Effect of enoxaparin on clinical events in complicated coronary lesions after percutaneous coronary intervention

2015 ◽  
Vol 36 (10) ◽  
pp. 1074
Author(s):  
Nian-zhong TANG ◽  
Shao-ping CHEN ◽  
Xiu-ying SHI ◽  
Yi-feng JIANG ◽  
Li SUN ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Coronary Lesions

Patient Selection and Procedural Considerations for Coronary Orbital Atherectomy System

2016 ◽  
Vol 11 (1) ◽  
pp. 33
Author(s):  
Yohei Sotomi ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Percutaneous Coronary ◽  
Orbital Atherectomy ◽  
Long Term Follow Up ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions

Despite advances in technology, percutaneous coronary intervention (PCI) of severely calcified coronary lesions remains challenging. Rotational atherectomy is one of the current therapeutic options to manage calcified lesions, but has a limited role in facilitating the dilation or stenting of lesions that cannot be crossed or expanded with other PCI techniques due to unfavourable clinical outcome in long-term follow-up. However the results of orbital atherectomy presented in the ORBIT I and ORBIT II trials were encouraging. In addition to these encouraging data, necessity for sufficient lesion preparation before implantation of bioresorbable scaffolds lead to resurgence in the use of atherectomy. This article summarises currently available publications on orbital atherectomy (Cardiovascular Systems Inc.) and compares them with rotational atherectomy.

scholarly journals Antegrade Approach of Percutaneous Coronary Intervention for Chronic Total Occlusion

2021 ◽  
Author(s):  
C. Raghu ◽  
Rahul K. Ghogre ◽  
Alekhya Mandepudi
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Chronic Total Occlusion ◽  
Bypass Surgery ◽  
Coronary Intervention ◽  
Technical Expertise ◽  
Total Occlusion ◽  
Antegrade Approach ◽  
Percutaneous Coronary ◽  
Coronary Lesions

AbstractChronic total occlusion (CTO) is a common challenge accounting for 10% of coronary lesions found on coronary angiography. Patients are frequently referred for bypass surgery because percutaneous coronary intervention is challenging in this subset. Recent advances in the hardware as well as the technical expertise and an algorithm approach have improved the success to more than 90%.Antegrade approach is the cornerstone for managing CTO and has two distinct strategies: antegrade wire escalation, and antegrade dissection and reentry strategy. Step-wise approach to perform these procedures and the use of adjunct imaging are discussed.

scholarly journals Unique referral system contributes to long-term net clinical benefits in patients undergoing secondary prevention therapy after percutaneous coronary intervention

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242707
Author(s):  
Shigetaka Kageyama ◽  
Koichiro Murata ◽  
Ryuzo Nawada ◽  
Tomoya Onodera ◽  
Yuichiro Maekawa
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Ischemic Heart Disease ◽  
Coronary Intervention ◽  
Ischemic Heart ◽  
Referral System ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Clinical Benefits

Cardiovascular disease, including ischemic heart disease, is a leading cause of death worldwide. Improvement of the secondary prevention of ischemic heart disease is necessary. We established a unique referral system to connect hospitals and outpatient clinics to coordinate care between general practitioners and cardiologists. Here, we evaluated the impact and long-term benefits of our system for ischemic heart disease patients undergoing secondary prevention therapy after percutaneous coronary intervention. This single-center retrospective observational study included 3658 consecutive patients who underwent percutaneous coronary intervention at Shizuoka City Hospital between 2010 and 2019. After percutaneous coronary intervention, patients were considered conventional outpatients (conventional follow-up group) or subjected to our unique referral system (referral system group) at the attending cardiologist’s discretion. To audit compliance of the treatment with the latest Japanese guidelines, we adopted a circulation-type referral system, whereby general practitioners needed to refer registered patients at least once a year, even if no cardiac events occurred. Clinical events in each patient were evaluated. Net adverse clinical events were defined as a combination of major adverse cardiac, cerebrovascular, and major bleeding events. There were 2241 and 1417 patients in the conventional follow-up and referral system groups, with mean follow-ups of 1255 and 1548 days and cumulative net adverse clinical event incidences of 27.6% and 21.5%, respectively. Kaplan–Meier analysis showed that the occurrence of net adverse clinical events was significantly lower in the referral system group than in the conventional follow-up group (log-rank: P<0.001). Univariate and multivariate analyses revealed that the unique referral system was a significant predictor of the net clinical benefits (hazard ratio: 0.56, 95% confidence interval: 0.37–0.83, P = 0.004). This result was consistent after propensity-score matching. In summary, our unique referral system contributed to long-term net clinical benefits for the secondary prevention of ischemic heart disease after percutaneous coronary intervention.

Abstract 4471: Long-Term Follow-Up After Deferral of Percutaneous Coronary Intervention (PCI) in Patients With Moderate Coronary Lesions and Borderline Fractional Flow Reserve Measurements

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Takafumi Yamane ◽  
Koichi Tamita ◽  
Noriomi Kimura ◽  
Shunsuke Funakoshi ◽  
Kite Kim ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Percutaneous Coronary ◽  
Coronary Lesions ◽  
Group 2 ◽  
Group 1

Background: Many studies have demonstrated that deferral of percutaneous coronary intervention (PCI) on the basis of a myocardial fractional flow reserve (FFR) ≥0.75 is associated with a very low coronary event rate. However, some groups have empirically chosen the cut-off value of 0.80 rather than 0.75 for decision to defer PCI and the FFR measurement between 0.75 and 0.80 has been established as a grey zone. The aim of this study was to evaluate the long-term clinical outcomes of patients with moderate coronary lesions and FFR measurements between 0.75 and 0.80. Methods: The study included 125 anigiographically moderate coronary lesions (>50% diameter stenosis by visual assessment) in 125 patients but in whom the PCI was deferred on the basis of an FFR ≥ 0.75. The FFR was calculated as the ratio of mean distal pressure divided by the proximal pressure during hyperemia. Patients were divided into two groups according to the result of FFR: ≥ 0.80 (n=99, group 1) and between 0.75 and 0.79 (n=26, group 2). We evaluated the long-term major adverse cardiovascular events (MACE) related and unrelated to the FFR-evaluated lesion. Results: During a follow-up period of 82 ± 29 months (mean ± SD), The Kaplan-Meier event-free survival curves showed that group 2 was poorer than group 1 in prognosis (p=0.0148). The incidence of MACE unrelated FFR-evaluated lesion in group 1 was equivalent to that in group 2 (p=0.96). Conclusions: In patients with moderate coronary lesions and borderline FFR measurements, deferral of PCI was associated with a higher rate of MACE related to the FFR-evaluated lesion. FFR cut-off point of 0.80 instead of 0.75 may be more appropriate for deferring PCI.

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