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8 results on '"Montefusco, Antonio"'

1. Impact of Kissing Balloon in Patients Treated With Ultrathin Stents for Left Main Lesions and Bifurcations

Author

Gaido, Luca, D’ascenzo, Fabrizio, Imori, Yoichi, Wojakowski, Wojciech, Saglietto, Andrea, Figini, Filippo, Mattesini, Alessio, Trabattoni, Daniela, Rognoni, Andrea, Tomassini, Francesco, Bernardi, Alessandro, Ryan, Nicola, Muscoli, Saverio, Helft, Gerard, de Filippo, Ovidio, Parma, Radoslaw, de Luca, Leonardo, Ugo, Fabrizio, Cerrato, Enrico, Montefusco, Antonio, Pennacchi, Mauro, Wańha, Wojciech, Smolka, Grzegorz, de Lio, Giulia, Bruno, Francesco, Huczek, Zenon, Boccuzzi, Giacomo, Cortese, Bernardo, Capodanno, Davide, Omedè, Pierluigi, Mancone, Massimo, Nuñez-Gil, Ivan, Romeo, Francesco, Varbella, Ferdiando, Rinaldi, Mauro, Escaned, Javier, Conrotto, Federico, Burzotta, Francesco, Chieffo, Alaide, Perl, Leor, D’amico, Maurizio, Di Mario, Carlo, Sheiban, Imad, Gagnor, Andrea, Giammaria, Massimo, de Ferrari, Gaetano Maria, Maria Vittoria Hospital [Turin], Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino, Nippon Medical School [Tokyo, Japon], Medical University of Silesia (SUM), Careggi University Hospital [Florence, Italie], Università degli Studi di Milano = University of Milan (UNIMI), University Hospital 'Maggiore della Carità' [Novara, Italy], Ospedale di Rivoli [Rivoli, Italy] (OR), San Luigi Gonzaga University Hospital [Turin, Italy] (SLGUH Orbassano), Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Università degli Studi di Roma Tor Vergata [Roma], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Università degli studi di Torino = University of Turin (UNITO), Medical University of Warsaw - Poland, Ospedale San Giovanni Evangelista [Rome, Italy] (OSGE), Clinica San Carlo [Milan, Italy] (CSC), AOU Policlinico Vittorio-Emanuele [Catania, Italia], Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), IRCCS San Raffaele Scientific Institute [Milan, Italie], Rabin Medical Center [Tel Aviv, Israël], Clinica Pederzoli [Peschiera del Garda, Italy] (CP), and Lesnik, Philippe

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], percutaneous coronary intervention, drug-eluting stents, thrombosis, coronary artery disease
Abstract

Background: There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. Methods: All patients undergoing left main or bifurcations percutaneous coronary intervention enrolled in the RAIN registry (Very Thin Stents for Patients With MAIN or BiF in Real Life: The RAIN, a Multicenter Study) evaluating ultrathin stents were included. Major adverse cardiac event (a composite of all-cause death, myocardial infarction, target lesion revascularization, and stent thrombosis) was the primary end point, while its components, along with target vessel revascularization, were the secondary end points. The main analysis was performed comparing patients with and without FKI after adjustment with inverse probability of treatment weighting. Subgroup analyses were performed according to FKI (short [

Published
2020
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2. Clinical performance of a dedicated self-apposing stent for the treatment of left main stem disease. Results of the left Main AngioplasTy wIth a Self-apposing StEnt - the MATISSE study.

Author

Cortese, Bernardo, Montefusco, Antonio, D'Ascenzo, Fabrizio, La Manna, Alessio, Andò, Giuseppe, Bisceglia, Teodoro, Secco, Gioel G., Meyer-Gessner, Markus, Wańha, Wojciech, Sganzerla, Paolo, Napodano, Massimo, Di Palma, Gaetano, Latini, Roberto A., Tamburino, Corrado, Orrego, Pedro Silva, and Baumbach, Andreas

Subjects
*SURGICAL stents, *ANGIOPLASTY, *CLINICAL trials, *TREATMENT effectiveness, *DRUG-eluting stents
Abstract

