المؤلفون: Hamid Amoozgar, Narjes Nouri, Sajad Shabanpourhaghighi, Neda Bagherian, Nima Mehdizadegan, Mohammad Reza Edraki, Amir Naghshzan, Hamid Mohammadi, Gholamhossein Ajami, Ashkan Abdollahi

المصدر: BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-7 (2021)
BMC Cardiovascular Disorders

مصطلحات موضوعية: Male, Time Factors, Research, Angioplasty, Infant, Newborn, Infant, Equipment Design, Aortic coarctation, Treatment Outcome, Echocardiography, Recurrence, RC666-701, Retreatment, Pressure, Humans, Diseases of the circulatory (Cardiovascular) system, Female, Recoarctation, Cardiology and Cardiovascular Medicine, Angioplasty, Balloon, Vascular Access Devices, Balloon, Retrospective Studies

الوصف: Objective Coarctation of the Aorta (CoA) is a relatively common cardiovascular disorder. The present study aimed to evaluate the effect of COA anatomy and high versus low-pressure balloons on the outcome of balloon angioplasty among neonates and infants. Methods In this retrospective study, the neonates and infants undergoing balloon angioplasty at Namazi hospital were enrolled. After balloon angioplasty, immediate data results were promptly recorded.Moreover, midterm echocardiographic information was collected via electronic cardiac records of pediatric wards and clinical and echocardiographic data at least 12 months after balloon angioplasty. Finally, data were analyzed using SPSS-20. Results In this study, 42 infants were included. The median age at the time of balloon angioplasty was 1.55 (range 0.1–12) months and 66.7% of the patients were male. The mean pressure gradient of coarctation was 38.49 ± 24.97 mmHg, which decreased to 7.61 ± 8.00 mmHg (P Conclusion Recoarctation rate was lower in the high-pressure balloon. The infant with discrete COA had a better response to the balloon with more decrease in gradient and lower recoarctation rate. Therefore, the stenotic segment anatomy needs to be considered in the selection of treatment methods.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::202934349a80fe4e7031239c1693a741Test
https://doaj.org/article/c8981a0f88c5482280a1df8b18af1d8aTest

المؤلفون: Qin-Hua Zhao, Su-Gang Gong, Jing He, Ping Yuan, Wen-Hui Wu, Ci-Jun Luo, Rong Jiang, Rui Zhang, Hong-Ling Qiu, Hui-Ting Li, Yuan Li, Jin-Ming Liu, Lan Wang

المصدر: Trials, Vol 22, Iss 1, Pp 1-7 (2021)
Trials

مصطلحات موضوعية: Riociguat, Medicine (General), Hypertension, Pulmonary, Medicine (miscellaneous), Study Protocol, Pyrimidines, Balloon pulmonary Angioplasty, R5-920, Randomized controlled trial, Chronic Disease, Humans, Pyrazoles, Pharmacology (medical), Pulmonary Embolism, Angioplasty, Balloon, Randomized Controlled Trials as Topic, Chronic thromboembolic Pulmonary hypertension

الوصف: Background Management of inoperable chronic thromboembolic pulmonary hypertension (CTEPH) remains a clinical challenge. Currently, riociguat, a soluble guanylate-cyclase stimulator is recommended by international guidelines. More recently, balloon pulmonary angioplasty (BPA) develops as an alternative treatment for inoperable CTEPH. Method This study is a single-center randomized controlled trial. Subjects with inoperable CTEPH are randomized into either a BPA combined with riociguat or riociguat monotherapy group (2:1) and observed for 12 months after initiation of treatment. The primary endpoint is the change in pulmonary vascular resistance from baseline to 12 months after initiation of treatment. The secondary endpoints include 6-min walk distance (6MWD), WHO-FC, NT-proBNP, SF-36, and other hemodynamic parameters. Safety endpoints are analyzed too. Discussion This study aims to compare the efficacy and safety of BPA combined with riociguat and riociguat monotherapy for inoperable CTEPH. Trial registration Chinese Clinical Trial Registry ChiCTR2000032403. Registered on 27 April 2020.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ffa2fce6d06b6a1bb9321fce08f248ccTest
https://doaj.org/article/79cb40013f634c76956e1ebeb61bd0dfTest

