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Abstract Background Conus artery occlusion is a rare life-threatening event, typically secondary to iatrogenic etiology, and is treated mainly with conservative therapy and/or balloon angioplasty without stenting. However, treatment remains challenging. Case presentation We report the case of a 60-year-old man with a known history of coronary artery disease presenting with multiple internal defibrillator cardioversions due to an electrical storm (recurrent ventricular fibrillation). The coronary angiography showed an acute occlusion of the conus artery arising from the proximal segment of the right coronary artery, treated by percutaneous transluminal coronary angioplasty with stenting (drug-eluting stent) without any serious complications. Conclusions To our knowledge, this is the first case in the literature where a non-iatrogenic occlusion of the conus artery causing a ST-segment elevation myocardial infarction and electrical storm was treated with percutaneous coronary intervention with drug-eluting stenting. Graphical abstract

Background: The development of sirolimus-eluting stents (SES) was an important step in treating coronary artery disease (CAD). SES could decrease the angiographic restenosis and target vessel revascularization (TVR) as compared to bare-metal stent (BMS) and drug-eluting stent (DES). Nonetheless, there is scarce data regarding SES’s outcomes in Egyptians receiving DESs. Objective: We aimed to assess the effectiveness of SES vs. Paclitaxel-eluting stent (PES) in treating CAD and identifying severe adverse cardiovascular and cerebrovascular events. Patients and method: Data collected from 44 patients admitted to Cardiology Department of National Heart Institute from January 2004 and December 2005 and followed up for 3 months, who were scheduled to percutaneous intervention (PCI) due to severe angiographic stenosis (> 50 %) in a native coronary artery. Participants in this study were then divided into 2 groups: SES and PES groups. Results: The differences between both groups regarding the immediate angiographic outcomes like diameter of residual stenosis (DS%) and acute gain were non-significant. Stent characters including flexibility, deliverability, conformability and side branch preservation ability did not also show significant differences among groups. Similarly, no significant differences were found between both groups in the 3 months clinical follow up. Regarding the percentage of binary restenosis and the late luminal loss at follow-up angiography, both values were higher in group "B" than in group "A" but without a significant difference. Conclusion: We can conclude that it is better to utilize SES but not to the degree to recommend its utilization over the PES. [ABSTRACT FROM AUTHOR]

Background: Conus artery occlusion is a rare life-threatening event, typically secondary to iatrogenic etiology, and is treated mainly with conservative therapy and/or balloon angioplasty without stenting. However, treatment remains challenging. Case presentation: We report the case of a 60-year-old man with a known history of coronary artery disease presenting with multiple internal defibrillator cardioversions due to an electrical storm (recurrent ventricular fibrillation). The coronary angiography showed an acute occlusion of the conus artery arising from the proximal segment of the right coronary artery, treated by percutaneous transluminal coronary angioplasty with stenting (drug-eluting stent) without any serious complications. Conclusions: To our knowledge, this is the first case in the literature where a non-iatrogenic occlusion of the conus artery causing a ST-segment elevation myocardial infarction and electrical storm was treated with percutaneous coronary intervention with drug-eluting stenting. [ABSTRACT FROM AUTHOR]

In the current health context, there is a widespread increase in chronic non-communicable diseases that predominantly affect the cardiovascular system. Recent epidemiological data in Brazil indicate a rise in these diseases, which can result in severe harm to patients, including death. This study aims to present a study protocol to evaluate the effect of music in reducing anxiety and stress in patients undergoing coronary angioplasty. A randomized, controlled, double-blind clinical trial will be conducted with 52 patients undergoing coronary angioplasty. The patients will be randomly assigned to one of two groups: a Control Group or an Experimental Group, to assess the effect of music on anxiety and stress. Two key points will be considered to evaluate the intervention's impact: data on patients' anxiety and stress, collected through structured forms, will be gathered both before and after the intervention, along with an assessment of vital signs. The primary expected outcome is a reduction in anxiety and stress, while the secondary expected outcome is stability in vital signs.

Background and objectives. Coronary angioplasty is a common intervention for improving cardiac function postmyocardial infarction. However, the impact of this procedure in patients with type-2 diabetes mellitus (T2DM) compared to those without diabetes remains less understood. Material and methods. This study included 50 patients who underwent coronary angioplasty post-myocardial infarction. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of T2DM, with 6 patients in each group. We assessed left ventricular function using echocardiography, focusing on ejection fraction and wall motion score, at baseline, and at 1, 3, and 6 months post-angioplasty. Additional data on clinical outcomes, functional status, cardiac biomarkers, medication use, comorbid condition management, and hemodynamic measurements were also collected. Results. Both groups showed improvement in left ventricular function post-angioplasty, with no significant difference in ejection fraction and wall motion score between the two groups at each follow-up. Clinical outcomes, functional status, and biomarker levels were comparable between groups. Medication compliance was high in both groups. The control of comorbid conditions and hemodynamic stability post-angioplasty were similarly maintained in both diabetic and nondiabetic patients. Conclusion. Coronary angioplasty positively impacts left ventricular function in post-myocardial infarction patients, irrespective of the presence of T2DM. Both diabetic and non-diabetic patients demonstrated similar improvements in cardiac function and overall clinical outcomes, suggesting that angioplasty is an effective intervention for post-myocardial infarction patients regardless of their diabetes status. Further studies with larger sample sizes are recommended to validate these findings. [ABSTRACT FROM AUTHOR]

Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention. While the occurrence of gross LSD is a rare phenomenon, minor changes in length are common and have been recognized as accepted behavior of stents during implantation. Due to the proximity of the guide catheter, ostial or ostio-proximal lesions are prone to stent deformation either by the guide or other devices during navigation. Moreover, to satisfy the fractal geometry of coronary bifurcation, the proximal optimization technique is commonly performed during different bifurcation procedures, which can subject the stent to extreme overexpansion resulting in structural deformation. We describe two cases of longitudinal stent elongation during ostial deployment and try to analyze the factors behind this rare, yet complicated behavior of the latest-generation drug-eluting stent.

