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Elborae A, Hassan M, Meguid MA, Bakry K, Samir A, Brilakis E, Kandil H, ElGuindy A. Self-Apposing Stents in Coronary Chronic Total Occlusions: A Pilot Study. Heart Lung Circ 2024; 33:500-509. [PMID: 38448254 DOI: 10.1016/j.hlc.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are common after CTO PCI. METHODS We compared 20 patients who underwent CTO PCI using SA drug-eluting stents (DESs) with 20 matched control patients who underwent CTO PCI using balloon-expandable (BE)-DESs. All patients were followed up clinically for 12 months and had coronary angiography with optical coherence tomography at the end of the follow-up period. The primary end points were stent strut malapposition and strut coverage. The secondary end point was composite major adverse cardiovascular events (MACEs) at 12 months. RESULTS Both groups had high prevalence of diabetes mellitus, and most of the treated lesions were complex, with 62% having a J-CTO score of ≥3. All CTO PCI techniques were allowed for recanalisation, and 75% of the procedures were guided by intravascular ultrasound. At 12 months, the SA-DES group had fewer malapposed struts (0% [interquartile range (IQR) 0%-0%] vs 4.5% [IQR 0%-20%]; p<0.001) and uncovered struts (0.08% [IQR 0%-1.6%] vs 8.2% [IQR 0%-16%]; p<0.001). However, they showed significantly higher rates of MACEs due to clinically-driven target lesion revascularisation (45% vs 15%; p=0.038). CONCLUSIONS In this pilot study, compared with conventional BE-DESs, SA-DESs used in CTO PCI were associated with fewer malapposed and uncovered stent struts but also with significantly higher rates of in-stent restenosis and MACEs, mainly caused by clinically driven target lesion revascularisation.
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Affiliation(s)
- Ahmed Elborae
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt.
| | - Mohamed Hassan
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mohammed Abdel Meguid
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Karim Bakry
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
| | - Ahmad Samir
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
| | | | - Hossam Kandil
- Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ahmed ElGuindy
- Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt
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Ribeiro MH, Dallan LAP, Quesada FH, Rodriguez FH, Silveira C, Megaly MS, Brilakis E, Azzalini L. Extra-plaque rotational atherectomy for treating a balloon uncrossable ostial right coronary artery chronic total occlusion. Cardiovasc Revasc Med 2024; 58:50-51. [PMID: 37296001 DOI: 10.1016/j.carrev.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Performing atherectomy in the subintimal space remains controversial. We describe a case of successful ostial right coronary artery CTO recanalization using rotational atherectomy in subintimal space.
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Whitbeck MG, Chambers JW, Brilakis E. Techniques to overcome difficult delivery of the Impella CP device through a previously placed transcatheter aortic valve. Cardiovasc Revasc Med 2023:S1553-8389(23)00918-1. [PMID: 38052716 DOI: 10.1016/j.carrev.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/11/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
The utilization of mechanical circulatory support (MCS) for complex percutaneous coronary intervention (PCI) in patient with previous bioprosthetic aortic valve replacement continues to increase. This is due to an aging population and increased utilization of transcatheter aortic valve replacement (TAVR) to treat symptomatic severe aortic stenosis (AS). These patients often have concurrent high complexity coronary artery disease (CAD). Various strategies are available for the management of significant CAD in patients undergoing TAVR, including PCI before or after TAVR. However, placement of the Impella (Abiomed Danvers, MA) device in the left ventricle post TAVR can be challenging based on the device interaction with the TAVR cage or angulations of the ascending aorta. We describe a case of unsuccessful delivery of the Impella device through a previously placed 26 mm Sapien 3 TAVR (Edwards Irvine, CA) valve and the techniques that lead to successful placement of the device and review the tips and techniques that operators can employ to optimize success.
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Affiliation(s)
- Matthew G Whitbeck
- Metropolitan Heart & Vascular Institute, Minneapolis, MN, United States of America.
| | - Jeffrey W Chambers
- Metropolitan Heart & Vascular Institute, Minneapolis, MN, United States of America
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Minneapolis, MN, United States of America
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Park DY, Vemmou E, An S, Nikolakopoulos I, Regan CJ, Cambi BC, Frampton J, Vij A, Brilakis E, Nanna MG. Trends and impact of intravascular ultrasound and optical coherence tomography on percutaneous coronary intervention for myocardial infarction. Int J Cardiol Heart Vasc 2023; 45:101186. [PMID: 36852085 PMCID: PMC9957744 DOI: 10.1016/j.ijcha.2023.101186] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023]
Abstract
Background Intravascular imaging with either intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) is associated with improved outcomes, but these techniques have previously been underutilized in the real world. We aimed to examine the change in utilization of intravascular imaging-guided PCI over the past decade in the United States and assess the association between intravascular imaging and clinical outcomes following PCI for myocardial infarction (MI). Methods We surveyed the National Inpatient Sample from 2008 to 2019 to calculate the number of PCIs for MI guided by IVUS or OCT. Temporal trends were analyzed using Cochran-Armitage trend test or simple linear regression for categorical or continuous outcomes, respectively. Multivariable logistic regression was used to compare outcomes following PCI with and without intravascular imaging. Results A total of 2,881,746 PCIs were performed for MI. The number of IVUS-guided PCIs increased by 309.9 % from 6,180 in 2008 to 25,330 in 2019 (P-trend < 0.001). The percentage of IVUS use in PCIs increased from 3.4 % in 2008 to 8.7 % in 2019 (P-trend < 0.001). The number of OCT-guided PCIs increased 548.4 % from 246 in 2011 to 1,595 in 2019 (P-trend < 0.001). The percentage of OCT guidance in all PCIs increased from 0.0 % in 2008 to 0.6 % in 2019 (P-trend < 0.001). Intravascular imaging-guided PCI was associated with lower odds of in-hospital mortality (adjusted odds ratio 0.66, 95 % confidence interval 0.60-0.72, p < 0.001). Conclusions Although the number of intravascular imaging-guided PCIs have been increasing, adoption of intravascular imaging remains poor despite an association with lower mortality.
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Key Words
- BMS, Bare-metal stent
- CI, Confidence interval
- DES, Drug-eluting stent
- HCUP, Healthcare Cost and Utilization Project
- ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification
- ICD-10-PCS, International Classification of Diseases, 10th Revision, Procedural Coding System
- ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification
- ICD-9-PCS, International Classification of Diseases, 9th Revision, Procedural Coding System
- IVUS
- IVUS, Intravascular ultrasound
- Imaging
- Intravascular
- MI, Myocardial infarction
- Myocardial infarction
- NIS, National Inpatient Sample
- NSTEMI, Non-ST-elevation myocardial infarction
- OCT
- OCT, Optical coherence tomography
- PCI
- PCI, Percutaneous coronary intervention
- STEMI, ST-elevation myocardial infarction
- Trend
- U.S, United States
- aOR, Adjusted odds ratio
- cOR, Crude odds ratio
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Affiliation(s)
- Dae Yong Park
- Department of Medicine, Cook County Health, Chicago, IL, USA
| | - Evangelia Vemmou
- Department of Medicine, Yale New Haven Hospital, New Haven, CT, USA
| | - Seokyung An
- Department of Biomedical Science, Seoul National University, Seoul, Republic of Korea
| | | | | | - Brian C. Cambi
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Frampton
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Aviral Vij
- Division of Cardiology, Cook County Health, Chicago, IL, USA
- Division of Cardiology, Rush Medical College, Chicago, IL, USA
| | - Emmanouil Brilakis
- Division of Cardiology, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Michael G. Nanna
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Corresponding author at: Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, USA.
