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Tarantini G, Cardaioli F, De Iaco G, Tuccillo B, De Angelis MC, Mauro C, Boccalatte M, Trivisonno A, Ribichini F, Vadalà G, Caramanno G, Caruso M, Lombardi M, Fischetti D, Danesi A, Abbracciavento L, Lorenzoni G, Gregori D, Panza A, Nai Fovino L, Esposito G. A more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: an Italian post-maRketing study (the CAESAR registry). Front Cardiovasc Med 2024; 10:1326091. [PMID: 38299080 PMCID: PMC10828965 DOI: 10.3389/fcvm.2023.1326091] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/11/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction The use of contemporary drug-eluting stents (DES) has significantly improved outcomes of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, concerns exist regarding the long-term proinflammatory effects of durable polymer coatings used in most DES, potentially leading to long-term adverse events. First-generation polymer-free stent technologies, such as sirolimus- and probucol-eluting stents (PF-SES), have shown an excellent safety and efficacy profile. The aim of this study was to evaluate the safety and efficacy of the new ultrathin Coroflex ISAR NEO PF-SES, in a more-comers PCI population. Methods The CAESAR (a more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: An Italian post-maRketing study) registry is a multicenter, prospective study conducted in Italy, enrolling more-comers CAD patients undergoing PCI with the Coroflex ISAR NEO stent. Patients with left main (LM) disease, cardiogenic shock (CS), or severely reduced left-ventricular ejection fraction (LVEF) were excluded. The primary endpoint was target-lesion revascularization (TLR) at 1 year. Results A total of 425 patients were enrolled at 13 centers (mean age 66.9 ± 11.6 years, Diabetes mellitus 29%, acute coronary syndrome 67%, chronic total occlusion 9%). Of these, 40.9% had multivessel disease (MVD) and in 3.3% cases, the target lesion was in-stent restenosis (ISR). Clinical device success was reached in 422 (99.6%) cases. At 1 year, only two (0.5%) subjects presented ischemia-driven TLR. The 1-year rates of target vessel revascularization and MACE were 0.5% and 5.1%, respectively. Major bleeding was observed in four (1.0%) patients. Conclusion In this multicenter, prospective registry, the use of a new ultrathin Coroflex ISAR NEO PF-SES in a more-comers PCI population showed good safety and efficacy at 1 year.
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Francesco Cardaioli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Giuseppe De Iaco
- Department of Cardiology, Hospital “Cardinal G. Panico”, Tricase, Italy
| | | | | | - Ciro Mauro
- Department of Cardiology, Hospital Cardarelli, Naples, Italy
| | - Marco Boccalatte
- Interventional Cardiology Unit, Ospedale Santa Maria Delle Grazie Pozzuoli, Napoli, Italy
| | - Antonio Trivisonno
- Department of Cardiovascular Disease, “Antonio Cardarelli” Hospital, Campobasso, Italy
| | | | - Giuseppe Vadalà
- Division of Cardiology, University Hospital Paolo Giaccone, Palermo, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Marco Caruso
- Interventional Cardiology Unit, ARNAS Civico, G. Di Cristina Benfratelli, Palermo, Italy
| | - Mario Lombardi
- Interventional Cardiology Unit, A.O. Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | | | | | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Andrea Panza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Luca Nai Fovino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - Giovanni Esposito
- Division of Cardiology, Università Degli Studi di Napoli Federico II, Napoli, Italy
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Pastormerlo LE, Tondo C, Fassini G, Nicosia A, Ronco F, Contarini M, Giacchi G, Grasso C, Casu G, Romeo MR, Mazzone P, Limite L, Caramanno G, Geraci S, Pagnotta P, Chiarito M, Tamburino C, Berti S. Intra-Cardiac versus Transesophageal Echocardiographic Guidance for Left Atrial Appendage Occlusion with a Watchman FLX Device. J Clin Med 2023; 12:6658. [PMID: 37892796 PMCID: PMC10607018 DOI: 10.3390/jcm12206658] [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: 08/22/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to compare the peri-procedural success and complication rate within a large registry of intra-cardiac echocardiography (ICE)- vs. transesophageal echocardiography (TEE)-guided left atrial appendage occlusion (LAAO) procedures with a Watchmann FLX device. Data from 772 LAAO procedures, performed at 26 Italian centers, were reviewed. Technical success was considered as the final implant of a Watchmann FLX device in LAA; the absence of pericardial tamponade, peri-procedural stroke and/or systemic embolism, major bleeding and device embolization during the procedure was defined as a procedural success. One-year stroke and major bleeding rates were evaluated as outcome. ICE-guided LAA occlusion was performed in 149 patients, while TEE was used in 623 patients. Baseline characteristics were similar between the ICE and TEE groups. The technical success was 100% in both groups. Procedural success was also extremely high (98.5%), and was comparable between ICE (98.7%) and TEE (98.5%). ICE was associated with a slightly longer procedural time (73 ± 31 vs. 61.9 ± 36 min, p = 0.042) and shorter hospital stay (5.3 ± 4 vs. 5.8 ± 6 days, p = 0.028) compared to the TEE group. At one year, stroke and major bleeding rates did not differ between the ICE and TEE groups. A Watchmann FLX device showed high technical and procedural success rate, and ICE guidance does not appear inferior to TEE.
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Affiliation(s)
- Luigi Emilio Pastormerlo
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (L.E.P.); (M.R.R.)
| | - Claudio Tondo
- Department of Clinical Electrophysiology and Cardiac Pacing, Heart Rhythm Center at Monzino Cardiac Center, IRCCS, 20138 Milan, Italy; (C.T.); (G.F.)
| | - Gaetano Fassini
- Department of Clinical Electrophysiology and Cardiac Pacing, Heart Rhythm Center at Monzino Cardiac Center, IRCCS, 20138 Milan, Italy; (C.T.); (G.F.)
| | - Antonino Nicosia
- Dipartimento Cardio-Neuro-Vascolare, Ospedale GP II—Asp di Ragusa, 97100 Ragusa, Italy;
| | | | - Marco Contarini
- Cardiology Department, Umberto I Hospital, ASP 8 Siracusa, 96100 Syracuse, Italy; (M.C.); (G.G.)
| | - Giuseppe Giacchi
- Cardiology Department, Umberto I Hospital, ASP 8 Siracusa, 96100 Syracuse, Italy; (M.C.); (G.G.)
| | - Carmelo Grasso
- AOU Policlinico ‘G. Rodolico-San Marco’, Centro Alte Specialità e Trapianti—C.A.S.T., 95123 Catania, Italy; (C.G.); (C.T.)
| | - Gavino Casu
- Cardiologia Clinica e Interventistica, Azienda Ospedaliero Universitaria Sassari, 07100 Sassari, Italy;
| | - Maria Rita Romeo
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (L.E.P.); (M.R.R.)
| | - Patrizio Mazzone
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (P.M.); (L.L.)
| | - Luca Limite
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Vita-Salute University, 20132 Milan, Italy; (P.M.); (L.L.)
| | | | - Salvatore Geraci
- Ospedale San Giovanni di Dio, 92100 Agrigento, Italy; (G.C.); (S.G.)
| | - Paolo Pagnotta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy; (P.P.); (M.C.)
- Humanitas Research Hospital IRCCS, 20089 Rozzano, Italy
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy; (P.P.); (M.C.)
- Humanitas Research Hospital IRCCS, 20089 Rozzano, Italy
| | - Corrado Tamburino
- AOU Policlinico ‘G. Rodolico-San Marco’, Centro Alte Specialità e Trapianti—C.A.S.T., 95123 Catania, Italy; (C.G.); (C.T.)
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (L.E.P.); (M.R.R.)
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Tarantini G, Fovino LN, Varbella F, Trabattoni D, Caramanno G, Trani C, De Cesare N, Esposito G, Montorfano M, Musto C, Picchi A, Sheiban I, Gasparetto V, Ribichini FL, Cardaioli F, Saccà S, Cerrato E, Napodano M, Martinato M, Azzolina D, Andò G, Mugnolo A, Caruso M, Rossini R, Passamonti E, Teles RC, Rigattieri S, Gregori D, Tamburino C, Burzotta F. A large, prospective, multicentre study of left main PCI using a latest-generation zotarolimus-eluting stent: the ROLEX study. EUROINTERVENTION 2023; 18:e1108-e1119. [PMID: 36043326 PMCID: PMC9909455 DOI: 10.4244/eij-d-22-00454] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 05/18/2022] [Accepted: 07/11/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Data on left main (LM) percutaneous coronary interventions (PCI) have mostly been obtained in studies using drug-eluting stent (DES) platforms without dedicated large-vessel devices and with limited expansion capability. AIMS Our study aimed to investigate the safety and efficacy of LM PCI with the latest-generation Resolute Onyx DES. METHODS ROLEX (Revascularization Of LEft main with resolute onyX) is a prospective, multicentre study (ClinicalTrials.gov: NCT03316833) enrolling patients with unprotected LM coronary artery disease and a SYNTAX score <33 undergoing PCI with the Resolute Onyx zotarolimus-eluting coronary stent, that includes dedicated extra-large vessel platforms. The primary endpoint (EP) was target lesion failure (TLF): a composite of cardiac death, target vessel myocardial infarction (TVMI) and ischaemia-driven target lesion revascularisation (ID-TLR), at 1 year. All events were adjudicated by an independent clinical event committee. An independent core lab analysed all procedural angiograms. RESULTS A total of 450 patients (mean age 71.8 years, SYNTAX score 24.5±7.2, acute coronary syndrome in 53%) were enrolled in 26 centres. Of these, 77% of subjects underwent PCI with a single-stent and 23% with a 2-stent technique (8% double kissing [DK] crush, 6% culotte, 9% T/T and small protrusion [TAP] stenting). Intravascular imaging guidance was used in 45% (42% intravascular ultrasound [IVUS], 3% optical coherence tomography [OCT]). At 1 year, the primary EP incidence was 5.1% (cardiac death 2.7%, TVMI 2.7%, ID-TLR 2.0%). The definite/probable stent thrombosis rate was 1.1%. In a prespecified adjusted subanalysis, the primary EP incidence was significantly lower in patients undergoing IVUS/OCT-guided versus angio-guided PCI (2.0 vs 7.6%; hazard ratio [HR] 0.28, 95% confidence interval [CI]: 0.13-0.58; p<0.001). CONCLUSIONS In this large, multicentre, prospective registry, LM PCI with the Resolute Onyx DES showed good safety and efficacy at 1 year, particularly when guided by intracoronary imaging.
