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https://www.readbyqxmd.com/read/29784630/what-are-the-causes-of-a-suboptimal-ffr-after-coronary-stent-deployment-insights-from-a-consecutive-series-using-oct-imaging
#1
Mathias Wolfrum, Giovanni Luigi De Maria, Stefano Benenati, Jeremy Langrish, Andrew J Lucking, Keith M Channon, Rajesh K Kharbanda, Adrian P Banning
AIMS: Fractional flow reserve (FFR) can be used to detect a suboptimal result after percutaneous coronary intervention (PCI). A lower post procedure FFR (< 0.90) has been shown to be associated with adverse clinical outcomes at follow-up. This pilot study aimed to understand the mechanisms resulting in a suboptimal FFR and whether Optical Coherence Tomography (OCT) guided optimisation could improve final FFR. METHODS AND RESULTS: Thirty five patients undergoing complex PCI were prospectively enrolled...
May 21, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#2
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29748151/patient-specific-3d-printing-simulation-to-guide-complex-coronary-intervention
#3
Manuel Oliveira-Santos, Eduardo Oliveira Santos, Ana Vera Marinho, Luís Leite, Jorge Guardado, Vítor Matos, Guilherme Mariano Pego, João Silva Marques
The field of three-dimensional printing applied to patient-specific simulation is evolving as a tool to enhance intervention results. We report the first case of a fully simulated percutaneous coronary intervention in a three-dimensional patient-specific model to guide treatment. An 85-year-old female presented with symptomatic in-stent restenosis in the ostial circumflex and was scheduled for percutaneous coronary intervention. Considering the complexity of the anatomy, patient setting and intervention technique, we elected to replicate the coronary anatomy using a three-dimensional model...
May 7, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29747919/temporal-trends-in-coronary-angiography-and-percutaneous-coronary-intervention-insights-from-the-va-clinical-assessment-reporting-and-tracking-program
#4
Stephen W Waldo, Madhura Gokhale, Colin I O'Donnell, Mary E Plomondon, Javier A Valle, Ehrin J Armstrong, Richard Schofield, Stephan D Fihn, Thomas M Maddox
OBJECTIVES: The aim of this study was to evaluate temporal trends in characteristics and outcomes among patients referred for invasive coronary procedures within a national health care system for veterans. BACKGROUND: Coronary angiography and percutaneous coronary intervention remain instrumental diagnostic and therapeutic interventions for coronary artery disease. METHODS: All coronary angiographic studies and interventions performed in U...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29747912/defining-staged-procedures-for-percutaneous-coronary-intervention-trials-a-guidance-document
#5
REVIEW
Ernest Spitzer, Eugène McFadden, Pascal Vranckx, Ton de Vries, Ben Ren, Carlos Collet, Yoshinobu Onuma, Hector M Garcia-Garcia, Renato D Lopes, Gregg W Stone, Donald E Cutlip, Patrick W Serruys
Patients in coronary intervention trials may require more than 1 procedure to complete the intended revascularization strategy. However, these staged interventions are not consistently defined. Standardized definitions are needed to allow meaningful comparisons of this outcome among trials. This document provides guidance on relevant parameters involving staged procedures, including minimum data collection and consistent classification of coronary procedures initially identified as staged; the aim is to achieve consistency among clinical trialists, sponsors, health authorities, and regulators...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743903/novel-predictors-of-outcome-after-coronary-angioplasty-with-rotational-atherectomy-not-only-low-ejection-fraction-and-clinical-parameters-matter
#6
Piotr Kübler, Wojciech Zimoch, Michał Kosowski, Brunon Tomasiewicz, Oscar Rakotoarison, Artur Telichowski, Krzysztof Reczuch
Introduction: Most established risk factors after rotational atherectomy (RA) of heavily fibro-calcified lesions are associated with patients' general risk and clinical related factors and are not specific for either coronary and culprit lesion anatomy or the RA procedure. Aim: To assess novel predictors of poor outcome after percutaneous coronary intervention using RA in an all-comers population. Material and methods: A total of 207 consecutive patients after RA were included in a single-center observational study...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29743410/safety-of-reversing-anticoagulation-by-protamine-following-elective-transfemoral-percutaneous-coronary-intervention-in-the-drug-eluting-stent-era
#7
Shingo Yamamoto, Kenichi Sakakura, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Bleeding complications following percutaneous coronary interventions (PCI) have been closely associated with morbidity and mortality. Although radial arteries have been widely used in current PCI, including primary PCI, transfemoral PCI remains necessary for complex PCI. The purpose of this study was to compare the incidence of complications following elective transfemoral PCI between manual compression with and without protamine. We identified 249 consecutive patients who underwent elective transfemoral PCI from hospital records, and divided them into two groups: patients who used protamine for manual compression (the protamine group; n = 205) and patients who did not (the non-protamine group, n = 44)...
