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Coronary intervention technique

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https://www.readbyqxmd.com/read/28914558/robotics-in-percutaneous-cardiovascular-interventions
#1
Ali Pourdjabbar, Lawrence Ang, Omid Behnamfar, Mitul P Patel, Ryan R Reeves, Paul T Campbell, Ryan D Madder, Ehtisham Mahmud
The fundamental technique of performing percutaneous cardiovascular (CV) interventions has remained unchanged and requires operators to wear heavy lead aprons to minimize exposure to ionizing radiation. Robotic technology is now being utilized in interventional cardiology partially as a direct result of the increasing appreciation of the long-term occupational hazards of the field. This review was undertaken to report the clinical outcomes of percutaneous robotic coronary and peripheral vascular interventions...
September 15, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28903139/percutaneous-coronary-intervention-vs-coronary-artery-bypass-grafting-in-patients-with-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#2
Daniele Giacoppo, Roisin Colleran, Salvatore Cassese, Antonio H Frangieh, Jens Wiebe, Michael Joner, Heribert Schunkert, Adnan Kastrati, Robert A Byrne
Importance: In patients with left main coronary artery (LMCA) stenosis, coronary artery bypass grafting (CABG) has been the standard therapy for several decades. However, some studies suggest that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative. Objective: To compare the long-term safety of PCI with drug-eluting stent vs CABG in patients with LMCA stenosis. Data Sources: PubMed, Scopus, EMBASE, Web of Knowledge, and ScienceDirect databases were searched from December 18, 2001, to February 1, 2017...
September 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28900715/radial-versus-femoral-access-site-for-percutaneous-coronary-intervention-in-patients-suffering-acute-myocardial-infarction-a%C3%A2-randomized-prospective-multicenter-trial
#3
Christiana Schernthaner, Matthias Hammerer, Stefan Harb, Matthias Heigert, Kurt Hoellinger, Elisabeth Lassnig, Edwin Maurer, Jochen Schuler, Peter Siostrzonek, Hanno Ulmer, Andreas Winter, Johann Altenberger
BACKGROUND: Transradial access (TRA) in percutaneous coronary intervention (PCI) is a widely used standard technique with lower complication rates compared to transfemoral access (TFA). The aim of this study was to evaluate the impact of TRA versus TFA for PCI on clinically significant vascular access complications in the setting of acute myocardial infarction (AMI). METHODS: This multicenter study randomly assigned 250 patients in a 1:1 fashion (TRA vs. TFA) admitted with or without ST-segment elevation AMI undergoing immediate PCI...
September 12, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28894596/magmaris-a-new-generation-metallic-sirolimus-eluting-fully-bioresorbable-scaffold-present-status-and-future-perspectives
#4
REVIEW
Claudio Rapetto, Massimo Leoncini
Drug-eluting stents (DES) have reached a high safety and efficacy profile, becoming the best option for percutaneous coronary interventions (PCI) based revascularization. However, despite their optimal performance, a few concerns remain regarding their use, mainly due to permanent caging of the vessels and its consequences, first of all late stent thrombosis (ST). Bioresorbable scaffolds (BRS) aim to overcome these issues. The results achieved in randomized controlled trials (RCT) by the first generation of poly-L-lactic acid (PLLA) based scaffolds were promising at 1 year, but the first long term reports (albeit flawed by non-optimal implantation technique) have been disappointing, showing, for instance, an increased risk of ST and target vessel myocardial infarction (TV-MI)...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28894595/the-impact-of-the-3-year-absorb-ii-trial-results-on-my-clinical-practice-an-italian-survey
#5
Matteo Serenelli, Simone Biscaglia, Elisabetta Tonet, Arnaldo Poli, Elisa Nicolini, Alfonso Ielasi, Andrea Erriquez, Gianluca Campo
BACKGROUND: To evaluate how the 3-year results from the "A clinical evaluation to compare the safety, efficacy and performance of ABSORB everolimus eluting bioresorbable vascular scaffold (BVS) system against XIENCE everolimus eluting coronary stent system in the treatment of subjects with ischemic heart disease caused by de novo native coronary artery lesions" (ABSORB II) trial have influenced clinical practice among Italian interventional cardiologists. METHODS: We performed a survey among 95 interventional cardiologists sending a brief questionnaire by electronic mail...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28894594/effectiveness-and-safety-of-the-absorb-bioresorbable-vascular-scaffold-for-the-treatment-of-coronary-artery-disease-systematic-review-and-meta-analysis-of-randomized-clinical-trials
