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coronary bifurcation intervention

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https://www.readbyqxmd.com/read/28926354/neointimal-coverage-of-jailed-side-branches-in-coronary-bifurcation-lesions-an-optical-coherence-tomography-analysis
#1
Teruyoshi Kume, Ryotaro Yamada, Koyama Terumasa, Tomoko Tamada, Koichiro Imai, Kenzo Fukuhara, Yutaka Goryo, Ai Kawamura, Okamoto Hiroshi, Yoji Neishi, Shiro Uemura
OBJECTIVES: The jailed strut at the side-branch (SB) orifice may be a cause of delayed neointimal coverage and SB flow disturbance after single stenting to bifurcation. The aim of this study was to characterize the exact relationship between the jailed strut pattern at the SB orifice immediately after stent implantation and neointimal coverage of the jailed SB orifice in the chronic phase. PATIENTS AND METHODS: A total of 29 bifurcation (left anterior descending coronary artery and diagonal branch) lesions treated by optical coherence tomography-guide single-stent implantation and followed at 18 months after a percutaneous coronary intervention were included in this study...
September 18, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28844030/state-of-the-art-balloon-catheter-technologies-drug-coated-balloon
#2
Fernando Alfonso, Bruno Scheller
Four decades after its introduction into clinical practice, coronary balloon angioplasty is still used during most coronary interventions. Conventional balloon angioplasty is frequently used to predilate complex or severe lesions and remains of major value to optimise the results of stent implantation. Plain balloon angioplasty is still used alone in some anatomic scenarios where stent implantation is not desirable (very small vessels or diffuse lesions, large resistant thrombus burden, side branches of bifurcations)...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844026/state-of-the-art-coronary-angiography
#3
Carlos Collet, Maik J Grundeken, Taku Asano, Yoshinobu Onuma, William Wijns, Patrick W Serruys
In the early days of coronary angiography, the precise quantification of luminal narrowing was challenging. The introduction of balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) by Andreas Grüntzig in 1977 was perhaps the greatest incentive to the development of quantitative coronary angiography (QCA). QCA has played a crucial role in evaluating interventional techniques and assessing the results of new technologies. With the advent of drug-eluting stents (DES), QCA metrics such as late lumen loss and diameter stenosis (restenosis) proved to be instrumental in assessing new technologies...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28835831/three-dimensional-optical-frequency-domain-imaging-of-a-true-bifurcation-lesion-after-stent-implantation-using-the-jailed-semi-inflated-balloon-technique
#4
Yohei Numasawa, Hiromu Hase, Hiroyuki Yamazaki, Ryota Tabei, Toshiki Kuno, Masaki Kodaira, Tetsuya Saito
OBJECTIVE: Percutaneous coronary intervention for coronary bifurcation lesion is very challenging, especially for true bifurcation lesions. Although the jailed semi-inflated balloon technique is one of the established methods for treatment of coronary bifurcation lesions, little is known regarding the configuration of the side branch orifice after stent implantation using this technique. METHODS: We report a 73-year-old male patient with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a true bifurcation lesion of the right coronary artery with an obtuse angle using the jailed semi-inflated balloon technique...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28830751/treatment-of-de-novo-coronary-artery-bifurcation-lesions-with-drug-coated-balloons-a-reappraisal-according-to-the-available-scientific-data
#5
REVIEW
Marco Zuin, Gianluca Rigatelli
The treatment of coronary artery bifurcation often represents a challenge for interventional cardiologist. Although several stenting techniques are available for the treatment of de novo coronary bifurcation lesions, over the last years, different studies have proposed and analysed the use of drug-coated balloon (DCB) in the treatment of coronary artery bifurcation lesions as an alternative treatment. To date, even considering those studies which have analysed a combined strategy (DCB+stenting) or a DCB-only approach, the evidences are scant and the results debatable...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28829743/intracoronary-electrocardiogram-to-guide-percutaneous-interventions-in-coronary-bifurcations-a-proof-of-concept-the-fiesta-ffr-vs-icecgsta-study
#6
Dobrin Vassilev, Liubomir Dosev, Carlos Collet, Kiril Karamfiloff, Jivka Stoikova, Ralica Pancheva, Monika Shumkova, Galina Zlatancheva, Vladimir Naunov, Gianluca Rigatelli, Ghassan S Kassab, Robert J Gil, Patrick W Serruys
AIMS: The aim of this study was to determine the accuracy of the intracoronary electrocardiogram (icECG) to detect ischemia during bifurcation lesions percutaneous coronary intervention (PCI) with fractional flow reserve (FFR) as a reference. METHODS AND RESULTS: Patients with significant bifurcation lesions defined as FFR≤0.80 were included. FFR and icECG were performed in the main vessel (MV) and side branch (SB) before and after provisional stenting. icECG was recorded with a uninsulated proximal wire end connected to a unipolar lead...