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Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Jaffer FA, Khatri JJ, Choi JW, Jaber WA, Rinfret S, Nicholson W, Patel MP, Mahmud E, Toma C, Davies RE, Kerrigan JL, Haddad EV, Gorgulu S, Abi-Rafeh N, ElGuindy AM, Goktekin O, Allana S, Burke MN, Mastrodemos OC, Rangan BV, Brilakis E. Development and validation of a scoring system for predicting clinical coronary artery perforation during percutaneous coronary intervention of chronic total occlusions: the PROGRESS-CTO perforation score. EUROINTERVENTION 2023; 18:1022-1030. [PMID: 36281650 PMCID: PMC9853034 DOI: 10.4244/eij-d-22-00593] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/12/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Coronary artery perforation is a feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and often leads to serious adverse clinical events. AIMS We sought to develop a risk score to predict clinical coronary artery perforation in patients undergoing CTO PCI. METHODS We analysed clinical and angiographic parameters from 9,618 CTO PCIs in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO). Logistic regression prediction modelling was used to identify variables independently associated with clinical perforation, and the model was internally validated with bootstrapping. Clinical coronary artery perforation was defined as any perforation requiring treatment. RESULTS The incidence of clinical coronary perforation was 3.8% (n=367). Five factors were independently associated with perforation and were included in the score: patient age ≥65 years +1 point (odds ratio [OR] 1.79, 95% confidence interval [CI]: 1.37-2.33), moderate/severe calcification +1 point (OR 1.85, 95% CI: 1.41-2.42), blunt/no stump +1 point (OR 1.45, 95% CI: 1.10-1.92), use of antegrade dissection and re-entry +1 point (OR 2.43, 95% CI: 1.61-3.69), and use of the retrograde approach +2 points (OR 4.02, 95% CI: 2.95-5.46). The resulting score showed acceptable performance on receiver operating characteristic (ROC) curve (area under the curve [AUC]: 0.741, 95% CI: 0.712-0.773). The Hosmer-Lemeshow test indicated a good fit (p=0.991), and internal validation with bootstrapping demonstrated good agreement with the model with observed AUC: 0.736 (95% bias-corrected CI: 0.706-0.767). CONCLUSIONS The PROGRESS-CTO perforation score may be a useful tool for predicting clinical coronary perforation during CTO PCI.
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Affiliation(s)
- Spyridon Kostantinis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Judit Karacsonyi
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | | | | | - James W Choi
- Texas Health Presbyterian Hospital, Dallas, TX, USA
| | | | | | | | | | | | - Catalin Toma
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | - Elias V Haddad
- Ascension Saint Thomas Heart Hospital, Nashville, TN, USA
| | | | | | | | | | - Salman Allana
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Olga C Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
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Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Karmpaliotis D, Jaffer FA, Khatri JJ, Poommipanit P, Choi JW, Jaber WA, Rinfret S, Nicholson W, Patel MP, Mahmud E, Dattilo P, Gorgulu S, Koutouzis M, Tsiafoutis I, Elbarouni B, Sheikh AM, Uretsky BF, ElGuindy AM, Jefferson BK, Patel TN, Wollmuth J, Riley RF, Benton SM, Davies RE, Chandwaney RH, Toma C, Yeh RW, Schimmel DR, Abi Rafeh N, Goktekin O, Kerrigan JL, Mastrodemos OC, Rangan BV, Garcia S, Sandoval Y, Burke MN, Brilakis E. In-hospital outcomes and temporal trends of percutaneous coronary interventions for chronic total occlusion. EUROINTERVENTION 2022; 18:e929-e932. [PMID: 36065983 PMCID: PMC9743233 DOI: 10.4244/eij-d-22-00599] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Spyridon Kostantinis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bahadir Simsek
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Judit Karacsonyi
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Khaldoon Alaswad
- Cardiovascular Division, Henry Ford Hospital Cardiology Heart Care, Detroit, MI, USA
| | | | | | | | | | | | - Paul Poommipanit
- University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - James W Choi
- Texas Health Presbyterian Hospital, Dallas, TX, USA
| | | | | | | | | | | | - Philip Dattilo
- UC Health Medical Center of the Rockies, Loveland, CO, USA
| | | | | | | | - Basem Elbarouni
- St. Boniface General Hospital, Winnipeg, Manitoba, MB, Canada
| | | | - Barry F Uretsky
- Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | | | | | - Taral N Patel
- Tristar Centennial Medical Center, Nashville, TN, USA
| | - Jason Wollmuth
- Providence Heart and Vascular Institute, Portland, OR, USA
| | | | | | | | | | - Catalin Toma
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Robert W Yeh
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | | | | | | - Olga C Mastrodemos
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Bavana V Rangan
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Santiago Garcia
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Yader Sandoval
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - M Nicholas Burke
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, MN, USA
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Chami T, Mahowald MK, Brilakis E. Retrograde approach for rewiring a jailed side branch during double kissing crush stenting. Catheter Cardiovasc Interv 2022; 100:756-758. [PMID: 36054321 DOI: 10.1002/ccd.30387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/09/2022] [Indexed: 11/08/2022]
Abstract
Double kissing crush (DK crush) is one of the preferred strategies for bifurcation stenting due to the lower risk of target vessel failure but can be difficult to perform. Difficulty in wiring the jailed side branch after stenting the main vessel is not uncommon. The retrograde crossing can provide a solution in selected cases when antegrade rewiring of a jailed side branch fails during DK crush (or other bifurcation stenting techniques).
