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Bifurcation stenting

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https://www.readbyqxmd.com/read/29777394/biomechanical-impact-of-wrong-positioning-of-a-dedicated-stent-for-coronary-bifurcations-a-virtual-bench-testing-study
#1
Claudio Chiastra, Maik J Grundeken, Carlos Collet, Wei Wu, Joanna J Wykrzykowska, Giancarlo Pennati, Gabriele Dubini, Francesco Migliavacca
The treatment of coronary bifurcations is challenging for interventional cardiologists. The Tryton stent (Tryton Medical, Inc., USA) is one of the few devices specifically designed for coronary bifurcations that underwent large clinical trials. Although the manufacturer provides specific recommendations to position the stent in the bifurcation side branch (SB) according to four radio-opaque markers under angiographic guidance, wrong device positioning may accidentally occur. In this study, the virtual bench testing approach was used to investigate the impact of wrong positioning of the Tryton stent in coronary bifurcations in terms of geometrical and biomechanical criteria...
May 17, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29772314/urgent-use-of-gore-excluder-iliac-branch-endoprosthesis-ibe-with-left-transaxillary-approach-for-preservation-of-the-residual-hypogastric-artery-a-case-series
#2
D'Oria Mario, Chiarandini Stefano, Pipitone Marco, Calvagna Cristiano, Riccitelli Francesco, Rotelli Alice, Zamolo Francesca, Griselli Filippo
Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. MethodsWe report the case of two high-risk patients (unfit for open surgery), with previous EVAR and exclusion of one HGA, treated in emergency setting. Both patients met the anatomical requirements for Gore IBE use...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29766011/use-of-iliac-branch-device-for-endovascular-treatment-for-abdominal-aorta-aneurysm-with-small-diameter-neck
#3
Umberto G Rossi, Davide Santuari, Raffaello Dallatana, Maurizio Cariati
We present the case of a 78-year-old woman with a 4.5-cm symptomatic abdominal aortic aneurysm with a small diameter (13-mm diameter) infrarenal aortic neck who underwent endovascular treatment using an iliac branch device as a bifurcated aortic stent-graft.
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29765397/lvis-jr-device-for-y-stent-assisted-coil-embolization-of-wide-neck-intracranial-aneurysms-a-multicenter-experience
#4
Edgar A Samaniego, Aldo A Mendez, Thanh N Nguyen, Vladimir Kalousek, Waldo R Guerrero, Sudeepta Dandapat, Guilherme Dabus, Italo Linfante, Ameer E Hassan, Alexander Drofa, Evgueni Kouznetsov, David Leedahl, David Hasan, Alberto Maud, Santiago Ortega-Gutierrez
Background and Purpose: Complex wide-neck intracranial aneurysms are challenging to treat. We report a multicenter experience using the LVIS Jr stent for "Y-stent"-assisted coiling embolization of wide-neck bifurcation aneurysms. Methods: Seven centers provided retrospective data on patients who underwent Y-stenting. Technical complications, immediate posttreatment angiographic results, clinical outcomes, and imaging follow-up were assessed. Results: Thirty patients/aneurysms were treated: 15 basilar tip, 8 middle cerebral artery, 4 anterior communicating artery, 1 pericallosal, and 2 posterior inferior cerebellar artery aneurysms...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765392/carotid-stenting-for-treatment-of-symptomatic-carotid-webs-a-single-center-case-series
#5
Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29762775/combination-superficial-temporal-artery-middle-cerebral-artery-bypass-and-m2-m2-reanastomosis-with-trapping-of-a-stented-distal-middle-cerebral-artery-aneurysm-3-dimensional-operative-video
#6
Jan-Karl Burkhardt, Sonia Yousef, Halima Tabani, Arnau Benet, Roberto Rodriguez Rubio, Michael T Lawton
Distal middle cerebral artery (MCA) aneurysms often have non-saccular morphology and cannot be clipped, requiring revascularization and trapping instead. Combination bypasses are needed when 2 arteries exit the aneurysm, and extracranial-intracranial and intracranial-intracranial bypasses can be used. This video demonstrates a combination bypass used to treat a previously stented distal MCA aneurysm with both a superficial temporal artery (STA)-to-MCA bypass and an M2-to-M2 reanastomosis. This 56-yr-old man presented with distal left-sided MCA aneurysm 2 years earlier and attempted stent-assisted coiling was aborted after the aneurysm was perforated with stenting alone...
