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Left main stent

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https://www.readbyqxmd.com/read/28621162/single-centre-experience-of-stentys-xposition-s-in-treatment-of-left-main-stem-lesions
#1
Nitin Kumar, Sri Raveen Kandan, Hazim Rahbi, Abdul Mozid, Thomas W Johnson, Julian W Strange, Andreas Baumbach
BACKGROUND: The second generation STENTYS Xposition S self-expanding stent with a novel balloon delivery system was launched in May 2015. The stents unique properties are well suited for the treatment of left main stem disease where large diameters, coverage of diameter differences and precise positioning are required. We report the first consecutive experience of using this device in the treatment of left main stem lesions. METHODS: 20 consecutive patients with a mean age of 73...
June 16, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28616647/outcomes-of-direct-stenting-in-patients-with-st-elevated-myocardial-infarction
#2
A Kalayci, V Oduncu, C Y Karabay, A Erkol, A C Tanalp, I H Tanboga, O Candan, C Gecmen, I A Izgi, C Kirma
BACKGROUND: We compared direct stenting (DS) with conventional stenting (CS) - i.e., stenting after predilation - during primary percutaneous coronary intervention (P-PCI) in terms of procedural results and long-term mortality in patients with ST-elevated myocardial infarction (STEMI). METHODS: We retrospectively analyzed 2306 patients (mean age 59 years, 22% female) who underwent P‑PCI within 12 h of symptom onset. Patients were then followed up prospectively for clinical events...
June 14, 2017: Herz
https://www.readbyqxmd.com/read/28607000/percutaneous-coronary-intervention-of-left-main-disease-pre-and-post-excel-evaluation-of-xience-everolimus-eluting-stent-versus-coronary-artery-bypass-surgery-for-effectiveness-of-left-main-revascularization-and-noble-nordic-baltic-british-left-main-revascularization
#3
Duk-Woo Park, Seung-Jung Park
For nearly half a century, coronary artery bypass grafting has been the standard treatment for patients with obstructive left main coronary artery (LMCA) disease. However, there has been considerable evolution in the field of percutaneous coronary intervention, and especially, percutaneous coronary intervention for LMCA disease has been rapidly expanded with adoption of drug-eluting stents. Some, but not all randomized trials, have shown that percutaneous coronary intervention with drug-eluting stents might be a suitable alternative for selected patients with LMCA disease instead of bypass surgery...
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28606023/over-expansion-of-drug-eluting-stents-in-patients-with-left-main-coronary-artery-disease-an-in%C3%A2-vivo-study
#4
Yicong Ye, Hao Qian, Ming Yang, Xueqing Zhu, Tianpeng Gan, Shuyang Zhang, Yong Zeng
Objective We aimed to determine the capacity of drug-eluting stent (DES) over-expansion in left main coronary artery disease. Methods Left main interventions with the largest available DES platforms (4.0 mm) and post-dilation performed with large non-compliant balloons (≥ 4.5 mm) were included. Maximal stent diameter (mm) and area (mm(2)) were measured using post-intervention intravascular ultrasound (IVUS). Stent diameter and area were calculated with the balloon diameter and inflation pressure. The diameter and area expansion indices were defined as follows: maximal/calculated stent diameter and maximal/calculated stent area, respectively...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28602923/successful-hybrid-neurovascular-surgery-for-a-ruptured-basilar-artery-dissecting-aneurysm-in-a-patient-with-jeopardized-collateral-circulation-associated-with-aortitis-syndrome-case-report
#5
Kazuaki Yamamoto, Takahisa Mori, Tsuyoshi Watanabe, Tomonori Iwata, Gakuji Gondo, Masahiko Tanaka, Satoshi Tanaka
BACKGROUND: Dissecting aneurysms of the basilar artery (BA) are rare lesions and the management of them has been controversial and challenging. The treatment becomes much more difficult when the patient has a disorder such as aortitis syndrome, which makes cerebral arteries occluded and tortuous. The authors describe a case of a ruptured BA dissecting aneurysm associated with aortitis syndrome, successfully treated with hybrid neurovascular surgery. CASE DESCRIPTION: A 64-year-old woman with a medical history of aortitis syndrome developed a severe headache and was diagnosed with a subarachnoid hemorrhage from a BA dissecting aneurysm...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28595861/comparison-of-outcome-of-coronary-artery-bypass-grafting-versus-drug-eluting-stent-implantation-for-non-st-elevation-acute-coronary-syndrome
#6
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Minkyu Han, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
There is limited data comparing effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). We compared the long-term outcomes of the 2 revascularization strategies in 1,246 patients presented with NSTE-ACS for left main or multivessel coronary artery disease. Data were pooled from the Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease (BEST) trial, the Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease (PRECOMBAT) trial, and the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28595696/left-main-coronary-artery-compression-in-patients-with-pulmonary-arterial-hypertension-and%C3%A2-angina