المؤلفون: Teichgräber, Ulf, Ingwersen, Maja, Platzer, Stephanie, Lehmann, Thomas, Zeller, Thomas, Aschenbach, René, Scheinert, Dierk

المصدر: Trials, Vol 22, Iss 1, Pp 1-13 (2021)
Trials

مصطلحات موضوعية: Sirolimus, Quality of life, Medicine (General), Paclitaxel, Peripheral artery disease, Popliteal artery, Study Protocol, Peripheral Arterial Disease, Treatment Outcome, R5-920, Coated Materials, Biocompatible, Randomized controlled trial, Femoral artery, Humans, Multicenter Studies as Topic, Balloon angioplasty, Angioplasty, Balloon, Vascular Patency, Randomized Controlled Trials as Topic

الوصف: Background Endovascular revascularization has established as the first-line therapy of femoropopliteal artery disease. Paclitaxel-coated balloon angioplasty proved to be superior to plain old balloon angioplasty (POBA) regarding prevention of restenosis and need for recurrent revascularization. Over the past years, paclitaxel was the only active drug to inhibit neointimal proliferation which could be processed to an appropriate balloon coating. The purpose of this study is to assess whether efficacy and safety of sirolimus-coated balloon angioplasty is noninferior to paclitaxel-coated balloon angioplasty. Methods This randomized controlled, single-blinded, multicentre, investigator-initiated noninferiority trial aims to enrol a total of 478 participants with symptomatic femoropopliteal artery disease of Rutherford category 2 to 4 due to de novo stenosis or restenosis. After pre-dilation, participants will be allocated in a 1:1 ratio to either sirolimus- or paclitaxel-coated balloon angioplasty. Post-dilation with the drug-coated balloon (DCB) used or standard balloon is mandatory in case ≥ 50%, and optional in case of ≥ 30% residual diameter stenosis. Bailout stenting with bare-metal nitinol stents should be conducted in case of flow-limiting dissection. Primary noninferiority endpoints are primary patency and the composite of all-cause mortality, major target limb amputation, and clinically driven target lesion revascularization at 12 months. Secondary outcomes are clinical and hemodynamic improvement, change in health-related quality of life, and safety throughout 60 months. Discussion Although concerns about long-term safety of paclitaxel-coated devices were not confirmed by recent patient-level data analyses, conflicting evidence contributed to a loss of confidence among patients and physicians. Therefore, sirolimus, known for a broader therapeutic range than paclitaxel, may serve as a welcome alternative. This will be justified if noninferiority of sirolimus-coated balloon angioplasty against the current standard of paclitaxel-coated balloon angioplasty can be demonstrated. Trial registration ClinicalTrials.gov NCT04475783 . Registered on 17 July 2020 EUDAMED No. CIV-20-11-035172, DRKS00022452

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::d0fe4799178516fcc70004efa2c17978Test
https://doaj.org/article/4ca06bcbab594471af6daeeae75cfd69Test

المؤلفون: Mohammad Ali Akrami, Ava Zamani, Reza Zamani, James Ian Atkins Osborne, Joseph Robert Stevens

المصدر: BioMedical Engineering OnLine, Vol 20, Iss 1, Pp 1-21 (2021)
BioMedical Engineering

مصطلحات موضوعية: Male, medicine.medical_specialty, Percutaneous, Revascularisation, medicine.medical_treatment, Biomedical Engineering, Coronary, Intervention, Review, 030204 cardiovascular system & hematology, Biomaterials, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Angioplasty, Coronary stent, medicine, Stent, Medical technology, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, cardiovascular diseases, Angioplasty, Balloon, Coronary, R855-855.5, Intensive care medicine, Radiological and Ultrasound Technology, business.industry, General Medicine, Middle Aged, medicine.disease, equipment and supplies, Thrombosis, surgical procedures, operative, Scaffold material, Female, Stents, business, Cobalt alloy

