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https://www.readbyqxmd.com/read/28803800/-ping-pong-technique-for-treating-a-balloon-uncrossable-chronic-total-occlusion
#1
Michael Koutouzis, Grigorios Avdikos, Georgios Nikitas, Theodoros Zografos, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris
Balloon uncrossable lesions are a well-known challenge during chronic total occlusion (CTO) interventions. The technique of using two different catheters into the same coronary artery, the so-called "ping-pong" technique, is a technique described for treating complications during percutaneous coronary intervention (PCI), like perforations or rotational atherectomy burr entrapment. We describe a case where the "ping-pong" technique was successfully used to facilitate treatment of a balloon uncrossable CTO lesion...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28781024/intraluminal-intensity-of-blood-speckle-on-intravascular-ultrasound-a-novel-predictor-of-periprocedural-myocardial-injury-after-coronary-stenting
#2
Yoshiyuki Okuya, Yuichi Saito, Hideki Kitahara, Takashi Nakayama, Yoshihide Fujimoto, Yoshio Kobayashi
The difference in the intraluminal intensity of blood speckle (IBS) on integrated backscatter-intravascular ultrasound (IB-IVUS) across a coronary artery stenosis (i.e., ΔIBS) has previously shown a negative correlation with fractional flow reserve, reflecting an impaired coronary blood flow. Periprocedural myocardial injury (PMI) after coronary stenting has also been associated with coronary circulatory dysfunction. The aim of this study was to investigate the relation between ΔIBS after coronary stenting and PMI...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28766833/coronary-atherectomy-is-associated-with-improved-procedural-and-clinical-outcomes-among-patients-with-calcified-coronary-lesions-insights-from-the-va-cart-program
#3
Ehrin J Armstrong, Maggie A Stanislawski, Damianos G Kokkinidis, Mary E Plomondon, Anna E Barón, Jay Giri, Kendrick A Shunk, Subhash Banerjee, Thomas M Maddox, Stephen W Waldo
OBJECTIVES: We sought to evaluate the prevalence of calcified coronary lesions and the association between the use of atherectomy and clinical outcomes. BACKGROUND: Calcified coronary arteries are associated with an increased risk of procedural complications during percutaneous coronary intervention (PCI). The outcomes of coronary atherectomy for adjunctive treatment of calcified coronary lesions are not well described. METHODS: We identified all patients treated for calcified coronary lesions at VA hospitals...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28759543/endovascular-repair-of-peripheral-arterial-disease-midterm-results-from-a-single-center
#4
Kemal Korkmaz, Hikmet Selcuk Gedik, Ali Baran Budak, Serdar Gunaydin, Kerim Cagli
OBJECTIVE: One thousand consecutive patients who underwent endovascular repair in an 8-year period were studied retrospectively to evaluate technical success, freedom from reinterventions, early clinical outcome, and risk factors for restenosis/occlusion. METHODS: Mean ± SD Rutherford class was 3.29 ± 0.8. A total of 755 patients have claudication, 423 from rest pain, and 569 from ischemic ulceration. RESULTS: A total of 552 men and 448 women (mean ± SD = 69...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28756957/comparison-of-the-diameters-of-the-major-epicardial-coronary-arteries-by-angiogram-in-asian-indians-versus-european-americans-40-years-of-age-undergoing-percutaneous-coronary-artery-intervention
#5
Amgad N Makaryus, Rajiv Jauhar, Leanne M Tortez, Renee Pekmezaris
Coronary artery disease (CAD) rates are higher in Asian-Indians than in Caucasians. CAD occurs at an earlier age in this group, with about a quarter of all myocardial infarctions occurring under the age of 40. Previous reports have suggested smaller coronary artery size in Asian-Indians as a major cause for increased CAD in this population. This study sought to evaluate the size of normal "atheroma-free" segments of the epicardial coronary arteries in Asian-Indians and Caucasians aged ≤40 years undergoing coronary artery intervention in other diseased segments...