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Affiliation(s)
- Tarek Chami
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Madeline K Mahowald
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
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Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Megaly M, Krestyaninov O, Khelimskii D, Jaffer F, Khatri J, Poommipanit P, Patel M, Mahmud E, Koutouzis M, Tsiafoutis I, Gorgulu S, Elbarouni B, Nicholson W, Jaber W, Rinfret S, Goktekin O, ElGuindy A, Sandoval Y, Burke MN, Allana S, Rangan B, Brilakis E. TCT-117 Impact of Proximal Cap Ambiguity on the Outcomes of Chronic Total Occlusion Intervention: Insights From the PROGRESS-CTO Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Megaly M, Buda K, Basir M, Mashayekhi K, Rinfret S, McEntegart M, Azzalini L, Alaswad K, Brilakis E. TCT-121 Extraplaque Versus Intraplaque Tracking in Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Simsek B, Kostantinis S, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Davies R, Rier J, Goktekin O, Gorgulu S, ElGuindy A, Chandwaney R, Patel M, Karmpaliotis D, Khatri J, Jaffer F, Poommipanit P, Rangan B, Sandoval Y, Elbarouni B, Nicholson W, Rinfret S, Koutouzis M, Tsiafoutis I, Yeh R, Burke MN, Allana S, Mastrodemos O, Brilakis E. TCT-112 Predicting In-Hospital Acute Myocardial Infarction in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Acute Myocardial Infarction Score. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Megaly M, Buda K, Mashayekhi K, Werner G, Grantham JA, Rinfret S, McEntegart M, Brilakis E, Alaswad K. TCT-118 Comparative Analysis of Patients’ Characteristics in Chronic Total Occlusion Revascularization Studies: Trials Versus Real-World Registries. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Megaly M, Jaffer F, Khatri J, Poommipanit P, Davies R, Rinfret S, Elbarouni B, Ybarra L, Sheikh A, Toma C, Chandwaney R, Goktekin O, ElGuindy A, Mastrodemos O, Rangan B, Burke MN, Brilakis E. TCT-128 Saphenous Vein Graft Occlusion Following Native Vessel Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Karacsonyi J, Simsek B, Kostantinis S, Alaswad K, Krestyaninov O, Karmpaliotis D, Kirtane A, McEntegart M, Khatri J, Poommipanit P, Jaffer F, Choi J, Mahmud E, Patel M, Koutouzis M, Tsiafoutis I, Elbarouni B, Jaber W, Rinfret S, Jefferson B, Patel T, Gorgulu S, ElGuindy A, Abi-Rafeh N, Goktekin O, Ungi I, Rangan B, Mastrodemos O, Sandoval Y, Allana S, Burke MN, Brilakis E. TCT-110 Use of Atherectomy in Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Khalil M, Maqsood MH, Basir M, Saad M, Yassa G, Hakam L, Hennawy B, El Etriby S, Garcia S, Brilakis E, Alaswad K, Megaly M. TCT-7 Invasive Versus Conservative Strategy in Elderly Patients With Non–ST-Segment Elevation Myocardial Infarction: A Meta-analysis of Randomized Controlled Trials. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Simsek B, Kostantinis S, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Davies R, Rier J, Goktekin O, Gorgulu S, ElGuindy A, Chandwaney R, Patel M, Karmpaliotis D, Khatri J, Jaffer F, Poommipanit P, Rangan B, Sandoval Y, Elbarouni B, Nicholson W, Rinfret S, Koutouzis M, Tsiafoutis I, Yeh R, Burke MN, Allana S, Mastrodemos O, Brilakis E. TCT-171 Predicting the Risk of Perforation Requiring Pericardiocentesis in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO Pericardiocentesis Score. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Simsek B, Kostantinis S, Karacsonyi J, Alaswad K, Krestyaninov O, Khelimskii D, Davies R, Rier J, Goktekin O, Gorgulu S, ElGuindy A, Chandwaney R, Patel M, Karmpaliotis D, Khatri J, Jaffer F, Poommipanit P, Rangan B, Sandoval Y, Elbarouni B, Nicholson W, Rinfret S, Koutouzis M, Tsiafoutis I, Yeh R, Burke MN, Allana S, Brilakis E. TCT-113 Predicting the Risk of In-Hospital Major Adverse Cardiovascular Events in Chronic Total Occlusion Percutaneous Coronary Intervention: The PROGRESS-CTO MACE Score. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Karacsonyi J, Kostantinis S, Simsek B, Alaswad K, Karmpaliotis D, Kirtane A, McEntegart M, Jaffer F, Choi J, Poommipanit P, Koutouzis M, Tsiafoutis I, Khatri J, Kandzari D, Chandwaney R, Elbarouni B, Gorgulu S, ElGuindy A, Abi-Rafeh N, Goktekin O, Ungi I, Rangan B, Mastrodemos O, Sandoval Y, Allana S, Burke MN, Brilakis E. TCT-109 Use of Subintimal Tracking and Reentry Technique in Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Megaly M, Zakhour S, Karacsonyi J, Basir M, Kunkel K, Simsek B, Kostantinis S, Mashayekhi K, Kandzari D, Brilakis E, Alaswad K. TCT-126 Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention of the Left Anterior Descending Artery. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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19
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Vazquez DF, Tsai S, Liu YL, Hoang L, Lu H, Rosol Z, Brilakis E, Shishehbor M, Banerjee S. TCT-221 Outcomes of Below the Knee Balloon-Only Percutaneous Transluminal Angioplasty: Data From the XLPAD Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Simsek B, Kostantinis S, Karacsonyi J, Alaswad K, Karmpaliotis D, Jaffer F, Khatri J, Poommipanit P, Gorgulu S, Goktekin O, Krestyaninov O, Davies R, ElGuindy A, Haddad E, Kerrigan J, Patel M, Chandwaney R, Mastrodemos O, Allana S, Rangan B, Brilakis E. TCT-123 Predictors of Success in Primary Retrograde Strategy in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Jaffer F, Khatri J, Choi J, Jaber W, Rinfret S, Nicholson W, Patel M, Mahmud E, Toma C, Davies R, Kerrigan J, Haddad E, Gorgulu S, ElGuindy A, Goktekin O, Allana S, Burke MN, Mastrodemos O, Rangan B, Brilakis E. TCT-170 Development and Validation of a Scoring System for Predicting Clinical Coronary Artery Perforation During Percutaneous Coronary Interventions of Chronic Total Occlusions: The PROGRESS-CTO Perforation Score. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Megaly M, Basir MB, Brilakis E, Alaswad K. Extra-stent subintimal plaque modification; a novel technique to overcome resistant stent underexpansion. Cardiovascular Revascularization Medicine 2022; 40S:276-278. [DOI: 10.1016/j.carrev.2022.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/12/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022]
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23
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Megaly M, Basir MB, Brilakis E, Alaswad K. Wire Entrapment and Unraveling in the Aorta: Snaring Technique for the Nonvisible Filament. JACC Cardiovasc Interv 2022; 15:e21-e22. [PMID: 34973909 DOI: 10.1016/j.jcin.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/28/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Michael Megaly
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA. https://twitter.com/MichaelMegalyMD
| | - Mir B Basir
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Khaldoon Alaswad
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA.
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Goula A, Chatzis A, Stamouli MA, Kelesi M, Kaba E, Brilakis E. Assessment of Health Professionals' Attitudes on Radiation Protection Measures. Int J Environ Res Public Health 2021; 18:ijerph182413380. [PMID: 34948989 PMCID: PMC8708066 DOI: 10.3390/ijerph182413380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.
