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complexe coronary intervention

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https://www.readbyqxmd.com/read/28515854/determinants-of-percutaneous-coronary-intervention-success-in-repeat-chronic-total-occlusion-procedures-following-an-initial-failed-attempt
#1
Cecilia Cuevas, Nicola Ryan, Alicia Quirós, Juan Gustavo Del Angel, Nieves Gonzalo, Pablo Salinas, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, Antonio Fernandez-Ortiz, Carlos Macaya, Javier Escaned
AIM: To investigate the rates and determinants of success of repeat percutaneous coronary intervention (PCI) following an initial failed attempt at recanalising the chronic total occlusions (CTO) percutaneously. METHODS: In 445 consecutive first attempt CTO-PCI procedures in our institution, procedural failure occurred in 149 (33.5%). Sixty-four re-PCI procedures were performed in 58 patients (39%) all had a single CTO. Procedural and outcome data in the re-PCI population was entered into the institutional database...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28506937/bivalirudin-infusion-to-reduce-ventricular-infarction-the-open-label-randomised-bivalirudin-infusion-for-ventricular-infarction-limitation-bival-study
#2
Robert Jan van Geuns, Georgios Sideris, Niels Van Royen, Rami El Mahmoud, Roberto Diletti, Claire Bal Dit Sollier, Jerome Garot, Nina W Van Der Hoeven, Bernardo Cortese, Li Ding, Ilknur Lechthaler, Efthymios N Deliargyris, Prodromos Anthopoulos, Ludovic Drouet
AIMS: The aim of the study was to investigate whether bivalirudin versus unfractionated heparin (UFH) reduces infarct size (IS) for primary percutaneous coronary intervention (PPCI) in large acute myocardial infarction (AMI). METHODS AND RESULTS: This multicentre open-label trial randomised 78 patients undergoing PPCI for large AMI to bivalirudin or UFH. The primary endpoint was IS, assessed by cardiac magnetic resonance (CMR) five days after PPCI. Secondary endpoints included index of microcirculatory resistance (IMR), CMR-assessed microvascular obstruction (MVO) and ejection fraction, and biomarkers for thrombin activity and cell injury...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28506936/assessment-of-long-term-mortality-in-patients-with-complex-coronary-artery-disease-undergoing-percutaneous-intervention-comparison-of-multiple-anatomical-and-clinical-prognostic-risk-scores
#3
Bruno L Janella, Carlos M Campos, Adriano Caixeta, Breno O Almeida, Fabio Sandoli Brito, Alexandre Abizaid, Marco A Perin
AIMS: Three-vessel and left main coronary artery disease (CAD) have important prognostic implications. Consequently, numerous risk scores have been developed to stratify patients with complex CAD. The aim of the present study is to compare the predictive performance of six risk scores for occurrence of 4-year all-cause mortality. METHODS AND RESULTS: From March 2008 to December 2012, 348 consecutive patients with complex CAD undergoing percutaneous coronary intervention in a tertiary center in São Paulo, Brazil were analyzed...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#4
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28500478/effect-of-stenosis-eccentricity-on-the-functionality-of-coronary-bifurcation-lesions-a-numerical-study
#5
Catherine Pagiatakis, Jean-Claude Tardif, Philippe L L'Allier, Rosaire Mongrain
Interventional cardiologists still rely heavily on angiography for the evaluation of coronary lesion severity, despite its poor correlation with the presence of ischemia. In order to improve the accuracy of the current diagnostic procedures, an understanding of the relative influence of geometric characteristics on the induction of ischemia is required. This idea is especially important for coronary bifurcation lesions (CBLs), whose treatment is complex and is associated with high rates of peri- and post-procedural clinical events...
