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  • 1
    In: Journal of Interventional Cardiology, Wiley, Vol. 31, No. 4 ( 2018-08), p. 471-477
    Abstract: Transfemoral approach (TFA) may be preferred access site in order to facilitate complex percutaneous procedures such as rotational atherectomy (RA). Notwithstanding, there is a growing evidence that transradial approach (TRA) is associated with lower access site complication rates and even lower mortality. The aim was to assess in‐hospital and 1‐year outcomes in patients undergoing RA using TRA, in comparison to TFA. Methods A single center observational study included all consecutive patients, who underwent RA from 2010 to 2015. Primary endpoints were procedural success, in‐hospital mortality and major adverse cardiovascular events (MACE). Secondary endpoints were 1‐year all‐cause mortality and MACE. Results The study included 177 patients, 69% in TRA group and 31% in TFA group. Except for male sex and logistic Euroscore II there were no differences in common risk factors. There was no difference in procedural success (95% vs 87%, P  = 0.07) with even a trend in favor of TRA. Performing RA via TRA lower amount of contrast volume ( P  = 0.009) was used and hospital stay after the procedure was shorter ( P  = 0.004). Periprocedural complication rates were similar, however patients with TFA had significantly higher rate of major access site bleedings (13% vs 1%, P  = 0.001), with no differences in mortality and other adverse events both in‐hospital and during 1‐year observation. Conclusions Even though RA is a demanding technique, when performed via TRA allows to maintain the same procedural success and long‐term results in comparison to TFA, reduces in‐hospital major access site bleedings, lowers the amount of contrast media and shortens hospital stay.
    Type of Medium: Online Resource
    ISSN: 0896-4327 , 1540-8183
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2103585-4
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  • 2
    In: Catheterization and Cardiovascular Interventions, Wiley, Vol. 93, No. 4 ( 2019-03), p. 574-582
    Abstract: There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI) therapy with dedicated DES platforms. The LM‐STENTYS is a multicenter registry aimed at evaluating clinical outcome after PCI of LM performed with a self‐apposing Stentys DES implantation. Methods The registry consists of 175 consecutive patients treated with Stentys DES implanted to LM. The primary endpoint was the composite of major adverse cardiac and cerebral events (MACCE) defined as cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stroke assessed after 1 year. The secondary endpoint was stent thrombosis (ST) at 1 year. Results The median age was 69 years (IQR, 62–78 years). Acute coronary syndrome (ACS) was the presenting diagnosis in 117 (66.9%) patients [74 (63.2%) unstable angina, 31 (26.5%) NSTEMI, 12 (10.3%) STEMI] and stable angina (SA) was present in 58 (33.1%) patients. The median SYNTAX score was 23.0 (IQR, 18.7–32.2) in the SA group and 25.0 (IQR, 20.0–30.7) in the ACS group. During 1‐year follow‐up in the SA group two (3.4%) MACCE occurred, both of them were cardiac deaths. In ACS patients there were 19 (16.2%) MACCE [9 (7.7%) cardiac deaths, 11 (9.4%) MIs, 11(9.4%) TLR, 1(0.9%) stroke] . Altogether, three (1.7%) cases of acute ST were noted, all of them in ACS subset. Conclusion LM PCI using self‐apposing Stentys DES showed favorable clinical outcomes at 1‐year in patients with SA. Events of ST in the ACS group warrant further research.
    Type of Medium: Online Resource
    ISSN: 1522-1946 , 1522-726X
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2001555-0
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