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460 results on '"Guagliumi, G."'

1. Biases in Ecoacoustics Analysis: A Protocol to Equalize Audio Recorders

Author

Potenza, A, Zaffaroni-Caorsi, V, Benocci, R, Guagliumi, G, Fouani, J, Bisceglie, A, Zambon, G, Potenza A., Zaffaroni-Caorsi V., Benocci R., Guagliumi G., Fouani J. M., Bisceglie A., Zambon G., Potenza, A, Zaffaroni-Caorsi, V, Benocci, R, Guagliumi, G, Fouani, J, Bisceglie, A, Zambon, G, Potenza A., Zaffaroni-Caorsi V., Benocci R., Guagliumi G., Fouani J. M., Bisceglie A., and Zambon G.

Abstract

Eco-acoustic indices allow us to rapidly evaluate habitats and ecosystems and derive information about anthropophonic impacts. However, it is proven that indices' values and trends are not comparable between studies. These incongruences may be caused by the availability on the market of recorders with different characteristics and costs. Thus, there is a need to reduce these biases and incongruences to ensure an accurate analysis and comparison between soundscape ecology studies and habitat assessments. In this study, we propose and validate an audio recording equalization protocol to reduce eco-acoustic indices' biases, by testing three soundscape recorder models: Song Meter Micro, Soundscape Explorer Terrestrial and Audiomoth. The equalization process aligns the signal amplitude and frequency response of the soundscape recorders to those of a type 1 level meter. The adjustment was made in MATLAB R2023a using a filter curve generated comparing a reference signal (white noise); the measurements were performed in an anechoic chamber using 11 audio sensors and a type 1 sound level meter (able to produce a .WAV file). The statistical validation of the procedure was performed on recordings obtained in an urban and Regional Park (Italy) assessing a significant reduction in indices' biases on the Song Meter Micro and Audiomoth.

Published
2024

2. PB0774 The Role of Immunothrombosis in Acute Coronary Syndrome (ACS) Patients during COVID-19 Pandemic: Analysis during a 2 Year Follow-Up

Author

Gomez Rosas, P., primary, Marchetti, M., additional, Pescetelli, L., additional, Sanga, E., additional, Russo, L., additional, Gamba, S., additional, Verzeroli, C., additional, Pellegrini, D., additional, Fiocca, L., additional, Canova, P., additional, Vassileva, A., additional, Moretti, F., additional, Grosu, A., additional, Guagliumi, G., additional, and Falanga, A., additional

Published
2023
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3. Clinical quantitative coronary artery stenosis and coronary atherosclerosis imaging: a Consensus Statement from the Quantitative Cardiovascular Imaging Study Group

Author

Mézquita, AJV, Biavati, F, Falk, V, Alkadhi, H, Hajhosseiny, R, Maurovich-Horvat, P, Manka, R, Kozerke, S, Stuber, M, Derlin, T, Channon, KM, Išgum, I, Coenen, A, Foellmer, B, Dey, D, Volleberg, RHJA, Meinel, FG, Dweck, MR, Piek, JJ, van de Hoef, T, Landmesser, U, Guagliumi, G, Giannopoulos, AA, Botnar, RM, Khamis, R, Williams, MC, Newby, DE, Dewey, M, and University of Zurich

Subjects
10042 Clinic for Diagnostic and Interventional Radiology, 610 Medicine & health, 10181 Clinic for Nuclear Medicine
Abstract

The detection and characterization of coronary artery stenosis and atherosclerosis using imaging tools are key for clinical decision-making in patients with known or suspected coronary artery disease. In this regard, imaging-based quantification can be improved by choosing the most appropriate imaging modality for diagnosis, treatment and procedural planning. In this Consensus Statement, we provide clinical consensus recommendations on the optimal use of different imaging techniques in various patient populations and describe the advances in imaging technology. Clinical consensus recommendations on the appropriateness of each imaging technique for direct coronary artery visualization were derived through a three-step, real-time Delphi process that took place before, during and after the Second International Quantitative Cardiovascular Imaging Meeting in September 2022. According to the Delphi survey answers, CT is the method of choice to rule out obstructive stenosis in patients with an intermediate pre-test probability of coronary artery disease and enables quantitative assessment of coronary plaque with respect to dimensions, composition, location and related risk of future cardiovascular events, whereas MRI facilitates the visualization of coronary plaque and can be used in experienced centres as a radiation-free, second-line option for non-invasive coronary angiography. PET has the greatest potential for quantifying inflammation in coronary plaque but SPECT currently has a limited role in clinical coronary artery stenosis and atherosclerosis imaging. Invasive coronary angiography is the reference standard for stenosis assessment but cannot characterize coronary plaques. Finally, intravascular ultrasonography and optical coherence tomography are the most important invasive imaging modalities for the identification of plaques at high risk of rupture. The recommendations made in this Consensus Statement will help clinicians to choose the most appropriate imaging modality on the basis of the specific clinical scenario, individual patient characteristics and the availability of each imaging modality.

Published
2023
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5. Covid-19 and gender: lower rate but same mortality of severe disease in women-an observational study

Author

Raimondi, F, Novelli, L, Ghirardi, A, Russo, F, Pellegrini, D, Biza, R, Trapasso, R, Giuliani, L, Anelli, M, Amoroso, M, Allegri, C, Imeri, G, Sanfilippo, C, Comandini, S, Hila, E, Manesso, L, Gandini, L, Mandelli, P, Monti, M, Gori, M, Senni, M, Lorini, F, Rizzi, M, Barbui, T, Paris, L, Rambaldi, A, Cosentini, R, Guagliumi, G, Cesa, S, Colledan, M, Sessa, M, Masciulli, A, Gavazzi, A, Buoro, S, Remuzzi, G, Ruggenenti, P, Callegaro, A, Gianatti, A, Farina, C, Bellasi, A, Sironi, S, Fagiuoli, S, Di Marco, F, Raimondi F, Novelli L, Ghirardi A, Russo FM, Pellegrini D, Biza R, Trapasso R, Giuliani L, Anelli M, Amoroso M, Allegri C, Imeri G, Sanfilippo C, Comandini S, Hila E, Manesso L, Gandini L, Mandelli P, Monti M, Gori M, Senni M, Lorini FL, Rizzi M, Barbui T, Paris L, Rambaldi A, Cosentini R, Guagliumi G, Cesa S, Colledan M, Sessa M, Masciulli A, Gavazzi A, Buoro S, Remuzzi G, Ruggenenti P, Callegaro A, Gianatti A, Farina C, Bellasi A, Sironi S, Fagiuoli S, Di Marco F, Raimondi, F, Novelli, L, Ghirardi, A, Russo, F, Pellegrini, D, Biza, R, Trapasso, R, Giuliani, L, Anelli, M, Amoroso, M, Allegri, C, Imeri, G, Sanfilippo, C, Comandini, S, Hila, E, Manesso, L, Gandini, L, Mandelli, P, Monti, M, Gori, M, Senni, M, Lorini, F, Rizzi, M, Barbui, T, Paris, L, Rambaldi, A, Cosentini, R, Guagliumi, G, Cesa, S, Colledan, M, Sessa, M, Masciulli, A, Gavazzi, A, Buoro, S, Remuzzi, G, Ruggenenti, P, Callegaro, A, Gianatti, A, Farina, C, Bellasi, A, Sironi, S, Fagiuoli, S, Di Marco, F, Raimondi F, Novelli L, Ghirardi A, Russo FM, Pellegrini D, Biza R, Trapasso R, Giuliani L, Anelli M, Amoroso M, Allegri C, Imeri G, Sanfilippo C, Comandini S, Hila E, Manesso L, Gandini L, Mandelli P, Monti M, Gori M, Senni M, Lorini FL, Rizzi M, Barbui T, Paris L, Rambaldi A, Cosentini R, Guagliumi G, Cesa S, Colledan M, Sessa M, Masciulli A, Gavazzi A, Buoro S, Remuzzi G, Ruggenenti P, Callegaro A, Gianatti A, Farina C, Bellasi A, Sironi S, Fagiuoli S, and Di Marco F

Abstract

Background Gender-related factors might affect vulnerability to Covid-19. The aim of this study was to describe the role of gender on clinical features and 28-day mortality in Covid-19 patients. Methods Observational study of Covid-19 patients hospitalized in Bergamo, Italy, during the first three weeks of the outbreak. Medical records, clinical, radiological and laboratory findings upon admission and treatment have been collected. Primary outcome was 28-day mortality since hospitalization. Results 431 consecutive adult patients were admitted. Female patients were 119 (27.6%) with a mean age of 67.0 +/- 14.5 years (vs 67.8 +/- 12.5 for males, p = 0.54). Previous history of myocardial infarction, vasculopathy and former smoking habits were more common for males. At the time of admission PaO2/FiO(2) was similar between men and women (228 [IQR, 134-273] vs 238 mmHg [150-281], p = 0.28). Continuous Positive Airway Pressure (CPAP) assistance was needed in the first 24 h more frequently in male patients (25.7% vs 13.0%; p = 0.006). Overall 28-day mortality was 26.1% in women and 38.1% in men (p = 0.018). Gender did not result an independent predictor of death once the parameters related to disease severity at presentation were included in the multivariable analysis (p = 0.898). Accordingly, the Kaplan-Meier survival analysis in female and male patients requiring CPAP or non-invasive ventilation in the first 24 h did not find a significant difference (p = 0.687). Conclusion Hospitalized women are less likely to die from Covid-19; however, once severe disease occurs, the risk of dying is similar to men. Further studies are needed to better investigate the role of gender in clinical course and outcome of Covid-19.

Published
2021

6. Effect of respiratory impairment on the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction and Coronavirus disease-2019 (COVID-19)

Author

Pellegrini, D, Fiocca, L, Pescetelli, I, Canova, P, Vassileva, A, Faggi, L, Senni, M, Guagliumi, G, Pellegrini D, Fiocca L, Pescetelli I, Canova P, Vassileva A, Faggi L, Senni M, Guagliumi G, Pellegrini, D, Fiocca, L, Pescetelli, I, Canova, P, Vassileva, A, Faggi, L, Senni, M, Guagliumi, G, Pellegrini D, Fiocca L, Pescetelli I, Canova P, Vassileva A, Faggi L, Senni M, and Guagliumi G

Abstract

Background: Coronavirus Disease-2019 (COVID-19) may impair outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The extent of this phenomenon and its mechanisms are unclear. Methods and Results: This study prospectively included 50 consecutive STEMI patients admitted to our center for primary percutaneous coronary intervention (PCI) at the peak of the Italian COVID-19 outbreak. At admission, a COVID-19 test was positive in 24 patients (48%), negative in 26 (52%). The primary endpoint was in-hospital all-cause mortality. Upon admission, COVID-19 subjects had lower PO2/FiO2 (169 [100–425] vs. 390 [302–477], P<0.01), more need for oxygen support (62.5% vs. 26.9%, P=0.02) and a higher rate of myocardial dysfunction (ejection fraction <30% in 45.8% vs. 19.2%, P=0.04). All patients underwent emergency angiography. In 12.5% of COVID-19 patients, no culprit lesions were detected, thus PCI was performed in 87.5% and 100% of COVID-19 positive and negative patients, respectively (P=0.10). Despite a higher rate of obstinate thrombosis in the COVID-19 group (47.6% vs. 11.5%, P<0.01), the PCI result was similar (TIMI 2-3 in 90.5% vs. 100%, P=0.19). In-hospital mortality was 41.7% and 3.8% in COVID-19 positive and negative patients, respectively (P<0.01). Respiratory failure was the leading cause of death (80%) in the COVID-19 group, frequently associated with severe myocardial dysfunction. Conclusions: In-hospital mortality of COVID-19 patients with STEMI remains high despite successful PCI, mainly due to coexisting severe respiratory failure. This may be a critical factor in patient management and treatment selection.

