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Bypass vs Angioplasty

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https://www.readbyqxmd.com/read/28315286/coronary-endarterectomy-or-patch-angioplasty-for-diffuse-left-anterior-descending-artery-disease
#1
Ohad Bitan, Paul A Pirundini, Eyal Leshem, Carrie Consalvi, Siobhan McGurk, Quincy King, Dan Loberman
Background Coronary endarterectomy and patch angioplasty for the left anterior descending (LAD) artery have been shown to be effective adjunct techniques to surgical revascularization for severe coronary lesions. The objective of this study is to review the short- and long-term results of these two methods in our institution. Methods We retrospectively reviewed 166 consecutive patients who underwent internal thoracic artery grafting to the LAD, with either adjunct endarterectomy (95 patients) or patch angioplasty (71 patients) between 2002 and 2014...
March 17, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28314486/insulin-provision-therapy-and-mortality-in-older-adults-with-diabetes-mellitus-and-stable-ischemic-heart-disease-insights-from-bari-2d-trial
#2
Abdulla A Damluji, Erin R Cohen, Mauro Moscucci, Robert J Myerburg, Mauricio G Cohen, Maria M Brooks, Michael W Rich, Daniel E Forman
IMPORTANCE: Optimal strategies for glucose control in very old adults with diabetes and stable ischemic heart disease (SIHD) are unclear. OBJECTIVE: To compare the effects of insulin provision (IP) therapy versus insulin sensitizing (IS) therapy for glycemic control in older (≥75years) and younger (<75years) adults with type II diabetes (DM) and SIHD. DESIGN, SETTING, AND PARTICIPANTS: Adults enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) were studied...
March 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#3
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28274753/results-for-primary-bypass-versus-primary-angioplasty-stent-for-lower-extremity-chronic-limb-threatening-ischemia
#4
Jeremy D Darling, John C McCallum, Peter A Soden, Lindsey Korepta, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
BACKGROUND: Long-term results comparing percutaneous transluminal angioplasty with or without stenting (PTA/S) and open surgical bypass for chronic limb-threatening ischemia (CLTI) in patients who have had no prior intervention are lacking. METHODS: All patients undergoing a first-time lower extremity revascularization for CLTI by vascular surgeons at our institution from 2005 to 2014 were retrospectively reviewed. Outcomes included perioperative complications, wound healing, restenosis, primary patency, reintervention, major amputation, RAS events (ie, reintervention, major amputation, or stenosis), and mortality...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#5
MULTICENTER STUDY
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#6
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28126156/syntax-score-and-long-term%C3%A2-outcomes-the-bari-2d-trial
#7
Fumiaki Ikeno, Maria Mori Brooks, Kaori Nakagawa, Min-Kyu Kim, Hideaki Kaneda, Yoshiaki Mitsutake, Helen A Vlachos, Leonard Schwartz, Robert L Frye, Sheryl F Kelsey, Katsuhisa Waseda, Mark A Hlatky
BACKGROUND: The extent of coronary disease affects clinical outcomes and may predict the effectiveness of coronary revascularization with either coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score quantifies the extent of coronary disease. OBJECTIVES: This study sought to determine whether SYNTAX scores predicted outcomes and the effectiveness of coronary revascularization compared with medical therapy in the BARI-2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial...
January 31, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28007199/coronary-artery-bypass-surgery-versus%C3%A2-drug-eluting-stent-implantation-for%C3%A2-left%C3%A2-main-or-multivessel-coronary-artery%C3%A2-disease-a-meta-analysis-of-individual-patient-data
#8
Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Pannipa Suwannasom, Erhan Tenekecioglu, Sung-Cheol Yun, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The authors undertook a patient-level meta-analysis to compare long-term outcomes after coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents (DES) in 3,280 patients with left main or multivessel coronary artery disease (CAD). BACKGROUND: The relative efficacy and safety of CABG versus PCI with DES for left main or multivessel CAD remain controversial. METHODS: Data were pooled from the BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery vs...
December 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27810235/impact-of-coronary-collaterals-on-long-term-prognosis-in-patients-treated-with-primary-angioplasty
#9
Francisco José Hernández-Pérez, Josebe Goirigolzarri-Artaza, María Alejandra Restrepo-Córdoba, Arturo García-Touchard, Juan Francisco Oteo-Domínguez, Lorenzo Silva-Melchor, José Antonio Fernández-Díaz, José Ramón Domínguez-Puente, Luis Alonso-Pulpón, Javier Goicolea-Ruigómez
INTRODUCTION AND OBJECTIVES: The beneficial effect of coronary collateral circulation (CC) in patients with ST-segment elevation myocardial infarction is controversial. The aim of this study was to evaluate the impact of CC before reperfusion with primary angioplasty (PA) on the long-term prognosis of these patients. METHODS: Retrospective observational study of a cohort of 947 patients treated with PA and TIMI grade ≤ 1 flow in a single center from 2005 to 2013...
