35 results on '"Andrzej Ochala"'
Search Results
2. Exposure of the eye lens and brain for interventional cardiology staff
- Author
-
Joanna Kidoń, Kinga Polaczek-Grelik, Przemysław Żurek, Wojciech Wojakowski, and Andrzej Ochala
- Subjects
interventional cardiology ,exposure to the lenses ,exposure to the brain. ,Medicine - Published
- 2021
- Full Text
- View/download PDF
3. Short-term safety and efficacy of transcarotid transcatheter aortic valve implantation with balloon-expandable vs. self-expandable valves
- Author
-
Damian Hudziak, Wojciech Wańha, Radosław Gocol, Radosław Parma, Andrzej Ochala, Grzegorz Smolka, Joanna Ciosek, Tomasz Darocha, Marek Deja, and Wojciech Wojakowski
- Subjects
aortic stenosis ,transcarotid access ,transcatheter aortic valve implantation ,balloon-expandable valve ,self-expandable valve. ,Medicine - Published
- 2021
- Full Text
- View/download PDF
4. PHYSICAL ACTIVITY OF PHYSIOTHERAPY STUDENTS AT THE MEDICAL UNIVERSITY OF WARSAW
- Author
-
Dariusz Boguszewski, Andrzej Ochala, Jakub Adamczyk, Paweł Jasiński, Agata Szymańska, Anna Obszyńska-Litwiniec, and Dariusz Białoszewski
- Subjects
physical activity ,students ,lifestyle ,physiotherapy ,Medicine - Published
- 2020
- Full Text
- View/download PDF
5. Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study
- Author
-
Tomasz Roleder, Elvin Kedhi, Balazs Berta, Pawel Gasior, Wojciech Wanha, Magda Roleder, Joanna Fluder, Grzegorz Smolka, Andrzej Ochala, and Wojciech Wojakowski
- Subjects
zotarolimus-eluting stent ,vessel healing ,optical coherence tomography ,1-month follow-up ,Medicine - Published
- 2019
- Full Text
- View/download PDF
6. Performance of Integrated Near-Infrared Spectroscopy and Intravascular Ultrasound (NIRS-IVUS) System against Quantitative Flow Ratio (QFR)
- Author
-
Magdalena M. Dobrolińska, Paweł M. Gąsior, Elżbieta Pociask, Grzegorz Smolka, Andrzej Ochala, Wojciech Wojakowski, and Tomasz Roleder
- Subjects
quantitative flow ratio ,near-infrared spectroscopy ,intravascular ultrasound ,coronary artery disease ,ischemia ,Medicine (General) ,R5-920 - Abstract
Quantitative flow ratio (QFR) is a new opportunity to analyze functional stenosis during invasive coronary angiography. Together with a well-known intravascular ultrasound (IVUS) and a new player in the field, near-infrared spectroscopy (NIRS), it is gaining a lot of interest. The aim of the study was to compare QFR results with integrated IVUS-NIRS results acquired simultaneously in the same coronary lesion. We retrospectively enrolled 66 patients in whom 66 coronary lesions were assessed by NIRS-IVUS and QFR. Lesions were divided into two groups based on QFR results as QFR-positive group (QFR ≤ 0.8) or QFR-negative group (QFR > 0.8). Based on ROC curve analysis, the best cut-off values of minimal lumen area (MLA), minimal lumen diameter (MLD) and percent diameter stenosis for predicting QFR ≤ 80 were 2.4 (AUC 0.733, 95%CI 0.61, 0.834), 1.6 (AUC 0.768, 95%CI 0.634, 0.872) and 59.5 (AUC 0.918, 95%CI 0.824, 0.971), respectively. In QFR-positive lesions, the maxLCBI4mm was significantly higher than in QFR-negative lesions (450.12 ± 251.0 vs. 329.47 ± 191.14, p = 0.046). The major finding of the present study is that values of IVUS-MLA, IVUS-MLD and percent diameter stenosis show a good efficiency in predicting QFR ≤ 0.80. Moreover, QFR-positive lesions are characterized by higher maxLCBI4mm as compared to the QFR-negative group.
