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coronary bifurcation intervention

Mathieu Kerneis, C Michael Gibson, Gerald Chi, Roxana Mehran, Fahad AlKhalfan, Usama Talib, Seyedmahdi Pahlavani, Mahshid Mir, Christoph Bode, Jonathan L Halperin, Tarek Nafee, Eric D Peterson, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Keith A A Fox, Marc Cohen
OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear...
March 8, 2018: JACC. Cardiovascular Interventions
Jiannan Dai, Lei Xing, Haibo Jia, Yinchun Zhu, Shaotao Zhang, Sining Hu, Lin Lin, Lijia Ma, Huimin Liu, Maoen Xu, Xuefeng Ren, Huai Yu, Lulu Li, Yanan Zou, Shaosong Zhang, Gary S Mintz, Jingbo Hou, Bo Yu
Aims: Plaque erosion is a significant substrate of acute coronary thrombosis. This study sought to determine in vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: A prospective series of 822 STEMI patients underwent pre-intervention optical coherence tomography. Using established diagnostic criteria, 209 had plaque erosion (25.4%) and 564 had plaque rupture (68.6%). Plaque erosion was more frequent in women <50 years when compared with those ≥50 years of age (P = 0...
March 13, 2018: European Heart Journal
Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Ryoji Nagoshi, Takayuki Okamura, Yoshinobu Murasato, Tatsuhiro Fujimura, Masahiro Yamawaki, Shiro Ono, Takeshi Serikawa, Yutaka Hikichi, Fumiaki Nakao, Tomohiro Sakamoto, Toshiro Shinke, Yoichi Kijima, Amane Kozuki, Hiroyuki Shibata, Junya Shite
This article comprised the data related to the research article entitled "Feasibility and usefulness of three-dimensional optical coherence tomography guidance for optimal side branch treatment in coronary bifurcation stenting" (Nagoshi et al., In press) [1]. In this article we reports details about two patterns of guide wire (GW) recrossing position after crossover stenting in bifurcation lesion classified with three-dimensional optical coherence tomography (3D-OCT) (Okamura et al., 2014) [2] and follow-up data about the treatment with percutaneous coronary intervention(PCI) for bifurcation lesion in terms of the two- (2D) or 3D-OCT guidance...
February 2018: Data in Brief
Zlatko H Mehmedbegovic, Vladan D Vukcevic, Goran R Stankovic
Coronary bifurcation lesions are accounted in about 20% of all percutaneous coronary interventions and despite all-round improvements in their treatment are still perceived as complex lesion subset in interventional cardiology. Treatment of bifurcations, being technically demanding primarily due to the unique bifurcation anatomy, is related to lower procedural success rate and increased rates of long-term adverse cardiac events. According to published data, provisional approach remains a default strategy for majority of bifurcation PCI, but when perfected, two-stent bifurcation techniques can also yield good clinical outcomes...
March 8, 2018: Minerva Cardioangiologica
Tadatsugu Gamou, Kenji Sakata, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masakazu Yamagishi, Masa-Aki Kawashiri
OBJECTIVES: To investigate the impact of stent deformity induced by final kissing balloon technique (KBT) for coronary bifurcation lesions on in-stent restenosis (ISR). BACKGROUND: In experimental models, the detrimental effects of KBT have been clearly demonstrated, but few data exists regarding the impact of proximal stent deformity induced by KBT on clinical outcomes. METHODS: We examined 370 coronary lesions where intravascular ultrasound (IVUS)-guided second-generation drug-eluting stent (DES) implantation for coronary bifurcation lesions was performed...
