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Coronary artery stent

Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Lucia Barbieri, Monica Verdoia, Alon Schaffer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Patients with coronary artery disease who undergo stent implantation and have concomitant indication for long-term oral anticoagulation represent a considerable proportion of the overall population. To date there is still no consensus about the optimal antithrombotic strategy to choose in this kind of patients, due to the difficult balance between an increased risk of bleeding and thromboembolic complications. Therefore, the aim of this study was to perform a meta-analysis to evaluate the risk and benefits of triple antithrombotic therapy versus dual antithrombotic therapy in patients undergoing coronary stent implantation, requiring long-term oral anticoagulation...
October 18, 2016: Cardiovascular Drugs and Therapy
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Donghoon Choi
: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
Ivana Burazor, Stamenko Susak
OBJECTIVE: After stent or bypass surgery blood pressure (BP) can go up for multiple reasons among which are: stress and tense of the patient unsure about the future, the pain of the cut and because some of the blood pressure medication, which the patient was receiving preoperatively may get withdrawn post operatively, thereby leading to shooting up the BP. In certain patients, BP actually comes down after surgery and returns back to the pre-operative levels 4 to 6 weeks down the track...
September 2016: Journal of Hypertension
Pankaj Aggarwal, Pravin Saxena, Anil Bhan
Coronary artery stent infection has been reported with both bare metal stent and drug eluting stent and can present as mycotic coronary artery aneurysm, pseudoaneurysm, myocardial abscess, pericarditis or exudative effusion. Infection at the site of coronary stent implantation is rare and is believed to result typically from either direct stent contamination at the time of delivery or transient bacteraemia from access site. Introduction of drug-eluting stent (DES) has led to a marked reduction in the problem of in-stent restenosis across all patient subsets and lesions complexities...
September 2016: Indian Heart Journal
Arindam Pande, Soumya Patra, Manabhanjan Jena, Rabin Chakraborty
Thirty-nine year male had a history of road traffic accident with polytrauma. At emergency room he started having chest pain with ventricular tachycardia. He was subsequentially diagnosed with right coronary artery dissection secondary to blunt trauma which is an extremely rare cause of inferior wall myocardial infarction. After some dilemmas, he was ultimately treated with intravascular ultrasound guided coronary angioplasty with stenting and had an uneventful recovery.
September 2016: Indian Heart Journal
Lei Zhao, Long-Bo Li, Zhi-Hui Wang, Yong-Feng Shi, Jun-Duo Wu, Ji-Chang Zhang, Bin Liu
BACKGROUND: The CrossBoss coronary chronic total occlusion (CTO) crossing catheter has been demonstrated to have greatly improved the success rate of crossing CTO lesions, but there are no published data on its application for in-stent CTO lesions. METHODS: In the current study, we retrospectively reviewed the clinical data of 8 patients with in-stent CTO lesions that were managed with the CrossBoss catheter and herein we report the efficacy and safety of the CrossBoss crossing and re-entry system for this clinically challenging condition...
October 2016: Medicine (Baltimore)
Yalcin Velibey, Tolga Sinan Guvenc, Ahmet Taha Alper
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Tzu-Hsien Tsai, Cheng-I Cheng
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Philine J Köln, Bruno Scheller, Houng Bang Liew, Tuomas T Rissanen, Wan Azman Wan Ahmad, Ralf Weser, Telse Hauschild, Amin Ariff Nuruddin, Yvonne P Clever, Hee Hwa Ho, Franz X Kleber
BACKGROUND: Chronic total occlusions remain one of the biggest challenges for interventional cardiologists and the high risk of restenosis and stent thrombosis is still a major problem. Drug-coated balloons showed favorable results for the treatment of in-stent restenosis and other lesion types. The aim of this study was to evaluate the feasibility and outcome of a drug-coated balloon only approach for chronic total occlusion. METHODS: We included 34 patients with a native chronic total occlusion treated only by drug-coated balloons...
September 27, 2016: International Journal of Cardiology
Theodor Baars, Philipp Kahlert, Albert Baars, Heike Preibsch, Tienush Rassaf, Gerd Heusch, Petra Kleinbongard
OBJECTIVE: Stent implantation into atherosclerotic coronary vessels induces the release of particulate debris and soluble vasoactive substances, which impair downstream microvascular function. Microvascular perfusion, however, is also determined by hemorheological parameters. We therefore analyzed now changes in erythrocyte (RBC) aggregation in coronary arterial blood during stent implantation. METHODS: Symptomatic male patients with stable angina pectoris and stenosis in their native right coronary artery (RCA) or saphenous vein graft on right coronary artery (SVG-RCA) were enrolled...