Published
2021

7. Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author

Araki, M., Park, S.J., Dauerman, H.L., Uemura, S., Kim, J.S., Mario, C. di, Johnson, T.W., Guagliumi, G., Kastrati, A., Joner, M., Holm, N.R., Alfonso, F., Wijns, W., Adriaenssens, T., Nef, H., Rioufol, G., Amabile, N., Souteyrand, G., Meneveau, N., Gerbaud, E., Opolski, M.P., Gonzalo, N., Tearney, G.J., Bouma, B., Aguirre, A.D., Mintz, G.S., Stone, G.W., Bourantas, C.V., Raber, L., Gili, S., Mizuno, K., Kimura, S., Shinke, T., Hong, M.K., Jang, Y., Cho, J.M., Yan, B.P., Porto, I., Niccoli, G., Montone, R.A., Thondapu, V., Papafaklis, M.I., Michalis, L.K., Reynolds, H., Saw, J., Libby, P., Weisz, G., Iannaccone, M., Gori, T., Toutouzas, K., Yonetsu, T., Minami, Y., Takano, M., Raffel, O.C., Kurihara, O., Soeda, T., Sugiyama, T., Kim, H.O., Lee, T., Higuma, T., Nakajima, A., Yamamoto, E., Bryniarski, K.L., Vito, L. di, Vergallo, R., Fracassi, F., Russo, M., Seegers, L.M., McNulty, I., Park, S., Feldman, M., Escaned, J., Prati, F., Arbustini, E., Pinto, F.J., Waksman, R., Garcia-Garcia, H.M., Maehara, A., Ali, Z., Finn, A.V., Virmani, R., Kini, A.S., Daemen, J., Kume, T., Hibi, K., Tanaka, A., Akasaka, T., Kubo, T., Yasuda, S., Croce, K., Granada, J.F., Lerman, A., Prasad, A., Regar, E., Saito, Y., Sankardas, M.A., Subban, V., Weissman, N.J., Chen, Y.D., Yu, B., Nicholls, S.J., Barlis, P., West, N.E.J., Arbab-Zadeh, A., Ye, J.C., Dijkstra, J., Lee, H., Narula, J., Crea, F., Nakamura, S., Kakuta, T., Fujimoto, J., Fuster, V., and Jang, I.K.

Abstract

Optical coherence tomography (OCT) has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimize percutaneous coronary intervention. In this Review, Jang and colleagues summarize this rapidly progressing field, with the aim of standardizing the use of OCT in coronary atherosclerosis.Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.

Published
2022

8. Antecedent use of renin-angiotensin system inhibitors is associated with reduced mortality in elderly hypertensive Covid-19 patients

Author

Gori, M, Berzuini, C, D'Elia, E, Ghirardi, A, Bernardinelli, L, Gavazzi, A, Balestrieri, G, Giammarresi, A, Trevisan, R, Di Marco, F, Bellasi, A, Amoroso, M, Raimondi, F, Novelli, L, Magro, B, Mangia, G, Lorini, F, Guagliumi, G, Fagiuoli, S, Parati, G, Senni, M, Gori, Mauro, Berzuini, Carlo, D'Elia, Emilia, Ghirardi, Arianna, Bernardinelli, Luisa, Gavazzi, Antonello, Balestrieri, Giulio, Giammarresi, Andrea, Trevisan, Roberto, Di Marco, Fabiano, Bellasi, Antonio, Amoroso, Mariangela, Raimondi, Federico, Novelli, Luca, Magro, Bianca, Mangia, Gianpaolo, Lorini, Ferdinando L, Guagliumi, Giulio, Fagiuoli, Stefano, Parati, Gianfranco, Senni, Michele, Gori, M, Berzuini, C, D'Elia, E, Ghirardi, A, Bernardinelli, L, Gavazzi, A, Balestrieri, G, Giammarresi, A, Trevisan, R, Di Marco, F, Bellasi, A, Amoroso, M, Raimondi, F, Novelli, L, Magro, B, Mangia, G, Lorini, F, Guagliumi, G, Fagiuoli, S, Parati, G, Senni, M, Gori, Mauro, Berzuini, Carlo, D'Elia, Emilia, Ghirardi, Arianna, Bernardinelli, Luisa, Gavazzi, Antonello, Balestrieri, Giulio, Giammarresi, Andrea, Trevisan, Roberto, Di Marco, Fabiano, Bellasi, Antonio, Amoroso, Mariangela, Raimondi, Federico, Novelli, Luca, Magro, Bianca, Mangia, Gianpaolo, Lorini, Ferdinando L, Guagliumi, Giulio, Fagiuoli, Stefano, Parati, Gianfranco, and Senni, Michele

Abstract

Objectives:The effect of renin-angiotensin system inhibitors (RASIs) on mortality in patients with coronavirus disease (Covid-19) is debated. From a cohort of 1352 consecutive patients admitted with Covid-19 to Papa Giovanni XXIII Hospital in Bergamo, Italy, between February and April 2020, we selected and studied hypertensive patients to assess whether antecedent (prior to hospitalization) use of RASIs might affect mortality from Covid-19 according to age.Methods and results:Arterial hypertension was present in 688 patients. Overall mortality (in-hospital or shortly after discharge) was 35% (N = 240). After adjusting for 26 medical history variables via propensity score matching, antecedent use of RASIs (N = 459, 67%) was associated with a lower mortality in older hypertensive patients (age above the median of 68 years in the whole series), whereas no evidence of a significant effect was found in the younger group of the same population (P interaction = 0.001). In an analysis of the subgroup of 432 hypertensive patients older than 68 years, we considered two RASI drug subclasses, angiotensin-converting enzyme inhibitors (ACEIs, N = 156) and angiotensin receptor blockers (ARBs, N = 140), and assessed their respective effects by taking no-antecedent-use of RASIs as reference. This analysis showed that both antecedent use of ACEIs and antecedent use of ARBs were associated with a lower Covid-19 mortality (odds ratioACEI = 0.57, 95% confidence interval 0.36 - 0.91, P = 0.018) (odds ratioARB = 0.49, 95% confidence interval 0.29 - 0.82, P = 0.006).Conclusion:In the population of over-68 hypertensive Covid-19 patients, antecedent use of ACEIs or ARBs was associated with a lower all-cause mortality, whether in-hospital or shortly after discharge, compared with no-antecedent-use of RASIs.

Published
2022

9. Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author

Araki, M. Park, S.-J. Dauerman, H.L. Uemura, S. Kim, J.-S. Di Mario, C. Johnson, T.W. Guagliumi, G. Kastrati, A. Joner, M. Holm, N.R. Alfonso, F. Wijns, W. Adriaenssens, T. Nef, H. Rioufol, G. Amabile, N. Souteyrand, G. Meneveau, N. Gerbaud, E. Opolski, M.P. Gonzalo, N. Tearney, G.J. Bouma, B. Aguirre, A.D. Mintz, G.S. Stone, G.W. Bourantas, C.V. Räber, L. Gili, S. Mizuno, K. Kimura, S. Shinke, T. Hong, M.-K. Jang, Y. Cho, J.M. Yan, B.P. Porto, I. Niccoli, G. Montone, R.A. Thondapu, V. Papafaklis, M.I. Michalis, L.K. Reynolds, H. Saw, J. Libby, P. Weisz, G. Iannaccone, M. Gori, T. Toutouzas, K. Yonetsu, T. Minami, Y. Takano, M. Raffel, O.C. Kurihara, O. Soeda, T. Sugiyama, T. Kim, H.O. Lee, T. Higuma, T. Nakajima, A. Yamamoto, E. Bryniarski, K.L. Di Vito, L. Vergallo, R. Fracassi, F. Russo, M. Seegers, L.M. McNulty, I. Park, S. Feldman, M. Escaned, J. Prati, F. Arbustini, E. Pinto, F.J. Waksman, R. Garcia-Garcia, H.M. Maehara, A. Ali, Z. Finn, A.V. Virmani, R. Kini, A.S. Daemen, J. Kume, T. Hibi, K. Tanaka, A. Akasaka, T. Kubo, T. Yasuda, S. Croce, K. Granada, J.F. Lerman, A. Prasad, A. Regar, E. Saito, Y. Sankardas, M.A. Subban, V. Weissman, N.J. Chen, Y. Yu, B. Nicholls, S.J. Barlis, P. West, N.E.J. Arbab-Zadeh, A. Ye, J.C. Dijkstra, J. Lee, H. Narula, J. Crea, F. Nakamura, S. Kakuta, T. Fujimoto, J. Fuster, V. Jang, I.-K.

Subjects
genetic structures, sense organs, eye diseases
Abstract

Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application. © 2022, Springer Nature Limited.

Published
2022

10. A prospective evaluation of COVID-19 associated coagulopathy with acute coronary syndrome (ACS)

Author

Pescetelli, I, primary, Marchetti, M, additional, Gomez Rosas, P, additional, Sanga, E, additional, Russo, L, additional, Moretti, F, additional, Pellegrini, D, additional, Fiocca, L, additional, Canova, P A, additional, Vassileva, A, additional, Gamba, S, additional, Verzeroli, C, additional, Grosu, A, additional, Guagliumi, G, additional, and Falanga, A, additional

Published
2021
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11. Coronary pathology of inherited generalized arterial calcification of infancy: a case report

Author

Federici, D, Torii, S, Ciuffreda, M, Galletti, L, Lorini, F, Bonanomi, E, Gianatti, A, Iascone, M, Park, J, Guo, L, Romero, M, Kolodgie, F, Guagliumi, G, Virmani, R, Federici D, Torii S, Ciuffreda M, Galletti L, Lorini F, Bonanomi E, Gianatti A, Iascone M, Park J, Guo L, Romero ME, Kolodgie FD, Guagliumi G, Virmani R., Federici, D, Torii, S, Ciuffreda, M, Galletti, L, Lorini, F, Bonanomi, E, Gianatti, A, Iascone, M, Park, J, Guo, L, Romero, M, Kolodgie, F, Guagliumi, G, Virmani, R, Federici D, Torii S, Ciuffreda M, Galletti L, Lorini F, Bonanomi E, Gianatti A, Iascone M, Park J, Guo L, Romero ME, Kolodgie FD, Guagliumi G, and Virmani R.

Abstract

Generalized arterial calcification of infancy (GACI), or idiopathic infantile arterial calcification, is a rare autosomal-recessive disease recognized aAs an inherited disorder characterized by severe pathologic calcification of large- and medium-sized arteries accompanied by smooth muscle cell (SMC) hyperplasia leading to vascular obstruction [1]. The prognosis is extremely poor, with 85% of affected infants dying within the first 6 months of life. Loss-of-function mutations in the ectonucleotide pyrophosphatase phosphodiesterase 1 (ENPP1) gene is recognized as the main defect associated with GACI [1]. The underlying pathogenesis of osteogenic transition leading to calcification and severe stenosis in GACI, however, is poorly understood. Herein, we present a case of a GACI patient with cardiac complications who exhibited extensive vascular disease at autopsy.

Published
2018

12. Autologous blood reinfusion during iatrogenic acute hemorrhagic cardiac tamponade: Safety and feasibility in a cohort of 30 patients

Author

Fiocca, L, Cereda, A, Bernelli, C, Canova, P, Serino, F, Niglio, T, Musumeci, G, Guagliumi, G, Vassileva, A, Senni, M, Valsecchi, O, Fiocca L, Cereda AF, Bernelli C, Canova PA, Serino F, Niglio T, Musumeci G, Guagliumi G, Vassileva A, Senni M, Valsecchi O, Fiocca, L, Cereda, A, Bernelli, C, Canova, P, Serino, F, Niglio, T, Musumeci, G, Guagliumi, G, Vassileva, A, Senni, M, Valsecchi, O, Fiocca L, Cereda AF, Bernelli C, Canova PA, Serino F, Niglio T, Musumeci G, Guagliumi G, Vassileva A, Senni M, and Valsecchi O

Abstract

Background: Iatrogenic hemorrhagic pericardial tamponade (IHPT) represents a life-threating condition requiring emergency pericardiocentesis. In this clinical context, reinfusion of pericardial blood can stabilize the patient and sustain hemodynamic conditions. Aims and Methods: We reviewed all cases of IHPT occurred at our hospital over a 10 years span. In all patient autologous blood reinfusion through a femoral vein was performed. Results: In our clinical experience of 30 consecutive patients with hemorrhagic cardiac tamponade, this technique was successful to limit blood transfusions, to prevent further clinical worsening and bridge patients with intractable bleeding, to cardiac surgery. No major adverse reactions were directly related to blood autotransfusion. Conclusion: In the complex clinical scenario of acute tamponade occurring during catheter-based cardiac procedures, autotransfusion of pericardial blood through a femoral vein is safe and effective. It can be a useful trick up the sleeve of the interventional cardiologist.