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Luca Nai Fovino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | | | | | - Carlo Trani
- Fondazione Policlinico Universitario A. Gemelli ICCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Matteo Montorfano
- Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmine Musto
- Department of Cardiosciences, A.O. San Camillo-Forlanini Hospital, Rome, Italy
| | - Andrea Picchi
- Cardiovascular Department, Azienda USL Toscana SudEst, Misericordia Hospital, Grosseto, Italy
| | - Imad Sheiban
- Division of Cardiology, Peschiera del Garda Hospital, Verona, Italy
| | | | - Flavio L Ribichini
- Division of Cardiovascular Medicine, Department of Medicine, University of Verona, Verona, Italy
| | - Francesco Cardaioli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Enrico Cerrato
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Massimo Napodano
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Matteo Martinato
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Giuseppe Andò
- Division of Cardiology, University of Messina, Messina, Italy
| | | | - Marco Caruso
- Division of Cardiology, University of Palermo, Palermo, Italy
| | - Roberta Rossini
- Division of Cardiology, ASST Papa Giovanni XXIII Hospital, Cuneo, Italy
| | - Enrico Passamonti
- Division of Cardiology, Azienda Socio-Sanitaria Territoriale di Cremona, Cremona, Italy
| | - Rui Campante Teles
- Hospital de Santa Cruz, CHLO, Nova Medical School, CEDOC, Lisbon, Portugal
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy
| | - Corrado Tamburino
- Cardiology, CAST-Policlinico Hospital, Cardio-Thorax-Vascular and Transplant Department, University of Catania, Catania, Italy
| | - Francesco Burzotta
- Fondazione Policlinico Universitario A. Gemelli ICCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Boriani G, Guerra F, De Ponti R, D'Onofrio A, Accogli M, Bertini M, Bisignani G, Forleo GB, Landolina M, Lavalle C, Notarstefano P, Ricci RP, Zanotto G, Palmisano P, De Bonis S, Pangallo A, Talarico A, Maglia G, Aspromonte V, Nigro G, Bianchi V, Rapacciuolo A, Ammendola E, Solimene F, Stabile G, Biffi M, Ziacchi M, Malpighi PSO, Saporito D, Casali E, Turco V, Malavasi VL, Vitolo M, Imberti JF, Bertini M, Anna AS, Zardini M, Placci A, Quartieri F, Bottoni N, Carinci V, Barbato G, De Maria E, Borghi A, Ramazzini OB, Bronzetti G, Tomasi C, Boggian G, Virzì S, Sassone B, Corzani A, Sabbatani P, Pastori P, Ciccaglioni A, Adamo F, Scaccia A, Spampinato A, Patruno N, Biscione F, Cinti C, Pignalberi C, Calò L, Tancredi M, Di Belardino N, Ricciardi D, Cauti F, Rossi P, Cardinale M, Ansalone G, Narducci ML, Pelargonio G, Silvetti M, Drago F, Santini L, Pentimalli F, Pepi P, Caravati F, Taravelli E, Belotti G, Rordorf R, Mazzone P, Bella PD, Rossi S, Canevese LF, Cilloni S, Doni LA, Vergara P, Baroni M, Perna E, Gardini A, Negro R, Perego GB, Curnis A, Arabia G, Russo AD, Marchese P, Dell’Era G, Occhetta E, Pizzetti F, Amellone C, Giammaria M, Devecchi C, Coppolino A, Tommasi S, Anselmino M, Coluccia G, Guido A, Rillo M, Palamà Z, Luzzi G, Pellegrino PL, Grimaldi M, Grandinetti G, Vilei E, Potenza D, Scicchitano P, Favale S, Santobuono VE, Sai R, Melissano D, Candida TR, Bonfantino VM, Di Canda D, Gianfrancesco D, Carretta D, Pisanò ECL, Medico A, Giaccari R, Aste R, Murgia C, Nissardi V, Sanna GD, Firetto G, Crea P, Ciotta E, Sgarito G, Caramanno G, Ciaramitaro G, Faraci A, Fasheri A, Di Gregorio L, Campsi G, Muscio G, Giannola G, Padeletti M, Del Rosso A, Notarstefano P, Nesti M, Miracapillo G, Giovannini T, Pieragnoli P, Rauhe W, Marini M, Guarracini F, Ridarelli M, Fedeli F, Mazza A, Zingarini G, Andreoli C, Carreras G, Zorzi A, Zanotto G, Rossillo A, Ignatuk B, Zerbo F, Molon G, Fantinel M, Zanon F, Marcantoni L, Zadro M, Bevilacqua M. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing). Intern Emerg Med 2023; 18:137-149. [PMID: 36352300 PMCID: PMC9646282 DOI: 10.1007/s11739-022-03140-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care. METHODS A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched. RESULTS A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined. CONCLUSIONS The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo 71, 41121, Modena, Italy.
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital Umberto I-Lancisi-Salesi, Ancona, Italy
| | - Roberto De Ponti
- Department of Heart and Vessels, Ospedale di Circolo-University of Insubria, Varese, Italy
| | - Antonio D'Onofrio
- Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy
| | | | - Matteo Bertini
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara "Arcispedale S. Anna", Cona, Ferrara, Italy
| | - Giovanni Bisignani
- Cardiology Division, Castrovillari Hospital, ASP Cosenza, Castrovillari, Italy
| | | | | | - Carlo Lavalle
- Department of Cardiology, Policlinico Universitario Umberto I, Rome, Italy
| | | | | | - Gabriele Zanotto
- Department of Cardiology, Mater Salutis Hospital, Legnago, Verona, Italy
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Berti S, De Caterina AR, Grasso C, Casu G, Giacchi G, Pagnotta P, Maremmani M, Mazzone P, Limite L, Tomassini F, Greco F, Romeo MR, Caramanno G, Fassini G, Geraci S, Chiarito M, Tondo C, Tamburino C, Contarini M. Periprocedural outcome in patients undergoing left atrial appendage occlusion with the Watchman FLX device: The ITALIAN-FLX registry. Front Cardiovasc Med 2023; 10:1115811. [PMID: 37180775 PMCID: PMC10172664 DOI: 10.3389/fcvm.2023.1115811] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/04/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction The Watchman FLX is a novel device for transcatheter left atrial appendage occlusion (LAAO) specifically designed to improve procedural performance in more complex anatomies with a better safety profile. Recently, small prospective non-randomized studies have shown good procedural success and safety compared with previous experiences. Results from large multicenter registries are needed to confirm the safety and efficacy of the Watchman FLX device in a real-world setting. Methods Italian FLX registry is a retrospective, non-randomized, multicentric study across 25 investigational centers in Italy including consecutive patients undergoing LAAO with the Watchman FLX between March 2019 and September 2021 (N = 772). The primary efficacy outcome was the technical success of the LAAO procedure (peri-device flow ≤ 5 mm) as assessed by intra-procedural imaging. The peri-procedural safety outcome was defined as the occurrence of one of the following events within 7 days after the procedure or by hospital discharge: death, stroke, transient ischemic attack, major extracranial bleeding (BARC type 3 or 5), pericardial effusion with tamponade or device embolization. Results A total of 772 patients were enrolled. The mean age was 76 ± 8 with a mean CHA2DS2-VASc score of 4.1 ± 1.4 and a mean HAS-BLED score of 3.7 ± 1.1. Technical success was achieved in 772 (100%) patients with the first device implanted in 760 (98.4%) patients. A peri-procedural safety outcome event occurred in 21 patients (2.7%) with major extracranial bleeding being the most common (1.7%). No device embolization occurred. At discharge 459 patients (59.4%) were treated with dual antiplatelet therapy (DAPT). Conclusions The Italian FLX registry represents the largest multicenter retrospective real-world study reporting periprocedural outcome of LAAO with the Watchman FLX device, resulting in a procedural success rate of 100% and a low incidence of peri-procedural major adverse events (2.7%).
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Affiliation(s)
- Sergio Berti
- Fondazione Toscana G. Monasterio, Ospedale del Cuore G. Pasquinucci, Massa, Italy
- Correspondence: Sergio Berti
| | | | - Carmelo Grasso
- Cardiac-Thoracic-Vascular Department, Ferrarotto Hospital and University of Catania, Catania, Italy
| | - Gavino Casu
- Cardiology Unit, Ospedale San Francesco, Nuoro, Italy
| | | | - Paolo Pagnotta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
| | - Michele Maremmani
- Fondazione Toscana G. Monasterio, Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | - Patrizio Mazzone
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Luca Limite
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital and Vita-Salute University, Milan, Italy
| | - Francesco Tomassini
- Unità interaziendale di emodinamica-Ospedale degli Infermi, Rivoli(To)-Ospedale San Luigi Gonzaga, Turin, Italy
| | | | - Maria Rita Romeo
- Fondazione Toscana G. Monasterio, Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | | | - Gaetano Fassini
- Department of Clinical Electrophysiology & Cardiac Pacing Heart Rhythm Center at Monzino Cardiac Center, IRCCS, Milan, Italy
| | - Salvatore Geraci
- Interventional Cardiology Unit, Umberto I Hospital, Syracuse, Italy
| | - Mauro Chiarito
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
| | - Claudio Tondo
- Department of Clinical Electrophysiology & Cardiac Pacing Heart Rhythm Center at Monzino Cardiac Center, IRCCS, Milan, Italy
| | - Corrado Tamburino
- Cardiac-Thoracic-Vascular Department, Ferrarotto Hospital and University of Catania, Catania, Italy
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Diana D, Diana G, Geraci S, Martello NM, Savarino D, Caramanno G. 809 A CASE OF CASEOUS MITRAL ANNULUS CALCIFICATION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.179] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Caseous mitral annular calcification (CMAC) is a rare variant of degenerative mitral annular calcification (MAC) with an echocardiographic prevalence of 0.6% of all MACs and an overall prevalence of up to 0.07% in the general population. It primarily affects older patients with hypertension and chronic kidney disease. Due to the general benign prognosis, conservative management of this lesion is recommended in most cases.
