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Emmanouil Brilakis

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https://www.readbyqxmd.com/read/28506646/virtual-resting-pd-pa-from-coronary-angiography-and-blood-flow-modelling-diagnostic-performance-against-fractional-flow-reserve
#1
Michail I Papafaklis, Takashi Muramatsu, Yuki Ishibashi, Christos V Bourantas, Dimitrios I Fotiadis, Emmanouil S Brilakis, Héctor M Garcia-Garcia, Javier Escaned, Patrick W Serruys, Lampros K Michalis
BACKGROUND: Fractional flow reserve (FFR) has been established as a useful diagnostic tool. The distal coronary pressure to aortic pressure (Pd/Pa) ratio at rest is a simpler physiologic index but also requires the use of the pressure wire, whereas recently proposed virtual functional indices derived from coronary imaging require complex blood flow modelling and/or are time-consuming. Our aim was to test the diagnostic performance of virtual resting Pd/Pa using routine angiographic images and a simple flow model...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28499595/impact-of-calcium-on-chronic-total-occlusion-percutaneous-coronary-interventions
#2
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R Wyman, Anthony Doing, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A Danek, Aris Karatasakis, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0...
April 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28488413/preventing-and-treating-coronary-perforations-lessons-from-disaster-management
#3
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Coronary artery perforations (CAP) are rare in patients undergoing routine PCI with recent contemporary databases reporting an incidence ∼0.3%. Older age, cardiomyopathy or left ventricular dysfunction, mechanical circulatory support prior to PCI, and CTO lesions have the strongest association with CAP. Prevention, early detection, preparedness and familiarity with the equipment used to treat perforations (such as efficient use of covered stents, and fat or coil embolization) and regrouping to examine and educate about these experiences are key for improving our response to cath lab disasters...
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28473108/contemporary-incidence-management-and%C3%A2-long-term-outcomes-of-percutaneous%C3%A2-coronary-interventions-for-chronic%C3%A2-coronary-artery-total-occlusions-insights-from-the-va-cart%C3%A2-program
#4
Thomas T Tsai, Maggie A Stanislawski, Kendrick A Shunk, Ehrin J Armstrong, Gary K Grunwald, Alan H Schob, Javier A Valle, Carlos E Alfonso, Brahmajee K Nallamothu, P Michael Ho, John S Rumsfeld, Emmanouil S Brilakis
OBJECTIVES: The aim of this study was to describe the contemporary incidence of chronic total occlusions (CTOs) and the success rates of CTO percutaneous coronary intervention (PCI), as well as the complications and long-term outcomes of these patients. BACKGROUND: The contemporary prevalence and management of coronary CTOs is understudied. METHODS: Consecutive veterans undergoing coronary angiography at 79 Veterans Affairs sites between 2007 and 2013 were examined...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28441644/management-of-guidewire-entrapment-with-laser-atherectomy
#5
Judit Karacsonyi, Jose R Martinez-Parachini, Barbara A Danek, Aris Karatasakis, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis
A 62-year-old man was referred for percutaneous coronary intervention of a severe circumflex lesion. The guidewire became entangled in the previously implanted left anterior descending artery stent. The left main was engaged with a second guide catheter, followed by balloon dilations, various microcatheters, and laser atherectomy. The wire eventually fractured without protruding into the aorta. The circumflex lesion was stented with two stents, followed by left main stenting that covered the fragment. Caution should be used when wiring through stents; wire fracture can be treated with stent implantation, as long as the wire fragment does not protrude into the aorta...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28440113/major-limb-outcomes-following-lower-extremity-endovascular-revascularization-in-patients-with-and-without-diabetes-mellitus
#6
Andrew N Shammas, Haekyung Jeon-Slaughter, Shirling Tsai, Houman Khalili, Mujtaba Ali, Hao Xu, Gerardo Rodriguez, Ian Cawich, Ehrin J Armstrong, Emmanouil S Brilakis, Subhash Banerjee
PURPOSE: To determine whether diabetes mellitus has an independent impact on major limb outcomes at 1 year after endovascular treatment of lower extremity peripheral artery disease (PAD). METHODS: The study involved 1906 consecutive patients (mean age 66 years; 1469 men) enrolled in the observational Excellence in Peripheral Artery Disease (XLPAD) registry ( ClinicalTrials.gov identifier NCT01904851) between January 2005 and October 2015 after undergoing index endovascular procedures in 2426 limbs for arterial occlusive disease...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28420803/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-valvular-heart-disease
#7
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Paul Sorajja, Mario Gössl, Santiago Garcia, Hani Jneid, Nikolaos Kakouros, Jose Roberto Martinez-Parachini, Erica Resendes, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have developed guidelines to assist clinicians in making evidence-based decisions. This study compares the ACC/AHA and ESC guidelines for the management of patients with valvular heart disease (VHD). METHODS: The current ACC/AHA and ESC guidelines for VHD, last updated in 2014 and 2012, respectively, were compared by class of recommendation (COR), level of evidence (LOE), and content...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28419791/the-role-of-rotational-atherectomy-in-contemporary-chronic-total-occlusion-percutaneous-coronary-intervention
#8
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Rotational atherectomy is performed infrequently (∼3.5%) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for two indications: treatment of balloon uncrossable and balloon undilatable lesions. Use of rotational atherectomy in CTO PCI was associated with high success and acceptable complication rates. Rotational atherectomy remains a "must have" device for interventional cardiologists performing complex PCI.