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Affiliation(s)
- Aspasia Goula
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
- Correspondence:
| | - Athanasios Chatzis
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Maria-Aggeliki Stamouli
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
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25
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Koutouzis M, Liontou C, Xenogiannis I, Tajti P, Tsiafoutis I, Lazaris E, Oikonomidis N, Kontopodis E, Rangan B, Brilakis E. Same day discharge after chronic total occlusion interventions: A single center experience. Catheter Cardiovasc Interv 2021; 98:1232-1239. [PMID: 33048434 DOI: 10.1002/ccd.29320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To assess the feasibility and safety of same day discharge (SDD) after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND CTO PCI has been associated with higher complication rates and procedural and hospitalization costs. Shortening post-PCI hospitalization length not only increases the patients' comfort but at the same time it consists an important part of cost reduction policies. METHODS We retrospectively compared the 30-day outcomes of patients who underwent CTO PCI at the Red Cross Hospital, Greece between January 2016 and June 2019 and underwent SDD versus non-SDD. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction, urgent repeat target vessel revascularization, tamponade, and stroke. RESULTS A total of 173 patients (mean age 63.7 ± 8.9 years) were included, of whom 51 (30%) underwent SDD. SDD patients were less likely to have diabetes mellitus (51 vs. 31%, p = .015), arterial hypertension (89 vs. 67%, p < .001), and acute coronary syndrome presentation (39.7 vs. 21.6%, p = .022), compared with non-SDD patients. Forearm access was used in all SDD patients and in 83% of the non-SDD patients. The 30-day incidence of MACE was 0% in the SDD group and 1.6% in the non-SDD group. Multivariable analysis showed that diabetes mellitus and longer procedural time were associated with lower probability of SDD (OR: 0.34, 95% CI: 0.15, 0.73 and OR: 0.29, 95% CI: 0.12, 0.71, respectively). CONCLUSIONS SDD appears to be feasible and safe in selected patients undergoing an uncomplicated CTO PCI through forearm approach.
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Affiliation(s)
| | | | - Iosif Xenogiannis
- Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| | - Peter Tajti
- Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| | | | | | | | | | - Bavana Rangan
- Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
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26
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Megaly M, Basir MB, Brilakis E, Alaswad K. "Power Carlino": A Novel Method for Modifying Wire-Impenetrable Proximal Caps During Chronic Total Occlusion Revascularization. JACC Cardiovasc Interv 2021; 14:2521-2522. [PMID: 34743898 DOI: 10.1016/j.jcin.2021.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Michael Megaly
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Mir B Basir
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
| | - Khaldoon Alaswad
- Department of Cardiology, Henry Ford Hospital, Detroit, Michigan, USA.
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27
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Nikolakopoulos I, Quadros A, Dens J, Rafeh NA, Agostoni P, Alaswad K, Avran A, Belli K, Campos C, Carlino M, Choi J, De Los Santos FD, ElGuindy A, Jaffer FA, Karmpaliotis D, Khatri J, Khelimskii D, Knaapen P, Krestyaninov O, La Manna A, Lamelas P, Ojeda S, Padilla L, Piccaro de Oliveira P, Rinfret S, Santiago R, Spratt J, Walsh S, Kostantinis S, Simsek B, Karacsonyi J, Rangan B, Vemmou E, Brilakis E, Azzalini L. TCT-71 Characteristics and Outcomes of Men and Women Undergoing Chronic Total Occlusion Percutaneous Coronary Intervention: Individual Patient Data Pooled Analysis of 4 Multicenter Registries. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Karacsonyi J, Kostantinis S, Gutierrez A, Avula V, Simsek B, Burke MN, Garcia S, Goessl M, Sorajja P, Chavez I, Mooney M, Poulose A, Traverse J, Wang Y, Ungi I, Nikolakopoulos I, Vemmou E, Guddeti R, Rangan B, Brilakis E. TCT-464 Outcomes of Patients With Bifurcation Lesions: Preliminary Results From the Prospective Global Registry for the Study of Bifurcation Lesion Interventions (PROGRESS-BIFURCATION) Registry. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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29
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Kostantinis S, Alaswad K, Karmpaliotis D, Jaffer FA, Jaber W, Nicholson W, Rinfret S, Khatri J, Poommipanit P, Karacsonyi J, Vemmou E, Nikolakopoulos I, Avula V, Gutierrez A, Tsiafoutis I, Riley R, Sheikh A, Patel M, Gorgulu S, ElGuindy A, Goktekin O, Abi-Rafeh N, Rangan B, Garcia S, Burke MN, Brilakis E. TCT-72 Primary Versus Secondary Retrograde Approach in Chronic Total Occlusion Interventions. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Avula V, Karacsonyi J, Kostantinis S, Rangan B, Gutierrez A, Brilakis E, Burke MN, Garcia S, Mooney M, Sorajja P, Traverse J, Poulose A, Chavez I, Wang Y, Goessl M. TCT-384 Incidence, Treatment, and Outcomes of Coronary Artery Perforation During Percutaneous Coronary Intervention: Insights From the PROGRESS-COMPLICATIONS Registry. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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31
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Nikolakopoulos I, Vemmou E, Karacsonyi J, Garcia S, Henry T, Goessl M, Sharkey S, Burke MN, Sorajja P, Traverse J, Wang Y, Mooney M, Poulose A, Chavez I, Simsek B, Kostantinis S, Rangan B, Brilakis E. TCT-34 Hemoglobin Drop in the Absence of Overt Bleeding After Percutaneous Coronary Intervention is Associated With In-Hospital Mortality. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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32
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Malahias MA, Kostretzis L, Gkiatas I, Chronopoulos E, Brilakis E, Antonogiannakis E. Clinical and radiographic outcomes of total shoulder arthroplasty with a partially cemented all-polyethylene pegged bone-ingrowth glenoid component: a systematic review. Shoulder Elbow 2021; 13:627-641. [PMID: 34804212 PMCID: PMC8600676 DOI: 10.1177/1758573220944168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/21/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several articles have been published reporting on the clinical performance of a novel pegged, all-polyethylene glenoid component design which features a central peg, circumferentially fluted, interference-fit peg for tissue integration and three small peripheral pegs for cementing. However, no systematic review exists to this date. METHODS The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications up to May 2020. RESULTS Overall, 13 articles were included for analysis (560 operated shoulders, range of mean follow-up: 2-6 years). The survival rate was 98.2% (550 out of 560 cases), while the rate of aseptic loosening was 0.2% (1 out of 560 cases). There were 139 cases (out of 399 reported; 34.1%) with peri-glenoid radiolucency, and 35 cases (out of 223 reported; 15.7%) of asymptomatic central peg osteolysis, with 1 of them undergoing revision. CONCLUSIONS There was fair quality of evidence to show that partially cemented all-polyethylene pegged bone-ingrowth glenoid components produce promising results, with a low revision rate in the short- to medium-term follow-up. Nevertheless, this analysis showed high rates of both radiolucency of the glenoid component and osteolysis around the central peg which raise concern for potential failure of this glenoid component in the long-term follow-up. LEVEL OF EVIDENCE Systematic review, IV.
