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GMG Interventional

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507 papers 100 to 500 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
Matthew Allan, Dominic Vickers, Mark Pitney, Nigel Jepson
BACKGROUND: Refractory coronary in-stent restenosis remains a clinically relevant problem in interventional cardiology despite the use of drug coated balloon angioplasty and further drug eluting stent deployment. In this study, we investigated whether the novel approach of lesion debulking with rotational atherectomy prior to drug coated balloon angioplasty for challenging coronary in-stent restenosis is safe and effective. METHODS: Procedural and registry data was retrospectively analysed for 26 patients who underwent rotational atherectomy immediately followed by drug coated balloon angioplasty to 43 coronary in-stent restenosis lesions with mean follow up of 19 months...
August 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Evan Shlofmitz, Allen Jeremias, Alec Goldberg, Thomas Pappas, Andrew Berke, George Petrossian, Theofanis Tsiamtsiouris, Andrew Lituchy, Michael Lee, Richard Shlofmitz
BACKGROUND: Severely calcified lesions present many challenges to percutaneous coronary intervention (PCI). Orbital atherectomy (OA) aids vessel preparation and treatment of severely calcified coronary lesions. Same-day discharge (SDD) after PCI has numerous advantages including cost savings and improved patient satisfaction. The aim of this study is to evaluate the safety of SDD among patients treated with OA in a real-world setting. METHODS: This was a single-center retrospective analysis of patients undergoing OA...
September 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Kyle D Buchanan, Paul Kolm, Micaela Iantorno, Deepakraj Gajanana, Toby Rogers, Jiaxiang Gai, Rebecca Torguson, Itsik Ben-Dor, William O Suddath, Lowell F Satler, Ron Waksman
BACKGROUND/PURPOSE: Appropriate patient selection for mechanical circulatory support following percutaneous coronary intervention (PCI) remains a challenge. This study aims to evaluate the role of coronary perfusion pressure and other left ventricular hemodynamics to predict cardiovascular collapse following PCI. METHODS/MATERIALS: We retrospectively analyzed all patients who underwent PCI for acute coronary syndrome (ACS) from 2003 to 2016. Coronary perfusion pressure was calculated for each patient and defined as the difference in mean arterial pressure and left ventricular end diastolic pressure (LVEDP)...
September 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Shozo Sueda, Kaori Fujimoto, Yasuhiro Sasaki, Tomoki Sakaue, Hirokazu Habara, Hiroaki Kohno
Objectives The clinical characteristics in patients with catheter-induced spasm in the proximal right coronary artery (RCA) are controversial. We performed a clinical analysis of catheter-induced spasm in the RCA. Methods We retrospectively analyzed 5,352 consecutive patients who underwent diagnostic or follow-up angiography during a 26-year period. During this period, we found 40 patients with catheter-induced spasm in the RCA. We compared the clinical characteristics and procedures of cardiac catheterization in patients with catheter-induced spasm in the RCA with those in patients without such spasm...
August 10, 2018: Internal Medicine
Peter Ong, Giancarlo Pirozzolo, Anastasios Athanasiadis, Udo Sechtem
PURPOSE: Coronary spasm is frequently found in patients with angina and unobstructed coronaries. The pathophysiology is incompletely understood, although sex differences have been described. Often a positive family history (PFH) is encountered. We assessed the relationship between sex, coronary spasm, and a PFH for cardiovascular disease. METHODS: This single-center observational study recruited 415 stable angina patients with unobstructed coronaries (no stenosis >50%) between 2008 and 2011 (mean [SD] age, 62 [10] years; 38% men)...
August 16, 2018: Clinical Therapeutics
Toshiki Sawai, Yu Tajima, Atsuya Hirota, Shigetada Yamamoto, Hiroshi Nakajima, Katsutoshi Makino, Masaaki Ito
A 69-year-old man who had been hospitalized with acute coronary syndrome (ACS), underwent urgent percutaneous coronary intervention. In the subacute phase, he developed sudden chest pain and hemodynamic deterioration, and urgent coronary angiogram showed multiple coronary artery spasms. The discontinuation of beta-blocker treatment and the administration of a calcium antagonist helped prevent angina attacks. In Japanese patients who tend to have coronary artery spasm, the routine administration of beta-blockers for post-ACS patients with a preserved left ventricular systolic function should be considered carefully...
August 24, 2018: Internal Medicine
Fabien Picard, Neila Sayah, Vincent Spagnoli, Julien Adjedj, Olivier Varenne
Vasospastic angina (VSA) is a variant form of angina pectoris, in which angina occurs at rest, with transient electrocardiogram modifications and preserved exercise capacity. VSA can be involved in many clinical scenarios, such as stable angina, sudden cardiac death, acute coronary syndrome, arrhythmia or syncope. Coronary vasospasm is a heterogeneous phenomenon that can occur in patients with or without coronary atherosclerosis, can be focal or diffuse, and can affect epicardial or microvasculature coronary arteries...
