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ESTUDIOS


14 mayo 2020

Comparison of Robotic Percutaneous Coronary Intervention With Traditional Percutaneous Coronary Intervention

Tejas M. Patel, Sanjay C. Shah, Yash Y. Soni, Rajni C. Radadiya, Gaurav A. Patel, Pradyot O. Tiwari and Samir B. Pancholy

Abstract Background: Robotic percutaneous coronary intervention (R-PCI) has been shown to benefit the operator but has not shown any significant benefit to the patient. We sought to compare a large cohort of R-PCI to traditional percutaneous coronary intervention (PCI) procedures performed at a tertiary care center in the same time frame.

27 abril 2020

Retrograde Approach to Chronic Total Occlusion Percutaneous Coronary Intervention

Michael Megaly, Iosif Xenogiannis, Nidal Abi Rafeh, Dimitri Karmpaliotis, Stephane Rinfret, Masahisa Yamane, M. Nicholas Burke and Emmanouil S. Brilakis

Abstract The retrograde approach has increased the success rate of chronic total occlusion percutaneous coronary intervention but has also been associated with a higher risk of complications. The retrograde approach is usually performed in complex lesions, in which the antegrade approach is not feasible or has failed previously. Using a systematic 10-step approach can maximize the likelihood of success and minimize the risks of retrograde chronic total occlusion interventions.

14 mayo 2020

Relative Costs of Surgical and Transcatheter Aortic Valve Replacement and Medical Therapy

Andrew M. Goldsweig, Hyo Jung Tak, Li-Wu Chen, Herbert D. Aronow, Binita Shah, Dhaval Kolte, Nihar R. Desai, Molly Szerlip, Poonam Velagapudi and J. Dawn Abbott

Abstract Background: The number of patients treated for aortic valve disease in the United States is increasing rapidly. Transcatheter aortic valve replacement (TAVR) is supplanting surgical aortic valve replacement (SAVR) and medical therapy (MT). The economic implications of these trends are unknown. Therefore, we undertook to determine the costs, inpatient days, and number of admissions associated with treating aortic valve disease with SAVR, TAVR, or MT.

27 abril 2020

Healthy Strut Coverage After Coronary Stent Implantation

Hiroyuki Jinnouchi, Fumiyuki Otsuka, Yu Sato, Rahul R. Bhoite, Atsushi Sakamoto, Sho Torii, Kazuyuki Yahagi, Anne Cornelissen, Masayuki Mori, Rika Kawakami, Frank D. Kolodgie, Renu Virmani and Aloke V. Finn

Abstract Background: Struts have been considered as covered when tissue overlying the struts is >0 μm by optical coherence tomography (OCT). However, there is no confirmatory study to validate this definition by histology which is the gold standard. The aim of the present study was to assess the appropriate cutoff value of neointimal thickness of stent strut coverage by OCT with histology confirmation.

01 mayo 2020

Clinical Usefulness of PRECISE-DAPT Score for Predicting Bleeding Events in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Ki Hong Choi, Young Bin Song, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Hyeon-Cheol Gwon and Joo-Yong Hahn

Abstract Background: Although the current guidelines endorse the PRECISE-DAPT score (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy) to inform clinical decisions regarding duration of DAPT in patients undergoing percutaneous coronary intervention, use of the PRECISE-DAPT score to guide duration of DAPT has not been properly validated by randomized trials focused on the population with acute coronary syndrome. This study aimed to evaluate the usefulness of the PRECISE-DAPT score for predicting future bleeding and ischemic events and to compare clinical outcomes of short-term and long-term DAPT duration according to the PRECISE-DAPT score in patients with acute coronary syndrome.

12 junio 2020

Management of Percutaneous Coronary Intervention Complications

Jacob A. Doll, Ravi S. Hira, Kathleen E. Kearney, David E. Kandzari, Robert F. Riley, Steven P. Marso, James A. Grantham, Craig A. Thompson, James M. McCabe, Dimitrios Karmpaliotis, Ajay J. Kirtane and William Lombardi

Complications of percutaneous coronary intervention (PCI) may have significant impact on patient survival and healthcare costs. PCI procedural complexity and patient risk are increasing, and operators must be prepared to recognize and treat complications, such as perforations, dissections, hemodynamic collapse, no-reflow, and entrapped equipment. Unfortunately, few resources exist to train operators in PCI complication management. Uncertainty regarding complication management could contribute to the undertreatment of patients with high-complexity coronary disease. We, therefore, coordinated the Learning From Complications: How to Be a Better Interventionalist courses to disseminate the collective experience of high-volume PCI operators with extensive experience in chronic total occlusion and high-risk PCI. From these conferences in 2018 and 2019, we developed algorithms that emphasize early recognition, effective treatment, and team-based care of PCI complications. We think that an algorithmic approach will result in a logical and systematic response to life-threatening complications. This construct may be useful for operators who plan to perform complex PCI procedures.

09 junio 2020

Antegrade Intentional Laceration of the Anterior Mitral Leaflet to Prevent Left Ventricular Outflow Tract Obstruction

John C. Lisko, Adam B. Greenbaum, Jaffar M. Khan, Norihiko Kamioka, Patrick T. Gleason, Isida Byku, Jose F. Condado, Andres Jadue, Gaetano Paone, Kendra J. Grubb, Jasleen Tiwana, James M. McCabe, Toby Rogers, Robert J. Lederman and Vasilis C. Babaliaros

Abstract Background: Intentional laceration of the anterior mitral leaflet (LAMPOON) is an effective adjunct to transcatheter mitral valve replacement that prevents left ventricular outflow tract (LVOT) obstruction. To date, LAMPOON has been performed in over 150 patients using a retrograde approach that can be technically challenging. A modified antegrade transseptal technique may simplify the procedure.

