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coronary bifurcation intervention

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https://www.readbyqxmd.com/read/28067200/quantitative-angiography-methods-for-bifurcation-lesions-a-consensus-statement-update-from-the-european-bifurcation-group
#1
Carlos Collet, Yoshinobu Onuma, Rafael Cavalcante, Maik Grundeken, Philippe Généreux, Jeffrey Popma, Ricardo Costa, Goran Stankovic, Shengxian Tu, Johan H C Reiber, Jean-Paul Aben, Jens Flensted Lassen, Yves Louvard, Alexandra Lansky, Patrick W Serruys
Bifurcation lesions represent one of the most challenging lesions subset in interventional cardiology. The European Bifurcation Club (EBC) is an academic consortium whose goal has been to assess and recommend the appropriate strategies to manage bifurcation lesions. The quantitative coronary angiography (QCA) methods for the evaluation of bifurcation lesions has been subject to extensive research. Single vessel quantitative coronary angiography (QCA) has shown to be inaccurate to assess bifurcation lesions dimensions...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28065691/difference-in-vascular-response-between-sirolimus-eluting-and-everolimus-eluting-stents-in-ostial-left-circumflex-artery-after-unprotected-left-main-as-observed-by-optical-coherence-tomography
#2
Yusuke Fujino, Guilherme F Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Kentaro Tanaka, Takahiro Matsumoto, Hiroyoshi Kawamoto, Yuya Yamada, Shinnosuke Amano, Yusuke Watanabe, Takayuki Warisawa, Tomohiko Sato, Satoru Mitomo, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Takahiro Tsukahara, Masahiro Motosuke, Hiram G Bezerra, Shotaro Nakamura, Sunao Nakamura
BACKGROUND: Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28028693/a-study-of-coronary-bifurcation-shape-in-a-normal-population
#3
Pau Medrano-Gracia, John Ormiston, Mark Webster, Susann Beier, Chris Ellis, Chunliang Wang, Örjan Smedby, Alistair Young, Brett Cowan
During percutaneous coronary intervention, stents are placed in narrowings of the arteries to restore normal blood flow. Despite improvements in stent design, deployment techniques and drug-eluting coatings, restenosis and stent thrombosis remain a significant problem. Population stent design based on statistical shape analysis may improve clinical outcomes. Computed tomographic (CT) coronary angiography scans from 211 patients with a zero calcium score, no stenoses and no intermediate artery, were used to create statistical shape models of 446 major coronary artery bifurcations (left main, first diagonal and obtuse marginal and right coronary crux)...
December 27, 2016: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28012553/comparison-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-disease
#4
REVIEW
Syed Yaseen Naqvi, Jordan Klein, Tisa Saha, Daniel J McCormick, Sheldon Goldberg
Coronary artery bypass grafting (CABG) decreases mortality in patients with significant left main (LM) coronary artery disease and for years remained the therapy of choice for patients with this ominous lesion. Advances in percutaneous coronary intervention (PCI) have enabled it to become an alternative to CABG. The results of observational registries and randomized comparisons have shown the safety and efficacy of PCI in appropriately selected patients with low or intermediate angiographic risk scores. Furthermore, the use of physiological measures of flow limitation and the use of intracoronary imaging techniques has added benefit and improved outcomes...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27969870/tct-507-computed-tomography-angiography-versus-angiography-for-guiding-percutaneous-coronary-interventions-in-bifurcation-lesions-prospective-randomized-pilot-study
#5
Rafał Wolny, Jerzy Pregowski, Mariusz Kruk, Cezary Kepka, Artur Debski, Michal Ciszewski, Krzysztof Kukula, Maksymilian Opolski, Zbigniew Chmielak, Adam Witkowski
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969673/tct-326-major-predictors-of-long-term-clinical-outcomes-after-percutaneous-coronary-intervention-for-coronary-bifurcation-lesions-with-2-stent-strategy-patient-level-analysis-of-the-korean-bifurcation-pooled-cohorts
#6
Ji-Hoon Jang, Dong-Kie Kim, Pil Sang Song, Doo-Il Kim, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Seung-Hyuck Choi, Hyo-Soo Kim, Hyeon-Cheol Gwon
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27931557/dedicated-bifurcation-stents-mechanistic-hardware-and-technical-aspects
#7
Sundeep Mishra
Percutaneous coronary intervention (PCI) in bifurcation lesions is associated with lower success rate, higher acute complication rates and higher event rates in follow-up. The reason for this higher than usual complication rate relates to the relationship between anatomy, flow, and atheroma distribution in bifurcation lesions. Further, stenting these lesions can be a prolonged procedure and can be technically more demanding. The most common complication is the loss of significant side branch (SB). Main vessel (MV) stenting may enhance the carina displacement and atheroma shift across the SB ostium leading to SB ostium narrowing...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27916742/angiographic-and-clinical-outcomes-of-patients-treated-with-drug-coated-balloon-angioplasty-for-in-stent-restenosis-after-coronary-bifurcation-stenting-with-a-two-stent-technique
