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Bifurcation intervention

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https://www.readbyqxmd.com/read/28926354/neointimal-coverage-of-jailed-side-branches-in-coronary-bifurcation-lesions-an-optical-coherence-tomography-analysis
#1
Teruyoshi Kume, Ryotaro Yamada, Koyama Terumasa, Tomoko Tamada, Koichiro Imai, Kenzo Fukuhara, Yutaka Goryo, Ai Kawamura, Okamoto Hiroshi, Yoji Neishi, Shiro Uemura
OBJECTIVES: The jailed strut at the side-branch (SB) orifice may be a cause of delayed neointimal coverage and SB flow disturbance after single stenting to bifurcation. The aim of this study was to characterize the exact relationship between the jailed strut pattern at the SB orifice immediately after stent implantation and neointimal coverage of the jailed SB orifice in the chronic phase. PATIENTS AND METHODS: A total of 29 bifurcation (left anterior descending coronary artery and diagonal branch) lesions treated by optical coherence tomography-guide single-stent implantation and followed at 18 months after a percutaneous coronary intervention were included in this study...
September 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28844030/state-of-the-art-balloon-catheter-technologies-drug-coated-balloon
#2
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
#3
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/28843859/aortic-pseudoaneurysm-after-endarterectomy-for-small-aorta-syndrome
#4
M Domanin, D Bissacco, S Romagnoli, A Buora
INTRODUCTION: Small Aorta Syndrome (SAS) or hypoplastic aorto-iliac syndrome is a rare pathology of the aorta that affects almost exclusively young or middle-aged women and is characterized by smaller dimension of the aorta and iliac axes. Etiopathogenesis is unclear and many factors have been invoked. The smaller caliber of the aorta and iliac arteries may predispose to aorto-iliac occlusive disease development. In the past aorto-iliac endarterectomy (AE) with patch closure was utilized as an alternative to surgical bypass in order to correct steno-obstructive syndromes affecting carriers of SAS...
August 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28843589/hemorrhage-risk-with-transjugular-intrahepatic-portosystemic-shunt-tips-insertion-at-the-main-portal-vein-bifurcation-with-stent-grafts
#5
A S Griffin, S R Preece, J Ronald, T P Smith, P V Suhocki, C Y Kim
PURPOSE: The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS: TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic...
August 23, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28835831/three-dimensional-optical-frequency-domain-imaging-of-a-true-bifurcation-lesion-after-stent-implantation-using-the-jailed-semi-inflated-balloon-technique
#6
Yohei Numasawa, Hiromu Hase, Hiroyuki Yamazaki, Ryota Tabei, Toshiki Kuno, Masaki Kodaira, Tetsuya Saito
OBJECTIVE: Percutaneous coronary intervention for coronary bifurcation lesion is very challenging, especially for true bifurcation lesions. Although the jailed semi-inflated balloon technique is one of the established methods for treatment of coronary bifurcation lesions, little is known regarding the configuration of the side branch orifice after stent implantation using this technique. METHODS: We report a 73-year-old male patient with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a true bifurcation lesion of the right coronary artery with an obtuse angle using the jailed semi-inflated balloon technique...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28830751/treatment-of-de-novo-coronary-artery-bifurcation-lesions-with-drug-coated-balloons-a-reappraisal-according-to-the-available-scientific-data
#7
REVIEW
Marco Zuin, Gianluca Rigatelli
The treatment of coronary artery bifurcation often represents a challenge for interventional cardiologist. Although several stenting techniques are available for the treatment of de novo coronary bifurcation lesions, over the last years, different studies have proposed and analysed the use of drug-coated balloon (DCB) in the treatment of coronary artery bifurcation lesions as an alternative treatment. To date, even considering those studies which have analysed a combined strategy (DCB+stenting) or a DCB-only approach, the evidences are scant and the results debatable...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28829743/intracoronary-electrocardiogram-to-guide-percutaneous-interventions-in-coronary-bifurcations-a-proof-of-concept-the-fiesta-ffr-vs-icecgsta-study
#8
Dobrin Vassilev, Liubomir Dosev, Carlos Collet, Kiril Karamfiloff, Jivka Stoikova, Ralica Pancheva, Monika Shumkova, Galina Zlatancheva, Vladimir Naunov, Gianluca Rigatelli, Ghassan S Kassab, Robert J Gil, Patrick W Serruys
AIMS: The aim of this study was to determine the accuracy of the intracoronary electrocardiogram (icECG) to detect ischemia during bifurcation lesions percutaneous coronary intervention (PCI) with fractional flow reserve (FFR) as a reference. METHODS AND RESULTS: Patients with significant bifurcation lesions defined as FFR≤0.80 were included. FFR and icECG were performed in the main vessel (MV) and side branch (SB) before and after provisional stenting. icECG was recorded with a uninsulated proximal wire end connected to a unipolar lead...
