Base de dados : MEDLINE
Pesquisa : E02.148.050.120.125 [Categoria DeCS]
Referências encontradas : 1580 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 158 ir para página                         

  1 / 1580 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29443790
[Au] Autor:Si D; Liu G; Tong Y; He Y
[Ad] Endereço:Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Jilin Provincial Cardiovascular Research Institute, Changchun, Jilin, China.
[Ti] Título:Rotational atherectomy ablation for an unexpandable stent under the guide of IVUS: A case report.
[So] Source:Medicine (Baltimore);97(7):e9978, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Inadequate stent expansion due to rigid calcified may result in restenosis lesions, but the available options are limited. PATIENT CONCERNS: We report a case via the trans-radial approach of the severely underexpanded freshly deployed stent due to heavily calcified plaques DIAGNOSES:: Coronary angiography revealed that there was no adequate expansion of the freshly deployed stent. INTERVENTIONS: Under the guide of intravascular ultrasound (IVUS), rotational atherectomy (RA) successfully ablated the stent layers and the protruding calcified plaque. Followed by balloon angioplasty, the ablated segment was scaffolded with another stent, well expanded and documented by IVUS. OUTCOMES: The patient was uneventful during the procedure and remained angina free at the point of one year of clinical follow-up. LESSONS: This case indicated that RA via the trans-radial approach could be a useful remedy in the situation of under-expansion of implanted stents, and the debulking should be performed under IVUS-guidance.
[Mh] Termos MeSH primário: Aterectomia Coronária/métodos
Placa Aterosclerótica/diagnóstico por imagem
Placa Aterosclerótica/cirurgia
Stents
Ultrassonografia de Intervenção
[Mh] Termos MeSH secundário: Idoso
Aterectomia Coronária/instrumentação
Angiografia Coronária
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009978


  2 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29332914
[Au] Autor:Ichimoto E; Kadohira T; Nakayama T; De Gregorio J
[Ad] Endereço:Department of Invasive Cardiology, Englewood Hospital and Medical Center.
[Ti] Título:Long-Term Clinical Outcomes after Treatment with Excimer Laser Coronary Atherectomy for In-Stent Restenosis of Drug-Eluting Stent.
[So] Source:Int Heart J;59(1):14-20, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Excimer laser coronary atherectomy (ELCA) has been used for the treatment of complex percutaneous coronary intervention (PCI) such as in-stent restenosis (ISR). However, little information was provided about the clinical outcomes after treatment with ELCA for ISR of drug-eluting stents (DES). This study aimed to investigate the long-term clinical outcomes after PCI with ELCA for ISR of DES.A total of 81 consecutive patients with 87 lesions who underwent PCI for ISR of DES were included. Patients were classified into a PCI with ELCA group (23 patients with 24 lesions) and a PCI without ELCA group (58 patients with 63 lesions). The major adverse cardiac events (MACE) were evaluated. The mean duration of clinical follow-up was 29.8 ± 11.6 months. The incidences of diffuse restenosis and AHA/ACC type B2 or C lesion in the PCI with ELCA group were higher than in the PCI without ELCA group. Quantitative coronary angiography showed the acute luminal gain in the PCI with ELCA group was greater than in the PCI without ELCA group (1.64 ± 0.48 mm versus 1.26 ± 0.42 mm, P < 0.001). There were no significant differences in all-cause death, myocardial infarction, or target lesion revascularization between the 2 groups. Multivariate analysis due to a Cox proportional-hazards model showed that multivessel disease was an independent predictor of MACE (hazard ratio 3.05, 95% confidence interval 1.22 to 7.61, P = 0.02). ELCA was effective as an atherectomy device for lumen enlargement and optimal lesion preparation. Even though ELCA was used for ISR of DES in significantly more complex lesions, the long-term clinical outcomes were favorable and similar.
[Mh] Termos MeSH primário: Aterectomia Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Stents Farmacológicos/efeitos adversos
Oclusão de Enxerto Vascular/cirurgia
Lasers de Excimer/uso terapêutico
Intervenção Coronária Percutânea/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico
Feminino
Seguimentos
Oclusão de Enxerto Vascular/diagnóstico
Oclusão de Enxerto Vascular/epidemiologia
Seres Humanos
Incidência
Masculino
New Jersey/epidemiologia
Desenho de Prótese
Reoperação
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180116
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-638


