TY - JOUR. T1 - Impact of the Extent of Coronary Artery Disease on Outcomes After Revascularization for Unprotected Left Main Coronary Artery Stenosis. AU - Kim, Young Hak. AU - Park, Duk Woo. AU - Kim, Won Jang. AU - Lee, Jong Young. AU - Yun, Sung Cheol. AU - Kang, Soo Jin. AU - Lee, Seung Whan. AU - Lee, Cheol Whan. AU - Hong, Myeong Ki. AU - Park, Seong Wook. AU - Park, Seung Jung. PY - 2010/6/8. Y1 - 2010/6/8. N2 - Objectives: This study was designed to examine the impact of the extent of coronary disease on long-term outcomes after coronary stenting or coronary artery bypass graft (CABG) surgery for unprotected left main coronary artery (ULMCA) stenosis. Background: The differential outcome of ULMCA revascularization according to the coronary involvement remains uncertain. Methods: From the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty versus Surgical Revascularization) registry, 2,240 patients with ULMCA ...
In the United States, ULMCA PCI is performed primarily in patients with a high burden of comorbidities and frequently in those with high-urgency clinical presentations. In this population, in-hospital mortality was substantially higher in those with ULMCA disease who were treated percutaneously; however, this early risk is driven by those with high-urgency, rather than lower-urgency, presentations.. Among ULMCA patients selected for PCI in the United States, 30-month mortality is high (42.7%), with a predominance of cardiovascular events. These findings are especially notable when compared to the 10% mortality reported at 30 months in the MAIN-COMPARE (Korean Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) study (11), and the 4% mortality reported at 1 year in the SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial (12). The increased patient age, burden of comorbidities, and ...
The long-term safety and efficacy of drug-eluting stent (DES) implantation in the treatment of unprotected left main coronary artery (LMCA) stenosis is still a matter of debate. All consecutive patients (pts) who had sirolimus (SES, Cypher, Cordis, Johnson and Johnson Company, Warren, NJ) or paclitaxel-eluting stent (PES, Taxus, Boston Scientific, Natick, MA) electively implanted in de novo lesions on LMCA between March 2002 and July 2006 were analyzed. A total of 267 patients were treated: 107 with PES and 160 with SES. Sixty-four (23.4%) patients were diabetics, 95 (35.6%) had unstable angina, mean age was 64.5±11.6 years and LVEF 52.2±10.7 %. High mortality risk scores (Euroscore ,6) were present in 84 (31.5%) of the patients. Glycoprotein IIb/IIIa inhibitors were used in 50 (18.7%) patients, 80 (29.9%) underwent intravascular ultrasound. Distal left main lesions were present in 223 (83.5%) of the patients: 209 bifurcations and 14 trifurcations. Both branches were stented in 108 (48.4%) ...
TY - JOUR. T1 - Current management of unprotected left main coronary artery disease. T2 - Run-in survey of the RITMO (Registro Italiano sul Trattamento del tronco coMune non protettO) study. AU - Sheiban, Imad. AU - Sillano, Dario. AU - Biondi-Zoccai, Giuseppe G L. AU - De Servi, Stefano. AU - Tamburino, Corrado. AU - Marzocchi, Antonio. AU - Trevi, Gian Paolo. AU - Moretti, Claudio. PY - 2009/9. Y1 - 2009/9. N2 - The optimal approach for a significant unprotected left main coronary stenosis (ULM) is debated, in light of the recent progresses of percutaneous coronary intervention (PCI). However, coronary artery bypass grafting (CABG) is still considered the first choice treatment. Randomized trials comparing PCI and CABG are ongoing, yet patient selection will considerably limit their clinical applicability. We thus designed a prospective multicenter registry which will include patients with ULM disease independently from the subsequent medical, interventional or surgical treatment: the RITMO ...
