bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of long‐term outcomes of drug‐eluting stents and bare metal stents for saphenous vein graft stenosis
Authors: Chakravarty Tarun , Morrissey Ryan P. , Wertman Brett , Naghi Jesse , Chou Stanley , Goykhman Pavel , Doctor Niraj , Mirocha James , Forrester James S. , Makkar Raj 
Published: July 2011

AbstractObjective: Our aim was to compare the long‐term outcomes between drug‐eluting stents and bare‐metal stents for saphenous vein graft stenosis. Background: The ideal type of stent to treat saphenous vein graft stenosis has not been clearly established. Short‐term randomized controlled trial results comparing drug‐eluting stents with bare‐metal stents for saphenous vein graft stenosis are conflicting, intermediate‐term retrospective studies and meta‐analyses at two years suggest no difference in outcomes, and there are no long term follow‐up studies. The need for long term follow‐up data has become emerged with concern over late stent thrombosis. Methods: 246 saphenous vein graft patients undergoing stenting from August 2002–December 2008 were studied. Overall survival and event‐free survival were compared by Kaplan‐Meier method. Hazard ratios (HR) were calculated by Cox‐proportional hazards models. Results: We treated 133 patients with DES (median follow‐up four years) and 113 patients with BMS (median follow‐up four years) for SVG stenosis. Overall survival (77.0% ± 3.9% vs. 70.6% ± 4.6%, log‐rank P = 0.60) and MACE‐free survival (57.5% ± 4.6% vs. 56.8% ± 4.9, log‐rank P = 0.70) were not significantly different between the DES and BMS groups. Although BMS was associated with increased risk of target lesion revascularization (TLR) (freedom from TLR 85.2% ± 3.5% vs. 90.0% ± 3.0%, HR 2.07, 95% CI 0.97–4.42, log‐rank P = 0.05), there was no significant difference in the freedom from myocardial infarction (86.7% ± 3.3% vs. 88.7% ± 3.2%, log‐rank P = 0.39) or target vessel revascularization (77.1% ± 4.2% vs. 76.1% ± 4.2%, log‐rank P = 0.33) between the two groups. Conclusions: Although mortality is not statistically different between DES and BMS for SVG stenosis, BMS is associated with increased risk of revascularization, thus suggesting the superiority of DES over BMS in the long term. © 2011 Wiley Periodicals, Inc.
Stent migration during transcatheter management of coarctation of aorta
Authors: Kannan Bhava R.J. , Srinivasan Muthusamy 
Published: July 2011

AbstractA 13‐year‐old girl underwent endovascular stent placement for coarctation of aorta. The fully expanded stent migrated to ascending aorta which could be stabilized, recrimped, and repositioned with a 20‐mm goose neck snare. Postdilatation was performed from the left brachial route resulting in a good outcome. © 2011 Wiley Periodicals, Inc.
Transfemoral use of the guideLiner catheter in complex coronary and bypass graft interventions
Authors: Luna Michael , Papayannis Aristotelis , Holper Elizabeth M. , Banerjee Subhash , Brilakis Emmanouil S. 
Published: July 2011

AbstractThe GuideLiner catheter (Vascular Solutions, Minneapolis, MN) is a novel, rapid exchange catheter that allows deep vessel intubation. We describe 21 patients in whom the GuideLiner catheter [7 French (F) in 76% and 6F in 24%] was used to facilitate equipment delivery (n = 14) or vessel engagement (n = 7). Pressure dampening after GuideLiner catheter insertion was observed in 12 patients (57%). The procedure was successfully completed in 19 patients (90%) and one patient developed acute vessel closure, likely due to dissection. The GuideLiner catheter can facilitate complex coronary interventions but should be used with caution to minimize the risk for vessel injury. © 2011 Wiley Periodicals, Inc.
Clinical outcome of transcatheter aortic valve implantation in patients with low‐flow, low gradient aortic stenosis
Authors: Gotzmann Michael , Lindstaedt Michael , Bojara Waldemar , Ewers Aydan , Mügge Andreas 
Published: July 2011

