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Bifurcation stenting coronaries

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https://www.readbyqxmd.com/read/28714525/dedicated-bifurcation-stents-or-regular-drug-eluting-stents-in-distal-left-main-stenosis-a-retrospective-study
#1
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Krzysztof Bednarski, Jerzy Górny, Jacek Bil
BACKGROUND: Mainly atherosclerosis develops in distal left main (LM) within bifurcation or trifurcation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland. METHODS: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28709701/optical-coherence-tomography-guidance-for-the-management-of-angiographically-intermediate-left-main-bifurcation-lesions-early-clinical-experience
#2
Ilaria Dato, Francesco Burzotta, Carlo Trani, Andrea Romano, Lazzaro Paraggio, Cristina Aurigemma, Italo Porto, Antonio Maria Leone, Giampaolo Niccoli, Filippo Crea
BACKGROUND: Left main (LM) atherosclerotic lesions affect clinical outcomes. Frequency domain-optical coherence tomography (FD-OCT) allows detailed characterization of non-ostial coronary atherosclerotic lesions. The clinical impact of FD-OCT assessment of LM bifurcation disease on the revascularization decision is unknown. METHODS: Patients who underwent FD-OCT assessment to guide management of angiographically intermediate distal LM stenosis were retrospectively selected...
July 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28707445/angiographic-and-clinical-outcome-after-crush-of-everolimus-eluting-stent-for-distal-unprotected-left-main-disease
#3
Angela Migliorini, Renato Valenti, Ruben Vergara, Maria Grazia De Gregorio, Eleonora Gabrielli, Elena De Vito, Maria Raffaella Aicale, Nazario Carrabba, David Antoniucci
Obiectives: Angiographic and clinical outcomes after crushing of everolimus-eluting stent (EES) for distal unprotected left main disease (ULMD). BACKGROUND: Few data exist about crushing of EES for distal ULMD. METHODS: From the Florence ULMD Percutaneous Coronary Interevention Registry consecutive patients with distal ULMD treated with EES were included in the analysis. Patients treated with provisional stenting were compared with patients treated with crush stenting...
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28705057/applicability-and-procedural-success-rate-of-bioresorbable-vascular-scaffolds-for-percutaneous-coronary-intervention-in-an-all-comer-cohort-of-383-consecutive-patients
#4
Christian Schlundt, Stephan Achenbach, Fabiola Felten, Jens Roether, Mohamed Marwan, Holger Nef, Josef Ludwig, Monique Tröbs
Objectives The purpose of this study was to determine applicability and procedural success of bioresorbable vascular scaffolds (BVS) for percutaneous coronary intervention (PCI) in an all-comer cohort. Background BVS use in bifurcations and severely calcified lesions is not recommended, and a relatively large crossing profile may cause limitations. It is has never been studied how widely BVS can be applied in all-comer cohorts. Methods In 383 consecutive patients (acute coronary syndrome: 124, stable coronary disease 259), a BVS (Absorb) was used as first-line device unless any of the following contraindications were present: bifurcation with side branch >2...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28683937/demonstration-of-the-safety-and-feasibility-of-robotically-assisted-percutaneous-coronary-intervention-in%C3%A2-complex-coronary-lesions-results-of-the-cora-pci-study-complex-robotically-assisted%C3%A2-percutaneous-coronary-intervention
#5
Ehtisham Mahmud, Jesse Naghi, Lawrence Ang, Jonathan Harrison, Omid Behnamfar, Ali Pourdjabbar, Ryan Reeves, Mitul Patel
OBJECTIVES: The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). BACKGROUND: R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown...
July 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28667810/coronary-artery-aneurysm-after-mini-crush-drug-eluting-stent-technique-in-a-chronic-total-occlusion
#6
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Fernando Lozano Ruíz-Poveda
A 53-year-old man underwent percutaneous coronary intervention of a chronic total occlusion of the circumflex artery. A mini-crush stent technique with two drug-eluting stents was performed. To the best of our knowledge, this is the first case of coronary artery aneurysm affecting a bifurcated chronic total occlusion treated with a two-stent technique.
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28641842/long-term-clinical-outcomes-of-patients%C3%A2-treated-with-everolimus-eluting-bioresorbable-stents-in-routine-practice-2-year-results-of-the-isar-absorb-registry
#7
Jens Wiebe, Petra Hoppmann, Roisin Colleran, Sebastian Kufner, Michael Valeskini, Salvatore Cassese, Simon Schneider, Michael Joner, Heribert Schunkert, Karl-Ludwig Laugwitz, Adnan Kastrati, Robert A Byrne
OBJECTIVES: The aim of this study was to report clinical outcomes in patients treated in routine practice 2 years after everolimus-eluting bioresorbable stent (BRS) implantation. BACKGROUND: Long-term results in patients undergoing BRS implantation in routine clinical practice are sparse, and existing evidence from randomized trials considers mostly selected patients. METHODS: The ISAR-ABSORB registry enrolled consecutive patients undergoing BRS implantation in routine clinical practice at 2 high-volume centers in Germany...
