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Arterial revascularization

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https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#1
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#2
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28428521/-simple-evaluation-of-left-hand-function-after-thoracic-endovascular-aortic-repair-with-obstruction-of-left-subclavian-artery
#3
Ryo Onishi, Nobuhiro Kataoka, Tomomi Nakajima, Masami Kuramochi, Mayumi Shinonaga, Setsuo Kuraoka
We evaluated left hand function with or without obstruction of left subclavian artery for 29 cases of thoracic endovascular aortic repair (TEVAR). 18 cases of distal true aortic aneurysm were undergone surgery with simple direct closure of left subclavian artery (LSCA). The other 11 cases of true arch aneurysm were revascularized by axilla-carotid-axilla bypass grafting with TEVAR. Later 26 cases were evaluated by blood pressure, maximal grasping power, persisting duration of 60% maximal grasping power, circumferential length of upper and forearms, and simple test for evaluating hand function (STEF)...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428349/toll-like-receptor-4-mediates-hemorrhagic-transformation-after-delayed-tissue-plasminogen-activator-administration-in-in-situ-thromboembolic-stroke
#4
Alicia García-Culebras, Sara Palma-Tortosa, Ana Moraga, Isaac García-Yébenes, Violeta Durán-Laforet, Maria I Cuartero, Juan de la Parra, Ana L Barrios-Muñoz, Jaime Díaz-Guzmán, Jesús M Pradillo, María A Moro, Ignacio Lizasoain
BACKGROUND AND PURPOSE: Hemorrhagic transformation is the main complication of revascularization therapies after stroke. Toll-like receptor 4 (TLR4) is implicated in cerebral damage and inflammation in stroke. This study was designed to determine the role of TLR4 in hemorrhagic transformation development after tissue plasminogen activator (tPA) administration. METHODS: Mice expressing (TLR4(+/+)) or lacking functional TLR4 (TLR4(-)(/-)) were subjected to middle cerebral artery occlusion using an in situ thromboembolic model by thrombin injection into the middle cerebral artery, and tPA (10 mg/kg) was administered 20 minutes or 3 hours after ischemia...
April 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28427867/outcomes-from-anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-repair-long-term-complications-in-relation-to-residual-myocardial-abnormalities
#5
Miki Kanoh, Kei Inai, Tokuko Shinohara, Hirofumi Tomimatsu, Toshio Nakanishi
BACKGROUND: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary artery irregularity. This study aimed to clarify the long-term postoperative outcomes in ALCAPA patients, and to compare the infantile and adult types. METHODS: We retrospectively analyzed the clinical data from 33 patients with ALCAPA who underwent surgical repairs after 1980. The patients were grouped based on whether presentation occurred before (infantile type: n=14) or after (adult type: n=19) 1 year of age...
April 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28427735/comparison-of-frequency-and-characteristics-of-patients-with-atrial-fibrillation-having-ablation-with-versus-without-coronary-narrowing-%C3%A2-50-by-angiography
#6
Toshiro Tomomatsu, Itsuro Morishima, Kenji Okumura, Hideyuki Tsuboi, Yasuhiro Morita, Kensuke Takagi, Ruka Yoshida, Hiroaki Nagai, Yoshihiro Ikai, Naoki Shibata, Kazuhito Tsuzuki, Takahito Sone, Toyoaki Murohara
Atrial fibrillation (AF) shares background comorbidities with coronary artery disease (CAD), including hypertension and diabetes mellitus. The aim of the study is to evaluate the prevalence, risk factors, and prognostic significance of CAD among patients who underwent catheter ablation for AF. In 544 consecutive registered patients who underwent catheter ablation for AF (CHADS2 score 1.2 ± 1.1, paroxysmal AF 57%), quantitative coronary angiography was used to detect CAD, defined as luminal narrowing of ≥50% in diameter...
March 16, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28427580/quality-of-life-after-surgery-or-des-in-patients-with-3-vessel-or-left-main-disease
#7
Mouin S Abdallah, Kaijun Wang, Elizabeth A Magnuson, Ruben L Osnabrugge, A Pieter Kappetein, Marie-Claude Morice, Friedrich A Mohr, Patrick W Serruys, David J Cohen
BACKGROUND: In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization. OBJECTIVES: This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#8
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28427383/is-ischemia-the-only-factor-predicting-cardiovascular-outcomes-in-all-diabetes-mellitus-patients
#9
REVIEW
Mark W Kennedy, Enrico Fabris, Harry Suryapranata, Elvin Kedhi
Diabetes mellitus (DM) is associated with an excess in cardiovascular morbidity and mortality, and is characterized by increased rates of coronary artery disease. Furthermore, once atherosclerosis is established, this is associated with an increased extent, complexity and a more rapid progression than seen in non-DM patients. Ischemia is the single most important predictor of future hard cardiac events and ischemia correction remains the cornerstone of current revascularization strategies. However recent data suggests that, in DM patients, coronary atherosclerosis despite the absence of ischemia, detected by either invasive or non-invasive methods, may not be associated with the same low risk of future cardiac events as seen in non-DM patients...