May 13, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28500138/legacy-effect-of-coronary-perforation-complicating-percutaneous-coronary-intervention-for-chronic-total-occlusive-disease-an-analysis-of-26-807-cases-from-the-british-cardiovascular-intervention-society-database
#6
Tim Kinnaird, Richard Anderson, Nicholas Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark deBelder, Simon Walsh, Elliot Smith, Colm Hanratty, James Spratt, Julian Strange, David Hildick-Smith, Mamas A Mamas
BACKGROUND: Coronary perforation (CP) during chronic total occlusion percutaneous coronary intervention for stable angina (CTO-PCI) is a rare but serious event. The evidence base is limited, and the long-term effects are unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during CTO-PCI were defined. METHODS AND RESULTS: Data analyzed from the British Cardiovascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales between 2006 and 2013...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28496021/feasibility-and-safety-of-transulnar-catheterization-in-ipsilateral-radial-artery-occlusion
#7
Shu-Kai Hsueh, Cheng-I Cheng, Hsiu-Yu Fang, Mostafa Mohammad Omran, Wen-Hao Liu, Wen-Jung Chung, Chien-Jen Chen, Cheng-Hsu Yang, Chih-Yuan Fang, Chiung-Jen Wu
To investigate the postprocedural cardiovascular events and vascular outcomes, including hand ischemia and neurological compromise, after transulnar (TU) catheterization in ipsilateral radial artery occlusion.Previous randomized trials have shown that the transulnar (TU) approach for coronary angiogram and intervention has safety and outcomes similar to those of the transradial (TR) approach. However, the safety of the TU procedure when ipsilateral radial artery occlusion occurs is unknown.We retrospectively reviewed 87 TU cases with ipsilateral radial artery occlusion confirmed by a forearm angiogram...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28495431/evolution-of-australian-percutaneous-coronary-intervention-from-the-melbourne-interventional-group%C3%A2-mig-registry
#8
Julian Yeoh, Matias B Yudi, Nick Andrianopoulos, Bryan P Yan, David J Clark, Stephen J Duffy, Angela Brennan, Gishel New, Melanie Freeman, David Eccleston, Martin Sebastian, Christopher M Reid, William Wilson, Andrew E Ajani
Percutaneous coronary intervention (PCI) continues to evolve with shifting patient demographics, treatments, and outcomes. We sought to document the specific changes observed over a 9-year period in a contemporary Australian PCI cohort. The Melbourne Interventional Group is an established multicenter PCI registry in Melbourne, Australia. Data were collected prospectively with 30-day and 12-month follow-ups. Demographic, procedural, and outcome data for all consecutive patients were analyzed with a year-to-year comparison from 2005 to 2013...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28487356/intravascular-ultrasound-guidance-is-associated-with-better-outcome-in-patients-undergoing-unprotected-left-main-coronary-artery-stenting-compared-with-angiography-guidance-alone
#9
Pontus Andell, Sofia Karlsson, Moman A Mohammad, Matthias Götberg, Stefan James, Jens Jensen, Ole Fröbert, Oskar Angerås, Johan Nilsson, Elmir Omerovic, Bo Lagerqvist, Jonas Persson, Sasha Koul, David Erlinge
BACKGROUND: Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome in patients undergoing unprotected LMCA PCI in a Swedish nationwide observational study. METHODS AND RESULTS: Patients who underwent unprotected LMCA PCI between 2005 and 2014 because of stable coronary artery disease or acute coronary syndrome were included from the nationwide SCAAR (Swedish Coronary Angiography and Angioplasty Registry)...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28484995/management-of-cad-in-patients-with-active-cancer-the-interventional-cardiologists-perspective
#10
REVIEW
Dana Elena Giza, Kostas Marmagkiolis, Elie Mouhayar, Jean-Bernard Durand, Cezar Iliescu
PURPOSE OF REVIEW: Coronary artery disease in patients with active cancer presents particular challenges for clinicians, as optimum management is required in order to treat the underlying malignancy and to reduce morbidity and mortality associated with cardiovascular diseases. Special considerations must be made in respect to either primary or secondary thrombocytopenia, the presence of coagulopathies and the propensity of bleeding, vascular access complications, and increased risk of stent thrombosis...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28480680/ventricular-late-potentials-immediately-post-st-elevation-myocardial-infarction-and-very-long-term-mortality
#11
Alexander Shturman, Shira Vardi, Amitai Bickel, Shaul Atar
BACKGROUND: The very long-term prognostic significance of ventricular late potentials (VLP) in patients post ST-elevation myocardial infarction (STEMI) is unclear. OBJECTIVES: To evaluate the long-term predictive value of VLP for mortality post-STEMI. METHODS: We conducted serial signal-averaged electrocardiography (SAECG) measurements in 63 patients on the 1st, 2nd and 3rd day pre-discharge, and 30 days after STEMI in patients admitted in 2001...
