bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful recanalization of a chronic occluded left anterior descending coronary artery with a modification of the retrograde proximal true lumen puncture technique: The antegrade microcatheter probing technique
Authors: Christ Günter , Glogar Dietmar 
Published: October 2008

AbstractChronic total occlusions (CTO) still remain one of the most technically challenging fields in interventional cardiology. Here we report a case of successful retrograde recanalization of an occluded proximal left anterior descending coronary artery with a modification of the “retrograde proximal true lumen puncture” technique. By combining this strategy with a novel antegrade guide wire access through a microcatheter which was placed into the antegrade guiding catheter with the “reverse anchoring balloon” technique (the “antegrade microcatheter probing” technique), the need for retrograde CTO lesion dilatations has been eliminated, making the procedure easier and faster. This modified retrograde approach might provide a feasible and safe technique for antegrade guide wire access during retrograde CTO recanalization. © 2009 Wiley‐Liss, Inc.
Catheter closure of atrial septal defects with deficient inferior vena cava rim under transesophageal echo guidance
Authors: Remadevi K.S. , Francis Edwin , Kumar Raman Krishna 
Published: October 2008

AbstractObjectives: To describe the case selection, imaging considerations, technique, and results of catheter closure of atrial septal defects (ASD) with deficient inferior vena cava (IVC) rim. Background: Transcatheter closure with Amplatzer septal occluder (ASO) has become standard treatment for most secundum ASDs. Defects with deficient IVC rim continue to be challenging to image and close in the catheterization laboratory. Methods: Records of 12 patients with deficient IVC rim (<5 mm), who underwent catheter closure (April 2007 to June 2008) were reviewed. General anesthesia and transesophageal echo (TEE) guidance was used in all. The IVC rim was imaged at 70°–90° with retroflexion of the TEE probe, in addition to the conventional views. Devices 1–4 mm > maximal ASD size were selected. Deployment was accomplished either from the left atrium, left upper or from the right pulmonary veins. Results: The median age was 5.5 (2.5–27) years and median weight was 19.5 (9‐65) kg. The defects measured 16–32 mm and 18–36 mm septal occluders were used. The median fluoroscopic time was 13.1 (4.2–32.7) min. Initial device selection was revised in four patients. Two patients had residual flows at IVC margin. The device embolized to right ventricular outflow tract in one patient. This was retrieved, and a larger device was deployed. No other complications were observed immediately or on follow‐up (median 6; range 1–14 months). Conclusions: Transcatheter closure of ASDs with deficient IVC rim is feasible under TEE guidance. The modified retroflexed view allows adequate imaging of IVC rim through TEE. © 2008 Wiley‐Liss, Inc.
Early and long‐term results of percutaneous coronary intervention for unprotected left main trifurcation disease
Authors: Sheiban Imad , Gerasimou Argyrios , Bollati Mario , Biondi‐Zoccai Giuseppe , Sciuto Filippo , Omedé Pierluigi , Sillano Dario , Trevi Gian Paolo , Moretti Claudio 
Published: October 2008

AbstractObjectives: We aimed to conduct a retrospective cohort study focusing on our 5‐year experience in the percutaneous treatment of unprotected left main (ULM) trifurcation disease. Background: Percutaneous treatment of ULM trifurcation remains a challenging and rare procedure for most interventional cardiologists. Moreover, data on long‐term outcomes are lacking. Methods: We retrieved all patients with ULM trifurcation disease treated percutaneously at our Institution since 2002, and adjudicated baseline, procedural, and outcome data. The primary end point was the long‐term rate of major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, bypass surgery, or target vessel revascularization). Results: A total of 27 patients underwent percutaneous coronary intervention with stent implantation for ULM trifurcation disease, with 14 (52%) cases of true trifurcations, i.e., with concomitant significant stenoses of the distal ULM/ostial left anterior descending plus ostial ramus intermedius and ostial circumflex. Bare‐metal stents were implanted in 8 (29%) patients and drug‐eluting stents (DES) in 26 (96%), with a main branch stent only strategy in 11 (40%), T stenting in 9 (33%), and V stenting in 6 (27%). Procedural and clinical success occurred in 26 (96%), with one postprocedural death. Angiographic follow‐up was obtained in 22 patients (81%), and clinical follow‐up was completed in all subjects after a median of 28 ± 17 months, showing overall MACE in 9 (33%), with cardiac death in 4 (15%), myocardial infarction in 1 (4%), coronary artery bypass grafting (CABG) in 4 (15%), and percutaneous target vessel revascularization in 5 (19%). Definite stent thrombosis was adjudicated in 1 (3%) patient. Treatment of a true trifurcation lesion and recurrence of angina during follow‐up were significantly associated with an increased risk of MACE (P = 0.029 and P = 0.050, respectively). Conclusions: Percutaneous treatment of ULM trifurcation disease is feasible, associated with favorable mid‐term results, and may be considered given its low invasiveness in patients at high surgical risk or with multiple comorbidities. © 2008 Wiley‐Liss, Inc.
Analysis of left main coronary artery bifurcation lesions treated with biolimus‐eluting DEVAX AXXESS plus nitinol self‐expanding stent: Intravascular ultrasound results of the AXXENT trial
Authors: Hasegawa Takao , Ako Junya , Koo Bon‐Kwon , Miyazawa Akiyoshi , Sakurai Ryota , Chang Hyeonsoo , Dens Joseph , Verheye Stefan , Grube Eberhard , Honda Yasuhiro , Fitzgerald Peter J. 
Published: October 2008