Introduction: Acute Myocardial Infarction (AMI) is one of the main causes of hospitalizations, and consequently, of death in the modern world. Type 4 is the AMI related to stent thrombosis/restenosis in patients who have previously undergone to a endovascular treatment with stent implantation to restore coronary blood flow. Objectives: Investigate and collect data on the epidemiological and clinical profile, risk factors and use of patients' medications and the incidence of stent restenosis/thrombosis, type of stent used (pharmacological or not) and affected arteries in those treated at the Hemodynamics of a large hospital in the North of Paraná. Methodology: Quantitative, retrospective, descriptive, integrative and observational research, through analysis of the medical records of patients undergoing coronary angioplasty due to stent thrombosis/restenosis, in the period from July to December 2022.Result: A rate of 4.1% was found of CTA procedures performed in the service due to stent thrombosis/restenosis, 93.75% over 51 years old, 75% male, 81% with drug-eluting stent, with 93.75% of patients with at least 3 risk factors; 87.5% being hypertensive, followed by 62.5% smokers, 56.5% dyslipidemia, 50% diabetic and 25% sedentary; 62.5% admitted with unstable angina, 37.5% requiring ICU admission, and 12.5% deaths. Argument: as the data collected, there was agreement between the study and those found in the scientific literature, where: the prevalence of restenosis is higher than stent thrombosis, that SAH was the main risk factor in both groups and gender, a strong relationship between risk factor and restenosis and suspected strong association between poor medication adherence and event. Conclusion: This study, carried out by collecting data through analysis of medical records, showed agreement with data from the scientific literature found. With limitations to the study, such as the retrospective analysis that did not allow evaluating conditions other than those provided in the medical records. It is suggested that strategies be developed through continued work, with the possibility of collecting other pertinent data such as medication adherence and other risk factors involved, to reduce events, with an impact not only on mortality but also on the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Background/Aims: To prevent contrast induced renal dysfunction a periprocedural prophylactic hydration is applied. Due to dilution it should cause a drop in serum creatinine concentration (SCR). Surprisingly, no reduction in SCR after contrast admission is found in up to 25% of patients as early as 12-18 hours after coronary angiography/angioplasty. This study aims to find a clinical explanation as well as predict circumstances for this phenomenon. Methods: Retrospective clinical and laboratory data was used from 341 patients who underwent elective coronary angiography/angioplasty, received a prophylactic hydration, and had serum creatinine concentration measured prior to, and 12-18 hours after invasive procedure with iodine contrast administration. To exclude an improper hydration due to no creatinine decrease, the number of red blood cells was analysed as well as hemoglobin and hematocrit in blood donations collected during the study time points. Results: The resulting lack of serum creatinine reduction could be explained by dehydration (measured by increase in number of RBC, HGB and HCT) only in 13.5% , 10.8 %, and 20% of cases, respectively. Any form of abnormal glucose metabolism combined with either baseline serum creatinine concentration <0.87 mg/dL or creatinine clearance >86.77 mL/min, or GFR by CKD EPI >80.08 mL/min/1.73 m2, or GFR by MDRD >74.48 mL/min/1.73 m2 were the predictors for no creatinine decrease at outcome. Additionally, it was demonstrated that the lack of creatinine decrease was more often observed among those patients whose initial renal function was better than in the subjects with reduction of SCR. Conclusions: This observation requires further prospective investigation on extended group of patients. [ABSTRACT FROM AUTHOR]

Hypersensitivity to aspirin is rare disorder occurring in 1.88% of the patients. Aspirin-hypersensitive patients requiring single antiplatelet agent may be treated with clopidogrel, an alternative antiplatelet agent. However, aspirin desensitization is more cost-effective than the usage of clopidogrel in these patients. Furthermore, aspirin desensitization is of greater value in patients requiring dual antiplatelet therapy, for example following procedures like percutaneous transluminal coronary angioplasty (PTCA) instead of using non-aspirin-based combinations. Herein, we report a 74-year-old hypertensive male presented with features of acute coronary syndrome and planned for percutaneous transluminal coronary angioplasty of RCA followed by dual antiplatelet therapy. Since he had aspirin allergy, desensitization was done using rapid desensitization protocol for which he responded well. This case highlights the importance of aspirin-desensitization in patients with aspirin allergy instead of choosing non-aspirin based antiplatelet agents.

Abstract Background This study aimed to determine the effect of telephone counseling based on Orem’s Self-Care Model on adherence to treatment and resilience of patients with coronary angioplasty. Methods This randomized clinical trial was performed on 80 patients in the Cardiac Intensive Care Unit of Shiraz University of Medical Sciences. Patients were randomly divided into two groups of 40 (intervention and control). Questionnaires on adherence to treatment of chronic patients and resilience for patients with cardiovascular and respiratory diseases were filled out before and 8 weeks after the intervention. In the intervention group, the telephone call schedule consisted of three calls per week for 8 weeks. Results Before the intervention, no significant difference was found between the groups about adherence to treatment and resilience. However, after the intervention, a significant difference was found between the groups as to adherence to treatment and resilience (P

Objective: Registry-based prospective study was conducted to evaluate association of body mass index (BMI) with major adverse coronary events (MACE) following percutaneous coronary intervention (PCI). Methods: Successive patients undergoing PCI were enrolled from April‘19 to March’22 and classified into five BMI categories (