March 6, 2018: Journal of Interventional Cardiology
Q-H Li, Q Zhang, X-L Li, J-F Yin, H-G Ji
OBJECTIVE: To evaluate the plaque distribution and composition pattern in the left main coronary artery (LMCA) disease using intracoronary ultrasound. PATIENTS AND METHODS: Intravascular ultrasound data of 50 patients from the January 2010 to December 2015 with significant LMCA bifurcation lesions, with angiographic diameter stenosis >50%, and requiring revascularization, were evaluated. Plaque burden and percentage of necrotic core (% NC) at the minimal lumen area site and maximal % NC site were measured in different segments...
February 2018: European Review for Medical and Pharmacological Sciences
Li Li, Jia Liu, Qinhua Jin, Shaoliang Chen
BACKGROUND: Despite advancements in the devices and techniques used for percutaneous coronary intervention, side branch (SB) wiring remains highly challenging in certain complex bifurcation intervention cases. METHODS AND RESULTS: In this report, we demonstrate the efficacy and safety of the balloon block and support technique (BBST), which comprises inflation of an appropriately sized balloon 1-2 mm distal from the carina in the distal main branch to facilitate wire access to the SB...
January 2018: Medicine (Baltimore)
Ki Hong Choi, Young Bin Song, Jin-Ok Jeong, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Myung-Ho Jeong, Bon-Kwon Koo, Hyo-Soo Kim, Cheol Woong Yu, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Ju Hyeon Oh, Jong-Seon Park, Hyeon-Cheol Gwon
INTRODUCTION AND OBJECTIVES: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). METHODS: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009...
February 20, 2018: Revista Española de Cardiología
Jaya Chandrasekhar, Usman Baber, Samantha Sartori, Melissa Aquino, Annapoorna S Kini, Sunil Rao, William Weintraub, Timothy D Henry, Serdar Farhan, Birgit Vogel, Sabato Sorrentino, Zhen Ge, Samir Kapadia, Joseph B Muhlestein, Sandra Weiss, Craig Strauss, Catalin Toma, Anthony DeFranco, Mark B Effron, Stuart Keller, Brian A Baker, Stuart Pocock, George Dangas, Roxana Mehran
BACKGROUND: Potent P2Y12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. METHODS: PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm...
March 2018: Canadian Journal of Cardiology
Hsin-Fu Lee, Shing-Hsien Chou, Ying-Chang Tung, Chia-Pin Lin, Yu-Shien Ko, Chi-Jen Chang
Background: This study aims to analyze the lesion characteristics of bifurcations that required reverse wire technique and the efficacy and safety of this technique in approaching branches with a highly angulated take-off. Methods: We enrolled patients in whom reverse wire technique was used after failed conventional antegrade wiring with the support of a Crusade catheter. The study endpoints were the technical success defined as succeeding in sending the reversely bent wire to the targeted branches without complications and the procedural success defined as succeeding in revascularization of the bifurcation lesions without complications...
January 2018: Acta Cardiologica Sinica
Mostafa Elwany, Gaetano Di Palma, Bernardo Cortese
Coronary lesions at bifurcation sites are frequent and still remain a challenging subset for the interventional cardiologist. Although in the last years the provisional stenting technique has shown more consistent results, coronary bifurcation interventions still share a worse procedural success rate and increased rates of mid- and long-term cardiac events. Most of the dedicated devices proposed in the last few years have failed to show improved results when compared with standard devices. The broader use of imaging techniques, such as intravascular ultrasound and optical coherence tomography, lead to a better understanding of the real anatomy of bifurcations and has shown to be a great tool for percutaneous coronary intervention optimization...
January 26, 2018: Future Cardiology
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Minh Trí Nhân Nguyễn, Nicolas Foin
OBJECTIVES: We assess the mid-term outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (Nano-Crush) technique in large complex coronary bifurcation. BACKGROUND: Complex bifurcations have been suggested to be better approached by a planned double stent technique. METHODS: Two hundred and five consecutive patients (107 males and 98 females) referred for large complex coronary bifurcation percutaneous coronary interventions were enrolled...