AbstractObjective: To assess the efficacy of the AXXESS stent on the treatment of left main coronary artery (LMCA) bifurcation lesions using IVUS. Background: The treatment of LMCA bifurcation lesions remains challenging even with the use of drug‐eluting stents. The AXXESS system is a biolimus A9‐eluting self‐expanding stent, dedicated to the treatment of bifurcation lesions. Methods: Data were obtained from the AXXENT trial, a prospective, single‐arm, multicenter study designed to evaluate the efficacy of the AXXESS stent on the treatment of LMCA bifurcation lesions. IVUS was available in 26 cases at 6‐months follow‐up. Volumetric and cross‐sectional analyses within the AXXESS stent, and cross‐sectional analyses at the ostia of left anterior descending (LAD) and left circumflex coronary arteries (LCX) were performed. Results: Within the AXXESS stent, percent neointimal volume obstruction was (3.0 ± 4.1)% with a minimal lumen area of 10.3 ± 2.6 mm2. AXXESS stent volume showed an 12.4% increase at follow‐up compared with postprocedure (P = 0.04). Lumen area was significantly smaller in the LCX ostium compared with the LAD ostium at follow‐up (3.6 ± 1.3 mm2 vs. 5.5 ± 2.0 mm2, P = 0.0112). There was greater neointimal formation in the LCX ostium compared with the LAD ostium (1.37 ± 1.20 mm2 vs. 0.30 ± 0.36 mm2, P = 0.0003). Conclusions: The AXXESS stent in the LMCA showed enlargement through 6‐months follow‐up and significant neointimal suppression. Greater neointimal formation and relatively inadequate stent expansion may contribute to luminal narrowing in the LCX ostium. © 2008 Wiley‐Liss, Inc.
The pharmacokinetics of Biolimus A9 after elution from the Nobori stent in patients with coronary artery disease: The NOBORI PK study
Authors: Ostojic Miodrag , Sagic Dragan , Jung Robert , Zhang Yan‐Ling , Nedeljkovic Milan , Mangovski Ljupco , Stojkovic Sinisa , Debeljacki Dragan , Colic Mirko , Beleslin Branko , Milosavljevic Bratislav , Orlic Dejan , Topic Dragan , Karanovic Nevena , Paunovic Dragica , Christians Uwe ,   on behalf of NOBORI PK Investigators
Published: October 2008

AbstractObjectives:The aim of this study was to assess the pharmacokinetics and tolerability of Biolimus A9 eluted from Nobori coronary stents.Background:The release kinetics and pharmacokinetics of drugs delivered via coronary stents have been shown to play an essential role in the efficacy and safety of drug eluting stents.Methods:Twenty patients with coronary artery disease were treated with single 14‐mm (10 patients) or 28‐mm long stent (10 patients). Blood samples were drawn at 16 time points to determine the pharmacokinetics of Biolimus A9. At seven time points, complete laboratory and toxicology panels were assessed to screen for potential Biolimus A9 toxicity. The primary endpoint of the study was the systemic blood concentrations of Biolimus A9 after 28 days and 6 months as measured using highly specific and sensitive liquid chromatography‐ tandem mass spectrometry assay.Results:At 28 days, 6 patients (30%) had quantifiable Biolimus A9 concentrations in blood. The highest Biolimus A9 blood concentration measured in any sample was 32.2 pg/mL. The median time to maximum concentration was 2 hr, ranging from 0.05 hr to 3 months. Six months after stent implantation, only 1 of 20 patients had measurable Biolimus A9 concentrations at the lowest level of quantification, while at 9 months no sample had quantifiable Biolimus A9 concentrations. Laboratory and toxicology assessments did not indicate any impact of Biolimus A9 on the evaluated parameters.Conclusion:Results of this study suggest that systemic exposure to Biolimus A9 was very low and that Biolimus A9 was well tolerated. © 2008 Wiley‐Liss, Inc.
Intracoronary delivery of mesenchymal stem cells at high flow rates after myocardial infarction improves distal coronary blood flow and decreases mortality in pigs
Authors: Llano Raul , Epstein Samuel , Zhou Rong , Zhang Hualei , Hamamdzic Damir , Keane Martin G. , Freyman Toby , Wilensky Robert L. 
Published: October 2008

