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Johnson NP, Ahn JM. Left main PCI: beware the circumflex! Eur Heart J 2023; 44:4337-4339. [PMID: 37477204 DOI: 10.1093/eurheartj/ehad434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Affiliation(s)
- Nils P Johnson
- Weatherhead PET Center, Division of Cardiology, Department of Medicine, McGovern Medical School at UTHealth and Memorial Hermann Hospital, 6431 Fannin St., Room MSB 4.256, Houston, TX 77030, USA
| | - Jung-Min Ahn
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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2
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Clinical expert consensus document on quantitative coronary angiography from the Japanese Association of Cardiovascular Intervention and Therapeutics. Cardiovasc Interv Ther 2020; 35:105-116. [PMID: 32125622 PMCID: PMC7105443 DOI: 10.1007/s12928-020-00653-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 01/15/2023]
Abstract
Quantitative coronary angiography (QCA) remains to play an important role in clinical trials and post-marketing surveillance related to the safety and efficacy of new PCI devices. In this document, the current standard methodology of QCA is summarized. In addition, its history, recent development and future perspectives are also reviewed.
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3
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Cesaro A, Gragnano F, Di Girolamo D, Moscarella E, Diana V, Pariggiano I, Alfieri A, Perrotta R, Golino P, Cesaro F, Mercone G, Campo G, Calabrò P. Functional assessment of coronary stenosis: an overview of available techniques. Is quantitative flow ratio a step to the future? Expert Rev Cardiovasc Ther 2018; 16:951-962. [DOI: 10.1080/14779072.2018.1540303] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Arturo Cesaro
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Felice Gragnano
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Domenico Di Girolamo
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Elisabetta Moscarella
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Diana
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ivana Pariggiano
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfonso Alfieri
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Rocco Perrotta
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Pasquale Golino
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Francesco Cesaro
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Giuseppe Mercone
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
| | - Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | - Paolo Calabrò
- Division of Clinical Cardiology, A.O.R.N. Sant’Anna e San Sebastiano, Caserta, Italy
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
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4
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Kumar A, Hung OY, Piccinelli M, Eshtehardi P, Corban MT, Sternheim D, Yang B, Lefieux A, Molony DS, Thompson EW, Zeng W, Bouchi Y, Gupta S, Hosseini H, Raad M, Ko YA, Liu C, McDaniel MC, Gogas BD, Douglas JS, Quyyumi AA, Giddens DP, Veneziani A, Samady H. Low Coronary Wall Shear Stress Is Associated With Severe Endothelial Dysfunction in Patients With Nonobstructive Coronary Artery Disease. JACC Cardiovasc Interv 2018; 11:2072-2080. [PMID: 30268874 PMCID: PMC6217963 DOI: 10.1016/j.jcin.2018.07.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study investigated the relationship between low wall shear stress (WSS) and severe endothelial dysfunction (EDFx). BACKGROUND Local hemodynamic forces such as WSS play an important role in atherogenesis through their effect on endothelial cells. The study hypothesized that low WSS independently predicts severe EDFx in patients with coronary artery disease (CAD). METHODS Forty-four patients with CAD underwent coronary angiography, fractional flow reserve, and endothelial function testing. Segments with >10% vasoconstriction after acetylcholine (Ach) infusion were defined as having severe EDFx. WSS, calculated using 3-dimensional angiography, velocity measurements, and computational fluid dynamics, was defined as low (<1 Pa), intermediate (1 to 2.5 Pa), or high (>2.5 Pa). RESULTS Median age was 52 years, 73% were women. Mean fractional flow reserve was 0.94 ± 0.06. In 4,510 coronary segments, median WSS was 3.67 Pa. A total of 24% had severe EDFx. A higher proportion of segments with low WSS had severe EDFx (71%) compared with intermediate WSS (22%) or high WSS (23%) (p < 0.001). Segments with low WSS demonstrated greater vasoconstriction in response to Ach than did intermediate or high WSS segments (-10.7% vs. -2.5% vs. +1.3%, respectively; p < 0.001). In a multivariable logistic regression analysis, female sex (odds ratio [OR]: 2.44; p = 0.04), diabetes (OR: 5.01; p = 0.007), and low WSS (OR: 9.14; p < 0.001) were independent predictors of severe EDFx. CONCLUSIONS In patients with nonobstructive CAD, segments with low WSS demonstrated more vasoconstriction in response to Ach than did intermediate or high WSS segments. Low WSS was independently associated with severe EDFx.
