Excimer laser coronary atherectomy prior to paclitaxel-coated balloon angioplasty for de novo coronary artery lesions

This study aimed to evaluate the efficacy and safety of excimer laser coronary atherectomy (ELCA) prior to paclitaxel-coated balloon angioplasty for de novo coronary artery lesions. This retrospective observational study analyzed 118 eligible patients with de novo coronary artery disease whose only percutaneous coronary intervention was a drug-coated balloon angioplasty (i.e., no subsequent stent placement). Data related to our primary outcomes of interest —incidence of major adverse cardiovascular and cerebral events (MACCE), and incidence of procedural complications (bailout stenting and minor complications)—were collected and retrospectively analyzed. ELCA was used significantly more often in the cases of main branch and ostial lesions (i.e., o f the circumflex, right coronary, or left anterior descending arteries, or high lateral branch), normally associated with poor treatment outcomes (55.6% vs. 14.3%,p 
Source: Lasers in Medical Science - Category: Laser Surgery Source Type: research

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CONCLUSION: The present case demonstrates that both diabetes mellitus and carriage of CYP2C19*2 allele are associated with a reduced response to clopidogrel in the setting of this standard dose of clopidogrel and a high risk of stent thrombosis. CYP2C19 genetic testing seems to be helpful for identifying patients-at-risk, and optimal antiplatelet regimen should be considered in these fragile populations.
. PMID: 32352367 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research
This study found no difference between the two treatments for the main endpoint. The stenting group had a slightly higher rate of death, but it wasn’t due to cardiac causes. (There were slightly more patients in the stenting group who died from infection and cancer, which was felt to be unrelated to the procedure.) Similar to NOBLE, EXCEL also found that patients undergoing stenting had higher rates of needing bypass surgery or repeat stenting. There was no difference in stroke rates. A recent meta-analysis (a study that pools together and analyzes many studies) found that bypass surgery and stenting were equal in te...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Heart Health Surgery Source Type: blogs
We report 4 cases of patients in whom we used the transradial approach to treat complex lesions in the left anterior descending coronary artery with bifurcation balloon angioplasty reconstruction (2 cases), in the ostium of the first diagonal branch, and in the right coronary artery. PMID: 32603464 [PubMed - in process]
Source: Texas Heart Institute Journal - Category: Cardiology Authors: Tags: Tex Heart Inst J Source Type: research
This article outlines the scientific background, experimental data, practical procedural techniques, and clinical applications of excimer laser coronary angioplasty in the treatment of coronary artery disease. PMID: 32005787 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
AbstractBackgroundThe randomized BASKET-SMALL 2 trial showed non-inferiority for treatment with drug-coated balloon (DCB) compared with drug-eluting stents (DES) in patients undergoing percutaneous coronary intervention (PCI) for de novo lesions in small coronary arteries regarding clinical endpoints at 1  year. In this predefined substudy, we investigated the angiographic findings in patients undergoing a clinically indicated follow-up angiography during the study phase.MethodsEight-hundred and eighty-three patients underwent PCI with either DES or DCB in a culprit vessel  
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
AbstractClinical trial data suggest that intravascular ultrasound (IVUS) may improve clinical outcomes after PCI. The aim of this study was to investigate the safety of IVUS in its broader use for percutaneous coronary intervention (PCI). A total of 11,570 consecutive patients undergoing PCI between 2008 and 2014 in Japan were analyzed. Associations between IVUS use, PCI-related complications were assessed with logistic regression and propensity score matching analyses. Subgroup analysis was performed in elective PCI patients. IVUS was used in 84.8% of patients (N = 9814; IVUS group); its use was almost unive...
Source: Heart and Vessels - Category: Cardiology Source Type: research
This study compared 9-month angiographic and physiologic results in patients with high bleeding risk and de novo coronary lesions treated with either paclitaxel-coated balloon (PCB) or bare-metal stent (BMS). Patients and methods A total of 40 patients (40 lesions) with high bleeding risk who underwent successful balloon angioplasty with fractional flow reserve (FFR) after balloon angioplasty more than 0.80 were randomized 1: 1 to treatment with PCB versus BMS. Dual antiplatelet therapy was limited to 1 month after the procedure. Results Baseline clinical and lesional characteristics were well balanced between the tw...
Source: Coronary Artery Disease - Category: Cardiology Tags: PCI Source Type: research
CONCLUSION:  Cangrelor produces more potent P2Y12 inhibition at the time of first coronary balloon inflation time compared with ticagrelor. Despite this enhanced P2Y12 inhibition, coronary microvascular function and final infarct size did not differ between groups. PMID: 31129911 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
ConclusionAcute limb ischemia caused by an EXOSEAL vascular closure device is a very rare complication. Balloon angioplasty and stenting are considered to be effective options to deal with the plug dislodgement of an EXOSEAL vascular closure device. We must be prepared for every rare complication during endovascular treatment.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Rescue Percutaneous Coronary Intervention for a Lethal "Jailed" Septal Perforator Branch to Resolve Delayed Complete Atrioventricular Block. Int Heart J. 2019 Feb 22;: Authors: Nojima Y, Ihara M, Adachi H, Kurimoto T, Nanto S Abstract Delayed complete atrioventricular (AV) block associated with an occluded septal perforator branch (SPB) is an uncommon complication after performing percutaneous coronary intervention (PCI) for the left anterior descending coronary artery (LAD). Here we report the case of a 74-year-old man who underwent elective PCI for proximal LAD complicated with occlusion of...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
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