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https://www.readbyqxmd.com/read/29786539/percutaneous-coronary-intervention-in-left-main-coronary-artery-disease-the-13th-consensus-document-from-the-european-bifurcation-club
#1
Francesco Burzotta, Jens Flensted Lassen, Adrian P Banning, Thierry Lefèvre, David Hildick-Smith, Alaide Chieffo, Olivier Darremont, Manuel Pan, Yiannis S Chatzizisis, Remo Albiero, Yves Louvard, Goran Stankovic
The 2017 European Bifurcation Club (EBC) meeting was held in Porto (Portugal) and allowed a multidisciplinary international faculty to review and discuss the latest data collected in the field of coronary bifurcation interventions. In particular, the topic of percutaneous coronary intervention (PCI) on left main coronary artery (LM) disease was highlighted as a contemporary priority. Herein, we summarise the key LM anatomy features, the diagnostic modalities and available data that are relevant for a patient's procedural management...
May 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29780431/mathematical-modelling-of-bacterial-meningitis-transmission-dynamics-with-control-measures
#2
Joshua Kiddy K Asamoah, Farai Nyabadza, Baba Seidu, Mehar Chand, Hemen Dutta
Vaccination and treatment are the most effective ways of controlling the transmission of most infectious diseases. While vaccination helps susceptible individuals to build either a long-term immunity or short-term immunity, treatment reduces the number of disease-induced deaths and the number of infectious individuals in a community/nation. In this paper, a nonlinear deterministic model with time-dependent controls has been proposed to describe the dynamics of bacterial meningitis in a population. The model is shown to exhibit a unique globally asymptotically stable disease-free equilibrium ℰ 0 , when the effective reproduction number ℛ VT ≤ 1, and a globally asymptotically stable endemic equilibrium ℰ 1 , when ℛ VT > 1; and it exhibits a transcritical bifurcation at ℛ VT = 1...
2018: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/29779971/bifurcation-and-ostial-optical-coherence-tomography-mapping-boom-case-description-of-a-novel-bifurcation-stent-technique
#3
Evan Shlofmitz, Fernando Sosa, Alec Goldberg, Akiko Maehara, Ziad A Ali, Gary S Mintz, Jeffery W Moses, Gregg W Stone, Richard A Shlofmitz, Allen Jeremias
Stent placement guided by angiography alone is often inexact, but of increased importance with bifurcation percutaneous coronary intervention (PCI). We describe a novel technique using optical coherence tomography (OCT)-guided angiographic co-registration termed "Bifurcation and Ostial OCT Mapping" (BOOM). The technique is based on the precise identification and mapping of the side-branch ostium using co-registration to minimize protrusion of stent struts into the main branch while ensuring full coverage of the ostium in the side-branch...
May 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29777394/biomechanical-impact-of-wrong-positioning-of-a-dedicated-stent-for-coronary-bifurcations-a-virtual-bench-testing-study
#4
Claudio Chiastra, Maik J Grundeken, Carlos Collet, Wei Wu, Joanna J Wykrzykowska, Giancarlo Pennati, Gabriele Dubini, Francesco Migliavacca
The treatment of coronary bifurcations is challenging for interventional cardiologists. The Tryton stent (Tryton Medical, Inc., USA) is one of the few devices specifically designed for coronary bifurcations that underwent large clinical trials. Although the manufacturer provides specific recommendations to position the stent in the bifurcation side branch (SB) according to four radio-opaque markers under angiographic guidance, wrong device positioning may accidentally occur. In this study, the virtual bench testing approach was used to investigate the impact of wrong positioning of the Tryton stent in coronary bifurcations in terms of geometrical and biomechanical criteria...
