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Hybrid revascularization

Vladimir Dedovic, Goran Stankovic
Despite permanent improvement in success rate and technical developments, chronic total occlusion (CTO) remains undertreated by percutaneous coronary intervention (PCI). Dedicated CTO operators from Japan, Europe and USA perform these procedures with success rate beyond 90%, but there is still huge gap between this group of specialists and broader population of PCI operators. Recently proposed CTO scores can be used for patients' selection according to the CTO operators' experience. Patients with low CTO score values may be suitable for less experienced operators at the beginning of the CTO PCI learning curve, while more complex CTOs (higher CTO score values) should be differed to CTO experts...
October 19, 2016: Panminerva Medica
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Javier G Poveda, Gustavo L Silva, Pedro C Silva, Ângelo Nobre
Our goal is to introduce a new hybrid coronary revascularization concept-coronary surgical stenting. The procedure was performed on a 78-year old woman with severe, long and calcified involvement of the proximal left anterior descending artery, chronic total occlusion of the mid-left anterior descending artery and severe disease in the distal left anterior descending artery. An off-pump minimally invasive procedure was performed through the fifth intercostal space, including concurrent surgical placement of a drug-eluting stent in the distal left anterior descending artery, through the left anterior descending artery graft incision, associated with the left internal mammary artery to the mid-left anterior descending artery graft...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
Ludovic Canaud, Vincent Ziza, Baris Ata Ozdemir, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Pierre Alric
BACKGROUND: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching. METHODS: Between 1998 and 2015, 68 patients (41 men, mean age 67+/-16 years) underwent TEVAR with LSA coverage, 19.2% (n = 13) were never revascularized and the remaining patients underwent LSA revascularization (n = 55; 80.8%) . Revascularization was achieved by LSA-carotid transposition via a medial approach in 81.8% (n = 45) and a lateral approach in 18...
September 23, 2016: Annals of Vascular Surgery
Ombretta Martinelli, Alban Malaj, Roberto Gattuso, Luigi Irace, Bruno Gossetti
The aim of this study is to present the treatment of a juxtarenal inflammatory aneurysm using a Nellix device (Endologix, Inc., Irvine, CA) to seal the entire aneurysmatic aorta combined with bilateral iliac-renal bypass using the Gore hybrid vascular graft (W. L. Gore & Associates, Inc., Flagstaff, AZ). A 63-year-old man was diagnosed with a 6-cm juxtarenal inflammatory aneurysm. It was initially decided to treat him with an aorto-aortic bypass and to revascularize the 2 renal arteries with "graft to renal artery bypass" using Gore hybrid vascular grafts...
September 22, 2016: Annals of Vascular Surgery
Carola Marie Wieker, Eva Schönefeld, Nani Osada, Christina Lührs, Roland Beneking, Giovanni Torsello, Dittmar Böckler
OBJECTIVE: The aim of this study was to investigate the long-term outcome of common femoral artery thromboendarterectomy in patients with peripheral arterial occlusive disease. METHODS: The study retrospectively evaluated 713 vessels in 655 patients (75% male; mean age, 69.4 ± 9.5 years) who underwent common femoral thromboendarterectomy from January 2006 until May 2012 in two high-volume vascular centers. Critical limb ischemia was present in 221 patients, and intermittent claudication was present in 434...
October 2016: Journal of Vascular Surgery
Krzysztof Milewski, Paweł Gąsior, Stefan Samborski, Piotr P Buszman, Aleksandra Błachut, Adam Wojtaszczyk, Adam Młodziankowski, Artur Mendyk, Marek Król, Wojciech Wojakowski, Paweł E Buszman
INTRODUCTION: Despite the dominance of drug-eluting stents in modern interventional cardiology, there is still a niche for bare metal stents. AIM: The aim of the Polish NexGen registry was to evaluate the safety and efficacy of a new generation cobalt-chromium NexGen stent in a real life patient population. MATERIAL AND METHODS: A prospective multi-center registry was conducted in five clinical sites of American Heart of Poland. Three hundred and eighty-three patients who underwent percutaneous coronary intervention (PCI) with NexGen stent implantation were included...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Suvi Väärämäki, Velipekka Suominen, Georg Pimenoff, Jukka Saarinen, Ilkka Uurto, Juha Salenius
OBJECTIVE: To report our long-term experience in using the hybrid technique in complex thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between March 2005 and September 2013, 10 patients with TAAA underwent hybrid procedures with open renovisceral revascularization and thoracoabdominal aortic endografting. Patients were analyzed retrospectively. RESULTS: Six men and 4 women with a mean age of 66 years (range 54-81 years) were treated electively during the study period...
