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incomplete revascularization

Lorenzo Azzalini, Luciano Candilio, Soledad Ojeda, Joseph Dens, Alessio La Manna, Susanna Benincasa, Barbara Bellini, Francisco Hidalgo, Jorge Chavarría, Joren Maeremans, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel Pan, Mauro Carlino, Antonio Colombo
We aimed to evaluate the impact of incomplete revascularization (ICR) on long-term outcomes of patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Consecutive patients undergoing CTO PCI at 4 centers were included. Baseline SYNTAX score (bSS: low [≤ 22], intermediate [>22 and <33], high [≥33]), residual SYNTAX score (rSS: 0, >0 and ≤8, >8), and SYNTAX revascularization index (SRI: 100 × (bSS-rSS)/bSS: 100%, 50% to 99%, <50%) were calculated. The primary end point was major adverse cardiac events (MACEs; cardiac death, any myocardial infarction, any revascularization) on follow-up...
February 23, 2018: American Journal of Cardiology
Kathryn F Kirchoff-Torres, Ekaterina Bakradze
PURPOSE OF REVIEW: Cerebral hyperperfusion syndrome (CHS) is a rare but significant complication after carotid revascularization and is increasingly recognized after acute stroke treatments. In this review, we discuss the epidemiology and pathophysiology of CHS, clinical presentation including ipsilateral headache, seizures, and focal neurological deficits, and radiographic presentation. We propose preventive therapies with emphasis on acute stroke post-thrombectomy hyperperfusion. RECENT FINDINGS: CHS was first described after carotid revascularization but is now also reported in patients with acute ischemic stroke...
March 19, 2018: Current Pain and Headache Reports
Cristina Aurigemma, Francesco Burzotta, Giulio Russo, Leonardo Previ, Carlo Trani
The Completeness of Revascularization in patients with multivessel coronary artery disease (CAD) remains an unanswered question. Despite 20 years of investigation there are still major doubts in this topic, reaching as far as to the lack of a standardized definition. The employment of different definition and the multiplicity of confounding variables that in general favor patients who receive a complete revascularization (CR) are the reason of difficult comparisons between studies. The complexity of coronary anatomy diseases and the clinical features play important role in the revascularization strategy...
March 15, 2018: Minerva Cardioangiologica
Guofeng Gao, Lei Feng, Dong Zhang, Chenxi Song, Chenggang Zhu, Weihua Song, Yanyan Zhao, Bo Xu, Dong Yin, Kefei Dou
OBJECTIVES: The purpose of this study was to assess the prognostic significance of the residual SYNTAX score (rSS) in a large-scale cohort of consecutive percutaneous coronary intervention (PCI) patients and to analyze whether residual proximal left anterior descending coronary artery (pLAD) lesions affect the prognosis of patients with same or similar rSS levels. BACKGROUND: The rSS, measured after PCI, has been assessed as an independent predictor of long-term clinical outcome and a tool for quantification of incomplete revascularization, and still needs to be validated in various PCI populations...
February 15, 2018: Catheterization and Cardiovascular Interventions
C Randall Harrell, Bojana Simovic Markovic, Crissy Fellabaum, Aleksandar Arsenijevic, Valentin Djonov, Vladislav Volarevic
BACKGROUND: Pericytes are multipotent cells present in every vascularized tissue in the body. Despite the fact that they are well-known for more than a century, pericytes are still representing cells with intriguing properties. This is mainly because of their heterogeneity in terms of definition, tissue distribution, origin, phenotype and multi-functional properties. The body of knowledge illustrates importance of pericytes in the regulation of homeostatic and healing processes in the body...
