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Bifurcation intervention

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https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#1
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/28210239/flow-diversion-for-the-treatment-of-mca-bifurcation-aneurysms-a-single-centre-experience
#2
Pervinder Bhogal, Muhammad AlMatter, Hansjörg Bäzner, Oliver Ganslandt, Hans Henkes, Marta Aguilar Pérez
BACKGROUND: Intracranial aneurysms located at the bifurcation of the middle cerebral artery (MCA) can often be challenging for the neurointerventionalist. We aimed to evaluate the efficacy and safety of flow diverting stents (FDS) in the treatment of these aneurysms. MATERIALS AND METHODS: We retrospectively reviewed our prospectively maintained database to collect information for all patients with unruptured saccular bifurcation MCA aneurysms treated with FDS between January 2010 and January 2016...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28209184/arterial-access-site-complications-after-use-of-a-vascular-closure-device-related-to-puncture-height
#3
Benjamin Sartorius, Michael Behnes, Melike Ünsal, Ursula Hoffmann, Siegfried Lang, Kambis Mashayekhi, Martin Borggrefe, Ibrahim Akin
BACKGROUND: To analyze differences of access-site complications related to the height of femoral arterial puncture and the use of a vascular closure device (VCD) following percutaneous coronary intervention (PCI). METHODS: A subgroup of the FERARI study being treated by femoral arterial access and valuable inguinal angiography before implantation of a VCD were included. Inguinal angiographies were systematically reviewed by two independent cardiologists to determine the correct height of femoral arterial puncture...
February 16, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28191726/risk-stratification-of-periprocedural-myocardial-infarction-after-percutaneous-coronary-intervention-analysis-based-on-the-scai-definition
#4
Dong Zhang, Yiping Li, Dong Yin, Yuan He, Changzhe Chen, Chenxi Song, Ruohua Yan, Chen'gang Zhu, Bo Xu, Kefei Dou
OBJECTIVES: To investigate the predictors of and generate a risk prediction method for periprocedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI) using the new PMI definition proposed by the Society for Cardiovascular Angiography and Interventions (SCAI). BACKGROUND: The SCAI-defined PMI was found to be associated with worse prognosis than the PMI diagnosed by other definitions. However, few large-sample studies have attempted to predict the risk of SCAI-defined PMI...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28190716/five-year-outcomes-of-the-pythagoras-u-s-clinical-trial-of-the-aorfix-endograft-for-endovascular-aneurysm-repair-in-patients-with-highly-angulated-aortic-necks
#5
Mahmoud B Malas, Caitlin W Hicks, William D Jordan, Kim J Hodgson, Joseph L Mills, Michel S Makaroun, Michael Belkin, Mark F Fillinger
OBJECTIVE: Early and midterm outcomes of the Prospective Aneurysm Trial: High Angle Aorfix Bifurcated Stent Graft (PYTHAGORAS) trial in patients with highly angulated aortic necks (≥60 degrees) have already been published and shown comparable outcomes to other endografts in normal anatomy. Herein, we present the long-term outcomes of the PYTHAGORAS trial of Aorfix (Lombard Medical, Irvine, Calif) for patients with highly angulated aortic neck anatomy. METHODS: The Aorfix endograft is a highly conformable nitinol/polyester device designed for transrenal fixation...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28169091/predictors-of-excess-patient-radiation-exposure-during-chronic-total-occlusion-coronary-intervention-insights-from-a-contemporary-multicentre-registry
#6
Georgios E Christakopoulos, Georgios Christopoulos, Dimitri Karmpaliotis, Khaldoon Alaswad, Robert W Yeh, Farouc A Jaffer, Michael R Wyman, William L Lombardi, Muhammad Nauman J Tarar, J Aaron Grantham, David E Kandzari, Nicholas Lembo, Jeffrey W Moses, Ajay J Kirtane, Manish Parikh, Philip Green, Matthew Finn, Santiago Garcia, Anthony H Doing, Raja Hatem, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: High patient radiation dose during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) might lead to procedural failure and radiation skin injury. METHODS: We examined the association between several clinical and angiographic variables on patient air kerma (AK) radiation dose among 748 consecutive CTO PCIs performed at 9 experienced US centres between May 2012 and May 2015. RESULTS: The mean age was 65 ± 10 years, 87% of patients were men, and 35% had previous coronary artery bypass graft surgery (CABG)...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28163519/telescoping-dual-covered-stent-graft-construct-for-endovascular-treatment-of-a-giant-extracranial-carotid-artery-pseudoaneurysm
#7
Dale Ding, Robert M Starke, Maurice Moriarty, Stefan Brew
Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA) pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA) bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA)...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28146144/percutaneous-coronary-intervention-for-ostial-and-bifurcation-lesions-using-the-szabo-technique-a-single-centre-experience
#8
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
#9
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
#10
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/28121936/fatal-remote-cerebellar-hemorrhage-after-supratentorial-unruptured-aneurysm-surgery-in-patient-with-previous-cerebellar-infarction-a-case-report
#11
Eun-Jeong Koh, Jung-Soo Park
RATIONALE: Remote cerebellar hemorrhage (RCH) is a rare complication of supratentorial and spinal surgeries, seldom requiring intervention but occasionally causing significant morbidity or even mortality. Although a number of theories have been proposed, the exact pathophysiology of RCH remains incompletely understood. PATIENT CONCERNS: We present a 62-year-old patient with RCH encountered following surgical clipping of an unruptured middle cerebral artery bifurcation aneurysm in a patient with previous cerebellar infarction...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28119044/a-novel-side-branch-protection-technique-in-coronary-stent-implantation-jailed-corsair-technique
#12
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
#13
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
#14
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/28109497/management-of-carotid-body-tumor-in-pediatric-patients-a-case-report-and-review-of-the-literature
#15
Apanisile Ifeoluwa, István Lázár, Éva Szövördi, Tamás Karosi
Carotid body tumors (CBTs) are rare types of extra-adrenal paragangliomas, which originate from the neuroendocrine cells of the adventitial layer of carotid bifurcation. An 8-year-old girl was admitted to our department with left-sided and pulsating neck swelling, which progressively grew over several months. The patient had no family history of CBTs. Computed tomography (CT) and CT angiography (CTA) scans revealed a contrast material enhancing, hypervascularized mass involving the left carotid bifurcation, internal carotid artery (ICA), and external carotid artery (ECA), respectively...
February 2017: International Journal of Pediatric Otorhinolaryngology
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
#16
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/28105600/approach-to-cto-intervention-overview-of-techniques
#17
REVIEW
Aris Karatasakis, Barbara Anna Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Minh Vo, Mauro Carlino, Mitul P Patel, Stéphane Rinfret, Emmanouil S Brilakis
Successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has been associated with significant clinical benefits, but remains technically demanding. Failure to cross the CTO with a guidewire is the most common cause of CTO PCI failure. CTO crossing can be achieved in the antegrade or retrograde direction and can be accomplished by maintaining true lumen position throughout or via subintimal dissection/reentry techniques. A procedural plan should be created prior to the procedure through careful angiographic review of four key parameters: (a) morphology of the proximal occlusion cap; (b) length of the occlusion; (c) quality of the distal vessel and presence of bifurcation at the distal cap; and (d) suitability of collateral circulation for retrograde crossing...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28100350/-clinical-applications-and-research-advances-of-optical-coherence-tomography-in-guiding-percutaneous-coronary-intervention-for-bifurcation-lesions
#18
J Z Cai, C Y Man, Y X Zhu
No abstract text is available yet for this article.
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
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
#19
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/28099289/orthogonal-views-of-coronary-vessels-a-method-for-imaging-the-delivery-of-blood-cardioplegia-using-transesophageal-echocardiography
#20
Luiz F Maracaja Neto, Raj Modak, Robert B Schonberger
Coronary blood flow can be disrupted during cardiac interventions such as mitral valve surgeries, left atrial appendage ligation, transcatheter aortic valve implantation, and aortic procedures involving reimplantation of coronary buttons. Although difficult to accomplish, coronary imaging using transesophageal echocardiography can be performed by the use of orthogonal imaging with the ability for real-time tilt for angle adjustment. The technique described herein allows imaging of the right coronary artery, left main coronary artery bifurcation, left anterior descending, and circumflex coronary arteries...
January 17, 2017: Anesthesia and Analgesia
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