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Bifurcation stenting coronaries

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https://www.readbyqxmd.com/read/29777394/biomechanical-impact-of-wrong-positioning-of-a-dedicated-stent-for-coronary-bifurcations-a-virtual-bench-testing-study
#1
Claudio Chiastra, Maik J Grundeken, Carlos Collet, Wei Wu, Joanna J Wykrzykowska, Giancarlo Pennati, Gabriele Dubini, Francesco Migliavacca
The treatment of coronary bifurcations is challenging for interventional cardiologists. The Tryton stent (Tryton Medical, Inc., USA) is one of the few devices specifically designed for coronary bifurcations that underwent large clinical trials. Although the manufacturer provides specific recommendations to position the stent in the bifurcation side branch (SB) according to four radio-opaque markers under angiographic guidance, wrong device positioning may accidentally occur. In this study, the virtual bench testing approach was used to investigate the impact of wrong positioning of the Tryton stent in coronary bifurcations in terms of geometrical and biomechanical criteria...
May 17, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#2
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29741487/regular-drug-eluting-stents-versus-dedicated-bifurcation-drug-eluting-bioss%C3%A2-stents-for-coronary-bifurcation-treatment-four-year-results-of-randomized-polbos-i-and-polbos-ii-clinical-trials
#3
Robert J Gil, Jacek Bil, Adam Kern, Luis A Ingio Garcia, Radoslaw Formuszewicz, Slawomir Dobrzycki, Dobrin Vassilev, Agnieszka Segiet
AIMS: The aim of this study was to analyze 4-year follow-up data of two clinical trials POLBOS I & II to compare regular DES (rDES) and dedicated bifurcation stents BiOSS®. METHODS AND RESULTS: In POLBOS trials BiOSS® stents were compared with rDES in patients with stable CAD or NSTE-ACS (POLBOS I: paclitaxel eluting BiOSS® Expert vs rDES; POLBOS II: sirolimus eluting BiOSS® LIM vs rDES). 445 patients with 222 patients in BiOSS group and 223 patients in rDES group were analyzed...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29735349/true-double-bifurcation-lesions-new-application-of-the-self-expandable-axxess-stent-and-review-of-literature-with-dedicated-bifurcation-devices
#4
REVIEW
Francesco Borgia, Tullio Niglio, Nicola De Luca, Luigi Di Serafino, Giovanni Esposito, Bruno Trimarco, Plinio Cirillo
Complex coronary artery bifurcation lesions occurred in hard clinical scenarios, such as acute coronary syndromes, may represent a challenge for interventional cardiologists, with not-defined general consensus on treatment. Even if provisional stenting is the most common option used to restore rapidly the coronary branches flow, improvements in industrial technologies and design of new dedicated bifurcation devices might open new modalities of treatment in these complex cases. The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding biolimus-eluting conical V-shape stent, specifically designed to treat "easily" coronary artery bifurcation lesions, with reported favorable long-term clinical results in stable patients compared to a provisional technique...
April 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#5
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716707/balloon-embedded-stenting-a-novel-technique-for-percutaneous-coronary-intervention-of-bifurcation-lesions-experience-in-indian-population
#6
Desabandhu Vinayakumar, Bijilesh Uppalakal, Kailash Kumar Goyal, Anishkumar Nair
BACKGROUND: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events. In this study, we describe a novel balloon embedded stenting technique which can be incorporated with traditional culotte or TAP technique and facilitates conversion to bail out crush in case of such an event...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29706477/usefulness-of-the-finet-law-to-guide-stent-size-selection-in-ostial-left-main-stenting-comparison-with-standard-angiographic-estimation
#7
Gianluca Rigatelli, Marco Zuin, Federico Ronco, Francesco Caprioglio, Daniele Cavazzini, Sara Giatti, Gabriele Braggion, Stefano Perilli, Van Tan Nguyen
BACKGROUNDS: Intravascular ultrasound has been suggested to optimize stent diameter and length in Left Main (LM) procedures, but in the real-world ostial LM stenting is often accomplished with angiography only guidance. The Finet law which regulates the fractal geometry of human bifurcation has the potential to increase the accuracy of stent-sizing. To retrospectively evaluating the impact on outcomes of the addition of Finet Law to standard quantitative coronary angiography (QCA) in guiding stent selection of ostial LM stenting compared to standard angiography estimation...
