ACCIS2001 angiography & interventional cardiology
Identifieur interne : 001C33 ( Istex/Corpus ); précédent : 001C32; suivant : 001C34ACCIS2001 angiography & interventional cardiology
Auteurs :Source :
- Journal of the American College of Cardiology [ 0735-1097 ] ; 2001.
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DOI: 10.1016/S0735-1097(01)80001-2
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type="DOI">10.1016/S0735-1097(01)80001-2</identifier><identifier type="PII">S0735-1097(01)80001-2</identifier><identifier type="ArticleID">80001</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/A38E6E5240E9789E1EE356A6467E9CAF993D71F1/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">CARDIAC & CARDIOVASCULAR SYSTEMS</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI><istex:refBibTEI uri="https://api.istex.fr/document/A38E6E5240E9789E1EE356A6467E9CAF993D71F1/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><monogr><title level="m" type="main">An elevated serum level of cardiac troponin I (Tn I) after percutaneous cor-onary intervention (PCl)is a marker with high specificity for myocardial injury that corre-lates with late events. The purpose of this study was to detect the frequency of Tn I elevation after percutaneous coronary intervention and its influence in the long-term out-come of patients with chronic renal failure</title><author><persName><forename type="first">Luis</forename><surname>Gruberg</surname></persName></author><author><persName><forename type="first">Shmuel</forename><surname>Fuchs</surname></persName></author><author><persName><forename type="first">Roxana</forename><surname>Mehran</surname></persName></author><author><persName><forename type="first">Lowell</forename><forename type="middle">F</forename><surname>Satler</surname></persName></author><author><persName><forename type="first">Augusta</forename><forename type="middle">D</forename><surname>Pichard</surname></persName></author><author><persName><forename type="first">Kenneth</forename><forename type="middle">M</forename><surname>Kent</surname></persName></author><author><persName><forename type="first">Rakefet</forename><surname>Einav-Gruberg</surname></persName></author><author><persName><forename type="first">Natalie</forename><surname>Gevorkian</surname></persName></author><author><persName><forename type="first">W</forename><forename type="middle">"</forename><surname>Hongsheng</surname></persName></author><author><persName><forename type="first">Ron</forename><surname>Waksman</surname></persName></author><imprint><publisher>CRF</publisher><pubPlace>Washington Hospital Center, Washington, DC Background</pubPlace></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">8 mg/dL, not on dialysis) who had normal Tn I baseline levels and underwent elective PCI. Tn I levels were measured at baseline, at 6 and 18-24 hours after intervention. Results: Of 116 patients with CRF and normal baseline Tn I, elevated Tn I levels (20.15 ngiml) were found in 50 patients (43%, Group 1) and normal values in 66 patients (57%, Group 2) Baseline clinical characteristics including left ventricular function and serum creatinine levels were similar between the two groups, except for age (higher in Group 1, p=O.O04). Platelet glycoprotein Ilb/llla inhibitor " se was similar between the two groups (2.2% and 2.3%, respectively) Procedural and clinical success rates were similar between the two groups. At 12-month follow-up, target lesion and vessel revasculariza-tion and Ml rates were comparable between the two groups. However, mortality was sig nificantly higher in patients with elevated serum levels of Tn I (28</title></analytic><monogr><title level="m">Methods: We analyzed the long-term outcome of 116 consecutive patients with CRF (serum creatinine >I</title></monogr><note>0%. vs. 9.9%, p=O.O02</note></biblStruct><biblStruct><analytic><title level="a" type="main">OR:2.86, p=O.O32) and Tn I elevation (OR32.58, p=O.O42) as the only independent correlates for death. Conclusions: 1) Patients with CRF have a high frequency of Tn I elevation after PCI. 2) Elevation of Tn I levels after PCI is an important and powerful predictor of long-term prog-nosis in patients with CRY? * ~~0</title></analytic><monogr><title level="m">Cox multivariate regression analysis detected CK-MBx3 normal values</title><imprint><biblScope unit="page">05</biblScope></imprint></monogr></biblStruct><biblStruct><monogr><title level="m" type="main">05 vs ECC and No ECC Conclusion : In native, de nova. non-calcified lesions, the mechanisms of lumen enlargement after stenting are significantly influenced by preintervention lesion remodel-ing and by plaque eccentricity. Positive remodekng is assocrated with a higher luminal gain due to greater plaque reduction (compressionlembolization)</title></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Orange County Convention Center, Hall A4 Presentation Hour: 9:00 a.m.