AbstractBackground: Low‐flow, low‐gradient aortic stenosis is associated with relevant postoperative mortality whereas conservative management results in dismal prognosis. We present the initial experience of low‐flow, low‐gradient aortic stenosis treated with transcatheter aortic valve implantation (TAVI). Methods: From June 2008 to December 2010 167 consecutive patients with native severe aortic stenosis and an excessive operative risk underwent TAVI. Of these, 15 patients presented with low‐flow, low‐gradient aortic stenosis (aortic valve area < 1 cm2, left ventricular (LV) ejection fraction < 40%, aortic mean gradient < 40 mm Hg). The CoreValve prosthesis 18‐F‐generation (Medtronic, Minneapolis, Minnesota) was inserted retrograde. Clinical follow‐up and echocardiography were performed 6 months after procedure. Results: Patients with low‐flow, low‐gradient aortic stenosis (mean LV ejection fraction 32 ± 6%, mean aortic gradient 27 ± 7 mm Hg) had higher all‐cause mortality 6 months after TAVI compared to patients without low‐flow, low‐gradient aortic stenosis (33% vs. 13%, P = 0.037). In the surviving 10 patients with low‐flow, low‐gradient aortic stenosis, LV ejection fraction increased (34 ± 6% before vs. 46 ± 11% 6 months after TAVI, p = 0.005) and more distance covered in the 6‐minute walk test (218 ± 102 meters before vs. 288 ± 129 meters 6 months after TAVI, p = 0.038). Conclusion: Our study suggests that TAVI is feasible in patients with severe co‐morbidities and low‐flow, low‐gradient aortic stenosis. Within the first 6 months after treatment all‐cause mortality was considerable high, but the surviving patients showed symptomatic benefit and significant improvement of myocardial function and exercise capacity. © 2011 Wiley Periodicals, Inc.
Percutaneous revascularization of left main
Authors: Palmerini Tullio , Alessi Laura , Rizzo Nicole , Dangas George 
Published: July 2011

AbstractRefinement of interventional techniques, adjunctive pharmacological therapy, and the introduction of drug‐eluting stents have fostered new interest for the percutaneous treatment of unprotected left main coronary artery (ULMCA) stenosis. Several observational registries, some randomized trials and several meta‐analyses have consistently shown no difference in mortality and myocardial infarction between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in patients with ULMCA stenosis, but a higher rate of target vessel revascularization in patients treated with PCI. As a consequence, PCI of ULMCA stenosis has been upgraded to class IIa or IIb indication in the current European or American practice guidelines. However, several critical issues should be properly addressed when pursuing a percutaneous strategy for the treatment of ULMCA stenosis, such as the use of IVUS for procedural guidance, assessment of disease location, optimal technique for distal ULMCA stenosis, risk of stent thrombosis, optimal duration of dual antiplatelet therapy, and the most appropriate strategy for post‐procedure follow up. Multidisciplinary team approach remains essential to provide a balanced information to the patient and to offer the beast treatment option. © 2011 Wiley Periodicals, Inc.
Periaortic hematoma after transcatheter aortic valve replacement: Description of a new complication
Authors: Généreux Philippe , Reiss George R. , Kodali Susheel K. , Williams Mathew R. , Hahn Rebecca T. 
Published: July 2011

AbstractWe report a case series of three patients with periaortic hematomas following transcatheter aortic valve replacement (TAVR). The TAVRs were performed by either trans‐apical or transfemoral approach. An intraprocedural transesophageal echocardiogram (TEE) was performed in all patients. Clinical features of all three cases included advanced age, female gender, and small body weight. In addition, the following characteristics were present in all cases: presence of bulky calcification of the noncoronary cusp (NCC) of the aortic valve, mismatch between the annulus and device diameter, and severe intraprocedural hypertension immediately following TAVR. These characteristics may be potential causative factors. Early recognition of this complication by intra‐procedural TEE was integral to the initiation of rapid and appropriate therapy, resulting in a favorable outcome. Herein, we present possible theories for the occurrence of this rare complication. © 2011 Wiley Periodicals, Inc.
Unprotected left main coronary artery stenting with zotarolimus (Endeavor) drug‐eluting stents
Authors: Simard Trevor , Hibbert Benjamin , Chong Aun‐Yeong , Ruchin Peter , Le May Michel , Labinaz Marino , Froeschl Michael , So Derek , Glover Christopher , Marquis Jean‐Francois , O'Brien Edward 
Published: July 2011

