Publications by authors named "Mashayekhi Kambis"
Objective: The study investigates long-term outcomes of unselected inpatients undergoing invasive coronary angiography (CA) with and without diabetes mellitus type II (T2DM).
Background: Due to continual shifts in demographics and advancements in treating cardiovascular disease, there has been a notable evolution in the types of patients undergoing CA over the past decades. Comprehensive data on the extended outcomes of CA patients, both with and without concurrent T2DM, remains scarce.
Background: Advancing the retrograde microcatheter (MC) into the antegrade guide catheter during retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can be challenging or impossible, preventing guidewire externalization.
Objectives: To detail and evaluate all the techniques focused on wiring to achieve intubation of the distal tip of a microcatheter, balloon, or stent with an antegrade or retrograde guidewire, aiming to reduce complications by minimizing tension on fragile collaterals during externalization and enabling rapid antegrade conversion in various clinical scenarios.
Methods: We describe the two main techniques, tip-in and rendezvous, and their derivatives such a facilitated tip-in, manual MC-tip modification, tip-in the balloon, tip-in the stent, deep dive rendezvous, catch-it and antegrade microcatheter probing.
Background: The parallel wire technique (PW) is a classic part of the antegrade strategy to open chronic total coronary occlusions (CTO).
Aims: With modern wires and dual-lumen catheters (DLC) the approach has evolved, but this progress had not been evaluated in a contemporary registry of CTO interventions.
Method: This analysis is based on 26,589 CTO procedures performed by 36 operators with > 50 procedures annually between 2015 and 2022.
Background: There is limited data regarding the influence of lung compliance on the outcome of patients with cardiogenic shock (CS). Thus, a registry study was conducted to assess the prognostic influence of lung compliance in invasively ventilated patients with CS.
Methods: Hospital records for consecutive invasively ventilated CS-patients from June 2019 to May 2021 were collected into a prospective registry.
Article Synopsis
- The CTO-ARC identified the need for standardized definitions in chronic total occlusion (CTO) procedures to avoid bias in attributing complications to different crossing strategies.
- A study analyzed data from 8,673 patients in the European Registry of Chronic Total Occlusions, finding that the antegrade approach was used in 79.2% of cases, while retrograde was used in 20.8%.
- Results showed that alternative antegrade crossing had lower technical success rates and higher complication rates compared to true antegrade and retrograde methods, though it was primarily used as a rescue strategy in most instances.
Dissection and re-entry techniques are essential to achieve safe and effective chronic total occlusion recanalization. Several studies have demonstrated similar outcomes following extraplaque stenting compared with intraplaque stenting. Dissection techniques most often involve the use of knuckled wires to progress within and beyond the chronic total occlusion segment.
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- The study evaluates the impact of right bundle branch block (RBBB) and left bundle branch block (LBBB) on the prognosis of patients with cardiogenic shock (CS), focusing on 30-day mortality rates.
- It involved 248 adult patients from an ICU in Germany, finding that those with RBBB had the highest mortality at 72.5%, compared to 52.9% for LBBB and 50.0% for no block.
- RBBB significantly predicted increased mortality even after adjusting for key health indicators, while LBBB showed no significant association with mortality outcomes.
Article Synopsis
- The study assessed the safety and effectiveness of catheter-directed thrombolysis (CDT) using rt-PA in patients with symptomatic peripheral artery disease from January 2013 to December 2020.
- Of the 1238 patients treated, serious adverse events occurred in 41.3%, with bleeding being the most common complication at 25.4%, and notable rates of limb salvage at 91.6% and 88.8% after 12 and 24 months, respectively.
- Key predictors for complications included increasing age, the use of certain medications (abciximab and alprostadil), and the duration of the lysis treatment, highlighting a significant risk associated with CDT despite its high success rate.
Objective: This study investigates the prevalence and prognostic impact of diastolic dysfunction (DD) in patients hospitalized with heart failure (HF) with mildly reduced ejection fraction (HFmrEF) in sinus rhythm.
Background: Data regarding the prognostic impact of DD in patients with HFmrEF is limited.
Methods: From 2016 to 2022, all patients hospitalized with HFmrEF (i.
Objective: The study investigates the characteristics and prognostic impact of different heart failure (HF) etiologies in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
Background: Data regarding the characterization of patients with HFmrEF and their outcomes is scarce.
Methods: Consecutive patients with HFmrEF (i.
Article Synopsis
- * The 12 areas include issues like setup for PCI, managing vessel injuries, preventing haemodynamic collapse, and dealing with complications like perforations and radiation injuries.
- * The statement serves to enhance clinical practice, research, and education by providing strategies to prevent complications and improve patient outcomes during CTO PCI procedures.
Article Synopsis
- Bifurcation involvement in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a significant challenge, but this factor hasn't been widely studied or included in existing scoring systems.
- An analysis of 3,948 CTO-PCI procedures from 92 European centers revealed that 33% of these cases involved bifurcation lesions, which were generally more complex and required more sophisticated devices, resulting in higher radiation and contrast exposure.
- Despite comparable overall technical success rates between bifurcation and non-bifurcation lesions, bifurcation lesions located within the CTO segment faced significantly lower success rates, making it crucial to consider their presence in future PCI assessments.