Published
2018

14. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

Author

Raber, L., Mintz, G. S., Koskinas, K. C., Johnson, T. W., Holm, N. R., Onuma, Y., Radu, M. D., Joner, M., Yu, B., Jia, H., Meneveau, N., De La Torre Hernandez, J. M., Escaned, J., Hill, J., Prati, F., Colombo, A., Di Mario, C., Regar, E., Capodanno, D., Wijns, W., Byrne, R. A., Guagliumi, G., Alfonso, F., Bhindi, R., Ali, Z., Carter, R., University of Zurich, Guagliumi, Giulio, and Cardiology

Subjects
Percutaneous, medicine.medical_treatment, Psychological intervention, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Graft Occlusion, Coronary artery disease, Postoperative Complications, 0302 clinical medicine, Restenosis, Intravascular ultrasound, Percutaneous coronary intervention (PCI), 030212 general & internal medicine, Tomography, Ultrasonography, Interventional, medicine.diagnostic_test, Graft Occlusion, Vascular, Prosthesis Failure, Treatment Outcome, surgical procedures, operative, Stents, Cardiology and Cardiovascular Medicine, Tomography, Optical Coherence, medicine.medical_specialty, Consensus, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, Percutaneous Coronary Intervention, Vascular, Medical imaging, medicine, Humans, Medical physics, cardiovascular diseases, Ultrasonography, Interventional, Optical coherence tomography, business.industry, Percutaneous coronary intervention, Stent, Intracoronary imaging, equipment and supplies, medicine.disease, 10020 Clinic for Cardiac Surgery, Optical Coherence, Conventional PCI, business
Abstract

This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

Published
2018
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15. Assessing the cardiology community position on transradial intervention and the use of bivalirudin in patients with acute coronary syndrome undergoing invasive management: results of an EAPCI survey

Author

Adamo, Marianna, Byrne, Robert A., Baumbach, Andreas, Haude, Michael, Windecker, Stephan, Valgimigli, Marco, Aaroe, J., Abdeltawab, A. A., Accardi, R., Addad, F., Agostoni, P., Alajab, A., Alcázar, E., Alhabil, B., Altug Cakmak, H., Amico, F., Amoroso, G., Anderson, R., Andò, G., Andreou, A. Y., Antoniadis, D., Aquilina, M., Aramberry, L., Auer, J., Auffret, V., Ausiello, A., Austin, D., Avram, A., Ayman, E., Babunashvili, V., Bagur, R., Bakotic, Z., Balducelli, M., Ballesteros, S. M., Baptista, S., Baranauskas, A., Barbeau, G., Bax, M., Benchimol, C., Berroth, R., Biasco, L., Bilal, A., Binias, K., Blanco Mata, R., Boccuzzi, G., Bolognese, L., Boskovic, S., Bourboulis, N., Briguori, C., Bunc, M., Buysschaert, I., Calabro’, P., Campo, G., Candiello, A., Caprotta, U. F., Cardenas, M., Carrilho-Ferreira, P., Carrizo, S., Caruso, M., Cassar, A., Cernigliaro, C., Chacko, G., Chamie, D., Clapp, B., Coceani, M., Colangelo, S., Colombo, A., Comeglio, M., Connaughton, M., Conway, D., Cortese, B., Cosgrave, J., Costa, F., Couvoussis, E., Crimi, G., Crook, R., Cruz-Alvarado, J. E., Curello, S., D’Ascenzo, F., D’Urbano, M., Dana, A., De Backer, O., De Carlo, M., De Cesare, N., De Iaco, G., De La Torre, H. J. M., De Oliveira Netoj, B., Devlin, G. P., Di Lorenzo, E., Díaz, A., Dina, C., Dorsel, T. H., Eberli, F. R., Echeverría, R., Eftychiou, C., Elguindy, A., Ercilla, J., Ernst, A., Esposito, G., Ettori, F., Eufracino, Null, Ezquerra Aguilera, W., Falcone, C., Falu, R. M., Feres, F., Ferlini, M., Fernández, G., Fernández-Rodríguez, D., Fileti, L., Fischetti, D., Florescu, N., Formigli, D., Fouladvand, F., Franco, N., Fresco, C., Frigoli, E., Furmaniuk, J., Gabaldo, K., Galli, M., Galli, S., Garbo, R., Garducci, S., Garg, S., Gavrielatos, G., Gensch, J., Giacchi, G., Giunio, L., Giustino, G., Goldberg, L., Goldsmit, R., Gommeaux, A., González Godínez, H., Gosselin, G., Govorov, A., Grimfjard, P., Gross, E., Grosz, C., Guagliumi, G., Hadad, W., Hadadi, L., Hansen, P. R., Harb, S., Hatrick, R., Hayrapetyan, H. G., Hernández-Enríquez, M., Ho Heo, J., Horvath, I. G., Huan Loh, P., Ibrahim, A. M., Ierna, S., Ilic, I., Imperadore, F., Ionescu-Silva, E., Jacksch, R., James, S., Janiak, B., Jensen, S. E., Jeroen, S., Jugessur, R. K., Kala, P., Kambis, M., Kanakakis, J., Karamasis, G., Karchevsky, D., Karpovskiy, A., Kayaert, P., Kedev, S., Kemala, E., Ketteler, T., Khan, S. Q., Kharlamov, A., Kiernan, T., Kiviniem, T., Koltowski, L., Koskinas, K. C., Kouloumpinis, A., Kraaijeveld, A. O., Krizanic, F., Krötz, B., Kuczmik, W., Kukreja, N., Kuksa, D., Yav, K., Kyriakos, D., Labrunie, A., Laine, M., Lapin, O., Larosa, C., Latib, A., Lattuca, B., Lauer, B., Lefèvre, T., Legrand, V., Lehto, P., Leiva-Pons, J. L., Leone, A. M., Lev, G., Lim, R., Limbruno, U., Linares Vicente, J. A., Lindsay, S., Linnartz, C., Liso, A., Lluberas, R., Locuratolo, N., Lokshyn, S., Lunde, K., Lupi, A., Magnavacchi, P., Maia, F., Mainar, V., Mancone, M., Manolios, M. G., Mansour, S., Mariano, E., Marques, K., Martins, H., Mckenzie, D., Meco, S., Meemook, K., Mehmed, K., Melikyan, A., Mellwig, K. P., Mendiz, O. A., Merkulov, E., Mesquita, H. G., Mezzapelle, G., Miloradovic, V., Mohamed, S., Mohammed, B., Mohammed, F., Mohammed, K., Mohanad, A., Morawiec, B., More, R., Moreno-Martínez, F. L., Mrevlje, B., Muhammad, F., Näveri, H., Nazzaro, M. S., Neary, P., Negus, B. H., Nelson Durval, F. G., Nick, H., Nilva, E., Oldroyd, K. G., Olivares Asencio, C., Omerovic, E., Ortiz, M. A., Ota, H., Otasevic, P., Otieno, H. A., Paizis, I., Papp, E., Pasquetto, G., Patsourakos, N. G., Peels, J., Pelliccia, F., Pennacchi, M., Penzo, C., Perez, P., Perkan, A., Petrou, E., Phipathananunth, W., Pierri, A., Pinheiro, L. F., Pipa, J. L., Piva, T., Polad, J., Porto, I., Poveda, J., Predescu, L., Prog, R., Puri, R., Raco, D. L., Ramazan, O., Ramazzotti, V., Rao, S. V., Raungaard, B., Reczuch, K., Rekik, S., Rhouati, A., Rigattieri, S., Rodríguez-Olivares, R., Roik, M., Romagnoli, E., Román, A. J., Routledge, H., Rubartelli, P., Rubboli, A., Ruiz-García, J., Russo, F., Ruzsa, Z., Ryding, A., Saad, Aly, Sabate, M., Sabouret, P., Sadowski, M., Saia, F., Sanchez Perez, I., Santoro, G. M., Sarenac, D., Saririan, M., Sarma, J., Schuetz, T., Sciahbasi, A., Sebastian, M., Sebik, R., Sesana, M., Hur, Seung-Ho, Sganzerla, P., Shalva, R., Sharma, S., Sheiban, I., Shein, K. K., Shiekh, I. 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J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gössl, M., Götberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. 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B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodríguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schühlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Şimşek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stefanini, G., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Türkoğlu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. 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A., Almorraweh, A., Altnji, I., Alvarez Iorio, C., Anchidin, O., Angel, J., Antonopoulos, A., Apshilava, G., Arana, C., Ashikaga, T., Assomull, R., Atef, S. Z., Azmus, A. D., Azzalini, L., Azzouz, A., Baglioni, P., Bampas, G., Basil, M. P., Besh, D., Bhushan Sharm, A., Bien Hsien, H., Bihui, L., Bing-Chen, L., Biryukov, S., Blatt, A., Bocchi, E., Boghdady, A., Bonarjee, V. V. S., Bosnjak, I., Bravo Baptista, S., Brinckman, S. L., Buchter, B., Burzotta, F., Cacucci, M., Cagliyan, C. E., Cernetti, C., Chavez Mizraym, R., Choo, W. S., Choudhury, R., Cicco, N., Cisneros Clavijo, P., Citaku, H., Collet, J. P., Consuegra-Sanchez, L., Conte, M., Corral, J. M., Damonte, A., Dangoisse, V., Dastani, M., Della Rosa, F., Deora, S., Devadathan, S., Dharma, S., Di Giorgio, A., Diez, J. L., Dinesha, B., Duplancic, D., El Behwashi, M. F., Elghawaby, H., Elshahawy, O., Eskola, M. J., Etman, A., Eun Gyu, L., Fabiano, L., Facta, A., Fan, Y., Fang-Yang, H., Farag, E., Fathi, Y., Fazeli, N., Federico, P., Fereidoun, M. Z., Fernandez-Nofrerias, E., Flensted Lassen, J., Flessas, D., Fouad, H., Franco-Pelaez, J. A., Fu, Q., Furtado, R., Gadepalli, R., Gallino, R., Gasparetto, V., Gentiletti, A., Gholoobi, A., Ghosh, A. K., Gkizas, S., Golchha, S. K., Goncharov, A., Gossl, M., Gotberg, M., Greco, F., Grundeken, M. J., Gupta, D., Gupta, S., Guray, U., Hahalis, G., Hakim Vista, J., Hamid, M. A., Hammoudeh, A., Hasan, A. R. I., Hatsumura, F. E., Heintzen, M. P., Helal, T., Hetherington, S., Hewarathna, U. I., Hioki, H., Hissein, F., Ho-Ping, Y., Homs, S., Huber, K., Ibarra, F. M., Ielasi, A., Ipek, E., Jambunathan, R., Jamshidi, P., Jarrad, I., Javier, W., Jensen, J., Jimenez-Quevedo, P., Kalpak, O., Kan, J., Kanaan, T., Kao, D. H. M., Karamfiloff, K., Karegren, A., Karjalainen, P. P., Kasabov, R., Katsimagklis, G. D., Kaul, U., Khan, A., Kiemeneij, E., Kiviniemi, T., Kleiban, A., Komiyama, N., Konteva, M., Koshy, G., Krepsky, A. M., Kuljit, S., Kulkarni, P., Kumar, V., Kuznetsov, I., Lai, G., Lateef, M. A., Lawand, S., Le Hong, T., Lettieri, C., Levy, G., Lindvall, P., Maitra, A., Makowski, M., Mamas, M. A., Mandal, S. C., Mangalanandan, P., Marin, R., Mashhadi, M., Matsukage, T., Meier, B., Milosavljevic, B., Miro, S. S., Mitov, A., Moeriel, M., Moguel, R., Mohanty, A., Montalescot, G., Morsdorf, W., Moscato, F., Muniz, A., Muraglia, S., Myc, J., Nada, A., Nair, P., Namazi, M. H., Naraghipour, F., Nguyen, Q. N., Nicosia, A., Nikas, D., Ober, M., Ocaranza-Sanchez, R., Olivecrona, G., Pahlajani, D., Pandey, B. P., Parma, A., Parma, R., Patsilinakos, S. P., Pattam, J., Peddi, S., Perez, P. R., Peruga, J. Z., Pescoller, F., Petrov, I., Piatti, L., Pico-Aracil, F., Pina, J., Piroth, Z., Popa, V., Pourbehi, M. R., Pradhan, A. K., Prida, X. E., Purohit, B. V., Pyun, W. B., Quang Hung, D., Rada, I., Rafizadeh, O., Rahman, M. A., Rai, L., Ramsewak, A., Ravindran, R., Rodriguez De Leiras, O. S., Rodriguez Esteban, M., Roque Figueira, H., Saket, A., Sakhov, O., Saktheeswaran, M. K., Salachas, A., Sallam, A., Sampaolesi, A., Samy, A., Sanchis, J., Santaera, O., Santarelli, A., Santharaj, W. S., Sarango, B., Satheesh, S., Schmitz, T., Schuhlen, H., Seewoosagur, R., Segev, A., Seisembekov, V., Semitko, S., Sengottuvelu, G., Sepulveda Varela, P., Sethi, A., Sharma, A., Sharma, R. K., Shi, Hy., Simsek, M. A., Siqueira, B., Skalidis, E., Slawin, J., Sorokhtey, L., Spaulding, C., Srinivas, B., Srinivasan, M., Stakos, D., Stojkovic, S., Tacoy, G., Tawade, M., Tiecco, F., Tondi, S., Torresani, E. M., Tousek, P., Tran, T., Trantalis, G., Triantafyllou, K., Trivedi, R., Trivisonno, A., Tsui, K. L., Turkoglu, C., Tzung-Dau, W., Ueno, H., Urban, U., Uretsky, B. F., Uscumlic, A., Venugopal, V., Verney, R., Vilar, J. V., Villacorta, V. G., Vishwanath, R., Vlachojannis, G. J., Vlachojannis, M., Vlad, V., Von Birgelen, C., Vukcevic, V., Wahab, A., Waksman, R., Wei-Wen, L., Weisz, G., Whittaker, A., Yadav, A., Yokoi, Y., Zacharoulis, A., Zahran, M., Zamani, J., Ziakas, A., Zimmermann, J. P., and Cardiology

