Publications by authors named "S Moscardelli"
Background: The therapeutic management of patients with multivessel disease and severe left ventricular dysfunction is complex and controversial.
Aims: The aim of this study was to analyze the clinical outcomes and the changes in left ventricular ejection fraction (LVEF) in patients with severe left ventricular dysfunction and at least one chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI) with hemodynamic support provided by Impella.
Methods: Retrospective, multicenter study enrolling patients with severe left ventricular dysfunction and severe coronary artery disease with at least one CTO who required percutaneous mechanical circulatory support with Impella, from January 2019 to December 2023.
Article Synopsis
- - Balloon aortic valvuloplasty (BAV) is a procedure used for patients with severe aortic valve stenosis, either as preparation for trans-catheter aortic valve replacement (TAVR) or alone in certain cases; the study focused on the newly available Mammoth balloon catheter (BC) used in this context.
- - A retrospective analysis was conducted on patients treated with the Mammoth BC at a hospital in Milan, where technical success was defined by the ability to successfully deploy and inflate the catheter without significant complications like injury or stroke.
- - The results showed a 100% technical success rate in 121 procedures with no complications attributed to the Mammoth BC; however, some patients in the stand-alone group
Despite early stagnation in success rates for percutaneous coronary intervention for chronic total occlusion with the traditional antegrade wiring approach, the introduction of dissection/re-entry techniques and the retrograde approach opened new avenues for operators to tackle more complex occlusions. Dissection/re-entry techniques (both antegrade and retrograde) are commonly used in angiographic scenarios characterised by long, tortuous and calcified occlusions, as well as in those with proximal cap ambiguity. Familiarity and comfort using the extraplaque space (with either an antegrade or retrograde approach) have become fundamental to achieving safe and effective recanalisation of complex chronic total occlusions.
View Article and Find Full Text PDFIn seeking to improve upon chronic total occlusion (CTO) percutaneous coronary intervention success rates and minimize risk, CTO modification procedures (investment procedures) have been developed and utilized with increasing frequency. Two key techniques have emerged: subintimal tracking and re-entry (STAR) and subintimal plaque modification (SPM). Both require a staged approach with an index procedure for plaque modification and a second procedure weeks later for stenting.
View Article and Find Full Text PDFArticle Synopsis
- Antegrade techniques are methods used to treat blocked heart arteries in a procedure called PCI.
- Sometimes, it's hard to get the guidewire into the right place, so doctors might have to use a special method called antegrade dissection and reentry.
- This article talks about different tools, methods, and problems doctors face when using antegrade techniques for these complex blockages.