AbstractObjectives: Evaluate the effects of pressure and duration of intracoronary (IC) infusion of mesenchymal stem cells (MSCs) on delivery efficiency and safety after myocardial infarction (MI). Background: Standard IC delivery of MSCs can lead to intravascular plugging and reduced coronary blood flow. The optimal delivery pressure and duration is unknown. Methods: Immediately after MI pigs were randomized to 1 of 3 delivery protocols of 5 × 107 iron‐fluorescent microspheres labeled MSCs, control received 2 ml infusions at 1 ml/min (five times), very high flow rate (VHFR) a single 10 ml infusion at 60 ml/min and the high flow rate (HFR) group a single 10 ml infusion at 20 ml/min. TIMI grade flow was assessed throughout the procedure and at sacrifice (day 14). MSCs distribution was analyzed in isolated hearts by 4.7T MRI. Delivery efficiency was quantified via fluorescent microsphere recovery using a magnetic separation technique and by light microscopy. Results: TIMI grade flow did not change following MI (all groups TIMI 3). However, following MSCs delivery only 18% (2/11) of control animals had TIMI 3 blood flow vs. 56% (5/9) in VHFR and 67% (4/6) in HFR (P = 0.03). As a consequence, 63% of control animals died within 24 hr, 33% in VHFR and none in HFR (P = 0.02). MSCs delivery in the infarct tissue did not differ between the groups (P = 0.06). Conclusions: A single MSCs infusion at 20 ml/min resulted in improved coronary blood flow and decreased mortality, without sacrificing delivery efficiency. © 2008 Wiley‐Liss, Inc.
Assessment with optical coherence tomography of a new strategy for bifurcational lesion treatment: The Tryton Side‐Branch Stent
Authors: Ferrante Giuseppe , Kaplan Aaron V. , Di Mario Carlo 
Published: October 2008

AbstractThe Tryton‐Side Branch Stent™ (Tryton Medical, Inc., Newton, MA, USA) is a dedicated stent designed to provide complete carinal coverage of bifurcational lesions. After implantation of a 18 mm cobalt chromium Tryton stent from the left circumflex into the obtuse marginal branch, recrossing with an everolimus eluting Promus stent and final kissing balloon dilatation, optical coherence tomography (OCT) (LightLab Imaging Inc., Westford, MA, USA) was performed with a non‐occlusive technique with motorized pullback (3 mm/s) during continuous pump injection of iso‐osmolar contrast, in both LCx and OM1. OCT imaging showed good strut apposition at the level of the carina, with full coverage and no stent protrusion at the ostium of the side branch. Few malapposed struts were present in the proximal main vessel in the segment of stent superimposition, with a maximal separation from to the vessel wall of 160 μm. The implantation of the Tryton‐Side Branch Stent™ allowed full coverage of the side branch ostium with uniform apposition of the stent struts at the level of the carina assessed by OCT. © 2008 Wiley‐Liss, Inc.
Percutaneous endovascular treatment for isolated spontaneous superior mesenteric artery dissection: Report of two cases and literature review
Authors: Wu Xue‐Ming , Wang Tzung‐Dau , Chen Ming‐Fong 
Published: October 2008

