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Bifurcation stenting

François Dérimay, Gérard Finet, Geraud Souteyrand, Luc Maillard, Adel Aminian, Benoit Lattuca, Guillaume Cayla, Guillaume Cellier, Pascal Motreff, Gilles Rioufol
AIMS: A new coronary bifurcation provisional stenting technique without kissing balloon, rePOT, associating proximal optimizing technique (POT), side-branch inflation and final POT, showed excellent mechanical results in a bench test. The present study sought to use optical coherence tomography (OCT) to quantify the mechanical results of rePOT in vivo in a large patient sample with complex coronary bifurcations. METHODS AND RESULTS: 106 patients with coronary bifurcations were included in a multicenter prospective registry (left main, 40...
March 20, 2018: EuroIntervention
Zilun Li, Henghui Yin, Mian Wang, Ridong Wu, Chenshu Liu, Chen Yao, Guangqi Chang
PURPOSE: To report the use of the octopus endograft technique to treat a patient with a ruptured thoracoabdominal aortic aneurysm (TAAA). CASE REPORT: A 46-year-old man was diagnosed with a contained rupture of a 9-cm type V TAAA. The presence of an occluded superior mesenteric artery (SMA), a stenotic celiac trunk, an enlarged inferior mesenteric artery (IMA), and rich collaterals with the SMA and celiac trunk made endovascular repair with the octopus endograft technique appear feasible...
April 2018: Journal of Endovascular Therapy
Mathieu Kerneis, C Michael Gibson, Gerald Chi, Roxana Mehran, Fahad AlKhalfan, Usama Talib, Seyedmahdi Pahlavani, Mahshid Mir, Christoph Bode, Jonathan L Halperin, Tarek Nafee, Eric D Peterson, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Keith A A Fox, Marc Cohen
OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear...
March 8, 2018: JACC. Cardiovascular Interventions
Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Up Huh, Chung Won Lee, Seon Hee Kim, Chan Ik Park, Sung Woon Chung, Seunghwan Song, Chang Won Kim
Blunt abdominal aortic injury (BAAI) is extremely rare. Three known treatments of BAAI exist: medical treatment, conventional surgical treatment, and endovascular treatment. Outcomes of medical and conventional surgical treatments, such as bypass graft, thrombectomy, and intimal suture, were not satisfactory. A 47-year-old man presented with multiple injuries after a high-speed vehicular accident. He was diagnosed with the traumatic aortic injury to be an intra-mural hematoma in the bifurcation of the terminal aorta...
March 15, 2018: Cardiovascular and Interventional Radiology
Ryoji Nagoshi, Takayuki Okamura, Yoshinobu Murasato, Tatsuhiro Fujimura, Masahiro Yamawaki, Shiro Ono, Takeshi Serikawa, Yutaka Hikichi, Fumiaki Nakao, Tomohiro Sakamoto, Toshiro Shinke, Yoichi Kijima, Amane Kozuki, Hiroyuki Shibata, Junya Shite
This article comprised the data related to the research article entitled "Feasibility and usefulness of three-dimensional optical coherence tomography guidance for optimal side branch treatment in coronary bifurcation stenting" (Nagoshi et al., In press) [1]. In this article we reports details about two patterns of guide wire (GW) recrossing position after crossover stenting in bifurcation lesion classified with three-dimensional optical coherence tomography (3D-OCT) (Okamura et al., 2014) [2] and follow-up data about the treatment with percutaneous coronary intervention(PCI) for bifurcation lesion in terms of the two- (2D) or 3D-OCT guidance...
February 2018: Data in Brief
J Bennett, T Adriaenssens, K McCutcheon, J Dens, W Desmet, P Sinnaeve, M Vrolix, C Dubois
OBJECTIVES: We evaluated healing responses with optical coherence tomography, and long-term clinical outcomes after treatment with a dedicated stent versus a conventional culotte technique. BACKGROUND: Dedicated bifurcation stents have been proposed as an alternative treatment for coronary bifurcation lesions. The long-term performance of dedicated stents versus conventional dual-stent techniques for the treatment of complex coronary bifurcation lesions is unknown...
