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https://www.readbyqxmd.com/read/28314731/long-term-outcomes-of-provisional-stenting-compared-with-a-two-stent-strategy-for-bifurcation-lesions-a-meta-analysis-of-randomised-trials
#1
Ramez Nairooz, Marwan Saad, Islam Y Elgendy, Ahmed N Mahmoud, Fuad Habash, Partha Sardar, David Anderson, David M Shavelle, J Dawn Abbott
BACKGROUND: The optimal interventional technique for addressing coronary bifurcation lesions is debatable. Long-term clinical outcomes with provisional stenting (PS) compared with a two-stent (TS) strategy for bifurcation lesions are scarce. We aim to perform the first meta-analysis of randomised controlled trials (RCTs) to explore long-term outcomes comparing both strategies. METHODS: An electronic search was performed for online databases until August 2016 for RCTs comparing PS with TS for bifurcation lesions reporting outcomes at 1 year of follow-up or more...
March 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28314675/a-hybrid-strategy-with-bioresorbable-vascular-scaffolds-and-drug-eluting-stents-for-treating-complex-coronary-lesions
#2
Richard J Jabbour, Alfonso Ielasi, Akihito Tanaka, Massimo Leoncini, Bernado Cortese, Giulietta Grigis, Satoru Mitomo, Damiano Regazzoli, Gaetano Di Palma, Claudio Rapetto, Maurizio Tespili, Antonio Colombo, Azeem Latib
BACKGROUND: Due to the inherent limitations of current generation BVSs, complex coronary artery disease often contains BVS unsuitable segments. Our aim was to assess the feasibility of a hybrid approach using bioresorbable vascular scaffolds (BVSs) and drug-eluting stents (DESs) for the treatment of complex coronary artery lesions not suitable for a scaffolding only approach. METHODS: A retrospective multicenter cohort analysis was performed on patients with complex de novo or in-stent restenosis lesions treated with a hybrid BVS (Absorb BVS, Abbott Vascular, Santa Clara, CA) and DES strategy...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28304190/the-second-generation-eclips-endovascular-clip-system-initial-experience
#3
Albert H Chiu, Joost De Vries, Cian J O'Kelly, Howard Riina, Ian McDougall, Jonathan Tippett, Martina Wan, Airton Leonardo de Oliveira Manoel, Thomas R Marotta
OBJECTIVE Treatment of wide-necked intracranial aneurysms is associated with higher recanalization and complication rates; however, the most commonly used methods are not specifically designed to work in bifurcation lesions. To address these issues, the authors describe the evolution in the design and use of the eCLIPs (Endovascular Clip System) device, a novel hybrid stent-like assist device with flow diverter properties that was first described in 2008. METHODS A registry was established covering 13 international centers at which patients were treated with the second-generation eCLIPs device...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28304189/physiological-remodeling-of-bifurcation-aneurysms-preclinical-results-of-the-eclips-device
#4
Thomas R Marotta, Howard A Riina, Ian McDougall, Donald R Ricci, Monika Killer-Oberpfalzer
OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28299676/bioresorbable-scaffolds-for-coronary-stenosis-when-and-how-based-upon-current-studies
#5
REVIEW
Alexandre Abizaid, J Ribamar Costa
PURPOSE OF REVIEW: First-generation bioresorbable scaffolds (BRS), largely represented by the poly-l-lactic acid (PLLA) ABSORB (Abbott Vascular, Temecula, Illinois, US), have demonstrated, in low to moderate lesion complexity, similar efficacy to current generation metallic drug-eluting stents. However, a trend toward more device thrombosis has been observed, especially when the scaffolds are used in off-label situations. In this review, we address the most relevant drawbacks of these devices and, based on the available scientific data, we visit the scenarios where there is more uncertainty about their indication, trying to identify the lesions/patients to whom this technology should be voided at its current stage of development...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28274589/contemporary-use-of-drug-coated-balloons-in-coronary-artery-disease-where-are-we-now
#6
REVIEW
Fabien Picard, Serge Doucet, Anita W Asgar
The drug-coated balloon (DCB) has emerged as an additional tool in the arsenal of interventional cardiology devices; it delivers antiproliferative drugs to local arterial tissue by single prolonged coated balloon angioplasty inflation, and prevents restenosis, leaving no implant behind. This strategy theoretically decreases the risk of late inflammatory response to device components, without preventing positive remodelling. DCBs, when used carefully and with a good technique, may have a role in the treatment of lesion subsets, such as in-stent restenosis, small vessel disease or side branch bifurcations, in which the implantation of a drug-eluting stent is not desirable or is technically challenging...