May 12, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#7
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29741487/regular-drug-eluting-stents-versus-dedicated-bifurcation-drug-eluting-bioss%C3%A2-stents-for-coronary-bifurcation-treatment-four-year-results-of-randomized-polbos-i-and-polbos-ii-clinical-trials
#8
Robert J Gil, Jacek Bil, Adam Kern, Luis A Ingio Garcia, Radoslaw Formuszewicz, Slawomir Dobrzycki, Dobrin Vassilev, Agnieszka Segiet
AIMS: The aim of this study was to analyze 4-year follow-up data of two clinical trials POLBOS I & II to compare regular DES (rDES) and dedicated bifurcation stents BiOSS®. METHODS AND RESULTS: In POLBOS trials BiOSS® stents were compared with rDES in patients with stable CAD or NSTE-ACS (POLBOS I: paclitaxel eluting BiOSS® Expert vs rDES; POLBOS II: sirolimus eluting BiOSS® LIM vs rDES). 445 patients with 222 patients in BiOSS group and 223 patients in rDES group were analyzed...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29735349/true-double-bifurcation-lesions-new-application-of-the-self-expandable-axxess-stent-and-review-of-literature-with-dedicated-bifurcation-devices
#9
REVIEW
Francesco Borgia, Tullio Niglio, Nicola De Luca, Luigi Di Serafino, Giovanni Esposito, Bruno Trimarco, Plinio Cirillo
Complex coronary artery bifurcation lesions occurred in hard clinical scenarios, such as acute coronary syndromes, may represent a challenge for interventional cardiologists, with not-defined general consensus on treatment. Even if provisional stenting is the most common option used to restore rapidly the coronary branches flow, improvements in industrial technologies and design of new dedicated bifurcation devices might open new modalities of treatment in these complex cases. The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding biolimus-eluting conical V-shape stent, specifically designed to treat "easily" coronary artery bifurcation lesions, with reported favorable long-term clinical results in stable patients compared to a provisional technique...
April 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#10
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716707/balloon-embedded-stenting-a-novel-technique-for-percutaneous-coronary-intervention-of-bifurcation-lesions-experience-in-indian-population
#11
Desabandhu Vinayakumar, Bijilesh Uppalakal, Kailash Kumar Goyal, Anishkumar Nair
BACKGROUND: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events. In this study, we describe a novel balloon embedded stenting technique which can be incorporated with traditional culotte or TAP technique and facilitates conversion to bail out crush in case of such an event...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29706477/usefulness-of-the-finet-law-to-guide-stent-size-selection-in-ostial-left-main-stenting-comparison-with-standard-angiographic-estimation
#12
Gianluca Rigatelli, Marco Zuin, Federico Ronco, Francesco Caprioglio, Daniele Cavazzini, Sara Giatti, Gabriele Braggion, Stefano Perilli, Van Tan Nguyen
BACKGROUNDS: Intravascular ultrasound has been suggested to optimize stent diameter and length in Left Main (LM) procedures, but in the real-world ostial LM stenting is often accomplished with angiography only guidance. The Finet law which regulates the fractal geometry of human bifurcation has the potential to increase the accuracy of stent-sizing. To retrospectively evaluating the impact on outcomes of the addition of Finet Law to standard quantitative coronary angiography (QCA) in guiding stent selection of ostial LM stenting compared to standard angiography estimation...
April 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29698797/current-status-of-the-pulserider-in-the-treatment-of-bifurcation-aneurysms-a-systematic-review
#13
REVIEW
Pedro Aguilar-Salinas, Leonardo B C Brasiliense, Christina M Walter, Ricardo A Hanel, Travis M Dumont
BACKGROUND: The PulseRider is an innovative stent-like device designed for the treatment of intracranial bifurcation aneurysms. The aim of this study was to assess the current evidence on safety and effectiveness of the PulseRider. METHODS: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were searched: PubMed, Ovid MEDLINE, and Scopus. The search strategy consisted of 'pulserider', 'bifurcation aneurysm', and 'endovascular' in both AND and OR combinations...
April 23, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29693768/simultaneous-kissing-stents-to-treat-unprotected-left-main-stem-coronary-artery-bifurcation-disease-stent-expansion-vessel-injury-hemodynamics-tissue-healing-restenosis-and-repeat-revascularization
#14
Paul D Morris, Javaid Iqbal, Claudio Chiastra, Wei Wu, Francesco Migliavacca, Julian P Gunn
OBJECTIVES: To perform detailed analysis of stent expansion, vessel wall stress, hemodynamics, re-endothelialization, restenosis, and repeat PCI in the simultaneous kissing stents (SKS) technique of bifurcation left main stem (LMS) stenting. BACKGROUND: The SKS technique is useful to treat patients with true bifurcation disease of the LMS but remains controversial. METHODS AND RESULTS: Computational structural analysis of SKS expansion demonstrated undistorted and evenly expanded stents...
