1
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Bouisset F, Ribichini F, Bataille V, Reczuch K, Lhermusier T, Dobrzycki S, Meyer-Gessner M, Bressollette E, Zajdel W, Faurie B, Mezilis N, Palazuelos J, Vaquerizo B, Ferenc M, Cayla G, Barbato E, Carrié D. Clinical Outcomes of Left Main Coronary Artery PCI With Rotational Atherectomy. Am J Cardiol 2023; 186:36-42. [PMID: 36343444 DOI: 10.1016/j.amjcard.2022.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/18/2022] [Revised: 09/10/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Abstract
Data regarding rotational atherectomy percutaneous coronary intervention (RA PCI) angioplasty in the left main (LM) coronary artery are scarce, and mostly outdated. We aimed to describe clinical outcomes of RA PCI in LM. Patients requiring RA in 8 European countries and 19 centers were prospectively and consecutively included in the European registry of Cardiac Care of Calcified and Complex patients registry. In-hospital data collection and 1-year follow-up were performed for each patient. Between October 2016 and July 2018, 966 patients with complete data were included. Among them, 241 presented with an LM lesion, and 171 required an LM lesion preparation by RA. The latter, allocated to the LM-RA group, were compared with the 725 patients in the non-LM-RA group. Clinical success of the RA procedure was comparable in both groups, but in-hospital major adverse cardiac events were higher in the RA-LM group (7.6% vs 3.2%, adjusted p = 0.04), mainly driven by a higher in-hospital mortality rate (5.3 vs 0.3%, adjusted p = 0.005). At 1-year follow-up, mortality and major adverse cardiac event rates were comparable in both groups (12.9% vs 8.0%, adjusted p value: 0.821, and 15.8% vs 10.9%, adjusted p value: 0.329, respectively), but the rate of target vessel revascularization remained higher in the RA-LM group (5.3% vs 3.2%, adjusted p = 0.021). In conclusion, RA PCI is an efficient option for calcified LM lesions, providing acceptable outcomes regarding this population with high risk at 1 year, and yields comparable outcomes with RA PCI performed on non-LM lesions.
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Affiliation(s)
- Frédéric Bouisset
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France.
| | | | - Vincent Bataille
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France; Association pour la Diffusion de la Médecine de Prévention (ADIMEP), Toulouse, France
| | - Krzysztof Reczuch
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Thibault Lhermusier
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France
| | | | | | | | - Wojciech Zajdel
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Benjamin Faurie
- Cardiovascular Institute, Groupe Hospitalier Mutualiste, Grenoble, France
| | - Nikolaos Mezilis
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | - Jorge Palazuelos
- Department of Cardiology, Interventional Cardiology Unit, Hospital La Luz, Madrid, Spain
| | - Beatriz Vaquerizo
- Department of Cardiology, Hospital del Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group (GREC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Miroslaw Ferenc
- Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Guillaume Cayla
- Department of Cardiology, Centre Hospitalier Universitaire de Nîmes, Université de Montpellier, Nîmes, France
| | - Emanuele Barbato
- Division of Cardiology, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Didier Carrié
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France
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2
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Amabile N, Bressollette E, Souteyrand G, Landolff Q, Veugeois A, Honton B. [Invasive and non-invasive imaging analysis for calcified coronary artery lesions]. Ann Cardiol Angeiol (Paris) 2022; 71:372-380. [PMID: 36220707 DOI: 10.1016/j.ancard.2022.09.003] [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: 09/11/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Coronary calcifications are frequently identified within coronary lesions as their incidence increases with age and cardiovascular risk factors. Their location can be superficial or deep, according to different pathological process. In all cases, the presence of calcifications within the vascular wall predicts poor clinical prognosis and unfavorable evolution after percutaneous revascularization. Coronary calcifications can be analyzed by angiography, CT or intracoronary imaging (IVUS or OCT) with variable accuracies. Angiography is the most frequently used method but is not very sensitive (sensitivity close to 50%) and insufficient for their precise quantification. The CT scan is a more effective non-invasive method leading to an accurate analysis of the lesion before coronary angiography. IVUS and OCT have an excellent spatial resolution and are the most sensitive methods for the identification (present in nearly 75-80% of lesions) and quantification of calcifications. These intracoronary imaging techniques offer interesting perspectives for identification of the highest-risk lesions, PCI procedures planning (including the choice of an optimal dedicated plaque preparation devices), the monitoring of their execution and the evaluation of the immediate post-stenting results.
