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GMG Interventional

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512 papers 100 to 500 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
Marco Zuin, Gianluca Rigatelli, Loris Roncon
Over the last years, fentanyl, a potent synthetic μ receptor-stimulating opioid, has become one of the most used drugs for both procedural analgesia and sedation in patients undergoing coronary angiography (CA) and/or percutaneous coronary intervention (PCI). However, few studies have been performed to evaluate the efficacy and the impact of this drug in patients with coronary artery disease (CAD) treated with PCI. Most of the previous studies have investigated the self-reported discomfort pain, demonstrating that patients premedicated with fentanyl generally reported a lower pain/discomfort when compared to placebo, benzodiazepines, or local anesthesia at the site of the artery cannulation, without significant variation in the hemodynamic response...
October 24, 2018: Cardiovascular Drugs and Therapy
Pontus Andell, Karolina Berntorp, Evald H Christiansen, Ingibjörg J Gudmundsdottir, Lennart Sandhall, Dimitrios Venetsanos, David Erlinge, Ole Fröbert, Sasha Koul, Christian Reitan, Matthias Götberg
OBJECTIVES: The authors sought to compare reclassification of treatment strategy following instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). BACKGROUND: iFR was noninferior to FFR in 2 large randomized controlled trials in guiding coronary revascularization. Reclassification of treatment strategy by FFR is well-studied, but similar reports on iFR are lacking. METHODS: The iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome Trial) study randomized 2,037 participants with stable angina or acute coronary syndrome to treatment guided by iFR or FFR...
October 22, 2018: JACC. Cardiovascular Interventions
Tommaso Gori, Remzi Anadol
Up to 50% of the patients undergoing coronary angiography present no epicardial disease. Most of these patients are women. Takotsubo cardiomyopathy, coronary microvascular dysfunction, and spontaneous coronary artery dissection are the most common syndromes that affect these patients. Their mechanisms are complex, with a interplay between neurohormonal factors and a number of other systems. The present review describes how changes in the estrogen state may lead to changes in vasomotor tone and endothelial dysfunction which result in coronary epicardial and microvascular spasm and coronary arterial wall instability in these three conditions...
October 11, 2018: Clinical Hemorheology and Microcirculation
Thomas F Lüscher
No abstract text is available yet for this article.
September 14, 2018: European Heart Journal
Rasha K Al-Lamee, Alexandra N Nowbar, Darrel P Francis
The adverse consequences of stable coronary artery disease (CAD) are death, myocardial infarction (MI) and angina. Trials in stable CAD show that percutaneous coronary intervention (PCI) does not reduce mortality. PCI does appear to reduce spontaneous MI rates but at the expense of causing some periprocedural MI. Therefore, the main purpose of PCI is to relieve angina. Indeed, patients and physicians often choose PCI rather than first attempting to control symptoms with anti-anginal medications as recommended by guidelines...
September 21, 2018: Heart: Official Journal of the British Cardiac Society
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 the standard of care for patients with symptomatic severe aortic stenosis who are extreme, high, or intermediate risk for surgical aortic valve replacement (SAVR). OBJECTIVES: The authors sought to evaluate TAVR in a prospective multicenter trial involving low-risk patients. METHODS: The Low Risk TAVR (Feasibility of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic, Severe Aortic Stenosis) trial was the first U...
October 30, 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
2018-09-09 12:12:46
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