#6
Rita Pavasini, Matteo Serenelli, Francesco Gallo, Giulia Bugani, Salvatore Geraci, Paolo Vicinelli, Gianluca Campo
BACKGROUND: In the last years bioresorbable vascular scaffold (BVS) become a new therapeutic option for interventional cardiologists, with the advantage of a scaffold inducing a possible vessel wall restoration. Nevertheless, several trials tried to prove the safety and efficacy profile of scaffolds, but with conflicting results. METHODS: A systematic review and meta-analysis was performed. The search was carried out in PubMed, Google Scholar, Biomed Central and Cochrane Library between January and March 2017...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28889135/acute-outcome-of-chronic-total-occlusion-cto-recanalizsation-in-the-elderly
#7
J E Guelker, T Rock, R Ott, M Katoh, K Kroeger, R Guelker, H G Klues, D I Shin, A Bufe
OBJECTIVES: Percutaneous coronary intervention (PCI) of total chronic total occlusion (CTO) still remains a major challenge in interventional cardiology. There is only insignificant knowledge reported in the literature about age differences in CTO recanalization. We analyzed in this study the issue of the impact of age on procedural characteristics, complications and short-term outcome. METHODS: Between 2012-2016 we included 440 patients. They underwent PCI for at least one CTO...
August 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28885062/out-of-hospital-cardiac-arrest-always-coronary-angiography
#8
Andrea Rognoni, Chiara Cavallino, Marco Giovanni Mennuni, Lucia Barbieri, Roberta Rosso, Francesco Rametta, Federico Nardi, Alessandro Lupi, Angelo Sante Bongo
Out-of-hospital cardiac arrest (OHCA) remains one of the principle challenges in the setting of critical care medicine and emergency cardiology. Areas covered: Long-term survival rates even after successful resuscitation are variable but increasing in the recent years; due to the improvement of base and advanced cardiac life support techniques an increasing number of resuscitated patients are admitted to the hospital. Some recent data have suggested that patients surviving to hospital discharge after OHCA presented long-term outcome similar to patients with ST-elevation myocardial infarction...
September 8, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28877121/begin-again-and-continue-with-life-a-qualitative-study-on-the-experiences-of-cardiac-rehabilitation-patients
#9
Fariba Jokar, Hojatllah Yousefi, Alireza Yousefy, Masoumeh Sadeghi
BACKGROUND: Cardiovascular diseases are a main cause of mortality worldwide. However, new diagnostic techniques and treatments have increased the rate of survival for patients with cardiovascular disease. Cardiac rehabilitation programs aim to maintain and enhance the quality of life of patients and improve the secondary prevention of coronary artery disease. Suboptimal participation in rehabilitation programs, early exit from these programs, and not achieving lasting changes are cardiac rehabilitation challenges that are associated with health issues, including the increased need for medication, repeated hospitalization, failure in the secondary prevention programs, and long waiting lists...
October 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28873361/-1-h-nmr-based-pharmacometabolomics-analysis-of-urine-identifies-metabolic-phenotype-of-clopidogrel-high-on-treatment-platelets-reactivity-in-coronary-artery-disease-patients
#10
Arwa M Amin, Lim Sheau Chin, Chin-Hoe Teh, Hamza Mostafa, Dzul Azri Mohamed Noor, Muhamad Ali Sk Abdul Kader, Yuen Kah Hay, Baharudin Ibrahim
Clopidogrel high on treatment platelets reactivity (HTPR) has burdened achieving optimum therapeutic outcome. Although there are known genetic and non-genetic factors associated with clopidogrel HTPR, which explain in part clopidogrel HTPR, yet, great portion remains unknown, often hindering personalizing antiplatelet therapy. Nuclear magnetic resonance ((1)H NMR) pharmacometabolomics analysis is useful technique to phenotype drug response. We investigated using (1)H NMR analysis to phenotype clopidogrel HTPR in urine...