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Affiliation(s)
- Nicolas Amabile
- Service de Cardiologie, Institut Mutualiste Montsouris, Paris, France.
| | | | - Géraud Souteyrand
- Service de Cardiologie, CHU Gabriel Montpied, Clermont Ferrand, France
| | | | - Aurèlie Veugeois
- Service de Cardiologie, Institut Mutualiste Montsouris, Paris, France
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van Geuns RJ, Chun-Chin C, McEntegart MB, Merkulov E, Kretov E, Lesiak M, O’Kane P, Hanratty CG, Bressollette E, Silvestri M, Wlodarczak A, Barragan P, Anderson R, Protopopov A, Peace A, Menown I, Rocchiccioli P, Onuma Y, Oldroyd KG. Bioabsorbable polymer drug-eluting stents with 4-month dual antiplatelet therapy versus durable polymer drug-eluting stents with 12-month dual antiplatelet therapy in patients with left main coronary artery disease: the IDEAL-LM randomised trial. EUROINTERVENTION 2022; 17:1467-1476. [PMID: 35285803 PMCID: PMC9900447 DOI: 10.4244/eij-d-21-00514] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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 Improvements in drug-eluting stent design have led to a reduced frequency of repeat revascularisation and new biodegradable polymer coatings may allow a shorter duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). AIMS The Improved Drug-Eluting stent for All-comers Left Main (IDEAL-LM) study aims to investigate long-term clinical outcomes after implantation of a biodegradable polymer platinum-chromium everolimus-eluting stent (BP-PtCr-EES) followed by 4 months DAPT compared to a durable polymer cobalt-chromium everolimus-eluting stent (DP-CoCr-EES) followed by 12 months DAPT in patients undergoing PCI of unprotected left main coronary artery (LMCA) disease. METHODS This is a multicentre randomised clinical trial study in patients with an indication for coronary artery revascularisation who have been accepted for PCI for LMCA disease after Heart Team consultation. Patients were randomly assigned in a 1:1 ratio to receive either the BP-PtCr-EES or the DP-CoCr-EES. The primary endpoint was a non-inferiority comparison of the rate of major adverse cardiovascular events (MACE), defined as all-cause death, myocardial infarction, or ischaemia-driven target vessel revascularisation at 2 years. RESULTS Between December 2014 and October 2016, 818 patients (410 BP-PtCr-EES and 408 DP-CoCr-EES) were enrolled at 29 centres in Europe. At 2 years, the primary endpoint of MACE occurred in 59 patients (14.6%) in the BP-PtCr-EES group and 45 patients (11.4%) in the DP-CoCr-EES group; 1-sided upper 95% confidence interval (CI) 7.18%; p=0.04 for non-inferiority; p=0.17 for superiority. The secondary endpoint event of BARC 3 or 5 bleeding occurred in 11 patients (2.7%) in the BP-PtCr-EES group and 2 patients (0.5%) in the DP-CoCr-EES group (p=0.02). CONCLUSIONS In patients undergoing PCI of LMCA disease, after two years of follow-up, the use of a BP-PtCr-EES with 4 months of DAPT was non-inferior to a DP-CoCr-EES with 12 months of DAPT with respect to the composite endpoint of all-cause death, myocardial infarction or ischaemia-driven target vessel revascularisation.
