1
|
Zhong W, Zhang H, Gao Z, Hau WK, Yang G, Liu X, Xu L. Distraction-aware hierarchical learning for vascular structure segmentation in intravascular ultrasound images. Comput Med Imaging Graph 2024; 115:102381. [PMID: 38640620 DOI: 10.1016/j.compmedimag.2024.102381] [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: 11/16/2023] [Revised: 02/19/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
Vascular structure segmentation in intravascular ultrasound (IVUS) images plays an important role in pre-procedural evaluation of percutaneous coronary intervention (PCI). However, vascular structure segmentation in IVUS images has the challenge of structure-dependent distractions. Structure-dependent distractions are categorized into two cases, structural intrinsic distractions and inter-structural distractions. Traditional machine learning methods often rely solely on low-level features, overlooking high-level features. This way limits the generalization of these methods. The existing semantic segmentation methods integrate low-level and high-level features to enhance generalization performance. But these methods also introduce additional interference, which is harmful to solving structural intrinsic distractions. Distraction cue methods attempt to address structural intrinsic distractions by removing interference from the features through a unique decoder. However, they tend to overlook the problem of inter-structural distractions. In this paper, we propose distraction-aware hierarchical learning (DHL) for vascular structure segmentation in IVUS images. Inspired by distraction cue methods for removing interference in a decoder, the DHL is designed as a hierarchical decoder that gradually removes structure-dependent distractions. The DHL includes global perception process, distraction perception process and structural perception process. The global perception process and distraction perception process remove structural intrinsic distractions then the structural perception process removes inter-structural distractions. In the global perception process, the DHL searches for the coarse structural region of the vascular structures on the slice of IVUS sequence. In the distraction perception process, the DHL progressively refines the coarse structural region of the vascular structures to remove structural distractions. In the structural perception process, the DHL detects regions of inter-structural distractions in fused structure features then separates them. Extensive experiments on 361 subjects show that the DHL is effective (e.g., the average Dice is greater than 0.95), and superior to ten state-of-the-art IVUS vascular structure segmentation methods.
Collapse
Affiliation(s)
- Wenhao Zhong
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, 518055, Guangdong, China
| | - Heye Zhang
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, 518055, Guangdong, China
| | - Zhifan Gao
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, 518055, Guangdong, China
| | - William Kongto Hau
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Guang Yang
- Bioengineering Department and Imperial-X, Imperial College London, W12 7SL London, UK; Cardiovascular Research Centre, Royal Brompton Hospital, SW3 6NP London, UK; National Heart and Lung Institute, Imperial College London, SW7 2AZ London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, WC2R 2LS London, UK
| | - Xiujian Liu
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, 518055, Guangdong, China.
| | - Lin Xu
- Department of Geriatric Cardiology, PLA General Hospital of the Southern Theatre Command, Guangzhou, China.
| |
Collapse
|
2
|
He Y, Sun T, Han M, Wang D. Effect of the pipeline embolization device placement on branching vessels in anterior circulation: a systematic review and meta-analysis. Acta Neurochir (Wien) 2024; 166:2. [PMID: 38200390 PMCID: PMC10781815 DOI: 10.1007/s00701-024-05895-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND PURPOSE Pipeline embolization device (PED) is widely used in intracranial aneurysms, and the scope of applications for the PED, which is frequently used to treat cerebral aneurysms, is also growing. It has some effect on branching vessels as a result of its inherent properties. The effects of PED on the complications rate and branching vessels blockage have not yet been thoroughly investigated. OBJECTIVE We conducted a systematic review searching reports from multiple databases on PED use for intracranial aneurysms, and analyzed the influence of PED on the occlusion rate of different branching vessels, and the influence of the amount of PED on the occlusion rate of branching vessels by meta-analysis. METHODS We searched the literature using PUBMED, Web of Science, and OVID databases until August 2023. Inclusion criteria were that the study used only PED, included at least 10 patients, and recorded branching vessels occlusion rates, mortality, and neurological complications. RESULTS Nine studies were analyzed consisting of 706 patients with 986 side branches. The results of the meta-analysis showed that application of more than one PED did not significantly elevate the rate of branching vessels occlusion compared to application of one PED (OR = 0.70; 95% CI: 0.34 to 1.43; P = 0.33). In the comparison of branching vessels occlusion rates in the anterior circulation, the anterior cerebral artery (ACA) had a significantly higher occlusion rate compared to the ophthalmic artery (OphA) (OR = 6.54; 95% CI: 3.05 to 14.01; P < 0.01), ACA also had a higher occlusion rate compared to the anterior choroidal artery (AchA) (OR = 15.44; 95% CI: 4.11 to 57.94 P < 0.01), ACA versus posterior communicating artery (PcomA) occlusion rate difference was not statistically significant (OR = 2.58; 95% CI: 0.63 to 12.82; P = 0.17), OphA versus AchA occlusion rate difference was not statistically significant (OR = 2.56; 95% CI: 0.89 to 7.38; P = 0.08), and the occlusion rate was significantly higher for PcomA compared to AchA (OR = 7.22; 95% CI: 2.49 to 20.95; P < 0.01) and lower for OphA compared to PcomA (OR = 0.33; 95% CI: 0.19 to 0.55; P < 0.01). CONCLUSION The meta-analysis shows that use of multiple PEDs did not significantly increase the occlusion rate of branching vessels, and the larger the diameter of branching vessels covered by PED, the higher the occlusion rate of branching vessels. However, the incidence of complications is low after branching vessels occlusion in anterior circulation, which is related to the collateral circulation compensation of the branching vessels.