May 9, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29732926/imaging-guided-pre-dilatation-stenting-post-dilatation-ipsp-a-protocolized-approach-highlighting-the-importance-of-intravascular-imaging-for-implantation-of-bioresorbable-scaffolds
#8
Ziad A Ali, Keyvan Karimi Galougahi, Richard Shlofmitz, Akiko Maehara, Gary S Mintz, Alexandre Abizaid, Daniel Chamié, Jonathan Hill, Patrick W Serruys, Yoshinobu Onuma, Gregg W Stone
The advent of the fully bioresorbable vascular scaffold (BVS) is the latest step in a series of advancements in the design of intracoronary stents over the past few decades. The novelty of this technology is in providing temporary vessel scaffolding and local antiproliferative therapy to prevent neointimal hyperplasia after percutaneous coronary intervention followed by gradual resorption of the scaffold to restore the native vessel anatomy and physiology-a process termed vascular reparative therapy. Areas covered: The first generation of BVS has not been able to fully match the high benchmark in safety and efficacy set by contemporary metallic drug-eluting stents...
May 7, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29724974/comparison-of-the-transradial-and-transfemoral-approach-in-treatment-of-chronic-total-occlusions-with-similar-lesion-characteristics
#9
Mustafa Ahmet Huyut, Aylin Hatice Yamaç
OBJECTIVE: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) of chronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity. METHODS: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179 patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2...
May 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29718894/transradial-percutaneous-coronary-intervention-for-left-main-bifurcation-lesions-using-7-5-fr-sheathless-guide-catheter
#10
Huiqiang Zhao, Subhash Banerjee, Hui Chen, Hongwei Li
Recent studies have shown sheathless guide catheters (GCs) to be safe and effective during complex lesions such as bifurcations, chronic total occlusion (CTO), and/or calcified lesions. We investigated the feasibility and safety of using 7.5-Fr sheathless GC for transradial percutaneous coronary intervention (PCI) to treat left main bifurcation lesions.A total of 82 patients were consecutively enrolled from March 2013 to February 2016. They underwent transradial PCI for left main bifurcation lesions using the 7...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29718158/management-of-left-main-disease-an-update
#11
Jean Fajadet, Davide Capodanno, Gregg W Stone
A severe narrowing of the left main coronary artery (LMCA), usually due to atherosclerosis, jeopardizes a large area of myocardium and increases the risk of major adverse cardiac events. Management strategies for LMCA disease include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). In general, PCI offers more rapid recovery and a lower early adverse event rate, whereas CABG offers a more durable procedure. The largest of six LMCA trials comparing PCI with CABG recently reported that in patients with site-reported low or intermediate anatomical complexity PCI was non-inferior to CABG with respect to the composite of death, stroke, or myocardial infarction at 3 years...
April 30, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29713989/optimal-duration-of-dual-antiplatelet-therapy-for-coronary-artery-disease
#12
REVIEW
W J Kikkert, P Damman
The optimal duration of dual antiplatelet therapy (DAPT) for stable coronary artery disease and acute coronary syndrome is a complex decision. We review current literature on standard duration DAPT versus short duration DAPT (6 months or shorter) or extended duration DAPT (>12 months) after percutaneous coronary intervention with drug-eluting stent placement, and prolonged treatment after 12 months in acute coronary syndrome. Current guideline recommendations are summarised, including the use of risk scores for ischaemic and bleeding risk assessment...
April 30, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29703625/elevated-lipoprotein-a-and-low-density-lipoprotein-cholesterol-as-predictors-of-the-severity-and-complexity-of-angiographic-lesions-in-patients-with-premature-coronary-artery-disease
#13
David Chieng, Jing Pang, Katrina L Ellis, Graham S Hillis, Gerald F Watts, Carl J Schultz
BACKGROUND: Elevated lipoprotein(a) (Lp[a]) and low-density lipoprotein (LDL) cholesterol are important inheritable risk factors for premature coronary artery disease (CAD). Lp(a) mediates cardiovascular risk through prothrombotic, proinflammatory, and proatherogenic properties. The association of Lp(a) and LDL cholesterol with angiographic disease severity and complexity in patients with premature CAD has yet to be established. OBJECTIVE: To investigate the relationship of Lp(a) and LDL cholesterol with the severity and complexity of coronary artery lesions using the SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery (SYNTAX) and Gensini scores, in patients with premature CAD...