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Affiliation(s)
- Robert-Jan van Geuns
- Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands
| | - Chang Chun-Chin
- Department of Cardiology, Thorax Center, Erasmus Medical Center, Rotterdam, the Netherlands,Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Evgeny Merkulov
- Russian Cardiology Research Center, Moscow, Russian Federation
| | - Evgeny Kretov
- E.N. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Peter O’Kane
- Department of Cardiology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | | | | | | | - Adrian Wlodarczak
- Department of Cardiology, Miedziowe Centrum Zdrowia S.A., Lubin, Poland
| | - Paul Barragan
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | | | | | - Aaron Peace
- Altnagelvin Hospital, Londonderry, United Kingdom
| | - Ian Menown
- Craigavon Area Hospital, Craigavon, United Kingdom
| | | | - Yoshinobu Onuma
- Department of Cardiology, Thorax Center, Erasmus Medical Center, Rotterdam, the Netherlands,Cardialysis, Rotterdam, the Netherlands
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4
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Bouisset F, Ribichini F, Bataille V, Reczuch K, Dobrzycki S, Meyer-Gessner M, Bressollette E, Zajdel W, Faurie B, Mezilis N, Palazuelos J, Spedicato L, Valdés M, Vaquerizo B, Ferenc M, Cayla G, Barbato E, Carrié D. Effect of Sex on Outcomes of Coronary Rotational Atherectomy Percutaneous Coronary Intervention (From the European Multicenter Euro4C Registry). Am J Cardiol 2021; 143:29-36. [PMID: 33359202 DOI: 10.1016/j.amjcard.2020.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Data regarding the potential influence of gender on outcomes of rotational atherectomy (RA) percutaneous coronary intervention (PCI) are scarce and conflicting. Using the Euro4C registry, an international prospective multicentric registry of RA PCI, we evaluated the influence of gender on clinical outcomes of RA PCI. Between October 2016 and July 2018, 966 patients were included. In them, 267 (27.6%) were females. Female patients were older than males (77.7 years old ± 9.8 vs 73.3 ± 9.5 years old respectively, p < 0.001) had a poorer renal function (43,1% of females had a GFR < 60 ml/min:1.73m² vs 30.4% of males, p < 0.001) and were more frequently admitted for an acute coronary syndrome (32.2% vs 22.3% p = 0.002). During RA procedure, women were less likely to be treated by radial approach (65.0% vs 74.4%, p = 0.004). In-hospital major adverse cardiac event rate-defined as cardiovascular death, myocardial infarction, stroke/transient ischemic attack, target lesion revascularization, and coronary artery bypass grafting surgery-was higher in the female group (7.1% vs 3.7%, p = 0.043). However, coronary perforation, dissection, slow/low flow and tamponade did not significantly differ in gender, neither did cardiovascular medications at discharge. At 1 year follow-up, rate of major adverse cardiac event was 18.4% in the female group vs 11.2% in the male group (adjusted Hazard Ratio 1.82 [1.24 to 2.67], p = 0.002). No significant bleeding differences were observed in gender, neither in hospital, nor during follow-up. In conclusion women had worse clinical outcomes following RA PCI during hospitalization and at 1 year follow-up than did men.
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5
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Bouisset F, Barbato E, Reczuch K, Dobrzycki S, Meyer-Gessner M, Bressollette E, Cayla G, Lhermusier T, Zajdel W, Palazuelos Molinero J, Ferenc M, Ribichini FL, Carrié D. Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry. EUROINTERVENTION 2020; 16:e305-e312. [DOI: 10.4244/eij-d-19-01129] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Levesque S, Gamet A, Lattuca B, Lemoine J, Bressollette E, Avran A, Motreff P, Boudou N, Faurie B, Christiaens L. Post-stEnting assessment of Re-endothelialization with optical Frequency domain imaging aftEr Chronic Total Occlusion procedure: The PERFE-CTO Study Design and Rationale. Cardiovasc Revasc Med 2019; 21:760-764. [PMID: 31679911 DOI: 10.1016/j.carrev.2019.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/06/2019] [Revised: 10/07/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The treatment of chronic total occlusion of coronary arteries by percutaneous coronary intervention (CTO PCI) is one of the most representative technical advances in ischemic cardiomyopathy of last decade. However, how the complex histopathological remodeling and the new techniques affect healing processes after stent implantation remains unknown. OBJECTIVE The objective of the PERFE-CTO study is to analyze stent coverage, malapposition and other mechanical abnormalities 3 months after CTO recanalization using intravascular imaging. METHODS In a French prospective interventional multicenter study, stent strut coverage, acquired malapposition and neointimal hyperplasia (NIH) proliferation will be systematically assessed with 3 months angiogram control and intracoronary optical frequency domain imaging (OFDI) after successful CTO PCI of >20 mm in length. The impact of routine systematical intracoronary imaging after these complex procedures will also be evaluated by measuring the rate of significant mechanical abnormalities (strut malapposition, edge dissection, thrombus) that was undetected by fluoroscopy alone and by complementary PCI when needed. Secondarily, these data will be compared according to clinical characteristics, antiplatelet therapy use or desobstruction technique (antegrade vs. retrograde, true lumen vs. subintima). Each patient will undergo a one-year clinical follow-up. A total of 150 analyzed CTO lesions is expected. CONCLUSION The PERFE-CTO study will provide essential understanding of the early history after CTO recanalization and the identification of inadequate evolution (stent thrombosis, restenosis or late delayed stent endothelization and cardiovascular outcomes) using intravascular imaging to improve long-term CTO results.