Background and Aims: A sedentary lifestyle can lead to cardiovascular diseases such as atherosclerosis. Despite the use of therapeutic interventions such as angioplasty in patients with atherosclerosis, the recurrence of stenosis is possible. Rehabilitation exercises can improve the function and structure of blood vessels by improving the biomechanics of the blood flow. In this study, we aim to assess the effect of eight weeks of aerobic exercise on selected blood biomechanical variables in the bilateral femoral artery of middle-aged men up to seven days after coronary angioplasty. Methods: In this quasi-experimental study, participants were 30 men with coronary angioplasty aged 45-60 years, referred to the cardiac rehabilitation clinic of Tehran Heart Hospital. They were assigned to two exercise and control groups. Their systolic and diastolic blood velocity, pressure, and intensity were first measured. The aerobic exercise program was then performed according to the American College of Sports Medicine instructions. Analysis of covariance, paired t-test, or Wilcoxon test were used based on their results. The significance level was set at 0.05. Results: The resting heart rate and systolic and diastolic blood pressures were at the same level in both groups, but the maximum heart rate of the control group was lower. The results showed no significant difference between two groups in any blood variables. Conclusion: The effect of aerobic exercise was not confirmed in this study, may be due to heart disease or structural changes in the arteries (increased arterial stiffness and decreased arterial elasticity, especially in peripheral arteries). To increase the effect of rehabilitation exercises on peripheral arteries rather than central arteries, more intensity and duration of exercises are recommended to achieve the desired result. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the effect of telephone counseling based on Orem's Self-Care Model on adherence to treatment and resilience of patients with coronary angioplasty. Methods: This randomized clinical trial was performed on 80 patients in the Cardiac Intensive Care Unit of Shiraz University of Medical Sciences. Patients were randomly divided into two groups of 40 (intervention and control). Questionnaires on adherence to treatment of chronic patients and resilience for patients with cardiovascular and respiratory diseases were filled out before and 8 weeks after the intervention. In the intervention group, the telephone call schedule consisted of three calls per week for 8 weeks. Results: Before the intervention, no significant difference was found between the groups about adherence to treatment and resilience. However, after the intervention, a significant difference was found between the groups as to adherence to treatment and resilience (P < 0.001). Conclusion: Nursing consultation using telephone calls based on Orem's model increases the adherence to treatment and resilience of patients undergoing coronary angioplasty. Telephone counseling can help the patients adhere to their treatment plans and develop resilience skills. [ABSTRACT FROM AUTHOR]

Method: The study involved 905 patients after coronary interventions, qualified for invasive diagnosis due to symptomatic coronary disease. Aim: The aim of this study was to check the implementation of recommendations on the control of risk factors for cardiovascular diseases in patients undergoing re-interventions. Results: Compared to elderly persons, younger people more often increased their physical activity (62 vs. 65 years, p = 0.009), stopped smoking (61 vs. 65 years, p < 0.001) and reduced alcohol consumption (62 vs. 65 years, p = 0.001). People with secondary and higher education increased their physical activity more often than those with primary education (51%, 31% vs. 23%, p = 0.006). Men more often than women decided to limit their alcohol consumption (48% vs. 37%, p = 0.007). Patients with a history of acute coronary syndrome were more likely to quit smoking and reduce their alcohol consumption than those without such a history (47% vs. 37%, p = 0.003 and 42% vs. 34%, p = 0.020, respectively). Only 2% of the subjects achieved the recommended LDL cholesterol values. Forty-eight percent were qualified for reinvasive procedures on the coronary arteries. Less than half of the patients undertook health-promoting behaviors that required modification of existing habits. Conclusion: Age, gender, and education level influence pro-health behaviors. The majority of patients do not achieve the levels of LDL cholesterol and triglycerides consistent with the ESC guidelines in the secondary prevention of coronary disease. Inadequate check of risk factors may result in faster disease progression and coronary re-interventions. [ABSTRACT FROM AUTHOR]

Background: Acute kidney disease (AKD) following coronary angiography (CAG) indicates a higher risk of chronic kidney disease and follow-up cardiovascular comorbidities. However, the predictive risk factor of AKD is not clear. We sought to verify whether preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) level was associated with AKD in patients undergoing CAG. Method: We analyzed 7602 patients underwent CAG in this multi-center registry cohort study. Cardiorenal ImprovemeNt II (CIN-II) in five Chinese tertiary hospitals from 2007 to 2020. The primary outcome was AKD, defined as a ≥ 50% increase of serum creatinine within 7–90 days. Multivariable logistic regressions were used to assess the association between NT-proBNP and AKD. Result: 1009 patients (13.27%) eventually developed AKD, who were more likely to be female, older, and with comorbidities of chronic heart failure and anemia. After adjusting to the potential confounders, the NT-proBNP level remained an independent predictor of AKD (lnNT-proBNP OR: 1.20, 95% CI 1.13–1.28, p < 0.005). Restricted cubic spline analysis demonstrated a linear relationship between elevated NT-proBNP and AKD (p for trend < 0.001). In the subgroup analysis, elevated NT-proBNP level in patients with percutaneous coronary intervention (p for interaction < 0.001) or without previous congestive heart failure (p for interaction = 0.0346) has a more significant value of AKD prediction. Conclusion: Pre-operative NT-proBNP level was independently associated with the risk of AKD in patients following CAG. Perioperative strategies are warranted to prevent AKD in patients with elevated NT-proBNP levels. [ABSTRACT FROM AUTHOR]

Resumen: Las técnicas modernas de angioplastia coronaria con stent liberador de fármaco suponen una excelente opción terapéutica, sobre todo en situaciones de síndrome coronario agudo. Sin embargo, la progresión de la enfermedad de base, así como la reestenosis intra-stent, siguen siendo retos en la práctica clínica diaria. Las angioplastias reiterativas llevadas a cabo en ciertas ocasiones pueden dar lugar a la cobertura completa del vaso coronario por la malla metálica del stent, situación a veces referida como «chaqueta metálica» o full metal jacket según su término inglés. Existe poca evidencia sobre la mejor aproximación terapéutica en estos casos, planteando un desafío para la revascularización coronaria quirúrgica. La extracción quirúrgica completa de los stents previamente implantados, con posterior reconstrucción de la arteria coronaria e implante de injerto de revascularización, puede ser una alternativa útil en determinados escenarios complejos y casos altamente seleccionados. Presentamos el caso de un paciente con full metal jacket en la arteria descendente anterior, con reestenosis intra-stent severa y progresión de su enfermedad coronaria, que precisó de la extracción total de los stents implantados en descendente anterior, seguida de la reparación con parche de la arteria mamaria interna. Abstract: Modern techniques of coronary angioplasty with drug-eluting stents are a good therapeutic option, especially in acute coronary syndrome. Nevertheless, intra-stent restenosis and progression of native vessel disease are common medical challenges in this population. Repetitious angioplasties could lead to a complete covering of the vessel by the metallic stent mesh, usually called as “full metal jacket”. There is still controversy about the best treatment in this complex scenario. Surgical removal of the stents, with reconstruction of the native vessel and by-pass grafting could be a good surgical alternative in selected cases. We present the case of a male patient with an anterior descending artery full metal jacket, with in-stent restenosis and progression of the native vessel disease, treated with surgical removal of the stent, and reconstruction of the anterior descending artery using the internal mammary artery as a patch.