August 22, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28797113/clinical-outcomes-of-biodegradable-polymer-biolimus-eluting-biomatrix-stents-versus-durable-polymer-everolimus-eluting-xience-stents
#9
Da Hyon Lee, Taek Kyu Park, Young Bin Song, Woo Jung Chun, Rak Kyeong Choi, Jin-Ok Jeong, Eul Soon Im, Sang Wook Kim, Joo Myung Lee, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
There are limited data about clinical outcomes of biodegradable polymer biolimus-eluting BioMatrix stents (BP-BES) and durable polymer everolimus-eluting Xience stents (DP-EES) in real world practice. We sought to compare the clinical outcomes of BP-BES and DP-EES in real world cohorts of patients undergoing percutaneous coronary intervention. A prospective multicenter registry enrolled 999 patients treated with BP-BES and 1,000 patients treated with DP-EES. The primary outcome was target lesion failure, defined as a composite of cardiac death, target vessel-related myocardial infarction, or target lesion revascularization...
2017: PloS One
https://www.readbyqxmd.com/read/28794001/randomized-comparison-of-ridaforolimus-eluting-and-zotarolimus-eluting-coronary-stents-in-patients-with-coronary-artery-disease-primary-results-from-the-bionics-trial
#10
David E Kandzari, Pieter C Smits, Michael P Love, Ori Ben-Yehuda, Shmuel Banai, Simon D Robinson, Michael Jonas, Ran Kornowski, Rodrigo Bagur, Andres Iniguez, Haim D Danenberg, Robert L Feldman, Rajiv Jauhar, Harish Chandna, Manish A Parikh, Gidon Y Perlman, Mercedes Balcells, Peter M Markham, Melek Ozgu Ozan, Philippe Genereux, Elazer Edelman, Martin B Leon, Gregg W Stone
Background -The safety and efficacy of a novel cobalt alloy-based coronary stent with a durable elastomeric polymer eluting the antiproliferative agent ridaforolimus for treatment of patients with coronary artery disease is undetermined. Methods -A prospective, international 1:1 randomized trial was conducted to evaluate in a noninferiority design the relative safety and efficacy of ridaforolimus-eluting stents (RES) and slow-release zotarolimus-eluting stents (ZES) among 1,919 patients at 76 centers undergoing percutaneous coronary intervention...
August 9, 2017: Circulation
https://www.readbyqxmd.com/read/28792156/successful-treatment-of-unprotected-left-main-coronary-bifurcation-lesion-using-minimum-contrast-volume-with-intravascular-ultrasound-guidance
#11
Oh Hyun Lee, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong
Contrast-induced nephropathy (CIN) is a serious complication in patients undergoing percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality. The limiting volume of contrast medium is safest and most reliable strategy for CIN prevention. Intravascular ultrasound (IVUS) serves as an attractive alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of contrast agents. Here, we reported a case of successfully treated unprotected left main bifurcation lesion with heavily calcified and diffuse lesion under the IVUS-guided PCI using low volumes of contrast dye of total 12 cc in an elderly patient...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28790213/-surgical-treatment-of-cervical-carotid-artery-aneurysm
#12
Ryo Hamasaki, Toshiharu Yanagisawa, Yusuke Takahashi, Hiroaki Shimizu
Cervical carotid aneurysms are rare, and surgical treatment should be planned for each patient. The authors report 9 cases of cervical carotid aneurysm in 9 patients(mean age, 53.7 years;5 men)who were treated surgically between 2005 and 2014. The aneurysm was located in the internal carotid artery in 6 patients, the common carotid artery in 2 patients, and the carotid bifurcation in 1 patient. Four aneurysms were recurrences after a previous endovascular intervention(parent artery coil embolization, covered stent placement, or stent with coil embolization)...