Collapse
Affiliation(s)
- Yiming He
- Department of Neurosurgery and Shandong Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, 250000, Shandong, China
| | - Tao Sun
- Department of Neurosurgery and Shandong Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, 250000, Shandong, China
| | - Mengtao Han
- Department of Neurosurgery and Shandong Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, 250000, Shandong, China
| | - Donghai Wang
- Department of Neurosurgery and Shandong Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, 250000, Shandong, China.
- Department of Neurosurgery, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou, China), Cheeloo Hospital of Shandong University, Jinan, 250000, Shandong, China.
| |
Collapse
|
3
|
Abstract
Background The objectives of this study were to evaluate the relationship between ductal morphometry and ramification patterns in the submandibular gland and pancreas in order to validate their common fractal dimension. Methods X-ray ductography with software-aided morphometry were obtained by injecting barium sulphate in the ducts of post-mortem submandibular gland and pancreas specimens harvested from 42 adult individuals. Results Three cases were excluded from the study because of underlying pathology. There was a significant correlation between the length of the main pancreatic duct (MPD) and the intraglandular portion of the right submandibular duct (SMD) (r = 0.3616; p = 0.028), and left SMD (r = 0.595; p < 0.01), respectively, but their maximal diameters did not correlate (r = 0.139—0.311; p > 0.05). Both dimensions of the SMD showed a significant right-left correlation (p < 0.05). The number of MPD side branches (mean = 37) correlated with the number of side branches of left SMD, but not with the right one (mean = 9). Tortuosity was observed in 54% of the MPD, 32% of the right SMD, and 24% of the left SMD, with mutual association only between the two salivary glands. Conclusions Although the length of intraglandular SMD and MPD correlate, other morphometric ductal features do not, thus suggesting a more complex relationship between the two digestive glands.
Collapse
Affiliation(s)
- Bojan V Stimec
- Anatomy Sector, Teaching Unit, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211, Geneva, Switzerland.
| | - Dejan Ignjatovic
- Department of Digestive Surgery, Akershus University Hospital, University of Oslo, 1478, Lorenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Blindern, P.O. Box 1171, 0318, Oslo, Norway
| | - Johannes A Lobrinus
- Department of Clinical Pathology, Geneva University Hospitals, C.M.U., Rue Michel-Servet 1, 1206, Geneva, Switzerland
| |
Collapse
|
4
|
Purwono GY, Sultana R, Lee RE, Yap CJQ, Soon SXY, Tan RY, Tan CS, Chong TT, Tang TY. Accessory Vein Obliteration and Balloon-Assisted Maturation for Immature Arteriovenous Fistulas for Haemodialysis: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol 2022. [PMID: 35853955 DOI: 10.1007/s00270-022-03212-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/22/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE This study aims to examine outcomes of immature arteriovenous fistula salvage using balloon angioplasty (PTA) without and with accessory vein obliteration (PTA + VO). MATERIALS AND METHODS PubMed and Embase were accessed on 21 September 2020 to retrieve cohort studies on adult patients with end-stage renal failure (ESRF) requiring dialysis. Risk of bias was assessed using Newcastle-Ottawa Scale. Studies were pooled into PTA or PTA + VO arms, with outcomes (technical/clinical success, primary/secondary post-intervention patency until 12 months) reported as event rates with 95% confidence intervals. Random-effects model and maximum likelihood meta-regression were used for meta-analysis. RESULTS Fourteen studies (1030 participants) were included. The between-subgroup difference in outcomes was largely non-significant (p > 0.050). CONCLUSION The evidence does not support balloon angioplasty with concomitant accessory vein obliteration for immature fistula salvage.