#7
Nazzareno Galiè, Francesco Saia, Massimiliano Palazzini, Alessandra Manes, Vincenzo Russo, Maria Letizia Bacchi Reggiani, Gianni Dall'Ara, Enrico Monti, Fabio Dardi, Alessandra Albini, Andrea Rinaldi, Enrico Gotti, Nevio Taglieri, Cinzia Marrozzini, Luigi Lovato, Maurizio Zompatori, Antonio Marzocchi
BACKGROUND: Left main coronary artery (LMCA) compression is increasingly recognized as a cause of angina in pulmonary arterial hypertension (PAH). OBJECTIVES: This study aimed to evaluate the prevalence of LMCA extrinsic compression from a dilated pulmonary artery (PA) in patients with PAH and angina or angina-like symptoms, determine the usefulness of screening with computed tomography coronary angiography (CTCA), and assess the safety and efficacy of percutaneous coronary interventions (PCIs)...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28588834/successful-bailout-stenting-strategy-against-lethal-coronary-dissection-involving-left-main-bifurcation
#8
Hiroshi Kubota, Tetsuya Nomura, Yusuke Hori, Kenichi Yoshioka, Daisuke Miyawaki, Ryota Urata, Takeshi Sugimoto, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
Catheter-induced coronary dissection involving left main bifurcation is a rare complication during cardiac catheterization but can become lethal unless it is treated appropriately. Interventional cardiologists always have to pay attention to the risk of complications related to cardiac catheterization and prepare for determining the best bailout strategy for the situation.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28571187/study-of-short-and-intermediate-term-clinical-outcomes-of-patients-with-protected-and-unprotected-lmca-stenting
#9
Pooja M Vyas, Jayesh S Prajapati, Sibasis S Sahoo, Iva Vipul Patel, Jagjeet K Deshmukh, Chirag Patel, Roopesh Singhal
INTRODUCTION: Significant unprotected Left Main Coronary Artery (LMCA) disease is detected in 5%-7% of cases undergoing Coronary Angiography (CAG). Present guidelines have revealed the significance of anatomical location in left main artery stenosis and syntax scores for determination of Major Adverse Cardiac Events (MACE). Debate still persists over the best treatment regarding outcomes of Coronary Artery Bypass Grafting (CABG) and LMCA stenting for patients with LMCA disease. AIM: Aim of the study was to evaluate short and intermediate term clinical outcomes of Percutaneous Coronary Intervention (PCI) in LMCA disease in respect to mortality, Cerebrovascular Accidents (CVA), reinfarction, stent restenosis and need for repeat target lesion revascularization...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567361/unexpected-evolution-of-a-non-stenotic-lesion-in-the-left-main-coronary-artery-of-a-patient-with-non-st-segment-elevation-myocardial-infarction
#10
Alexandru Florin Ispas, Lionel Mangin, Alexandru Paziuc, Loic Belle
A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28562382/impact-of-mean-platelet-aggregation-degree-on-long-term-clinical-outcomes-among-patients-undergoing-a-complex-percutaneous-coronary-intervention
#11
Quan Li, Mengmeng Li, Xianpeng Yu, Jiqiang He, Yuechun Gao, Xiaoling Zhang, Changyan Wu, Yawei Luo, Yuchen Zhang, Xuejun Ren
OBJECTIVE: The aim of this study was to evaluate the association between the mean platelet aggregation degree and long-term clinical outcomes in patients receiving a complex percutaneous coronary intervention (CPCI). PATIENTS AND METHODS: We screened 2141 patients after a percutaneous coronary intervention (PCI) treated with aspirin and clopidogrel. CPCI was defined as a procedure targeted to at least one of the following: left main disease, bifurcation lesion, ostial lesion, chronic total occlusion, and small-vessel stenting...
May 30, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28554669/patterns-and-associations-between-dapt-cessation-and-2-year-clinical-outcomes-in-left-main-proximal-lad-versus-other-pci-results-from-the-patterns-of-non-adherence-to-dual-antiplatelet-therapy-in-stented-patients-paris-registry
#12
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Matthew Tomey, Mitchell Kruckoff, David Moliterno, Timothy D Henry, Giora Weisz, C Michael Gibson, Ioannis Iakovou, Annapoorna Kini, Michela Faggioni, Birgit Vogel, Serdar Farhan, Antonio Colombo, P Gabriel Steg, Bernhard Witzenbichler, Alaide Chieffo, David Cohen, Thomas Stuckey, Cono Ariti, Stuart Pocock, George Dangas, Roxana Mehran
OBJECTIVES: Percutaneous coronary intervention (PCI) of the left main (LM) or proximal left anterior descending artery (pLAD) is considered high-risk as these segments subtend substantial left ventricular myocardial area. We assessed the patterns and associations between dual antiplatelet therapy (DAPT) cessation and 2-year outcomes in LM/pLAD vs. other PCI from the all-comer PARIS registry. METHODS: Two-year major adverse cardiovascular events (MACE) were a composite of cardiac death, myocardial infarction, definite/probable stent thrombosis or target lesion revascularization...
