04 octubre 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Effects of Hydration in Contrast-Induced Acute Kidney Injury After Primary Angioplasty A Randomized, Controlled Trial

Mauro Maioli, MD, Anna Toso, MD, Mario Leoncini, MD, Carlo Micheletti, RN and Francesco Bellandi, MD

Background—Intravascular volume expansion represents a beneficial measure against contrast-induced acute kidney injury (CI-AKI) in patients undergoing elective angiographic procedures. However, the efficacy of this preventive strategy has not yet been established for patients with ST-elevation–myocardial infarction (STEMI), who are at higher risk of this complication after primary percutaneous coronary intervention (PCI). In this randomized study we investigated the possible beneficial role of periprocedural intravenous volume expansion and we compared the efficacy of 2 different hydration strategies in patients with STEMI undergoing primary PCI. Circulation: Cardiovascular Interventions. 2011; 4: 456-462 Published online before print October 4, 2011, doi: 10.1161/​CIRCINTERVENTIONS.111.961391. Copyright © 2011 American Heart Association, Inc.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Transradial Versus Transfemoral Artery Approach for Coronary Angiography and Percutaneous Coronary Intervention in the Extremely Obese

Objectives This study sought to evaluate the safety and efficacy of transradial versus transfemoral access for coronary angiography and percutaneous coronary intervention in patients with a body mass index ≥40 kg/m2. J Am Coll Cardiol Intv. 2012;5(8):819-826. doi:10.1016/j.jcin.2012.04.009. Copyright © 2012 by the American College of Cardiology Foundation

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Stem Cell–Based Transcatheter Aortic Valve Implantation First Experiences in a Pre-Clinical Model

Maximilian Y. Emmert, MD; Benedikt Weber, MD; Petra Wolint; Luc Behr, VDM, PhD; Sebastien Sammut, PhD; Thomas Frauenfelder, MD; Laura Frese, PhD; Jacques Scherman, MD; Chad E. Brokopp, PhD; Christian Templin, MD; Jürg Grünenfelder, MD; Gregor Zünd, MD; Volkmar Falk, MD; Simon P. Hoerstrup, MD, PhD

Objectives This study sought to investigate the combination of transcatheter aortic valve implantation and a novel concept of stem cell-based, tissue-engineered heart valves (TEHV) comprising minimally invasive techniques for both cell harvest and valve delivery. J Am Coll Cardiol Intv. 2012;5(8):874-883. doi:10.1016/j.jcin.2012.04.010. Copyright © 2012 by the American College of Cardiology Foundation

04 octubre 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Impact of Incomplete Revascularization on Long-Term Mortality After Coronary Stenting

Chuntao Wu, MD, PhD, Anne-Marie Dyer, MS, Spencer B. King III, MD, Gary Walford, MD, David R. Holmes Jr, MD, Nicholas J. Stamato, MD, Ferdinand J. Venditti, MD, Samin K. Sharma, MD, Icilma Fergus, MD, Alice K. Jacobs, MD and Edward L. Hannan, PhD

Background—The impact of incomplete revascularization (IR) on adverse outcomes after percutaneous coronary intervention remains inconclusive, and few studies have examined mortality during follow-ups longer than 5 years. The objective of this study is to test the hypothesis that IR is associated with higher risk of long-term (8-year) mortality after stenting for multivessel coronary disease. Circulation: Cardiovascular Interventions. 2011; 4: 413-421 Published online before print October 4, 2011, doi: 10.1161/​CIRCINTERVENTIONS.111.963058. Copyright © 2011 American Heart Association, Inc.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. 3-Year Clinical Outcomes in the Randomized SORT OUT III Superiority Trial Comparing Zotarolimus- and Sirolimus-Eluting Coronary Stents

Michael Maeng, MD, PhD; Hans-Henrik Tilsted, MD; Lisette Okkels Jensen, MD, DMSci; Anne Kaltoft, MD, PhD; Henning Kelbæk, MD, DMSci; Ulrik Abildgaard, MD, DMSci; Anton B. Villadsen, MD; Lars Romer Krusell, MD; Jan Ravkilde, MD, DMSci; Knud Nørregaard Hansen, MD; Evald Høj Christiansen, MD, PhD; Jens Aarøe, MD; Jan Skov Jensen, MD, DMSci; Steen Dalby Kristensen, MD, DMSci; Hans Erik Bøtker, MD, DMSci; Morten Madsen, MSc; Per Thayssen, MD, DMSci; Henrik Toft Sørensen, MD, DMSci; Leif Thuesen, MD, DMSci; Jens Flensted Lassen, MD, PhD

