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https://www.readbyqxmd.com/read/28338552/is-the-future-of-coronary-arterial-revascularization-a-hybrid-approach-the-canadian-experience-across-three-centers
#1
Vincenzo Giambruno, Ahmad Hafiz, Stephanie A Fox, Hugues Jeanmart, Richard C Cook, Feras H Khaliel, Patrick Teefy, Kumar Sridhar, Shahar Lavi, Rodrigo Bagur, Varinder K Randhawa, Ivan Iglesias, Philip M Jones, Christopher C Harle, Daniel Bainbridge, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28335899/percutaneous-plug-based-arteriotomy-closure-device-for-large-bore-access-a-multicenter-prospective-study
#2
Nicolas M Van Mieghem, Azeem Latib, Jan van der Heyden, Lennart van Gils, Joost Daemen, Todd Sorzano, Jurgen Ligthart, Karin Witberg, Thom de Kroon, Nathaniel Maor, Antonio Mangieri, Matteo Montorfano, Peter P de Jaegere, Antonio Colombo, Gary Roubin
OBJECTIVES: The authors sought to study the safety and efficacy of the MANTA Vascular Closure Device (VCD), a novel collagen-based technology dedicated to closure of large-bore arteriotomies. BACKGROUND: Novel transfemoral therapeutic interventions requiring large-bore catheters have become valid minimally invasive options but have inherent access management challenges. To date, no dedicated vascular closure devices exist for large arteriotomies. METHODS: A prospective, single-arm clinical investigation enrolling patients who underwent elective percutaneous interventions with large-bore catheters and planned percutaneous arteriotomy closure in 3 European institutions...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28330794/radiation-exposure-and-vascular-access-in-acute-coronary-syndromes-the-radmatrix-trial
#3
Alessandro Sciahbasi, Enrico Frigoli, Alessandro Sarandrea, Martina Rothenbühler, Paolo Calabrò, Alessandro Lupi, Francesco Tomassini, Bernardo Cortese, Stefano Rigattieri, Enrico Cerrato, Dennis Zavalloni, Antonio Zingarelli, Paolo Calabria, Paolo Rubartelli, Gennaro Sardella, Matteo Tebaldi, Stephan Windecker, Peter Jüni, Dik Heg, Marco Valgimigli
BACKGROUND: It remains unclear whether radial increases the risk of operator or patient radiation exposure when performed by expert operators OBJECTIVES: To determine whether radial access increases radiation exposure METHODS: We randomly assigned 8404 patients, with or without ST-segment elevation acute coronary syndrome, to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose area product (DAP). In the radiation sub-study (RAD-MATRIX), we anticipated that 13 or more operators, each wearing a thorax (primary endpoint), wrist and head (secondary endpoints) lithium fluoride thermo luminescent dosimeter and randomizing at least 13 patients per access site were needed to establish non-inferiority of radial versus femoral access...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28325053/-iatrogenic-biliary-tract-lesions-requiring-surgical-reconstruction-presentation-and-classification-of-the-lesions-their-reconstruction-and-evaluation-of-the-results
#4
M Straka, E Holášková, L Burda, M Vávrová, P Fojtík, M Škrovina
INTRODUCTION: The incidence of biliary duct injuries requiring surgical reconstruction has stabilised between 0.30.7%. Biliary reconstruction in the hands of a trained hepatobiliary surgeon may lead to better short- and long-term outcomes in patients with this infrequent, but serious complication. METHODS: This study presents a retrospective analysis of single surgeon experience with biliary injury repair during the period of 20072016. Extramucosal hepaticojejunostomy on the excluded segment of the jejunal loop was performed without the use of any transanastomotic drain...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#5
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28302464/coronary-artery-perforation-complicated-by-recurrent-cardiac-tamponade-a-case-illustration-and-review
#6
Michael DePersis, Safi U Khan, Edo Kaluski, William Lombardi
Coronary artery perforation during percutaneous intervention is a rare but potentially life threatening complication. The treatment of coronary perforation can be challenging in view of potential life threatening consequences such as cardiac tamponade or myocardial infarction. Presented is a clinical course of a 69year-old female who developed cardiac tamponade as a result of presumed wire related perforation of the posterolateral branch of the right coronary artery. Her clinical course was further complicated by recurrent tamponade, atrial fibrillation, stress induced cardiomyopathy, heparin induced thrombocytopenia and cardiogenic pulmonary edema...