Herein we describe the case of a 78-year-old female patient admitted for sustained ventricular tachycardia treated with Amiodaron infusion followed by electrical cardioversion for hemodynamically instability. Her past medical history was remarkable for hypertension, HFpEF and chronic kidney disease. Trans-thoracic echocardiogram showed the presence of an echo-dense mass with central echo-lucency surrounded by calcifications at the posterior peri-annular and leaflet region of the mitral valve, not associated with valvular disfunction.
To define the etiology of the arrythmia, a coronary angiography was performed and excluded significant coronary artery disease. Nevertheless, a round-shape hyperdense mass was observed in the left atrium near the atrio-ventricular groove (figure 1): during injection through coronary vessels the contrast was not visible in the lesion. In order to better define the nature of the mass, a Trans-esophageal Echocardiogram was performed and showed a “toothpaste-like” echo-dense mass with central echo-lucency surrounded by a calcified envelope at the posterior peri-annular region of the mitral valve suggestive for CMAC (figure 2); 3D zoom imaging clarified its relationship with P2 scallop of posterior mitral valve leaflet (figure 3). For the best tissue characterization and to definitely exclude other mass-like lesions, such as myxoma, papillary fibroelastoma, myocardial abscess, vegetations, lipomatous hypertrophy, Cardiac Magnetic Resonance was performed and showed low-signal intensity in both T1- and T2-weighted sequences, reflecting its calcium content. First-pass perfusion sequence reveals no contrast enhancement, whereas late gadolinium enhancement depicts a peripheral rim of enhancement confirming our suspect.
In Conclusion, CMAC is a rare disorder requiring a multimodal imaging approach to differentiate it with other intra-cardiac masses. Its course is generally benign and whether not associated with valvular or hemodynamic significance, it could be considered as a bystander.
Figure 1
Figure 2
Figure 3
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Affiliation(s)
- Davide Diana
- Ospedale San Giovanni Di Dio Di Agrigento
- Universita’ Degli Studi Di Palermo
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7
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Golino L, Caiazzo G, Calabrò P, Colombo A, Contarini M, Fedele F, Gabrielli G, Galassi AR, Golino P, Scotto di Uccio F, Tarantini G, Argentino V, Balbi M, Bernardi G, Boccalatte M, Bonmassari R, Bottiglieri G, Caramanno G, Cesaro F, Cigala E, Chizzola G, Di Lorenzo E, Intorcia A, Fattore L, Galli S, Gerosa G, Giannotta D, Grossi P, Monda V, Mucaj A, Napodano M, Nicosia A, Perrotta R, Pieri D, Prati F, Ramazzotti V, Romeo F, Rubino A, Russolillo E, Spedicato L, Tuccillo B, Tumscitz C, Vigna C, Bertinato L, Armigliato P, Ambrosini V. Excimer laser technology in percutaneous coronary interventions: Cardiovascular laser society's position paper. Int J Cardiol 2022; 350:19-26. [PMID: 34995700 DOI: 10.1016/j.ijcard.2021.12.054] [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: 09/28/2021] [Revised: 12/07/2021] [Accepted: 12/29/2021] [Indexed: 11/28/2022]
Abstract
Excimer Laser Coronary Atherectomy (ELCA) is a well-established therapy that emerged for the treatment of peripheral vascular atherosclerosis in the late 1980s, at a time when catheters and materials were rudimentary and associated with the most serious complications. Refinements in catheter technology and the introduction of improved laser techniques have led to their effective use for the treatment of a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non-crossable or non-expandable lesions, chronic occlusions, and stent under-expansion. The gradual introduction of high-energy strategies combined with the contrast infusion technique has enabled us to treat an increasing number of complex cases with a low rate of periprocedural complications. Currently, the use of the ELCA has also been demonstrated to be effective in acute coronary syndrome (ACS), especially in the context of large thrombotic lesions.
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Affiliation(s)
- L Golino
- UOC Cardiologia/UTIC, Laboratorio di Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero S. Giuseppe Moscati, Aversa, Caserta, Italy.
| | - G Caiazzo
- UOC Cardiologia/UTIC, Laboratorio di Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero S. Giuseppe Moscati, Aversa, Caserta, Italy
| | - P Calabrò
- Cattedra di Cardiologia, Dipartimento di Medicina Traslazionale, Università degli Studi della Campania "Luigi Vanvitelli" - U.O.C. di Cardiologia Clinica a Direzione Universitaria A.O.R.N. Sant'Anna e San Sebastiano, Caserta, Italy
| | - A Colombo
- Cardiologia Interventistica, Centro Cuore Columbus, Milano, Italy
| | - M Contarini
- Cardiologia e Laboratorio di Emodinamica, Presidio Ospedaliero Umberto I° Siracusa, Italy
| | - F Fedele
- Cattedra di Cardiologia, Azienda Ospedaliero Universitaria Policlinico Umberto I°, Roma, Italy
| | - G Gabrielli
- Cardiologia Interventistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti, Ancona, Italy
| | - A R Galassi
- Cattedra di Cardiologia, Azienda Ospedaliera Universitaria, Policlinico "P. Giaccone", Palermo, Italy
| | - P Golino
- Cattedra di Cardiologia, Dipartimento di Scienze Medico-Translazionali, Università degli Studi della Campania "Luigi Vanvitelli", Sezione di Cardiologia, c/o Ospedale Monaldi, Napoli, Italy
| | | | - G Tarantini
- Unità Operativa Semplice Dipartimentale di "Emodinamica e Cardiologia Interventistica", Dipartimento Strutturale Aziendale Cardio-Toraco-Vascolare, Azienda Ospedaliera di Padova, Italy
| | - V Argentino
- Cardiologia Interventistica, Azienda Ospedaliera per l'Emergenza Cannizzaro, Catania, Italy
| | - M Balbi
- Cardiologia Interventistica, IRCCS Azienda Ospedaliera Universitaria S. Martino, Genova, Italy
| | - G Bernardi
- Associazione per la Ricerca in Cardiologia, Ospedale S. Maria degli Angeli, Pordenone, Italy
| | - M Boccalatte
- Laboratorio Emodinamica P.O. S. Maria delle Grazie ASL NA2, Pozzuoli, Napoli, Italy
| | - R Bonmassari
- Cardiologia Interventistica, Presidio Ospedaliero S. Chiara, Trento, Italy
| | - G Bottiglieri
- Cardiologia Interventistica, Ospedale "SS.Addolorata", Eboli, Salerno, Italy
| | - G Caramanno
- Cardiologia Interventistica, Presidio Ospedaliero S. Giovanni di Dio, Agrigento, Italy
| | - F Cesaro
- Cardiologia Università "Luigi Vanvitelli", Caserta, Italy
| | - E Cigala
- Cardiologia Interventistica, Azienda Ospedaliera dei Colli, Ospedale Monaldi, Napoli, Italy
| | - G Chizzola
- Cardiologia Interventistica, Azienda ospedaliera Universitaria Spedali Civili, Brescia, Italy
| | - E Di Lorenzo
- Cardiologia e Laboratorio di Emodinamica, AORN S. Giuseppe Moscati, Avellino, Italy
| | - A Intorcia
- Cardiologia e Laboratorio di Emodinamica, AORN S. Giuseppe Moscati, Avellino, Italy
| | - L Fattore
- UOC Cardiologia/UTIC, Laboratorio di Emodinamica e Cardiologia Interventistica, Presidio Ospedaliero S. Giuseppe Moscati, Aversa, Caserta, Italy
| | - S Galli
- Cardiologia Interventistica, IRCCS Centro Cardiologico Monzino, Milano, Italy
| | - G Gerosa
- Dipartimento di Scienze Cardio-Toraco-Vascolari e Sanità Pubblica, Università di Padova, Italy
| | - D Giannotta
- Cardiologia, Presidio Ospedaliero Gravina e Santo Pietro, Caltagirone, Catania, Italy
| | - P Grossi
- Cardiologia e Laboratorio di Emodinamica, Presidio Ospedaliero Mazzoni, Ascoli Piceno, Italy
| | - V Monda
- Cardiologia Interventistica, Azienda Ospedaliera dei Colli, Ospedale Monaldi, Napoli, Italy
| | - A Mucaj
- Cardiologia Interventistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti, Ancona, Italy
| | - M Napodano
- Unità Operativa Semplice Dipartimentale di "Emodinamica e Cardiologia Interventistica", Dipartimento Strutturale Aziendale Cardio-Toraco-Vascolare, Azienda Ospedaliera di Padova, Italy
| | - A Nicosia
- Cardiologia Interventistica, Presidio Ospedaliero Giovanni Paolo II°, Ragusa, Italy
| | - R Perrotta
- Cardiologia Interventistica, Azienda Ospedaliera S. Anna e S. Sebastiano, Caserta, Italy
| | - D Pieri
- Cardiologia Interventistica, Presidio Ospedaliero G.F. Ingrassia, Palermo, Italy
| | - F Prati
- Cardiologia d'Urgenza ed Interventistica, Azienda Ospedaliera S. Giovanni Addolorata, Roma, Italy
| | - V Ramazzotti
- Cardiologia d'Urgenza ed Interventistica, Azienda Ospedaliera S. Giovanni Addolorata, Roma, Italy
| | - F Romeo
- UniCamillus International Medical University, Rome, Italy
| | - A Rubino
- Cardiologia Interventistica, Presidio Ospedaliero G.F. Ingrassia, Palermo, Italy
| | - E Russolillo
- Cardiologia Interventistica, Ospedale S. Giovanni Bosco, Napoli, Italy
