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Cardiac stent

Rajveer Joea, Sarah J Strube, Todd K Zynda
Spontaneous coronary artery dissection (SCAD) is a variant of acute coronary syndrome (ACS) that is poorly understood. SCAD has been linked to fibromuscular dysplasia (FMD), connective tissue disease (CTD), pregnancy and hormonal imbalance, systemic inflammatory conditions (e.g. IBD, vasculitis), and coronary artery vasospasm rather than traditional cardiac risk factors. Symptomology generally accompanying SCAD is indistinguishable from ACS making the timely recognition and diagnosis vital for prompt treatment...
June 2018: Cardiology Research
Stephen Wai Luen Lee, Frankie C C Tam, Kelvin K W Chan, Simon C C Lam, Shun-Ling Kong, Catherine P Shea, Michael K L Wong, Anthony Y T Wong, Arthur S Y Yung, Li-Wei Zhang, Yui-Ming Lam, Gary S Mintz, Ricardo A Costa, Hans-Peter Stoll, Akiko Maehara
AIMS: In patients at high bleeding risk treated with 1 month of dual antiplatelet therapy, the polymer-free, biolimus A9-coated BioFreedom stent (BFS) was found safer and more efficacious than bare metal stents. We used sequential optical coherence tomography (OCT) to assess the time course of strut coverage and neointimal transformation from 1 to 9 months. METHODS AND RESULTS: We randomly assigned 104 BFS recipients to 1 of 5 groups with angiography and OCT follow-up at 1, 2, 3, 4, or 5 months, together with another follow-up for all at 9 months...
June 12, 2018: EuroIntervention
Raisuke Iijima, Norihiro Kougame, Hidehiko Hara, Masao Moroi, Masato Nakamura
BACKGROUND: The aim of this study was to investigate whether drug-coated balloon (DCB) treatment is effective for de novo coronary lesions that are unsuitable for drug-eluting stent (DES) implantation.Methods and Results:This retrospective study included 118 de novo lesions that were not suitable for DES implantation. Of the lesions, 40% was treated because of very small vessel disease. Patients with planned non-cardiac surgery and at high bleeding risk were 3% and 19%, respectively, and lesions that easily develop stent fracture comprised 26%...
June 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Yue Wang, Gary S Mintz, Zhichun Gu, Yue Qi, Yue Wang, Mengru Liu, Xiaofan Wu
BACKGROUND: Although several meta-analyses have demonstrated the utility of intravascular ultrasound (IVUS) in guiding drug-eluting stent (DES) implantation compared to angiography-guidance, there has been a dearth of evidence in the left main coronary artery (LMCA) lesion subset. METHODS: We performed a meta-analysis to compare clinical outcomes of IVUS versus conventional angiography guidance during implantation of DES for patients with LMCA disease. Pubmed, Cochrane Library, Embase were searched...
June 14, 2018: BMC Cardiovascular Disorders
Akanksha N Thakkar, Ponraj Chinnadurai, John P Breinholt, C Huie Lin
A 63-year-old man with cirrhosis, hepatocellular carcinoma, and coagulopathy was diagnosed with a sinus venosus atrial septal defect (ASD) and partial anomalous pulmonary venous return (PAPVR) of the right upper pulmonary vein (RUPV). Transcatheter repair by positioning a stent graft in the superior vena cava was planned. Based on three-dimensional (3D) reconstruction of gated cardiac CTA, a 28 mm × 7 cm Endurant II® aortic extension stent graft (Medtronic, MN) was chosen. A 3D model printed from the CTA was used to simulate device deployment, demonstrating successful exclusion of the sinus venosus ASD with return of the RUPV to the left atrium (LA)...