October 31, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27621858/a-comparison-of-balloon-angioplasty-of-native-coarctation-versus-surgical-repair-for-short-segment-coarctation-associated-with-ventricular-septal-defect-a-single-center-retrospective-review-of-92-cases
#10
Huifeng Zhang, Ming Ye, Gang Chen, Fang Liu, Lin Wu, Bing Jia
BACKGROUND: The hybrid technique combining balloon angioplasty for discrete coarctation (CoA) and surgical repair of a ventricular septal defect (VSD) is a novel treatment for patients with aortic CoA and VSD, but the efficacy of this approach is unknown. METHODS: We performed a retrospective analysis of 92 patients with short segment CoA and VSD who underwent complete repair between January 2004 and July 2014 in our center. Patients were divided into two groups according to the surgical approach employed: hybrid procedure (group A, n=39) and traditional midline surgical repair (group B, n=53)...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27590533/clinical-results-of-single-vessel-versus-multiple-vessel-infrapopliteal-intervention
#11
Jeremy D Darling, John C McCallum, Peter A Soden, John J Hon, Raul J Guzman, Mark C Wyers, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The effects of concomitant endovascular interventions on multiple infrapopliteal vessels are not well known, and the short-term and long-term sequelae of such procedures have not been reported. METHODS: From 2004 to 2014, 673 limbs in 528 patients underwent an infrapopliteal endovascular intervention for tissue loss (77%), rest pain (13%), stenosis of a previously treated vessel (5%), acute limb ischemia (3%), or claudication (2%). Outcomes included wound healing, RAS events (reintervention, major amputation, or stenosis [>3...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27565589/resolution-of-ischemic-symptoms-after-percutaneous-angioplasty-for-a-symptomatic-subclavian-artery-stenosis
#12
Leszek Wrotniak, Anna Kabłak-Ziembicka, Agnieszka Rosławiecka, Piotr Musiałek, Paweł Bogacki, Mariusz Trystuła, Krzysztof Żmudka, Tadeusz Przewłocki
OBJECTIVE: A minor part of patients with subclavian or innominate artery occlusive disease (subclavian artery stenosis [SAS]) experience symptoms of vertebrobasilar insufficiency, upper extremity exertional ischemia (UEEI), or cardiac ischemia owing to subclavian-coronary steal (SCS) in some instances. The study aimed to assess the impact of percutaneous transluminal angioplasty (PTA) of symptomatic SAS on symptom resolution and to determine factors related with SAS recurrence. METHODS: Symptom resolution and incidence of restenosis (RS) were evaluated for up to 15 years in patients who had undergone successful PTA of SAS...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27491605/individual-long-term-mortality-prediction%C3%A2-following-either-coronary-stenting-or%C3%A2-bypass-surgery-in-patients%C3%A2-with-multivessel-and-or-unprotected-left-main%C3%A2-disease-an-external-validation-of-the-syntax-score-ii-model-in-the-1-480-patients-of-the-best-and-precombat
#13
Yohei Sotomi, Rafael Cavalcante, David van Klaveren, Jung-Min Ahn, Cheol Whan Lee, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
OBJECTIVES: The study sought to validate the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II mortality prediction model after percutaneous coronary intervention (PCI) or coronary artery bypass grafting in a large pooled population of patients with multivessel coronary disease (MVD) and/or unprotected left main disease (UPLMD) enrolled in the PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease) and BEST (Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) randomized controlled trials...
August 8, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27487304/implications-of-intraoperative-vascular-surgery-assistance-for-hospitals-and-vascular-surgery-trainees
#14
Tadaki M Tomita, Heron E Rodriguez, Andrew W Hoel, Karen J Ho, William H Pearce, Mark K Eskandari
Importance: Vascular surgeons possess a skill set that allows them to assist nonvascular surgeons in the operating room. Existing studies on this topic are limited in their scope to specific procedures or clinical settings. Objective: To describe the broad spectrum of cases that require intraoperative vascular surgery assistance. Design, Setting, and Participants: A retrospective medical record review of patients undergoing nonvascular surgery procedures that required intraoperative vascular surgery assistance between January 2010 and June 2014 at a single urban academic medical center (Northwestern Memorial Hospital, Chicago, Illinois)...
November 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27428499/results-of-bypass-graft-surgery-after-prior-angioplasty-in-critical-limb-ischaemia-treatment
#15
Marcus Vinícius Martins Cury, Francisco Cardoso Brochado-Neto, Marcelo Fernando Matielo, Rafael de Athayde Soares, Anna Karina Paiva Sarpe, Roberto Sacilotto
BACKGROUND: The aim of this study was to determine the outcomes of primary bypass graft surgery (BGS) compared to BGS after failed angioplasty (PTA). PATIENTS AND METHODS: Between January 2007 and January 2014, we performed 136 BGSs exclusively for the treatment of critical limb ischaemia. Two cohorts were identified: 1) primary BGS (n = 102; group I), and 2) BGS after prior PTA (n = 34; group II). Data were analysed retrospectively and the primary endpoints were the rates of secondary patency, amputation-free survival, freedom from major adverse outcomes (graft occlusion, amputation, or death), and overall survival, which were assessed with the Kaplan-Meier method...