April 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28404624/bypass-graft-failure-changing-what-we-can-accepting-what-we-cannot-change-and-developing-the-science-to-know-the-difference
#9
EDITORIAL
Judit Karacsonyi, Emmanouil S Brilakis
No abstract text is available yet for this article.
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28385410/comparative-efficacy-of-endovascular-revascularization-versus-supervised-exercise-training-in-patients-with-intermittent-claudication-meta-analysis-of-randomized-controlled-trials
#10
Ambarish Pandey, Subhash Banerjee, Christian Ngo, Purav Mody, Steven P Marso, Emmanouil S Brilakis, Ehrin J Armstrong, Jay Giri, Marc P Bonaca, Aruna Pradhan, Anthony A Bavry, Dharam J Kumbhani
OBJECTIVES: The authors performed a meta-analysis of randomized controlled trials to compare the efficacy of initial endovascular treatment with or without supervised exercise training (SET) versus SET alone in patients with intermittent claudication. BACKGROUND: Current guidelines recommend SET as the initial treatment modality for patients with intermittent claudication, in addition to optimal medical therapy. The role of endovascular therapy as primary treatment for claudication has been controversial...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28342253/ipsilateral-vs-contralateral-vs-no-collateral-antegrade-only-chronic-total-occlusion-percutaneous-coronary-interventions-what-is-the-right-choice-for-your-practice
#11
EDITORIAL
Lorenzo Azzalini, Emmanouil S Brilakis
No abstract text is available yet for this article.
March 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#12
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28306587/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-non-st-segment-elevation-acute-coronary-syndromes
#13
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
June 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#14
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28303639/covered-stent-implantation-through-a-single-8-french-guide-catheter-for-the-management-of-a-distal-coronary-perforation
#15
Yader Sandoval, Angie S Lobo, Emmanouil S Brilakis
Distal coronary perforation can cause early or late tamponade and is usually treated with fat or coil embolization. An alternative treatment strategy is occlusion of the ostium of the perforated vessel via implantation of a covered stent in the main vessel, which is typically achieved using the ping-pong guide catheter technique. In this technique, a balloon is inflated over one guide catheter to stop pericardial bleeding and a covered stent is delivered through a second guide catheter due to inability to fit both a balloon and a covered stent through a single guide catheter...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296639/impact-of-chronic-total-occlusions-on-revascularization-scores-and-outcome-prediction
#16
Björn Redfors, Tullio Palmerini, Adriano Caixeta, Girma Minalu Ayele, Dominic P Francese, Roxana Mehran, Emmanouil S Brilakis, Ajay J Kirtane, Dimitri Karmpaliotis, Gregg W Stone, Philippe Généreux
OBJECTIVES: To evaluate the contribution of chronic total occlusion (CTO)-related SYNTAX score (SS) to the overall SS for patients with CTO and compare the traditional SS to a simplified variant. The SS algorithm assigns CTO lesions a greater weight (5× points) than non-CTO lesions (50% to <100% diameter stenosis; 2× points). METHODS: We calculated the SS and the simplified SS (2× points also to CTO lesions) for 4356 patients from the angiographic substudy of the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial...
April 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28285030/the-evolution-of-arterial-access-for-cardiac-catheterization-lessons-from-central-and-northern-greece
#17
EDITORIAL
Emmanouil S Brilakis, Aris Karatasakis
No abstract text is available yet for this article.
September 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28255103/percutaneous-coronary-intervention-of-coronary-chronic-total-occlusions-improves-peak-oxygen-uptake-during-cardiopulmonary-exercise-testing
#18
Shuaib M Abdullah, Jeffrey L Hastings, Suwetha Amsavelu, Fransisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating symptom improvement have been mostly limited to questionnaire responses. The current study assessed for changes in peak oxygen uptake during cardiopulmonary exercise testing after CTO-PCI. METHODS: Patients with heart failure or angina symptoms referred for CTO-PCI were prospectively enrolled. The primary outcome of the study was improvement in peak oxygen uptake during cardiopulmonary exercise (CPX) testing 5 months after CTO-PCI...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28242587/impact-of-crossing-strategy-on-mid-term-outcomes-following-percutaneous-revascularisation-of-coronary-chronic-total-occlusions
#19
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
AIMS: To compare the impact of crossing strategies on mid-term outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We compiled a multicentre registry of consecutive patients undergoing successful CTO PCI. Patients were divided in three groups: true-to-true (TTT) approach, modern dissection/re-entry (DR) techniques (CrossBoss/Stingray, reverse CART), and old DR techniques (LAST, STAR, CART). Cox regression was used to identify independent predictors of major adverse cardiac events (MACE: cardiac death, myocardial infarction and target-vessel revascularisation)...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#20
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
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