-IO:00 a.m. 129520 Percutaneous Coronary Intervention of Unprotected Left Main Stenosis in High Risk Patients: In-Hospital, 30-Day, and One-Year Outcome The Mount Sinai Medicai Center, New York NY Elective stenting of the left main coronary artery (LMCA) with normal left ventricular func-tion has been reported to have excellent short and long term results, comparable to CABG. Outcome of LMCA intervention in patients considered at high risk for CABG due to low ejection fraction, comorbid conditions and advanced age, has not been published. We report our experience of 100 consecutive patients who underwent LMCA interven-tion, deemed unsuitable for CABG. Methods and results: Mean age was 8428 years (range 62-98) 40% female and indication for procedure being unstable angina and post Ml in 60%, CHF rn 25% and both in 15% patients. Mean LVEF was 32~14% (range 1 l-63%) with 42% of patients had LVEF ~25%. Stenosis location was at the ostium in 25% in body/distal in 60% and at bifurcation in 15%. All patients underwent stenting: 89% after rotational atherectomy @A) GP llb/llla inhibitors were used in 78% of cases and elective IABP assistance in 38% of cases. Procedural success was achieved in all patients with-out any in-hospital major complications of Q-wave Ml, CABG or death. Major vascular complications occurred rn 3.2%. Mean reference vessel diameter was 3.81t0.81 mm with MLD pre-procedure 1.12*0.36 mm, post-debufking 2.1110.26 mm and post-proce-dure 3.67*0.52 mm with residual of 8%. Slow flow and minor dissection occurred in 8% and 13% respectively. Any CK-MB elevation occurred in 21%, with >5x normal in 4%. All patients were discharged alive at a mean duration of 6i5 days with 30.day MACE occur-ring in 3 patients: one cardiac, two non-cardiac. At a mean follow-up of Ok3 months there have been 6 additional deaths: 3 cardiac (2 CHF, one arrhythmia), 3 non-cardiac, while 12 patients (12%) required target lesion revascularization. Freedom from Q-wave MI, repeat intervention and death in first 62 patients who have completed at least one-year follow-up is 80%. No patient underwent CABG at follow-up. Conclusion: Unprotected LMCA stenting with RA in high-risk subset of patients can be performed with very high procedural success and favorable 30</title><author><persName><forename type="first">K</forename><surname>Samin</surname></persName></author><author><persName><surname>Sharma</surname></persName></author><author><persName><forename type="first">S</forename><surname>Annapoorna</surname></persName></author><author><persName><forename type="first">David</forename><surname>Krni</surname></persName></author><author><persName><forename type="first">Mazzulah</forename><surname>Reich</surname></persName></author><author><persName><forename type="first">Jonathan</forename><forename type="middle">D</forename><surname>Kamran</surname></persName></author><author><persName><surname>Marmur</surname></persName></author></analytic><monogr><title level="m">Eccentric lesions are also associated with more luminal gain but due to greater vessel expansion. POSTER SESSlbN 1295 Coronary Stents: Clinical Factors in Outcome Wednesday</title><imprint><date type="published" when="2001-03-21"></date></imprint></monogr><note>day. and one-year outcome. Extremely low inci-dence of sudden death at follow-up may obviate the need of routine F/U angiography. Long-term follow-up of these patients is ongoing</note></biblStruct><biblStruct><analytic></analytic><monogr><title level="m">6%) 1 (0,6%) Q-wave Ml 3 (1,7%) 2 (1,2%) 4 (2,3%) 2 (1,3%) Non Q-wave Ml</title><imprint><biblScope unit="page">7</biblScope></imprint></monogr></biblStruct><biblStruct><monogr><author><persName><surname>0%</surname></persName></author></monogr></biblStruct><biblStruct><monogr><title level="m" type="main">9%)</title></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">2%)</title></analytic><monogr><title level="j">* CABG</title><imprint><biblScope unit="volume">3</biblScope><biblScope unit="issue">1</biblScope></imprint></monogr></biblStruct><biblStruct><monogr></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">4%) events * P= 0.14 vs PTGA " P= 0.05 vs PTCA Conclusion: In small arteries between 2.3 and 2.9 mm stenting does not appear to reduce angiographic restenosis rate at 6 months. Although there is a trend for less non Q-Wave Ml at 6 and 12 months with stent, there is</title></analytic><monogr><title level="m">5%) Re-PTCA 339%) Pts with any 41 (23,0%) 31 (18,8%) 46</title><imprint><biblScope unit="page" from="5" to="25"></biblScope></imprint></monogr><note>reduction. in total cardiac events or re-PTCA</note></biblStruct><biblStruct><analytic><title level="a" type="main">Results: In 1998 we made 417 PTCA overall In 79 patients (pts) we implanted small vessel stems Averaged age was 60,3 yrs +9,7 with left ventricle ejection fraction 54,3*10,0, 40 pts3%) had dyslipidemia3%) had previous myocardial infarction and 31 (39,2%) had positive family history Incom-plete revascularization was performed in 46 pts (58,2%) Predischarge complication rate was 2,53% -once nonQ wave acute myocardial infarction and once puncture site compli-cation. Angina resp</title></analytic><monogr><title level="m">-ACCIS2001 (Angiography & Interventional Cardiology) JACC February 2001 SD. Angina was classified according to CCS score, dyspnoe according to NYHA score6%) were smokers, 57 (72,2%) had hypertension, 26 (32,9%) had diabetes Three vessel disease was observed in 35 pts (44,3%). Angina CCS class at baseline was 2,17r0,77, dyspnoe NYHA 1,5*023+1,03 at 12 months. 