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Coronary intervention technique

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https://www.readbyqxmd.com/read/28317788/current-status-of-transcatheter-mitral-valve-therapy-in-europe-results-from-an-eapci-survey-part-ii
#1
Anna Sonia Petronio, Piera Capranzano, Emanuele Barbato, Nicolò Piazza, Andreas Baumbach, Michael Haude, Stephan Windecker
AIMS: The European Association of Percutaneous Coronary Interventions (EAPCI) assessed the current status of transcatheter valve therapy in Europe through a web-based survey. Our aim here was to report the results of that survey regarding trends in percutaneous mitral valve repair (PMVR) therapy. METHODS AND RESULTS: Among 301 European centres participating in the overall EAPCI survey, 246 (81.7%) responded to the PMVR section questions. A total of 176 (71.5%) have been undertaking a PMVR programme...
March 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28315286/coronary-endarterectomy-or-patch-angioplasty-for-diffuse-left-anterior-descending-artery-disease
#2
Ohad Bitan, Paul A Pirundini, Eyal Leshem, Carrie Consalvi, Siobhan McGurk, Quincy King, Dan Loberman
Background Coronary endarterectomy and patch angioplasty for the left anterior descending (LAD) artery have been shown to be effective adjunct techniques to surgical revascularization for severe coronary lesions. The objective of this study is to review the short- and long-term results of these two methods in our institution. Methods We retrospectively reviewed 166 consecutive patients who underwent internal thoracic artery grafting to the LAD, with either adjunct endarterectomy (95 patients) or patch angioplasty (71 patients) between 2002 and 2014...
March 17, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#3
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314731/long-term-outcomes-of-provisional-stenting-compared-with-a-two-stent-strategy-for-bifurcation-lesions-a-meta-analysis-of-randomised-trials
#4
Ramez Nairooz, Marwan Saad, Islam Y Elgendy, Ahmed N Mahmoud, Fuad Habash, Partha Sardar, David Anderson, David M Shavelle, J Dawn Abbott
BACKGROUND: The optimal interventional technique for addressing coronary bifurcation lesions is debatable. Long-term clinical outcomes with provisional stenting (PS) compared with a two-stent (TS) strategy for bifurcation lesions are scarce. We aim to perform the first meta-analysis of randomised controlled trials (RCTs) to explore long-term outcomes comparing both strategies. METHODS: An electronic search was performed for online databases until August 2016 for RCTs comparing PS with TS for bifurcation lesions reporting outcomes at 1 year of follow-up or more...
March 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#5
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296143/targeting-the-safe-zone
#6
Andrea Mignatti, Patricia Friedmann, David Paul Slovut
OBJECTIVE: The aim of this study was to assess the effectiveness of a quality improvement (QI) program in reducing vascular complications during cardiac catheterization. BACKGROUND: Vascular access complications during cardiac catheterization are associated with higher morbidity and mortality. We implemented a QI program focused on using micropuncture techniques and targeting the "safe zone," an area below the inferior border of the inferior epigastric artery and above the inferior border of the femoral head, for femoral artery puncture...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#7
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291731/a-parallel-wire-technique-in-aortosubclavian-loops-and-tortuosities-a-simple-and-useful-technique-during-transradial-coronary-angiography-and-interventions
#8
Félix Valencia-Serrano, Natalia Bolívar Herrera, Manuel Vida Gutiérrez, Ricardo Fajardo Molina, Manuel Gómez Recio, Rosa Lázaro-García
No abstract text is available yet for this article.
March 10, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28291665/cardiac-arrest-in-acute-myocardial-infarction-concept-of-circulatory-support-with-mechanical-chest-compression-and-impella-to-facilitate-percutaneous-coronary-intervention
#9
Kaleab N Asrress, Maciej Marciniak, Natalia Briceno, Divaka Perera
Cardiogenic shock in the context of acute ST-elevation myocardial infarction (STEMI) remains a challenge to manage and results in significant mortality and morbidity, cardiac arrest in this setting even more so. The increase in myocardial oxygen demand and consumption with the use of inotropes is recognised as increasing mortality. Alternatives include the intra-aortic balloon pump (IABP), which has yet to be shown to improve outcomes, and extracorporeal membrane oxygenation (ECMO), which requires super-specialised techniques not widely available...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28290842/-serial-assessment-of-transthoracic-coronary-flow-reserve-as-method-of-assessing-efficacy-of-intracoronary-intervention-in-the-left-anterior-and-posterior-descending-arteries
#10
A A Boshchenko, A V Vrublevsky, R S Karpov
Transthoracic echocardiography (TTE) has been described as an accurate technique for noninvasive evaluation of coronary flow reserve (CFR) of the left anterior descending artery (LAD) and posterior descending artery (PDA). Aim of this study was to find out whether serial measurement of CFR in LAD and PDA using TTE allows detection of stenosis elimination after intracoronary intervention and is a marker of successful procedure. METHODS: The study group comprised 14 patients with single-vessel coronary disease (stenosis 82+/-14%) of the LAD (9 patients) or right coronary artery (RCA, 5 patients) scheduled for stent implantation...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290815/-a-single-preventive-counseling-in-the-hospital-does-not-improve-the-prognosis-of-patients-after-percutaneous-coronary-intervention
#11
N V Pogosova, O J Sokolova, A K Ausheva, A V Karpova, Yu M Yufereva, S A Salbieva, A I Yusubova, S S Isakova, M A Iosifyan, V A Vygodin
The purpose of the study "Invasive Techniques for the treatment of atherosclerosis: the effectiveness of secondary preventive intervention" (IMLA-TRAC) - long-term efficacy of single preventive counseling of patients with coronary heart disease (CHD) in a stationary treatment for percutaneous coronary intervention (PCI). MATERIAL AND METHODS: In a prospective, randomized, controlled trial included 160 patients with coronary artery disease who underwent PCI between the ages of 38 to 87 years (mean age 59,43+/-8,94 years, 81...
