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  1 / 10180 MEDLINE  
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PMID:29231013
Author:Qian H; Shao Y; Li ZD; Zou DH; Qin ZQ; Wan L; Chen YJ
Address:Department of Forensic Medicine, Medical College of Soochow University, Suzhou 215123, China.
Title:[Diagnostic Value of Postmortem CT Angiography in Coronary Atherosclerosis].
Source:Fa Yi Xue Za Zhi; 33(2):109-113, 2017 Apr.
ISSN:1004-5619
Country of publication:China
Language:chi
Abstract:OBJECTIVES: To explore the application value of postmortem computed tomography (CT) angiography on diagnosis of coronary atherosclerotic stenosis degree. METHODS: Based on the previous experimental results, the postmortem CT angiography device of human isolated heart was improved. Different coronary atherosclerotic stenosis degree of sudden death cases was selected. Before the cardiac anatomy, hearts were removed out completely and CT angiography was performed immediately. The CT angiography results were compared with histopathological findings. Meanwhile, the advantages and disadvantages of the angiography device before and after improvement were compared. RESULTS: The improved angiography device of isolated heart could get better imaging results. The postmortem CT angiography results had high consistency with the histopathological findings on diagnosis of coronary atherosclerotic stenosis degree. And the coronary artery lesions could be revealed more objectively and vividly by 3D reconstruction technology. However, CT angiography could only be used to examine the pathological changes of blood vessels, which might have some limitations on the diagnosis of cause of death. CONCLUSIONS: Postmortem CT angiography can be used as an additional method for the conventional autopsy in the cases of coronary atherosclerosis.
Publication type:JOURNAL ARTICLE


  2 / 10180 MEDLINE  
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PMID:29204999
Author:Wu YB; Guo HJ; Chen WJ; Li QJ
Address:Institute of Criminal Science Technology, Shijiazhuang Public Security Bureau, Shijiazhuang 050021,China.
Title:[Coronary Angiography in Isolated Hearts and Its Forensic Application].
Source:Fa Yi Xue Za Zhi; 32(5):329-331, 2016 Oct.
ISSN:1004-5619
Country of publication:China
Language:chi
Abstract:OBJECTIVES: To check the isolated heart by coronary angiography to discover the location, nature and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease. METHODS: Ten fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimensional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results. RESULTS: The imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳ coronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed. CONCLUSIONS: Isolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.
Publication type:JOURNAL ARTICLE


