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https://www.readbyqxmd.com/read/28799701/drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-left-main-coronary-artery-disease
#1
Hisato Takagi, Tomo Ando, Takuya Umemoto
OBJECTIVES: To compare follow-up outcomes after percutaneous coronary intervention with drug-eluting stents (DES-PCI) versus coronary artery bypass grafting (CABG) for left-main coronary artery disease (LMCAD), we performed a meta-analysis of randomized controlled trials (RCTs) and observational studies with propensity-score analysis. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through November 2016. Eligible studies were RCTs or observational studies with propensity-score analysis of DES-PCI versus CABG enrolling patients with LMCAD and reporting ≥ 6-month mortality, myocardial infarction (MI), stroke, or repeat revascularization (RRV)...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797009/left-main-coronary-stenosis-surgery-still-reigns
#2
Marc Ruel, Hidetake Kawajiri, David Glineur, Juan Grau, Mario Gaudino, Subodh Verma
PURPOSE OF REVIEW: Coronary artery bypass grafting (CABG) has been regarded as the mainstream treatment for unprotected left main coronary artery (ULMCA) stenosis. However, the results of the Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial, in which percutaneous coronary intervention (PCI) was deemed noninferior to CABG, have raised a question whether the guidelines should be changed. This article provides a critical appraisal of recent randomized control trials (RCTs) on ULMCA stenosis...
September 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28792156/successful-treatment-of-unprotected-left-main-coronary-bifurcation-lesion-using-minimum-contrast-volume-with-intravascular-ultrasound-guidance
#3
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/28789842/impact-of-target-vessel-on-long-term-cardiac-mortality-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention-insights-from-a-japanese-multicenter-registry
#4
Satoru Mitomo, Toru Naganuma, Richard J Jabbour, Katsumasa Sato, Hideo Takebayashi, Tsuyoshi Kobayashi, Jun-Ei Obata, Kenji Sakamoto, Kenichi Tsujita, Kiyotaka Kugiyama, Hisao Ogawa, Sunao Nakamura
BACKGROUND: The impact of successful chronic total occlusion (S-CTO) percutaneous coronary intervention (PCI) on cardiac mortality may differ depending on target CTO vessel; however, to date this has not yet been adequately evaluated. The aim of this study was to investigate the impact of target vessel on cardiac mortality after S-CTO PCI. METHODS: From January 2004 to December 2011, 1517 CTO PCIs were performed in 4 Japanese centers and enrolled in a multicenter registry...
August 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28776266/impact-of-left-main-coronary-artery-disease-on-long-term-mortality-in-patients-undergoing-drug-eluting-stent-implantation
#5
Se Hun Kang, Cheol Whan Lee, Seunghee Baek, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Seung-Jung Park
BACKGROUND: Limited data are available on long-term mortality according to the extent of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). We assessed long-term mortality DES implantation according to the extent of CAD and the impact of left main CAD alone on mortality among patients undergoing PCI with DES. METHODS AND RESULTS: A total of 18,716 patients were pooled from real-world PCI registries...
August 3, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28763313/generalizability-of-excel-and-noble-results-to-a-large-registry-population-with-unprotected-left-main-coronary-artery-disease
#6
Pil Hyung Lee, Se Hun Kang, Seungbong Han, Jung-Min Ahn, Jae Seok Bae, Cheol Hyun Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Duk-Woo Park, Seung-Jung Park
OBJECTIVE: The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. PATIENTS AND METHODS: We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481)...
July 31, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28760214/clinical-outcomes-with-percutaneous-coronary-revascularization-vs-coronary-artery-bypass-grafting-surgery-in-patients-with-unprotected-left-main-coronary-artery-disease-a-meta-analysis-of-6-randomized-trials-and-4-686-patients
#7
Tullio Palmerini, Patrick Serruys, Arie Pieter Kappetein, Philippe Genereux, Diego Della Riva, Letizia Bacchi Reggiani, Evald Christiansen, Niels R Holm, Leif Thuesen, Timo Makikallio, Marie Claude Morice, Jung-Min Ahn, Seung-Jung Park, Holger Thiele, Enno Boudriot, Mario Sabatino, Mattia Romanello, Giuseppe Biondi-Zoccai, Raphael Cavalcante, Joseph F Sabik, Gregg W Stone
Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT. METHODS: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28750147/micro-catheter-balloon-pinning-technique-to-facilitate-wiring-of-a-left-circumflex-cto
#8
Kevin N Oguayo, Chris C Oguayo, Ravi Vallabhan, James W Choi
INTRODUCTION: Coronary chronic total occlusions (CTOs) are commonly encountered during diagnostic angiograms. With recent advances, especially in experienced centers, success rates with CTO percutaneous coronary intervention (PCI) have approached 80% or higher. It is important to note that despite these advancements in techniques, CTOs remain difficult to treat. We present a case of a left circumflex artery (LCX) CTO that was successfully revascularized using a microcatheter balloon pinning technique that allowed additional wire support...
