Publications by authors named "Ahmed ElGuindy"
Article Synopsis
- The study focused on elderly patients (70+) undergoing primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) at a tertiary center in Upper Egypt, highlighting a growing concern for cardiovascular disease in aging populations.
- The research included data from 3,627 patients, finding that 15.9% were elderly, with significantly higher in-hospital mortality rates, particularly among octogenarians (23.3%) compared to younger patients (4%).
- Elderly patients showed distinct clinical characteristics, such as higher rates of hypertension and chronic kidney disease, and were more likely to have severe complications post-procedure, emphasizing the need for tailored strategies in managing this demographic in cardiovascular care.
Purpose: Cumulative cisplatin doses of ≥ 200 mg/m improve survival in adults with head-and-neck squamous cell carcinoma (HNSCC) undergoing chemoradiation, but many older adults with HNSCC cannot receive this prognostically relevant dose due to toxicities. This study aims to develop predictive models to assess the likelihood of older adults with HNSCC receiving ≥ 200 mg/m cisplatin during chemoradiation.
Methods: 366 patients from the SENIOR database, an international cohort of adults ≥ 65 years with HNSCC, received definitive chemoradiation with single-agent cisplatin and were analyzed.
Background: Proximal vessel tortuosity can hinder wiring and equipment delivery during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Aims: We sought to examine the association of proximal vessel tortuosity with the short and long-term outcomes of patients undergoing CTO PCI.
Methods: We examined the association of proximal vessel tortuosity with clinical outcomes in patients who underwent CTO PCI at 50 US and non-US centers between 2012 and 2024.
Patients who undergo percutaneous coronary intervention (PCI) to the left main (LM) coronary artery in the setting of acute coronary syndrome (ACS) were not adequately studied in the era of modern PCI. We investigated early and long-term outcomes of these patients, especially those with a true LM bifurcation stenosis. The Left Main Intervention in Acute Coronary Syndrome (LIMACS) is a multicenter registry that enrolled patients who underwent PCI to unprotected LM disease in the setting of ACS using a drug-eluting stent.
View Article and Find Full Text PDFPurpose: Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation is being used more frequently in the spinal oncology landscape. Better visualization with this material allows for more precise postoperative stereotactic body radiation therapy (SBRT) planning using either computed tomography (CT)-myelography or magnetic resonance imaging (MRI) studies. We compared the dosimetric planning equivalencies and outcomes.
View Article and Find Full Text PDFLate coronary complications after an arterial switch operation (ASO) may occur due to vessel kinking, compression resulting from growth of the great vessels, ostial fibro-intimal thickening after reimplantation or possibly secondary to accelerated atherosclerosis. Given that many of these patients are asymptomatic, adult ASO survivors require special attention and an individualised approach to the early detection of coronary artery disease. Most previously reported cases of coronary artery disease after an ASO have been managed surgically.
View Article and Find Full Text PDFIntravascular Lithotripsy Versus Rotational Atherectomy in Coronary Chronic Total Occlusions: Analysis from the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention Registry.
Am J Cardiol
January 2025
There are limited comparative data on the use of plaque modification devices during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared intravascular lithotripsy (IVL) with rotational atherectomy (RA) for lesion preparation in patients who underwent CTO PCI across 50 US and non-US centers from 2019 to 2024. Of 15,690 patients who underwent CTO PCI during the study period, 436 (2.
View Article and Find Full Text PDFArticle Synopsis
- Spine metastases significantly affect cancer care, and a common treatment approach involves surgery followed by stereotactic body radiotherapy (SBRT); the study compares Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) spinal instrumentation with titanium instrumentation in patients undergoing spinal fusion for metastatic disease.
- A retrospective review of oncology patients from 2012 to 2023 matched 99 CFR-PEEK cases with 50 titanium cases based on tumor type and spinal instability neoplastic score (SINS), analyzing various outcomes including complications and progression-free survival (PFS).
- Results indicated similar complication rates between CFR-PEEK and titanium groups, but CFR-PEEK patients experienced earlier local recurrence detection; further long-term studies are
Article Synopsis
- A study analyzed the outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) specifically in patients with anomalous coronary arteries (ACA) from a large dataset of over 14,000 patients between 2012 and 2023.
- Among 14,470 CTO procedures, only 36 (0.24%) were performed on patients with ACA, who displayed similar baseline characteristics to those without ACA, but had more complicated lesions, requiring longer procedures and greater contrast volume.
- Despite the increased complexity, ACA patients achieved similar procedural success rates to non-ACA patients, with no major adverse cardiac events reported in the ACA group, indicating a favorable outcome for CTO PCI in
Article Synopsis
- A study was conducted to create and validate a machine learning model to predict the success of chronic total occlusion crossing through primary antegrade wiring, using a large dataset from 12,136 cases in the PROGRESS CTO registry.
- The extreme gradient boosting model showed the best performance with an area under the receiver-operating characteristic curve of around 0.78, indicating its effectiveness.
- Key factors influencing the success included occlusion length and vessel characteristics, while aorto-ostial lesion location had minimal impact; a web application for predicting outcomes is available online.
Article Synopsis
- The study analyzed over 11,500 chronic total occlusion percutaneous coronary intervention (CTO-PCI) procedures across North America and other regions from 2017 to 2023.
