Stepwise layered provisional stenting (PS) is the most commonly used strategy to treat coronary bifurcation lesions (CBL). The term 'stepwise layered' emphasises the versatility of this approach that allows the adjustment of the procedure plan according to the CBL complexity, starting with stent implantation in one branch and implantation of a second stent in the other branch only when required. A series of refinements have been implemented over the years to facilitate the achievement of predictable procedural results using this approach. However, despite its simplicity and versatility, operators using this technique require full knowledge of the pitfalls of each procedural step. Part I of this 16 European Bifurcation Club consensus paper provides a detailed step-by-step overview of the pitfalls and technical troubleshooting during the implantation of the first stent using the PS strategy for the treatment of CBL.
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http://dx.doi.org/10.4244/EIJ-D-22-00165 | DOI Listing |
J Am Heart Assoc
January 2025
John P. Hussman Institute for Human Genomics, University of Miami Miami FL USA.
Background: Carotid intima-media thickness (IMT) is a measure of atherosclerosis and a predictor of vascular diseases. Traditional vascular risk factors and genetic variants do not completely explain the variation in carotid IMT. We sought to identify epigenetic factors that may contribute to the remaining carotid IMT variability.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Division of Cardiac Surgery, Inova Heart and Vascular Institute, Inova Health Systems, Falls Church, Virginia.
Background: DeBakey type I aortic dissections (AD) are most frequently treated with hemiarch repair. A subset of patients demonstrates persistent distal end-organ ischemia secondary to persistent true lumen (TL) compression. We describe the use of bare metal stent grafting across the residual arch dissection with the Zenith Dissection Endovascular Stent (ZDES, Cook Medical) in 7 patients with type I AD that was repaired in a hemiarch configuration with a compromised distal TL and organ malperfusion.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Division of Pediatric Cardiac Surgery, Department of Cardiovascular Surgery, Children's Heart Institute, Children's Memorial Hermann Hospital, University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas.
Aorticopulmonary paragangliomas are exceedingly rare tumors in pediatric populations. Complete surgical resection is the only curative treatment. However, resection is challenging due to the vascularity of paragangliomas and their close relationship with the great vessels.
View Article and Find Full Text PDFBiomolecules
December 2024
State Key Laboratory of Transvascular Implantation Devices, Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Foam cell formation is a hallmark of atherosclerosis, yet the cellular complexity within foam cells in human plaques remains unexplored. Here, we integrate published single-cell RNA-sequencing, spatial transcriptomic, and chromatin accessibility sequencing datasets of human atherosclerotic lesions across eight distinct studies. Through this large-scale integration of patient-derived information, we identified foamy macrophages enriched for genes characteristic of the foamy signature.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Carotid body tumors (CBTs), rare neuroendocrine neoplasms near the carotid bifurcation, are mostly asymptomatic but may cause discomfort and autonomic dysfunction. Computed tomography angiography (CTA) is used for diagnosis, eliminating the need for a biopsy to avoid the risk of hemorrhage. Surgical excision is the preferred treatment, while radiotherapy is an option when surgery is impractical.
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