Allograft vasculopathy is the leading cause of death and morbidity after the first year of transplantation. Its prevalence is high: 11%, 22%, and 45% at one, two, and four years after transplantation, respectively.13,14 The accelerated coronary artery disease involves both the epicardial and the intramyocardial arteries. Its diagnosis is difficult because of the absence of angina in the denervated heart and the low sensitivity of non-invasive stress testing.15 The first manifestation of allograft vasculopathy is often congestive heart failure, ventricular arrhythmias, or sudden death.16 The ineffective medical treatment and the limited suitability of CABG and retransplantation have motivated interest in PCI for the subset of heart transplant recipients presenting with allograft vasculopathy in proximal segments. Schnetzler and colleagues17 reported 94.3% primary success (, 50% residual stenosis) in 53 lesions. Two of these patients had symptomatic left main stenosis, which were dilated with ...
Definition of Left main coronary artery in the Legal Dictionary - by Free online English dictionary and encyclopedia. What is Left main coronary artery? Meaning of Left main coronary artery as a legal term. What does Left main coronary artery mean in law?
All the papers appraised note an association between this pattern and severe stenosis of the LMCA or 3-vessel disease. However, the evidence identified from nine cohort studies consistently shows that lone ST elevation in lead aVR has little diagnostic value for identifying patients with stenosis of the LMCA. Both sensitivity and specificity are suboptimal to guide clinical decision making. The evidence suggests that diagnostic performance may improve when there is accompanying diffuse ST depression. Kosuge et al 8 found that such changes have a specificity of 93% for LMCA stenosis or 3-vessel disease, although the positive predictive value in that sample was only 58%, which limits the value of the finding for ruling in LMCA stenosis. As such, taken alone this finding could not be used to guide the need for primary percutaneous coronary intervention, for example. However, as patients with LMCA stenosis are at particularly high risk, ST elevation in aVR may help to identify patients for early ...
Background and Purpose: Acute myocardial infarction(AMI) occurs in 1-2% of patients treated with carotid artery stenting(CAS), and is considered as one of the most serious perioperative complication. We assessed coronary artery stenosis in patients treated with CAS using coronary CTA or coronary angiography.. Methods: Consecutive sixty-two patients (47 men, mean age 73.4 years) treated with CAS were examined by coronary CTA or angiography within 3 months before CAS between January 2010 and August 2012. In patients suspected coronary artery stenosis by coronary CTA, coronary angiography was performed. Significantly coronary artery stenosis was defined as that greater than 75%.. Results: CAS was performed in 62 patients, and coronary artery was evaluated in 57 patients. Patients with allergic reaction for contrast agents, renal failure, and poor general condition were excluded from this study. Thirty-eight patients had significant coronary artery stenosis. Twenty-nine of them had any history of ...
Catheter intervention treatment is now widely accepted as a nonsurgical revascularization option for adult patients with coronary artery disease. However, the experiences in KD have been limited.7,10,11 In contrast to the success of PTCA for treatment of atheromatous coronary artery disease in the adult, it was reported10,11 that PTCA is not as effective in the dilatation of the severely calcified stenotic lesions in patients with KD via balloon angioplasty. In this study, we introduced the new device of PTCRA, which was effective in ablating stenotic vessel lesions with hard calcification in the children with coronary artery stenosis after KD. Although PTCA was effective in only one of our four patients, the other three required PTCRA to ablate the hardened stenotic coronary lesions.. The mechanism of coronary artery stenosis in KD is uncertain. One possibility is acute occlusion by massive thrombus formation in the coronary aneurysms, which occur mostly in acute or subacute stages of illness. ...
The use of percutaneous coronary intervention (PCI) for unprotected left main coronary artery stenosis is increasing but it remains unclear whether this approach is non-inferior to coronary artery bypass grafting (CABG). Both the Nordic-Baltic-British left main revascularisation study (NOBLE, n=1201) and Evaluation of an everolimus eluting stent versus coronary artery bypass surgery for effectiveness of left main revascularisation study (EXCEL, n=1905) randomised patients with severe left main coronary artery stenosis to PCI or CABG to address this question. Though similar, there are important differences in these studies design and results. Primary outcomes were defined as all cause death, stroke and non-procedural myocardial infarction (MI) in both trials with the addition of repeat revascularisation in NOBLE and post-procedural MI in EXCEL. Other study differences include intended duration of follow-up, non-inferiority margins, allowable coronary complexity, and stent type. The prevalence of ...
