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coronary bifurcation intervention

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https://www.readbyqxmd.com/read/29779971/bifurcation-and-ostial-optical-coherence-tomography-mapping-boom-case-description-of-a-novel-bifurcation-stent-technique
#1
Evan Shlofmitz, Fernando Sosa, Alec Goldberg, Akiko Maehara, Ziad A Ali, Gary S Mintz, Jeffery W Moses, Gregg W Stone, Richard A Shlofmitz, Allen Jeremias
Stent placement guided by angiography alone is often inexact, but of increased importance with bifurcation percutaneous coronary intervention (PCI). We describe a novel technique using optical coherence tomography (OCT)-guided angiographic co-registration termed "Bifurcation and Ostial OCT Mapping" (BOOM). The technique is based on the precise identification and mapping of the side-branch ostium using co-registration to minimize protrusion of stent struts into the main branch while ensuring full coverage of the ostium in the side-branch...
May 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29777394/biomechanical-impact-of-wrong-positioning-of-a-dedicated-stent-for-coronary-bifurcations-a-virtual-bench-testing-study
#2
Claudio Chiastra, Maik J Grundeken, Carlos Collet, Wei Wu, Joanna J Wykrzykowska, Giancarlo Pennati, Gabriele Dubini, Francesco Migliavacca
The treatment of coronary bifurcations is challenging for interventional cardiologists. The Tryton stent (Tryton Medical, Inc., USA) is one of the few devices specifically designed for coronary bifurcations that underwent large clinical trials. Although the manufacturer provides specific recommendations to position the stent in the bifurcation side branch (SB) according to four radio-opaque markers under angiographic guidance, wrong device positioning may accidentally occur. In this study, the virtual bench testing approach was used to investigate the impact of wrong positioning of the Tryton stent in coronary bifurcations in terms of geometrical and biomechanical criteria...
May 17, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29754928/pathological-mechanisms-of-left-main-stent-failure
#3
Hiroyoshi Mori, Sho Torii, Emanuel Harari, Hiroyuki Jinnouchi, Ryan Brauman, Samantha Smith, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: Despite the increasing use of left main (LM) percutaneous coronary intervention (LM-PCI), there have been no pathological studies devoted to understanding the causes of LM stent failure. We aimed to systematically determine the pathological mechanisms of LM stent failure. METHODS AND RESULTS: From the CVPath Stent registry, a total of 46 lesions were identified to have LM-PCI. Pathologic stent failure (PSF) was defined as stent thrombosis, restenosis and in-stent chronic total occlusion (CTO)...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29735349/true-double-bifurcation-lesions-new-application-of-the-self-expandable-axxess-stent-and-review-of-literature-with-dedicated-bifurcation-devices
#4
REVIEW
Francesco Borgia, Tullio Niglio, Nicola De Luca, Luigi Di Serafino, Giovanni Esposito, Bruno Trimarco, Plinio Cirillo
Complex coronary artery bifurcation lesions occurred in hard clinical scenarios, such as acute coronary syndromes, may represent a challenge for interventional cardiologists, with not-defined general consensus on treatment. Even if provisional stenting is the most common option used to restore rapidly the coronary branches flow, improvements in industrial technologies and design of new dedicated bifurcation devices might open new modalities of treatment in these complex cases. The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding biolimus-eluting conical V-shape stent, specifically designed to treat "easily" coronary artery bifurcation lesions, with reported favorable long-term clinical results in stable patients compared to a provisional technique...
April 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#5
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29716707/balloon-embedded-stenting-a-novel-technique-for-percutaneous-coronary-intervention-of-bifurcation-lesions-experience-in-indian-population
#6
Desabandhu Vinayakumar, Bijilesh Uppalakal, Kailash Kumar Goyal, Anishkumar Nair
BACKGROUND: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events. In this study, we describe a novel balloon embedded stenting technique which can be incorporated with traditional culotte or TAP technique and facilitates conversion to bail out crush in case of such an event...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29682422/comparison-of-clinical-outcomes-after-drug-eluting-balloon-and-drug-eluting-stent-use-for-in-stent-restenosis-related-acute-myocardial-infarction-a-retrospective-study
#7
Chih-Yuan Fang, Hsiu-Yu Fang, Chien-Jen Chen, Cheng-Hsu Yang, Chiung-Jen Wu, Wei-Chieh Lee
Background: Good results of drug-eluting balloon (DEB) use are achieved in in-stent restenosis (ISR) lesions, small vessel disease, long lesions, and bifurcations. However, few reports exist about DEB use in acute myocardial infarction (AMI) with ISR. This study's aim was to evaluate the efficacy of DEB for AMI with ISR. Methods: Between November 2011 and December 2015, 117 consecutive patients experienced AMI including ST-segment elevation MI, and non-ST-segment elevation MI due to ISR, and received percutaneous coronary intervention (PCI)...
2018: PeerJ
https://www.readbyqxmd.com/read/29656938/vitamin-d-deficiency-and-periprocedural-myocardial-infarction-in-patients-undergoing-percutaneous-coronary-interventions
#8
Monica Verdoia, Claudia Ceccon, Matteo Nardin, Harry Suryapranata, Giuseppe De Luca
Vitamin D deficiency has been implicated in the progression of atherosclerosis and acute thrombotic events. We aimed at evaluating the impact of vitamin D deficiency on periprocedural myocardial infarction (PMI) in patients undergoing percutaneous coronary interventions (PCI). We included 934 patients undergoing non-urgent PCI. Assessment of myocardial biomarkers was performed from 6 to 48 h after PCI. PMI was defined as Creatine Kinase-MB increase by 3 times the Upper Limit Normal or by 50% of an elevated baseline value, periprocedural myocardial damage as Troponin I increase by 3 × ULN or 50% of baseline...