Background: In the recent years percutaneous treatment of the left main stem (LM) has gained a precise role as a result of consistent scientific evidence vs. coronary artery bypass. A self-apposing stent offers an improved adaptation to the vessel wall, especially in case of tapered vessels; aim of this study was to investigate the role of a novel self-apposing, sirolimus-eluting stent (Stentys, France) for the treatment of LM coronary artery disease.Methods and Results: MATISSE is a retrospective, multicenter registry, which enrolled 151 patients treated with the device at 17 international centers. Primary study endpoint was the occurrence of major adverse cardiovascular events (MACE), a composite endpoint of cardiac death, target lesion revascularization (TLR) and target-vessel myocardial infarction, at 9months clinical follow-up. Secondary endpoints included procedural success, the single determinants of MACE and stent thrombosis. Lesions were located in distal LM bifurcation in 84% of the patients. Procedural success was achieved in 150 patients. The average follow-up length was 348±52days. MACE occurred in 14 (9.3%) patients with 2 (1.3%) cardiac deaths. TLR occurred in 8 patients (5.3%). There were 2 cases of definite stent thrombosis, 1 acute and 1 very late.Conclusions: A self-apposing stent, when used for LM PCI in a real world, high risk population, showed good immediate procedural results with low rates of adverse events at mid-term follow-up. [ABSTRACT FROM AUTHOR]

Published
2018
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3. Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis.

Author

Iannaccone, Mario, D'Ascenzo, Fabrizio, Templin, Christian, Omedè, Pierluigi, Montefusco, Antonio, Guagliumi, Giulio, Serruys, Patrick W., Di Mario, Carlo, Kochman, Janusz, Quadri, Giorgio, Biondi-Zoccai, Giuseppe, Lüscher, Thomas F., Moretti, Claudio, D'amico, Maurizio, Gaita, Fiorenzo, and Stone, Gregg W.

Subjects
CONFIDENCE intervals, DIETHYLSTILBESTROL, EXPERIMENTAL design, CASE studies, META-analysis, SCIENTIFIC observation, REGRESSION analysis, RESEARCH evaluation, SYSTEMATIC reviews, DATA analysis, OPTICAL coherence tomography, RANDOMIZED controlled trials, DISEASE incidence, DRUG-eluting stents
Abstract

Aims The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. Methods and results All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6-12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 mm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 mm), while SES, EES, and BES had the least NIT. Conclusion Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first- generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6-12 months. Further studies with clinical correlation are warranted to determine the implications of these findings. [ABSTRACT FROM AUTHOR]

Published
2017
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5. Daily risk of adverse outcomes in patients undergoing complex lesions revascularization: A subgroup analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life).

Author

Biolè, Carloalberto, Huczek, Zenon, Nuñez-Gil, Ivan, Boccuzzi, Giacomo, Autelli, Michele, Montefusco, Antonio, Trabattoni, Daniela, Ryan, Nicola, Venuti, Giuseppe, Imori, Yoichi, Takano, Hitoshi, Matsuda, Junya, Shimizu, Wataru, Muscoli, Saverio, Montabone, Andrea, Wojakowski, Wojciech, Rognoni, Andrea, Helft, Gerard, Gallo, Diego, and Parma, Radoslaw

Subjects
*PERCUTANEOUS coronary intervention, *ACUTE coronary syndrome, *SUBGROUP analysis (Experimental design), *CORONARY disease, *MYOCARDIAL revascularization, *DRUG-eluting stents
Abstract

Percutaneous coronary intervention (PCI) for complex lesions, including unprotected left main (ULM) and bifurcations, is gaining a relevant role in treating coronary artery disease with good outcomes, also thanks to new generation stents. The daily risk of adverse cardiovascular events and their temporal distribution after these procedures is not known. All consecutive patients presenting with a critical lesion of ULM or bifurcation treated with very thin struts stents, enrolled in the RAIN-Cardiogroup VII study, were analyzed. The daily risk of major acute cardiovascular events (MACE), target lesion revascularization (TLR) and stent thrombosis (ST) and their temporal distribution in the first year of follow-up was the primary endpoint. Differences among subgroups (ULM, patient presentation, kind of stent polymer) were the secondary endpoint. 2745 patients were included, mean age 68 ± 11 years, 33.3% diabetics, 54.5% had an acute coronary syndrome (ACS); 88.5% of treated lesions were bifurcations, 27.2% ULM. Average daily risk was 0.022% for MACE, 0.005% for TLR and 0.004% for ST, in the first year. Bimodal distribution of adverse events, especially TLR, with an early peak in the first 50 days and a late one after 150 days, was observed. Patients with ULM presented a significantly higher daily risk of events, and ACS patients presented higher MACE risk. No difference emerged according to the type of stent polymer. The daily risk of adverse events in the first year after complex PCI in our study is acceptably low. PCI on ULM carries a higher risk of complications. • PCI for complex lesions with new stents carries a low daily risk of adverse events. • Daily risks are 0.022% for MACE, 0.005% for TLR and 0.004% for ST in the first year. • Daily risks of TLR and ST show a bimodal distribution. • PCI on ULM carries a higher risk of complications. • Stent polymer is not associated with a difference in the daily risk of events. [ABSTRACT FROM AUTHOR]