Video 297e-30 The bifurcation lesion in the left main coronary artery extending into the LCx and LAD ostia is treated using a "culotte" technique. First, a drug-eluting stent is placed in the left main coronary artery and into the proximal LCx. ...
CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): Abstract. Recently conducted clinical studies prove the utility of Coronary Computed Tomography Angiography (CCTA) as a viable alternative to invasive angiography for the detection of Coronary Artery Disease (CAD). This has lead to the development of several algorithms for automatic detection and grading of coronary stenoses. However, most of these methods focus on detecting calcified plaques only. A few methods that can also detect and grade non-calcified plaques require substantial user involvement. In this paper, we propose a fast and fully automatic system that is capable of detecting, grading and classifying coronary stenoses in CCTA caused by all types of plaques. We propose a four-step approach including a learning-based centerline verification step and a lumen crosssection estimation step using random regression forests. We show state-of-the-art performance of our method in experiments conducted on a set of 229 CCTA
Then we fast forward till September 15th 1977, when Dr A Greuntzig successfully dilated an LAD stenosis in a Swiss dentist. This further proved that the goal post has moved again. That it was safe ( with all the appropriate training and precautions ) to safely work within coronary arteries. This began the journey of "percutaneous coronary interventions ". One by one, the goal post moved. Initially, Dr Greuntzig only advocated angioplasty ( as the new procedure was initially called ) for single lesion CAD. Then with better equipment and devices we began to do two vessels and then three vessels disease, much to the chargrin of our cardiac surgeons. The goal post was moving and still is. Coronary interventionist, ably led by the Korean Dr SJ Park and the French, Dr Jean Marco and Fajadet, began to take on left main stem disease, initially in the protected left main ( left main disease with a good functioning bypass graft ), and later in unprotected left main stem disease ( isolated ) and gradually ...
Coronary artery disease had spread in a larger number among the people worldwide. According to statistics, about 50 percent of the patients suffered from left main coronary artery stenosis. Many of the people possess the risk of the heart failure due to blockage in vessels that mainly occurs at the left main coronary artery. This Read more ...
For patients suspected of having hemodynamically significant coronary stenosis, exercise computed tomography (CT) myocardial perfusion imaging is feasible and accurate.
Among the bifurcation type, bifurcation lesion without significant side branch stenosis (,50%) usually did not require side branch stenting, but owing to several putative mechanism including dissection, thrombosis formation, embolization of plaque debris, ostial compromise by displaced stent strut, and snow plow effect, the side branch might be compromised. In this situation, the strategy to achieve optimal results has not been reported. Recently, FFR study showed that most jailed side branch (vessel size ,2.0 mm. DS,50%) after main branch stenting did not have functional significance. We compared strategies with or without routine kissing balloon dilatation for less than 50% stenosis after simple DES crossing for bifurcation lesions (bifurcation type 1.1.0, 1.0.0, and 0.1.0 according to Medina classification) with serial change of FFR measurement ...
... is that situation in which a coronary artery got lessened and backed up in the company of materials like cholesterol or fat. Coronary artery
Watch this LIVE case if you want to learn more about left main PCI, unprotected left main angioplasty strategy and distal LM bifurcation stenting.A 64-year-old male with distal LM bifurcation, LAD and LCX diseases:Two-stent techniquesIVUS assessment
Teaching Files with CT Medical Imaging and case studies on Anatomical Regions including Adrenal, Colon, Cardiac, Stomach, Pediatric, Spleen, Vascular, Kidney, Small Bowel, Liver, Chest | CTisus
By and For the Interventional Cardiovascular community. Sharing knowledge, experience and practice in cardiovascular interventional medicine. ...
