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Bifurcation stenting coronaries

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https://www.readbyqxmd.com/read/28228303/impact-of-very-high-pressure-stent-deployment-on-angiographic-and-long-term-clinical-outcomes-in-true-coronary-bifurcation-lesions-treated-by-the-mini-crush-stent-technique-a-single-center-experience
#1
Antoine Gerbay, Jeremy Terreaux, Alexis Cerisier, Marco Vola, Karl Isaaz
BACKGROUND: Percutaneous coronary intervention (PCI) for bifurcation lesions (BL) using 2 stents technique is known to be associated with high rates of procedural failure especially on the side branch (SB) mainly due to stent incomplete apposition. Stent deployment at very high pressure (SDHP) may lead to better stent expansion and apposition. However, SDHP may also be at the origin of deeper wall injury resulting into major cardiac adverse events. No data are available on evaluation of SDHP in BL treated by a mini-crush stent technique...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28227224/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#2
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Takahiro Tsukahara, Yuya Yamada, Yusuke Fujino, Masahiro Motosuke
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226721/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#3
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#4
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28205195/is-it-possible-to-further-improve-clinical-results-with-coronary-bifurcation-stenting-or-what-is-more-important-the-technique-or-the-stent
#5
Dobrin Vassilev, Liubomir Dosev, Robert J Gil
No abstract text is available yet for this article.
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28176183/improving-the-visual-field-in-coronary-artery-by-with-non-obstructive-angioscopy-dual-infusion-method
#6
Sei Komatsu, Tomoki Ohara, Satoru Takahashi, Mitsuhiko Takewa, Chikao Yutani, Kazuhisa Kodama
Non-obstructive angioscopy (NOA) is used to visualize the surface of the coronary artery, and a clear visual field is obtained by injecting transparent fluid into the gap between the probing catheter and the fiber. This study examines visual field expansion by a dual infusion method, which involves an infusion from the probing and guiding catheters, and the relationships between visual grade and vessel characteristics. Thirty-two patients and thirty patients performed coronary plaque analysis with NOA using the conventional method and the novel dual infusion method, respectively...
February 7, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#7
Benedikt Schrage, Michael Schwarzl, Christoph Waldeyer, Peter M Becher, Christoph Sinning, Ulrich Schäfer, Moritz Seiffert, Elvin Zengin-Sahm, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Aorto-ostial lesions as well as bifurcation lesions still provide challenges in percutaneous coronary intervention (PCI), as meticulous stent placement is needed. The Szabo-technique, which uses a second wire to anchor the stent at the osmium, may be helpful here. In this article, we will provide detailed information on the technique including video material as well as procedural and long-term follow-up data of a cohort of patients treated with this technique. METHODS AND RESULTS: A retrospective single-centre study was performed in patients undergoing Szabo-PCI from 2014 to 2016 (n=28)...
January 31, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28145616/bailout-polytetrafluoroethylene-covered-stent-implantation-for-left-main-bifurcation-perforation-using-the-kissing-stent-technique
#8
Noriaki Moriyama, Yutaka Tanaka, Shigeru Saito
Coronary artery perforation during percutaneous coronary intervention is a rare, but potentially lethal complication. Immediate balloon expansion at the perforation site can halt the bleeding. Implantation of a coronary polytetrafluoroethylene (PTFE)-covered stent enables the efficient endovascular repair of a coronary artery perforation. However, if the perforation occurs at a bifurcation, a PTFE-covered stent may jail the side branch. We report a difficult case of blowout coronary perforation (Ellis type III) at a left main coronary artery bifurcation, which was successfully sealed with a PTFE-covered stent without interference with the side branch coronary artery circulation...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28122805/clinical-outcome-of-double-kissing-crush-versus-provisional-stenting-of-coronary-artery-bifurcation-lesions-the-5-year-follow-up-results-from-a-randomized-and-multicenter-dkcrush-ii-study-randomized-study-on-double-kissing-crush-technique-versus-provisional
#9
Shao-Liang Chen, Teguh Santoso, Jun-Jie Zhang, Fei Ye, Ya-Wei Xu, Qiang Fu, Jing Kan, Feng-Fu Zhang, Yong Zhou, Du-Jiang Xie, Tak W Kwan
BACKGROUND: Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). METHODS AND RESULTS: A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#10
REVIEW
Yohei Numasawa, Kenichi Sakakura, Kei Yamamoto, Shingo Yamamoto, Yousuke Taniguchi, Hideo Fujita, Shin-Ichi Momomura
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel...