March 5, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28259663/bioresorbable-everolimus-eluting-vascular-scaffold-for-long-coronary-lesions-a-subanalysis-of-the-international-multicenter-ghost-eu%C3%A2-registry
#7
Salvatore Geraci, Hiroyoshi Kawamoto, Giuseppe Caramanno, Neil Ruparelia, Davide Capodanno, Tommaso Gori, Holger Nef, Julinda Mehilli, Maciej Lesiak, Christoph Naber, Carlo Di Mario, Piera Capranzano, Jens Wiebe, Aleksander Araszkiewicz, Stelios Pyxaras, Alessio Mattesini, Thomas Münzel, Corrado Tamburino, Antonio Colombo, Azeem Latib
OBJECTIVES: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND: The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS: The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm...
February 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28258843/mid-to-long-term-outcome-of-patients-treated-with-everolimus-eluting-bioresorbable-vascular-scaffolds-data-of-the-bvs-registry-g%C3%A3-ttingen-predominantly-from-acs-patients
#8
Kristian Hellenkamp, Alexander Becker, Yannick D Gabriel, Gerd Hasenfuß, Mark Hünlich, Claudius Jacobshagen, Wolfgang Schillinger, Marco R Schroeter
BACKGROUND: Bioresorbable vascular scaffolds (BVS) are widely used in routine clinical practice. While previous studies reported acceptable short- to midterm outcome after BVS implantation, data on longer-term outcome are rare. METHODS: Patients treated with at least one Absorb®-BVS were consecutively enrolled. Follow-up data were assessed after 834.0 [769.0-1026.0] days. The primary device-oriented composite endpoint (DOCE) was defined as cardiovascular death, myocardial infarction (MI) and/or target lesion revascularization (TLR)...
May 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28254257/snuggle-t-and-protrusion-s-tap-technique-for-coronary-bifurcation-stenting-a-step-by-step-angiographic-and-illustration-demonstration
#9
Ziad Dahdouh, Bahaa M Fadel, Vincent Roule, Antoine Sarkis, Gilles Grollier
T and small protrusion (TAP) is a stenting technique that is utilized for the management of coronary bifurcation lesions when using a two-stent strategy. This technique is also useful whenever stenting of a main vessel (MV) jeopardizes a side branch (SB) or when a sub-optimal result is encountered in a daughter vessel after starting with one-stent approach. The conversion from one-stent strategy to TAP could be achieved smoothly and often leads to good results. Technically, optimal positioning of the SB stent to achieve the required protrusion into the lumen of the MV remains a challenge...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28228303/impact-of-very-high-pressure-stent-deployment-on-angiographic-and-long-term-clinical-outcomes-in-true-coronary-bifurcation-lesions-treated-by-the-mini-crush-stent-technique-a-single-center-experience
#10
Antoine Gerbay, Jeremy Terreaux, Alexis Cerisier, Marco Vola, Karl Isaaz
BACKGROUND: Percutaneous coronary intervention (PCI) for bifurcation lesions (BL) using 2 stents technique is known to be associated with high rates of procedural failure especially on the side branch (SB) mainly due to stent incomplete apposition. Stent deployment at very high pressure (SDHP) may lead to better stent expansion and apposition. However, SDHP may also be at the origin of deeper wall injury resulting into major cardiac adverse events. No data are available on evaluation of SDHP in BL treated by a mini-crush stent technique...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#11
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28191876/clinical-and-angiographic-predictors-of-hemodynamically-significant-angiographic-lesions-development-and-validation-of-a-risk-score-to-predict-positive-fractional-flow-reserve
#12
Nishtha Sareen, Usman Baber, Safwan Kezbor, Sonny Sayseng, Melissa Aquino, Roxana Mehran, Joseph Sweeny, Nitin Barman, Annapoorna Kini, Samin K Sharma
AIMS: Coronary revascularization based upon physiological evaluation of lesions improves clinical outcomes. Angiographic or visual stenosis assessment alone is insufficient in predicting hemodynamic stenosis severity by Fractional Flow reserve (FFR) and therefore cannot be used to guide revascularization, particularly in the lesion subset (<70%). Accordingly, we sought to identify independent determinants of angiographic intermediate lesions with hemodynamic significance. METHODS AND RESULTS: We assessed consecutive intermediate lesions for patients from January 2014-April 2015 at our institution...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28191744/endovascular-therapy-for-angio-seal-tm-related-acute-limb-ischemia-perioperative-and-long-term-results
#13
Hui Dong, Meng Peng, Xiongjing Jiang, Wuqiang Che, Yubao Zou, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-seal(TM) -related acute limb ischemia. BACKGROUND: Currently, limited data are available on the optimal treatment strategy for Angio-seal(TM) -related acute lower limb ischemia. METHODS: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-Seal(TM) and received endovascular treatment from January 2010 to February 2016...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28191726/risk-stratification-of-periprocedural-myocardial-infarction-after-percutaneous-coronary-intervention-analysis-based-on-the-scai-definition
