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Emmanouil Brilakis

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https://www.readbyqxmd.com/read/28945162/orbital-atherectomy-for-the-treatment-of-severely-calcified-coronary-lesions-evidence-technique-and-best-practices
#1
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...
September 25, 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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28668315/full-metal-jacket-is-it-en-vogue
#7
EDITORIAL
Subhash Banerjee, Emmanouil S Brilakis
No abstract text is available yet for this article.
June 21, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28570257/the-impact-of-proximal-vessel-tortuosity-on-the-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-insights-from-a-contemporary-multicenter-registry
#8
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, Anthony Doing, Catalin Toma, Barry Uretsky, James Choi, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, William L Lombardi, David E Kandzari, Nicholas Lembo, Santiago Garcia, Michael R Wyman, Jose R Martinez-Parachini, Aris Karatasakis, Barbara A Danek, Aya J Alame, Erica Resendes, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: We examined the impact of proximal vessel tortuosity on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: The baseline clinical and angiographic characteristics and procedural outcomes of 1618 consecutive CTO-PCIs performed between 2012 and 2016 at 14 United States centers in 1589 patients were reviewed. RESULTS: Mean patient age was 65.3 ± 10.0 years and 85% were men. Moderate/severe proximal vessel tortuosity was present in 35...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28506646/virtual-resting-pd-pa-from-coronary-angiography-and-blood-flow-modelling-diagnostic-performance-against-fractional-flow-reserve
#9
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
#10
MULTICENTER STUDY
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...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28488413/preventing-and-treating-coronary-perforations-lessons-from-disaster-management
#11
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
#12
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
#13
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
#14
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...
June 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
#15
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...
September 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28419791/the-role-of-rotational-atherectomy-in-contemporary-chronic-total-occlusion-percutaneous-coronary-intervention
#16
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
#17
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
#18
REVIEW
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
#19
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
#20
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)...
July 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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