March 14, 2018: Catheterization and Cardiovascular Interventions
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Zlatko H Mehmedbegovic, Vladan D Vukcevic, Goran R Stankovic
Coronary bifurcation lesions are accounted in about 20% of all percutaneous coronary interventions and despite all-round improvements in their treatment are still perceived as complex lesion subset in interventional cardiology. Treatment of bifurcations, being technically demanding primarily due to the unique bifurcation anatomy, is related to lower procedural success rate and increased rates of long-term adverse cardiac events. According to published data, provisional approach remains a default strategy for majority of bifurcation PCI, but when perfected, two-stent bifurcation techniques can also yield good clinical outcomes...
March 8, 2018: Minerva Cardioangiologica
Hong Kuan Kok, Shirish G Prabhudesai, Irfan Ahmed, Narayan Karunanithy, Said Abisi, Konstantinos Katsanos, Athanasios Diamantopoulos
PURPOSE: Endovascular treatment of infrapopliteal peripheral arterial disease (PAD) is an established and effective treatment strategy for patients with symptomatic PAD. Increasingly, complex infrapopliteal lesions are treated with an endovascular first approach, especially in the setting of critical limb ischemia for limb salvage, avoiding major amputations which impact on mobility and quality of life. However, many complex infrapopliteal lesions involving the bifurcation of the tibial arteries remain challenging to treat due to recoil or acute dissection following angioplasty and may require stenting using specialized techniques...
March 5, 2018: Annals of Vascular Surgery
Jun-Jie Zhang, Xiao-Fei Gao, Ya-Ling Han, Jing Kan, Ling Tao, Zhen Ge, Damras Tresukosol, Shu Lu, Li-Kun Ma, Feng Li, Song Yang, Jun Zhang, Muhammad Munawar, Li Li, Rui-Yan Zhang, He-Song Zeng, Teguh Santoso, Ping Xie, Ze-Ning Jin, Leng Han, Wei-Hsian Yin, Xue-Song Qian, Qi-Hua Li, Lang Hong, Chotnoparatpat Paiboon, Yan Wang, Li-Jun Liu, Lei Zhou, Xue-Ming Wu, Shang-Yu Wen, Qing-Hua Lu, Jun-Qiang Yuan, Liang-Long Chen, Francesco Lavarra, Alfredo E Rodríguez, Li-Min Zhou, Shi-Qin Ding, Kitigon Vichairuangthum, Yuan-Sheng Zhu, Meng-Yue Yu, Chan Chen, Imad Sheiban, Yong Xia, Yu-Long Tian, Zheng-Lu Shang, Qing Jiang, Yong-Hong Zhen, Xin Wang, Fei Ye, Nai-Liang Tian, Song Lin, Zhi-Zhong Liu, Shao-Liang Chen
INTRODUCTION: Provisional stenting (PS) for simple coronary bifurcation lesions is the mainstay of treatment. A systematic two-stent approach is widely used for complex bifurcation lesions (CBLs). However, a randomised comparison of PS and two-stent techniques for CBLs has never been studied. Accordingly, the present study is designed to elucidate the benefits of two-stent treatment over PS in patients with CBLs. METHODS AND ANALYSIS: This DEFINITION II study is a prospective, multinational, randomised, endpoint-driven trial to compare the benefits of the two-stent technique with PS for CBLs...
March 6, 2018: BMJ Open
Tadatsugu Gamou, Kenji Sakata, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: To investigate the impact of stent deformity induced by final kissing balloon technique (KBT) for coronary bifurcation lesions on in-stent restenosis (ISR). BACKGROUND: In experimental models, the detrimental effects of KBT have been clearly demonstrated, but few data exists regarding the impact of proximal stent deformity induced by KBT on clinical outcomes. METHODS: We examined 370 coronary lesions where intravascular ultrasound (IVUS)-guided second-generation drug-eluting stent (DES) implantation for coronary bifurcation lesions was performed...
March 6, 2018: Journal of Interventional Cardiology
Ki Hong Choi, Young Bin Song, Jin-Ok Jeong, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Myung-Ho Jeong, Bon-Kwon Koo, Hyo-Soo Kim, Cheol Woong Yu, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Ju Hyeon Oh, Jong-Seon Park, Hyeon-Cheol Gwon
INTRODUCTION AND OBJECTIVES: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). METHODS: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009...
