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incomplete revascularization

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
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...
August 30, 2016: American Journal of Cardiology
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...
October 7, 2016: Journal of Endodontics
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
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
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...
September 15, 2016: Journal of Cardiology
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
Khaled Yazji, Fairoz Abdul, Senthil Elangovan, Nick Ossei-Gerning, Anirban Choudhury, James Cockburn, Richard Anderson, Mamas Mamas, Tim Kinnaird
Although randomized trial data suggest that complete revascularization improves outcomes after percutaneous coronary intervention (PCI), the impact of differing revascularization strategies in octogenarians is not well defined. We performed a retrospective analysis, which was conducted of 9,628 consecutive patients who underwent PCI at a large UK center. Octogenarians were more likely to have significant co-morbidity, a higher Mehran bleed risk score (24.5 ± 6.8 vs 13.3 ± 7.4, p <0.0001), and more complex disease (baseline SYNTAX score 18...
October 15, 2016: American Journal of Cardiology
Lisbeth Antonsen, Per Thayssen, Henrik Steen Hansen, Anders Junker, Karsten Tange Veien, Knud Nørregaard Hansen, Mikkel Hougaard, Lisette Okkels Jensen
BACKGROUND: Stenting-induced edge dissections (ED) can be assessed in detail by optical coherence tomography (OCT). This study sought to investigate the incidence, morphological characteristics, and spontaneous healing course of OCT-identified EDs following drug-eluting stent (DES) implantation in a non-ST segment elevation myocardial infarction (NSTEMI) patient-population. METHODS: Acute vessel wall injury at the 5-mm stent adjacent distal and proximal reference segments was assessed by post-procedure OCT and intravascular ultrasound (IVUS) in n=97 NSTEMI-patients (n=97 lesions)...
November 15, 2016: International Journal of Cardiology
Umberto Benedetto, Massimo Caputo, Hunaid Vohra, Alan Davies, James Hillier, Alan Bryan, Gianni D Angelini
OBJECTIVES: We conducted a single-center analysis on short-term outcomes and long-term survival in actively treated diabetic patients undergoing off-pump coronary artery bypass versus on-pump coronary artery bypass surgery. METHODS: The final population consisted of 2450 patients with actively treated diabetes (mean age, 66 ± 9 years; female/male 545/1905, 22%). Of those, 1493 subjects were orally treated and 1011 subjects were taking insulin. Off-pump coronary artery bypass and on-pump coronary artery bypass were performed in 1253 and 1197 patients, respectively...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Won Yu Kang, Umberto Campia, Romain J Didier, Sarkis Kiramijyan, Edward Koifman, Smita I Negi, Michael J Lipinski, Nevin C Baker, Ricardo O Escarcega, Rebecca Torguson, Ron Waksman, Nelson L Bernardo
BACKGROUND: Clinical trial data show overall favorable outcomes of paclitaxel-eluting stents for treatment of femoro-popliteal (FP) occlusive disease. However, external validity of trial results may be restricted to less complex FP lesions, and limited data on outcomes of paclitaxel-eluting stents in real world practice have been published. METHODS: This is a retrospective analysis of data of all patients who received Zilver® PTX® for FP lesion from February 2013 to October 2014 at our center...
September 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Vigyan V Bang, Michael S Levy
Based on this meta-analysis of primarily observational data, complete revascularization (CR) is associated with a reduced risk of death, MI, and repeat revascularization in patients with multivessel coronary artery disease (MVCAD) as compared with incomplete revascularization (IR). Given the current state of evidence, the likelihood of achieving complete revascularization should influence whether PCI or CABG is the best strategy in patients with MVCAD. Given the lack of randomized trials in this area, more robust trial data will address the validity of these findings...
January 1, 2016: Catheterization and Cardiovascular Interventions
Andrea Perrotti, Amedeo Spina, Enrica Dorigo, Camille Durst, Djamel Kaili, Sidney Chocron
Introduction Multivessel coronary artery bypass graft (CABG) with bilateral internal thoracic arteries (BITA) has only been uncommon and technically demanding. We describe our experience with BITA only CABGs requiring ≥ 4 anastomoses. Material and Methods The department's database was queried for patients undergoing isolated CABG with ≥ 4 anastomoses. The surgical technique included systematically a right internal thoracic artery (ITA) of left ITA Y graft. The multivariate model included variables with a p < 0...
