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Left main PCI

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https://www.readbyqxmd.com/read/28512744/incremental-benefit-of-three-dimensional-transesophageal-echocardiography-in-the-assessment-of-left-main-coronary-artery-stent-protrusion
#1
Mohammed J Arisha, Ming C Hsiung, Amier Ahmad, Navin C Nanda, Ahmed Elkaryoni, Ahmed H Mohamed, Wei-Hsian Yin
Ostial lesions represent a challenging clinical scenario and percutaneous intervention (PCI) of left main coronary artery ostial lesions has been associated with postintervention complications, including protrusion of deployed stents into a sinus of Valsalva or aortic root. We report a case of stent protrusion into the aortic root following aorto-ostial left main coronary artery PCI, in which three-dimensional transesophageal echocardiography (3DTEE) provided incremental benefit over standard two-dimensional images...
May 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28506936/assessment-of-long-term-mortality-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-intervention-comparison-of-multiple-anatomical-and-clinical-prognostic-risk-scores
#2
Bruno L Janella, Carlos M Campos, Adriano Caixeta, Breno O Almeida, Fabio Sandoli Brito, Alexandre Abizaid, Marco A Perin
AIMS: Three-vessel and left main coronary artery disease (CAD) have important prognostic implications. Consequently, numerous risk scores have been developed to stratify patients with complex CAD. The aim of the present study is to compare the predictive performance of six risk scores for occurrence of 4-year all-cause mortality. METHODS AND RESULTS: From March 2008 to December 2012, 348 consecutive patients with complex CAD undergoing percutaneous coronary intervention in a tertiary center in São Paulo, Brazil were analyzed...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504230/macedonia-coronary-and-structural-heart-interventions-from-2010-to-2015
#3
Sasko Kedev, Biljana Zafirovska, Oliver Kalpak, Slobodan Antov, Jorgo Kostov, Igor Spiroski, Hristo Pejkov, Marjan Boshev, Ivan Vasllev, Aleksandar Jovkovski, Hajber Taravari, Danica Petkoska, Darko Kitanoski
The aim of this report is to describe invasive cardiology procedural practice in Macedonia during the period from 2010 to 2015. Details of all consecutive 39,899 patients who underwent cardiovascular, peripheral or structural heart procedures during the period from 2010 until 2015 were examined. Clinical and procedure characteristics, access site, procedural success and complications were analysed. The number of coronary angiographies increased from 5,540 in 2010 to 8,550 in 2015. Transfemoral access (TFA) was present in 4% of coronary angiographies in 2010 and had decreased to 1% in 2015...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28495897/geographical-difference-of-the-interaction-of-sex-with-treatment-strategy-in-patients-with-multivessel-disease-and-left-main-disease-a-meta-analysis-from-syntax-synergy-between-pci-with-taxus-and-cardiac-surgery-precombat-bypass-surgery-versus-angioplasty-using
#4
Yohei Sotomi, Yoshinobu Onuma, Rafael Cavalcante, Jung-Min Ahn, Cheol Whan Lee, David van Klaveren, Robbert J de Winter, Joanna J Wykrzykowska, Vasim Farooq, Marie-Claude Morice, Ewout W Steyerberg, Seung-Jung Park, Patrick W Serruys
BACKGROUND: The impact of sex on clinical outcomes of percutaneous coronary intervention and coronary artery bypass graft for patients with multivessel coronary disease and unprotected left main disease could be dissimilar between Western and Asian populations. METHODS AND RESULTS: To assess clinical outcomes after percutaneous coronary intervention or coronary artery bypass graft in women and men with multivessel coronary disease and unprotected left main disease, a pooled analysis (n=3280) was performed using the patient-level data from 3 large randomized trials: SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery), PRECOMBAT (Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease) trials...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28487356/intravascular-ultrasound-guidance-is-associated-with-better-outcome-in-patients-undergoing-unprotected-left-main-coronary-artery-stenting-compared-with-angiography-guidance-alone
#5
Pontus Andell, Sofia Karlsson, Moman A Mohammad, Matthias Götberg, Stefan James, Jens Jensen, Ole Fröbert, Oskar Angerås, Johan Nilsson, Elmir Omerovic, Bo Lagerqvist, Jonas Persson, Sasha Koul, David Erlinge