May 17, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29764544/-effects-of-peroxisome-proliferator-activated-receptor-%C3%AE-toll-like-receptor-4-tumor-necrosis-factor-%C3%AE-targeted-pathway-on-hyperglycemia-induced-myocardium-inflammation-and-oxidative-stress
#5
Changle Liu, Ruimeng Liu, Xiaohan Wu, Peize Tan, Huaying Fu, Xinghua Wang, Tong Liu, Guangping Li
OBJECTIVE: To investigate the potential effects and mechanism on peroxisome proliferator-activated receptor γ-toll-like receptor 4-tumor necrosis factor-α (PPARγ-TLR4-TNF-α) targeted pathway on hyperglycemia induced myocardium inflammation and oxidative stress. METHODS: Thirty-two Japanese healthy adult rabbits were randomly divided into four groups with 8 rabbits in each group: normal control group (NC group), diabetes mellitus group (DM group), diabetes mellitus + pioglitazone 4 mg×kg-1 ×d-1 and 8 mg×kg-1 ×d-1 groups (DM+PGZ 4 mg and 8 mg groups)...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#6
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29735349/true-double-bifurcation-lesions-new-application-of-the-self-expandable-axxess-stent-and-review-of-literature-with-dedicated-bifurcation-devices
#7
REVIEW
Francesco Borgia, Tullio Niglio, Nicola De Luca, Luigi Di Serafino, Giovanni Esposito, Bruno Trimarco, Plinio Cirillo
Complex coronary artery bifurcation lesions occurred in hard clinical scenarios, such as acute coronary syndromes, may represent a challenge for interventional cardiologists, with not-defined general consensus on treatment. Even if provisional stenting is the most common option used to restore rapidly the coronary branches flow, improvements in industrial technologies and design of new dedicated bifurcation devices might open new modalities of treatment in these complex cases. The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding biolimus-eluting conical V-shape stent, specifically designed to treat "easily" coronary artery bifurcation lesions, with reported favorable long-term clinical results in stable patients compared to a provisional technique...
April 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#8
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716707/balloon-embedded-stenting-a-novel-technique-for-percutaneous-coronary-intervention-of-bifurcation-lesions-experience-in-indian-population
#9
Desabandhu Vinayakumar, Bijilesh Uppalakal, Kailash Kumar Goyal, Anishkumar Nair
BACKGROUND: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events. In this study, we describe a novel balloon embedded stenting technique which can be incorporated with traditional culotte or TAP technique and facilitates conversion to bail out crush in case of such an event...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29691597/preoperative-digital-subtraction-angiography-in-incidental-unruptured-intracranial-aneurysms-how-much-is-too-much
#10
Moriz Herzberg, Robert Forbrig, Christian Schichor, Hartmut Brückmann, Franziska Dorn
PURPOSE: Digital subtraction angiography (DSA) is deemed necessary to precisely visualize intracranial aneurysms and define individual treatment strategies. In patients with unruptured intracranial aneurysms (UIA) who were diagnosed by MRI, a four-vessel DSA is usually performed to detect additional aneurysms. This study aimed to evaluate whether the evaluation of all vessels beyond the aneurysm-harboring artery is really necessary. MATERIAL AND METHODS: Patients with an UIA that was detected on MRA (TOF/ceMRA) were prospectively included...
April 24, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29682422/comparison-of-clinical-outcomes-after-drug-eluting-balloon-and-drug-eluting-stent-use-for-in-stent-restenosis-related-acute-myocardial-infarction-a-retrospective-study
#11
Chih-Yuan Fang, Hsiu-Yu Fang, Chien-Jen Chen, Cheng-Hsu Yang, Chiung-Jen Wu, Wei-Chieh Lee
Background: Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study's aim was to evaluate the efficacy of DEB for AMI with ISR. Methods: Between November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI)...
2018: PeerJ
https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#12
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
https://www.readbyqxmd.com/read/29656938/vitamin-d-deficiency-and-periprocedural-myocardial-infarction-in-patients-undergoing-percutaneous-coronary-interventions
#13
Monica Verdoia, Claudia Ceccon, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
Vitamin D deficiency has been implicated in the progression of atherosclerosis and acute thrombotic events. We aimed at evaluating the impact of vitamin D deficiency on periprocedural myocardial infarction (PMI) in patients undergoing percutaneous coronary interventions (PCI). We included 934 patients undergoing non-urgent PCI. Assessment of myocardial biomarkers was performed from 6 to 48 h after PCI. PMI was defined as Creatine Kinase-MB increase by 3 times the Upper Limit Normal or by 50% of an elevated baseline value, periprocedural myocardial damage as Troponin I increase by 3 × ULN or 50% of baseline...