April 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28472484/adverse-events-while-awaiting-myocardial-revascularization-a-systematic-review-and-meta-analysis
#12
Stuart J Head, Bruno R da Costa, Berend Beumer, Giulio G Stefanini, Fernando Alfonso, Peter M Clemmensen, Jean-Philippe Collet, Jochen Cremer, Volkmar Falk, Gerasimos Filippatos, Christian Hamm, A Pieter Kappetein, Adnan Kastrati, Juhani Knuuti, Philippe Kolh, Ulf Landmesser, Günther Laufer, Franz-Josef Neumann, Dimitrios J Richter, Patrick Schauerte, David P Taggart, Lucia Torracca, Marco Valgimigli, William Wijns, Adam Witkowski, Stephan Windecker, Peter Jüni, Miguel Sousa-Uva
OBJECTIVES: The aim of the current study was to estimate adverse event rates while awaiting myocardial revascularization and review criteria for prioritizing patients. METHODS: A PubMed search was performed on 19 January 2015, to identify English-language, original, observational studies reporting adverse events while awaiting coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Rates of death, non-fatal myocardial infarction (MI) and emergency revascularization were calculated as occurrence rates per 1000 patient-weeks and pooled using random-effects models...
May 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28463463/transradial-versus-transfemoral-ancillary-approach-in-complex-structural-coronary-and-peripheral-interventions-results-from-the-multicenter-ancillary-registry-a-study-of-the-italian-radial-club
#13
Bernardo Cortese, Stefano Rigattieri, Tiziana C Aranzulla, Filippo Russo, Azeem Latib, Francesco Burzotta, Pierfrancesco Agostoni, Alfonso Ielasi, Fabio Tarantino, Alessandro Sticchi, Gaetano Di Palma, Mauro de Benedictis, Carlo Trani, Roberto Boccaletti, Rosa Miccoli, Orazio Valsecchi, Antonio Colombo
OBJECTIVES: to understand the role of a transradial (TR) secondary approach during complex percutaneous interventions. BACKGROUND: The value of the TR route for ancillary vascular approach has not been adequately validated in this setting, and there is scant data on its role in reducing bleeding complications. METHODS: In the present study we retrospectively included patients undergoing the following interventions requiring two vascular approaches at nine high-volume centers in Italy: structural cardiac interventions, complex PCI, endovascular aortic repair (EVAR) and complex lower limb angioplasty...
May 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28459664/the-development-of-robotic-technology-in-cardiac-and-vascular-interventions
#14
Ali Pourdjabbar, Lawrence Ang, Ryan R Reeves, Mitul P Patel, Ehtisham Mahmud
Robotic technology has been used in cardiovascular medicine for over a decade, and over that period its use has been expanded to interventional cardiology and percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted interventions has been demonstrated in multiple studies ranging from simple to complex coronary lesions, and in the treatment of iliofemoral and infrapopliteal disease. These studies have shown a reduction in operator exposure to harmful ionizing radiation, and the use of robotics has the intuitive benefit of alleviating the occupational hazard of operator orthopedic injuries...
April 26, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28450349/vascular-cxcr4-limits-atherosclerosis-by-maintaining-arterial-integrity-evidence-from-mouse-and-human-studies
#15
Yvonne Döring, Heidi Noels, Emiel P C van der Vorst, Carlos Neideck, Virginia Egea, Maik Drechsler, Manuela Mandl, Lukas B Pawig, Yvonne Jansen, Katrin Schröder, Kiril Bidzhekov, Remco T A Megens, Wendy Theelen, Barbara M Klinkhammer, Peter Boor, Leon J Schurgers, Rick H van Gorp, Christian Ries, Pascal J H Kusters, Allard C van der Wal, Tilman M Hackeng, Gabor Gäbel, Ralf P Brandes, Oliver Soehnlein, Esther Lutgens, Dietmar Vestweber, Daniel Teupser, Lesca M Holdt, Daniel J Rader, Danish Saleheen, Christian Weber
Background -The CXCL12/CXCR4 chemokine ligand/receptor axis controls (progenitor) cell homeostasis and trafficking. So far, an atheroprotective role of CXCL12/CXCR4 has only been implied through pharmacological intervention, particularly as the somatic deletion of the CXCR4 gene in mice is embryonically lethal. Moreover, cell-specific effects of CXCR4 in the arterial wall and underlying mechanisms remain elusive, prompting us to investigate the relevance of CXCR4 in vascular cell types for atheroprotection...