June 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28756420/safety-and-feasibility-of-rotational-atherectomy-in-elderly-patients-with-severe-aortic-stenosis
#6
Matthew Lippmann, Jigar Patel, Jared Kvapil, David Westover, Michael Pierpoline, Peter Tadros, Mark Wiley, George Zorn, Greg Muehlebach, Ashwani Mehta, Eric Hockstad, Matthew Earnest, Kamal Gupta
BACKGROUND: Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28733974/impact-of-diabetes-mellitus-on-procedural-and-one-year-clinical-outcomes-following-treatment-of-severely-calcified-coronary-lesions-with-the-orbital-atherectomy-system-a-subanalysis-of-the-orbit-ii-study
#7
Michael S Lee, Brad J Martinsen, Arthur C Lee, Ann N Behrens, Richard A Shlofmitz, Christopher Y Kim, Jeffrey W Chambers
OBJECTIVES: The goal of the study was to investigate the safety and efficacy of the coronary orbital atherectomy system to treat severe coronary artery calcification (CAC) prior to stent placement in diabetic and non-diabetic patients. BACKGROUND: The ORBIT II study reported the safety and efficacy of orbital atherectomy treatment in 443 patients with severe CAC. Percutaneous coronary intervention in diabetic patients is associated with an increased risk of major adverse cardiac events (MACE) compared with non-diabetics...
July 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722196/safety-of-orbital-atherectomy-in-patients-with-left-ventricular-systolic-dysfunction
#8
Evan Shlofmitz, Perwaiz Meraj, Rajiv Jauhar, Sanjum S Sethi, Richard A Shlofmitz, Michael S Lee
OBJECTIVES: We evaluated the angiographic and clinical outcomes in patients with severely calcified lesions and systolic dysfunction who underwent orbital atherectomy (OA). We hypothesized that OA would provide similar outcomes in patients with systolic dysfunction compared with patients with preserved systolic function. BACKGROUND: Systolic dysfunction is associated with an increased risk of adverse clinical events after percutaneous coronary intervention (PCI)...
July 19, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28707447/cto-revascularization-obstacles-and-options-in-balloon-nonpenetrable-lesions
#9
EDITORIAL
On Topaz
CTO lesions resisting balloon crossing are located in moderate/severe tortuous coronary arteries contain more moderate/severe calcification burden and carry a higher J-CTO score as compared with balloon crossable CTO lesions. CTO lesions resisting balloon crossing do not constitute a homogenous group. In 25% of the patients, the resisting CTO was caused by stent restenosis and thrombus is an integral component of CTO in addition to calcium and fibrosis. The excimer laser and rotational/orbital atherectomy are among useful debulking technologies capable of creating a "pilot recanalization channel" in the CTO that enables completion of the revasularization...
July 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
#10
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/28690118/clinical-outcomes-of-percutaneous-coronary-intervention-with-rotablation-in-patients-with-acute-or-recent-myocardial-infarction
#11
Ta-Jung Wang, Meng-Hsiu Chiang, Shao-Sung Huang, Cheng-Hsueh Wu, Shih-Hsien Sung, Wan-Leong Chan, Shing-Jong Lin, Wen-Lieng Lee, Tse-Min Lu
BACKGROUND: Although rotational atherectomy (RA) has been an accepted and widely used medical procedure for more than 15 years, the clinical outcomes of RA in high-risk populations remain elusive. Therefore, the purpose of this study was to investigate the safety and efficacy of RA for patients with acute or recent myocardial infarction (MI), and report the short- and long-term clinical outcomes in this population. METHODS: We enrolled patients undergoing percutaneous coronary intervention (PCI) and RA at two medical centers in Taiwan between January 2004 and December 2013...
July 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28683937/demonstration-of-the-safety-and-feasibility-of-robotically-assisted-percutaneous-coronary-intervention-in%C3%A2-complex-coronary-lesions-results-of-the-cora-pci-study-complex-robotically-assisted%C3%A2-percutaneous-coronary-intervention
#12
Ehtisham Mahmud, Jesse Naghi, Lawrence Ang, Jonathan Harrison, Omid Behnamfar, Ali Pourdjabbar, Ryan Reeves, Mitul Patel
OBJECTIVES: The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). BACKGROUND: R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown...
July 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28660560/jetstream-atherectomy-and-balloon-angioplasty-with-distal-embolic-protection-for-angio-seal%C3%A2-related-vascular-access-complications
#13
Mihir Barvalia, Mohammad Thawabi, Yassir Nawaz, Nishant Sethi, John Shao, Michael Amponsah, Gautam Visveswaran, Marc Cohen, Najam Wasty
Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases...