April 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29693768/simultaneous-kissing-stents-to-treat-unprotected-left-main-stem-coronary-artery-bifurcation-disease-stent-expansion-vessel-injury-hemodynamics-tissue-healing-restenosis-and-repeat-revascularization
#8
Paul D Morris, Javaid Iqbal, Claudio Chiastra, Wei Wu, Francesco Migliavacca, Julian P Gunn
OBJECTIVES: To perform detailed analysis of stent expansion, vessel wall stress, hemodynamics, re-endothelialization, restenosis, and repeat PCI in the simultaneous kissing stents (SKS) technique of bifurcation left main stem (LMS) stenting. BACKGROUND: The SKS technique is useful to treat patients with true bifurcation disease of the LMS but remains controversial. METHODS AND RESULTS: Computational structural analysis of SKS expansion demonstrated undistorted and evenly expanded stents...
April 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29682422/comparison-of-clinical-outcomes-after-drug-eluting-balloon-and-drug-eluting-stent-use-for-in-stent-restenosis-related-acute-myocardial-infarction-a-retrospective-study
#9
Chih-Yuan Fang, Hsiu-Yu Fang, Chien-Jen Chen, Cheng-Hsu Yang, Chiung-Jen Wu, Wei-Chieh Lee
Background: Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study's aim was to evaluate the efficacy of DEB for AMI with ISR. Methods: Between November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI)...
2018: PeerJ
https://www.readbyqxmd.com/read/29667231/feasibility-and-clinical-outcomes-of-rotational-atherectomy-for-heavily-calcified-side-branches-of-complex-coronary-bifurcation-lesions-in-the-real-world-practice-of-the-drug-eluting-stent-era
#10
Yu-Wei Chen, Chieh-Shou Su, Wei-Chun Chang, Tsun-Jui Liu, Kae-Woei Liang, Chih-Hung Lai, Hong-Xu Liu, Wen-Lieng Lee
OBJECTIVES: To evaluate the outcomes of rotational atherectomy for heavily-calcified side branches of coronary bifurcation lesions. BACKGROUND: Side-branch (SB) preservation is clinically important but technically challenging in heavily-calcified non-left main true bifurcation lesions. SB rotational atherectomy (SB RA) is sometimes mandatory but the clinical outcomes are not well studied. METHODS: We retrospectively studied the outcomes of patients who underwent RA at our institute for heavily calcified, balloon-uncrossable or-undilatable SB lesions over an approximately 5-year period (January 2011 to September 2016)...
April 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29661597/clinical-performance-of-a-dedicated-self-apposing-stent-for-the-treatment-of-left-main-stem-disease-results-of-the-left-main-angioplasty-with-a-self-apposing-stent-the-matisse-study
#11
Bernardo Cortese, Antonio Montefusco, Fabrizio D'Ascenzo, Alessio La Manna, Giuseppe Andò, Teodoro Bisceglia, Gioel G Secco, Markus Meyer-Gessner, Wanha Wojciech, Paolo Sganzerla, Massimo Napodano, Gaetano Di Palma, Roberto A Latini, Corrado Tamburino, Pedro Silva Orrego, Andreas Baumbach
BACKGROUND: In the recent years percutaneous treatment of the left main stem (LM) has gained a precise role as a result of consistent scientific evidence vs. coronary artery bypass. A self-apposing stent offers an improved adaptation to the vessel wall, especially in case of tapered vessels; aim of this study was to investigate the role of a novel self-apposing, sirolimus-eluting stent (Stentys, France) for the treatment of LM coronary artery disease. METHODS AND RESULTS: MATISSE is a retrospective, multicenter registry, which enrolled 151 patients treated with the device at 17 international centers...
April 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29656938/vitamin-d-deficiency-and-periprocedural-myocardial-infarction-in-patients-undergoing-percutaneous-coronary-interventions
#12
Monica Verdoia, Claudia Ceccon, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
Vitamin D deficiency has been implicated in the progression of atherosclerosis and acute thrombotic events. We aimed at evaluating the impact of vitamin D deficiency on periprocedural myocardial infarction (PMI) in patients undergoing percutaneous coronary interventions (PCI). We included 934 patients undergoing non-urgent PCI. Assessment of myocardial biomarkers was performed from 6 to 48 h after PCI. PMI was defined as Creatine Kinase-MB increase by 3 times the Upper Limit Normal or by 50% of an elevated baseline value, periprocedural myocardial damage as Troponin I increase by 3 × ULN or 50% of baseline...
March 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29589515/rheolytic-effects-of-left-main-mid-shaft-distal-stenting-a-computational-flow-dynamic-analysis
#13
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Thach Nguyen
Background The aim of this study was to evaluate the rheolytic effects of stenting a mid-shaft/distal left main coronary artery (LMCA) lesion with and without ostial coverage. Stenting of the LMCA has emerged as a valid alternative in place of traditional coronary bypass graft surgery. However, in case of mid-shaft/distal lesion, there is no consensus regarding the extension of the strut coverage up to the ostium or to stent only the culprit lesion. Methods We reconstructed a left main-left descending coronary artery (LM-LCA)-left circumflex (LCX) bifurcation after analysing 100 consecutive patients (mean age 71...