2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27322095/association-between-achieved-low-density-lipoprotein-levels-and-major-adverse-cardiac-events-in-patients-with-stable-ischemic-heart-disease-taking-statin-treatment
#16
Morton Leibowitz, Tomas Karpati, Chandra J Cohen-Stavi, Becca S Feldman, Moshe Hoshen, Haim Bitterman, Samy Suissa, Ran D Balicer
IMPORTANCE: International guidelines recommend treatment with statins for patients with preexisting ischemic heart disease to prevent additional cardiovascular events but differ regarding target levels of low-density lipoprotein cholesterol (LDL-C). Trial data on this question are inconclusive and observational data are lacking. OBJECTIVE: To assess the relationship between levels of LDL-C achieved with statin treatment and cardiovascular events in adherent patients with preexisting ischemic heart disease...
August 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27195520/complex-infra-popliteal-revascularisation-in-octogenarians-and-nonagenarians-with-critical-limb-ischaemia-impact-of-multidisciplinary-integrated-care-on-mid-term-outcome
#17
Lukla Biasi, Sanjay D Patel, Talia Lea, Tommaso Donati, Konstantinos Katsanos, Judith S Partridge, Jugdeep K Dhesi, Hany Zayed
BACKGROUND: The incidence of Critical Limb Ischaemia (CLI) is exponentially rising among our aging population. There is a paucity of scientific evidence on best management and clinical outcome of infra-popliteal (IP) revascularisation in elderly CLI patients. METHODS: A prospectively collected database was analysed to identify consecutive octogenarian and nonagenarian patients who underwent IP revascularisation (bypass or angioplasty) for CLI (Rutherford 4-6) in a single centre between 2010-2014...
May 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27177699/contemporary-management-of-acute-aortic-occlusion-has-evolved-but-outcomes-have-not-significantly-improved
#18
COMPARATIVE STUDY
William P Robinson, Rupal K Patel, Jesse A Columbo, Julie Flahive, Francesco A Aiello, Donald T Baril, Andres Schanzer, Louis M Messina
BACKGROUND: Most existing series of acute aortic occlusion (AAO) predate the changes in surgical and endovascular therapy of the last 2 decades. We examined the contemporary management and outcomes of AAO. METHODS: We reviewed consecutive patients with AAO at a tertiary referral center from 2004 to 2012. Outcomes were stratified and compared according to etiology and procedure performed. RESULTS: AAO in 29 patients was due to in situ thrombosis in 21 (72%) and embolism in 8 (28%) patients...
July 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27174511/multiple-arterial-grafts-improve-survival-with-coronary-artery-bypass-graft-surgery-versus-conventional-coronary-artery-bypass-grafting-compared-with-percutaneous-coronary-interventions
#19
Chaim Locker, Hartzell V Schaff, Richard C Daly, Joseph A Dearani, Malcolm R Bell, Robert L Frye, Kevin L Greason, John M Stulak, Lyle D Joyce, Alberto Pochettino, Zhuo Li, Ryan J Lennon, Amir Lerman
OBJECTIVE: To compare long-term survival with multiple arterial coronary artery bypass grafting (CABG) (MultArt) versus percutaneous coronary intervention (PCI) in patients with multivessel disease (MVD). METHODS: We reviewed 12,615 patients with MVD with isolated primary CABG or PCI from 1993 to 2009. Patients with CABG (n = 6667) were grouped according to the number of arterial grafts into left internal thoracic artery (LITA)/saphenous vein (SV) (n = 5712) or MultArt (n = 955); patients with PCI (n = 5948) were grouped into balloon angioplasty (BA) (n = 1020), drug-eluting stent (DES) (n = 1686), and bare metal stent (BMS) (n = 3242)...
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27162649/bioprosthetic-versus-mechanical-prostheses-for-valve-replacement-in-end-stage-renal-disease-patients-systematic-review-and-meta-analysis
#20
Kevin Phan, Dong Fang Zhao, Jessie J Zhou, Aran Karagaratnam, Steven Phan, Tristan D Yan
BACKGROUND: Patients with end-stage renal disease (ESRD) indicated for dialysis are increasingly requiring cardiac valve surgery. The choice of bioprosthetic or mechanic valve prosthesis for such patients requires careful risk assessment. A systematic review and meta-analysis was performed to assess current evidence available. METHODS: A comprehensive search from six electronic databases was performed from their inception to February 2015. Results from patients with ESRD undergoing cardiac surgery for bioprosthetic or mechanical valve replacement were identified...
May 2016: Journal of Thoracic Disease
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