| | - L Spedicato
- Cardiologia Interventistica, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy
| | - B Tuccillo
- Cardiologia Interventistica Ospedale del Mare, Napoli, Italy
| | - C Tumscitz
- Cattedra di Cardiologia, Azienda Ospedaliera Universitaria, Arcispedale S. Anna, Ferrara, Italy
| | - C Vigna
- Cardiologia Interventistica, IRCCS Casa Sollievo della Sofferenza, S. Giovanni Rotondo, Foggia, Italy
| | - L Bertinato
- Clinical Governance, Istituto Superiore di Sanità, Italy
| | - P Armigliato
- Scientific Board Cardiovascular Laser Society, Italy
| | - V Ambrosini
- Cardiologia e Laboratorio di Emodinamica, AORN S. Giuseppe Moscati, Avellino, Italy
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8
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Rapetto C, Leoncini M, Cerrato E, Regazzoli D, Cortese B, Rossi A, Fetiveau R, Geraci S, De Angelis MC, Tespili M, Iannaccone M, Centola A, Durante A, De Carlo M, De Caterina A, Ribichini F, Favaretto E, Testa L, Pirisi R, Varbella F, Nicolini E, di Palma G, Loi B, Poli A, Caramanno G, Varricchio A, Garbo R, Cuculo A, Petronio AS, Berti S, Bollati M, Spedicato L, De Candia G, Piva T, Quadri G, Colombo A, Ielasi A. ImpaCt of an Optimal Implantation Strategy on Absorb Long-Term Outcomes: The CIAO Registry. Cardiovascular Revascularization Medicine 2021; 30:1-8. [DOI: 10.1016/j.carrev.2020.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/16/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
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9
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Ortega-Paz L, Brugaletta S, Capodanno D, Gómez-Hospital JA, Íñiguez A, Gori T, Urbano C, Nef H, Trillo R, Latib A, Benedicto A, Caramanno G, de Prado AP, Di Mario C, Naber C, Salinas P, Sanchis J, Mehilli J, Piñón P, Martins D, Avanzas P, López-Mínguez JR, Martins C, Santos R, Torres A, Lozano Í, Moreno R, Sabaté y M, Hernández F. Efecto de la técnica de implantación en los resultados en pacientes tratados con armazón bioabsorbible en diferentes escenarios clínicos. RECIC 2021. [DOI: 10.24875/recic.m19000043] [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] [Indexed: 11/17/2022] Open
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10
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Di Liberto IA, Pilato G, Geraci S, Milazzo D, Vaccaro G, Buccheri S, Caramanno G. Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital. J Cardiovasc Med (Hagerstown) 2020; 21:722-724. [PMID: 32658006 DOI: 10.2459/jcm.0000000000001053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | - Gerlando Pilato
- Department of Interventional Cardiology, San Giovanni Di Dio Hospital, Agrigento, Italy
| | - Salvatore Geraci
- Department of Interventional Cardiology, San Giovanni Di Dio Hospital, Agrigento, Italy
| | - Diego Milazzo
- Department of Interventional Cardiology, San Giovanni Di Dio Hospital, Agrigento, Italy
| | - Giovanni Vaccaro
- Department of Interventional Cardiology, San Giovanni Di Dio Hospital, Agrigento, Italy
| | - Sergio Buccheri
- Department of Medical Sciences-Cardiology and Uppsala Clinical Research Center, Uppsala Univerisity, Uppsala, Sweden
| | - Giuseppe Caramanno
- Department of Interventional Cardiology, San Giovanni Di Dio Hospital, Agrigento, Italy
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11
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Abstract
Abstract
A 33-year-old man, ex drug addict on methadone therapy. He arrives to emergency department for syncope, reported by his wife reversion of the eyeballs and fine tremors with subsequent recovery of consciousness. A similar episode had happened a year ago. It was performed ECG: sinus bradycardia , 45 bpm, QT 600 msec, QTc 554 msec . Neurological examination performed: no motor deficits, negative Romberg. At brain CT no parenchymal tomodensitometric changes. Median line structures in axis. At the EEG: slight diffuse slow intercritical changes. Prescribed therapy with levetiracetam 500 mg. Cardiological examination and echocardiogram performed within the limits. Laboratory tests showed Trop HS 80 pg / ml. On the basis of the ECG and the slight increase of the troponin he was hospitalized in Cardiology and monitored. The following day, cardiac arrest due to torsade de pointes degenerated into ventricular fibrillation, DC shock was performed with the restoration of electrical and mechanical activity. Urgent coronary angiography was performed with evidence of coronary artery free from angiographically significant stenosis. SERT has been contacted: the patient had not been treated by them for some time and was using excessive doses of self-procuring methadone. In consideration of cardiac arrest from methadone long QT ventricular arrhythmia, ICD implantation was proposed, refused by the patient because he wanted to start detoxification therapy. During the hospitalization, progressive reduction of QT up to normalization in discharge. After a month new access to emergency department for presynopal episode, ECG showed sinus bradycardia with QTC 552 msec; the patient reports continuing to take excessive methadone doses and refuses treatment at a recovery center; considering that the ICD can be life-saving in this typ77e of patient (intractable addiction), we have re-proposed the ICD implant, rejected by the patient.
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Affiliation(s)
| | - P Sidoti
- OSPEDALE S GIOVANNI DI DIO, AGRIGENTO
| | - A Frenda
- OSPEDALE S GIOVANNI DI DIO, AGRIGENTO
| | | | - S Geraci
- OSPEDALE S GIOVANNI DI DIO, AGRIGENTO
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12
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Di Liberto IA, Pilato G, Buccheri S, Geraci S, Milazzo D, Vaccaro G, Caramanno G. Epicardial fat study-AG: relationship between echocardiographic epicardial fat and coronary artery disease in patients after invasive coronary artery angiography. Future Cardiol 2020; 16:635-643. [PMID: 32519916 DOI: 10.2217/fca-2020-0025] [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] [Indexed: 11/21/2022] Open
Abstract
Background: Epicardial fat increase has not yet a clear correlation with coronary artery disease (CAD). Aim: This study had as goal to demonstrate a relationship between an increase of epicardial fat thickness (EFT) and CAD. Materials & methods: In this observational study, we included 234 patients who underwent invasive coronary angiography. Before invasive coronary angiography, all patients underwent echocardiographic-2D for evaluation of EFT and they were divided into groups based on Gensini score and also on Syntax score. Results: EFT was significantly correlated to the presence and severity of CAD assessed by Gensini score with a cut-off value of 5.2 mm (sensitivity of 90.9%-specificity of 87.3%- area under the ROC curve = 92.1%). Conclusion: EFT increase (fat index ≥5.2 mm) evaluated by echocardiographic-2D could be considered as a risk factor for predicting CAD.
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Affiliation(s)
| | - Gerlando Pilato
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Sergio Buccheri
- Department of Medical Sciences-Cardiology, Uppsala Univerisity & Uppsala Clinical Research Center, Uppsala, Sweden
| | - Salvatore Geraci
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Diego Milazzo
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giovanni Vaccaro
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
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13
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Ielasi A, Cerrato E, Geraci S, Campo G, Garro N, Leoncini M, Sganzerla P, Granata F, Ruggiero R, Varbella F, Caramanno G, Grigis G, Tespili M. Sirolimus-Eluting Magnesium Resorbable Scaffold Implantation in Patients with Acute Myocardial Infarction. Cardiology 2019; 142:93-96. [DOI: 10.1159/000499536] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 03/01/2019] [Indexed: 11/19/2022]
Abstract
To date, very little is known about the performance of a sirolimus-eluting bioresorbable magnesium scaffold (Mg-BRS) in patients with acute myocardial infarction (AMI). A multicenter cohort analysis was performed on 69 consecutive AMI subjects treated with Mg-BRS. Procedural success was obtained in all cases, and no in-hospital events were reported. At 9-month follow-up, no cardiac death, target-vessel myocardial infarction, ischemia-driven target lesion revascularization, or Mg-BRS thrombosis was reported. Although our analysis showed encouraging results, larger studies and longer-term follow-up are needed to better understand the potential benefits associated with the use of a Mg-BRS in AMI patients.
