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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/28530484/in%C3%A2-vivo-geometry-of-the-kissing-stent-and-covered-endovascular-reconstruction-of-the-aortic-bifurcation-configurations-in-aortoiliac-occlusive-disease
#2
Erik Groot Jebbink, Thijs G Ter Mors, Cornelis H Slump, Robert H Geelkerken, Suzanne Holewijn, Michel Mpj Reijnen
Objectives Various configurations of kissing stent (KS) configurations exist and patency rates vary. In response the covered endovascular reconstruction of the aortic bifurcation configuration was designed to minimize mismatch and improve outcome. The aim of the current study is to compare geometrical mismatch of kissing stent with the covered endovascular reconstruction of the aortic bifurcation configuration in vivo. Methods Post-operative computed tomographic data and patient demographics from 11 covered endovascular reconstruction of the aortic bifurcation and 11 matched kissing stent patients were included...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28524121/-the-use-of-high-flow-extracranial-intracranial-artery-bypass-in-pathology-of-the-cerebral-and-brachiocephalic-arteries-technical-features-and-surgical-outcomes
#3
A V Dubovoy, K S Ovsyannikov, V E Guzhin, A V Cherepanov, D M Galaktionov, A M Perfil'ev, A O Sosnov
BACKGROUND: Poor outcomes of surgical treatment for complex cerebral aneurysms due to the development of cerebral ischemia were the cause to use cerebral revascularization surgery for this pathology. OBJECTIVE: the study objective was to master a high-flow extracranial-intracranial (EC-IC) artery bypass technique and evaluate its application in surgical treatment of complex and giant cerebral aneurysms as well as complex lesions of the brachiocephalic arteries. MATERIAL AND METHODS: Fifty two patients underwent high-flow IC-EC bypass surgery; of these, 34 patients had complex cerebral aneurysms, and 18 patients had complex stenotic occlusive lesions of the brachiocephalic arteries...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28515858/three-dimensional-optical-coherence-tomography-reconstruction-of-bifurcation-stenting-using-the-szabo-anchor-wire-technique
#4
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/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/28499904/completely-thrombosed-distal-middle-cerebral-artery-aneurysm-mimicking-a-cavernous-angioma-case-report-and-review-of-the-literature
#7
Sokol Trungu, Placido Bruzzaniti, Stefano Forcato, Marco Cimatti, Antonino Raco
BACKGROUND: Distal middle cerebral artery (MCA) aneurysms originate from branches of MCA distal to its main bifurcation or the peripheral branches. Distal MCA aneurysms are uncommon compared to saccular aneurysms developing along the proximal trunks of MCA. However, thrombotic aneurysms, characterized by organized intraluminal thrombus and solid mass, are frequently in the large and giant size range, while complete thrombosis of non-giant MCA aneurysms is very rare. CASE PRESENTATION: We present the clinical case of a 53 years-old woman with a completely thrombosed medium distal MCA aneurysm which mimics a cavernous angioma...
May 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28498326/a-histopathological-scheme-for-the-quantitative-scoring-of-intervertebral-disc-degeneration-and-the-therapeutic-utility-of-adult-mesenchymal-stem-cells-for-intervertebral-disc-regeneration
#8
Cindy C Shu, Margaret M Smith, Susan M Smith, Andrew J Dart, Christopher B Little, James Melrose
The purpose of this study was to develop a quantitative histopathological scoring scheme to evaluate disc degeneration and regeneration using an ovine annular lesion model of experimental disc degeneration. Toluidine blue and Haematoxylin and Eosin (H&E) staining were used to evaluate cellular morphology: (i) disc structure/lesion morphology; (ii) proteoglycan depletion; (iii) cellular morphology; (iv) blood vessel in-growth; (v) cell influx into lesion; and (vi) cystic degeneration/chondroid metaplasia...
May 12, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28487806/synchronous-carotid-bifurcation-endarterectomy-and-retrograde-kissing-stenting-of-the-innominate-and-left-common-carotid-artery-in-a-patient-with-a-bovine-aortic-arch
#9
Alessandro Robaldo, Guido Carignano, Alberto Balderi, Claudio Novali
Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a "bovine" aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28465113/comparison-of-branch-and-distally-focused-main-renal-artery-denervation-using-two-different-radio-frequency-systems-in-a-porcine-model
#10
Felix Mahfoud, Catherine A Pipenhagen, L Boyce Moon, Sebastian Ewen, Saarraaken Kulenthiran, Jeffrey M Fish, James A Jensen, Renu Virmani, Michael Joner, Kazuyuki Yahagi, Costas Tsioufis, Michael Böhm
OBJECTIVES: Anatomic placement of lesions may impact efficacy of radio-frequency (RF) catheter renal denervation (RDN). However, it is unclear if it is necessary to perform treatments post bifurcation with systems that may provide deeper penetration to achieve successful RDN. METHODS: Sixteen domestic swine (n=16) were randomly assigned to 4 groups: 1) 8 lesions created in the branch arteries using the Spyral catheter (SP8); 2) 8 lesions created in the branch arteries plus 4 lesions created in the main artery using the SP catheter (SP12); 3) 8 lesions created in the main artery using the EnligHTN catheter with the distal position as close as possible to the bifurcation (EN8); and 4) 12 lesions created in the main artery using the EN catheter with the distal position as close as possible to the bifurcation (EN12)...
April 26, 2017: International Journal of Cardiology
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/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
#15
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/28437485/t-cell-function-is-dispensable-for-intracranial-aneurysm-formation-and-progression
#16
Haruka Miyata, Hirokazu Koseki, Katsumi Takizawa, Hidetoshi Kasuya, Kazuhiko Nozaki, Shuh Narumiya, Tomohiro Aoki
Given the social importance of intracranial aneurysm as a major cause of a lethal subarachnoid hemorrhage, clarification of mechanisms underlying the pathogenesis of this disease is essential for improving poor prognosis once after rupture. Previous histopathological analyses of human aneurysm walls have revealed the presence of T cells in lesions suggesting involvement of this type of cell in the pathogenesis. However, it remains unclear whether T cell actively participates in intracranial aneurysm progression...
2017: PloS One
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
#17
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
#18
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
#19
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
https://www.readbyqxmd.com/read/28400985/spanning-from-the-west-to-east-an-updated-review-on-endovascular-treatment-of-intracranial-atherosclerotic-disease
#20
REVIEW
Mohammed Hussain, Neil Datta, Zhe Cheng, David Dornbos, Asif Bashir, Ibrahim Sultan, Tapan Mehta, Faris Shweikeh, Paul Mazaris, Nora Lee, Amre Nouh, Xiaokun Geng, Yuchuan Ding
Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Intracranial atherosclerotic disease (ICAD) accounts for 10-15% of ischemic stroke in Western societies, but is an underlying pathology in up to 54% of ischemic strokes in Asian populations. ICAD has largely been treated with medical management, although a few studies have examined outcomes following endovascular treatment. Our objective was to summarize the major trials that have been performed thus far in regard to the endovascular treatment of ICAD and to provide direction for future management of this disease process...
April 2017: Aging and Disease
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