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https://www.readbyqxmd.com/read/28228292/a-fresh-look-at-bioresorbable-scaffold-technology-intuition-pumps
#1
EDITORIAL
Sundeep Mishra
Bioresorbable scaffolds (BRS) are a new enticing treatment option in coronary interventions. Absorb BVS™ Is the most widely used and researched polymer based BRS, eluting everolimus. However currently it has several technical limitations; low radial support, larger strut size, poor visualization, poor deliverability and complex implantation technique. Magnesium based BRS are an alternate but they are also limited not only by lower radial support and poor visualization but also earlier bio-absorption. Material processing: blow-molding, annealing, polymer orientation, change in composition and use of higher molecular weight polymer, as well new polymers like tyrosine or salicyclate analogs and even hybrid (polymer and metallic) combined with intelligent cell design has led to evolution of BRS technology...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28220330/synchronous-cardiocerebral-infarction-in-the-era-of-endovascular-therapy-which-to-treat-first
#2
Leonard L L Yeo, Tommy Andersson, Kong Wan Yee, Benjamin Y Q Tan, Prakash Paliwal, Anil Gopinathan, Mahendran Nadarajah, Eric Ting, Hock L Teoh, Robin Cherian, Erik Lundström, Edgar L W Tay, Vijay K Sharma
A cardiocerebral ischemic attack (CCI) or a concurrent acute ischemic stroke (AIS) and myocardial infarction (AMI) is a severe event with no clear recommendations for ideal management because of the rarity of the scenario. The narrow time window for treatment and complexity of the treatment decision puts immense pressure on the treating physician. We evaluated this challenging situation at our tertiary center. Using our prospective stroke database out of a total of 555 patients with acute ischemic stroke between 2009 and 2014, we identified five consecutive cases with CCI (incidence 0...
February 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#3
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28202032/cost-effectiveness-analysis-for-a-tele-based-health-coaching-program-for-chronic-disease-in-primary-care
#4
Erja Oksman, Miika Linna, Iiris Hörhammer, Johanna Lammintakanen, Martti Talja
BACKGROUND: The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF)...
February 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28197870/intravascular-ultrasound-guidance-of-percutaneous-coronary-intervention-in-ostial-chronic-total-occlusions-a-description-of-the-technique-and-procedural-results
#5
Nicola Ryan, Nieves Gonzalo, Philip Dingli, Oscar Vedia Cruz, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, María Del Trigo, Pablo Salinas, Carlos Macaya, Antonio Fernandez-Ortiz, Javier Escaned
Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution...
February 14, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28183464/transradial-coronary-interventions-for-complex-chronic-total-occlusions
#6
Yutaka Tanaka, Noriaki Moriyama, Tomoki Ochiai, Takuma Takada, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Futoshi Yamanaka, Shingo Mizuno, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVES: The aims of this study were to assess whether the transradial approach can be applied to treat complex chronic total occlusion (CTO) and to determine the predictors of transradial percutaneous coronary intervention (PCI) failure. BACKGROUND: Consistent data on the outcomes of transradial PCI for treating CTO are scarce. METHODS: Consecutive patients who were not receiving hemodialysis and had undergone PCI for CTO were enrolled...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183306/third-generation-drug-eluting-stent-des-with-biodegradable-polymer-in-diabetic-patients-5%C3%A2-years-follow-up
#7
Marcus Wiemer, Sinisa Stoikovic, Alexander Samol, Zisis Dimitriadis, Juan M Ruiz-Nodar, Ralf Birkemeyer, Jacques Monsegu, Gérard Finet, David Hildick-Smith, Damras Tresukosol, Enrique Garcia Novo, Jacques J Koolen, Emanuele Barbato, Gian Battista Danzi
OBJECTIVE: To report the long-term safety and efficacy data of a third generation drug eluting stent (DES) with biodegradable polymer in the complex patient population of diabetes mellitus after a follow-up period of 5 years. BACKGROUND: After percutaneous coronary intervention patients with diabetes mellitus are under higher risk of death, restenosis and stent thrombosis (ST) compared to non-diabetic patients. METHODS: In 126 centers worldwide 3067 patients were enrolled in the NOBORI 2 registry, 888 patients suffered from diabetes mellitus (DM), 213 of them (14%) being insulin dependent (IDDM)...
February 10, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28181450/management-of-iatrogenic-aortal-dissection-as-a-complication-of-coronary-intervention-wait-and-watch
#8
Rajesh Dandale, Alexander Krapivsky, Feraydoon Niroomand
Iatrogenic aortic dissection (AD) is quite a rare complication during percutaneous coronary intervention (PCI). The exact mechanism of iatrogenic AD during PCI is unknown. A standard of care in the management of iatrogenic AD is still lacking. We describe a case of an 83-year-old man, with an aortocoronary bypass graft, who underwent complex PCI with rotational atherectomy catheterization with a radial approach for a chronic right coronary artery stenosis, complicated by AD. According to our experience, retrograde dissection into the aorta during PCI can be sealed with a coronary stent that covers the coronary ostium and should be treated conservatively in most circumstances, unless complication like extension of dissection into other vessels or pericardial effusion or hemodynamic instability occurs...
