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left main stenting

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https://www.readbyqxmd.com/read/29681535/percutaneous-coronary-intervention-of-unprotected-left-main-stenoses-procedural-data-and-outcome-depending-on-syntax-i-score
#1
Florian Blachutzik, Stephan Achenbach, Jens Röther, Monique Tröbs, Reinhard Schneider, Mohamed Marwan, Christian Schlundt
BACKGROUND: We hypothesized that SYNTAX I score is a predictor for procedure complexity in left main PCI. Procedure complexity, duration and contrast load may contribute to adverse outcome of complex left main percutaneous coronary intervention (PCI). METHODS: In 105 consecutive patients who underwent PCI of unprotected left main coronary artery stenoses between 2014 and 2016, clinical parameters as well as PCI characteristics and follow-up data were analyzed. RESULTS: The mean SYNTAX I score was 29 ± 12, with 66 patients having a SYNTAX I score ≤ 32 and 39 patients a SYNTAX I score > 32...
April 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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
#2
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/29666071/b-type-natriuretic-peptide-assessment-in-patients-undergoing-revascularization-for-left-main-coronary-artery-disease-analysis-from-the-excel-trial
#3
Björn Redfors, Shmuel Chen, Aaron Crowley, Ori Ben-Yehuda, Bernard J Gersh, Nicholas J Lembo, W Morris Brown, Adrian P Banning, David P Taggart, Patrick W Serruys, Arie Pieter Kappetein, Joseph F Sabik, Gregg W Stone
Background -Elevated B-type natriuretic peptide (BNP) is reflective of impaired cardiac function and is associated with worse prognosis among patients with coronary artery disease (CAD). We sought to assess the association between baseline BNP, adverse outcomes, and the relative efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with left main (LM) CAD. Methods -The EXCEL trial randomized patients with LMCAD and low or intermediate SYNTAX scores to PCI with everolimus-eluting stents versus CABG...
April 17, 2018: Circulation
https://www.readbyqxmd.com/read/29662510/long-term-outcomes-of-drug-eluting-stent-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease-a-meta-analysis
#4
Kong-Yong Cui, Shu-Zheng Lyu, Xian-Tao Song, Fei Yuan, Feng Xu, Min Zhang, Ming-Duo Zhang, Wei Wang, Dong-Feng Zhang, Jing Dai, Jin-Fan Tian, Yun-Lu Wang
Background: It is still controversial whether percutaneous coronary intervention with drug-eluting stent (DES) is safe and effective compared to coronary artery bypass graft surgery (CABG) for unprotected left main coronary artery (ULMCA) disease at long-term follow up (≥ 3 years). Methods: Eligible studies were selected by searching PubMed, EMBASE, and Cochrane Library up to December 6, 2016. The primary endpoint was a composite of death, myocardial infarction (MI) or stroke during the longest follow-up...
February 2018: Journal of Geriatric Cardiology: JGC
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
#5
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
https://www.readbyqxmd.com/read/29661004/percutaneous-versus-surgical-revascularization-for-left-main-or-multivessel-coronary-artery-disease-results-from-a-large-scale-meta-analysis-in-the-era-of-drug-eluting-stents
#6
Monica Verdoia, Lucia Barbieri, Elvin Kedhi, Harry Suryapranata, Giuseppe De Luca
The best treatment options for left main (LM) or multivessel coronary disease (MVD) are still debated. We performed a meta-analysis of randomized trials comparing percutaneous versus surgical revascularization for LM or MVD. Primary end point was overall mortality. Secondary end points were major adverse cardiovascular events, recurrent myocardial infarction, repeated revascularization, or stroke. A total of 8 randomized trials were included, involving 8694 patients, 50% undergoing percutaneous coronary intervention (PCI)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29658403/endobronchial-stenting-on-vv-ecmo-in-a-6-month-old-girl-with-right-lung-agenesis-and-severe-stenosis-of-the-left-main-bronchus
#7
Vaclav Vobruba, Jiri Votruba, Jan Bělohlávek, Tomas Grus, Pavel Leden, Tomas Zaoral, Jan Hřídel
INTRODUCTION: Lung agenesis is a rare disorder with a variable, but potentially very bad clinical course. It necessitates complex clinical management, especially in life-threatening situations. CASE REPORT: We describe a case of a 6-month-old girl with right lung agenesis who required venovenous extracorporeal membrane oxygenation (VV-ECMO) due to pneumonia complicated by exacerbated previously diagnosed left main bronchus stenosis. The stenosis was resolved by endobronchial intervention and X-ray-guided stent insertion, which enabled weaning from ECMO and was aimed at preventing such a life-threatening respiratory failure in the future...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29644230/noble-and-excel-the-debate-for-excellence-in-dealing-with-left-main-stenosis
#8
Hamood Al Kindi, Amir Samaan, Hatem Hosny
Left main coronary artery (LMCA) disease is associated with increased morbidity and mortality. Coronary artery bypass grafting surgery (CABG) has always been the standard revascularization strategy for this group of patients. However, with the recent developments in stents design and medical therapy over the past decade, several trials have been designed to evaluate the safety and efficacy of percutaneous coronary intervention (PCI) as an alternative to CABG surgery in patients with LMCA disease. Recently, the results of two major trials, EXCEL and NOBLE, comparing CABG versus PCI in this patient population have been released...
