Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch: the Nordic-Baltic Bifurcation Study IV.

Background: It is still uncertain whether coronary bifurcations with lesions involving a large side branch (SB) should be treated by stenting the main vessel and provisional stenting of the SB (simple) or by routine two-stent techniques (complex). We aimed to compare clinical outcome after treatment of lesions in large bifurcations by simple or complex stent implantation.

Methods: The study was a randomised, superiority trial.

Takotsubo syndrome in Sørlandet Hospital Arendal 2010-16.

Bakgrunn: Takotsubosyndrom er en akutt hjertesykdom med symptomer som ved akutt hjerteinfarkt, men med åpne koronararterier og regionale funksjonsforstyrrelser i venstre ventrikkel. Vi har undersøkt forekomst av og forløp ved tilstanden hos pasienter i Agder og Telemark.

Materiale Og Metode: Alle pasienter innlagt i Sørlandet sykehus Arendal fra 1.

Coronary bifurcation lesions treated with simple or complex stenting: 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study.

Aims: Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE).

Methods And Results: Both multicentre randomized trials compared simple (provisional T-stenting) vs.

Are the guidelines for treatment of myocardial infarction complied with?

Background: New guidelines recommend early invasive evaluation and treatment for most patients with acute myocardial infarction--including patients with myocardial infarction without ST elevation in the ECG. This study examines compliance with the new guidelines at Sørlandet Hospital Arendal.

Material And Method: All patients admitted to Sørlandet Hospital Arendal with acute myocardial infarction in 2012 were registered in the Norwegian Myocardial Infarction Register.

Clinical outcome after crush versus culotte stenting of coronary artery bifurcation lesions: the Nordic Stent Technique Study 36-month follow-up results.

Objectives: The aim of the study was to compare long-term follow-up results of crush versus culotte stent techniques in coronary bifurcation lesions.

Background: The randomized Nordic Stent Technique Study showed similar 6-month clinical and 8-month angiographic results with the crush and culotte stent techniques of de novo coronary artery bifurcation lesions using sirolimus-eluting stents. Here, we report the 36-month efficacy and safety of the Nordic Stent Technique Study.

Long-term results after simple versus complex stenting of coronary artery bifurcation lesions: Nordic Bifurcation Study 5-year follow-up results.

Objectives: This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study.

Background: Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy.

Methods: A total of 413 patients with a coronary bifurcation lesion were randomly assigned to a simple stenting strategy of main vessel (MV) and optional stenting of side branch (SB) or to a complex stenting strategy, namely, stenting of both MV and SB.

Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic-Baltic Bifurcation Study III.

Background: It is unknown whether the preferred 1-stent bifurcation stenting approach with stenting of the main vessel (MV) and optional side branch stenting using drug-eluting stents should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD.

Methods And Results: We randomized 477 patients with a bifurcation lesion to FKBD (n=238) or no FKBD (n=239) after MV stenting.

Randomized comparison of coronary bifurcation stenting with the crush versus the culotte technique using sirolimus eluting stents: the Nordic stent technique study.

Background: In a number of coronary bifurcation lesions, both the main vessel and the side branch need stent coverage. Using sirolimus eluting stents, we compared 2 dedicated bifurcation stent techniques, the crush and the culotte techniques in a randomized trial with separate clinical and angiographic end-points.

Methods And Results: A total of 424 patients with a bifurcation lesion were randomized to crush (n=209) and culotte (n=215) stenting.

Safety in simple versus complex stenting of coronary artery bifurcation lesions. The nordic bifurcation study 14-month follow-up results.

Aims: The risk of stent thrombosis has been reported to increase with percutaneous coronary intervention (PCI) complexity. The present study reports the pre-specified secondary endpoint of a 14-month stent thrombosis and major adverse cardiac events in patients stented with a simple versus a complex bifurcation technique using sirolimus eluting stents (SES).

Methods And Results: A total of 413 patients with a coronary bifurcation lesion were randomised to a simple treatment strategy; stenting of main vessel and optional stenting of side branch (MV group), or to a complex stenting strategy; stenting of both main vessel and side branch (MV+SB group).

Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study.

Background: The optimal stenting strategy in coronary artery bifurcation lesions is unknown. In the present study, a strategy of stenting both the main vessel and the side branch (MV+SB) was compared with a strategy of stenting the main vessel only, with optional stenting of the side branch (MV), with sirolimus-eluting stents.

Methods And Results: A total of 413 patients with a bifurcation lesion were randomized.

Histopathology of material captured by embolic protection device after percutaneous coronary interventions in atherosclerotic saphenous vein grafts.

Aims: Different distal protections devices have been developed to prevent embolisation during percutaneous coronary intervention (PCI) in atherosclerotic saphenous vein grafts (SVG). The purpose of this descriptive study was to characterise the composition of material captured by embolic protection device from saphenous vein graft interventions by light and electron microscopy, to determine the age of the thrombotic component and to relate the pathological findings to the clinical condition, lesion characteristics and to the use of conventional or membrane covered self-expanding stents during the intervention.

