Effects of stent design on side branch occlusion after coronary stent placement

Cho, Goo Yeong; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung

doi:10.1002/1522-726x(200101)52:1<18::aid-ccd1006>3.0.co;2-#

Cited by 30 publications

(29 citation statements)

References 19 publications

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“…There was no mortality or emergency CABG within 24 hours during the in-hospital period both in group I and group II. These findings were consistent with study done by Dehghani et al, 14 Lee et al, 13 Ghayemain et al, 11 Cho et al 7 and Nozari et al 15 Dehghani et al 14 reported in their study that during hospital stay the incidence of major adverse cardiac events (MACE) comprising death, need for target vessel revascularization, and Q-wave MI was almost similar in the patients with and in those without acute side branch occlusion. Lee et al 13 found that there were no clinical in-hospital events for either group.…”

Section: Discussionsupporting

confidence: 88%

“…Ghayemain et al 11 demonstrated that the incidence of complications in patients with compromising side branches smaller than 2 mm is small, compromising side branches larger than 2 mm can be accompanied by clinical outcomes as non Q-wave MI. Cho, et al 7 reported in their study that there was no emergency bypass surgery or deaths during the acute hospitalization in patients with side branch occlusion (SBO). Nozari et al 15 found in their study that side branch compromise (<2mm) was not associated with adverse clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

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In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention

Ali

Patwary

et al. 2014

Cardiovasc. j.

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Background: Side branch occlusion is a well known complication of percutaneous coronary intervention. Although occlusion of small side branches is well tolerated, occlusion of larger side branches may cause more serious complications. After PCI the incidence of complications in patients with compromised side branches smaller than 2 mm is small. Compromising side branches larger than 2 mm can be accompanied by clinical outcomes as non Q-wave MI. This study was undertaken to assess the in-hospital outcomes of compromised small (<2mm) side branch after percutaneous coronary intervention. Methods: This cross sectional analytical study was carried out in the department of cardiology, National Institute of Cardiovascular Diseases, Dhaka during the period of September 2011 to June 2012. A total of 100 consecutive patients with coronary artery disease who underwent elective PCI were included in the study. Study patients were divided into two groups on the basis of presence of compromised small (< 2 mm) side branch. In Group- I, small (< 2 mm) side branch were compromised after PCI and in Group- II, side branches were patent after PCI, with 50 patients in each group. In-hospital outcome were evaluated in both groups. Result: There were no significant differences of the baseline clinical demographics between two groups. Post PCI angina was higher in group I than group II (10.0% vs. 9.0%). Non ST elevation myocardial infarction and significant arrhythmia was identical in both groups (2.0% vs. 2.0%) but hypotension was more in group II than group I (4.0% vs. 2.0%). The findings were statistically insignificant between the study groups. There was no mortality, emergency CABG within 24 hours, ST elevation myocardial infarction, cardiogenic shock or acute left ventricular failure during their hospital course in either group. Conclusion: The present study concluded that compromised small (<2mm) side branch after percutaneous coronary intervention was not associated with adverse in-hospital outcome. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20795 Cardiovasc. j. 2014; 7(1): 11-16

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention

Ali

Patwary

et al. 2014

Cardiovasc. j.

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“…This observation is in accordance with that of bifurcation "jailed ostia" crossed unintentionally by stents. 1,2 No flow compromise was observed after device implantations and during follow-up. This finding is not unexpected given the amount of coverage over the guarded ostium cross-sectional area.…”

Section: Discussionmentioning

confidence: 93%

A Novel Endovascular Device for Emboli Rerouting

Grad

Sievert²,

Nishri³

et al. 2008

Stroke

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Background and Purpose-The feasibility and safety of a novel endovascularly delivered tubular mesh designed to reroute emboli away from a critical artery as a means of ischemic stroke prevention was tested in vitro and in vivo. Methods-Emboli rerouting efficacy was assessed in vitro. Perfusion through the external femoral artery that was jailed by the device, cellular proliferation rate over the jailing mesh, and the resulting tissue coverage of the orifice were assessed in the swine iliofemoral bifurcation. Device-induced embolization was assessed in a swine kidney model. Results-In vitro experiments demonstrated that particles as small as 60% of the pore dimension can be rerouted by the device, although at low efficacy, and rerouting efficacy approached 100% as the particle size approached the pore dimension. Repeat assessment of flow preimplantation and at various follow-up times by Doppler ultrasound showed no significant changes in the perfusion ratio of the jailed branch to the parent artery or the jailed branch to the naive contralateral artery either as a result of device implantation or at the follow-up times. Tissue coverage over the jailed ostium was limited to approximately 12% after stabilization. Cellular proliferation rate gradually decreased to diminishing level approximately 22 weeks postimplantation. The devices implanted across the renal arteries did not demonstrate any device-induced embolization after 1 month. Conclusions-It is proposed that this device could be used to reroute emboli away from important intracranial vessels as a means of stroke prevention.

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“…13) The presence of ostial narrowing that arises from within or just beyond the diseased portion is a powerful predictor of side branch occlusion. 14) As ostial narrowing was present in our case, we sought to protect D 2 with protective wire in order to avoid side branch injury.…”

Section: )mentioning

confidence: 99%

Side Branch Protection with Hydrophilic Polymer Coated Guide Wire During Cutting Balloon Angioplasty of a Bifurcated Lesion

et al. 2003

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SUMMARYCutting balloon angioplasty (CBA) was performed in a patient with in-stent restenosis (ISR) which had an important side branch. We used a hydrophilic polymer-coated guide wire for side branch protection during CBA. After CBA was successfully performed, the cutting balloon and guide wire were microscopically examined and proven to have suffered minor damage which, in itself, did not disturb the procedure. Hydrophilic polymercoated wire might be an effective and safe choice for ISR which needs to be treated by CBA while protecting an important side branch. (Jpn Heart J 2003; 44: 565-573)

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Effects of stent design on side branch occlusion after coronary stent placement

Cited by 30 publications

References 19 publications

In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention

In-Hospital Outcome of Compromised Small Side Branch after Percutaneous Coronary Intervention

A Novel Endovascular Device for Emboli Rerouting

Side Branch Protection with Hydrophilic Polymer Coated Guide Wire During Cutting Balloon Angioplasty of a Bifurcated Lesion

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