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Affiliation(s)
- Michael-Alexander Malahias
- 3rd Orthopaedic Department, Hygeia
Hospital, Athens, Greece,The Stavros Niarchos Foundation Complex
Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Lazaros Kostretzis
- 2nd Orthopaedic Department, Aristotle
University of Thessaloniki, G.Gennimatas General Hospital, Thessaloniki,
Greece,Lazaros Kostretzis, 2nd Orthopaedic
Department, Aristotle University of Thessaloniki, G.Gennimatas General Hospital,
Eth. Aminis 41, Thessaloniki, Greece.
| | - Ioannis Gkiatas
- The Stavros Niarchos Foundation Complex
Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
| | - Efstathios Chronopoulos
- 2nd Orthopaedic Department, National
& Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Kwon O, Lee P, Lee SW, Brilakis E, Lee JY, Yoon YH, Lee K, Park H, Kang SJ, Kim YH, Lee C, Park SW. Clinical outcomes of post-stent intravascular ultrasound examination for chronic total occlusion intervention with drug-eluting stents. EUROINTERVENTION 2021; 17:e639-e646. [PMID: 33589410 PMCID: PMC9724988 DOI: 10.4244/eij-d-20-00941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have evaluated intravascular ultrasound (IVUS) use in chronic total occlusion (CTO) percutaneous coronary intervention (PCI). AIMS In CTO-PCI, we aimed to (1) evaluate the clinical benefits of performing post-stent IVUS in preventing adverse clinical events, and (2) identify IVUS parameters and cut-off values for prediction of target lesion revascularisation (TLR)/reocclusion. METHODS A total of 1,077 patients with 1,077 CTO lesions treated with drug-eluting stents (DES) were included. Clinical outcomes during a median follow-up of 6.3 years were compared between subjects with and those without post-stent IVUS using the inverse probability weighting method. RESULTS Of 1,077 patients, post-stent IVUS was performed in 838 (77.8%) cases while in the remaining 239 (22.2%) cases it was not. In the weighted population, the risk of TLR/reocclusion was significantly lower in subjects with post-stent IVUS (9.6% vs 18.9%, hazard ratio [HR] 0.54, 95% confidence interval [CI]: 0.34-0.86, p=0.01), compared with those without post-stent IVUS. Cox regression analysis showed that minimal stent area (MSA) measured by IVUS was the only parameter independently associated with TLR/reocclusion (HR 0.78, 95% CI: 0.64-0.95; p=0.01) and the optimal MSA cut-off value was 4.9 mm2 for prediction of TLR/reocclusion (area under the curve=0.632, p=0.001). CONCLUSIONS In CTO-PCI with DES, post-stent IVUS evaluation was associated with a lower risk of TLR/reocclusion. The final MSA was independently associated with TLR/reocclusion with a cut-off value of 4.9 mm2.
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Affiliation(s)
- Osung Kwon
- Division of Cardiology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Pil Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Whan Lee
- Division of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, South Korea
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Jong-Young Lee
- Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong-Hoon Yoon
- Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Kyusup Lee
- Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Hanbit Park
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soo-Jin Kang
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Hak Kim
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Cheol Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seong-Wook Park
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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34
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Kandzari DE, Alaswad K, Jaffer FA, Brilakis E, Croce K, Kearney K, Spaedy A, Yeh R, Thompson C, Nicholson W, Wyman RM, Riley R, Lansky A, Buller C, Karmpaliotis D. Safety and efficacy of dedicated guidewire, microcatheter, and guide catheter extension technologies for chronic total coronary occlusion revascularization: Primary results of the Teleflex Chronic Total Occlusion Study. Catheter Cardiovasc Interv 2021; 99:263-270. [PMID: 34582080 DOI: 10.1002/ccd.29962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/05/2021] [Accepted: 09/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Description of procedural outcomes using contemporary techniques that apply specialized coronary guidewires, microcatheters, and guide catheter extensions designed for chronic total occlusion (CTO) percutaneous revascularization is limited. METHODS A prospective, multicenter, single-arm study was conducted to evaluate procedural and in-hospital outcomes among 150 patients undergoing attempted CTO revascularization utilizing specialized guidewires, microcatheters and guide extensions. The primary endpoint was defined as successful guidewire recanalization and absence of in-hospital cardiac death, myocardial infarction (MI), or repeat target lesion revascularization (major adverse cardiac events, MACE). RESULTS The prevalence of diabetes was 32.7%; prior MI, 48.0%; and previous bypass surgery, 32.7%. Average (mean ± standard deviation) CTO length was 46.9 ± 20.5 mm, and mean J-CTO score was 1.9 ± 0.9. Combined radial and femoral arterial access was performed in 50.0% of cases. Device utilization included: support microcatheter, 100%; guide catheter extension, 64.0%; and mean number of study guidewires/procedure was 4.8 ± 2.6. Overall, procedural success was achieved in 75.3% of patients. The rate of successful guidewire recanalization was 94.7%, and in-hospital MACE was 19.3%. Achievement of TIMI grade 2 or 3 flow was observed in 93.3% of patients. Crossing strategies included antegrade (54.0%), retrograde (1.3%) and combined antegrade/retrograde techniques (44.7%). Clinically significant perforation resulting in hemodynamic instability and/or requiring intervention occurred in 16 (10.7%) patients. CONCLUSIONS In a multicenter, prospective registration study, favorable procedural success was achieved despite high lesion complexity using antegrade and retrograde guidewire maneuvers and with acceptable safety, yet with comparably higher risk than conventional non-CTO PCI.