#8
Yukinori Harada, Roisin Colleran, Susanne Pinieck, Daniele Giacoppo, Jonathan Michel, Sebastian Kufner, Salvatore Cassese, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Adnan Kastrati, Robert A Byrne
AIMS: We conducted this study to evaluate the efficacy of drug-coated balloon therapy for in-stent restenosis after coronary bifurcation stenting. METHODS AND RESULTS: Patients who underwent angioplasty with at least one paclitaxel-coated balloon for in-stent restenosis after bifurcation intervention using a two-stent approach were included. Two types of paclitaxel-coated balloon were used, with either iopromid (iopromide-PCB) or butyryltri-n-hexyl citrate excipient (BTHC-PCB)...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27887688/long-term-outcomes-after-stent-implantation-for-left-main-coronary-artery-from-the-multicenter-assessing-optimal-percutaneous-coronary-intervention-for-left-main-coronary-artery-stenting-registry
#9
Masanobu Ohya, Kazushige Kadota, Mamoru Toyofuku, Takeshi Morimoto, Hirooki Higami, Yasushi Fuku, Kyohei Yamaji, Hiromi Muranishi, Yuhei Yamaji, Koji Nishida, Daisuke Furukawa, Tomohisa Tada, Euihong Ko, Kenji Ando, Hiroki Sakamoto, Takashi Tamura, Kazuya Kawai, Takeshi Kimura
We assessed long-term outcomes after left main coronary artery (LMCA) stenting based on lesion types and stenting strategies. In the Assessing Optimal percutaneous coronary Intervention for Left Main Coronary Artery stenting registry, we evaluated 1,607 consecutive patients undergoing stent implantation for unprotected LMCA lesions (bifurcation lesions: n = 1318 and nonbifurcation lesions: n = 289). Among the bifurcation lesions, 1,281 lesions were treated with stenting across the bifurcation (bifurcation 1-stent strategy: n = 999 or bifurcation 2-stent strategy: n = 282)...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27884628/skirt-followed-by-trouser-stenting-technique-true-anatomical-preservation-of-coronary-y-shaped-bifurcation-lesions-while-using-vanishing-bioresorbable-scaffolds-a-report-of-two-cases
#10
Wael Elabbassi, Arif Al Nooryani
We report on two cases in which Y-shaped coronary bifurcations were treated with the use of Bioresorbable scaffolds. The first case was of a 50-year-old man with NSTEMI. Coronary angiography showed stenosis involving a Y-shaped bifurcation of proximal to mid LAD and diagonal. The lesion was wired using two 0.14 BMW guide wires, followed by serial pre-dilatation of LAD and Diagonal branch. The stent into proximal LAD was deployed first as a skirt (3.5 × 12 BVS). Stent was post-dilated. A second 2.5 × 28 BVS was deployed into diagonal branch, protruding backwards; along with a 2...
November 3, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27867140/impact-of-calcified-bifurcation-lesions-in-patients-undergoing-percutaneous-coronary-intervention-using-drug-eluting-stents-results-from-the-coronary-bifurcation-stent-cobis-ii-registry
#11
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 Seun
AIMS: Few data regarding clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions are available. METHODS AND RESULTS: This prospective, multicenter, observational registry enrolled 2,897 patients undergoing percutaneous coronary intervention with drug-eluting stents for coronary bifurcation lesions. We compared target lesion failure (TLF), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target lesion revascularization (TLR), according to severity of calcification in coronary bifurcation target lesions, assessed by an angiographic core laboratory using quantitative coronary angiography...
November 22, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27862314/impact-of-diabetes-mellitus-on-intravascular-ultrasound-guided-provisional-stenting-in-coronary-bifurcation-lesions-j-reverse-sub-study
#12
Masahiro Yamawaki, Daisuke Terashita, Hachidai Takahashi, Toshiro Shinke, Kenichi Fujii, Yoshihisa Shimada, Yoshihiro Takeda, Shinichiro Yamada, Yoshihisa Kinoshita, Yoshinobu Murasato
OBJECTIVE: To investigate the impact of diabetes mellitus (DM) on provisional coronary bifurcation stenting under the complete guidance of intravascular-ultrasound (IVUS). BACKGROUND: The efficacy of such intervention has not yet been fully elucidated in the DM patients. METHODS: A total of 100 DM and 139 non-DM patients in a prospective multi-center registry of IVUS-guided bifurcation stenting were compared in angiographic results at 9 months...
December 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27806900/optical-coherence-tomography-compared-with-intravascular-ultrasound-and-with-angiography-to-guide-coronary-stent-implantation-ilumien-iii-optimize-pci-a-randomised-controlled-trial
#13
Ziad A Ali, Akiko Maehara, Philippe Généreux, Richard A Shlofmitz, Franco Fabbiocchi, Tamim M Nazif, Giulio Guagliumi, Perwaiz M Meraj, Fernando Alfonso, Habib Samady, Takashi Akasaka, Eric B Carlson, Massoud A Leesar, Mitsuaki Matsumura, Melek Ozgu Ozan, Gary S Mintz, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation...
