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coronary bifurcation

Jiannan Dai, Lei Xing, Haibo Jia, Yinchun Zhu, Shaotao Zhang, Sining Hu, Lin Lin, Lijia Ma, Huimin Liu, Maoen Xu, Xuefeng Ren, Huai Yu, Lulu Li, Yanan Zou, Shaosong Zhang, Gary S Mintz, Jingbo Hou, Bo Yu
Aims: Plaque erosion is a significant substrate of acute coronary thrombosis. This study sought to determine in vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: A prospective series of 822 STEMI patients underwent pre-intervention optical coherence tomography. Using established diagnostic criteria, 209 had plaque erosion (25.4%) and 564 had plaque rupture (68.6%). Plaque erosion was more frequent in women <50 years when compared with those ≥50 years of age (P = 0...
March 13, 2018: European Heart Journal
Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Ilaria Bo, Thomas Semple, Emma Cheasty, Michael B Rubens, Siew Yen Ho, Michael L Rigby, Edward D Nicol
BACKGROUND: Scimitar syndrome is a rare combination of cardiopulmonary abnormalities found in 1-3 per 1000 live births. Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is only found in 1 in 250-400 congenital heart disease patients. OBJECTIVE: We aimed to investigate the incidence of left circumflex ALCAPA within our referral center's cohort of scimitar syndrome patients. MATERIALS AND METHODS: A review of medical records, cardiac imaging and operative notes from all patients diagnosed with scimitar syndrome at our center between 1992 and 2016 was undertaken and all imaging reviewed...
March 14, 2018: Pediatric Radiology
Ryoji Nagoshi, Takayuki Okamura, Yoshinobu Murasato, Tatsuhiro Fujimura, Masahiro Yamawaki, Shiro Ono, Takeshi Serikawa, Yutaka Hikichi, Fumiaki Nakao, Tomohiro Sakamoto, Toshiro Shinke, Yoichi Kijima, Amane Kozuki, Hiroyuki Shibata, Junya Shite
This article comprised the data related to the research article entitled "Feasibility and usefulness of three-dimensional optical coherence tomography guidance for optimal side branch treatment in coronary bifurcation stenting" (Nagoshi et al., In press) [1]. In this article we reports details about two patterns of guide wire (GW) recrossing position after crossover stenting in bifurcation lesion classified with three-dimensional optical coherence tomography (3D-OCT) (Okamura et al., 2014) [2] and follow-up data about the treatment with percutaneous coronary intervention(PCI) for bifurcation lesion in terms of the two- (2D) or 3D-OCT guidance...
February 2018: Data in Brief
J Bennett, T Adriaenssens, K McCutcheon, J Dens, W Desmet, P Sinnaeve, M Vrolix, C Dubois
OBJECTIVES: We evaluated healing responses with optical coherence tomography, and long-term clinical outcomes after treatment with a dedicated stent versus a conventional culotte technique. BACKGROUND: Dedicated bifurcation stents have been proposed as an alternative treatment for coronary bifurcation lesions. The long-term performance of dedicated stents versus conventional dual-stent techniques for the treatment of complex coronary bifurcation lesions is unknown...
March 14, 2018: Catheterization and Cardiovascular Interventions
Zlatko H Mehmedbegovic, Vladan D Vukcevic, Goran R Stankovic
Coronary bifurcation lesions are accounted in about 20% of all percutaneous coronary interventions and despite all-round improvements in their treatment are still perceived as complex lesion subset in interventional cardiology. Treatment of bifurcations, being technically demanding primarily due to the unique bifurcation anatomy, is related to lower procedural success rate and increased rates of long-term adverse cardiac events. According to published data, provisional approach remains a default strategy for majority of bifurcation PCI, but when perfected, two-stent bifurcation techniques can also yield good clinical outcomes...