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Affiliation(s)
- Arnav Kumar
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Olivia Y Hung
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Marina Piccinelli
- Department of Radiology, Emory University School of Medicine, Atlanta, Georgia
| | - Parham Eshtehardi
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Michel T Corban
- Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota
| | - David Sternheim
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Boyi Yang
- Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia
| | - Adrien Lefieux
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia; Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia
| | - David S Molony
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Elizabeth W Thompson
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Wenjie Zeng
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Yasir Bouchi
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Sonu Gupta
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Hossein Hosseini
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Mohamad Raad
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Chang Liu
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Michael C McDaniel
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Bill D Gogas
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - John S Douglas
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Arshed A Quyyumi
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Don P Giddens
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Alessandro Veneziani
- Department of Mathematics and Computer Science, Emory University, Atlanta, Georgia
| | - Habib Samady
- Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
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5
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High Coronary Shear Stress in Patients With Coronary Artery Disease Predicts Myocardial Infarction. J Am Coll Cardiol 2018; 72:1926-1935. [DOI: 10.1016/j.jacc.2018.07.075] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 07/10/2018] [Accepted: 07/16/2018] [Indexed: 01/09/2023]
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6
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Collet C, Grundeken MJ, Asano T, Onuma Y, Wijns W, Serruys PW. State of the art: coronary angiography. EUROINTERVENTION 2018; 13:634-643. [PMID: 28844026 DOI: 10.4244/eij-d-17-00465] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the early days of coronary angiography, the precise quantification of luminal narrowing was challenging. The introduction of balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) by Andreas Grüntzig in 1977 was perhaps the greatest incentive to the development of quantitative coronary angiography (QCA). QCA has played a crucial role in evaluating interventional techniques and assessing the results of new technologies. With the advent of drug-eluting stents (DES), QCA metrics such as late lumen loss and diameter stenosis (restenosis) proved to be instrumental in assessing new technologies. Refinements in QCA with the advent of dedicated bifurcation analysis and three-dimensional (3D) QCA have broadened the application of QCA. Beyond angiographic metrics, new developments in the field of QCA have introduced the functional component in the assessment of coronary lesions. Angiography-derived fractional flow reserve (FFR) may be a good tool for diagnosing ischaemia-producing lesions in patients with non-complex coronary artery disease. Furthermore, the incremental functional information can be used to expand the traditional late lumen loss (LLL) and restenosis concepts.