August 22, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28797113/clinical-outcomes-of-biodegradable-polymer-biolimus-eluting-biomatrix-stents-versus-durable-polymer-everolimus-eluting-xience-stents
#7
Da Hyon Lee, Taek Kyu Park, Young Bin Song, Woo Jung Chun, Rak Kyeong Choi, Jin-Ok Jeong, Eul Soon Im, Sang Wook Kim, Joo Myung Lee, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
There are limited data about clinical outcomes of biodegradable polymer biolimus-eluting BioMatrix stents (BP-BES) and durable polymer everolimus-eluting Xience stents (DP-EES) in real world practice. We sought to compare the clinical outcomes of BP-BES and DP-EES in real world cohorts of patients undergoing percutaneous coronary intervention. A prospective multicenter registry enrolled 999 patients treated with BP-BES and 1,000 patients treated with DP-EES. The primary outcome was target lesion failure, defined as a composite of cardiac death, target vessel-related myocardial infarction, or target lesion revascularization...
2017: PloS One
https://www.readbyqxmd.com/read/28794001/randomized-comparison-of-ridaforolimus-eluting-and-zotarolimus-eluting-coronary-stents-in-patients-with-coronary-artery-disease-primary-results-from-the-bionics-trial
#8
David E Kandzari, Pieter C Smits, Michael P Love, Ori Ben-Yehuda, Shmuel Banai, Simon D Robinson, Michael Jonas, Ran Kornowski, Rodrigo Bagur, Andres Iniguez, Haim D Danenberg, Robert L Feldman, Rajiv Jauhar, Harish Chandna, Manish A Parikh, Gidon Y Perlman, Mercedes Balcells, Peter M Markham, Melek Ozgu Ozan, Philippe Genereux, Elazer Edelman, Martin B Leon, Gregg W Stone
Background -The safety and efficacy of a novel cobalt alloy-based coronary stent with a durable elastomeric polymer eluting the antiproliferative agent ridaforolimus for treatment of patients with coronary artery disease is undetermined. Methods -A prospective, international 1:1 randomized trial was conducted to evaluate in a noninferiority design the relative safety and efficacy of ridaforolimus-eluting stents (RES) and slow-release zotarolimus-eluting stents (ZES) among 1,919 patients at 76 centers undergoing percutaneous coronary intervention...
August 9, 2017: Circulation
https://www.readbyqxmd.com/read/28792156/successful-treatment-of-unprotected-left-main-coronary-bifurcation-lesion-using-minimum-contrast-volume-with-intravascular-ultrasound-guidance
#9
Oh Hyun Lee, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong Ki Hong
Contrast-induced nephropathy (CIN) is a serious complication in patients undergoing percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality. The limiting volume of contrast medium is safest and most reliable strategy for CIN prevention. Intravascular ultrasound (IVUS) serves as an attractive alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of contrast agents. Here, we reported a case of successfully treated unprotected left main bifurcation lesion with heavily calcified and diffuse lesion under the IVUS-guided PCI using low volumes of contrast dye of total 12 cc in an elderly patient...
September 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28764604/optical-coherence-tomography-to-guide-percutaneous-treatment-of-coronary-bifurcation-disease
#10
Mathias Wolfrum, Giovanni Luigi De Maria, Adrian P Banning
Cardiovascular disease remains the most common cause of death worldwide. Enormous progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease has been made, and the number of percutaneous coronary interventions (PCI) is increasing. Coronary bifurcations are involved in a substantial number of PCIs and despite recent advances, bifurcation PCI remains a challenge in terms of immediate success and long-term outcome. Angiography has a limited capacity for showing important features of the 3 dimensional coronary vessel anatomy, position of stent struts and exact wire positions and is therefore suboptimal for guiding bifurcation PCI...