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Affiliation(s)
- Sébastien Levesque
- Department of Cardiology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
| | - Alexandre Gamet
- Department of Cardiology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Benoit Lattuca
- Department of Cardiology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Julien Lemoine
- Department of Cardiology, Clinique Louis Pasteur, Nancy, France
| | | | - Alexandre Avran
- Department of Cardiology, Institut Arnaud Tzanck, Saint Laurent du Var, France
| | - Pascal Motreff
- Department of Cardiology, Centre Hospitalier Universitaire de Clermont-Ferrand, France
| | - Nicolas Boudou
- Department of Cardiology, Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | - Benjamin Faurie
- Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France
| | - Luc Christiaens
- Department of Cardiology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
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7
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Widder JD, Cortese B, Levesque S, Berliner D, Eccleshall S, Graf K, Doutrelant L, Ahmed J, Bressollette E, Zavalloni D, Piraino D, Roguin A, Scheller B, Stella PR, Bauersachs J. Coronary artery treatment with a urea-based paclitaxel-coated balloon: the European-wide FALCON all-comers DCB Registry (FALCON Registry). EUROINTERVENTION 2019; 15:e382-e388. [DOI: 10.4244/eij-d-18-00261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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8
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Maeremans J, Avran A, Walsh S, Knaapen P, Hanratty CG, Faurie B, Agostoni P, Bressollette E, Kayaert P, Smith D, Chase A, Mcentegart MB, Smith WHT, Harcombe A, Irving J, Ladwiniec A, Spratt JC, Dens J. One-Year Clinical Outcomes of the Hybrid CTO Revascularization Strategy After Hospital Discharge: A Subanalysis of the Multicenter RECHARGE Registry. J Invasive Cardiol 2018; 30:62-70. [PMID: 29138365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) has historically been associated with higher event rates during follow-up. The hybrid algorithm and contemporary wiring and dissection re-entry (DR) techniques can potentially improve long-term outcomes after CTO-PCI. This study assessed the long-term clinical outcomes of the hybrid CTO practice, when applied by operators with varying experience levels. METHODS We examined the 1-year clinical events after hospital discharge of the RECHARGE population, according to technical outcome and final technique. The primary endpoint was major adverse cardiac event (MACE) rate. Centers that provided ≥90% complete 12-month follow-up were included. RESULTS Follow-up data of 1067 out of 1165 patients (92%) were provided by 13 centers. Mean follow-up duration was 362.8 ± 0.9 days. One-year MACE-free survival rate was 91.3% (974/1067). MACE included death (1.9%; n = 20), myocardial infarction (1.4%; n = 15), target-vessel failure (5.9%; n = 63), and target-vessel revascularization (TVR) (5.5%; n = 59). Non-TVR was performed in 6.7% (n = 71). MACE was significantly in favor of successful CTO-PCI (8.0% vs 13%; P=.04), even after adjusting for baseline differences (adjusted hazard ratio, 0.59; 95% confidence interval, 0.36-0.98; P=.04). Other events, including individual MACE components, were comparable with respect to technical outcome and final technique (DR vs non-DR techniques). CONCLUSIONS The use of the hybrid algorithm with contemporary techniques by moderate to highly experienced operators for CTO-PCI is safe and associated with a low 1-year event rate. Successful procedures are associated with a better MACE rate. DR techniques can be used as first-line strategies alongside intimal wiring techniques without compromising clinical outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jo Dens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium.