Subjects
Hirudin, Percutaneous, Antithrombin, medicine.medical_treatment, Psychological intervention, 030204 cardiovascular system & hematology, medical, 0302 clinical medicine, Peptide Fragment, Surveys and Questionnaires, Surveys and Questionnaire, Medicine, Bivalirudin, 030212 general & internal medicine, Societies, Medical, Transradial, Anticoagulant, Hirudins, Middle Aged, Recombinant Protein, Recombinant Proteins, Femoral Artery, Radial Artery, Cardiology, acute coronary syndrome, bivalirudin, transradial, adult, antithrombins, cardiology, femoral artery, hirudins, humans, middle aged, peptide fragments, percutaneous coronary intervention, recombinant proteins, societies, medical, surveys and questionnaires, attitude of health personnel, radial artery, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Human, medicine.drug, Adult, medicine.medical_specialty, Attitude of Health Personnel, medicine.drug_class, MEDLINE, Antithrombins, 03 medical and health sciences, societies, Percutaneous Coronary Intervention, Internal medicine, Humans, Acute Coronary Syndrome, Peptide Fragments, Management of acute coronary syndrome, business.industry, Percutaneous coronary intervention, medicine.disease, business
Abstract

AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) collecting the opinion of the cardiology community on the invasive management of acute coronary syndrome (ACS), before and after the MATRIX trial presentation at the American College of Cardiology (ACC) 2015 Scientific Sessions. METHODS AND RESULTS A web-based survey was distributed to all individuals registered on the EuroIntervention mailing list (n=15,200). A total of 572 and 763 physicians responded to the pre- and post-ACC survey, respectively. The radial approach emerged as the preferable access site for ACS patients undergoing invasive management with roughly every other responder interpreting the evidence for mortality benefit as definitive and calling for a guidelines upgrade to class I. The most frequently preferred anticoagulant in ACS patients remains unfractionated heparin (UFH), due to higher costs and greater perceived thrombotic risks associated with bivalirudin. However, more than a quarter of participants declared the use of bivalirudin would increase after MATRIX. CONCLUSIONS The MATRIX trial reinforced the evidence for a causal association between bleeding and mortality and triggered consensus on the superiority of the radial versus femoral approach. The belief that bivalirudin mitigates bleeding risk is common, but UFH still remains the preferred anticoagulant based on lower costs and thrombotic risks.

Published
2016
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16. Incidence, mechanisms and clinical impact of largely uncovered struts in current generation drug-eluting-stents: insight from the TRANSFORM-OCT Study

Author

Bernelli, C, primary, Pellegrini, D, additional, Pescetelli, I, additional, Garbo, R, additional, Sirbu, V, additional, Fiocca, L, additional, Canova, P, additional, Colombo, F, additional, Cereda, A, additional, Boccuzzi, G, additional, Rodriguez Pereira, G.T, additional, Bezerra, H, additional, Saia, F, additional, Capodanno, D, additional, and Guagliumi, G, additional

Published
2020
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18. Meeting Report: ESC Forum on Drug Eluting Stents European Heart House, Nice, 27–28 September 2007

Author

Daemen, Joost, Simoons, Maarten L., Wijns, William, Bagust, Adrian, Bos, Gert, Bowen, James M., Braunwald, Eugene, Camenzind, Edoardo, Chevalier, Bernard, DiMario, Carlo, Fajadet, Jean, Gitt, Anselm, Guagliumi, Giulio, Hillege, Hans L., James, Stefan, Jüni, Peter, Kastrati, Adnan, Kloth, Sabine, Kristensen, Steen D., Krucoff, Mitchell, Legrand, Victor, Pfisterer, Matthias, Rothman, Martin, Serruys, Patrick W., Silber, Sigmund, Steg, Philippe G., Tariah, Ibrahim, Wallentin, Lars, Windecker, Stephan W., Aimonetti, A., Allocco, D., Baczynska, A., Bagust, A., Berenger, M., Bos, G., Boam, A., Bowen, J.M., Braunwald, E., Calle, J.P., Camenzind, E., Campo, G., Carlier, S., Chevalier, B., Daemen, J., de Schepper, J., Di Bisceglie, G., DiMario, C., Dobbels, H., Fajadet, J., Farb, A., Ghislain, J.C., Gitt, A., Guagliumi, G., Hellbardt, S., Hillege, H.L., ten Hoedt, R., Isaia, C., James, S., de Jong, P., Jüni, P., Kastrati, A., Klasen, E., Kloth, S., Kristensen, S.D., Krucoff, M., Legrand, V., Lekehal, M., LeNarz, L., Ni Mhullain, F., Nagai, H., Patteet, A., Paunovic, D., Pfisterer, M., Potgieter, A., Purdy, I., Raveau-Landon, C., Rothman, M., Serruys, P.W., Silber, S., Simoons, M.L., Steg, P.G., Tariah, I., Ternstrom, S., Van Wuytswinkel, J., Waliszewski, M., Wallentin, L., Wijns, W., and Windecker, S.W.

Published
2009

20. Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial

Author

Thuijs, D. J. F. M., Kappetein, A. P., Serruys, P. W., Mohr, F. -W., Morice, M. -C., Mack, M. J., Holmes, D. R., Curzen, N., Davierwala, P., Noack, T., Milojevic, M., Dawkins, K. D., da Costa, B. R., Juni, P., Head, S. J., Casselman, F., de Bruyne, B., Hoj Christiansen, E., Ruiz-Nodar, J. M., Vermeersch, P., Schultz, W., Sabatelli, Mario, Guagliumi, G., Grubitzsch, H., Stangl, K., Darremont, O., Bentala, M., den Heijer, P., Preda, I., Stoler, R., Szerafin, T., Buckner, J. K., Guber, M. S., Verberkmoes, N., Akca, F., Feldman, T., Beyersdorf, F., Drieghe, B., Oldroyd, K., Berger, Gerit, Jeppsson, A., Barber, K., Wolschleger, K., Heiser, J., van der Harst, P., Mariani, M. A., Reichenspurner, H., Stark, C., Laineri Milazzo, Marco, Ho, P. C., Chen, J. C., Zelman, R., Horwitz, P. A., Bochenek, A., Krauze, A., Grothusen, C., Dudek, D., Heyrich, G., Kolh, P., Legrand, V., Coelho, P., Ensminger, S., Nasseri, B., Ingemansson, R., Olivecrona, G., Escaned, J., Guera, R., Berti, S., Chieffo, A., Burke, N., Mooney, M., Spolaor, A., Hagl, C., Nabauer, M., Suttorp, M. J., Stine, R. A., Mcgarry, T., Lucas, S., Endresen, K., Taussig, A., Accola, K., Canosi, U., Horvath, I., Cannon, L., Talbott, J. D., Akins, C. W., Kramer, R., Aschermann, M., Killinger, W., Narbute, I., Burzotta, Francesco, Bogers, A., Zijlstra, F., Eltchaninoff, H., Berland, J., Stefanini, G., Cruz Gonzalez, I., Hoppe, U., Kiesz, S., Gora, B., Ahlsson, A., Corbascio, M., Bilfinger, T., Carrie, D., Tchetche, D., Hauptman, K. -E., Stahle, E., James, S., Sandner, S., Laufer, G., Lang, I., Witkowski, A., Thourani, V., Suryapranata, H., Redwood, S., Knight, C., Maccarthy, P., de Belder, A., Banning, A., Gershlick, A., Sabate M. (ORCID:0000-0001-6635-4985), Berg G., Laine M., Burzotta F. (ORCID:0000-0002-6569-9401), Thuijs, D. J. F. M., Kappetein, A. P., Serruys, P. W., Mohr, F. -W., Morice, M. -C., Mack, M. J., Holmes, D. R., Curzen, N., Davierwala, P., Noack, T., Milojevic, M., Dawkins, K. D., da Costa, B. R., Juni, P., Head, S. J., Casselman, F., de Bruyne, B., Hoj Christiansen, E., Ruiz-Nodar, J. M., Vermeersch, P., Schultz, W., Sabatelli, Mario, Guagliumi, G., Grubitzsch, H., Stangl, K., Darremont, O., Bentala, M., den Heijer, P., Preda, I., Stoler, R., Szerafin, T., Buckner, J. K., Guber, M. S., Verberkmoes, N., Akca, F., Feldman, T., Beyersdorf, F., Drieghe, B., Oldroyd, K., Berger, Gerit, Jeppsson, A., Barber, K., Wolschleger, K., Heiser, J., van der Harst, P., Mariani, M. A., Reichenspurner, H., Stark, C., Laineri Milazzo, Marco, Ho, P. C., Chen, J. C., Zelman, R., Horwitz, P. A., Bochenek, A., Krauze, A., Grothusen, C., Dudek, D., Heyrich, G., Kolh, P., Legrand, V., Coelho, P., Ensminger, S., Nasseri, B., Ingemansson, R., Olivecrona, G., Escaned, J., Guera, R., Berti, S., Chieffo, A., Burke, N., Mooney, M., Spolaor, A., Hagl, C., Nabauer, M., Suttorp, M. J., Stine, R. A., Mcgarry, T., Lucas, S., Endresen, K., Taussig, A., Accola, K., Canosi, U., Horvath, I., Cannon, L., Talbott, J. D., Akins, C. W., Kramer, R., Aschermann, M., Killinger, W., Narbute, I., Burzotta, Francesco, Bogers, A., Zijlstra, F., Eltchaninoff, H., Berland, J., Stefanini, G., Cruz Gonzalez, I., Hoppe, U., Kiesz, S., Gora, B., Ahlsson, A., Corbascio, M., Bilfinger, T., Carrie, D., Tchetche, D., Hauptman, K. -E., Stahle, E., James, S., Sandner, S., Laufer, G., Lang, I., Witkowski, A., Thourani, V., Suryapranata, H., Redwood, S., Knight, C., Maccarthy, P., de Belder, A., Banning, A., Gershlick, A., Sabate M. (ORCID:0000-0001-6635-4985), Berg G., Laine M., and Burzotta F. (ORCID:0000-0002-6569-9401)

Abstract

Background: The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial was a non-inferiority trial that compared percutaneous coronary intervention (PCI) using first-generation paclitaxel-eluting stents with coronary artery bypass grafting (CABG) in patients with de-novo three-vessel and left main coronary artery disease, and reported results up to 5 years. We now report 10-year all-cause death results. Methods: The SYNTAX Extended Survival (SYNTAXES) study is an investigator-driven extension of follow-up of a multicentre, randomised controlled trial done in 85 hospitals across 18 North American and European countries. Patients with de-novo three-vessel and left main coronary artery disease were randomly assigned (1:1) to the PCI group or CABG group. Patients with a history of PCI or CABG, acute myocardial infarction, or an indication for concomitant cardiac surgery were excluded. The primary endpoint of the SYNTAXES study was 10-year all-cause death, which was assessed according to the intention-to-treat principle. Prespecified subgroup analyses were performed according to the presence or absence of left main coronary artery disease and diabetes, and according to coronary complexity defined by core laboratory SYNTAX score tertiles. This study is registered with ClinicalTrials.gov, NCT03417050. Findings: From March, 2005, to April, 2007, 1800 patients were randomly assigned to the PCI (n=903) or CABG (n=897) group. Vital status information at 10 years was complete for 841 (93%) patients in the PCI group and 848 (95%) patients in the CABG group. At 10 years, 244 (27%) patients had died after PCI and 211 (24%) after CABG (hazard ratio 1·17 [95% CI 0·97–1·41], p=0·092). Among patients with three-vessel disease, 151 (28%) of 546 had died after PCI versus 113 (21%) of 549 after CABG (hazard ratio 1·41 [95% CI 1·10–1·80]), and among patients with left main coronary artery disease, 93 (26%) of 357 had died after PCI versus 98 (28%) of 348 after CABG (0·90 [0·68–

Published
2019

21. Impact of bridging with perioperative low-molecular-weight heparin on cardiac and bleeding outcomes of stented patients undergoing non-cardiac surgery

Author

Capodanno, D, Musumeci, G, Lettieri, C, Limbruno, U, Senni, M, Guagliumi, G, Valsecchi, O, Angiolillo, D, Rossini, R, Capodanno D, Musumeci G, Lettieri C, Limbruno U, Senni M, Guagliumi G, Valsecchi O, Angiolillo DJ, Rossini R, Capodanno, D, Musumeci, G, Lettieri, C, Limbruno, U, Senni, M, Guagliumi, G, Valsecchi, O, Angiolillo, D, Rossini, R, Capodanno D, Musumeci G, Lettieri C, Limbruno U, Senni M, Guagliumi G, Valsecchi O, Angiolillo DJ, and Rossini R

Abstract

When patients with coronary stents undergo non-cardiac surgery, bridging therapy with low-molecular-weight heparin (LMWH) is not infrequent in clinical practice. However, the efficacy and safety of this approach is poorly understood. This was a retrospective analysis of pa­tients with coronary stent(s) on any antiplatelet therapy undergoing non-cardiac surgery between March 2003 and February 2012. The primary efficacy endpoint was the 30-day incidence of major adverse cardiac or cerebrovascular events (MACCE), defined as the composite of cardiac death, myocardial infarction, acute coronary syndrome leading to hospitalisation, or stroke. The primary safety endpoint was the 30-day composite of Bleeding Academic Research Consortium (BARC) bleedings ≥ 2. Among 515 patients qualifying for the analysis, LMWH bridging was used in 251 (49 %). At 30 days, MACCE occurred more frequently in patients who received LMWH (7.2 % vs 1.1 %, p=0.001), driven by a higher rate of myocardial infarction (4.8 % vs 0 %, p< 0.001). This finding was consistent across several instances of stat­istical adjustment and after the propensity matching of 179 pairs. Pa­tients bridged with LMWH also experienced a significantly higher risk of BARC bleedings ≥ 2 (21.9 % vs 11.7 %, p=0.002) compared to those who were not, which remained significant across different methods of statistical adjustment and propensity matching. In con­clusion, LMWH bridging in patients with coronary stents undergoing surgery is a common and possibly harmful practice, resulting in worse ischaemic outcomes at 30 days, and a significant risk of bleeding.