June 28, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28656738/mid-term-outcomes-of-consecutive-998-cases-of-coronary-atherectomy-in-contemporary-clinical-practice
#14
Nishtha Sareen, Usman Baber, Melissa Aquino, Sonny Sayseng, Joseph Sweeny, Nitin Barman, Vishal Kapur, Annapoorna Kini, Samin K Sharma
OBJECTIVES: To compare clinical and safety endpoints with use of rotational (RA) and orbital (OA) atherectomy in a large patient population with moderate to severely calcified lesions undergoing percutaneous coronary intervention (PCI). BACKGROUND: Coronary artery calcification (CAC) has been recognized as a risk factor for adverse outcomes with coronary artery disease (CAD). Though atheroablative techniques, RA and OA have been used extensively, comparison of their clinical and safety endpoints is lacking...
June 27, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28648437/utility-of-adjunctive-modalities-in-coronary-chronic-total-occlusion-intervention
#15
REVIEW
Hemal Bhatt, Sean Janzer, Jon C George
Coronary chronic total occlusion (CTO) intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI) attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#16
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28631258/long-term-effects-of-rotational-atherectomy-in-patients-with-heavy-calcified-coronary-artery-lesions-a-single-centre-experience
#17
Stanisław Bartuś, Rafał Januszek, Jacek Legutko, Łukasz Rzeszutko, Artur Dziewierz, Dariusz Dudek
BACKGROUND: Rotational atherectomy (RA) plays a significant role in contemporary percutaneous coronary interventions (PCI), especially in the era of population aging and expansion of PCI indications. AIM: The aim of the current study was to evaluate the rate of periprocedural complications, the long-term effectiveness of RA, and potential factors influencing the incidence of major adverse cardiac events (MACE) and major cardiac as well as cerebrovascular events (MACCE) after RA...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28623669/outcomes-after-successful-percutaneous-coronary-intervention-of-calcified-lesions-using-rotational-atherectomy-cutting-balloon-angioplasty-or-balloon-only-angioplasty-before-drug-eluting-stent-implantation
#18
Björn Redfors, Akiko Maehara, Bernhard Witzenbichler, Giora Weisz, Thomas D Stuckey, Timothy D Henry, Thomas McAndrew, Roxana Mehran, Ajay J Kirtane, Gregg W Stone, Philippe Généreux
OBJECTIVES: To report adverse event rates after rotational atherectomy (RA) with contemporary drug-eluting stent (DES) implantation and compare RA to cutting balloon (CB) angioplasty and balloon-only angioplasty (BA) in the all-comers ADAPT-DES trial. BACKGROUND: Percutaneous coronary intervention (PCI) of calcified lesions is increasingly common and is associated with a high risk of adverse events. RA can ablate calcified plaque and facilitate stent delivery; however, in conjunction with first-generation DES, RA was not superior to BA alone in regard to adverse events...
June 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28612417/length-and-pressure-matter-expediting-evidence-based-progress-in-femoropoliteal-intervention
#19
EDITORIAL
Arka Chatterjee, William B Hillegass
Preprocedural lesion length and ankle-brachial indices (ABI) synergistically predict 12-month patency and repeat revacularization in claudicants treated with bare metal nitinol stents for femoropopliteal disease. This predictive length-ABI model will permit broader evidence-based indirect comparisons of newer femoropopliteal approaches such as drug eluting balloon treatment with or without atherectomy. The length-ABI model is a step to supplement and supplant randomized controlled trials with indirect comparisons as the necessary evidence source expediting innovation and optimizing personalized endovascular therapy for infrainguinal obstructive peripheral arterial disease...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595481/retrograde-popliteal-access-to-percutaneous-peripheral-intervention-for-chronic-total-occlusion-of-superficial-femoral-arteries
#20
Mert Dumantepe
OBJECTIVE: The aim of this study is to present our initial experience with the use of the retrograde popliteal artery access in patients with chronic total occlusions of superficial femoral artery (SFA). METHOD: From July 2012 to May 2014, a total of 28 patients (20 men, mean age 61.2 ± 11.5 years) with total occlusion of the SFA and good distal runoff were treated with percutaneous atherectomy, balloon angioplasty, and stenting (mean length 165.3 ± 57.5 mm, range 72-336 mm)...
July 2017: Vascular and Endovascular Surgery
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