Collapse
|
5
|
Adachi Y, Kinoshita Y, Murata A, Kawase Y, Okubo M, Suzuki Y, Ito T, Matsuo H, Suzuki T. The importance of side branch preservation in the treatment of chronic total occlusions with bifurcation lesions. Int J Cardiol Heart Vasc 2021; 36:100873. [PMID: 34568542 PMCID: PMC8449161 DOI: 10.1016/j.ijcha.2021.100873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to identify the predictive factors for suboptimal result in side branch (SB) in chronic total occlusion (CTO) bifurcation lesions and clinical outcomes of patients with suboptimal result in SB. Background There is little evidence on the optimal strategy for bifurcation lesions in CTO. Methods We retrospectively reviewed 314 consecutive bifurcation lesions in CTO with SB ≥ 2.5 mm in 3 hospitals from March 2010 to June 2018. Patients were divided into the two groups based on the suboptimal SB treatment (SST) and optimal SB treatment (OST) groups. The baseline characteristics, procedural and clinical outcomes were compared between the two groups. This study also evaluated the predictors of suboptimal result in SB. Results Suboptimal result in SB occurred in 47 cases. Presence of stenosis in SB, bifurcations located within the occluded segment and sub-intimal tracking at SB ostium was an independent predictor of suboptimal result in SB. The cumulative incidence of target lesion revascularization (TLR) in all lesions was not significantly different between the two groups, however, TLR in right coronary artery (RCA) was significantly higher in the SST group. In the Cox regression analysis, suboptimal result in SB in RCA and sub-intimal tracking were independent predictors of TLR for MB. In patients with bifurcations located within the occluded segment, usage of two-stent technique was significantly lower in the SST group. Conclusions Meticulous procedures are required for SB preservation to improve not only SB prognosis but also MB, especially in RCA.
Collapse
Affiliation(s)
- Yuya Adachi
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
| | - Yoshihisa Kinoshita
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
- Corresponding author at: Department of cardiology, Toyohashi Heart Center, 21-1 Gobutori, Oyamachyo, Toyohashi, Aichi 441-8530, Japan.
| | - Akira Murata
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
| | - Yoshiaki Kawase
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Munenori Okubo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | | | - Tatsuya Ito
- Department of Cardiology, Nagoya Heart Center, Aichi, Japan
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Takahiko Suzuki
- Department of Cardiology, Toyohashi Heart Center, Aichi, Japan
| |
Collapse
|
6
|
Murasato Y, Yamaji K, Kohsaka S, Wada H, Ishii H, Kinoshita Y, Shite J, Hikichi Y, Amano T, Ikari Y. Percutaneous coronary intervention in side branch coronary arteries: Insights from the Japanese nationwide registry. Int J Cardiol Heart Vasc 2021; 36:100856. [PMID: 34430704 PMCID: PMC8374521 DOI: 10.1016/j.ijcha.2021.100856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/27/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
Background Performance of percutaneous coronary intervention (PCI) in side-branch vessels (SB-PCI) has not been fully investigated despite the technical advancement of PCI. Methods We investigated 257,492 patients registered in the Japanese nationwide PCI registry from January to December 2018; 199,767 (78%) underwent PCI for major vessel PCI (MV-PCI), 21,555 (8.4%) underwent SB-PCI, and 24,862 (9.6%) underwent PCI for both vessels (SB + MV-PCI). The frequencies of primary composite adverse events, defined as in-hospital mortality and procedural complications (i.e., peri-procedural myocardial infarction, tamponade, new-onset cardiogenic shock, stent thrombosis, emergent surgery, and bleeding), and PCI for restenotic lesions were investigated. Their association with institutional frequency of each PCI was also investigated. Results Fewer drug-eluting stents (66% vs. 86%) and more drug-coated balloons (23% vs. 9%) were used in SB-PCI than in MV-PCI (p < 0.001). Pre-procedure non-invasive testing was similarly performed in SB-PCI and MV-PCI (57% vs. 61%). The composite endpoint was observed in 0.7%, 1.9%, and 2.2% of the SB-PCI, SB + MV-PCI, and MV-PCI groups, respectively (p < 0.001). Institutional frequency of SB-PCI was inversely associated with the composite-endpoint risk for all PCI procedures (odds ratio 1.37, 95% confidence interval 1.04–1.81 in the lowest tertile, with reference to the middle tertile, p = 0.02). Frequency of PCI for restenotic lesions was also inversely associated with the institutional frequency of MV-PCI (p < 0.001). Conclusion SB-PCI was performed safely with a low frequency of acute complications, and higher SB-PCI frequency presented a lower risk of in-hospital adverse events, albeit with a cost of an increase in PCI for restenotic lesions.
