of this strategy using optical coherence tomography...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102580/usefulness-of-the-jailed-balloon-technique%C3%A2-in-percutaneous-intervention-for%C3%A2-severe-coronary-perforation-involving%C3%A2-left-main-bifurcation
#12
Kensuke Takagi, Koichi Furui, Itsuro Morishima, Tsuboi Hideyuki
No abstract text is available yet for this article.
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29097079/one-versus-2-stent-strategy-for-the-treatment-of-bifurcation-lesions-in-the-context-of-a-coronary-chronic-total-occlusion-a-multicenter-registry
#13
Soledad Ojeda, Lorenzo Azzalini, Jorge Chavarría, Antonio Serra, Francisco Hidalgo, Susanna Benincasa, Livia L Gheorghe, Roberto Diletti, Miguel Romero, Barbara Bellini, Alejandro Gutiérrez, Javier Suárez de Lezo, Francisco Mazuelos, José Segura, Mauro Carlino, Antonio Colombo, Manuel Pan
INTRODUCTION AND OBJECTIVES: There is little evidence on the optimal strategy for bifurcation lesions in the context of a coronary chronic total occlusion (CTO). This study compared the procedural and mid-term outcomes of patients with bifurcation lesions in CTO treated with provisional stenting vs 2-stent techniques in a multicenter registry. METHODS: Between January 2012 and June 2016, 922 CTO were recanalized at the 4 participating centers. Of these, 238 (25...
October 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29096915/double-kissing-crush-versus-provisional%C3%A2-stenting-for-left-main-distal%C3%A2-bifurcation-lesions-dkcrush-v-randomized-trial
#14
Shao-Liang Chen, Jue-Jie Zhang, Yaling Han, Jing Kan, Lianglong Chen, Chunguang Qiu, Tiemin Jiang, Ling Tao, Hesong Zeng, Li Li, Yong Xia, Chuanyu Gao, Teguh Santoso, Chootopol Paiboon, Yan Wang, Tak W Kwan, Fei Ye, Nailiang Tian, Zhizhong Liu, Song Lin, Chengzhi Lu, Shangyu Wen, Lang Hong, Qi Zhang, Imad Sheiban, Yawei Xu, Lefeng Wang, Tanveer S Rab, Zhanquan Li, Guanchang Cheng, Lianqun Cui, Martin B Leon, Gregg W Stone
BACKGROUND: Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurcation lesions in patients with unprotected LM coronary artery disease undergoing percutaneous coronary intervention. The double kissing (DK) crush planned 2-stent technique has been shown to improve clinical outcomes in non-LM bifurcations compared with PS, and in LM bifurcations compared with culotte stenting, but has never been compared with PS in LM bifurcation lesions. OBJECTIVES: The authors sought to determine whether a planned DK crush 2-stent technique is superior to PS for patients with true distal LM bifurcation lesions...
October 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29094411/a-jail-escape-technique-jet-for-distal-side-branch-wiring-during-provisional-stenting-feasibility-and-first-in-man-study
#15
Han Xiao, Shengda Chen, Guixue Wang, Ruolin Du, Yaoming Song, Jun Jin, Lan Huang, Richard Jabbour, Lorenzo Azzalini, Xiaohui Zhao
OBJECTIVE: To evaluate the feasibility of a novel technique for achieving distal SB access and improve strut apposition during provisional stenting. BACKGROUND: While distal rewiring and stent expansion toward the side branch (SB) are associated with better results during provisional stenting of coronary artery bifurcation lesions, these techniques are technically challenging and often leave unopposed struts near the carina. METHODS: The "Jail Escape Technique" (JET) is performed by passing the proximal tip of the SB wire between the main vessel (MV) stent struts and balloon before implantation, allowing the MV stent to push the SB wire against the distal part of the carina...
