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coronary bifurcation intervention

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https://www.readbyqxmd.com/read/29336945/current-treatment-of-significant-left-main-coronary-artery-disease-a-review
#1
REVIEW
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
https://www.readbyqxmd.com/read/29331437/influence-of-operator-experience-and-pci-volume-on-transfemoral-access-techniques-a-collaboration-of-international-cardiovascular-societies
#2
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
https://www.readbyqxmd.com/read/29314555/lost-and-found-coronary-stent-retrieval-and-review-of-literature
#3
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
https://www.readbyqxmd.com/read/29311287/comparison-of-a-simple-angiographic-approach-with-a-synergy-between-percutaneous-coronary-intervention-with-taxus-and-cardiac-surgery-score-based-approach-for-left-main-coronary-artery-stenting-a-pooled-analysis-of-serial-precombat-premier-of-randomized-comparison
#4
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
https://www.readbyqxmd.com/read/29306470/sex-differences-in-left-main-coronary-artery-stenting-different-characteristics-but-similar-outcomes-for-women-compared-with-men
#5
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
https://www.readbyqxmd.com/read/29283054/drug-coated-balloons-applications-in-interventional-cardiology
#6
Gianluca Rigatelli, Marco Zuin
BACKGROUNDS: Drug coated balloons (DCBs) are new on stented-based anti-proliferative drug delivery systems, recently introduced in interventional cardiology. Their primary aim is to transfer an anti-proliferative drug to reduce the subsequent neo-intima hyperplasia and to maintain the normal vessel diameter and function. METHODS: A review of the most recent influential studies about DCBs in all the fields of interventional cardiology has been performed. RESULTS: As demonstrated by different studies, DCBs have different theoretical advantages over drug eluting stents (DESs), especially for the treatment of some endovascular lesions, as in-stent restenosis (ISR), coronary bifurcations, small vessels disease and peripheral artery disease at femoropopliteal and below the knee sites...
December 27, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29220345/a-randomized-trial-of-bifurcation-stenting-technique-in-chronic-total-occlusions-percutaneous-coronary-intervention
#7
Vitaly I Baystrukov, Evgeniy I Kretov, Marouane Boukhris, Alexander G Osiev, Igor O Grazhdankin, Alexey V Biryukov, Hatem Najjar, Vladimir V Verin, Dmitriy D Zubarev, Ivan A Naryshkin, Alexander V Bogachev-Prokophiev, Kambis Mashayekhi, Alfredo R Galassi, Alexey A Prokhorikhin
BACKGROUND: The optimal strategy to treat bifurcation lesions (BFLs) in a percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. AIMS: We sought to assess whether T-provisional or mini-crush is appropriate for BFLs within CTO vessels. PATIENTS AND METHODS: From January 2011 to December 2013, patients who underwent successful CTO guidewire crossing and with a BFL within the CTO target vessel were enrolled prospectively and assigned randomly to either T-provisional stenting or the mini-crush technique for BFL treatment...
January 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29214736/definite-stent-thrombosis-after-drug-eluting-stent-implantation-in-coronary-bifurcation-lesions-a-meta-analysis-of-3-107-patients-from-14-randomized-trials
#8
Yu Zhou, Shengda Chen, Lan Huang, David Hildick-Smith, Miroslaw Ferenc, Richard J Jabbour, Lorenzo Azzalini, Antonio Colombo, Alaide Chieffo, Xiaohui Zhao
BACKGROUND: Bifurcation percutaneous coronary intervention (PCI) is a challenging procedure, but there are currently inadequate data about definite stent thrombosis (ST) rates of single-stent versus double-stent strategies (SS and DS, respectively). METHODS AND RESULTS: Randomized clinical trials (RCTs) comparing SS and DS strategies were searched through PubMed, Embase, and the Cochrane Central Register of Controlled Trials. Fourteen RCTs involving 3,107 patients were analyzed...