Collapse
Affiliation(s)
- Yoshinobu Murasato
- Department of Cardiology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kyohei Yamaji
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Shun Kohsaka
- Department of Cardiology, Keio University, Tokyo, Japan
| | - Hideki Wada
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Hideki Ishii
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan
| | | | - Junya Shite
- Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Yutaka Hikichi
- Department of Cardiology, Saga Prefectural Hospital Koseikan, Saga, Japan
| | - Tetsuya Amano
- Department of Cardiology, Aichi Medical University, Nagakute, Japan
| | - Yuji Ikari
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| |
Collapse
|
7
|
Suzuki S, Okamura A, Nagai H, Iwakura K, Shiojima I, Fujii K. Usefulness of tip detection method for side branches where guidewires are difficult to pass in coronary intervention. Cardiovasc Interv Ther 2021; 37:383-384. [PMID: 33591456 DOI: 10.1007/s12928-021-00763-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/28/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Satoshi Suzuki
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Atsunori Okamura
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan.
| | - Hiroyuki Nagai
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Katsuomi Iwakura
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| | - Ichiro Shiojima
- Division of Cardiology, Department of Medicine II, Kansai Medical University, Osaka, Japan
| | - Kenshi Fujii
- Division of Cardiology, Sakurabashi Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan
| |
Collapse
|
8
|
Kim J, Lee JM, Park TK, Yang JH, Hahn JY, Choi JH, Choi SH, Seung KB, Hur SH, Rha SW, Kim JH, Choi RK, Oh JH, Kim HS, Lee SH, Park JS, Lee SY, Jeon DW, Jeong MH, Lee JH, Lee SY, Park WJ, Song YB, Gwon HC. Optimal strategy for side branch treatment in patients with left main coronary bifurcation lesions. ACTA ACUST UNITED AC 2020; 74:691-699. [PMID: 32690388 DOI: 10.1016/j.rec.2020.06.011] [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: 12/18/2019] [Accepted: 06/02/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES There are no guidelines regarding the most appropriate approach for provisional side branch (SB) intervention in left main (LM) bifurcation lesions. METHODS The present prospective, randomized, open-label, multicenter trial compared conservative vs aggressive strategies for provisional SB intervention during LM bifurcation treatment. Although the trial was designed to enroll 700 patients, it was prematurely terminated due to slow enrollment. For 160 non-true bifurcation lesions, a 1-stent technique without kissing balloon inflation was applied in the conservative strategy, whereas a 1-stent technique with mandatory kissing balloon inflation was applied in the aggressive strategy. For 46 true bifurcation lesions, a stepwise approach was applied in the conservative strategy (after main vessel stenting, SB ballooning when residual stenosis> 75%; then, SB stenting if residual stenosis> 50% or there was a dissection). An elective 2-stent technique was applied in the aggressive strategy. The primary outcome was a 1-year target lesion failure (TLF) composite of cardiac death, myocardial infarction, or target lesion revascularization. RESULTS Among non-true bifurcation lesions, the conservative strategy group used a smaller amount of contrast dye than the aggressive strategy group. There were no significant differences in 1-year TLF between the 2 strategies among non-true bifurcation lesions (6.5% vs 4.9%; HR, 1.31; 95%CI, 0.35-4.88; P=.687) and true bifurcation lesions (17.6% vs 21.7%; HR, 0.76; 95%CI, 0.20-2.83; P=.683). CONCLUSIONS In patients with a LM bifurcation lesion, conservative and aggressive strategies for a provisional SB approach have similar 1-year TLF rates.
Collapse
Affiliation(s)
- Jihoon Kim
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Taek Kyu Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joo-Yong Hahn
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin-Ho Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seung-Hyuk Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ki Bae Seung
- Division of Cardiology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Ho Hur
- Division of Cardiology, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Seung-Woon Rha
- Division of Cardiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - June-Hong Kim
- Division of Cardiology, Pusan National University Yangsan Hospital, Pusan, Republic of Korea
| | - Rak Kyeong Choi
- Division of Cardiology, Mediplex Sejong Hospital, Incheon, Republic of Korea
| | - Ju Hyeon Oh
- Division of Cardiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Hyo-Soo Kim
- Division of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Division of Cardiology, Yonsei University Wonju Christian Hospital, Wonju, Republic of Korea
| | - Jong-Seon Park
- Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Sung Yun Lee
- Division of Cardiology, Inje University Ilsan Paik Hospital, Ilsan, Republic of Korea
| | - Dong Woon Jeon
- Division of Cardiology, National Health Insurance Service Ilsan Hospital, Ilsan, Republic of Korea
| | - Myung Ho Jeong
- Division of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jae-Hwan Lee
