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https://www.readbyqxmd.com/read/28801540/time-course-reduction-in-patient-exposure-to-radiation-from-coronary-interventional-procedures-the-greater-paris-area-percutaneous-coronary-intervention-registry
#1
Jean-Louis Georges, Nicole Karam, Muriel Tafflet, Bernard Livarek, Sophie Bataille, Aurélie Loyeau, Mireille Mapouata, Hakim Benamer, Christophe Caussin, Philippe Garot, Olivier Varenne, Franck Barbou, Emmanuel Teiger, François Funck, Gaëtan Karrillon, Yves Lambert, Christian Spaulding, Xavier Jouven
BACKGROUND: The frequency of complex percutaneous coronary interventions (PCIs) has increased in the last few years, with a growing concern on the radiation dose received by the patients. Multicenter data from large unselected populations on patients' radiation doses during coronary angiography (CA) and PCI and temporal trends are lacking. This study sought to evaluate the temporal trends in patients' exposure to radiation from CA and PCI. METHODS AND RESULTS: Data were taken from the CARDIO-ARSIF registry that prospectively collects data on all CAs and PCIs performed in the 36 catheterization laboratories in the Greater Paris Area, the most populated regions in France with about 12 million inhabitants...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28798016/bayesian-analysis-a-practical-approach-to-interpret-clinical-trials-and-create-clinical-practice-guidelines
#2
John A Bittl, Yulei He
Bayesian analysis is firmly grounded in the science of probability and has been increasingly supplementing or replacing traditional approaches based on P values. In this review, we present gradually more complex examples, along with programming code and data sets, to show how Bayesian analysis takes evidence from randomized clinical trials to update what is already known about specific treatments in cardiovascular medicine. In the example of revascularization choices for diabetic patients who have multivessel coronary artery disease, we combine the results of the FREEDOM trial (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) with prior probability distributions to show how strongly we should believe in the new Class I recommendation ("should be done") for a preference of bypass surgery over percutaneous coronary intervention...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28798015/morbidity-and-mortality-conference-for-percutaneous-coronary-intervention
#3
Jacob A Doll, Robert Overton, Manesh R Patel, Sunil V Rao, Michael H Sketch, J Kevin Harrison, James E Tcheng
BACKGROUND: Morbidity and mortality conference is a common educational and quality improvement activity performed in cardiac catheterization laboratories, but best practices for case selection and for maximizing the effectiveness of peer review have not been determined. METHODS AND RESULTS: We reviewed the 10-year percutaneous coronary intervention morbidity and mortality conference experience of an academic medical center. Cases were triggered for review by the occurrence of prespecified procedural events...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28797429/early-procedural-and-health-status-outcomes-after-chronic-total-occlusion%C3%A2-angioplasty-a-report-from-the-open-cto-registry-outcomes-patient-health-status-and-efficiency-in-chronic-total-occlusion-hybrid-procedures
#4
James Sapontis, Adam C Salisbury, Robert W Yeh, David J Cohen, Taishi Hirai, William Lombardi, James M McCabe, Dimitri Karmpaliotis, Jeffrey Moses, William J Nicholson, Ashish Pershad, R Michael Wyman, Anthony Spaedy, Stephen Cook, Parag Doshi, Robert Federici, Craig R Thompson, Steven P Marso, Karen Nugent, Kensey Gosch, John A Spertus, J Aaron Grantham
OBJECTIVES: This study sought to accurately describe the success rate, risks, and patient-reported benefits of contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: In light of the evolving techniques to successfully revascularize CTO lesions, there remains a compelling need to more accurately quantify the success rates, risks, and benefits of these complex procedures. METHODS: Using a uniquely comprehensive, core-lab adjudicated, single-arm, multicenter registry of 1,000 consecutive patients undergoing CTO PCI by the hybrid approach, we evaluated the technical success rates, complication rates, and raw and adjusted health status benefits at 1 month among successfully as compared to unsuccessfully treated patients...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797011/the-coronary-heart-team
#5
Bobby Yanagawa, John D Puskas, Deepak L Bhatt, Subodh Verma
PURPOSE OF REVIEW: The concept of a Coronary Heart Team has generated increased interest, including support from major practice guidelines. Here, we review the rationale and the published experience of Coronary Heart Teams. RECENT FINDINGS: A Coronary Heart Team should be led by both cardiology and cardiac surgery with a shared decision-making approach. The team should incorporate data from anatomic and clinical risk prediction models to offer individualized care...
September 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28795527/utility-of-the-guideliner-catheter-for-percutaneous-coronary-interventions-in-patients-with-prior-transcatheter-aortic-valve-replacement
#6
Aditya S Bharadwaj, Samit Bhatheja, Samin K Sharma, Annapoorna S Kini
The safety and utility of GuideLiner catheters in complex percutaneous coronary interventions (PCI) has been well established. Patients with prior trans-catheter aortic valve replacement especially with CoreValve, who present for PCI, pose a unique set of challenges. Not only does the operator often encounter difficulty with selective engagement of coronary ostia through the struts of the CoreValve, but also the complex nature of the underlying CAD in this high-risk population. We present a case series to illustrate the use of GuideLiner catheter as an adjunctive tool for PCI in this patient population...