June 26, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28606906/a-randomised-comparison-of-conventional-versus-intentional-strategy-in-patients-with-high-risk-prediction-of-side-branch-occlusion-in-coronary-bifurcation-intervention-rationale-and-design-of-the-cit-resolve-trial
#8
Dong Zhang, Dong Yin, Chenxi Song, Chengang Zhu, Ajay J Kirtane, Bo Xu, Kefei Dou
INTRODUCTION: The intentional strategy (aggressive side branch (SB) protection strategy: elective two-stent strategy or jailed balloon technique) is thought to be associated with lower SB occlusion rate than conventional strategy (provisional two-stent strategy or jailed wire technique). However, most previous studies showed comparable outcomes between the two strategies, probably due to no risk classification of SB occlusion when enrolling patients. There is still no randomised trial compared the intentional and conventional strategy when treating bifurcation lesions with high risk of SB occlusion...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28606788/coronary-bifurcation-model-created-using-a-novel-directional-heat-injury-catheter
#9
Kenji Nakatsuma, Shin Watanabe, Akihiro Tokushige, Erika Yamamoto, Bingyuan Bao, Hiroki Watanabe, Takeshi Kimura, Naritatsu Saito
OBJECTIVES: The present study aimed to develop a swine coronary bifurcation model. BACKGROUND: In human coronary bifurcation lesion, atherosclerotic plaques are usually observed in the lateral wall, whereas the flow divider regions are spared. There is currently no suitable coronary bifurcation animal model, on which a new stent can be tested. METHODS: We developed a novel directional heat injury catheter, which comprised of a non-compliant balloon catheter (diameter: 3...
June 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28588834/successful-bailout-stenting-strategy-against-lethal-coronary-dissection-involving-left-main-bifurcation
#10
Hiroshi Kubota, Tetsuya Nomura, Yusuke Hori, Kenichi Yoshioka, Daisuke Miyawaki, Ryota Urata, Takeshi Sugimoto, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
Catheter-induced coronary dissection involving left main bifurcation is a rare complication during cardiac catheterization but can become lethal unless it is treated appropriately. Interventional cardiologists always have to pay attention to the risk of complications related to cardiac catheterization and prepare for determining the best bailout strategy for the situation.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28581348/safety-and-efficacy-of-the-tryton-side-branch-stent%C3%A2-for-the-treatment-of-coronary-bifurcation-lesions-an-update
#11
Maik J Grundeken, Robbert J de Winter, Joanna J Wykrzykowska
Percutaneous coronary interventions (PCIs) involving coronary bifurcation lesions are associated with adverse outcomes compared with non-bifurcation lesions. The Tryton Side Branch Stent has been developed to improve clinical outcomes after bifurcation PCI. Areas covered: We will discuss observational data (clinical registries and intravascular imaging studies) and randomized data from the TRYTON trial (comparing Tryton [used in combination with a main branch drug-eluting stent (DES)] with side branch balloon angioplasty [in combination with a main branch DES; also referred to the provisional strategy])...
June 13, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28574987/reconstruction-of-stented-coronary-arteries-from-optical-coherence-tomography-images-feasibility-validation-and-repeatability-of-a-segmentation-method
#12
Claudio Chiastra, Eros Montin, Marco Bologna, Susanna Migliori, Cristina Aurigemma, Francesco Burzotta, Simona Celi, Gabriele Dubini, Francesco Migliavacca, Luca Mainardi
Optical coherence tomography (OCT) is an established catheter-based imaging modality for the assessment of coronary artery disease and the guidance of stent placement during percutaneous coronary intervention. Manual analysis of large OCT datasets for vessel contours or stent struts detection is time-consuming and unsuitable for real-time applications. In this study, a fully automatic method was developed for detection of both vessel contours and stent struts. The method was applied to in vitro OCT scans of eight stented silicone bifurcation phantoms for validation purposes...
2017: PloS One
https://www.readbyqxmd.com/read/28562382/impact-of-mean-platelet-aggregation-degree-on-long-term-clinical-outcomes-among-patients-undergoing-a-complex-percutaneous-coronary-intervention
#13
Quan Li, Mengmeng Li, Xianpeng Yu, Jiqiang He, Yuechun Gao, Xiaoling Zhang, Changyan Wu, Yawei Luo, Yuchen Zhang, Xuejun Ren
OBJECTIVE: The aim of this study was to evaluate the association between the mean platelet aggregation degree and long-term clinical outcomes in patients receiving a complex percutaneous coronary intervention (CPCI). PATIENTS AND METHODS: We screened 2141 patients after a percutaneous coronary intervention (PCI) treated with aspirin and clopidogrel. CPCI was defined as a procedure targeted to at least one of the following: left main disease, bifurcation lesion, ostial lesion, chronic total occlusion, and small-vessel stenting...