Published
2015

22. Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery Results of a multicentre registry

Author

Rossini, R, Musumeci, G, Capodanno, D, Lettieri, C, Limbruno, U, Tarantini, G, Russo, N, Calabria, P, Romano, M, Inashvili, A, Sirbu, V, Guagliumi, G, Valsecchi, O, Senni, M, Gavazzi, A, Angiolillo, D, Rossini R, Musumeci G, Capodanno D, Lettieri C, Limbruno U, Tarantini G, Russo N, Calabria P, Romano M, Inashvili A, Sirbu V, Guagliumi G, Valsecchi O, Senni M, Gavazzi A, Angiolillo DJ, Rossini, R, Musumeci, G, Capodanno, D, Lettieri, C, Limbruno, U, Tarantini, G, Russo, N, Calabria, P, Romano, M, Inashvili, A, Sirbu, V, Guagliumi, G, Valsecchi, O, Senni, M, Gavazzi, A, Angiolillo, D, Rossini R, Musumeci G, Capodanno D, Lettieri C, Limbruno U, Tarantini G, Russo N, Calabria P, Romano M, Inashvili A, Sirbu V, Guagliumi G, Valsecchi O, Senni M, Gavazzi A, and Angiolillo DJ

Abstract

The aim was to investigate the perioperative risk of ischaemic and bleeding events in patients with coronary stents undergoing cardiac and non-cardiac surgery and how these outcomes are affected by the perioperative use of oral antiplatelet therapy. This was a multicentre, retrospective, observational study conducted in patients with coronary stent(s) undergoing cardiac or non-cardiac surgery. The primary efficacy endpoint was the 30-day incidence of major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction (MI) or stroke. The primary safety endpoint was the 30-day incidence of Bleeding Academic Research Consortium (BARC) bleeding ≥ 2. A total of 666 patients were included. Of these, 371 (55.7 %) discontinued their antiplatelet medication(s) (all or partly) before undergoing surgery. At 30 days, patients with perioperative discontinuation of antiplatelet therapy experienced a significantly higher incidence of MACE (7.5 % vs 0.3 %, p< 0.001), cardiac death (2.7 % vs 0.3 %, p=0.027), and MI (4.0 % vs 0 %, p< 0.001). After adjustment, peri-operative antiplatelet discontinuation was the strongest independent predictor of 30-day MACE (odds ratio [OR]=25.8, confidence interval [CI]=3.37–198, p=0.002). Perioperative aspirin (adjusted OR 0.27, 95 % CI 0.11–0.71, p=0.008) was significantly associated with a lower risk of MACE. The overall incidence of BARC ≥ 2 bleeding events at 30-days was significantly higher in patients who discontinued oral antiplatelet therapy (25.6 % vs 13.9 %, p< 0.001). However, after adjustment, antiplatelet discontinuation was not independently associated with BARC ≥ 2 bleeding. In conclusion antiplatelet discontinuation increases the 30-day risk of MACE, in patients with coronary stents undergoing cardiac and non-cardiac surgery, while not offering significant protection from BARC≥ 2 bleeding.

Published
2015

23. Everolimus-eluting stents or bypass surgery for left main coronary artery disease

Author

Stone, Gw, Sabik, Jf, Serruys, Pw, Simonton, Ca, Généreux, P, Puskas, J, Kandzari, De, Morice, Mc, Lembo, N, Brown WM 3rd, Taggart, Dp, Banning, A, Merkely, B, Horkay, F, Boonstra, Pw, van Boven AJ, Ungi, I, Bogáts, G, Mansour, S, Noiseux, N, Sabaté, M, Pomar, J, Hickey, M, Gershlick, A, Buszman, P, Bochenek, A, Schampaert, E, Pagé, P, Dressler, O, Kosmidou, I, Mehran, R, Pocock, Sj, Kappetein, Ap, van Es GA, Leon, Mb, Gersh, B, Chaturvedi, S, Kint, Pp, Valgimigli, M, Colombo, A, Costa, M, Di Mario, C, Ellis, S, Fajadet, J, Fearon, W, Kereiakes, D, Makkar, R, Mintz, Gs, Moses, Jw, Teirstein, P, Ruel, M, Sergeant, P, Mack, M, Fontana, G, Mohr, Fw, Nataf, P, Smith, C, Boden, B, Fox, K, Maron, D, Steg, G, Blackstone, E, Juni, P, Parise, H, Wallentin, L, Bertrand, M, Krucoff, M, Turina, M, Ståhle, E, Tijssen, J, Brill, D, Atkins, C, Applegate, B, Argenziano, M, Faly, Rc, Dauerman, H, Davidson, C, Griffith, B, Reisman, M, Rizik, D, Sakwa, M, Shemin, R, Romano, M, Hamm, C, Gummert, J, Tamburino, C, Alfieri, O, Savina, C, de Bruyne, B, Machado, Fp, Uva, S, Moccetti, T, Siclari, F, Hildick Smith, D, Szekely, L, Erglis, A, Stradins, P, Abizaid, A, Bento Sousa LC, Belardi, J, Navia, D, Park, Sj, Lee, Jw, Meredith, I, Smith, J, Yehuda, Ob, Schneijdenberg, R, Ronden, J, Jonk, J, Jonkman, A, van Remortel, E, de Zwart, I, Elshout, L, de Vries, T, Andreae, R, Tol van, J, Teurlings, E, Balachandran, S, Breazna, A, Jenkins, P, Mcandrew, T, Marx, So, Connolly, Mw, Hong, Mk, Weinberger, J, Wong, Sc, Dizon, J, Biviano, A, Morrow, J, Wang, D, Corral, M, Alfonso, M, Sanchez, R, Wright, D, Djurkovic, C, Lustre, M, Jankovic, I, Sanidas, E, Lasalle, L, Maehara, A, Matsumura, M, Sun, E, Iacono, S, Greenberg, T, Jacobson, J, Pullano, A, Gacki, M, Liu, S, Cohen, Dj, Magnuson, E, Baron, Sj, Wang, K, Traylor, K, Worthley, S, Stuklis, R, Barbato, E, Stockman, B, Dubois, C, Meuris, B, Vrolix, M, Dion, R, Bento de Souza LC, Costantini, C, Woitowicz, V, Hueb, W, Stolf, N, Beydoun, H, Baskett, R, Curtis, M, Kieser, T, Doucet, S, Pellerin, M, Hamburger, J, Cook, R, Kutryk, M, Peterson, M, Madan, M, Fremes, S, Mehta, S, Cybulsky, I, Prabhakar, M, Peniston, C, Welsh, R, Macarthur, R, Berland, J, Bessou, Jp, Carrié, D, Glock, Y, Darremont, O, Deville, C, Grimaud, Jp, Soula, P, Lefèvre, T, Maupas, E, Durrleman, N, Silvestri, M, Houel, R, Pratt, A, Francis, J, Van Belle, E, Vicentelli, A, Luchner, A, Hilker, M, Endemann, Dh, Felix, S, Wollert, Hg, Walther, T, Erbel, R, Jacob, H, Kahlert, P, Kupatt, C, Näbauer, M, Schmitz, C, Scholtz, W, Börgermann, J, Schuler, G, Borger, M, Davierwala, P, Fontos, G, Székely, L, Bedogni, F, Panisi, P, Berti, S, Glauber, M, Marzocchi, A, Di Bartolomeo, R, Merlo, M, Guagliumi, G, Fenili, F, Napodano, M, Gerosa, G, Ribichini, F, Faggian, Giuseppe, Saccà, S, Giacomin, A, Mignosa, C, Tumscitz, C, Savini, C, Van Mieghem, N, von Birgelen, C, Grandjean, J, Kubica, J, Anisimowicz, L, Zmudka, K, Sadowski, J, Hernández García, J, Such, M, Macaya, C, Rodríguez Hernández JE, Maroto, L, Serra, A, Padro, J, Tenas, Ms, De Souza, A, Egred, M, Clark, S, Trivedi, U, Jain, A, Uppal, R, Redwood, S, Young, C, Stables, Rh, Pullan, M, Uren, N, Pessotto, R, Abu Fadel, M, Peyton, M, Allaqaband, S, O’Hair, D, Bachinsky, W, Mumtaz, M, Blankenship, J, Casale, A, Brott, B, Davies, J, Brown, D, Cannon, L, Talbott, J, Chang, G, Macheers, S, Choi, J, Henry, C, Cutlip, D, Khabbaz, K, Das, G, Liao, K, Diver, D, Thayer, J, Dobies, D, Fliegner, K, Fischbein, M, Feldman, T, Pearson, P, Foster, M, Briggs, R, Giugliano, G, Engelman, D, Gordon, P, Ehsan, A, Grantham, J, Allen, K, Grodin, J, Jessen, M, Gruberg, L, Taylor JR Jr, Gupta, S, Hermiller J., Jr, Heimansohn, D, Iwaoka, R, Chan, B, Kander, Nh, Duff, S, Brown, W, Karmpaliotis, D, Kini, A, Filsoufi, F, Kong, D, Lin, S, Kutcher, M, Kincaid, E, Leya, F, Bakhos, M, Liberman, H, Halkos, M, Lips, D, Eales, F, Mahoney, P, Rich, J, Barreiro, C, Cheng, W, Metzger, C, Greenfield, T, Moses, J, Palacios, I, Macgillivray, T, Perin, E, Del Prete, J, Pompili, V, Kilic, A, Ragosta, M, Kron, I, Rashid, J, Mueller, D, Riley, R, Reimers, C, Patel, N, Resar, J, Shah, A, Schneider, J, Landvater, L, Reardon, M, Shavelle, D, Baker, C, Singh, J, Maniar, H, Wei, L, Strain, J, Zapolanski, A, Taheri, H, Ad, N, Tannenbaum, M, Prabhakar, G, Waksman, R, Corso, P, Wang, J, Fiocco, M, Wilson, Bh, Steigel, Rm, Chadwick, S, Zidar, F, Oswalt, J., Stone, Gregg W., Sabik, Joseph F., Serruys, Patrick W., Simonton, Charles A., Généreux, Philippe, Puskas, John, Kandzari, David E., Morice, Marie Claude, Lembo, Nichola, Brown, W. Morri, Taggart, David P., Banning, Adrian, Merkely, Béla, Horkay, Ferenc, Boonstra, Piet W., Van Boven, Ad J., Ungi, Imre, Bogáts, Gabor, Mansour, Samer, Noiseux, Nicola, Sabaté, Manel, Pomar, José, Hickey, Mark, Gershlick, Anthony, Buszman, Pawel, Bochenek, Andrzej, Schampaert, Erick, Pagé, Pierre, Dressler, Ovidiu, Kosmidou, Ioanna, Mehran, Roxana, Pocock, Stuart J., Kappetein, A. Pieter, for the EXCEL Trial Investigators:, [. . ., Antonio, Marzocchi, DI BARTOLOMEO, Roberto, ], . ., and Cardiothoracic Surgery

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Clinical endpoint, Drug-Eluting Stent, Humans, Everolimus, 030212 general & internal medicine, cardiovascular diseases, Coronary Artery Bypass, Aged, Female, Middle Aged, Drug-Eluting Stents, business.industry, Coronary Artery Bypa, Medicine (all), Percutaneous coronary intervention, General Medicine, medicine.disease, Surgery, Cardiac surgery, Everolimu, surgical procedures, operative, Bypass surgery, Conventional PCI, Cardiology, business, medicine.drug, Human
Abstract

BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients). Anatomic complexity was assessed at the sites and defined by a Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score of 32 or lower (the SYNTAX score reflects a comprehensive angiographic assessment of the coronary vasculature, with 0 as the lowest score and higher scores [no upper limit] indicating more complex coronary anatomy). The primary end point was the rate of a composite of death from any cause, stroke, or myocardial infarction at 3 years, and the trial was powered for noninferiority testing of the primary end point (noninferiority margin, 4.2 percentage points). Major secondary end points included the rate of a composite of death from any cause, stroke, or myocardial infarction at 30 days and the rate of a composite of death, stroke, myocardial infarction, or ischemia-driven revascularization at 3 years. Event rates were based on Kaplan-Meier estimates in time-to-first-event analyses. RESULTS: At 3 years, a primary end-point event had occurred in 15.4% of the patients in the PCI group and in 14.7% of the patients in the CABG group (difference, 0.7 percentage points; upper 97.5% confidence limit, 4.0 percentage points; P=0.02 for noninferiority; hazard ratio, 1.00; 95% confidence interval, 0.79 to 1.26; P=0.98 for superiority). The secondary end-point event of death, stroke, or myocardial infarction at 30 days occurred in 4.9% of the patients in the PCI group and in 7.9% in the CABG group (P

Published
2017
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24. Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview

Author

Tenekecioglu, E., Albuquerque, F.N., Sotomi, Y., Zeng, Y.P., Suwannasom, P., Tateishi, H., Cavalcante, R., Ishibashi, Y., Nakatani, S., Abdelghani, M., Dijkstra, J., Bourantas, C., Collet, C., Karanasos, A., Radu, M., Wang, A., Muramatsu, T., Landmesser, U., Okamura, T., Regar, E., Raber, L., Guagliumi, G., Pyo, R.T., Onuma, Y., Serruys, P.W., Cardiology, Amsterdam Cardiovascular Sciences, Other departments, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, University of Zurich, and Serruys, Patrick W

Subjects
ATH, Reproducibility of Results, 610 Medicine & health, PCI, Coronary Artery Disease, Atherosclerosis, Coronary Vessels, 2705 Cardiology and Cardiovascular Medicine, Plaque, Atherosclerotic, 10020 Clinic for Cardiac Surgery, Imaging, PCI - Percutaneous Coronary Intervention (PCI), ATH - Atherosclerosis, Percutaneous Coronary Intervention, Surgery, Computer-Assisted, IOCT, IOCT - Imaging, 2741 Radiology, Nuclear Medicine and Imaging, Humans, Optical Coherence Tomography, Tomography, Optical Coherence, Percutaneous Coronary Intervention (PCI)
Abstract

By providing valuable information about the coronary artery wall and lumen, intravascular imaging may aid in optimizing interventional procedure results and thereby could improve clinical outcomes following percutaneous coronary intervention (PCI). Intravascular optical coherence tomography (OCT) is a light-based technology with a tissue penetration of approximately 1 to 3 mm and provides near histological resolution. It has emerged as a technological breakthrough in intravascular imaging with multiple clinical and research applications. OCT provides detailed visualization of the vessel following PCI and provides accurate assessment of post-procedural stent performance including detection of edge dissection, stent struts apposition, tissue prolapse, and healing parameters. Additionally, it can provide accurate characterization of plaque morphology and provides key information to optimize post-procedural outcomes. This manuscript aims to review the current clinical and research applications of intracoronary OCT and summarize the analytic OCT imaging software packages currently available. © 2017 Wiley Periodicals, Inc.

Published
2017

29. Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies

Author

Rossini, R, Musumeci, G, Visconti, L, Bramucci, E, Castiglioni, B, De Servi, S, Lettieri, C, Lettino, M, Lorini, F, Antonelli, M, Bovenzi, F, Cremonesi, A, Angiolillo, D, Guagliumi, G, Rossini R, Musumeci G, Visconti LO, Bramucci E, Castiglioni B, De Servi S, Lettieri C, Lettino M, Lorini F, Antonelli M, Bovenzi F, Cremonesi A, Angiolillo DJ, Guagliumi G, Rossini, R, Musumeci, G, Visconti, L, Bramucci, E, Castiglioni, B, De Servi, S, Lettieri, C, Lettino, M, Lorini, F, Antonelli, M, Bovenzi, F, Cremonesi, A, Angiolillo, D, Guagliumi, G, Rossini R, Musumeci G, Visconti LO, Bramucci E, Castiglioni B, De Servi S, Lettieri C, Lettino M, Lorini F, Antonelli M, Bovenzi F, Cremonesi A, Angiolillo DJ, and Guagliumi G

Abstract

Optimal perioperative antiplatelet therapy in patients with coronary stents undergoing surgery still remains poorly defined and a matter of debate among cardiologists, surgeons and anaesthesiologists. Surgery represents one of the most common reasons for premature antiplatelet therapy discontinuation, which is associated with a significant increase in mortality and major adverse cardiac events, in particular stent thrombosis. Clinical practice guidelines provide little support with regard to managing antiplatelet therapy in the perioperative phase in the case of patients with non-deferrable surgical interventions and/or high haemorrhagic risk. Moreover, a standard definition of ischaemic and haemorrhagic risk has never been determined. Finally, recommendations shared by cardiologists, surgeons and anaesthesiologists are lacking. The present consensus document provides practical recommendations on the perioperative management of antiplatelet therapy in patients with coronary stents undergoing surgery. Cardiologists, surgeons and anaesthesiologists have contributed equally to its creation. On the basis of clinical and angiographic data, the individual thrombotic risk has been defined. All surgical interventions have been classified according to their inherent haemorrhagic risk. A consensus on the optimal antiplatelet regimen in the perioperative phase has been reached on the basis of the ischaemic and haemorrhagic risk. Aspirin should be continued perioperatively in the majority of surgical operations, whereas dual antiplatelet therapy should not be withdrawn for surgery in the case of low bleeding risk. In selected patients at high risk for both bleeding and ischaemic events, when oral antiplatelet therapy withdrawal is required, perioperative treatment with short-acting intravenous glycoprotein IIb/IIIa inhibitors (tirofiban or eptifibatide) should be taken into consideration.

Published
2014

30. Meeting Report: ESC Forum on Drug Eluting Stents European Heart House, Nice, 27-28 September 2007

Author

Daemen, Joost, Simoons, Maarten L., Wijns, William, Bagust, Adrian, Bos, Gert, Bowen, James M., Braunwald, Eugene, Camenzind, Edoardo, Chevalier, Bernard, DiMario, Carlo, Fajadet, Jean, Gitt, Anselm, Guagliumi, Giulio, Hillege, Hans L., James, Stefan, Jüni, Peter, Kastrati, Adnan, Kloth, Sabine, Kristensen, Steen D., Krucoff, Mitchell, Legrand, Victor, Pfisterer, Matthias, Rothman, Martin, Serruys, Patrick W., Silber, Sigmund, Steg, Philippe G., Tariah, Ibrahim, Wallentin, Lars, Windecker, Stephan W., Aimonetti, A., Allocco, D., Baczynska, A., Bagust, A., Berenger, M., Bos, G., Boam, A., Bowen, J.M., Braunwald, E., Calle, J.P., Camenzind, E., Campo, G., Carlier, S., Chevalier, B., Daemen, J., de Schepper, J., Di Bisceglie, G., DiMario, C., Dobbels, H., Fajadet, J., Farb, A., Ghislain, J.C., Gitt, A., Guagliumi, G., Hellbardt, S., Hillege, H.L., ten Hoedt, R., Isaia, C., James, S., de Jong, P., Jüni, P., Kastrati, A., Klasen, E., Kloth, S., Kristensen, S.D., Krucoff, M., Legrand, V., Lekehal, M., LeNarz, L., Ni Mhullain, F., Nagai, H., Patteet, A., Paunovic, D., Pfisterer, M., Potgieter, A., Purdy, I., Raveau-Landon, C., Rothman, M., Serruys, P.W., Silber, S., Simoons, M.L., Steg, P.G., Tariah, I., Ternstrom, S., Van Wuytswinkel, J., Waliszewski, M., Wallentin, L., Wijns, W., Windecker, S.W., Daemen, Joost, Simoons, Maarten L., Wijns, William, Bagust, Adrian, Bos, Gert, Bowen, James M., Braunwald, Eugene, Camenzind, Edoardo, Chevalier, Bernard, DiMario, Carlo, Fajadet, Jean, Gitt, Anselm, Guagliumi, Giulio, Hillege, Hans L., James, Stefan, Jüni, Peter, Kastrati, Adnan, Kloth, Sabine, Kristensen, Steen D., Krucoff, Mitchell, Legrand, Victor, Pfisterer, Matthias, Rothman, Martin, Serruys, Patrick W., Silber, Sigmund, Steg, Philippe G., Tariah, Ibrahim, Wallentin, Lars, Windecker, Stephan W., Aimonetti, A., Allocco, D., Baczynska, A., Bagust, A., Berenger, M., Bos, G., Boam, A., Bowen, J.M., Braunwald, E., Calle, J.P., Camenzind, E., Campo, G., Carlier, S., Chevalier, B., Daemen, J., de Schepper, J., Di Bisceglie, G., DiMario, C., Dobbels, H., Fajadet, J., Farb, A., Ghislain, J.C., Gitt, A., Guagliumi, G., Hellbardt, S., Hillege, H.L., ten Hoedt, R., Isaia, C., James, S., de Jong, P., Jüni, P., Kastrati, A., Klasen, E., Kloth, S., Kristensen, S.D., Krucoff, M., Legrand, V., Lekehal, M., LeNarz, L., Ni Mhullain, F., Nagai, H., Patteet, A., Paunovic, D., Pfisterer, M., Potgieter, A., Purdy, I., Raveau-Landon, C., Rothman, M., Serruys, P.W., Silber, S., Simoons, M.L., Steg, P.G., Tariah, I., Ternstrom, S., Van Wuytswinkel, J., Waliszewski, M., Wallentin, L., Wijns, W., and Windecker, S.W.

Published
2017

31. Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study

Author

Teo, Jing Chun, Foin, Nicolas, Otsuka, Fumiyuki, Bulluck, Heerajnarain, Fam, Jiang Ming, Wong, Philip, Low, Fatt Hoe, Leo, Hwa Liang, Mari, Jean-Martial, Joner, Michael, Girard, Michael J A, Virmani, Renu, Bezerra, HG., Costa, MA., Guagliumi, G., Rollins, AM., Simon, D., Gutiérrez-Chico, JL., Alegría-Barrero, E., Teijeiro-Mestre, R., Chan, PH., Tsujioka, H., de Silva, R., Otsuka, F., Joner, M., Prati, F., Virmani, R., Narula, J., Members, WC., Levine, GN., Bates, ER., Blankenship, JC., Bailey, SR., Bittl, JA., Mintz, G.S., Costa, Marco, Regar, E., Akasaka, T., Roleder, T., Jąkała, J., Kałuża, GL., Partyka, Ł., Proniewska, K., Pociask, E., Girard, MJA., Strouthidis, NG., Ethier, CR., Mari, JM., Park, SC., van der Lee, R., Foin, N., Wong, P.K., Mari, J-M., Nakano, M., Vorpahl, M., Taniwaki, M., Yazdani, SK., Finn, AV., Yahagi, K., Yamamoto, H., Ladich, ER., Girard, MJ., Ang, M., Chung, CW., Farook, M., Strouthidis, N., Mehta, JS., Nijjer, S., Sen, S., Petraco, R., Ghione, M., Liu, X., Kang, JU., Kolodgie, F.D., Burke, AP., Farb, A., Schwartz, S.M., Davis, HR., Kume, T., Kawamoto, T., Watanabe, N., Toyota, E., Neishi, Y., Rieber, J., Meissner, O., Babaryka, G., Reim, S., Oswald, M.E., Koenig, A.S., Tearney, G. J., Adriaenssens, T., Barlis, P., Yabushita, H., Bouma, BE., Houser, S. L., Aretz, HT., Jang, I-K., Schlendorf, KH., Guo, J., Sun, L., Chen, Y.D., Tian, F., Liu, HB., Chen, L., Kawasaki, M., Bressner, J. E., Nadkarni, S. K., MacNeill, BD., Jansen, CHP., Onthank, DC., Cuello, F., Botnar, RM., Wiethoff, AJ., Warley, A., von Birgelen, C., Hartmann, A. M., Kubo, T., Shite, J., Suzuki, T., Uemura, S., Yu, B., Habara, M., Nasu, K., Terashima, M., Kaneda, H., Yokota, D., Ko, E., Takarada, S., Imanishi, T., Tanimoto, T., Kitabata, H., Nakamura, N., Hattori, K., Ozaki, Y., Ismail, TF., Okumura, M., Naruse, H., Kan, S., Nishio, R., Shinke, T., Otake, H., Nakagawa, M., Nagoshi, R., Inoue, T., Sinclair, H.D., Bourantas, C., Bagnall, A., Kunadian, V., van Soest, G., Goderie, T., Koljenović, S., Leenders, GL. van, Gonzalo, N., Xu, C., Schmitt, JM., Carlier, SG., van der Meer, FJ, Faber, D.J., Sassoon, DMB., Aalders, M.C., Pasterkamp, G., Leeuwen, TG. van, Knuttel, A., Yadlowsky, M., Eckhaus, MA., Karamata, B., Laubscher, M., Leutenegger, M., Bourquin, S., Lasser, T., Lambelet, P., Vermeer, K.A., Mo, J., Weda, J.J.A., Lemij, H.G., Boer, JF. de, Biophotonics and Medical Imaging, LaserLaB - Biophotonics and Microscopy, Application des ultrasons à la thérapie (LabTAU), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM), Géopôle du Pacifique Sud (GePaSUD), Université de la Polynésie Française (UPF), Department of Urology Université de Montréal, and National University of Singapore (NUS)