AbstractObjectives: To report the safety and efficacy of zotarolimus eluting stents for treatment of unprotected left main coronary artery disease. Background:Percutaneous stent insertion is an increasingly popular alternative to bypass surgery for the management of left main (LM) coronary artery disease. While data support the use of sirolimus‐ and paclitaxel‐coated stents in the LM coronary artery, there are no published series reporting results with Endeavor (zotarolimus) stents, particularly in the context of unprotected left main (ULM) lesions. Methods:We retrospectively identified 40 consecutive patients who had ULM disease treated with Endeavor stents (ZES) and who had follow‐up angiography. The primary endpoint was the prevalence of major adverse cardiac events (MACE), including cardiac/unexplained death, nonfatal myocardial infarction (MI), and in‐stent restenosis (ISR)/target lesion revascularization (TLR). Results:Angiographic and procedural success was achieved in all cases. Follow‐up angiography occurred on average 5.6 ± 0.9 months after the index procedure. There were three incidences of ISR requiring TLR and another patient who had a NSTEMI in the follow‐up period. At late follow‐up (12.4 ± 1.8 months) three patients underwent CABG (one for RCA stenosis) and four patients died without knowledge of the status of the ULM stent (two cardiovascular and two deaths related to cancer progression). Conclusions:In conclusion, our experience with Endeavor stents for the treatment of ULM disease demonstrates excellent angiographic and clinical outcomes, with a 7.5% ISR/TLR rate and a 15% MACE rate, respectively, at an average clinical follow‐up of 12.4 months. © 2011 Wiley Periodicals, Inc.
Tulip malformation of the left atrial disc in the lifetech cera ASD device: A novel complication of percutaneous ASD closure
Authors: Hayes Nicholas , Rosenthal Eric 
Published: July 2011

AbstractA previously unreported tulip‐like malformation of the left atrial disc was encountered during percutaneous closure of an atrial septal defect (ASD) using the LifeTech Cera ASD device, requiring snare assistance to permit recapture into the delivery sheath. This was likely to be as a result of attempting to recapture the left atrial disc whilst it remained in contact with some part of the atrial septum or left atrial wall. To help avoid this, it is recommended to ensure complete intracavity positioning of the Cera device prior to retrieval into the sheath. © 2011 Wiley Periodicals, Inc.
A case of spontaneous multivessel coronary artery dissection presenting with acute myocardial infarction and ventricular tachycardia
Authors: Karabag Turgut , Dogan Sait M. 
Published: July 2011

AbstractSpontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia. Multivessel SCAD is much rarer than single vessel involvement and acute coronary syndrome remains the most common clinical presentation of a patient with SCAD. It predominantly occurs in association with atherosclerosis or in the absence of atherosclerosis. We, hereby, present a case of spontaneous multivessel coronary artery dissection in a 35‐year‐old male patient presenting with chest pain and ventricular tachycardia following emotional stress and discuss the etiology and treatment options. © 2011 Wiley‐Liss, Inc.
Kissing drug eluting balloons for in‐stent restenosis complicating bifurcations treated with drug‐eluting stents
Authors: Raja Yogesh , Doshi Sagar N. , Townend Jonathan N. 
Published: July 2011

AbstractThe management of in‐stent restenosis (ISR) complicating bifurcation lesions is technically challenging and implant of further stents may not be feasible. The use of drug‐eluting balloons provides an attractive option for treatment of such lesions allowing a technically simple procedure without the need for further complex stenting. The SeQuent Please paclitaxel‐eluting balloon (B. Braun, Berlin, Germany) has been shown to be superior to a paclitaxel eluting stent or balloon angioplasty for ISR complicating a bare‐metal stent. However, there is no data on the efficacy of the SeQuent Please in ISR complicating drug‐eluting stents or bifurcation lesions. We report two cases where the SeQuent Please was used in this setting with angiographic success and freedom from target vessel failure and angina at 24 months. In both cases the Sheathless Eau Cath guide (Asahi Intecc, Japan) was employed to perform a kissing‐balloon dilatation with the SeQuent Please, so allowing treatment via radial access. © 2012 Wiley Periodicals, Inc.
Needle in the haystack purulent pericarditis from injection drug use
Authors: Steiner Johannes , Dhingra Ravi , DeVries James T. 
Published: July 2011