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9
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Maeremans J, Avran A, Walsh S, Knaapen P, Faurie B, Agostoni P, Bressollette E, Smith D, McEntegart M, Smith W, Harcombe A, Irving J, Spratt J, Dens J. TCT-261 One-year outcomes of the hybrid CTO revascularization strategy: a sub-analysis of the multicenter RECHARGE Registr. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.336] [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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10
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Bakker EJ, Maeremans J, Zivelonghi C, Faurie B, Avran A, Walsh S, Spratt JC, Knaapen P, Hanratty CG, Bressollette E, Kayaert P, Bagnall AJ, Egred M, Smith D, McEntegart MB, Smith WH, Kelly P, Irving J, Smith EJ, Strange JW, Dens J, Agostoni P. Fully Transradial Versus Transfemoral Approach for Percutaneous Intervention of Coronary Chronic Total Occlusions Applying the Hybrid Algorithm. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.117.005255. [DOI: 10.1161/circinterventions.117.005255] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 03/12/2017] [Accepted: 07/17/2017] [Indexed: 11/16/2022]
Abstract
Background—
Small observational studies demonstrate the feasibility of transradial approach for chronic total occlusion (CTO) percutaneous coronary intervention. The aim of the current study is to assess technical success, complication rates, and procedural efficiency in fully transradial approach (fTRA) and transfemoral approach (TFA) in a large prospective European registry adopting the hybrid algorithm for CTO percutaneous coronary intervention (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom, RECHARGE registry).
Methods and Results—
We analyzed 1253 CTO percutaneous coronary intervention procedures performed according to the hybrid protocol in 17 European centers, comparing fTRA (single or biradial access) and TFA (single or bifemoral or combined radial and femoral access). fTRA was applied in 306 (24%) and TFA in 947 (76%) cases. The average Japanese CTO score was 2.1±1.2 in fTRA and 2.3±1.1 in TFA (
P
=0.06). Technical success was achieved in 85% in fTRA and 86% in TFA (
P
=0.51). Technical success was comparable for fTRA and TFA in different Japanese CTO score subgroups after multivariable analysis and after propensity adjustment. In-hospital major adverse cardiac and cerebral events occurred in 2.0% in fTRA and 2.9% in TFA (
P
=0.40). Major access site bleeding occurred in 0.3% in fTRA and 0.5% in TFA (
P
=0.66). fTRA compared with TFA had similar procedural duration (80 minutes [54–120 minutes] versus 90 minutes [60–121 minutes];
P
=0.07), similar radiation dose (dose area product 89 Gray×cm
2
[52–163 Gray×cm
2
] versus 101 Gray×cm
2
[59–171 Gray×cm
2
];
P
=0.06), and lower contrast agent use (200 mL [150–310 mL] versus 250 mL [200–350 mL];
P
<0.01).
Conclusions—
fTRA CTO percutaneous coronary intervention is a valid alternative to TFA with a high rate of success, low complication rates, and no decrease in procedural efficiency.
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Affiliation(s)
- Erik Jan Bakker
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Joren Maeremans
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Carlo Zivelonghi
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Benjamin Faurie
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Alexandre Avran
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Simon Walsh
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - James C. Spratt
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Paul Knaapen
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Colm G. Hanratty
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Erwan Bressollette
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Peter Kayaert
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Alan J. Bagnall
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Mohaned Egred
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - David Smith
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Margaret B. McEntegart
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - William H.T. Smith
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Paul Kelly
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - John Irving
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Elliot J. Smith
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Julian W. Strange
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Joseph Dens
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
| | - Pierfrancesco Agostoni
- From the Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands (E.J.B., C.Z., P.A.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Faculty of Medicine and Life Sciences, University of Hasselt, Belgium (J.M.); Department of Cardiology, Groupe Hospitalier Mutualiste, Grenoble, France (B.F.); Department of Cardiology, Clinique de Marignane, France (A.A.); Department of Cardiology, Arnault Tzanck Institut, St Laurent du Var, France (A.A.)
