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coronary bifurcation angioplasty

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https://www.readbyqxmd.com/read/29066340/drug-eluting-balloon-for-the-treatment-of-patients-with-coronary-artery-disease-current-perspectives
#1
REVIEW
Mattia Lunardi, Carlo Zivelonghi, Floris S van den Brink, Matteo Ghione, Giulia Vinco, Giovanni Benfari, Roberto Scarsini, Flavio Ribichini, Pierfrancesco Agostoni
Despite the improvement of outcomes after the introduction of bare metal and drug eluting stents for the treatment of CAD, certain type of patients have still an increased risk of stent failure. An alternative is represented by drug-eluting balloons (DEB). This innovation could give potential benefits in particular for the in-stent restenosis (ISR) and the de-novo lesions. In the first setting DEB have shown results superior to those with plain-balloon angioplasty and similar to those with first generation DES...
September 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29038413/percutaneous-coronary-intervention-for-coronary-bifurcation-lesions
#2
William Finch, Michael S Lee
Percutaneous coronary intervention (PCI) of lesions at coronary bifurcations poses a technical challenge. Short-term complications, including periprocedural myocardial infarction, and long-term complications such as in-stent restenosis and stent thrombosis, are higher in patients with bifurcation lesions. Techniques for PCI of bifurcation lesions include stenting of the main branch alone, and the use of two or more stents to cover the main and side branches. Two- or three-stent techniques include T-stenting, crush, culotte, simultaneous kissing stents, V-stenting, and Y-stenting...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28844030/state-of-the-art-balloon-catheter-technologies-drug-coated-balloon
#3
Fernando Alfonso, Bruno Scheller
Four decades after its introduction into clinical practice, coronary balloon angioplasty is still used during most coronary interventions. Conventional balloon angioplasty is frequently used to predilate complex or severe lesions and remains of major value to optimise the results of stent implantation. Plain balloon angioplasty is still used alone in some anatomic scenarios where stent implantation is not desirable (very small vessels or diffuse lesions, large resistant thrombus burden, side branches of bifurcations)...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844026/state-of-the-art-coronary-angiography
#4
Carlos Collet, Maik J Grundeken, Taku Asano, Yoshinobu Onuma, William Wijns, Patrick W Serruys
In the early days of coronary angiography, the precise quantification of luminal narrowing was challenging. The introduction of balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) by Andreas Grüntzig in 1977 was perhaps the greatest incentive to the development of quantitative coronary angiography (QCA). QCA has played a crucial role in evaluating interventional techniques and assessing the results of new technologies. With the advent of drug-eluting stents (DES), QCA metrics such as late lumen loss and diameter stenosis (restenosis) proved to be instrumental in assessing new technologies...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28802533/bifurcation-culprit-lesions-in-st-segment-elevation-myocardial-infarction-procedural-success-and-5-year-outcome-compared-with-nonbifurcation-lesions
#5
Pablo Salinas, Hernán Mejía-Rentería, Raúl Herrera-Nogueira, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Iván Javier Núñez-Gil, Nieves Gonzalo, María Del Trigo, María José Pérez-Vizcayno, Alicia Quirós, Javier Escaned, Carlos Macaya, Antonio Fernández-Ortiz
INTRODUCTION AND OBJECTIVES: We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. METHODS: Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years...
