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https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#1
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28427580/quality-of-life-after-surgery-or-des-in-patients-with-3-vessel-or-left-main-disease
#2
Mouin S Abdallah, Kaijun Wang, Elizabeth A Magnuson, Ruben L Osnabrugge, A Pieter Kappetein, Marie-Claude Morice, Friedrich A Mohr, Patrick W Serruys, David J Cohen
BACKGROUND: In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization. OBJECTIVES: This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#3
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#4
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28400029/meta-analysis-of-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-coronary%C3%A2-narrowing
#5
Partha Sardar, Jay Giri, Sammy Elmariah, Saurav Chatterjee, Dhaval Kolte, Amartya Kundu, Ramez Nairooz, Wilbert S Aronow, Theophilus Owan, Debabrata Mukherjee, Dmitriy N Feldman, J Dawn Abbott
Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES); however, the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI with DES compared with CABG for the treatment of ULMCA stenosis. Databases were searched through November 30, 2016. Randomized controlled trials (RCTs) comparing DES with PCI versus CABG for ULMCA stenosis were identified...
March 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28398396/-bioresorbable-vascular-scaffolds-clinical-experience-of-the-emilia-romagna-region-italy
#6
Alberto Menozzi, Gianluca Calogero Campo, Vincenzo Guiducci, Gianni Dall'Ara, Andrea Santarelli, Paolo Sbarzaglia, Marco Balducelli, Paolo Magnavacchi, Fabio Sgura, Luciano Losi, Luigi Vignali, Gianni Casella, Luigi Steffanon, Fabio Tarantino, Francesco Saia
BACKGROUND: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28396082/pregnancy-related-spontaneous-coronary-artery-dissection-a%C3%A2-case-series-and-literature-review
#7
Emily Rose, Maheedhar Gedela, Nathan Miller, Paul L Carpenter
BACKGROUND: Cardiac emergencies during pregnancy are rare but have significant associated morbidity and mortality when they do occur. The emergency physician must not only be aware of potentially life-threatening conditions in the pregnant woman, but also know the emergent management and treatment of these conditions to avoid worsening of the underlying condition. Pregnancy-related spontaneous coronary artery dissection has been described in the cardiology literature, but is not well-known in emergency medicine literature...
April 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28388767/treatment-of-coronary-artery-disease-randomized-trials-on-myocardial-revascularization-and-complete-arterial-bypass-grafting
#8
Ardawan J Rastan
Friedrich Wilhelm Mohr from the very beginning of his career as a cardiac surgeon was involved in the refinements of coronary artery bypass grafting (CABG). At the Leipzig Heart Center, his spirit of early adapting to new technologies inspired the entire team and led to a matchless scientific atmosphere to find solutions to improve almost all fields of cardiac surgery, including CABG. In combination with a tremendous number of patients with indications for isolated coronary artery bypass Prof. Mohr as the surgical principle investigator and the Leipzig Heart Center were able to include patients in the Synergy between PCI [percutaneous coronary intervention] with Taxus and Cardiac Surgery (SYNTAX) trial, the first randomized trials comparing CABG and PCIs using the drug-eluting stents...
April 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28379441/preventive-left-main-and-right-coronary-artery-stenting-to-avoid-coronary-ostia-occlusion-in-high-risk-stentless-valve-in-valve-transcatheter-aortic-valve-implantation
#9
Silvia Maggio, Alessia Gambaro, Roberto Scarsini, Flavio Ribichini
Transcatheter aortic valve implantation is becoming an attractive and promising alternative to redo surgery for aortic bioprosthetic valves degeneration, especially in high-risk patients. However, valve-in-valve transcatheter aortic valve implantation itself carries some procedural risks and potential challenges that interventionists must be aware of. An accurate preprocedural planning is fundamental for the prevention of potentially fatal complications. This case describes a novel strategy of simultaneous right and left coronary artery stenting preventing bilateral coronary obstruction in a patient with a stentless surgical aortic valve and extremely low origin of the 2 coronary arteries...
March 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28357625/a-case-of-double-stent-implantation-for-left-main-coronary-artery-occlusion-in-transcatheter-aortic-valve-implantation-using-sapien-xt-device
#10
Masaki Ito, Norio Tada, Tatsushi Ootomo, Naoto Inoue
Transcatheter aortic valve implantation is an established alternative and less invasive procedure to replace heart valves in symptomatic aortic stenosis patients; however, severe, life-threatening complications still exist. Coronary artery occlusion is a primary complication. We report a case of left main coronary artery occlusion after transcatheter aortic valve replacement, which was ameliorated using a double stent implantation technique.
March 29, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28353317/self-expanding-stentys-stent-in-daily-routine-use
#11
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
https://www.readbyqxmd.com/read/28344214/the-outcomes-of-intravascular-ultrasound-guided-drug-eluting-stent-implantation-among-patients-with-complex-coronary-lesions-a-comprehensive-meta-analysis-of-15-clinical-trials-and-8-084-patients
#12
Zhong Guo Fan, Xiao Fei Gao, Xiao Bo Li, Ming Xue Shao, Ya Li Gao, Shao Liang Chen, Nai Liang Tian
OBJECTIVE: The effects of intravascular ultrasound (IVUS)-guided drug-eluting stent (DES) implantation in patients with complex coronary artery lesions remains to be controversial. This study sought to evaluate the outcomes of IVUS guidance in these patients. METHODS: The EMBASE, Medline, and other internet sources were searched for relevant articles. The primary endpoint was major adverse cardiac events (MACE), including all-cause mortality, myocardial infarction (MI), and target-vessel revascularization (TVR)...