February 20, 2018: Revista Española de Cardiología
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Annapoorna S Kini, Sunil Rao, William Weintraub, Timothy D Henry, Serdar Farhan, Birgit Vogel, Sabato Sorrentino, Zhen Ge, Samir Kapadia, Joseph B Muhlestein, Sandra Weiss, Craig Strauss, Catalin Toma, Anthony DeFranco, Mark B Effron, Stuart Keller, Brian A Baker, Stuart Pocock, George Dangas, Roxana Mehran
BACKGROUND: Potent P2Y12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. METHODS: PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm...
March 2018: Canadian Journal of Cardiology
Bernardo Cortese, Gaetano DI Palma, Roberto Latini
Drug-coated balloons (DCB) have been developed in recent years to overcome some of the DES limitations. There is an established indication for the use of DCB in the treatment of in-stent restenosis and they are also variably used in various setting, in particular small coronary vessels and bifurcations. Until 2016, all DCBs available in Europe eluted paclitaxel, a highly lipophilic drug with narrow therapeutic window. In April 2016 a new sirolimus-coated balloon (SCB, Magic Touch®, Envision Scientific PVT, India), obtained the CE Mark...
February 19, 2018: Minerva Cardioangiologica
Alessia Sonetto, Mauro Gargiulo, Enrico Gallitto, Stefano Ancetti, Gianluca Faggioli, Andrea Stella
PURPOSE: To report the endovascular treatment of a spontaneous iliac artery dissection (IAD) involving iliac bifurcation, complicated by a type B intramural aortic hematoma (IMH). CASE REPORT: A 38-year-old female patient came to our institution referring an acute ascending back pain. The angioCT-scan showed the presence of a retrograde right IAD with entry tear at the iliac bifurcation and a concomitant aortic IMH. After hypogastric embolization with a vascular plug, self-expanding stent-graft was placed to cover the iliac entry tear...
February 15, 2018: Annals of Vascular Surgery
Cleverson Zukowski, Felipe Maia, Maurício Oliveira, Luiz A Mattos, Alvaro Pontes, Ricardo A Costa, Daniel Chamié
No abstract text is available yet for this article.
February 9, 2018: JACC. Cardiovascular Interventions
Kei Harada, Kosuke Kakumoto, Shogo Oshikata, Kozo Fukuyama
BACKGROUND: Carotid artery stenting (CAS) with proximal occlusion effectively prevent distal cerebral embolism by flow arrest at internal carotid artery (ICA); however, the method can expose antegrade flow at ICA due to incomplete flow arrest. The aim of this study was to identify predictors of antegrade flow during CAS with proximal protection. METHODS: We retrospectively analyzed clinical and angiographic data among 143 lesions treated with CAS with proximal protection by occluding the common carotid artery (CCA) and external carotid artery (ECA)...
February 16, 2018: Acta Neurochirurgica
Benjamin Gory, Raphaël Blanc, Francis Turjman, Jérôme Berge, Michel Piotin
BACKGROUND AND PURPOSE: The Barrel vascular reconstruction device (Barrel VRD) is a novel stent with design features that allow endovascular coiling of wide-necked bifurcation aneurysms while preserving adjacent branches, without necessitating dual stent implantation. This study aimed to assess the safety and effectiveness of the Barrel VRD at 12-month follow-up. MATERIALS AND METHODS: The Barrel VRD trial is a prospective, multicenter, observational post-marketing registry evaluating the use of the Barrel VRD for treatment of wide-necked bifurcation aneurysms...
February 2, 2018: Journal of Neurointerventional Surgery
Serkan Ertugay, Ahmet Daylan, Halil Bozkaya, Emrah Oğuz, Anıl Apaydın, Mustafa Parıldar, Hakan Posacıoğlu
PURPOSE: The snorkel technique is commonly used to preserve renal arteries in juxta renal aneurysm during endovascular repair. Herein, we present a patient who underwent bifurcated endograft implantation with snorkel technique for inferior mesenteric artery (IMA) in order to preserve the major source of bowel circulation. CASE REPORT: A 69-year-old male patient was diagnosed with abdominal aortic aneurysm. His history revealed that he had bowel resection due to a car accident 30 years ago...
January 1, 2018: Vascular and Endovascular Surgery
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