(1) Background: Cardiovascular prevention was left in second place during the COVID-19 pandemic and the use of telemedicine turned out to be very useful. We aimed to evaluate the effectiveness of a telemedicine application for remote monitoring and treatment adjustments in terms of improving cardiovascular prevention. (2) Methods: A prospective study of 3439 patients evaluated between the 1st of March 2019 and the 1st of March 2022, in the pre-pandemic period by face-to-face visits and during the pandemic by teleconsultations or hybrid follow-up. We compared four periods: pre-pandemic—Pre-P (1 March 2019–1 March 2020), lockdown—Lock (1 March–1 September 2020), restrictive-pandemic—Restr-P (1 September 2020–1 March 2021), and relaxed–pandemic—Rel-P (1 March 2021–1 March 2022). (3) Results: The average values of total cholesterol (TC), LDL cholesterol, triglycerides, uric acid, and glucose had an increasing trend during Lock and Restr-P, and they decreased close to the baseline level during the Rel-P, with the exception of glucose which remained elevated in Rel-P. The number of patients with newly discovered DM increased significantly in the Rel-P, and 79.5% of them had mild/moderate forms of COVID-19. During Lock and Res-P, the percentage of obese, smoking, or hypertensive patients increased, but probably through the use of telemedicine, we managed to reduce it, although it remained slightly higher than the pre-pandemic level. Physical activity decreased in the first year of the pandemic, but in Rel-P people became more active than before the pandemic. (4) Conclusions: The use of telemedicine for cardiovascular prevention seems to yield favorable results, especially for secondary prevention in the very high-risk group and during the second year. [ABSTRACT FROM AUTHOR]

The safety and efficacy of elective drug-coated balloon (DCB) angioplasty for unrestrictive de novo coronary stenosis in daily practice is not fully understood, especially in comparison to those of drug-eluting stents (DESs). A total of 588 consecutive de novo coronary stenotic lesions electively and successfully treated with either DCB (n = 275) or DESs (n = 313) between January 2016 and December 2019 at our medical center were included. The primary safety endpoint was the incidence of target lesion failure (TLF), comprising cardiac death, non-fatal myocardial infarction, and target vessel revascularization. The secondary angiographic efficacy endpoint was angiographic restenosis frequency, defined as a follow-up percent diameter stenosis of >50. The endpoints were compared after baseline adjustment using propensity score matching. In addition, the frequency and predictors of late lumen enlargement (LLE), defined as minus late luminal loss, were examined in 201 crude angiographic follow-up lesions after DCB angioplasty. A total of 31 baseline parameters were adjusted to analyze 177 lesions in each group. The TLF frequencies (DCB group: 9.6 % during a mean observational interval of 789 ± 488 days vs. DES group: 10.2 %, 846 ± 484 days, p = 0.202) and cumulative TLF-free ratios of both groups were not significantly different (p = 0.892, log-rank test). The angiographic restenosis frequency in the DCB group (6.3 %, n = 128) was not significantly different from that of the DES group (10.1 %, n = 100, p = 0.593). LLE was observed in 45.3 % of entire lesions, and a type-A dissection was a significant predictor of LLE among 23 variables (odds ratio: 3.02, 95 % CI: 1.31–6.95, p = 0.010). The present single-center retrospective study revealed statistically equivalent midterm clinical safety and angiographic efficacy among both elective DCB angioplasty and DESs placements in the treatment of unrestrictive de novo coronary lesions. In our daily practice environment, LLE was achieved in approximately half after DCB angioplasty. The serial processes of drug-coated balloon (DCB) angioplasty and late lumen enlargement (LLE) are shown. Upper (A) and lower (B) figures show the long and short axes of the targeted coronary vessels, respectively. In 1 (left side), the target de novo coronary plaque with the significant stenosis is shown. In 2 (middle left), DCB was inflated in the lesion. White color shows the powder of drug. In 3 (middle right), plaque suppression with final type-A dissection is shown. Type-A dissection in the lower side plaque (A) corresponded to the tear in 5 o'clock direction (B). In 4 (right side), the vessel remodeling (enlargement) and the plaque regression are shown. Dissection formed after DCB angioplasty (3) was sealed. LLE was established by combining these factors. In these DCB angioplasty processes, the step of lesion preparation (described in the text) is not shown. [Display omitted] • Efficacy of drug-coated balloon (DCB) for de novo coronary lesions was examined. • Baselines were statistically adjusted in DCB and drug-eluting stent (DES) arms. • Frequencies of target lesion failure in both groups were statistically equivalent. • Mean late luminal loss was 0.07 mm with 45 % of late lumen enlargement in DCB group. • DCB angioplasty for adjusted de novo coronary lesions is feasible. [ABSTRACT FROM AUTHOR]

Background Coronary intramural haematoma from spontaneous coronary artery dissection (SCAD) presents as an acute coronary syndrome, usually in young or middle-aged female patients. Conservative management in the absence of ongoing symptoms is best practice, and the artery eventually heals fully. Case summary A 49-year-old female presented with a non-ST elevation myocardial infarction. Initial angiography and intravascular ultrasound (IVUS) demonstrated typical intramural haematoma of the ostial to mid left circumflex artery. Initial conservative management was selected, but the patient developed further chest pain 5 days later and with worsening electrocardiogram changes. Further angiography was carried out demonstrating near-occlusive disease with organized thrombus in the false lumen. The angioplasty result from this is juxtaposed with another acute SCAD case on the same day with fresh intramural haematoma. Discussion Reinfarction is a common occurrence in SCAD, and little is known about how to predict it. These cases demonstrate the appearance on IVUS of fresh vs. organized thrombus and the relative angioplasty result in each case. Follow-up IVUS due to ongoing symptoms in one patient demonstrated significant stent malapposition, not apparent at the index intervention, in all likeliness due to intramural haematoma regression. [ABSTRACT FROM AUTHOR]