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Maeremans J, Dens J, Spratt JC, Bagnall AJ, Stuijfzand W, Nap A, Agostoni P, Wilson W, Hanratty CG, Wilson S, Faurie B, Avran A, Bressollette E, Egred M, Knaapen P, Walsh S, Smith D, Chase A, Smith WH, Harcombe A, Kayaert P, Smith EJ, Kelly P, Irving J, McEntegart MB, Strange JW. Antegrade Dissection and Reentry as Part of the Hybrid Chronic Total Occlusion Revascularization Strategy. Circ Cardiovasc Interv 2017. [DOI: 10.1161/circinterventions.116.004791] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 11/16/2022]
Abstract
Background—
Development of the CrossBoss and Stingray devices for antegrade dissection and reentry (ADR) of chronic total occlusions has improved historically suboptimal outcomes. However, the outcomes, safety, and failure modes of the technique have to be studied in a larger patient cohort. This preplanned substudy of the RECHARGE registry (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom) aims to evaluate the value and use of ADR and determine its future position in contemporary chronic total occlusion intervention.
Methods and Results—
Patients were selected if an ADR strategy was applied. Outcomes, safety, and failure modes of the technique were assessed. The ADR technique was used in 23% (n=292/1253) of the RECHARGE registry and was mainly applied for complex lesions (Japanese chronic total occlusion score=2.7±1.1). ADR was the primary strategy in 30% (n=88/292), of which 67% were successful. Bail-out ADR strategies were successful in 63% (n=133/210). The Controlled ADR (ie, combined CrossBoss-Stingray) subtype was applied most frequently (32%; n=93/292) and successfully (81%; n=75/93). Overall per-lesion success rate was 78% (n=229/292), after use of additional bail-out strategies. The inability to reach the distal target zone (n=48/100) or to reenter (n=43/100) most commonly led to failure. ADR-associated major events occurred in 3.4% (n=10/292).
Conclusions—
Although mostly applied as a bail-out strategy for complex lesions, the frequency, outcomes, and low complication rate of the ADR technique and its subtypes confirm the benefit and value of the technique in hybrid chronic total occlusion percutaneous coronary intervention, especially when antegrade wiring or retrograde approaches are not feasible.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02075372.
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Affiliation(s)
- Joren Maeremans
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Jo Dens
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - James C. Spratt
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Alan J. Bagnall
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Wynand Stuijfzand
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Alexander Nap
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Pierfrancesco Agostoni
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - William Wilson
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Colm G. Hanratty
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Simon Wilson
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Benjamin Faurie
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Alexandre Avran
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Erwan Bressollette
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Mohaned Egred
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Paul Knaapen
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
| | - Simon Walsh
- From the Faculty of Medicine and Life Sciences, Universiteit Hasselt, Belgium (J.M., J.D.); Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium (J.M., J.D.); Department of Cardiology, Forth Valley Royal Hospital, Edinburgh, United Kingdom (J.C.S., W.W., S.W.); Department of Cardiology, Freeman Hospital, Newcastle upon Tyne, United Kingdom (A.J.B., M.E.); Institute of Cellular Medicine, Newcastle University, United Kingdom (A.J.B., M.E.); Department of Cardiology, VU University Medical