  3 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28966325
[Au] Autor:Shiraishi J; Shoji K; Yanagiuchi T; Yashige M; Shikuma A; Ito D; Kimura M; Kishita E; Nakagawa Y; Hyogo M; Sawada T
[Ad] Endereço:Department of Cardiology, Kyoto First Red Cross Hospital.
[Ti] Título:Rotational Atherectomy Followed by Drug-Coated Balloon Dilation for Left Main In-Stent Restenosis in the Setting of Acute Coronary Syndrome Complicated with Right Coronary Chronic Total Occlusion.
[So] Source:Int Heart J;58(5):806-811, 2017 Oct 21.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support. Because of difficulty in crossing a guidewire through the just proximal LCx lesion, we first performed rotational atherectomy against the LMCA in-stent eccentric lesion. After successfully crossing the guidewire into the LCx, we added balloon dilation with kissing balloon inflation followed by alternate drug-coated balloon dilation. An eight-month follow-up coronary angiography revealed no further vessel narrowing in the LMCA bifurcation lesion.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/complicações
Angioplastia Coronária com Balão/instrumentação
Aterectomia Coronária/métodos
Materiais Revestidos Biocompatíveis
Oclusão Coronária/cirurgia
Oclusão de Enxerto Vascular/terapia
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/diagnóstico
Síndrome Coronariana Aguda/cirurgia
Idoso de 80 Anos ou mais
Angiografia Coronária
Oclusão Coronária/diagnóstico
Oclusão Coronária/etiologia
Vasos Coronários/diagnóstico por imagem
Oclusão de Enxerto Vascular/diagnóstico
Oclusão de Enxerto Vascular/etiologia
Seres Humanos
Masculino
Desenho de Prótese
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Coated Materials, Biocompatible)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-518


  4 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28631258
[Au] Autor:Bartus S; Januszek R; Legutko J; Rzeszutko L; Dziewierz A; Dudek D
[Ti] Título:Long-term effects of rotational atherectomy in patients with heavy calcified coronary artery lesions: a single-centre experience.
[So] Source:Kardiol Pol;75(6):564-572, 2017.
[Is] ISSN:1897-4279
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rotational atherectomy (RA) plays a significant role in contemporary percutaneous coronary interventions (PCI), especially in the era of population aging and expansion of PCI indications. AIM: The aim of the current study was to evaluate the rate of periprocedural complications, the long-term effectiveness of RA, and potential factors influencing the incidence of major adverse cardiac events (MACE) and major cardiac as well as cerebrovascular events (MACCE) after RA. METHODS: The study included 60 consecutive patients who underwent effective RA between January 2002 and May 2016. Patients were followed-up for 2,616 days for MACE and MACCE. RESULTS: The mean age of the enrolled patients was 72.1 years, and 78.3% were males. The mean follow-up period lasted 835.3 ± 611.8 days. Periprocedural complications occurred in 12 (20.0%) patients. In the follow-up of up to 2,616 days, 64% of patients were free of MACCE and 68% were free of MACE. Univariate Cox analysis revealed that MACCE occurred more often in patients from the high-risk group based on the EuroSCORE II and those with longer lengths of the implanted stent(s) after the RA procedure. In multivariate Cox regression analysis, both high-risk category and mean stent(s) length were identified as independent predictors of MACCE. EuroSCORE II was confirmed to be the only independent predictor of MACE after RA. CONCLUSIONS: Rotational atherectomy is a safe and sufficient technique for the endovascular treatment of heavily calcified coronary artery lesions. Individuals at a higher risk as assessed by the EuroSCORE II before RA and those with longer stent(s) implanted after RA are predisposed to MACCE in the follow-up.
[Mh] Termos MeSH primário: Aterectomia Coronária/efeitos adversos
Doença da Artéria Coronariana/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doenças Cardiovasculares/epidemiologia
Doenças Cardiovasculares/etiologia
Transtornos Cerebrovasculares/epidemiologia
Transtornos Cerebrovasculares/etiologia
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Segurança do Paciente
Período Perioperatório
Polônia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.5603/KP.a2017.0042