August 9, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28756418/one-year-clinical-outcomes-of-patients-presenting-with-st-segment-elevation-myocardial-infarction-caused-by-bifurcation-culprit-lesions-treated-with-the-stentys-self-apposing-coronary-stent-results-from-the-apposition-iii-study
#11
Maik J Grundeken, Huangling Lu, Nicola Vos, Alexander IJsselmuiden, Robert-Jan van Geuns, Rainer Wessely, Thomas Dengler, Alessio La Manna, Johanne Silvain, Gilles Montalescot, René Spaargaren, Jan G P Tijssen, Robbert J de Winter, Joanna J Wykrzykowska, Giovanni Amoroso, Karel T Koch
OBJECTIVE: To investigate outcomes in patients with ST-segment elevation myocardial infarction (STEMI) after treatment with the Stentys self-apposing stent (Stentys SAS; Stentys S.A.) for bifurcation culprit lesions. BACKGROUND: The nitinol, self-expanding Stentys was initially developed as a dedicated bifurcation stent. The stent facilitates a provisional strategy by accommodating its diameter to both the proximal and distal reference diameters and offering an opportunity to "disconnect" the interconnectors, opening the stent toward the side branch...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28714525/dedicated-bifurcation-stents-or-regular-drug-eluting-stents-in-distal-left-main-stenosis-a-retrospective-study
#12
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Krzysztof Bednarski, Jerzy Górny, Jacek Bil
BACKGROUND: Mainly atherosclerosis develops in distal left main (LM) within bifurcation or trifurcation. The aim of this study was to analyze the strategy of distal LM stenosis treatment and associated clinical outcomes in a large hospital in Northern Poland. METHODS: The study population consisted of consecutive patients with stable coronary artery disease or acute coronary syndrome (ACS) and distal LM stenosis who were hospitalized between June 2012 and June 2013...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28705057/applicability-and-procedural-success-rate-of-bioresorbable-vascular-scaffolds-for-percutaneous-coronary-intervention-in-an-all-comer-cohort-of-383-consecutive-patients
#13
Christian Schlundt, Stephan Achenbach, Fabiola Felten, Jens Roether, Mohamed Marwan, Holger Nef, Josef Ludwig, Monique Tröbs
Objectives The purpose of this study was to determine applicability and procedural success of bioresorbable vascular scaffolds (BVS) for percutaneous coronary intervention (PCI) in an all-comer cohort. Background BVS use in bifurcations and severely calcified lesions is not recommended, and a relatively large crossing profile may cause limitations. It is has never been studied how widely BVS can be applied in all-comer cohorts. Methods In 383 consecutive patients (acute coronary syndrome: 124, stable coronary disease 259), a BVS (Absorb) was used as first-line device unless any of the following contraindications were present: bifurcation with side branch >2...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28683937/demonstration-of-the-safety-and-feasibility-of-robotically-assisted-percutaneous-coronary-intervention-in%C3%A2-complex-coronary-lesions-results-of-the-cora-pci-study-complex-robotically-assisted%C3%A2-percutaneous-coronary-intervention
#14
Ehtisham Mahmud, Jesse Naghi, Lawrence Ang, Jonathan Harrison, Omid Behnamfar, Ali Pourdjabbar, Ryan Reeves, Mitul Patel
OBJECTIVES: The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). BACKGROUND: R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown...
July 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28667810/coronary-artery-aneurysm-after-mini-crush-drug-eluting-stent-technique-in-a-chronic-total-occlusion
#15
Alfonso Jurado-Román, María T López-Lluva, Ignacio Sánchez-Pérez, Fernando Lozano Ruíz-Poveda
A 53-year-old man underwent percutaneous coronary intervention of a chronic total occlusion of the circumflex artery. A mini-crush stent technique with two drug-eluting stents was performed. To the best of our knowledge, this is the first case of coronary artery aneurysm affecting a bifurcated chronic total occlusion treated with a two-stent technique.
July 2017: Journal of Invasive Cardiology
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
#16
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
#17
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
#18
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
#19
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
#20
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
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