August 19, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28865843/activation-and-inflammation-of-the-venous-endothelium-in-vein-graft-disease
#11
REVIEW
Alexander O Ward, Massimo Caputo, Gianni D Angelini, Sarah J George, Mustafa Zakkar
The long saphenous vein is the most commonly used conduit in coronary artery bypass graft (CABG) surgery when bypassing multiple diseased arteries; however, its use is complicated by the development of vascular inflammation, intimal hyperplasia and accelerated atherosclerosis leading to compromised graft efficacy. Despite refinement of surgical techniques to improve graft patency, late vein graft failure remains a significant problem. Moreover, there is a lack of pharmacological interventions proven to be effective in the treatment of late vein graft failure...
August 24, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28845857/-fractional-flow-reserve-a-practical-guide-for-interventional-cardiologists-and-the-cardiologist-s-point-of-view
#12
Serafina Valente, Alessio Mattesini, Roberta Rossini, Sergio Berti, Carlotta Sorini Dini, Alessandro Politi, Luca Golino, Francesco Romeo, Giuseppe Musumeci, Gian Franco Gensini, Carlo Di Mario
Fractional flow reserve (FFR) is considered the gold standard for functional assessment of coronary stenosis in stable coronary artery disease. The use of FFR enables an ischemia-guided revascularization with improvement of clinical outcomes in a cost-effective fashion. Both clinical and interventional cardiologists should be aware of the advantages and potential pitfalls of this technique. We focus on FFR with the aim to provide the clinical cardiologist with information on indications and technical aspects to confirm a correct execution of FFR in different coronary anatomical settings...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28844031/state-of-the-art-evolving-concepts-in-the-treatment-of-heavily-calcified-and-undilatable-coronary-stenoses-from-debulking-to-plaque-modification-a-40-year-long-journey
#13
Emanuele Barbato, Evan Shlofmitz, Anastasios Milkas, Richard Shlofmitz, Lorenzo Azzalini, Antonio Colombo
Since the first balloon angioplasty by Andreas Grüntzig 40 years ago, interventional cardiology has witnessed the introduction of countless tools and techniques that have significantly contributed to broadening the application of percutaneous coronary interventions (PCI) in unprecedented anatomic settings. Heavily calcified, fibrotic coronary stenosis has traditionally represented a very challenging scenario for PCI, and a very common indication for surgical revascularisation. This was mostly due to the difficulty in adequately dilating these lesions and/or to the inability to deliver and implant stents appropriately, which is often associated with high rates of procedural complications and suboptimal long-term clinical outcomes...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844030/state-of-the-art-balloon-catheter-technologies-drug-coated-balloon
#14
Fernando Alfonso, Bruno Scheller
Four decades after its introduction into clinical practice, coronary balloon angioplasty is still used during most coronary interventions. Conventional balloon angioplasty is frequently used to predilate complex or severe lesions and remains of major value to optimise the results of stent implantation. Plain balloon angioplasty is still used alone in some anatomic scenarios where stent implantation is not desirable (very small vessels or diffuse lesions, large resistant thrombus burden, side branches of bifurcations)...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844026/state-of-the-art-coronary-angiography
#15
Carlos Collet, Maik J Grundeken, Taku Asano, Yoshinobu Onuma, William Wijns, Patrick W Serruys
In the early days of coronary angiography, the precise quantification of luminal narrowing was challenging. The introduction of balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) by Andreas Grüntzig in 1977 was perhaps the greatest incentive to the development of quantitative coronary angiography (QCA). QCA has played a crucial role in evaluating interventional techniques and assessing the results of new technologies. With the advent of drug-eluting stents (DES), QCA metrics such as late lumen loss and diameter stenosis (restenosis) proved to be instrumental in assessing new technologies...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28838915/radial-artery-and-ulnar-artery-occlusions-following-coronary-procedures-and-the-impact-of-anticoagulation-artemis-radial-and-ulnar-artery-occlusion-meta-analysis-systematic-review-and-meta-analysis
#16
REVIEW
George Hahalis, Konstantinos Aznaouridis, Gregory Tsigkas, Periklis Davlouros, Ioanna Xanthopoulou, Nikolaos Koutsogiannis, Ioanna Koniari, Marianna Leopoulou, Olivier Costerousse, Dimitris Tousoulis, Olivier F Bertrand
BACKGROUND: Incidence of radial artery occclusions (RAO) and ulnar artery occclusions (UAO) in coronary procedures, factors predisposing to forearm arteries occlusion, and the benefit of anticoaggulation vary significantly in existing literature. We sought to determine the incidence of RAO/UAO and the impact of anticoagulation intensity. METHODS AND RESULTS: Meta-analysis of 112 studies assessing RAO and/or UAO (N=46 631) were included. Overall, there was no difference between crude RAO and UAO rates (5...