  5 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28419791
[Au] Autor:Sandoval Y; Brilakis ES
[Ad] Endereço:Division of Cardiology, Hennepin County Medical Center, Minneapolis, Minnesota.
[Ti] Título:The role of rotational atherectomy in contemporary chronic total occlusion percutaneous coronary intervention.
[So] Source:Catheter Cardiovasc Interv;89(5):829-831, 2017 04.
[Is] ISSN:1522-726X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rotational atherectomy is performed infrequently (∼3.5%) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for two indications: treatment of balloon uncrossable and balloon undilatable lesions. Use of rotational atherectomy in CTO PCI was associated with high success and acceptable complication rates. Rotational atherectomy remains a "must have" device for interventional cardiologists performing complex PCI.
[Mh] Termos MeSH primário: Aterectomia Coronária
Oclusão Coronária
[Mh] Termos MeSH secundário: Angioplastia Coronária com Balão
Doença Crônica
Angiografia Coronária
Seres Humanos
Intervenção Coronária Percutânea
Resultado do Tratamento
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1002/ccd.27052


  6 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28274573
[Au] Autor:Ielasi A; Kawamoto H; Latib A; Boccuzzi GG; Sardella G; Garbo R; Meliga E; D'Ascenzo F; Presbitero P; Nakamura S; Colombo A
[Ad] Endereço:Department of Cardiology, Bolognini Hospital Seriate, ASST Bergamo Est, Seriate, Bergamo, Italy.
[Ti] Título:In-Hospital and 1-Year Outcomes of Rotational Atherectomy and Stent Implantation in Patients With Severely Calcified Unprotected Left Main Narrowings (from the Multicenter ROTATE Registry).
[So] Source:Am J Cardiol;119(9):1331-1337, 2017 May 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Heavily calcified unprotected left main (ULM) disease continues to be a challenging situation and represent a high-risk subset for interventional cardiologist. To date, there are limited data investigating the results after rotational atherectomy (RA) in this setting. The aim of this study was to investigate the in-hospital and 1-year outcomes after RA of heavily calcified ULM lesions. A retrospective cohort analysis was performed on all calcified patients with ULM (n = 86) enrolled in the multicenter international ROTATE registry (overall patients, n = 962). End points of the study were the in-hospital and 1-year incidence of major adverse cardiovascular events (MACE): a composite of death, myocardial infarction, and target-vessel revascularization in the ULM versus non-ULM group. Patients in the ULM group were older (p = 0.01) and more frequently with diabetes (p = 0.001) compared with the non-ULM group, whereas intravascular ultrasound guidance was higher, even if not systematic, in the ULM group (p <0.001). No difference was reported between ULM versus non-ULM groups in terms of in-hospital MACE (5.8% vs 8%). At 1 year, MACE rate was higher in ULM versus non-ULM (26.4% vs 14.9%, p = 0.002) mostly driven by target-vessel revascularization (20.3% vs 12.7%, p = 0.05). Even definite/probable stent thrombosis rate was higher in the ULM group (3.9% vs 0.8%). All these events were subacute and 2/3 (75%) were fatal. In conclusion, our multicenter experience shows that RA followed by stent implantation in patients with heavily calcified ULM narrowing is feasible and associated with good in-hospital results. Patient (age and diabetes) and procedural aspects (relatively low intravascular ultrasound guidance) may affect the worse subacute mid-term prognosis in the more complex ULM group.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/cirurgia
Aterectomia Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Stents Farmacológicos
Placa Aterosclerótica/cirurgia
Sistema de Registros
Calcificação Vascular/cirurgia
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/etiologia
Idoso
Idoso de 80 Anos ou mais
Doença da Artéria Coronariana/complicações
Trombose Coronária/epidemiologia
Feminino
Mortalidade Hospitalar
Seres Humanos
Incidência
Masculino
Meia-Idade
Infarto do Miocárdio/epidemiologia
Revascularização Miocárdica/utilização
Placa Aterosclerótica/complicações
Complicações Pós-Operatórias/epidemiologia
Estudos Retrospectivos
Resultado do Tratamento
Calcificação Vascular/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE


  7 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28258729
[Au] Autor:Lee MS; Park KW; Shlofmitz E; Shlofmitz RA
[Ad] Endereço:Division of Cardiology, UCLA Medical Center, Los Angeles, California. Electronic address: mslee@mednet.ucla.edu.
[Ti] Título:Comparison of Rotational Atherectomy Versus Orbital Atherectomy for the Treatment of Heavily Calcified Coronary Plaques.
[So] Source:Am J Cardiol;119(9):1320-1323, 2017 May 01.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We evaluated the outcomes of patients with severe coronary artery calcification (CAC) who underwent rotational atherectomy (RA) and orbital atherectomy (OA). Severe CAC increases the complexity of percutaneous coronary intervention (PCI) because of the difficulty in optimizing stent expansion, leading to worse clinical outcomes. Both devices are effective treatment strategies for severe CAC. No comparisons have been performed to evaluate the clinical outcomes after RA and OA. The outcomes of 67 patients with severe CAC who underwent RA from July 2012 to June 2015 and 60 patients who underwent OA from February 2014 to September 2016 were evaluated. The primary end point was the rate of 30-day major adverse cardiac and cerebrovascular events, comprising cardiac death, myocardial infarction, target vessel revascularization, and stroke. The primary end point was similar in the RA and OA groups (6% vs 6%, p >0.9), as were the individual end points of death (0% vs 2%, p = 0.8), myocardial infarction (6% vs 4%, p = 0.7), target vessel revascularization (0% vs 0%, p >0.9), and stroke (0% vs 0%, p >9). Procedural success was achieved in all patients. Angiographic complications were uncommon in both groups. No patient had stent thrombosis. In conclusion, both RA and OA are safe and effective for the treatment of severe CAC as they provided similar clinical outcomes at short-term follow-up.
[Mh] Termos MeSH primário: Aterectomia Coronária/métodos
Doença da Artéria Coronariana/cirurgia
Placa Aterosclerótica/cirurgia
Stents
Calcificação Vascular/cirurgia
[Mh] Termos MeSH secundário: Idoso
Angina Instável/etiologia
Angina Instável/cirurgia
Doença da Artéria Coronariana/complicações
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio/epidemiologia
Infarto do Miocárdio sem Supradesnível do Segmento ST/etiologia
Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia
Intervenção Coronária Percutânea/métodos
Placa Aterosclerótica/complicações
Estudos Retrospectivos
Índice de Gravidade de Doença
Acidente Vascular Cerebral/epidemiologia
Resultado do Tratamento
Calcificação Vascular/complicações
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170305
[St] Status:MEDLINE


  8 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28250353
[Au] Autor:Sakakura K; Taniguchi Y; Yamamoto K; Wada H; Momomura SI; Fujita H
[Ad] Endereço:Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University.
[Ti] Título:When a Burr Can Not Penetrate the Calcified Lesion, Increasing Burr Size as Well as Decreasing Burr Size Can Be a Solution in Rotational Atherectomy.
[So] Source:Int Heart J;58(2):279-282, 2017 Apr 06.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:In rotational atherectomy (RA), several burr sizes are available, such as 1.25 mm, 1.5 mm, 1.75 mm, or ≥ 2.0 mm. It is important to select an appropriate burr size for each lesion because rotational atherectomy has several unique complications regarding burrs such as entrapment or perforation. When a burr cannot penetrate the lesion, downsizing of the burr is generally recommended. Also, if the smallest burr (1.25 mm) cannot penetrate the lesion, a change to a more supportive or larger French guiding catheter has been recommended. We describe the case of a 68 year-old female who was referred to our department for percutaneous coronary intervention to the calcified stenosis in the middle of the left anterior descending coronary artery. We used the smallest burr (1.25 mm) and a supportive 7 Fr guiding catheter to penetrate the lesion. However, the smallest burr could not pass the lesion even after 14 sessions (total ablation time: 339 seconds). We intentionally increased the burr size from 1.25 mm to 1.5 mm. The 1.5 mm burr successfully passed the lesion without any perforation or burr entrapment. In this manuscript, we discuss why increasing the burr size was successful for this severely calcified lesion that was not penetrated by the smallest burr.
[Mh] Termos MeSH primário: Aterectomia Coronária/instrumentação
[Mh] Termos MeSH secundário: Idoso
Doença da Artéria Coronariana/terapia
Feminino
Seres Humanos
Calcificação Vascular/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-248


