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https://www.readbyqxmd.com/read/28318135/effect-of-coronary-dominance-on-2-year-outcomes-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndrome
#1
Chen He, Yuan-Liang Ma, Chuang-Shi Wang, Ying Song, Xiao-Fang Tang, Xue-Yan Zhao, Run-Lin Gao, Yue-Jin Yang, Bo Xu, Jin-Qing Yuan
OBJECTIVES: This retrospective, single-center, observational analysis from prospectively collected database evaluated whether left dominance affected the long-term outcomes of acute coronary syndrome patients undergoing percutaneous coronary intervention, and whether the effect was independent of SYNTAX score. BACKGROUND: Left dominance is believed to be associated with worse prognoses. The anatomical SYNTAX score is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict short- and long-term outcomes...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28316035/management-of-percutaneous-coronary-intervention-complications
#2
REVIEW
Gregory Means, Christopher End, Prashant Kaul
With the recent increase in complex coronary interventions including percutaneous coronary intervention (PCI) for chronic total occlusions and complex higher risk (and indicated) patients, the spectrum of potential periprocedural complications and their prompt management has become even more relevant. Vascular access-related problems remain the most prevalent of all PCI complications and with randomized controlled trial data from over 20,000 patients supporting the superiority of radial over femoral access in reducing bleeding and vascular complications, a default radial strategy should be promoted...
April 2017: Current Treatment Options in Cardiovascular Medicine
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/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#4
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28303645/zero-contrast-percutaneous-coronary-intervention-on-calcified-lesions-facilitated-by-rotational-atherectomy
#5
Keyvan Karimi Galougahi, Gary S Mintz, Dimitri Karmpaliotis, Ziad A Ali
Percutaneous coronary intervention (PCI) in patients with advanced chronic kidney disease (CKD) is challenging due to frequent presence of complex calcified lesions and the very high risk of contrast-induced nephropathy (CIN). We report a strategy of "zero contrast" PCI, guided by intravascular imaging and physiology, performed in three patients with advanced CKD in whom severe calcification necessitated rotational atherectomy (RA) to facilitate and optimize PCI. This approach resulted in safe and successful PCI while preserving renal function...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302642/pregnancy-and-the-risk-of-spontaneous-coronary-artery-dissection-an-analysis-of-120-contemporary-cases
#6
Ofer Havakuk, Sorel Goland, Anil Mehra, Uri Elkayam
BACKGROUND: Because of the rarity of this condition, information on pregnancy-associated spontaneous coronary artery dissection is limited. We reviewed a large number of contemporary pregnancy-associated spontaneous coronary artery dissection cases in an attempt to define the clinical characteristics and provide management recommendations. METHODS AND RESULTS: A literature search for cases of pregnancy-associated spontaneous coronary artery dissection reported between 2000 and 2015 included 120 cases; 75% presented with ST-segment-elevation myocardial infarction, and 80% had anterior myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296410/a-light-responsive-nanoparticle-based-delivery-system-using-pheophorbide-a-graft-polyethyleneimine-for-dendritic-cell-based-cancer-immunotherapy
#7
Chuangnian Zhang, Ju Zhang, Gaona Shi, Huijuan Song, Shengbin Shi, Xiuyuan Zhang, Pingsheng Huang, Zhihong Wang, Weiwei Wang, Chun Wang, Deling Kong, Chen Li
In this study, the photochemical internalization (PCI) technique was adopted in a nanoparticle-based antigen delivery system to enhance antigen-specific CD8(+) T cell immune response for cancer immunotherapy. Pheophorbide-A, a hydrophobic photosensitizer, grafted with polyethyleneimine (PheoA-PEI) with endosome escape activity and near infrared imaging capability was prepared. A model antigen ovalbumin (OVA) was then complexed with PheoA-PEI to form PheoA-PEI/OVA nanoparticles (PheoA-PEI/OVA NPs) that are responsive to light...