In Reply: Dr Dewey and colleagues asked about discrimination of ischemia by FFRCT vs CT. Discrimination was determined by area under the receiver operating char
Teaching Files with CT Medical Imaging and case studies on Anatomical Regions including Adrenal, Colon, Cardiac, Stomach, Pediatric, Spleen, Vascular, Kidney, Small Bowel, Liver, Chest | CTisus
Spheric, ovoid or irregular intraluminal filling defect or lucency surrounded on three sides by contrast medium seen just distal or within the coronary stenosis in multiple projections or a visible embolization of intraluminal material downstream ...
AUM Cardiovasculars CADence System for Coronary Artery Stenosis Testing http://www.medgadget.com/2015/01/aum-cardiovasculars-cadence-system-for-coronary-artery-stenosis-testing.html via @medgadget
This work demonstrates that the sequence of a Ge co-implant with a B,inf,2,/inf,H,inf,6,/inf, PLAD in the source/drain is very… Expand ...
TY - JOUR. T1 - Fractional Flow Reserve/Instantaneous Wave-Free Ratio Discordance in Angiographically Intermediate Coronary Stenoses An Analysis Using Doppler-Derived Coronary Flow Measurements. AU - Cook, Christopher M.. AU - Jeremias, Allen. AU - Petraco, Ricardo. AU - Sen, Sayan. AU - Nijjer, Sukhjinder. AU - Shun-Shin, Matthew J.. AU - Ahmad, Yousif. AU - de Waard, Guus. AU - van de Hoef, Tim. AU - Echavarria-Pinto, Mauro. AU - van Lavieren, Martijn. AU - Al Lamee, Rasha. AU - Kikuta, Yuetsu. AU - Shiono, Yasutsugu. AU - Buch, Ashesh. AU - Meuwissen, Martijn. AU - Danad, Ibrahim. AU - Knaapen, Paul. AU - Maehara, Akiko. AU - Koo, Bon-Kwon. AU - Mintz, Gary S.. AU - Escaned, Javier. AU - Stone, Gregg W.. AU - Francis, Darrel P.. AU - Mayet, Jamil. AU - Piek, Jan J.. AU - van Royen, Niels. AU - Davies, Justin E.. PY - 2017/12/26. Y1 - 2017/12/26. KW - CFR. KW - coronary flow reserve. KW - coronary physiology. KW - FFR. KW - fractional flow reserve. KW - iFR. KW - instantaneous wave-free ...
The main purpose of this study is to observe the incidence of major adverse cardiac and cerebrovascular events (MACCE), target vessel failure (TVF), target vessel revascularization (TVR) and stent thrombosis out to 5 years after the procedure in patients who underwent percutaneous coronary intervention (PCI) with everolimus-eluting stents for unprotected left main coronary artery (ULMCA) disease and lesions involving the ULMCA in Japan. The investigators will also establish a method of adjustment to the Japanese version of the SYNTAX score by conducting an assessment using the SYNTAX score recently reported in the US and Europe as well as the EuroSCORE, and by clarifying the differences of PCI procedures and treatment results in Japan with those reported in the US and Europe ...
Fractional flow reserve (FFR) is a well-validated tool for determining the functional significance of a coronary artery stenosis, facilitating clinical decisions regarding the need for revascularization. FFR-guided revascularization improves clinical and economic outcomes. However, its application remains challenging in certain complex anatomic subsets, including left main coronary artery stenosis, bifurcation disease, and saphenous vein graft disease. This article reviews recent data supporting the use of FFR in these complex anatomic subsets. [Rev Cardiovasc Med.
TY - JOUR. T1 - Performance of computed tomography-derived fractional flow reserve using reduced-order modelling and static computed tomography stress myocardial perfusion imaging for detection of haemodynamically significant coronary stenosis. AU - Ihdayhid, Abdul Rahman. AU - Sakaguchi, Takuya. AU - Linde, Jesper J.. AU - Sørgaard, Mathias H.. AU - Kofoed, Klaus F.. AU - Fujisawa, Yasuko. AU - Hislop-Jambrich, Jacqui. AU - Nerlekar, Nitesh. AU - Cameron, James D.. AU - Munnur, Ravi K.. AU - Crosset, Marcus. AU - Wong, Dennis T.L.. AU - Seneviratne, Sujith K.. AU - Ko, Brian S.. PY - 2018/11/1. Y1 - 2018/11/1. N2 - Aims: To compare the diagnostic performance of a reduced-order computed tomography-derived fractional flow reserve (CT-FFR) technique derived from luminal deformation and static CT stress myocardial perfusion (CTP).Methods and results: Forty-six patients (84 vessels) with suspected coronary artery disease from a single institution planned for elective coronary angiography ...