March 14, 2018: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/29623280/neo-left-main-channel-creation-using-double-stenting-alongside-a-sapien-3-aortic-valve-bioprosthesis-for-left-main-coronary-obstruction-following-valve-in-valve-transcatheter-aortic-valve-replacement-a-case-report-with-review-of-literature
#9
Apurva D Patel, Thomas Haldis, Kais Al Balbissi, Timir Paul
Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel ("neo left main") that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29622157/delayed-coronary-obstruction-after-transcatheter-aortic-valve-replacement
#10
Richard J Jabbour, Akihito Tanaka, Ariel Finkelstein, Michael Mack, Corrado Tamburino, Nicolas Van Mieghem, Ole de Backer, Luca Testa, Pamela Gatto, Paola Purita, Zouhair Rahhab, Verena Veulemans, Anja Stundl, Marco Barbanti, Roberto Nerla, Jan Malte Sinning, Danny Dvir, Giuseppe Tarantini, Molly Szerlip, Werner Scholtz, Smita Scholtz, Didier Tchetche, Fausto Castriota, Christian Butter, Lars Søndergaard, Mohamed Abdel-Wahab, Horst Sievert, Ottavio Alfieri, John Webb, Josep Rodés-Cabau, Antonio Colombo, Azeem Latib
BACKGROUND: Delayed coronary obstruction (DCO) is an uncommon and barely reported complication following transcatheter aortic valve replacement (TAVR). OBJECTIVES: The aim of this study was to describe the incidence and pathophysiological features of DCO after TAVR, obtained from a large international multicenter registry. METHODS: Data were retrospectively collected from an international multicenter registry consisting of 18 centers between November 2005 and December 2016...
April 10, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29589515/rheolytic-effects-of-left-main-mid-shaft-distal-stenting-a-computational-flow-dynamic-analysis
#11
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Thach Nguyen
Background The aim of this study was to evaluate the rheolytic effects of stenting a mid-shaft/distal left main coronary artery (LMCA) lesion with and without ostial coverage. Stenting of the LMCA has emerged as a valid alternative in place of traditional coronary bypass graft surgery. However, in case of mid-shaft/distal lesion, there is no consensus regarding the extension of the strut coverage up to the ostium or to stent only the culprit lesion. Methods We reconstructed a left main-left descending coronary artery (LM-LCA)-left circumflex (LCX) bifurcation after analysing 100 consecutive patients (mean age 71...
March 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29588723/use-of-intravascular-ultrasound-imaging-in-percutaneous-coronary-intervention-to-treat-left-main-coronary-artery-disease
#12
Giovanni Luigi De Maria, Adrian P Banning
Due to its potential prognostic implications and technical complexity, revascularisation of left main coronary artery (LMCA) disease requires careful consideration. Since publication of the results of the SYNTAX study, and more recently the EXCEL and NOBLE trials, there has been particular interest in percutaneous revascularisation of the LMCA. It is becoming clear that percutaneous revascularisation of LMCA disease requires appropriate lesion preparation and carefully optimised stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting...
May 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29582857/gastric-ischemia-due-to-critical-stenosis-of-the-celiac-trunk
#13
C Saldaña Dueñas, A Elosua González, A Guerra Lacunza
Gastric ischemia (GI) results from diffuse or localized vascular insufficiency caused by different aetiologies such as systemic hypotension, vasculitis, disseminated thromboembolism and celiac or mesenteric stenosis. We present a case of gastric ischemia due to critical stenosis of the celiac artery treated using endovascular therapy. The celiac artery is the first major branch of the abdominal aorta and provides some of the blood supply to the stomach through the left gastric artery and other organs like the spleen (splenic artery branch) and the liver...
