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coronary bifurcation intervention

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https://www.readbyqxmd.com/read/28606906/a-randomised-comparison-of-conventional-versus-intentional-strategy-in-patients-with-high-risk-prediction-of-side-branch-occlusion-in-coronary-bifurcation-intervention-rationale-and-design-of-the-cit-resolve-trial
#1
Dong Zhang, Dong Yin, Chenxi Song, Chengang Zhu, Ajay J Kirtane, Bo Xu, Kefei Dou
INTRODUCTION: The intentional strategy (aggressive side branch (SB) protection strategy: elective two-stent strategy or jailed balloon technique) is thought to be associated with lower SB occlusion rate than conventional strategy (provisional two-stent strategy or jailed wire technique). However, most previous studies showed comparable outcomes between the two strategies, probably due to no risk classification of SB occlusion when enrolling patients. There is still no randomised trial compared the intentional and conventional strategy when treating bifurcation lesions with high risk of SB occlusion...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28603592/jailing-polymer-jacketed-guide-wires-during-bifurcation-coronary-interventions-is-associated-with-procedural-myocardial-infarction
#2
Arka Chatterjee, Jeremy S White, Taimoor Hashim, Massoud A Leesar
AIM: To study the relationship of jailed polymer jacketed guide wires (PGW) with procedural myocardial infarction (PMI) after bifurcation coronary interventions. METHODS: Consecutive bifurcation interventions performed from January 2010 to October 2014 were included in the study. Chart review was performed to obtain demographic, clinical and procedural data. PMI was defined as Creatine Kinase MB > 3 × upper reference limit of normal. Multivariate logistic regression was used to ascertain relationship of PGW use with PMI...
May 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28588834/successful-bailout-stenting-strategy-against-lethal-coronary-dissection-involving-left-main-bifurcation
#3
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/28581348/safety-and-efficacy-of-the-tryton-side-branch-stent%C3%A2-for-the-treatment-of-coronary-bifurcation-lesions-an-update
#4
Maik J Grundeken, Robbert J de Winter, Joanna J Wykrzykowska
Percutaneous coronary interventions (PCIs) involving coronary bifurcation lesions are associated with adverse outcomes compared with non-bifurcation lesions. The Tryton Side Branch Stent has been developed to improve clinical outcomes after bifurcation PCI. Areas covered: We will discuss observational data (clinical registries and intravascular imaging studies) and randomized data from the TRYTON trial (comparing Tryton [used in combination with a main branch drug-eluting stent (DES)] with side branch balloon angioplasty [in combination with a main branch DES; also referred to the provisional strategy])...
June 13, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28574987/reconstruction-of-stented-coronary-arteries-from-optical-coherence-tomography-images-feasibility-validation-and-repeatability-of-a-segmentation-method
#5
Claudio Chiastra, Eros Montin, Marco Bologna, Susanna Migliori, Cristina Aurigemma, Francesco Burzotta, Simona Celi, Gabriele Dubini, Francesco Migliavacca, Luca Mainardi
Optical coherence tomography (OCT) is an established catheter-based imaging modality for the assessment of coronary artery disease and the guidance of stent placement during percutaneous coronary intervention. Manual analysis of large OCT datasets for vessel contours or stent struts detection is time-consuming and unsuitable for real-time applications. In this study, a fully automatic method was developed for detection of both vessel contours and stent struts. The method was applied to in vitro OCT scans of eight stented silicone bifurcation phantoms for validation purposes...
2017: PloS One
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
#6
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/28555728/platelet-distribution-width-as-the-prognostic-marker-in-coronary-bifurcation-treatment
#7
Adam Kern, Robert J Gil, Krystian Bojko, Ewa Sienkiewicz, Beata Januszko-Giergielewicz, Jerzy Górny, Jacek Bil
INTRODUCTION: Mean platelet volume (MPV) was proved to be a reliable prognostic factor in cardiac patients. However, platelet distribution width (PDW) was disclosed to be more specific marker of platelet reactivity. The aim of study was to evaluate whether baseline PDW value can predict the outcome in patients undergoing percutaneous coronary interventions (PCI) with drug-eluting stent implantation within coronary bifurcation lesions. MATERIAL AND METHODS: It was a two-center observational study, which included patients who underwent PCI within bifurcation lesions between January 2014 and December 2014...
May 28, 2017: European Journal of Clinical Investigation
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
#8
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
#9
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/28541601/the-approach-to-coronary-bifurcation-treatment-and-its-outcomes-in-poland-the-single-center-experience
#10
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Rakesh Jalali, Jerzy Górny, Jacek Bil
BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland. METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®)...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28515858/three-dimensional-optical-coherence-tomography-reconstruction-of-bifurcation-stenting-using-the-szabo-anchor-wire-technique
#11
Katherine Yu, Harkawal Hundal, Todd Zynda, Arnold Seto
Ostial lesions present unique challenges for percutaneous coronary intervention (PCI). These lesions are often more calcified, fibrotic, rigid, and more prone to elastic recoil. Intervention on these lesions is associated with higher procedural complications and higher rates of restenosis. Ostial lesions require precise stent placement in the ostium with the absence of side branch compromise. Accurate stent placement in the ostium without side branch compromise is difficult to accomplish with angiography alone...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28508393/reversed-single-string-technique-for-coronary-bifurcation-stenting-first-report-of-case-demonstrations-in-vitro
#12
Julien Adjedj, Gabor G Toth, Mariano Pellicano, William Wijns
OBJECTIVES: This work reports the concept and the practical feasibility of Reversed Single String bifurcation stenting technique by demonstrating three in vitro cases. BACKGROUND: Provisional T stenting is the most used interventional technique to treat coronary bifurcation lesions. However, after main branch (MB) stenting, treatment of the side branch (SB) may become indicated to provide a good final result. Currently applied methods all have their structural limitations with respect to wall coverage, multiple strut layers, poor apposition rate...