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Affiliation(s)
| | - Khaldoon Alaswad
- Division of Cardiology, Henry Ford Health System, Detroit, Michigan, USA
| | - Farouc A Jaffer
- Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Kevin Croce
- Division of Cardiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Kathleen Kearney
- Division of Cardiology, University of Washington, Seattle, Washington, USA
| | - Anthony Spaedy
- Missouri Cardiovascular Specialists, Columbia, Missouri, USA
| | - Robert Yeh
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Craig Thompson
- Division of Cardiology, New York University Langone Health, New York, New York, USA
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35
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Affiliation(s)
- Emmanouil Brilakis
- Minneapolis Heart Institute, Abbott Northwestern Hospital, 920 E 28th Street #300, Minneapolis, MN 55407, USA
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36
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Xenogiannis I, Jaffer F, Shah A, Omer M, Megaly M, Vemmou E, Nikolakopoulos I, Rangan B, Garcia S, Lesser J, Cavalcante J, Burke M, Brilakis E. Computed tomography angiography co-registration with real-time fluoroscopy in percutaneous coronary intervention for chronic total occlusions. EUROINTERVENTION 2021; 17:e433-e435. [PMID: 32657275 PMCID: PMC9724964 DOI: 10.4244/eij-d-20-00175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Iosif Xenogiannis
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Farouc Jaffer
- Interventional Cardiology Department, Massachusetts General Hospital, Boston, MA, USA
| | - Alpesh Shah
- Interventional Cardiology Department, Houston Methodist Hospital, Houston, TX, USA
| | - Mohamed Omer
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Michael Megaly
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Evangelia Vemmou
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Ilias Nikolakopoulos
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Bavana Rangan
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Santiago Garcia
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - John Lesser
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - João Cavalcante
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - M. Burke
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, 920 E 28th Street #300, Minneapolis, MN 55407, USA
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Megaly M, Sedhom R, Pershad A, Vemmou E, Nikolakopoulos I, Karacsonyi J, Saad M, Mentias A, Garcia S, Karmpaliotis D, Egred M, Burke M, Brilakis E. Complications and failure modes of coronary microcatheters. EUROINTERVENTION 2021; 17:e436-e438. [PMID: 32624461 PMCID: PMC9725064 DOI: 10.4244/eij-d-20-00572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Michael Megaly
- Banner University Medical Center/University of Arizona, Phoenix, AZ, USA
| | - Ramy Sedhom
- Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Ashish Pershad
- Banner University Medical Center/University of Arizona, Phoenix, AZ, USA
| | - Evangelia Vemmou
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | - Judit Karacsonyi
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Marwan Saad
- The Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Amgad Mentias
- Roy and Lucille J. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Santiago Garcia
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | - Mohaned Egred
- Freeman Hospital, Newcastle upon Tyne Hospitals, NHS Foundation Trust, Newcastle, United Kingdom
| | - M. Burke
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, 920 E 28th Street #300, Minneapolis, MN 55407, USA
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Malahias MA, Brilakis E, Chytas D, Gerogiannis D, Avramidis G, Antonogiannakis E. Functional Outcomes of Bilateral Reverse Total Shoulder Arthroplasty: A Systematic Review. Joints 2021; 7:188-198. [PMID: 34235384 PMCID: PMC8253605 DOI: 10.1055/s-0041-1730974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
Purpose
To answer the question whether bilateral reverse total shoulder arthroplasty (RTSA) is a safe and effective treatment which results in satisfactory clinical and functional outcomes with low complications rates. A second question to be answered was: what is the quality of the evidence of the already published studies which investigate the use of bilateral RTSA?
Methods
Two reviewers independently conducted a systematic search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms “reverse” AND “total” AND “shoulder” AND “arthroplasty” AND “clinical.” Descriptive statistics were used to summarize the data.
Results
From the 394 initial studies we finally selected and assessed 6 clinical studies which were eligible to our inclusion–exclusion criteria. The aforementioned studies included in total 203 patients (69% females; mean age range: 67.1–75 years; mean follow-up range: 12–61 months). From those, 168 patients underwent staged bilateral RTSA (mean duration between first and second operation range: 8–21.6 months) and the rest of them a unilateral RTSA as controlled treatment. Almost all mean clinical and functional scores, which were used to assess the therapeutic value of bilateral RTSA, depicted significant postoperative improvement in comparison with the mean preoperative values. The modified Coleman methodology score, which was used to assess the quality of the studies, ranged from a minimum of 36/100 to a maximum of 55/100.
Conclusion
Despite the lack of high-quality evidence, staged bilateral RTSA seems to be a safe and effective procedure for patients with cuff tear arthropathy, which results in significantly improved clinical and functional outcomes and low reoperations' rates.
Level of Evidence
Systematic review of level III-IV therapeutic studies.
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Affiliation(s)
| | | | - Dimitrios Chytas
- 2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Karacsonyi J, Tsiafoutis I, Alaswad K, Khatri J, Choi J, Karmpaliotis D, ElGuindy A, Sheikh AM, Jaber W, Elbarouni B, Jaffer F, Poomipanit P, Chandwaney R, Krestianinov O, Uretsky B, Patel M, Toma C, Yeh R, Vemmou E, Nikolakopoulos I, Xenogiannis I, Rangan B, Ungi I, Brilakis E, Koutouzis M. THE IMPACT OF ANNUAL OPERATOR VOLUME ON THE OUTCOMES OF CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nikolakopoulos I, Karacsonyi J, Vemmou E, Rangan B, Guddeti R, Garcia S, Tsioufis K, Siasos G, Tousoulis D, Gossl M, Chavez I, Mooney M, Traverse J, Wang Y, Poulose A, Sorajja P, Burke MN, Brilakis E. TREATMENT PATTERNS AND OUTCOMES OF BIFURCATION LESIONS: FIRST RESULTS FROM THE PROSPECTIVE GLOBAL REGISTRY FOR THE STUDY OF BIFURCATION LESION INTERVENTIONS (PROGRESS-BIFURCATION). J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02323-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Radaideh Q, Armstrong E, Brilakis E, Banerjee S, Shammas N. TREATING INFLOW AND OUTFLOW VS INFLOW ONLY IN CRITICAL LIMB ISCHEMIA PATIENTS RESULTS FROM THE XLPAD REGISTRY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02423-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vemmou E, Nikolakopoulos I, Nowariak M, Schmidt C, Karacsonyi J, Xenogiannis I, Brilakis E, Sharkey SW. IS IT SAFE TO DISCHARGE PATIENTS WITH TAKOTSUBO CARDIOMYOPATHY AND LONG QTC INTERVAL. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02206-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nikolakopoulos I, Vemmou E, Karacsonyi J, Alaswad K, Karmpaliotis D, Schimmel D, Benzuly K, Flaherty J, Krestianinov O, Khelimskii D, Rafeh NA, Ahmed E, Goktekin O, Gorgulu S, Reddy N, Khatri J, Jaffer F, Koutouzis M, Tsiafoutis I, Riley R, Choi J, Jaber W, Samady H, Burke MN, Brilakis E. CHRONIC TOTAL OCCLUSION PERCUTANEOUS CORONARY INTERVENTION IN YOUNG PATIENTS: INSIGHTS FROM THE PROGRESS-CTO REGISTRY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vemmou E, Alaswad K, Khatri J, Karmpaliotis D, Mahmud E, Doing A, Dattilo P, Koutouzis M, Tsiafoutis I, Uretsky B, Toma C, Elbarouni B, Love M, Jaber W, Samady H, Jefferson B, Patel T, Abi-Rafeh N, Rangan B, Nikolakopoulos I, Karacsonyi J, Garcia S, Burke MN, Baechler C, Brilakis E. CHARACTERISTICS AND OUTCOMES OF CHRONIC TOTAL OCCLUSION (CTO) PERCUTANEOUS CORONARY INTERVENTION (PCI) ACCORDING TO RACE, INSIGHTS FROM THE PROGRESS-CTO REGISTRY. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02554-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chatzis A, Brilakis E, Papadopoulou D, Giannouli V, Stamouli MA, Goula A, Sarris M, Soulis S. Beliefs and behaviours of radiographers and other health professionals concerning radiation protection safety in a high-volume Greek public hospital. Development of a new measuring instrument. Radiography (Lond) 2021; 27:1038-1043. [PMID: 33933361 DOI: 10.1016/j.radi.2021.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The use of fluoroscopy-assisted surgical procedures has been increasing recently. The extensive use of fluoroscopy, combined with the lack of knowledge about radiation risks among operating room (OR) personnel (surgeons, anaesthetists, nurses, and radiographers), may lead to misconceptions. The perceptions and beliefs of any health professional concerning radiation protection safety (RPS) may affect their behaviour during surgery, leading to negative outcomes. The aim of this study was to construct a new, original, reliable, and valid instrument to record the beliefs, perceptions, and behaviours of health professionals during surgery, which reflects the established culture of RPS. METHODS A questionnaire was designed, consisting of 95 questions grouped into six coherent sections. The study was performed at a Greek public hospital with a high workload in terms of fluoroscopically guided surgical operations. RESULTS It was distributed among 136 people, and 132 completed questionnaires were collected (response rate 97%). Exploratory factor analysis was performed separately for each scale studied and Cronbach's Alpha reliability analysis was also performed. The reliability of the greater part of the new measurement tool ranged from very good to acceptable. CONCLUSION The questionnaire developed in this study is a valid and reliable option for recording health professionals' perceptions, beliefs, and behaviours concerning the RPS culture. IMPLICATIONS FOR PRACTICE This study helps clinical radiographers to understand a possible knowledge gap about RPS and locates the specific fields that the OR personnel misunderstand. It also can support and establish local learning organisations with regular targeted staff training for health professionals, thereby leading to a generally improved RPS culture.