March 15, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#8
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/28288978/mff-dependent-mitochondrial-fission-contributes-to-the-pathogenesis-of-cardiac-microvasculature-ischemia-reperfusion-injury-via-induction-of-mros-mediated-cardiolipin-oxidation-and-hk2-vdac1-disassociation-involved-mptp-opening
#9
Hao Zhou, Shunying Hu, Qinhua Jin, Chen Shi, Ying Zhang, Pingjun Zhu, Qiang Ma, Feng Tian, Yundai Chen
BACKGROUND: The cardiac microvascular system ischemia/reperfusion injury following percutaneous coronary intervention is a clinical thorny problem. This study explores the mechanisms by which ischemia/reperfusion injury induces cardiac microcirculation collapse. METHODS AND RESULTS: In wild-type mice, mitochondrial fission factor (Mff) expression increased in response to acute microvascular ischemia/reperfusion injury. Compared with wild-type mice, homozygous Mff-deficient (Mff(gt)) mice exhibited a smaller infarcted area, restored cardiac function, improved blood flow, and reduced microcirculation perfusion defects...
March 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28275942/bioresorbable-polymers-and-stent-devices
#10
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/28267472/intravascular-ultrasound-guided-vs-angiography-guided-drug-eluting-stent-implantation-in-complex-coronary-lesions-meta-analysis-of-randomized-trials
#11
Chirag Bavishi, Partha Sardar, Saurav Chatterjee, Abdur Rahman Khan, Arpit Shah, Sameer Ather, Pedro A Lemos, Pedro Moreno, Gregg W Stone
The relative outcomes of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) compared with angiography-guided PCI with drug-eluting stent (DES) in complex lesions have not been established. We sought to compare the efficacy and safety of IVUS-guided PCI with angiography-guided PCI in patients with complex coronary lesions treated with DES. METHODS: Electronic databases were searched to identify all randomized trials comparing IVUS-guided vs angiography-guided DES implantation...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28266826/cardiovascular-disease-update-care-of-patients-after-coronary-artery-bypass-graft
#12
Craig Barstow, Johnathan D McDivitt
Coronary artery bypass graft (CABG) is a surgical procedure in which a vessel, normally the left internal mammary artery and/or a segment of an excised vein (typically from the leg), is grafted to the coronary arteries to bypass a blockage. CABG has been shown to be superior to percutaneous coronary intervention for patients with complex three vessel disease and left main coronary artery disease. All patients undergoing CABG should receive aspirin preoperatively; they also should receive a beta blocker preoperatively to reduce the likelihood of postsurgical atrial fibrillation...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28266098/characteristics-and-outcomes-of-patients-undergoing-percutaneous-coronary-intervention-within-1-year-of-coronary-artery-bypass-graft-surgery
#13
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/28260288/-usefulness-of-the-residual-syntax-score-to-predict-long-term-outcome-in-acute-coronary-syndrome-patients-underwent-percutaneous-coronary-intervention
#14
Y Song, J J Xu, X F Tang, Y L Ma, Y Yao, C He, H H Wang, R Liu, N Xu, P Jiang, L Jiang, X Y Zhao, Z Gao, R L Gao, S B Qiao, Y J Yang, B Xu, J Q Yuan
Objective: To quantify the extent and complexity of residual coronary stenosis following PCI by the residual SYNTAX score, and to evaluate its impact on adverse ischemic outcomes in acute coronary syndrome(ACS) patients. Methods: From January 2013 to December 2013, a total of 1 414 consecutive moderate- and high-risk ACS patients who underwent any PCI with multi-vessel coronary artery disease were evaluated.Patients were stratified by rSS quartiles and their outcomes were compared. Results: The rSS was 4.8±6...