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14
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La Franca E, Falletta C, Raffa GM, Gentile G, Di Gesaro G, Baravoglia CMH, Gandolfo C, Frenda A, Caramanno G, Clemenza F, Pilato M. Spontaneous coronary artery dissection: the great pretender. J Thorac Dis 2019; 10:S4179-S4182. [PMID: 30631588 DOI: 10.21037/jtd.2018.10.123] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Eluisa La Franca
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Calogero Falletta
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Giuseppe Maria Raffa
- Cardiac Surgery Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Giovanni Gentile
- Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, Palermo, Italy
| | - Gabriele Di Gesaro
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Cesar Mario Hernandez Baravoglia
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Caterina Gandolfo
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Antonella Frenda
- U.O. Emodinamica e Cardiologia Interventistica, Asp Agrigento, Agrigento, Italy
| | - Giuseppe Caramanno
- U.O. Emodinamica e Cardiologia Interventistica, Asp Agrigento, Agrigento, Italy
| | - Francesco Clemenza
- Cardiology Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Michele Pilato
- Cardiac Surgery Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
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Rosenberg M, Waliszewski M, Chin K, Ahmad WAW, Caramanno G, Milazzo D, Nuruddin AA, Liew HB, Maskon O, Aubry P, Poyet R, Frey N. Prospective, large‐scale multicenter trial for the use of drug‐coated balloons in coronary lesions:
The DCB‐only All‐Comers Registry. Catheter Cardiovasc Interv 2018; 93:181-188. [DOI: 10.1002/ccd.27724] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 01/12/2018] [Revised: 05/14/2018] [Accepted: 06/10/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Mark Rosenberg
- Innere Medizin III, Universitätsklinikum Schleswig‐Holstein Campus Kiel Germany
| | - Matthias Waliszewski
- Medical Scientific Affairs, B.Braun Melsungen AG Berlin Germany
- Department of Internal Medicine and CardiologyCharité – Universitätsmedizin Berlin Campus Virchow Berlin Germany
| | | | | | | | | | | | | | - Oteh Maskon
- Pusat Perubatan Universiti Kebangsaan Kuala Lumpur Malaysia
| | | | | | - Norbert Frey
- Innere Medizin III, Universitätsklinikum Schleswig‐Holstein Campus Kiel Germany
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16
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Cerrato E, Ielasi A, Geraci S, Quadri G, Tomassini F, Paolo Sganzerla, Ferrari F, Garro N, Rolfo C, Leoncini M, Bellucca S, Bernelli C, Barbero U, Giorgio Sacchetta, Iannaccone M, Claudio Rapetto, Campo G, Tespili M, Caramanno G, Ferdinando Varbella, Cerrato E. TCT-353 Acute and mid-term performance of Magmaris Bioresorbable Scaffold implantation in complex lesions: a multicenter experience. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1502] [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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17
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Quadri G, Cerrato E, Ielasi A, Geraci S, Tomassini F, Ferrari F, Rolfo C, Garro N, Leoncini M, Bellucca S, Caramanno G, Bernelli C, Sganzerla P, Granata F, Barbero U, Giorgio Sacchetta, Iannaccone M, Campo G, Claudio Rapetto, Tespili M, Milazzo D, Pilato G, Vaccaro G, Ferdinando varbella. TCT-704 Feasibility of overlapped Magnesium-made bioresorbable scaffold implantation in long lesions: results from the multicenter italian registry (MAGIC). J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1920] [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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Schnorbus B, Wiebe J, Capodanno D, Brugaletta S, Geraci S, Mehilli J, Latib A, Lesiak M, Jensen C, Mattesini A, Münzel T, Capranzano P, Di Mario C, Naber C, Araszkiewicz A, Colombo A, Caramanno G, Sabate M, Tamburino C, Nef H, Gori T. Twelve-month outcomes after bioresorbable vascular scaffold implantation in patients with acute coronary syndromes. Data from the European Multicenter GHOST-EU Extended Registry. EUROINTERVENTION 2018; 13:e1104-e1111. [PMID: 28320687 DOI: 10.4244/eij-d-16-00568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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
AIMS The aim of this study was to report on the midterm outcomes of patients undergoing percutaneous coronary intervention with bioresorbable vascular scaffolds (BVS) for the treatment of acute coronary syndromes (ACS) and compare with those of patients with stable coronary artery disease (sCAD). METHODS AND RESULTS One thousand four hundred and seventy-seven (1,477) patients underwent implantation of one or more BVS (Absorb BVS; Abbott Vascular, Santa Clara, CA, USA) at 11 European centres and were included in the GHOST-EU registry. Admissions comprised 47.1% of the patients (951 BVS) with ACS, and 52.8% (1,274 BVS) with sCAD. During a median follow-up of 384 (359-460) days, patient-oriented endpoints (PoCE), including all-cause death, any infarction, any revascularisation, were recorded in 271 patients (12-month incidence in ACS patients: 18.5% vs. 11.6% in the sCAD group, p<0.001). Device-oriented composite endpoints (DoCE), cardiac death, target vessel infarction and target lesion revascularisation, were observed in 98 patients (12-month incidence of 4.2% in the sCAD group, 6.4% in the ACS group; p=0.052). The 12-month incidence of definite scaffold thrombosis was 2.6% in ACS patients and 0.8% in XIENCE patients (p=0.006). In multivariate analysis, ACS was a predictor of DoCE (HR: 2.26 [1.34-3.81], p=0.002), PoCE (HR: 1.71 [1.13-2.58], p=0.011), and stent thrombosis (HR: 2.51 [1.13-5.60], p=0.025). In contrast, the incidence of target lesion revascularisation was not different between groups. There was no difference in the incidence of any of these endpoints among the different clinical presentations (unstable angina, non-ST-elevation infarction and ST-elevation infarction). CONCLUSIONS PoCE, DoCE and scaffold thromboses were more frequent in ACS patients, without any difference among different forms of ACS.
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Affiliation(s)
- Boris Schnorbus
- Zentrum für Kardiologie I, Universitätsmedizin Mainz, University Medical Center, German Center for Cardiovascular Research (DZHK, Standort Rhein-Main), Mainz, Germany
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Buccheri D, Chirco PR, Geraci S, Caramanno G, Cortese B. Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies. Heart Lung Circ 2018; 27:940-951. [PMID: 29503240 DOI: 10.1016/j.hlc.2017.07.014] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [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: 11/08/2016] [Revised: 04/03/2017] [Accepted: 07/10/2017] [Indexed: 12/27/2022]
Abstract
Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% of the general population and represents 14% of all the anomalies of coronary arteries. Its clinical relevance focusses mainly on the mechanism of "coronary steal phenomenon", causing myocardial functional ischaemia even in the absence of stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach is guided by the patient's symptoms and consists of a number of instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance and coronary angiography. If it is not an incidental finding, coronary angiography is required in view of the optimal therapeutic planning. Small-sized fistulae are usually asymptomatic and have an excellent prognosis if managed medically with clinical follow-up with echocardiography every 2 to 5 years. In the case of symptomatic, large-sized or giant fistulae an invasive treatment, by transcatheter approach or surgical ligation, is usually a reasonable choice, and both strategies show equivalent results at long-term follow-up. Antibiotic prophylaxis for the prevention of bacterial endocarditis is recommended in all patients with coronary artery fistulae who undergo dental, gastrointestinal or urological procedures. A life-long follow-up is always essential to ensure that the patient is not undergoing progression of disease or further cardiac complications.
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Affiliation(s)
- Dario Buccheri
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy.
| | - Paola Rosa Chirco
- Emergency Department, Paolo Giaccone University Hospital, Palermo, Italy
| | - Salvatore Geraci
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
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Buccheri D, Milazzo D, Geraci S, Vaccaro G, Caramanno G. A lesson from intravascular imaging: insights for recognizing a spontaneous coronary artery dissection. J Thorac Dis 2017; 9:5363-5367. [PMID: 29312747 DOI: 10.21037/jtd.2017.10.146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Spontaneous coronary artery dissection (SCAD) is still today an underdiagnosed disease due to the absence of angiographic hallmarks in more than 70% of cases. In several cases, an intravascular imaging is a sole tool for recognizing a dissection. Particularly, optical coherence tomography analysis (OCT) could represent the gold standard technique of easy interpretation and prompt diagnosis. Here we present a rare case of multivessel spontaneous coronary artery disease (SCAD) with atypical collateral circulation.
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Affiliation(s)
- Dario Buccheri
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Diego Milazzo
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Salvatore Geraci
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giovanni Vaccaro
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
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21
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Di Rosa S, Frenda A, Casalicchio C, Catalano C, Siracusa R, Caramanno G. [Quadricuspid aortic valve in a patient with previous patent arterial duct closure]. G Ital Cardiol (Rome) 2017; 18:742-743. [PMID: 29105690 DOI: 10.1714/2790.28265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Salvatore Di Rosa
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
| | - Antonella Frenda
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
| | - Calogero Casalicchio
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
| | - Calogero Catalano
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
| | - Roberta Siracusa
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
| | - Giuseppe Caramanno
- U.O.C. Cardiologia-UTIC, ASP 1 Agrigento, Ospedale San Giovanni di Dio, Agrigento
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22
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Capranzano P, Capodanno D, Brugaletta S, Latib A, Mehilli J, Nef H, Gori T, Lesiak M, Geraci S, Pyxaras S, Mattesini A, Münzel T, Araszkiewicz A, Caramanno G, Naber C, Di Mario C, Sabatè M, Colombo A, Wiebe J, Tamburino C. Clinical outcomes of patients with diabetes mellitus treated with Absorb bioresorbable vascular scaffolds: a subanalysis of the European Multicentre GHOST-EU Registry. Catheter Cardiovasc Interv 2017; 91:444-453. [PMID: 29068130 DOI: 10.1002/ccd.27388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/08/2017] [Revised: 07/23/2017] [Accepted: 10/05/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Data on the clinical performance of bioresorbable scaffolds in patients with diabetes mellitus (DM) are still limited. The present study reported 1-year clinical outcomes associated with the use of everolimus-eluting bioresorbable vascular scaffolds (Absorb BVS; Abbott Vascular, Santa Clara, CA) in DM patients. METHODS AND RESULTS This was a subanalysis from the GHOST-EU (Gauging coronary Healing with biOresorbable Scaffolding plaTforms in Europe) multicenter retrospective registry including patients treated with Absorb BVS between November 2011 and September 2014. In this study, a comparative analysis stratified according to DM was performed. The primary endpoint was target lesion failure (TLF), defined as the combination of cardiac death, target-vessel myocardial infarction (MI) and clinically-driven target-lesion revascularization (TLR). A total of 1,477 patients were treated with 2,224 Absorb BVS; 381 (25.8%) and 1,096 (74.2%) patients were with and without DM, respectively. The 1-year rate of TLF was higher among patients with DM (7.8%) than those without DM (4.3%); the increase in TLF was driven by TLR (6.5% vs. 3.3%, P = 0.009); no significant differences in cardiac death (1.1% vs. 0.9%, P = 0.68) and target-vessel MI (3.1% vs. 2.2%, P = 0.38) were observed, respectively. Definite/probable scaffold thrombosis rate tended to be higher among patients with DM than those without DM (3.0% vs. 1.7%, P = 0.14, respectively). CONCLUSIONS Absorb BVS use in patients with DM was associated with increased 1-year TLF and scaffold thrombosis compared with non-diabetes patients.