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Affiliation(s)
- Carlos Collet
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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7
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Incidence of thrombosis in perioperative and non-operative myocardial infarction. Br J Anaesth 2018; 120:725-733. [DOI: 10.1016/j.bja.2017.11.063] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 11/20/2022] Open
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8
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Lassen J, Burzotta F, Banning A, Lefèvre T, Darremont O, Hildick-Smith D, Chieffo A, Pan M, Holm N, Louvard Y, Stankovic G. Percutaneous coronary intervention for the left main stem and other bifurcation lesions: 12th consensus document from the European Bifurcation Club. EUROINTERVENTION 2018; 13:1540-1553. [DOI: 10.4244/eij-d-17-00622] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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9
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Grundeken MJ, Collet C, Ishibashi Y, Généreux P, Muramatsu T, LaSalle L, Kaplan AV, Wykrzykowska JJ, Morel MA, Tijssen JG, de Winter RJ, Onuma Y, Leon MB, Serruys PW. Visual estimation versus different quantitative coronary angiography methods to assess lesion severity in bifurcation lesions. Catheter Cardiovasc Interv 2017; 91:1263-1270. [DOI: 10.1002/ccd.27243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 02/21/2017] [Accepted: 07/20/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Maik J. Grundeken
- Amsterdam Heart Center, Academic Medical Center; Amsterdam The Netherlands
| | - Carlos Collet
- Amsterdam Heart Center, Academic Medical Center; Amsterdam The Netherlands
| | - Yuki Ishibashi
- Thoraxcenter, Erasmus Medical Center; Rotterdam The Netherlands
| | - Philippe Généreux
- Cardiovascular Research Foundation; New York
- Columbia University Medical Center; New York
- Morristown Medical Center; Morristown New Jersey
- Hôpital du Sacré-Coeur de Montréal, Université de Montréal; Montréal Québec Canada
| | - Takashi Muramatsu
- Department of Cardiology; Fujita Health University Hospital; Toyoake Japan
| | | | - Aaron V. Kaplan
- Geisel School of Medicine/Dartmouth-Hitchcock Medical Center; New Hampshire Lebanon
| | | | | | - Jan G. Tijssen
- Amsterdam Heart Center, Academic Medical Center; Amsterdam The Netherlands
- Cardialysis B.V; Rotterdam The Netherlands
| | | | - Yoshinobu Onuma
- Thoraxcenter, Erasmus Medical Center; Rotterdam The Netherlands
- Cardialysis B.V; Rotterdam The Netherlands
| | - Martin B. Leon
- Cardiovascular Research Foundation; New York
- Columbia University Medical Center; New York
| | - Patrick W. Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London; United Kingdom
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10
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Grundeken MJ, de Winter RJ, Wykrzykowska JJ. Safety and efficacy of the Tryton Side Branch Stent™ for the treatment of coronary bifurcation lesions: an update. Expert Rev Med Devices 2017; 14:545-555. [DOI: 10.1080/17434440.2017.1338135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maik J. Grundeken
- Department of Cardiology, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Robbert J. de Winter
- Department of Cardiology, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Joanna J. Wykrzykowska
- Department of Cardiology, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
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11
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Gil RJ, Bil J, Grundeken MJ, Iñigo Garcia LA, Vassilev D, Kern A, Pawłowski T, Wykrzykowska JJ, Serruys PW. Long-term effectiveness and safety of the sirolimus-eluting BiOSS LIM® dedicated bifurcation stent in the treatment of distal left main stenosis: an international registry. EUROINTERVENTION 2017; 12:1246-1254. [PMID: 26465375 DOI: 10.4244/eijy15m10_05] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS The aim of this study was to assess prospectively the effectiveness and safety of a new version of the dedicated bifurcation BiOSS stent, the sirolimus-eluting BiOSS LIM, for the treatment of distal left main (LM) stenosis. METHODS AND RESULTS This was a prospective international registry which enrolled patients with NSTE-ACS or stable angina. Provisional T-stenting was the mandated strategy. The primary endpoint was the cumulative rate of cardiac death, myocardial infarction (MI) and target lesion revascularisation (TLR) at 12 months. Twelve-month quantitative coronary angiography endpoints included late lumen loss and percent diameter stenosis. A total of 74 patients with distal LM stenosis were enrolled. Seventy-three of the 74 patients (aged 67±9 years, 23% women, 20.3% NSTE-ACS, SYNTAX score 22.4±4.4) were successfully treated with the BiOSS LIM stent, with additional side branch placement of regular DES in 11 patients (14.9%). Periprocedural MI occurred in one (1.4%) patient. The 12-month MACE rate was 9.5% without cardiac death or definite stent thrombosis. TLR and MI rates were 6.8% (n=5) and 2.7% (n=2), respectively. CONCLUSIONS The use of the BiOSS LIM dedicated bifurcation stent for the treatment of distal LM stenosis was feasible and safe, with promising long-term clinical effectiveness.