April 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29685694/corrigendum-to-provisional-versus-elective-two-stent-strategy-for-unprotected-true-left-main-bifurcation-lesions-insights-from-a-fails-2-sub-study-int-j-cardiol-250-2018-80-85
#15
Hiroyoshi Kawamoto, Alaide Chieffo, Fabrizio D'Ascenzo, Richard J Jabbour, Toru Naganuma, Enrico Cerrato, Fabrizio Ugo, Marco Pavani, Ferdinando Varbella, Giacomo Boccuzzi, Mauro Pennone, Roberto Garbo, Federico Conrotto, Giuseppe Biondi-Zoccai, Maurizio D'Amico, Claudio Moretti, Javier Escaned, Fiorenzo Gaita, Sunao Nakamura, Antonio Colombo
No abstract text is available yet for this article.
April 20, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29685515/cerebral-embolization-during-endovascular-infrarenal-juxtarenal-and-suprarenal-aortic-aneurysm-repair-high-risk-maneuvers-and-associated-neurologic-outcomes
#16
Ruth A Benson, David Matthews, Vanessa Loftus, Grainne Nicholson, David Tropman, Ian M Loftus
BACKGROUND: Risk factors for postoperative cognitive decline after noncardiac surgery are multifactorial and poorly understood. Evidence suggests that perioperative microembolic damage to the brain on movement of wires and catheters during endovascular aortic procedures may play an important role. Endovascular aortic aneurysm repair requires invasive manipulation of wires and cannulas within the aorta, but research into cerebral emboli during aortic aneurysm repair and cognitive or neurologic injury is scarce and limited to thoracic aneurysms...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29682422/comparison-of-clinical-outcomes-after-drug-eluting-balloon-and-drug-eluting-stent-use-for-in-stent-restenosis-related-acute-myocardial-infarction-a-retrospective-study
#17
Chih-Yuan Fang, Hsiu-Yu Fang, Chien-Jen Chen, Cheng-Hsu Yang, Chiung-Jen Wu, Wei-Chieh Lee
Background: Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study's aim was to evaluate the efficacy of DEB for AMI with ISR. Methods: Between November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI)...
2018: PeerJ
https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#18
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
https://www.readbyqxmd.com/read/29667231/feasibility-and-clinical-outcomes-of-rotational-atherectomy-for-heavily-calcified-side-branches-of-complex-coronary-bifurcation-lesions-in-the-real-world-practice-of-the-drug-eluting-stent-era
#19
Yu-Wei Chen, Chieh-Shou Su, Wei-Chun Chang, Tsun-Jui Liu, Kae-Woei Liang, Chih-Hung Lai, Hong-Xu Liu, Wen-Lieng Lee
OBJECTIVES: To evaluate the outcomes of rotational atherectomy for heavily-calcified side branches of coronary bifurcation lesions. BACKGROUND: Side-branch (SB) preservation is clinically important but technically challenging in heavily-calcified non-left main true bifurcation lesions. SB rotational atherectomy (SB RA) is sometimes mandatory but the clinical outcomes are not well studied. METHODS: We retrospectively studied the outcomes of patients who underwent RA at our institute for heavily calcified, balloon-uncrossable or-undilatable SB lesions over an approximately 5-year period (January 2011 to September 2016)...
April 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29661597/clinical-performance-of-a-dedicated-self-apposing-stent-for-the-treatment-of-left-main-stem-disease-results-of-the-left-main-angioplasty-with-a-self-apposing-stent-the-matisse-study
#20
Bernardo Cortese, Antonio Montefusco, Fabrizio D'Ascenzo, Alessio La Manna, Giuseppe Andò, Teodoro Bisceglia, Gioel G Secco, Markus Meyer-Gessner, Wanha Wojciech, Paolo Sganzerla, Massimo Napodano, Gaetano Di Palma, Roberto A Latini, Corrado Tamburino, Pedro Silva Orrego, Andreas Baumbach
BACKGROUND: In the recent years percutaneous treatment of the left main stem (LM) has gained a precise role as a result of consistent scientific evidence vs. coronary artery bypass. A self-apposing stent offers an improved adaptation to the vessel wall, especially in case of tapered vessels; aim of this study was to investigate the role of a novel self-apposing, sirolimus-eluting stent (Stentys, France) for the treatment of LM coronary artery disease. METHODS AND RESULTS: MATISSE is a retrospective, multicenter registry, which enrolled 151 patients treated with the device at 17 international centers...
April 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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