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Affiliation(s)
- Piera Capranzano
- Cardiovascular department, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Davide Capodanno
- Cardiovascular department, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Salvatore Brugaletta
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Biomedical Investigation Institute, IDIBAPS, University of Barcelona, Spain
| | - Azeem Latib
- EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy
| | - Julinda Mehilli
- Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilian Universität, Munich, Germany
| | - Holger Nef
- Department of Cardiology, University of Giessen, Giessen, Germany
| | - Tommaso Gori
- Zentrum für Kardiologie I, Universitätsmedizin Mainz, University Medical Center, and German Center for Cardiovascular Research (DZHK, Standort Rhein-Main), Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
| | - Maciej Lesiak
- Department of Cardiology, University Medical Sciences, Poznan, Poland
| | | | - Stelios Pyxaras
- Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany
| | | | - Thomas Münzel
- Zentrum für Kardiologie I, Universitätsmedizin Mainz, University Medical Center, and German Center for Cardiovascular Research (DZHK, Standort Rhein-Main), Mainz, Germany.,Center for Thrombosis and Hemostasis, University Medical Center, Mainz, Germany
| | - Aleksander Araszkiewicz
- National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital & Imperial College, London, United Kingdom
| | | | - Christoph Naber
- Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany
| | - Carlo Di Mario
- Careggi Hospital, University of Florence, Florence, Italy.,National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital & Imperial College, London, United Kingdom
| | - Manel Sabatè
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Biomedical Investigation Institute, IDIBAPS, University of Barcelona, Spain
| | - Antonio Colombo
- EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy
| | - Jens Wiebe
- Department of Cardiology, University of Giessen, Giessen, Germany
| | - Corrado Tamburino
- Cardiovascular department, Ferrarotto Hospital, University of Catania, Catania, Italy
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Cutaia A, Casalicchio C, Siracusa R, Di Rosa S, Catalano C, Biasiolo M, Di Gregorio F, Caramanno G. 073_16733-J4 Atrial Sensing Stability in Acute and Chronic Implants of a VDD Single-Pass Lead. JACC Clin Electrophysiol 2017. [DOI: 10.1016/j.jacep.2017.09.150] [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] [Indexed: 11/26/2022]
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Geraci S, Kawamoto H, Capodanno D, Caramanno G, Latib A. Reply. JACC Cardiovasc Interv 2017. [DOI: 10.1016/j.jcin.2017.05.013] [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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25
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Buccheri D, Caramanno G, Geraci S, Cortese B. Should we reconsider dual antiplatelet therapy duration following bioresorbable scaffold angioplasty? J Thorac Dis 2017; 9:417-418. [PMID: 28449432 DOI: 10.21037/jtd.2017.03.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Dario Buccheri
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy.,Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Giuseppe Caramanno
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Salvatore Geraci
- Interventional Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy
| | - Bernardo Cortese
- Interventional Cardiology, ASST Fatebenefratelli-Sacco, Milano, Italy
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26
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Jabbour RJ, Tanaka A, Capranzano P, Cortese B, Lesiak M, Testa L, Gatto P, Suarez de Lezo J, Mattesini A, Geraci S, Ielasi A, Diletti R, Capodanno D, Buccheri D, Iwanczyk S, Bedogni F, Tchetche D, Di Mario C, Caramanno G, Van Mieghem NM, Tamburino C, Colombo A, Latib A. Bioresorbable Vascular Scaffolds as a Treatment Option for Left Main Lesions. JACC Cardiovasc Interv 2017; 10:743-745. [PMID: 28385415 DOI: 10.1016/j.jcin.2017.01.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 01/17/2017] [Accepted: 01/27/2017] [Indexed: 11/27/2022]
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Ortega-Paz L, Capodanno D, Gori T, Nef H, Latib A, Caramanno G, Di Mario C, Naber C, Lesiak M, Capranzano P, Wiebe J, Mehilli J, Araszkiewicz A, Pyxaras S, Mattesini A, Geraci S, Naganuma T, Colombo A, Münzel T, Sabaté M, Tamburino C, Brugaletta S. Predilation, sizing and post-dilation scoring in patients undergoing everolimus-eluting bioresorbable scaffold implantation for prediction of cardiac adverse events: development and internal validation of the PSP score. EUROINTERVENTION 2017; 12:2110-2117. [DOI: 10.4244/eij-d-16-00974] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [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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28
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Jabbour R, Tanaka A, Capranzano P, Cortese B, Lesiak M, Testa L, Gatto P, de Lezo JS, Mattesini A, Geraci S, Ielasi A, Diletti R, Capodanno D, Buccheri D, Iwanczyk S, Bedogni F, Tchetche D, Di Mario C, Caramanno G, Van Mieghem NM, Tamburino C, Colombo A, Latib A. CRT-100.86 Bioresorbable Vascular Scaffolds As A Treatment Option For Left Main Lesions. JACC Cardiovasc Interv 2017. [DOI: 10.1016/j.jcin.2016.12.110] [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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29
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Godino C, Chiarito M, Donahue M, Testa L, Colantonio R, Cappelletti A, Monello A, Magni V, Milazzo D, Parisi R, Nicolino A, Moshiri S, Fattori R, Aprigliano G, Palloshi A, Caramanno G, Montorfano M, Bedogni F, Briguori C, Margonato A, Colombo A. Midterm and one-year outcome of amphilimus polymer free drug eluting stent in patients needing short dual antiplatelet therapy. Insight from the ASTUTE registry (AmphilimuS iTalian mUlticenTer rEgistry). Int J Cardiol 2017; 231:54-60. [PMID: 28104306 DOI: 10.1016/j.ijcard.2017.01.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 09/18/2016] [Revised: 12/08/2016] [Accepted: 01/02/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND To assess clinical outcomes of patients needing short dual antiplatelet therapy (S-DAPT) after PCI with Cre8 polymer-free amphilimus eluting-stent (AES). The Cre8-AES with pure i-Carbofilm coating was supposed to induce faster stent endothelialization and reduce device thrombogenicity. METHODS We performed a sub-analysis of unrestricted consecutive patients treated with Cre8-AES between August 2011 and January 2015. Two groups were formed: 1) patients discharged with S-DAPT (≤3-month), because of high bleeding risk or attending urgent non-cardiac surgery; and 2) patients discharged with Recommended DAPT duration (R-DAPT; ≥6-month). The primary ischemic- and bleeding-safety endpoints were Target Vessel Failure (TVF, composite endpoint of cardiac-death, target vessel-myocardial infarction and target vessel-revascularization), and major-bleeding (BARC ≥type-3a) at 6-month and 1-year. RESULTS 106 patients (8.7%) were discharged with ≤3-month DAPT (83±19days; S-DAPT group) and 1102 patients (90.6%) with ≥6-month DAPT (342±62days; R-DAPT group). Between S-DAPT and R-DAPT groups no significant differences were observed in TVF at 1-year (5.7% vs 5.1%); 1-year BARC major bleeding rate was higher in S-DAPT group (3.4% vs 0.2%, p=0.007) with all bleeding events occurred within 3months. The landmark analysis (started at 90days, ended at 1year) showed no differences in BARC major bleedings between groups (0% vs. 0.3%). CONCLUSIONS The results of this multicenter registry show that the use of Cre8 AES in patients needing short DAPT (≤3-month) was safe regarding ischemic events and could favor a reduction of bleeding events related to the recommended DAPT. A large randomized trial is necessary to support these preliminary findings.
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Affiliation(s)
- Cosmo Godino
- San Raffaele Scientific Institute, Milan, Italy.