June 13, 2018: Catheterization and Cardiovascular Interventions
Kenji Nakatsuma, Hiroki Shiomi, Takeshi Morimoto, Hirotoshi Watanabe, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Koh Ono, Satoshi Shizuta, Takeshi Kimura
Aims: To evaluate the influence of a history of cancer on clinical outcomes in coronary artery disease (CAD) patients who underwent percutaneous coronary intervention (PCI). Methods and Results: In the CREDO-Kyoto PCI/coronary bypass grafting (CABG) Registry Cohort-2, there were 12,180 CAD patients who received PCI with stents. There were 1109 patients with a history of cancer (cancer group), and 11,071 patients without cancer (non-cancer group). The cumulative 5-year incidences of cardiac death and heart failure (HF) hospitalization were significantly higher in the cancer group than in the non-cancer group (12...
April 20, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Syed M Rehman, Antonio Ravaglioli, Kanchana Singappuli, Kevin Roman, James Gnanapragasam, Duminda Samarasinghe, Nicola Viola
Single-stage repair of complex cardiac abnormalities in high-risk neonates presents formidable challenges. The majority of hybrid strategies involving bilateral pulmonary artery banding (bPAB) with or without patent ductus arteriosus (PDA) stenting is described in the setting of hypoplastic left heart syndrome. We present a series of cases describing two-stage repair with initial palliative hybrid procedures involving bPAB with or without PDA stenting. This allows weight gain and stabilization of circulation before complete repair, provides good results, and may overcome risk factors associated with single-stage repair in neonates...
June 12, 2018: Journal of Cardiac Surgery
Wen-Xia Fu, Tie-Nan Zhou, Xiao-Zeng Wang, Lei Zhang, Quan-Min Jing, Ya-Ling Han
Background: Females with ST-segment elevation myocardial infarction (STEMI) have higher in-hospital and short-term mortality rates compared with males in China, suggesting that a sex disparity exists. The age of onset of STEMI is ahead of time and tends to be younger. However, there are relatively little data on the significance of sex on prognosis for long-term outcomes for adult patients with STEMI after percutaneous coronary intervention (PCI) in China. This study sought to analyze the sex differences in 30-day, 1-year, and long-term net adverse clinical events (NACEs) in Chinese adult patients with STEMI after PCI...
June 20, 2018: Chinese Medical Journal
Hai-Wei Liu, Ya-Ling Han, Quan-Min Jin, Xiao-Zeng Wang, Ying-Yan Ma, Geng Wang, Bin Wang, Kai Xu, Yi Li, Shao-Liang Chen
Background: Very few data have been reported for ST-segment elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) occlusion, and very little is known about the results of this subgroup of patients who underwent primary percutaneous coronary intervention (PCI). The aim of this study was to determine the clinical features and outcomes of patients with STEMI who underwent primary PCI for acute ULMCA occlusion. Methods: From January 2000 to February 2014, 372 patients with STEMI caused by ULMCA acute occlusion (ULMCA-STEMI) who underwent primary PCI at one of two centers were enrolled...
June 20, 2018: Chinese Medical Journal
Yuan-Liang Ma, Xiao-Fang Tang, Yi Yao, Na Xu, Ying Song, Ping Jiang, Jing-Jing Xu, Huan-Huan Wang, Lin Jiang, Ru Liu, Xue-Yan Zhao, Jue Chen, Zhan Gao, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
Background: It remains undetermined whether second-generation drug-eluting stents (G2-DESs) outperform first-generation DESs (G1-DESs) in patients with acute coronary syndrome (ACS). We aimed to compare the efficacy and safety of G1-DES and G2-DES in ACS patients in a high-volume cardiovascular center. Methods: In 2013, 10,724 consecutive patients underwent percutaneous coronary intervention in our institution. We included 4037 patients with ACS who underwent exclusively G1-DES or G2-DES implantation (n = 364 and n = 3673, respectively)...
