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Complex pci

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113 papers 0 to 25 followers
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John Bahadorani, Anthony Doing, Ziad A Ali, Aris Karatasakis, Barbara A Danek, Bavana V Rangan, Aya J Alame, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Balloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. METHODS: We examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion (CTO) percutaneous coronary intervention (PCI) registry. RESULTS: Between 2012 and 2016, 718 CTO PCIs (in which the occlusion was successfully crossed with a guidewire) were performed in 701 patients at 11 US centers...
September 21, 2016: Catheterization and Cardiovascular Interventions
Umihiko Kaneko, Yoshifumi Kashima, Daitaro Kanno, Takuro Sugie, Ken Kobayashi, Tsutomu Fujita
Although performing rotational atherectomy (RA) requires guidewire exchange for the dedicated guidewire, RotaWire guidewire (Boston Scientific) exhibits much lower performance than conventional guidewire. Consequently, there are times when RotaWire cannot be advanced past the lesion independently or using a microcatheter exchange technique, rendering RA impossible. We present a case of a heavily calcified, device-uncrossable, and non-expansible chronic total occlusion lesion successfully revascularized with RA over RG3 guidewire (Asahi Intecc), which has a length of 330 cm, hydrophilic coating, and a 0...
September 28, 2016: Cardiovascular Intervention and Therapeutics
Takayuki Mori, Kenichi Sakakura, Hiroshi Wada, Yousuke Taniguchi, Kei Yamamoto, Yusuke Adachi, Hiroshi Funayama, Shin-Ichi Momomura, Hideo Fujita
While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94)...
October 5, 2016: Heart and Vessels
Sang-Hong Lee, Jae-Hwan Cho, Hee-Eun Kim, Sung-Chul Kim
OBJECTIVE: This study examined the effect of coronary artery calcification score by lifestyle and correlation with coronary artery stenosis in persons who underwent coronary artery computed tomography (CT) angiography among health examinees for heart diseases in Korea. METHODS AND MATERIALS: The study included 506 subjects (256 men and 250 women) who underwent coronary artery CT angiography among health examines for heart diseases at the Incheon Branch of the Korea Association of Health Promotion between January 2, 2014, and December 31, 2014...
September 27, 2016: Journal of Computer Assisted Tomography
Constantinos Andreou, Ioannis Karalis, Christos Maniotis, Johan W Jukema, Michael Koutouzis
Coronary stent delivery can be extremely challenging in tortuous and calcified lesions especially when radial approach is chosen. Guide extension catheter is a useful tool for overcoming the inherent difficulties arising by the use of radial access in complex percutaneous interventions. We describe a technique for guide extension catheter system advancement by presenting two cases. This was performed stepwise by repeated distal balloon anchoring in the coronary artery of interest.
August 8, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Kuan Leong Yew
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Aly Tohamy, Margo Klomp, Hein Putter, Amr Youssef, Hamdy Shams-Eddin, Mahmoud Abdelsabour, M J Schalij, J Wouter Jukema
We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57...
August 23, 2016: Angiology
Tiberio M Frisoli, Harold Friedman, William W O'Neill
A patient was referred to us for Canadian Cardiovascular Society class III refractory angina. He was found to have in-stent restenosis within three layers of underexpanded stents implanted in 2004, 2011, and 2014. Rotational atherectomy safely yielded stent strut ablation (reduced to one layer), lesion expansion, and very good angiographic and physiologic results.
September 2016: Journal of Invasive Cardiology
Taro Nihei, Yoshito Yamamoto, Shun Kudo, Kenichiro Hanawa, Yuhi Hasebe, Yusuke Takagi, Yutaka Minatoya, Masafumi Sugi, Hiroaki Shimokawa
The Rendezvous technique, which requires bidirectional wiring, is one of the useful methods for improving the success rate of recanalization for chronic total occlusion (CTO) in the field of peripheral intervention. Recently, advanced new devices for percutaneous coronary intervention have enabled us to perform the Rendezvous technique for peripheral as well as for coronary CTO lesions. We used the Intracoronary Rendezvous technique to perform angioplasty for coronary CTO. "Intracoronary Rendezvous" means that Rendezvous was achieved within the CTO lesion...