March 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29642691/high-risk-pci-how-to-define-it-today
#9
Vincenzo DE Marzo, Domenico D'Amario, Mattia Galli, Rocco Vergallo, Italo Porto
Before the percutaneous spread, the mortality rate of patients with coronary heart disease not suitable for cardiac surgery was markedly high. This limit has been progressively exceeded with the advent of minimally invasive approaches, which, although was initially intended exclusively for low risk patients, was then employed in complex patients often too compromised to undergo cardiac surgery. Given to the rising of high-risk population, due to an increase of patients with multiple chronic conditions linked to the best care offered, we are witnessing an expansion of the high-risk percutaneous coronary interventions (PCI) population...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29606297/ultra-rapid-progression-of-coronary-artery-disease-or-undiagnosed-unstable-plaque-a-brief-review-from-a-case-report
#10
REVIEW
Fernando Montenegro Sá, Catarina Ruivo, Luís Graça Santos, Alexandre Antunes, Francisco Campos Soares, José Baptista, João Morais
Coronary artery disease rarely manifests itself in the first decades of life, which explains why this population is underrepresented in clinical studies. The mechanisms and natural history of the disease seem to differ between this population and older patients. Recent studies suggest a more rapid disease progression in youth, presenting more unstable atherosclerotic plaques, although this correlation has yet to be proven. In this paper, we present the case of a 41-year-old man who presented with a non-ST elevation myocardial infarction, with percutaneous coronary intervention of the culprit lesion (70-90% lesion at bifurcation of the circumflex artery with the first marginal obtuse artery and a sub-occlusive lesion of the ramus intermedius)...
March 29, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29588738/the-proximal-optimisation-technique-for-intervention-of-coronary-bifurcations
#11
Angela Hoye
The proximal optimisation technique (POT) has been proposed as a strategy to improve the results of stent scaffolding of bifurcation lesions. It is a straightforward technique whereby a short, appropriately-sized balloon is inflated in the main vessel just proximal to the carina. The technique has several advantages: it reduces the risk of side branch compromise related to shifting of the carina, it improves stent apposition in the proximal main vessel, and it facilitates side branch access after main vessel stent implantation...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29576596/effect-of-side-branch-predilation-in-coronary-bifurcation-stenting-with-the-provisional-approach-results-from-the-cobis-coronary-bifurcation-stenting-ii-registry
#12
Seung Hwa Lee, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Sang Hoon Lee, Joong Hyun Ahn, Keumhee C Carriere, Myung-Ho Jeong, Hyo-Soo Kim, Ju Hyeon Oh, Yangsoo Jang, Hyeon-Cheol Gwon
BACKGROUND: Whether side branch (SB) predilation before main vessel (MV) stenting is beneficial is uncertain, so we investigated the effects of SB predilation on procedural and long-term outcomes in coronary bifurcation lesions treated using the provisional approach.Methods and Results:A total of 1,083 patients with true bifurcation lesions undergoing percutaneous coronary intervention were evaluated. The primary outcome was a major adverse cardiovascular event (MACE): cardiac death, myocardial infarction, or target lesion revascularization...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29573537/comparison-of-the-planned-one-and-elective-two-stent-techniques-in-patients-with-coronary-bifurcation-lesions-with-or-without-acute-coronary-syndrome-from-the-cobis-ii-registry
#13
Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Hyeon-Cheol Gwon, Hyo-Soo Kim, Seung Woon Rha, Jung Han Yoon, Yangsoo Jang, Seung-Jea Tahk, Ki Bae Seung
OBJECTIVES: To evaluate the impacts of stent techniques on long-term clinical outcomes after percutaneous coronary intervention (PCI) using drug-eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS). BACKGROUND: Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS. METHODS: This multicenter registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions...
March 24, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29570758/benchmark-for-numerical-models-of-stented-coronary-bifurcation-flow
#14
Pedro Garcia Carrascal, Javier Garcia, Jose Sierra Pallares, Francisco Castro Ruiz, Fernando Manuel Martín
In-stent restenosis ails many patients who have undergone stenting. When the stented artery is a bifurcation, the intervention is especially critical because of the complex stent geometry involved in these structures. Computational Fluid Dynamics (CFD) has demonstrated to be an effective approach when modelling blood flow behavior and understanding the mechanisms that underlie in-stent restenosis. These CFD models, however, require validation through experimental data in order to be reliable. It is with this purpose in mind that we performed Particle Image Velocimetry (PIV) measurements of velocity fields within flows through a simplified coronary bifurcation...
March 22, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29550085/effect-of-procedure-and-coronary-lesion-characteristics-on-clinical-outcomes-among-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-insights-from-the-pioneer-af-pci-trial
#15
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...
April 9, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29547992/in-vivo-predictors-of-plaque-erosion-in-patients-with-st-segment-elevation-myocardial-infarction-a-clinical-angiographical-and-intravascular-optical-coherence-tomography-study
#16
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
https://www.readbyqxmd.com/read/29546748/bioresorbable-scaffolds-for-complex-coronary-interventions
#17
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
https://www.readbyqxmd.com/read/29541673/data-on-two-and-three-dimensional-optical-coherence-tomography-guidance-for-the-treatment-for-the-bifurcation-lesion
#18
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
https://www.readbyqxmd.com/read/29527865/delivering-ultimate-bifurcation-treatment
#19
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
https://www.readbyqxmd.com/read/29510464/impact-of-stent-deformity-induced-by-the-kissing-balloon-technique-for-bifurcating-lesions-on-in-stent-restenosis-after-coronary-intervention
#20
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
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