Subjects
Male, STATIN THERAPY, genetic structures, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Coronary Artery Disease, 030204 cardiovascular system & hematology, medicine.disease_cause, Severity of Illness Index, 01 natural sciences, Cohort Studies, 0302 clinical medicine, Cause of Death, Intravascular ultrasound, Image Processing, Computer-Assisted, Contrast (vision), Prospective Studies, media_common, medicine.diagnostic_test, General Medicine, Middle Aged, INTEGRATED BACKSCATTER-IVUS, Female, Tomography, Radiology, Cardiology and Cardiovascular Medicine, Tomography, Optical Coherence, medicine.medical_specialty, IMAGES, media_common.quotation_subject, Image processing, Risk Assessment, Sensitivity and Specificity, CLASSIFICATION, 010309 optics, 03 medical and health sciences, ENHANCEMENT, VULNERABLE PLAQUE, Optical coherence tomography, SDG 3 - Good Health and Well-being, 0103 physical sciences, INTRAVASCULAR ULTRASOUND, medicine, Humans, DIAGNOSTIC-ACCURACY, Radiology, Nuclear Medicine and imaging, ADAPTIVE COMPENSATION, Ultrasonography, Interventional, Aged, business.industry, Attenuation, Survival Analysis, Vulnerable plaque, OCT, Nuclear medicine, business, Kappa
Abstract

International audience; Aim To optimize conventional coronary optical coherence tomography (OCT) images using the attenuation-compensated technique to improve identification of plaques and the external elastic lamina (EEL) contourMethods and results The attenuation-compensated technique was optimized via manipulating contrast exponent C, and compression exponent N, to achieve an optimal contrast and signal-to-noise ratio (SNR). This was applied to 60 human coronary lesions (38 native and 22 stented) ex vivo conventional coronary OCT images acquired from heart autopsies of 10 patients and matching histology was available as reference. Three independent reviewers assessed the conventional and attenuation-compensated OCT images blindly for plaque characteristics and EEL detection. Conventional OCT and compensated OCT assessment were compared against histology. Using an optimized algorithm, the attenuation-compensated OCT images had a 2-fold improvement in contrast between different tissues in both stented and non-stented epicardial coronaries (P < 0.05). Overall sensitivity and specificity for plaque classification increased from 84 to 89% and from 92 to 94%, respectively, with substantial agreement among the three reviewers (Fleiss' Kappa k, 0.72 and 0.71, respectively). Furthermore, operators were 2.5 times more likely to identify the EEL contour in the attenuation-compensated OCT images (k = 0.72) than in the conventional OCT images (k = 0.36)Conclusion The attenuation-compensated technique can be retrospectively applied to conventional OCT images and improves the detection of plaque characteristics and the EEL contour. This approach could complement conventional OCT imaging in the evaluation of plaque characteristics and quantify plaque burden in the clinical setting.

Published
2016
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35. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

Author

Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, de Silva R, Dijkstra J, Di Mario C, Dudek D, Falk E, Feldman MD, Fitzgerald P, Garcia Garcia HM, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CC, Lamouche G, Lee DP, Leon MB, Maehara A, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, Pietrasik A, Prati F, Räber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PW, Shimada K, Shinke T, Shite J, Siegel E, Sonoda S, Suter M, Takarada S, Tanaka A, Terashima M, Thim T, Uemura S, Ughi GJ, van Beusekom HM, van der Steen AF, van Es GA, van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G, International Working Group for Intravascular Optical Coherence Tomography, MANFRINI, OLIVIA, Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, de Silva R, Dijkstra J, Di Mario C, Dudek D, Falk E, Feldman MD, Fitzgerald P, Garcia-Garcia HM, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CC, Lamouche G, Lee DP, Leon MB, Maehara A, Manfrini O, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, Pietrasik A, Prati F, Räber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PW, Shimada K, Shinke T, Shite J, Siegel E, Sonoda S, Suter M, Takarada S, Tanaka A, Terashima M, Thim T, Uemura S, Ughi GJ, van Beusekom HM, van der Steen AF, van Es GA, van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G, and International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT)

Subjects
optical coherence tomography
Abstract

OBJECTIVES:The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. BACKGROUND: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ~10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. METHODS: The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. RESULTS: Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. CONCLUSIONS: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data.

Published
2012

36. Comparative analysis method of permanent metallic stents (XIENCE) and bioresorbable poly-L-lactic (PLLA) scaffolds (Absorb) on optical coherence tomography at baseline and follow-up

Author

Nakatani, T. (Tomoya), Sotomi, Y. (Yohei), Ishibashi, Y. (Yuki), Grundeken, M.J. (Maik), Tateishi, H. (Hiroki), Tenekecioglu, E. (Erhan), Zeng, Y. (Yaping), Suwannasom, P. (Pannipa), Regar, E.S. (Eveline), Radu, M. (Maria), Räber, L. (Lorenz), Bezerra, H.G. (Hiram), Costa, M.A. (Marco), Fitzgerald, P. (Peter), Prati, F. (Francesco), Costa, R.A. (Ricardo), Dijkstra, J. (Jouke), Kimura, T. (Takeshi), Kozuma, K. (Ken), Tanabe, K. (Kengo), Akasaka, T. (Takashi), Mario, C. (Carlo) di, Serruys, P.W.J.C. (Patrick), Onuma, Y. (Yoshinobu), Guagliumi, G. (Giulio), Nakatani, T. (Tomoya), Sotomi, Y. (Yohei), Ishibashi, Y. (Yuki), Grundeken, M.J. (Maik), Tateishi, H. (Hiroki), Tenekecioglu, E. (Erhan), Zeng, Y. (Yaping), Suwannasom, P. (Pannipa), Regar, E.S. (Eveline), Radu, M. (Maria), Räber, L. (Lorenz), Bezerra, H.G. (Hiram), Costa, M.A. (Marco), Fitzgerald, P. (Peter), Prati, F. (Francesco), Costa, R.A. (Ricardo), Dijkstra, J. (Jouke), Kimura, T. (Takeshi), Kozuma, K. (Ken), Tanabe, K. (Kengo), Akasaka, T. (Takashi), Mario, C. (Carlo) di, Serruys, P.W.J.C. (Patrick), Onuma, Y. (Yoshinobu), and Guagliumi, G. (Giulio)

Abstract

Aims: Fully bioresorbable Absorb poly-L-lactic-acid (PLLA) scaffolds (Abbott Vascular, Santa Clara, CA, USA) are a novel approach for the treatment of coronary narrowing. Due to the translucency of the material (PLLA), the optical coherence tomography (OCT) measurement methods used in the ABSORB trials were unique but not applicable for permanent metallic stents. When the Absorb scaffold and metallic stents are compared in the context of randomised trials, it is challenging to compare the two devices using the conventional methods. The primary purpose of this report is to explain the biases in conventional methodologies applied for metallic stents and for PLLA scaffolds at baseline and follow-up, and to propose a new standard methodology that enables us to compare two different devices using an almost identical and methodological language. Methods and results: A consensus amongst multiple core labs and expert researchers of OCT was reached on a new standard OCT measurement methodology that enables us to compare these two different devices. In brief, the proposed OCT methods are summarised as follows. 1) Both endoluminal and abluminal scaffold/stent contours should be traced. 2) Consistently, endoluminal and abluminal incomplete stent apposition areas should be measured. 3) The area occupied by scaffold/stent struts should be quantified directly or virtually. 4) The strut area should be systematically excluded from the flow area as well as the neointimal area. 5) Additional information on the degree of embedment could be reported using the interpolated lumen contour. Interobserver variability of the proposed method was excellent (intraclass correlation 0.89-100). Conclusions: A standardised OCT measurement methodology is proposed. This should be implemented in ongoing and future trials comparing the Absorb scaffolds and metallic stents.

Published
2016
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37. Impact of culprit plaque and atherothrombotic components on incomplete stent apposition in patients with ST-elevation myocardial infarction treated with Everolimus-eluting stents-an OCTAVIA Substudy

Author

Bernelli, C., Shimamura, K., Komukai, K., Capodanno, D., Saia, F., Garbo, R., Burzotta, F., Sirbu, V., Coccato, M., Campo, G., Vignali, L., Yamamoto, H., Niccoli, G., Ladich, E., Biondi-Zoccai, G., Guagliumi, G., Burzotta F. (ORCID:0000-0002-6569-9401), Campo G., Niccoli G. (ORCID:0000-0002-3187-6262), Bernelli, C., Shimamura, K., Komukai, K., Capodanno, D., Saia, F., Garbo, R., Burzotta, F., Sirbu, V., Coccato, M., Campo, G., Vignali, L., Yamamoto, H., Niccoli, G., Ladich, E., Biondi-Zoccai, G., Guagliumi, G., Burzotta F. (ORCID:0000-0002-6569-9401), Campo G., and Niccoli G. (ORCID:0000-0002-3187-6262)

Abstract

Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarctrelated artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm2. The presence of thrombus before stent implantation (odds ratio (OR) 5.5, 95% confidence interval (CI) [1.1–26.9], P=0.04) and the lipid content in the target segment (OR 1.3, 95% CI [1.0–1.5], P=0.04) independently predicted acute ISA. At 9-month follow-up, ISA persisted in 46 lesions (56.1%). The volume of acute ISA significantly predicted persistent ISA (OR 1.3, 95% CI [1.1–1.5], P=0.01). Late-acquired ISA occurred in 39 lesions (34.2%) with a median area of 0.3 mm2. Red/mixed thrombus before stent implantation (OR 3.7, 95% CI [1.0–13.3], P=0.05) and length of the underlying ruptured plaque (OR 1.7, 95% CI [1.1–2.8] P=0.02) were independently associated with late-acquired ISA. Conclusions: In STEMI patients, culprit plaque and atherothrombotic components of the infarct-related artery significantly contribute to the onset of acute and late ISA. ISA persistence at follow-up depends on the initial volume of acute ISA.

Published
2016

38. Mechanism of luminal patency of the self-expanding sideguard sidebranch stent: Evaluation by intravascular ultrasound and optical coherence tomography

Author

Ma, S.X., Maehara, A., Hauptmann, K.E., Guagliumi, G., Valsecchi, O., Vassileva, A.N., Appelman, Y.E.A., Sangiorgi, G., Prati, F., Mintz, G.S., Cardiology, and ICaR - Ischemia and repair

Subjects
optical coherence tomography, bifurcation, stent, intravascular ultrasound, Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Published
2014
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39. Risks Related To Fluoroscopy Radiation Associated With Electrophysiology Procedures

Author

Picano, E., Piccaluga, E., Padovani, R., Traino, C. A., Maria Grazia Andreassi, and Guagliumi, G.

Subjects
Featured Review
Abstract

The benefits of cardiac imaging are immense, and modern cardiac electrophysiology (EP) requires the extensive and versatile use of a variety of cardiac imaging and radiology-based techniques. In the cardiac electrophysiology lab, doses can range around a reference effective dose (ED) of 15 milliSievert corresponding to 750 chest x-rays for a cardiac radiofrequency ablation, ranging from less than 2 to60 mSv. The reference dose for a regular pacemaker or ICD implant is 4 mSv (range 1.4-17) and for a CRT implant is 22 mSv (range 2.2-95). Doses on the order of magnitude of 10-100 milliSievert (mSv) correspond to a low (albeit definite, not negligible) additional lifetime risk of fatal and non-fatal cancer from between 1 in 1000 (10 mSv) to 1 in 100 (100 mSv). The increasing use and complexity of cardiac electrophysiology techniques have not been matched by increasing awareness and knowledge by prescribers and practitioners. The protection of doctors is just as important as protection of patients. Most experienced (and most exposed) interventional cardiologists and electrophysiologists have an exposure per annum of around 5 mSv, two to three times higher than diagnostic radiologists, with a typical cumulative lifetime attributable risk on the order of magnitude of 1 cancer (fatal and non-fatal) per 100 exposed subjects. Operator dose per procedure correlates somewhat with the patient dose, but may be typically 1000 times lower depending upon the shielding employed (one unit of incidence scatter dose for the operator when 1000 units of incident dose are given to the patient). However, adequate radiation protection training and diligent protection can reduce this radiation exposure by 90%. The priority given to radioprotection in every cardiology department is an effective strategy for primary prevention of cancer, a strong indicator of the quality of the cardiology division, and the most effective shielding for enhancing the safety of patients, doctors, and staff.