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Affiliation(s)
- Robert J Gil
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
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12
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Collet C, Onuma Y, Cavalcante R, Grundeken M, Généreux P, Popma J, Costa R, Stankovic G, Tu S, Reiber JHC, Aben JP, Lassen JF, Louvard Y, Lansky A, Serruys PW. Quantitative angiography methods for bifurcation lesions: a consensus statement update from the European Bifurcation Club. EUROINTERVENTION 2017; 13:115-123. [PMID: 28067200 DOI: 10.4244/eij-d-16-00932] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Bifurcation lesions represent one of the most challenging lesion subsets in interventional cardiology. The European Bifurcation Club (EBC) is an academic consortium whose goal has been to assess and recommend the appropriate strategies to manage bifurcation lesions. The quantitative coronary angiography (QCA) methods for the evaluation of bifurcation lesions have been subject to extensive research. Single-vessel QCA has been shown to be inaccurate for the assessment of bifurcation lesion dimensions. For this reason, dedicated bifurcation software has been developed and validated. These software packages apply the principles of fractal geometry to address the "step-down" in the bifurcation and to estimate vessel diameter accurately. This consensus update provides recommendations on the QCA analysis and reporting of bifurcation lesions based on the most recent scientific evidence from in vitro and in vivo studies and delineates future advances in the field of QCA dedicated bifurcation analysis.
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Affiliation(s)
- Carlos Collet
- Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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13
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Two-by-two cross-over study to evaluate agreement between versions of a quantitative coronary analysis system (QAngio XA). Int J Cardiovasc Imaging 2017; 33:779-787. [DOI: 10.1007/s10554-017-1068-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
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14
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Park TK, Lee JH, Song YB, Jeong JO, Hahn JY, Yang JH, Choi SH, Choi JH, Lee SH, Jeong MH, Kim HS, Oh JH, Yu CW, Rha SW, Jang Y, Yoon JH, Tahk SJ, Seung KB, Park JS, Gwon HC. Impact of non-compliant balloons on long-term clinical outcomes in coronary bifurcation lesions: results from the COBIS (COronary BIfurcation Stent) II registry. EUROINTERVENTION 2016; 12:456-64. [DOI: 10.4244/eijv12i4a79] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Barlis P, Poon EKW, Thondapu V, Grundeken MJ, Tu S, Hayat U, Ooi A, Moore S, Tenekecioglu E, Wykrzykowska JJ, Serruys PW. Reversal of flow between serial bifurcation lesions: insights from computational fluid dynamic analysis in a population-based phantom model. EUROINTERVENTION 2016; 11:e1-3. [PMID: 26390509 DOI: 10.4244/eijv11i5a111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Peter Barlis
- Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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16
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Lassen JF, Holm NR, Banning A, Burzotta F, Lefèvre T, Chieffo A, Hildick-Smith D, Louvard Y, Stankovic G. Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club. EUROINTERVENTION 2016; 12:38-46. [PMID: 27173860 DOI: 10.4244/eijv12i1a7] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Coronary bifurcations are involved in 15-20% of all percutaneous coronary interventions (PCI) and remain one of the most challenging lesions in interventional cardiology in terms of procedural success rate as well as long-term cardiac events. The optimal management of bifurcation lesions is, despite a fast growing body of scientific literature, the subject of considerable debate. The European Bifurcation Club (EBC) was initiated in 2004 to support a continuous overview of the field, and aims to facilitate a scientific discussion and an exchange of ideas on the management of bifurcation disease. The EBC hosts an annual, compact meeting, dedicated to bifurcations, which brings together physicians, engineers, biologists, physicists, epidemiologists and statisticians for detailed discussions. Every meeting is finalised with a consensus statement which reflects the unique opportunity of combining the opinions of interventional cardiologists with the opinions of a large variety of other scientists on bifurcation management. The present 11th EBC consensus document represents the summary of the up-to-date EBC consensus and recommendations. It points to the fact that there is a multitude of strategies and approaches to bifurcation stenting within the provisional strategy and in the different two-stent strategies. The main EBC recommendation for PCI of bifurcation lesions remains to use main vessel (MV) stenting with a proximal optimisation technique (POT) and provisional side branch (SB) stenting as a preferred approach. The consensus document covers a moving target. Much more scientific work is needed in non-left main (LM) and LM bifurcation lesions for continuous improvement of the outcome of our patients.