August 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28774222/transradial-delivery-of-a-renal-snorkel-during-complex-endovascular-aortic-aneurysm-repair
#13
Jordan R Stern, Sharif H Ellozy
Transradial access has been described in a variety of clinical contexts but has been rarely utilized for visceral artery interventions and during complex endovascular aortic aneurysm repair (EVAR) when upper extremity access is required. This is usually accomplished via brachial artery access, and although brachial access is generally safe and effective, radial access may offer some benefits with regard to patient comfort and potential complications. Here we report a case of successful delivery of a renal snorkel via a radial artery approach during EVAR...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28767806/extracranial-carotid-stenosis-evidence-based-review
#14
Carolina Dutra Queiroz Flumignan, Ronald Luiz Gomes Flumignan, Túlio Pinho Navarro
Extracranial cerebrovascular disease is one of the most important causes of death and disability worldwide and its treatment is based on clinical and surgical strategies, the latter being performed by conventional or endovascular techniques. The management of stenosis of the carotid bifurcation is mainly aimed at preventing stroke and has been the subject of extensive investigation. The role of clinical treatment has been re-emphasized, but carotid endarterectomy remains the first-line treatment for symptomatic patients with 50% to 99% stenosis and for asymptomatic patients with 60% to 99% stenosis...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28764604/optical-coherence-tomography-to-guide-percutaneous-treatment-of-coronary-bifurcation-disease
#15
Mathias Wolfrum, Giovanni Luigi De Maria, Adrian P Banning
Cardiovascular disease remains the most common cause of death worldwide. Enormous progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease has been made, and the number of percutaneous coronary interventions (PCI) is increasing. Coronary bifurcations are involved in a substantial number of PCIs and despite recent advances, bifurcation PCI remains a challenge in terms of immediate success and long-term outcome. Angiography has a limited capacity for showing important features of the 3 dimensional coronary vessel anatomy, position of stent struts and exact wire positions and is therefore suboptimal for guiding bifurcation PCI...
August 9, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28756418/one-year-clinical-outcomes-of-patients-presenting-with-st-segment-elevation-myocardial-infarction-caused-by-bifurcation-culprit-lesions-treated-with-the-stentys-self-apposing-coronary-stent-results-from-the-apposition-iii-study
#16
Maik J Grundeken, Huangling Lu, Nicola Vos, Alexander IJsselmuiden, Robert-Jan van Geuns, Rainer Wessely, Thomas Dengler, Alessio La Manna, Johanne Silvain, Gilles Montalescot, René Spaargaren, Jan G P Tijssen, Robbert J de Winter, Joanna J Wykrzykowska, Giovanni Amoroso, Karel T Koch
OBJECTIVE: To investigate outcomes in patients with ST-segment elevation myocardial infarction (STEMI) after treatment with the Stentys self-apposing stent (Stentys SAS; Stentys S.A.) for bifurcation culprit lesions. BACKGROUND: The nitinol, self-expanding Stentys was initially developed as a dedicated bifurcation stent. The stent facilitates a provisional strategy by accommodating its diameter to both the proximal and distal reference diameters and offering an opportunity to "disconnect" the interconnectors, opening the stent toward the side branch...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28748256/bioresorbable-vascular-scaffolds-in-interventional-neuroradiology
#17
Anil Arat, Ergun Daglioglu, Ilkay Akmangit, Ahmet Peker, Murat Arsava, Mehmet Akif Topcuoglu, Deniz Belen
PURPOSE: Bioresorbable vascular scaffolds (BVS) have changed practice patterns in cardiology. These resorbable stents have not yet been utilized in the cerebrovascular circulation. We report the initial experiences with these devices in interventional neuroradiology. METHODS: A retrospective review of clinical presentations, imaging findings and follow-up results of all patients treated using a BVS by our neurovascular team was carried out using hospital electronic charts and the hospital radiographic archive system...
July 26, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28714525/dedicated-bifurcation-stents-or-regular-drug-eluting-stents-in-distal-left-main-stenosis-a-retrospective-study
#18
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Krzysztof Bednarski, Jerzy Górny, Jacek Bil
BACKGROUND: Mainly atherosclerosis develops in distal left main (LM) within bifurcation or trifurcation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland. METHODS: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28705057/applicability-and-procedural-success-rate-of-bioresorbable-vascular-scaffolds-for-percutaneous-coronary-intervention-in-an-all-comer-cohort-of-383-consecutive-patients
#19
Christian Schlundt, Stephan Achenbach, Fabiola Felten, Jens Roether, Mohamed Marwan, Holger Nef, Josef Ludwig, Monique Tröbs
Objectives The purpose of this study was to determine applicability and procedural success of bioresorbable vascular scaffolds (BVS) for percutaneous coronary intervention (PCI) in an all-comer cohort. Background BVS use in bifurcations and severely calcified lesions is not recommended, and a relatively large crossing profile may cause limitations. It is has never been studied how widely BVS can be applied in all-comer cohorts. Methods In 383 consecutive patients (acute coronary syndrome: 124, stable coronary disease 259), a BVS (Absorb) was used as first-line device unless any of the following contraindications were present: bifurcation with side branch >2...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28683937/demonstration-of-the-safety-and-feasibility-of-robotically-assisted-percutaneous-coronary-intervention-in%C3%A2-complex-coronary-lesions-results-of-the-cora-pci-study-complex-robotically-assisted%C3%A2-percutaneous-coronary-intervention
#20
Ehtisham Mahmud, Jesse Naghi, Lawrence Ang, Jonathan Harrison, Omid Behnamfar, Ali Pourdjabbar, Ryan Reeves, Mitul Patel
OBJECTIVES: The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). BACKGROUND: R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown...
July 10, 2017: JACC. Cardiovascular Interventions
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