BACKGROUND: Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome in patients undergoing unprotected LMCA PCI in a Swedish nationwide observational study. METHODS AND RESULTS: Patients who underwent unprotected LMCA PCI between 2005 and 2014 because of stable coronary artery disease or acute coronary syndrome were included from the nationwide SCAAR (Swedish Coronary Angiography and Angioplasty Registry)...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28473112/impact-of-collateral-circulation-on-survival-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention-with-a-concomitant-chronic-total-occlusion
#6
Joëlle Elias, Loes P C Hoebers, Ivo M van Dongen, Bimmer E P M Claessen, José P S Henriques
OBJECTIVES: This study sought to compare long-term clinical outcome in ST-segment elevation myocardial infarction (STEMI) patients with a concomitant chronic total occlusion (CTO) with well-developed versus poorly developed collaterals toward the CTO. BACKGROUND: In STEMI patients, presence of a CTO is associated with increased morbidity and mortality. CTOs are often (partially) perfused by collateral vessels. Therefore, when the infarct-related artery (IRA) is the main donor vessel for the collateral blood supply of the CTO, infarct size may increase significantly...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28455632/utility-of-stress-perfusion-cardiac-magnetic-resonance-in-follow-up-of-patients-undergoing-percutaneous-coronary-interventions-of-the-left-main-coronary-artery
#7
Samuele Nanni, Luigi Lovato, Gabriele Ghetti, Fabio Vagnarelli, GianGaspare Mineo, Rossella Fattori, Francesco Saia, Antonio Marzocchi, Cinzia Marrozzini, Maurizio Zompatori, Letizia Bacchi Reggiani, Franco Semprini, Giovanni Melandri, Elena Biagini, Anna Corsini, Giulia Norscini, Claudio Rapezzi
To assess the accuracy of cardiac magnetic resonance (CMR) for the diagnosis of angiographic stenosis after percutaneous coronary intervention (PCI) of left main coronary artery (LMCA). Patients undergone in the last year PCI of unprotected LMCA and scheduled for conventional X-ray coronary angiography (CXA) were evaluated with stress perfusion CMR within 2 weeks before CXA. Main contraindications to CMR were exclusion criteria. Stress perfusion CMR was performed to follow a bolus of contrast Gadobutrol after 3 min of adenosine infusion...
April 28, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28454794/reduced-duration-of-dual-antiplatelet-therapy-using-an-improved-drug-eluting-stent-for-percutaneous-coronary-intervention-of-the-left-main-artery-in-a-real-world-all-comer-population-rationale-and-study-design-of-the-prospective-randomized-multicenter-ideal
#8
Miguel E Lemmert, Keith Oldroyd, Paul Barragan, Maciej Lesiak, Robert A Byrne, Evgeny Merkulov, Joost Daemen, Yoshinobu Onuma, Karen Witberg, Robert-Jan van Geuns
BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. STUDY DESIGN: IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28442067/meta-analysis-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#9
Abdur R Khan, Harsh Golwala, Avnish Tripathi, Haris Riaz, Arnav Kumar, Michael P Flaherty, Deepak L Bhatt
Despite the increase in use of percutaneous coronary intervention (PCI) in left main coronary disease, its efficacy compared with coronary artery bypass grafting (CABG) is unclear. We performed a meta-analysis of randomized controlled trials to assess the optimal revascularization strategy. Our search yielded 8 studies reporting relevant outcomes that were pooled using the inverse variance method, and the hazard ratio (HR) was calculated. The primary outcome was all-cause mortality, myocardial infarction (MI), or stroke (major adverse cardiac events [MACE]), and the secondary outcome was death/MI/stroke/repeat revascularization (expanded MACE)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28438354/coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-with-drug-eluting-stents-for-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#10
Alessandro Putzu, Michele Gallo, Enrico Antonio Martino, Enrico Ferrari, Giovanni Pedrazzini, Tiziano Moccetti, Tiziano Cassina
BACKGROUND: Despite several clinical studies, efficacy of coronary artery bypass grafting (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with left main (LM) disease remains controversial. The objective of this meta-analysis of randomized trials was to evaluate the clinical outcome of CABG versus PCI with drug-eluting stents in LM coronary disease. METHODS: We systematically searched online databases up to March 2017 for randomized trials comparing CABG to PCI with drug-eluting stents...