March 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#14
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29622356/risk-and-outcome-profile-of-carotid-endarterectomy-with-proximal-intervention-is-concerning-in-multi-institutional-assessment
#15
W Darrin Clouse, Emel A Ergul, Zachary J Wanken, Julia Kleene, David H Stone, R Clement Darling, Richard P Cambria, Mark F Conrad
OBJECTIVE: Approaching tandem bifurcation and brachiocephalic disease using carotid endarterectomy (CEA) with ipsilateral proximal endovascular intervention (IPE) has been promulgated as safe and durable. There have been recent concerns about neurologic risk with this technique. The goal of this study was to define stroke and perioperative risk with this uncommon procedure across multiple centers. METHODS: Between August 2002 and July 2016, patients who underwent CEA + IPE were identified by operative records at three institutions...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29616524/systematic-review-of-type-iiib-endoleak-after-elective-endovascular-aneurysm-repair
#16
Christopher Lowe, Vivak Hansrani, Manmohan Madan, George A Antoniou
INTRODUCTION: To investigate the presentation, aetiology, management and outcomes of type IIIb endoleak after endovascular aneurysm repair (EVAR). EVIDENCE ACQUISITION: Electronic bibliographic databases were searched to identify published reports of type IIIb endoleak after EVAR, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. EVIDENCE SYNTHESIS: In total 33 articles were identified reporting on a total of 50 patients spanning 19 years of EVAR (1998-2017)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29606297/ultra-rapid-progression-of-coronary-artery-disease-or-undiagnosed-unstable-plaque-a-brief-review-from-a-case-report
#17
REVIEW
Fernando Montenegro Sá, Catarina Ruivo, Luís Graça Santos, Alexandre Antunes, Francisco Campos Soares, José Baptista, João Morais
Coronary artery disease rarely manifests itself in the first decades of life, which explains why this population is underrepresented in clinical studies. The mechanisms and natural history of the disease seem to differ between this population and older patients. Recent studies suggest a more rapid disease progression in youth, presenting more unstable atherosclerotic plaques, although this correlation has yet to be proven. In this paper, we present the case of a 41-year-old man who presented with a non-ST elevation myocardial infarction, with percutaneous coronary intervention of the culprit lesion (70-90% lesion at bifurcation of the circumflex artery with the first marginal obtuse artery and a sub-occlusive lesion of the ramus intermedius)...
March 29, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29601146/quantification-of-near-wall-hemodynamic-risk-factors-in-large-scale-cerebral-arterial-trees
#18
Mahsa Ghaffari, Ali Alaraj, Xinjian Du, Xiaohong Joe Zhou, Fady T Charbel, Andreas A Linninger
In the last decade, detailed hemodynamic analysis of blood flow in pathological segments close to aneurysm and stenosis has provided physicians with invaluable information about the local flow patterns leading to vascular disease. However, these diseases have both local and global effects on the circulation of the blood within the cerebral tree. The aim of this paper is to demonstrate the importance of extending subject-specific hemodynamic simulations to the large-scale cerebral arterial tree with hundreds of bifurcations and vessels, as well as evaluate hemodynamic risk factors and waveform shape characteristics throughout the cerebral arterial trees...
March 30, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29588738/the-proximal-optimisation-technique-for-intervention-of-coronary-bifurcations
#19
Angela Hoye
The proximal optimisation technique (POT) has been proposed as a strategy to improve the results of stent scaffolding of bifurcation lesions. It is a straightforward technique whereby a short, appropriately-sized balloon is inflated in the main vessel just proximal to the carina. The technique has several advantages: it reduces the risk of side branch compromise related to shifting of the carina, it improves stent apposition in the proximal main vessel, and it facilitates side branch access after main vessel stent implantation...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29576596/effect-of-side-branch-predilation-in-coronary-bifurcation-stenting-with-the-provisional-approach-results-from-the-cobis-coronary-bifurcation-stenting-ii-registry
#20
Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C Carriere, Myung-Ho Jeong, Hyo-Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon-Cheol Gwon
BACKGROUND: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach.Methods and Results:A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
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