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Diabetes AND Chronic Total Occlusion

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https://www.readbyqxmd.com/read/30308588/safety-and-efficacy-of-dedicated-guidewire-and-microcatheter-technology-for-chronic-total-coronary-occlusion-revascularization-principal-results-of-the-asahi-intecc-chronic-total-occlusion-study
#1
David E Kandzari, J Aaron Grantham, Dimitrios Karmpaliotis, William Lombardi, Jeffrey W Moses, William Nicholson, Stephen Cook, Ashish Pershad, Jeffrey J Popma
BACKGROUND: Limited study has detailed the procedural outcomes and utilization of contemporary coronary guidewires and microcatheters designed for chronic total occlusion (CTO) percutaneous revascularization and with application of modern techniques. PATIENTS AND METHODS: A prospective, multicenter, single-arm trial was carried out to evaluate procedural and in-hospital outcomes among 163 patients undergoing attempted CTO revascularization with specialized guidewires and microcatheters...
October 10, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/30302101/does-the-effectiveness-of-recanalization-of-chronic-occlusion-depend-on-the-location-of-the-obstruction
#2
Leszek Bryniarski, Łukasz Klima, Sławomir Surowiec, Krzysztof L Bryniarski, Michał Terlecki, Dariusz Dudek
Introduction: In past studies, it has been questioned whether success of recanalization of chronic total occlusion (CTO) depends on the location of the occlusion - the circumflex artery (Cx) was considered as the most difficult to open. Aim: To determine whether the effectiveness of recanalization of CTO depends on the location of the obstruction. Material and methods: From January 2011 to January 2016, a single operator dedicated to chronic total occlusions performed in our center 357 procedures on 337 patients...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/30292337/contrast-induced-nephropathy-after-percutaneous-coronary-intervention-for-chronic-total-occlusion-versus-non-occlusive-coronary-artery-disease
#3
Ozan M Demir, Francesca Lombardo, Enrico Poletti, Alessandra Laricchia, Alessandro Beneduce, Davide Maccagni, Massimo Slavich, Francesco Giannini, Mauro Carlino, Alberto Margonato, Alberto Cappelletti, Antonio Colombo, Lorenzo Azzalini
Contrast volume is associated with the incidence of contrast-induced nephropathy (CIN), and CIN risk could be particularly high in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Our aim was to evaluate the incidence of CIN in patients who underwent CTO versus non-CTO PCI. All PCIs performed at our institution from January 2012 to December 2016 were included in this study. CIN was defined as an increase of ≥0.3 mg/dl or ≥50% from baseline within 72 hours. Multivariable logistic regression analysis was performed to identify independent predictors of CIN...
September 8, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/30218557/in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-in-patients-with-chronic-kidney-disease
#4
Peter Tajti, Aris Karatasakis, Barbara A Danek, Khaldoon Alaswad, Dimitri Karmpaliotis, Farouc A Jaffer, James W Choi, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, M Nicholas Burke, Oleg Krestyaninov, Dmitrii Khelimskii, Catalin Toma, Anthony H Doing, Barry Uretsky, Michalis Koutouzis, Ioannis Tsiafoutis, R Michael Wyman, Santiago Garcia, Elizabeth Holper, Iosif Xenogiannis, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². RESULTS: Compared with patients without CKD (n = 1444; 73%), patients with CKD (n = 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity...
September 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/30075761/interactive-effect-of-acute-and-chronic-glycemic-indexes-for-severity-in-acute-ischemic-stroke-patients
#5
Keon-Joo Lee, Ji Sung Lee, Keun-Hwa Jung
BACKGROUND: Diabetes mellitus is a well-established risk factor for ischemic stroke and is known to increase stroke risk by 2-6 fold. Numerous studies have reported the relationship between parameters for glycemic status and stroke-related outcomes; however, studies focusing on the interaction between acute and chronic glycemic status indexes with stroke phenotype are lacking. METHODS: Acute ischemic stroke patients who were admitted to a tertiary hospital stroke center from 2002 to 2015 were consecutively enrolled in this study...
