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Percutaneous coronary interventions

Abraham Speedie, Cinosh Mathew, Rashmi Kerr, Rajneesh Calton
Coronary artery anomalies include anomalies of origin, termination, structure or course. Coronary artery fistulae (CAF) are classified as abnormalities of termination and are considered a major congenital anomaly. A coronary artery fistula involves a sizable communication between a coronary artery, bypassing the myocardial capillary bed and entering either a chamber of the heart (coronary-cameral fistula) or a great vessel. Bilateral coronary artery fistula, are a rare variant. We describe a bilateral CAF with angina and significant coronary artery disease requiring percutaneous coronary intervention...
August 2016: Journal of the Association of Physicians of India
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Ravi S Hira, Larry S Dean
Provisional use of rotational atherectomy (RA) is indicated for procedural success in heavily calcified lesions. In the current study, RA use at three high volume percutaneous coronary intervention (PCI) centers between 2005 and 2013 was 1.4%. MACE rate was 17.8% at median follow-up of 22 months. Peripheral vascular disease (PVD), diabetes mellitus (DM), acute coronary syndrome (ACS), and SYNTAX > 23 were found to be independently associated with MACE. With increasing complexity of disease and SYNTAX score, there is usually an increase in severity of calcification and need for atherectomy...
October 2016: Catheterization and Cardiovascular Interventions
Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO score values) should be differed to CTO experts...
October 19, 2016: Panminerva Medica
Jill Moser, Joris van Ark, Marcory C van Dijk, Dale L Greiner, Leonard D Shultz, Harry van Goor, Jan-Luuk Hillebrands
Percutaneous coronary intervention is widely adopted to treat patients with coronary artery disease. However, restenosis remains an unsolved clinical problem after vascular interventions. The role of the systemic and local immune response in the development of restenosis is not fully understood. Hence, the aim of the current study was to investigate the role of the human immune system on subsequent neointima formation elicited by vascular injury in a humanized mouse model. Immunodeficient NOD.Cg-Prkdc(scid)IL2rg(tm1Wjl)(NSG) mice were reconstituted with human (h)PBMCs immediately after both carotid wire and femoral cuff injury were induced in order to identify how differences in the severity of injury influenced endothelial regeneration, neointima formation, and homing of human inflammatory and progenitor cells...
October 19, 2016: Scientific Reports
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Ahmed Farag, Aneesha Chauhan, Sunita Avinash, Chee K Liew, Jonas Eichhöfer, Anoop Chauhan
This case illustrates the complexities of performing a primary percutaneous intervention in a patient with chronic Type A aortic aneurysm and dissection with contraindications for surgical management. We also discuss the significant risk that the patient had to overcome to survive an undiagnosed aortic dissection and an acute ST elevation myocardial infarction.
April 2016: Aorta (Stamford, Conn.)
Raffaele Piccolo, Gennaro Galasso, Ingo Eitel, Alberto Dominguez-Rodriguez, Allan Zeeberg Iversen, Youlan L Gu, Pedro Abreu-Gonzalez, Bart J G L de Smet, Giovanni Esposito, Stephan Windecker, Holger Thiele, Federico Piscione
Cigarette smokers with ST-segment elevation myocardial infarction (STEMI) may present different response to potent antithrombotic therapy compared to nonsmokers. We assessed the impact of smoking status and intracoronary abciximab in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). We pooled data from 5 randomized trials comparing intracoronary versus intravenous abciximab bolus in patients undergoing primary PCI. The primary end point was the composite of death or reinfarction at a mean follow-up of 292 ± 138 days...
September 13, 2016: American Journal of Cardiology
Mark A Groh, Ivan Diaz, Alan M Johnson, Stephen W Ely, Oliver A Binns, Gerard L Champsaur
BACKGROUND: Patients at intermediate risk (IR) according to The Society of Thoracic Surgeons risk score are today frequently oriented toward the transfemoral aortic valve replacement (TAVR) option. Our goal was to evaluate the best treatment strategies for IR patients with severe aortic stenosis. METHODS: Of a consecutive series of 1,144 surgical aortic valve replacements (AVRs) performed in our institution between 2008 and 2014, we reviewed the early and late outcomes of two different groups: a low-risk (LR) group of 470 patients, and an IR group of 620...
October 15, 2016: Annals of Thoracic Surgery
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
James Sapontis, Steven P Marso, David J Cohen, William Lombardi, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
BACKGROUND: Patients with chronic total occlusions of a coronary artery represent a complex, yet common, clinical conundrum among patients with ischemic heart disease. Chronic total occlusion angioplasty is increasingly being used as a treatment for these complex lesions. There is a compelling need to better quantify the safety, efficacy, benefits, and costs of the procedure. METHODS: To address these gaps in knowledge, we designed the Outcomes, Patient Health Status, and Efficiency IN Chronic Total Occlusion Hybrid Procedures (OPEN CTO) study, an investigator-initiated multicenter, single-arm registry including 12 centers with a planned enrollment of 1000 patients...
October 13, 2016: Coronary Artery Disease
(no author information available yet)
No abstract text is available yet for this article.