  3 / 10180 MEDLINE  
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PMID:29406046
Author:Zhang HP; Ai H; Zhao Y; Li H; Tang GD; Zheng NX; Sun FC; Liu JH
Address:Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Title:Effect of Chronic Total Occlusion Percutaneous Coronary Intervention on Clinical Outcomes in Elderly Patients.
Source:Am J Med Sci; 355(2):174-182, 2018 02.
ISSN:1538-2990
Country of publication:United States
Language:eng
Abstract:BACKGROUND: There are little published data reporting the effect of coronary artery chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on the prognosis of elderly patients with identified CTOs. We sought to evaluate the clinical effect of CTO PCI on the prognosis of elderly patients with CTOs. METHODS: A total of 445 consecutive patients diagnosed with a CTO by angiography from January 2011 to December 2013 were enrolled. We compared long-term clinical outcomes between the elderly group (≥75 years; n = 120, 27.0%), and the nonelderly group (<75 years; n = 325, 73.0%) as well as between patients with unopened CTOs and patients with CTOs who were recanalized by PCI either during the index hospitalization or at a staged procedure within 30 days after discharge from the index hospitalization. The primary endpoint was defined as the composite of hospitalization from angina, reinfarction, heart failure or repeat revascularization and cardiac death at the 3-year follow-up. RESULTS: More elderly CTO patients had left main (LM) disease (25.0 versus 15.1%, P = 0.015), 3-vessel disease (96.4% versus 73.8%, P < 0.001) and a Japan-CTO score ≥2 (36.7% versus 23.7%, P = 0.006) than nonelderly CTO patients. Furthermore, elderly patients had a higher syntax score than nonelderly patients (27.0 [25.0, 30.0] versus 26.0 [23.0, 30.0], P = 0.006). PCI was attempted for 33 out of 135 CTO lesions (24.4%) in the elderly group, and 127 out of 378 lesions (33.6%) in the nonelderly group (P = 0.049); however, there were no statistically significant differences in the CTO PCI success rates between the 2 groups (69.7% versus 82.7%, P = 0.097). The 3-year cardiac mortality rate was 15.0% and 4.6% (P < 0.011) for the elderly and nonelderly groups, respectively. Elderly patients with CTOs who were recanalized by PCI and those with unopened CTOs exhibited comparable 3-year cardiac mortality rates (15.0% versus 16.0%, P = 1.000). There was no significant difference in primary endpoint incidence (25.0% versus 33.0%, P = 0.486). Multivariate analysis revealed that after corrections for baseline and procedural differences, right coronary artery CTO (odds ratio = 4.600, 95% CI: 1.320-16.031; P = 0.017) and LM disease combined with 3-vessel disease (odds ratio = 4.296, 95% CI: 1.166-15.831; P = 0.028) were independent predictors of 3-year cardiac mortality among elderly patients with CTOs. CONCLUSIONS: Elderly patients with CTOs presented with seriously diseased coronary arteries and poor prognoses. CTO PCI did not seem to significantly improve long-term clinical outcomes among elderly patients with CTOs. Right coronary artery CTO and LM disease combined with 3-vessel disease might be independent predictors of 3-year cardiac mortality in elderly CTO patients.
Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T


  4 / 10180 MEDLINE  
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PMID:29390384
Author:Yasuda M; Spaccarotella C; Mongiardo A; De Rosa S; Torella D; Indolfi C
Address:Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Title:Migration of a stent from left main and its retrieval from femoral artery: A case report.
Source:Medicine (Baltimore); 96(50):e9281, 2017 Dec.
ISSN:1536-5964
Country of publication:United States
Language:eng
Abstract:RATIONALE: Embolization of a deployed stent is a rare complication and its mechanism remains unclear in most cases. PATIENT CONCERNS: A 52-year-old man underwent coronary angiography for effort angina, revealing an 80% stenosis of the proximal left anterior descending (LAD) involving the distal left main (LM). After luminal sizing with intravascular ultrasound two drug-eluting stents were deployed (5.0  12 mm and 3.5  15 mm) to cover the LM-LAD lesion. After postdilatation, the proximal stent had disappeared from the LM. DIAGNOSES: The missing stent was found in the right deep femoral artery. INTERVENTIONS: A new 5.0  15 mm stent was deployed onto the LM-LAD ostium, in overlapping with the previously implanted. Then, the stent migrated to the deep femoral artery was successfully retieved through the contralateral femoral artery. OUTCOMES: The patient was discharged 2 days later, after an uneventful hospital stay. LESSONS: Stent deformation after postdilation is a possible causes of stent migration.
Publication type:CASE REPORTS; JOURNAL ARTICLE