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Affiliation(s)
- A Chatzis
- General Hospital "Asklepieio Voulas", Voula, Greece; Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - E Brilakis
- Associate Director of 3rd Orthopaedic Department of Hygeia Hospital, Athens, Greece.
| | | | - V Giannouli
- Department of Business Administration, University of West Attica, Egaleo, Greece; Attica Psychiatric Hospital "Dafni", Dafni, Greece.
| | - M-A Stamouli
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - A Goula
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - M Sarris
- Department of Business Administration, University of West Attica, Egaleo, Greece.
| | - S Soulis
- Department of Business Administration, University of West Attica, Egaleo, Greece.
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Manly DA, Karrowni W, Rymer JA, Kaltenbach LA, Swaminathan RV, Messenger JC, Abbott JD, Seto A, Panetta C, Brilakis E, Nikolakopoulos I, Gilchrist IC, Kaul P, Dakik H, Rao SV. Characteristics and Outcomes of Patients With History of CABG Undergoing Cardiac Catheterization Via the Radial Versus Femoral Approach. JACC Cardiovasc Interv 2021; 14:907-916. [PMID: 33812824 DOI: 10.1016/j.jcin.2021.01.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/18/2020] [Accepted: 01/05/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aims of this study were to examine rates of radial artery access in post-coronary artery bypass grafting (CABG) patients undergoing diagnostic catherization and/or percutaneous coronary intervention (PCI), whether operators with higher procedural volumes and higher percentage radial use were more likely to perform diagnostic catherization and/or PCI via the radial approach in post-CABG patients, and clinical and procedural outcomes in post-CABG patients who undergo diagnostic catherization and/or PCI via the radial or femoral approach. BACKGROUND There are limited data comparing outcomes of patients with prior CABG undergoing transradial or transfemoral diagnostic catheterization and/or PCI. METHODS Using the National Cardiovascular Data Registry CathPCI Registry, all diagnostic catheterizations and PCIs performed in patients with prior CABG from July 1, 2009, to March 31, 2018 (n = 1,279,058, 1,173 sites) were evaluated. Temporal trends in transradial access were examined, and mortality, bleeding, vascular complications, and procedural metrics were compared between transradial and transfemoral access. RESULTS The rate of transradial access increased from 1.4% to 18.7% over the study period. Transradial access was associated with decreased mortality (adjusted odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.75 to 0.91), decreased bleeding (OR: 0.57; 95% CI: 0.51 to 0.63), decreased vascular complications (OR: 0.38; 95% CI: 0.30 to 0.47), increased PCI procedural success (OR: 1.11; 95% CI: 1.06 to 1.16; p < 0.0001), and significantly decreased contrast volume across all procedure types. Transradial access was associated with shorter fluoroscopy time for PCI-only procedures but longer fluoroscopy time for diagnostic procedures plus ad hoc PCI and diagnostic procedures only. Operators with a higher rate of transradial access in non-CABG patients were more likely to perform transradial access in patients with prior CABG. CONCLUSIONS The rate of transradial artery access in patients with prior CABG undergoing diagnostic catheterization and/or PCI has increased over the past decade in the United States, and it was more often performed by operators using a transradial approach in non-CABG patients. Compared with transfemoral access, transradial access was associated with improved clinical outcomes in patients with prior CABG.
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Affiliation(s)
- David A Manly
- Prisma Health-Upstate, Greenville Memorial Medical Campus, Greenville, South Carolina, USA
| | - Wassef Karrowni
- St. Luke's Hospital-Unity Point Health, Cedar Rapids, Iowa, USA
| | | | | | | | - John C Messenger
- Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - J Dawn Abbott
- The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Arnold Seto
- University of California-Irvine, Irvine, California, USA
| | | | | | | | - Ian C Gilchrist
- Penn State Heart and Vascular Institute, Hershey, Pennsylvania, USA
| | | | - Habib Dakik
- American University of Beirut, Beirut, Lebanon
| | - Sunil V Rao
- Duke Clinical Research Institute, Durham, North Carolina, USA.