August 3, 2018: BMC Neurology
https://www.readbyqxmd.com/read/30037739/early-outcomes-of-routine-delayed-shunting-in-carotid-endarterectomy-for-asymptomatic-patients
#6
Michele Piazza, Marco Zavatta, Margherita Lamaina, Jacopo Taglialavoro, Francesco Squizzato, Franco Grego, Michele Antonello
OBJECTIVE/BACKGROUND: The aim was to evaluate early outcomes of carotid endarterectomy (CEA) in asymptomatic patients using a standardised technique based on routine shunting after rapid plaque removal ("delayed"). METHODS: A retrospective review of all asymptomatic patients who underwent CEA during a 10 year single centre experience (January 2007-December 2016) was performed. The technique was based on rapid endarterectomy with distal intimal edge visualisation, followed by routine shunt insertion; subsequent time spent on the manoeuvre and closure were completed under shunting...
September 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29985189/outcomes-after-chronic-total-occlusion-percutaneous-coronary-interventions-an-observational-study-of-5496-patients-from-the-pan-london-cto-cohort
#7
Daniel A Jones, Krishnaraj S Rathod, Antonis N Pavlidis, Sean M Gallagher, Zoe Astroulakis, Pitt Lim, Alexander Sirker, Charles J Knight, Miles C Dalby, Iqbal S Malik, Anthony Mathur, Roby Rakhit, Simon Redwood, Philip A MacCarthy, Chris Baker, Ranil Desilva, Carlo Di Mario, Roshan Weerackody, Jonathan Hill, Andrew Wragg, Elliot J Smith
BACKGROUND: Chronic total occlusions (CTO) are commonly encountered in patients undergoing coronary angiography; however, percutaneous coronary intervention (PCI) is infrequently performed owing to technical difficulty, the perceived risk of complications and a lack of randomized data. The aim of this study was to analyse the frequency and outcomes of CTO-PCI procedures in a large contemporary cohort of successive patients. PATIENTS AND METHODS: We undertook an observational cohort study of 48 234 patients with stable angina of which 5496 (11...
November 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29979449/the-appropriate-management-algorithm-for-diabetic-foot-a-single-center-retrospective-study-over-12-years
#8
Jung Woo Chang, Woong Heo, Matthew Seung Suk Choi, Jang Hyun Lee
BACKGROUND: Diabetic foot management is a challenge for reconstructive surgeons because it combines dramatically decreased circulation and chronic infection. The goal of managing this condition is to maximize viable tissue; however, unsatisfactory results, such as extremity amputation, are unavoidable in some cases. For appropriate management, thorough understanding of diabetic foot and the phased approach to its management is needed. The purpose of this study is to introduce an optimal algorithm for diabetic foot management by analyzing cases >12 years...
July 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29859086/donor-artery-stenosis-interactions-with-diastolic-blood-pressure-on-coronary-collateral-flow-in-type-2-diabetic-patients-with-chronic-total-occlusion
#9
Ying Shen, Zhen Kun Yang, Jian Hu, Xiao Qun Wang, Yang Dai, Su Zhang, Rui Yan Zhang, Lin Lu, Feng Hua Ding, Wei Feng Shen
BACKGROUND: We investigated whether and to what extent stenosis of predominant collateral donor artery (PCDA) affects coronary collateral flow in relation to blood pressure (BP) in type 2 diabetic patients with chronic total occlusion (CTO). METHODS: Collateral flow index (CFI) as derived from intracoronary pressure distal to occluded segment and mean aortic pressure in 220 type 2 diabetic patients and 220 propensity score matched non-diabetic controls undergoing percutaneous coronary intervention for CTO...