| | | | | | - Luca Testa
- IRCCS Policlinico San Donato, San Donato M.ne, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Antonio Colombo
- San Raffaele Scientific Institute, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy
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30
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Ruparelia N, Kawamoto H, Capodanno D, Gori T, Nef H, Mehilli J, Lesiak M, Caramanno G, Naber C, Di Mario C, Capranzano P, Wiebe J, Araszkiewicz A, Geraci S, Pyxaras S, Mattesini A, Munzel T, Tamburino C, Colombo A, Latib A. TCT-401 Bioresorbable Scaffolds And Thrombosis: Insights From The GHOST-EU (Gauging coronary Healing with biOresorbable Scaffolding plaTforms in Europe) Registry. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.536] [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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Ortega-Paz L, Capodanno D, Giacchi G, Gori T, Nef H, Latib A, Caramanno G, Di Mario C, Naber C, Lesiak M, Capranzano P, Wiebe J, Mehilli J, Araszkiewicz A, Pyxaras S, Mattesini A, Geraci S, Naganuma T, Colombo A, Münzel T, Sabaté M, Tamburino C, Brugaletta S. Impact of overlapping on 1-year clinical outcomes in patients undergoing everolimus-eluting bioresorbable scaffolds implantation in routine clinical practice: Insights from the European multicenter GHOST-EU registry. Catheter Cardiovasc Interv 2016; 89:812-818. [PMID: 27515568 DOI: 10.1002/ccd.26674] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 01/30/2016] [Revised: 06/05/2016] [Accepted: 07/02/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Overlapping implantation of bioresorbable scaffolds (BRSs) are frequent in long coronary lesions. Its impact on clinical outcomes is unknown. OBJECTIVE To compare the clinical outcomes of patients treated with overlapping BRS with those patients treated with no-overlap BRS. METHODS We analyzed the 1-year clinical outcomes of 1,477 patients treated with BRS in the GHOST-EU registry, according to the implantation of overlapping BRS. Primary endpoint was patient oriented composite endpoint (PoCE) of: all-cause death, any myocardial infarction (MI) and any repeated revascularization. Scaffold thrombosis, according to Academic Research Consortium definition, was also analyzed. RESULTS A total of 320 (21.7%) patients were treated with overlapping BRS (overlap group), whereas the remaining 1,157 (78.3%) received no-overlap BRS (no-overlap group). The overlap group had significantly higher frequency of male sex, diabetes mellitus, stable angina, B2/C lesion type, SYNTAX score ≥22, lesion length >34 mm, use of intracoronary imaging guidance, pre- and postdilatation. At 1-year, there were no differences in PoCE between the overlap versus no-overlap group (18.4% vs. 18.2%; HR 1.07, [0.80-1.44]; P = 0.636), even after adjustment (HR 1.05, [0.48-2.20]; P = 0.904). Scaffold thrombosis rate did not differ either at one-month (1.3% vs. 1.5%, P = 0.769) or at 1-year (1.9% vs. 2.1%, P = 0.823). CONCLUSIONS In "Real-world" clinical practice, overlapping BRS does not appear to have an impact on clinical outcomes as compared to no-overlapping BRS. These preliminary data should be confirmed. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Luis Ortega-Paz
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Giuseppe Giacchi
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Tommaso Gori
- Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany
| | - Holger Nef
- Department of Cardiology, University of Giessen, Giessen, Germany
| | - Azeem Latib
- EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy
| | | | - Carlo Di Mario
- Royal Brompton Hospital & Imperial College, London, United Kingdom
| | - Christoph Naber
- Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany
| | - Maciej Lesiak
- Department of Cardiology, University of Medical Sciences, Poznan, Poland
| | | | - Jens Wiebe
- Department of Cardiology, University of Giessen, Giessen, Germany
| | - Julinda Mehilli
- Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilian Universität, Munich, Germany
| | | | - Stelios Pyxaras
- Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany
| | | | | | - Toru Naganuma
- EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy
| | - Antonio Colombo
- EMOGVM Centro Cuore and San Raffaele Hospitals, Milan, Italy
| | - Thomas Münzel
- Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany
| | - Manel Sabaté
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Salvatore Brugaletta
- Cardiovascular Clinic Institute, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
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Gori T, Wiebe J, Capodanno D, Latib A, Lesiak M, Pyxaras SA, Mehilli J, Caramanno G, Di Mario C, Brugaletta S, Weber J, Capranzano P, Sabate M, Mattesini A, Geraci S, Naber CK, Araszkiewicz A, Colombo A, Tamburino C, Nef H, Münzel T. Early and midterm outcomes of bioresorbable vascular scaffolds for ostial coronary lesions: insights from the GHOST-EU registry. EUROINTERVENTION 2016; 12:e550-6. [PMID: 26348681 DOI: 10.4244/eijy15m09_10] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subset, with higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long term, but their safety in this setting remains to be explored. METHODS AND RESULTS Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA), left anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular death, target vessel myocardial infarction or target lesion revascularisation. The database included a total of 1,549 lesions in 1,304 patients with a mean age of 62±11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14; 16%), LCX (29; 32%), or LAD (47; 52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostial, p=0.618), post-dilation in 43% (versus 58% in the non-ostial group, p=0.008). At quantitative coronary angiography, treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37], p=0.035), but no difference in minimum lumen diameter existed (p=0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groups, respectively, log-rank p=0.005). The device-oriented composite endpoint occurred, respectively, in 12.6% and 4.6% at 12 months (log-rank p=0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p=0.0025, HR 2.65 [1.41-4.97]). CONCLUSIONS In combination with a suboptimal implantation technique, treatment of coronary ostial lesions was an independent predictor of clinical events in a cohort of patients treated with BVS.
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Affiliation(s)
- Tommaso Gori
- 2. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz and DZHK Rhein-Main, Germany
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Naganuma T, Colombo A, Lesiak M, Capodanno D, Gori T, Nef H, Caramanno G, Naber C, Di Mario C, Ruparelia N, Capranzano P, Wiebe J, Araszkiewicz A, Geraci S, Kawamoto H, Pyxaras S, Mattesini A, Münzel T, Tamburino C, Latib A. Bioresorbable vascular scaffold use for coronary bifurcation lesions: A substudy from GHOST EU registry. Catheter Cardiovasc Interv 2016; 89:47-56. [DOI: 10.1002/ccd.26634] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 05/28/2016] [Accepted: 06/05/2016] [Indexed: 01/21/2023]
Affiliation(s)
- Toru Naganuma
- EMO-GVM Centro Cuore and San Raffaele Hospitals; Milan Italy
- New Tokyo Hospital; Chiba Japan
| | - Antonio Colombo
- EMO-GVM Centro Cuore and San Raffaele Hospitals; Milan Italy
| | - Maciej Lesiak
- Department of Cardiology; University of Medical Sciences; Poznan Poland
| | | | - Tommaso Gori
- Medizinische Klinik Und Poliklinik, Universitätsmedizin Mainz, University Medical Center; Mainz Germany
| | - Holger Nef
- Department of Cardiology; University of Giessen; Giessen Germany
| | | | - Christoph Naber
- Klinik Für Kardiologie Und Angiologie, Elisabeth-Krankenhaus; Essen Germany
| | - Carlo Di Mario
- National Institute of Health Research Cardiovascular BRU; Royal Brompton Hospital and Imperial College; London United Kingdom
| | - Neil Ruparelia
- EMO-GVM Centro Cuore and San Raffaele Hospitals; Milan Italy
| | | | - Jens Wiebe
- Department of Cardiology; University of Giessen; Giessen Germany
| | | | | | - Hiroyoshi Kawamoto
- EMO-GVM Centro Cuore and San Raffaele Hospitals; Milan Italy
- New Tokyo Hospital; Chiba Japan
| | - Stelios Pyxaras
- Klinik Für Kardiologie Und Angiologie, Elisabeth-Krankenhaus; Essen Germany
| | - Alessio Mattesini
- National Institute of Health Research Cardiovascular BRU; Royal Brompton Hospital and Imperial College; London United Kingdom
| | - Thomas Münzel
- Medizinische Klinik Und Poliklinik, Universitätsmedizin Mainz, University Medical Center; Mainz Germany
| | | | - Azeem Latib
- EMO-GVM Centro Cuore and San Raffaele Hospitals; Milan Italy
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Colombo A, Godino C, Donahue M, Testa L, Chiarito M, Pavon AG, Colantonio R, Cappelletti A, Monello A, Magni V, Milazzo D, Parisi R, Nicolino A, Moshiri S, Fattori R, Aprigliano G, Palloshi A, Caramanno G, Montorfano M, Bedogni F, Margonato A, Briguori C. One-year clinical outcome of amphilimus polymer-free drug-eluting stent in diabetes mellitus patients. Int J Cardiol 2016; 214:113-20. [DOI: 10.1016/j.ijcard.2016.03.088] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 03/17/2016] [Accepted: 03/19/2016] [Indexed: 01/04/2023]
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Ielasi A, Miyazaki T, Geraci S, Testa L, Abdel-Wahab M, Kawamoto H, Ruparelia N, Sato T, Caramanno G, Bedogni F, Tespili M, Colombo A, Latib A. Hybrid strategy with a bioresorbable scaffold and a drug-coated balloon for diffuse coronary artery disease: the “no more metallic cages” multicentre pilot experience. EUROINTERVENTION 2016; 11:e1589-95. [DOI: 10.4244/eijv11i14a309] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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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Tamburino C, Capranzano P, Gori T, Latib A, Lesiak M, Nef H, Caramanno G, Naber C, Mehilli J, Di Mario C, Sabaté M, Münzel T, Colombo A, Araszkiewicz A, Wiebe J, Geraci S, Jensen C, Mattesini A, Brugaletta S, Capodanno D. 1-Year Outcomes of Everolimus-Eluting Bioresorbable Scaffolds Versus Everolimus-Eluting Stents. JACC Cardiovasc Interv 2016; 9:440-9. [DOI: 10.1016/j.jcin.2015.10.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/30/2015] [Accepted: 10/27/2015] [Indexed: 10/22/2022]
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Capodanno D, Gori T, Nef H, Latib A, Mehilli J, Lesiak M, Caramanno G, Naber C, Di Mario C, Colombo A, Capranzano P, Wiebe J, Araszkiewicz A, Geraci S, Pyxaras S, Mattesini A, Naganuma T, Münzel T, Tamburino C. Percutaneous coronary intervention with everolimus-eluting bioresorbable vascular scaffolds in routine clinical practice: early and midterm outcomes from the European multicentre GHOST-EU registry. EUROINTERVENTION 2015; 10:1144-53. [PMID: 25042421 DOI: 10.4244/eijy14m07_11] [Citation(s) in RCA: 357] [Impact Index Per Article: 39.7] [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
AIMS Clinical data on the early and midterm outcomes of bioresorbable vascular scaffolds (BVS) in routine clinical practice are limited. To fill this gap, we report on the early and midterm clinical outcomes of PCI with everolimus-eluting BVS from the large multicentre GHOST-EU registry. METHODS AND RESULTS Between November 2011 and January 2014, 1,189 patients underwent percutaneous coronary intervention with one or more BVS (Absorb BVS; Abbott Vascular, Santa Clara, CA, USA) at 10 European centres. The primary outcome of interest was target lesion failure (TLF), defined as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularisation (TLR). A total of 1,731 Absorb BVS were implanted at a mean of 12.3±3.4 atm. Technical success was achieved in 99.7% of cases. TLF was recorded in 67 of 1,189 patients at a median of 109 (interquartile range 8-227) days after implantation. The cumulative incidence of TLF was 2.2% at 30 days and 4.4% at six months. The annualised rate of TLF was 10.1%. At six months, the rate of cardiac death was 1.0%, target vessel myocardial infarction was 2.0%, TLR was 2.5%, and target vessel revascularisation was 4.0%. Diabetes mellitus was the only independent predictor of TLF (hazard ratio 2.41, 95% confidence interval: 1.28-4.53; p=0.006). The cumulative incidence of definite/probable scaffold thrombosis was 1.5% at 30 days and 2.1% at six months, with 16 of 23 cases occurring within 30 days. CONCLUSIONS "Real-world" outcomes of BVS showed acceptable rates of TLF at six months, although the rates of early and midterm scaffold thrombosis, mostly clustered within 30 days, were not negligible.