May 16, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28500478/effect-of-stenosis-eccentricity-on-the-functionality-of-coronary-bifurcation-lesions-a-numerical-study
#13
Catherine Pagiatakis, Jean-Claude Tardif, Philippe L L'Allier, Rosaire Mongrain
Interventional cardiologists still rely heavily on angiography for the evaluation of coronary lesion severity, despite its poor correlation with the presence of ischemia. In order to improve the accuracy of the current diagnostic procedures, an understanding of the relative influence of geometric characteristics on the induction of ischemia is required. This idea is especially important for coronary bifurcation lesions (CBLs), whose treatment is complex and is associated with high rates of peri- and post-procedural clinical events...
May 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28473107/current-interventions-for-the-left-main%C3%A2-bifurcation
#14
REVIEW
Tanveer Rab, Imad Sheiban, Yves Louvard, Fadi J Sawaya, Jun Jie Zhang, Shao Liang Chen
Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28462716/treatment-of-bifurcation-lesions-by-bail-out-tap-or-culotte-lost-in-translation
#15
Francesco Burzotta, Thierry Lefèvre, Jens Flensted Lassen, Niels Ramsing Holm, Goran Stankovic
BACKGROUND: Coronary bifurcated lesions (CBL) represent a hot topic of interventional cardiology. Provisional stenting, i.e. implantation of a drug-eluting (DES) in the main branch followed by side-branch (SB) intervention in case of suboptimal SB result, represents the gold standard to treat the vast majority of CBL undergoing percutaneous coronary interventions (PCI). The best technique for bail-out SB stenting has not been established. Prospective randomized trials comparing different stenting techniques may help provide important insights regarding the best way to conduct PCI in patients with CBL...
April 26, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#16
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/28401352/randomized-comparison-between-provisional-and-routine-kissing-balloon-technique-after-main-vessel-crossover-stenting-for-coronary-bifurcation-lesions
#17
Masahiro Yamawaki, Masaki Fujita, Shinya Sasaki, Masanori Tsurugida, Mamoru Nanasato, Motoharu Araki, Keisuke Hirano, Yoshiaki Ito, Reiko Tsukahara, Toshiya Muramatsu
We compared the myocardial ischemic burden of provisional and routine final kissing-balloon inflation (FKI) with the 1-stent strategy using a second-generation drug-eluting stent for coronary bifurcation lesions (CBL). There are no established guidelines for side branch (SB) intervention after main vessel stenting. In total, 113 CBL patients were randomized to receive different SB intervention strategies: provisional-FKI group (n = 57; FKI only when SB flow was TIMI <3) and routine-FKI group (n = 56; mandatory FKI with aggressive treatment until SB-residual stenosis <50%)...
April 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28394644/bioss-lim-c-thin-strut-cobalt-chromium-version-of-the-dedicated-bifurcation-stent
#18
Robert J Gil, Jacek Bil, Mateusz Kaczynski, Krzysztof P Milewski
Coronary bifurcation lesions pose therapeutic challenges during percutaneous coronary interventions. Dedicated bifurcation stents are one of the treatment options available. Areas covered: This paper will analyze the results of the BiOSS (Bifurcation Optimization Stent System) Clinical Program with a special focus on the cobalt-chromium BiOSS LIM C stent which has recently been introduced into the market (CE 2016). The stent is characterized by a strut thickness of 70 µm and sirolimus concentration of 1.4 µg/mm(2)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28365415/immediate-and-short-term-performance-of-a-novel-sirolimus-coated-balloon-during-complex-percutaneous-coronary-interventions-the-fatebenefratelli-sirolimus-coated-balloon-fasico-registry
#19
Bernardo Cortese, Gaetano di Palma, Roberto A Latini, Mostafa Elwany, Pedro Silva Orrego, Romano G Seregni
BACKGROUND AND PURPOSES: Drug-coated balloons (DCB) currently represent an alternative to drug-eluting stents (DES) for the treatment of in-stent restenosis and they are also variably used for small coronary vessel and bifurcation lesion management. All DCB variably elute paclitaxel as an anti-proliferative drug. The first sirolimus coated balloon (SCB) received the CE mark in 2016, but its clinical performance has not been shown yet. METHODS AND RESULTS: FASICO in an all-comer registry of the first consecutive patients with at least one lesion treated with SCB between March and July 2016 at the first European centre that used this device...
March 25, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28353317/self-expanding-stentys-stent-in-daily-routine-use
#20
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
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