April 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#11
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28427580/quality-of-life-after-surgery-or-des-in-patients-with-3-vessel-or-left-main-disease
#12
Mouin S Abdallah, Kaijun Wang, Elizabeth A Magnuson, Ruben L Osnabrugge, A Pieter Kappetein, Marie-Claude Morice, Friedrich A Mohr, Patrick W Serruys, David J Cohen
BACKGROUND: In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) with drug-eluting stents (DES), improvements driven mainly by differences in myocardial infarction and repeat revascularization. OBJECTIVES: This study compared the long-term quality-of-life benefits of DES-PCI versus CABG for patients with 3-vessel or left main CAD...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#13
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28419573/impella-2-5-initiated-prior-to-unprotected-left-main-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-improves-early-survival
#14
Perwaiz M Meraj, Rajkumar Doshi, Theodore Schreiber, Brijeshwar Maini, William W O'Neill
OBJECTIVES: To assess post-procedural outcomes when Impella 2.5 percutaneous left ventricular assist device (pLVAD) support is initiated either prior to or after percutaneous coronary intervention (PCI) on unprotected left main coronary artery (ULMCA) culprit lesion in the context of acute myocardial infarction cardiogenic shock (AMICS). BACKGROUND: Initiation of Impella 2.5 pLVAD prior to PCI is associated with significant survival benefit in the setting of AMICS...
April 17, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28417594/real-world-supported-unprotected-left-main-percutaneous-coronary-intervention-with-impella-device-data-from-the-uspella-registry
#15
Theodore Schreiber, Wah Wah Htun, Nimrod Blank, Tesfaye Telila, Nestor Mercado, Alexandros Briasoulis, Amir Kaki, Ashok Kondur, Ahmad Munir, Cindy Grines
BACKGROUND: Patients with left main (LM) coronary artery disease are increasingly being treated with percutaneous revascularization (PCI). The safety, feasibility, and efficacy of unprotected LM intervention (ULMI) with hemodynamic support by Impella device have not been evaluated previously. OBJECTIVE: Using a large retrospective single center database from the USpella registry, we evaluated the safety, feasibility, and potential benefits of periprocedural left ventricular assist with axial flow Impella 2...
April 18, 2017: Catheterization and Cardiovascular Interventions
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/28409597/pci-has-more-benefits-and-harms-than-cabg-for-selected-patients-with-left-main-coronary-artery-disease
#17
Mark H Ebell
No abstract text is available yet for this article.
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28400034/association-of-syntax-score-with-short-term-outcomes-among-acute-st-elevation-myocardial-infarction-patients-undergoing-primary-pci
#18
Sarita Choudhary
OBJECTIVE: Syntax score (SX) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on location and complexity of each lesion. It has been shown to predict long-term clinical outcomes in patients with left main or multi-vessel disease and recently also in ST-segment elevation myocardial infarction undergoing primary PCI. The aim of this study was to evaluate whether the syntax score is associated with short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI)...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28400029/meta-analysis-of-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-coronary%C3%A2-narrowing
#19
Partha Sardar, Jay Giri, Sammy Elmariah, Saurav Chatterjee, Dhaval Kolte, Amartya Kundu, Ramez Nairooz, Wilbert S Aronow, Theophilus Owan, Debabrata Mukherjee, Dmitriy N Feldman, J Dawn Abbott
Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES); however, the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI with DES compared with CABG for the treatment of ULMCA stenosis. Databases were searched through November 30, 2016. Randomized controlled trials (RCTs) comparing DES with PCI versus CABG for ULMCA stenosis were identified...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28388767/treatment-of-coronary-artery-disease-randomized-trials-on-myocardial-revascularization-and-complete-arterial-bypass-grafting
#20
Ardawan J Rastan
Friedrich Wilhelm Mohr from the very beginning of his career as a cardiac surgeon was involved in the refinements of coronary artery bypass grafting (CABG). At the Leipzig Heart Center, his spirit of early adapting to new technologies inspired the entire team and led to a matchless scientific atmosphere to find solutions to improve almost all fields of cardiac surgery, including CABG. In combination with a tremendous number of patients with indications for isolated coronary artery bypass Prof. Mohr as the surgical principle investigator and the Leipzig Heart Center were able to include patients in the Synergy between PCI [percutaneous coronary intervention] with Taxus and Cardiac Surgery (SYNTAX) trial, the first randomized trials comparing CABG and PCIs using the drug-eluting stents...
April 2017: Thoracic and Cardiovascular Surgeon
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