August 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28795481/robotic-technology-in-interventional-cardiology-current-status-and-future-perspectives
#7
Ehtisham Mahmud, Ali Pourdjabbar, Lawrence Ang, Omid Behnamfar, Mitul P Patel, Ryan R Reeves
Robotic technology has been utilized in cardiovascular medicine for over a decade, and over that period, its use has been expanded to percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted percutaneous cardiovascular interventions has been demonstrated in studies including simple to complex coronary lesions, and both iliac and femoropopliteal lesions. These reports have shown that robotically assisted PCI significantly reduces operator exposure to harmful ionizing radiation without a detrimental effect on procedural success or clinical efficacy...
August 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28794001/randomized-comparison-of-ridaforolimus-eluting-and-zotarolimus-eluting-coronary-stents-in-patients-with-coronary-artery-disease-primary-results-from-the-bionics-trial
#8
David E Kandzari, Pieter C Smits, Michael P Love, Ori Ben-Yehuda, Shmuel Banai, Simon D Robinson, Michael Jonas, Ran Kornowski, Rodrigo Bagur, Andres Iniguez, Haim D Danenberg, Robert L Feldman, Rajiv Jauhar, Harish Chandna, Manish A Parikh, Gidon Y Perlman, Mercedes Balcells, Peter M Markham, Melek Ozgu Ozan, Philippe Genereux, Elazer Edelman, Martin B Leon, Gregg W Stone
Background -The safety and efficacy of a novel cobalt alloy-based coronary stent with a durable elastomeric polymer eluting the antiproliferative agent ridaforolimus for treatment of patients with coronary artery disease is undetermined. Methods -A prospective, international 1:1 randomized trial was conducted to evaluate in a noninferiority design the relative safety and efficacy of ridaforolimus-eluting stents (RES) and slow-release zotarolimus-eluting stents (ZES) among 1,919 patients at 76 centers undergoing percutaneous coronary intervention...
August 9, 2017: Circulation
https://www.readbyqxmd.com/read/28764604/optical-coherence-tomography-to-guide-percutaneous-treatment-of-coronary-bifurcation-disease
#9
Mathias Wolfrum, Giovanni Luigi De Maria, Adrian P Banning
Cardiovascular disease remains the most common cause of death worldwide. Enormous progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease has been made, and the number of percutaneous coronary interventions (PCI) is increasing. Coronary bifurcations are involved in a substantial number of PCIs and despite recent advances, bifurcation PCI remains a challenge in terms of immediate success and long-term outcome. Angiography has a limited capacity for showing important features of the 3 dimensional coronary vessel anatomy, position of stent struts and exact wire positions and is therefore suboptimal for guiding bifurcation PCI...
August 2, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28764234/basic-concepts-and-clinical-outcomes-of-drug-eluting-balloons-for-treatment-of-coronary-artery-disease-an-overview
#10
REVIEW
C D Ramakrishna, Bhargav A Dave, Pankaj S Kothavade, Kajal J Joshi, Ashok S Thakkar
The technology of percutaneous coronary intervention for atherosclerotic coronary artery disease has evolved considerably since its inception. Though Drug-Eluting Stent (DES) reduces the rate of restenosis, long-term safety outcomes and persistent restenosis in complex lesion subset remain area of concern. Recently, Drug-Eluting Balloon (DEB) represents a novel treatment strategy for atherosclerotic coronary artery disease. DEB demonstrated its added value in preclinical studies. Inspired by these results, several clinical trials particularly in complex lesion subsets have been started to explore the value of this novel treatment strategy in a broader range of lesions...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28763313/generalizability-of-excel-and-noble-results-to-a-large-registry-population-with-unprotected-left-main-coronary-artery-disease
#11
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/28748153/prognostic-superiority-of-coronary-artery-bypass-grafting-to-percutaneous-coronary-intervention-in-non-diabetic-patients-with-anatomically-complex-multivessel-coronary-artery-disease
#12
EDITORIAL
Kenji Sakata, Takuya Nakahashi, Masa-Aki Kawashiri
No abstract text is available yet for this article.