AbstractCentral needle embolization is a rare complication of intravenous drug abuse which has only been reported on a handful of occasions. Previously reported cases of needle embolization to the heart have been managed conservatively (observation alone) or by surgical intervention. We report a case of purulent pericarditis without evidence of valvular vegetations resulting from an embolized, infected needle fragment. In the present case, the needle was successfully removed from the right ventricle percutaneously. This case illustrates the unique finding of purulent pericarditis due to a persistent foreign body in the right ventricle, and the nontraditional intervention performed for needle fragment removal which resulted in full clinical recovery of the patient. © 2011 Wiley Periodicals, Inc.
Guideliner® catheter—Friend or foe?
Authors: Murphy John Conleth , Spence Mark S. 
Published: July 2011

AbstractPerforming percutaneous coronary intervention (PCI) in arteries with complex anatomy remains a clinical problem. In particular tortuosity within a coronary vessel is frequently encountered and can hamper delivery of balloons or stents to coronary stenoses. This has led to the development of a number of adjuvant devices to assist stent delivery in difficult cases. The safety profile of these novel devices remains to be clearly ascertained. The Guideliner® “child” support catheter is one such device and comprises of a 20‐cm silicon‐coated guide extension that assists delivery of stents in tortuous arteries when conventional techniques have failed. Initial reports suggest it is efficacious and no previous complications relating to the device have been published. We report the first complication involving the Guideliner® catheter which was encountered during primary PCI. We hypothesize regarding the mechanism of the complication and discuss the ways it may be avoided in the future. © 2011 Wiley Periodicals, Inc.
Correlation between index electrocardiographic patterns and pre‐intervention angiographic findings: Insights from the HORIZONS‐AMI trial
Authors: Rokos Ivan C. , Farkouh Michael E. , Reiffel James , Dressler Ovidiu , Mehran Roxana , Stone Gregg W. 
Published: July 2011

AbstractObjectives: To improve ECG interpretation accuracy in patients with chest pain prior to activation of the cardiac catheterization laboratory for primary percutaneous coronary intervention (PPCI). Background: Despite current guideline‐based ECG criteria, challenges remain in optimizing the rate of appropriate catheterization laboratory activation. Methods: The HORIZONS‐AMI trial enrolled 3,602 patients with chest pain consistent with myocardial infarction (MI). ECG and angiographic core laboratory databases were analyzed for correlation between the qualifying study ECG and the baseline coronary angiogram. Results: LAD occlusion manifested in >80% of cases as ST‐segment elevation in leads V2 and V3, while the culprit vessel was the RCA and LCx in 75 and 25% of cases, respectively, for inferior MI ECG patterns. The study threshold of ≥1.0 mm ST‐segment elevation in ≥2 contiguous ECG leads was not met in 189 (5.3%) patients. When stratified by culprit artery, the prevalence of reciprocal ST‐segment depression ranged from 24 to 88%, being least common for lesions in the mid‐ and distal left anterior descending artery. Despite study eligibility, no posterior MIs were enrolled. Only 36 LBBB cases were identified (25% of whom did not undergo PCI), and 5 of 11 left main coronary occlusions (45%) had ST‐segment elevation in lead aVR. Conclusions: The present study confirms prior ischemic ECG findings predicted by vectorcardiography, validates certain ECG patterns as reliable surrogate markers for acute coronary occlusion, and provides novel insights correlating index ECG ischemic changes and pre‐intervention coronary angiography. These results may enhance the rate of appropriate catheterization laboratory activation. © 2011 Wiley Periodicals, Inc.
Acute and 16‐month outcomes of a new stent: The first‐in‐man evaluation of the medtronic S9 (integrity) stent
Authors: Lee Stephen Wai Luen , Chan Michael P.H. , Chan Kelvin K.W. 
Published: July 2011