February 9, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28180008/use-of-orbital-atherectomy-in-acute-myocardial-infarction-via-the-transradial-approach
#9
REVIEW
Samer Mowakeaa, Branden Snyder, Nikolaos Kakouros
Severe coronary artery calcifications pose an ongoing challenge when performing percutaneous coronary interventions, resulting in an increased likelihood of procedural complications. Orbital atherectomy (OA) has emerged as a promising technology that helps improve outcomes in this complex patient population. Its safety and efficacy are yet to be demonstrated in the setting of acute myocardial infarction. We present a case of a patient with acute ST-elevation myocardial infarction (STEMI) evaluated with emergent transradial coronary angiography...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28178148/monitoring-the-hemostasis-with-rotation-thromboelastometry-in-patients-with-acute-stemi-on-dual-antiplatelet-therapy-first-experiences
#10
Matej Samoš, Lucia Stančiaková, Lukáš Duraj, František Kovář, Marián Fedor, Radoslava Šimonová, Tomáš Bolek, Peter Galajda, Ján Staško, Peter Kubisz, Marián Mokáň
Rotation thromboelastometry (ROTEM) is a viscoelastometric point-of-care-test for the complex evaluation of changes in hemostasis, performed in whole blood. However, no prospective study evaluating the efficacy of the antiplatelet therapy using ROTEM was performed.Fifty-six patients (34 men, 22 women, mean age 67.75 years, and age range 34-88 years) with acute ST-elevation myocardial infarction (STEMI), treated with dual antiplatelet therapy, undergoing urgent coronary angiography and percutaneous coronary intervention (PCI) of culprit coronary lesion were included...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28162989/orbital-atherectomy-for-treating-de-novo-severely-calcified-coronary-lesions-3-year-results-of-the-pivotal-orbit-ii-trial
#11
Michael Lee, Philippe Généreux, Richard Shlofmitz, Daniel Phillipson, Bynthia M Anose, Brad J Martinsen, Stevan I Himmelstein, Jeff W Chambers
BACKGROUND/PURPOSE: The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc...
January 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28151527/-management-of-acute-coronary-syndromes-in-the-abruzzi-region-in-italy-abruzzi-inter-societary-consensus-document
#12
Marco Mascellanti, Marco Zimarino, Raffaele De Caterina
Consensus documents allow on the one hand the stardardization of therapeutic interventions to allow patients to receive the best possible treatments, but also imply practical choices, which reduce decision uncertainties and the often too many therapeutic options, possible source of errors. This standardization implies a necessary simplification of therapeutic options facing the complexity and multiplicity of clinical presentations. However, the risk of an over-simplification is smaller than to allow arbitrary treatments, which have dominated Medicine in the absence of evidences...
2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28145873/incidence-of-bradycardia-and-outcomes-of-patients-who-underwent-orbital-atherectomy-without-a-temporary-pacemaker
#13
Michael S Lee, Heajung Nguyen, Richard Shlofmitz
OBJECTIVE: We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. BACKGROUND: The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145612/coronary-artery-perforations-after-contemporary-percutaneous-coronary-interventions-evaluation-of-incidence-risk-factors-outcomes-and-predictors-of-mortality
#14
Jessica Parsh, Milan Seth, Jacqueline Green, Nadia R Sutton, Stanley Chetcuti, Simon Dixon, Paul M Grossman, Akshay Khandelwal, James M Dupree, Hitinder S Gurm
OBJECTIVES: We sought to evaluate the incidence, risk factors, in-hospital, and long-term outcomes and predictors of mortality of coronary artery perforations (CAP) in the contemporary percutaneous coronary intervention (PCI) era. BACKGROUND: CAP is a rare but serious complication of PCI associated with increased risk of morbidity and mortality. METHODS: We included 181,590 procedures performed across 47 hospitals in Michigan from January 1, 2010 to December 31, 2015...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28144260/the-rs2228145-polymorphism-in-the-interleukin-6-receptor-and-its-association-with-long-term-prognosis-after-myocardial-infarction-in-a-pilot-study
#15
Anna Szpakowicz, Witold Pepinski, Ewa Waszkiewicz, Małgorzata Skawronska, Anna Niemcunowicz-Janica, Wlodzimierz J Musial, Karol A Kaminski
INTRODUCTION: Interleukin-6 (IL-6) is a cytokine with a complex function that is described as both pro- and anti-inflammatory. One factor that influences its function is the rs2228145 A/C single nucleotide polymorphism (SNP) of the IL-6 receptor (IL6R) gene. C allele carriers have a decreased inflammatory response and decreased prevalence of ischemic heart disease. The aim of the study was to investigate the association of the rs2228145 SNP of the IL6R gene with long-term total mortality in patients with ST-elevation myocardial infarction (STEMI) treated invasively...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28143840/educational-intervention-to-improve-effectiveness-in-treatment-and-control-of-patients-with-high-cardiovascular-risk-in-low-resource-settings-in-argentina-study-protocol-of-a-cluster-randomised-controlled-trial