July 27, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28748149/the-prognostic-value-of-residual-coronary-stenoses-after-functionally-complete-revascularisation
#9
EDITORIAL
Dennis T L Wong
Fractional flow reserve (FFR) has become the gold standard for functional assessment of coronary artery stenosis. Studies have confirmed the superiority of FFR guided percutaneous coronary intervention (PCI) compared to angiography guided PCI. Due to the high cost of FFR, it is not economically viable for FFR to be incorporated into every routine invasive coronary angiography. As a result, visual estimation of diameter stenosis on invasive coronary angiography still remains the cornerstone for decision making regarding revascularisation treatment for patients...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28738485/-impact-and-clinical-outcome-of-intra-aortic-balloon-pump-use-during-percutaneous-coronary-intervention
#10
J J Xu, Z Gao, Y Song, Y L Ma, X F Tang, Y Yao, C He, H H Wang, Y J Yang, R L Gao, S B Qiao, B Xu, J Q Yuan
Objective: To observe the impact and clinical outcome of intra-aortic balloon pump(IABP) use in patients underwent percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were enrolled.After 2 years' follow-up, the incidence of major adverse cardiovascular and cerebrovascular events such as death, myocardial infarction, stent thrombosis, revascularization, recurrent stroke were recorded, propensity score was used to match baseline data, and the clinical outcomes in patients with IABP and non-IABP were compared...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28728654/comparison-of-stenting-versus-bypass-surgery-according-to-the-completeness-of-revascularization-in-severe-coronary-artery-disease-patient-level-pooled-analysis-of-the-syntax-precombat-and-best-trials
#11
Jung-Min Ahn, Duk-Woo Park, Cheol Whan Lee, Mineok Chang, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Erhan Tenekecioglu, Minkyu Han, Pil Hyung Lee, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
OBJECTIVES: The aim of this study was to compare long-term survival between patients with severe coronary artery disease undergoing coronary artery bypass grafting (CABG) and those undergoing percutaneous coronary intervention (PCI) achieving complete revascularization (CR) or incomplete revascularization. BACKGROUND: The importance of CR in decision making regarding revascularization strategy in patients with severe coronary artery disease is unknown. METHODS: Data were pooled from the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery), PRECOMBAT (Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease), and BEST (Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients With Multivessel Coronary Artery Disease) trials...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722295/prevalence-correlates-and-impact-of-coronary-calcification-on-adverse-events-following-pci-with-newer-generation-des-findings-from-a-large-multiethnic-registry
#12
Robert S Copeland-Halperin, Usman Baber, Melissa Aquino, Anitha Rajamanickam, Swathi Roy, Choudhury Hasan, Nitin Barman, Jason C Kovacic, Pedro Moreno, Prakash Krishnan, Joseph M Sweeny, Roxana Mehran, George Dangas, Annapoorna S Kini, Samin K Sharma
OBJECTIVES: We sought to determine the prevalence, predictors, and clinical impact of target lesion calcification in patients undergoing percutaneous coronary intervention (PCI) with newer generation drug-eluting stents (DES) and devices. BACKGROUND: Coronary calcification is independently associated with adverse outcomes following PCI. While newer DES and contemporary devices are considered safer and more efficacious, their influence on outcomes following PCI of heavily calcified lesions is unknown...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722266/second-generation-drug-eluting-stents-versus-bare-metal-stents-for-percutaneous-coronary-intervention-of-the-proximal-left-anterior-descending-artery-an-analysis-of-the-basket-prove-i-and-ii-trials
#13
Fernanda Marinho Mangione, Tor Biering-Sørensen, Kotaro Nochioka, Tannas Jatene, Odilson Marcos Silvestre, Kim Wadt Hansen, Rikke Sørensen, Jan Skov Jensen, Peter Godsk Jorgensen, Raban Jeger, Christoph Kaiser, Matthias Pfisterer, Søren Galatius
OBJECTIVES: To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS). BACKGROUND: PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707446/percutaneous-coronary-intervention-after-a-surgeon-says-no-way
#14
EDITORIAL
Samuel M Butman
The rate of surgical turndowns (1.5-2.5%) in this report that went on to PCI is relatively consistent across centers. Unprotected left main intervention in patients turned down for surgery has high hospital mortality. With certain caveats, the HEART Team approach to these unique patients may be the answer.