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Affiliation(s)
- Jens Flensted Lassen
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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17
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Grundeken MJ, Wykrzykowska JJ, Ishibashi Y, Garg S, de Vries T, Garcia-Garcia HM, Onuma Y, de Winter RJ, Buszman P, Linke A, Ischinger T, Klauss V, Eberli F, Corti R, Wijns W, Morice MC, di Mario C, Meier B, Jüni P, Yazdani A, Copt S, Windecker S, Serruys PW. First generation versus second generation drug-eluting stents for the treatment of bifurcations: 5-year follow-up of the LEADERS all-comers randomized trial. Catheter Cardiovasc Interv 2015; 87:E248-60. [DOI: 10.1002/ccd.26344] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 09/21/2015] [Accepted: 11/08/2015] [Indexed: 01/12/2023]
Affiliation(s)
| | | | - Yuki Ishibashi
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
| | - Scot Garg
- East Lancashire Hospitals NHS Trust; Blackburn United Kingdom
| | | | - Hector M. Garcia-Garcia
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- Cardialysis BV; Rotterdam The Netherlands
| | - Yoshinobu Onuma
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- Cardialysis BV; Rotterdam The Netherlands
| | | | | | | | | | | | - Franz Eberli
- Department of Cardiology; Triemli Spital, Zurich; Switzerland
| | | | - William Wijns
- Department of Cardiology; Onze Lieve Vrouw Ziekenhuis; Aalst Belgium
| | - Marie-Claude Morice
- Institut Hospitalier Jacques-Cartier; Institut Cardiovasculaire Paris-Sud; Massy France
| | | | - Bernhard Meier
- Department of Cardiology; University of Bern; Bern Switzerland
| | - Peter Jüni
- Department of Cardiology/University of Bern; CTU Bern and Institute of Social and Preventive Medicine; Bern Switzerland
| | | | | | | | - Patrick W. Serruys
- International Centre for Circulatory Health, NHLI, Imperial College London; London the United Kingdom
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18
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Généreux P, Kini A, Lesiak M, Kumsars I, Fontos G, Slagboom T, Ungi I, Metzger DC, Wykrzykowska JJ, Stella PR, Bartorelli AL, Fearon WF, Lefèvre T, Feldman RL, Tarantini G, Bettinger N, Minalu Ayele G, LaSalle L, Francese DP, Onuma Y, Grundeken MJ, Garcia-Garcia HM, Laak LL, Cutlip DE, Kaplan AV, Serruys PW, Leon MB. Outcomes of a dedicated stent in coronary bifurcations with large side branches: A subanalysis of the randomized TRYTON bifurcation study. Catheter Cardiovasc Interv 2015; 87:1231-41. [DOI: 10.1002/ccd.26240] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/21/2015] [Accepted: 08/24/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Philippe Généreux
- Columbia University Medical Center/NewYork Presbyterian Hospital; New York New York
- Cardiovascular Research Foundation; New York New York
- Hôpital Du Sacré-Coeur De Montréal, Université De Montréal; Montréal Québec Canada
| | | | - Maciej Lesiak
- 1st Department of Cardiology; University of Medical Sciences; Poznan Poland
| | - Indulis Kumsars
- Latvian Center of Cardiology, Paul Stradins Clinical University Hospital; Riga Latvia
| | - Géza Fontos
- Gottsegen Hungarian Institute of Cardiology; Budapest Hungary
| | - Ton Slagboom
- Department of Cardiology; OLVG, Onze Lieve Vrouwe Gasthuis; Amsterdam The Netherlands
| | - Imre Ungi
- 2nd Department of Medicine and Cardiology Center Medical Faculty; Albert Szent-Györgyi Clinical Center, University of Szeged- Department of Cardiology; Szeged Hungary
| | | | | | - Pieter R. Stella
- Department of Interventional Cardiology; University Medical Center Utrecht; Utrecht The Netherlands