August 9, 2017: Revista Española de Cardiología
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
#6
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/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#7
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28398398/-new-technologies-and-applications-for-drug-coated-balloons
#8
Bernardo Cortese, Gaetano Di Palma, Roberto Nerla, Antonio Micari
Drug-eluting stents (DES) represent nowadays the gold standard treatment for coronary artery disease. Despite the safety and efficacy, and favorable long-term clinical outcomes of new generation DES, their use is still associated with a not negligible risk of long-term events, related to the presence of a definitive prosthesis in the vessel wall. In addition, DES implantation is not always desirable in particular anatomic settings (small vessels, bifurcations) or in patients with higher bleeding risk. In recent years, drug-coated balloons (DCB) have been developed to overcome some of these limitations, offering a combined mechanical (balloon dilation) and biological therapy (drug-release)...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28353317/self-expanding-stentys-stents-in-daily-routine-use
#9
Michał Kidawa, Krzysztof Chiżyński, Michał Kacprzak, Anna Ledakowicz-Polak, Marzenna Zielińska
BACKGROUND: In the era of modern interventional cardiology, implantation of a balloon expandable stent is the finishing touch of almost every coronary angioplasty. However, sometimes we face a clinical situation in which the decision regarding the stent diameter is complicated, especially in the ectatic part of arteries, in situations when the artery lumen is obscured with the thrombus, or when the reference diameter of the proximal and distal part of the lesion vary greatly. That is why the idea of a self-apposing stent similar to the one used in peripheral vascular interventions was adopted into cardiology...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28274589/contemporary-use-of-drug-coated-balloons-in-coronary-artery-disease-where-are-we-now
#10
REVIEW
Fabien Picard, Serge Doucet, Anita W Asgar
The drug-coated balloon (DCB) has emerged as an additional tool in the arsenal of interventional cardiology devices; it delivers antiproliferative drugs to local arterial tissue by single prolonged coated balloon angioplasty inflation, and prevents restenosis, leaving no implant behind. This strategy theoretically decreases the risk of late inflammatory response to device components, without preventing positive remodelling. DCBs, when used carefully and with a good technique, may have a role in the treatment of lesion subsets, such as in-stent restenosis, small vessel disease or side branch bifurcations, in which the implantation of a drug-eluting stent is not desirable or is technically challenging...
April 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28038806/bioresorbable-coronary-stent-for-the-treatment-of-complex-coronary-lesions-data-from-an-all-comer-registry
#11
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/27969671/tct-325-the-effects-of-types-of-guidewires-and-pressure-applied-during-stent-implantation-in-the-main-vessel-on-the-incidence-of-damage-to-coronary-guidewires-during-angioplasty-of-coronary-bifurcation-lesions-wide-beast-study
#12
Piotr Kwiatkowski, Edyta Sutkowska, Jerzy Malachowski, Wioletta Jakubas-Kwiatkowska, Slawomir Golebiewski, Robert Gil
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27916742/angiographic-and-clinical-outcomes-of-patients-treated-with-drug-coated-balloon-angioplasty-for-in-stent-restenosis-after-coronary-bifurcation-stenting-with-a-two-stent-technique
#13
Yukinori Harada, Roisin Colleran, Susanne Pinieck, Daniele Giacoppo, Jonathan Michel, Sebastian Kufner, Salvatore Cassese, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Adnan Kastrati, Robert A Byrne
AIMS: We conducted this study to evaluate the efficacy of drug-coated balloon therapy for in-stent restenosis after coronary bifurcation stenting. METHODS AND RESULTS: Patients who underwent angioplasty with at least one paclitaxel-coated balloon for in-stent restenosis after bifurcation intervention using a two-stent approach were included. Two types of paclitaxel-coated balloon were used, with either an iopromide (iopromide-PCB) or a butyryl tri-n-hexyl citrate (BTHC-PCB) excipient...
April 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/27777957/optimal-revascularization-strategy-on-medina-0-1-0-left-main-bifurcation-lesions-in-type-2-diabetes
#14
Xuwei Zheng, Hongyu Peng, Donghui Zhao, Qin Ma, Kun Fu, Guo Chen, Qian Fan, Jinghua Liu
Aim. Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. The implications of a diagnosis of DM are as severe as the diagnosis of coronary artery disease. For many patients with complex coronary artery disease, optimal revascularization strategy selection and optimal medical therapy are equally important. In this study, we compared the hemodynamic results of different stenting techniques for Medina 0,1,0 left main bifurcation lesions. Methods. We use idealized left main bifurcation models and computational fluid dynamics analysis to evaluate hemodynamic parameters which are known to affect the risk of restenosis and thrombosis at stented bifurcation...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27757830/off-label-use-of-7fr-guideliner-in-the-bifurcation-coronary-intervention-protecting-2-side-branches
#15
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27718756/drug-eluting-balloons-in-coronary-interventions-the-quiet-revolution
#16
Fernando Alfonso, Marcos García-Guimaraes, Gonzalo Navarrete, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Fernando Rivero, Bernardo Cortese
Drug-eluting balloons (DEB) may be considered as a 'quiet revolution' in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES)...