April 3, 2018: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29703048/tolvaptan-rescue-contrast-induced-acute-kidney-injury-a-case-report
#14
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
RATIONALE: Contrast-induced acute kidney injury is one of the most serious adverse effects of contrast media and is related to three distinct but interacting mechanisms: medullary ischemia, formation of reactive oxygen species and direct tubular cell toxicity, especially in the patients with chronic kidney disease. The strategies of treatment, including stabilization of hemodynamic parameters and maintenance of normal fluid and electrolyte balance, were similar to the management of other types of acute kidney injury...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29692936/safety-and-efficacy-of-triple-therapeutic-targets-with-rivaroxaban-after-acute-myocardial-infarction-complicated-by-left-ventricular-thrombi-in-a-case-of-nonvalvular-atrial-fibrillation
#15
Francesco Summaria, Gregory A Sgueglia, Fabrizio D'Errico, Antonella De Santis, Fabiana Piccioni, Gaetano Gioffrè, Achille Gaspardone
We present the complex case of a high-risk patient with nonvalvular atrial fibrillation, who experienced a non-ST elevation myocardial infarction complicated by left ventricular (LV) thrombi and underwent percutaneous coronary intervention with drug-eluting stent implantation. The patient was initially treated with short-term triple therapy including aspirin, clopidogrel, and rivaroxaban 15 mg/die. Following aspirin dropping one month after discharge, the patient continued on dual therapy with clopidogrel and rivaroxaban, and a clinical and imaging follow-up at 6 and 12 months confirmed the LV thrombi resolution, with no thromboembolic episodes and a good safety profile...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29691625/cytoreductive-surgery-and-intraperitoneal-hyperthermic-chemotherapy-hipec-by-minimally-invasive-approach-an-initial-experience
#16
A Arjona-Sanchez, S Rufian-Peña, J M Sanchez-Hidalgo, A Casado-Adam, A Cosano-Alvarez, J Briceño-Delgado
BACKGROUND: The cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal chemotherapy (HIPEC) has become the standard treatment in patients with carcinomatosis peritoneal from different origins. The use of a minimally invasive approach for this high complex procedure might be an alternative that provides them less morbidity and faster recovery with similar oncologic outcomes. METHODS: We describe the initial experience of CRS and HIPEC done via the laparoscopic route in patients with minimal peritoneal metastases in our Unit from March 2016 to January 2018...
April 24, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29691185/common-themes-in-patients-requiring-urgent-cardiothoracic-surgery-after-percutaneous-coronary-interventions-case-series-and-review-of-the-literature
#17
REVIEW
Saad Ezad, Trent D Williams, Jeremy Condon, Andrew J Boyle, Nicholas J Collins
Urgent cardiothoracic surgical intervention for the management of complications of percutaneous coronary intervention is uncommon in the stent era. Nonetheless, given increasing procedural complexity, in part reflecting an aging population, an ongoing hazard for urgent surgery remains. We sought to review the incidence and outcome of urgent cardiothoracic surgery in patients undergoing PCI in a contemporary cohort at a tertiary referral centre. The incidence of cardiothoracic intervention for PCI related complications was low at 0...
March 21, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29685691/mid-term-clinical-outcomes-after-bailout-drug-eluting-stenting-for-suboptimal-drug-coated-balloon-results-insights-from-a-milan-registry
#18
Satoru Mitomo, Richard J Jabbour, Antonio Mangieri, Marco Ancona, Damiano Regazzoli, Akihito Tanaka, Francesco Giannini, Mauro Carlino, Matteo Montorfano, Alaide Chieffo, Azeem Latib, Antonio Colombo
BACKGROUND: Drug-coated balloon (DCB) is an alternative to drug-eluting stent (DES) for the treatment of small vessel or in-stent restenosis (ISR) lesions, with bailout stenting reserved for poor results after DCB inflation (residual stenosis or dissection). Data regarding bailout stenting with DES are limited. The aim of this study was to evaluate clinical outcomes after bailout stenting with DES for suboptimal DCB results. METHODS: From June 2009 to December 2015, patients who underwent bailout DES implantation for suboptimal results after DCB (residual stenosis > 30% or type C-F dissection) in 2 high-volume centers in Italy were analyzed...
April 13, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29682132/creating-a-foundation-for-implementing-an-electronic-health-records-ehr-integrated-social-knowledge-networking-skn-system-on-medication-reconciliation
#19
P Rangachari, K C Dellsperger, D Fallaw, I Davis, M Sumner, W Ray, S Fiedler, T Nguyen, R Rethemeyer
Background: In fall 2016, Augusta University received a two-year grant from AHRQ, to implement a Social Knowledge Networking (SKN) system for enabling its health system, AU-Health, to progress from "limited use" of EHR Medication Reconciliation (MedRec) Technology, to "meaningful use." Phase 1 sought to identify a comprehensive set of issues related to EHR MedRec encountered by practitioners at AU-Health. These efforts helped develop a Reporting Tool , which, along with a Discussion Tool , was incorporated into the AU-Health EHR, at the end of Phase 1...
April 2018: Journal of Hospital Administration
https://www.readbyqxmd.com/read/29681535/percutaneous-coronary-intervention-of-unprotected-left-main-stenoses-procedural-data-and-outcome-depending-on-syntax-i-score
#20
Florian Blachutzik, Stephan Achenbach, Jens Röther, Monique Tröbs, Reinhard Schneider, Mohamed Marwan, Christian Schlundt
BACKGROUND: We hypothesized that SYNTAX I score is a predictor for procedure complexity in left main PCI. Procedure complexity, duration and contrast load may contribute to adverse outcome of complex left main percutaneous coronary intervention (PCI). METHODS: In 105 consecutive patients who underwent PCI of unprotected left main coronary artery stenoses between 2014 and 2016, clinical parameters as well as PCI characteristics and follow-up data were analyzed. RESULTS: The mean SYNTAX I score was 29 ± 12, with 66 patients having a SYNTAX I score ≤ 32 and 39 patients a SYNTAX I score > 32...
April 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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