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Bo Xu, Björn Redfors, Yuejin Yang, Shubin Qiao, Yongjian Wu, Jilin Chen, Haibo Liu, Jue Chen, Liang Xu, Yanyan Zhao, Changdong Guan, Runlin Gao, Philippe Généreux
OBJECTIVES: The aim of this study was to assess the impact of operator experience on prognosis after left main coronary artery (LM) percutaneous coronary intervention (PCI). BACKGROUND: LM PCI can be technically challenging and potentially risky considering the amount of supplied myocardium. METHODS: Consecutive patients who underwent unprotected LM PCI at a single institution were included and compared according to whether the primary operator was an experienced, high-volume LM operator (defined as an operator who performed at least 15 LM PCIs per year for at least 3 consecutive years) or not...
October 24, 2016: JACC. Cardiovascular Interventions
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Tzu-Hsien Tsai, Cheng-I Cheng
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Kensuke Takagi, Yusuke Fujino, Toru Naganuma, Yusuke Watanabe, Hiroto Yabushita, Satoru Mitomo, Hiroyoshi Kawamoto, Satoko Tahara, Tsuyoshi Kobayashi, Takayuki Warisawa, Kenichi Karube, Takahiro Matsumoto, Tomohiko Sato, Hisaaki Ishiguro, Naoyuki Kurita, Shotaro Nakamura, Koji Hozawa, Sunao Nakamura
BACKGROUND: There is no consensual opinion regarding the percutaneous coronary intervention (PCI) procedure for unprotected distal left main (UDLM) lesion. METHODS: Between April 2005 and August 2011, 586 consecutive patients with UDLM stenosis treated with drug-eluting stents were recruited for this study to clarify the impact of combination of full-coverage stenting and proximal optimization technique (POT) for UDLM lesion. An optimal strategy of full-coverage stenting and POT was performed in 353 patients and the other 233 patients were not optimally treated...
September 4, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Timo H Mäkikallio, Juhani Junttila, Antti Kiviniemi, Sudhir Kurl, Kari Ylitalo, Jarkko Magga, Vesa Jokinen, Olli-Pekka Piira, Kari Kervinen, Matti Niemelä, Jari A Laukkanen
No abstract text is available yet for this article.
September 28, 2016: International Journal of Cardiology
Takayuki Mori, Kenichi Sakakura, Hiroshi Wada, Yousuke Taniguchi, Kei Yamamoto, Yusuke Adachi, Hiroshi Funayama, Shin-Ichi Momomura, Hideo Fujita
While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94)...
October 5, 2016: Heart and Vessels
Devraj Sukul, Milan Seth, Simon R Dixon, Mark Zainea, Nicklaus K Slocum, Elizabeth J Pielsticker, Hitinder S Gurm
OBJECTIVES: We examined clinical outcomes following percutaneous coronary intervention (PCI) in patients turned down for surgical revascularization across a broad population. BACKGROUND: Prior studies suggest that surgical ineligibility is associated with increased mortality in patients with unprotected left main or multivessel coronary artery disease undergoing PCI. METHODS: This study included consecutive patients who underwent PCI in a multicenter registry in Michigan from January 2010 to December 2014...
September 21, 2016: Catheterization and Cardiovascular Interventions
Pil Hyung Lee, Jung-Min Ahn, Mineok Chang, Seunghee Baek, Sung-Han Yoon, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
Left main coronary artery (LMCA) disease is the highest-risk lesion subset of ischemic heart disease, and has traditionally been an indication for coronary artery bypass grafting (CABG). Recent evidence suggests comparable clinical outcomes between percutaneous coronary intervention (PCI) and CABG for LMCA disease, with similar rates of mortality and serious composite outcomes, a higher rate of stroke with CABG, and a higher rate of repeat revascularization with PCI. These results have been translated to the current guideline recommendation that PCI is a reasonable alternative to CABG in patients with low to intermediate anatomic complexity...
September 13, 2016: Journal of the American College of Cardiology
Rafael Cavalcante, Yohei Sotomi, Cheol W Lee, Jung-Min Ahn, Vasim Farooq, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zeng, Pannipa Suwannasom, Carlos Collet, Felipe N Albuquerque, Yoshinobu Onuma, Seung-Jung Park, Patrick W Serruys
BACKGROUND: Currently available randomized data on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for the treatment of unprotected left main coronary disease (LMD) lacks statistical power due to low numbers of patients enrolled. OBJECTIVES: This study assessed long-term outcomes of PCI and CABG for the treatment of LMD in specific subgroups according to disease anatomic complexity. METHODS: We conducted a pooled analysis of individual patient-level data of the LMD patients included in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and SYNTAX (Synergy Between PCI With TAXUS and Cardiac Surgery) trials...
