Complete Versus culprit-Lesion only PRimary PCI Trial (CVLPRIT): a multicentre trial testing management strategies when multivessel disease is detected at the time of primary PCI: rationale and design

2013 ◽  
Vol 8 (10) ◽  
pp. 1190-1198 ◽  
Author(s):  
Damian J. Kelly ◽  
Gerald P. McCann ◽  
Daniel Blackman ◽  
Nicholas P. Curzen ◽  
Miles Dalby ◽  
...  
Keyword(s):  
Multicentre Trial ◽  
Management Strategies ◽  
Multivessel Disease ◽  
Primary Pci ◽  
Culprit Lesion ◽  
Trial Testing ◽  
Testing Management

scholarly journals Effect of transradial ECG guided immediate intervention on culprit lesion with a single guiding catheter on door to balloon time

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G.J.C Guo ◽  
W.G.Z Wang ◽  
L.Z.J Liu ◽  
L.H.D Li ◽  
N.D Niu ◽  
...  
Keyword(s):  
Fluoroscopy Time ◽  
Health Improvement ◽  
Funding Source ◽  
Primary Pci ◽  
Culprit Lesion ◽  
Catheterization Laboratory ◽  
Catheter Group ◽  
Procedural Time ◽  
Door To Balloon ◽  
Guiding Catheter

Abstract Objective There is limited literature on procedure of primary PCI in catheterization laboratory. This study was designed to assess the impact of electrocardiogram-guided immediate intervention on culprit lesion with a single guiding catheter in ST-elevation myocardial infarction (STEMI) patients on door-to-balloon (D2B) time and clinical outcomes. Methods In this prospective, randomized single center study, 560 patients with STEMI who underwent primary PCI from February 2017 to July 2019 were randomized into two groups. In single catheter group, a single guiding catheter (MAC3.5 or JL 3.5 guiding catheter) was used to perform angiogram and PCI of culprit vessel, followed by contralateral angiography (n=280). In contral group, 280 patients underwent primary PCI after complete diagnostic angiography. The primary evaluation was D2B time and second endpoint include catheterization laboratory-to-balloon (C2B) time, major adverse cardiac events (MACE) at 30 days. This trial was registered with ClinicalTrials.gov, NCT03272451. Results Baseline characteristics were not different between the two groups. The median D2B time (54.83 [IQR 40.00–68.0] min versus 58.32 [IQR 44.12–78.40] min, P=0.007), C2B time (16.91 [IQR 13.88–21.42] min versus 23.80 [IQR 18.92–28.52] min, P<0.001), total procedural time (45.17 [34.06–59.48] min versus 48.51 [37.04–64.60] min, P=0.012) and fluoroscopy time (9.70 [6.50–14.15] min versus 11.26 [8.01–14.27] min, P=0.025)were significantly shorter in single catheter group Compared with control group. The proportion of patients achieving D2B time within 60 minutes increased significantly in the single catheter group (61.79% vs. 52.14%, P=0.021). The rate of radial perforation was significantly reduced in single catheter group (0.71% vs. 3.21%, P=0.033). The total number of catheters was significantly less in single catheter group (1.18±0.54 vs. 2.23±0.60, p<0.001). There was no significant difference in the MACE at 30 days (2.5% vs. 4.64%, P=0.172) between the 2 groups. Conclusion ECG-guided immediate intervention on culprit lesion with a single guiding catheter in STEMI patients can reduce D2B time, C2B time, procedural time and fluoroscopy time. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Capital's Funds for Health Improvement and Research

scholarly journals Complete Revascularization Versus Culprit Lesion Only in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease

2019 ◽  
Vol 12 (8) ◽  
pp. 721-730 ◽  
Author(s):  
Kasper Kyhl ◽  
Kiril Aleksov Ahtarovski ◽  
Lars Nepper-Christensen ◽  
Kathrine Ekström ◽  
Adam Ali Ghotbi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Multivessel Disease ◽  
Complete Revascularization ◽  
Culprit Lesion ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Value of gated-SPECT MPI for ischemia-guided PCI of non-culprit vessels in STEMI patients with multivessel disease after primary PCI