November 1, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29089685/use-of-multidetector-computed-tomography-angiography-of-upper-limb-circulation-in-patients-undergoing-coronary-artery-bypass-grafting-surgery
#16
Hasan B Altinsoy, Ozkan Alatas, Hidayet Kayancicek, Erhan Hafiz, Omer F Dogan
OBJECTIVE: This study aimed to evaluate the bilateral forehand circulation using a 64-channel multidetector computed tomography (MDCT) as a noninvasive method to define criteria for an upper extremity arterial anatomy and pathology prior to the use of arterial conduits. MATERIALS AND METHODS: Fifty-five patients with coronary artery disease who underwent total arterial coronary artery bypass grafting (CABG) were randomly selected for this prospective study. MDCT angiography was performed for 110 examinations of forearm and hand arterial anatomy...
July 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/29074039/percutaneous-coronary-intervention-of-bifurcation-lesions-and-platelet-reactivity
#17
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Ajay J Kirtane, Akiko Maehara, Giora Weisz, Mahesh V Madhavan, Thomas McAndrew, Roxana Mehran, Gregg W Stone
BACKGROUND: Although bifurcation percutaneous coronary intervention (PCI) is associated with lower procedural success rates and higher risk of complications, there are little data regarding outcomes after successful bifurcation PCI with contemporary stents and techniques. Whether residual platelet reactivity (PR) affects outcomes differently after bifurcation versus non-bifurcation PCI is also unknown. We studied the association between bifurcation PCI, PR, and clinical outcomes among patients undergoing successful PCI with drug-eluting stents...
October 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29073947/lesion-complexity-and-outcomes-of-extended-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention
#18
RANDOMIZED CONTROLLED TRIAL
Robert W Yeh, Dean J Kereiakes, P Gabriel Steg, Donald E Cutlip, Kevin J Croce, Joseph M Massaro, Laura Mauri
BACKGROUND: Subjects undergoing coronary stenting with complex lesion anatomy may experience different risks and benefits with prolonged dual antiplatelet therapy. OBJECTIVES: The authors assessed the effect of 30 months versus 12 months of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) based on the presence or absence of anatomically-complex target lesions. METHODS: In the DAPT Study, combined myocardial infarction (MI) or stent thrombosis and moderate/severe bleeding were assessed in enrolled (n = 25,416) and randomized (n = 11,554) subjects...
October 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29069325/serial-changes-in-the-side-branch-ostial-area-after-main-vessel-stenting-with-kissing-balloon-inflation-for-coronary-bifurcation-lesions-assessed-by-3d-optical-coherence-tomography
#19
Tatsuhiro Fujimura, Takayuki Okamura, Hiroki Tateishi, Takeshi Nakamura, Jutaro Yamada, Tetsuro Oda, Mamoru Mochizuki, Shigehiko Nishimura, Takashi Nishimura, Masafumi Yano
Aims: We evaluated the influence of the jailing configuration and guidewire rewiring position in front of the side-branch (SB) ostium before kissing balloon inflation (KBI) against side-branch ostial area (SBOA) at follow-up using 3D optical coherence tomography (3D-OCT). Methods and results: We retrospectively analysed the cases of the 37 consecutive patients who underwent main-vessel (MV) stenting with KBI for coronary bifurcation lesion under OCT guidance and the follow-up OCT 6-12 months...
October 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29066340/drug-eluting-balloon-for-the-treatment-of-patients-with-coronary-artery-disease-current-perspectives
#20
REVIEW
Mattia Lunardi, Carlo Zivelonghi, Floris S van den Brink, Matteo Ghione, Giulia Vinco, Giovanni Benfari, Roberto Scarsini, Flavio Ribichini, Pierfrancesco Agostoni
Despite the improvement of outcomes after the introduction of bare metal and drug eluting stents for the treatment of CAD, certain type of patients have still an increased risk of stent failure. An alternative is represented by drug-eluting balloons (DEB). This innovation could give potential benefits in particular for the in-stent restenosis (ISR) and the de-novo lesions. In the first setting DEB have shown results superior to those with plain-balloon angioplasty and similar to those with first generation DES...
September 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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