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Coronary intervention technique

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https://www.readbyqxmd.com/read/28092294/outcomes-of-a-combined-approach-of-percutaneous-coronary-revascularization-and-cardiac-valve-surgery
#1
Orlando Santana, Sandeep Singla, Christos G Mihos, Andrés M Pineda, Gregg W Stone, Paul A Kurlansky, Isaac George, Ajay J Kirtane, Craig R Smith, Nirat Beohar
A subset of patients requiring coronary revascularization and valve surgery may benefit from a combined approach of percutaneous coronary intervention (PCI) and valve surgery, as opposed to the standard median sternotomy approach of combined coronary artery bypass and valve surgery. To evaluate its potential benefits and limitations, a literature search was performed using PubMed, EMBASE, Ovid, and the Cochrane library, through March 2016 to identify all studies involving a combined approach of PCI and valve surgery in patients with coronary artery and valvular disease...
January 13, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28090817/coronary-or-ventricular-rupture-after-blunt-chest-trauma-a-clinical-dilemma
#2
Anton Sabashnikov, Guido Michels, Javid Fatullayev, Kaveh Eghbalzadeh, Mohamed Zeriouh, Stephan Baldus, Jens Wippermann, Thorsten Wahlers, Navid Madershahian
Cardiac rupture (CR) is one of the most serious and life-threatening complications of blunt chest trauma (BCT) usually associated with high mortality. Moreover, its diagnosis and treatment strategies may be extremely challenging for clinicians due to various anatomical localisations of the tear. Whereas most injuries fall under the category of right atrial ruptures, left ventricular lesions represent a rare type of this injury, with greater mortality, particularly in cases of multi-chamber injuries. However, not only cardiac chamber or great vessel ruptures may occur as a result of BCT; a growing number of reports also describe BCT-induced isolated coronary artery injuries, including ruptures...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28089148/percutaneous-revascularization-of-chronic-total-occlusions-rationale-indications-techniques-and-the-cardiac-surgeon-s-point-of-view
#3
Lorenzo Azzalini, Gianluca Torregrossa, John D Puskas, Emmanouil S Brilakis, William L Lombardi, Dimitri Karmpaliotis, Sunao Nakamura, Antonio Colombo, Mauro Carlino
Chronic total occlusions (CTO) are frequently found in clinical practice, yet they are still undertreated, despite the frequent presence of clinical indications for revascularization. The presence of a CTO is a frequent cause of incomplete revascularization, which has been associated with worse long-term outcomes (including mortality), compared to complete revascularization. Such low rates of attempted revascularization can be attributed to a common misconception about the lack of benefit of CTO revascularization, combined with historically lower success rates and higher complication rates of CTO percutaneous coronary intervention...
January 5, 2017: International Journal of Cardiology
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
#4
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/28065491/meta-analysis-of-randomized-trials-on-remote-ischemic-conditioning-during-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction
#5
Ayman Elbadawi, Le Dung Ha, Ahmed S Abuzaid, Gabriele Crimi, Muhammad S Azzouz
Ischemia/reperfusion injury adversely affects the final infarct size (IS) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Few studies have evaluated the role of remote ischemic conditioning (RIC) in reducing ischemia/reperfusion injury. However, the results of these studies were not consistent, and an overview of overall effectiveness of this technique in patients with STEMI is lacking. We conducted this meta-analysis to evaluate the available evidence in literature regarding the application of RIC in patients with STEMI who underwent primary PCI...