October 2016: Vascular and Endovascular Surgery
Anouk Grandjean, Katia Iglesias, Céline Dubuis, Sébastien Déglise, Jean-Marc Corpataux, François Saucy
BACKGROUND: Multilevel peripheral arterial disease is frequently observed in patients with intermittent claudication or critical limb ischemia. This report evaluates the efficacy of one-stage hybrid revascularization in patients with multilevel arterial peripheral disease. PATIENTS AND METHODS: A retrospective analysis of a prospective database included all consecutive patients treated by a hybrid approach for a multilevel arterial peripheral disease. The primary outcome was the patency rate at 6 months and 1 year...
September 2016: VASA. Zeitschrift Für Gefässkrankheiten
Juergen Zanow, Martin Breuer, Eric Lopatta, Christoph Schelenz, Utz Settmacher
Aortic arch aneurysms can be treated with hybrid procedures by endovascular exclusion and prior debranching of supraaortic arteries. We report on a case of symptomatic arch aneurysm following previous supracoronary ascending aorta and hemi-arch replacement with a very short proximal landing zone. A successful reconstruction was performed by retrograde revascularization of supraaortic vessels from the descending aorta and subsequent endovascular repair deploying a proximal stent graft directly above the sinotubular junction with good results in the four-year follow up...
August 20, 2016: Annals of Vascular Surgery
Robert Ward, Joie Dunn, Leonardo Clavijo, David Shavelle, Vincent Rowe, Karen Woo
OBJECTIVES: Patients presenting to a public hospital with critical limb ischemia (CLI) typically have advanced disease with significant co-morbidities. The purpose of this study was to assess the influence of revascularization on one year amputation rate of CLI patients presenting to Los Angeles County USC Medical Center, classified according to the SVS WIfI. METHODS: A retrospective review of patients who presented to a public hospital with CLI from February 2010 to July 2014 was performed...
August 18, 2016: Annals of Vascular Surgery
Hitoshi Yaku, Satoshi Numata, Sachiko Yamazaki
No abstract text is available yet for this article.
June 20, 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Peter B Bartline, Bjoern D Suckow, Benjamin S Brooke, Larry W Kraiss, Michelle T Mueller
OBJECTIVES: Little data exist regarding the effect of referral distance on outcomes after revascularization for critical limb ischemia (CLI). We tested the assumption that patients who travel longer distances for revascularization procedures have worse outcomes. METHODS: We identified a retrospective cohort of 300 CLI patients who underwent revascularization between Jan 1, 2000 and Dec 31, 2010 at a single academic medical center. Patients were stratified into two groups based on distance greater than or less than 100 miles from the referral center...
August 12, 2016: Annals of Vascular Surgery
Junjiro Kobayashi, Yusuke Shimahara, Tomoyuki Fujita, Hideaki Kanzaki, Makoto Amaki, Hiroki Hata, Yuta Kume, Kizuku Yamashita, Atsushi Okada
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become an alternative procedure for treating aortic stenosis (AS) in patients with advanced age and severe comorbidities. Ischemic heart disease (IHD) is present with AS in 40-50% of patients with typical angina. Considering the high operative mortality and morbidity rates in these patients, hybrid TAVI and off-pump CABG (OPCAB) have become realistic treatment options. METHODS AND RESULTS: Between August 2014 and November 2015, 12 patients were evaluated for simultaneous TAVI and OPCAB...