AbstractObjective: A first‐in‐man evaluation of the safety, feasibility, deliverability, and efficacy of the new Medtronic S9 (Integrity) bare metal stent (BMS) in complex coronary diseases. Background: Excellent deliverability remains an unmet clinical need among stents especially in complex lesions. The S9 (Integrity) BMS utilizes a new, continuous sinusoidal manufacturing technology to enhance stent flexibility and deliverability, without sacrificing radial strength. Methods: This is a first‐in‐man, open label observational study in 15 patients treated with S9 (Integrity) BMS. Device success during implantation, clinical outcomes, 30‐day and 12‐month device‐oriented and patient‐oriented composite efficacy end‐points, and 16‐month angiographic restudy were evaluated (with amended protocols). Results: Thirty‐four stents were deployed to treat 30 complex lesions. Mean lesion length was 22.93 ± 11.78 mm, and mean percentage diameter stenosis was 78.59% ± 9.01%. Mean stent delivery time was 125 ± 68.3 sec. Acute device, lesion, and procedure success, as defined, were 100%. Device‐oriented and patient‐oriented composite end‐points were zero at 30 days. Two patients had ischemic driven revascularization before 12 months. One patient had non‐cardiac death at 13 months; all remaining 12 patients received 16 months angiographic restudy and only one had angiographic restenosis. The mean diameter of stenosis was 27.0% ± 18.3%, and mean late loss was 0.73 ± 0.50 mm. Total target vessel failure rate was 21.4% (3/14) at 16 months. Conclusion: The new S9 (Integrity) BMS exhibited excellent deliverability, flexibility, and conformability, contributing to good acute and 16 months outcomes in complex cases. © 2011 Wiley Periodicals, Inc.
Sirolimus‐eluting stent fracture detection by three‐dimensional optical coherence tomography
Authors: Okamura Takayuki , Matsuzaki Masunori 
Published: July 2011

AbstractStent fracture has emerged as a complication of drug‐eluting stent and is now recognized as contributing to in‐stent restenosis and possibly stent thrombosis. Although optical coherence tomography (OCT) can detect stent fractures in the absence of circumference struts, it is challenging to visualize stent fractures with only cross‐sectional OCT images. We describe two cases of restenosis with stent fracture detected by a novel three‐dimensional OCT image reconstruction technique. This technique allows identification of a single stent fracture even in the absence of angiographic signs. © 2011 Wiley Periodicals, Inc.
Cardiogenic shock secondary to severe acute ischemic mitral regurgitation managed with an impella 2.5 percutaneous left ventricular assist device
Authors: Harmon Laura , Boccalandro Fernando 
Published: July 2011

AbstractWe report a case of a patient successfully treated with an Impella Recover LP 2.5 (ABIOMED, Danvers, MA) left ventricular assist device, in the setting of cardiogenic shock secondary to severe acute mitral regurgitation associated with an acute myocardial infarction. © 2011 Wiley Periodicals, Inc.
Scanning electron microscopic assessment of coating irregularities and their precursors in unexpanded durable polymer‐based drug‐eluting stents
Authors: Basalus Mounir W.Z. , Tandjung Kenneth , van Westen Thea , Sen Hanim , van der Jagt Pasquelle K.N. , Grijpma Dirk W. , van Apeldoorn Aart A. , von Birgelen Clemens 
Published: July 2011

AbstractObjectives: To assess and quantify coating irregularities on unexpanded and expanded durable polymer‐based drug‐eluting stents (DES) to gain insights into the origin of coating irregularities. Background: Previous scanning electron microscopy (SEM) studies in various expanded DES revealed differences in frequency and size of coating irregularities between DES types and specific distribution patterns, however, the origin of these irregularities is unclear. Methods: We assessed at bench side a total of 1,200 SEM images obtained in 30 DES samples (15 expanded and 15 unexpanded) of Cypher Select Plus, Taxus Liberté, Endeavor, Xience V, and resolute. Results: For most coating irregularities seen on expanded DES (72%; 23/32), a matching irregularity (n = 18/23) and/or its precursor (n = 11/23) was observed in unexpanded DES. Unexpanded Cypher select showed (small) crater lesions and cracks together with precursors of “peeling.” On unexpanded Taxus Liberté, thinning of polymer, small bare metal areas, wrinkles, and one precursor type were found. Unexpanded endeavor showed cracks, small bare metal areas, crater lesions, and precursors of the latter. Unexpanded Xience V and resolute mainly revealed crater lesions and their precursors. On unexpanded versus expanded DES, there was no difference in measured frequency of coating irregularities and precursors (P = ns) with the exception of more bare metal areas on expanded Taxus Liberte (P = 0.01). Conclusions: Most coating irregularities, or the potential to develop them, are inherent to the unexpanded DES. Important determinants of the formation of coating irregularities may be the stent geometry and the physical properties of the coating, while stent‐balloon interaction plays no major role. © 2011 Wiley Periodicals, Inc.