May 30, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28555728/platelet-distribution-width-as-the-prognostic-marker-in-coronary-bifurcation-treatment
#14
Adam Kern, Robert J Gil, Krystian Bojko, Ewa Sienkiewicz, Beata Januszko-Giergielewicz, Jerzy Górny, Jacek Bil
INTRODUCTION: Mean platelet volume (MPV) was proved to be a reliable prognostic factor in cardiac patients. However, platelet distribution width (PDW) was disclosed to be more specific marker of platelet reactivity. The aim of study was to evaluate whether baseline PDW value can predict the outcome in patients undergoing percutaneous coronary interventions (PCI) with drug-eluting stent implantation within coronary bifurcation lesions. MATERIAL AND METHODS: It was a two-center observational study, which included patients who underwent PCI within bifurcation lesions between January 2014 and December 2014...
May 28, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28554669/patterns-and-associations-between-dapt-cessation-and-2-year-clinical-outcomes-in-left-main-proximal-lad-versus-other-pci-results-from-the-patterns-of-non-adherence-to-dual-antiplatelet-therapy-in-stented-patients-paris-registry
#15
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Matthew Tomey, Mitchell Kruckoff, David Moliterno, Timothy D Henry, Giora Weisz, C Michael Gibson, Ioannis Iakovou, Annapoorna Kini, Michela Faggioni, Birgit Vogel, Serdar Farhan, Antonio Colombo, P Gabriel Steg, Bernhard Witzenbichler, Alaide Chieffo, David Cohen, Thomas Stuckey, Cono Ariti, Stuart Pocock, George Dangas, Roxana Mehran
OBJECTIVES: Percutaneous coronary intervention (PCI) of the left main (LM) or proximal left anterior descending artery (pLAD) is considered high-risk as these segments subtend substantial left ventricular myocardial area. We assessed the patterns and associations between dual antiplatelet therapy (DAPT) cessation and 2-year outcomes in LM/pLAD vs. other PCI from the all-comer PARIS registry. METHODS: Two-year major adverse cardiovascular events (MACE) were a composite of cardiac death, myocardial infarction, definite/probable stent thrombosis or target lesion revascularization...
May 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28553569/a-case-of-awake-percutaneous-extracorporeal-membrane-oxygenation-for-high-risk-percutaneous-coronary-intervention
#16
Shuangbo Liu, Amir Ravandi, Malek Kass, Basem Elbarouni
With significant improvements in percutaneous coronary intervention (PCI) technology, complex high risk PCI is increasingly offered to patients with limited revascularization options. Percutaneous mechanical circulatory support devices are often utilized for hemodynamic support during these complex procedures. Veno-arterial extracorporeal membrane oxygenation (ECMO) allows full hemodynamic support and provides systemic oxygenation. We describe a case of left main bifurcation stenting performed at our center with ECMO support in an awake patient without general anesthesia...
April 25, 2017: Curēus
https://www.readbyqxmd.com/read/28541601/the-approach-to-coronary-bifurcation-treatment-and-its-outcomes-in-poland-the-single-center-experience
#17
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Rakesh Jalali, Jerzy Górny, Jacek Bil
BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland. METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®)...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28515858/three-dimensional-optical-coherence-tomography-reconstruction-of-bifurcation-stenting-using-the-szabo-anchor-wire-technique
#18
Katherine Yu, Harkawal Hundal, Todd Zynda, Arnold Seto
Ostial lesions present unique challenges for percutaneous coronary intervention (PCI). These lesions are often more calcified, fibrotic, rigid, and more prone to elastic recoil. Intervention on these lesions is associated with higher procedural complications and higher rates of restenosis. Ostial lesions require precise stent placement in the ostium with the absence of side branch compromise. Accurate stent placement in the ostium without side branch compromise is difficult to accomplish with angiography alone...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28508393/reversed-single-string-technique-for-coronary-bifurcation-stenting-first-report-of-case-demonstrations-in-vitro
#19
Julien Adjedj, Gabor G Toth, Mariano Pellicano, William Wijns
OBJECTIVES: This work reports the concept and the practical feasibility of Reversed Single String bifurcation stenting technique by demonstrating three in vitro cases. BACKGROUND: Provisional T stenting is the most used interventional technique to treat coronary bifurcation lesions. However, after main branch (MB) stenting, treatment of the side branch (SB) may become indicated to provide a good final result. Currently applied methods all have their structural limitations with respect to wall coverage, multiple strut layers, poor apposition rate...
May 16, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28485275/influence-of-platform-design-of-six-different-drug-eluting-stents-in-provisional-coronary-bifurcation-stenting-by-repot-sequence-a-comparative-bench-analysis
#20
Francois Derimay, Geraud Souteyrand, Pascal Motreff, Gilles Rioufol, Gerard Finet
AIMS: The rePOT (proximal optimizing technique) sequence proved significantly more effective than final kissing balloon (FKB) with two drug-eluting stents (DES) in a bench test. We sought to experimentally validate efficacy in a large range of latest-generation DESs. METHODS AND RESULTS: On left main fractal coronary bifurcation bench models, 5 samples of each of the 6 main latest-generation DESs (Coroflex Isar™, Orsiro™, Promus Premier™, Resolute Integrity™, Ultimaster™, Xience Xpedition™) were implanted on rePOT (initial POT, side-branch inflation, final POT)...
May 9, 2017: EuroIntervention
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