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28663763/long-term-outcomes-of-pci-vs-cabg-for-ostial-midshaft-lesions-in-unprotected-left-main-coronary-artery
#15
Cheng-Long Guo, Xian-Peng Yu, Bang-Guo Yang, Meng-Meng Li, Ji-Qiang He, Quan Li, Cheng-Xiong Gu, Shu-Zheng Lyu, Jian-Zeng Dong
BACKGROUND: There are limited data on long-term (> 5 years) outcomes of drug-eluting stent (DES) implantation compared with coronary artery bypass grafting (CABG) for ostial/midshaft left main coronary artery (LMCA) lesions. METHODS: Of the 259 consecutive patients in Beijing Anzhen Hospital with ostial/midshaft LMCA lesions, 149 were treated with percutaneous coronary intervention (PCI) with DES and 110 were with CABG. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, and major adverse cardiac and cerebrovascular events (MACCE, the composite of cardiac death, MI, stroke or repeat revascularization)...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28658308/unprotected-left-main-revascularization-percutaneous-coronary-intervention-versus-coronary-artery-bypass-an-updated-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#16
Luca Testa, Azeem Latib, Mario Bollati, Rocco Antonio Montone, Antonio Colombo, Filippo Crea, Francesco Bedogni
BACKGROUND: The optimal treatment of unprotected left main (UPLM) with either PCI or CABG remains uncertain. AIM: The purpose of this study was to determine the comparative safety and efficacy of PCI versus CABG in patients with UPLM disease. METHODS: Search of BioMedCentral, CENTRAL, mRCT, PubMed, major cardiological congresses proceedings and references cross-check (updated November 2016). Outcomes were the rate of MACE [all cause death, MI, stroke], the rates of the individual components of MACE and the rate of target vessel revascularisation (TVR)...
2017: PloS One
https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#17
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#18
S Chava, G Gentchos, A Abernethy, B Leavitt, E Terrien, H L Dauerman
Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28640875/percutaneous-coronary-intervention-in-left-main-coronary-artery-disease-with-or-without-intravascular-ultrasound-a-meta-analysis
#19
Yicong Ye, Ming Yang, Shuyang Zhang, Yong Zeng
This meta-analysis compared IVUS-guided with angiography-guided PCI to determine the effect of IVUS on the mortality in patients with LM CAD. Current guidelines recommend intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with left main coronary artery disease (LM CAD; Class IIa, level of evidence B). A systematic search of the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases was conducted to identify randomized or non-randomized studies comparing IVUS-guided PCI with angiography-guided PCI in LM CAD...
2017: PloS One
https://www.readbyqxmd.com/read/28616647/outcomes-of-direct-stenting-in-patients-with-st-elevated-myocardial-infarction
#20
A Kalayci, V Oduncu, C Y Karabay, A Erkol, A C Tanalp, I H Tanboga, O Candan, C Gecmen, I A Izgi, C Kirma
BACKGROUND: We compared direct stenting (DS) with conventional stenting (CS) - i.e., stenting after predilation - during primary percutaneous coronary intervention (P-PCI) in terms of procedural results and long-term mortality in patients with ST-elevated myocardial infarction (STEMI). METHODS: We retrospectively analyzed 2306 patients (mean age 59 years, 22% female) who underwent P‑PCI within 12 h of symptom onset. Patients were then followed up prospectively for clinical events...
June 14, 2017: Herz
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