Aim. To study the safety and efficacy of Angipure in acute ST-segment elevation coronary syndrome (STE-ACS) and high-risk percutaneous transluminal coronary angioplasty (PTCA) compared with eptifibatide.Material and methods. The study included 157 patients with STE-ACS. High-risk PTCA included massive or total coronary artery thrombosis, noreflow/slow-reflow phenomenon, and acute stent thrombosis. Fifty-five people received Angipure at a dose of 0,72 mg/kg, 52 — at a dose of 0,40 mg/kg, while 50 patients received eptifibatide (Integrilin). We conducted clinical and laboratory studies, electrocardiography (ECG), coronary angiography.Results. According to the criteria "Frequency and severity of hemorrhagic events, including hemorrhagic stroke", "Frequency, severity of other adverse events", there were no differences in safety between Angipure at doses of 0,40 and 0,72 mg/kg and eptifibatide. Complaints, clinical symptoms, vital signs, complete blood count, biochemical and coagulation tests, ECG in patients of different groups were similar and had unidirectional dynamics. The use of Angipure or eptifibatide was considered effective if no adverse outcomes (death, recurrent acute ischemic event, need for urgent revascularization) were observed within 30 days. There were no lethal outcomes. One repeated acute ischemic event was registered in each group. In groups of patients receiving Angipure 0,40 mg/kg and eptifibatide, urgent revascularization was required once each.Conclusion. Angipure and eptifibatide have similar safety and efficacy.

The article in Acta Cardiologica revisits Andreas Grüntzig's first coronary angioplasty in 1977 and discusses modern modifications and improvements in the procedure. It compares the crossover stenting (CS) technique with the emerging hybrid provisional stenting (HPS) method, highlighting their respective benefits for different patient populations. The document also presents a case study of a 45-year-old man with a proximal left anterior descending (LAD) lesion who underwent successful treatment with a drug-coated balloon and follow-up assessments. The article acknowledges the medical team involved in the procedures and expresses gratitude to the patient for allowing the case to be shared for educational purposes. [Extracted from the article]

Abstract Background Research shows that people with stable angina need decision support when considering elective treatments. Initial treatment is with medicines but patients may gain further benefit with invasive percutaneous coronary intervention (PCI). Choosing between these treatments can be challenging for patients because both confer similar benefits but have different risks. Patient decision aids (PtDAs) are evidence-based interventions that support shared decision-making (SDM) when making healthcare decisions. This study aimed to develop and user-test a digital patient decision aid (CONNECT) to facilitate SDM for people with stable angina considering invasive treatment with elective PCI. Methods A multi-phase study was conducted to develop and test CONNECT (COroNary aNgioplasty dECision Tool) using approaches recommended by the International Patient Decision Aid Standards Collaboration: (i) Steering Group assembled, (ii) review of clinical guidance, (iii) co-design workshops with patients and cardiology health professionals, (iv) first prototype developed and ‘alpha’ tested (semi-structured cognitive interviews and 12-item acceptability questionnaire) with patients, cardiologists and cardiac nurses, recruited from two hospitals in Northern England, and (v) final PtDA refined following iterative user-feedback. Quantitative data were analysed descriptively and qualitative data from the interviews analysed using deductive content analysis. Results CONNECT was developed and user-tested with 34 patients and 29 cardiology health professionals. Findings showed that CONNECT was generally acceptable, usable, comprehensible, and desirable. Participants suggested that CONNECT had the potential to improve care quality by personalising consultations and facilitating SDM and informed consent. Patient safety may be improved as CONNECT includes questions about symptom burden which can identify asymptomatic patients unlikely to benefit from PCI, as well as those who may need to be fast tracked because of worsening symptoms. Conclusions CONNECT is the first digital PtDA for people with stable angina considering elective PCI, developed in the UK using recommended processes and fulfilling international quality criteria. CONNECT shows promise as an approach to facilitate SDM and should be evaluated in a clinical trial. Further work is required to standardise the provision of probabilistic risk information for people considering elective PCI and to understand how CONNECT can be accessible to underserved communities.

Progress in coronary angioplasty has enabled outpatients treatment with rates of immediate complications below 1%. This shows a clear improvement in patient's comfort and it represents an important medical and economic gain. Considering the demographic evolution of the population, there is an increasing number of calcified coronary lesions which represent, according to the series, up to a quarter of angioplasties. However, their care is more delicate with a greater risk of complications and procedural failure. In fact, with the difficulties of crossing and with the vascular intrusions related to pre-dilation or sub-dilation stent deployment, the complication risk increases by almost 10% in these cases of angioplasties. Similarly, the death rate at 30 days goes from 4.7% in angioplasty in general up to 24.4% in calcified lesions. Several devices for atherectomy and plaque preparation have been developed in order to better overcome the lesions and better prepare the stent installation at the cost of a risk of complications between 2 and 10%. The three most frequent complications are dissection (1.8 to 7%), slow/no-flow (0.1 to 3%) and coronary perforation (0.2 to 4%). Nevertheless, despite this procedural increased risk, ambulatory angioplasty of calcified complex lesions can become a reality subject to 4-6 hours monitoring in a specialized unit with dedicated protocols. [ABSTRACT FROM AUTHOR]

Background: Recently, researchers have become more interested in the role of thyroid hormones in acute coronary syndromes. In the present study, the serum levels of thyroid hormones in STEMI patients at the time of hospital admission and the it's correlation in the success rate in primary percutaneous intervention which is depicted in the form of ST-resolution was evaluated. Methods: In this study, 500 patients who underwent primary angioplasty in Shahid Madani Tabriz hospital within early 2016 and late 2017 were included. The participants were divided in two groups: group 1 (decrease in ST-resolution less than 50%) and group 2 (decrease in ST-RESOLUTION more than 50%). Correlations between thyroid hormones, ST resolution, mortality and Major Adverse Cardiovascular Events (MACE) were assessed. Findings: The mean age of the patients was 57.22 ± 11.32 years old while 401 patients (80.2%) were male and 99 patients (19.8%) were female. In 152 patients (30.4%) ST resolution was 50% and less (group 1) and in 348 patients (69.6%) ST-RESOLUTION was more than 50%. No significant correlation was found between TSH and FT3 levels and ST resolution. Also, MACE and thyroid hormones didn’t have any correlation. Conclusion: The finding of the present study showed there was no significant relationship between ST resolution and MACE and FT4, TSH and FT3 levels.