#14
Dong Zhang, Yiping Li, Dong Yin, Yuan He, Changzhe Chen, Chenxi Song, Ruohua Yan, Chen'gang Zhu, Bo Xu, Kefei Dou
OBJECTIVES: To investigate the predictors of and generate a risk prediction method for periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI) using the new PMI definition proposed by the Society for Cardiovascular Angiography and Interventions (SCAI). BACKGROUND: The SCAI-defined PMI was found to be associated with worse prognosis than the PMI diagnosed by other definitions. However, few large-sample studies have attempted to predict the risk of SCAI-defined PMI...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28163519/telescoping-dual-covered-stent-graft-construct-for-endovascular-treatment-of-a-giant-extracranial-carotid-artery-pseudoaneurysm
#15
Dale Ding, Robert M Starke, Maurice Moriarty, Stefan Brew
Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA) pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA) bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA)...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28163518/double-barrel-y-configuration-stenting-for-flow-diversion-of-a-giant-recurrent-basilar-apex-aneurysm-with-the-pipeline-flex-embolization-device
#16
Dale Ding, Robert M Starke, Ben McGuinness, Stefan Brew
Giant basilar apex aneurysms are extremely challenging to successfully manage. The Pipeline Flex embolization device (PFED) is a new generation flow-diverting stent with a modified delivery system which allows resheathing of the stent after partial deployment. We describe a case of double-barrel Y-configuration stenting of a giant, recurrent basilar apex aneurysm using the PFED. A 73-year-old male was previously treated for an unruptured 11-mm basilar apex aneurysm with stent-assisted coiling using a Neuroform stent...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28154342/complications-and-predictors-of-hypotension-requiring-vasopressor-after-carotid-artery-stenting
#17
Masataka Nanto, Yudai Goto, Hiroyuki Yamamoto, Seisuke Tanigawa, Hayato Takeuchi, Yoshikazu Nakahara, Hiroshi Tenjin, Michiko Takado
A significant controversy exists regarding the clinical impact of hemodynamic depression on major adverse events after carotid artery stenting (CAS). The purpose of this study was to evaluate the incidence, predictors, and clinical significance of hypotension after CAS. A total of 118 cases of carotid artery stenosis were treated with CAS. Hypotension was defined as sustained systolic blood pressure <80 mmHg and requiring intravenous administration of vasopressor to maintain adequate systolic blood pressure after the procedure...
January 31, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28150223/growth-of-untreated-unruptured-small-sized-aneurysms-%C3%A2-%C2%BA7mm-incidence-and-related-factors
#18
Hyun Ho Choi, Young Dae Cho, Jin Pyeong Jeon, Dong Hyun Yoo, Jusun Moon, Jeongjun Lee, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, Li Zhang, Moon Hee Han
PURPOSE: The need to treat small (<7 mm) unruptured aneurysms is still controversial, despite data collected through several large cohort studies. Such lesions typically are incidental findings, usually followed for potential growth through serial imaging. For this study, growth estimates for untreated unruptured small-sized aneurysms were generated, examining incidence and related risk factors. METHODS: A cohort of 135 consecutive patients harboring 173 untreated unruptured small-sized aneurysms (<7 mm) was subjected to extended monitoring (mean, 73...
February 1, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#19
Benedikt Schrage, Michael Schwarzl, Christoph Waldeyer, Peter M Becher, Christoph Sinning, Ulrich Schäfer, Moritz Seiffert, Elvin Zengin-Sahm, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Aorto-ostial lesions as well as bifurcation lesions still provide challenges in percutaneous coronary intervention (PCI), as meticulous stent placement is needed. The Szabo-technique, which uses a second wire to anchor the stent at the osmium, may be helpful here. In this article, we will provide detailed information on the technique including video material as well as procedural and long-term follow-up data of a cohort of patients treated with this technique. METHODS AND RESULTS: A retrospective single-centre study was performed in patients undergoing Szabo-PCI from 2014 to 2016 (n=28)...
January 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28124515/anatomic-criteria-determining-high-risk-carotid-surgery-patients
#20
REVIEW
Pavlos Tsantilas, Andreas Kuehnl, Erich Brenner, Hans-Henning Eckstein
INTRODUCTION: Based on randomized trials, carotid endarterectomy (CEA) is the standard procedure for patients with a 50-99% symptomatic carotid stenosis and carefully selected patients with an asymptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) is a technical alternative for patients with a high surgical risk or difficult anatomic conditions (e.g., recurrent stenosis). This study aims to provide an overview of anatomic factors associated with a higher risk of CEA complications...
April 2017: Journal of Cardiovascular Surgery
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