September 6, 2016: Journal of the American College of Cardiology
Carlos López-Aguilar, Arturo Abundes-Velasco, Guering Eid-Lidt, Yigal Piña-Reyna, Jorge Gaspar-Hernández
BACKGROUND: The best revascularization method of the unprotected left main is a current and evolving topic. METHODS: Within 3 years, 2439 percutaneous coronary interventions (PCI) were registered. We included all the patients with PCI of the unprotected left main, n=48 and matched with patients who underwent coronary artery bypass graft (CABG), n=50. Mayor adverse cerebral-cardiac events (MACCE) were assessed in-hospital and out-hospital during a 16 months follow up...
August 20, 2016: Archivos de Cardiología de México
Erion Xhepa, Tomohisa Tada, Sebastian Kufner, Gjin Ndrepepa, Robert A Byrne, Johanna Kreutzer, Tareq Ibrahim, Klaus Tiroch, Marco Valgimigli, Ralf Tölg, Salvatore Cassese, Massimiliano Fusaro, Heribert Schunkert, Karl L Laugwitz, Julinda Mehilli, Adnan Kastrati
OBJECTIVES: To evaluate the long-term prognostic value of risk scores in the setting of drug-eluting stent (DES) implantation for uLMCA. BACKGROUND: Data on the prognostic value of novel risk scores developed to select the most appropriate revascularization strategy in patients undergoing DES implantation for uLMCA disease are relatively limited. METHODS: The study represents a patient-level pooled analysis of the ISAR-LEFT-MAIN (607 patients randomized to paclitaxel-eluting or sirolimus-eluting stents) and the ISAR-LEFT-MAIN-2 (650 patients randomized to everolimus-eluting or zotarolimus-eluting stents) randomized trials...
August 12, 2016: Catheterization and Cardiovascular Interventions
Stylianos A Pyxaras, Lukas Hunziker, Alaide Chieffo, Emanuele Meliga, Azeem Latib, Seung-Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R Makkar, Igor F Palacios, Young-Hak Kim, Piotr P Buszman, Tarun Chakravarty, Imad Sheiban, Roxana Mehran, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Davide Capodanno, Martin B Leon, Jeffrey W Moses, Jean Fajadet, Thierry Lefevre, Marie-Claude Morice, Andrejs Erglis, Corrado Tamburino, Ottavio Alfieri, Patrick W Serruys, Antonio Colombo, Christoph K Naber
AIMS: Our aim was to compare, in a large unprotected left main coronary artery (ULMCA) all-comer registry, the long-term clinical outcome after percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS). METHODS AND RESULTS: Of a total of 2,775 patients enrolled in the Drug Eluting Stents for Left Main Coronary Artery Disease (DELTA) multicentre registry, 379 (13...
2016: EuroIntervention
Yohei Sotomi, Rafael Cavalcante, David van Klaveren, Jung-Min Ahn, Cheol Whan Lee, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
OBJECTIVES: The study sought to validate the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II mortality prediction model after percutaneous coronary intervention (PCI) or coronary artery bypass grafting in a large pooled population of patients with multivessel coronary disease (MVD) and/or unprotected left main disease (UPLMD) enrolled in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and BEST (Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) randomized controlled trials...
August 8, 2016: JACC. Cardiovascular Interventions
Hiroyoshi Kawamoto, Kensuke Takagi, Alaide Chieffo, Neil Ruparelia, Yusuke Fujino, Hiroto Yabushita, Yusuke Watanabe, Azeem Latib, Mauro Carlino, Matteo Montorfano, Sunao Nakamura, Antonio Colombo
OBJECTIVES: This study aimed to investigate the long-term outcomes following mini-crush versus culotte stenting with drug-eluting stents (DES) for the treatment of unprotected left main coronary artery (LMCA) disease. BACKGROUND: Both mini-crush and culotte stenting are considered efficacious treatment options when a planned 2-stent strategy is deemed necessary for unprotected LMCA disease. However, there are limited data available with regard to the long-term clinical outcomes of each strategy in this setting...