June 1, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#10
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29706508/the-hybrid-approach-to-chronic-total-occlusion-percutaneous-coronary-intervention-update-from-the-progress-cto-registry
#11
Peter Tajti, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, James W Choi, M Nicholas Burke, Anthony H Doing, Phil Dattilo, Catalin Toma, A J Conrad Smith, Barry Uretsky, Elizabeth Holper, R Michael Wyman, David E Kandzari, Santiago Garcia, Oleg Krestyaninov, Dmitrii Khelimskii, Michalis Koutouzis, Ioannis Tsiafoutis, Jeffrey W Moses, Nicholas J Lembo, Manish Parikh, Ajay J Kirtane, Ziad A Ali, Darshan Doshi, Bavana V Rangan, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: The aim of this study was to determine the techniques and outcomes of hybrid chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in a diverse group of patients and operators on 2 continents. BACKGROUND: CTO PCI has been evolving with constant improvement of equipment and techniques. METHODS: Contemporary outcomes of CTO PCI were examined by analyzing the clinical, angiographic, and procedural characteristics of 3,122 CTO interventions performed in 3,055 patients at 20 centers in the United States, Europe, and Russia...
July 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29532645/coronary-chronic-total-occlusions-how-to-dilate-the-tough-ones
#12
EDITORIAL
Asaad A Khan, George D Dangas
Several chronic total occlusions (CTOs) may be undilatable despite successful wire passage; several techniques can be used for lesion preparation, such as high-pressure balloon inflations, rotational atherectomy laser, cutting balloon, and scoring balloons. Presence of moderate to severe calcification and lesion length over 40 mm in association with comorbidities, such as diabetes mellitus and reduced ejection fraction, may contribute to making a CTO lesion undilatable. Still, appropriate therapy selection for a patient with CTO should be individualized and procedure safety attended to...
March 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29527509/diabetic-muscle-infarction-in-end-stage-renal-disease-a-scoping-review-on-epidemiology-diagnosis-and-treatment
#13
REVIEW
Tuck Yean Yong, Kareeann Sok Fun Khow
Diabetic muscle infarction (DMI) refers to spontaneous ischemic necrosis of skeletal muscle among people with diabetes mellitus, unrelated to arterial occlusion. People with DMI may have coexisting end-stage renal disease (ESRD) but little is known about its epidemiology and clinical outcomes in this setting. This scoping review seeks to investigate the characteristics, clinical features, diagnostic evaluation, management and outcomes of DMI among people with ESRD. Electronic database (PubMed/MEDLINE, CINAHL, SCOPUS and EMBASE) searches were conducted for ("diabetic muscle infarction" or "diabetic myonecrosis") and ("chronic kidney disease" or "renal impairment" or "dialysis" or "renal replacement therapy" or "kidney transplant") from January 1980 to June 2017...
March 6, 2018: World Journal of Nephrology
https://www.readbyqxmd.com/read/29482487/two-wire-technique-with-a-gooseneck-snare-to-bail-out-the-tip-separation-of-a-crosser-catheter
#14
Yoshito Kadoya, Kan Zen, Yohei Oda, Satoaki Matoba
Tip separation of a Crosser catheter is a serious complication; however, there is limited information on bailout methods. Here, we describe a case of successful retrieval of the separated tip of a Crosser catheter using a 2-wire technique with a gooseneck snare. A 76-year-old woman with a history of hemodialysis and diabetes mellitus who developed ulcers on her right toes was diagnosed as having critical limb ischemia and underwent transfemoral antegrade endovascular treatment of the anterior tibial artery (ATA)...