April 27, 2017: Circulation
https://www.readbyqxmd.com/read/28442067/meta-analysis-of-percutaneous-coronary-intervention-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#16
Abdur R Khan, Harsh Golwala, Avnish Tripathi, Haris Riaz, Arnav Kumar, Michael P Flaherty, Deepak L Bhatt
Despite the increase in use of percutaneous coronary intervention (PCI) in left main coronary disease, its efficacy compared with coronary artery bypass grafting (CABG) is unclear. We performed a meta-analysis of randomized controlled trials to assess the optimal revascularization strategy. Our search yielded 8 studies reporting relevant outcomes that were pooled using the inverse variance method, and the hazard ratio (HR) was calculated. The primary outcome was all-cause mortality, myocardial infarction (MI), or stroke (major adverse cardiac events [MACE]), and the secondary outcome was death/MI/stroke/repeat revascularization (expanded MACE)...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#17
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432005/radial-ulnar-angioplasty-in-selected-patients-undergoing-elective-angiography-or-pci-using-complex-forearm-approach
#18
Santiago Jesús Camacho Freire, Antonio Enrique Gómez Menchero, Javier León Jiménez, Jessica Roa Garrido, Rosa Cardenal Piris, José Francisco Díaz Fernández
BACKGROUND: Angioplasty on the radial artery have been performed with good success rates in patients with critical hand ischemia. We sought to assess the feasibility and safety of radial angioplasty on complex radial access in patients undergoing coronary angiography. METHODS/MATERIAL: A prospective series of procedures with complex radial/ulnar access to which radial-ulnar angioplasty (RU-A) was performed. We set goals of efficacy and safety that included the success rate of the procedure (need for ¨Crossover femoral¨) and the existence of radial pulse at one month...
April 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28431047/impact-of-the-syntax-scores-i-and-ii-in-patients-with-diabetes-and-multivessel-coronary-disease-a-pooled-analysis-of-patient-level-data-from-the-syntax-precombat-and-best-trials
#19
Rafael Cavalcante, Yohei Sotomi, Massimo Mancone, Cheol Whan Lee, Jung-Min Ahn, Yoshinobu Onuma, Pedro A Lemos, Robert-Jan van Geuns, Seung-Jung Park, Patrick W Serruys
Aims: To assess the impact of the SYNTAX scores I and II in outcomes after percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) for patients with diabetes and multivessel disease (MVD). Methods and Results: We performed a patient-level pooled analysis of three large randomized trials of patients with MVD. The impact of coronary anatomic complexity as measured by the SYNTAX score in the differences in outcomes following PCI and CABG was assessed at a median follow-up of 5 years...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28429689/relationship-between-fragmented-qrs-complexes-in-leads-v4-v6-and-left-ventricular-apical-thrombus-formation-in-patients-presenting-with-first-acute-anterior-myocardial-infarction
#20
Erkan Baysal, Cengiz Burak, Barış Yaylak, Bernas Altıntaş, Önder Öztürk, Hacı Çiftçi, Rojhat Altındağ, Serdar Söner
OBJECTIVE: The present study was an investigation of the relationship between fragmented QRS (fQRS) and left ventricular apical thrombus (LVAT) in patients presenting with first acute anterior myocardial infarction (MI). METHODS: Consecutive 148 patients (mean age: 60.1±10.1 years; male: 75.6%) with first acute anterior MI who underwent primary percutaneous coronary intervention (PCI) were included. Study population was divided into 2 groups based on presence of LVAT...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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