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Bifurcation stenting

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28394644/bioss-lim-c-thin-strut-cobalt-chromium-version-of-the-dedicated-bifurcation-stent
#7
Robert J Gil, Jacek Bil, Mateusz Kaczynski, Krzysztof P Milewski
Coronary bifurcation lesions pose therapeutic challenges during percutaneous coronary interventions. Dedicated bifurcation stents are one of the treatment options available. Areas covered: This paper will analyze the results of the BiOSS (Bifurcation Optimization Stent System) Clinical Program with a special focus on the cobalt-chromium BiOSS LIM C stent which has recently been introduced into the market (CE 2016). The stent is characterized by a strut thickness of 70 µm and sirolimus concentration of 1.4 µg/mm(2)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28390920/systematic-review-of-results-of-kissing-stents-in-the-treatment-of-aortoiliac-occlusive-disease
#8
REVIEW
Erik Groot Jebbink, Suzanne Holewijn, Cornelis H Slump, Jan-Willem Lardenoije, Michel M P J Reijnen
OBJECTIVES: The goal of this review is to give an overview of current results and role of the kissing stent (KS) technique in AIOD treatment. BACKGROUND: Endovascular treatment of aortoiliac occlusive disease (AIOD) involving the aortic bifurcation is challenging. The gold standard is open surgery with patency rates up to 90% at 5 years, but has considerable morbidity and mortality. The KS technique was introduced as an alternative. METHODS: The Cochrane guidelines were used to assure a systematic method...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28377907/initial-clinical-experience-with-the-endologix-afx-unibody-stent-graft-system-for-treating-patients-with-abdominal-aortic-aneurysms-a-case-controlled-comparative-study
#9
George N Kouvelos, Petroula Nana, Vasilios Bouris, Michalis Peroulis, Aikaterini Drakou, Nikolaos Rousas, Athanasios Giannoukas, Miltiadis I Matsagkas
PURPOSE: The newly designed unibody AFX endograft system for endovascular aortic aneurysm repair is the only graft with anatomical fixation to the aortic bifurcation in comparison to most other grafts that use the infrarenal neck as the main fixation point. The aim of this study was to assess the preliminary results of the AFX stent-graft system used with infrarenal aortic component and compare them with those obtained in patients treated with a well established endograft of the same material and pure infrarenal fixation as the Gore Excluder...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28368544/one-year-angiographic-results-after-pconus-stent-assisted-coiling-of-40-wide-neck-middle-cerebral-artery-aneurysms
#10
Benjamin Gory, Marta Aguilar-Pérez, Elisa Pomero, Francis Turjman, Werner Weber, Sebastian Fischer, Hans Henkes, Alessandra Biondi
BACKGROUND: Bifurcation middle cerebral artery (MCA) aneurysms with wide neck are amenable to endovascular coiling with pCONus stent, a recent device dedicated to wide-neck bifurcation intracranial aneurysms. OBJECTIVE: To evaluate the 1-year angiographic follow-up of wide-neck MCA aneurysms treated with pCONus. METHODS: Forty MCA aneurysms (mean dome size, 7.7 mm; mean neck size, 5.6 mm) coiled with pCONus were retrospectively evaluated. "Recanalization" was defined as worsening, and "progressive thrombosis" was defined as improvement on the Raymond scale...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28366303/comparison-of-midterm-results-for-the-talent-and-endurant-stent-graft
#11
Yannick W 't Mannetje, Philippe W M Cuypers, Ben R Saleem, Aron S Bode, Joep A W Teijink, Marc R H M van Sambeek
OBJECTIVE: Stent graft evolution is often addressed as a cause for improved outcomes of endovascular aneurysm repair for patients with an abdominal aortic aneurysm. In this study, we directly compared the midterm result of Endurant stent graft with its predecessor, the Talent stent graft (both Medtronic, Santa Rosa, Calif). METHODS: Patient treated from January 2005 to December 2010 in a single tertiary center in The Netherlands with a Talent or Endurant stent graft were eligible for inclusion...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28366057/development-of-a-recalcitrant-large-clot-burden-bifurcation-occlusion-model-for-mechanical-thrombectomy
#12
Visish M Srinivasan, Stephen R Chen, Kevin M Camstra, Gouthami Chintalapani, Peter Kan
OBJECTIVE Stroke is a major cause of disability and death in adults. Several large randomized clinical trials have shown the significant benefit of mechanical thrombectomy with modern stent retrievers in the treatment of large-vessel occlusions. However, large clots located at bifurcations remain challenging to treat. An in vivo model of these recalcitrant clots needs to be developed to test future generations of devices. METHODS Autologous blood was drawn from anesthetized swine via a femoral sheath. Blood was then mixed with thrombin, calcium chloride, and saline, and injected into silicone tubing to form cylindrical clots in the standard fashion...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28365415/immediate-and-short-term-performance-of-a-novel-sirolimus-coated-balloon-during-complex-percutaneous-coronary-interventions-the-fatebenefratelli-sirolimus-coated-balloon-fasico-registry
#13
Bernardo Cortese, Gaetano di Palma, Roberto A Latini, Mostafa Elwany, Pedro Silva Orrego, Romano G Seregni
BACKGROUND AND PURPOSES: Drug-coated balloons (DCB) currently represent an alternative to drug-eluting stents (DES) for the treatment of in-stent restenosis and they are also variably used for small coronary vessel and bifurcation lesion management. All DCB variably elute paclitaxel as an anti-proliferative drug. The first sirolimus coated balloon (SCB) received the CE mark in 2016, but its clinical performance has not been shown yet. METHODS AND RESULTS: FASICO in an all-comer registry of the first consecutive patients with at least one lesion treated with SCB between March and July 2016 at the first European centre that used this device...
