scholarly journals Real-Life Outcomes of Coronary Bifurcation Stenting in Acute Myocardial Infarction (Zabrze–Opole Registry)

2021 ◽  
Vol 8 (11) ◽  
pp. 155
Author(s):  
Wojciech Milejski ◽  
Jerzy Sacha ◽  
Piotr Feusette ◽  
Marek Cisowski ◽  
Piotr Muzyk ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Factor ◽  
Real Life ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Side Branch ◽  
Inflation Pressure ◽  
Coronary Bifurcation

Percutaneous coronary intervention (PCI) of bifurcation lesions is a technical challenge associated with high risk of adverse events, especially in primary PCI. The aim of the study is to analyze long-term outcomes after PCI for coronary bifurcation in acute myocardial infarction (AMI). The outcome was defined as the rate of major adverse cardiac event related to target lesion failure (MACE-TLF) (death-TLF, nonfatal myocardial infarction-TLF and target lesion revascularization (TLR)) and the rate of stent thrombosis (ST). From 306 patients enrolled to the registry, 113 were diagnosed with AMI. In the long term, AMI was not a risk factor for MACE-TLF. The risk of MACE-TLF was dependent on the culprit lesion, especially in the right coronary artery (RCA) and side branch (SB) with a diameter >3 mm. When PCI was performed in the SB, the inflation pressure in SB remained the single risk factor of poor prognosis. The rate of cumulative ST driven by late ST in AMI was dependent on the inflation pressure in the main branch (MB). In conclusion, PCI of bifurcation culprit lesions should be performed carefully in case of RCA and large SB diameter and attention should be paid to high inflation pressure in the SB. On the contrary, the lower the inflation pressure in the MB, the higher the risk of ST.

Provisional and Complex Techniques for Bifurcation Treatment – Trading Apposition for Scaffolding?

2012 ◽  
Vol 7 (1) ◽  
pp. 44
Author(s):  
Nicolas Foin ◽  
Eduardo Alegria-Barrero ◽  
Ryo Torii ◽  
Pak H Chan ◽  
Ajay K Jain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
New Technology ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Side Branch ◽  
Simultaneous Increase ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Stent Coverage ◽  
Bifurcation Lesions

Provisional T-stenting with stenting of the main branch and optional side branch (SB) stenting in the case of significant SB occlusion with thrombolysis in myocardial infarction (TIMI) flow <3 is the strategy chosen nowadays by most interventionalists for treating simple bifurcation lesions. Percutaneous coronary intervention (PCI) of complex true bifurcation lesions remains, however, the subject of debate: treatment of complex bifurcation lesions requires more time than treatment of simple bifurcations and can lead to significantly higher rates of restenosis, target lesion revascularisation and myocardial infarction. Current bifurcation techniques often fail to ensure continuous stent coverage of the SB ostium and of the two bifurcation branches without a simultaneous increase in the rate of malapposed struts. Stent struts left unapposed in the lumen disturb blood flow and are increasingly recognised as increasing the risk of stent thrombosis and focal in-stent restenosis, limiting the success of stent procedures in these lesions. New technology and dedicated designs may, in the near future, overcome such limitations of conventional two-stent bifurcation strategies.

scholarly journals Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Cochrane Library ◽  
Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

scholarly journals Two-Year Outcomes after Left Main Coronary Artery Percutaneous Coronary Intervention in Patients Presenting with Acute Coronary Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Si-Da Jia ◽  
Yi Yao ◽  
Ying Song ◽  
Xiao-Fang Tang ◽  
Xue-Yan Zhao ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Left Main ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Objectives. We aim to evaluate long-term outcomes after left main coronary artery (LMCA) percutaneous coronary intervention (PCI) in patients presenting with acute coronary syndrome (ACS). Background. PCI of the LMCA has been an acceptable revascularization strategy in stable coronary artery disease. However, limited studies on long-term clinical outcomes of LMCA PCI in ACS patients are available. Methods. A total of 6429 consecutive patients with ACS undergoing PCI in Fuwai Hospital in 2013 were enrolled. Patients are divided into LMCA group and Non-LMCA group according to whether the target lesion was located in LMCA. Prognosis impact on 2-year major adverse cardiovascular and cerebrovascular events (MACCE) is analyzed. Results. 155 (2.4%) patients had target lesion in LMCA, while 6274 (97.6%) patients belong to the non-LMCA group. Compared with non-LMCA patients, LMCA patients have generally more comorbidities and worse baseline conditions. Two-year follow-up reveals that LMCA patients have significantly higher rate of cardiac death (2.6% vs. 0.7%, p=0.034), myocardial infarction (7.1% vs. 1.8%, p<0.001), in-stent thrombosis (4.5% vs. 0.8%, p<0.001), and stroke (7.1% vs. 6.4%, p=0.025). After adjusting for confounding factors, LMCA remains independently associated with higher 2-year myocardial infarction rate (HR = 2.585, 95% CI = 1.243–5.347, p=0.011). Conclusion. LMCA-targeted PCI is an independent risk factor for 2-year myocardial infarction in ACS patients.

Sign in / Sign up

Export Citation Format

Share Document