Fractional flow reserve (FFR) is a technique used in coronary catheterization to measure pressure differences across a coronary artery stenosis (narrowing, usually due to atherosclerosis) to determine the likelihood that the stenosis impedes oxygen delivery to the heart muscle (myocardial ischemia). FFR is a novel and potentially clinically useful mathematical solution for estimation of stenotic coronary artery atherosclerosis. Reliability/collaborative measurement between capable laboratories in measuring this essential metric appears muddled in a proprietary race to claim cardiac mathematics dedicated to risk in ischemic cardiac disease. Proprietary claims of cardiac mathematics have not been previously argued in patent law. Fractional flow reserve is defined as the pressure after (distal to) a stenosis relative to the pressure before the stenosis. The result is an absolute number; an FFR of 0.80 means that a given stenosis causes a 20% drop in blood pressure. In other words, FFR expresses the ...
Diabetes mellitus (DM), low ejection fraction (EF), and the extent of coronary artery disease (CAD) have all been identified as predictors of cardiovascular eve...
Methods and Results-Using intracoronary measurements, 91 coronaries (78 patients) with intermediate stenoses were classified in 4 FFR and coronary flow reserve (CFR) agreement groups, using FFR,0.80 and CFR,2 as cutoffs. Index of microcirculatory resistance (IMR) and atherosclerotic burden (Gensini score) were also assessed. MCD was assumed when IMR≥29.1 (75th percentile). Fifty-four (59.3%) vessels had normal FFR, from which only 20 (37%) presented both normal CFR and IMR. Among vessels with FFR,0.80, most (63%) presented disturbed hemodynamics: abnormal CFR in 28 (52%) and MCD in 18 (33%). Vessels with FFR,0.80 presented higher IMR [adjusted mean 27.6 (95% confidence interval, 23.4-31.8)] than those with FFR≤0.80 [17.3 (95% confidence interval, 13.0-21.7), p=0.001]. Atherosclerotic burden was inversely correlated with CFR (r=−0.207,P=0.055), and in vessels with FFR,0.80 and CFR,2 (n=28, 39%), IMR had a wide dispersion (7-72.7 U), suggesting a combination of diffuse atherosclerotic ...
OBJECTIVE To compare the consistency of angiography-guided and fractional flow reserve (FFR)-guided management strategy for intermediate coronary lesions. METHODS The patients whose coronary intermediate lesions were assessed by measuring FFR from November 2012 to August 2014. The stenosis percentage and value of FFR during the procedure were collected. All the image data were collected and four experienced interventional cardiologists were invited to assess the target lesions and make a management strategy independently. The consistency of angiography-guided and fractional flow reserve-guided management strategy were analyzed. RESULTS In the study, 151 patients were included, of whom, 70.2% were male, the average age was (62.7±9.6) years, 169 vessels were assessed by measuring FFR, 1 being left main, 116 left anterior descending, 27 left circumflex branch, and 25 right coronary artery. There were some correlationship between the stenosis percentage judged by four interventional cardiologists and
TY - JOUR. T1 - The long-term clinical outcome of T-stenting and small protrusion technique for coronary bifurcation lesions. AU - Naganuma, Toru. AU - Latib, Azeem. AU - Basavarajaiah, Sandeep. AU - Chieffo, Alaide. AU - Figini, Filippo. AU - Carlino, Mauro. AU - Montorfano, Matteo. AU - Godino, Cosmo. AU - Ferrarello, Santo. AU - Hasegawa, Tasuku. AU - Kawaguchi, Masanori. AU - Nakamura, Sunao. AU - Colombo, Antonio. PY - 2013/6. Y1 - 2013/6. N2 - Objectives This study sought to report long-term clinical outcomes in patients treated with the provisional T-stenting and small protrusion (TAP) technique. Background Several strategies have been proposed for treating bifurcation lesions, each with its own merits and technical challenges. The TAP technique is a relatively new strategy that is technically less challenging, ensures complete coverage of the side-branch ostium, and minimizes stent overlap. Although there is reasonable amount of data for other bifurcation strategies, the long-term ...
Second generation drug-eluting stents are safe and effective in treatment of left main coronary artery disease. A study found that second-generation drug-eluting stents are safe and effective in the treatment of left main coronary artery lesions. Results of the ISAR-LEFT MAIN 2 trial were presented at the 24th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the worlds premier educational meeting specializing in interventional cardiovascular medicine.. Patients undergoing invasive treatment of unprotected left main coronary artery (uLMCA) lesions are often considered at high-risk of adverse cardiovascular events. The use of first generation drug-eluting stents in these lesions has previously been shown to be feasible, safe, and effective. The second-generation zotarolimus-eluting (ZES) and everolimus-eluting stents (EES), used more widely in clinical practice at present, perform very similarly in ...
In the present study, we compared the prognostic impact of treatment strategy on clinical outcomes according to bifurcation lesion location (LM vs. non-LM bifurcation lesion) using data from a large, multicenter, dedicated bifurcation registry. The main findings of the present study are that compared with the 1-stent strategy, the 2-stent strategy was associated with higher risks of cardiovascular events in patients with LM bifurcation lesion, whereas this association was attenuated in those with non-LM bifurcation lesions, and that significant interactions were present between treatment strategy and bifurcation lesion location in the adjusted risks of target lesion failure, target lesion revascularization, and target vessel revascularization.. Coronary bifurcation lesions are complex, and their treatment continues to be the subject of substantial debate, even in the DES era (1,2). Previous randomized trials comparing the 1-stent strategy with the elective 2-stent strategy (mainly in patients ...
ST. PAUL, Minn.--(BUSINESS WIRE)--St. Jude Medical, Inc. (NYSE: STJ), a global medical device company, today announced its wireless PressureWire™ Aeris technology, which aids in the diagnosis and treatment of coronary artery blockages by measuring Fractional Flow Reserve (FFR), will now be available to hospitals using the Philips Xper Flex Cardio physiomonitoring system. Physicians will have greater access to the markets only wireless FFR measurement system through this new Philips agreement. FFR measurements indicate the severity of blood flow blockages in the coronary arteries, allowing physicians to better identify which specific lesion or lesions are responsible for a patients ischemia, a deficiency of blood supply to the heart caused by blood flow restriction. The PressureWire Aeris technology helps physicians determine the best treatment options for patients during coronary interventions, such as stent procedures. The PressureWire Aeris system offers a secure, wireless interface between ...
... : The Heart (Function, Facts (The heart pumps about 6 quarts (5.7 liters) of blood throughout the body, The heart beats about 100,000 times per day (about 3 billion beats in a lifetime), An adult heart beats about 60 to 80 times per minute, The heart weighs between about 10 to 12 ounces (280 to 340 grams) in men and 8 to 10 ounces (230 to 280 grams) in women, Newborns hearts beat faster than adult hearts, about 70 to 190 beats per minute, A human heart is roughly the size of a large fist, The heart is located in the center of the chest, usually pointing slightly left ), Anatomy (Two lower chambers (the ventricles), The right atrium and right ventricle together make up the right heart, Two upper chambers (the atria), The left atrium and left ventricle make up the left heart, The physiology of the heart comes down to structure, electricity and plumbing , A double-walled sac called the pericardium encases the heart, which serves
A free platform for explaining your research in plain language, and managing how you communicate around it - so you can understand how best to increase its impact.