April 20, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28424224/novel-strategies-to-reduce-femoropopliteal-restenosis-low-dose-paclitaxel-coated-balloons-and-paclitaxel-coated-balloons-plus-stenting
#10
Andrew M Goldsweig, Herbert D Aronow
Peripheral artery disease (PAD) affects more than 200 million individuals worldwide, and those with exertional leg discomfort, rest pain, and tissue or limb loss have significantly impaired functional status and quality of life. Despite their lower associated risk of repeat revascularization, open surgical procedures have been largely supplanted by endovascular intervention for symptomatic PAD given the lower associated morbidity and mortality. Although standalone plain-old percutaneous transluminal angioplasty (PTA) was previously the standard endovascular strategy for these patients, high procedural failure and restenosis rates led to the development of new therapeutic technologies...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28424223/low-dose-paclitaxel-coated-versus-uncoated-percutaneous-transluminal-balloon-angioplasty-for-femoropopliteal-peripheral-artery-disease-1-year-results-of-the-illumenate-european-randomized-clinical-trial
#11
Henrik Schroeder, Martin Werner, Dirk-Roelfs Meyer, Peter Reimer, Karsten Krüger, Michael R Jaff, Marianne Brodmann
Background -Numerous studies have reported favorable outcomes using drug-coated balloons (DCBs) for treatment of symptomatic peripheral artery disease (PAD) of the superficial femoral and popliteal arteries. However, the treatment effect compared to an uncoated balloon has differed greatly amongst the randomized trials with better outcomes observed with higher-dose DCBs. This European trial was designed to assess the safety and effectiveness of a next-generation low dose (2 µg/mm(2) surface dose of paclitaxel) DCB...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28424222/randomized-comparison-of-paclitaxel-eluting-balloon-angioplasty-plus-stenting-versus-standard-balloon-angioplasty-plus-stenting-versus-directional-atherectomy-for-symptomatic-femoral-artery-disease-isar-stath
#12
Ilka Ott, Salvatore Cassese, Philipp Groha, Birgit Steppich, Martin Hadamitzky, Tareq Ibrahim, Sebastian Kufner, Karl Dewitz, Regina V Hiendlmayer, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati, Massimiliano Fusaro
Background -Atherosclerosis in the superficial femoral artery (SFA) is common in patients suffering from peripheral artery disease. Paclitaxel-eluting balloon (PEB) angioplasty, stenting and directional atherectomy (DA) have provided new options for the treatment of SFA disease, however the comparative efficacy remains uncertain. Methods -One hundred and fifty five patients with symptomatic peripheral artery disease with de novo SFA stenotic or occlusive lesions were randomized to treatment with plain balloon angioplasty (BA) followed by PEB angioplasty and stenting (n=48), BA followed by stenting (n=52) or directional DA with distal protection and bailout stenting (n=55)...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28424044/emergent-carotid-thromboendarterectomy-for-acute-symptomatic-occlusion-of-the-extracranial-internal-carotid-artery
#13
Igor Gunka, Dagmar Krajickova, Michal Lesko, Stanislav Jiska, Jan Raupach, Miroslav Lojik, Radovan Maly
BACKGROUND: Strokes secondary to acute internal carotid artery (ICA) occlusion are associated with an extremely poor prognosis. The best treatment approach in this setting is still unknown. The aim of our study was to evaluate the efficacy, safety, and outcomes of emergent surgical revascularization of acute extracranial ICA occlusion in patients with minor to severe ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data of consecutive patients who underwent carotid thromboendarterectomy for symptomatic acute ICA occlusion during the period from January 2013 to December 2015...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28421375/obstructive-sleep-apnea-increases-the-risk-of-cardiac-events-after-percutaneous-coronary-intervention-a-meta-analysis-of-prospective-cohort-studies
#14
REVIEW
Hua Qu, Ming Guo, Ying Zhang, Da-Zhuo Shi
PURPOSE: Recent studies have shown an association between obstructive sleep apnea (OSA) and coronary artery disease; however, the association between OSA and cardiac outcomes in patients after percutaneous coronary intervention (PCI) remains undetermined. METHODS: PubMed, EMBASE, and CENTRAL were searched from inception to July 2016 for cohort studies that followed up with patients after PCI, and evaluated their overnight sleep patterns within 1 month for major adverse cardiac events (MACEs) as primary outcomes including cardiac death, non-fatal myocardial infarction (MI), and coronary revascularization and secondary outcomes including re-admission for heart failure and stroke...
