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Emmanouil Brilakis

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https://www.readbyqxmd.com/read/29226736/the-effect-of-major-adverse-renal-cardiovascular-event-marce-incidence-procedure-volume-and-unit-cost-on-the-hospital-savings-resulting-from-contrast-media-use-in-inpatient-angioplasty
#1
Eric Keuffel, Peter A McCullough, Thomas M Todoran, Emmanouil S Brilakis, Swetha R Palli, Michael P Ryan, Candace Gunnarsson
OBJECTIVE: Determine the net economic impact of switching from low-osmolar contrast media (LOCM) to iso-osmolar contrast media (IOCM; iodixanol) in patients undergoing inpatient coronary or peripheral angioplasty in the United States (US). METHODS: A budget impact model (BIM) was developed from a hospital perspective. Nationally representative procedural and contrast media prevalence rates, along with MARCE (major adverse renal cardiovascular event) incidence and episode-related cost data were derived from Premier Hospital Data (October 2014 to September 2015)...
December 11, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29223954/effect-of-pcsk9-inhibitors-on-clinical-outcomes-in-patients-with-hypercholesterolemia-a-meta-analysis-of-35-randomized-controlled-trials
#2
REVIEW
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele K Roesle, Thomas Knickelbine, Michael D Miedema, Houman Khalili, Zahid Ahmad, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included. Mean age was 61.0±2.8 years, and mean baseline low-density lipoprotein cholesterol was 106±22 mg/dL...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29207363/improvement-in-aortic-valve-area-in-patients-with-aortic-stenosis-through-use-of-a-new-hourglass-shaped-valvuloplasty-balloon
#3
Elizabeth Goldenberg, Wesley Pedersen, Emmanouil S Brilakis, Michael Mooney, Mario Gössl, Anil Poulose, Bilal Murad, James Kolbeck, Paul Sorajja
OBJECTIVES: The study aim was to assess the effect of hourglass-shaped V8 and TAV8 balloons (InterValve, Inc) on aortic valve area (AVA) and other outcomes in patients with severe aortic stenosis undergoing balloon aortic valvuloplasty (BAV). BAV has re-emerged with transcatheter therapy. Cylindrical balloons have been the device of choice despite limitations. The hourglass-shaped balloons, with shorter, broader segments separated by a narrowed waist, permit enhanced fixation and better leaflet opening without annular or sinotubular compromise...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29169496/transfemoral-approach-for-coronary%C3%A2-angiography-and-intervention-a-collaboration-of-international-cardiovascular-societies
#4
Abdulla A Damluji, Daniel W Nelson, Marco Valgimigli, Stephan Windecker, Robert A Byrne, Fernando Cohen, Tejas Patel, Emmanouil S Brilakis, Subhash Banerjee, Jorge Mayol, Warren J Cantor, Carlos E Alfonso, Sunil V Rao, Mauro Moscucci, Mauricio G Cohen
OBJECTIVES: The aim of this study was to examine the current practice and use of transfemoral approach (TFA) for coronary angiography and intervention. BACKGROUND: Wide variability exists in TFA techniques for coronary procedures. METHODS: The authors developed a survey instrument that was distributed via e-mail lists from professional societies to interventional cardiologists from 88 countries between March and December 2016. RESULTS: Of 987 operators, 18% were femoralists, 38% radialists, 42% both, and 2% neither...
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29169493/contemporary-arterial-access-in-the-cardiac-catheterization-laboratory
#5
REVIEW
Yader Sandoval, M Nicholas Burke, Angie S Lobo, Daniel L Lips, Arnold H Seto, Ivan Chavez, Paul Sorajja, Mazen S Abu-Fadel, Yale Wang, Anil Poulouse, Mario Gössl, Michael Mooney, Jay Traverse, David Tierney, Emmanouil S Brilakis
Obtaining femoral and radial arterial access in the cardiac catheterization laboratory using state-of-the-art techniques is essential to optimize outcomes, patient satisfaction, and procedural efficiency. Although transradial access is increasingly used for coronary angiography and percutaneous coronary intervention, femoral access remains necessary for numerous procedures, many requiring large-bore access, including complex high-risk coronary interventions, structural procedures, and procedures involving mechanical circulatory support...
