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Author(s): Thierry Lefèvre , Yves Louvard , Marie-Claude Morice Added: 3 years ago
Coronary bifurcation lesions with involvement of a significant side branch are a frequent occurrence. The Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) study showed that systematic use of drug-eluting stents (DES) resulted in an increase from 8% to 16% in the number of bifurcation lesions being stented over a one-year period. 1 This high incidence of coronary… View more

Intervention
Author(s): Goran Stankovic , Zlatko Mehmedbegovic , Milorad Zivkovic Added: 3 years ago
Approximately 15–20% of percutaneous coronary interventions (PCIs) are performed to treat coronary bifurcations. These procedures are renowned for being technically challenging and historically have been associated with lower procedural success rates and worse clinical outcomes compared with non-bifurcation lesions.1,2 A bifurcation lesion is a lesion occurring at, or adjacent to, a significant… View more

MI/ACS

Intervention
Author(s): Ricardo Costa , Alexandre Abizaid , Jean Fajadet , et al Added: 3 years ago
Embolisation of atherothrombotic material is a common occurrence during percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). This may lead to distal vessel occlusion resulting in impaired myocardial perfusion, which is associated with larger infarct size, incomplete ST resolution and increased mortality. Unfortunately, there is a lack of significant adjunctive… View more

MI/ACS

Intervention
Author(s): Georgios J Vlachojannis , Bimmer E Claessen , George D Dangas Added: 3 years ago
Platelet adhesion, activation and aggregation play key roles in the initiation of intracoronary thrombosis that causes acute coronary syndromes (ACS) and ischaemic complications following coronary artery interventions, including recurrent myocardial infarction (MI) and stent thrombosis (ST). Indeed, the most feared complication related to coronary stent placement is ST. ST might occur after… View more

MI/ACS

Intervention
Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease
Author(s): Giovanni Luigi De Maria , Adrian P Banning Added: 3 years ago
Detection of obstructive disease of the left main coronary artery (LMCA) is relatively unusual in the catheterisation laboratory, as it accounts for approximately 4 % of all coronary angiograms, with isolated LMCA disease observed in only 5–10 % of these cases.1 Intervention to the LMCA is, however, notable compared to the treatment of coronary stenosis elsewhere in the coronary tree. First,… View more

Vascular Disease and Surgery

Imaging & Diagnostics
Author(s): Samir R Kapadia , Stephen G Ellis , Nyal Borges Added: 3 years ago
Obstructive unprotected left main coronary artery (ULMCA) disease has been recognised as a high-risk condition since the 1960s owing to the large quantum of myocardium supplied by this system (see Figure 1). In that era, medical therapy was the only available management and 5-year mortality rates exceeded 60 %.1 With the introduction of coronary artery bypass grafting (CABG) it became clear that… View more

Electrophysiology & Arrhythmia

Intervention
Intracoronary Imaging: When to use IVUS and OCT
Author(s): Sudheer Koganti , Tushar Kotecha , Roby D Rakhit Added: 3 years ago
Intracoronary imaging is able to aid the interventional cardiologist in the characterisation of atherosclerotic plaque morphology, in optimising stent sizing, and in minimising the complications associated with percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are commonly used methods, while newer spectroscopic methods are under… View more

Imaging & Diagnostics

Prevention & Chronic Conditions
Antegrade Chronic Total Occlusion Strategies: A Technical Focus for 2020
Author(s): Calum Creaney , Simon J Walsh Added: 3 years ago
There has been rapid development in the techniques used for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) over the past decade, with success rates in experienced centres now exceeding 90%.1 This is in part due to advances in devices and techniques for CTO crossing, but also an improved understanding of strategy. The development of the ‘hybrid algorithm’ has improved… View more

Prevention & Chronic Conditions
Percutaneous Coronary Intervention in Older People
Author(s): Sami A Omar , Adam de Belder Added: 3 years ago
There will be guidelines about the optimal management of most clinical situations. It makes decision making in medicine more universal, but often you have to think about all of the awkward situations that sit outside the guidelines. One neglected area of research involves the management of illness in older people. The older patient is often not included in trial protocols, and so a well of… View more

Vascular Disease and Surgery

Imaging & Diagnostics
Deferred Stenting for Heavy Thrombus Burden During PCI for STEMI
Author(s): Akshyaya Pradhan , Monika Bhandari , Pravesh Vishwakarma , et al Added: 3 years ago

MI/ACS