January 25, 2018: Catheterization and Cardiovascular Interventions
Yuan He, Dong Zhang, Dong Yin, Chen'gang Zhu, Lei Feng, Chenxi Song, Changzhe Chen, Bo Xu, Kefei Dou
OBJECTIVES: This study sought to validate the V-RESOLVE score system. BACKGROUND: The V-RESOLVE score was developed to predict the risk of side branch (SB) occlusion after stenting in the main vessel (MV) of coronary bifurcation lesions based on visual estimation of the angiographic data, but it needed to be validated. METHODS: From January to June 2013, 1,286 patients with 1,820 bifurcation lesions undergoing elective intervention with provisional strategy were included...
January 23, 2018: Catheterization and Cardiovascular Interventions
Keisuke Hirai, Kenichi Sakakura, Yusuke Watanabe, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
BACKGROUND: Percutaneous coronary interventions (PCI), especially medical devices, consume large amounts of medical resources. It is important to know which type of lesions requires high device costs among current PCI. The purpose of this study was to investigate the association between lesion characteristics and medical device costs in current PCI. METHODS: We identified 593 coronary artery lesions in our PCI database between January 1, 2015 and December 31, 2015...
December 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Mariama Akodad, Marie-Claude Morice
Though infrequent, left main stenosis has a major prognostic impact. The management of left main disease has evolved over the last few decades with the growing evidence of the efficacy and safety of percutaneous interventions, as attested by the most recent trials. However, mastery of the technical aspects of left main bifurcation stenting is essential in ensuring optimal results. This review focuses on recent data concerning left main angioplasty results as well as the current technical approaches.
January 5, 2018: Trends in Cardiovascular Medicine
Daniel W Nelson, Abdulla A Damluji, Nish Patel, Marco Valgimigli, Stephan Windecker, Robert Byrne, James Nolan, Tejas Patel, Emmanouil Brilakis, Subhash Banerjee, Jorge Mayol, Warren J Cantor, Carlos E Alfonso, Sunil V Rao, Mauro Moscucci, Mauricio G Cohen
INTRODUCTION: Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. METHODS: A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. RESULTS: A total of 988 physicians from 88 countries responded to the survey...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Shahbaz A Malik, Emmanouil S Brilakis, Vincent Pompili, Yiannis S Chatzizisis
A 61-year-old man with a history of percutaneous coronary intervention (PCI) of the mid right coronary artery (RCA) with a drug eluting stent (DES), presented with non-ST segment elevation myocardial infarction. Coronary angiography demonstrated complex disease of the distal RCA as well as in-stent stenosis of the previously placed mid RCA stent. The patient underwent bifurcation PCI of the distal RCA followed by attempted intervention with a DES on the mid RCA lesion. The stent could not cross the lesion and eventually became dissociated from its delivery system...
January 4, 2018: Catheterization and Cardiovascular Interventions
Pil Hyung Lee, Jong-Young Lee, Cheol Whan Lee, Seon-Ok Kim, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The applicability of Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery scores to left main coronary artery disease (CAD) has been questioned. A simplified alternative is needed for guiding decision making. METHODS AND RESULTS: We evaluated the prognostic value of a simplified angiographic classification in comparison with a Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery score-based approach for patients with left main CAD undergoing drug-eluting stent implantation...
January 2018: Circulation. Cardiovascular Interventions
Eun-Seok Shin, Cheol Whan Lee, Jung-Min Ahn, Pil Hyung Lee, Mineok Chang, Min-Ju Kim, Sung-Han Yoon, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: The clinical outcomes for women compared with men undergoing left main PCI were sparse. We compared the characteristics and long-term outcomes in women versus men after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for unprotected left main CAD. METHODS: We identified 2328 patients (545 women; 1783 men) with unprotected left main CAD who received PCI with DES between January 2007 and December 2013 in the Interventional Cardiology Research In-cooperation Society-left MAIN revascularization (IRIS-MAIN) registry...
February 15, 2018: International Journal of Cardiology
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