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https://www.readbyqxmd.com/read/28532780/meta-analysis-comparing-coronary-artery-bypass-grafting-to-drug-eluting-stents-and-to-medical-therapy-alone-for-left-main-coronary-artery-disease
#1
Rahman Shah, Mohamed S Morsy, Darryl S Weiman, George W Vetrovec
Historically, coronary artery bypass graft (CABG) surgery has been the standard revascularization method for unprotected left main coronary artery (LMCA) disease. Over the last decade, several randomized controlled trials (RCTs) have shown favorable results for percutaneous coronary intervention (PCI) with drug-eluting stent (DES) compared with CABG; however, no RCT has been conducted directly comparing DESs with medical therapy alone (MTA). Furthermore, the 2 most recently reported larger RCTs, using new-generation DESs reached somewhat conflicting conclusions comparing the 2 revascularization strategies...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#2
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28527528/awareness-knowledge-and-interest-in-interventional-radiology-among-final-year-medical-students-in-england
#3
P A Atiiga, M Drozd, R Veettil
AIM: To investigate awareness, knowledge, and interests in interventional radiology (IR) among final year students. MATERIALS AND METHODS: Three hundred and fifty-nine anonymous questionnaires were distributed to final year medical students at two medical institutions in England. A total of 220 students (61%) responded. RESULTS: In the present study, 167 students (75.9%) correctly identified that interventional radiologists perform angioplasty and stenting of arteries...
May 17, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#4
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#5
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28520861/influence-of-practice-patterns-on-outcome-among-countries-enrolled-in-the-syntax-trial-5-year-results-between-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting%C3%A2
#6
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, Arie Pieter Kappetein
OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis...
May 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28516101/early-spontaneous-resolution-of-an-iatrogenic-acute-type-a-aortic-dissection
#7
Mohammad A Zafar, Philip Y K Pang, Glen A Henry, Bulat A Ziganshin, Maryann Tranquilli, John A Elefteriades
Acute aortic dissection is a rare but devastating complication during cardiac catheterization. We present the case of an elderly female who incurred a Stanford Type A/DeBakey Type I acute aortic dissection extending into the arch vessels and descending aorta likely occurring during right coronary artery engagement for angioplasty. The patient was treated successfully by immediately sealing the entrance of the dissection via the placement of a stent and anti-impulse therapy. Follow-up computed tomography scan showed complete resolution of the dissection within one month...
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28511772/transcoronary-concentration-gradient-of-microrna-133a-and-outcome-in-patients-with-coronary-artery-disease
#8
Roberta De Rosa, Salvatore De Rosa, David Leistner, Jes-Niels Boeckel, Till Keller, Stephan Fichtlscherer, Stefanie Dimmeler, Andreas M Zeiher
Circulating levels of microRNA (miR)-133a are increased in patients with coronary atherosclerotic disease (CAD). Whether the cardiac release of this miR provides any prognostic information in patients with CAD is currently unknown. We aimed to investigate if changes in concentration of miR-133a trough the coronary circulation may be associated with patients' cardiovascular outcome. We enrolled 111 patients (82 with stable CAD and 29 with acute coronary syndromes [ACS]) who underwent coronary angiography. Circulating levels of miR-133a were measured across the transcoronary circulation...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28504231/poland-coronary-and-structural-heart-interventions-from-2010-to-2015
#9
Jacek Legutko, Zbigniew Siudak, Radosław Parma, Andrzej Ochała, Dariusz Dudek
For the last five years, invasive cardiology in Poland has developed extensively. Currently, 98% of the 161 Polish cathlabs operate in 24/7 mode, 37 of them supported by cardiac surgery departments on-site. A certification curriculum for interventional cardiology operators is supported by dedicated workshops and scientific meetings during national conferences. The rise in the number of coronary angiographies and PCIs was paralleled by an increased use of drug-eluting stents, bioresorbable vascular scaffolds and physiologic assessment of coronary arteries...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504228/italy-coronary-and-structural-heart-interventions-from-2010-to-2015
#10
Sergio Berti, Ferdinando Varbella, Alfredo Marchese, Luigi Emilio Pastormerlo, Giuseppe Musumeci