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146022/performance-of-j-cto-and-progress-cto-scores-in-predicting-angiographic-success-and-long-term-outcomes-of-percutaneous-coronary-interventions-for-chronic-total-occlusions
#6
Farshad Forouzandeh, Jon Suh, Eric Stahl, Yi-An Ko, Suegene Lee, Udit Joshi, Nitin Sabharwal, Zakaria Almuwaqqat, Rounak Gandhi, Hee Su Lee, Sung Gyun Ahn, Bill D Gogas, John S Douglas, Gregory Robertson, Wissam Jaber, Dimitri Karmpaliotis, Emmanouil S Brilakis, William J Nicholson, Spencer B King, Habib Samady
Patient selection for and predicting clinical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) remain challenging. We hypothesized that both J-CTO (Multicenter Chronic Total Occlusion Registry of Japan) and PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) scores will predict not only angiographic success but also long-term clinical outcomes of the patients who underwent PCI of CTO. Of 325 CTO PCIs performed at 2 Emory University hospitals from January 2012 to August 2015, 249 patients with complete baseline clinical, angiographic and follow-up data, were included in this analysis...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29138364/retrograde-cto-pci-of-native-coronary-arteries-via-left-internal-mammary-artery-grafts-insights-from-a-multicenter-u-s-registry
#7
Peter Tajti, Aris Karatasakis, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, James W Choi, Anthony H Doing, Catalin Toma, Barry Uretsky, Santiago Garcia, Jeffrey W Moses, Manish Parikh, Ajay Kirtane, Ziad A Ali, Raja Hatem, Judit Karacsonyi, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
BACKGROUND: Retrograde percutaneous coronary intervention (PCI) of native coronary artery chronic total occlusion (CTO) via left internal mammary artery (LIMA) graft has received limited study. METHODS AND RESULTS: We compared the clinical and procedural characteristics and outcomes of retrograde CTO-PCI through LIMA grafts vs other conduits in a contemporary multicenter CTO registry. The LIMA was used as the collateral channel in 20 of 990 retrograde CTO-PCIs (2...
November 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29122132/clinical-endpoints-and-key-data-elements-in-percutaneous-coronary-intervention-of-coronary-chronic-total-occlusion-studies-a-call-to-the-academic-research-consortium-for-standardized-definitions
#8
REVIEW
Luiz Fernando Ybarra, Nicolo Piazza, Emmanouil Brilakis, J Aaron Grantham, Gregg W Stone, Stéphane Rinfret
No abstract text is available yet for this article.
November 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29117715/iso-osmolar-contrast-media-and-adverse-renal-and-cardiac-events-after-percutaneous-cardiovascular-intervention
#9
Peter A McCullough, Guy David, Thomas M Todoran, Emmanouil S Brilakis, Michael P Ryan, Candace Gunnarsson
AIM: To assess the relationship between type of contrast media (CM), iso-osmolar contrast media (IOCM) or low-osmolar contrast media (LOCM), and major adverse renal and cardiovascular events (MARCE). MATERIALS & METHODS: Coronary or peripheral angioplasty visits were stratified into CM cohorts: IOCM or LOCM. Multivariable regression analysis used hospital fixed effects to assess the relationship between MARCE events and type of CM. RESULTS: Among 333,533 visits (357 hospitals), the incidence of MARCE was 7...
November 9, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29105577/comparative-assessment-of-patient-outcomes-with-intraluminal-or-subintimal-crossing-of-infrainguinal-peripheral-artery-chronic-total-occlusions
#10
Ananya Kondapalli, Haekyung Jeon-Slaughter, Hua Lu, Hao Xu, Houman Khalili, Anand Prasad, Ehrin J Armstrong, Emmanouil S Brilakis, Subhash Banerjee
This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications...
November 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/29105328/does-the-end-justify-the-means-the-contemporary-role-of-dissection-re-entry-strategies-for-recanalization-of-coronary-chronic-total-occlusions
#11
EDITORIAL
Aris Karatasakis, Emmanouil S Brilakis
Antegrade and retrograde dissection/re-entry techniques are frequently utilized in contemporary CTO PCI, especially for complex lesions. One-year outcomes with modern dissection/re-entry techniques appear favorable and comparable with those achieved after intraplaque crossing, supporting their increased use. Randomized data on the procedural safety, efficiency, and long-term outcomes of subadventitial CTO PCI techniques are needed.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29096916/dk-crush-should-become-preferred%C3%A2-strategy-for-treating-unprotected-lm-bifurcation-lesions-no-pain-no-gain
#12
EDITORIAL
Emmanouil S Brilakis, M Nicholas Burke, Subhash Banerjee
No abstract text is available yet for this article.
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29068125/novel-use-of-cutting-balloon-to-treat-subintimal-hematomas-during-chronic-total-occlusion-interventions
#13
Minh N Vo, Emmanouil S Brilakis, J Aaron Grantham
Contemporary chronic total occlusion (CTO) percutaneous coronary interventional (PCI) techniques are increasingly dependent upon dissection and reentry techniques (DARTs) especially for long occluded lesions. DARTs can result in compressive hematomas during CTO interventions and traditional treatment with balloon angioplasty and/or coronary stenting are often suboptimal and may extend the hematoma distally. We describe the novel use of a cutting balloon to "express" these compressive hematomas and restore antegrade coronary blood flow...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29035846/current-perspectives-and-practices-on-chronic-total-occlusion-percutaneous-coronary-interventions
#14
Siddharth M Patel, Rohan V Menon, M Nicolas Burke, Farouc A Jaffer, Robert W Yeh, Minh Vo, Dimitri Karmpaliotis, Lorenzo Azzalini, Mauro Carlino, Kambis Mashayekhi, Alfredo R Galassi, Stephane Rinfret, Stephen G Ellis, Mitul Patel, Bavana V Rangan, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Erica Resendes, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to examine contemporary perspectives and practices on chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: The frequency and success of CTO-PCI have been increasing in recent years. METHODS: An online questionnaire was created and distributed to cardiologists within the United States and internationally. RESULTS: A total of 1149 responses were obtained. The United States (n = 845; 73...
