Percutaneous transcatheter therapy of aorto-ostial stenoses

Kereiakes, Dean J.

doi:10.1002/(sici)1097-0304(199607)38:3<292::aid-ccd18>3.0.co;2-j

Cited by 19 publications

(8 citation statements)

References 26 publications

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“…[20][21][22][23] The pathology of ostial disease may lead to a much more complex process; therefore, it seems possible that restenosis of ostial stenosis and nonostial lesions have a different pathophysiologic basis. Moreover, in common with other studies, due to the unusual manifestation of ostial stenosis (<0.5% of all patients with atherosclerotic coronary artery disease), 15 the number of patients is small.…”

Section: Discussionsupporting

confidence: 70%

“…The ostial origins of both native coronaries and saphenous vein grafts are exposed to nonlaminar turbulent shear forces that may contribute to specific histopathologic characteristics such as increased fibrous cellularity, calcification, and sclerosis observed at this location. 15 Several studies demonstrated that patients with coronary ostial disease or at the ostium of a major branch respond poorly to interventional treatment, 16,17 frequently with unacceptable short-to medium-term results. 18 Tan et al reported an angiographic restenosis rate for aorto-ostial stenoses of 71%.…”

Section: Discussionmentioning

confidence: 99%

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Restenosis after Successful Ostial Stent Implantation:

Horlitz¹,

Amin²,

Boerrigter³

et al. 2004

J Interven Cardiology

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Despite the introduction of coronary stents and effective anticoagulation regimens, the treatment of ostial lesions is limited by high restenosis rates. Initial results have been published asserting that statin therapy is associated with a significant reduction in restenosis after stent deployment. However, no information is available about the effect of statins after ostial stenting. Between 1993 and 2000, 122 patients required ostial placement of coronary stents at the Royal Brompton Hospital in London, United Kingdom. Statin treatment was continued or begun in 52 patients with a documentated hypercholesterolemia. Follow-up was feasible in 97 patients undergoing successful stent implantation. Restenosis rate was lower in patients receiving statins, but did not differ significantly from the nonstatin group (34.6% as against 42.2%, P = 0.531).

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Restenosis after Successful Ostial Stent Implantation:

Horlitz¹,

Amin²,

Boerrigter³

et al. 2004

J Interven Cardiology

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“…The concept of complex percutaneous transluminal coronary angioplasty (PTCA) is related to both clinical and technical factors. Patient's age, sex, previous coronary artery bypass graft (CABG) operation, poor ejection fraction (EF), the number of vessels treated [1][2][3][4], the presence of unstable angina [5,6], occluded arteries [7][8][9][10], or diffuse disease [11,12], bifurcation lesions [13,14], aorto-ostial location [15,16], and vessel tortuosity [11,17] have proved to be related to success and complications rates as well as to clinical events at followup. Nevertheless, little attention has been devoted to the complexity of PTCA in relation to patient irradiation parameters.…”

Section: Introductionmentioning

confidence: 99%

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Bernardi

Padovani

Morocutti

et al. 2000

Cathet. Cardiovasc. Intervent.

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Few data are available on the quantitative assessment of complexity (C), especially in relation to a patient's exposure to radiation. The relationship between several clinical (CFs), anatomic (AFs), and technical factors (TFs) versus fluoroscopy time (FT) was evaluated in 402 random percutaneous transluminal coronary angioplasty (PTCA) procedures. CFs were age, sex, single or multivessel disease, ejection fraction, and previous coronary artery bypass graft. AFs were assessed based on the American Heart Association / American College of Cardiology classification. TFs were multivessel PTCA, use of the double wire or double balloon technique, stenting, ostial stenting, bifurcation stenting, and intravascular ultrasonography. No CFs significantly influenced FT, whereas all AFs and TFs (except multivessel PTCA) did significantly influence FT. A scoring system was developed, and two complexity indexes (CI) were conceived, based on which the procedures were divided into three groups: simple, medium, and complex. The mean FTs were 471+/-289, 805+/-532, and 1,190+/-641 (P <0.0001), respectively. Total cine frame recordings were 1,119+/-572, 1,265+/-644 (P = 0.0355), and 1,418+/-785 (P<0.0001 vs. simple; P = NS vs. medium). The dose/area product measurement was 65.8+/-41.4, 93 +/-58.5 (P<0.0001), and 116.7+/-72.8 (P<0.0001 vs. simple; P = 0.00159 vs. medium), respectively. In our series, CI was directly related to AF and TF, but not to CF. Comparison of PTCA procedures and definition of appropriate FT should consider CIs.

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“…Patient's age, sex, previous coronary artery bypass graft (CABG) operation, poor ejection fraction (EF), the number of vessels treated [1][2][3][4], the presence of unstable angina [5,6], occluded arteries [7][8][9][10], or diffuse disease [11,12], bifurcation lesions [13,14], aorto-ostial location [15,16], and vessel tortuosity [11,17] have proved to be related to success and complications rates as well as to clinical events at followup. Patient's age, sex, previous coronary artery bypass graft (CABG) operation, poor ejection fraction (EF), the number of vessels treated [1][2][3][4], the presence of unstable angina [5,6], occluded arteries [7][8][9][10], or diffuse disease [11,12], bifurcation lesions [13,14], aorto-ostial location [15,16], and vessel tortuosity [11,17] have proved to be related to success and complications rates as well as to clinical events at followup.…”

Section: Introductionmentioning

confidence: 99%

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Bernardi¹,

Padovani²,

Morocutti³

et al. 2000

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

Few data are available on the quantitative assessment of complexity (C), especially in relation to a patient's exposure to radiation. The relationship between several clinical (CFs), anatomic (AFs), and technical factors (TFs) versus fluoroscopy time (FT) was evaluated in 402 random percutaneous transluminal coronary angioplasty (PTCA) procedures. CFs were age, sex, single or multivessel disease, ejection fraction, and previous coronary artery bypass graft. AFs were assessed based on the American Heart Association / American College of Cardiology classification. TFs were multivessel PTCA, use of the double wire or double balloon technique, stenting, ostial stenting, bifurcation stenting, and intravascular ultrasonography. No CFs significantly influenced FT, whereas all AFs and TFs (except multivessel PTCA) did significantly influence FT. A scoring system was developed, and two complexity indexes (CI)were conceived, based on which the procedures were divided into three groups: simple, medium, and complex. The mean FTs were 471 ؎ 289, 805 ؎ 532, and 1,190 ؎ 641 (P < 0.0001), respectively. Total cine frame recordings were 1,119 ؎ 572, 1,265 ؎ 644 (P ‫؍‬ 0.0355), and 1,418 ؎ 785 (P < 0.0001 vs. simple; P ‫؍‬ NS vs. medium). The dose/area product measurement was 65.8 ؎ 41.4, 93 ؎ 58.5 (P < 0.0001), and 116.7 ؎ 72.8 (P < 0.0001 vs. simple; P ‫؍‬ 0.00159 vs. medium), respectively. In our series, CI was directly related to AF and TF, but not to CF. Comparison of PTCA procedures and definition of appropriate FT should consider CIs. Cathet. Cardiovasc. Intervent. 51:1-9, 2000.

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Percutaneous transcatheter therapy of aorto-ostial stenoses

Cited by 19 publications

References 26 publications

Restenosis after Successful Ostial Stent Implantation:

Restenosis after Successful Ostial Stent Implantation:

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

Clinical and technical determinants of the complexity of percutaneous transluminal coronary angioplasty procedures: Analysis in relation to radiation exposure parameters

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