- Division of Cardiology, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sang Yeub Lee
- Division of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Woo-Jung Park
- Division of Cardiology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Young Bin Song
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hyeon-Cheol Gwon
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
9
|
Perl L, Witberg G, Greenberg G, Vaknin-Assa H, Kornowski R, Assali A. Prognostic significance of the Medina classification in bifurcation lesion percutaneous coronary intervention with second-generation drug-eluting stents. Heart Vessels 2020; 35:331-339. [PMID: 31529179 DOI: 10.1007/s00380-019-01504-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/18/2019] [Accepted: 09/06/2019] [Indexed: 01/24/2023]
Abstract
The Medina classification is the most widespread method to describe bifurcation lesions. However, little is known regarding its prognostic impact. Therefore, the aim of this study is to assess the prognostic significance of the Medina classification following percutaneous coronary intervention (PCI). From a prospective registry of 738 consecutive patients undergoing PCI for bifurcation lesions, 505 were treated with second-generation drug-eluting stents (DES). Of these, 407 (80.6%) presented with "true bifurcation" (TB) lesions (Medina class 1.0.1, 1.1.1, 0.1.1) and 98 (19.4%) in all other categories ("non-true bifurcation" = NTB). We compared rates of death and major adverse cardiac events (MACE: cardiac death, myocardial infarction, or target vessel revascularization) at 12 months and 3 years. Patients with TB had lower rates of previous bypass surgery (7.4% vs. 11.2%, p = 0.043). TB lesions were more likely to be calcified (33.9% vs. 28.6%, p = 0.003) and ulcerated (8.8% vs. 4.1%, p < 0.01). At 12 months, mortality was numerically higher for TB PCI (4.1% vs. 2.1%, p = 0.052) and MACE rates were higher (19.2% vs. 10.2%, p < 0.001). At 3 years, both all-cause death (10.1% vs. 5.1%, p = 0.002) and rates of MACE (37.2% vs. 17.6%, p < 0.001) were higher for TB PCI. After performing regression analysis, TB remained an independent predictor for poor outcomes (OR-2.28 at 12 months, CI 1.45-9.50, p = 0.007, OR-3.75 at 3 years, CI 1.52-6.77, p = 0.001 for MACE). In conclusion, TB lesions, according to the Medina classification, portend worse prognosis for patients undergoing bifurcation PCI. This may guide prognostication and decision-making in treatment.
Collapse
Affiliation(s)
- Leor Perl
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel.
| | - Guy Witberg
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel
| | - Gabriel Greenberg
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel
| | - Hana Vaknin-Assa
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel
| | - Ran Kornowski
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel
| | - Abid Assali
- Cardiology Department, Rabin Medical Center and The "Sackler" Faculty of Medicine, Tel-Aviv University, 39 Jabotinsky St., 49100, Petah-Tikva, Israel
| |
Collapse
|
10
|
Affiliation(s)
- Fumiaki Nakao
- Department of Cardiology, Yamaguchi Grand Medical Center, 10077 Ohsaki, Hofu, Yamaguchi 747-8511, Japan.
| |
Collapse
|
11
|
Cao Y, Mintz GS, Matsumura M, Zhang W, Lin Y, Wang X, Fujino A, Lee T, Murai T, Hoshino M, Usui E, Kanaji Y, Yonetsu T, Kakuta T, Maehara A. The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion after Provisional Stenting of Coronary Bifurcation Lesions. Cardiovasc Revasc Med 2019; 20:1007-1013. [PMID: 30683562 DOI: 10.1016/j.carrev.2018.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/12/2018] [Accepted: 12/21/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/PURPOSE Layered pattern (presumed to be healed plaque after a thrombotic event) can be observed by optical coherence tomography (OCT). We sought to assess the ability of OCT-detected plaque composition to predict acute side branch (SB) occlusion after provisional bifurcation stenting. METHODS This is a retrospective observational study using pre-intervention OCT in the main vessel to predict Thrombolysis in Myocardial Infarction (TIMI) flow grade ≤1 in a SB (diameter ≥ 1.5 mm) after provisional bifurcation stenting. OCT-detected layered pattern was defined as plaque with a superficial layer that had a different optical intensity and a clear demarcation from underlying tissue. RESULTS Overall, 207 patients with stable coronary disease were included. SB occlusion occurred in 26/207 (12.6%) bifurcation lesions. Operators decided not to perform additional treatment, and TIMI flow did not improve to ≥2 in cases with SB occlusion. The prevalence of OCT-detected layered pattern was more common in lesions with versus without SB occlusion (88.5% versus 33.7%, p < 0.0001); OCT-detected layered pattern was more often located on the same side of the SB (73.9% versus 21.3%, p < 0.0001) circumferentially compared to lesions without SB occlusion. Multivariable analysis showed that OCT-detected layered pattern was an independent predictor of SB occlusion (odds ratio 18.8, 95% confidence interval 5.1-68.8, p < 0.0001) along with true bifurcation lesion and wider angiographic bifurcation angle. CONCLUSIONS The presence of an OCT-detected layered pattern near its ostium was a strong predictor of SB occlusion after provisional bifurcation stenting.