March 26, 2018: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29563393/accelerated-atherogenicity-in-tangier-disease
#14
Jun Muratsu, Masahiro Koseki, Daisaku Masuda, Yuji Yasuga, Satoki Tomoyama, Keiji Ataka, Yoshiki Yagi, Atsushi Nakagawa, Hidehumi Hamada, Shigeki Fujita, Hiroaki Hattori, Tohru Ohama, Makoto Nishida, Hisatoyo Hiraoka, Yuji Matsuzawa, Shizuya Yamashita
We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout childhood. At 46 years old, he experienced effort angina, and coronary angiography demonstrated 75% stenosis in the right coronary artery. Orange-colored tonsils, mild hepatosplenomegaly and very low levels of serum high-density lipoprotein cholesterol (HDL-C) were observed, and the patient was diagnosed with Tangier disease. At 52 years old, effort angina recurred...
March 20, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29561462/rupture-of-multiple-pseudoaneurysms-as-a-rare-complication-of-common-iliac-artery-balloon-occlusion-in-a-patient-with-placenta-accreta-a-case-report-and-review-of-literature
#15
Qiaozhen Peng, Weishe Zhang
RATIONALE: Placenta accreta is the main cause of severe obstetric postpartum hemorrhage (PPH) and hysterectomy. Several hemostatic techniques have been performed in patients with placenta accreta to prevent PPH and reserve fertility. Abdominal aorta and pelvic arteries balloon occlusion are the only techniques which could be performed before cesarean section (CS) in patients who want to keep the fetus and reserve fertility. However, abdominal aorta and pelvic arteries balloon occlusion might lead to severe complications such as formation and rupture of pseudoaneurysm, angiorrhexis, etc...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29553940/benefit-of-a-new-provisional-stenting-strategy-the-re-proximal-optimizing-technique-the-repot-clinical-study
#16
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
https://www.readbyqxmd.com/read/29540631/current-use-of-intracoronary-imaging-in-interventional-practice-results-of-a-european-association-of-percutaneous-cardiovascular-interventions-eapci-and-japanese-association-of-cardiovascular-interventions-and-therapeutics-cvit-clinical-practice-survey
#17
Konstantinos C Koskinas, Masato Nakamura, Lorenz Räber, Roisin Colleran, Kazushige Kadota, Davide Capodanno, William Wijns, Takashi Akasaka, Marco Valgimigli, Giulio Guagliumi, Stephan Windecker, Robert A Byrne
BACKGROUND: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI).Methods and Results:A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69.8% with optical coherence tomography [OCT], and 7...
March 15, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29537966/current-use-of-intracoronary-imaging-in-interventional-practice-results-of-a-european-association-of-percutaneous-cardiovascular-interventions-eapci-and-japanese-association-of-cardiovascular-interventions-and-therapeutics-cvit-clinical-practice-survey
#18
Konstantinos C Koskinas, Masato Nakamura, Lorenz Räber, Roisin Colleran, Kazushige Kadota, Davide Capodanno, William Wijns, Takashi Akasaka, Marco Valgimigli, Giulio Guagliumi, Stephan Windecker, Robert A Byrne
AIMS: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI). METHODS AND RESULTS: A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69...
March 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29521440/patient-selection-and-percutaneous-technique-of-unprotected-left-main-revascularization
#19
L Testa, A Latib, M Bollati, F Bedogni
Increasing evidence suggests that percutaneous coronary intervention with newer generation drug-eluting stents may be an acceptable alternative, or even preferred in selected cases to the surgical approach, in patients with left main disease. This review will discuss the anatomic factors, the clinical variables, and the procedural strategies to consider, including physiology assessment and imaging guidance, in order to optimize outcomes.
March 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29517516/hybrid-coronary-revascularization-versus-percutaneous-strategies-in-left-main-stenosis-a-propensity-match-study
#20
Alberto Repossini, Lorenzo Di Bacco, Fabrizio Rosati, Maurizio Tespili, Antonio Saino, Alfonso Ielasi, Claudio Muneretto
AIMS: Hybrid revascularization (HCR) has been recently proposed as an alternative strategy in multivessel coronary disease, particularly in patients with high SYNTAX scores and risk scores. The objective of this study is to evaluate the outcomes of HCR versus percutaneous coronary intervention (PCI) drug-eluting stenting in left main treatment. METHODS: A series of 198 consecutive patients with left main stenosis have been treated. HCR, was performed in 77 patients (G1) whereas 121 patients (G2) received PCI on left main...
March 6, 2018: Journal of Cardiovascular Medicine
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