The aim of this report is to analyse trends in Italian cathlab activity between 2010 and 2015. Data were obtained from the national database of the Italian Society of Interventional Cardiology (GISE), which includes 97% of Italian cardiac catheterisation laboratories. The number of percutaneous coronary interventions (PCI) has remained relatively stable in the past five years. We have observed a significant increase in the number of primary PCI (pPCI) from 471.5 to 557.5 per million inhabitants with a consequent reduction of rescue primary PCI/fibrinolysis...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504227/israel-coronary-and-structural-heart-interventions-from-2010-to-2015
#11
Ariel Finkelstein, Saar Minha, Ran Kornowski, Haim Danenberg, Shmuel Banai, Haim Lotan, Amit Segev, Israel M Barbash
The Israel Heart Society is a member of the European Society of Cardiology, and the Israeli Working Group of Interventional Cardiology is an active participant in EAPCI. The aim of this manuscript is to provide a snapshot of cardiac interventions performed in the State of Israel during the period 2010-2015. Data for this manuscript were collected via collaboration with the National Diseases Registries Unit of the Israel Center for Disease Control. During the survey period, the Israeli population increased by 7% but only one additional hospital with an active cardiac catheterisation laboratory was opened...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28501658/hybridizing-the-sandwich-and-chimney-techniques-in-the-endovascular-repair-of-coarctation-of-the-aortic-arch-and-postcoarctation-ectasia-concomitant-with-a-left-subclavian-artery-aneurysm
#12
Mingguang Zhang, Hao Nie, Xinyu Gui, Jiang Shao, Bao Liu, Yongjun Li, Changwei Liu, Yuehong Zheng
Coarctation of aorta is a rare congenital malformation and is usually accompanied by other cardiac or vascular lesions. In this case we describe a 51-year-old patient presented with coarctation of the aortic arch and postcoarctation ectasia concomitant with a left subclavian artery aneurysm. Endovascular therapy included the deployment of an inverted wedge-shaped covered stent inserted by a long "chimney" stent and another cylinder-covered stent, forming a "sandwich"-like configuration. The symptoms were alleviated after surgery, and no perioperative or stent-graft-related complications were observed at a 2-year follow-up...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28500737/clinical-outcomes-of-overlapping-versus-non-overlapping-everolimus-eluting-absorb-bioresorbable-vascular-scaffolds-an-analysis-from-the-multicentre-prospective-rai-registry-clinicaltrials-gov-identifier-nct02298413
#13
Giuseppe Tarantini, Marco Mojoli, Giulia Masiero, Bernardo Cortese, Bruno Loi, Attilio Varricchio, Gabriele Gabrielli, Alessandro Durante, Giampaolo Pasquetto, Paolo Calabrò, Roberto Gistri, Gabriele Tumminello, Leonardo Misuraca, Francesco Pisano, Alfonso Ielasi, Pietro Mazzarotto, Sebastian Coscarelli, Valerio Lucci, Luciano Moretti, Annamaria Nicolino, Alessandro Colombo, Zoran Olivari, Massimo Fineschi, Davide Piraino, Luigi Piatti, Umberto Canosi, Paola Tellaroli, Donatella Corrado, Chiara Rovera, Giuseppe Steffenino
OBJECTIVES: To compare clinical outcomes of patients treated with overlapping versus non-overlapping Absorb BVS. BACKGROUND: Limited data are available on the clinical impact of stent overlap with the Absorb BVS bioresorbable stent. METHODS: We compared outcomes of patients receiving overlapping or non-overlapping Absorb BVS in the multicenter prospective RAI Registry. RESULTS: Out of 1,505 consecutive patients treated with Absorb BVS, 1,384 were eligible for this analysis...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28495897/geographical-difference-of-the-interaction-of-sex-with-treatment-strategy-in-patients-with-multivessel-disease-and-left-main-disease-a-meta-analysis-from-syntax-synergy-between-pci-with-taxus-and-cardiac-surgery-precombat-bypass-surgery-versus-angioplasty-using
#14
Yohei Sotomi, Yoshinobu Onuma, Rafael Cavalcante, Jung-Min Ahn, Cheol Whan Lee, David van Klaveren, Robbert J de Winter, Joanna J Wykrzykowska, Vasim Farooq, Marie-Claude Morice, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
BACKGROUND: The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. METHODS AND RESULTS: To assess clinical outcomes after percutaneous coronary intervention or coronary artery bypass graft in women and men with multivessel coronary disease and unprotected left main disease, a pooled analysis (n=3280) was performed using the patient-level data from 3 large randomized trials: SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) trials...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28495896/percutaneous-coronary-intervention-of-saphenous-vein-graft
#15