September 6, 2018: Archives of Cardiovascular Diseases
John C Moscona, Jason D Stencel, Gregory Milligan, Christopher Salmon, Rohit Maini, Paul Katigbak, Qusai Saleh, Ryan Nelson, Sudesh Srivastav, Owen Mogabgab, Rohan Samson, Thierry Le Jemtel
Background: An accurate diagnostic assessment of coronary artery disease is crucial for patients undergoing coronary artery bypass grafting (CABG). Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) to guide complete revascularization have not been adequately studied in patients prior to CABG. We compared an anatomic to a physiologic assessment of moderate coronary lesions (40-70% stenosis) in patients referred for CABG. Methods: We retrospectively reviewed 109 medical records of patients who underwent CABG at Tulane Medical Center from 2014 to 2016...
August 2018: Annals of Translational Medicine
Syed A Sadeque, Clifford W Barlow
No abstract text is available yet for this article.
July 20, 2018: Journal of Thoracic and Cardiovascular Surgery
Ron Waksman, Toby Rogers, Rebecca Torguson, Paul Gordon, Afshin Ehsan, Sean R Wilson, John Goncalves, Robert Levitt, Chiwon Hahn, Puja Parikh, Thomas Bilfinger, David Butzel, Scott Buchanan, Nicholas Hanna, Robert Garrett, Federico Asch, Gaby Weissman, Itsik Ben-Dor, Christian Shults, Roshni Bastian, Paige E Craig, Hector M Garcia-Garcia, Paul Kolm, Quan Zou, Lowell F Satler, Paul J Corso
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is now standard of care for patients with symptomatic severe aortic stenosis who are extreme, high or intermediate risk for surgical aortic valve replacement (SAVR). OBJECTIVES: To evaluate TAVR in a prospective multicenter trial involving low-risk patients. METHODS: The Low Risk TAVR trial was the first FDA-approved Investigational Device Exemption trial to enroll in the US. This investigator-led trial was a prospective, multicenter, unblinded, comparison to historical controls from the Society of Thoracic Surgeons (STS) database...
August 9, 2018: Journal of the American College of Cardiology
Miguel Sousa-Uva, Franz-Josef Neumann, Anders Ahlsson, Fernando Alfonso, Adrian P Banning, Umberto Benedetto, Robert A Byrne, Jean-Philippe Collet, Volkmar Falk, Stuart J Head, Peter Jüni, Adnan Kastrati, Akos Koller, Steen D Kristensen, Josef Niebauer, Dimitrios J Richter, Petar M Seferovic, Dirk Sibbing, Giulio G Stefanini, Stephan Windecker, Rashmi Yadav, Michael O Zembala
No abstract text is available yet for this article.
August 27, 2018: European Journal of Cardio-thoracic Surgery
Pascal Vranckx, Marco Valgimigli, Peter Jüni, Christian Hamm, Philippe Gabriel Steg, Dik Heg, Gerrit Anne van Es, Eugene P McFadden, Yoshinobu Onuma, Cokky van Meijeren, Ply Chichareon, Edouard Benit, Helge Möllmann, Luc Janssens, Maurizio Ferrario, Aris Moschovitis, Aleksander Zurakowski, Marcello Dominici, Robert Jan Van Geuns, Kurt Huber, Ton Slagboom, Patrick W Serruys, Stephan Windecker
BACKGROUND: We hypothesised that ticagrelor, in combination with aspirin for 1 month, followed by ticagrelor alone, improves outcomes after percutaneous coronary intervention compared with standard antiplatelet regimens. METHODS: GLOBAL LEADERS was a randomised, open-label superiority trial at 130 sites in 18 countries. Patients undergoing percutaneous coronary intervention with a biolimus A9-eluting stent for stable coronary artery disease or acute coronary syndromes were randomly assigned (1:1) to 75-100 mg aspirin daily plus 90 mg ticagrelor twice daily for 1 month, followed by 23 months of ticagrelor monotherapy, or standard dual antiplatelet therapy with 75-100 mg aspirin daily plus either 75 mg clopidogrel daily (for patients with stable coronary artery disease) or 90 mg ticagrelor twice daily (for patients with acute coronary syndromes) for 12 months, followed by aspirin monotherapy for 12 months...
September 15, 2018: Lancet
Clay M Barbin, Anupama Vasudevan, James W Choi, Peter A McCullough, Jeffrey M Schussler, Ravi C Vallabhan, Robert C Stoler
BACKGROUND: Fractional flow reserve(FFR) is a validated tool for evaluating functional severity and guiding the revascularization of angiographically moderate coronary artery lesions. OBJECTIVE: To study if there is a higher frequency of positive FFR measurements in the left anterior descending(LAD) versus other major coronary arteries and also evaluate the differences in the total length of the stent placed. METHODS: A retrospective cohort study including all subjects (January 2011 to December 2015) who had fractional flow reserve (FFR) measured during coronary catheterization was conducted...