AbstractIsolated spontaneous superior mesenteric artery (SMA) dissection is a rare and sporadically reported condition. Therapeutic options include medical treatment, surgery, and endovascular treatment. However, the optimal treatment strategy has still not been established. We herein present two patients with acute abdomen due to isolated spontaneous SMA dissection, in whom symptoms remained despite initial anticoagulation therapy. Percutaneous endovascular treatment with stenting of the dissected main trunk to achieve complete coverage of the entry site and balloon angioplasty for the distally involved side branches were performed successfully and resulted in complete resolution of the symptoms. According to our experience and previous case reports, early (within 1 week) elective percutaneous endovascular intervention with background anticoagulation therapy is a feasible and effective treatment strategy for symptomatic patients with isolated SMA dissection. © 2009 Wiley‐Liss, Inc.
Percutaneous management of acutely thrombosed hemodialysis grafts: The double balloon occlusion technique
Authors: Lai Chi‐Cheng , Kang Pei‐Leun , Tsai Han‐Lin , Mar Guang‐Yuan , Liu Chun‐Peng 
Published: October 2008

AbstractObjectives: The aim of this article is to introduce a new technique, named the “double balloon occlusion technique” (DBOT), for the salvage of acutely thrombosed grafts and to demonstrate its safety and efficacy. Background: Acute thrombosis is recognized as the most common factor of acute graft failures. A suitably percutaneous technique should be devised to remove thrombi safely and effectively. Care should also be taken to prevent possible thromboembolic complications during procedures. Mainly composed of two balloons, the percutaneous DBOT has been developed to meet the clinical needs. Methods: Thirty‐two patients with graft failures undergoing the DBOT were recruited between May 2007 and May 2008. The DBOT is itemized in the text and a practical case undergoing successful DBOT is also demonstrated. Results: Of the 32 DBOT treatments, the procedural success rate was 100% (32/32). The clinical success rate was 94% (30/32). One complicated case with severe hematoma resulting from a balloon‐induced graft rupture received surgery, although the graft outflow restored. The mean procedure time was 92 minutes. Three patients died and two patients were lost within the 3‐month follow‐up. The 3‐month graft patency rate was 70% (19/27). Conclusion: The DBOT has the potential to be operated safely and effectively. Preliminary results had high success rates and patency rates. With basic devices, it may serve as an option to rescue thrombosed grafts. More data are needed to identify its clinical role. © 2008 Wiley‐Liss, Inc.
Transcatheter closure of patent foramen ovale with radiofrequency: Acute and intermediate term results in 144 patients
Authors: Sievert Horst , Ruygrok Peter , Salkeld Matt , Baumgartner Helmut , Meier Bernhard , Windecker Stephan , Juliard Jean‐Michel , Aubry Pierre , Tiefenbacher Christiane , Krumsdorf Ulrike , Vermeersch Paul , Ewert Peter , Piéchaud Jean François 
Published: October 2008

AbstractAims:Currently available devices for transcatheter closure of patent foramen ovale (PFO) which rely on a permanent implant have limitations, including late complications. The study objective was to evaluate the safety, feasibility, and effectiveness of the PFx™ Closure System, the first transcatheter technique for PFO closure without an implantable device.Methods and Results:A prospective study of 144 patients was conducted at nine clinical sites from October 2005 through August 2007. All patients had a history of cryptogenic stroke, transient ischemic attack, migraines, or decompression illness. The mean balloon stretched diameter of the PFO was 7.9 ± 2.5 mm. Technical success (successful application of radiofrequency energy) was achieved in 130 patients. One patient required a transfusion as a result of blood loss during the procedure. There were no other major procedural complications. There were no recurrent strokes, deaths, conduction abnormalities, or perforations following the procedure. At a mean follow‐up of 6 months, successful closure was achieved in 79 patients (55%). In PFOs with balloon sized or stretched diameters less than 8 mm, the closure rate was 72% (53/74).Conclusion:This study demonstrates that transcatheter closure of a PFO without a permanent implant is technically feasible and safe. Further technique and device modifications are required to achieve higher closure rates. © 2009 Wiley‐Liss, Inc.
Quantitative angiographic methods for bifurcation lesions : A consensus statement from the European Bifurcation Group
Authors: Lansky Alexandra , Tuinenburg Joan , Costa Marco , Maeng Micheal , Koning Gerhard , Popma Jeffrey , Cristea Ecatarina , Gavit Laurence , Costa Ricardo , Rares Andrei , Van Es Gerritt‐Ann , Lefevre Thierry , Reiber Hans , Louvard Yves , Morice Marie‐Claude 
Published: October 2008

