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Latest Advances in Complex Coronary Interventions
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Latest Advances in Complex Coronary Interventions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 11014

Special Issue Editor

Dr. M. Chadi Alraies

E-Mail Website
Guest Editor
Detroit Medical Center, DMC Heart Hospital, Detroit, MI, USA
Interests: complex coronary interventions; mechanical circulatory support; large bore vascular access; medical education; social media as learning tools for physicians

Special Issue Information

Dear Colleagues,

In recent years, patients with multiple comorbidities are increasingly referred for coronary interventions due to advancement in coronary intervention technology and operator techniques. Intra-coronary imaging has helped to better characterize coronary lesions and identify calcification burden which is perceived as challenge to the treating interventionist. Therefore, the heart team approach has been recommended by the current guidelines as a tool for better patient selection and offering best therapy to these patients. All of these efforts have improved the clinician’s approach to diagnosis, treatment, and the prediction of prognosis for challenging coronary interventions. The aim of this Special Issue is to highlight recent advances in the context of diagnosis, treatment, and the prediction of prognosis for complex coronary interventions.

Dr. M. Chadi Alraies
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Complex coronary interventions
  • Mechanical circulatory support
  • Large bore vascular access
  • Intra-coronary imaging
  • Medical education
  • Social media as learning tools for physicians

Published Papers (3 papers)