March 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28336185/self-expanding-metallic-stent-as-a-bridge-to-surgery-in-the-treatment-of-left-colon-cancer-obstruction-cost-benefit-analysis-and-oncologic-results
#13
Blas Flor-Lorente, Gloria Báguena, Matteo Frasson, Alvaro García-Granero, Andrés Cervantes, Vicente Sanchiz, Andres Peña, Alejandro Espí, Pedro Esclapez, Eduardo García-Granero
INTRODUCTION: The use of a self-expanding metallic stent as a bridge to surgery in acute malignant left colonic obstruction has been suggested as an alternative treatment to emergency surgery. The aim of the present study was to compare the morbi-mortality, cost-benefit and long-term oncological outcomes of both therapeutic options. METHODS: This is a prospective, comparative, controlled, non-randomized study (2005-2010) performed in a specialized unit. The study included 82 patients with left colon cancer obstruction treated by stent as a bridge to surgery (n=27) or emergency surgery (n=55) operated with local curative intention...
March 20, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28329291/coronary-artery-bypass-graft-surgery-versus-drug-eluting-stent-implantation-for-high-surgical-risk-patients-with-left-main-or-multivessel-coronary-artery-disease
#14
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: There are limited data comparing long-term outcomes of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in patients with high surgical risk. We evaluated 5-year outcomes following CABG versus PCI with DES in 598 patients with left main or multivessel coronary artery disease (CAD) and a high surgical risk [EuroSCORE (European system for cardiac operative risk evaluation) ≥ 6]. METHODS: Databases were merged from the BEST, PRECOMBAT and SYNTAX trials...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28324943/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#15
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28321023/hybrid-strategy-to-treat-life-threatening-giant-coronary-artery-aneurysm-with-severe-in-stent-restenosis
#16
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
Coronary artery aneurysm following drug-eluting stent implantation is rare in the literature. The presentation combined a life-threatening condition with severe in-stent restenosis. How to treat this condition is a complex problem because a surgical approach for a proximal left circumflex lesion is difficult. A hybrid method that is a combination of coronary bypass surgery and coronary stenting for left main bifurcation in-stent restenosis and proximal coronary artery aneurysm is a feasible strategy.
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28319567/treatment-of-biliary-stricture-after-live-donor-liver-transplantation-with-combined-metal-and-plastic-stent-%C3%A4-nsertion-a-feasibility-and-safety-study
#17
Erkan Parlak, Aydin Seref Koksal, Ahmet Tarik Eminler, Bilal Toka, Mustafa Ihsan Uslan
BACKGROUND: Fully covered-self expandable metal stents (Fc-SEMSs) have a challenging use in the treatment of anastomosis strictures (ASs) after live donor liver transplantation (LDLT) because they can occlude secondary branch biliary ducts when placed above the biliary bifurcation. In this study we evaluated the technical feasibility and safety of combining Fc-SEMSs with plastic stent(s) inserted to the secondary branch biliary ducts for the treatment of ASs after LDLT. METHODS: The study group included 22 patients (12 men, aged 51±11 years) with anastomotic biliary stricture after LDLT...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28314673/can-we-perform-rotational-atherectomy-in-patients-with-severe-aortic-stenosis-substudy-from-the-ocean-tavi-registry
#18
Toru Naganuma, Hiroyoshi Kawamoto, Kensuke Takagi, Hiroto Yabushita, Satoru Mitomo, Yusuke Watanabe, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Masanori Yamamoto, Hirokazu Onishi, Sunao Nakamura, Akihiro Higashimori, Minoru Tabata, Kazuki Mizutani, Hiroshi Ueno, Kentaro Hayashida
PURPOSE: The aim of this study was to report the safety of coronary rotational atherectomy (RA) in patients with severe aortic stenosis (AS). RA in the clinical setting seems challenging because coronary slow flow leads to hemodynamic instability. METHODS: Between October 2013 and May 2016, 1401 patients in the Optimized transCathEter vAlvular iNtervention (OCEAN) registry in Japan underwent transcatheter aortic valve implantation (TAVI). The primary study endpoint was procedural success, defined as residual stenosis <20% with final Thrombolysis in Myocardial Infarction flow 3...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#19
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28296170/percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#20
Ahmed N Mahmoud, Islam Y Elgendy, Amgad Mentias, Marwan Saad, Walid Ibrahim, Mohammad K Mojadidi, Ramez Nairooz, Parham Eshtehardi, R David Anderson, Habib Samady
BACKGROUND: Recent trials comparing PCI with CABG for unprotected left main disease yielded discrepant evidence. OBJECTIVES: To perform an updated meta-analysis of randomized trials comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery disease. METHODS: Randomized trials comparing PCI versus CABG for patients with unprotected left main coronary artery disease were included...
March 15, 2017: Catheterization and Cardiovascular Interventions
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