December 21, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28049984/clinical-outcomes-in-diabetic-patients-who-underwent-percutaneous-coronary-intervention-during-the-plain-old-balloon-angioplasty-poba-bare-metal-stents-bms-and-drug-eluting-stents-des-eras-from-1984-to-2010
#6
Ryo Naito, Katsumi Miyauchi, Hirokazu Konishi, Shuta Tsuboi, Manabu Ogita, Tomotaka Dohi, Takatoshi Kasai, Hiroshi Tamura, Shinya Okazaki, Kikuo Isoda, Hiroyuki Daida
Objective Diabetes is a negative predictor in coronary artery disease patients. Since the introduction of percutaneous coronary intervention (PCI), PCI has evolved through technological advances in devices, improvements in operators' techniques and the establishment of effective therapeutic protocols. The aim of this study is to examine the changes in the clinical outcomes following PCI in patients with diabetes. Methods We compared the clinical outcomes in patients with diabetes following PCI from 1984 to 2010 at Juntendo University over three eras (plain old balloon angioplasty (POBA)-, bare metal stents (BMS)- and drug-eluting stents (DES)-eras)...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28045933/optimization-of-peripheral-vascular-sizing-with-conductance-guidewire-theory-and-experiment
#7
Hyo Won Choi, Zachary C Berwick, Matthew S Sulkin, Christopher D Owens, Ghassan S Kassab
Although the clinical range of interventions for coronary arteries is about 2 to 5 mm, the range of diameters of peripheral vasculature is significantly larger (about 10 mm for human iliac artery). When the vessel diameter is increased, the spacing between excitation electrodes on a conductance sizing device must also increase to accommodate the greater range of vessel diameters. The increase in the excitation electrodes distance, however, causes higher parallel conductance or current losses outside of artery lumen...
2017: PloS One
https://www.readbyqxmd.com/read/28041697/validity-of-the-j-cto-score-and-the-cl-score-for-predicting-successful-cto-recanalization
#8
J E Guelker, L Bansemir, R Ott, T Rock, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge in interventional cardiology. To predict the probability of a successful intervention different scoring systems are available. We analyzed in this study the validity of two scoring systems, the Japanese CTO score (J-CTO score) and the newly developed Clinical and Lesion-related score (CL Score). METHODS: Between 2012 and 2015 we included 379 consecutive patients...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28031686/successful-percutaneous-retrieval-of-a-guiding-catheter-tip-that-had-unexpectedly-become-detached-using-a-two-wire-technique
#9
Kiyoshi Kume, Yoshinori Yasuoka, Tatsuya Sasaki
Device dislodgement during percutaneous coronary intervention (PCI) is a rare but potentially life-threatening complication. We herein report the successful retrieval of a guiding catheter tip that had unexpectedly become detached in the right coronary artery during PCI in a 68-year-old man. Interventional cardiologists must be familiar with a safer and more reliable retrieval technique.
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031658/reverse-movahed-maneuver-maximal-expiration-maneuver-during-saphenous-vein-graft-intervention-for-facilitated-balloon-and-stent-delivery-in-tortuous-vein-grafts-a-novel-technique
#10
Mohammad Reza Movahed
Percutaneous coronary intervention involving tortuous saphenous vein grafts can be difficult during balloon or stent advancement. There are many available techniques to facilitate stent delivery in tortuous vessel, such as using specialized catheter body wires, use of extra support wires or using extra back up guide catheters. All these techniques have limitations and can be costly and time-consuming. We previously published a maneuver that showed how to facilitate stent delivery in tortuous native coronary arteries by instructing the patient to take a deep breath leading to straightening of the coronary tree, thereby, substantially improving stent deliverability...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#11
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Antonio Serra, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Livia L Gheorghe, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: To study the long-term outcomes of rotational atherectomy (RA) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: There is little evidence on the incidence, procedural results and long-term outcomes of RA for CTO PCI. METHODS: This registry included data from consecutive patients undergoing CTO PCI at four specialized centers. Major adverse cardiac events (MACE: cardiac death, target-vessel myocardial infarction and ischemia-driven target-vessel revascularization) on follow-up were the primary endpoint...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28028693/a-study-of-coronary-bifurcation-shape-in-a-normal-population
#12
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
#13
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/28005512/cardiac-mr-imaging-in-acute-coronary-syndrome-application-and-image-interpretation
#14
Farhood Saremi
Acute coronary syndrome (ACS) is a frequent cause of hospitalization and coronary interventions. Cardiac magnetic resonance (MR) imaging is an increasingly used technique for initial work-up of chest pain and early post-reperfusion and follow-up evaluation of ACS to identify patients at high risk of further cardiac events. Cardiac MR imaging can evaluate with accuracy a variety of prognostic indicators of myocardial damage, including regional myocardial dysfunction, infarct distribution, infarct size, myocardium at risk, microvascular obstruction, and intramyocardial hemorrhage in both acute setting and later follow-up examinations...