Collapse
Affiliation(s)
- Yang Cao
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA; Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Gary S Mintz
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Mitsuaki Matsumura
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
| | - Wenbin Zhang
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA; Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yongqing Lin
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Xiao Wang
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Akiko Fujino
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Tetsumin Lee
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | | | | | | | | | | | | | - Akiko Maehara
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA; NewYork-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA.
| |
Collapse
|
12
|
Nakamura T, Okamura T, Fujimura T, Yamada J, Nao T, Tateishi H, Maeda T, Oda T, Shiraishi K, Nakashima T, Nishimura S, Miura T, Matsuzaki M, Yano M. Serial changes in the three-dimensional aspect of the side-branch ostium jailed by a drug-eluting stent assessed by optical coherence tomography. Int J Cardiovasc Imaging 2017; 33:797-806. [PMID: 28168562 DOI: 10.1007/s10554-017-1080-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/20/2017] [Indexed: 01/03/2023]
Abstract
The present study investigated serial changes in the three-dimensional (3D) aspect of the jailed side-branch (SB) ostium. We evaluated 32 patients who underwent examination with optical coherence tomography (OCT) both at baseline and at follow-up. After reconstruction of the 3D images, we classified the configuration of overhanging struts at the SB orifice into three groups according to the 3D aspect of the jailing configuration. The number of compartments divided by the stent strut was counted. The side-branch flow area (SBFA), i.e., the area of the SB ostium except for jailing struts, was measured by cut-plane analysis. Forty-eight SBs of 25 patients were analyzed. Thirteen SBs were classified as the No-jail type (N-type), 19 as the Simple-jail type (S-type; no longitudinal link at the carina), and 16 as the Complex-jail type (C-type; had a link at the carina). In the N-type, the SBFA was significantly increased at follow-up (P = 0.018). In the C-type, the SBFA was significantly decreased at follow-up (P = 0.002). Percent reduction of SBFA in the C-type group was significantly greater than that in the N-type or S-type groups (S-type vs. C-type P = 0.002, N-type vs. C-type P < 0.001). 3D-OCT images showed that some of the compartments were filled with tissue. The number of compartments was significantly decreased at follow-up (P < 0.001). In the C-type group, the SBFA was significantly decreased and small compartments were filled with tissue. These findings suggest that stent jail complexity is associated with the progression of SB ostial stenosis.
Collapse
|
13
|
Heckler M, Michalski CW, Schaefle S, Kaiser J, Büchler MW, Hackert T. The Sendai and Fukuoka consensus criteria for the management of branch duct IPMN - A meta-analysis on their accuracy. Pancreatology 2017; 17:255-262. [PMID: 28189431 DOI: 10.1016/j.pan.2017.01.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/27/2017] [Accepted: 01/28/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The risk of malignancy in branch duct intraductal papillary mucinous neoplasia of the pancreas (BD-IPMN) is controversially debated. An increasing number of studies report on outcomes using the Sendai or Fukuoka consensus criteria for treatment decision-making. The objective of this work was to evaluate the diagnostic accuracy of the Sendai and Fukuoka criteria. METHODS We systematically reviewed studies on Sendai or Fukuoka criteria-guided management of BD-IPMN. Pooled sensitivity, specificity and diagnostic odds ratios as compound measures of diagnostic accuracy were calculated from studies matching the inclusion criteria. The meta-analysis was performed using a random effects model. RESULTS Fifteen studies with a total of 2710 patients were included. Twelve of these used the Sendai criteria. In these studies, 23% of Sendai-negative patients had a high grade dysplastic lesion or an invasive carcinoma in final histology. Pooled sensitivity was 56%, specificity was 74% and the diagnostic odds ratio for malignancy in Sendai-positive lesions was 7.45. When the results of follow-up examinations were included, diagnostic accuracy improved significantly (14.66, p < 0.001). Three studies were identified that used the Fukuoka criteria for decision making. Of 200 patients with Fukuoka-negative lesions who underwent surgery, 22 had a malignant lesion in final histology (11%). Pooled sensitivity was 83%, specificity was 53% and the diagnostic odds ratio was 8.76. CONCLUSION The Fukuoka criteria have considerably improved sensitivity but still lack adequate specificity. For further reduction of a potential surgical overtreatment of BD-IPMN, the development of criteria with an increased specificity is required.