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Pantekidis I, Malahias MA, Kokkineli S, Brilakis E, Antonogiannakis E. Comparison between all-suture and biocomposite anchors in the arthroscopic treatment of traumatic anterior shoulder instability: A retrospective cohort study. J Orthop 2021; 24:264-270. [PMID: 33867751 DOI: 10.1016/j.jor.2021.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/01/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022] Open
Abstract
Purpose Suture anchors have revolutionized arthroscopic surgery, enabling direct soft tissue-to-bone repair. There are many types of anchors still used in arthroscopic shoulder operations. We sought to compare the clinical outcome of all-suture and biocomposite anchors when used in arthroscopic Bankart repair for patients suffering from anterior shoulder instability. Methods A single-center retrospective cohort study of 30 patients (mean age: 26.6 years, SD: 8.8 years, male/female ratio: 5/1, mean follow up: 28 months, SD: 23.8, range: 12-92) with anterior shoulder instability was conducted. Patients were divided into 2 groups based upon the type of suture anchors used for the Bankart repair: group A (14 patients) used only all-suture anchors and group B (16 patients) used only biocomposite anchors. Outcomes reported were postoperative dislocations, positive shoulder apprehension test, self-reported sense of shoulder instability, return to activities of daily living, return to sports, patient satisfaction and complications. Patient reported outcome measures (PROMs) used were the Rowe Score for Instability, Constant Shoulder Score, Walch Duplay Score, The American Shoulder and Elbow Surgeons (ASES) Shoulder Score, Oxford Shoulder Instability Score and external rotation at 90° of arm abduction, external rotation at 0° of arm abduction, forward flexion, abduction, adduction and internal rotation. Results Rates of postoperative shoulder dislocation demonstrated no significant difference between the 2 groups (p > .05). Four postoperative dislocations happened, two in each group (14.3% and 12.5% for all suture only and biocomposite only groups, respectively), with three of them being traumatic. In addition, no significant differences were observed amongst groups regarding shoulder apprehension test (group A: 85.7% vs. group B: 93.8%), sense of shoulder instability (7.1% vs. 6.3%), return to activities of daily living (group A: 85.7% vs. group B: 93.8%), return to sports (group A: 85.7% vs. group B: 87.5%), patient satisfaction (moderate level: group A 21.4% vs. group B 12.5%), and PROMs. Conclusion The short-term failure rate and clinical/functional outcomes of arthroscopic Bankart repair using all-suture anchors is similar to the use of biocompatible anchors. Level of evidence Level III, retrospective cohort study.
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Affiliation(s)
- Ioannis Pantekidis
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
| | | | - Stefania Kokkineli
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
| | - Emmanouil Brilakis
- 3rd Orthopaedic Department, HYGEIA Hospital, Erythrou Stavrou 4, Marousi, 15123, Athens, Greece
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Xenogiannis I, Brilakis E. Reply: How should coronary computed tomography angiography co-registration be applied in the chronic total occlusion hybrid algorithm? EUROINTERVENTION 2021; 16:1374-1375. [PMID: 33749603 PMCID: PMC9724858 DOI: 10.4244/eij-d-20-00924r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Iosif Xenogiannis
- Center for Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern, Minneapolis, MN, USA
| | - Emmanouil Brilakis
- Minneapolis Heart Institute, Abbott Northwestern Hospital, Heart Hospital, 800 E 28th St, Minneapolis, MN 55407, USA
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Avramidis G, Kokkineli S, Trellopoulos A, Tsiogka A, Natsika M, Brilakis E, Antonogiannakis E. Excellent Clinical and Radiological Midterm Outcomes for the Management of Recurrent Anterior Shoulder Instability by All-Arthroscopic Modified Eden-Hybinette Procedure Using Iliac Crest Autograft and Double-Pair Button Fixation System: 3-Year Clinical Case Series With No Loss to Follow-Up. Arthroscopy 2021; 37:795-803. [PMID: 33127552 DOI: 10.1016/j.arthro.2020.10.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 02/09/2023]
Abstract
PURPOSE To evaluate the clinical, functional, and radiological midterm outcomes of the all-arthroscopic modified Eden-Hybinette procedure in patients with recurrent anterior shoulder instability. METHODS A retrospective, single-center case series with prospectively collected data was conducted. The inclusion criterion was traumatic recurrent anterior shoulder instability with significant glenoid bone loss; patients with atraumatic or multidirectional instability were excluded. An all-arthroscopic modified Eden-Hybinette procedure using iliac crest autograft and double-pair button fixation was carried out. All patients were postoperatively assessed for recurrence and apprehension. Shoulder range of motion values and functional scores, including American Shoulder and Elbow Surgeons Score, Oxford instability, Rowe instability, and Walch-Dupplay, were recorded. Graft positions, healing, and absorption were evaluated with computed tomography. Comparisons of values were performed with paired t tests for normally distributed differences and with nonparametric Wilcoxon's signed rank test otherwise. RESULTS The final study cohort included 28 patients, mean age 36 ± 10 years, and mean follow-up period 43 ± 6 months (range 36 to 53). Median glenoid bone loss was 12.4% (range 8% to 33%). No recurrence occurred, no subjective shoulder instability was reported, and no major complications were documented through the last follow-up. Postoperative shoulder range of motion had no significant differences compared with the healthy side. All final postoperative functional scores significantly increased to show excellent results compared with preoperative values. All grafts were positioned and healed optimally, and none was completely reabsorbed. CONCLUSIONS The all-arthroscopic modified Eden-Hybinette procedure is safe, leading to excellent clinical and radiological midterm outcomes in patients with recurrent anterior shoulder instability. This technique restores glenoid bone defects and preserves the normal shoulder anatomy. LEVEL OF EVIDENCE IV, therapeutic, retrospective case series.
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Malahias MA, Chytas D, Kostretzis L, Trellopoulos A, Brilakis E, Antonogiannakis E. Modern trabecular metal-backed glenoid components in total shoulder arthroplasty: What is the evidence? A systematic review. Shoulder Elbow 2021; 13:29-37. [PMID: 33717216 PMCID: PMC7905522 DOI: 10.1177/1758573220914277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND A number of papers have been published reporting on the clinical performance of modern trabecular metal-backed glenoid components in total shoulder arthroplasty. However, no systematic review of the literature has been published to date. METHODS The US National Library of Medicine (PubMed/MEDLINE), and the Cochrane Database of Systematic Reviews and EMBASE were queried for publications from January 1980 to October 2019 utilizing keywords pertinent to total shoulder arthroplasty, trabecular metal, and clinical outcomes. RESULTS Overall, seven articles were included for analysis (322 operated shoulders, mean follow-up range: 2-4 years). The survival rate of modern trabecular metal-backed glenoid components was 96% (309 out of 322 cases) at 43 months mean follow-up, while the rate of aseptic loosening was 0.3% (1 out of 322 cases). There were 35 cases (10.9%) with glenoid component radiolucency (one of them required revision), and 37 cases (11.5%) of metal debris formation, with four of them undergoing revision. CONCLUSIONS There was low quality evidence to show that the use of modern trabecular metal-backed glenoid components in total shoulder arthroplasty may be safe and effective at short-term follow-up. However, this analysis showed alarmingly high rates of both radiolucency of the glenoid component and metal debris formation which raise concern for potential failure of this glenoid component in the long term. Therefore, we feel that modern trabecular metal-backed glenoid components should be still used with caution as part of a structured surveillance or research program until we know if there is a detriment to the prosthesis in the medium to long term.Level: Systematic review, IV.
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Affiliation(s)
- Michael-Alexander Malahias
- 3rd Orthopaedic Department, Hygeia Hospital, Athens, Greece,Michael-Alexander Malahias, 3rd Orthopaedic Department, Hygeia Hospital, Erythrou Stavrou 4, Marousi, Athens 15123, Greece.
| | - Dimitrios Chytas
- 2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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