Aim: To demonstrate that in patients with acute coronary syndrome (ACS), using Cordis 6F Infiniti diagnostic catheters for angioplasty may represent a safe alternative associated with lower contrast volume and radiation dosage, improving cardiovascular and renal outcomes.

ABSTRACT Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 ± 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice.

Backgroundwhile the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in France.AimTo analyze the real duration of DAPT post coronary angioplasty in CCS, as well as the factors affecting this duration.MethodsBetween 2014 and 2019, 8.836 percutaneous coronary interventions for CCS from the France-PCI registry were evaluated, with 1 year follow up, after exclusion of patients receiving oral anticoagulants, procedures performed within one year of an acute coronary syndrome, and repeat angioplasty.ResultsPost-percutaneous coronary intervention (PCI) DAPT duration was > 12 months for 53.1% of patients treated for CCS; 30.5% had a DAPT between 7 and 12 months, and 16.4% a DAPT ≤ 6 months. Patients with L-DAPT (>12 months) were at higher ischemic risk [25.0% of DAPT score ≥2 vs. 18.8% DAPT score ≥2 in S&I-DAPT group (≤12 months)]. The most commonly used P2Y12 inhibitor was clopidogrel (82.2%). The prescription of ticagrelor increased over the period.Conclusionspost-PCI DAPT duration in CCS was higher than international recommendations in the France PCI registry between 2014 and 2019. More than half of the angioplasty performed for CCS are followed by a DAPT > 12 months. Ischemic risk assessment influences the duration of DAPT. This risk is probably overestimated nowadays, leading to a prolongation of DAPT beyond the recommended durations, thus increasing the bleeding risk.

Small-vessel disease (SVD) is an important subset of the population with coronary artery disease which may account for up to 30-70% according to different series. The challenges of SVD interventions are first to detect the true small-vessel size along with the true length of the lesion by intravascular imaging, then to decide about the interventional strategies as there is difficulty in delivering the stent to the lesion, dissections, under expansions of the stent during percutaneous coronary intervention with increased incidence of restenosis, and need for revascularization on the long term as well. Special attention is to be paid to this subset of patients of SVD as the treatment strategies need to be improvised than simple balloon dilatation or stenting with drug-eluting stents. At present, drug-coated or eluting balloon emerging as an improvised strategy for treating these patients with intravascular imaging. This article concentrates on the latest updates in SVD treatment. [ABSTRACT FROM AUTHOR]

Coronary intravascular lithotripsy (IVL) is the latest developed technique available for stent underexpansion treatment, although it is unclear if this therapy causes stent structure damage. We present the case of a patient with severe, refractory stent underexpansion after primary angioplasty, which was resolved with a double session of IVL. Elective angiographic and optical coherence tomography (OCT) follow‐up was performed 1 year after the procedure, which demonstrated the absence of any damage in the stent platform. Paradoxically, the study revealed a critical restenotic lesion in an area distant from the one of interest. Review of the first OCT after the primary procedure revealed 78% underexpansion in that area, which went by unnoticed and could be the cause of restenosis. Repeated IVL therapy may be helpful in cases of rebel stent underexpansion, and it conveys the impression of being safe in the long term in relation to the integrity and effectiveness of the drug‐eluting coronary stents. [ABSTRACT FROM AUTHOR]

Progress in coronary angioplasty has enabled outpatients treatment with rates of immediate complications below 1%. This shows a clear improvement in patient's comfort and it represents an important medical and economic gain. Considering the demographic evolution of the population, there is an increasing number of calcified coronary lesions which represent, according to the series, up to a quarter of angioplasties. However, their care is more delicate with a greater risk of complications and procedural failure. In fact, with the difficulties of crossing and with the vascular intrusions related to pre-dilation or sub-dilation stent deployment, the complication risk increases by almost 10% in these cases of angioplasties. Similarly, the death rate at 30 days goes from 4.7% in angioplasty in general up to 24.4% in calcified lesions. Several devices for atherectomy and plaque preparation have been developed in order to better overcome the lesions and better prepare the stent installation at the cost of a risk of complications between 2 and 10%. The three most frequent complications are dissection (1.8 to 7%), slow/no-flow (0.1 to 3%) and coronary perforation (0.2 to 4%). Nevertheless, despite this procedural increased risk, ambulatory angioplasty of calcified complex lesions can become a reality subject to 4-6 hours monitoring in a specialized unit with dedicated protocols., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent n'avoir aucun lien d'intérêt., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Objectives: The objective of this study investigated the relation between QT-dispersion (QTd) and both number of coronary artery disease and major adverse cardiovascular events (MACEs) among patients with type 2 diabetes after elective percutaneous coronary intervention (PCI). Methods: One hundred ischemic heart disease patients undergoing elective coronary angioplasty were included; 49 patients with diabetes (group I) and 51 patients without diabetes mellitus (group II). Based on the QTd parameter after PCI, both groups were subdivided into tertiles. Angiographic, electrocardiographic parameters, and MACE were compared. Results: Both QTd after PCI and delta QTd were correlated to the number of diseased coronary arteries and MACE in patients with diabetes compared to patients without diabetes. QTd was longer in patients with diabetes developing MACE than those without MACE (r = −0.31, P = 0.04). Conclusion: QTd after PCI and delta QTd are the independent predictors of MACE in patients with type 2 diabetes.

Background: Percutaneous coronary intervention (PCI) has been effective in increasing the longevity of patients with cardiovascular disease. Notwithstanding paucity of Indian studies on the psychological effects of PCI, there have been conflicting evidences with regard to improvement of quality of life in patients undergoing angioplasty. Aim: To evaluate change in the quality of life and emotional factors like depression, stress, and anxiety in patients undergoing angioplasty. Methods: This prospective longitudinal study was carried out at a tertiary care hospital and research centre in the western part of Maharashtra in a semi-urban location on 70 consecutive patients undergoing angioplasty from July 2019 to July 2021. Besides sociodemographic data patients were assessed with Type D Scale-14 (DS14), Depression Anxiety Stress Scale, and The MacNew heart disease health-related quality of life Questionnaire. After 15 days of the procedure, patients were re-evaluated with the same scales. Results: Mean age of our study population was 58.67 years of which 77.14% were men. The prevalence of Type D personality was 28.57%. There was a significant reduction in anxiety and stress scores and significant improvement in emotional and physical sub scales of Quality of life post angioplasty. On multiple regression analysis, anxiety and social inhibition emerged as predictors of depression. Conclusion: Angioplasty is associated with significant improvement in anxiety, stress, and emotional and physical subscales of Quality of life. Social inhibition, which is a component of Type D personality, anxiety, and loss of libido are significant predictors of depression in patients undergoing angioplasty.

