Sam Mirzaee, Mourushi Isa, Udit Thakur, James D Cameron, Stephen J Nicholls, Benjamin K Dundon
BACKGROUND: Despite the high prevalence of coronary bifurcation lesions in routine interventional cardiology practice, the best strategy for managing this challenging lesion subset remains debatable. Due to potential for complications, the routine practice of side-branch (SB) predilation is controversial. METHODS: An electronic search was performed of online databases up until April 2018 for studies reporting periprocedural angiographic outcomes comparing provisional main-branch stenting with and without SB predilation...
February 2020: Journal of Invasive Cardiology
Masahiro Yamawaki, Toshiya Muramatsu, Kazuhiro Ashida, Koichi Kishi, Yoshihiro Morino, Yoshihisa Kinoshita, Takashi Fujii, Yuichi Noguchi, Shingo Hosogi, Kazuya Kawai, Kiyoshi Hibi, Yoshisato Shibata, Hiroshi Ohira, Yasuhiro Morita, Yasuhiro Tarutani, Mikihito Toda, Yoshihisa Shimada, Yuji Ikari, Jiro Ando, Yutaka Hikichi, Yoritaka Otsuka, Yasushi Fuku, Shigenori Ito, Harumi Katoh, Kazushige Kadota, Yoshiaki Ito, Kazuaki Mitsudo
The appropriate stent platform for treating coronary bifurcation lesions (CBLs) remains controversial. Previous bench tests have demonstrated the superiority of a 2-link cell design to 3-link cell design for creating inter-strut dilation at the side branch ostium. This randomized multicenter prospective BEGIN trial compared the biodegradable polymer-based biolimus A9-eluting stent (2-link BES) with the durable polymer-based cobalt chromium everolimus-eluting stent (3-link EES) in 226 patients with de novo CBLs...
March 11, 2019: Heart and Vessels
Noriaki Moriyama, Yutaka Tanaka, Shigeru Saito
Coronary artery perforation during percutaneous coronary intervention is a rare, but potentially lethal complication. Immediate balloon expansion at the perforation site can halt the bleeding. Implantation of a coronary polytetrafluoroethylene (PTFE)-covered stent enables the efficient endovascular repair of a coronary artery perforation. However, if the perforation occurs at a bifurcation, a PTFE-covered stent may jail the side branch. We report a difficult case of blowout coronary perforation (Ellis type III) at a left main coronary artery bifurcation, which was successfully sealed with a PTFE-covered stent without interference with the side branch coronary artery circulation...
May 2017: Catheterization and Cardiovascular Interventions
Benedikt Schrage, Michael Schwarzl, Christoph Waldeyer, Peter M Becher, Christoph Sinning, Ulrich Schäfer, Moritz Seiffert, Elvin Zengin-Sahm, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Aorto-ostial lesions as well as bifurcation lesions still provide challenges in percutaneous coronary intervention (PCI), as meticulous stent placement is needed. The Szabo-technique, which uses a second wire to anchor the stent at the ostium, may be helpful here. In this article, we will provide detailed information on the technique including video material as well as procedural and long-term follow-up data of a cohort of patients treated with this technique. METHODS: A retrospective single-centre study was performed in patients undergoing Szabo-PCI from 2014 to 2016 (N...
August 2017: Minerva Cardioangiologica
Shao-Liang Chen, Teguh Santoso, Jun-Jie Zhang, Fei Ye, Ya-Wei Xu, Qiang Fu, Jing Kan, Feng-Fu Zhang, Yong Zhou, Du-Jiang Xie, Tak W Kwan
BACKGROUND: Provisional stenting is effective for anatomic simple bifurcation lesions. Double kissing crush stenting reduces the 1-year rate of target lesion revascularization. This study aimed to investigate the 5-year clinical results of the DKCRUSH-II study (Randomized Study on Double Kissing Crush Technique Versus Provisional Stenting Technique for Coronary Artery Bifurcation Lesions). METHODS AND RESULTS: A total of 370 patients with coronary bifurcation lesions who were randomly assigned to either the double kissing crush or provisional stenting group in the DKCRUSH-II study were followed for 5 years...
February 2017: Circulation. Cardiovascular Interventions
Hiroyuki Omori, Yoshiaki Kawase, Toru Tanigaki, Hitoshi Matsuo
A 56-year-old male was admitted to our hospital complaining of chest pain. The patient had chronic kidney disease requiring a minimum contrast procedure when performing percutaneous coronary intervention. A jailed wire technique is known to reduce the risk of side branch occlusion. We report a case measuring the presence of ischemia in the side branch (SB) by a jailed Opto Wire (Opsens, Quebec) after implantation of a stent in the main vessel for the treatment of a bifurcation lesion. This method provides for a decrease in usage of contrast without leaving the side branch at risk of ischemia...
July 2017: Cardiovascular Intervention and Therapeutics
Kensuke Takagi, Toru Naganuma, Alaide Chieffo, Yusuke Fujino, Azeem Latib, Satoko Tahara, Hisaaki Ishiguro, Matteo Montorfano, Mauro Carlino, Hiroyoshi Kawamoto, Naoyuki Kurita, Koji Hozawa, Shotaro Nakamura, Sunao Nakamura, Antonio Colombo
BACKGROUND: There are only little data available on the comparison of clinical outcomes between a 1-stent strategy (1-SS) and a 2-stent strategy (2-SS) for percutaneous coronary intervention in unprotected distal left main disease. METHODS AND RESULTS: Between April 2005 and August 2011, we recruited 937 consecutive unprotected distal left main patients treated with drug-eluting stents (1-SS, 608 patients; 2-SS, 329 patients). Major adverse cardiovascular events were defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR) during the median follow-up period of 1592 days...
November 2016: Circulation. Cardiovascular Interventions
Pil Sang Song, Young Bin Song, Joo Myung Lee, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Kyung Woo Park, Hyo-Soo Kim, Yangsoo Jang, Ki Bae Seung, Ju Hyeon Oh, Hyeon-Cheol Gwon
OBJECTIVES: This study investigated the long-term outcomes and predictors of target vessel failure (a composite of cardiac death, myocardial infarction, stent thrombosis, or target vessel revascularization) in patients with bifurcation lesion treated by percutaneous coronary intervention (PCI) utilizing the 2-stent strategy with a drug-eluting stent (DES). BACKGROUND: There are limited data on outcomes of the 2-stent strategy in bifurcation PCI. METHODS: Patient-level pooled analysis was performed with patients undergoing PCI with 2-stent strategy from the Korean Bifurcation Pooled Cohorts...
September 26, 2016: JACC. Cardiovascular Interventions
Annapoorna S Kini, Yuliya Vengrenyuk, Jacobo Pena, Takahiro Yoshimura, Sadik R Panwar, Sadako Motoyama, Safwan Kezbor, Choudhury M Hasan, Sameet Palkhiwala, Jason C Kovacic, Pedro Moreno, Usman Baber, Roxana Mehran, Jagat Narula, Samin K Sharma
OBJECTIVES: The aim of this study was to identify the predictors of side branch (SB) ostial stenosis developed after provisional stenting of the main vessel (MV) using optical coherence tomography (OCT). BACKGROUND: Provisional stenting remains the main approach to treatment of bifurcation lesions; however, it may result in the narrowing of SB ostium. There is little information about underlying plaque morphology of the MV lesion and its potential impact on the SB after provisional stenting...
February 1, 2017: Catheterization and Cardiovascular Interventions
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