AbstractThe treatment of bifurcation lesions is complex and increasingly common. A growing number of dedicated bifurcation devices are under clinical evaluation, but no standardized methodology exists. Specifically, the angiographic analysis of bifurcation lesions is not standardized and current QCA packages are not designed for bifurcation lesions. This consensus statement outlines the limitations of conventional QCA in the bifurcation application, and outlines a new standard approach for the analysis and reporting of the angiographic results of the bifurcation lesion allowing for future trial and device comparisons and mechanistic insight into location and modes of treatment failure. © 2008 Wiley‐Liss, Inc.
Step‐by‐step StentBoost‐guided small vessel stenting using the self‐expandable sparrow stent‐in‐wire
Authors: Agostoni Pierfrancesco , Verheye Stefan 
Published: October 2008

AbstractA 56 year‐old woman underwent percutaneous coronary intervention for a lesion in a small mid‐left anterior descending coronary artery (reference vessel diameter by quantitative coronary angiography: 2.11 mm) with a novel drug‐eluting stent specifically designed for small vessels, the CardioMind Sparrow stent delivery system. This is a self‐expandable sirolimus‐eluting nitinol stent directly mounted into a 0.014‐inch coronary guidewire. The stent has a very thin strut thickness (67 micron), limiting its radiopacity. A specific X‐ray stent‐enhancing visualization technique, “StentBoost”, allowed clear visualization and understanding of the steps needed for an appropriate release and deployment of the aforementioned stent. © 2008 Wiley‐Liss, Inc.
Collagen embolization for the successful treatment of a distal coronary artery perforation
Authors: Aleong Godfrey , Jimenez‐Quevedo Pilar , Alfonso Fernando 
Published: October 2008

AbstractA 42‐year old man suffered a coronary artery perforation in the right coronary artery secondary to a hydrophilic guidewire. We describe for the first time the use of collagen embolization to successfully treat this complication © 2009 Wiley‐Liss, Inc.
Multiple coronary artery fistulae treated with a single Amplatzer vascular plug: Check the back door when the front is locked
Authors: Brown Michael A. , Balzer David , Lasala John 
Published: October 2008

AbstractCongenital coronary artery fistulae are rare anomalies, which can result in myocardial ischemia or infarction, congestive heart failure, fistula rupture, or death. In this report, the authors describe a 56‐year‐old woman with new onset chest pain and palpitations. Exercise myocardial perfusion imaging was significant for a reversible perfusion defect in the anterior left ventricular wall. Left and right heart catheterization demonstrated multiple fistulous communications between the right coronary and left anterior descending coronary arteries with the pulmonary artery. All fistulae drained into the pulmonary artery by a common ampulla. Closure was achieved via a percutaneous approach using a single Amplatzer vascular plug. © 2009 Wiley‐Liss, Inc.
Transcatheter closure of atrial septal defect in elderly patients with permanent atrial fibrillation
Authors: Taniguchi Manabu , Akagi Teiji , Ohtsuki Shinichi , Okamoto Yoshio , Tanabe Yasuharu , Watanabe Nobuhisa , Nakagawa Koji , Toh Norihisa , Kusano Kengo , Sano Shunji 
Published: October 2008

AbstractObjectives:The aim of this study is to evaluate the feasibility and efficacy of device closure of atrial septal defect (ASD) in elderly patients with permanent atrial fibrillation.Background:Little is known about the feasibility of device closure of ASD in those patients.Methods:Nine consecutive patients (mean age 68.1 years) with permanent atrial fibrillation (>1 year persistent) underwent catheter closure using the Amplatzer septal occluder. Transthoracic echocardiography and plasma B‐type natriuretic peptide (BNP) level were assessed before and at 24 hours; and 1, 3, and >6 months after the closure. Before the procedure, appropriate dose of warfarin was used in all, diuretics was used in 8/9. Same amount of medications were continued after the procedure.Results:ASD could be closed in all (mean device size 27.3 mm) without hemodynamic and thromboembolic complications. New York Heart Association (NYHA) functional classification was significantly improved in all patients after device closure. No hemodynamic and thromboembolic complications were observed during the follow‐up period (mean 10.6 months). Although permanent atrial fibrillation did not change in all after the procedure, resting heart rate decreased from 76.2 ± 16.0 to 68.3 ± 13.2 beats/min (P = 0.015). There was statistically significant improvement in right ventricular/left ventricular diameter ratio (1.08 ± 0.16 to 0.73 ± 0.10, P = 0.008) and plasma BNP level (183.7 ± 90.5 to 94.6 ± 47.4 pg/mL, P = 0.008) after >6 months device closure.Conclusions:Even in the patients complicated with permanent fibrillation, transcatheter closure of ASD can contribute to symptomatic improvement as well as cardiac geometric remodeling. © 2009 Wiley‐Liss, Inc.