Article Synopsis
- "Full moon" calcification in coronary arteries represents a blockage detectable via coronary computed tomography angiography (CCTA) and is linked to poorer outcomes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
- In a study of 140 patients undergoing elective CTO-PCI, those with "full moon" calcification were older and exhibited higher cardiovascular risks, with a significantly greater failure rate to cross the lesion compared to patients without this morphology (53.5% vs 12.5%).
- The study employed multivariable logistic regression to assess factors influencing procedural success, finding full moon calcification significantly correlated with higher incidences of complications like chronic kidney failure and previous coronary artery bypass surgery.
Article Synopsis
- The study looked at how tricuspid regurgitation (TR), a heart problem, affects patients who are in cardiogenic shock (CS), which is a serious condition where the heart can't pump enough blood.
- Researchers checked medical records and used special tests to see how different levels of TR influenced how long patients survived after 30 days.
- They found that patients with severe TR had a higher chance of dying within 30 days compared to those with less severe TR, especially in patients without a heart attack.
Article Synopsis
- The study examines how previous left ventricular ejection fraction (LVEF) affects prognosis in patients with mildly reduced ejection fraction (HFmrEF) heart failure, a condition often overlooked in terms of prognostic impact.
- It retrospectively analyzed 689 patients from 2016 to 2022, categorizing them into three groups based on changes in LVEF: stable, improved, and deteriorated.
- Results showed no significant differences in all-cause mortality or hospital readmissions among the groups at 12 and 30 months, indicating that changes in LVEF do not significantly influence patient outcomes in this population.
Article Synopsis
- Mitral valve regurgitation (MR) is prevalent among patients with mildly reduced ejection fraction heart failure (HFmrEF), yet data on its impact is limited.
- A study of over 2,000 hospitalized HFmrEF patients found that those with MR had significantly higher risk of all-cause mortality and hospital readmissions for worsening heart failure compared to those without MR.
- The findings also indicated that the severity of MR correlates with increased mortality risk, and secondary MR is associated with better outcomes than primary MR.
Contemporary medical practices allow complete percutaneous coronary intervention (PCI) in a considerable number of patients who previously would have been considered too 'high-risk' for such procedures. The use of mechanical circulatory support (MCS) devices during these high-risk PCIs (HR-PCIs) is thought to reduce the potential risk for major adverse events during and after revascularization. The intra-aortic balloon pump (IABP), veno-arterial extracorporeal membrane oxygenation (V-A ECMO), and the Impella are the most common MCS devices in use.
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- Low operator and institutional volume in percutaneous coronary interventions (PCI) can lead to worse outcomes for patients, prompting this study to assess the link between operator experience and procedural success in chronic total occlusion (CTO) cases.
- The study analyzed data from nearly 15,000 CTO-PCIs performed between 2014 and 2020, finding that higher annual caseloads per operator correlated with better procedural success rates and fewer complications.
- Results indicated that operators performing around 40 CTO cases annually had the best outcomes, suggesting that increasing experience could enhance the quality of treatments in PCI.
Article Synopsis
- Large vessel perforation during coronary intervention is a rare but serious complication that often requires a covered stent for treatment.
- Covered stents have lower long-term success rates compared to drug-eluting stents and should be used with caution due to the risk of misplacing them, which can lead to additional complications.
- This text presents a case series aimed at examining the anatomy and mechanisms of large vessel perforations, along with guidelines for successful covered stent implantation.
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) continues to evolve. This review summarizes recent publications categorized by outcomes, techniques, complications, and ongoing studies in this rapidly growing area.
View Article and Find Full Text PDFChronic total occlusions (CTOs) of coronary arteries can be found in the context of chronic or acute coronary syndromes; sometimes they are an incidental finding in those apparently healthy individuals undergoing imaging for preoperative risk assessment. Recently, the invasive management of CTOs has made impressive progress due to sophisticated preinterventional assessment, including advanced non-invasive imaging, the availability of novel and dedicated tools for CTO percutaneous coronary intervention (PCI), and experienced interventionalists working in specialised centres. Thus, it is crucial that referring physicians who see patients with CTO be aware of recent developments and of the initial evaluation requirements for such patients.
View Article and Find Full Text PDFBackground: Percutaneous coronary interventions (PCI) of chronic total occlusions (CTO) have reached high procedural success rates thanks to dedicated equipment, evolving techniques, and worldwide adoption of state-of-the-art crossing algorithms.
Aims: We report the contemporary results of CTO PCIs performed by a large European community of experienced interventionalists. Furthermore, we investigated the impact of different risk factors for procedural major adverse cardiac and cerebrovascular events (MACCE) and trends of employment of specific devices like dual lumen microcatheters, guiding catheter extensions, intravascular ultrasound and calcium-modifying tools.
Article Synopsis
- * It included 2,184 patients, revealing that those with COPD had a higher risk of all-cause mortality (45% vs. 30%) and re-hospitalization due to worsening heart failure compared to those without COPD.
- * The findings suggest that COPD significantly worsens outcomes for patients hospitalized with HFmrEF, indicating a need for targeted management strategies for this population.
Article Synopsis
- Cardiac remodeling happens in people with heart failure (HF) and helps doctors see how serious the disease is.
- A study looked at 1881 patients with a specific type of heart failure (called HFmrEF) from 2016 to 2022 to see how septal hypertrophy (a condition where part of the heart muscle gets thicker) affected them.
- Although having septal hypertrophy wasn't linked to higher death rates, it was connected to a higher chance of being hospitalized again due to heart problems in the following months.