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Thomas McAndrew, Jamie Diamond, Xin Huang, Akiko Maehara, Giora Weisz, Roxana Mehran, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) has historically been associated with a high risk of adverse ischemic events, but there is a paucity of contemporary data on the second-generation drug-eluting stent use within SVG, and the relative importance of high platelet reactivity (HPR) in SVG PCI versus native lesion PCI is unknown. We studied ischemic and bleeding events after SVG PCI and their association with HPR. METHODS AND RESULTS: Subjects in the prospective, multicenter ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) were stratified according to whether they had PCI of an SVG or a non-SVG lesion...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28495247/hospital-variation-in-treatment-and-outcomes-in-acute-coronary-syndromes-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#16
Kevin R Bainey, Padma Kaul, Paul W Armstrong, Anamaria Savu, Cynthia M Westerhout, Colleen M Norris, Neil Brass, Dean Traboulsi, Blair O'Neill, Jayan Nagendran, Imtiaz Ali, Merril Knudtson, Robert C Welsh
BACKGROUND: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. METHODS: Patients hospitalized in 106 hospitals in Alberta, Canada with a primary diagnosis of ACS were included (July 1, 2010-March 31, 2013) with comparisons made across the three cardiac catheterization-capable hospitals (Sites A-C). Cox proportional-hazard regression models were used to examine the multivariable-adjusted association between site and 1-year death or repeat cardiovascular (CV) hospitalization (primary endpoint)...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28491182/aortoenteric-fistulae-temporization-and-treatment-lessons-learned-from-a-multidisciplinary-approach-to-3-patients
#17
Jeffrey Forris Beecham Chick, Jordan C Castle, Kyle J Cooper, Ravi N Srinivasa, Jonathan L Eliason, Nicholas H Osborne, Karen M Kim, Wael E Saad, Minhaj S Khaja
Aortoenteric fistulae are life-threatening conditions characterized by abnormal communications between the aorta and gastrointestinal tract. Aortoenteric fistulae may be characterized by the triad of bleeding, abdominal pain, or a pulsatile abdominal mass. Although hemorrhage is the most common presentation, it does not always occur; thus, patients may present with nonspecific symptoms. Computed tomography angiography findings suggestive of aortoenteric fistulae include ectopic gas within or adjacent to the aorta, discontinuity of the aortic wall, bowel wall thickening, and extravasation of contrast into the bowel...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28491085/stenting-versus-non-stenting-treatment-of-intermediate-stenosis-culprit-lesion-in-acute-st-segment-elevation-myocardial-infarction-a-multicenter-randomized-clinical-trial
#18
Jing Dai, Shu-Zheng Lyu, Yun-Dai Chen, Xian-Tao Song, Min Zhang, Wei-Min Li, Yang Zheng, Shang-Yu Wen, Shao-Ping Nie, Yu-Jie Zeng, Hai Gao, Yi-Tong Ma, Shu-Yang Zhang, Li-Jun Guo, Zheng Zhang
BACKGROUND: The benefit/risk ratio of stenting in acute ST-segment elevation myocardial infarction (STEMI) patients with single vessel intermediate stenosis culprit lesions merits further study, therefore the subject of the present study. METHODS AND RESULTS: It was a prospective, multicenter, randomized controlled trial. Between April 2012 and July 2015, 399 acute STEMI patients with single vessel disease and intermediate (40%-70%) stenosis of the culprit lesion before or after aspiration thrombectomy and/or intracoronary tirofiban (15 µg/kg) were enrolled and were randomly assigned (1: 1) to stenting group (n = 201) and non-stenting group (n = 198)...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28488370/patients-with-cirrhosis-who-have-coronary-artery-disease-treated-with-cardiac-stents-have-high-rates-of-gastrointestinal-bleeding-but-no-increased-mortality
#19
T Krill, G Brown, R A Weideman, D J Cipher, S J Spechler, E Brilakis, L A Feagins
BACKGROUND: Patients with coronary artery disease (CAD) treated with stents require dual antiplatelet therapy (DAPT). For cirrhotics, who often have varices and coagulopathy, it is not clear if the risk of gastrointestinal bleeding (GIB) should preclude use of DAPT. AIM: To compare GIB and mortality rates in cirrhotics with CAD treated medically or with stents. METHODS: Using institutional databases, we identified patients with cirrhosis and CAD treated with stents or medical therapy between January 2000-September 2015...
May 9, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28486843/emergent-endovascular-repair-of-challenging-aortocaval-fistula-with-hostile-anatomy
#20
Yuewei Wang, Wenjuan Yu, Yongxin Li, Haofu Wang
Aortocaval fistula (ACF) is a rare complication. Endovascular repair is an option for this fatal condition. However, endoleak and persistent fistula may occur and lead to technical failure. We performed endovascular repair for 3 cases of challenging ACF with hostile anatomy. Patient 1 was an 80-year-old man who complained of abdominal distension and lower limb edema for 15 days. He had renal and cardiac dysfunction. Computed tomography angiography (CTA) showed an ACF and extreme tortuosity of right iliac artery...
January 1, 2017: Vascular and Endovascular Surgery
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