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incomplete revascularization

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https://www.readbyqxmd.com/read/28089148/percutaneous-revascularization-of-chronic-total-occlusions-rationale-indications-techniques-and-the-cardiac-surgeon-s-point-of-view
#1
Lorenzo Azzalini, Gianluca Torregrossa, John D Puskas, Emmanouil S Brilakis, William L Lombardi, Dimitri Karmpaliotis, Sunao Nakamura, Antonio Colombo, Mauro Carlino
Chronic total occlusions (CTO) are frequently found in clinical practice, yet they are still undertreated, despite the frequent presence of clinical indications for revascularization. The presence of a CTO is a frequent cause of incomplete revascularization, which has been associated with worse long-term outcomes (including mortality), compared to complete revascularization. Such low rates of attempted revascularization can be attributed to a common misconception about the lack of benefit of CTO revascularization, combined with historically lower success rates and higher complication rates of CTO percutaneous coronary intervention...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28077819/association-between-blood-transfusions-and-12-month-mortality-after-transcatheter-aortic-valve-implantation
#2
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Maciej Stapor, Dariusz Dudek
Blood transfusions are considered as an important predictor of adverse outcome in patients with severe aortic (AS) undergoing transcatheter aortic valve implantation (TAVI). We sought to investigate the association between blood transfusions and mortality after TAVI. We enrolled 101 consecutive patients with severe AS undergoing TAVI. Patients who required transfusion were defined as patients in whom at least one unit of packed red blood cells (PRBCs) was transfused in the perioperative period. Twelve-month outcomes were assessed based on Valve Academic Research Consortium definitions...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28040276/clinical-impact-of-complete-revascularization-in-elderly-patients-with-multi-vessel-coronary-artery-disease-undergoing-percutaneous-coronary-intervention-a-sub-analysis-of-the-shinano-registry
#3
Mikiko Harada, Takashi Miura, Takahiro Kobayashi, Hideki Kobayashi, Masanori Kobayashi, Hiroyuki Nakajima, Hikaru Kimura, Hiroshi Akanuma, Eiichiro Mawatari, Toshio Sato, Shoji Hotta, Yuichi Kamiyoshi, Takuya Maruyama, Noboru Watanabe, Takayuki Eisawa, Naoto Hashizume, Soichiro Ebisawa, Yusuke Miyashita, Uichi Ikeda
BACKGROUND: Prior reports have revealed that complete revascularization (CR) by percutaneous coronary intervention (PCI) decreased ischemic events. However, little is known about the efficacy of CR using PCI in elderly patients with multi-vessel coronary artery disease (CAD). We evaluated the 1-year effectiveness of CR-PCI in elderly patients (≥75years old) with multi-vessel CAD. METHODS: The SHINANO Registry, a prospective, observational, multi-center, all-comer cohort study, has enrolled 1923 patients...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28024554/moving-beyond-shock-new-paradigms-in-the-management-of-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#4
REVIEW
Dimitri Kalavrouziotis, Josep Rodés-Cabau, Siamak Mohammadi
The current management of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is associated with a high rate of mortality, despite widespread regional implementation of rapid transfer to percutaneous coronary intervention-capable centres for prompt infarct-related artery reperfusion. The limited clinical effectiveness of early revascularization in patients with AMI-CS might be secondary to the extent of coronary artery disease in these patients and the risk of incomplete revascularization, as well as the lower probability of achieving successful reperfusion compared with acute myocardial infarction without hemodynamic instability...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28008095/intracranial-carotid-artery-calcification-relates-to-recanalization-and-clinical-outcome-after-mechanical-thrombectomy
#5
María Hernández-Pérez, Daniel Bos, Laura Dorado, Karlijn Pellikaan, Meike W Vernooij, Elena López-Cancio, Natalia Pérez de la Ossa, Meritxell Gomis, Carlos Castaño, Josep Munuera, Josep Puig, Mònica Millán, Antoni Dávalos
BACKGROUND AND PURPOSE: Intracranial carotid artery calcification (ICAC) is a surrogate marker of intracranial arteriosclerosis, which may impact the revascularization and clinical outcome of acute stroke patients who undergo mechanical thrombectomy. METHODS: We included 194 patients admitted to our Stroke Unit between January 2009 and September 2015 who underwent mechanical thrombectomy for an anterior circulation occlusion. ICAC was quantified in both intracranial carotid arteries on the nonenhanced computed tomographic scan that was acquired before thrombectomy...
December 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27986755/impact-of-incomplete-percutaneous-revascularization-in-patients-with-multivessel-coronary-artery-disease-a-systematic-review-and-meta-analysis
#6
Vinayak Nagaraja, Sze-Yuan Ooi, James Nolan, Adrian Large, Mark De Belder, Peter Ludman, Rodrigo Bagur, Nick Curzen, Takashi Matsukage, Fuminobu Yoshimachi, Chun Shing Kwok, Colin Berry, Mamas A Mamas
BACKGROUND: Up to half of patients undergoing percutaneous coronary intervention have multivessel coronary artery disease (MVD) with conflicting data regarding optimal revascularization strategy in such patients. This paper assesses the evidence for complete revascularization (CR) versus incomplete revascularization in patients undergoing percutaneous coronary intervention, and its prognostic impact using meta-analysis. METHODS AND RESULTS: A search of PubMed, EMBASE, MEDLINE, Current Contents Connect, Google Scholar, Cochrane library, Science Direct, and Web of Science was conducted to identify the association of CR in patients with multivessel coronary artery disease undergoing percutaneous coronary intervention with major adverse cardiac events and mortality...