الوصف: Background Coronary stents are routinely placed in the treatment and prophylaxis of coronary artery disease (CAD). Current coronary stent designs are prone to developing blockages: in-stent thrombosis (IST) and in-stent re-stenosis (ISR). This is a systematic review of the design of current coronary stent models, their structural properties and their modes of application, with a focus on their associated risks of IST and ISR. The primary aim of this review is to identify the best stent design features for reducing the risk of IST and ISR. To review the three major types of stents used in clinical settings today, determining best and relevant clinical practice by exploring which types and features of offer improved patient outcomes regarding coronary angioplasty. This information can potentially be used to increase the success rate of coronary angioplasty and stent technology in the future taking into account costs and benefits. Methods Scientific databases were searched to find studies concerning stents. After the exclusion criteria were applied, 19 of the 3192 searched literature were included in this review. Studies investigating three major types of stent design were found: bare-metal stents (BMS), drug-eluting stents (DES) and bioresorbable stents (BRS). The number of participants varied between 14 and 1264. On average 77.4% were male, with a mean age of 64 years. Results From the findings of these studies, it is clear that DES are superior in reducing the risk of ISR when compared to BMS. Conflicting results do not clarify whether BRS are superior to DES at reducing IST occurrence, although studies into newer BRS technologies show reducing events of IST to 0, creating a promising future for BRS showing them to be non-inferior. Thinner stents were shown to reduce IST rates, due to better re-endothelialisation. Scaffold material has also been shown to play a role with cobalt alloy stents reducing the risk of IST. This study found that thinner stents that release drugs were better at preventing re-blockages. Some dissolvable stents might be better at stopping blood clots blocking the arteries when compared to metal stents. The method and procedure of implanting the stent during coronary angioplasty influences success rate of these stents, meaning stent design is not the only significant factor to consider. Conclusions Positive developments in coronary angioplasty could be made by designing new stents that encompass all the most desirable properties of existing stent technology. Further work is needed to investigate the benefits of BRS in reducing the risk of IST compared to DES, as well as to investigate the effects of different scaffold materials on IST and ISR outcomes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::71c65dc4ab0ad4a375c44e9aca65b51aTest
https://doaj.org/article/2a9b2866bf47449687a26d1275f4c1d1Test

المؤلفون: Kawin Anusonadisai, Nattawut Wongpraparut, N. Premasathian, Archan Jaspttananon, Thunyarat Chaipruckmalakarn, Thongtum Tongdee, Rungtiwa Pongakasira, A. Vongwiwatana

المصدر: BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-9 (2021)
BMC Cardiovascular Disorders

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Percutaneous, Time Factors, Databases, Factual, Transplant renal artery stenosis (TRAS), 030232 urology & nephrology, Urology, Renal function, Anastomosis, Renal Artery Obstruction, Risk Assessment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Restenosis, Risk Factors, medicine.artery, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, Percutaneous transluminal renal angioplasty (PTRA), Renal artery, Kidney transplantation, Retrospective Studies, business.industry, Angioplasty, Retrospective cohort study, Middle Aged, medicine.disease, Thailand, Kidney Transplantation, Long-term outcome, Progression-Free Survival, Cardiac surgery, RC666-701, Female, Stents, Cardiology and Cardiovascular Medicine, business, Percutaneous transluminal renal angioplasty with stenting (PTRAS), Research Article