  5 / 10180 MEDLINE  
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PMID:29390379
Author:Choi S; Song M
Title:Successful coronary stenting in a patient with factor V deficiency in the absence of fresh frozen plasma transfusion: Case report.
Source:Medicine (Baltimore); 96(50):e9274, 2017 Dec.
ISSN:1536-5964
Country of publication:United States
Language:eng
Abstract:RATIONALE: Drug-eluting stent (DES) implantation in a patient with factor V deficiency (F5D) is very complex. No antithrombotic therapy study has been reported for F5D patients who undergo a coronary stenting procedure. PATIENT CONCERNS: A 73-year-old woman presented with chest discomfort and exertional dyspnea. Coronary stenting was performed successfully using DES stents. DIAGNOSES: The D-dimer, prothrombin time, and partial thromboplastin time prolongation persisted from admission until 24 hours after coronary stenting. Epistaxis and blood-tinged sputum occurred on day 3. The antiplatelet therapy measured using a Multiplate Analyzer was adequate, and other laboratory findings except factor V activity (14%) were within normal ranges; she was diagnosed with F5D based on low factor V activity. INTERVENTIONS: While taking 90 mg of ticagrelor and 100 mg of aspirin daily, the patient revisited due to recurrent epistaxis, hemoptysis, and coughing on day 26. Epistaxis and hemoptysis stopped after the aspirin was discontinued. Finally, the daily maintenance dose was reduced to 90 mg of ticagrelor once. OUTCOMES: She led healthy life for 9 months without any recurrent symptoms and the test results also were stabilized. LESSONS: We report a case of an F5D patient who underwent coronary stenting in the absence of frozen fresh plasma transfusion who received successful maintenance therapy using a single antiplatelet agent (90 mg of ticagrelor/day) with recurrent multiple mucosal bleeding events after coronary stenting.
Publication type:CASE REPORTS; JOURNAL ARTICLE
Name of substance:0 (Purinergic P2Y Receptor Antagonists); GLH0314RVC (Ticagrelor); K72T3FS567 (Adenosine)


  6 / 10180 MEDLINE  
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PMID:28460760
Author:Nabati M; Taghavi M; Saffar N; Yazdani J; Bagheri B
Address:Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Electronic address: Dr.mr.nabati@gmail.com.
Title:Alterations in echocardiographic left ventricular function after percutaneous coronary stenting in diabetic patients with isolated severe proximal left anterior descending artery stenosis.
Source:Indian Heart J; 69(2):146-150, 2017 Mar - Apr.
ISSN:0019-4832
Country of publication:India
Language:eng
Abstract:BACKGROUND: There are conflicting theories regarding the use of percutaneous coronary intervention (PCI) of isolated severe proximal left anterior descending (LAD) artery stenosis in place of left internal mammary artery grafting in diabetic patients. The aim of this study was to investigate the effect of PCI on left ventricular function and determine difference between diabetics and non-diabetics. METHODS: A prospective study was conducted on 50 patients with isolated severe proximal LAD stenosis: 23 diabetic and 27 non-diabetic patients. Successful PCI with everolimus-eluting stents was performed for all of the patients. These patients underwent transthoracic echocardiography within 24h before and 1 month after PCI, and alterations in the left ventricular parameters were compared between the two groups. RESULTS: There was a significant 12% increment in the mitral annular peak systolic velocity (s') (p=0.02), 21% decrement in the trans mitral early filling deceleration time (DT) (p<0.001), 10% decrement in the systolic left ventricular internal dimension (LVIDs) (p=0.002), significant increment in the left ventricular ejection fraction (LVEF) (p=0.004), and significant decrement in the left atrial diameter (p=0.006) in the diabetic patients after performing PCI. Conversely, the non-diabetic patients showed a statistically significant 14% increase in the DT, 6.3% decrease in the s' velocity, 8% increase in the LVIDs, significant increment in the left atrial diameter and no change in LVEF after PCI. CONCLUSION: Our study demonstrated that everolimus-eluting stents favorably improved the markers of left ventricular systolic and diastolic function in diabetic patients with isolated severe proximal LAD stenosis compared with those of non-diabetic patients with the same condition.
Publication type:JOURNAL ARTICLE