December 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29208251/drug-coated-balloon-versus-drug-eluting-stent-in-primary-percutaneous-coronary-intervention-a-feasibility-study
#9
RANDOMIZED CONTROLLED TRIAL
David Gobić, Vjekoslav Tomulić, Davorka Lulić, David Židan, Sandro Brusich, Tomislav Jakljević, Luka Zaputović
BACKGROUND: Drug-eluting stents (DES) represent a significant evolution in the treatment of patients with acute myocardial infarction with ST elevation. However, stent-related adverse events have led to an introduction of drug-coated balloons (DCB) applied particularly to bifurcation lesions, in-stent restenosis and small vessel disease. The aim of this study was to determine whether a DCB-only strategy has a similar safety profile and equal angiographic and clinical outcomes to DES implantation in primary percutaneous coronary intervention (pPCI)...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29207368/the-reverse-t-stenting-and-small-protrusion-technique-a-novel-technique-for-coronary-bifurcation-lesions
#10
Ioannis Tsiafoutis, Theodoros Zografos, Athanasios Antonakopoulos, Michael Koutouzis, Grigorios Tsigkas, Nikolaos Bourboulis, Apostolos Katsivas
Bifurcation lesions may be encountered in approximately 15%-20% of percutaneous coronary interventions. A 2-stent approach is required in up to 30% of these procedures. We describe a novel technique based on a modification of TAP stenting, suitable for procedures where a 2-stent strategy is predetermined.
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205789/modified-jailed-balloon-technique-for-bifurcation-lesions
#11
Shigeru Saito, Koki Shishido, Noriaki Moriyama, Tomoki Ochiai, Shingo Mizuno, Futoshi Yamanaka, Kazuya Sugitatsu, Kazuki Tobita, Junya Matsumi, Yutaka Tanaka, Masato Murakami
OBJECTIVES: We propose a new systematic approach in bifurcation lesions, modified jailed balloon technique (M-JBT), and report the first clinical experience. BACKGROUND: Side branch occlusion brings with a serious complication and occurs in more than 7.0% of cases during bifurcation stenting. METHODS: A jailed balloon (JB) is introduced into the side branch (SB), while a stent is placed in the main branch (MB) as crossing SB. The size of the JB is half of the MB stent size...
December 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29148142/outcomes-of-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-due-to-unprotected-left-main-thrombosis-the-asia-pacific-left-main-st-elevation-registry-aster
#12
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
November 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29146671/predictors-and-long-term-clinical-outcome-of-longitudinal-stent-deformation-insights-from-pooled-analysis-of-korean-multicenter-drug-eluting-stent-cohort
#13
Tae-Min Rhee, Kyung Woo Park, Joo Myung Lee, Michael S Lee, Ki-Hyun Jeon, Hyun-Jae Kang, Bon-Kwon Koo, Jay Young Rhew, Kwang Soo Cha, Jang-Ho Bae, Kyoo-Rok Han, Si-Hoon Park, Woo-Jung Park, Seung-Woon Rha, Seok-Kyu Oh, Hyuck Moon Kwon, Ki-Bae Seung, Taehoon Ahn, Sang-Hyun Kim, Hyo-Soo Kim
BACKGROUND: There are limited data on the frequency of and factors associated with quantitative coronary angiography (QCA)-defined longitudinal stent deformation (LSD) in various contemporary drug-eluting stents platforms. This study sought to evaluate the predictors of LSD and its long-term clinical implication. METHODS AND RESULTS: A patient-level pooled analysis was performed with 7350 lesions in 5871 patients treated with platinum-chromium-based everolimus-eluting stent (Promus Element), cobalt-chromium-based everolimus-eluting stent (Promus/Xience V), or cobalt-chromium-based zotarolimus-eluting stent (Endeavor Resolute)...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146551/dual-lumen-microcatheters-for-complex-percutaneous-coronary-interventions
#14
REVIEW
Jacopo A Oreglia, Roberto Garbo, Andrea Gagnor, Gabriele L Gasparini
In some bifurcation anatomies side branch wiring can be difficult particularly when side branch is highly angulated. Furthermore a combination of bifurcations and chronic total occlusion can be a real challenge for interventional cardiologists. New devices have been produced to facilitate complex PCI and recently introduced dual lumen microcatheters can be really helpful in these scenarios. All these devices have both a rapid-exchange and an over-the-wire lumen. The rationale for dual lumen microcatheters is to preserve the highest number of side-branches...
October 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29124548/development-of-an-experimental-and-digital-cardiovascular-arterial-model-for-transient-hemodynamic-and-postural-change-studies-a-preliminary-framework-analysis
#15
Rodward L Hewlin, John P Kizito
The ultimate goal of the present work is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present work an experimental and digital computational fluid dynamics (CFD) arterial model consisting of a number of major arteries (aorta, carotid bifurcation, cranial, femoral, jejunal, and subclavian arteries) were fabricated to study: (1) the effects of local hemodynamics (flow parameters) on global hemodynamics (2) the effects of transition from bedrest to upright position (postural change) on hemodynamics, and (3) diffusion of dye (medical drug diffusion simulation) in the arterial system via experimental and numerical techniques...
