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stent implantation

Dhaval R Parekh, Zvonimir Krajcer
Children with branch pulmonary artery stenosis represent a challenging cohort for stenting Premounted stent implantation provides immediate obstruction relief and hemodynamic improvement in infants Planned stent intervention is required to account for somatic growth and next stage palliation in children Continued slenderization of adult coronary and peripheral interventions, stent technology, and delivery systems may allow for more durable solutions in light of patient size.
February 15, 2019: Catheterization and Cardiovascular Interventions
Sung-Jin Hong, Min-Ji Kim, Jung-Sun Kim, Eun Hwa Kim, Jinae Lee, Chul-Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
We investigated the association of perioperative antiplatelet therapy (APT) and outcomes in patients with drug-eluting stent (DES) placement for noncardiac surgery (NCS). In consecutive 23,358 patients who underwent percutaneous coronary interventions between 2005 and 2016, total of 2,179 patients that required 2,179 elective NCS after DES placement were retrospectively analyzed. A net adverse clinical event (NACE), composite of death, myocardial infarction, stent thrombosis, and major bleeding, was assessed at 30 days...
February 7, 2019: American Journal of Cardiology
Jesse Manunga
The authors describe a technique of treating patients with aortic arch aneurysm using surgeon-modified fenestrated stent graft (SMFSG). The technique is demonstrated in a 80-year-old patient whose aneurysm was successfully excluded with a SMFSG using Cook Alpha thoracic stent graft. The device was deployed, removed from its delivery system, and a fenestration created before being mounted back on the delivery system and constrained. It was transitioned through a series of sheaths before being introduced into its original sheath...
April 2018: Aorta (Stamford, Conn.)
Zhao An, Meng-Wei Tan, Zhi-Gang Song, Hao Tang, Fang-Lin Lu, Zhi-Yun Xu
BACKGROUND: Retrograde type A dissection (RTAD) is a serious complication after ascending aorta involved endovascular repair (AAIER). We here report our surgical approach to this serious complication. METHODS: From July 2011 to July 2014, 8 RTAD after AAIER patients received surgical repair in our institution. Data of these RTAD patients were retrospectively collected for further analysis. All patients received urgent surgical repair based on the stented elephant trunk technique...
February 12, 2019: Annals of Vascular Surgery
Xiao-Jun Song, Zhi-Li Liu, Rong Zeng, Chang-Wei Liu, Wei Ye
OBJECTIVE: The aim of this study is to examine the efficacy and safety of Angiojet rheolytic thrombectomy for the treatment of subacute deep venous thrombosis (DVT) in lower limbs. METHODS: A retrospective study was performed on 90 patients with subacute DVT (15 ∼90 days) in lower limbss in our center from November 2015 to December 2016. In total, 27 patients with subacute DVT in lower limbs treated with Angiojet rheolytic thrombectomy were included in the study, including 17 males and 10 females...
February 12, 2019: Annals of Vascular Surgery
Timothée Noterdaeme, Nikolaus Marx, Rüdiger Lange
OBJECTIVES: Our goal was to assess the viability of an alternative anchoring design for a transcatheter aortic valve based on a form-fitting principle with a self-expanding nitinol frame to reduce issues related to excess radial force. METHODS: A 26-mm outer diameter prototype of a self-expanding nitinol frame was developed to reduce the amount of necessary radial force by utilizing additional anchoring via protruding arms in each aortic sinus, thus allowing for a form-fitting principle as well as the coaxial self-alignment of the valve inside the native anatomy...
February 14, 2019: Interactive Cardiovascular and Thoracic Surgery
Suko Adiarto, Sung Gwon Kang, Ismoyo Sunu, Taofan Siddiq, Hananto Andriantoro, Iwan Dakota, Raman Uberoi
INTRODUCTION: Although Fenestrated TEVAR (F-TEVAR) has been considered to be a more physiologic approach to treat proximal descending aortic pathology, its application is still limited due to availability, cost and technical difficulties. We introduce a new design of fenestrated stent graft with a new delivery system and successfully performed first in human implantation in two patients, one with an aortic aneurysm and one with an acute aortic dissection. MATERIALS AND METHODS: The design of these two wires fenestrated stent graft include creation of an additional lumen at the side of the olive tip during manufacture, from which an additional wire can be introduced for a side branch passing into the fenestration, running inside the stent graft and exit the delivery sheath through additional hub...