Abstract Coronary intravascular lithotripsy (IVL) is the latest developed technique available for stent underexpansion treatment, although it is unclear if this therapy causes stent structure damage. We present the case of a patient with severe, refractory stent underexpansion after primary angioplasty, which was resolved with a double session of IVL. Elective angiographic and optical coherence tomography (OCT) follow‐up was performed 1 year after the procedure, which demonstrated the absence of any damage in the stent platform. Paradoxically, the study revealed a critical restenotic lesion in an area distant from the one of interest. Review of the first OCT after the primary procedure revealed 78% underexpansion in that area, which went by unnoticed and could be the cause of restenosis. Repeated IVL therapy may be helpful in cases of rebel stent underexpansion, and it conveys the impression of being safe in the long term in relation to the integrity and effectiveness of the drug‐eluting coronary stents.

Background: Percutaneous coronary intervention (PCI) has been effective in increasing the longevity of patients with cardiovascular disease. Notwithstanding paucity of Indian studies on the psychological effects of PCI, there have been conflicting evidences with regard to improvement of quality of life in patients undergoing angioplasty. Aim: To evaluate change in the quality of life and emotional factors like depression, stress, and anxiety in patients undergoing angioplasty. Methods: This prospective longitudinal study was carried out at a tertiary care hospital and research centre in the western part of Maharashtra in a semi-urban location on 70 consecutive patients undergoing angioplasty from July 2019 to July 2021. Besides sociodemographic data patients were assessed with Type D Scale-14 (DS14), Depression Anxiety Stress Scale, and The MacNew heart disease health-related quality of life Questionnaire. After 15 days of the procedure, patients were re-evaluated with the same scales. Results: Mean age of our study population was 58.67 years of which 77.14% were men. The prevalence of Type D personality was 28.57%. There was a significant reduction in anxiety and stress scores and significant improvement in emotional and physical sub scales of Quality of life post angioplasty. On multiple regression analysis, anxiety and social inhibition emerged as predictors of depression. Conclusion: Angioplasty is associated with significant improvement in anxiety, stress, and emotional and physical subscales of Quality of life. Social inhibition, which is a component of Type D personality, anxiety, and loss of libido are significant predictors of depression in patients undergoing angioplasty. [ABSTRACT FROM AUTHOR]

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Coronary Heart Disease (CHD) has become a global concernment due to the increased rate of mortality and compromised quality of life (QoL) among people suffering from this illness. There are many dimensions that influence cardiac patients' QoL and still the amount of research done in India on this topic, especially post Percutaneous Coronary Intervention (PCI), is meagre. The present study is focused towards evaluating health related quality of life (Hr-QoL) among cardiac patients in a one-month follow-up following the coronary angioplasty treatment and those who have not been through the intervention alongside a healthy control group. Purposive sampling technique was employed in order to select the sample consisting of 65 participants, which included 23 patients coming after one-month of the coronary angioplasty treatment for follow-up, 17 cardiac patients who had undergone angiography assessment and 25 healthy controls. EQ-5D-3L by EuroQol Research Foundation (2018) was used as psychometric tool for data collection. The administration of tool, scoring and interpretation were conducted according to the test manual. Kruskal Wallis H-test was used to statistically analyse the data. The results revealed significant difference amongst the three groups, H (2) = 7.672, p = .022 with regards to the index value of their Hr-QoL. Furthermore, mobility as a domain was found to be most significant H (2) = 7.599, p= .022 in contributing to the difference between these three groups. Thus, it can be construed that cardiac rehabilitation can be remarkably beneficial for improving cardiac patients' Hr-QoL by engaging them in activities that increase their mobility. [ABSTRACT FROM AUTHOR]

Percutaneous treatment of heavily calcified coronary lesions remains a challenge for interventional cardiologists with increased risk of incomplete lesion preparation, suboptimal stent deployment, procedural complications, and a higher rate of acute and late stent failure. Adequate lesion preparation through calcium modification is crucial in optimising procedural outcomes. Several calcium modification devices and techniques exist, with rotational atherectomy the predominant treatment for severely calcified lesions. Novel technologies such as intravascular lithotripsy are now available and show promise as a less technical and highly effective approach for calcium modification. Emerging evidence also emphasises the value of detailed characterisation of calcification severity and distribution especially with intracoronary imaging for appropriate device selection and individualised treatment strategy. This review aims to provide an overview of the non-invasive and invasive evaluation of coronary calcification, discuss calcium modification techniques and propose an algorithm for the management of calcified coronary lesions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the value of MTHFR C677T combined with CYP2C19 gene detection in patients after paclitaxel releasing coronary balloon catheter. Methods: 300 patients who underwent paclitaxel releasing coronary balloon catheterization were randomly divided into two groups: first group was the control group, which was treated according to the routine medication scheme; second group was the experimental group. The patients were tested for MTHFR C677T and CYP2C19 genes, and targeted drug intervention was carried out according to the gene test results. Mace events (including cardiac death, myocardial infarction, heart failure, readmission for cardiac reasons, target vessel revascularization), important organ complications (including cerebral infarction, intracerebral hemorrhage, gastrointestinal bleeding, urinary bleeding, fundus hemorrhage and epistaxis) and adverse drug reactions occurred within 360 days of follow-up (including liver and kidney function injury, gastrointestinal symptoms, rash, decreased platelet or hemoglobin) were recorded. Results: (1) The incidence of mace events and important organ complications 360 days after operation in the test group was significantly lower than those in the control group (P < 0.05). (2) There was no significant difference in the incidence of adverse drug reactions between the experimental group and the control group (P > 0.05). Conclusions: (1) MTHFR C677T and CYP2C19 gene detection in patients after paclitaxel releasing coronary balloon catheter can significantly improve the clinical efficacy. (2) After the detection of MTHFR C677T and CYP2C19 genes in patients after paclitaxel releasing coronary balloon catheter, the medication did not increase the adverse drug reactions. [ABSTRACT FROM AUTHOR]

