Editorial | By Ajay J. Kirtane, Robert O. Bonow
It can be argued that severe left main coronary artery (LMCA) disease represents the only anatomic subtype of coronary artery disease for which there is clear and unequivocal prognostic evidence in favor of coronary revascularization across the spectrum of clinical presentation—from stable ischemic heart disease to acute coronary syndrome. For decades, the standard approach to LMCA revascularization has been through coronary artery bypass grafting (CABG...
Clinical Case Study | By Lee OH, Ahn CM, Hong MK et al.
Contrast-induced nephropathy (CIN) is a serious complication in patients undergoing percutaneous coronary intervention (PCI), and is associated with higher morbidity and mortality. The limiting volume of contrast medium is safest and most reliable strategy for CIN prevention. Intravascular ultrasound (IVUS) serves as an attractive alternative imaging tool to angiography in many steps during PCI, thereby reducing the use of contrast agents. Here, w...
Review Article | By Qian C, Feng H, Cao J et al.
OBJECTIVES - Previous evidence suggested that intravascular ultrasound (IVUS) guidance could improve outcomes after drug-eluting stents (DES) placement, largely driven by data from observational studies. We, therefore, performed a meta-analysis and trial sequential analysis of randomized controlled trials to overcome this limitation. RESULTS - The retrieval process yielded 7 RCTs with 3,192 patients. Compared ...
Clinical Trial | By Haiek C, Fernández-Pereira C, Rodriguez AE et al.
OBJECTIVE - To compare second generation drug eluting stents (2DES) with first generation (1DES) for the treatment of patients (pts) with multiple coronary vessel disease (MVD). BACKGROUND - Although 2DES improved safety and efficacy compared to 1DES, MVD remains a challenge for percutaneous coronary interventions. METHODS - ERACI IV was a prospective, observational, and controlled...
Review Article | By Sulaiman MJ, Chen SL.
Drug-eluting stent (DES) intervention is now emerging as an alternative approach for unprotected left main coronary artery (ULMCA) other than coronary artery bypass graft (CABG). Untreated left main (LM) coronary occlusion is always associated with poor prognosis and high mortality rate. Collective data from numerous worldwide registries and results from randomized Synergy between Percutaneous Coronary Intervention with Taxus an...
Optical coherence tomography is a kid on the block: I would choose intravascular ultrasound
Intravascular imaging has improved our understanding of in vivo pathophysiology of coronary artery disease (CAD) and predicted decision-making in percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) has emerged as the first clinical imaging method contributing significantly to modern PCI techniques. This modality has outlived many other intravascular techniques 26 years after its inception. It has assisted us in understanding dynam...
Robotics in percutaneous cardiovascular interventions
Review Article | By Pourdjabbar A, Ang L, Mahmud E et al.
Areas covered - A systematic literature review of percutaneous robotic CV interventions was undertaken. The safety and feasibility of percutaneous robotically-assisted CV interventions has been validated in simple to complex coronary disease, and iliofemoral disease. Studies have shown that robotically-assisted PCI significantly reduces operator exposure to harmful ionizing radiation without compromising procedural success or clinical efficacy. In additi...
Clinical Trial | By Danek BA, Karatasakis A, Brilakis ES et al.
Coronary perforation is a potential complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We analyzed 2,097 CTO PCIs performed in 2,049 patients from 2012 to 2017. Patient age was 65 ± 10 years, 85% were men, and 36% had prior coronary artery bypass graft surgery. Technical and procedural success were 88% and 87%, respectively. A major periprocedural adverse cardiovascular event occurred in 2.6%. Coronary pe...
Clinical Trial | By Karacsonyi J, Karmpaliotis D, Brilakis ES et al.
INTRODUCTION - We examined the impact of proximal vessel tortuosity on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS - The baseline clinical and angiographic characteristics and procedural outcomes of 1618 consecutive CTO-PCIs performed between 2012 and 2016 at 14 United States centers in 1589 patients were reviewed. RESULTS - Mean patient age...
Clinical Trial | By Zuin M, Rigatelli G, Roncon L et al.
BACKGROUND/PURPOSE - The neutrophil/lymphocyte ratio (NLR) has been proposed as a prognostic marker in acute myocardial infarction (AMI). The aim of our study is to demonstrates the correlation between SYNTAX score (SXs) and NLR and its association with 1-year cardiovascular (CV) mortality in patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (N...