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Research

9 pages, 1037 KiB  
Article
Comparison of Distal Radial, Proximal Radial, and Femoral Access in Patients with ST-Elevation Myocardial Infarction
by Oh-Hyun Lee, Yongcheol Kim, Nak-Hoon Son, Ji Woong Roh, Eui Im, Deok-Kyu Cho and Donghoon Choi
J. Clin. Med. 2021, 10(15), 3438; https://doi.org/10.3390/jcm10153438 - 2 Aug 2021
Cited by 6 | Viewed by 2830
Abstract
Recent studies have indicated that distal radial access (DRA) is feasible in patients undergoing percutaneous coronary intervention (PCI). The present study aimed to compare DRA, proximal radial access (PRA), and femoral access (FA) in patients with ST-elevation myocardial infarction (STEMI) undergoing PCI. Data [...] Read more.
Recent studies have indicated that distal radial access (DRA) is feasible in patients undergoing percutaneous coronary intervention (PCI). The present study aimed to compare DRA, proximal radial access (PRA), and femoral access (FA) in patients with ST-elevation myocardial infarction (STEMI) undergoing PCI. Data were analyzed for 109 patients with STEMI treated via primary PCI from March 2020 to May 2021. The success rate of DRA was 83.3% (35/42), including seven cases of failed puncture (puncture failure = 5, severe radial artery spasm = 2). Primary PCI via the DRA was successful in all 35 patients. After classifying the patients requiring crossover into a separate group, the percentage of the puncture time in the door-to-wiring time was 2.7% [2.2–4.3], 3.3% [2.3–4.0], 2.6% [1.2–4.9], and 27.0% [13.5–29.3] in the DRA (n = 35), PRA (n = 24), FA (n = 26), and crossover (n = 9) groups, respectively (p < 0.01). Only two local hematomas (≤5 cm) occurred in the DRA group, while one patient in the FA group required surgical treatment and a transfusion for an access-site vascular injury. When performed by an experienced operator, DRA may represent a feasible alternative to other access routes in select patients with STEMI undergoing PCI, such as those with a high risk of bleeding. Full article
(This article belongs to the Special Issue Latest Advances in Complex Coronary Interventions)
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11 pages, 725 KiB  
Article
Differential Factors for Predicting Outcomes in Left Main versus Non-Left Main Coronary Bifurcation Stenting
by Jung-Joon Cha, Soon Jun Hong, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Tae Hoon Ahn, Hyo-Soo Kim, Woo Jung Chun, Seung-Ho Hur, Seung Hwan Han, Seung-Woon Rha, In-Ho Chae, Jin-Ok Jeong, Jung Ho Heo, Junghan Yoon, Ki Hong Choi, Young Bin Song, Hyeon-Cheol Gwon, Jong-Seon Park, Myeong-Ki Hong, Joon-Hyung Doh, Kwang Soo Cha, Doo-Il Kim, Sang Yeub Lee, Kiyuk Chang, Byung-Hee Hwang, So-Yeon Choi, Myung Ho Jeong, Chang-Wook Nam, Bon-Kwon Koo and Do-Sun Limadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(14), 3024; https://doi.org/10.3390/jcm10143024 - 7 Jul 2021
Cited by 4 | Viewed by 2026
Abstract
Background: No large-scale study has compared the clinical and angiographic predictors of cardiovascular events in patients with left main bifurcation (LMB) and non-LMB stenting after second-generation DES implantation. Herein, we investigated differential clinical and angiographic factors for predicting outcomes in LMB versus non-LMB [...] Read more.
Background: No large-scale study has compared the clinical and angiographic predictors of cardiovascular events in patients with left main bifurcation (LMB) and non-LMB stenting after second-generation DES implantation. Herein, we investigated differential clinical and angiographic factors for predicting outcomes in LMB versus non-LMB stenting. Methods: A total of 2648 patients with bifurcation lesions treated with second-generation DESs from the retrospective patient cohort were divided into an LMB group (n = 935) and a non-LMB group (n = 1713). The primary outcome was the 7-year incidence of target lesion failure (TLF), defined as the composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: The incidence of TLF was 9.8%. Those in the LMB group were associated with a higher risk of TLF (14.2% versus 7.5%, p < 0.001) than those in the non-LMB group. Regarding the LMB group, independent predictors of TLF were chronic kidney disease (CKD), reduced left ventricular ejection fraction (LVEF), and two-stenting. Regarding the non-LMB group, CKD, reduced LVEF, old age, diabetes, and small diameter of the main vessel stent were independent predictors of TLF. Conclusions: The two-stent strategy could potentially increase TLF for the LMB lesions, and achieving the maximal diameter of the main vessel stent could result in better clinical outcomes for non-LMB lesions. Full article
(This article belongs to the Special Issue Latest Advances in Complex Coronary Interventions)
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10 pages, 9367 KiB  
Article
Feasibility and Safety of the Left Distal Radial Approach in Percutaneous Coronary Intervention for Bifurcation Lesions
by Oh-Hyun Lee, Ji Woong Roh, Eui Im, Deok-Kyu Cho, Myung Ho Jeong, Donghoon Choi and Yongcheol Kim
J. Clin. Med. 2021, 10(10), 2204; https://doi.org/10.3390/jcm10102204 - 19 May 2021
Cited by 4 | Viewed by 5689
Abstract
Recently, the left distal radial approach (DRA) for percutaneous coronary intervention (PCI) has been shown to be a feasible option, but there are limited data regarding the feasibility of performing bifurcation PCI via the left DRA. Therefore, this study aimed to describe our [...] Read more.
Recently, the left distal radial approach (DRA) for percutaneous coronary intervention (PCI) has been shown to be a feasible option, but there are limited data regarding the feasibility of performing bifurcation PCI via the left DRA. Therefore, this study aimed to describe our experience with the contemporary left DRA to perform PCI of bifurcation lesions. Between December 2017 and December 2019, we identified 106 patients treated with bifurcation PCI via the left DRA. We evaluated the success rate of PCI, access-site complications including major bleeding requiring surgery or transfusion, hematoma, distal and forearm radial artery occlusion, and 30-day mortality. Eleven patients (10.4%) treated with left main bifurcation and true bifurcations accounted for 39.6% of cases, with the left anterior descending artery/diagonal branch being the most frequent bifurcation site (57.5%, 61/106). PCI was performed using a 6-French guiding catheter in 101 (95.3%) cases. Successful PCI for bifurcation lesions via the left DRA was achieved in all 106 patients without access-site cross-over. There was no major bleeding, distal and forearm radial artery occlusion, forearm hematoma, or mortality at 30 days. The left DRA is a safe and feasible alternative access site for bifurcation PCI in selected patients. Full article
(This article belongs to the Special Issue Latest Advances in Complex Coronary Interventions)
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