November 26, 2016: Lancet
https://www.readbyqxmd.com/read/27785622/evaluation-of-bifurcation-stenting-techniques-at-catharina-hospital-eindhoven-in-2013
#14
S J L Leus, E van Hagen, F M Zimmermann, L X van Nunen, M van 't Veer, J Koolen, N H J Pijls
AIMS: Percutaneous coronary intervention (PCI) of bifurcation lesions can be performed using various techniques. The aim of this study was to analyse the outcome of various techniques of bifurcation stenting in all patients undergoing bifurcation stenting at one large intervention centre in 2013, taking into account that more complex lesions might more often warrant a two-stent technique. METHODS AND RESULTS: This retrospective study included 260 consecutive patients who underwent non-primary PCI of a bifurcation lesion at the Catharina Hospital, Eindhoven, in 2013...
January 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27765302/impact-of-operator-experience-and%C3%A2-volume-on-outcomes-after-left%C3%A2-main%C3%A2-coronary-artery-percutaneous%C3%A2-coronary-intervention
#15
Bo Xu, Björn Redfors, Yuejin Yang, Shubin Qiao, Yongjian Wu, Jilin Chen, Haibo Liu, Jue Chen, Liang Xu, Yanyan Zhao, Changdong Guan, Runlin Gao, Philippe Généreux
OBJECTIVES: The aim of this study was to assess the impact of operator experience on prognosis after left main coronary artery (LM) percutaneous coronary intervention (PCI). BACKGROUND: LM PCI can be technically challenging and potentially risky considering the amount of supplied myocardium. METHODS: Consecutive patients who underwent unprotected LM PCI at a single institution were included and compared according to whether the primary operator was an experienced, high-volume LM operator (defined as an operator who performed at least 15 LM PCIs per year for at least 3 consecutive years) or not...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27757830/off-label-use-of-7fr-guideliner-in-the-bifurcation-coronary-intervention-protecting-2-side-branches
#16
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27718756/drug-eluting-balloons-in-coronary-interventions-the-quiet-revolution
#17
Fernando Alfonso, Marcos García-Guimarães, Gonzalo Navarrete, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Fernando Rivero, Bernardo Cortese
Drug-eluting balloons (DEB) may be considered as a "quiet revolution" in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES)...
October 8, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27717991/-bifurcation-lesions-how-should-they-be-assessed-and-treated
#18
H M Nef, O Dörr, H Möllmann, A Elsässer
Bifurcation lesions are a therapeutic challenge in the interventional treatment of coronary artery disease. Thus, consideration of anatomical aspects and selection of the most appropriate strategy for an individual bifurcation have an impact on the interventional outcome. Accordingly, assessment of the type of bifurcation stenosis, including the relevance of the side branches, vessel diameter and the angle between the two branches are critical for the optimal choice of interventional strategy. The fractional flow reserve (FFR) is a parameter that provides a measure of the severity of coronary stenosis and despite some limitations, FFR can be applied to bifurcation lesions...
November 2016: Herz
https://www.readbyqxmd.com/read/27692566/clinical-outcome-of-treatment-with-or-without-a-final-kissing-balloon-technique-for-bifurcation-in-stent-restenosis-lesions
#19
Takayuki Yabe, Mikihoto Toda, Rine Nakanishi, Daiga Saito, Ippei Watanabe, Ryo Okubo, Hideo Amano, Takanori Ikeda
BACKGROUND: The treatment strategy for in-stent restenosis (ISR) with bifurcation lesions has not been well explored. We examined the clinical outcomes between final kissing balloon technique (FKBT) after stent implantation and single-stent implantation without FKBT for bifurcation ISR lesions. METHODS: We identified 115 consecutive ISR with bifurcation lesions among 108 patients who underwent drug-eluting stent implantation. The patients were divided into the FKBT group (34 patients, 35 lesions) and the non-FKBT group (74 patients, 80 lesions)...
September 27, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27659568/structural-damage-of-jailed-guidewire-during-the-treatment-of-coronary-bifurcation-lesions-a-microscopic-randomized-trial
#20
Manuel Pan, Soledad Ojeda, Elena Villanueva, Jorge Chavarria, Miguel Romero, Javier Suarez de Lezo, Francisco Mazuelos, Jose Segura, Francisco Carrasco, Francisco Hidalgo, Jose Lopez Aguilera, Sara Rodriguez, Miguel Puente, Jose Suarez de Lezo
OBJECTIVES: The study sought to compare the safety (resistance to damage) and efficacy (ability to cross the side branch) of polymer-coated and non-polymer-coated guidewires in the jailed wire technique used during the percutaneous treatment of bifurcation lesions. BACKGROUND: The jailed wire technique is a useful strategy in the treatment of bifurcation lesions by provisional stenting. However, these wires can be damaged or even be broken during their removal...
September 26, 2016: JACC. Cardiovascular Interventions
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