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Author(s):
Angela Hoye
Added:
3 years ago
The coronary tree is comprised of arteries which divide into ever smaller branches to supply the myocardium. This means that the diameter of the vessel proximal to a bifurcation is always larger than the diameter of the main vessel distal to the bifurcation. The proximal optimisation technique (POT) was proposed by Dr Olivier Darremont as a technique to compensate for this difference in diameters…
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Author(s):
J Raider Estrada
,
Jonathan D Paul
,
Atman P Shah
,
et al
Added:
3 years ago
While the breadth of procedural offerings in interventional cardiology (IC) has exponentially expanded over the past four decades to include cardiac structural, peripheral arterial, and venous interventions, percutaneous coronary intervention (PCI) remains at the core of the field, accounting for the greatest percentage of therapeutic catheter-based procedures performed by IC practitioners in the…
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Author(s):
Shao-Liang Chen
,
Imad Sheiban
Added:
3 years ago
Bifurcation lesions account for approximately 20–30% of all percutaneous coronary interventions (PCIs). Coronary bifurcation sites are prone to developing obstructive atherosclerotic disease due to turbulent blood flow and change of shear stress. With the complexity of bifurcation lesions, several classification systems have been advocated in order to extablish percutaneous strategies.1–3 In fact…
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Provisional Stenting Tricks
Author(s):
Francesco Burzotta
,
Carlo Trani
Added:
3 years ago
Article
Author(s):
Helen Routledge
Added:
3 years ago
The preferred treatment approach for bifurcation disease can be generally summed up as ‘keep it simple’, otherwise known as provisional stenting. Based on several contemporary studies, coronary interventionalists have settled on a minimalist approach: starting with a single-stent approach for the main vessel (MV) and ignoring side branch (SB) disease unless clinical circumstances warrant…
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Author(s):
Yasushi Ueki
,
Tatsuhiko Otsuka
,
Kiyoshi Hibi
,
et al
Added:
3 years ago
Heavily calcified coronary artery lesions hinder device delivery and limit stent expansion, which is the most relevant predictor of stent failure. This may result in low procedural success and poor clinical outcomes. Coronary angiography has a limited ability to detect calcifications when planning an optimal percutaneous coronary intervention (PCI) strategy. Intracoronary imaging can provide…
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Author(s):
Joanna J Wykrzykowska
,
Willem J van der Giessen
Added:
3 years ago
Approach to the Bifurcation Patient
Historically, bifurcation lesions have been associated with lower procedural success and a poorer clinical outcome than non-bifurcation lesions. This may be due to the technical difficulty of the procedure but also due to the complexity of the patients. According to the recently presented LEADERS trial sub-study,1 patients who have bifurcation disease are…
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Author(s):
Ashok Seth
,
Sajal Gupta
,
Vivudh Pratap Singh
,
et al
Added:
3 years ago
In 1995, stent implantation became the second revolution in interventional cardiology when Colombo et al. demonstrated that intravascular ultrasound (IVUS)-guided post-dilatation of stents to achieve optimal expansion and larger lumens led to reduced restenosis and stent thrombosis (ST).1 This ‘bigger is better’ hypothesis became the technical cornerstone of all stent implantation in the bare…
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Author(s):
Carlotta Sorini Dini
,
Giulia Nardi
,
Francesca Ristalli
,
et al
Added:
3 years ago
In the 18th century, Edward Jenner and Caleb Hillier Parry, two British physicians, independently noticed that coronary ossification was often present in patients dying of ‘syncope anginosa’.1 Coronary angiography opened the possibility of expanding these observations to living patients and offered revascularisation options. During surgery, it was often possible to modify the position of the…
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Author(s):
Aleardo Maresta
,
Marco Balducelli
,
Elisabetta Varani
Added:
3 years ago
Cardiovascular disease is a major consequence of diabetes and is associated with peculiar features in this subgroup of patients, representing roughly 25% of the total population treated with percutaneous coronary interventions (PCIs). A consistent proportion of these patients have asymptomatic myocardial ischaemia, which is a more extensive and diffuse atherosclerotic disease with more prevalent…
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