Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions.

Background: A sirolimus-eluting stent (Cypher, Cordis Corp) has been reported to markedly decrease restenosis in selected lesions; higher-risk lesions, including coronary bifurcations, have not been studied.

Methods And Results: This prospective study evaluated the safety and efficacy of sirolimus-eluting stents for treatment of coronary bifurcation lesions. Patients were randomly assigned to either stenting of both branches (group A) or stenting of the main branch with provisional stenting of the side branch (SB) (group B).

Incidence, predictors, in-hospital, and late outcomes of coronary artery perforations.

We sought to determine the incidence of coronary perforations, predisposing factors, and in-hospital and late outcome of patients with coronary perforations. Perforations occurred in 0.84% of treated lesions and more frequently in patients with complex lesions after atheroablative procedures and who underwent intravascular ultrasound guided lumen optimization.

Initial experience with a new 8 French-compatible directional atherectomy catheter: immediate and mid-term results.

The purpose of this study was to evaluate the safety and efficacy of the new Fox Hollow atherectomy device (FHT) designed for more efficient and easier plaque removal. The FHT has short rigid section and low-profile cutter mounted on a monorail catheter. The FHT catheter was utilized in 77 patients with 98 lesions.

Modified T-stenting technique with crushing for bifurcation lesions: immediate results and 30-day outcome.

We report a new stenting technique employed in 20 consecutive patients to treat true bifurcation lesions using the Cypher stent (Cordis, Warren, NJ). Both stents are advanced at the site of the bifurcation. The proximal marker of the side-branch stent must be situated in the main branch at a distance of 4-5 mm proximal to the carina of the bifurcation and the main branch stent must cover the bifurcation as well as the protruding segment of the side-branch stent.

A tortuous distal carotid artery: how to overcome the problem, with the aim of guaranteeing distal protection.

This report describes a case of stent implantation in a right internal carotid artery with severe distal tortuosity, which caused difficulty in advancing a filter protection device. Advancement of the introducing sheath at the level of the carotid bifurcation and exchange for a third-generation distal filter protection device overcame the problem.

Preliminary observations regarding angiographic pattern of restenosis after rapamycin-eluting stent implantation.

Background: Restenosis after implantation of drug-eluting stents (DES) is a rare phenomenon, occurring more frequently peri-stent.

Methods And Results: We evaluated the pattern of restenosis occurring after implantation of DES in unselected lesions. From April 15 to December 6, 2002, we treated 368 patients with 735 lesions by using 841 rapamycin-eluting stents (Cypher, Cordis, a Johnson & Johnson Company).

Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty.

Background: Elective intra-aortic balloon pump (IABP) support may reduce acute complications occurring during percutaneous coronary interventions (PCI) in patients with severe depression of the left ventricular ejection fraction (EF < or = 30%).

Methods: Since February 1998, 133 consecutive patients with EF < or =30% underwent elective PCI in our institution; 61 had elective preprocedural IABP support (group A) and 72 patients had conventional PCI (group B). Jeopardy score was calculated in each patient from the coronary angiograms to quantify the myocardium at risk.

Results and long-term predictors of adverse clinical events after elective percutaneous interventions on unprotected left main coronary artery.

Background: The safety and efficacy of percutaneous coronary intervention of de novo lesions in unprotected left main coronary arteries remains an unresolved issue.

Methods And Results: We analyzed 67 consecutive patients treated with the following devices: 39 with stents, 12 with rotational atherectomy plus stents, 13 with directional coronary atherectomy plus stents (a total of 64 patients were treated with stents), and 3 patients with directional coronary atherectomy only. The reference vessel size was 3.