July 29, 2016: Catheterization and Cardiovascular Interventions
Kensuke Takagi, Alaide Chieffo, Joanne Shannon, Toru Naganuma, Satoko Tahara, Yusuke Fujino, Azeem Latib, Matteo Montorfano, Mauro Carlino, Hiroyoshi Kawamoto, Sunao Nakamura, Antonio Colombo
BACKGROUND: Although percutaneous intervention (PCI) for ULM is common, the impact of gender remains unclear. This study aimed to clarify the impact of gender in patients treated with drug-eluting stents (DES) for unprotected left main (ULM) disease. METHODS: Between April 2002 and August 2011, 1026 consecutive patients (212 women and 814 men) undergoing PCI using first or second generation DES for ULM stenosis were analyzed. Study endpoints included major adverse cardiac events (MACE) defined as composite of all-cause death, myocardial infarction (MI), and target lesion revascularization (TLR)...
September 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Li Xu, Hao Sun, Le-Feng Wang, Xin-Chun Yang, Kui-Bao Li, Da-Peng Zhang, Hong-Shi Wang, Wei-Ming Li
INTRODUCTION: Acute myocardial infarction (AMI) due to unprotected left main coronary artery (ULMCA) disease is clinically catastrophic although it has a low incidence. Studies on the long-term prognosis of these patients are rare. METHODS: From January 1999 to September 2013, 55 patients whose infarct-related artery was the ULMCA were enrolled. Clinical, angiographic and interventional data was collected. Short-term and long-term clinical follow-up results as well as prognostic determinants during hospitalisation and follow-up were analysed...
July 2016: Singapore Medical Journal
Daisuke Sueta, Yuichiro Arima, Seiji Hokimoto, Toshifumi Mukunoki, Noriaki Tabata, Tomonori Akasaka, Takahiro Sato, Jun Otani, Hisao Ogawa
BACKGROUND: Percutaneous coronary intervention (PCI) for unprotected left main truncus (LMT) lesions is controversial. Inoperable status with advanced age, renal dysfunction, frailty, or patient request may require an unprotected left main PCI. PCI for LMT is not recommended in the typical clinical situation; however, when it is the only feasible option, the performance is not bad. We demonstrated the result of a cobalt-chromium everolimus-eluting stent (CoCr-EES) in the LMT stenting and serial changes via micro-computed tomography (μCT)...
October 15, 2016: International Journal of Cardiology
Li Li, Debabrata Dash, Lu-Yue Gai, Yun-Shan Cao, Qiang Zhao, Ya-Rong Wang, Yao-Jun Zhang, Jun-Xia Zhang
BACKGROUND: Accurately, characterizing plaques is critical for selecting the optimal intervention strategy for the left main coronary artery (LMCA) bifurcation. Coronary angiography cannot precisely assess the location or nature of plaques in bifurcation lesions. Few intravascular ultrasound (IVUS) classification scheme has been reported for angiographic imaging of true bifurcation lesions of the unprotected LMCA thus far. In addition, the plaque composition at the bifurcation has not been elucidated...
July 5, 2016: Chinese Medical Journal
Michael S Lee, Evan Shlofmitz, Barry Kaplan, Dragos Alexandru, Perwaiz Meraj, Richard Shlofmitz
OBJECTIVES: We evaluated the safety and efficacy of orbital atherectomy in real-world patients with severe coronary artery calcification (CAC). BACKGROUND: The presence of severe CAC increases the complexity of percutaneous coronary intervention as it may impede stent delivery and optimal stent expansion. Atherectomy may be an indispensable tool for uncrossable or undilatable lesions by modifying severe CAC. Although the ORBIT I and II trials report that orbital atherectomy was safe and effective for the treatment of severe CAC, patients with kidney disease, recent myocardial infarction, long diffuse disease, severe left ventricular dysfunction, and unprotected left main disease were excluded...
August 2016: Journal of Interventional Cardiology
Yusuke Fujino, Guilherme F Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Takayuki Warisawa, Yusuke Watanabe, Satoru Mitomo, Tomohiko Sato, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Shotaro Nakamura, Hiram G Bezerra, Sunao Nakamura
BACKGROUND: Optical coherence tomography (OCT) has contributed to a better understanding of in-stent restenosis (ISR); however, studies evaluating ISR pattern after two-stent technique in unprotected left main (ULM) are lacking. We aim to evaluate the ISR pattern of proximal LAD and LCX after two-stent technique in ULM. METHODS: We performed OCT in 26 patients with isolated or combined ISR (identified by angiography as >50%) after two stent implantation in the proximal LCX and LAD...
September 15, 2016: International Journal of Cardiology
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