Collapse
Affiliation(s)
- Max Heckler
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | | | - Susanne Schaefle
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - Jörg Kaiser
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - Markus W Büchler
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
| | - Thilo Hackert
- Department of Surgery, University of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
14
|
Numasawa Y, Sakakura K, Yamamoto K, Yamamoto S, Taniguchi Y, Fujita H, Momomura SI. A novel side branch protection technique in coronary stent implantation: Jailed Corsair technique. Cardiovasc Revasc Med 2017; 18:295-298. [PMID: 28119044 DOI: 10.1016/j.carrev.2017.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 12/21/2016] [Revised: 01/07/2017] [Accepted: 01/11/2017] [Indexed: 12/01/2022]
Abstract
Side branch occlusion, which was one of the common complications in percutaneous coronary interventions, was closely associated with cardiac death and myocardial infarction. Clinical guidelines also support the importance of preservation of physiologic blood flow in SB during PCI to bifurcation lesions. In order to avoid side branch occlusion during stent implantation, we often performed the jailed wire technique, in which a conventional guide wire was inserted to the side branch before stent implantation to the main vessel. However, the jailed wire technique could not always prevent side branch occlusion. In this case report, we described a case of 72-year-old male suffering from angina pectoris. Coronary angiography revealed the diffuse calcified stenosis in the proximal and middle of left anterior descending coronary artery, and the large diagonal branch originated from the middle of the stenosis. To prevent side branch occlusion, we performed a novel side branch protection technique by using the Corsair microcatheter (Asahi Intecc, Nagoya, Japan). In this case report, we illustrated this "Jailed Corsair technique", and discussed the advantage compared to other side branch protection techniques such as the jailed balloon technique.
Collapse
Affiliation(s)
- Yohei Numasawa
- Department of Cardiology, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
| | - Kei Yamamoto
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shingo Yamamoto
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Yousuke Taniguchi
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Shin-Ichi Momomura
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| |
Collapse
|
15
|
Jang WJ, Park YH, Hahn JY, Song YB, Choi SH, Chun WJ, Hyeon Oh J, Koo BK, Rha SW, Jang Y, Tahk SJ, Kim HS, Gwon HC. Differential effect of side branch intervention on long-term clinical outcomes according to side branch stenosis after main vessel stenting: Results from the COBIS (Coronary Bifurcation Stenting) Registry II. Int J Cardiol 2016; 221:471-7. [PMID: 27414725 DOI: 10.1016/j.ijcard.2016.07.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/04/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Indication of side branch (SB) intervention after main vessel (MV) stenting is not established for coronary bifurcation lesions. METHODS We evaluated 2017 patients who were treated with 1-stent technique or MV stenting as a first strategy. Patients undergoing SB intervention after MV stenting (SB intervention group, n=929) were compared to those treated with MV stenting only (no-SB intervention group, n=1088). RESULTS During a median follow-up of 37months, cardiac death or myocardial infarction (MI) tended to occur less frequently in the SB intervention group than in the no-SB intervention group (1.8% versus 2.9%; adjusted hazard ratio [HR] 0.53; 95% confidence interval [CI] 0.25-1.11; P=0.09). There was a significant interaction between SB intervention and SB stenosis after MV stenting (P for interaction <0.01). Among 1077 patients with diameter stenosis of SB ≥50% after MV stenting, SB intervention was associated with a lower risk of cardiac death or MI (1.2% versus 4.2%; adjusted HR 0.22; 95% CI 0.09-0.52; P<0.01). However, among 940 patients with diameter stenosis of SB <50%, there was no significant difference in cardiac death or MI between the SB intervention group and the no-SB intervention group (3.5% versus 2.2%; adjusted HR 1.36; 95% CI 0.58-3.20; P=0.48). CONCLUSIONS The effect of SB intervention differed according to SB stenosis after MV stenting. SB intervention may reduce cardiac death or MI in bifurcation lesions with diameter stenosis of SB ≥50% after MV stenting.
Collapse
|
16
|
Gur DO, Kumbasar D, Hüral R, Oral D, Erol Ç. The fate of small side branches following drug eluting stent implantation. Int J Cardiol Heart Vasc 2016; 12:34-37. [PMID: 28616540 PMCID: PMC5454145 DOI: 10.1016/j.ijcha.2016.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/10/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Although drug eluting stents (DES) have documented convenience in bifurcation lesions, possible unfavorable effects on small side branch ostium (SBO) remain a question. We aimed to explore the effects of DES on small jailed SBs (1.5-2.25 mm) which originated from the lesion on the main vessel and were not treated with either stenting or balloon dilatation. METHODS Angiographic data of 107 consecutive patients (129 SB) with Medina 1,1,1 or 1,1,0 lesions were evaluated at the time of procedure and at the follow-up. RESULTS Of all DES used, 70 (54.7%) was sirolimus-eluting, 39 (30.5%) was paclitaxel-eluting and 20 (14.8%) was zotarolimus-eluting. The diameter of SBs was 1.84 ± 0.41 mm with a stenosis of 20.7 ± 26.6% at SBO at baseline. The lesion at the SBO had progressed after the procedure when the pre vs postprocedure values and follow-up vs pre-procedure values are compared (20.7 ± 26.6% vs 29.4 ± 27.4%; p < 0.0001 and 25.4 ± 25.1 vs 20.7 ± 26.6%; p = 0.004 respectively). A significant reduction in stenosis was revealed over the follow-up (29.4 ± 27.4 vs 25.4 ± 25.1 respectively; p = 0.013). The severity of the disease at the SBO at baseline was the only parameter that affected the severity of SB stenosis in acute, longterm and follow-up. Additional parameters with influence on SB patency at different times were female gender, stent deployment with low pressure, cTFC of the main lesion, age, cTFC of the lesion, late loss index and the preprocedure TIMI flow grade of the SB. CONCLUSIONS Although there was a significant deterioration of SBO immediately after stenting, follow-up data showed that the lesion at SBO improved but remained worse than baseline.
