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Bifurcation stenting

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https://www.readbyqxmd.com/read/28515858/three-dimensional-optical-coherence-tomography-reconstruction-of-bifurcation-stenting-using-the-szabo-anchor-wire-technique
#1
Katherine Yu, Harkawal Hundal, Todd Zynda, Arnold Seto
Ostial lesions present unique challenges for percutaneous coronary intervention (PCI). These lesions are often more calcified, fibrotic, rigid, and more prone to elastic recoil. Intervention on these lesions is associated with higher procedural complications and higher rates of restenosis. Ostial lesions require precise stent placement in the ostium with the absence of side branch compromise. Accurate stent placement in the ostium without side branch compromise is difficult to accomplish with angiography alone...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28511617/secondary-procedures-following-iliac-branch-device-treatment-of-aneurysms-involving-the-iliac-bifurcation-the-pelvis-registry
#2
Konstantinos P Donas, Mirjam Inchingolo, Piergiorgio Cao, Carlo Pratesi, Giovanni Pratesi, Giovanni Torsello, Georgios A Pitoulias, Ciro Ferrer, Gianbattista Parlani, Fabio Verzini
PURPOSE: To evaluate the incidence and reasons for secondary procedures in patients treated with iliac branch devices (IBDs) for isolated iliac aneurysm or aortoiliac aneurysms involving the iliac bifurcation. METHODS: Between January 2005 and December 2015, 575 surgical-high-risk patients (mean age 72.0±8.4 years; 558 men) with isolated iliac aneurysms (n=79) or aortoiliac aneurysms involving the iliac bifurcation (n=496) were treated with placement of 650 ZBIS or Gore IBDs (75 bilateral) in 6 European centers...
June 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28508393/reversed-single-string-technique-for-coronary-bifurcation-stenting-first-report-of-case-demonstrations-in-vitro
#3
Julien Adjedj, Gabor G Toth, Mariano Pellicano, William Wijns
OBJECTIVES: This work reports the concept and the practical feasibility of Reversed Single String bifurcation stenting technique by demonstrating three in vitro cases. BACKGROUND: Provisional T stenting is the most used interventional technique to treat coronary bifurcation lesions. However, after main branch (MB) stenting, treatment of the side branch (SB) may become indicated to provide a good final result. Currently applied methods all have their structural limitations with respect to wall coverage, multiple strut layers, poor apposition rate...
May 16, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28502552/bifurcated-bifurcated-aneurysm-repair-is-a-novel-technique-to-repair-infrarenal-aortic-aneurysms-in-the-setting-of-iliac-aneurysms
#4
Susanna Hewon Shin, Benjamin Ware Starnes
BACKGROUND: Up to 40% of abdominal aortic aneurysms (AAAs) have coexistent iliac artery aneurysms (IAAs). In the past, successful endovascular repair required internal iliac artery (IIA) embolization, which can lead to pelvic or buttock ischemia. This study describes a technique that uses a readily available solution with a minimally altered off-the-shelf bifurcated graft in the IAA to maintain IIA perfusion. METHODS: From August 2009 to May 2015, 14 patients with AAAs and coexisting IAAs underwent repair with a bifurcated-bifurcated approach...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28487806/synchronous-carotid-bifurcation-endarterectomy-and-retrograde-kissing-stenting-of-the-innominate-and-left-common-carotid-artery-in-a-patient-with-a-bovine-aortic-arch
#5
Alessandro Robaldo, Guido Carignano, Alberto Balderi, Claudio Novali
Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a "bovine" aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28485275/influence-of-platform-design-of-six-different-drug-eluting-stents-in-provisional-coronary-bifurcation-stenting-by-repot-sequence-a-comparative-bench-analysis
#6
Francois Derimay, Geraud Souteyrand, Pascal Motreff, Gilles Rioufol, Gerard Finet
AIMS: The rePOT (proximal optimizing technique) sequence proved significantly more effective than final kissing balloon (FKB) with two drug-eluting stents (DES) in a bench test. We sought to experimentally validate efficacy in a large range of latest-generation DESs. METHODS AND RESULTS: On left main fractal coronary bifurcation bench models, 5 samples of each of the 6 main latest-generation DESs (Coroflex Isar™, Orsiro™, Promus Premier™, Resolute Integrity™, Ultimaster™, Xience Xpedition™) were implanted on rePOT (initial POT, side-branch inflation, final POT)...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#7
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28464724/abluminal-coated-drug-eluting-bifurcation-dedicated-stent-for-the-treatment-of-tibioperoneal-bifurcation
#8
Tullio Niglio, Plinio Cirillo, Giuseppe Giugliano, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
Endovascular treatment of below-the-knee region disease is often challenging because of the involvement of arterial bifurcations. Several cases have been reported on the use of coronary stents for the treatment of these patients, but limited evidence is available on the use of dedicated coronary bifurcation devices. We here report the endovascular treatment of a symptomatic bifurcation lesion in below-the-knee region, using a self-expanding Biolimus A9-eluting stent in combination with a "conventional" coronary drug-eluting stent...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28462902/two-stent-techniques-for-coronary-bifurcation-lesions-main-vessel-first-versus-side-branch-first-results-from-the-cobis-coronary-bifurcation-stenting-ii-registry
#9
Taek Kyu Park, Young Bin Song, Jeong Hoon Yang, Joo Myung Lee, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Ju Hyeon Oh, Cheol Woong Yu, Jin-Ok Jeong, Hyeon-Cheol Gwon
AIMS: It has not been known which 2-stent technique is best for treating bifurcation lesions. We compared the outcomes from main vessel (MV) first and side branch (SB) first techniques for patients with bifurcation lesions requiring 2-stent approach. METHODS AND RESULTS: A total of 673 patients with bifurcation lesions were treated with 2- stent techniques-MV first (n=250) or SB first (n=423). The rate of a composite of cardiac death, myocardial infarction, or target lesion revascularization (TLR) was similar in the 2 groups (SB first versus MV first, 15...