October 17, 2016: BMJ: British Medical Journal
Xingyu Wang, Xin Liu, Wei Zhang, Xianmin Meng, Lisheng Liu
OBJECTIVE: High on-treatment platelet reactivity (HTPR) was associated with an increased risk of ischemic events in clopidogrel-treated patients. Cigarette smoking was considered as an inducer of CYP1A2, and may theoretically enhance the biological effects and clinical efficacy of clopidogrel through facilitating the conversion of clopidogrel into its active metabolite. The purpose of this study was to examine the effect of cigarette smoking on the platelet response to clopidogrel. DESIGN AND METHOD: A total of 713 patients undergoing percutaneous coronary intervention were selected from Beijing Shijingshan Hospital and assigned to treatment with a loading 300 mg dose of clopidogrel...
September 2016: Journal of Hypertension
Rha Seung-Woon, Choi Byoung Geol, Li Hu, Na Jin Oh, Choi Cheol Ung, Park Chang Gyu, Seo Hong Seog, Oh Dong Joo, Kim Yong Hoon, Her Ae-Young, Park Sang-Ho
OBJECTIVE: Recently several studies reported that anti-hypertensive drugs were associated with development of new-onset diabetes mellitus (NODM). However, data on the relationship between detailed prescription types and long-term incidence of NODM are still limited in Asian patients (pts). DESIGN AND METHOD: A total of 3,208 consecutive hypertension pts prescribed with calcium channel blockers (CCB) were enrolled with the exclusion of diabetic pts. Pts were divided into two groups according to the additional prescription of renin angiotensin system (RAS) blockers; 1) the CCB group (n = 1,987) and 2) CCB + RAS group (n = 1,221)...
September 2016: Journal of Hypertension
Rha Seung-Woon, Choi Byoung Geol, Li Hu, Na Jin Oh, Choi Cheol Ung, Park Chang Gyu, Seo Hong Seog, Oh Dong Joo, Kim Yong Hoon, Her Ae-Young, Park Sang-Ho
OBJECTIVE: Hypertension (HTN) and its organ damage such as left ventricular hypertrophy (LVH) can lead to worsening heart failure, cardiovascular morbidity and mortality. However, there are limited data regarding the impact of LVH in HTN patients (pts) who underwent successful percutaneous coronary intervention (PCI) with drug eluting stents (DESs) on long-term clinical outcomes. DESIGN AND METHOD: A total of 1,704 consecutive HTN pts who underwent PCI from 2004 to 2014 were enrolled...
September 2016: Journal of Hypertension
Davyd Yakhontov
OBJECTIVE: To study the risk factors (RF) prevalence and compliance in hypertension (Ht) associated with coronary artery diseases (CAD) pts - West Siberia residents. MATERIAL AND METHOD: 151 pts with Ht grade 1-3 and stable angina 54,8 ± 0,7 years old divided in 3 groups. The 1 group included 43 Ht pts with uncomplicated angina and intact coronary arteries, the 2 group - 47 Ht pts with angina and percutaneous coronary intervention last 1-3 years, the 3 group - 61 Ht pts with myocardial infarction (MI) or stroke last 1-3 years...
September 2016: Journal of Hypertension
Mikkel M Schoos, Giuseppe De Luca, George D Dangas, Peter Clemmensen, Girma Minalu Ayele, Roxana Mehran, Gregg W Stone
AIMS: In the HORIZONS-AMI trial, bivalirudin compared to unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) improved net clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) at the cost of an increased rate of acute stent thrombosis. We sought to examine whether these effects are dependent on time to treatment. METHODS AND RESULTS: The interaction between anticoagulation regimen and symptom onset to first balloon inflation time (SBT) on the 30-day and three-year rates of major adverse cardiac events (MACE) was examined in 3,199 randomised patients according to SBT ≤3 hours versus >3 hours...
October 20, 2016: EuroIntervention
Ernest Spitzer, Susanne Hadorn, Thomas Zanchin, Kyohei Yamaji, Aris Moschovitis, Thomas Pilgrim, Stefan Stortecky, Peter Jüni, Dik Heg, Stephan Windecker, Lorenz Räber
AIMS: Randomised controlled trials (RCTs) represent the most robust source of evidence-based medicine. However, the generalisability of RCTs is limited by the inclusion of selected populations. We sought to assess the external validity of a contemporary trial including patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: Patients presenting to Bern University Hospital during the inclusion period of the COMFORTABLE AMI trial were divided into three groups: RCT participants (41%), eligible not included (17...
October 20, 2016: EuroIntervention
Yohei Sotomi, Rafael Cavalcante, Richard A Shlofmitz, Pannipa Suwannasom, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zheng, Mohammad Abdelghani, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Patrick W Serruys
AIMS: Recently, favourable procedural 30-day and one-year outcomes with the Diamondback 360 Orbital Atherectomy System (OAS) in the treatment of severely calcified lesions have been reported. The purpose of this study was to assess the therapeutic mechanism and efficacy of the OAS with optical coherence tomography (OCT) imaging. METHODS AND RESULTS: This was an observational imaging study in 18 patients with complex calcified coro-nary artery lesions who underwent percutaneous coronary intervention with the OAS...
October 20, 2016: EuroIntervention
Tuomas O Kiviniemi, Arto Pietilä, Jarmo M Gunn, Jenni M Aittokallio, Markku S Mähönen, Veikko V Salomaa, Teemu J Niiranen
AIMS: The aim of the study was to investigate the 20-year trends in rates, patient selection and prognosis of coronary revascularisations in Finland. METHODS AND RESULTS: We identified patients from nationwide registers who had undergone first-ever percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) between 1994 and 2013. We examined changes in procedure rates, patient characteristics and estimated hazard ratios (HR) and 95% confidence intervals for cardiovascular events during this period...
October 20, 2016: EuroIntervention
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