December 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27969608/tct-269-impact-of-incomplete-revascularization-in-diabetes-mellitus-patients-with-multivessel-disease-treated-with-percutaneous-coronary-intervention
#7
Sang Yeub Lee, Hector M Garcia-Garcia, Kayode Kuku, Viana Azizi, Gilbert Tang, Toby Rogers, Sarkis Kiramijyan, Smita I Negi, Jiaxiang Gai, Rebecca Torguson, Lowell Satler, Augusto Pichard, Ron Waksman
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#8
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27939502/magnetic-resonance-imaging-assessment-of-cardiac-function-in-a-swine-model-of-hibernating-myocardium-3%C3%A2-months-following-bypass-surgery
#9
Laura L Hocum Stone, Cory Swingen, Christopher Holley, Christin Wright, Erin Chappuis, Herbert B Ward, Edward O McFalls, Rosemary F Kelly
OBJECTIVE: Clinical studies demonstrate delayed recovery of hibernating myocardium (HM) following coronary artery bypass graft (CABG) surgery. Cardiac magnetic resonance (CMR) imaging is effective in identifying HM in clinical settings. Our animal model of HM shows partial but incomplete functional recovery 1 month following CABG using echocardiography. This study uses CMR imaging to determine completeness of recovery 3 months post-CABG. METHODS: Swine (N = 12) underwent left anterior descending artery (LAD) 1...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27894264/optical-coherence-tomography-findings-after-longitudinal-ablation-for-an-underexpanded-stent-in-a-heavily-calcified-lesion-a-case-report
#10
Masahiro Koide, Keiji Inoue, Akiko Matsuo, Hiroshi Fujita
BACKGROUND: Heavy coronary artery calcification is responsible for stent underexpansion, which is associated with increased in-stent restenosis. Here we report a case in which optical coherence tomography (OCT) demonstrated that the metal component of an underexpanded stent previously implanted in a heavy calcified lesion had been completely removed after ablation with rotational atherectomy. CASE PRESENTATION: An 83-year-old man with exertional angina was referred to our hospital...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27874937/impact-of-complete-and-incomplete-revascularization-on-short-and-long-term-quality-of-life-in-patients-with-multivessel-coronary-artery-disease
#11
N Chen, J-Y Zhang, S-Z Yang, Y-D Li
OBJECTIVE: In this study, we compared the impact of two main strategies of intervention against multivessel coronary disease (MVD), complete revascularization (CR) and incomplete revascularization (IR), on patients' quality of life. PATIENTS AND METHODS: 210 patients with multivessel disease were selected for this study. The diagnosis was confirmed by coronary angiography, and patients were divided in two different groups according to the type of revascularization method they received: (1) the complete revascularization (CR) group and (2) the incomplete revascularization (IR) group...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27816320/comparison-of-mid-term-clinical-outcomes-between-complete-full-metal-jacket-strategy-versus-incomplete-full-metal-jacket-strategy-for-diffuse-right-coronary-artery-stenosis-with-drug-eluting-stents
#12
Kei Yamamoto, Kenichi Sakakura, Yusuke Adachi, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
BACKGROUND: The optimal strategy for diffuse right coronary artery (RCA) stenosis remains unclear. OBJECTIVE: The objective of this study was to compare the mid-term outcomes of "complete full-metal jacket (c-FMJ) stenting strategy" with "incomplete full-metal jacket (i-FMJ) stenting strategy" for the diffuse long RCA lesion using drug-eluting stents (DES). METHODS: Between July 2007 and October 2015, 121 patients underwent percutaneous coronary intervention (PCI) for diffuse RCA lesions using DES...
November 2, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27766510/ivabradine-in-patients-with-stable-coronary-artery-disease-a-rationale-for-use-in-addition-to-and-beyond-percutaneous-coronary-intervention
#13
REVIEW
Cosmo Godino, Antonio Colombo, Alberto Margonato
Heart rate is an established prognostic marker for longevity and is an important contributor in the pathophysiology of various cardiovascular diseases, including ischemic heart disease and heart failure. Most ischemic episodes are triggered by an increase in heart rate, which causes an imbalance between myocardial oxygen delivery and consumption. In addition, increased heart rate is a modifiable risk factor for chronic heart failure. Ivabradine, an inhibitor of If ion channels, is an approved second-line anti-ischemic drug for the treatment of angina...