May 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28553569/a-case-of-awake-percutaneous-extracorporeal-membrane-oxygenation-for-high-risk-percutaneous-coronary-intervention
#13
Shuangbo Liu, Amir Ravandi, Malek Kass, Basem Elbarouni
With significant improvements in percutaneous coronary intervention (PCI) technology, complex high risk PCI is increasingly offered to patients with limited revascularization options. Percutaneous mechanical circulatory support devices are often utilized for hemodynamic support during these complex procedures. Veno-arterial extracorporeal membrane oxygenation (ECMO) allows full hemodynamic support and provides systemic oxygenation. We describe a case of left main bifurcation stenting performed at our center with ECMO support in an awake patient without general anesthesia...
April 25, 2017: Curēus
https://www.readbyqxmd.com/read/28539596/intravascular-ultrasound-guidance-improves-the-long-term-prognosis-in-patients-with-unprotected-left-main-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#14
Jian Tian, Changdong Guan, Wenyao Wang, Kuo Zhang, Jue Chen, Yongjian Wu, Hongbing Yan, Yanyan Zhao, Shubin Qiao, Yuejin Yang, Gary S Mintz, Bo Xu, Yida Tang
This study compared the long term outcomes in patients with unprotected left main coronary artery (LMCA) disease who underwent stenting under the guidance of intravascular ultrasound (IVUS) or conventional angiography at a large single center. The primary outcome was the composite of all-cause death and myocardial infarction (MI) at 3 years. Target vessel revascularization (TVR) at 3 years was one of the secondary outcomes. Between January 2004 and December 2011, a total of 1,899 patients who underwent IVUS-guided (n = 713, 37...
May 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28539567/syntax-score-ii-predicts-long-term-mortality-in-patients-who-underwent-left-main-percutaneous-coronary-intervention-treated-with-second-generation-drug-eluting-stents
#15
Jiqiang He, Hua Zhao, Xianpeng Yu, Quan Li, Shuzheng Lv, Fang Chen, Tengyong Jiang
The aim of this study was to evaluate the capacity of the SYNTAX Score-II (SS-II) to predict long-term mortality in patients undergoing left main percutaneous coronary intervention (LM-PCI) treated with second-generation drug-eluting stents (DES).Data from 487 consecutive patients with de novo left main coronary artery disease undergoing PCI were retrospectively studied. The patients were divided into tertiles according to the SS-II: low SS-II tertile (SS-II ≤ 22), intermediate SS-II tertile (SS-II of 23 to 30), and high SS-II tertile (SS-II ≥ 30)...
May 31, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28538020/incidence-and-risk-factors-of-hypoxemia-during-interventional-rigid-bronchoscopy-under-spontaneous-assisted-ventilation
#16
Saowapark Chumpathong, Jamsak Tscheikuna, Thanatporn Boonsombat, Saipin Muangman, Choopong Luansritisakul
BACKGROUND: Interventional rigid bronchoscopy for tracheobronchial stenosis can be performed under total intravenous anesthesia and spontaneous-assisted ventilation. Intraoperative hypoxemia can occur during this procedure, but the incidence and risk factors have not yet been determined. MATERIALS AND METHODS: Medical records of patients who underwent rigid bronchoscopy for the treatment of tracheobronchial stenosis under total intravenous anesthesia and spontaneous-assisted ventilation during the study period from January 2011 to December 2012 were retrospectively reviewed...
May 19, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#17
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28532780/meta-analysis-comparing-coronary-artery-bypass-grafting-to-drug-eluting-stents-and-to-medical-therapy-alone-for-left-main-coronary-artery-disease
#18
Rahman Shah, Mohamed S Morsy, Darryl S Weiman, George W Vetrovec
Historically, coronary artery bypass graft (CABG) surgery has been the standard revascularization method for unprotected left main coronary artery (LMCA) disease. Over the last decade, several randomized controlled trials (RCTs) have shown favorable results for percutaneous coronary intervention (PCI) with drug-eluting stent (DES) compared with CABG; however, no RCT has been conducted directly comparing DESs with medical therapy alone (MTA). Furthermore, the 2 most recently reported larger RCTs, using new-generation DESs reached somewhat conflicting conclusions comparing the 2 revascularization strategies...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#19
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28515826/successful-restoration-of-complete-heart-block-to-normal-sinus-rhythm-by-primary-angioplasty-of-dual-left-anterior-descending-artery
#20
Santosh Kumar Sinha, Vikas Mishra, Mukesh Jitendra Jha, Mahmadula Razi, Nasar Abdali, Anupam Mahrotra, Mohammad Asif, Lokendra Rekwal, Vikas Chaturvedi, Shravan Singh, Vinay Krishna
Dual left anterior descending (LAD) artery is a rare coronary anomaly. We present a patient with a rare case of dual LAD, smaller one arising from the left main coronary stem and larger one from right coronary artery who presented with acute anterior wall myocardial infarction with complete heart block (CHB). Temporary pacemaker was implanted and coronary angiogram revealed critical occlusion of proximal LAD which was subsequently revascularized by primary angioplasty using drug-eluting stent (Xience prime, 2...
April 2017: Cardiology Research
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