July 1, 2016: Thoracic and Cardiovascular Surgeon
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Andrzej Gackowski, Dariusz Dudek
OBJECTIVES: The aim of the study was to compare 12-month mortality rate of patients with and without complete coronary revascularization before transcatheter aortic valve implantation (TAVI). BACKGROUND: There are limited data on the impact of coronary artery disease burden in patients with severe aortic stenosis undergoing TAVI. METHODS: One hundred and one consecutive patients undergoing TAVI were enrolled. Of them 16 (15.8%) had an incomplete coronary revascularization...
August 2016: Journal of Interventional Cardiology
Diane Riccobono, Diane Agay, Sabine François, Harry Scherthan, Michel Drouet, Fabien Forcheron
Cutaneous radiation syndrome caused by high dose located irradiation is characterized by delayed symptoms, incomplete wound healing, and poor revascularization. Subcutaneous adipose tissue derived stromal/stem cells have been shown to improve skin repair in a minipig model of cutaneous radiation syndrome despite a subcutaneous defect being a consequence of radio-induced muscular fibrosis. Based on the pro-myogenic potential of stromal/stem cells, a new protocol combining subcutaneous and intramuscular injections was evaluated in a preliminary study...
August 2016: Health Physics
R S Tarasov
The study was aimed at analysing the outcomes of multivessel revascularization by means of percutaneous coronary intervention (PCI) in a total of 190 patients presenting with ST segment elevation myocardial infarction (STEMI) and multivessel lesion (MVL) of coronary arteries. Patients with unsuccessful PCI or those having received no planned second stage of revascularization for any reason were excluded from the study. The patients were subdivided into two groups: Group One comprised those having received appropriate complete revascularization (CR) within the framework of multivessel stenting (MVS) during primary PCI or a stagewise approach (n=137), Group Two included patients with the so-called appropriate incomplete revascularization (AIR) after MVS or stagewise PCI (n=53)...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Fei Xia, Dalin Jia, Yang Han, Shaojun Wang, Xin Wang
We sought to evaluate the prognosis of different treatment strategies on patients with multivessel coronary disease and high SYNTAX score. 171 patients with multivessel coronary disease and SYNTAX score ε33, who underwent coronary angiography between July 2009 and July 2010 at our hospital were retrospectively selected and divided into incomplete and complete revascularization intervention groups (IR), a coronary artery bypass surgery group (CABG), a conservative drug therapy group according to treatment strategies chosen and agreed by the patients...
December 2015: Cell Biochemistry and Biophysics
Aurel Toma, Michael Gick, Jan Minners, Miroslaw Ferenc, Christian Valina, Nikolaus Löffelhardt, Catherine Gebhard, Florian Riede, Franz-Josef Neumann, Heinz Joachim Buettner
BACKGROUND: There is limited data on prognosis after percutaneous coronary intervention (PCI) for coronary chronic total occlusions (CTO) in the era of drug-eluting stents (DES). AIMS: This study investigates the specific contribution of CTO recanalization to the survival benefit of complete revascularization. METHODS: Consecutive patients who underwent PCI of a CTO at our center between 01/2005 and 12/2013 were followed for a median of 2...
June 1, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Mohammad Alidoosti, Sepideh Saroukhani, Masoumeh Lotfi-Tokaldany, Arash Jalali, Amir Sobh-Rakhshankhah
BACKGROUND: Previous studies reported conflicting results regarding the impact of incomplete revascularization on the outcome of percutaneous coronary intervention (PCI). We evaluated the association between residual SYNTAX score (RSS) as a quantitative measure of incomplete revascularization and one-year outcome of patients with native multi-vessel disease undergoing PCI. METHODS: A total of 760 patients (mean age=59.14±10.36years, 70.4% males) who underwent successful PCI with the incomplete revascularization strategy between September 2008 and March 2010 were included...
July 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Sripal Bangalore, Yu Guo, Zaza Samadashvili, Saul Blecker, Edward L Hannan
BACKGROUND: Guidelines recommend coronary artery bypass graft surgery (CABG) over percutaneous coronary intervention (PCI) for multivessel disease and severe left ventricular systolic dysfunction. However, CABG has not been compared with PCI in such patients in randomized trials. METHODS AND RESULTS: Patients with multivessel disease and severe left ventricular systolic dysfunction (ejection fraction ≤35%) who underwent either PCI with everolimus-eluting stent or CABG were selected from the New York State registries...
May 31, 2016: Circulation
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