March 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28300677/wound-disruption-after-lower-extremity-bypass-surgery-is-a-predictor-of-subsequent-development-of-wound-infection
#7
Faisal Aziz, Tiffany Bohr, Erik B Lehman
OBJECTIVES: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the gold standard treatment for severe, symptomatic Peripheral Arterial Disease (PAD). With recent changes in healthcare, there has been an increasing emphasis on reducing the hospital length of stay (LOS). The purpose of this study is to identify the postoperative complications, which occur after discharge from hospital, and to find risk factors for developing such complications. METHODS: The 2013 lower extremity revascularization -targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP PUF were used for this study...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28294557/double-blind-randomized-controlled-trial-of-the-routine-peri-operative-use-of-terlipressin-in-adult-living-donor-liver-transplantation
#8
Mettu Srinivas Reddy, Ilankumaran Kaliamoorthy, Akila Rajakumar, Selvakumar Malleeshwaran, Ellango Appuswamy, Sukanya Lakshmi, Joy Varghese, Mohamed Rela
BACKGROUND: Peri-operative terlipressin (Tp) during living donor liver transplantation (LDLT) has been shown to reduce intra-operative portal pressures and improve renal function. Its role and safety profile has never been evaluated in a double-blinded RCT. AIM: To evaluate the haemodynamic effects, clinical benefits and safety of peri-operative terlipressin infusion in adult LDLT. METHODS: This was a single centre double-blind RCT. Consenting adults with chronic liver disease and low risk of post-transplant renal dysfunction (PTRD) undergoing their first LDLT were randomized...
March 14, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28279410/complications-in-percutaneous-dialysis-interventions-how-to-avoid-them-and-how-to-treat-them-when-they-do-occur
#9
Tamir Friedman, Emilio E Lopez, Keith B Quencer
Because of the increasing prevalence of end-stage renal disease, more percutaneous interventions are being performed. They serve an important role, allowing for restoration of access function, which is achieved with high level of technical success. However, complications are inevitable during any types of procedure, and percutaneous dialysis interventions are no exception. To provide safe and effective care these patients need, anyone performing endovascular dialysis interventions needs to understand the possible complications, how they can be avoided, and how they can be addressed if they are to occur...
March 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/28279319/infective-endocarditis-risk-after-percutaneous-pulmonary-valve-implantation-with-the-melody-and%C3%A2-sapien%C3%A2-valves
#10
Sebastien Hascoet, Lucia Mauri, Caroline Claude, Emmanuelle Fournier, Julie Lourtet, Jean-Yves Riou, Philippe Brenot, Jérôme Petit
OBJECTIVES: This study compared the risk of infective endocarditis (IE) after percutaneous pulmonary valve implantation (PPVI) with the Sapien and Melody valves. BACKGROUND: The incidence of IE after PPVI is estimated at 3% per year with the Melody valve. The Sapien valve is a more recently marketed valve used for PPVI. METHODS: We retrospectively included consecutive patients who underwent PPVI at a single center between 2008 and 2016. IE was diagnosed using the modified DUKE criteria...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28271356/geometric-modeling-of-hepatic-arteries-in-3d-ultrasound-with-unsupervised-mra-fusion-during-liver-interventions
#11
Maxime Gérard, François Michaud, Alexandre Bigot, An Tang, Gilles Soulez, Samuel Kadoury
PURPOSE: Modulating the chemotherapy injection rate with regard to blood flow velocities in the tumor-feeding arteries during intra-arterial therapies may help improve liver tumor targeting while decreasing systemic exposure. These velocities can be obtained noninvasively using Doppler ultrasound (US). However, small vessels situated in the liver are difficult to identify and follow in US. We propose a multimodal fusion approach that non-rigidly registers a 3D geometric mesh model of the hepatic arteries obtained from preoperative MR angiography (MRA) acquisitions with intra-operative 3D US imaging...
March 7, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28269443/robotic-system-with-multiplex-power-transmission-for-mri-guided-percutaneous-interventions
#12
Yang Wang, Sungmin Kim, Everette C Burdette, Peter Kazanzides, Iulian Iordachita
In minimally invasive prostate percutaneous interventions, Magnetic Resonance Imaging (MRI) compatible robotic assistive systems developed over the years tend to have multiple degrees of freedom (DOF) to accomplish complex surgical tasks. This paper presents a novel design of an MRI-compatible transmission that allows one driving motor to control a multiplexed DOF robot system. The transmission could reduce the number of motors in the system, while maintaining the functionality of the system, by controlling each motion sequentially rather than simultaneously...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28260440/vascular-complications-after-renal-transplant-a-single-center-experience
#13
Ebru H Ayvazoglu Soy, Aydincan Akdur, Mahir Kirnap, Fatih Boyvat, Gokhan Moray, Mehmet Haberal
OBJECTIVES: Despite surgical and medical advances, vascular complications are still among the major concerns after renal transplant, with a reported incidence of 3% to 15%. We evaluated the incidence and management of our transplant team 's vascular complications over 40 years. MATERIALS AND METHODS: From November 1975 to the present, we have performed a total of 2594 renal transplant procedures. Of these, 1997 grafts (76%) were obtained from living donors, and 597 grafts (24%) were obtained from deceased donors...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28255546/aggressive-restenosis-after-percutaneous-intervention-in-two-coronary-loci-in-a-patient-with-human-immunodeficiency-virus-infection
#14
Mohammad Alkhalil, Christopher P Conlon, Houman Ashrafian, Robin P Choudhury
A 54-year-old black African woman, 22 years human immunodeficiency virus (HIV)-positive, presented with an acute coronary syndrome. She was taking two nucleoside reverse transcriptase inhibitors and two protease inhibitors. Viral load and CD4 count were stable. Angiography revealed a right coronary artery lesion, which was treated with everolimus eluting stent. She also underwent balloon angioplasty to the first diagonal. She re-presented on three different occasions and technically successful coronary intervention was performed...
