共查询到20条相似文献,搜索用时 15 毫秒
1.
Jorge A. Belardi MD FACC FSCAI Mariano Albertal MD PhD FACC 《Catheterization and cardiovascular interventions》2017,89(1):24-25
- Unprotected distal left main (ULM) lesions often require double‐stenting.
- In the MITO Registry, a mini‐crush stenting technique was safer than culotte stenting.
- Performing mini‐crush arises as the best approach in patients with distal ULM lesions requiring elective double‐stenting.
2.
Leonardo De Luca MD PhD FACC Luca Altamura MD Pierfrancesco Corvo MD Giovanni De Persio MD Anna S. Ghini MD Alessandro Petrolini MD Cristina Aurigemma MD Fabrizio Tomai MD FACC FESC 《Catheterization and cardiovascular interventions》2011,77(6):765-772
Percutaneous coronary intervention (PCI) on distal left main (LM) remains an independent predictor of poor outcome. The strategy of implanting one stent on the main branch (MB), with provisional stenting on the side‐branch (SB) only when required (provisional T‐stenting), has become the default approach to most bifurcation lesions. This prospective registry sought to investigate the long‐term safety and efficacy of provisional SB T‐stenting for the treatment of unprotected distal LM disease in patients undergoing PCI. From January 2006 to May 2009, 107 consecutive patients affected by unprotected distal LM disease underwent PCI at our center with the intent to use a provisional SB‐stenting technique. We evaluated the rate of major adverse cardiac events (MACE) at long‐term follow‐up (up to 12–41 months). Procedural success was obtained in 98% of patients. A final kissing balloon inflation was performed in 95% and intravascular ultrasound in 83% of patients. Additional stenting on the SB after provisional stenting on MB was required in 29% of lesions. Long‐term follow‐up (3.5 years; 25–75th percentile and 1.1–4.5 years) was completed in 97% of patients. The cumulative incidence of MACE was 32.7%: all‐cause death was 15.8%, nonfatal myocardial infarction 8.4%, and target vessel revascularization 21.5%. At multivariable analysis, age (hazard ratio, 2.08; 95% confidence interval: 2.01–3.32, P = 0.03), European System for Cardiac Operative Risk Evaluation (HR 1.20, 95% CI: 1.04–1.33, P = 0.02), and diabetes mellitus (HR 3.48, 95% CI: 1.12–6.87, P = 0.01) were identified as independent predictors of MACE. In patients with unprotected distal LM disease undergoing PCI, a provisional strategy of stenting the MB only is associated with good long‐term clinical outcomes. © 2011 Wiley‐Liss, Inc. 相似文献
3.
4.
Darren Mylotte MRCPI MD Helen Routledge MRCP MD Talal Harb MD Philippe Garot MD FESC Thomas Hovasse MD Hakim Benamer MD Thierry Unterseeh MD Bernard Chevalier MD Marie‐Claude Morice MD FACC FESC Yves Louvard MD FSCAI Thierry Lefèvre MD FESC FSCAI 《Catheterization and cardiovascular interventions》2013,82(4):E437-E445
5.
Technique of left main stenting is dependent on lesion location and distal branch protection. 总被引:2,自引:0,他引:2
Frances Wood Elizabeth Bazemore Joel E Schneider R Lee Jobe Tift Mann 《Catheterization and cardiovascular interventions》2005,65(4):499-503
The purpose of this study was to review our experience with left main stenting and evaluate initial results with drug-eluting stents (DESs). Drug-eluting stents delivered with contemporary techniques could change the traditional surgical approach to patients with significant left main disease. One hundred sixty-one patients underwent left main stenting (100 bare metal, 61 drug-eluting) after being excluded from surgery. In group A, disease was confined to the ostium or main stem; in group B, disease involved the bifurcation. Patients were classified as either unprotected (U) or protected (P) depending on the presence of a patent bypass graft. Study endpoints were any major adverse cardiac event (MACE). In-hospital MACE was 6% with no deaths; 74% of patients in group A underwent direct stenting, whereas 89% of the patients in group B had predilatation performed prior to stent implantation. A total of 98% of patients in BU had kissing balloon inflations after stent deployment; provisional side-branch stenting was required in one patient. V-stenting was performed in 13% of patients in group BU. The 1-year mortality in the bare metal stent group was 9% with the majority of deaths in group BU. There was one noncardiac death in the DES group at 6 months and five patients (8.2%) underwent target vessel revascularization for restenosis. Event-free survival at 6 months in group BU treated with DESs was 87%. Significant left main disease presents a spectrum of angiographic abnormalities and different interventional techniques are required depending on lesion location and distal protection. Although in-hospital complications with left main stenting were low in this single-center study, follow-up events were common in patients treated with bare metal stents. A randomized multicenter trial will be required to determine whether drug-eluting stents will improve survival in patients with left main disease. 相似文献
6.
Ductal stenting using side‐branch cell dilation for aortic coarctation in high‐risk patients with hypoplastic left heart syndrome 下载免费PDF全文
Masataka Kitano MD Satoshi Yazaki MD Koji Kagisaki MD 《Catheterization and cardiovascular interventions》2016,87(1):E23-E29
For high‐risk neonates with hypoplastic left heart syndrome (HLHS) undergoing Norwood operation, the strategy of bilateral pulmonary artery banding and ductal stenting is risky in case of coarctation of the aorta (CoA), often resulting in death. Therefore, we devised a new method of ductal stenting with side‐branch cell dilation, which could overcome the constriction of the ductal arch with CoA in two HLHS patients. This is the first report that presents this method and the results. © 2015 Wiley Periodicals, Inc. 相似文献
7.