April 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Panagiotis K Siogkas, Michail I Papafaklis, Lampros Lakkas, Themis P Exarchos, Dimitri Karmpaliotis, Ziad A Ali, Gualtiero Pelosi, Oberdan Parodi, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
AIMS: We aimed to investigate the performance of virtual functional assessment of coronary stenoses using intravascular ultrasound (IVUS)-based three-dimensional (3D) coronary artery reconstruction against the invasively measured fractional flow reserve (FFR). METHODS AND RESULTS: Twenty-two patients with either typical symptoms of stable angina or a positive stress test, who underwent IVUS and FFR, were included in this study. Five patients presented FFR values lower than the 0...
March 2, 2018: Heart, Lung & Circulation
Giuseppe Tarantini, Alberto Barioli, Luca Nai Fovino, Chiara Fraccaro, Giulia Masiero, Sabino Iliceto, Massimo Napodano
BACKGROUND: Invasive physiological assessment of myocardial bridges (MBs) is largely unsettled. Unlike fractional flow reserve (FFR), instantaneous wave-free ratio (iFR) is a diastole-specific index. As such, its value might not be hampered by systolic pressure overshooting and negative systolic pressure gradient caused by the compression of the tunneled coronary artery. METHODS AND RESULTS: We prospectively enrolled 20 patients with angina and/or positive noninvasive stress test, absence of significant coronary artery stenosis, and angiographic suspicion/evidence of MB in the left anterior descending artery...
June 2018: Circulation. Cardiovascular Interventions
Sasko Kedev, Ivan Vasilev
Functional tests used in the catheterization laboratory have emerged as a very important adjunctive tool to coronary angiography that can identify patients with myocardial blood flow impairment. Fractional flow reserve (FFR) measurement is highly recommended for detection of ischemia-related coronary lesion(s) when objective evidence of vessel-related ischemia is not available. Recently, much simpler instantaneous wave free ratio (iFR) was proposed as an alternative to FFR without requirement for administration of vasodilators...
July 1, 2018: Current Pharmaceutical Design
Valérie E Stegehuis, Gilbert W Wijntjens, Jan J Piek, Tim P van de Hoef
PURPOSE OF REVIEW: Accumulating evidence exists for the value of coronary physiology for clinical decision-making in ischemic heart disease (IHD). The most frequently used pressure-derived index to assess stenosis severity, the fractional flow reserve (FFR), has long been considered the gold standard for this purpose, despite the fact that the FFR assesses solely epicardial stenosis severity and aims to estimate coronary flow impairment in the coronary circulation. The coronary flow reserve (CFR) directly assesses coronary blood flow in the coronary circulation, including both the epicardial coronary artery and the coronary microvasculature, but is nowadays less established than FFR...
July 26, 2018: Current Cardiology Reports
Ahmed Almomani, Naga Venkata Pothineni, Mohan Edupuganti, Jason Payne, Shiv Agarwal, Barry Uretsky, Abdul Hakeem
Fractional flow reserve (FFR) has been shown to improve clinical decision-making for revascularization in intermediate coronary stenosis in native coronary arteries of patients with stable coronary disease. However, its use for saphenous vein graft (SVG) lesions has not been well validated. We sought to determine the prognostic value of deferring intervention in lesions with FFR >0.8 in SVG lesions. Clinical, angiographic, and hemodynamic variables and long-term outcomes were recorded in consecutive patients in whom percutaneous coronary intervention was deferred based on an FFR >0...
June 9, 2018: American Journal of Cardiology
Joo Myung Lee, Ki Hong Choi, Doyeon Hwang, Jonghanne Park, Ji-Hyun Jung, Hyung Yoon Kim, Hae Won Jung, Yun-Kyeong Cho, Hyuck-Jun Yoon, Young Bin Song, Joo-Yong Hahn, Joon-Hyung Doh, Chang-Wook Nam, Eun-Seok Shin, Seung-Ho Hur, Bon-Kwon Koo
OBJECTIVES: This study investigated the prognostic implication of coronary flow reserve (CFR) in patients who underwent fractional flow reserve (FFR) measurement. BACKGROUND: Limited data are available regarding the long-term prognosis associated with thermodilution CFR in patients with coronary artery disease. METHODS: A total of 519 patients (737 vessels) who did not undergo revascularization were classified according to FFR and CFR values...
August 13, 2018: JACC. Cardiovascular Interventions
Daisuke Nakamura, William Wijns, Matthew J Price, Michael R Jones, Emanuele Barbato, Takashi Akasaka, Stephen W-L Lee, Sandeep M Patel, Setsu Nishino, Wei Wang, Ajay Gopinath, Guilherme F Attizzani, David Holmes, Hiram G Bezerra
OBJECTIVES: This study sought to compare conventional methodology (CM) with a newly described optical coherence tomography (OCT)-derived volumetric stent expansion analysis in terms of fractional flow reserve (FFR)-derived physiology and device-oriented composite endpoints (DoCE). BACKGROUND: The analysis of coronary stent expansion with intracoronary imaging has used CM that relies on the analysis of selected single cross-sections for several decades. The introduction of OCT with its ability to perform semiautomated volumetric analysis opens opportunities to redefine optimal stent expansion...
August 13, 2018: JACC. Cardiovascular Interventions
2018-09-09 12:01:47
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