March 9, 2018: Journal of Biomedical Science
I-Chang Hsieh, Ming-Jer Hsieh, Chun-Chi Chen, Chao-Yung Wang, Shang-Hung Chang, Cheng-Hung Lee, Dong-Yi Chen, Chia-Hung Yang, Ming-Lung Tsai
BACKGROUND: Data regarding the long-term outcomes of a large patient population with multivessel coronary artery disease (MV-CAD) after complete revascularization (CR) and incomplete revascularization (IR) with drug-eluting stent (DES) implantation are controversial. The objective of this study was to evaluate differences between the clinical outcomes of CR and IR in such patients.Methods and Results:A total of 1,502 patients with MV-CAD who received DES between April 2005 and August 2016 were enrolled in this study after propensity score matching...
March 2, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Toshio Takayama, Jon S Matsumura
BACKGROUND: Complete revascularization, achieving inline flow to the foot through at least 1 patent tibioperoneal artery, is considered to be desirable for treating critical limb ischemia (CLI). Hybrid procedure, combined femoral endarterectomy and endovascular treatment, is commonly performed on patients with CLI because they often present with complicated lower extremity lesions involving the common femoral artery. This study aimed to investigate the efficacy of complete revascularization (CR) achieved by hybrid procedure on limb salvage in patients with CLI...
January 1, 2018: Vascular and Endovascular Surgery
Jihoon Kim, Joo Myung Lee, Ki Hong Choi, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Chul Ahn, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Jin-Ho Choi, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: There are limited data regarding the prognostic impact of angiographic complete revascularization (CR) in patients with chronic kidney disease (CKD). We sought to investigate the differential prognostic impact of angiographic CR over incomplete revascularization (IR), according to the presence of CKD in the drug-eluting stent era. METHODS AND RESULTS: Between 2003 and 2011 at Samsung Medical Center, consecutive patients with multivessel disease were stratified by the presence of CKD (estimated glomerular filtration rate <60 mL/min per 1...
February 15, 2018: Journal of the American Heart Association
Speranza Rubattu, Sebastiano Sciarretta, Simona Marchitti, Franca Bianchi, Maurizio Forte, Massimo Volpe
Atrial natriuretic peptide (ANP) is a cardiac hormone which plays important functions to maintain cardio-renal homeostasis. The peptide structure is highly conserved among species. However, a few gene variants are known to fall within the human ANP gene. The variant rs5065 (T2238C) exerts the most substantial effects. The T to C transition at the 2238 position of the gene (13-23% allele frequency in the general population) leads to the production of a 30-, instead of 28-, amino-acid-long α-carboxy-terminal peptide...
February 11, 2018: International Journal of Molecular Sciences
Michele Di Mauro, Massimiliano Foschi, Antonio Maria Calafiore
No abstract text is available yet for this article.
March 1, 2018: International Journal of Cardiology
Umberto Benedetto, Mario Gaudino, Antonino Di Franco, Massimo Caputo, Lucas B Ohmes, Juan Grau, David Glineur, Leonard N Girardi, Gianni D Angelini
BACKGROUND: We sought to investigate the impact of incomplete revascularization (IR) on long-term survival after isolated coronary artery bypass grafting (CABG). The possible interaction between IR and off-pump surgery was also explored. METHODS: A total of 13,701 patients with multivessel disease undergoing CABG were included in the analysis. All patients received left internal thoracic artery (LITA) to the left anterior descending artery (LAD) territory. IR was defined as at least one diseased arterial territory (right coronary artery [RCA] and/or circumflex [CX] artery) incompletely revascularized...
March 1, 2018: International Journal of Cardiology
Ki Hong Choi, Joo Myung Lee, Bon-Kwon Koo, Chang-Wook Nam, Eun-Seok Shin, Joon-Hyung Doh, Tae-Min Rhee, Doyeon Hwang, Jonghanne Park, Jinlong Zhang, Kyung-Jin Kim, Xinyang Hu, Jianan Wang, Fei Ye, Shaoliang Chen, Junqing Yang, Jiyan Chen, Nobuhiro Tanaka, Hiroyoshi Yokoi, Hitoshi Matsuo, Hiroaki Takashima, Yasutsugu Shiono, Takashi Akasaka
OBJECTIVES: The aim of this study was to investigate the prognostic implication of functional incomplete revascularization (IR) and residual functional SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (rFSS) in comparison with 3-vessel fractional flow reserve (FFR) and residual SYNTAX score. BACKGROUND: IR is associated with poor clinical outcomes in patients who underwent percutaneous coronary intervention. METHODS: A total of 385 patients who underwent 3-vessel FFR measurement after stent implantation were included in this study...