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Ortega-Paz L, Giacchi G, Brugaletta S, Sabate M, Capodanno D, Gori T, Nef H, Latib A, Mehilli J, Lesiak M, Caramanno G, Naber C, Di Mario C, Colombo A, Capranzano P, Wiebe J, Araszkiewicz A, Geraci S, Pyxaras SA, Mattesini A, Naganuma T, Munzel T, Tamburino C. TCT-12 Impact of overlap on long-term clinical outcomes in patients undergoing everolimus-eluting bioresorbable vascular scaffolds implantation in routine clinical practice: insights from the European multicenter GHOST-EU registry. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tamburino C, Latib A, van Geuns RJ, Sabate M, Mehilli J, Gori T, Achenbach S, Alvarez MP, Nef H, Lesiak M, Di Mario C, Colombo A, Naber CK, Caramanno G, Capranzano P, Brugaletta S, Geraci S, Araszkiewicz A, Mattesini A, Pyxaras SA, Rzeszutko L, Depukat R, Diletti R, Boone E, Capodanno D, Dudek D. Contemporary practice and technical aspects in coronary intervention with bioresorbable scaffolds: a European perspective. EUROINTERVENTION 2015; 11:45-52. [DOI: 10.4244/eijy15m01_05] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [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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Catalano C, Armaro A, Di Rosa S, Caramanno G, Pilato M, Vaccaro I. [Asymptomatic perforation of the left ventricular apex by an active-fixation defibrillation lead]. G Ital Cardiol (Rome) 2013; 14:750-751. [PMID: 24326638 DOI: 10.1714/1360.15088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Ribichini F, Romano M, Rosiello R, La Vecchia L, Cabianca E, Caramanno G, Milazzo D, Loschiavo P, Rigattieri S, Musarò S, Pironi B, Fiscella A, Amico F, Indolfi C, Spaccarotella C, Bartorelli A, Trabattoni D, Della Rovere F, Rolandi A, Beqaraj F, Belli R, Sangiorgio P, Villani R, Berni A, Sheiban I, Lopera Quijada MJ, Cappi B, Ribaldi L, Vassanelli C. A clinical and angiographic study of the XIENCE V everolimus-eluting coronary stent system in the treatment of patients with multivessel coronary artery disease: the EXECUTIVE trial (EXecutive RCT: evaluating XIENCE V in a multi vessel disease). JACC Cardiovasc Interv 2013; 6:1012-22. [PMID: 24055444 DOI: 10.1016/j.jcin.2013.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 05/15/2013] [Accepted: 05/24/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study sought to investigate the efficacy and performance of the XIENCE V everolimus-eluting stent (EES) (Abbott Vascular, Santa Clara, California) in the treatment of de novo coronary lesions in patients with 2- to 3-vessel multivessel coronary artery disease (MV-CAD). BACKGROUND Drug-eluting stents (DES) have emerged as an alternative to conventional coronary artery bypass surgery in patients with MV-CAD although first-generation DES yielded inferior efficacy and safety compared with surgery. METHODS Prospective, randomized (1:1), multicenter feasibility trial was designed to assess angiographic efficacy of EES compared with the TAXUS paclitaxel-eluting stent (PES) in 200 patients, and a prospective, open-label, single-arm, controlled registry was designed to analyze the clinical outcome of EES at 1-year follow-up in 400 MV-CAD patients. For the randomized trial, the primary endpoint was in-stent late loss at 9 months. For the registry, the primary endpoint was a composite of all-cause death, myocardial infarction, and ischemia-driven target vessel revascularization at 12 months. RESULTS The primary endpoint per single lesion was significantly lower in the EES group compared with the PES group (-0.03 ± 0.49 mm vs. 0.23 ± 0.51 mm, p = 0.001). Similar results were observed when analyzing all lesions (0.05 ± 0.51 mm vs. 0.24 ± 0.50 mm, p < 0.001). Clinical outcome at 1 year yielded a composite of major adverse cardiac events of 9.2% in the single-arm registry, and 11.1% and 16.5% in the EES and PES randomized groups, respectively (p = 0.30). CONCLUSIONS The EXECUTIVE trial was a randomized pilot trial dedicated to the comparison of the efficacy of 2 different DES among patients with 2- to 3-vessel MV-CAD. The study shows lower in-stent late loss at 9 months with the EES XIENCE V compared with the PES TAXUS Libertè, and a low major adverse cardiac event rate at 1 year in patients with 2-to 3-vessel MV-CAD. (EXECUTIVE [EXecutive RCT: Evaluating XIENCE V in a Multi Vessel Disease]; NCT00531011).
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Di Rosa S, Caramanno G, Catalano C, Andò G, Innocente P, Cutaia A, Carlino G, Vaccaro G, Vaccaro I. [Massive pulmonary embolism treated with selective infusion of tenecteplase]. G Ital Cardiol (Rome) 2011; 12:619-622. [PMID: 21892224 DOI: 10.1714/926.10177] [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: 05/31/2023]
Abstract
Massive pulmonary embolism (PE) is a cardiovascular emergency due to a substantial obstruction of the pulmonary vascular bed, resulting in rapid right heart failure with a potentially fatal outcome.We present the case of a 50-year-old woman with massive PE and recent trans-sphenoid surgery because of pituitary adenoma. An occluding embolus, arising from deep venous thrombosis of the lower limbs, was demonstrated in the right pulmonary artery with selective angiography and treated with selective loco-regional infusion of low-dose tenecteplase. To the best of our knowledge, this is the first case of selective administration of low-dose tenecteplase in the pulmonary artery with successful resolution of PE without the need for adjunctive interventional procedures.
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Milazzo D, Caramanno G, Innocente P, La Mantia R, Vaccaro I. An unpleasant surprise in the setting of primary percutaneous coronary intervention: diffuse and severe vessel ectasia with acute thrombosis of the distal right coronary artery in a patient with acute inferior myocardial infarction. Ital Heart J 2005; 6:353-6. [PMID: 15902937] [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: 05/02/2023]
Abstract
Coronary artery ectasia is defined as a > 1.5-fold dilation of the coronary artery compared to the diameter of adjacent normal segments. It must be distinguished from discrete aneurysms that appear in areas adjacent to coronary artery stenosis. It is usually considered a variant of coronary atherosclerosis. Dilated segments are thought to modify the rheology of blood, sluggish or turbulent flow predisposing to myocardial ischemia and its sequelae, including myocardial infarction and sudden death. We report the case of a 52-year-old man, light smoker, with arterial hypertension and family history of coronary artery disease, who was referred to our coronary care unit for an inferior ST-elevation acute myocardial infarction and presented with severe and diffuse vessel ectasia and right coronary thrombosis at coronary angiography.
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Affiliation(s)
- Diego Milazzo
- Catheterization Unit, Division of Cardiology, San Giovanni di Dio Hospital, Agrigento, Italy.
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Caramanno G, Innocente P, Di Giovanna F. [Clinical tolerance of oral loading with elevated doses of amiodarone in a group of patients with heart failure]. Clin Ter 1997; 148:627-31. [PMID: 9528199] [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: 02/07/2023]
Abstract
Amiodarone is a choice drug for the treatment of patients suffering from life-threatening hyperkinetic ventricular arrhythmias and depressed ventricular function. The drug is characterized by a remarkably long halflife and a delayed initial activity after oral administration of the usual loading levels. The aim of this study was to establish: -the clinical tolerance to elevated doses in patients with heart failure presenting complex, hyperkinetic ventricular arrhythmias; -the possibility to shorten hospitalization as a result of the oral loading; -whether this administration route would take less time to be efficacious. For this purpose, 30 patients with heart failure and complex, hyperkinetic ventricular arrhythmias were treated with 0.50 mg/kg body weight of amiodarone for three days and with 0.30 mg/kg on the 4th and 5th days, followed by a maintenance period of treatment with 200-400 mg daily. All patients underwent a 24-h Holter test before and after administration and an echocardiographic examination showing an average ejection fraction of approximately 30%. Amiodarone was clinically well tolerated; only 2 patients required discontinuation of therapy whereas, among the the remaining 28 patients, 2 cases of transient hypotension and 3 cases of gastroenteric disorders were observed. It was concluded that elevated doses of amiodarone were well tolerated, which allowed to reduce the loading period and, therefore, hospitalization.
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Affiliation(s)
- G Caramanno
- Azienda Ospedaliera S. Giovanni di Dio-Agrigento Cardiologia e U.T.I.C
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Di Giovanna F, Caramanno G, Cacioppo S. [Total agenesis of the left pericardium. Description of a case]. G Ital Cardiol 1988; 18:498-501. [PMID: 3215424] [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: 01/04/2023]
Abstract
Total agenesia of the left pericardium is an uncommon congenital anomaly. The case of a 20-year-old male patient practising sports and complaining of atypical chest pain is described. The Authors point out the importance of the particular ECG and Rx findings obtained varying the patient's supine position. The fundamental role of chest CAT scanning as a non-invasive diagnosis technique is confirmed.
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Affiliation(s)
- F Di Giovanna
- Servizio di Cardiologia ed U.T.I.C., Ospedale di Sciacca, Agrigento
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Di Giovanna F, Costanza G, Indelicato V, Caramanno G, Gambino P, Monteleone F. [Behavior of blood ferritin in acute myocardial infarct]. G Ital Cardiol 1986; 16:1018-21. [PMID: 3556938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Ferritin (F) is an iron-protein (molecular weight 445.000) present in various organs including the heart. Using the immunoenzymatic method (Ferrizyme Abbott), ferritinemia (Fe) was determined daily in 28 patients with acute myocardial infarction (AMI). A significant rise was revealed, already evident in the first few days 8-9 after with Fe gradually returns to baseline levels. The results have shown that this pattern is not evident in patients with angina, heart failure, valve defects, pericarditis or cor pulmonale and may thus be considered a reliable, if not early, marker of myocardial cytolysis. In those cases studied no correlations were observed between CPK and Fe peak or between these and clinical intensity of AMI.
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