75 pts (94,9%) were less symptomatic at 6 months and 61 pts5%) at 12 months. 12 patients (152%) were lost from 12</title></monogr><note>month. follow-up</note></biblStruct><biblStruct><analytic><title level="a" type="main">5%) with significant resteno-sis observed in 9 pts (11,4%) Conclusion: Small coronary vessel stenting is safe and higly effective in reducing angina and dyspnoe (pcO,OOl) at 6 and 12.month follow-up. Periprocedural complications and clinical restenosis rate were very acceptable</title></analytic><monogr><title level="m">Repeated coronary angiography was indicated in 13 pts</title><editor>John A. Fry, Michael J. Curran, Theodore L. Schreiber, Cindy L. Grines</editor><meeting><address>Steven L</address></meeting></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Diffuse in-stent restenosis (ISR) has a high rate of recurrence despite treatment with conventional interventional modalities. Preliminary data show that local delivery of dilute ethanol (ETOH) may attenuate the proliferative response of smooth muscle cells and reduce neointimal hyperplasia. In this phase 1 study, we evaluated the safety and efficacy of intramural ETOH following optimal conventional treatment of diffuse ISR. Methods: Patients presenting with clinical evidence of ischemia and diffuse in-stent restenosis (reference vessel diameter 2.5-4.0 mm, lesion length < 45mm) were enrolled. Coronary intervention was performed using standard techniques. Following PCI, 15 % ETOH was delivered using the lnfiltratorTM (Interventional Technologies</title><author><persName><forename type="first">Terry</forename><surname>Almany</surname></persName></author><author><persName><surname>Fi</surname></persName></author><author><persName><forename type="first">Robert</forename><forename type="middle">D</forename><surname>Bowers</surname></persName></author><author><persName><forename type="first">Harold</forename><forename type="middle">Z</forename><surname>Safian</surname></persName></author><author><persName><forename type="first">William</forename><forename type="middle">W</forename><surname>Friedman</surname></persName></author><author><persName><surname>Oneill</surname></persName></author><author><persName><surname>William</surname></persName></author><author><persName><forename type="first">Royal</forename><surname>Hospital</surname></persName></author><author><persName><surname>Oak</surname></persName></author><author><persName><surname>Mi</surname></persName></author></analytic><monogr><title level="m">Diagonal (I)</title><meeting><address>San Diego, CA ; RCA (I@, and SVG</address></meeting></monogr><note>local. drug delivery catheter. Results: Thirty-seven patients (30males, 7 females) were studied. Vessels treated included LAD (7), LCX</note></biblStruct><biblStruct><analytic><title level="a" type="main">1%), rotational atherectomy (40.5%), excimer laser (17.1%), cutting balloon (8.1%), and re-stent (5.4%) Procedural success was 100%. Two patients developed type B dissection following delivery of the Infiltrator catheter, which were successfully treated with additional stent placement. Transient no-reflow developed in one patient following ETOH delivery. There were no other procedural complications or major adverse in hospi-tal cardiac even@ One patient had a significant post-procedure CK elevation with no MB release related to multiple countershocks given for ventricular fibrillation that developed following rotational atherectomy. To date, 3 TLR and 4 TVR have occurred within 3 months of treatment. Conclusions: Local drug delivery with intramural ETOH using the Infiltrator catheter in patients with diffuse ISR is safe a'nd feasible. Prelimary findings indi-cate that this treatment may be an effective strategy to prevent recurrent ISR</title></analytic><monogr><title level="m">Sixty-two percent had undergone at least one prior treatment for ISR. PCI included PTCA only</title><imprint><date type="published" when="000-1-02"></date></imprint></monogr></biblStruct></listBibl></back></text></istex:refBibTEI></enrichments><author></author><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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