- North American CTO patients were generally older and had more health issues, such as diabetes and hypertension, as well as more complex lesions compared to non-North American patients.
- Despite differences in procedure techniques and patient complexity, the overall success rates and rates of major adverse cardiovascular events were similar between North American and non-North American centers.
Background: The complex high-risk indicated percutaneous coronary intervention (CHIP) score is a tool developed using the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and predict in-hospital major adverse cardiac or cerebrovascular events (MACCE).
Aim: To assess the validity of the CHIP score in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We evaluated the performance of the CHIP score on 8341 CTO PCIs from the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) performed at 44 centers between 2012 and 2023.
Background: There is limited data on retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) via ipsilateral epicardial collaterals (IEC).
Aims: To compare the clinical and angiographic characteristics, and outcomes of retrograde CTO PCI via IEC versus other collaterals in a large multicenter registry.
Methods: Observational cohort study from the Prospective Global registry for the study of Chronic Total Occlusion Intervention (PROGRESS-CTO).
Background: Trans-catheter mitral valve replacement (TMVR) procedures had emerged as an alternative solution for patients who are at high risk for mitral valve surgery. Although cardiac computed tomography (CT) remains the standard method for procedural planning, there is no full agreement on the best systolic phase for quantitation of the neoLVOT. Furthermore, a new three-dimensional trans-esophageal echocardiography (3DTEE) based software was developed to serve as filter and or an alternative for patients who cannot have CT due to any contraindication.
View Article and Find Full Text PDFObjectives: This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Background: Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are common after CTO PCI.
Methods: We compared 20 patients who underwent CTO PCI using SA drug-eluting stents (DESs) with 20 matched control patients who underwent CTO PCI using balloon-expandable (BE)-DESs.
Background: Antegrade wiring is the most commonly used chronic total occlusion (CTO) crossing technique.
Methods: Using data from the PROGRESS CTO registry (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention; Clinicaltrials.gov identifier: NCT02061436), we examined the clinical and angiographic characteristics and procedural outcomes of CTO percutaneous coronary interventions (PCIs) performed using a primary antegrade wiring strategy.
Objectives: There is limited data on race and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The authors sought to evaluate CTO PCI techniques and outcomes in different racial groups.
Methods: We examined the baseline characteristics and procedural outcomes of 11 806 CTO PCIs performed at 44 US and non-US centers between 2012 and March 2023.
There is significant variation in wire utilization patterns for chronic total occlusion (CTO) percutaneous coronary intervention. This study aimed to compare the outcomes of polymer-jacketed wires (PJWs) versus non-PJWs in anterograde procedures. We analyzed clinical and angiographic characteristics, and procedural outcomes of 7,575 anterograde CTO percutaneous coronary interventions that were performed at 47 centers between 2012 and 2023.
View Article and Find Full Text PDFImpact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study.
JACC Cardiovasc Interv
February 2024
Article Synopsis
- The COVID-19 pandemic led to significant treatment delays for patients needing transcatheter aortic valve replacement (TAVR), with a marked decrease in procedure volumes during the first two waves of the pandemic.
- The study analyzed TAVR case data from 130 centers in 61 countries, finding a 15% drop in cases during the first wave and 7% in the second, particularly affecting regions like Africa, Central-South America, and Asia.
- Factors such as hospital type (private vs public), urban vs rural location, low procedure volumes, a country's socioeconomic status, and stringent public health measures contributed to these reductions, highlighting the need for improved public health policies for future health crises.
Article Synopsis
- Ostial chronic total occlusions (CTOs) make up 12% of all CTOs and present more challenges in percutaneous coronary interventions (PCI), resulting in lower success rates compared to non-ostial CTOs.
- Patients with ostial CTOs show a higher risk of major adverse cardiac events (MACE), including in-hospital death and stroke.
- Interventions for ostial CTOs often require longer procedure times and increased radiation exposure, indicating their complexity and difficulty.
Impact of Multiple Sclerosis Subtypes on Pain Management in Patients With Trigeminal Neuralgia After Stereotactic Radiosurgery: An International Multicenter Analysis.
Neurosurgery
April 2024
Background And Objectives: Trigeminal neuralgia affects approximately 2% of patients with multiple sclerosis (MS) and often shows higher rates of pain recurrence after treatment. Previous studies on the effectiveness of stereotactic radiosurgery (SRS) for trigeminal neuralgia did not consider the different MS subtypes, including remitting relapsing (RRMS), primary progressive (PPMS), and secondary progressive (SPMS). Our objective was to investigate how MS subtypes are related to pain control (PC) rates after SRS.
View Article and Find Full Text PDFBackground: Contemporary chronic total occlusion (CTO) percutaneous coronary intervention (PCI) practice has received limited study.
Aim: To examine the contemporary CTO PCI practice.
Methods: We performed an online, anonymous, international survey of CTO PCI operators.
Background: There is limited information on the impact of the target vessel on the procedural techniques and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 11,580 CTO PCIs performed between 2012 and 2022 at 44 centers.
Results: The most common CTO target vessel was the right coronary artery (RCA) (53.
Background: We examined the effect of atrial fibrillation on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Methods: We examined the baseline characteristics and procedural outcomes of 9,166 CTO PCIs performed at 39 US and non-US centers between 2012 and 2023.
Results: Atrial fibrillation was present in 1122 (12%) patients.