March 8, 2018: Minerva Cardioangiologica
Jun-Jie Zhang, Xiao-Fei Gao, Ya-Ling Han, Jing Kan, Ling Tao, Zhen Ge, Damras Tresukosol, Shu Lu, Li-Kun Ma, Feng Li, Song Yang, Jun Zhang, Muhammad Munawar, Li Li, Rui-Yan Zhang, He-Song Zeng, Teguh Santoso, Ping Xie, Ze-Ning Jin, Leng Han, Wei-Hsian Yin, Xue-Song Qian, Qi-Hua Li, Lang Hong, Chotnoparatpat Paiboon, Yan Wang, Li-Jun Liu, Lei Zhou, Xue-Ming Wu, Shang-Yu Wen, Qing-Hua Lu, Jun-Qiang Yuan, Liang-Long Chen, Francesco Lavarra, Alfredo E Rodríguez, Li-Min Zhou, Shi-Qin Ding, Kitigon Vichairuangthum, Yuan-Sheng Zhu, Meng-Yue Yu, Chan Chen, Imad Sheiban, Yong Xia, Yu-Long Tian, Zheng-Lu Shang, Qing Jiang, Yong-Hong Zhen, Xin Wang, Fei Ye, Nai-Liang Tian, Song Lin, Zhi-Zhong Liu, Shao-Liang Chen
INTRODUCTION: Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A systematic two-stent approach is widely used for complex bifurcation lesions (CBLs). However, a randomised comparison of PS and two-stent techniques for CBLs has never been studied. Accordingly, the present study is designed to elucidate the benefits of two-stent treatment over PS in patients with CBLs. METHODS AND ANALYSIS: This DEFINITION II study is a prospective, multinational, randomised, endpoint-driven trial to compare the benefits of the two-stent technique with PS for CBLs...
March 6, 2018: BMJ Open
Tadatsugu Gamou, Kenji Sakata, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: To investigate the impact of stent deformity induced by final kissing balloon technique (KBT) for coronary bifurcation lesions on in-stent restenosis (ISR). BACKGROUND: In experimental models, the detrimental effects of KBT have been clearly demonstrated, but few data exists regarding the impact of proximal stent deformity induced by KBT on clinical outcomes. METHODS: We examined 370 coronary lesions where intravascular ultrasound (IVUS)-guided second-generation drug-eluting stent (DES) implantation for coronary bifurcation lesions was performed...
March 6, 2018: Journal of Interventional Cardiology
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
Li Li, Jia Liu, Qinhua Jin, Shaoliang Chen
BACKGROUND: Despite advancements in the devices and techniques used for percutaneous coronary intervention, side branch (SB) wiring remains highly challenging in certain complex bifurcation intervention cases. METHODS AND RESULTS: In this report, we demonstrate the efficacy and safety of the balloon block and support technique (BBST), which comprises inflation of an appropriately sized balloon 1-2 mm distal from the carina in the distal main branch to facilitate wire access to the SB...
January 2018: Medicine (Baltimore)
Minsuk Kim, Myung-A Kim, Hack-Lyoung Kim, Won-Jae Lee, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Joo-Hee Zo
The inferior border of the femoral head (IBFH) is widely used as a landmark in femoral artery puncture during invasive coronary angiography (ICA). However, application of this technique can be challenging especially in obese patients. This study was performed to investigate the association between body mass index (BMI) and the risk of low puncture in femoral artery puncture.A total of 464 patients (64.8 ± 11.1 years, 55.8% male) who underwent ICA via trans-femoral access were retrospectively reviewed. IBFH was used as a landmark for a skin nick and the femoral artery cannulation site was confirmed by femoral angiography...
March 2018: Medicine (Baltimore)
Ki Hong Choi, Young Bin Song, Jin-Ok Jeong, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Myung-Ho Jeong, Bon-Kwon Koo, Hyo-Soo Kim, Cheol Woong Yu, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Ju Hyeon Oh, Jong-Seon Park, Hyeon-Cheol Gwon
INTRODUCTION AND OBJECTIVES: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). METHODS: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009...