June 20, 2018: Chinese Medical Journal
Giuseppe Tarantini, Giulia Masiero, Luca Nai Fovino, Marco Mojoli, Attilio Varricchio, Bruno Loi, Roberto Gistri, Leonardo Misuraca, Gabriele Gabrielli, Bernardo Cortese, Francesco Pisano, Luciano Moretti, Gabriele Tumminello, Zoran Olivari, Pietro Mazzarotto, Alessandro Colombo, Paolo Calabrò, Annamaria Nicolino, Paola Tellaroli, Donatella Corrado, Alessandro Durante, Giuseppe Steffenino
OBJECTIVES: The objective of this study was to investigate mid-term clinical outcomes of patients treated with 'full-plastic jacket' (FPJ) everolimus-eluting Absorb bioresorbable vascular scaffold (BRS) implantation. BACKGROUND: FPJ with BRS may represent an interesting option for patient with diffuse coronary artery disease (CAD), but data on the clinical impact of FPJ using the Absorb BRS are scant. METHODS: FPJ was defined as the implantation of >56 mm of overlapping BRS in at least one vessel...
September 1, 2018: International Journal of Cardiology
Ryota Kosaki, Yoshino Minoura, Kunihiro Ogura, Yosuke Oishi, Lisa Tanaka, Ken Arai, Kosuke Nomura, Koshiro Sakai, Teruo Sekimoto, Tenjin Nisikura, Hiroaki Tsujita, Seita Kondo, Shigeto Tsukamoto, Yuji Hamazaki, Youichi Kobayashi
BACKGROUND: Plasma levels of atherothrombosis-related markers such as endothelial biomarkers have been reported to predict the risk of first acute coronary syndrome (ACS) events. Percutaneous coronary intervention (PCI) by balloon angioplasty and stenting established as a treatment for ACS enabled early discharge and early clinic care. The procedure of PCI, however, may itself be associated with arterial injury with endothelial dysfunction. The clinical significance of those biomarkers for second events in patients after PCI has not yet been completely understood to identify patients who need strict follow-up...
June 7, 2018: Journal of Cardiology
Barbara E Stähli, Manfred B Wischnewsky, Philipp Jakob, Roland Klingenberg, Slayman Obeid, Dik Heg, Lorenz Räber, Stephan Windecker, Marco Roffi, François Mach, Baris Gencer, David Nanchen, Peter Jüni, Ulf Landmesser, Christian M Matter, Thomas F Lüscher, Willibald Maier
BACKGROUND: This study sought to investigate the predictive value of the age, creatinine, and ejection fraction (ACEF) score in patients with acute coronary syndromes (ACS). The ACEF score (age/left ventricular ejection fraction +1 [if creatinine > 176 μmol/L]) has been established in patients evaluated for coronary artery bypass surgery. Data on its predictive value in all-comer ACS patients undergoing percutaneous coronary intervention are scarce. METHODS: A total of 1901 patients prospectively enrolled in the Swiss ACS Cohort were included in the analysis...
June 1, 2018: International Journal of Cardiology
Saqib Zia, Kuldeep Singh, Amandeep Juneja, Jonathan Schor, Jonathan Deitch
PURPOSE: Transradial access (TRad) is becoming the preferred access for cardiac catheterization. The utility and safety of TRad in non-coronary and peripheral vascular interventions remains ill-defined and serves as the basis for this study. METHODS: Patients undergoing non-coronary and peripheral endovascular procedures via TRad from August 2010 to February 2013 at our institution were reviewed retrospectively. Demographic data, indications, interventions performed, sheath size, procedural outcomes and access site complications were evaluated...
June 6, 2018: Annals of Vascular Surgery
Kwi Hyun Bae, Sung Woo Kim, Yeon Kyung Choi, Jung Beom Seo, Namkyun Kim, Chang Yeon Kim, Won Kee Lee, Sungwoo Lee, Jung Guk Kim, In Kyu Lee, Jang Hoon Lee, Keun Gyu Park
BACKGROUND: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulating protein that promotes degradation of the low density lipoprotein receptor. PCSK9 has emerged as a target for lipid-lowering therapy, but the predictive value of the serum level of PCSK9 for the severity of coronary disease is largely unknown. METHODS: From December 2009 to July 2012, 121 individuals who underwent coronary angiography (CAG) because of clinically suspected acute coronary syndrome were enrolled in this study...