January 2017: Radiology
https://www.readbyqxmd.com/read/27999826/the-diagnosis-of-silent-myocardial-ischemia-motion-frozen-or-morphing-myocardial-perfusion-imaging
#15
EDITORIAL
Cheng Chang, Bo Ye, Wenhui Xie, Daoliang Zhang, Bei Lei, Xiaodan Ye
Silent myocardial ischemia is typically defined as objective evidence of myocardial ischemia in patients without subjective ischemia symptoms. Currently, coronary artery angiography is the gold standard for diagnosis of asymptomatic coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) can visually demonstrate the morphology, trend and extent of coronary stenosis and is commonly used in clinical screening of CAD. Myocardial perfusion imaging can be used not only to identify whether anatomical stenosis causes myocardial dysfunction, but to also assess the risk stratification and prognosis of myocardial disease (MD)...
September 2016: Hellenic Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/27977615/total-revascularization-for-an-epsilon-right-coronary-artery-and-severe-left-main-disease-combined-with-profound-cardiogenic-shock-a-case-report
#16
Hsiu-Yu Fang, Wei-Chieh Lee, Chiung-Jen Wu
RATIONALE: Severe left main disease combined with right coronary artery occlusion was rarely encountered in our daily practice. Percutaneous coronary intervention in these patients was most challenging due to high probability of hemodynamic changes. PATIENT CONCERNS: Here, we report a 67-year-old man with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) and profound cardiogenic shock and we attempted coronary intervention with total revisualization for severe left main (LM) disease and angulated epsilon right coronary artery total occlusion...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27976794/mother-and-child-catheter-facilitated-optical-coherence-tomography-a-novel-approach-to-improve-intracoronary-imaging
#17
Marcos Garcia-Guimaraes, Javier Cuesta, Fernando Rivero, Teresa Alvarado, Gonzalo Navarrete, Teresa Bastante, Amparo Benedicto, Fernando Alfonso
BACKGROUND: Our aim was to prospectively analyze the usefulness of mother-and-child catheter approach with the GuideLiner® (GL) catheter extension system to overcome some potential limitations associated with the use of optical coherence tomography (OCT). METHODS: We included consecutive patients referred to our institution for coronary angiogram in whom OCT image acquisition was obtained using GL. From February 2015 to May 2016, a total of 19 procedures (18 patients) were prospectively included...
2016: Cardiology Journal
https://www.readbyqxmd.com/read/27970313/tct-13-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-according-to-dissection-re-entry-versus-wire-escalation-techniques
#18
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Barbara Bellini, Susanna Benincasa, Jorge Chavarria Viquez, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27969640/tct-295-percutaneous-coronary-intervention-in-chronic-total-occlusions-a%C3%A2-single%C3%A2-center-experience-on-the-impact-and-efficacy-of-using-contemporary-techniques
#19
Sang Yeub Lee, Nelson Bernardo, Gallino Robert A, Hector M Garcia-Garcia, Gilbert Tang, Toby Rogers, Sarkis Kiramijyan, Edward Koifman, Smita I Negi, Jiaxiang Gai, Rebecca Torguson, Lowell Satler, Augusto Pichard, Ron Waksman
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27942403/the-future-of-off-pump-coronary-artery-bypass-grafting-a-north-american-perspective
#20
Bobby Yanagawa, Rashmi Nedadur, John D Puskas
Off-pump coronary artery bypass graft (OPCAB) is currently performed routinely in a minority of specialized centers and in many more centers, utilized only when a porcelain aorta mandates a no-touch aortic technique. The OPCAB literature can be summarized as follows: (I) large-scale randomized trials in relatively low risk patients that include surgeons with a range of experience demonstrating no consistent beneficial differences in major cardiovascular and cerebrovascular outcomes but lower transfusion rates and shorter length of stay, tempered by some reports of higher rates of incomplete revascularization and lower rates of long term graft patency; (II) smaller randomized controlled trials (RCTs) from highly specialized programs demonstrating equivalent or superior outcomes with OPCAB and similar completeness of revascularization and graft patency; and (III) observational data from large databases demonstrating a consistent benefit of OPCAB, especially in higher-risk patient subsets...
November 2016: Journal of Thoracic Disease
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