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28747945/the-impact-of-type-2-diabetes-mellitus-on-prognosis-in-patients-with-non-st-elevation-myocardial-infarction
#13
REVIEW
Katarzyna Birkner, Bartosz Hudzik, Mariusz Gąsior
Type 2 diabetes (T2D) is a recognized risk factor for acute coronary syndromes. There is currently no consensus concerning the intensification of antihyperglycemic treatment. According to the available guidelines, it seems that the goal is to achieve glycated hemoglobin (HbA1c) levels below 7% and avoid hypoglycemia. The choice of a revascularization method is influenced by many factors, such as the anatomy of the coronary arteries, severity of atherosclerosis, anatomical location of lesions, and presence of comorbidities...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28741573/novel-radiation-dose-reduction-fluoroscopic-technology-facilitates-chronic-total-occlusion-percutaneous-coronary-interventions
#14
Stephen Balter, Matthew Brinkman, Sanjog Kalra, Tamim Nazif, Manish Parikh, Ajay J Kirtane, Jeffrey Moses, Martin B Leon, Angeli Feri, Philip Green, Ziad A Ali, Ming Liao, Dimitrios Karmpaliotis
AIMS: Radiation exposure and prolonged procedure time continue to limit the complexity of CTO-PCI procedures attempted. This study aimed assess the impact of radiation-dose-limiting equipment on radiation dosage and fluoroscopic time in chronic total occlusion (CTO) percutaneous coronary interventions (PCI). METHODS AND RESULTS: Retrospective clinical and dosimetric data from diagnostic catheterizations (DXC) and CTO-PCI procedures performed on one of three variants of interventional fluoroscopic equipment were collected...
July 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28739037/trends-in-patient-exposure-to-radiation-in-percutaneous-coronary-interventions-over-a-10-year-period
#15
Laurent Faroux, Thierry Blanpain, Pierre Nazeyrollas, Sophie Tassan-Mangina, Benoît Herce, Christophe Tourneux, Damien Metz
Technological progress has made it possible to reduce the dose of radiation delivered by medical x-ray systems. In parallel, interventional coronary procedures have become increasingly complex and consequently, last longer. This study aimed to compare the estimated dose of radiation received by patients in interventional cardiology at 10 years interval (2006 vs 2016). The study population included all patients who underwent interventional coronary procedures in one of the catheterization laboratories of our institution during 2 periods, namely, period 1 from October 2005 to March 2006, and period 2 from November 2015 to October 2016...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28731914/phenotype-of-same-day-discharge-patients-after-percutaneous-coronary-intervention
#16
Donna V Ramharrack, Corrine Y Jurgens, Richard A Shlofmitz
BACKGROUND: Overnight observation is the standard of care for uncomplicated elective percutaneous coronary intervention (PCI). However, same-day discharge (SDD) is reportedly safe using predetermined criteria and patient risk categories. Characteristics of patients with SDD have not yet been described. OBJECTIVE: The purpose of this study was to describe the phenotype of patients appropriate for SDD after PCI without predetermined criteria and patient risk categories...
July 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28730857/controversies-in-complex-percutaneous-coronary-intervention-radial-versus-femoral
#17
Ian C Gilchrist, Stephen O Awuor, Rhian E Davies, Anene C Ukaigwe
Evolution in the technology used in the cardiac catheterization laboratory has permitted a migration from the femoral to radial artery access for many interventional procedures while concurrently improving outcomes. As a disruptive technology, transradial access has been associated with several controversies including a dichotomous relationship with femoral access. Areas covered: Several different patient subsets along with perceived technical challenges in interventional cardiology are reviewed with regard to the issue of access site...
July 21, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28724652/correlation-of-admission-heart-rate-with-angiographic-and-clinical-outcomes-in-patients-with-right-coronary-artery-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-horizons-ami-the-harmonizing-outcomes-with-revascularization
#18
Ioanna Kosmidou, Thomas McAndrew, Björn Redfors, Monica Embacher, José M Dizon, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Bradycardia on presentation is frequently observed in patients with right coronary artery ST-segment elevation myocardial infarction, but it is largely unknown whether it predicts poor angiographic or clinical outcomes in that patient population. We sought to determine the prognostic implications of admission heart rate (AHR) in patients with ST-segment elevation myocardial infarction and a right coronary artery culprit lesion. METHODS AND RESULTS: We analyzed 1460 patients with ST-segment elevation myocardial infarction and a right coronary artery culprit lesion enrolled in the randomized HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial who underwent primary percutaneous coronary intervention...
July 19, 2017: Journal of the American Heart Association
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
#19
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/28717115/coronary-artery-disease-and-type-2-diabetes-mellitus
#20
REVIEW
Ryo Naito, Katsumi Miyauchi
Type 2 diabetes mellitus (T2DM) is a major risk factor of coronary artery diseases (CAD). Clinical outcomes in CAD with T2DM are poor despite improvement in medications and intervention devices. Coronary artery bypass grafting (CABG) is superior to percutaneous coronary intervention (PCI) in treating diabetic patients with multivessel coronary artery diseases (MVD). However, selecting a revascularization strategy should depend not only on the lesion complexity but also on the patient's background and comorbidities...
August 3, 2017: International Heart Journal
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