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coronary bifurcation angioplasty

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
Michał Kidawa, Krzysztof Chiżyński, Michał Kacprzak, Anna Ledakowicz-Polak, Marzenna Zielińska
In the era of modern interventional cardiology implantation of balloon expandable stent is a finishing touch of almost every coronary angioplasty. However sometimes we face clinical situation when decision on stent diameter is complicated, especially in ectatic part of arteries, in situations when artery lumen is obscured with thrombus or when reference diameter of proximal and distal part of lesion vary greatly. That is why idea of self-apposing stent similar to one used in peripheral vascular interventions was adopted into cardiology...
March 29, 2017: Kardiologia Polska
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...
March 5, 2017: Archives of Cardiovascular Diseases
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
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
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 iopromid (iopromide-PCB) or butyryltri-n-hexyl citrate excipient (BTHC-PCB)...
December 6, 2016: EuroIntervention
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
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
Fernando Alfonso, Marcos García-Guimarães, 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 8, 2016: Expert Opinion on Drug Delivery
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
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
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
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
Maik J Grundeken, Hector M Garcia-Garcia, Indulis Kumsars, Maciej Lesiak, Peter Kayaert, Jo Dens, Pieter R Stella, Robbert J de Winter, Linda L Laak, Philippe Généreux, Aaron V Kaplan, Martin B Leon, Joanna J Wykrzykowska, Yoshinobu Onuma, Patrick W Serruys
OBJECTIVE: Randomized comparison between the Tryton Side Branch Stent (Tryton Medical, Durham, NC), used in combination with a main branch drug-eluting stent (DES), and side branch balloon angioplasty (SBBA, in combination with a main branch DES) using intravascular ultrasound (IVUS), and three-dimensional quantitative coronary angiography (3D-QCA). BACKGROUND: The Tryton stent has been developed to improve clinical outcomes after percutaneous coronary intervention (PCI) of bifurcation lesions...
February 1, 2017: Catheterization and Cardiovascular Interventions
Davide Piraino, Bernardo Cortese, Dario Buccheri, Gregory Dendramis, Giuseppe Andolina
No abstract text is available yet for this article.
January 15, 2016: International Journal of Cardiology
Marcello Dominici, Alessio Arrivi, Marco Bazzucchi, Marcella De Paolis, Caterina Milici, Carlo Bock, Attilio Placanica, Ludovico Lazzari, Roberto Diletti, Enrico Boschetti
BACKGROUND: The purpose of this registry is to report the immediate and long-term safety and efficacy of the Biotronik Orsiro stent in an unselected population during everyday practice. METHODS: Between May 2012 and June 2013, 246 consecutive coronary angioplasty procedures were performed using at least one Orsiro drug-eluting stent, in 225 patients and 303 lesions. RESULTS: Diabetes was present in 34.7% of patients. Procedures were non-elective percutaneous coronary intervention (PCI) in 17...
February 2016: Minerva Cardioangiologica
Paul D Morris, Jane Taylor, Sara Boutong, Sarah Brett, Amal Louis, James Heppenstall, Allison C Morton, Julian P Gunn
OBJECTIVES: To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning. BACKGROUND: As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown. METHODS: We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists...
March 2016: Catheterization and Cardiovascular Interventions
Mony Shuvy, Bradley H Strauss
No abstract text is available yet for this article.
May 2015: Canadian Journal of Cardiology
Robert J Gil, Jacek Bil, Vladimír Džavík, Dobrin Vassilev, Adam Kern, Radoslaw Formuszewicz, Małgorzata Zalewska-Adamiec, Sławomir Dobrzycki
BACKGROUND: Results of regular drug-eluting stents (rDESs) in bifurcation treatment are not optimal. The aim of the Polish Bifurcation Optimal Stenting I (POLBOS I) trial was to compare bifurcation treatment with any rDES vs the dedicated bifurcation paclitaxel-eluting stent BiOSS Expert (Balton, Poland). The second aim was to study the effect of final kissing balloon (FKB) inflation on clinical outcomes. METHODS: Between October 2010 and January 2013 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome were assigned 1:1 to 1 of 2 treatment strategies: BiOSS Expert stent or rDES implantation...
May 2015: Canadian Journal of Cardiology
Maik J Grundeken, Yuki Ishibashi, Philippe Généreux, Laura LaSalle, Javaid Iqbal, Joanna J Wykrzykowska, Marie-Angèle Morel, Jan G Tijssen, Robbert J de Winter, Chrysafios Girasis, Hector M Garcia-Garcia, Yoshinobu Onuma, Martin B Leon, Patrick W Serruys
OBJECTIVES: This study sought to evaluate inter-core lab variability in quantitative coronary angiography (QCA) analysis of bifurcation lesions. BACKGROUND: QCA of bifurcation lesions is challenging. To date there are no data available on the inter-core lab variability of bifurcation QCA analysis. METHODS: The randomized Tryton IDE (Tryton Pivotal IDE Coronary Bifurcation Trial) compared the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina) with balloon angioplasty as side branch treatment...
February 2015: JACC. Cardiovascular Interventions
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