March 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29588738/the-proximal-optimisation-technique-for-intervention-of-coronary-bifurcations
#14
Angela Hoye
The proximal optimisation technique (POT) has been proposed as a strategy to improve the results of stent scaffolding of bifurcation lesions. It is a straightforward technique whereby a short, appropriately-sized balloon is inflated in the main vessel just proximal to the carina. The technique has several advantages: it reduces the risk of side branch compromise related to shifting of the carina, it improves stent apposition in the proximal main vessel, and it facilitates side branch access after main vessel stent implantation...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29576596/effect-of-side-branch-predilation-in-coronary-bifurcation-stenting-with-the-provisional-approach-results-from-the-cobis-coronary-bifurcation-stenting-ii-registry
#15
Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C Carriere, Myung-Ho Jeong, Hyo-Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon-Cheol Gwon
BACKGROUND: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach.Methods and Results:A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29573537/comparison-of-the-planned-one-and-elective-two-stent-techniques-in-patients-with-coronary-bifurcation-lesions-with-or-without-acute-coronary-syndrome-from-the-cobis-ii-registry
#16
Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Hyeon-Cheol Gwon, Hyo-Soo Kim, Seung Woon Rha, Jung Han Yoon, Yangsoo Jang, Seung-Jea Tahk, Ki Bae Seung
OBJECTIVES: To evaluate the impacts of stent techniques on long-term clinical outcomes after percutaneous coronary intervention (PCI) using drug-eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS). BACKGROUND: Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS. METHODS: This multicenter registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions...
March 24, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29570758/benchmark-for-numerical-models-of-stented-coronary-bifurcation-flow
#17
Pedro Garcia Carrascal, Javier Garcia, Jose Sierra Pallares, Francisco Castro Ruiz, Fernando Manuel Martín
In-stent restenosis ails many patients who have undergone stenting. When the stented artery is a bifurcation, the intervention is especially critical because of the complex stent geometry involved in these structures. Computational Fluid Dynamics (CFD) has demonstrated to be an effective approach when modelling blood flow behavior and understanding the mechanisms that underlie in-stent restenosis. These CFD models, however, require validation through experimental data in order to be reliable. It is with this purpose in mind that we performed Particle Image Velocimetry (PIV) measurements of velocity fields within flows through a simplified coronary bifurcation...
March 22, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29563393/accelerated-atherogenicity-in-tangier-disease
#18
Jun Muratsu, Masahiro Koseki, Daisaku Masuda, Yuji Yasuga, Satoki Tomoyama, Keiji Ataka, Yoshiki Yagi, Atsushi Nakagawa, Hidehumi Hamada, Shigeki Fujita, Hiroaki Hattori, Tohru Ohama, Makoto Nishida, Hisatoyo Hiraoka, Yuji Matsuzawa, Shizuya Yamashita
We report a case of Tangier disease with Leriche syndrome and bleeding tendency. In this male patient, nasal hemorrhage had been observed frequently throughout childhood. At 46 years old, he experienced effort angina, and coronary angiography demonstrated 75% stenosis in the right coronary artery. Orange-colored tonsils, mild hepatosplenomegaly and very low levels of serum high-density lipoprotein cholesterol (HDL-C) were observed, and the patient was diagnosed with Tangier disease. At 52 years old, effort angina recurred...
March 20, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29553940/benefit-of-a-new-provisional-stenting-strategy-the-re-proximal-optimizing-technique-the-repot-clinical-study
#19
François Dérimay, Gérard Finet, Geraud Souteyrand, Luc Maillard, Adel Aminian, Benoit Lattuca, Guillaume Cayla, Guillaume Cellier, Pascal Motreff, Gilles Rioufol
AIMS: A new coronary bifurcation provisional stenting technique without kissing balloon, rePOT, associating proximal optimizing technique (POT), side-branch inflation and final POT, showed excellent mechanical results in a bench test. The present study sought to use optical coherence tomography (OCT) to quantify the mechanical results of rePOT in vivo in a large patient sample with complex coronary bifurcations. METHODS AND RESULTS: 106 patients with coronary bifurcations were included in a multicenter prospective registry (left main, 40...
March 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29550085/effect-of-procedure-and-coronary-lesion-characteristics-on-clinical-outcomes-among-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-insights-from-the-pioneer-af-pci-trial
#20
Mathieu Kerneis, C Michael Gibson, Gerald Chi, Roxana Mehran, Fahad AlKhalfan, Usama Talib, Seyedmahdi Pahlavani, Mahshid Mir, Christoph Bode, Jonathan L Halperin, Tarek Nafee, Eric D Peterson, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Keith A A Fox, Marc Cohen
OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear...
April 9, 2018: JACC. Cardiovascular Interventions
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