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https://www.readbyqxmd.com/read/28228950/outcomes-of-coronary-artery-bypass-grafting-versus-percutaneous-coronary-intervention-with-second-generation-drug-eluting-stents-for-patients-with-multivessel-and-unprotected-left-main-coronary-artery-disease
#1
Kyriacos Papadopoulos, Ioannis Lekakis, Evagoras Nicolaides
OBJECTIVES: To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina. BACKGROUND: Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28227224/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#2
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Takahiro Tsukahara, Yuya Yamada, Yusuke Fujino, Masahiro Motosuke
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226721/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
#3
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
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/28223049/outcomes-of-coronary-artery-bypass-and-stents-for-unprotected-left-main-coronary-stenosis
#4
Yin-Shu Chang, Jia-Xiang Wang, Da-Wei Chang
BACKGROUND: This study assessed the short-, medium-, and long-term outcomes of coronary artery bypass grafting vs stenting for patients with unprotected left main coronary artery disease through a meta-analysis of randomized controlled trials. METHODS: PubMed, Embase, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were systematically searched for randomized controlled trials of coronary artery bypass grafting compared with stents in unprotected left main coronary artery disease...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#5
REVIEW
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Javier Mendoza, Florencia Sartori
PURPOSE OF REVIEW: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings. RECENT FINDINGS: Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#6
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#7
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28186284/coronary-obstruction-after-valve-in-valve-transcatheter-aortic-valve-implantation-salvage-with-stent-in-the-left-main-stem
#8
Lars Oliver Conzelmann, Uwe Mehlhorn, Claus Schmitt, Gerhard Schymik
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28168062/undilatable-stent-neoatherosclerosis-treated-with-ad-hoc-rotational-atherectomy
#9
Michael Koutouzis, Maria Agelaki, Christos Maniotis, Ioannis Tsiafoutis, Vasileios Patris, Mihalis Argyriou
A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28165613/outcomes-of-coronary-artery-bypass-graft-surgery-versus-drug-eluting-stents-in-older-adults
#10
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: Little data are available to compare coronary artery bypass graft surgery (CABG) vs percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in older adults. We evaluate the long-term outcomes of CABG vs PCI with DES in older adults with left main or multivessel coronary artery disease (CAD). DESIGN: Individual patient-level meta-analysis. SETTINGS: Databases from the BEST, PRECOMBAT, and SYNTAX trials were combined...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28161261/incomplete-revascularization-is-associated-with-an-increased-risk-for%C3%A2-major-adverse-cardiovascular-events%C3%A2-among-patients-undergoing-noncardiac-surgery
#11
Ehrin J Armstrong, Laura A Graham, Stephen W Waldo, Javier A Valle, Thomas M Maddox, Mary T Hawn
OBJECTIVES: The aim of this study was to determine whether incomplete revascularization is associated with a higher risk for major adverse cardiovascular events (MACE) and myocardial infarction (MI) among patients undergoing noncardiac surgery. BACKGROUND: Patients with coronary artery disease and prior percutaneous coronary intervention (PCI) frequently undergo noncardiac surgery. These patients may have had PCI either on all obstructive lesions (i.e., complete revascularization) or only on some (i...
February 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28159375/dual-supply-of-left-anterior-descending-coronary-artery-on-coronary-computed-tomographic-angiography-not-recognized-on-previous-cardiac-catheterizations
#12
Edward Mardakhaev, Mark Guelfguat, Jay S Meisner, Noah Weg
A dual left anterior descending (LAD) artery is an infrequent anomaly of the coronary circulation with rare variations that may cause symptoms. We report a 60-year-old man who underwent multiple percutaneous cardiac catheterizations with stent placements and presented with recurrent angina pectoris. Coronary computed tomographic angiography demonstrated a dual LAD with the long and short LADs originating from the right coronary artery and the left main coronary artery, respectively.
November 30, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#13
Benedikt Schrage, Michael Schwarzl, Christoph Waldeyer, Peter M Becher, Christoph Sinning, Ulrich Schäfer, Moritz Seiffert, Elvin Zengin-Sahm, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Aorto-ostial lesions as well as bifurcation lesions still provide challenges in percutaneous coronary intervention (PCI), as meticulous stent placement is needed. The Szabo-technique, which uses a second wire to anchor the stent at the osmium, may be helpful here. In this article, we will provide detailed information on the technique including video material as well as procedural and long-term follow-up data of a cohort of patients treated with this technique. METHODS AND RESULTS: A retrospective single-centre study was performed in patients undergoing Szabo-PCI from 2014 to 2016 (n=28)...