  7 / 10180 MEDLINE  
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PMID:29298341
Author:Galassi F; Alkhalil M; Lee R; Martindale P; Kharbanda RK; Channon KM; Grau V; Choudhury RP
Address:Radcliffe Department of Medicine, Oxford Acute Vascular Imaging Centre, University of Oxford, Oxford, United Kingdom.
Title:3D reconstruction of coronary arteries from 2D angiographic projections using non-uniform rational basis splines (NURBS) for accurate modelling of coronary stenoses.
Source:PLoS One; 13(1):e0190650, 2018.
ISSN:1932-6203
Country of publication:United States
Language:eng
Abstract:OBJECTIVE: Assessment of coronary stenosis severity is crucial in clinical practice. This study proposes a novel method to generate 3D models of stenotic coronary arteries, directly from 2D coronary images, and suitable for immediate assessment of the stenosis severity. METHODS: From multiple 2D X-ray coronary arteriogram projections, 2D vessels were extracted. A 3D centreline was reconstructed as intersection of surfaces from corresponding branches. Next, 3D luminal contours were generated in a two-step process: first, a Non-Uniform Rational B-Spline (NURBS) circular contour was designed and, second, its control points were adjusted to interpolate computed 3D boundary points. Finally, a 3D surface was generated as an interpolation across the control points of the contours and used in the analysis of the severity of a lesion. To evaluate the method, we compared 3D reconstructed lesions with Optical Coherence Tomography (OCT), an invasive imaging modality that enables high-resolution endoluminal visualization of lesion anatomy. RESULTS: Validation was performed on routine clinical data. Analysis of paired cross-sectional area discrepancies indicated that the proposed method more closely represented OCT contours than conventional approaches in luminal surface reconstruction, with overall root-mean-square errors ranging from 0.213mm2 to 1.013mm2, and maximum error of 1.837mm2. Comparison of volume reduction due to a lesion with corresponding FFR measurement suggests that the method may help in estimating the physiological significance of a lesion. CONCLUSION: The algorithm accurately reconstructed 3D models of lesioned arteries and enabled quantitative assessment of stenoses. The proposed method has the potential to allow immediate analysis of the stenoses in clinical practice, thereby providing incremental diagnostic and prognostic information to guide treatments in real time and without the need for invasive techniques.
Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES


  8 / 10180 MEDLINE  
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PMID:29390466
Author:Li J; Guan X; Gong M; Wang X; Zhang H
Address:Department of Cardiac Surgery, Beijing Aortic Disease Center, Beijing Anzhen Hospital, Capital Medical University.
Title:Iatrogenic acute aortic dissection induced by off-pump coronary artery bypass grifting: A case report and review of the literature.
Source:Medicine (Baltimore); 96(51):e9206, 2017 Dec.
ISSN:1536-5964
Country of publication:United States
Language:eng
Abstract:RATIONALE: Iatrogenic acute aortic dissection (IAAD) induced by cardiac surgery is a fatal complication, with 0.04% of therapeutic procedures and worse outcomes than spontaneous aortic dissection. PATIENTS CONCERNS: A 64-year-old male complaining of intermittent chest tightness for 4 years received an off-pump coronary artery bypass grifting (OPCABG) and IAAD was found during surgery. DIAGNOSIS: Unstable angina, coronary artery triple vessel lesion, IAAD. INTERVENTIONS: An ascending aorta replacement surgery was implemented immediately and extracorporeal membrane oxygenation (ECMO) was applied during surgery. The patient suffered from oliguria symptoms and began to receive continuous renal replacement therapy (CRRT) after surgery. What was worse, osteofascial compartment syndrome (OCS) was also confirmed the day after surgery. OUTCOMES: The CRRT and ECMO were both removed and the condition of the right leg was also stable. But the patient passed away because of uncontrollable sepsis 18 days after the surgery. LESSONS: OPCABG is clearly the riskiest type of surgery associated with IAADs in cardiac surgical procedures, which should be considered with great concern. Whether ECMO should be used postoperatively in IAAD patients is still a controversial subject, due to some fatal complications linked with it.
Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW


  9 / 10180 MEDLINE  
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PMID:29390556
Author:Si D; Yang H; Liu G; Tong Y; He Y
Address:Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China.
Title:Treatment of longitudinal stent compression under intravenous ultrasound guidance: A case report.
Source:Medicine (Baltimore); 96(51):e9405, 2017 Dec.
ISSN:1536-5964
Country of publication:United States
Language:eng
Abstract:RATIONALE: Longitudinal stent compression is a rare phenomenon, which has been increasingly reported in recent years. PATIENT CONCERNS: Following 2 stents implanted into the middle and proximal segments of the left anterior descending (LAD) artery, longitudinal stent compression occurred when a post-dilation balloon was introduced into the proximal stent opening. DIAGNOSE: The intravenous ultrasound (IVUS) examination revealed overlapping at the opening of the proximal stent and poor stent adherence. INTERVENTIONS: Another balloon was carefully inserted into the opening for post-dilation, followed by angiography and IVUS examination. OUTCOMES: The IVUS examination indicated that the overlapping at the opening of the proximal stent was improved and the stents were well adhered. LESSONS: Such compression may be prevented by gentle and careful balloon maneuverability and improved with the use of additional balloon angioplasty or stent implantation.
Publication type:CASE REPORTS; JOURNAL ARTICLE


  10 / 10180 MEDLINE  
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PMID:28455632
Author:Nanni S; Lovato L; Ghetti G; Vagnarelli F; Mineo G; Fattori R; Saia F; Marzocchi A; Marrozzini C; Zompatori M; Reggiani LB; Semprini F; Melandri G; Biagini E; Corsini A; Norscini G; Rapezzi C
Address:Istituto di Cardiologia, Universit di Bologna, Policlinico S.Orsola-Malpighi, Via G. Massarenti 9, 40138, Bologna, Italy. samuele.nanni@aosp.bo.it.
Title:Utility of stress perfusion-cardiac magnetic resonance in follow-up of patients undergoing percutaneous coronary interventions of the left main coronary artery.
Source:Int J Cardiovasc Imaging; 33(10):1589-1597, 2017 Oct.
ISSN:1875-8312
Country of publication:United States
Language:eng
Abstract:To assess the accuracy of cardiac magnetic resonance (CMR) for the diagnosis of angiographic stenosis after percutaneous coronary intervention (PCI) of left main coronary artery (LMCA). Patients undergone in the last year PCI of unprotected LMCA and scheduled for conventional X-ray coronary angiography (CXA) were evaluated with stress perfusion CMR within 2 weeks before CXA. Main contraindications to CMR were exclusion criteria. Stress perfusion CMR was performed to follow a bolus of contrast Gadobutrol after 3min of adenosine infusion. Between the 50 patients enrolled, only 1 did not finish the CMR protocol and 49 patients with median age 71 (65-75) years (38 male, 11 female) were analyzed. Between 784 coronary angiographic segments evaluated we found 75 stenosis or occlusions (prevalence 9.5%), but only 13 stenosis or occlusions in proximal segments (prevalence 6.6%). Patients with coronary stenosis (n = 12, 24%) showed a significantly (p = 0.002) higher prevalence of diabetes (7 of 12, 58%). At CMR examination, late gadolinium enhancement was present in 25 (51%), reversible perfusion defects in 12 (24%), and fixed perfusion defects in 6 subjects (12%). The only patient with LMCA restenosis resulted positive at perfusion CMR. The accuracy of stress perfusion CMR in diagnosis of coronary stenosis was higher when the analysis was performed only in proximal coronary arteries (95%, CI 86-99) compared to overall vessels (84%, CI 70-92). Stress perfusion CMR could strongly reduce the need for elective CXA in follow up of LMCA PCI and should be validated in further multicenter prospective studies.
Publication type:EVALUATION STUDIES; JOURNAL ARTICLE
Name of substance:0 (Contrast Media); 0 (Organometallic Compounds); 0 (Vasodilator Agents); 1BJ477IO2L (gadobutrol); K72T3FS567 (Adenosine)



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