Collapse
Affiliation(s)
| | - Deniz Kumbasar
- Ankara University, Faculty of Medicine, Department of Cardiology, Turkey
| | | | - Derviş Oral
- Akay Hospital, Department of Cardiology, Turkey
| | - Çetin Erol
- Ankara University, Faculty of Medicine, Department of Cardiology, Turkey
| |
Collapse
|
17
|
Nomura T, Kato T, Kubota H, Miyawaki D, Urata R, Sugimoto T, Higuchi Y, Keira N, Tatsumi T. Instructive percutaneous coronary intervention to avoid the risk of side branch occlusion at a lesion with a lotus root appearance: a case report. BMC Cardiovasc Disord 2016; 16:157. [PMID: 27485191 PMCID: PMC4971715 DOI: 10.1186/s12872-016-0335-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/27/2016] [Indexed: 11/16/2022] Open
Abstract
Background A lotus root appearance is a rare entity, and there is little opportunity to perform coronary intervention for this kind of lesion. Because of its peculiar anatomical characteristics, one of the problems regarding percutaneous coronary intervention (PCI) for these lesions is related to the involvement of branch vessels. Case presentation We encountered a case of PCI for a stenotic lesion with a lotus root appearance in the mid-portion of the right coronary artery (RCA). To avoid the risk of right ventricular (RV) branch occlusion due to stent deployment in the main RCA, we re-crossed the third guidewire into the main RCA via the nearest point to the RV branch ostium through the communicating vascular lumen. Thereafter, we deployed a drug-eluting stent in the main RCA crossing over the RV branch, and the ostium of the RV branch remained intact, as we expected. Conclusions This case is the first report in the world describing the details of how to maintain the patency of the side branch bifurcating from a lesion with a lotus root appearance under optical coherence tomography guidance.
Collapse
Affiliation(s)
- Tetsuya Nomura
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan.
| | - Taku Kato
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Hiroshi Kubota
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Daisuke Miyawaki
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Ryota Urata
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Takeshi Sugimoto
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Yusuke Higuchi
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Natsuya Keira
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| | - Tetsuya Tatsumi
- Department of Cardiovascular Medicine, Nantan General Hospital, 25, Yagi-Ueno, Yagi-cho, Nantan City, Japan
| |
Collapse
|
18
|
Funatsu A, Hirokawa R, Nakamura S. Bailout technique to rescue the abruptly occluded side branch with collapsed true lumen after main vessel stenting. Cardiovasc Interv Ther 2016; 32:87-91. [PMID: 26754845 PMCID: PMC5215179 DOI: 10.1007/s12928-015-0376-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/30/2015] [Indexed: 11/08/2022]
Abstract
Guidewire recrossing into the abruptly occluded side branch (SB) after main vessel (MV) stenting in the coronary bifurcation is difficult, particularly if the SB has a dissection because the true lumen of SB is collapsed by a hematoma and the second guidewire easily goes into the false lumen. This paper reports a bailout technique to rescue the occluded SB that was complicated by a hematoma because of an unsuccessful guidewire recrossing after MV stenting using a small balloon dilation in the collapsed SB true lumen behind the stent strut and wire penetration.
Collapse
Affiliation(s)
- Atsushi Funatsu
- Cardiovascular Center, Kyoto-Katsura Hospital, 17 Yamada-Hirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan.
| | - Ryo Hirokawa
- Cardiovascular Center, Kyoto-Katsura Hospital, 17 Yamada-Hirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| | - Shigeru Nakamura
- Cardiovascular Center, Kyoto-Katsura Hospital, 17 Yamada-Hirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan
| |
Collapse
|
19
|
Roik M, Wretowski D, Wolny R, Łabyk A, Kostrubiec M, Pruszczyk P. StentBoost imaging for the assessment of optimal stent deployment and coverage of side branch ostium in coronary bifurcation intervention. Int J Cardiol 2014; 172:e458-60. [PMID: 24485620 DOI: 10.1016/j.ijcard.2014.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 12/28/2013] [Accepted: 01/01/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Marek Roik
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland.
| | - Dominik Wretowski
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland
| | - Rafał Wolny
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland
| | - Andrzej Łabyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland
| | - Maciej Kostrubiec
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Lindley'a 4, 02-005 Warsaw, Poland
| |
Collapse
|