Objectives This study sought to examine the 3-year clinical outcomes in patients treated with the Endeavor (Medtronic, Santa Rosa, California) zotarolimus-eluting stent (ZES) or the Cypher (Cordis, Johnson & Johnson, Warren, New Jersey) sirolimus-eluting stent (SES) in routine clinical practice. J Am Coll Cardiol Intv. 2012;5(8):812-818. doi:10.1016/j.jcin.2012.04.008. Copyright © 2012 by the American College of Cardiology Foundation

28 junio 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Changes in Left Main Bifurcation Geometry After a Single-Stent Crossover Technique

Soo-Jin Kang, MD, PhD, Gary S. Mintz, MD, Won-Jang Kim, MD, Jong-Young Lee, MD, Jun-Hyok Oh, MD, Duk-Woo Park, MD, PhD, Seung-Whan Lee, MD, PhD, Young-Hak Kim, MD, PhD, Cheol Whan Lee, MD, PhD, Seong-Wook Park, MD, PhD and Seung-Jung Park, MD, PhD

Background—We assessed geometric changes responsible for acute lumen loss at the left circumflex coronary artery (LCX) ostium after crossover stenting from the left anterior descending coronary artery (LAD) to the left main artery. Interventions. 2011; 4: 355-361 Published online before print June 28, 2011, doi: 10.1161/​CIRCINTERVENTIONS.110.961045. Copyright © 2011 American Heart Association, Inc.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Kissing Balloon Inflation in Percutaneous Coronary Interventions

Gregory A. Sgueglia, MD, PhD; Bernard Chevalier, MD

Bifurcation lesions are the most frequently approached complex coronary lesions in everyday interventional practice. Bifurcations complexity relies essentially on their very specific anatomy that is imperfectly handled by current coronary devices and, despite dedicated techniques and drug-eluting stents, percutaneous coronary interventions directed toward the treatment of bifurcations are technically demanding and require proper execution. Kissing balloon (KB) inflation was the first specific bifurcation technique to have been developed for percutaneous bifurcation interventions and continues to currently play an important role. Indeed, KB has been proposed to optimize stent apposition, improve side branch access while correcting stent deformation or distortion. Over the years, the KB technique has been deeply investigated by many different methods, from bench testing and computer simulations to in vivo intravascular imaging and clinical studies, producing a large amount of data pointing out the benefits and limitations of the technique. We sought to provide here a comprehensive overview of all those aspects. J Am Coll Cardiol Intv. 2012;5(8):803-811. doi:10.1016/j.jcin.2012.06.005. Copyright © 2012 by the American College of Cardiology Foundation

01 enero 2012

THE AMERICAN JOURNAL OF CARDIOLOGY. Association Between Bleeding Severity and Long-Term Mortality in Patients Experiencing Vascular Complications After Percutaneous Coronary Intervention

Rafael Romaguera, MD, Kohei Wakabayashi, MD, Ana Laynez-Carnicero, MD, Gabriel Sardi, MD, Gabriel Maluenda, MD, Itsik Ben-Dor, MD, Rebecca Torguson, MPH, Kenneth M. Kent, MD, Lowell F. Satler, MD, William O. Suddath, MD, Joseph Lindsay, MD, Augusto D. Pichard, MD, Ron Waksman, MD