October 19, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27713612/longitudinal-stent-deformation-caused-by-retraction-of-the-looped-main-branch-guidewire
#17
Hung-Hao Lee, Po-Chao Hsu, Wen-Hsien Lee, Chun-Yuan Chu, Ho-Ming Su, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Cheng-An Chiu
A 66-year-old male was treated percutaneously for a bifurcation lesion of the left anterior descending coronary artery by provisional stenting using the jailed wire technique. After successfully stenting the main branch, retraction of the looped main branch guidewire was impossible. After using an intravascular ultrasound we discovered the guidewire was entangled with a stent strut. Thereafter, the proximal stent elongated after retraction. With the support of an over-the-wire microcatheter, we finally pulled out the entrapped guidewire...
September 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27314678/endovascular-treatment-of-below-the-elbow-arteries-in-critical-hand-ischemia
#18
REVIEW
Roberto Gandini, Sebastiano Fabiano, Daniele Morosetti, Stefano Merolla, Giovanni Mauri, Roberto Ferraresi
Although uncommon, critical hand ischemia (CHI) represents a cause of significant disability because of its effect on hand function. Percutaneous transluminal angioplasty (PTA) is now considered a first-line therapy for above-the-elbow artery disease while there are few data regarding the treatment of below-the-elbow (BTE) arteries. The aim of this study is to review the current literature on BTE vessel PTA and to describe the technical approach. In case of favorable anatomy (absence of inflow arteries disease, standard humeral artery bifurcation), a 4-F antegrade trans-brachial approach is usually the preferred option...
December 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27242273/results-from-the-international-drug-coated-balloon-registry-for-the-treatment-of-bifurcations-can-a-bifurcation-be-treated-without-stents
#19
MULTICENTER STUDY
Leonhard Bruch, Mariusz Zadura, Matthias Waliszewski, Zeljko Platonic, Jaako Eränen, Bruno Scheller, Bettina Götting, Denny Herberger, Cataldo Palmieri, Giuseppe Sinicròpi, Wolfgang Motz
OBJECTIVES: This observational study assessed the 9-month clinical outcomes in patients with coronary bifurcation lesions suitable for drug-coated balloon (DCB) angioplasty. It was the intention to use DCB's without additional stenting (DCB-only strategy) in selected patients for this chosen strategy. Bail-out main branch (MB) and/or side branch (SB) stenting, however, were permissible when flow limiting dissections or excessive recoil occurred. BACKGROUND: A multitude of interventional strategies have been studied to treat bifurcation lesions...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27174651/a-specific-angiographic-view-of-left-coronary-artery-bifurcation-in-the-left-main-percutaneous-coronary-intervention-era
#20
Samir S A Reis, Roberto V Botelho, Alexandre Abizaid, Antônio D S Pereira, Rodrigo Alves, Denis F de Souza, Sebastião R Ferreira-Filho
OBJECTIVES: We propose a right lateral (90-120° RAO) with 30° cranial angiographic view to expose the bifurcation of the left main coronary artery (LMCA) when previously used routine projections were inefficient at clearly showing this region. BACKGROUND: Little has been published in the medical literature regarding angiographic projections dedicated to special anatomies. METHODS: A total of 84 patients were subjected to the proposed projections...
June 2016: Journal of Interventional Cardiology
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