February 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28250690/aortoiliac-reconstruction-in-the-setting-of-in-stent-restenosis
#15
H S Natraj Setty, T R Raghu, B C Srinivas, C M Nagesh, Babu Reddy, Jayashree Kharge, B K Geetha, B N Krishnamurthy, Shivanand Patil, C N Manjunath
Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28249382/when-surgery-is-not-an-option-is-there-a-clinical-need-for-transcatheter-tricuspid-valve-therapies
#16
Alec Vahanian, Jean M Juliard, Eric Brochet
Severe functional tricuspid regurgitation (FTR) is frequent and carries a poor prognosis when left untreated. The strategy in symptomatic patients should be decided by a Heart Team which will choose between valve surgery, transcatheter intervention, heart transplantation or palliative medical therapy. The field of application of transcatheter tricuspid valve therapy will certainly focus on inoperable or high-risk patients first, especially those with FTR occurring late after left-sided valve surgery. If surgery is contraindicated because of multiple comorbidities interventions which are likely to be "futile" should be avoided...
March 1, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28247641/-initial-experience-with-laparoscopic-anatrophic-nephrolithotomy
#17
A D Kochkin, A G Martov, F A Sevryukov, A V Knutov, V P Sergeev
Percutaneous nephrolithotomy is a recognized standard for minimally invasive treatment of large kidney stones. Percutaneous interventions for complete staghorn stones are associated with a higher risk of complications that precludes abandoning the traditional open operations, one of which is an anatrophic nephrolithotomy. This paper presents the first personal experience in laparoscopic transmesenteric anatrophic nephrolithotomy. The intervention was conducted in 3 patients (2 males and 1 female) aged 43 to 58 years, having a primary symptomatic complete left kidney staghorn stones sized from 7...
August 2016: Urologii︠a︡
https://www.readbyqxmd.com/read/28247458/prediction-of-infarct-size-using-two-dimensional-speckle-tracking-echocardiography-in-acute-myocardial-infarction
#18
Cem Doğan, Zübeyde Bayram, Özkan Candan, Onur Omaygenç, Fatih Yılmaz, Rezzan Deniz Acar, Özgür Yaşar Akbal, Cihangir Kaymaz, Nihal Özdemir
BACKGROUND: This study aimed to determine the myocardial damage (infarct size provided by cardiac single-photon emission tomography) in early stages of the infarction using longitudinal strain and rotational parameters of the left ventricle. METHODS: The study included 66 patients with anterior myocardial infarction (AMI) and 62 patients with inferior myocardial infarction (IMI) who underwent primary percutaneous intervention as well as a control group consisting of 50 healthy subjects...
March 2017: Echocardiography
https://www.readbyqxmd.com/read/28240675/impact-of-chronic-statin-therapy-on-clinical-presentation-and-underlying-lesion-morphology-in-patients-undergoing-percutaneous-intervention-an-adapt-des-ivus-substudy
#19
Tadayuki Kadohira, Gary S Mintz, Cristiano F Souza, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Ernest L Mazzaferri, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Aaron Crowley, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
OBJECTIVE: Previous intravascular ultrasound (IVUS) studies have not established a relationship between chronic statin use and plaque morphology and composition in patients undergoing percutaneous coronary intervention (PCI). We sought to use pre-PCI grayscale and virtual histology (VH)-IVUS to assess plaque morphology and composition in patients treated with chronic statin therapy compared with patients who were not taking statins before admission and PCI. METHODS: In a prespecified substudy of the Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents study, pre-PCI grayscale and VH-IVUS were performed in 780 patients with 916 culprit and 765 nonculprit lesions...
February 24, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28227689/robotic-system-with-multiplex-power-transmission-for-mri-guided-percutaneous-interventions
#20
Yang Wang, Sungmin Kim, Everette C Burdette, Peter Kazanzides, Iulian Iordachita, Yang Wang, Sungmin Kim, Everette C Burdette, Peter Kazanzides, Iulian Iordachita, Sungmin Kim, Peter Kazanzides, Everette C Burdette, Iulian Iordachita, Yang Wang
In minimally invasive prostate percutaneous interventions, Magnetic Resonance Imaging (MRI) compatible robotic assistive systems developed over the years tend to have multiple degrees of freedom (DOF) to accomplish complex surgical tasks. This paper presents a novel design of an MRI-compatible transmission that allows one driving motor to control a multiplexed DOF robot system. The transmission could reduce the number of motors in the system, while maintaining the functionality of the system, by controlling each motion sequentially rather than simultaneously...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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