scholarly journals Potential Predictors of Side-Branch Occlusion in Bifurcation Lesions after Percutaneous Coronary Intervention: A Coronary CT Angiography Study

Radiology ◽  
2014 ◽  
Vol 271 (3) ◽  
pp. 711-720 ◽  
Author(s):  
Jin Joo Park ◽  
Eun Ju Chun ◽  
Young-Seok Cho ◽  
Il-Young Oh ◽  
Chang-Hwan Yoon ◽  
...  
2015 ◽  
pp. 59-64
Author(s):  
Sonny Hilal Wicaksono

Tindakan Primary Percutaneous Coronary Intervention (PPCI) untuk pasien sindrom koroner akut (SKA) dengan ST elevasi (STEMI=ST elevation myocardial infarction) telah berjasa banyak dalam menurunkan mortalitas. Namun kerusakan jaringan miokard pasca PPCI tetap terjadi, akibat iskemia yang telah berlangsung sebelum reperfusi berhasil, atau kerusakan jaringan miokard akibat cedera reperfusi. Hal tersebut menimbulkan konsekuensi morbiditas akibat SKA berupa gagal jantung. Sehingga dikhawatirkan bila SKA tidak dicegah, di masa yang akan datang akan timbul epidemi gagal jantung. Oleh sebab itu strategi pencegahan terjadinya SKA perlu menjadi pengetahuan dasar bagi seluruh dokter spesialis jantung dan pembuluh darah (SpJP) agar epidemi gagal jantung dapat dicegah.Strategi pencegahan SKA tetap memegang 5 prinsip:1. Health Promotion2. Primary Prevention3. Early Detection and Prompt Treatment4. Secondary Prevention5. RehabilitationPoin pertama dan kedua dilakukan langsung ke tengah masyarakat di luar klinik atau rumah sakit, mulai dari poin ke-tiga, yaitu deteksi dini, dilakukan dalam praktek klinik.


2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Georgios Tzimas ◽  
Gaurav S. Gulsin ◽  
Hidenobu Takagi ◽  
Niya Mileva ◽  
Jeroen Sonck ◽  
...  

2010 ◽  
Vol 5 (1) ◽  
pp. 58
Author(s):  
Yves Louvard ◽  
Morice Marie-Claude ◽  
Thomas Hovasse ◽  
Thierry Lefèvre ◽  
◽  
...  

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.


2021 ◽  
Author(s):  
Youmei Li ◽  
Qi Mao ◽  
Huanyun Liu ◽  
Denglu Zhou ◽  
Jianhua Zhao

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.


2018 ◽  
Vol 28 (02) ◽  
pp. 137-141 ◽  
Author(s):  
Bogie Putra Palinggi ◽  
Doni Firman

AbstractSide branch occlusion has been implicated as a complication after percutaneous coronary intervention in coronary bifurcation lesions. The role of carina bifurcation angle as one of the characteristics of the coronary bifurcation lesions in causing side branch occlusion after percutaneous coronary intervention is still debated. This study aims to assess the correlation between carina bifurcation angles as one of the characteristics of the coronary bifurcation lesions and side branch occlusion in elective percutaneous coronary intervention. This is a cross-sectional study which utilizes CAAS 5.1 software to measure carina bifurcation angle. We collected 113 lesions in 108 patients that met the inclusion criteria from January 2016 to October 2016. Side branch occlusion occurred in 15 lesions (13.3%), with median carina bifurcation angle 19.17 degrees (p < 0.001). Multivariate analysis showed there is a correlation between carina bifurcation angle with side branch occlusion, OR (odds ratio) 0.86 (95% CI [confidence interval]: 0.80–0.92) with ≤ 33.71 degrees cut off value. Increased risk of side branch occlusion was found in small carina bifurcation angle.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Gao Hao-kao ◽  
Li Cheng-xiang

Percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) can be challenging when a bifurcation is present at the distal cap. We described a case of retrograde balloon outside the main branch stent to restore the occlusion of side branch in CTO bifurcation lesion through the jailed wire.


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