May 2, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28462716/treatment-of-bifurcation-lesions-by-bail-out-tap-or-culotte-lost-in-translation
#10
Francesco Burzotta, Thierry Lefèvre, Jens Flensted Lassen, Niels Ramsing Holm, Goran Stankovic
BACKGROUND: Coronary bifurcated lesions (CBL) represent a hot topic of interventional cardiology. Provisional stenting, i.e. implantation of a drug-eluting (DES) in the main branch followed by side-branch (SB) intervention in case of suboptimal SB result, represents the gold standard to treat the vast majority of CBL undergoing percutaneous coronary interventions (PCI). The best technique for bail-out SB stenting has not been established. Prospective randomized trials comparing different stenting techniques may help provide important insights regarding the best way to conduct PCI in patients with CBL...
April 26, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28457427/blood-flow-velocity-prediction-in-aorto-iliac-stent-grafts-using-computational-fluid-dynamics-and-taguchi-method
#11
Albert Y Chong, Barry J Doyle, Shirley Jansen, Stefan Ponosh, Julien Cisonni, Zhonghua Sun
Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB) is a new technique to treat extensive aortoiliac occlusive disease with covered expandable stent grafts to rebuild the aortoiliac bifurcation. Post stenting Doppler ultrasound (DUS) measurement of maximum peak systolic velocity (PSVmax) in the stented segment is widely used to determine patency and for follow up surveillance due to the portability, affordability and ease of use. Anecdotally, changes in hemodynamics created by CERAB can lead to falsely high PSVmax requiring CT angiography (CTA) for further assessment...
May 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28452616/an-ovine-model-of-cerebral-catheter-venography-for-implantation-of-an-endovascular-neural-interface
#12
Thomas James Oxley, Nicholas Lachlan Opie, Gil Simon Rind, Kishan Liyanage, Sam Emmanuel John, Stephen Ronayne, Alan James McDonald, Anthony Dornom, Timothy John Haynes Lovell, Peter John Mitchell, Iwan Bennett, Sebastien Bauquier, Leon Norris Warne, Chris Steward, David Bruce Grayden, Patricia Desmond, Stephen M Davis, Terence John O'Brien, Clive N May
OBJECTIVE Neural interface technology may enable the development of novel therapies to treat neurological conditions, including motor prostheses for spinal cord injury. Intracranial neural interfaces currently require a craniotomy to achieve implantation and may result in chronic tissue inflammation. Novel approaches are required that achieve less invasive implantation methods while maintaining high spatial resolution. An endovascular stent electrode array avoids direct brain trauma and is able to record electrocorticography in local cortical tissue from within the venous vasculature...
April 28, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28450550/biomechanical-impact-of-provisional-stenting-and-balloon-dilatation-on-coronary-bifurcation-clinical-implications
#13
Henry Y Chen, Khalid Al-Saadon, Yves Louvard, Ghassan S Kassab
BACKGROUND: In-stent restenosis (ISR) and stent thrombosis remain clinically significant problems for bifurcations. Although the role of wall shear stress (WSS) has been well investigated, the role of circumferential wall stresses (CWS) has not been well studied in provisional stenting with and without final kissing balloon (FKB). METHODS: We hypothesized that the perturbation of CWS at the SB in provisional stenting and balloon dilatation is an important factor in addition to WSS, and hence may affect restenosis rates (i...