January 17, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28117242/computed-tomography-angiography-versus-angiography-for-guiding-percutaneous-coronary-interventions-in-bifurcation-lesions-a-prospective-randomized-pilot-study
#11
Rafal Wolny, Jerzy Pregowski, Mariusz Kruk, Cezary Kepka, Gary S Mintz, Gabor G Toth, Artur Debski, Michal Ciszewski, Krzysztof Kukula, Maksymilian P Opolski, Zbigniew Chmielak, Adam Witkowski
BACKGROUND: There is no data on the impact of coronary computed tomography angiography (coronary CTA), as an addition to angiography, on the outcomes of percutaneous coronary interventions (PCI) in bifurcation lesions. METHODS: Patients with stable coronary artery disease scheduled for elective bifurcation PCI were randomized 1:1 to planning the procedure based on coronary CTA and angiography (CTA group) or angiography alone (CA group). The primary efficacy endpoint was the immediate angiographic result...
January 17, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28116778/percutaneous-coronary-intervention-of-complex-calcified-lesions-with-drug-coated-balloon-after-rotational-atherectomy
#12
Tuomas T Rissanen, Sanna Uskela, Antti Siljander, Jussi M Kärkkäinen, Pirjo Mäntylä, Juha Mustonen, Jaakko Eränen
OBJECTIVES: We investigated the safety and efficacy of PCI using drug-coated balloon (DCB) after rotational atherectomy (rotablation) in a retrospective single center study in patients with calcified de novo coronary lesions. The majority of patients had an increased risk for bleeding. BACKGROUND: DCB has been effective in the treatment of in-stent restenosis, small vessels, and bifurcations. DCB enables short one month dual antiplatelet treatment. No published data exist on the use of DCB after rotablation...
January 23, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28108202/evaluation-of-coronary-flow-conditions-in-complex-coronary-artery-bifurcations-stenting-using-computational-fluid-dynamics-impact-of-final-proximal-optimization-technique-on-different-double-stent-techniques
#13
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Nguyen Van Viet Thang, Nicolas Foin
BACKGROUND/PURPOSE: Computational fluid dynamics (CFD) have been recently adopted in many fields of cardiovascular medicine and in interventional cardiology. Using CFD analysis we compared the use of different PCI procedures, with and without the utilization of a proximal optimization technique (POT), on a complex coronary artery bifurcation. METHODS/MATERIALS: For the analysis, we considered a hypothetic model of a left anterior descending artery-diagonal Medina 1,1,1 bifurcation type with a diameter of the proximal main branch (MB) and the side branch (SB) set at 3...
January 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28102660/self-positioning-properties-of-dedicated-bifurcation-coronary-stent-bioss-lim%C3%A2-in-the-eye-of-3d-optical-coherence-tomography
#14
Jacek Bil, Maik J Grundeken, Tomasz Pawłowski, Robert J Gil
No abstract text is available yet for this article.