الوصف: Background Endovascular treatment is standard of care for transplant renal artery stenosis (TRAS). No study has evaluated long-term outcomes compared between percutaneous transluminal renal angioplasty (PTRA) and PTRA with stenting (PTRAS). Accordingly, this study aimed to investigate the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in patients diagnosed with TRAS at Thailand’s largest national tertiary referral center. Methods This single-center retrospective study included kidney transplant patients treated for TRAS during January 2001 to June 2019. Clinical success was defined as (1) increase in estimated glomerular filtration rate (eGFR) > 15%, or (2) reduction in mean arterial pressure (MAP) > 15% with no decrease in antihypertensive medication, or no reduction in MAP or reduction in MAP Results Sixty-five cases of TRAS were identified from 1072 patients who underwent kidney transplantation. The majority (98.5%) had end-to-side anastomosis technique. Thirty-four patients had PTRA, while 31 patients had PTRAS. One-year clinical success according to renal outcome and BP reduction was 78.5% and 49.2%, respectively. Both renal outcome (79.4% vs. 77.4%, p = 0.845) and BP reduction (40.6% vs. 58.1%, p = 0.166) at 1 year were similar between the PTRA and PTRAS groups. Compared between PTRA and PTRAS, event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher for PTRAS at 1 year (82.4% vs. 100%, p = 0.025), but not significantly different at 10 years (73.5% vs. 71%, p = 0.818). Conclusions We demonstrated the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in TRAS patients. One-year clinical success was found to be similar between groups. Event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher in PTRAS at 1 year, but similar between groups at 10 years. Trial registration Thai Clinical Trials Registry, TCTR20200626002. Registered 26 June 2020—Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialTest search&smenu = fulltext&task = search&task2 = view1&id = 6441

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6ce0924158891b04cb99dd1acc9a4a6cTest
https://doaj.org/article/0ef16e6945f2459ab21c4cb5720ece8aTest

المؤلفون: Andreas Greinacher, Robin Bülow, Uwe Zimmermann, Benedikt Martin, Martin Burchardt, Andreas Hoene, Fabian Hammer

المصدر: BMC Urology, Vol 21, Iss 1, Pp 1-5 (2021)
BMC Urology

مصطلحات موضوعية: Male, Clear cell renal cell carcinoma, medicine.medical_specialty, Acute coronary syndrome, Arterial embolism, Paraneoplastic Syndromes, medicine.drug_class, Urology, medicine.medical_treatment, Myocardial Infarction, Low molecular weight heparin, Acute arterial thrombotic emboli, Case Report, Nephrectomy, Percutaneous Coronary Intervention, Thromboembolism, Angioplasty, medicine, Humans, Acute Coronary Syndrome, Carcinoma, Renal Cell, Thrombectomy, Incidental Findings, Aspirin, business.industry, Anticoagulants, Drug-Eluting Stents, Arteries, General Medicine, Middle Aged, medicine.disease, Clopidogrel, Thrombosis, Kidney Neoplasms, Diseases of the genitourinary system. Urology, Surgery, Reproductive Medicine, Paraneoplastic syndrome, Drug Therapy, Combination, Laparoscopy, RC870-923, business, Ticagrelor, Platelet Aggregation Inhibitors, medicine.drug

الوصف: Background Cancer is often associated with a hypercoagulable state and new thrombosis is often the first clinical manifestation of cancer. Surgical treatment of the primary tumor is crucial since it provides the only curative approach in most cases, but management of patients is highly complex, especially in the presence of new antiplatelet drugs and/or anticoagulants. Paraneoplastic syndromes (PNS) represent a frequent complication of renal cell carcinomas (RCC) and include different hematological symptoms in patients, whilst occlusion of arterial blood vessels displays a rare form of PNS accompanying renal tumors. Case presentation We report the case of a 62-year old man who was initially hospitalized due to acute coronary syndrome. He subsequently underwent coronary angioplasty treatment including multiple stenting and treatment with ticagrelor and aspirin. Post-interventional, acute arterial thrombotic emboli of several limb arteries required thrombectomy. By computer tomography we identified a renal lesion suspicious for an RCC and suspected a PNS as underlying cause of the thrombotic complications. Triple anticoagulant therapy was maintained with therapeutic dose low molecular weight heparin (LMWH), aspirin, and clopidogrel, by which we replaced ticagrelor. Surgery was postponed for 4 weeks. We paused LMWH, aspirin and clopidogrel only at the day of surgery and perioperatively restored hemostasis by transfusion of two platelet concentrates. Laparoscopic nephrectomy was uneventful. Pathology confirmed a clear cell RCC. The patient fully recovered whilst slowly reducing anticoagulation dose. Conclusions A multidisciplinary team approach of experts in urology, cardiology and hemostasis was key in managing this patient since a personalized thrombosis consult was needed to minimize the risk of reinfarction due to in-stent thrombosis. We report a therapeutic protocol that may be helpful for the management of similar cases. Furthermore, the finding of thrombotic arterial occlusions in larger blood vessels represents a novel complication of PNS in RCC and adds to the varied possible manifestations of this clinical chameleon.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dab29594c19a2744de903db5f83cb5c0Test
https://doaj.org/article/b21ee452570449a288ec2328d1f69b00Test