March 25, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28359794/multilayered-parallel-endografting-for-urgent-endovascular-repair-of-a-severely-angulated-thoracoabdominal-aortic-aneurysm
#14
Sukgu M Han, Sarah Wartman, Sung W Ham, Eric C Kuo, Vincent L Rowe, Fred A Weaver
Total endovascular repair of TAAA using branched, fenestrated stent grafts have been performed with promising midterm results. However, severe angulation of the aorta as well as close proximity of the visceral and renal artery ostia pose a significant technical challenge in designing and implanting branched, fenestrated stent grafts. Parallel grafting offers an alternative technique, allowing an urgent, or emergent total endovascular repair of symptomatic, or ruptured TAAA. We describe a technique of 4-vessel incorporation in a total endovascular repair of TAAA, using multilayered parallel endografting via bilateral femoral and unilateral brachial access...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28359506/single-stage-hybrid-repair-of-right-aortic-arch-with-kommerell-s-diverticulum
#15
Cristian Rosu, Jean-François Dorval, Cherrie Zack Abraham, Raymond Cartier, Philippe Demers
Kommerell diverticulum is uncommon, and it carries risks of dissection or rupture. Hybrid aortic arch repair is being used increasingly for this pathology. We report the hybrid arch repair of Kommerell diverticulum in a 72-year-old woman known for muscular dystrophy and right aortic arch with aberrant left subclavian artery. Head-vessel debranching was performed through median sternotomy using a handmade, bifurcated, Dacron graft. Stent-grafting was performed from the ascending aorta to the proximal descending aorta...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28353317/self-expanding-stentys-stent-in-daily-routine-use
#16
Michał Kidawa, Krzysztof Chiżyński, Michał Kacprzak, Anna Ledakowicz-Polak, Marzenna Zielińska
In the era of modern interventional cardiology implantation of balloon expandable stent is a finishing touch of almost every coronary angioplasty. However sometimes we face clinical situation when decision on stent diameter is complicated, especially in ectatic part of arteries, in situations when artery lumen is obscured with thrombus or when reference diameter of proximal and distal part of lesion vary greatly. That is why idea of self-apposing stent similar to one used in peripheral vascular interventions was adopted into cardiology...
March 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28347159/stenotic-lesion-level-did-not-affect-outcomes-of-carotid-endarterectomy
#17
Masamitsu Suhara, Katsuyuki Hoshina, Atsushi Akai, Toshihiko Isaji, Daisuke Akagi, Kota Yamamoto, Takuya Miyahara, Toshiaki Watanabe
Background Carotid endarterectomy is the established treatment for carotid artery stenosis, and remains the primary surgical option due to its superior outcomes compared to carotid arterial stenting. However, Japanese patients are known to have unfavorable anatomical conditions for carotid endarterectomy, with a relatively higher level of the carotid artery bifurcation than in the Western population. We investigated the outcomes of carotid endarterectomy in our institute and evaluated the procedural quality by comparing patients based on higher or lower lesion levels...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28344214/the-outcomes-of-intravascular-ultrasound-guided-drug-eluting-stent-implantation-among-patients-with-complex-coronary-lesions-a-comprehensive-meta-analysis-of-15-clinical-trials-and-8-084-patients
#18
Zhong Guo Fan, Xiao Fei Gao, Xiao Bo Li, Ming Xue Shao, Ya Li Gao, Shao Liang Chen, Nai Liang Tian
OBJECTIVE: The effects of intravascular ultrasound (IVUS)-guided drug-eluting stent (DES) implantation in patients with complex coronary artery lesions remains to be controversial. This study sought to evaluate the outcomes of IVUS guidance in these patients. METHODS: The EMBASE, Medline, and other internet sources were searched for relevant articles. The primary endpoint was major adverse cardiac events (MACE), including all-cause mortality, myocardial infarction (MI), and target-vessel revascularization (TVR)...
March 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#19
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321023/hybrid-strategy-to-treat-life-threatening-giant-coronary-artery-aneurysm-with-severe-in-stent-restenosis
#20
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
Coronary artery aneurysm following drug-eluting stent implantation is rare in the literature. The presentation combined a life-threatening condition with severe in-stent restenosis. How to treat this condition is a complex problem because a surgical approach for a proximal left circumflex lesion is difficult. A hybrid method that is a combination of coronary bypass surgery and coronary stenting for left main bifurcation in-stent restenosis and proximal coronary artery aneurysm is a feasible strategy.
March 17, 2017: International Heart Journal
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