February 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28258731/hypotension-and-left-bundle-branch-block
#15
Mazen M Kawji, David Luke Glancy
A 69-year-old man with chronic kidney disease and no chest pain had the new onset of hypotension. An electrocardiogram revealed left bundle branch block and inferior ST-segment elevation concordant with the QRS complexes in leads II and aVF, a pattern diagnostic of acute inferior myocardial infarction. Coronary arteriography showed triple vessel disease with complete occlusion of the right. He was treated with an intraaortic balloon pump and percutaneous coronary intervention, followed by coronary artery bypass operation at a nearby hospital...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28258729/comparison-of-rotational-atherectomy-versus-orbital-atherectomy-for-the-treatment-of-heavily-calcified-coronary-plaques
#16
Michael S Lee, Kyung Woo Park, Evan Shlofmitz, Richard A Shlofmitz
We evaluated the outcomes of patients with severe coronary artery calcification (CAC) who underwent rotational atherectomy (RA) and orbital atherectomy (OA). Severe CAC increases the complexity of percutaneous coronary intervention (PCI) because of the difficulty in optimizing stent expansion, leading to worse clinical outcomes. Both devices are effective treatment strategies for severe CAC. No comparisons have been performed to evaluate the clinical outcomes after RA and OA. The outcomes of 67 patients with severe CAC who underwent RA from July 2012 to June 2015 and 60 patients who underwent OA from February 2014 to September 2016 were evaluated...
February 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28255104/-single-operator-technique-for-advancing-the-orbital-atherectomy-device
#17
Michael S Lee, Heajung Nguyen, Daniel Philipson, Richard A Shlofmitz
OBJECTIVE: We assessed the feasibility and safety of the "single-operator" technique in which the operator autonomously advanced the orbital atherectomy (OA) device while maintaining wire position. BACKGROUND: Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI), and is associated with lower procedural success rates and higher rates of adverse outcomes, including death, myocardial infarction, target-vessel revascularization, and stent thrombosis...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28249084/effect-of-short-procedural-duration-with-bivalirudin-on-increased-risk-of-acute-stent-thrombosis-in-patients-with-stemi-a-secondary-analysis-of-the-horizons-ami-randomized-clinical-trial
#18
Hector Tamez, Duane S Pinto, Ajay J Kirtane, Claire Litherland, Robert W Yeh, George D Dangas, Roxana Mehran, Efthymios N Deliargyris, Guillermo Ortiz, C Michael Gibson, Gregg W Stone
Importance: Bivalirudin has been associated with reduced bleeding and mortality during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). However, increased rates of acute stent thrombosis (AST) have been noted when bivalirudin is discontinued at the end of the procedure, which is perhaps related to this medication's short half-life. Objectives: To evaluate the clinical effect of procedure duration on AST when either bivalirudin or heparin plus glycoprotein IIb/IIIa receptor inhibitor (GPI) is used...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28244599/fragmented-qrs-complex-predicts-contrast-induced-nephropathy-and-in-hospital-mortality-after-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction
#19
Alparslan Kurtul, Mustafa Duran
BACKGROUND: Contrast-induced nephropathy (CIN) is associated with increased mortality after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Recently, fragmented QRS complex (fQRS) on 12-lead electrocardiography has been introduced as a marker of cardiovascular disease and is associated with increased morbidity and mortality. HYPOTHESIS: fQRS on ECG is associated with CIN and in-hospital mortality after primary PCI in patients with STEMI...
February 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28242587/impact-of-crossing-strategy-on-mid-term-outcomes-following-percutaneous-revascularisation-of-coronary-chronic-total-occlusions
#20
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
AIMS: To compare the impact of crossing strategies on mid-term outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We compiled a multicentre registry of consecutive patients undergoing successful CTO PCI. Patients were divided in three groups: true-to-true (TTT) approach, modern dissection/re-entry (DR) techniques (CrossBoss/Stingray, reverse CART), and old DR techniques (LAST, STAR, CART). Cox regression was used to identify independent predictors of major adverse cardiac events (MACE: cardiac death, myocardial infarction and target-vessel revascularisation)...
February 28, 2017: EuroIntervention
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