Published
2019
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6. Radial Versus Femoral Access for the Treatment of Left Main Lesion in the Era of Second-Generation Drug-Eluting Stents

Author

Sebastiano Gili, Hiroyoshi Kawamoto, Marco Pavani, Pierluigi Omedè, Claudio Moretti, Giuseppe Biondi Zoccai, Antonio Colombo, Maurizio D'Amico, Fabrizio D'Ascenzo, Roberto di Summa, Alaide Chieffo, Fabrizio Ugo, Fiorenzo Gaita, Ferdinando Varbella, Giacomo Boccuzzi, Francesco Tomassini, Antonio Montefusco, Federico Conrotto, Roberto Garbo, Javier Escaned, Enrico Cerrato, Gili, Sebastiano, D'Ascenzo, Fabrizio, Di Summa, Roberto, Conrotto, Federico, Cerrato, Enrico, Chieffo, Alaide, Boccuzzi, Giacomo, Montefusco, Antonio, Ugo, Fabrizio, Omedã©, Pierluigi, Kawamoto, Hiroyoshi, Tomassini, Francesco, Pavani, Marco, Varbella, Ferdinando, Garbo, Roberto, D'Amico, Maurizio, Biondi Zoccai, Giuseppe, Moretti, Claudio, Escaned, Javier, Colombo, Antonio, and Gaita, Fiorenzo

Subjects
Registrie, Male, medicine.medical_specialty, Acute coronary syndrome, Percutaneous, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Follow-Up Studie, Catheterization, Peripheral, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Retrospective Studie, Internal medicine, medicine.artery, Catheterization, Peripheral, Drug-Eluting Stent, medicine, Humans, Registries, 030212 general & internal medicine, Myocardial infarction, Radial artery, Coronary Vessel, Aged, Retrospective Studies, Coronary Vessels, Female, Femoral Artery, Follow-Up Studies, Radial Artery, Treatment Outcome, Drug-Eluting Stents, Cardiology and Cardiovascular Medicine, business.industry, Percutaneous coronary intervention, Retrospective cohort study, medicine.disease, Surgery, Propensity score matching, Cardiology, business, Human
Abstract

Transradial access (TRA) is often avoided in favor of the transfemoral access (TFA) during percutaneous coronary interventions of the unprotected left main coronary artery (ULM), due to technical and safety concerns. The aim of this study was to compare the performance of TRA and TFA in the treatment of ULM with second-generation drug-eluting stents. Consecutive patients who underwent percutaneous coronary intervention on ULM with second-generation drug-eluting stents were retrospectively enrolled in the multicenter Failure in Left Main Study With 2nd Generation Stents (FAILS 2) registry. Patients were stratified according to the arterial access. The choice between TRA and TFA was left to each operator's preferences. Bleedings during index hospitalization were the primary end point. Secondary end points were major adverse cardiovascular events (a composite of death, reinfarction, and target lesion revascularization), the single components of major adverse cardiovascular events at follow-up and stent thrombosis. Propensity score matching was executed to account for possible confounding. Overall, 1,247 patients were enrolled (23.2% [289] of female gender, mean age 70.2 ± 10.2 years). Diagnosis at presentation was stable angina in 603 (48.7%) cases, non–ST-segment elevation acute coronary syndrome in 465 (37.3%), ST-segment elevation myocardial infarction in 117 (9.5%). Mean follow-up was 726 ± 654 days. After propensity score with matching, 354 patients were included. The primary end point was significantly reduced in patients treated with TRA (2.0% vs 4.0%, p = 0.042), whereas no differences emerged pertaining the secondary end points, including target lesion revascularization and reinfarction. In conclusion, TRA may reduce in-hospital bleedings in patients undergoing percutaneous treatment of the ULM, without increasing the rate of adverse cardiovascular events at follow-up, and may therefore be safely used in the treatment of the ULM.

