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incomplete revascularization

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https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#1
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28303688/patient-level-meta-analysis-of-999-claudicants-undergoing-primary-femoropopliteal-nitinol-stent-implantation
#2
Krishna J Rocha-Singh, Joshua A Beckman, Gary Ansel, Sean P Lyden, Peter Schneider, Manish Mehta, Michael Dake, Christopher M Mullin, Michael R Jaff
CONDENSED ABSTRACT: The factors that impact the clinical effectiveness of bare nitinol stents in claudicants with symptomatic femoropopliteal atherosclerosis are incompletely known. The authors analyzed variables that may influence stent durability and provide a benchmark for their effectiveness. Data analyzed from six studies (999 patients) included baseline noninvasive hemodynamic tests, angiographic characteristics, ultrasound defined stent patency and target lesion revascularization through 12-months...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290875/-clinical-and-economic-aspects-of-meldonium-as-part-of-physical-rehabilitation-programs-in-patients-with-coronary-heart-disease-after-percutaneous-coronary-interventions
#3
N P Lyamina, I B Razborov, E S Karpov
PURPOSE: to analyze clinical and economical effectiveness of meldonium as component of integrated program of cardio-rehabilitation in patients with ischemic heart disease (IHD) in the early period after percutaneous coronary intervention (PCI) with incomplete revascularization. MATERIAL AND METHODS: A program of controlled physical training (CPT) was carried out in patients with stable IHD and positive post PCI exercise test (n=48, age less or equal 65 years) starting 8-10 days after PCI...
August 2016: Kardiologiia
https://www.readbyqxmd.com/read/28260288/-usefulness-of-the-residual-syntax-score-to-predict-long-term-outcome-in-acute-coronary-syndrome-patients-underwent-percutaneous-coronary-intervention
#4
Y Song, J J Xu, X F Tang, Y L Ma, Y Yao, C He, H H Wang, R Liu, N Xu, P Jiang, L Jiang, X Y Zhao, Z Gao, R L Gao, S B Qiao, Y J Yang, B Xu, J Q Yuan
Objective: To quantify the extent and complexity of residual coronary stenosis following PCI by the residual SYNTAX score, and to evaluate its impact on adverse ischemic outcomes in acute coronary syndrome(ACS) patients. Methods: From January 2013 to December 2013, a total of 1 414 consecutive moderate- and high-risk ACS patients who underwent any PCI with multi-vessel coronary artery disease were evaluated.Patients were stratified by rSS quartiles and their outcomes were compared. Results: The rSS was 4.8±6...
February 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28257773/inframalleolar-intervention-for-limb-preservation
#5
REVIEW
Javier A Valle, Andrew F Prouse, Robert K Rogers
Critical limb ischemia (CLI) is a relatively prevalent and highly morbid condition. Patients with CLI have a poor prognosis, especially in the setting of incomplete revascularization. Traditionally, achieving optimal revascularization has been limited by the high prevalence of small-vessel disease in this population. More recently, advanced endovascular techniques, increased operator experience, and new technologies have enabled complete revascularization of inframalleolar disease with encouraging clinical results...
April 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28242583/clinical-implications-of-the-residual-syntax-score-after-percutaneous-coronary-intervention-in-patients-with-chronic-total-occlusion-and-multi-vessel-coronary-artery-disease-a-comparison-with-coronary-artery-bypass-grafting
#6
Woo Jin Jang, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Woo Jung Chun, Ju Hyeon Oh, Yong Hwan Park, Wook Sung Kim, Young Tak Lee, Hyeon-Cheol Gwon, Seung-Hyuk Choi
AIMS: We evaluated clinical impact of residual SYNTAX score (rSS) after percutaneous coronary intervention (PCI) in patients with chronic total occlusion (CTO) and multi-vessel coronary artery disease (CAD). METHODS AND RESULTS: We analyzed data from 1,043 patients with CTO and multi-vessel CAD who were treated with PCI or coronary artery bypass grafting (CABG). Patients were divided into three groups: patients with rSS≤12 after PCI (rSS≤12 group, n=445), patients with rSS>12 after PCI (rSS>12 group, n=150), and patients who underwent CABG (CABG group, n=448)...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#7
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/28169217/complete-or-incomplete-coronary-revascularization-in-patients-with-myocardial-infarction-and-multivessel-disease-a-propensity-score-analysis-from-the-real-life-bleemacs-bleeding-complications-in-a-multicenter-registry-of-patients-discharged-with-diagnosis-of
#8
Giorgio Quadri, Fabrizio D Ascenzo, Claudio Moretti, Maurizio D'Amico, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose Paulo Simao Henriques, Jorge Saucedo, José Ramón González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, José María García-Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Pierluigi Omedè, Antonio Montefusco, Francesca Giordana, Silvia Scarano, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahashi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Ferdinando Varbella, Fiorenzo Gaita
AIMS: The benefit of complete or incomplete percutaneous coronary intervention (PCI) in patients with myocardial infarction and multivessel disease remains debated. METHODS AND RESULTS: We conducted a multicenter study including all patients with myocardial infarction and multivessel coronary disease included in the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome) registry. They were divided in two groups: Complete revascularization (CR) and Incomplete Revascularization (IR)...
