1.
Causes of death after treatment of small coronary artery disease with paclitaxel-coated balloons.
Jeger, RV, Kaiser, C, Mangner, N, Kleber, FX, Scheller, B, ,
Clinical research in cardiology : official journal of the German Cardiac Society. 2021;(2):307-311
2.
Chronic Total Occlusion Wiring: A State-of-the-Art Guide From The Asia Pacific Chronic Total Occlusion Club.
Wu, EB, Tsuchikane, E, Lo, S, Lim, ST, Ge, L, Chen, JY, Qian, J, Lee, SW, Kao, HL, Harding, SA
Heart, lung & circulation. 2019;(10):1490-1500
Abstract
OBJECTIVE Despite the advances in wire technology and development of algorithm-driven methodology for chronic total occlusion (CTO) intervention, there is a void in the literature about the technical aspects of CTO wiring. The Asia Pacific CTO Club, a group of 10 experienced operators in the Asia Pacific region, has tried to fill this void with this state-of-the-art review on CTO wiring. METHODS This review explains, for proximal cap puncture: choices of wires, shaping of the wire, use of dual lumen catheter, and method of step-down of wire penetration force for successful wiring. In wiring the CTO body, the techniques of loose tissue tracking, intentional intimal plaque tracking, and intentional subintimal wiring are described in detail. For distal lumen wiring, a blunt distal cap, presence of a distal cap side branch, calcium, and sharp tapered distal stump predict cap toughness, and wire penetration force should be stepped-up in these cases. The importance of choosing between redirection, parallel wiring, and Stingray (Boston Scientific, Marlborough, MA, USA) for angiographic guidance is discussed along with which will be more successful. On the retrograde side, the problems encountered with distal cap puncture and methods to overcome these problems are explained. The method of wiring the CTO body through a retrograde approach depending on the morphology of the CTO is described. Different reverse controlled antegrade and retrograde tracking (CART) wiring methods - including end balloon wiring, side balloon entry, and conventional reverse CART - are explained in detail. CONCLUSION This is a systematic CTO wiring review, which is believed to be beneficial for CTO operators worldwide.
3.
Prevention of postcontrast acute kidney injury after percutaneous transluminal angioplasty by inducing RenalGuard controlled furosemide forced diuresis with matched hydration: study protocol for a randomised controlled trial.
Bolt, LJJ, Sigterman, TA, Krasznai, AG, Sikkink, CJM, Schurink, GH, Bouwman, LH
BMJ open. 2018;(9):e021842
Abstract
INTRODUCTION Percutaneous transluminal angioplasty (PTA) is often complicated due to postcontrast acute kidney injury (PC-AKI) in patients diagnosed with chronic kidney disease (CKD). Hydration therapy is the cornerstone in the prevention of PC-AKI. Furosemide forced diuresis with matched hydration using the RenalGuard system enables a steady balance between diuresis and hydration. A randomised controlled trial will be performed in order to investigate whether furosemide forced diuresis with matched hydration in combination with the RenalGuard system decreases incidence of PC-AKI in patients with CKD receiving a PTA of the lower extremities. Furthermore, we will investigate whether sampling of urine biomarkers 4 hours after intervention can detect PC-AKI in an earlier stage compared with the golden standard, serum creatinine 48-72 hours postintervention. METHODS AND ANALYSIS A single-centre randomised controlled trial will be conducted. Patients >18 years in need of a PTA of the lower extremities and diagnosed with CKD will be randomly assigned to receive either standard of care prehydration and posthydration or furosemide forced diuresis with matched hydration periprocedural using the RenalGuard system. Four hours postintervention, a urine sample will be collected of all participating patients. Serum creatinine will be sampled within 10 days prior to intervention as well as 1, 3 and 30 days postintervention. The primary endpoint is incidence of PC-AKI post-PTA. Secondary endpoint is the rise of urine biomarkers 4 hours postintervention. ETHICS AND DISSEMINATION Study protocol is approved by the research ethics committee and institutional review board (reference number 16 T-201 and NL59809.096.16). Study results will be disseminated by oral presentation at conferences and will be submitted to a peer-reviewed journal. It is anticipated that study results will offer a solution to contrast-induced nephropathy in patients with CKD receiving a PTA of the lower extremities. TRIAL REGISTRATION NUMBER NTR6236; Pre-results. EUDRACT NUMBER 2016-005072-10.
4.
A new category stent with novel polyphosphazene surface modification.
Mori, H, Jinnouchi, H, Diljon, C, Torii, S, Sakamoto, A, Kolodgie, FD, Virmani, R, Finn, AV
Future cardiology. 2018;(3):225-235
Abstract
The COBRA-PzF™ (CeloNova BioSciences, Inc., TX, USA) is a new type of coronary stent composed of a cobalt chromium metallic backbone surrounded by a nanothin layer of Polyzene-F (PzF) without any added drug. Evidence from basic studies supports antithrombotic and anti-inflammatory properties for the PzF surface coating. Preclinical studies support the thromboresistance of PzF-coated surfaces and clinical studies have shown good outcomes for patients receiving this device with very low rates of stent thrombosis. COBRA-PzF may be especially useful in patients at high risk for bleeding. Ongoing clinical trials will determine whether shortening the duration of dual antiplatelet therapy to less than 1 month is feasible and these data may represent a new paradigm with regards to patients at high risk for bleeding.
5.
Manipal lifestyle modification score to predict major adverse cardiac events in postcoronary angioplasty patients.
Devasia, T, Shetty, PN, Kareem, H, Karkala, YR, Singh, A
Indian heart journal. 2018;(Suppl 3):S353-S358
Abstract
BACKGROUND Lifestyle modification (LSM) such as prudent diet, physical activity, avoidance of smoking, and maintaining a healthy weight may considerably decrease the risk for coronary artery disease. OBJECTIVE The primary objective of this study was to develop a new LSM scoring system and investigate the correlation between adherence to LSM and incidence of major adverse cardiac events (MACEs) at 12-month follow-up. METHOD A total of 1000 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were included in this prospective single-center study. Manipal lifestyle modification score (MLSMS) was developed by using five lifestyle-related factors. Adherence to LSM at the baseline and subsequent follow-ups was determined by using MLSMS. The MACE at 1-, 6-, and 12-month follow-up were analyzed. RESULTS There was a significant reduction in overall adherence to LSM (p < 0.001) at 12-month follow-up. Nonadherence to LSM [hazard ratio (HR) 0.575; 95% confidence interval (CI) 0.334-0.990; p < 0.046] and noncompliance to medication (HR 2.09; 95% CI 1.425-3.072; p < 0.001) were independent predictors of MACEs after PTCA. The cumulative MACE was 15.4%, which includes 4.9% of all-cause death, 5.2% of nonfatal myocardial infarction, 2.0% of target lesion revascularization, 1.8% of target vessel revascularization, and 1.3% of stroke at 12 months. The incidence of MACEs at 12 months was significantly (p = 0.03) higher in LSM nonadherent compared with LSM adherent patients. CONCLUSION There is an overall reduction in adherence to LSM on successive follow-ups and a significant association between the incidence of MACEs and the lack of adherence to LSM. MLSMS is a simple and effective evaluation tool in predicting MACEs in this group of patients.