#16
Pablo Gulayin, Vilma Irazola, Alfredo Lozada, Martin Chaparro, Marilina Santero, Laura Gutierrez, Rosana Poggio, Andrea Beratarrechea, Adolfo Rubinstein
INTRODUCTION: Hypercholesterolaemia is estimated to cause 2.6 million deaths annually and one-third of the cases of ischaemic heart disease. In Argentina, the prevalence of hypercholesterolaemia increased between 2005 and 2013 from 27.9% to 29.8%. Only one out of four subjects with a self-reported diagnosis of coronary heart disease is taking statins. Since 2014, statins (simvastatin 20 mg) are part of the package of drugs provided free-of-charge for patients according to cardiovascular disease (CVD) risk stratification...
January 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28137225/platelet-function-testing-a-role-for-personalised-therapy-in-coronary-disease
#17
Mohamed Farag, Diana A Gorog
Whilst there exist general guidelines regarding administration of antiplatelet therapy to prevent thrombotic events in patients with cardiovascular disease, the optimal therapy for a particular individuals in particular settings remains unclear. For patients with acute coronary syndrome (ACS) or those undergoing percutaneous coronary intervention (PCI), the use of potent antiplatelet agent combinations is recommended. However, some patients continue to have thrombotic events or experience bleeding events, which have been linked to the widely known variability in individual response to antiplatelet therapy, particularly to clopidogrel...
January 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28134094/outcome-after-long-segment-stenting-with-everolimus-eluting-bioresorbable-scaffolds-focusing-on-the-concept-of-overlapping-implantation
#18
Jens Wiebe, Oliver Dörr, Christoph Liebetrau, Timm Bauer, Eva Wilkens, Hanna Ilstad, Niklas Boeder, Albrecht Elsässer, Helge Möllmann, Christian W Hamm, Holger M Nef
INTRODUCTION AND OBJECTIVES: The implantation of bioresorbable scaffolds (BRS) is an emerging technique used in percutaneous coronary interventions. Their application has been extended to more complex lesions, although evidence is only available for simple lesions. The present study evaluated scaffold implantation in long lesions, focusing on overlapping scaffolds. METHODS: We retrospectively analyzed all consecutive patients eligible for stenting with everolimus-eluting poly-L-lactic acid-based BRS with a minimum total scaffold length of 28mm, irrespective of the number of BRS used...
December 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28132683/probability-of-accurate-heart-failure-diagnosis-and-the-implications-for-hospital-readmissions
#19
Sandra A Carey, Kyle Bass, Giovanna Saracino, Cara A East, Joost Felius, Paul A Grayburn, Ravi C Vallabhan, Shelley A Hall
Heart failure (HF) is a complex syndrome with inherent diagnostic challenges. We studied the scope of possibly inaccurately documented HF in a large health care system among patients assigned a primary diagnosis of HF at discharge. Through a retrospective record review and a classification schema developed from published guidelines, we assessed the probability of the documented HF diagnosis being accurate and determined factors associated with HF-related and non-HF-related hospital readmissions. An arbitration committee of 3 experts reviewed a subset of records to corroborate the results...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28129736/identification-of-new-biosignatures-for-clinical-outcomes-in-stable-coronary-artery-disease-the-study-protocol-and-initial-observations-of-a-prospective-follow-up-study-in-taiwan
#20
Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I Yeh, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Jaw-Wen Chen
BACKGROUND: Either classic or novel biomarkers have not been well investigated for clinical outcomes of coronary artery disease (CAD) in Asian people especially ethnic Chinese. We reported here a prospective national-based follow-up study that aims to elucidate the clinical profiles and to identify the new biosignatures (especially the non-lipid profile and inflammatory biomakers) for future clinical outcomes in a sizable cohort of stable CAD patients in Taiwan. METHODS: A total of 2500 CAD patients under stable condition after successful percutaneous coronary intervention will be enrolled for clinical data collection and blood/urine sampling in northern, southern, western, or eastern part of Taiwan between 2012 and 2017...
January 28, 2017: BMC Cardiovascular Disorders
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