Search results for "PCI"

Nonroutine Use of Intra-Aortic Balloon Pump in Cardiogenic Shock Complicating Myocardial Infarction With Successful and Unsuccessful Primary Percutan…

2018

Abstract Objectives The authors sought to compare outcomes of patients with myocardial infarction and cardiogenic shock (CS) treated with percutaneous coronary intervention (PCI) with or without intra-aortic balloon pump (IABP) support according to final epicardial flow in the infarct-related artery. Background A routine use of IABP is contraindicated in patients with myocardial infarction and CS. There are no data regarding the subpopulation of patients who may benefit from such support besides patients with mechanical complications of myocardial infarction. Methods Prospective nationwide registry data of patients with myocardial infarction and CS treated with PCI between 2003 and 2014 wer…

0200: Predictors of angiographically visible distal embolization in ST elevation myocardial infarction patients treated by primary percutaneous coron…

2016

Aspiration thrombectomy during primary percutaneous coronary intervention (p-PCI) in ST elevation myocardial infarction (STEMI) has been proposed to restore myocardial reperfusion. But important controversies remain concerning the usefulness of thrombectomy to improve this perfusion. Our objective was to evaluate the impact of manual thrombectomy on the occur-rence of angiographically visible distal embolization (AVDE) during p-PCI in STEMI. 346 consecutive patients admitted for STEMI who underwent p-PCI and thrombectomy were included. Clinical, angiographic and therapeutics characteristics were assessed. AVDE was defined as an abrupt vessel closure occurring at any point during the PCI pro…

Reperfusion Treatment in an Acute Myocardial Infarction in Patients Older Than 75 Years. Do We Need a Randomized Controlled Trial?

2005

Fibrinolytic therapy in ST-segment elevation acute myocardial infarction (AMI) constitutes one of the most important advances in cardiology in the last 25 years and has influenced the management and evolution of patients as much as the first coronary care units did. The most important limitations of fibrinolytics are the presence of absolute or relative contraindications to their administration in ≤25% of patients, their limited capacity to restore adequate coronary flow and the risk of inducing cerebral hemorrhage. They are at their most efficient in the first 2 hours’ evolution of AMI but lose their efficacy thereafter. 1 Consequently, treatment must be initiated as early as possible and …

Long-Term Clinical Outcomes After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Ostial/Midshaft Lesions in Unprotecte…

2014

Objectives The aim of this study was to report the long-term clinical outcomes after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus coronary artery bypass grafting (CABG) for ostial/midshaft lesions in an unprotected left main coronary artery (ULMCA). Background Data regarding outcomes in these patients are limited. Methods Of a total of 2,775 patients enrolled in the DELTA multinational registry, 856 patients with isolated ostial/midshaft lesions in an ULMCA treated by PCI with DES (n = 482) or CABG (n = 374) were analyzed. Results At a median follow-up period of 1,293 days, there were no significant differences in the propensity score-adjusted analyses for …

A Complex Combination of Microvascular and Macrovascular Diseases

2016

When FFR is larger than 0.80, a PCI is not justified. Transient microvascular dysfunction may, however, be associated with impaired hyperemia and falsely negative FFR. This case also emphasizes the dynamic nature of microvascular disease, and provides an example of both “typical” syndrome X and “less conventional” syndrome slow flow associated with increased peripheral resistances (see Chap. 35).

Multiple Lesions, Multiple Measures

2016

This case describes the assessment of FFR in the case of tandem intermediate lesions in the proximal and mid LAD. Hyperemia was induced with intravenous (IV) infusion of Adenosine, which allows pullback measurements. First, with the wire placed distal in the vessel, FFR provides information on whether the sum of the two stenoses causes ischemia. Thereafter, during pullback, the most severe stenosis can be identified as the most relevant pressure drop. Finally, a re-evaluation of FFR is important after PCI: after the first stenosis is treated, the degree of hyperemia achievable will be larger, thus unmasking the relevance of the second one.

The IMPACTOR-CTO Trial

2018

Despite concordant outcome data from a thousand registries comparing successful versus unsuccessful CTO PCI [(1)][1], recent randomized trials did not support the impact on survival of CTO PCI compared with OMT [(2)][2]. In contrast, more certainty exists about its importance in improving QoL [(2)][

Impact of admission hyperglycemia on one-year mortality in non-diabetic patients admitted for rescue PCI

2013

0197: Angiographically visible distal embolization is not linked with culprit lesion but with clinical characteristics

2016

Despite the recent improvements in percutaneous coronary intervention (PCI), angiographically visible distal embolization (AVDE) complicates 6 to 18% of ST elevation myocardial infarction (STEMI) treated with PCI, and is associated with poor clinical outcomes. Culprit lesion characteristics have been proved to be the main predictive factor of AVDE. But data regarding clinical characteristics predicting AVDE are lacking. We aimed to identify predictors of AVDE complicating PCI in STEMI management. 769 consecutive patients admitted for STEMI who underwent PCI were included. Clinical, angiographic and therapeutics characteristics were assessed for each patien. AVDE was defined as an abrupt ves…

1-Year Outcomes of FFRCT-Guided Care in Patients With Suspected Coronary Disease

2016

Abstract Background Coronary computed tomographic angiography (CTA) plus estimation of fractional flow reserve using CTA (FFR CT ) safely and effectively guides initial care over 90 days in patients with stable chest pain. Longer-term outcomes are unknown. Objectives The study sought to determine the 1-year clinical, economic, and quality-of-life (QOL) outcomes of using FFR CT instead of usual care. Methods Consecutive patients with stable, new onset chest pain were managed by either usual testing (n = 287) or CTA (n = 297) with selective FFR CT (submitted in 201, analyzed in 177); 581 of 584 (99.5%) completed 1-year follow-up. Endpoints were adjudicated major adverse cardiac events (MACE) …