August 30, 2016: Cardiovascular Intervention and Therapeutics
Andrea Di Marco, Ignasi Anguera, Luis Teruel, Paolo Dallaglio, José González-Costello, Valentina León, Elaine Nuñez, Nicolás Manito, Joan Antoni Gómez-Hospital, Xavier Sabaté, Ángel Cequier
AIMS: The aim of this article is to evaluate the impact of a coronary chronic total occlusion in an infarct-related artery (IRA-CTO) on the occurrence of ventricular arrhythmias (VAs) in patients implanted with an implantable cardioverter defibrillator (ICD) for primary prevention. METHODS AND RESULTS: The study includes a prospective cohort of 108 consecutive patients with ischaemic cardiomyopathy, in whom an ICD was implanted for primary prevention and a coronary angiography performed before ICD implantation...
September 7, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Mateusz Tajstra, Łukasz Pyka, Jarosław Gorol, Damian Pres, Marek Gierlotka, Elżbieta Gadula-Gacek, Anna Kurek, Michał Wasiak, Michał Hawranek, Michał Oskar Zembala, Andrzej Lekston, Lech Poloński, Leszek Bryniarski, Mariusz Gąsior
OBJECTIVES: This study sought to assess the impact of chronic total occlusion (CTO) on long-term prognosis in patients with ischemic cardiomyopathy. BACKGROUND: The presence of concomitant CTO in a nonculprit lesion in acute coronary syndromes is associated with worse prognosis. Coronary artery disease is the main cause of heart failure and in many cases at least 1 CTO is observed. METHODS: The study included all patients with systolic heart failure who underwent elective coronary angiography and were registered from January 2009 to December 2014 in the ongoing single-center COMMIT-HF (COnteMporary Modalities In Treatment of Heart Failure) registry (NCT02536443)...
September 12, 2016: JACC. Cardiovascular Interventions
Maksymilian P Opolski, Artur Debski, Bartosz A Borucki, Marcin Szpak, Adam D Staruch, Cezary Kepka, Adam Witkowski
We report a case of successful computed tomography-guided percutaneous revascularization of a chronically occluded right coronary artery using a wearable, hands-free computer with a head-mounted display worn by interventional cardiologists in the catheterization laboratory. The projection of 3-dimensional computed tomographic reconstructions onto the screen of virtual reality glass allowed the operators to clearly visualize the distal coronary vessel, and verify the direction of the guide wire advancement relative to the course of the occluded vessel segment...
June 2016: Canadian Journal of Cardiology
István F Édes, Zoltán Ruzsa, György Szabó, Árpád Lux, László Gellér, Levente Molnár, Fanni Nowotta, Ágota Hajas, Bálint Szilveszter, Dávid Becker, Béla Merkely
AIMS: Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations. METHODS AND RESULTS: Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device...
2016: EuroIntervention
Enrico Fabris, Mark W Kennedy, Carlo Di Mario, Gianfranco Sinagra, Vincent Roolvink, Jan Paul Ottervanger, Arnoud W J Van't Hof, Elvin Kedhi
Due to the aging population undergoing percutaneous coronary intervention (PCI), interventional cardiologists are confronted daily with treatment of lesions with complex anatomy. Despite improvements in stent devices and PCI techniques, these lesions remain a challenge in terms of procedural success. Guide-extensions (GE) are coaxial "mother and child" catheters employed to facilitate device delivery but they can be used in many different complex scenarios. A comprehensive review of the possible applications of GE and of the GuideLiner™ (GL), the most widely used GE device, is missing...
November 1, 2016: International Journal of Cardiology
Roberto Garbo, Jacopo A Oreglia, Gabriele L Gasparini
Coronary perforation (CP) is a rare but potentially lethal complication of percutaneous coronary intervention (PCI). Management of CP is mainly conditioned by the extension of coronary rupture and location of the perforation. Successful treatment is highly affected by the operator's familiarity with tools and dedicated techniques to achieve prompt sealing of the disruption. We describe a "Balloon-Microcatheter" technique that may allow fast, safe, and effective management of CP with a single ≥ 6 Fr guiding catheter...