المؤلفون: Jiatian Cao, Yuxiang Dai, Hongbo Yang, Chenguang Li, Junbo Ge, Juying Qian, Hao Lu, Yanan Song, Xueyi Weng, Feng Zhang, Zheyong Huang

المصدر: BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-9 (2021)
BMC Cardiovascular Disorders

مصطلحات موضوعية: Male, Coronary bifurcation lesion, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Balloon, Percutaneous coronary intervention, 03 medical and health sciences, 0302 clinical medicine, Side branch, Occlusion, Humans, Medicine, Diseases of the circulatory (Cardiovascular) system, 030212 general & internal medicine, Angioplasty, Balloon, Coronary, Vascular Patency, Aged, Retrospective Studies, Kissing balloon inflation, business.industry, Stent, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Stenosis, Side branch protection, Treatment Outcome, Technical Advance, RC666-701, Female, Stents, Cardiology and Cardiovascular Medicine, business, Mace

الوصف: BackgroundThe jailed balloon technique is widely used for coronary bifurcation lesions, but a residual risk of SB occlusion remains, necessitating SB rewiring and further interventions, including balloon inflation or stenting, which may result in failure and SB loss. This study introduced a novel modified technique of small side branch (SB) protection, namely, double kissing inflation outside the stent (DKo) technique, for coronary bifurcations without the need for SB rewiring.MethodsWe performed the DKo technique in consecutive patients in our center from 1/2019 to 12/2019. The procedure was as follows. We inserted a guide wire into both branches followed by proper preparation. The SB balloon was simultaneously inflated with main vessel (MV) stenting. The SB balloon remained in situ until it was kissing inflated with postdilation of the bifurcation core, which is different from traditional strategies. The proximal optimization technique was performed with a short noncompliant balloon strictly not exceeding the bifurcation. Rates of SB loss and in-hospital outcomes were evaluated.ResultsThe technique was successfully performed in all 117 enrolled patients without any rewiring or SB loss. The mean lesion lengths of the MV and SB were 38.3 ± 19.9 mm and 11.7 ± 7.1 mm, respectively. On average, 1.5 ± 0.6 stents were used per patient, while the mean pressure of the SB balloon was 7.4 ± 3.1 atm. DKo achieved excellent procedural success in the proximal and distal MVs: increased minimal lumen diameter (0.64 ± 0.58 mm to 3.05 ± 0.38 mm,p p p p ConclusionsDKo for bifurcation lesions was shown to be acceptable with high procedural success and excellent SB protection.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b17c2d28221cccb7087fe3f49e7fa54aTest
https://doaj.org/article/21e97312626e46c09dfa2fc08c2d53f8Test

المؤلفون: Thorsten A. Bley, Nicole Rickert, Thorsten Klink, Ralph Kickuth, Anne Marie Augustin, Irina Thein