February 14, 2019: Cardiovascular and Interventional Radiology
Goro Yoshioka, Nehiro Kuriyama, Nozomi Watanabe, Keiichi Ashikaga, Yoshisato Shibata, Koichi Node
The aims of this study are to evaluate the efficacy of percutaneous coronary intervention (PCI) using full-metal jacket (FMJ) with second-generation drug-eluting stents (DES). A single-center, non-randomized, retrospective study was performed from May 2005 to February 2014 at Miyazaki Medical Association Hospital, Japan. PCI using FMJ with DES was performed to treat 240 very long lesions (> 60 mm) in 240 patients. Subjects were divided into a first-generation or second-generation DES group. The primary endpoint was the incidence of major adverse cardiac events (MACE) at 2 years...
February 14, 2019: Cardiovascular Intervention and Therapeutics
Bernard Wong, Seif El-Jack, Ruth Newcombe, Timothy Glenie, Guy Armstrong, Ali Khan
BACKGROUND: Calcified coronary lesions often cause suboptimal stent expansion, which is one of the greatest predictors of adverse outcomes such as stent thrombosis and restenosis. Shockwave intravascular lithotripsy (S-IVL; Shockwave Medical, Inc) is a recently approved technique used in the treatment of heavily calcified coronary lesions. We present our early real-world experience with the S-IVL device. METHODS: All patients treated with S-IVL between October 2018 and January 2019 during their percutaneous coronary intervention (PCI) at our center were included...
February 15, 2019: Journal of Invasive Cardiology
Iain Mactier, Jonathan R Dalzell, David Carrick
CLINICAL INTRODUCTION: A 50-year-old woman presented with an inferoposterior ST-elevation myocardial infarction (STEMI) and underwent emergency percutaneous coronary intervention (PCI). Angiography revealed acute occlusion of the circumflex and right coronary (RCA) arteries. PCI was uncomplicated. Her medical history included asthma, hypertension and chronic sinusitis.Three months later, she presented with a non-STEMI (NSTEMI), and angiogram showed a new focal stenosis in the left anterior descending artery...
February 14, 2019: Heart: Official Journal of the British Cardiac Society
R Pop, I Zinchenko, V Quenardelle, D Mihoc, M Manisor, J S Richter, F Severac, M Simu, S Chibbaro, O Rouyer, V Wolff, R Beaujeux
BACKGROUND AND PURPOSE: There are very few published data on the patency of carotid stents implanted during thrombectomies for tandem lesions in the anterior circulation. We aimed to communicate our experience of stenting in the acute setting with systematic follow-up of stent patency and discuss predictors and clinical repercussions of delayed stent thrombosis. MATERIALS AND METHODS: We performed a retrospective study of stroke thrombectomies in a single center between January 2009 and April 2018...
February 14, 2019: AJNR. American Journal of Neuroradiology
Yvonne Bausback, Tim Wittig, Andrej Schmidt, Thomas Zeller, Marc Bosiers, Patrick Peeters, Steffen Brucks, Aaron E Lottes, Dierk Scheinert, Sabine Steiner
BACKGROUND: Randomized trials of drug-eluting stents (DES) and drug-coated balloons (DCB) for femoropopliteal interventions reported superior patency rates for both strategies compared to standard balloon angioplasty. To date, head-to-head comparisons are missing. OBJECTIVES: The authors sought to compare DES versus DCB for femoropopliteal lesions through 36 months. METHODS: Within a multicenter, randomized trial, 150 patients with symptomatic femoropopliteal disease were randomly assigned to primary DES implantation or DCB angioplasty with bailout stenting after stratification for lesion length (≤10 cm, >10 cm to ≤20 cm, and >20 cm to ≤30 cm)...
February 19, 2019: Journal of the American College of Cardiology
Jarosław Hiczkiewicz, Sylwia Iwańczyk, Aleksander Araszkiewicz, Magdalena Łanocha, Dariusz Hiczkiewicz, Stefan Grajek, Maciej Lesiak
BACKGROUND: The PSP (predilatation, sizing, post-dilatation)-technique was developed to improve the prognosis of patients after bioresorbable vascular scaffold (BVS) implantation. In acute coronary syndrome (ACS) the use of BVS is particularly demanding and carries some potential risk regarding aggressive lesion preparation, proper vessel sizing due to spasm and thrombus inside the artery. The aim herein, was to determine the long-term results of BVS stenting in ACS patients depending on the scaffold implantation technique...
February 14, 2019: Cardiology Journal
Arpan R Doshi, Sathish Chikkabyrappa
Coarctation of aorta (CoA) is a discrete narrowing in aorta causing obstruction to the flow of blood. It accounts for 6-8% of all congenital heart diseases. With advances in fetal echocardiography rate of prenatal diagnosis of coarctation of aorta has improved but it still remains a challenging diagnosis to make prenatally. Transthoracic echocardiography is mainstay of making initial diagnosis and routine follow-up. Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are great advanced imaging tools for two-dimensional and three-dimensional imaging of aortic arch in complex cases...