July 29, 2016: Catheterization and Cardiovascular Interventions
Kenichi Sakakura, Hiroshi Funayama, Yousuke Taniguchi, Yoshimasa Tsurumaki, Kei Yamamoto, Mitsunari Matsumoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
OBJECTIVES: The purpose of this randomized trial was to compare the incidence of slow flow between low-speed and high-speed rotational atherectomy (RA) of calcified coronary lesions. BACKGROUND: Preclinical studies suggest that slow flow is less frequently observed with low-speed than high-speed RA because of less platelet aggregation with low-speed RA. METHODS: This was a prospective, randomized, single center study. A total of 100 patients with calcified coronary lesions were enrolled and randomly assigned in a 1:1 ratio to low-speed (140,000 rpm) or high-speed (190,000 rpm) RA...
July 25, 2016: Catheterization and Cardiovascular Interventions
Mantian Chen, Linqing Shang, Qing Zhou, Shu Meng, Yacheng Zhang, Yi Feng, Chengxing Shen, Genshan Ma
OBJECTIVE: Percutaneous coronary intervention (PCI) for the heavily calcified coronary lesions remains a challenge, and the periprocedural complication rates of the transfemoral approach are high. This study was conducted to investigate the feasibility and long-term results of the transradial approach for rotational atherectomy (RA) prior to stent implantation via the transradial approach in patients with heavily calcified coronary artery lesions. METHODS: RA followed by stent implantation via the transradial approach was performed in 47 patients with severely calcified coronary artery lesions in this retrospectively case-control study...
September 2016: Anatolian Journal of Cardiology
Mahesh V Madhavan, Madhusudhan Tarigopula, Gary S Mintz, Akiko Maehara, Gregg W Stone, Philippe Généreux
Coronary artery calcification (CAC) is a risk factor for adverse outcomes in the general population and in patients with coronary artery disease. The pathogenesis of CAC and bone formation share common pathways, and risk factors have been identified that contribute to the initiation and progression of CAC. Efforts to control CAC with medical therapy have not been successful. Event-free survival is also reduced in patients with coronary calcification after both percutaneous coronary intervention (PCI) and bypass graft surgery...
May 6, 2014: Journal of the American College of Cardiology
Michael S Lee, Evan Shlofmitz, Barry Kaplan, Dragos Alexandru, Perwaiz Meraj, Richard Shlofmitz
OBJECTIVES: We evaluated the safety and efficacy of orbital atherectomy in real-world patients with severe coronary artery calcification (CAC). BACKGROUND: The presence of severe CAC increases the complexity of percutaneous coronary intervention as it may impede stent delivery and optimal stent expansion. Atherectomy may be an indispensable tool for uncrossable or undilatable lesions by modifying severe CAC. Although the ORBIT I and II trials report that orbital atherectomy was safe and effective for the treatment of severe CAC, patients with kidney disease, recent myocardial infarction, long diffuse disease, severe left ventricular dysfunction, and unprotected left main disease were excluded...
August 2016: Journal of Interventional Cardiology
Christos Eftychiou, David S Barmby, Simon J Wilson, Salahaddin Ubaid, Andrew J Markwick, Loukia Makri, Jonathan M Blaxill, James C Spratt, Mark Gunning, John P Greenwood
OBJECTIVES: To identify factors associated with outcomes following rotational atherectomy (RA). BACKGROUND: RA is an effective way to mechanically modify heavily calcified lesions before stenting; however its outcomes are not well defined. METHODS AND RESULTS: Retrospective evaluation of all patients who underwent RA in three large UK centers (Leeds General Infirmary (LGI), Royal Infirmary of Edinburgh (RIE) and University Hospital of North Staffordshire (UHNS)) from March 2005 to January 2013...
June 3, 2016: Catheterization and Cardiovascular Interventions
2016-06-19 11:40:29
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