Diagnosis of silent coronary ischemia with selective coronary revascularization might improve 2-year survival of patients with critical limb-threatening ischemia.

Abstract Background Patients with critical limb-threatening ischemia (CLTI) have had poor long-term survival after lower extremity revascularization owing to coexistent coronary artery disease. A new cardiac diagnostic test, coronary computed tomography-derived fractional flow reserve (FFRCT), can identify patients with ischemia-producing coronary stenosis who might benefit from coronary revascularization. We sought to determine whether the diagnosis of silent coronary ischemia before limb salvage surgery with selective postoperative coronary revascularization can reduce the incidence of adverse cardiac events and improve the survival of patients with CLTI compared with standard care. Metho…

TCT-361 Heart Team Approach to CAD Management in Patients Undergoing Elective Vascular Surgery Who Have Asymptomatic Ischemia-producing Coronary Stenosis

Patients undergoing peripheral vascular surgery (PVS) are at increased risk of post-op MI/death due to unrecognized CAD. Coronary CTA-derived fractional flow reserve (FFRCT) reliably identifies lesion-specific ischemia (LSI) in stable chest pain patients but has not been used in PVS patients. We

TCTAP A-059 Intrahospital and Long-term Outcomes After True Bifurcation Stenting

Bifurcation percutaneous coronary intervention (PCI) is challenging and is associated with lower rate of procedural success and higher risk of complications. The aim of this study was to evaluate intrahospital and long-term outcomes of patients who underwent PCI for bifurcation lesions involving

Diagnosis and management of silent coronary ischemia in patients undergoing carotid endarterectomy.

Abstract Background Coronary artery disease is the primary cause of death in patients with carotid artery disease and silent ischemia is a marker for adverse coronary events. A new noninvasive cardiac diagnostic test, coronary computed tomography-derived fractional flow reserve (FFRCT) can reliably identify ischemia-producing coronary stenosis in patients with coronary artery disease and help to select patients for coronary revascularization. The purpose of this study is to determine the prevalence of silent coronary ischemia in patients undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of FFRCT in selecting patients for coronary revascularization to decrease cardiac ev…

Pre-operative Diagnosis of Silent Coronary Ischaemia May Reduce Post-operative Death and Myocardial Infarction and Improve Survival of Patients Undergoing Lower Extremity Surgical Revascularisation.

Objective Patients undergoing peripheral vascular surgery have increased risk of death and myocardial infarction (MI), which may be due to unsuspected (silent) coronary ischaemia. The aim was to determine whether pre-operative diagnosis of silent ischaemia using coronary computed tomography (CT) derived fractional flow reserve (FFRCT) can facilitate multidisciplinary care to reduce post-operative death and MI, and improve survival. Methods This was a single centre prospective study with historic controls. Patients with no cardiac symptoms undergoing lower extremity surgical revascularisation with pre-operative coronary CTA-FFRCT testing were compared with historic controls with standard pre…

Carotid artery stenting outcomes in high-risk patients receiving best medical therapy: results from a single high-volume interventional cardiology practice

Kontext: Implantace stentů do karotických tepen (carotid artery stenting, CAS) se v soucasnosti ve velkem měřitku použiva v lecbě stenozy karotických tepen. Klinicke studie z posledni doby prokazaly nizkou incidenci přihod po CAS. Tato studie hodnoti 30denni a rocni výsledky pacientů lecených pro CAS intenzivni farmakoterapii na pracovisti provadějicim vysoke pocty perkutannich koronarnich intervenci rocně.Metoda: V obdobi od ledna 2011 do prosince 2013 byla CAS provedena celkem u 184 pacientů. Mimo protidestickove lecby byla provaděna i intenzivni antihypertenzni lecba spolu s vysoce intenzivni terapii statiny a lecbou zaměřenou na normalizaci srdecni frekvence. Pacienti byli stratifikovan…

Rational and design of the European randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER)

Background Percutaneous coronary intervention in complex bifurcation lesions is prone to suboptimal implantation results and is associated with increased risk of subsequent clinical events. Angiographic ambiguity is high during bifurcation stenting, but it is unknown if procedural guidance by intravascular optical coherence tomography (OCT) improves clinical outcome. Methods and design OCTOBER is a randomized, investigator-initiated, multicenter trial aimed to show superiority of OCT-guided stent implantation compared to standard angiographic-guided implantation in bifurcation lesions. The primary outcome measure is a 2-year composite end point of cardiac death, target lesion myocardial inf…

Tissue characterization comparison of culprit lesions between stable coronary disease and ST elevation myocardial infarction patients