May 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29431578/patency-of-the-arterial-pedal-plantar-arch-in-patients-with-chronic-kidney-disease-or-diabetes-mellitus
#15
COMPARATIVE STUDY
Axel Haine, Alan G Haynes, Andreas Limacher, Tim Sebastian, Wuttichai Saengprakai, Torsten Fuss, Iris Baumgartner
BACKGROUND: Patency of the pedal-plantar arch limits risk of amputation in peripheral artery disease (PAD). We examined patients without chronic kidney disease (CKD)/diabetes mellits (DM) [PAD-control], those with DM without CKD, and those with CKD without DM. METHOD: Uni- and multivariate logistic regression was used to assess association of CKD with loss of patency of the pedal-plantar arch and presence of tibial or peroneal vessel occlusion. Multivariate models adjusted for age, sex, hypertension, hyperlipidemia and smoking...
May 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29422093/reduced-coronary-collateralization-in-type-2-diabetic-patients-with-chronic-total-occlusion
#16
REVIEW
Ying Shen, Feng Hua Ding, Yang Dai, Xiao Qun Wang, Rui Yan Zhang, Lin Lu, Wei Feng Shen
BACKGROUND: The extent of coronary collateral formation is a primary determinant of the severity of myocardial damage and mortality after coronary artery occlusion. Type 2 diabetes mellitus (T2DM) represents an important risk factor for impaired collateral vessel growth. However, the mechanism of reduced coronary collateralization in type 2 diabetic patients remains unclear. METHODS: With the reference to the recent researches, this review article describes the pathogenic effects of T2DM on collateral development and outlines possible clinical and biochemical markers associated with reduced coronary collateralization in type 2 diabetic patients with chronic total occlusion (CTO)...
February 8, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29404750/acute-limb-ischemia-secondary-to-native-artery-occlusion-results-of-a-contemporary-case-series
#17
Nuria Seguí, Carlos Ruiz-Carmona, Alina Velescu, Eduardo Mateos, Roberto Elosua, Albert Clará
BACKGROUND: The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate the current results of the management of ALI secondary to a native artery occlusion. METHODS: Retrospective study of 220 consecutive patients (mean age 78 years; 49% male) was conducted between 2007 and 2015...
August 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29398309/percutaneous-axillary-artery-access-for-endovascular-interventions
#18
Emily Harris, Courtney J Warner, Jeffrey C Hnath, Yaron Sternbach, R Clement Darling
BACKGROUND: As endovascular therapy becomes increasingly complex, adjunct techniques such as upper extremity arterial access facilitate visceral branch interventions. The purpose of this study was to assess the viability of axillary artery percutaneous access in endovascular repair. METHODS: Records of all patients undergoing axillary artery percutaneous access as part of an endovascular intervention from December 2015 to December 2016 were examined. Demographics of the patients (age, sex, medical comorbidities, smoking status, and anticoagulation) were documented...
August 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29359452/prevalence-presentation-and-treatment-of-balloon-undilatable-chronic-total-occlusions-insights-from-a-multicenter-us-registry
#19
EDITORIAL
Peter Tajti, Dimitri Karmpaliotis, Khaldoon Alaswad, Catalin Toma, James W Choi, Farouc A Jaffer, Anthony H Doing, Mitul Patel, Ehtisham Mahmud, Barry Uretsky, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
BACKGROUND: The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study. METHODS: We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry. RESULTS: Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%)...
March 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29338303/evaluation-of-preprocedural-laboratory-parameters-as-predictors-of-drug-eluting-stent-restenosis-in-coronary-chronic-total-occlusion-lesions
#20
Chenguang Li, Yi Shen, Rende Xu, Yuxiang Dai, Shufu Chang, Hao Lu, Zhaohui Dong, Jianxin Deng, Juying Qian, Junbo Ge
This retrospective, single-center study assessed the prognostic value of several emerging inflammatory markers as predictors of in-stent restenosis (ISR) after drug-eluting stent implantation for coronary chronic total occlusion (CTO) lesions. Consecutive patients (n = 416) who underwent successful percutaneous coronary intervention (PCI) for documented CTO lesions and with follow-up angiography were enrolled. Preprocedural high-sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were analyzed...
January 1, 2018: Angiology
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