Objective To summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey Ⅰ thoracic aortic dissection. Methods From January 2006 to Oct...Objective To summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey Ⅰ thoracic aortic dissection. Methods From January 2006 to October 2010,101 cases of DeBakeyⅠaortic dissection were treated by modified total arch replacement and stent elephant trunk technique,in which emergencey surgery were performed on 73 cases. There were 76 male and 25展开更多
Coronary bifurcation lesions(CBLs)account for 15%-20%of all percutaneous coronary interventions.The complex nature of these lesions is responsible for poorer procedural,early and late outcomes.This complex lesion subs...Coronary bifurcation lesions(CBLs)account for 15%-20%of all percutaneous coronary interventions.The complex nature of these lesions is responsible for poorer procedural,early and late outcomes.This complex lesion subset has received great attention in the interventional cardiac community,and multiple stenting techniques have been developed.Of these,the provisional stenting technique is most often the default strategy;however,the elective double stenting(EDS)technique is preferred in certain subsets of complex CBLs.The double kissing crush technique may be the preferred EDS technique because of its efficacy and safety in comparative trials;however,this technique consists of many steps and requires training.Many new methods have recently been added to the EDS techniques to provide better stent scaffolding and to reduce early and late adverse outcomes.Intravascular imaging is necessary to determine the interventional strategy and postinterventional results.This review discusses the basic concepts,contemporary percutaneous interventional technical approaches,new methods,and controversial treatment issues of CBLs.展开更多
Background：The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment.However,their comparative performance remains elusive.Methods：A total of 300 patients with co...Background：The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment.However,their comparative performance remains elusive.Methods：A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush （n =150） and culotte （n =150） treatment.The primary endpoint was the occurrence of major adverse cardiac events （MACEs） at 12 months including cardiac death,myocardial infarction,stent thrombosis,and target vessel revascularization.Index lesion restenosis at 12 months was a secondary endpoint.The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified.Results：There were no significant differences in MACE rates between the two groups at 12-month follow-up：Crush 6.7%,culotte 5.3% （P =0.48）.The rates of index lesion restenosis were 12.7% versus 6.0% （P =0.047） in the crush and the culotte groups,respectively.At 12-month follow-up,the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group （[5.01 ± 0.95] × 10^-4 Newton and [6.08 ± 1.16] × 10^-4 Newton,respectively;P =0.003）.Conclusions：Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up.Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.展开更多
文摘Objective To summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey Ⅰ thoracic aortic dissection. Methods From January 2006 to October 2010,101 cases of DeBakeyⅠaortic dissection were treated by modified total arch replacement and stent elephant trunk technique,in which emergencey surgery were performed on 73 cases. There were 76 male and 25
文摘Coronary bifurcation lesions(CBLs)account for 15%-20%of all percutaneous coronary interventions.The complex nature of these lesions is responsible for poorer procedural,early and late outcomes.This complex lesion subset has received great attention in the interventional cardiac community,and multiple stenting techniques have been developed.Of these,the provisional stenting technique is most often the default strategy;however,the elective double stenting(EDS)technique is preferred in certain subsets of complex CBLs.The double kissing crush technique may be the preferred EDS technique because of its efficacy and safety in comparative trials;however,this technique consists of many steps and requires training.Many new methods have recently been added to the EDS techniques to provide better stent scaffolding and to reduce early and late adverse outcomes.Intravascular imaging is necessary to determine the interventional strategy and postinterventional results.This review discusses the basic concepts,contemporary percutaneous interventional technical approaches,new methods,and controversial treatment issues of CBLs.
文摘Background：The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment.However,their comparative performance remains elusive.Methods：A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush （n =150） and culotte （n =150） treatment.The primary endpoint was the occurrence of major adverse cardiac events （MACEs） at 12 months including cardiac death,myocardial infarction,stent thrombosis,and target vessel revascularization.Index lesion restenosis at 12 months was a secondary endpoint.The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified.Results：There were no significant differences in MACE rates between the two groups at 12-month follow-up：Crush 6.7%,culotte 5.3% （P =0.48）.The rates of index lesion restenosis were 12.7% versus 6.0% （P =0.047） in the crush and the culotte groups,respectively.At 12-month follow-up,the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group （[5.01 ± 0.95] × 10^-4 Newton and [6.08 ± 1.16] × 10^-4 Newton,respectively;P =0.003）.Conclusions：Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up.Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.