April 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28100341/-comparison-on-the-long-term-outcomes-post-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-bifurcation-lesions-in-unprotected-left-main-coronary-artery
#15
B G Yang, X P Yu, F Chen, S Z Lyu, Q Li, J Q He, F Yuan
Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28072714/optical-coherence-tomography-assessment-of-a-complex-bifurcation-lesion-treated-with-double-kissing-crush-technique-a-case-report
#16
Jin-Zan Cai, Yao-Jun Zhang, Tian Xu, Yong-Xiang Zhu, Chen-Yu Mao, Christos V Bourantas, Tom Crake, Shao-Liang Chen
The DEFINITION (Impact of the complexity of bifurcation lesions treated with drug-eluting stents) study has provided a novel classification to evaluate the complexity of coronary bifurcation lesion according to coronary angiography, but angiographic imaging due to its low resolution and inherited limitation may result in an inaccurate adjudication.We used optical coherence tomography (OCT) to further evaluate the coronary characteristics in a patient with "simple" bifurcation lesion which was classified by the DEFINITION criteria...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28065691/difference-in-vascular-response-between-sirolimus-eluting-and-everolimus-eluting-stents-in-ostial-left-circumflex-artery-after-unprotected-left-main-as-observed-by-optical-coherence-tomography
#17
Yusuke Fujino, Guilherme F Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Kentaro Tanaka, Takahiro Matsumoto, Hiroyoshi Kawamoto, Yuya Yamada, Shinnosuke Amano, Yusuke Watanabe, Takayuki Warisawa, Tomohiko Sato, Satoru Mitomo, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Takahiro Tsukahara, Masahiro Motosuke, Hiram G Bezerra, Shotaro Nakamura, Sunao Nakamura
BACKGROUND: Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT)...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28041711/bifurcation-lesions-involved-in-the-recanalization-process-of-coronary-chronic-total-occlusions-incidence-treatment-and-clinical-implications
#18
Soledad Ojeda, Manuel Pan, Alejandro Gutiérrez, Miguel Romero, Jorge Chavarría, Javier Suárez de Lezo, Francisco Mazuelos, Laura Pardo, Francisco Hidalgo, Francisco Carrasco, José Segura, Enrique Durán, Carlos Ferreiro, José J Sánchez, Sara Rodríguez, Jesús Oneto, Jose Suárez de Lezo
BACKGROUND: The presence of a bifurcation (BL) in the context of a coronary chronic total occlusion (CTO) represents an additional difficulty. This study analyzes the incidence of BLs in CTO recanalization, the treatment, predictors of bifurcation technical success and their clinical impact. METHODS AND RESULTS: BLs with a side branch (SB) ≥2.0mm located proximally, distally or within the occluded segment were observed in 130 (33%) of 391 CTO. Provisional stenting was the strategy more frequently used (94%)...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28038806/bioresorbable-coronary-stent-for-the-treatment-of-complex-coronary-lesions-data-from-an-all-comer-registry
#19
Andrea Cuculo, Antonio Ruggiero, Antonio Centola, Giulio Campanale, Tommaso Passero, Antonio Gaglione, Matteo Di Biase, Natale Daniele Brunetti
BACKGROUND: The study aimed to report the results from an all-comers registry of patients undergoing coronary angioplasty and treated with bioresorbable vascular scaffold (BVS). METHODS: Fifty-five consecutive patients with type B/C coronary lesions according to the AHA classification and treated with BVS were enrolled in the study. The clinical and procedural characteristics of enrolled patients were recorded. Fifty-five consecutive subjects with coronary lesions type B/C treated with everolimus eluting stent (EES) were used as control group...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28028712/numerical-study-of-blood-clots-influence-on-the-flow-pattern-and-platelet-activation-on-a-stented-bifurcation-model
#20
P García Carrascal, J García García, J Sierra Pallares, F Castro Ruiz, F J Manuel Martín
Stent implantation is a common procedure followed in arteries affected by atherosclerosis. This procedure can lead to other stenting-related problems. One of these is the deposition and accumulation of blood clots over stent struts. This process can have further consequences, in so far as it can introduce modifications to the flow pattern. This problem is especially critical in stented bifurcations, where resulting stent geometry is more complex. In this regard, a numerical study is presented of the effect on the flow pattern and platelet activation of blood clot depositions on the stent struts of a stented coronary bifurcation...
December 27, 2016: Annals of Biomedical Engineering
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