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Arterial revascularization

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https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#1
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29788961/relationships-among-medication-adherence-lifestyle-modification-and-health-related-quality-of-life-in-patients-with-acute-myocardial-infarction-a-cross-sectional-study
#2
Yu-Mi Lee, Rock Bum Kim, Hey Jean Lee, Keonyeop Kim, Min-Ho Shin, Hyeung-Keun Park, Soon-Ki Ahn, So Young Kim, Young-Hoon Lee, Byoung-Gwon Kim, Heeyoung Lee, Won Kyung Lee, Kun Sei Lee, Mi-Ji Kim, Ki-Soo Park
BACKGROUND: The healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients...
May 22, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29788799/management-of-the-left-subclavian-artery-during-tevar-complications-and-mid-term-follow-up
#3
Akram Youssef, Tamer Ghazy, Stephan Kersting, Jennifer Lynne Leip, Ralf-Thorsten Hoffmann, Utz Kappert, Klaus Matschke, Norbert Weiss, Adrian Mahlmann
BACKGROUND: Numerous conditions that affect the boundary between the aortic arch and descending aorta are treated with thoracic endovascular aortic repair (TEVAR). In 40 % of cases, coverage of the left subclavian artery (LSA) cannot be prevented. Subsequently, neurological complications such as stroke or ischemia of the left upper extremity may develop. However, the actual risk of these complications is subject to considerable controversy. The optimal treatment approach, specifically the question whether primary revascularization of the LSA should be performed in all cases, is unclear...
May 23, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29788460/general-principles-for-pial-synangiosis-in-pediatric-moyamoya-patients-2-dimensional-operative-video
#4
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Pial synangiosis is a method of indirect surgical revascularization developed at our institution for the treatment of moyamoya disease in pediatric patients. Similar surgical principles are employed in adult cases, often performed because of lack of an adequate donor vessel. Standardized protocols, including preadmission for preoperative intravenous hydration and aspirin administration, as well as intraoperative electroencephalography, are routinely employed to minimize operative risk. Perioperative heparinization is not required...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29786410/percutaneous-deep-venous-arterialization-in-patients-with-critical-limb-ischemia-a-technical-note
#5
Steven Kum, Eline Huizing, Michiel A Schreve, Çagdas Ünlü, Roberto Ferraresi, Lasitha B Samarakoon, Daniel A van den Heuvel
Critical limb ischemia (CLI) is the presentation of end stage peripheral arterial disease and typically presents with rest pain, ulceration and gangrene. The outcome of conservative treatment is poor and often leads to amputations. Arterial revascularization plays an important role in amputation prevention. Unfortunately, a significant percentage of CLI patients cannot be revascularized and subsequently end up with a palliative amputation. This has led to the need and exploration of new treatment options in this no option subgroup of CLI...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29786405/surgical-versus-endovascular-revascularization-of-subclavian-artery-arteriosclerotic-disease
#6
Marco V Usai, Michel J Bosiers, Theodosios Bisdas, Giovanni Torsello, Efthymis Beropoulis, Bernd Kasprzak, Arne Stachmann, Konstantinos Stavroulakis
BACKGROUND: Endovascular treatment offers an alternative less-invasive approach to open repair for subclavian artery atherosclerotic disease (SAAD). However, only few studies compared the outcomes of both strategies in the long run. This study reports on the performance of endovascular and surgical revascularization for SAAD. METHODS: A retrospective review was conducted on patients treated for SAAD at two institutions between January 1998 and December 2015. Primary outcome of this study was the composite endpoint of re-intervention-free survival (RFS) defined as time to re-intervention and/or death from any cause...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29785878/five-year-outcomes-with-pci-guided-by-fractional-flow-reserve
#7
Panagiotis Xaplanteris, Stephane Fournier, Nico H J Pijls, William F Fearon, Emanuele Barbato, Pim A L Tonino, Thomas Engstrøm, Stefan Kääb, Jan-Henk Dambrink, Gilles Rioufol, Gabor G Toth, Zsolt Piroth, Nils Witt, Ole Fröbert, Petr Kala, Axel Linke, Nicola Jagic, Martin Mates, Kreton Mavromatis, Habib Samady, Anand Irimpen, Keith Oldroyd, Gianluca Campo, Martina Rothenbühler, Peter Jüni, Bernard De Bruyne
Background We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Methods Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0...