2018 ◽  
Vol 25 (5) ◽  
pp. 1616-1620
Author(s):  
Lawrence M. Phillips ◽  
João V. Vitola ◽  
Leslee J. Shaw ◽  
Raffaele Giubbini ◽  
Ganesan Karthikeyan ◽  
...  
Keyword(s):  
Gated Spect ◽  
Multivessel Disease ◽  
Primary Pci ◽  
Spect Mpi

Abstract 2000: Incomplete ST-Segment Deviation Resolution after Primary Percutaneous Coronary Intervention in Patients with Multivessel Disease is Mainly Due to the Presence of a Non-Infarct-Related Chronic Total Occlusion

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Niels J Verouden ◽  
Bimmer E Claessen ◽  
René J van der Schaaf ◽  
Karel T Koch ◽  
Jan Baan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Multivessel Disease ◽  
Published Data ◽  
Primary Pci ◽  
Total Occlusion ◽  
St Segment ◽  
Percutaneous Coronary

Background Incomplete ST-segment deviation resolution (STR) after epicardial flow restoration may represent microvascular dysfunction and predicts an unfavorable outcome in patients with ST-segment elevation myocardial infarction (STEMI). From recently published data concerning STEMI patients that underwent primary percutaneous coronary intervention (PCI), increased mortality in patients with multivessel disease (MVD) was attributed to the presence of a chronic total occlusion (CTO) in a non-infarct-related artery (IRA). We evaluated whether the presence of MVD with or without a CTO in a non-IRA significantly contributes to incomplete STR in a large cohort of patients undergoing primary PCI for STEMI. Methods In this single-center study, 2127 STEMI patients underwent primary PCI between 2000 and 2006. The IRA and presence of MVD was determined during diagnostic angiography preceding primary PCI. MVD was assessed if ≥ 1 non-IRA showed ≥ 1 coronary stenosis of ≥ 70% and a CTO was defined as a 100% luminal narrowing in a non-IRA. STR was defined as the relative difference (in %) of the summed ST deviation between the pre-PCI and the immediately post-PCI 12-lead ECG. A post-PCI STR of ≥ 70% was considered complete. Results During emergency coronary angiography, singlevessel disease (SVD) was observed in 1474 (69.3 %) patients, MVD without a CTO in 433 (20.4 %) patients, and MVD with a CTO in a non-IRA in 220 (10.3 %) patients. MVD patients less frequently showed complete STR compared to patients with SVD (OR 1.2 95% CI, 1.0 – 1.5 p = 0.046). However, the occurrence of complete STR in SVD patients and MVD patients without a CTO was comparable (OR 1.1, 95% CI, 0.9 – 1.4 p = 0.43). In MVD patients with a CTO, STR was significantly less often complete compared to patients with SVD or with MVD without a CTO (OR 1.6 95% CI, 1.1 – 2.6 p = 0.01). Conclusion STEMI patients with MVD undergoing primary PCI showed complete STR less often compared to SVD patients. This effect is mainly due to a subgroup of MVD patients with a CTO in a non-IRA and not due to mere MVD.

scholarly journals Designing tools to evaluate fishery management strategies: can the scientific community deliver?

2007 ◽  
Vol 64 (6) ◽  
pp. 1077-1084 ◽  
Author(s):  
Jon T. Schnute ◽  
Mark N. Maunder ◽  
James N. Ianelli
Keyword(s):  
Programming Languages ◽  
Scientific Community ◽  
Fishery Management ◽  
Stock Assessment ◽  
Management Strategies ◽  
Academic Disciplines ◽  
Strategy Evaluation ◽  
Management Procedures ◽  
Human Skills ◽  
Testing Management

Abstract Schnute, J. T., Maunder, M. N., and Ianelli, J. N. 2007. Designing tools to evaluate fishery management strategies: can the scientific community deliver? – ICES Journal of Marine Science, 64: 1077–1084. Techniques for quantitative fishery management have evolved rapidly during a period when computers, programming languages, and computational algorithms have also changed dramatically. Despite these advances, many stock assessment methods remain untested. A process of management strategy evaluation (MSE) could potentially rectify this problem, but it would require a framework in which to conduct systematic tests. We survey the tools currently used for stock assessments and discuss the development of new standards for testing management procedures. A successful project would depend on human skills scattered among various nations, organizations, and academic disciplines. Analogies from civil engineering illustrate the discipline and collaboration required for an effective outcome. If the world community of fishery scientists could design, build, and support such a project, it would revolutionize the theory, teaching, and practice of scientific fishery management.

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