December 5, 2018: Curēus
Benyamin Rahmani, Christopher McGregor, Guerard Byrne, Gaetano Burriesci
Bioprosthetic leaflets made from animal tissues are used in the majority of surgical and transcatheter cardiac valve replacements. This study develops a new surgical bioprosthesis, using porcine pericardial leaflets. Porcine pericardium was obtained from genetically engineered pigs with a mutation in the GGTA-1 gene (GTKO) and fixed in 0.6% glutaraldehyde, and used to develop a new surgical valve design. The valves underwent in vitro hydrodynamic test in a pulse duplicator and high-cycled accelerated wear testing and were evaluated for acute haemodynamics and thrombogenicity in a juvenile sheep implant study for 48 h...
February 12, 2019: Journal of Cardiovascular Translational Research
Yonghui Qiao, Le Mao, Ying Ding, Jianren Fan, Kun Luo, Ting Zhu
OBJECTIVES: The left subclavian artery during thoracic endovascular aortic repair could be reconstructed by in situ fenestration. This study aims to evaluate the effects of thoracic endovascular aortic repair with in situ fenestration thoracic endovascular aortic repair on the hemodynamics. METHODS: A male patient suffering from aortic dissection is treated by in situ fenestration thoracic endovascular aortic repair and the fenestration stent implanted in the left subclavian artery is partially protruding in the aortic arch for the stability...
February 12, 2019: Vascular
Gergana T Taneva, Alejandro González García, Ana Begoña Arribas Díaz, Yasmina Baquero Yebra, Konstantinos P Donas, César Aparicio Martínez
OBJECTIVE: Data in literature suggest iliac artery dilatation and endograft retraction as complications after endovascular aneurysm repair. However, mainly older generation endografts were included. Therefore, we sought to evaluate the distal sealing zone chronological changes after endovascular aneurysm repair with newer generation stent-grafts. METHODS: Clinical and radiological data of patients with abdominal aortic aneurysms treated with endovascular aneurysm repair between January 2010 and December 2013 were reviewed...
February 12, 2019: Vascular
Daisuke Kaneyuki, Toshihisa Asakura, Atsushi Iguchi, Akihiro Yoshitake, Chiho Tokunaga, Masato Tochii, Hiroyuki Nakajima
OBJECTIVES: Endovascular repair has been proposed as an alternative to classical surgical repair for the management of blunt traumatic thoracic aortic injury. However, the long-term outcomes of endovascular repair and the risks of left subclavian coverage remain unclear. METHODS: From April 2001 to August 2018, 33 patients with blunt traumatic thoracic aortic injury underwent endovascular repair in our institution. A follow-up computed tomography and a clinical examination were performed before discharge and at 1 month, and yearly or every 2 years thereafter...
February 7, 2019: European Journal of Cardio-thoracic Surgery
Xiao-Fei Gao, Zhi-Mei Wang, Feng Wang, Yue Gu, Zhen Ge, Xiang-Quan Kong, Guang-Feng Zuo, Jun-Jie Zhang, Shao-Liang Chen
Intravascular ultrasound (IVUS) guidance is not routinely performed in real-word clinical practice partly because the benefit of IVUS guidance is not well established. This updated meta-analysis aims to compare IVUS-guided and angiography-guided drug-eluting stent (DES) implantation, simultaneously stressing the value of an optimal IVUS-defined procedure. Medline, Scopus, Google Scholar, and Cochrane Controlled Trials Registry were searched for the randomized trials comparing IVUS-guided and angiography-guided DES implantation...
February 12, 2019: International Journal of Cardiovascular Imaging
Birgit Vogel, Ridhima Goel, Vijay Kunadian, Deborah N Kalkman, Alaide Chieffo, Yolande Appelman, Roxana Mehran
Coronary revascularization, either percutaneous by stent implantation or surgical, has been established as the treatment of choice for patients with significant coronary stenosis. One of the main targets of coronary revascularization - especially in patients with stable disease - is to alleviate symptoms and thereby improve quality of life. Residual angina after successful coronary revascularization is not uncommon and indeed frustrating for the patient as much as for the treating physician. Several studies have shown worse outcomes in females with regard to post-revascularization morbidity and mortality in percutaneous as well as surgical coronary procedures...
January 11, 2019: International Journal of Cardiology
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