8.
9.
Functional and morphological assessment of side branch after left main coronary artery bifurcation stenting with cross‐over technique 下载免费PDF全文
Soo‐Jin Kang MD PhD Jung‐Min Ahn MD Won‐Jang Kim MD Jong‐Young Lee MD Duk‐Woo Park MD PhD Seung‐Whan Lee MD PhD Young‐Hak Kim MD PhD Cheol Whan Lee MD PhD Seong‐Wook Park MD PhD Seung‐Jung Park MD PhD 《Catheterization and cardiovascular interventions》2014,83(4):545-552
10.
11.
Kensuke Takagi MD Alfonso Ielasi MD Sandeep Basavarajaiah MD Alaide Chieffo MD Joanne Shannon MD Cosmo Godino MD Tasuku Hasegawa MD Toru Naganuma MD Yusuke Fujino MD Azeem Latib MD Mauro Carlino MD Matteo Montorfano MD Sunao Nakamura MD Antonio Colombo MD 《Catheterization and cardiovascular interventions》2014,84(3):341-348
12.
13.
14.
15.
16.
N.M. Van Mieghem P.P. de Jaegere 《Catheterization and cardiovascular interventions》2013,82(2):240-244
Transcatheter aortic valve implantation (TAVI) implies the introduction, positioning, and deployment of a stented bioprosthesis in the (calcified) native aortic valve. We report an at first glance uneventful TAVI with the Medtronic Corevalve System, which was followed by transient electrocardiographic changes suggesting acute left main stem disease. The diagnosis of acute left main stem dissection extending from the left coronary cusp was firmly established by intravascular ultrasound. The ostium of the left main stem was successfully treated with intravascular ultrasound‐guided placement of a drug eluting stent.© 2013 Wiley Periodicals, Inc. 相似文献
17.
18.
Francesco Burzotta MD PhD Carlo Trani MD Daniel Todaro MD Gaetano Antonio Lanza MD Luca Mariani MD Antonella Tommasino MD Giampaolo Niccoli MD PhD Italo Porto MD PhD Antonio Maria Leone MD PhD Filippo Crea MD 《Catheterization and cardiovascular interventions》2012,79(3):351-359
Objectives : To prospectively assess the impact of post‐procedural side‐branch (SB) stenosis on inducible myocardial ischemia in patients with bifurcated lesions undergoing percutaneous interventions. Background : Provisional‐stenting with drug‐eluting stents (DES) is the recommended strategy to treat percutaneously bifurcated lesions but is associated to variable degrees of residual SB stenosis. The role of SB residual stenosis on post‐procedural myocardial ischemia is uncertain. Methods : Patients with bifurcations treated by DES according to provisional‐stenting technique were enrolled in the study if they had no other untreated lesion. Patients were divided into two groups according to post‐procedural 3D‐quantitative coronary analysis (3DQCA): group OR (optimal result: stenosis < 50% of SB lumen area at 3DQCA) and group SR, suboptimal result: (stenosis ≥ 50% of SB lumen area at 3DQCA). Treadmill exercise stress test (EST) was performed within 1 week from PCI. The primary study endpoint was myocardial ischemia (≥1 mm ST‐segment depression at EST). Results : Sixty patients were enrolled: 49 (81.7%) comprised group OR and 11 (18.3%) group SR. Post‐PCI myocardial ischemia at EST was inducible in 17 (34.7%) patients of group OR versus 10 (90.9%) patients of group SR (P = 0.0007). During the follow‐up, patients of Group SR (vs. Group OR) had a significantly higher occurrence of inducible myocardial ischemia during late (>8 weeks) stress tests (P < 0.001). Conclusions : In patients with bifurcated lesions treated by a provisional‐stenting technique, residual SB stenosis ≥ 50% at 3DQCA is associated with post‐procedural inducible myocardial ischemia at EST. © 2011 Wiley Periodicals, Inc. 相似文献
19.
20.
Objectives: To verify in a clinical scenario a theory for predicting side branch (SB) stenosis after main vessel stent implantation in coronary bifurcation lesions. Background: Many unresolved issues remain regarding SB compromise when the parent vessel is stented. Methods: Bifurcation lesions (all Medina types) were subjected to angiographic analysis to determine the angle, defined as α, between the axes of the parent vessel and the SB. Using the prediction that the percent diameter stenosis (%DS) is equal to the cosine of angle α and relating it to a formula to determine the minimal lumen diameter (MLD) led to the following equation: MLD = ds · (1 –cos α); ds refers to the diameter of the SB. The predicted and observed SB stenosis values following angiography were compared. Results: Fifty‐two patients with 57 lesions were included in the analysis. Patient demographics and characteristics were similar to those in previous studies. There was a high coefficient of determination between the predicted and observed values of %DS (r2= 0.82, P < 0.001) and MLD (r2= 0.86, P < 0.001). We determined a cutoff value of 70% for predicted %DS for SB closure. When using multivariate regression analysis, the only predictor of SB ostial stenosis after stenting was α angle, whereas the predictors of MLD included the angle α and the RVD of the SB. Conclusions: Our analysis shows that the most powerful independent predictor of SB compromise is a new variable angle α. 相似文献