October 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28945162/orbital-atherectomy-for-the-treatment-of-severely-calcified-coronary-lesions-evidence-technique-and-best-practices
#15
Evan Shlofmitz, Brad J Martinsen, Michael Lee, Sunil V Rao, Philippe Généreux, Joe Higgins, Jeffrey W Chambers, Ajay J Kirtane, Emmanouil S Brilakis, David E Kandzari, Samin K Sharma, Richard Shlofmitz
The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed...
October 4, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28841230/rationale-and-design-of-the-drug-eluting-stents-vs-bare-metal-stents-in-saphenous-vein-graft-angioplasty-diva-trial
#16
Emmanouil S Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R Holmes, Deepak L Bhatt, Sunil V Rao, Mark W Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V Rangan, Beverly Ventura, Ying Lu, Mark Holodniy, Mei-Chiung Shih
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28826896/incidence-treatment-and-outcomes-of-coronary-perforation-during-chronic-total-occlusion-percutaneous-coronary-intervention
#17
MULTICENTER STUDY
Barbara Anna Danek, Aris Karatasakis, Peter Tajti, Yader Sandoval, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul P Patel, Ehtisham Mahmud, James W Choi, Anthony H Doing, William L Lombardi, R Michael Wyman, Catalin Toma, Santiago Garcia, Jeffrey W Moses, Ajay J Kirtane, Raja Hatem, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Houman Khalili, M Nicholas Burke, Subhash Banerjee, Emmanouil S Brilakis
Coronary perforation is a potential complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We analyzed 2,097 CTO PCIs performed in 2,049 patients from 2012 to 2017. Patient age was 65 ± 10 years, 85% were men, and 36% had prior coronary artery bypass graft surgery. Technical and procedural success were 88% and 87%, respectively. A major periprocedural adverse cardiovascular event occurred in 2.6%. Coronary perforation occurred in 85 patients (4.1%); The frequency of Ellis class 1, 2, and 3 perforations was 21%, 26%, and 52%, respectively...
October 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28707381/radiation-associated-lens-changes-in-the-cardiac-catheterization-laboratory-results-from-the-ic-cataract-cataracts-attributed-to-radiation-in-the-cath-lab-study
#18
Aris Karatasakis, Harilaos S Brilakis, Barbara A Danek, Judit Karacsonyi, Jose Roberto Martinez-Parachini, Phuong-Khanh J Nguyen-Trong, Aya J Alame, Michele K Roesle, Bavana V Rangan, Kenneth Rosenfield, Roxana Mehran, Ehtisham Mahmud, Charles E Chambers, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVE: To examine the relationship between occupational exposure to ionizing radiation and the prevalence of lens changes in interventional cardiologists (ICs) and catheterization laboratory ("cath-lab") staff. BACKGROUND: Exposure to ionizing radiation is associated with the development of lens opacities. ICs and cath-lab staff can receive high doses of ionizing radiation without protection, and may thus be at risk for lens opacity formation. METHODS: We conducted a cross-sectional study at an interventional cardiology conference...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707310/sleep-deprivation-in-interventional-cardiology-implications-for-patient-care-and-physician-health
#19
Yader Sandoval, Angie S Lobo, Virend K Somers, Kenneth Rosenfield, Steven M Bradley, Paul Sorajja, Peter Tajti, Emmanouil S Brilakis
The burden and impact of sleep deprivation on both patient care and on the health of interventional cardiologists is not well understood. Due to the nature of emergent procedures occurring in the cardiac catheterization laboratory, interventionalists are prone to suffer from acute and/or chronic sleep deprivation. Sleep deprivation has been associated with numerous adverse effects, such as impaired performance, cognitive deficits, reduced psychomotor vigilance, and workplace errors and injuries, among many others...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28706125/a-meta-analysis-of-contemporary-lesion-modification-strategies-during-percutaneous-coronary-intervention-in-244-795-patients-from-22-studies
#20
Barbara Anna Danek, Aris Karatasakis, Judit Karacsonyi, Waleed Alharbi, Michele Roesle, Bavana V Rangan, M Nicholas Burke, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: Outcomes with use of lesion-modification strategies in the drug-eluting stent era have received limited study. METHODS: We conducted a meta-analysis of 22 studies published between 2004-2016 reporting outcomes after use of rotational atherectomy, cutting-balloon, and scoring-balloon angioplasty. RESULTS: In observational trials, acute luminal gain was higher after lesion modification as compared with control (standardized mean difference, 0...
July 15, 2017: Journal of Invasive Cardiology
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