April 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28420647/incremental-value-of-transthoracic-doppler-echocardiography-assessed-coronary-flow-reserve-in-patients-with-suspected-myocardial-ischemia-undergoing-myocardial-perfusion-scintigraphy
#15
Li-Ming Gan, Sara Svedlund, Ann Wittfeldt, Charlotte Eklund, Sinsia Gao, Göran Matejka, Anders Jeppsson, Per Albertsson, Elmir Omerovic, Amir Lerman
BACKGROUND: Adenosine-assisted transthoracic Doppler-derived coronary flow reserve (TDE-CFR) reflects coronary vascular function. The prognostic and incremental value of left anterior descending coronary artery TDE-CFR above myocardial perfusion scintigraphy in patients with suspected myocardial ischemia has not yet been studied. METHODS AND RESULTS: Three hundred seventy-one patients (mean age, 62.3±8.7 years; 46.8% males) referred to myocardial perfusion scintigraphy attributed to suspected myocardial ischemia were included in the study...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28419280/fractional-flow-reserve-and-pressure-bounded-coronary-flow-reserve-to-predict-outcomes-in-coronary-artery-disease
#16
Jung-Min Ahn, Frederik M Zimmermann, Nils P Johnson, Eun-Seok Shin, Bon-Kwon Koo, Pil Hyung Lee, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Nico H J Pijls, Seung-Jung Park
Aims: Fractional flow reserve (FFR) has proven to its prognostic and therapeutic value. However, the additive prognostic value of coronary flow reserve (CFR) remains unclear. This study sought to investigate the clinical utility of combined FFR and CFR measurements to predict outcomes. Methods and results: Using the prospective, multicentre Interventional Cardiology Research Incooperation Society-FFR registry, a total of 2088 lesions from 1837 patients were included in this substudy...
April 17, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28417613/combination-therapy-for-complex-peripheral-artery-disease-the-evidence-for-combining-mechanical-revascularisation-with-anti-restenotic-drug-delivery-systems
#17
Ramon L Varcoe
The management of complex, lower-extremity peripheral artery disease remains a difficult challenge, with ample room for improvement in the results seen with current generation devices. Therapies which use a combination of multiple devices for their mechanical and anti-restenotic properties may be advantageous, and offer an opportunity to improve the durability of revascularization through optimizing and individualizing care. Combination therapy typically utilizes drug delivery devices in addition to stents and atherectomy to achieve improved results...
April 14, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28417594/real-world-supported-unprotected-left-main-percutaneous-coronary-intervention-with-impella-device-data-from-the-uspella-registry
#18
Theodore Schreiber, Wah Wah Htun, Nimrod Blank, Tesfaye Telila, Nestor Mercado, Alexandros Briasoulis, Amir Kaki, Ashok Kondur, Ahmad Munir, Cindy Grines
BACKGROUND: Patients with left main (LM) coronary artery disease are increasingly being treated with percutaneous revascularization (PCI). The safety, feasibility, and efficacy of unprotected LM intervention (ULMI) with hemodynamic support by Impella device have not been evaluated previously. OBJECTIVE: Using a large retrospective single center database from the USpella registry, we evaluated the safety, feasibility, and potential benefits of periprocedural left ventricular assist with axial flow Impella 2...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28416165/influence-of-cardiovascular-risk-in-the-prediction-and-timing-of-cardiac-events-after-exercise-echocardiogram-testing-without-ischemia
#19
Sonia Velasco Del Castillo, Ane Antón Ladislao, Verónica Gómez Sánchez, José Juan Onaindia Gandarias, Ángela Cacicedo Fernández de Bobadilla, Ibon Rodríguez Sánchez, Eva Laraudogoitia Zaldumbide
INTRODUCTION AND OBJECTIVES: There have been no analyses of the influence of cardiovascular risk as a predictor of events in patients with exercise echocardiography (EE) without ischemia. Our objective was to determine the predictors of cardiac events, paying special attention to cardiovascular risk. METHODS: This study included 1640 patients with EE without ischemia. Of these, there were 1206 with no previously known coronary artery disease (CAD), whose risk of a fatal cardiovascular disease event was estimated according to the European SCORE (Systematic COronary Risk Evaluation) risk assessment system, and 434 with known CAD...
April 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#20
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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