Published
2017
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7. Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents–Cardiogroup III Study)

Author

Claudio Moretti, Alaide Chieffo, Maurizio D'Amico, Javier Escaned, Giuseppe Biondi-Zoccai, Giacomo Boccuzzi, Roberto di Summa, Ferdinando Varbella, Fabrizio D'Ascenzo, Fabrizio Ugo, Roberto Garbo, Marco Pavani, Sara Rettegno, Antonio Colombo, Fiorenzo Gaita, Federico Conrotto, Hyroishi Kawamoto, Enrico Cerrato, Antonio Montefusco, Pierluigi Omedè, D'Ascenzo, Fabrizio, Chieffo, Alaide, Cerrato, Enrico, Ugo, Fabrizio, Pavani, Marco, Kawamoto, Hyroishi, Di Summa, Roberto, Varbella, Ferdinando, Boccuzzi, Giacomo, Omedã, Pierluigi, Rettegno, Sara, Garbo, Roberto, Conrotto, Federico, Montefusco, Antonio, Biondi zoccai, Giuseppe, D'Amico, Maurizio, Moretti, Claudio, Escaned, Javier, Gaita, Fiorenzo, and Colombo, Antonio

Subjects
Male, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 0302 clinical medicine, Restenosis, Coronary Restenosi, Retrospective Studie, Cause of Death, Intravascular ultrasound, Aged, Coronary Restenosis, Female, Humans, Incidence, Percutaneous Coronary Intervention, Prognosis, Retreatment, Retrospective Studies, Tomography, Optical Coherence, Treatment Outcome, Ultrasonography, Interventional, Drug-Eluting Stents, Cardiology and Cardiovascular Medicine, Drug-Eluting Stent, 030212 general & internal medicine, Myocardial infarction, Tomography, Ultrasonography, Cause of death, Interventional, medicine.diagnostic_test, Hazard ratio, Cardiology, Human, medicine.medical_specialty, Prognosi, Revascularization, 03 medical and health sciences, Internal medicine, medicine, business.industry, Percutaneous coronary intervention, medicine.disease, Optical Coherence, business
Abstract

Incidence, predictors, and impact on prognosis of target lesion revascularization (TLR) for patients treated with second-generation drug-eluting stents (DESs) on unprotected left main (ULM) remain to be defined. The present study is a multicenter study including patients treated with a second-generation DES on ULM from June 2007 to January 2015. Rate of TLR was the primary end point. All cause death, myocardial infarction, target vessel revascularization, and stent thrombosis were the secondary end points. A total of 1,270 patients were enrolled: after a follow-up of 650 days (230 to 1,170), 47 (3.7%) of them underwent a re–percutaneous coronary intervention TLR on the left main, 22 during a planned angiographic follow-up. Extent of coronary artery disease was similar among groups (median value of Syntax of 27 ± 10 vs 26 ± 9, p = 0.45), as localization of the lesion in the ULM. Of patients reporting with TLR on ULM, 56% presented with a focal restenosis, 33% diffuse and 10% proliferative. At multivariate analysis, insulin-dependent diabetes mellitus increased risk of TLR (hazard ratio [HR] 2.0: 1.1 to 3.6, p = 0.04), whereas use of intravascular ultrasound resulted protective (HR 0.5: 0.3 to 0.9, p = 0.02). At follow-up, rates of cardiovascular death did not differ among the 2 groups (4% vs 4%, p = 0.95). At multivariate analysis, TLR on LM did not increase risk of all cause death (HR 0.4: 0.1 to 1.6, p = 0.22), whereas cardiogenic shock and III tertile of Syntax portended a worse prognosis (HR 4.5: 2.1 to 10.2, p = 0.01 and HR 1.4: 1.1 to 1.6, p = 0.03, respectively). In conclusion, repeated revascularization after implantation of second-generation DES on ULM represents an unfrequent event, being increased in insulin-dependent patients and reduced by intravascular ultrasound. Impact on prognosis remains neutral, being related to clinical presentation and extent of coronary artery disease.