April 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28449503/re-crossing-the-distal-cell-in-bifurcation-verified-by-using-an-enhanced-stent-visualization-system-and-optical-coherence-tomography-a-report-of-two-cases
#14
Ruofei Jia, Zening Jin, Hong Li, Jing Han
The coronary guidewire re-crossing position before the final kissing balloon post-dilation is important to reduce the incidence of incomplete stent apposition in bifurcation lesions. Angiography and intravascular ultrasonography are unreliable at detecting the site of wire re-crossing. The high resolution of optical coherence tomography (OCT) offers the advantage of precise assessment of construction in bifurcation. However, the OCT technique still has some limitations, including the requirement for additional contrast and expense...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28423237/assessment-of-vascular-response-to-bioss-lim-c-%C3%A2-stents-vs-orsiro-%C3%A2-stents-in-the-porcine-coronary-artery-model
#15
Jacek Bil, Robert J Gil, Tomasz Pawlowski, Krzysztof P Milewski
AIMS: The optimal treatment strategy for coronary bifurcation lesions is still unknown. The aim of the study was to assess applicability of the new cobalt-chromium version of the sirolimus-eluting dedicated bifurcation BiOSS(®) LIM C stent in comparison with regular sirolimus-eluting Orsiro(®)  stent in a porcine coronary model. METHODS: A total of 13 BiOSS(®) LIM C stents and 6 Orsiro(®) stents were implanted in normal non-atherosclerotic porcine straight coronary arteries of six animals using 1...
April 19, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#16
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28401352/randomized-comparison-between-provisional-and-routine-kissing-balloon-technique-after-main-vessel-crossover-stenting-for-coronary-bifurcation-lesions
#17
Masahiro Yamawaki, Masaki Fujita, Shinya Sasaki, Masanori Tsurugida, Mamoru Nanasato, Motoharu Araki, Keisuke Hirano, Yoshiaki Ito, Reiko Tsukahara, Toshiya Muramatsu
We compared the myocardial ischemic burden of provisional and routine final kissing-balloon inflation (FKI) with the 1-stent strategy using a second-generation drug-eluting stent for coronary bifurcation lesions (CBL). There are no established guidelines for side branch (SB) intervention after main vessel stenting. In total, 113 CBL patients were randomized to receive different SB intervention strategies: provisional-FKI group (n = 57; FKI only when SB flow was TIMI <3) and routine-FKI group (n = 56; mandatory FKI with aggressive treatment until SB-residual stenosis <50%)...
April 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28401260/stent-assisted-coiling-of-wide-neck-bifurcation-aneurysms-with-a-branch-incorporated-in-the-aneurysm-base-long-term-follow-up-in-49-patients-with-53-aneurysms
#18
Boris Lubicz, Ricardo Morais, Pierre-Julien Bruyère, Noémie Ligot, Benjamin Mine
PURPOSE: Wide-neck bifurcation intracranial aneurysms (WNBA) with a branch incorporated in the aneurysm base remain difficult to treat by embolization. We aim to report our long-term follow-up of stent-assisted coiling (SAC) in this subgroup of patients. METHODS: This study was approved by our local ethical committee. A retrospective review of our prospectively maintained database identified all patients treated in our institution by SAC for a WNBA with a branch incorporated in the aneurysm base...
April 11, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28400985/spanning-from-the-west-to-east-an-updated-review-on-endovascular-treatment-of-intracranial-atherosclerotic-disease
#19
REVIEW
Mohammed Hussain, Neil Datta, Zhe Cheng, David Dornbos, Asif Bashir, Ibrahim Sultan, Tapan Mehta, Faris Shweikeh, Paul Mazaris, Nora Lee, Amre Nouh, Xiaokun Geng, Yuchuan Ding
Ischemic stroke is a major cause of morbidity and mortality, incurring significant cost. Intracranial atherosclerotic disease (ICAD) accounts for 10-15% of ischemic stroke in Western societies, but is an underlying pathology in up to 54% of ischemic strokes in Asian populations. ICAD has largely been treated with medical management, although a few studies have examined outcomes following endovascular treatment. Our objective was to summarize the major trials that have been performed thus far in regard to the endovascular treatment of ICAD and to provide direction for future management of this disease process...
April 2017: Aging and Disease
https://www.readbyqxmd.com/read/28398398/-new-technologies-and-applications-for-drug-coated-balloons
#20
Bernardo Cortese, Gaetano Di Palma, Roberto Nerla, Antonio Micari
Drug-eluting stents (DES) represent nowadays the gold standard treatment for coronary artery disease. Despite the safety and efficacy, and favorable long-term clinical outcomes of new generation DES, their use is still associated with a not negligible risk of long-term events, related to the presence of a definitive prosthesis in the vessel wall. In addition, DES implantation is not always desirable in particular anatomic settings (small vessels, bifurcations) or in patients with higher bleeding risk. In recent years, drug-coated balloons (DCB) have been developed to overcome some of these limitations, offering a combined mechanical (balloon dilation) and biological therapy (drug-release)...
February 2017: Giornale Italiano di Cardiologia
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