المصدر: BMC Medical Imaging, Vol 20, Iss 1, Pp 1-8 (2020)
BMC Medical Imaging

مصطلحات موضوعية: Male, Percutaneous, medicine.medical_treatment, Imaging analysis, 030204 cardiovascular system & hematology, Balloon, 030218 nuclear medicine & medical imaging, Peripheral arterial occlusive disease, 0302 clinical medicine, Aged, 80 and over, Observer Variation, medicine.diagnostic_test, Angiography, Interventional radiology, Middle Aged, Femoral Artery, Parametric color-coding, Treatment Outcome, lcsh:R855-855.5, Endovascular procedures, Diagnostic imaging, Female, Radiology, Research Article, Vascular imaging, Adult, medicine.medical_specialty, lcsh:Medical technology, Digital subtraction angiography, Color, Arterial Occlusive Diseases, 03 medical and health sciences, Angioplasty, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Angiography, Digital Subtraction, body regions, Monochromatic color, business, Imaging postprocessing, Angioplasty, Balloon

الوصف: Background Percutaneous transluminal angioplasty (PTA) is increasingly requested in the therapy of peripheral arterial occlusive disease. The evaluation of the technical result after balloon angioplasty with regard to bailout stenting is highly dependent on the operators´ subjective assessment and mainly based on the monochromatic digital subtraction angiography (DSA) images. The aim of this study was to compare color-coded single image as a novel diagnostic tool with monochromatic DSA for the analysis of flow limitation and need for stent implantation after PTA of superficial femoral artery (SFA) stenoses. Methods During a period of 18 months, 213 SFA lesions were treated by PTA with a standard balloon in 170 patients, resulting in a total of 193 endovascular procedures. The median age of the patients was 77 years (range, 35–96 years). Median length of the treated lesions was 10.5 cm (range, 1.0–50 cm). Three interventional radiologists retrospectively evaluated the results of balloon angioplasty with monochromatic as well as post-processed color-coded DSA images for flow limitations to decide if subsequent stent implantation was necessary. Consensus reading of two experienced interventional radiologists 2 months after the initial review served as reference standard to perform a receiver operating characteristics (ROC) analysis. Results ROC analysis for readers A, B and C showed area under the curve (AUC) values of 0.797, 0.865 and 0.804 for color-coded DSA and AUC values of 0.792, 0.843 and 0.872 for monochromatic DSA: a significant advantage of color-coded over conventional monochromatic DSA was not found for readers A and B (p > 0.05). Results of reader C were significantly better in the assessment of monochromatic images (p = 0.023). Diagnostic confidence using color-coded images was slightly higher than in monochromatic images (κ = 0.486 vs. κ = 0.459). Conclusions In this study, color coded DSA did not reveal to be superior to conventional monochromatic DSA when evaluating results of PTA and when deciding whether stent implantation is necessary or not. This technology, however, requires further experiences with special regard to homogeneously trained radiologists and to the time requirement.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::35aa87a2ee97b41907fe5bf010b38b22Test
http://link.springer.com/article/10.1186/s12880-020-00468-1Test

المؤلفون: Bingqiang Li, Jing Zhang, Zhanying Han, Ying Li, Xuemei Zong, Yaohui Wang, Xiaoqiong Wang, Xinjie Duan, Yaoli Wang

المصدر: BMC Cardiovascular Disorders, Vol 20, Iss 1, Pp 1-6 (2020)
BMC Cardiovascular Disorders

مصطلحات موضوعية: Target lesion, Male, medicine.medical_specialty, Cardiac Catheterization, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Aortasinus-in guard-wire technology, Cardiac Catheters, 03 medical and health sciences, 0302 clinical medicine, Ostial lesions, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Angioplasty, Balloon, Coronary, Aged, Retrospective Studies, Ejection fraction, business.industry, Guard-wire technology, Coronary Stenosis, Percutaneous coronary intervention, Stent, Middle Aged, Branch guard-wire technology, Surgery, Cardiac surgery, Treatment Outcome, surgical procedures, operative, lcsh:RC666-701, Conventional PCI, Balloon dilation, Feasibility Studies, Female, Stents, Cardiology and Cardiovascular Medicine, business, Complication, Research Article