Published
2017
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8. Self-expandable sirolimus-eluting stents compared to second-generation drug-eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS-2 registries

Author

Corrado Tamburino, Arnaldo Poli, Francesco Tomassini, Antonio Colombo, Alaide Chieffo, Sebastiano Gili, Paolo Sganzerla, Gioel Gabrio Secco, Luigi Emilio Pastormerlo, Antonio Montefusco, Fabrizio D'Ascenzo, Fiorenzo Gaita, Kuan Leong Yew, Gennaro Sardella, Bernardo Cortese, Massimo Mancone, Annamaria Nicolino, Plinio Cirillo, Andreas Baumbach, Grzegorz Smolka, Roberto di Summa, Fabrizio Ugo, Wojciech Wańha, Javier Escaned, Montefusco, Antonio, D'Ascenzo, Fabrizio, Gili, Sebastiano, Smolka, Grzegorz, Chieffo, Alaide, Baumbach, Andrea, Escaned, Javier, Sganzerla, Paolo, Tomassini, Francesco, Secco, Gioel Gabrio, Ugo, Fabrizio, Tamburino, Corrado, Nicolino, Annamaria, Mancone, Massimo, Poli, Arnaldo, Yew, Kuan-Leong, Cirillo, Plinio, Wanha, Wojciech, Pastormerlo, Luigi Emilio, di Summa, Roberto, Sardella, Gennaro, Colombo, Antonio, Gaita, Fiorenzo, and Cortese, Bernardo

Subjects
Radiology, Nuclear Medicine and Imaging, medicine.medical_treatment, 030204 cardiovascular system & hematology, time factors, 0302 clinical medicine, alloys, cardiovascular agents, self expandable metallic stents, Nuclear Medicine and Imaging, middle aged, 80 and over, risk factors, 030212 general & internal medicine, Myocardial infarction, second-generation drug-eluting stent, humans, media_common, Aged, 80 and over, risk assessment, drug-eluting stents, General Medicine, aged, retrospective studies, female, sirolimus, Cardiology, Radiology, Cardiology and Cardiovascular Medicine, coronary artery disease, medicine.drug, Drug, medicine.medical_specialty, Randomization, media_common.quotation_subject, 03 medical and health sciences, male, Internal medicine, medicine, percutaneous coronary intervention, self-expandable stent, unprotected left main, cardiovascular diseases, Unstable angina, business.industry, prosthesis design, registries, Percutaneous coronary intervention, medicine.disease, comparative effectiveness research, Sirolimus, Propensity score matching, treatment outcome, aged, 80 and over, business, Mace
Abstract

OBJECTIVES: To compare the effectiveness and safety of self-expandable, sirolimus-eluting Stentys stents (SES) and second-generation drug-eluting stents (DES-II) for the treatment of the unprotected left main (ULM). BACKGROUND: SES may provide a valuable option to treat distal ULM, particularly when significant caliber gaps with side branches are observed. METHODS: Patients from the multicenter SPARTA (clinicaltrials.gov: NCT02784405) and FAILS2 registries were included. Propensity-score with matching was performed to account for the lack of randomization. Primary end-point was the rate of major adverse cardiovascular events (MACE, a composite of all cause death, myocardial infarction, target lesion revascularization [TLR], unstable angina and definite stent thrombosis [ST]). Single components of MACE were the secondary end-points. RESULTS: Overall, 151 patients treated with SES and 1270 with DES-II were included; no differences in MACE rate at 250 days were observed (9.8% vs. 11.5%, P = 0.54). After propensity score with matching, 129 patients treated with SES and 258 with DES-II, of which about a third of female gender, were compared. After a follow-up of 250 days, MACE rate did not differ between the two groups (9.9% vs. 8.5%, P = 0.66), as well as the rate of ULM TLR (1.6% vs. 3.1%, P = 0.36) and definite ST (0.8% vs. 1.2%, P = 0.78). These results were consistent also when controlling for the treatment with provisional vs. 2-stents strategies for the ULM bifurcation. CONCLUSION: SES use for ULM treatment was associated with a similar MACE rate compared to DES-II at an intermediate-term follow-up. SES might represent a potential option in this setting.

Published
2019

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