10 junio 2020

Predictors of Treatment Response Following Ultrasound-Facilitated Catheter-Directed Thrombolysis for Submassive and Massive Pulmonary Embolism

Partha Sardar, Gregory Piazza, Samuel Z. Goldhaber, Ping-Yu Liu, William Prabhu, Peter Soukas and Herbert D. Aronow

Background: Little is known about which factors predict improvement in clinical and imaging parameters among patients undergoing catheter-directed thrombolysis for submassive or massive pulmonary embolism. The identification of such predictors may allow for more appropriate patient selection for ultrasound-facilitated catheter-directed thrombolysis.

12 junio 2020

Differential Use and Impact of Bleeding Avoidance Strategies on Percutaneous Coronary Intervention-Related Bleeding Stratified by Predicted Risk

Ty J. Gluckman, Lian Wang, Kateri J. Spinelli, John L. Petersen II, Paul Huang, Amit Amin, John C. Messenger and Sunil V. Rao

Background: Procedural anticoagulation with bivalirudin (BIV), trans-radial intervention (TRI), and use of a vascular closure device (VCD) are thought to mitigate percutaneous coronary intervention (PCI)-related bleeding. We compared the impact of these bleeding avoidance strategies (BAS) for PCIs stratified by bleeding risk.

12 junio 2020

Randomized Comparison of Intensified and Standard P2Y12-Receptor-Inhibition Before Elective Percutaneous Coronary Intervention

Julinda Mehilli, Moritz Baquet, Willibald Hochholzer, Katharina Mayer, Christian Tesche, Daniel Aradi, Yujun Xu, Manuela Thienel, Sarah Gschwendtner, Magda Zadrozny, David Jochheim, Dirk Sibbing, Stefanie Schüpke, Ulrich Mansmann, Ellen Hoffmann, Adnan Kastrati, Franz-Josef Neumann and Steffen Massberg

Background: Even among biomarker-negative patients undergoing elective percutaneous coronary intervention (PCI), periprocedural thrombotic and bleeding complications can lead to increased morbidity and mortality. Whether stronger platelet inhibition by an intensified oral loading strategy (ILS) before PCI impacts on outcomes among these patients in contemporary practice remains unclear.

29 mayo 2020

Final 3-Year Outcomes of MiStent Biodegradable Polymer Crystalline Sirolimus-Eluting Stent Versus Xience Permanent Polymer Everolimus-Eluting Stent

Kuniaki Takahashi, Patrick W. Serruys, Norihiro Kogame, Paweł Buszman, Philipp Lurz, Gillian A.J. Jessurun, Karel T. Koch, Roland P.T. Troquay, B.J.B Hamer, Ton Oude Ophuis, Krzysztof P. Milewski, Sjoerd H. Hofma, Joanna J. Wykrzykowska, Yoshinobu Onuma, Robbert J. de Winter and William Wijns

Background: Numerous randomized clinical trials have demonstrated the superiority of thin-strut biodegradable polymer second-generation drug-eluting stent to the first-generation drug-eluting stent and the noninferiority to the thin-strut second-generation permanent polymer drug-eluting stent. Data on long-term clinical outcomes with a novel ultrathin drug-eluting stent, to date, are limited.

12 septiembre 2017

CIRCULATION. Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis

Tom Adriaenssens, Michael Joner, Thea C. Godschalk, Nikesh Malik, Fernando Alfonso, Erion Xhepa, Dries De Cock, Kenichi Komukai, Tomohisa Tada, Javier Cuesta, Vasile Sirbu, Laurent J. Feldman, Franz-Josef Neumann, Alison H. Goodall, Ton Heestermans, Ian Buysschaert, Ota Hlinomaz, Ann Belmans, Walter Desmet, Jurrien M. ten Berg, Anthony H. Gershlick, Steffen Massberg, Adnan Kastrati, Giulio Guagliumi and Robert A. Byrne

Background: Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST.

01 noviembre 2017

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. Predicting Subclinical Atherosclerosis in Low-Risk Indivdualis: Ideal Cardiovascular Health Score and Fuster-BEWAT Score

Juan Miguel Fernández-Alvira, Valentín Fuster, Stuart Pocock, Javier Sanz, Leticia Fernández-Friera, Martín Laclaustra, Rodrigo Fernández-Jiménez, José Mendiguren, Antonio Fernández-Ortiz, Borja Ibáñez and Héctor Bueno

Background: The ideal cardiovascular health score (ICHS) is recommended for use in primary prevention. Simpler tools not requiring laboratory tests, such as the Fuster-BEWAT (blood pressure [B], exercise [E], weight [W], alimentation [A], and tobacco [T]) score (FBS), are also available.

01 mayo 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Transcatheter Device Closure of Atrial Septal Defects

John Moore, Sanjeet Hegde, Howaida El-Said, Robert Beekman III, Lee Benson, Lisa Bergersen, Ralf Holzer, Kathy Jenkins, Richard Ringel, Jonathan Rome, Robert Vincent, Gerard Martin and ACC IMPACT Steering Committee

This review discusses the current safety issues related to U.S. Food and Drug Administration approved atrial septal defect devices and proposes a potential avenue to gather additional safety data including factors, which may be involved in device erosion.

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