January 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28145616/bailout-polytetrafluoroethylene-covered-stent-implantation-for-left-main-bifurcation-perforation-using-the-kissing-stent-technique
#14
Noriaki Moriyama, Yutaka Tanaka, Shigeru Saito
Coronary artery perforation during percutaneous coronary intervention is a rare, but potentially lethal complication. Immediate balloon expansion at the perforation site can halt the bleeding. Implantation of a coronary polytetrafluoroethylene (PTFE)-covered stent enables the efficient endovascular repair of a coronary artery perforation. However, if the perforation occurs at a bifurcation, a PTFE-covered stent may jail the side branch. We report a difficult case of blowout coronary perforation (Ellis type III) at a left main coronary artery bifurcation, which was successfully sealed with a PTFE-covered stent without interference with the side branch coronary artery circulation...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28144066/erosion-of-esophageal-stent-into-left-main-bronchus-causing-airway-compromise
#15
S Aneeshkumar, L Sundararajan, Rajan Santosham, Rajkumar Palaniappan, Ubal Dhus
Covered or uncovered self-expanding metal stents are currently used for the palliative treatment of neoplastic esophageal strictures or compressions and esophageal leaks or fistulas due to malignancies. Erosion of esophageal stents into the respiratory tract is a rare complication and that too has been reported mostly as an early complication within few days or weeks. Here, we present the case of a 31-year-old female, who presented with a late complication of an esophageal stent eroding into the left main bronchus causing respiratory distress...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28133065/-efficacy-of-combined-therapy-drainage-of-the-bile-duct-high-dose-hepatic-artery-infusion-and-radiation-for-hilar-cholangiocellularcarcinoma-with-complete-portal-vein-obstruction
#16
Yasunori Hasuike, Ichiro Higuchi, Sanae Hosomi, Akira Ishikawa, Yousuke Akiyama, Takahiro Tanigawa, Atsuya Okada
We reported a case of hilar cholangiocellularcarcinoma with complete obstruction of the portal vein. The patient, who was a 65-year-old woman, suffered from fever and general fatigue as a result of acute cholangitis after insertion of a tube stent into the right bile duct. The main tumor was present on the right side of S1 and spread to both sides of the bile duct. S1 lobe was swollen and diffuse intrahepatic invasion was noted in the right lobe and S1. The portal vein was completely obstructed at the porta hepatis with a coronary vein-left renal vein shunt...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28131320/incidence-and-management-of-restenosis-after-treatment-of-unprotected-left-main-disease-with-second-generation-drug-eluting-stents-from-failure-in-left-main-study-with-2nd-generation-stents-cardiogroup-iii-study
#17
Fabrizio D'Ascenzo, Alaide Chieffo, Enrico Cerrato, Fabrizio Ugo, Marco Pavani, Hyroishi Kawamoto, Roberto di Summa, Ferdinando Varbella, Giacomo Boccuzzi, Pierluigi Omedè, Sara Rettegno, Roberto Garbo, Federico Conrotto, Antonio Montefusco, Giuseppe Biondi-Zoccai, Maurizio D'Amico, Claudio Moretti, Javier Escaned, Fiorenzo Gaita, Antonio Colombo
Incidence, predictors, and impact on prognosis of target lesion revascularization (TLR) for patients treated with second-generation drug-eluting stents (DESs) on unprotected left main (ULM) remain to be defined. The present study is a multicenter study including patients treated with a second-generation DES on ULM from June 2007 to January 2015. Rate of TLR was the primary end point. All cause death, myocardial infarction, target vessel revascularization, and stent thrombosis were the secondary end points. A total of 1,270 patients were enrolled: after a follow-up of 650 days (230 to 1,170), 47 (3...
January 6, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#18
REVIEW
Yohei Numasawa, Kenichi Sakakura, Kei Yamamoto, Shingo Yamamoto, Yousuke Taniguchi, Hideo Fujita, Shin-Ichi Momomura
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28116868/double-stenting-in-distal-left-main-lesions-let-s-crush
#19
EDITORIAL
Jorge A Belardi, Mariano Albertal
Unprotected distal left main (ULM) lesions often require double-stenting. In the MITO Registry, a mini-crush stenting technique was safer than culotte stenting. Performing mini-crush arises as the best approach in patients with distal ULM lesions requiring elective double-stenting.
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28112479/a-novel-stent-inflation-protocol-improves-long-term-outcomes-compared-with-rapid-inflation-deflation-deployment-method
#20
Srikanth Vallurupalli, Srikanth Kasula, Shiv Kumar Agarwal, Naga Venkata K Pothineni, Amjad Abualsuod, Abdul Hakeem, Zubair Ahmed, Barry F Uretsky
BACKGROUND: High-pressure inflation for coronary stent deployment is universally performed. However, the duration of inflation is variable and does not take into account differences in lesion compliance. We developed a standardized "pressure optimization protocol" (POP) using inflation pressure stability rather than an arbitrary inflation time or angiographic balloon appearance for stent deployment. Whether this approach improves long-term outcomes is unknown. METHODS AND RESULTS: 792 patients who underwent PCI using either rapid inflation/deflation (n = 376) or POP (n = 416) between January 2009 and March 2014 were included...
January 23, 2017: Catheterization and Cardiovascular Interventions
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