Clinical and lesion morphologic determinants of coronary angioplasty success and complications: Current experience

Tan, Kay Sin; Sulke, Neil; Taub, Nick; Sowton, Edgar

doi:10.1016/0735-1097(94)00462-y

Cited by 187 publications

(109 citation statements)

References 51 publications

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“…1,4,5,13,16,17) The results of this study extend our previous observations, demonstrating the predictive value of measuring plasma levels of IL-8 for early complications after coronary interventions. Buffon, et al reported that the preprocedural CRP level is a powerful predictor of both early and late outcome in patients undergoing single vessel PTCA.…”

Section: Discussionsupporting

confidence: 78%

“…4,5) Our previous study revealed that there were dynamic changes of plasma IL-8 level and a correlation between CRP and the expression of β 2 -integrin Mac-1 (CD11b/CD18) on monocytes in patients undergoing PCI. 6) Therefore, we investigated the prognostic value of peri-procedural plasma levels of IL-8, serum levels of CRP, and the expression of CD11b/CD18 on neutrophils in patients with early complications following PCI.…”

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confidence: 99%

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<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Qi¹,

Li²,

Gu³

et al. 2003

Jpn Heart J

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SUMMARYThe aim of the present study was to investigate the prognostic value of plasma interleukin-8 (IL-8) for early complications after percutaneous coronary intervention (PCI).The pre-and postprocedural plasma levels of IL-8 and serum C-reactive protein (CRP) were examined by immunoassay, and the expression of CD11b/CD18 on neutrophils was assessed by flow cytometry. Early complications (abrupt occlusion, threatened abrupt occlusion, early recurrence of ischemia, myocardial infarction, cardiac sudden death, and target vessel revascularization) occurred intra-procedure and 30 days after PCI and were observed in 121 consecutive patients with coronary heart disease.Sixteen patients with early complications had high preprocedural levels and high postprocedural differentials of IL-8, CRP, and CD11b/CD18 compared to those without complications (all P < 0.05). The occurrence of complications showed a significant increase in the patients according to the tertiles of IL-8, CRP, and CD11b / CD18. Preprocedural levels of IL-8 (RR = 5.864, CI = 1.658 −20.734, P = 0.006) and diabetes (RR = 1.587, CI = 1.246 − 2.132, P = 0.038) were independent predictors of early complications. There were significant correlations in the postprocedural differential between IL-8 and CD11b/ CD18 (r = 0.776, P = 0.002) in patients with complications.The results reveal that the early complications after PCI contribute to preprocedural inflammatory responses. Normal levels of IL-8 may be powerful negative predictors of early complications in patients with CHD following PCI. (Jpn Heart J 2003; 44: 451-461) Key words: Percutaneous coronary intervention (PCI), IL-8, C-reactive protein (CRP), CD11b/CD18, Complications PERCUTANEOUS coronary intervention (PCI) is an established myocardial revascularization procedure. However, the high initial success rate is limited by the risk of acute complications, which range from 5% to 30% in unstable patients.1,2) It would be desirable to preprocedurally predict the risks of complications related to PCI in patients who might benefit from early prevention and addiFrom

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Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 99%

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Qi¹,

Li²,

Gu³

et al. 2003

Jpn Heart J

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“…Massive calcifications of the coronary arteries constitute a major obstacle to the success of coronary angioplasty [10,11]. They can prevent the introduction of a balloon catheter and/or its expansion, can cause an injury to the polymer and/or drug layer of the coated stents and may prevent the delivery and full expansion of the stent.…”

Section: Discussionmentioning

confidence: 99%

Coronary rotational atherectomy in patients with unsuccessful classical angioplasty – in-hospital and six-month follow-up