February 7, 2017: EuroIntervention
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
#9
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/28150287/complete-percutaneous-revascularization-feasibility-in-ischemic-heart-failure-is-related-to-improve-outcomes-insights-from-the-commit-hf-registry
#10
Łukasz Pyka, Michał Hawranek, Mateusz Tajstra, Jarosław Gorol, Andrzej Lekston, Mariusz Gąsior
BACKGROUND AND AIM: Heart failure (HF) is the major cause of death in cardiovascular disease. In a post-STICH landscape, we lack data on the role of percutaneous coronary intervention (PCI) in systolic HF patients. Complete revascularization remains a key unanswered question in ischemic HF. METHODS: The COMMIT-HF is an ongoing systolic HF registry (inclusion criteria: HF with left ventricular ejection fraction ≤35%, exclusion: acute coronary syndrome). A total of 1798 patients were enrolled...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28117282/modified-residual-syntax-score-and-clinical-outcomes-in-patients-with-multivessel-disease-undergoing-percutaneous-coronary-intervention
#11
Taek Kyu Park, Joo-Yong Hahn, Jeong Hoon Yang, Young Bin Song, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Joonghyun Ahn, Keumhee Cho Carriere, Hyeon-Cheol Gwon
AIMS: We sought to determine reasonable level of revascularization using the modified residual Synergy Between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score in patients undergoing PCI. METHODS AND RESULTS: In 3,460 patients with multivessel disease receiving drug-eluting stents, residual SYNTAX score (rSS) was calculated for lesions with ≥50% diameter stenosis in vessels ≥1.5 mm after PCI. "Modified" rSS (mrSS) was determined by counting lesions with ≥70% diameter stenosis in vessels ≥2...
January 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28112467/predictors-of-long-term-outcomes-after-bypass-grafting-versus-drug-eluting-stent-implantation-for-left-main-or-multivessel-coronary-artery-disease
#12
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Minkyu Han, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
BACKGROUND: We assessed predictors of long-term outcomes after coronary artery bypass grafting (CABG) versus those after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in 3,230 patients with left main or multivessel coronary artery disease (CAD). METHODS AND RESULTS: Data were pooled from the BEST, PRECOMBAT, and SYNTAX trials. Age, chronic kidney disease, chronic obstructive lung disease, left ventricular dysfunction, and peripheral arterial disease (PAD) were common predictors of all-cause mortality...
January 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28109102/-long-term-outcomes-of-off-pump-coronary-artery-bypass-grafting-in-patients-aged-over-75-years
#13
Yi Guo, Chong-Lei Ren, Chang-Qing Gao, Cang-Song Xiao, Hua-Jun Zhang
OBJECTIVE: To investigate the long-term outcomes of off-pump coronary artery bypass grafting (OPCAB) in patients aged over 75 years and analyze the risk factors affecting the outcomes of the procedure. METHODS: Clinical data were reviewed for 97 consecutive patients aged 75 years or above receiving OPCAB at our center between November, 2000 and November, 2013. The perioperative data including length of ICU stay, duration of mechanical ventilation, incidence of postoperative complications and mortality rate of the patients were analyzed...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28108066/does-a-similar-procedure-result-in-similar-survival-for-women-and-men-undergoing-isolated-coronary-artery-bypass-grafting
#14
Tamer Attia, Colleen G Koch, Penny L Houghtaling, Eugene H Blackstone, Ellen Mayer Sabik, Joseph F Sabik
OBJECTIVES: To (1) identify sex-related differences in risk factors and revascularization strategies for patients undergoing coronary artery bypass grafting (CABG), (2) assess whether these differences influenced early and late survival, and (3) determine whether clinical effectiveness of the same revascularization strategy was influenced by sex. METHODS: From January 1972 to January 2011, 57,943 adults-11,009 (19%) women-underwent primary isolated CABG. Separate models for long-term mortality were developed for men and women, followed by assessing sex-related differences in strength of risk factors (interaction terms)...
November 21, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28089148/percutaneous-revascularization-of-chronic-total-occlusions-rationale-indications-techniques-and-the-cardiac-surgeon-s-point-of-view
#15
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...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28077819/association-between-blood-transfusions-and-12-month-mortality-after-transcatheter-aortic-valve-implantation
#16
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...
February 7, 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
#17
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...
March 1, 2017: 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
#18
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
#19
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
#20
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
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