Vascular complications (VCs) occur in 3% to 8% of percutaneous coronary interventions (PCIs). However, only a portion of patients who experience VCs bleed significantly. The aim of this study was to assess the covariates associated with the amount of blood loss in patients experiencing postprocedural VCs as well as the effect of the degree of blood loss on long-term mortality. Overall, 7,718 unselected patients who underwent PCI through femoral access were evaluated. Those experiencing VCs were identified and stratified with regard to the degree of hematocrit (HCT) decrease after the procedure. In total, 444 patients (5.8%) had VCs. Compared to those without VCs, patients with VCs were older and had more extensive co-morbidities. Severe blood loss was most frequent in those who had vascular perforation requiring surgical repair or in those who had retroperitoneal bleeding. Overall, <25% of patients with hematoma had severe blood loss. The raw 1-year mortality was doubled in patients with minimal or moderate HCT decrease and was tripled in those with severe decreases in HCT. Similarly, the rate of definite stent thrombosis was tripled in patients with VCs and moderate or severe decreases in HCT. After adjustment, only patients with VCs and the greater HCT decreases had an increased risk for death at 1 year (hazard ratio 1.80, 95% confidence interval 1.03 to 3.14). Independent predictors of severe HCT decrease included age, female gender, glycoprotein IIb/IIIa inhibitor use, and activated clotting time peak. Bivalirudin and closure devices were independently associated with less frequent severe HCT decrease. In conclusion, VCs do not entail an increased risk for death at 1 year unless associated with severe blood loss. The use of bivalirudin and closure devices seems to reduce the risk for such complications. American Journal of Cardiology Volume 109, Issue 1 , Pages 75-81, 1 January 2012. Copyright © 2012 Elsevier Inc. All rights reserved.

06 marzo 2012

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Incidence and Outcome of Surgical Procedures After Coronary Bare-Metal and Drug-Eluting Stent Implantation A Report From the CREDO-Kyoto PCI/CABG Registry Cohort-2

Akihiro Tokushige, MD*, Hiroki Shiomi, MD*, Takeshi Morimoto, MD, Yutaka Furukawa, MD, Yoshihisa Nakagawa, MD, Kazushige Kadota, MD, Masashi Iwabuchi, MD, Satoshi Shizuta, MD, Tomohisa Tada, MD, Junichi Tazaki, MD, Yoshihiro Kato, MD, Mamoru Hayano, MD, Mitsuru Abe, MD, Natsuhiko Ehara, MD, Tsukasa Inada, MD, Satoshi Kaburagi, MD, Shuichi Hamasaki, MD, Chuwa Tei, MD, Hitoshi Nakashima, MD, Hisao Ogawa, MD, Ryozo Tatami, MD, Satoru Suwa, MD, Akinori Takizawa, MD, Ryuji Nohara, MD, Hisayoshi Fujiwara, MD, Kazuaki Mitsudo, MD, Masakiyo Nobuyoshi, MD, Toru Kita, MD and Takeshi Kimura, MD on behalf of the CREDO-Kyoto PCI/CABG registry cohort-2 investigators

Background—There still remain safety concerns on surgical procedures after coronary drug-eluting stents (DES) implantation, and optimal management of perioperative antiplatelet therapy (APT) has not been yet established. Circulation: Cardiovascular Interventions. 2012; 5: 237-246 Published online before print March 6, 2012, doi: 10.1161/​CIRCINTERVENTIONS.111.963728. Copyright © 2012 American Heart Association, Inc. All rights reserved.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. The Recanalization of Chronic Total Occlusion Leads to Lumen Area Increase in Distal Reference Segments in Selected Patients An Intravascular Ultrasound Study

Jin Joo Park, MD; In-Ho Chae, MD; Young-Seok Cho, MD; Seong-Wook Kim, BS; Han-Mo Yang, MD; Jae-Bin Seo, MD; Song-Yi Kim, MD; Il-Young Oh, MD; Chang-Hwan Yoon, MD; Jung-Won Suh, MD; Kyung-Woo Park, MD; Woo-Young Chung, MD; Tae-Jin Youn, MD; Dong-Ju Choi, MD; Hyo-Soo Kim, MD

Objectives This study sought to investigate the extent of and factors related to lumen and vessel area change in coronary arteries after total occlusion (TO) recanalization. J Am Coll Cardiol Intv. 2012;5(8):827-836. doi:10.1016/j.jcin.2012.05.004. Copyright © 2012 by the American College of Cardiology Foundation

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of Paravalvular Leakage on Outcome in Patients After Transcatheter Aortic Valve Implantation

Mariuca Vasa-Nicotera, MD; Jan-Malte Sinning, MD; Derek Chin, MD; Tiong Keng Lim, MD; Tomasz Spyt, MD; Hasan Jilaihawi, MD; Eberhard Grube, MD; Nikos Werner, MD; Georg Nickenig, MD; Jan Kovac, MD