Wojtczak¹,

Kübler²,

Ferenc³

et al. 2012

pwki

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Rotablacja tętnic wieńcowych u pacjentów po nieskutecznej klasycznej angioplastyceobserwacja wewnątrzszpitalna i sześciomiesięczna M Ma ar rc ci in n W Wo oj jt tc cz za ak k 1 1 , , P Pi io ot tr r K Ku ub bl le er r 1 1 , , M Mi ir ro os sł ła aw w F Fe er re en nc c A b s t r a c t B Ba ac ck kg gr ro ou un nd d: : The data regarding follow-up of high-risk patients after coronary rotational atherectomy (RA) are poor. A Ai im m: : The aim of this study was to evaluate the in-hospital and 6-month outcome of patients with uncrossable or undilatable lesions who were treated with RA.M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : The RA was performed in 62 consecutive patients (mean EuroSCORE: 6.8 ±4) and all of them were enrolled. Major adverse cardiac events (MACE) were defined as all-cause death, cardiac death, stroke, myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR).R Re es su ul lt ts s: : The procedural success rate was 94%. The incidence of MACE was 9.7% in hospital (6 MIs, 3 of them with signs of ischemia) and 9.7% at 6-month follow-up (2 deaths, 3 MIs, 1 TLR). Death occurred in 2 patients (3%): due to definite stent thrombosis, and because of acute heart failure in a patient with low ejection fraction (EF).C Co on nc cl lu us si io on ns s: : In this very high risk population RA provides good outcomes with relatively low risk of MACE.K Ke ey y w wo or rd ds s: : percutaneous coronary interventions, highly calcified coronary lesions, rotational atherectomy S t r e s z c z e n i e W Ws st tę ęp p: : Dane dotyczące obserwacji pacjentów z wysokim ryzykiem poddawanych rotablacji tętnic wieńcowych są skąpe. C Ce el l: : Ocena bezpośrednia i półroczna pacjentów ze zmianami, na które nie można wprowadzić cewnika balonowego lub nie moż-na go w pełni rozprężyć, leczonych za pomocą rotablacji.M Ma at te er ri ia ał ł i i m me et to od dy y: : Rotablację wykonano u kolejnych 62 pacjentów (średni EuroScore 6,8 ±4) i wszyscy zostali włączeni do obserwacji. Złożony punkt końcowy zdefiniowano jako wystąpienie każdego zgonu, zgonu sercowego, udaru mózgu, zawału mięś-nia serca, konieczności ponownej rewaskularyzacji zmiany oraz rewaskularyzacji tętnicy.W Wy yn ni ik ki i: : Skuteczność procedury wyniosła 94%. Złożony punkt końcowy wystąpił w 9,7% przypadków w obserwacji wewnątrzszpi-talnej (6 zawałów mięśnia serca, 3 z nich z objawami niedokrwienia) i w 9,7% przypadków w obserwacji 6-miesięcznej (2 zgony, 3 zawały mięśnia serca, 1 konieczność ponownej rewaskularyzacji zmiany). Odnotowano 2 zgony (3%) -z powodu pewnej zakrzepicy w stencie oraz ostrej niewydolności serca u pacjenta z obniżoną funkcją skurczową.W Wn ni io os sk ki i: : W grupie osób z bardzo dużym ryzykiem rotablacja zapewnia dobre wyniki przy relatywnie niskim prawdopodobień -stwie wystąpienia złożonego punktu końcowego. S Sł ło ow wa a k kl lu uc cz zo ow we e: : przezskórne interwencje wieńcowe, zwapnienia tętnic wieńcowych, aterektomia rotacyjna

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“…В свою очередь, К. Tan и соавт. отметили, что поражения типа С по-разному предопределяют исход вмешательства, несмо-тря на то, что объединены в одну и ту же группу [13]. В ходе исследования было установлено, что непосредственный успех ЧКВ (57-88%) и частота острой окклюзии КА (3-16%), вызванная тромбозом или диссекцией, ассоциировались с определенными характеристиками (протяженность пора-жения, кальциноз и степень стенозирования 80-99%) [14].…”

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Complicated Forms of Coronary Lesions and Their Impact on the Forecast

Кононец¹

2017

Med. sov.

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E.N. KONONETS, PhD student, Russian Cardiology Research and Production Complex, Ministry of Health of Russia, Moscow COMPLICATED FORMS OF CORONARY LESIONS AND THEIR IMPACT ON THE FORECASTThe extension of indications for endovascular treatment of complex coronary lesions, along with ensuring efficiency and safety, is the priority target of percutaneous coronary intervention (PCI) application for the coronary heart disease (CHD). Among the independent predictors of the adverse events of PCI, the diffuse coronary artery lesions is a separate object of interest. Substantial progress in treatment of this category of patients was achieved with the introduction of drug-eluting stents (DES). However, the method had a downside of late and very late stent thrombosis. In order to solve the problem stents with biodegradable polymer were developed. Efficacy and safety evaluation of new generation long DES in treatment of diffuse coronary artery lesions has become a promising research trend.

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Clinical and lesion morphologic determinants of coronary angioplasty success and complications: Current experience

Cited by 187 publications

References 51 publications

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

Coronary rotational atherectomy in patients with unsuccessful classical angioplasty – in-hospital and six-month follow-up

Complicated Forms of Coronary Lesions and Their Impact on the Forecast

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