January 11, 2018: JACC. Cardiovascular Interventions
Aukelien C Dimitriu-Leen, Maaike P J Hermans, Alexander R van Rosendael, Erik W van Zwet, Bas L van der Hoeven, Jeroen J Bax, Arthur J H A Scholte
The best revascularization strategy (complete vs incomplete revascularization) in patients with ST-elevation myocardial infarction (STEMI) is still debated. The interaction between gender and revascularization strategy in patients with STEMI on all-cause mortality is uncertain. The aim of the present study was to evaluate gender-specific difference in all-cause mortality between incomplete and complete revascularization in patients with STEMI and multi-vessel coronary artery disease. The study population consisted of 375 men and 115 women with a first STEMI and multi-vessel coronary artery disease without cardiogenic shock at admission or left main stenosis...
December 11, 2017: American Journal of Cardiology
Peter Tajti, Darshan Doshi, Dimitri Karmpaliotis, Emmanouil S Brilakis
Antegrade dissection re-entry is often discouraged for chronic total occlusions (CTOs) with a bifurcation at the distal cap due to risk of side branch occlusion that can lead to periprocedural myocardial infarction and incomplete revascularization. Antegrade dissection re-entry, however, is often needed, especially in complex cases. We present the novel "double Stingray technique" for CTOs involving bifurcations, in which the Stingray system is used twice for re-entry into both vessel branches, followed by two-stent bifurcation stenting to maintain the patency of both branches...
January 23, 2018: Catheterization and Cardiovascular Interventions
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
Objective: To retrospectively evaluate the impact of pedal arch quality on tissue loss and time to healing in diabetic patients with foot wounds undergoing infrainguinal endovascular revascularization. Materials and Methods: Between January 2014 and June 2015, 137 consecutive diabetic patients with foot wounds underwent infrainguinal endovascular revascularization (femoro-popliteal or below-the-knee, arteries). Postprocedural angiography of the foot was used to divide the patients into the following three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA)...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Margot Den Hondt, Bart M Vanaudenaerde, Eric K Verbeken, Jan J Vranckx
OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
Min Joo Ahn, Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park
It remains unclear whether complete revascularization (CR) reduces the incidences of acute decompensated heart failure (ADHF) and adverse cardiac outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD). A total of 453 hemodynamically stable patients with STEMI and MVD were retrospectively evaluated; the patients were divided into 2 groups according to interventional strategy: CR (n = 240) and incomplete revascularization (IR) (n = 213)...
March 1, 2018: American Journal of Cardiology
Pravin K Goel, Roopali Khanna, C M Pandey, Fauzia Ashfaq
BACKGROUND: Long term clinical outcomes post chronic total occlusion (CTO) intervention may depend not only on CTO success/failure alone but also on Completeness of revascularization. OBJECTIVES: To determine long term outcomes post CTO intervention and relate them to both success versus failure and Complete Revascularization (CR) versus Incomplete Revascularization (IR). METHODS: Consecutive patients taken up for CTO intervention with at-least one CTO vessel between Jan 2006 to Dec 2015 were included...
January 4, 2018: Journal of Interventional Cardiology
Bartłomiej Perek, Veronica Casadei, Mateusz Puślecki, Sebastian Stefaniak, Dawid Maison, Adrian Gwizdała, Anna Perek, Łukasz Szarpak, Marek Jemielity
BACKGROUND: Aortic stenosis and coronary artery disease (CAD) sharing similar risk factors are associated with aging of the human population. AIM: The purpose of this study was to examine whether age affects clinical presentation, intraoperative management, and outcomes of patients who undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). METHODS: The study involved 452 consecutive patients aged 64...
2018: Kardiologia Polska
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