Objectives The aim of this study was to evaluate the performance of the aortic regurgitation (AR) index as a new hemodynamic parameter in an independent transcatheter aortic valve implantation (TAVI) cohort and validate its application. J Am Coll Cardiol Intv. 2012;5(8):858-865. doi:10.1016/j.jcin.2012.04.011. Copyright © 2012 by the American College of Cardiology Foundation

26 julio 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Everolimus-Eluting Versus Sirolimus-Eluting Stents A Meta-Analysis of Randomized Trials

Antoinette de Waha, MD, Alban Dibra, MD, Robert A. Byrne, MB BCh, Gjin Ndrepepa, MD, Julinda Mehilli, MD, Massimiliano Fusaro, MD, Karl-Ludwig Laugwitz, MD, Steffen Massberg, MD, Albert Schömig, MD and Adnan Kastrati, MD

Background—The aim of the study was to compare the outcomes after placement of the everolimus-eluting stent (EES; Xience V) and the sirolimus-eluting stent (SES; Cypher) in patients with coronary artery disease. The second-generation EES is currently one of the most commonly used drug-eluting stents in clinical practice. Although it has clearly been shown superior to paclitaxel-eluting stents, its relative merits against SES have been less extensively assessed. Circulation: Cardiovascular Interventions. 2011; 4: 371-377 Published online before print July 26, 2011, doi: 10.1161/​CIRCINTERVENTIONS.111.963256 Copyright © 2011 American Heart Association, Inc.

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Reduction in Treatment Times Through Formalized Data Feedback Results From a Prospective Multicenter Study of ST-Segment Elevation Myocardial Infarction

Karl Heinrich Scholz, MD; Sebastian K.G. Maier, MD; Jens Jung, MD; Claus Fleischmann, MD; Gerald S. Werner, MD; Hans G. Olbrich, MD; Dorothe Ahlersmann, MD; Friederike K. Keating, MD; Claudius Jacobshagen, MD; Hiller Moehlis, MD; Reinhard Hilgers, MD; Lars S. Maier, MD

Objectives This study sought to evaluate the effect of systematic data analysis and standardized feedback on treatment times and outcome in a prospective multicenter trial. J Am Coll Cardiol Intv. 2012;5(8):848-857. doi:10.1016/j.jcin.2012.04.012. Copyright © 2012 by the American College of Cardiology Foundation

01 agosto 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Vascular Closure Device Failure. We Are Getting Better But Not There Yet

Robert J. Applegate, MD

Manual compression for femoral artery access site hemostasis had been the standard of care until the early 1990s. At that time, 2 significant changes in clinical practice challenged the effectiveness of manual compression as the optimal hemostasis method: the use of large-bore catheters to perform coronary atherectomy, and intensive anticoagulant regimens needed for the first clinical introduction of intracoronary stents. At that time, large hematomas and other vascular bleeding complications after coronary intervention in these patients were commonplace and frustrating to most interventionalists. In parallel, several devices underwent development and final clinical approval to achieve hemostasis more directly as an alternative to manual compression. These vascular closure devices (VCDs) ushered in a new error of vascular access management that has undergone extensive clinical evaluation and scrutiny. J Am Coll Cardiol Intv. 2012;5(8):845-847. doi:10.1016/j.jcin.2012.06.006. Copyright © 2012 by the American College of Cardiology Foundation

25 octubre 2011

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Predictors and Implications of Stent Thrombosis in Non–ST-Segment Elevation Acute Coronary Syndromes

Tullio Palmerini, MD, George Dangas, MD, PhD, Roxana Mehran, MD, Adriano Caixeta, MD, PhD, Philippe Généreux, MD, Martin P. Fahy, MSc, Ke Xu, PhD, Ecaterina Cristea, MD, Alexandra J. Lansky, MD and Gregg W. Stone, MD

Background—The frequency, predictors, and consequences of stent thrombosis (ST) in patients with non–ST-segment elevation acute coronary syndromes (NSTE-ACS) have been incompletely studied. We sought to investigate the incidence, predictors, and clinical implications of ST occurring within 1 year after percutaneous coronary intervention in patients with NSTE-ACS. Circulation: Cardiovascular Interventions. 2011; 4: 577-584 Published online before print October 25, 2011, doi: 10.1161/​CIRCINTERVENTIONS.111.963884. Copyright © 2011 American Heart Association, Inc.