October 21, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27759927/fracking-the-code-to-complete-revascularization
#14
Ravi S Hira, Larry S Dean
Provisional use of rotational atherectomy (RA) is indicated for procedural success in heavily calcified lesions. In the current study, RA use at three high volume percutaneous coronary intervention (PCI) centers between 2005 and 2013 was 1.4%. MACE rate was 17.8% at median follow-up of 22 months. Peripheral vascular disease (PVD), diabetes mellitus (DM), acute coronary syndrome (ACS), and SYNTAX > 23 were found to be independently associated with MACE. With increasing complexity of disease and SYNTAX score, there is usually an increase in severity of calcification and need for atherectomy...
October 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27742424/long-term-prognostic-value-of-late-gadolinium-enhanced-magnetic-resonance-imaging-in-patients-with-and-without-left-ventricular-dysfunction-undergoing-coronary-artery-bypass-grafting
#15
Seung-Ah Lee, Yeonyee E Yoon, Jung-Eun Kim, Jin Joo Park, Il-Young Oh, Chang-Hwan Yoon, Jung-Won Suh, Jun-Sung Kim, Eun Ju Chun, Young-Suk Cho, Tae-Jin Youn, Cheong Lim, Goo-Young Cho, In-Ho Chae, Kay-Hyun Park, Dong-Ju Choi, Sang Il Choi
The value of late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI) for the prediction of functional recovery after surgical revascularization has been previously established. However, the impact of LGE-MRI on the long-term prognosis after coronary artery bypass grafting (CABG) remains incompletely understood. Therefore, we aimed to evaluate the long-term prognostic value of LGE-MRI, based on the presence or absence of left ventricular (LV) dysfunction, in patients with coronary artery disease undergoing CABG...
December 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27726882/outcome-of-revascularization-procedure-a-retrospective-case-series
#16
Sarah Bukhari, Meetu R Kohli, Frank Setzer, Bekir Karabucak
INTRODUCTION: The purpose of this retrospective case series was to investigate the outcome of the revascularization procedure in necrotic immature teeth. METHODS: The residents and faculty members at the University of Pennsylvania endodontic department were invited to submit consecutive revascularization cases treated by them, irrespective of the outcome, during the time period of 2009 to 2012. Twenty-eight of 35 submitted necrotic immature teeth met the inclusion criteria...
December 2016: Journal of Endodontics
https://www.readbyqxmd.com/read/27696973/tracheal-tissue-engineering-in-vivo-biocompatibility-of-mechanically-stripped-allogenic-rabbit-trachea-with-autologous-epithelial-covering
#17
Margot Den Hondt, Bart M Vanaudenaerde, Erik K Verbeken, Jan J Vranckx
BACKGROUND: Successful trachea transplantation comprises the use of biocompatible constructs with little immune-reactivity, submucosal revascularization and creation of an epithelial covering. Allogenic chondrocytes might be protected from an overt immune-response due to physical isolation. Our aim was to evaluate in-vivo biocompatibility of allotracheae, stripped of their highly-immunogenic inner lining. Secondly, we established whether these constructs might serve as suitable scaffolds for autologous epithelial grafting...
October 4, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27665400/is-it-time-to-change-how-we-think-about-incomplete-coronary-revascularization
#18
Cristiano Spadaccio, Francesco Nappi, Antonio Nenna, Gwyn Beattie, Massimo Chello, Fraser W H Sutherland
The optimal degree of revascularization for patients with chronic multivessel coronary artery disease remains an unsolved issue. Intuitively, complete revascularization decreases cardiovascular events and improves outcomes compared to incomplete procedures, but in recent years the concept of incomplete revascularization moved from a sub-optimal or a defective treatment towards the most appropriate revascularization technique in some categories of patients. A reasonable level of incomplete anatomic revascularization has been shown to be safe and achievable with both percutaneous (PCI) and surgical procedures (CABG), despite with different long-term outcomes...
September 18, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27641966/anti-troponin-antibodies-following-myocardial-infarction
#19
REVIEW
Tom J O'Donohoe, Natkunam Ketheesan, Ryan G Schrale
Recent improvements in medical and surgical coronary revascularization techniques have significantly improved outcomes for patients with acute myocardial infarction (MI). However, large infarctions are often followed by a poorly understood process of pathological ventricular remodelling, which fails to return the heart to its premorbid state. Although it remains incompletely understood, there is increasing interest in the role of the immune system in this process. One hypothesis is that released cardiac proteins become the focus of an immune response that results in the formation of functionally significant autoantibodies...
January 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27595691/complete-versus-incomplete-revascularization-in-patients-with-multivessel-coronary-artery-disease-treated-with-drug-eluting-stents
#20
Mineok Chang, Jung-Min Ahn, Nayoung Kim, Pil Hyung Lee, Jae-Hyung Roh, Sung-Han Yoon, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
BACKGROUND: The clinical impact of completeness of revascularization on adverse cardiovascular events remains unclear among patients with multivessel coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS: This analysis included consecutive patients with multivessel CAD, who underwent PCI with drug-eluting stents (DES) during the period from January 1, 2003, through to December 31, 2013. We compared the outcomes in patients, who achieved complete (CR) versus incomplete revascularization (IR) at the time of PCI...
September 2016: American Heart Journal
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