November 9, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29116819/double-guide-double-wrist-5f-left-coronary-artery-transradial-percutaneous-coronary-intervention-and-the-x-kiss-technique
#16
Dangoisse Vincent, Schroëder Erwin, Claude Hanet, Antoine Guédès, Pancholy Samir
Percutaneous coronary intervention for bifurcated anatomy, particularly at the proximal left coronary artery site, requires guide catheters (GC) of at least 6 french and preferably larger in diameter. We describe a new trans-radial approach more suitable for small artery size: the simultaneous use of both radial arteries for double cannulation of the LMCA with 5F GC: each GC will target either the LM/LAD or the LM/CX artery (or LM-LAD/LM-LAD-1st diagonal branch) stenoses. The technique successfully was applied to 5 cases...
November 8, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29108400/early-experience-and-favorable-clinical-outcomes-of-everolimus-eluting-bioresorbable-scaffolds-for-coronary-artery-disease-in-korea
#17
Osung Kwon, Jung-Min Ahn, Do-Yoon Kang, Se Hun Kang, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
Background/Aims: Compared with metallic drug-eluting stents (DES), bioresorbable vascular scaffolds (BVS) may further improve long-term outcomes of percutaneous coronary intervention (PCI) in patients with coronary artery disease. We report our early experience with BVS in Korea. Methods: We evaluated 105 consecutive patients with BVS implanted at Asan Medical Center, Korea between October 21, 2015 and June 3, 2016. Angiographic results, and in-hospital and 6-month clinical outcomes were assessed...
November 7, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29102580/usefulness-of-the-jailed-balloon-technique%C3%A2-in-percutaneous-intervention-for%C3%A2-severe-coronary-perforation-involving%C3%A2-left-main-bifurcation
#18
Kensuke Takagi, Koichi Furui, Itsuro Morishima, Hideyuki Tsuboi
No abstract text is available yet for this article.
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29096915/double-kissing-crush-versus-provisional%C3%A2-stenting-for-left-main-distal%C3%A2-bifurcation-lesions-dkcrush-v-randomized-trial
#19
RANDOMIZED CONTROLLED TRIAL
Shao-Liang Chen, Jue-Jie Zhang, Yaling Han, Jing Kan, Lianglong Chen, Chunguang Qiu, Tiemin Jiang, Ling Tao, Hesong Zeng, Li Li, Yong Xia, Chuanyu Gao, Teguh Santoso, Chootopol Paiboon, Yan Wang, Tak W Kwan, Fei Ye, Nailiang Tian, Zhizhong Liu, Song Lin, Chengzhi Lu, Shangyu Wen, Lang Hong, Qi Zhang, Imad Sheiban, Yawei Xu, Lefeng Wang, Tanveer S Rab, Zhanquan Li, Guanchang Cheng, Lianqun Cui, Martin B Leon, Gregg W Stone
BACKGROUND: Provisional stenting (PS) is the most common technique used to treat distal left main (LM) bifurcation lesions in patients with unprotected LM coronary artery disease undergoing percutaneous coronary intervention. The double kissing (DK) crush planned 2-stent technique has been shown to improve clinical outcomes in non-LM bifurcations compared with PS, and in LM bifurcations compared with culotte stenting, but has never been compared with PS in LM bifurcation lesions. OBJECTIVES: The authors sought to determine whether a planned DK crush 2-stent technique is superior to PS for patients with true distal LM bifurcation lesions...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29074039/percutaneous-coronary-intervention-of-bifurcation-lesions-and-platelet-reactivity
#20
Björn Redfors, Philippe Généreux, Bernhard Witzenbichler, Ajay J Kirtane, Akiko Maehara, Giora Weisz, Mahesh V Madhavan, Thomas McAndrew, Roxana Mehran, Gregg W Stone
BACKGROUND: Although bifurcation percutaneous coronary intervention (PCI) is associated with lower procedural success rates and higher risk of complications, there are little data regarding outcomes after successful bifurcation PCI with contemporary stents and techniques. Whether residual platelet reactivity (PR) affects outcomes differently after bifurcation versus non-bifurcation PCI is also unknown. We studied the association between bifurcation PCI, PR, and clinical outcomes among patients undergoing successful PCI with drug-eluting stents...
January 1, 2018: International Journal of Cardiology
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