الوصف: Background To explore potential value of guard-wire technology during percutaneous coronary intervention (PCI) in patients with ostial coronary lesions. Methods Patients, who underwent PCI, were collected between October 2011 and March 2017. Of the 141 patients, 63 (44.7%) have ostial lesions, and 78 (55.3%) have distal bifurcation sites. They were divided into group A (n = 71) and group B (n = 70). Group A received PCI after guard-wire technology. Group B were given balloon dilation and stent after placing guide wire through target lesion vessel. X-ray exposure time, contrast agent dosage, total PCI duration, pressure incarceration times, cases of malignant arrhythmia and cases of failed PCI of all patients were analyzed, respectively. Results The general clinical characteristics includes patients age, sex ratio, the proportion of complications, smoking ratio and left ventricular ejection fraction of both groups was not significantly different. X-ray exposure time, contrast agent dosage, PCI total time, stent positioning time, pressure infestation frequency, arrhythmia frequency and complication number of group B were higher than those of group A. There is no case of malignant arrhythmia and case of failed PCI in group A, while there were five malignant arrhythmia and four failed PCI in group B. Contrast agent dosage and cases of failed PCI increased in group B compared with group A. Conclusion The guard wire technology is safer and more feasible to patients with ostial coronary lesions who underwent PCI.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8ba43e32d03ad983b342ad323c71c423Test
http://link.springer.com/article/10.1186/s12872-020-01779-5Test

المؤلفون: Yusuke Hori, Natsuya Keira, Tetsuya Nomura, Hiroshi Kubota, Ryota Urata, Kenichi Yoshioka, Tetsuya Tatsumi, Masakazu Kikai, Daisuke Miyawaki, Takeshi Sugimoto

المصدر: Journal of Medical Case Reports, Vol 13, Iss 1, Pp 1-5 (2019)
Journal of Medical Case Reports

مصطلحات موضوعية: Male, medicine.medical_specialty, medicine.medical_treatment, lcsh:Medicine, Arterial Occlusive Diseases, Femoral artery, 030204 cardiovascular system & hematology, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Catheterization procedure, medicine.artery, Angioplasty, Intravascular ultrasound, Case report, medicine, Humans, Popliteal Artery, Vascular closure device, EXOSEAL, Acute limb ischemia, Aged, 80 and over, medicine.diagnostic_test, business.industry, Endovascular Procedures, lcsh:R, Angiography, Balloon catheter, General Medicine, Arterial occlusion, Popliteal artery, Surgery, Femoral Artery, 030220 oncology & carcinogenesis, business, Complication, Angioplasty, Balloon, Vascular Closure Devices

الوصف: Background Vascular closure devices have been widely used to achieve rapid hemostasis after percutaneous catheterization procedures via the common femoral artery. The EXOSEAL vascular closure device is a device that can deliver a bioabsorbable polyglycolic acid plug to fill the subcutaneous puncture route at the groin for rapid hemostasis, and this device has a lower risk of arterial occlusion than other vascular closure devices. Case presentation An 83-year-old Japanese man underwent percutaneous coronary intervention for a proximal stenosis in his left circumflex artery through a 7-Fr sheath from his right common femoral artery. We encountered acute popliteal artery occlusion associated with EXOSEAL vascular closure device. We detected the plug material of this device at the occluded lesion by intravascular ultrasound, and performed successful bailout stenting after pulling the embolus with an inflated balloon catheter up to the superficial femoral artery from the popliteal artery. Conclusion Acute limb ischemia caused by an EXOSEAL vascular closure device is a very rare complication. Balloon angioplasty and stenting are considered to be effective options to deal with the plug dislodgement of an EXOSEAL vascular closure device. We must be prepared for every rare complication during endovascular treatment.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3f8d7cefa74fc5eda423b9654bdf0cadTest
http://link.springer.com/article/10.1186/s13256-018-1950-2Test