| | | | - William F. Fearon
- Division of Cardiovascular Medicine; Stanford University Medical Center; Stanford California
| | - Thierry Lefèvre
- Institut Cardiovasculaire Paris Sud; Hôpital Privé Jacques Cartier; Massy France
| | | | | | - Nicolas Bettinger
- Columbia University Medical Center/NewYork Presbyterian Hospital; New York New York
- Cardiovascular Research Foundation; New York New York
| | | | - Laura LaSalle
- Cardiovascular Research Foundation; New York New York
| | | | - Yoshinobu Onuma
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
| | - Maik J. Grundeken
- Department of Cardiology; Academic Medical Center; Amsterdam The Netherlands
| | | | | | - Donald E. Cutlip
- Harvard Clinical Research Institute; Beth Israel Deaconess Medical Center; Boston Massachusetts
| | - Aaron V. Kaplan
- Tryton Medical Inc.; Durham North Carolina
- Dartmouth-Hitchcock Medical Center; New Hampshire Lebanon
| | | | - Martin B. Leon
- Columbia University Medical Center/NewYork Presbyterian Hospital; New York New York
- Cardiovascular Research Foundation; New York New York
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Louvard Y, Medina A. Definitions and classifications of bifurcation lesions and treatment. EUROINTERVENTION 2015; 11 Suppl V:V23-6. [DOI: 10.4244/eijv11sva5] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Grundeken MJ, Ishibashi Y, Ramcharitar S, Tuinenburg JC, Reiber JH, Tu S, Aben JP, Girasis C, Wykrzykowska JJ, Onuma Y, Serruys PW. The need for dedicated bifurcation quantitative coronary angiography (QCA) software algorithms to evaluate bifurcation lesions. EUROINTERVENTION 2015; 11 Suppl V:V44-9. [DOI: 10.4244/eijv11sva10] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Muramatsu T, Grundeken MJ, Ishibashi Y, Nakatani S, Girasis C, Campos CM, Morel MA, Jonker H, de Winter RJ, Wykrzykowska JJ, García-García HM, Leon MB, Serruys PW, Onuma Y. Comparison between two- and three-dimensional quantitative coronary angiography bifurcation analyses for the assessment of bifurcation lesions: A subanalysis of the TRYTON pivotal IDE coronary bifurcation trial. Catheter Cardiovasc Interv 2015; 86:E140-9. [DOI: 10.1002/ccd.25925] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/08/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Takashi Muramatsu
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- Department of Cardiology; Fujita Health University Hospital; Toyoake Japan
| | - Maik J. Grundeken
- Amsterdam Heart center; Academic Medical Center; Amsterdam The Netherlands
| | - Yuki Ishibashi
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
| | | | - Chrysafios Girasis
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- First Cardiology Department; Onassis Cardiac Surgery Center; Athens Greece
| | - Carlos M. Campos
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- Department of Interventional Cardiology; Heart Institute (InCor), University of São Paulo Medical School; São Paulo Brazil
| | | | - Hans Jonker
- Cardialysis; B.V.; Rotterdam The Netherlands
| | | | | | - Hector M. García-García
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
- Cardialysis; B.V.; Rotterdam The Netherlands
| | - Martin B. Leon
- Cardiovascular Research Foundation/Columbia University Medical Center; New York Presbyterian Hospital; New York New York
| | - Patrick W. Serruys
- International Centre for Circulatory Health; NHLI; Imperial College London; London United Kingdom
| | - Yoshinobu Onuma
- Thoraxcenter; Erasmus Medical Center; Rotterdam The Netherlands
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