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Maeremans J, Spratt JC, Knaapen P, Walsh S, Agostoni P, Wilson W, Avran A, Faurie B, Bressollette E, Kayaert P, Bagnall AJ, Smith D, McEntegart MB, Smith WH, Kelly P, Irving J, Smith EJ, Strange JW, Dens J. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score. Catheter Cardiovasc Interv 2017; 91:192-202. [DOI: 10.1002/ccd.27092] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/20/2017] [Accepted: 03/25/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Joren Maeremans
- Faculty of Medicine and Life Sciences; Universiteit Hasselt; Hasselt Belgium
- Department of Cardiology; Ziekenhuis Oost-Limburg; Genk Belgium
| | - James C. Spratt
- Department of Cardiology; Forth Valley Royal Hospital; Edinburgh United Kingdom
| | - Paul Knaapen
- Department of Cardiology; VU university medical center; Amsterdam the Netherlands
| | - Simon Walsh
- Department of Cardiology; Belfast City Hospital; Belfast United Kingdom
| | - Pierfrancesco Agostoni
- Department of Cardiology; Universitair Medisch Centrum Utrecht; Utrecht the Netherlands
- Department of Cardiology; St. Antonius Hospital; Nieuwegein the Netherlands
| | - William Wilson
- Department of Cardiology; Royal Melbourne Hospital; Melbourne Australia
| | - Alexandre Avran
- Department of Cardiology; Clinique de Marignane; Marignane Marseille France
| | - Benjamin Faurie
- Department of Cardiology; Groupe Hospitalier Mutualiste; Grenoble France
| | | | - Peter Kayaert
- Department of Cardiology; Universitair Ziekenhuis Brussel; Brussels Belgium
| | - Alan J. Bagnall
- Department of Cardiology; Freeman Hospital; Newcastle upon Tyne United Kingdom
- Institute of Cellular Medicine, Newcastle University; United Kingdom
| | - Dave Smith
- Department of Cardiology; Morriston Hospital; Swansea United Kingdom
| | | | - William H.T. Smith
- Department of Cardiology; Nottingham University Hospital; Nottingham United Kingdom
| | - Paul Kelly
- Department of Cardiology; Essex Cardio-thoracic Centre, Basildon Hospital; Essex United Kingdom
| | - John Irving
- Department of Cardiology; Ninewells Hospital; Dundee United Kingdom
| | - Elliot J. Smith
- Department of Cardiology; Barts Heart Centre, Barts Health NHS Trust; London United Kingdom
| | - Julian W. Strange
- Department of Cardiology; Bristol Heart Institute; Bristol United Kingdom
| | - Jo Dens
- Faculty of Medicine and Life Sciences; Universiteit Hasselt; Hasselt Belgium
- Department of Cardiology; Ziekenhuis Oost-Limburg; Genk Belgium
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Maeremans J, Avran A, Knaapen P, Walsh S, Hanratty C, Faurie B, Agostoni P, Spratt J, Bressollette E, Kayaert P, Dens J. IN-HOSPITAL OUTCOMES OF THE HYBRID ALGORITHM FOR CHRONIC TOTAL OCCLUSIONS: THE RECHARGE REGISTRY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30147-4] [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: 10/22/2022]
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Bressollette E. [The indispensable instrument for rotational atherectomy]. Ann Cardiol Angeiol (Paris) 2012; 61:432-9. [PMID: 23098612 DOI: 10.1016/j.ancard.2012.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Rotational atherectomy is the treatment of choice for calcified coronary lesions. It should not be used routinely but only in some appropriate cases, especially when the successful deployment of a stent may be uncertain. Complications are rare but serious. Several cases of "off label" use, however, have been reported in the literature without additional complications.
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Affiliation(s)
- E Bressollette
- Service cardiologie, Nouvelles Cliniques Nantaises, 2, rue Éric-Tabarly, 44227 Nantes cedex 2, France.