Methods And Results: Forty consecutive patients treated with the FilterWire EX (Boston Scientific) during 42 SVG interventions were included.

Clinical benefit of small vessel stenting: one-year follow-up of the SISCA trial.

Objective: To assess the long-term clinical benefit of elective stenting as compared with percutaneous transluminal coronary angioplasty (PTCA) in small coronary arteries.

Design: The Stenting in Small Coronary Arteries (SISCA) trial was a randomized trial comparing elective stenting with PTCA in coronary arteries with a reference diameter of 2.1-3.

[Long-term results with the left internal mammary artery as coronary bypass].

Background: From 1986 we have routinely used the left internal mammary artery instead of autologous vein as bypass to the left anterior descending coronary artery.

Material And Methods: A cohort of 52 patients has been followed up for up to 12 years. Six years postoperatively, 40 patients were evaluated by clinical examination, exercise testing and serum lipid assessment.

Stenting in small coronary arteries (SISCA) trial. A randomized comparison between balloon angioplasty and the heparin-coated beStent.

Objectives: The purpose of this study was to assess the clinical and angiographic benefits of elective stenting in coronary arteries with a reference diameter of 2.1 to 3.0 mm, as compared with traditional percutaneous transluminal coronary angioplasty (PTCA).

Magnum wire for percutaneous coronary balloon angioplasty in 800 total chronic occlusions.

The experience in consecutive procedures with 800 recanalization attempts of chronic total coronary occlusions using the Magnum wire was analyzed from a prospectively constituted computerized database. The data confirm that the Magnum wire, generally used as a primary intervention for occlusive angioplasty at our centers, is competitive with conventional systems in this setting.

Magnum wire for angioplasty of total and non-total coronary lesions.

The magnum wire is a stiff-shaft, blunt-tip wire constructed for recanalisation during angioplasty. Smaller series have demonstrated superior qualities compared to conventional wires. The purpose of this study was to analyze its feasibility in a larger number of procedures.

Pattern of coronary artery disease in patients with ventricular tachycardia and fibrillation exposed by exercise-induced ischemia.

The majority of patients with serious exercise-induced ventricular arrhythmias have extensive coronary artery disease. These arrhythmias develop, however, only in a minority of patients with angina pectoris. The purpose of the present study was therefore to investigate whether these arrhythmia patients are characterized by any specific "arrhythmogenic" pattern of coronary artery disease.

Surgical revascularization in the treatment of ventricular tachycardia and fibrillation exposed by exercise-induced ischaemia.

The role of myocardial revascularization in the treatment of malignant ventricular arrhythmias is not well defined. Our hypothesis was that in patients with ventricular tachycardia or fibrillation exposed by exercise-induced ischaemia, the acute transient ischaemia plays a principal causal role, and that in these patients surgical myocardial revascularization alone might be an effective treatment. Among 1100 consecutive patients undergoing isolated coronary artery bypass surgery (CABG) 30 patients (2.

Angiographic restenosis after successful Wallstent stent implantation: an analysis of risk predictors.

Follow-up angiographic study was performed in 86 patients after initially successful Wallstent stent (Medinvent, Lausanne, Switzerland) implantation between April 1986 and October 1990. The stent angiographic restenosis rate was 16% at a mean of 8 months after stenting despite the inclusion of a substantial number of patients at high risk of restenosis after percutaneous transluminal coronary angioplasty (PTCA). Of a total 15 variables analyzed, only suboptimal stent placement was found to be a significant predictor of stent restenosis.

[Arteria gastroepiploica dextra in coronary surgery. Complete revascularization in angina pectoris].

We have used the right gastroepiploic artery as a viable jump graft to the distal right coronary artery in two patients. The first patient was a 37 year-old man with recurrent angina after coronary bypass surgery with three vein grafts eight years previously. The second patient was a man aged 45 with angina in New York Heart Association Class III to IV.

Cardiac effects of secretin; an approach to its mechanisms of action as shown by beta-adrenergic blockade and measurement of left ventricular dimensions in dogs.

In previous studies, the peptide secretin has demonstrated the ability to increase cardiac output and peripheral organ flow. In this investigation the mechanisms of the myocardial effects of secretin were studied. The secretin effects on cardiac output, stroke volume and systemic resistance were unaltered after propranolol, whereas the effect on LVdP/dt was reduced and the heart rate effect negligible.

Inosine causing insulin release and increased myocardial uptake of carbohydrates relative to free fatty acids in dogs.

The aim of the present study was to determine the effect of i.v. inosine on myocardial substrate uptake and function in the in situ dog heart.

Peripheral distribution of the increased cardiac output by secretin during acute ischemic left ventricular failure.

Secretin, a 27-amino acid peptide with both vasodilating and inotropic properties, was investigated according to its effects on peripheral flow distribution in acute ischemic left ventricular failure accomplished by embolization of the left coronary artery in anesthetized dogs. Electromagnetic monitoring of renal, carotid, femoral and superior mesenteric artery flow was used. During the induction of heart failure a general reduction of flow with preponderance of that of the carotid and femoral arteries occurred.