May 2, 2018: Diabetes & Metabolism Journal
Teresa Ojode, Joshua W Sappenfield
Thoracic trauma poses a risk of injury to the thoracic organs and great vessels, including the coronaries. We present an interesting case of occult, life-threatening coronary bypass graft injury resulting from thoracic trauma. In this case, the diagnosis and management were contingent on understanding the nature of the bypass graft, which was not apparent at the time of presentation in extremis . Ultimate hemostasis required cardiac catheterization and placement of an exclusionary stent. Though there are several case reports describing native coronary injury resulting from thoracic injury, we found a single case of thoracic trauma-associated coronary bypass graft injury, which was managed medically...
June 2018: Trauma Case Reports
Payal K Gurnani, Allison Bohlmann, Robert J March
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used as a bridge to cardiac recovery in patients following a major cardiac event. There is a lack of literature surrounding prolonged use of eptifibatide and optimal dosing during ECMO. This case report describes our experience with extended durations and standard dosing of eptifibatide in the setting of ECMO. CASE: A 40-year-old male with a history of Marfan's syndrome, aortic root and ascending aortic aneurysm status post a modified Bentall with a St...
June 1, 2018: Perfusion
Filippo Russo, Anita Paggi, Giuseppe De Nittis, Mario Galli
Coronary artery fistula (CAF) is a rare, abnormal connection between one or more coronary arteries and a cardiac chamber, or great vessel.We describe the case of a male patient with worsening effort angina referred for coronary angiography. The examination revealed the presence of a CAF between the proximal left anterior descending (LAD) and pulmonary arteries, with mid LAD subocclusive stenosis. Ad hoc PCI with stenting was performed in the mid LAD, followed by CAF embolization with coils and plugs. Angiography and computed tomography scan at follow-up showed complete CAF occlusion, stent patency, and normal flow reserve of the LAD...
March 2018: Giornale Italiano di Cardiologia
Usman Baber, Shawn X Li, Rebecca Pinnelas, Stuart J Pocock, Mitchell W Krucoff, Cono Ariti, C Michael Gibson, Philippe Gabriel Steg, Giora Weisz, Bernhard Witzenbichler, Timothy D Henry, Annapoorna S Kini, Thomas Stuckey, David J Cohen, Ioannis Iakovou, George Dangas, Melissa B Aquino, Samantha Sartori, Alaide Chieffo, David J Moliterno, Antonio Colombo, Roxana Mehran
BACKGROUND: Patients with chronic kidney disease (CKD) experience high rates of ischemic and bleeding events after percutaneous coronary intervention (PCI), complicating decisions surrounding dual antiplatelet therapy (DAPT). This study aims to determine the pattern and impact of various modes of DAPT cessation for patients with CKD undergoing PCI. METHODS AND RESULTS: Patients from the PARIS registry (Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients) were grouped based on the presence of CKD defined as creatinine clearance <60 mL/min...
March 2018: Circulation. Cardiovascular Interventions
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Ajay J Kirtane, Thomas McAndrew, Giora Weisz, Thomas D Stuckey, Timothy D Henry, Akiko Maehara, Roxana Mehran, Gregg W Stone
BACKGROUND: In-hospital bleeding after percutaneous coronary intervention is associated with increased mortality. We studied the impact of bleeding severity, defined as magnitude of Hgb (hemoglobin) reduction from baseline (ΔHgb), on the risk of death and other adverse events. METHODS AND RESULTS: We studied the association between ΔHgb, baseline characteristics, and outcomes among 7608 patients in the ADAPT-DES registry (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) who had information on Hgb values before and after they underwent successful percutaneous coronary intervention...
March 2018: Circulation. Cardiovascular Interventions
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