  9 / 1580 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28145873
[Au] Autor:Lee MS; Nguyen H; Shlofmitz R
[Ad] Endereço:Division of Interventional Cardiology, UCLA Medical Center, Los Angeles, California, 100 Medical Plaza, Suite 630, Los Angeles, CA 90095 USA. mslee@mednet.ucla.edu.
[Ti] Título:Incidence of Bradycardia and Outcomes of Patients Who Underwent Orbital Atherectomy Without a Temporary Pacemaker.
[So] Source:J Invasive Cardiol;29(2):59-62, 2017 Feb.
[Is] ISSN:1557-2501
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. BACKGROUND: The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection. Suboptimal stent expansion is associated with stent thrombosis and restenosis. Orbital atherectomy safely and effectively modifies calcified plaque to facilitate optimal stent expansion. The incidence of bradycardia in orbital atherectomy is unknown. METHODS: Fifty consecutive patients underwent orbital atherectomy from February 2014 to September 2016 at our institution, none of whom underwent insertion of a temporary pacemaker. The final analysis included 47 patients in this retrospective study as 3 patients were excluded because of permanent pacemaker implantation. The primary endpoint was significant bradycardia, defined as bradycardia requiring emergent pacemaker placement or a heart rate <50 bpm at the end of atherectomy. RESULTS: The primary endpoint occurred in 4% of all patients, all driven by patients who experienced a heart rate decreasing to <50 bpm. The major adverse cardiac and cerebral event rate was 6%, driven by death (2%) and myocardial infarction (4%). No patient experienced target-vessel revascularization, stroke, or stent thrombosis. Angiographic complications included perforation in 2%, slow-flow in 4%, and flow-limiting dissection in 0%. CONCLUSION: Significant bradycardia was uncommon during orbital atherectomy. Performing orbital atherectomy without a temporary pacemaker appears to be safe.
[Mh] Termos MeSH primário: Aterectomia Coronária/efeitos adversos
Bradicardia/epidemiologia
Doença da Artéria Coronariana/cirurgia
Vasos Coronários/cirurgia
Frequência Cardíaca/fisiologia
Complicações Pós-Operatórias
Calcificação Vascular/cirurgia
[Mh] Termos MeSH secundário: Bradicardia/etiologia
Bradicardia/fisiopatologia
California/epidemiologia
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico
Vasos Coronários/diagnóstico por imagem
Eletrocardiografia
Feminino
Seguimentos
Seres Humanos
Incidência
Masculino
Meia-Idade
Marca-Passo Artificial
Estudos Retrospectivos
Calcificação Vascular/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170202
[St] Status:MEDLINE


  10 / 1580 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28116818
[Au] Autor:Lee MS; Shlofmitz E; Lluri G; Shlofmitz RA
[Ad] Endereço:UCLA Medical Center, Los Angeles, California.
[Ti] Título:Outcomes in Elderly Patients With Severely Calcified Coronary Lesions Undergoing Orbital Atherectomy.
[So] Source:J Interv Cardiol;30(2):134-138, 2017 Apr.
[Is] ISSN:1540-8183
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We evaluated the clinical outcomes of elderly patients who underwent orbital atherectomy for the treatment of severe coronary artery calcification (CAC) prior to stenting. BACKGROUND: Percutaneous coronary intervention (PCI) of severe CAC is associated with worse clinical outcomes including death, myocardial infarction (MI), and target vessel revascularization (TVR). The elderly represents a high-risk group of patients, often have more comorbid conditions, and have worse outcomes after PCI compared to younger patients. Clinical trials and a large multicenter registry have demonstrated the safety and efficacy of orbital atherectomy for the treatment of severe CAC. Clinical outcomes of elderly patients who undergo orbital atherectomy are unknown. METHODS: Of the 458 patients, 229 were ≥75 years old (elderly) and 229 were <75 years old (younger). The primary endpoint was rate of 30-day major adverse cardiac and cerebrovascular events (MACCE), comprised of cardiac death, MI, TVR, and stroke. RESULTS: The primary endpoint was similar in the elderly and younger groups (2.2% vs. 2.2%, P = 1), as were the individual endpoints of death (2.2% vs. 0.4%, P = 0.1), MI (0.9% vs. 1.3%, P = 0.65), TVR (0% vs. 0%, P = 1), and stroke (0% vs. 0.4%, P = 0.32). The rates of angiographic complications and stent thrombosis were similarly low in both groups. CONCLUSIONS: The elderly represented a sizeable number of patients who underwent orbital atherectomy. It is a safe and effective treatment strategy for elderly patients with severe CAC as the clinical outcomes were similar to their younger counterparts. A randomized trial should further clarify the role of orbital atherectomy in these patients.
[Mh] Termos MeSH primário: Aterectomia Coronária
Doença da Artéria Coronariana/cirurgia
Calcificação Vascular/cirurgia
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Stents
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1111/joic.12362



página 1 de 158 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde