scholarly journals Transcatheter embolization by autologous blood clot is useful management for small side branch perforation due to percutaneous coronary intervention guide wire

2008 ◽  
Vol 52 (3) ◽  
pp. 285-289 ◽  
Author(s):  
Shinichiro Tanaka ◽  
Kazuhiko Nishigaki ◽  
Shinsuke Ojio ◽  
Shinji Yasuda ◽  
Munenori Okubo ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Guide Wire ◽  
Blood Clot ◽  
Autologous Blood ◽  
Coronary Intervention ◽  
Transcatheter Embolization ◽  
Side Branch ◽  
Percutaneous Coronary ◽  
Autologous Blood Clot ◽  
Small Side

scholarly journals Effect of transcatheter embolization by tissue adhesive Histoacryl in treatment of coronary artery perforation during percutaneous coronary intervention

2017 ◽  
Vol 21 (1) ◽  
pp. 24
Author(s):  
A. A. Shermuk ◽  
O. V. Krestyaninov ◽  
D. A. Khelimskiy ◽  
I. A. Naryshkin ◽  
D. S. Grankin ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Conflict Of Interest ◽  
Task Force ◽  
Guide Wire ◽  
Coronary Intervention ◽  
Transcatheter Embolization ◽  
Tissue Adhesive ◽  
Coronary Artery Perforation ◽  
Percutaneous Coronary

<p><strong>Aim.</strong> Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI). The aim of our study was to evaluate the effect and safety of transcatheter embolization by tissue adhesive Histoacryl when treating CAP.<br /><strong>Methods</strong>. As CAP was confirmed, the final composition of the tissue adhesive histoacryl and radiopaque agent Lipiodol was prepared. The perforated vessel was embolized by tissue adhesive Histoacryl via a micro-catheter. There were eleven patients undergoing transcatheter embolization by Histoacryl in treatment of CAP during PCI at Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology from March 2013 to February 2016, and the clinical data of these patients were collected and analyzed retrospectively.<br /><strong>Results</strong>. The lesion morphology of the patients was classified by using the American College of Cardiology/American Heart Association Task Force classification, there were four patients with Class B2 lesions and seven patients with Class C lesions (there also were four patients with chronic total occlusion lesions). According to the Ellis classification of CAP, there were five patients with Class II perforations and six patients with Class III perforations. The causes of perforation were a guide wire (ten patients) and balloon predilation (one patient). Three patients had pericardial effusion. All of the eight patients with CAP underwent transcatheter embolization by Histoacryl. Coronary angiography confirmed that all of them had been embolized successfully. There were no severe postoperative complications. <br /><strong>Conclusion.</strong> Transcatheter embolization by Histoacryl is an effective, safe, cheap, and easy way to treat perforation of small vessels during PCI.</p><p>Received 14 September 2016. Accepted 2 February 2017.</p><p><strong>Financing:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Conflict of interest: Evgeny I. Kretov served as guest editor on this issue on vascular surgery. The other authors declare no conflict of interest.</p><p><strong>Author contributions</strong></p><p>Data collection and analysis: Shermuk A.A., Naryshkin I.A., Grankin D.S., Zubarev D.D., Ibragimov R.U., Baystrukov V.I. Drafting the article: Shermuk A.A., Khelimskiy D.A., Krestyaninov O.V. Critical revision: Shermuk A.A., Khelimskiy D.A., Krestyaninov O.V., Kretov E.I.</p>

scholarly journals OCT-guided Percutaneous Coronary Intervention in Bifurcation Lesions

2018 ◽  
Vol 14 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Luca Longobardo ◽  
Alessio Mattesini ◽  
Serafina Valente ◽  
Carlo Di Mario ◽  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Guide Wire ◽  
Coronary Intervention ◽  
Side Branch ◽  
Wire Crossing ◽  
Percutaneous Coronary ◽  
Bifurcation Stent ◽  
Bifurcation Stenting ◽  
Bifurcation Lesions ◽  
Procedural Success

Coronary artery bifurcation lesions remain challenging despite significant advancements in stent technology and development of specific bifurcation stenting approaches. Optical coherence tomography (OCT) is the intracoronary imaging technique with the highest resolution and can generate automatically contoured lumen areas across the variable geometry of bifurcation lesions. Knowledge of plaque severity and composition facilitates planning of the best strategy for percutaneous coronary intervention (PCI) and stenting. In particular, the provisional stent strategy preferred in this context can be modified when there is high risk of side-branch compromise at the ostium after main vessel stenting. OCT is unique because it allows the identification of the site of guide wire crossing, an important determinant of the final result. OCT can also be used to assess the procedural success of new dedicated bifurcation stent technologies and for the evaluation at follow-up of potential predictors of stent thrombosis, including stent malapposition, stent under-expansion and stent-edge dissection. Finally, the development of 3D OCT allows a better evaluation of coronary anatomy – particularly of side branch ostium that is difficult to visualise by 2D OCT – further improving the value of this technique in guiding PCI in these patients.

Percutaneous Coronary Intervention for Complex Bifurcation Lesions

2010 ◽  
Vol 5 (1) ◽  
pp. 58
Author(s):  
Yves Louvard ◽  
Morice Marie-Claude ◽  
Thomas Hovasse ◽  
Thierry Lefèvre ◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Drug Eluting Stents ◽  
Open Angle ◽  
Balloon Inflation ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
Stent Diameter

Coronary bifurcations are prone to the development of atherosclerosis. They pose technical difficulties for angioplasty treatment and are a predictor of stent thrombosis and restenosis. Treatment of coronary bifurcations is still subject to debate, especially when the side branch (SB) is large, not easily accessible and narrowed by a long lesion. There is currently no indexed treatment for this type of lesion (Medina classification), as the strategy of provisional SB stenting with drug-eluting stents (DES) has proved to be equally efficient as the dualstent technique. Complex techniques are associated with poor outcome in certain lesion types, such as T-stenting when the angle between the two distal branches is small or the crush and culotte technique in the presence of an open angle. Provisional SB stenting may be used when primary dual stenting is required, with a low risk of failure provided that the following guidelines are implemented: stenting of the main branch through the protected SB with a stent diameter adapted to the distal main branch, immediate optimisation of the proximal stent segment (Finet’s law), guidewire exchange, kissing balloon inflation with non-compliant balloons selected according to the diameter of the distal branches and T-stenting of the SB before final kissing inflation.

scholarly journals Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry

2021 ◽  
Vol 36 ◽  
pp. 100856
Author(s):  
Yoshinobu Murasato ◽  
Kyohei Yamaji ◽  
Shun Kohsaka ◽  
Hideki Wada ◽  
Hideki Ishii ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Arteries ◽  
Coronary Intervention ◽  
Side Branch ◽  
Nationwide Registry ◽  
Percutaneous Coronary

scholarly journals Safety and efficacy of bivalirudin in diabetic acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Golam Mostofa ◽  
T Parvin ◽  
R Masum Mandal ◽  
S Ali Ahsan ◽  
R Afrin
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Major Bleeding ◽  
Guide Wire ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Safety And Efficacy ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Hemorrhagic Complications

Abstract Background Prevention of hemorrhagic complications has emerged as a priority in patients undergoing Percutaneous Coronary Intervention (PCI) in addition to suppressing thrombotic complications. This goal is challenging to achieve in diabetic Acute Coronary Syndrome (ACS) patients as Diabetes Mellitus (DM) itself is a prothrombotic state with more pronounced vascular injury response and have a worse outcome after PCI compared with non-diabetic patients. In patients with ACS, Bivalirudin has been shown to result in similar rates of composite ischemia as Heparin plus GPI (GP IIb /IIIa inhibitor), while significantly reducing major bleeding and has received class I recommendation for PCI by American College of Cardiology (ACC 2013). Whether Bivalirudin is safe and effective specially in diabetic ACS patients undergoing PCI, as compared with Heparin (UFH) monotherapy, is unknown. Purpose To determine and compare the incidence of in-hospital and 30-day hemorrhagic complications and major adverse cardiac events (MACEs) as evidence of safety and efficacy using Bivalirudin versus Heparin in diabetic ACS patients undergoing PCI. Methods 218 diabetic ACS patients (age&gt;18 years and ≤75 years) who underwent PCI from May 2018 to April 2019 at University Cardiac Centre, BSM Medical University, Dhaka, Bangladesh were randomly assigned to have UFH or Bivalirudin. Before the guide wire crossed the lesion, 111 patients in the UFH group received a bolus of 70–100 U/kg (targeted activated clotting time, ACT: 200–250 s). 107 patients in the Bivalirudin group received a loading dose of 0.75 mg/kg, followed by an infusion of 1.75 mg/kg/h for up to 4 hours. Dual antiplatelet (DAPT) loading as Aspirin 300 mg plus P2Y12 inhibitors (Clopidogrel 600 mg or Prasugrel 60 mg or Ticagrelor 180 mg) was given in all patients before the procedure. The maintenance dose of DAPT was continued for at least one month and patients were followed telephonically up to 30 days. The outcome measures were in-hospital and 30-day hemorrhagic complications and MACEs [death, MI, target vessel revascularization (TVR) and stroke]. Results Patients treated with Bivalirudin compared with Heparin had a significantly lower in-hospital incidence of QMI (0% vs. 6%; p=0.03) and major bleeding (0% vs. 7%; p=0.02). However, the incidence of cardiac death, stent thrombosis, TVR were no differences between two groups (p&gt;0.05). There was only one NQMI in the Bivalirudin group as opposed to 8% in the Heparin group in 30 days following stenting (p=0.04). Conclusion In diabetic ACS patients undergoing PCI, Bivalirudin is safe and effective as it reduces immediate and short-term hemorrhagic complications as well as MACEs as compared with Heparin. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals TCT-697 Provisional Side Branch Stenting for 1.1.1 Distal Left Main Percutaneous Coronary Intervention

2012 ◽  
Vol 60 (17) ◽  
pp. B203
Author(s):  
Jérôme Van Rothem ◽  
Thierry Lefèvre ◽  
Philippe Garot ◽  
Didier Carrié ◽  
Marie-Claude Morice ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Left Main ◽  
Percutaneous Coronary

Effect of paclitaxel-coated balloon angioplasty on side branch lesion and cardiovascular outcomes in patients with de novo true coronary bifurcation lesions undergoing percutaneous coronary intervention

2021 ◽  
Author(s):  
Youmei Li ◽  
Qi Mao ◽  
Huanyun Liu ◽  
Denglu Zhou ◽  
Jianhua Zhao
Keyword(s):  
Percutaneous Coronary Intervention ◽  
De Novo ◽  
Coronary Intervention ◽  
Side Branch ◽  
Cardiovascular Outcomes ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Bifurcation ◽  
Percutaneous Coronary ◽  
Bifurcation Lesions

Abstract Purpose To compare the effects of paclitaxal-coated balloon (PCB) versus conventional balloon (CB) on side branch (SB) lesion and cardiovascular outcomes in patients with de novo true bifurcation lesions. Methods In total, 219 patients with de novo true bifurcation lesions were enrolled and divided into PCB group (102 cases) and CB group (117 cases) according to angioplasty strategy in SB. Drug-eluting stent (DES) was implanted in main vessel (MV) for each subject. All subjects underwent a 12-month follow-up for late lumen loss (LLL), restenosis and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). MACEs included cardiac death, nonfatal myocardial infarction and angina pectoris. Results There were no differences in diameter, minimum lumen diameter (MLD) and stenosis for bifurcation lesions between the two groups before and immediately after PCI (P > 0.05). After 12-month follow-up, no differences occurred in MV-MLD and MV-LLL between the two groups (P > 0.05); SB-MLD in PCB group was higher than that in CB group (1.97 ± 0.36 mm vs. 1.80 ± 0.43 mm, P = 0.007); SB-LLL in PCB group was lower than that in CB group (0.11 ± 0.18 mm vs. 0.19 ± 0.25 mm, P = 0.024). Multivariate COX analyses indicated that PCB group had lower MACE risk than CB group (HR = 0.480, 95%CI 0.244–0.941, P = 0.033). Conclusion PCB could decrease SB-LLL and MACE risk in patients with de novo true coronary bifurcation lesion 12 months after single-DES intervention.

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