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15
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Bammert A, Fihri OF, Bressollette E, Crochet D. [An evaluation of the effectiveness of applying 16-slice computed tomography (CT) to coronary arteries in preoperative aortic valve replacement]. Arch Mal Coeur Vaiss 2006; 99:883-8. [PMID: 17100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
UNLABELLED An evaluation of the effectiveness of applying 16-slice Computed Tomography (CT) to coronary arteries in preoperative aortic valve replacement. PURPOSE To evaluate the effectiveness of using 16-slice CT to diagnose a significant stenosis in coronary arteries in patients with severe aortic valve stenosis. MATERIAL AND METHODS 50 patients were included in the study. After a medium contrast injection, CT images of the arteries were taken using 0.75 mm slices. We paired the images with an ECG. Segments smaller than 1.5 mm were discarded, and the results were compared to those from the coronary angiography. RESULTS A satisfactory visualization of the coronary network was obtained for 80% (40/50) of the patients. For these 40 patients, 23 of the 29 patients without coronary stenosis were correctly classified but 4 of the 11 patients with coronary lesions were not recognized. The sensitivity of the multi-slice CT in detecting a least one significant coronary stenosis is 63.6%, the specificity 79.3%, positive predictive value 53.8% and negative predictive value 85.2%. CONCLUSION the 16-slice CT is a relatively effective and minimally invasive tool to highlight before valve replacement significant coronary stenosis in arteries greater than 1.5 mm in diameter in patients with severe aortic valvular stenosis. CT technology is currently insufficient for diagnosis, but we hope that with advances in multi-slice CT engineering, its use will help patients avoid invasive coronary angiographies.
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Affiliation(s)
- A Bammert
- Centre hémodynamique et vascu laire interventionnel, Clinique cardiolo gique et des maladies vasculaires, Ins titut du Thorax, CHU de Nantes, bd Jacques Monod, 44093 Saint-Herblain, Nantes 1.
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16
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Jacquier A, Bressollette E, Laissy JP, Gaubert JY, Crochet D, Moulin G, Bartoli JM. [MR imaging and arrhythmogenic right ventricular dysplasia (ARVD)]. ACTA ACUST UNITED AC 2004; 85:721-4. [PMID: 15243371 DOI: 10.1016/s0221-0363(04)97673-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Arrhythmogenic right ventricular dysplasia (ARVD) is a cardiomyopathy of unknown etiology responsible for 20% of cases of sudden death in young adults secondary to arrhythmia. It is characterized histologically by fatty or fibro-fatty infiltration of the right ventricular myocardium. Diagnostic criteria have been proposed for diagnosing ARVD. Imaging, especially MRI, plays an important role. MR imaging must be performed using cardiac gating, and should include both cine-MR sequences for evaluation of segmental and global right ventricular function or any morphological change of the right ventricular shape, and anatomic sequences to detect fatty or fibro-fatty infiltration of the right ventricular myocardium.
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Affiliation(s)
- A Jacquier
- Service d'Imagerie Médicale, Hôpital La Timone, Marseille.
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17
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Bressollette E, Dupuis J, Bonan R, Doucet S, Cernacek P, Tardif JC. Intravascular ultrasound assessment of pulmonary vascular disease in patients with pulmonary hypertension. Chest 2001; 120:809-15. [PMID: 11555514 DOI: 10.1378/chest.120.3.809] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Measurements of pulmonary pressure and resistance are still considered to be the "gold standard" in the evaluation of pulmonary hypertension (PH), despite their limitations in predicting irreversible disease. Hemodynamic assessment also only provides a global evaluation of the pulmonary vascular bed, whereas PH is an inhomogeneous disease of the vessel wall. METHODS AND RESULTS We assessed the value of intravascular ultrasound (IVUS) in 30 patients with suspected PH and correlated the structural changes in distal pulmonary arteries found on IVUS with conventional hemodynamic data. Plasma endothelin (ET)-1 levels and pulmonary ET-1 extraction also were measured as markers of the severity of PH. The anatomic abnormalities revealed by IVUS were more severe in the lower lobes than in the upper lobes, as evidenced by the greater percentage of wall thickness (WT), the smaller lumen diameter/WT and lumen area/total vessel area (p < 0.05 for each). IVUS anatomic indexes correlated directly with hemodynamic data (eg, with pulmonary arterial systolic pressure; r = 0.56; p < 0.001) and ET-1 levels but inversely with pulmonary ET-1 extraction. CONCLUSION Patients with PH have greater pulmonary arterial WT that is more severe in the lower lobes than in the upper lobes. The severity of structural abnormalities found on IVUS is directly correlated with hemodynamic findings and ET-1 levels. IVUS may provide useful additional information in the assessment of patients with PH.
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Affiliation(s)
- E Bressollette
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
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