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28285314/the-staged-urethroplasty-with-vascularised-scrotal-flap-and-buccal-mucosa-graft-after-failed-hypospadias-surgery-a-reliable-technique-with-a-novel-tool
#12
Abhishek Pandey, Anna-Maria Barta-Kelemen, Michael Borisenkov, Hansjörg Keller
Background/Aims/Objectives: To report the outcome of staged urethroplasty with buccal mucosa and vascularised scrotal flap after failed hypospadias surgery. METHODS: n = 35. INCLUSION CRITERIA: destroyed urethral plate, deficient local skin, fistula and penile deviation. Five out of 35 patients also had a secondary proximal stricture. Stage 1: excision of scarred tissue and fistulae, correction of the penile deviation through dorsal plication and the ventral placement and quilting of buccal graft...
March 11, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28279370/myocardial-infarct-size-by-cmr-in-clinical%C3%A2-cardioprotection-studies-insights-from-randomized-controlled-trials
#13
Heerajnarain Bulluck, Matthew Hammond-Haley, Shane Weinmann, Roberto Martinez-Macias, Derek J Hausenloy
OBJECTIVES: The aim of this study was to review randomized controlled trials (RCTs) using cardiac magnetic resonance (CMR) to assess myocardial infarct (MI) size in reperfused patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: There is limited guidance on the use of CMR in clinical cardioprotection RCTs in patients with STEMI treated by primary percutaneous coronary intervention. METHODS: All RCTs in which CMR was used to quantify MI size in patients with STEMI treated with primary percutaneous coronary intervention were identified and reviewed...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28275942/bioresorbable-polymers-and-stent-devices
#14
REVIEW
Payam Dehghani
Percutaneous coronary interventions will never become obsolete, as evolution is inherent to interventional cardiology. Current drug-eluting platforms have appreciably improved their safety and efficacy profiles in different clinical settings compared to first-generation devices such that it is difficult to consider other alternatives. However, there is definite biological plausibility to consider devices with bioabsorbable polymers and/or scaffolds. It is also an undeniable fact that many patients, based on variety of belief systems, would prefer not to have a permanently implanted device...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#15
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28274589/contemporary-use-of-drug-coated-balloons-in-coronary-artery-disease-where-are-we-now
#16
REVIEW
Fabien Picard, Serge Doucet, Anita W Asgar
The drug-coated balloon (DCB) has emerged as an additional tool in the arsenal of interventional cardiology devices; it delivers antiproliferative drugs to local arterial tissue by single prolonged coated balloon angioplasty inflation, and prevents restenosis, leaving no implant behind. This strategy theoretically decreases the risk of late inflammatory response to device components, without preventing positive remodelling. DCBs, when used carefully and with a good technique, may have a role in the treatment of lesion subsets, such as in-stent restenosis, small vessel disease or side branch bifurcations, in which the implantation of a drug-eluting stent is not desirable or is technically challenging...
March 5, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28266098/characteristics-and-outcomes-of-patients-undergoing-percutaneous-coronary-intervention-within-1-year-of-coronary-artery-bypass-graft-surgery
#17
Divyesh Sharma, Mark A Kotowycz, Vinoda Sharma, Anirban Choudhury, William Chan, Xavier Freixa, Vladimír Džavík, Christopher B Overgaard
OBJECTIVES: The aim of this study was to examine the clinical and procedural outcomes of patients undergoing percutaneous coronary intervention (PCI) within 1 year of coronary artery bypass graft surgery (CABG). BACKGROUND: CABG is the preferred revascularization strategy for patients with complex coronary artery disease due to a lower rate of repeat revascularization. Despite advances in surgical technique and medical therapy, >5% of patients require repeat revascularization within 1 year of CABG...
March 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28263941/assessing-hospital-performance-after-percutaneous-coronary-intervention-using-big-data
#18
Jacob V Spertus, Sharon-Lise T Normand, Robert Wolf, Matt Cioffi, Ann Lovett, Sherri Rose
BACKGROUND: Although risk adjustment remains a cornerstone for comparing outcomes across hospitals, optimal strategies continue to evolve in the presence of many confounders. We compared conventional regression-based model to approaches particularly suited to leveraging big data. METHODS AND RESULTS: We assessed hospital all-cause 30-day excess mortality risk among 8952 adults undergoing percutaneous coronary intervention between October 1, 2011, and September 30, 2012, in 24 Massachusetts hospitals using clinical registry data linked with billing data...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28257768/mechanisms-underlying-drug-delivery-to-peripheral-arteries
#19
REVIEW
Jun Li, Rami Tzafriri, Sandeep M Patel, Sahil A Parikh
Delivery of drugs onto arterial targets via endovascular devices commands several principles: dissolution, diffusion, convection, drug binding, barriers to absorption, and interaction between the drug, delivery vehicle, and accepting arterial wall. The understanding of drug delivery in the coronary vasculature is vast; there is ongoing work needed in the peripheral arteries. There are differences that account for some failures of application of coronary technology into the peripheral vascular space. Breakthroughs in peripheral vascular interventional techniques building on current technologies require investigators willing to acknowledge the similarities and differences between these different vascular territories, while developing technologies adapted for peripheral arteries...
April 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28256180/left-main-coronary-artery-stenosis-severity-evaluation-and-implications-for-management
#20
REVIEW
Susan E Habibi, Rahman Shah, Chalak O Berzingi, Ryan Melchior, Kevin F Sumption, Ion S Jovin
The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'...
March 2017: Expert Review of Cardiovascular Therapy
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