August 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28838092/percutaneous-coronary-intervention-vs-coronary-artery-bypass-grafting-for-left-main-revascularization-an-updated-meta-analysis
#17
Navkaranbir S Bajaj, Nirav Patel, Rajat Kalra, Peter Marogil, Ashwanikumar Bhardwaj, Garima Arora, Pankaj Arora
Aims: The optimal revascularization strategy for left main coronary artery disease (LMD) remains controversial, especially with two recent randomized controlled trials showing conflicting results. We sought to address this controversy with our analysis. Methods and results: Comprehensive literature search was performed. We compared percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for LMD revascularization using standard meta-analytic techniques...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28838087/quality-of-life-following-coronary-artery-bypass-graft-surgery-vs-percutaneous-coronary-intervention-in-diabetics-with-multivessel-disease-a-five-year-registry-study
#18
Brent M McGrath, Colleen M Norris, Emeleigh Hardwicke-Brown, Robert C Welsh, Kevin R Bainey
Aims: The aim of this study is to investigate the long-term relationship between revascularization technique and health status in diabetics with multivessel disease. Methods and results: Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry, we captured 1319 diabetics with multivessel disease requiring revascularization for an acute coronary syndrome (January 2009-December 2012) and reported health status using the Seattle Angina Questionnaire (SAQ) at baseline, 1, 3 and 5-years [599 underwent coronary artery bypass grafting (CABG); 720 underwent percutaneous coronary intervention (PCI)]...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28836346/the-trap-and-occlude-technique-for-retrograde-wire-externalization-during-chronic-total-occlusion-revascularization
#19
Gabriele L Gasparini, Jacopo A Oreglia, Roberto Garbo
Different strategies of retrograde approach were introduced in recent years to improve the success rate of percutaneous coronary intervention for coronary chronic total occlusions. The aim of this report is to describe a new technique, called "Trap and Occlude Technique," for retrograde wire externalization during CTO percutaneous revascularization. This technique may save time and reduce radiation exposure and procedure-related bleeding.
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28835831/three-dimensional-optical-frequency-domain-imaging-of-a-true-bifurcation-lesion-after-stent-implantation-using-the-jailed-semi-inflated-balloon-technique
#20
Yohei Numasawa, Hiromu Hase, Hiroyuki Yamazaki, Ryota Tabei, Toshiki Kuno, Masaki Kodaira, Tetsuya Saito
OBJECTIVE: Percutaneous coronary intervention for coronary bifurcation lesion is very challenging, especially for true bifurcation lesions. Although the jailed semi-inflated balloon technique is one of the established methods for treatment of coronary bifurcation lesions, little is known regarding the configuration of the side branch orifice after stent implantation using this technique. METHODS: We report a 73-year-old male patient with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a true bifurcation lesion of the right coronary artery with an obtuse angle using the jailed semi-inflated balloon technique...
2017: SAGE open medical case reports
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