October 13, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Ravi Varshney, Matthew Chamberlain, Erin Rayner-Hartley, Edel Kelliher, Arthur Lee, Richard Cook, Anthony Fung, Kenneth Gin, Parvathy Nair, Teresa S M Tsang
Formation of an intramural left atrial hematoma (ILAH) is a rare complication of coronary artery stenting. Rapid diagnosis with noninvasive multimodality imaging can potentially be lifesaving. We report a case of ILAH that resulted in left ventricular inflow obstruction and pericardial tamponade in a 55-year-old male who presented with hemodynamic instability and worsening dyspnea three weeks after seemingly uncomplicated left circumflex artery stenting. We demonstrate features on transthoracic echocardiography with contrast and cardiac computed tomography that were used for diagnosis and management...
October 13, 2016: Echocardiography
F Economou, S Katranas, G Giannoglou, K Gemitzis, I Styliadis, G Efthimiadis, H Karvounis, A Ziakas
BACKGROUND: Endothelial shear stress (ESS) may play a key role in the pathobiology of stent restenosis (SR). Nevertheless, limited data are available about ESS and its relation to SR. PATIENTS AND METHODS: We enrolled 14 patients who underwent successful percutaneous coronary intervention (PCI) in this study. Three-dimensional (3D) reconstruction of 14 coronary arteries before and after stent implantation was performed. Using computational fluid dynamics, mean ESS was calculated proximally, in tertiles within and distal to the stent, both before and after stent implantation...
October 12, 2016: Herz
Muhammad Dzafir Ismail, Wan Azman Wan Ahmad, Matthias Leschke, Matthias Waliszewski, Michael Boxberger, Imran Zainal Abidin, Ahmad Syadi Mahmood Zuhdi
BACKGROUND: Percutaneous coronary interventions (PCI) in coronary artery disease (CAD) with very small vessel diameters remains controversial and challenging. These lesions are usually more diffuse, calcified and tortuous. The usage of thin strut bare metal stents (BMS) with excellent crossing profiles in a very small caliber coronary lesions has increased the likelihood of procedural success. OBJECTIVES: This observational study assessed the 9-month clinical outcomes in an 'all-comers' population with very small caliber CAD after implantation of thin strut cobalt chromium BMS...
2016: SpringerPlus
Giuseppe Tarantini, Francesco Saia, Piera Capranzano, Bernardo Cortese, Marco Mojoli, Giacomo Boccuzzi, Andrea Cuculo, Salvatore Geraci, Alessio Mattesini, Jacopo Oreglia, Francesco Summaria, Luca Testa, Sergio Berti, Giovanni Esposito, Alessio La Manna, Ugo Limbruno, Alfredo Marchese, Ciro Mauro, Fabio Tarantino, Alessandro Salvi, Gennaro Santoro, Ferdinando Varbella, Roberto Violini, Giuseppe Musumeci
Drug-eluting stents (DES) are the current gold standard for percutaneous treatment of coronary artery disease. However, DES are associated with a non-negligible risk of long-term adverse events related to persistence of foreign material in the coronary artery wall. In addition, DES implantation causes permanent caging of the native vessel, thus impairing normal vasomotricity and the possibility of using non-invasive coronary imaging or preforming subsequent bypass surgery. On the contrary, coronary bioresorbable stents (BRS) may provide temporary mechanical support to coronary wall without compromising the subsequent recovery of normal vascular physiology, and have the potential to prevent late adverse events related to permanent elements...
October 2016: Giornale Italiano di Cardiologia
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Nabiul Islam, Sudip Misra
The network of novel nano-material based nanodevices, known as nanoscale communication networks or nanonetworks has ushered a new communication paradigm in the terahertz band (0.1-10 THz). In this work, first we envisage an architecture of nanonetworks-based Coronary Heart Disease (CHD) monitoring, consisting of nano-macro interface (NM) and nanodevice-embedded Drug Eluting Stents (DESs), termed as nanoDESs. Next, we study the problem of asymmetric data delivery in such nanonetworks-based systems and propose a simple distance-aware power allocation algorithm, named catch-the-pendulum, which optimizes the energy consumption of nanoDESs for communicating data from the underlying nanonetworks to radio frequency (RF) based macro-scale communication networks...
October 5, 2016: IEEE Transactions on Nanobioscience
Jae-Sik Jang, Ho-Cheol Shin, Jong Seok Bae, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Kyoung-Im Cho, Bo-Hyun Kim, Yong Hyun Park, Hyung-Gon Je, Dong-Soo Kim
BACKGROUND AND OBJECTIVES: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention frequently results in unnecessary stenting due to the low positive predictive value of IVUS-derived minimal lumen area (MLA) for identification of functionally significant coronary stenosis. We appraised the diagnostic accuracy of IVUS-derived MLA compared with the fractional flow reserve (FFR) to assess intermediate coronary stenosis. SUBJECTS AND METHODS: We searched MEDLINE and Cochrane databases for studies using IVUS and FFR methods to establish the best MLA cut-off values to predict significant non-left main coronary artery stenosis...
September 2016: Korean Circulation Journal
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