August 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Chenghui Zhou, Yunseok Jeon, Patrick Meybohm, Alexander Zarbock, Paul Jeffrey Young, Lihuan Li, Derek J Hausenloy
BACKGROUND: Remote ischemic conditioning (RIC) has been recognized an emerging non-invasive approach for preventing acute kidney injury (AKI) in patients undergoing either elective coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). On the other hand, accumulating evidence has indicated the involving role of pre-CABG contrast usage for coronary angiography in post-surgery AKI risk. Along with the shortening time delay of CABG after coronary angiography, and the prevalent hybrid coronary revascularization (HCR), the AKI prevention by RIC has faced challenges following coronary revascuralization...
November 1, 2016: International Journal of Cardiology
Crystal M Kavanagh, Michael J Heidenreich, Jeremy J Albright, Abdulhameed Aziz
OBJECTIVE: Long or multisegmental external iliac-to-femoral arterial lesions treated by angioplasty and stenting have achieved disappointing results. Conventional, open approaches are often complicated by significant morbidity, and endovascular stenting alone typically requires additional outflow procedures. We hypothesized that a hybrid approach, combining endovascular techniques with remote selective external iliac endarterectomy, produces superior outcomes in terms of patency compared with stenting alone, with minimal associated morbidity...
July 28, 2016: Journal of Vascular Surgery
Rustem Dautov, Henrique Barbosa Ribeiro, Omar Abdul-Jawad Altisent, Luis Nombela-Franco, Claire Gibrat, Can Manh Nguyen, Stéphane Rinfret
The experience with the transradial approach in percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) in the United States is limited. We looked at the safety and feasibility of a home-made sheathless transradial technique (STT) with regular 8Fr catheters in CTO PCI. In March 2013, we developed an 8Fr STT for CTO PCI. We compared 119 patients who had the STT versus 122 treated with a standard transradial or transfemoral approach. The primary outcomes of interest were major vascular or bleeding site access complications...
September 15, 2016: American Journal of Cardiology
Anno Diegeler
No abstract text is available yet for this article.
July 26, 2016: Journal of the American College of Cardiology
John D Puskas, Michael E Halkos, Joseph J DeRose, Emilia Bagiella, Marissa A Miller, Jessica Overbey, Johannes Bonatti, V S Srinivas, Mark Vesely, Francis Sutter, Janine Lynch, Katherine Kirkwood, Timothy A Shapiro, Konstantinos D Boudoulas, Juan Crestanello, Thomas Gehrig, Peter Smith, Michael Ragosta, Steven J Hoff, David Zhao, Annetine C Gelijns, Wilson Y Szeto, Giora Weisz, Michael Argenziano, Thomas Vassiliades, Henry Liberman, William Matthai, Deborah D Ascheim
BACKGROUND: Hybrid coronary revascularization (HCR) combines minimally invasive surgical coronary artery bypass grafting of the left anterior descending artery with percutaneous coronary intervention (PCI) of non-left anterior descending vessels. HCR is increasingly used to treat multivessel coronary artery disease that includes stenoses in the proximal left anterior descending artery and at least 1 other vessel, but its effectiveness has not been rigorously evaluated. OBJECTIVES: This National Institutes of Health-funded, multicenter, observational study was conducted to explore the characteristics and outcomes of patients undergoing clinically indicated HCR and multivessel PCI for hybrid-eligible coronary artery disease, to inform the design of a confirmatory comparative effectiveness trial...
July 26, 2016: Journal of the American College of Cardiology
Keita Kikuchi
INTRODUCTION: We report our clinical results of off-pump minimally invasive coronary artery bypass grafting( MICS CABG) under direct vision as our initial experience. SURGERY: An 8-10 cm incision was made in the left 4-5th intercostal space (ICS). Bilateral internal thoracic artery (BITA) were harvested under direct vision with the use of 32 cm Harmonic scalpel through the surgical port. And the right lung is displaced by a tissue stabilizer via subxiphoid incision...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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