Background: Research shows that people with stable angina need decision support when considering elective treatments. Initial treatment is with medicines but patients may gain further benefit with invasive percutaneous coronary intervention (PCI). Choosing between these treatments can be challenging for patients because both confer similar benefits but have different risks. Patient decision aids (PtDAs) are evidence-based interventions that support shared decision-making (SDM) when making healthcare decisions. This study aimed to develop and user-test a digital patient decision aid (CONNECT) to facilitate SDM for people with stable angina considering invasive treatment with elective PCI.Methods: A multi-phase study was conducted to develop and test CONNECT (COroNary aNgioplasty dECision Tool) using approaches recommended by the International Patient Decision Aid Standards Collaboration: (i) Steering Group assembled, (ii) review of clinical guidance, (iii) co-design workshops with patients and cardiology health professionals, (iv) first prototype developed and 'alpha' tested (semi-structured cognitive interviews and 12-item acceptability questionnaire) with patients, cardiologists and cardiac nurses, recruited from two hospitals in Northern England, and (v) final PtDA refined following iterative user-feedback. Quantitative data were analysed descriptively and qualitative data from the interviews analysed using deductive content analysis.Results: CONNECT was developed and user-tested with 34 patients and 29 cardiology health professionals. Findings showed that CONNECT was generally acceptable, usable, comprehensible, and desirable. Participants suggested that CONNECT had the potential to improve care quality by personalising consultations and facilitating SDM and informed consent. Patient safety may be improved as CONNECT includes questions about symptom burden which can identify asymptomatic patients unlikely to benefit from PCI, as well as those who may need to be fast tracked because of worsening symptoms.Conclusions: CONNECT is the first digital PtDA for people with stable angina considering elective PCI, developed in the UK using recommended processes and fulfilling international quality criteria. CONNECT shows promise as an approach to facilitate SDM and should be evaluated in a clinical trial. Further work is required to standardise the provision of probabilistic risk information for people considering elective PCI and to understand how CONNECT can be accessible to underserved communities. [ABSTRACT FROM AUTHOR]

Objectives: Poor medication adherence (MA) is a significant concern in patients with cardiovascular disease (CVD) in low and middle-income countries. Thus, understanding the factors affecting this concern is the first step in designing effective interventions in such societies. In this regard, the purpose of this study was to investigate MA in a sample of Iranian patients after coronary angioplasty and to identify prediction factors based on the World Health Organization framework. Materials and Methods: This descriptive-correlational research was conducted on 203 patients post carotid artery (CA) who were recruited from the Cardiology Clinics of Tabriz between November 2016 and February 2017. Data were collected based on socio-demographic characteristics and the Persian version of the Morisky Medication Adherence Scale (MMAS), and the Charlson comorbidity index was used as well. Finally, the multiple linear regression method was applied to identify the significant predictors of MA. Results: The mean (standard deviation) MMAS score was 5.85 (±1.83). A multivariable model (adjusted R2=0.136) predicted adherence using experienced medication side effects (B=-1.094, a 95% confidence interval (CI)= -1.700– -0.489, P

Sinus node artery (SNA) occlusion is a rare complication of percutaneous coronary intervention and usually has a benign prognosis; sinus arrest may occur but frequently resolves. We report a case of unresolved SNA obstruction following percutaneous coronary intervention of the mid-right coronary artery, for which permanent pacemaker implantation was required. (Level of Difficulty: Beginner.)

Objectives: The objective of this study investigated the relation between QT-dispersion (QTd) and both number of coronary artery disease and major adverse cardiovascular events (MACEs) among patients with type 2 diabetes after elective percutaneous coronary intervention (PCI). Methods: One hundred ischemic heart disease patients undergoing elective coronary angioplasty were included; 49 patients with diabetes (group I) and 51 patients without diabetes mellitus (group II). Based on the QTd parameter after PCI, both groups were subdivided into tertiles. Angiographic, electrocardiographic parameters, and MACE were compared. Results: Both QTd after PCI and delta QTd were correlated to the number of diseased coronary arteries and MACE in patients with diabetes compared to patients without diabetes. QTd was longer in patients with diabetes developing MACE than those without MACE (r = -0.31, P = 0.04). Conclusion: QTd after PCI and delta QTd are the independent predictors of MACE in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Coronary artery aneurysms (CAA) are reported in up to 5% of patients undergoing coronary angiography. Treatment of CAAs with covered stents has been reported in several case reports, however there is limited evidence available on the effectiveness and safety of this interventional practice.Purpose: To evaluate the current practice and outcomes of elective treatment of coronary artery aneurysms with covered stents.Methods: We conducted a systematic review of published case reports and case series of patients presenting with CAA that have been treated with covered stents in a non-emergency setting.Results: A total of 63 case reports and 3 case series were included in the final analysis comprising data from 81 patients. The treated CAA was situated in a native coronary artery in 92.6%, and in a saphenous vein graft in 7.4%. Procedural success was achieved in 95.1%. The types of stents used were mainly polytetrafluoroethylene (75.3%) and Papyrus (11.1%). In 11.0% of cases additional abluminal drug eluting stents (DES) and in 6.8% additional adluminal DES were implanted. After a mean follow up of 13.4 months overall major adverse cardiovascular events (MACE), mortality, myocardial infarction, stroke, stent thrombosis and target lesion revascularization were reported in 26.2, 0.0, 7.6, 0.0, 4.6 and 18.5% of cases, respectively.Conclusions: The use of covered stents for elective treatment of CAA appears to be effective and reasonably safe. Nevertheless, it is associated with higher MACE rate, driven mainly by higher target lesion revascularization. Further studies, particularly in form of randomized trials and controlled registries are warranted to identify patients who might profit the most from this procedure. [ABSTRACT FROM AUTHOR]