May 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29785339/identification-of-potential-crucial-genes-and-pathways-associated-with-vein-graft-restenosis-based-on-gene-expression-analysis-in-experimental-rabbits
#8
Qiang Liu, Xiujie Yin, Mingzhu Li, Li Wan, Liqiao Liu, Xiang Zhong, Zhuoqi Liu, Qun Wang
Occlusive artery disease (CAD) is the leading cause of death worldwide. Bypass graft surgery remains the most prevalently performed treatment for occlusive arterial disease, and veins are the most frequently used conduits for surgical revascularization. However, the clinical efficacy of bypass graft surgery is highly affected by the long-term potency rates of vein grafts, and no optimal treatments are available for the prevention of vein graft restenosis (VGR) at present. Hence, there is an urgent need to improve our understanding of the molecular mechanisms involved in mediating VGR...
2018: PeerJ
https://www.readbyqxmd.com/read/29784901/symptomatic-total-aortic-occlusion
#9
Bogdan Dutu, Dumitru Zdrenghea, Dana Pop, Gabriel Cismaru, Alexandru Martis, Adrian C Iancu
BACKGROUND Aortic occlusion, whether acute or subacute, is a rare but very serious entity with disastrous consequences if not treated in a timely fashion. Rapid diagnosis is crucial in this setting. In surgically treated patients there is a high degree of mortality and morbidity; therefore, percutaneous revascularization, whenever possible and independent of the available techniques, is much more desirable. CASE REPORT A 62-year-old woman with a history of diabetes mellitus, dyslipidemia, hypertension, and peripheral vascular disease, with previous femoral-femoral bypass for right common iliac artery occlusion, and with recent conventional angiography showing near occlusion of the ostial left common iliac artery (the donor vessel for the previous bypass), was referred to our hospital for conventional angioplasty...
May 22, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29784631/safety-and-efficacy-of-polymer-free-biolimus-eluting-stents-in-all-comer-patients-the-rudi-free-study
#10
Gennaro Sardella, Giulio G Stefanini, Carlo Briguori, Corrado Tamburino, Franco Fabbiocchi, Francesco Rotolo, Fabrizio Tomai, Anita Paggi, Mario Lombardi, Gaetano Gioffrè, Rocco Sclafani, Andrea Rolandi, Alessandro Sciahbasi, Francesco Scardaci, Nicola Signore, Simone Calcagno, Massimo Mancone, Mauro Chiarito, Arturo Giordano
AIMS: Polymer-free biolimus-eluting stents (PF-BES) have been shown superior to bare metal stents in high bleeding risk (HBR) patients treated with 1-month dual antiplatelet therapy (DAPT). However, limited evidence is available on PF-BES in non-HBR patients. We aim to evaluate the safety and efficacy of PF-BES in all-comer patients undergoing percutaneous coronary interventions (PCI). METHODS AND RESULTS: Patients with stable coronary artery disease or acute coronary syndromes (ACS) undergoing PCI with PF-BES in routine clinical practice were included in a multicenter, prospective registry...
May 21, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29784567/short-term-results-of-left-subclavian-artery-salvage-in-blunt-thoracic-aortic-injury-with-short-proximal-landing-zones
#11
Edvard Skripochnik, David Novikov, Thomas J Bilfinger, Shang A Loh
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is the standard treatment of blunt thoracic aortic injury (BTAI). The concept of seal was derived from the treatment of aneurysms and has been adopted for BTAI. Given the location of injury in BTAI, left subclavian artery (LSA) coverage is sometimes necessary. In these often healthier aortas, a shorter proximal landing zone may be acceptable and beneficial in avoiding some complications. Current practice patterns vary, and long-term effects of LSA coverage remain unknown...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#12
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29780241/patient-and-physician-preferences-for-attributes-of-coronary-revascularization
#13
Carlos Alberto da Silva Magliano, Andrea Liborio Monteiro, Bernardo Rangel Tura, Claudia Silvia Rocha Oliveira, Amanda Rebeca de Oliveira Rebelo, Claudia Cristina de Aguiar Pereira
Background: Patients with a diagnosis of coronary artery disease (CAD) may face important decisions regarding treatment options, with the "right choice" depending on the relative weights of risks and benefits. Studies performed as discrete choice experiments are used to estimate these weights, and attribute selection is an essential step in the design of these studies. Attributes not included in the design cannot be analyzed. In this study, we aimed to elicit, rank, and rate attributes that may be considered important to patients and physicians who must choose between angioplasty and surgery for coronary revascularization...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29779962/implementation-of-drug-eluting-stents-for-the-treatment-of-femoropopliteal-disease-provides-significant-cost-to-system-savings-in-a-single-state-outpatient-simulation
#14
Natalie Domenick Sridharan, Nathan Liang, Darve Robinson, Efthymios Avgerinos, Edith Tzeng, Michel S Makaroun, Rabih A Chaer, Mohammad H Eslami
OBJECTIVES: Initial data on drug-eluting stents (DES) shows that they may increase the durability of endovascular treatment of superficial femoral artery disease compared with traditional bare metal stents (BMS). Observed decreased target lesion revascularization (TLR) rates have potential for cost savings despite an increased initial cost. The purpose of this study was to run a simulation model of progressive transition from BMS to DES over 5 years evaluating the overall cost impact of that transition...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779046/sex-differences-in-the-long-term-prognostic-value-of-13-n-ammonia-myocardial-perfusion-positron-emission-tomography
#15
Catherine Gebhard, Michael Fiechter, Bernhard A Herzog, Christine Lohmann, Susan Bengs, Valerie Treyer, Michael Messerli, Dominik C Benz, Andreas A Giannopoulos, Christoph Gräni, Aju P Pazhenkottil, Ronny R Buechel, Philipp A Kaufmann
PURPOSE: Evidence to date on the unique female determinants of cardiovascular risk is inadequate. Positron Emission Tomography (PET) is considered to have the highest accuracy for the assessment of myocardial perfusion in patients with suspected coronary artery disease (CAD), but its long-term prognostic accuracy in women has not been established. METHODS: A total of 619 consecutive patients (138 women, mean age 60.0 ± 11.8 years) underwent clinically indicated 13 N-ammonia PET at our institution and were followed up (median 5...
May 19, 2018: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#16
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29778336/implementation-of-the-aortic-no-touch-technique-to-reduce-stroke-after-off-pump-coronary-surgery
#17
Alexander Albert, Jürgen Ennker, Yasser Hegazy, Sebastian Ullrich, Georgi Petrov, Payam Akhyari, Stefan Bauer, Eda Ürer, Ina Carolin Ennker, Artur Lichtenberg, Horst Priss, Alexander Assmann
OBJECTIVES: Despite substantial scientific effort, the relationship between stroke after coronary artery bypass grafting and the use of the aortic no-touch off-pump technique (anOPCAB) remains incompletely understood. The present study aimed to define the effect of anOPCAB on the occurrence and time point of stroke. METHODS: A total cohort of 15,042 consecutive patients underwent surgical myocardial revascularization at a single institution. After establishing anOPCAB as routine procedure, 4695 patients received surgery by 18 different surgeons using the anaortic approach...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778317/appropriate-use-of-noninvasive-ischemia-testing-to-guide-revascularization-decision-making-following-acute-st-elevation-myocardial-infarction-in-latin-american-countries-results-from-an-expert-panel-meeting-of-the-international-atomic-energy-agency
#18
I Berrocal, A Peix, F Mut, L J Shaw, G Karthikeyan, E Estrada Lobato, D Paez
Across Latin American and Caribbean countries, cardiovascular disease and especially ischemic heart disease is currently the main cause of death both in men and in women. For most Latin American and Caribbean countries, public and community health efforts aim to define care strategies which are both clinically and cost effective and promote primary and secondary prevention, resulting in improved patient outcomes. The optimal approach to deal with acute events such as ST-elevation myocardial infarction (STEMI) is a matter of controversy; however, there is an expanding role for assessing residual ischemic burden in STEMI patients following primary percutaneous coronary intervention...
May 16, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/29777848/effects-on-mortality-and-cardiovascular-events-of-adherence-to-guideline-recommended-therapy-4-years-after-lower-extremity-arterial-revascularization
#19
M Thiney, N Della Schiava, R Ecochard, P Feugier, P Lermusiaux, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme inhibitors (ACE) or Angiotensin receptor blockers (ARB), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the current risk for cardiovascular (CV) events and mortality and also to evaluate the effect of pharmacologic treatment on patient's survival, CV events and additional vascular surgery in vascularized LE-PAD patients...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#20
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
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