February 20, 2018: Revista Española de Cardiología
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
O A Pogorelova, M I Tripoten, D A Guchaeva, R M Shahnovich, M Y Ruda, T V Balakhonova
AIM: to study carotid plaques structure in patients with acute coronary syndrome by ultrasound duplex scanning. MATERIALS AND METHODS: We included in this study143 patients with acute coronary syndrome (ACS) aged 32-83 years and 28 patients with documented coronary heart disease (CHD) aged 46-83 years. Duplex scanning of carotid arteries was carried out with Philips iU22 ultrasound system and L9-3 linear array transducer. Atherosclerotic plaques in CCA, CCA bifurcation, and ICA from right and left side were investigated...
December 2017: Kardiologiia
Sekou Gregg, Terry Y Li, Marie-France Hétu, Stephen C Pang, Paul Ewart, Amer M Johri
The carotid bifurcation is a common site of atherosclerotic plaque. Plaque development is thought to occur preferentially at geometrically predisposed areas such as arterial branch points. The aim of this study was to investigate the geometric and anatomical variables that contribute to the development of carotid plaque using three-dimensional (3D) ultrasound. Sixty-seven consecutive outpatients referred for elective coronary angiography underwent 3D carotid ultrasound scans for the purpose of carotid plaque quantification...
February 20, 2018: International Journal of Cardiovascular Imaging
Bernardo Cortese, Gaetano DI Palma, Roberto Latini
Drug-coated balloons (DCB) have been developed in recent years to overcome some of the DES limitations. There is an established indication for the use of DCB in the treatment of in-stent restenosis and they are also variably used in various setting, in particular small coronary vessels and bifurcations. Until 2016, all DCBs available in Europe eluted paclitaxel, a highly lipophilic drug with narrow therapeutic window. In April 2016 a new sirolimus-coated balloon (SCB, Magic Touch®, Envision Scientific PVT, India), obtained the CE Mark...
February 19, 2018: Minerva Cardioangiologica
Mario Iannaccone, Salvatore Colangelo, Carlo Di Mario, Roberto Garbo
No abstract text is available yet for this article.
February 13, 2018: EuroIntervention
Congzhen Qiao, Shengdi Li, Haocheng Lu, Fan Meng, Yanbo Fan, Yanhong Guo, Y Eugene Chen, Jifeng Zhang
Macrophage migration inhibitory factor (MIF) is a non-canonical cytokine that is involved in multiple inflammatory diseases, including atherosclerosis. High MIF expression found in leukocytes which facilitates the initiation and progression of atherosclerosis. However, little is known about biomechanical forces in the induction of MIF in endothelial cells (ECs). Here, we show that laminar shear stress (LS) inhibits the expression of MIF in ECs. By profiling the whole transcriptome of human coronary artery ECs under different shear stress, we found that athero-protective LS attenuates the expression of MIF whereas pro-atherosclerotic oscillatory shear stress (OS) significantly increased the expression of MIF...
February 5, 2018: Scientific Reports
Bradley A Herbig, Scott L Diamond
Introduction: In regions of flow separation/reattachment within diseased arteries, the local hemodynamics can result in stagnation point flow that provides an atypical environment in atherosclerosis. Impinging flows occur with recirculation eddies distal of coronary stenosis or diseased carotid bifurcations. Methods: By perfusing whole blood directly perpendicular to a fibrillar collagen thrombotic surface, a microfluidic device produced a stagnation point flow...
December 2017: Cellular and Molecular Bioengineering
Hsin-Fu Lee, Shing-Hsien Chou, Ying-Chang Tung, Chia-Pin Lin, Yu-Shien Ko, Chi-Jen Chang
Background: This study aims to analyze the lesion characteristics of bifurcations that required reverse wire technique and the efficacy and safety of this technique in approaching branches with a highly angulated take-off. Methods: We enrolled patients in whom reverse wire technique was used after failed conventional antegrade wiring with the support of a Crusade catheter. The study endpoints were the technical success defined as succeeding in sending the reversely bent wire to the targeted branches without complications and the procedural success defined as succeeding in revascularization of the bifurcation lesions without complications...
January 2018: Acta Cardiologica Sinica
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