To the best of our knowledge, this is the only prospective, randomized study with long-term results at 7 years in patients with isolated lesions of the proximal LAD treated by either PCI with SES or MIDCAB surgery. There were no significant differences in the composite primary endpoint and individual "hard" endpoints such as cardiac death and myocardial infarction between PCI with SES and MIDCAB. However, TVR was more frequent with PCI.. Current guidelines for revascularization of stable coronary artery disease recommend a stop of the procedure and discussion of further therapy with the patient and the heart team, after the discovery of an isolated proximal LAD stenosis. In American guidelines, revascularization in patients with single-vessel disease and an isolated proximal LAD stenosis PCI has a Class IIb Level of Evidence: B recommendation and surgery with left internal mammary artery a Class IIa B recommendation, whereas in European guidelines PCI has a Class IIa Level of Evidence: B ...
AbeBooks.com: Physiological Assessment of Coronary Stenoses and the Microcirculation (9781447152446) and a great selection of similar New, Used and Collectible Books available now at great prices.
Relationship between epicardial adipose tissue volume measured using coronary computed tomography angiography and atherosclerotic plaque characteristics in patients with severe coronary artery stenosis Journal Article published 17 Sep 2013 in Journal of International Medical Research volume 41 issue 5 on pages 1520 to 1531 Authors: Dan-Dan Dong, Kai Wang, Dan Wang, Tong Zhang, Ying-Feng Tu, Bao-Zhong Shen. ...
BACKGROUND: The value of angiographic follow-up in unprotected left main (ULM) stenting remains undefined. METHODS: The FAILS-2 registry included consecutive patients presenting with a critical lesion of an ULM treated with second generation drug eluting stents in 6 centers from June 2007 to January 2015. Patients were stratified into two groups: those discharged with planned angiographic follow-up and those with clinical follow-up. MACE (Major Adverse Clinical Events, a composite end point of death, myocardial infarction, TLR, and ST) was the primary end point, while each component was a secondary endpoint Sensitivity analysis was performed for patients treated with a provisional or a two-stent strategy ...
BACKGROUND: Postoperative myocardial injury (PMI) is a strong predictor of mortality after noncardiac surgery. PMI is believed to be attributable to coronary artery disease (CAD), yet its etiology is largely unclear. We aimed to quantify the prevalence of significant CAD in patients with and without PMI using coronary computed tomography angiography (CCTA). METHODS: This prospective cohort study included patients of 60 years or older without a history of cardiac disease and with and without PMI after intermediate- to high-risk noncardiac surgery. PMI was defined as any serum troponin I level ≥60 ng/L on the first 3 postoperative days. Main exclusion criteria were known cardiac disease and postoperative ischemic symptoms or electrocardiography abnormalities. Noninvasive imaging consisted of a postoperative CCTA. Main outcome was CAD defined as >50% coronary stenosis on CCTA. RESULTS: The analysis included 66 patients. Median peak troponin levels in the PMI (n = 46) and control group (n = 20) ...
A method and system for determining fractional flow reserve (FFR) for a coronary artery stenosis of a patient is disclosed. In one embodiment, medical image data of the patient including the stenosis
Coronary CT angiography (CCTA) identified plaques in acute MI patients whose coronary angiograms did not produce evidence of significant coronary stenosis.
If we think we have unraveled all the mysteries of human coronary blood flow we are sadly mistaken . Most cardiac physicians spend their prime life in opening the obstructed coronary arteries playing a role of coronary plumber. Like any plumber , it is not going to be one time job and our patients …
A new study clarifies that statins are the greatest medical fraud of all time. The claims made for them are false. The amount of harm they do is staggering, resulting in millions of lives devastated and ended. The worst part of all, though, is that it was entirely predictable-but studies were designed to hide the truth. The media, the health agencies, and the doctors all provided cover for Big Pharma. After all, there was money to be made.. ...
Left main ostial lesion remains a challenging task .A new stent design is proposed here. The lesion The hardware The technique Final message This thought came when I recently encountered a patient with a left main ostial stent which was projecting well into aortic root .It is an open access patency ,whoever is capable of…