Published
2014

40. Mechanisms of atherothrombosis and vascular response to primary percutaneous coronary intervention in women versus men with acute myocardial infarction: results of the OCTAVIA study

Author

Guagliumi, G, Capodanno, D, Saia, F, Musumeci, G, Tarantini, Giuseppe, Garbo, R, Tumminello, G, Sirbu, V, Coccato, M, Fineschi, M, Trani, C, De Benedictis, M, Limbruno, U, De Luca, L, Niccoli, G, Bezerra, H, Ladich, E, Costa, M, Biondi Zoccai, G, Virmani, R, and OCTAVIA Trial Investigators

Subjects
Male, Time Factors, Myocardial Infarction, Coronary Artery Disease, Coronary Angiography, Coronary Restenosis, Percutaneous Coronary Intervention, Sex Factors, Risk Factors, Neointima, Odds Ratio, Humans, Everolimus, Prospective Studies, Aged, Aged, 80 and over, Sirolimus, Wound Healing, Chi-Square Distribution, Rupture, Spontaneous, Coronary Thrombosis, Cardiovascular Agents, Drug-Eluting Stents, Health Status Disparities, Middle Aged, Treatment Outcome, Female, Biomarkers, Tomography, Optical Coherence
Abstract

This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI).There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age.In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque rupture at baseline and everolimus-eluting stent strut coverage at 9-month follow-up as determined by optical coherence tomography.Men and women had similar rates of plaque rupture (50.0% vs. 48.4%; risk ratio [RR]: 1.03; 95% confidence interval [CI]: 0.73 to 1.47; p = 0.56). Nonruptured/eroded plaques comprised 25% of all cases (p = 0.86 in men vs. women). There were no sex differences in composition of aspirated thrombus and immune and inflammatory serum biomarkers. At 9 months, women had similar strut coverage (90.9% vs. 92.5%; difference in medians: RR: 0.2%; 95% CI: -0.4% to 1.3%; p = 0.89) and amount of in-stent neointimal obstruction (10.3% vs. 10.6%; p = 0.76) as men did. There were no sex differences in clinical outcome either at 30-day or 1-year follow-up.In patients presenting with STEMI undergoing primary PCI, no differences in culprit plaque morphology and factors associated with coronary thrombosis were observed between age-matched men and women. Women also showed similar vascular healing response to everolimus-eluting stents as men did. (Optical Coherence Tomography Assessment of Gender Diversity In Primary Angioplasty: The OCTAVIA Trial [OCTAVIA]; NCT01377207).

Published
2014

41. Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: Current status in 37 ESC countries

Author

Kristensen, S.D. Laut, K.G. Fajadet, J. Kaifoszova, Z. Kala, P. Di Mario, C. Wijns, W. Clemmensen, P. Agladze, V. Antoniades, L. Alhabib, K.F. De Boer, M.-J. Claeys, M.J. Deleanu, D. Dudek, D. Erglis, A. Gilard, M. Goktekin, O. Guagliumi, G. Gudnason, T. Hansen, K.W. Huber, K. James, S. Janota, T. Jennings, S. Kajander, O. Kanakakis, J. Karamfiloff, K.K. Kedev, S. Kornowski, R. Ludman, P.F. Merkely, B. Milicic, D. Najafov, R. Nicolini, F.A. Noč, M. Ostojic, M. Pereira, H. Radovanovic, D. Sabaté, M. Sobhy, M. Sokolov, M. Studencan, M. Terzic, I. Wahler, S. Widimsky, P.

Abstract

Aims: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. Methods and results A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. Conclusion Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encouraged. All rights reserved. © 2014 The Author.

Published
2014

44. Implementation of primary angioplasty in Europe: Stent for Life initiative progress report

Author

Kristensen, S.D. Fajadet, J. Di Mario, C. Kaifoszova, Z. Laut, K.G. Deleanu, D. Gilard, M. Guagliumi, G. Goktekin, O. Jorgova, J. Kanakakis, J. Ostojic, M. Pereira, H. Sabate, M. Sobhy, M. Vrints, C. Wijns, W. Widimsky, P.

Abstract

Aims: Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). Despite substantial evidence of its effectiveness, a 2007 study reported that only 40-45% of European STEMI patients were treated with PPCI, with large variations in treatment availability between countries. In 2008, the Stent for Life (SFL) initiative was launched by the European Association of Percutaneous Cardiovascular Interventions and EuroPCR in partnership with the European Society of Cardiology (ESC) Working Group on Acute Cardiac Care and country-specific national cardiac societies. The aim is to promote the prioritisation of percutaneous coronary intervention treatment towards those who will benefit most, namely STEMI patients. The following countries are currently participating: Bulgaria, Egypt, France, Greece, Italy, Portugal, Romania, Serbia, Spain and Turkey. Methods and results: Since SFL was launched, several activities have been initiated in the participating countries. Preliminary reports suggest that major increases have been seen in the numbers of PPCI performed, with some countries reporting very significant increases in PPCI use from 2008-2010. Improvements in STEMI mortality rates have also been observed. Conclusions: This report summarises the progress of the SFL initiative in the 10 target countries. © Europa Edition 2012. All rights reserved.

Published
2012

45. Coronary stenting and surgery: Perioperative management of antiplatelet therapy in patients undergoing surgery after coronary stent implantation [Stent coronarico e chirurgia: La gestione perioperatoria della terapia antiaggregante nel paziente portatore di stent coronarico candidato a intervento chirurgico]

Author

Rossini, R., Bramucci, E., Castiglioni, B., DE SERVI, S., Lettieri, C., Lettino, M., Masumeci, G., Visconti, L., Piccaluga, E., Savonitto, S., Trabattoni, D., Buffoli, F., Angiolillo, D., Bovenzi, F., Cremonesi, A., Scherillo, M., Guagliumi, G., Valdatta, Luigi, Boni, Luigi, Dionigi, G., Guffanti, E., Gerometta, P., Parolari, A., Biglioli, F., Beltramini, G., Devalle, L., Droghetti, A., Bozzani, A., Ravelli, P., Crescini, C., Staurenghi, G., Gaini, S., Scarone, P., Francetti, L., Corbella, S., Comel, A., Gadda, F., Salvi, L., Castelli, A., Menozzi, E., and D'Angelo, Fabio

Subjects
Surgical Procedures, Aspirin, Clopidogrel, Coronary heart disease, Stent, Surgery, Coronary Disease, Humans, Platelet Aggregation Inhibitors, Postoperative Hemorrhage, Risk Assessment, Risk Factors, Stents, Surgical Procedures, Operative, Cardiology and Cardiovascular Medicine, Operative
Published
2012

47. Expert review document part 2 : methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

Author

Prati, F, Guagliumi, G, Mintz, Gs, Costa, M, Regar, E, Akasaka, T, Barlis, P, Tearney, Gj, Jang, Ik, Arbustivi, E, Bezerra, Hg, Ozaki, Y, Bruining, N, Dudek, D, Radu, M, Erglis, A, Motreff, P, Alfonso, F, Toutouzas, K, Ponzalo, N, Tamburino, Corrado, Adriaenssens, T, Pinto, F, Serruys, Pw, Di Mario, C, and for the Expert’s OCT Review Document

Subjects
medicine.medical_specialty, genetic structures, medicine.medical_treatment, Field of view, Coronary Artery Disease, Optical coherence tomography, Recurrence, Angioplasty, Intravascular ultrasound, Medicine, Humans, Time domain, Vascular Calcification, Wound Healing, Modality (human–computer interaction), medicine.diagnostic_test, business.industry, Coronary Thrombosis, Graft Occlusion, Vascular, eye diseases, Plaque, Atherosclerotic, Prosthesis Failure, Current Opinion, Frequency domain, Stents, sense organs, Tomography, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, Optical Coherence, Biomedical engineering
Abstract

This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4 In the OCT Expert Review Document on Atherosclerosis, a comprehensive description of the physical principles for OCT imaging and time domain (TD) catheters (St Jude Medical, Westford, MA, USA) was provided.1 The main advantage of FD-OCT is that the technology enables rapid imaging of the coronary artery, using a non-occlusive acquisition modality. The FD-OCT catheter (DragonflyTM; St Jude Medical) employs a single-mode optical fibre, enclosed in a hollow metal torque wire that rotates at a speed of 100 r.p.s. It is compatible with a conventional 0.014″ angioplasty guide wire, inserted into a short monorail lumen at the tip. The frequency domain optical coherence tomography lateral resolution is improved in comparison with TD-OCT, while the axial resolution did not change. These features, together with reduced motion artefacts and an increased maximum field of view up to 11 mm, have significantly improved both the quality and ease of use of OCT in the catheterization laboratory.3,4 However, the imaging depth of the FD-OCT is still limited to 0.5–2.0 mm.5 The main obstacle to the adoption of TD-OCT imaging in clinical practice is that OCT cannot image through a blood field, and therefore requires clearing or flushing of blood from the lumen.1 The 6 Fr compatible DragonflyTM FD-OCT catheter is so far the only one in the market, as two other systems from Volcano and Terumo, which …

Published
2012

49. Strut coverage and vessel wall response to zotarolimus-eluting and bare-metal stents implanted in patients with ST-segment elevation myocardial infarction: the OCTAMI (Optical Coherence Tomography in Acute Myocardial Infarction) Study

Author

Guagliumi, G., Sirbu, V., Bezerra, H., BIONDI ZOCCAI, Giuseppe, Fiocca, L., Musumeci, G., Matiashvili, A., Lortkipanidze, N., Tahara, S., Valsecchi, O., and Costa, M.

Subjects
Male, Time Factors, Myocardial Infarction, acute myocardial infarction, Coronary Angiography, Prosthesis Design, Predictive Value of Tests, Humans, cardiovascular diseases, Prospective Studies, Angioplasty, Balloon, Coronary, Ultrasonography, Interventional, Aged, Sirolimus, coronary artery disease, optical coherence tomography, stent coverage, zotarolimus-eluting stent, Cardiovascular Agents, Drug-Eluting Stents, Middle Aged, Coronary Vessels, surgical procedures, operative, Treatment Outcome, Metals, Female, Stents, Tomography, Optical Coherence
Abstract

ObjectivesUsing optical coherence tomography, we assessed the proportion of uncovered struts at 6-month follow-up in zotarolimus-eluting stents (ZES), specifically Endeavor (Medtronic CardioVascular, Santa Rosa, California) stents, and identical bare-metal stents (BMS) implanted in patients with ST-segment elevation myocardial infarction (STEMI).BackgroundSirolimus- and paclitaxel-eluting stents implanted in STEMI have been associated with delayed healing and incomplete strut coverage. ZES are associated with a more complete and uniform strut coverage in stable patients, but whether this holds true also after STEMI is unknown.MethodsForty-four patients with STEMI who underwent primary PCI were randomized to ZES or BMS (3:1 randomization). Angiographic, intravascular ultrasound, and optical coherence tomography follow-up was conducted at 6 months and clinical follow-up at 1 year. All images were analyzed by an independent core laboratory that was blind to stent assignments.ResultsThere were no differences between ZES and BMS in percentage of uncovered struts (median: 0.00% [interquartile range (IQR): 0.00% to 1.78%] vs. 1.98% [IQR: 0.21% to 7.33%], p = 0.13), maximum length of uncovered segments (0.00 [IQR: 0.00 to 1.19] mm vs. 1.38 [IQR: 0.65 to 3.30] mm, p = 0.10), percentage of malapposed struts (0.00% [IQR: 0.00% to 0.23%] vs. 0.15% [IQR: 0.00% to 5.81%], p = 0.16), and maximum length of malapposed segments (0.00 [IQR: 0.00 to 0.67] mm vs. 0.33 [IQR: 0.00 to 2.55] mm, p = 0.20). Neointimal response was similar between ZES and BMS (332 [IQR: 240 to 429] μm vs. 186 [IQR: 136 to 348] μm, p = 0.99) and evenly distributed. No late acquired malapposition was observed in both groups. There were no deaths, myocardial infarction, or stent thromboses at 1 year.ConclusionsThis optical coherence tomography study found no difference in strut coverage and similar vessel response to ZES, when compared with identical BMS, implanted during primary percutaneous coronary intervention in STEMI patients. (Six-Month Coverage and Vessel Wall Response of the Zotarolimus Drug-Eluting Stent Implanted in AMI Assessed by Optical Coherence Tomography [OCTAMI]; NCT00704561)

Published
2010

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