- Published
- 2021
- Full Text
- View/download PDF
7. PHYSICAL ACTIVITY OF PHYSIOTHERAPY STUDENTS AT THE MEDICAL UNIVERSITY OF WARSAW
- Author
-
Agata Szymańska, Andrzej Ochala, Dariusz Boguszewski, Dariusz Białoszewski, Paweł Jasiński, Jakub Grzegorz Adamczyk, and Anna Obszyńska-Litwiniec
- Subjects
lifestyle ,medicine.medical_specialty ,students ,business.industry ,Physical activity ,Physical therapy ,physical activity ,Medicine ,business ,physiotherapy - Published
- 2021
8. Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries: Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging Pilot Study
- Author
-
Joanna Fluder-Wlodarczyk, Marek Milewski, Magda Roleder-Dylewska, Maciej Haberka, Andrzej Ochala, Wojciech Wojakowski, and Pawel Gasior
- Subjects
General Medicine - Abstract
Background: Scientific statements recommend multimodality imaging in myocardial infarction with non-obstructive coronary arteries (MINOCA) to define the underlying cause. Aim: We evaluated the diagnostic yield of intravascular optical coherence tomography (OCT) and cardiac magnetic resonance (CMR) in the MINOCA setting. Methods: In this prospective, single center, observational pilot study, we enrolled patients with MINOCA without previous coronary interventions. All patients underwent three vessel OCT, followed by CMR. Imaging results were combined to determine the mechanism of MINOCA, when possible. Results: We enrolled 10 patients in this pilot study. Women constituted 50% of the analyzed population. The mean age of patients was 52 years. ST-segment elevation was found in 30% of patients. A possible culprit lesion was identified by OCT in 70% of participants, most commonly plaque rupture or erosion. An ischemic pattern of CMR abnormalities was identified in 70% of participants. Myocarditis and Tako-Tsubo were identified in 30%. A cause of MINOCA was identified in all patients using multimodality imaging, while using OCT alone identification occurred in only 70% of patients. Conclusion: In this pilot study, multimodality imaging with OCT and CMR identified potential mechanisms in all patients with a diagnosis of MINOCA, and it has the potential to guide medical therapy for secondary prevention.
- Published
- 2022
9. TCT-188 Safety and Efficacy of Intravascular Lithotripsy in the Management of Stent Underexpansion Among Elderly Patients
- Author
-
Mariusz Tomaniak, Janusz Kochman, Rafał Januszek, Rafał Wolny, Maksymilian Opolski, Łukasz Kuźma, Lukasz Lewicki, Jacek Bil, Jan Kulczycki, Adrian Wlodarczak, Brunon Tomasiewicz, Sylwia Iwanczyk, Jerzy Sacha, Lukasz Koltowski, Milosz Dziarmaga, Milosz Jaguszewski, Pawel Kralisz, Grzegorz Sobieszek, Krzysztof Dyrbus, Piotr Wańczura, Mariusz Łebek, Krzysztof Reczuch, Tomasz Pawlowski, Robert Gil, Slawomir Dobrzycki, Piotr Kwiatkowski, Mariusz Gąsior, Andrzej Ochala, Adam Witkowski, Maciej Lesiak, Fabrizio D’Ascenzo, Stanislaw Bartus, Wojciech Wojakowski, and Wojciech Wańha
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
10. TCT-164 Targeted Therapy With a Localized Abluminal Groove Low-Dose Sirolimus-Eluting Biodegradable-Polymer Coronary Stent: Subgroup Analysis of 5-Year Outcomes of the TARGET All Comers Randomized Trial
- Author
-
Henning Kelbæk, Alexandra Lansky, Bo Xu, Andreas Baumbach, Niels van Royen, Paul Knaapen, Thomas Johnson, Pieter Smits, Georgios Vlachojannis, Karin Arkenbout, Lene Holmvang, Luc Janssens, Andrzej Ochala, and William Wijns
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
11. TCTAP A-054 Shockwave Intravascular Lithotripsy as a Novel Strategy for the Treatment of Stent Underexpansion Caused by Calcified Plaques
- Author
-
Wojciech Wańha, Mariusz Tomaniak, Jacek Bil, Rafał Januszek, Rafał Wolny, Maksymilian Opolski, Łukasz Kuźma, Adam Janas, Tomasz Figatowski, Łukasz Lewicki, Jakub Kulczycki, Adrian Wlodarczak, Brunon Tomasiewicz, Sylwia Iwańczyk, Jerzy Sacha, Łukasz Koltowski, Miłosz Dziarmaga, Miłosz Jaguszewski, Bartosz Olajossy, Krzysztof Dyrbuś, Krzysztof Reczuch, Robert Gil, Sławomir Dobrzycki, Janusz Kochman, Andrzej Ochala, Adam Witkowski, Maciej Lesiak, Fabrizio D'Ascenzo, Sławomir Bartuś, and Wojciech Wojakowski
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
12. Long-term mortality after transcatheter aortic valve implantation for aortic stenosis in immunosuppression-treated patients: a propensity-matched multicentre retrospective registry-based analysis
- Author
-
Michał Walczewski, Aleksandra Gąsecka, Adam Witkowski, Maciej Dabrowski, Zenon Huczek, Radosław Wilimski, Andrzej Ochała, Radosław Parma, Bartosz Rymuza, Marek Grygier, Marek Jemielity, Anna Olasińska-Wiśniewska, Dariusz Jagielak, Radosław Targoński, Krzysztof Pastuszak, Peter Grešner, Marcin Grabowski, and Janusz Kochman
- Subjects
aortic stenosis ,immunosuppression ,mortality ,outcomes ,transcatheter aortic valve implantation ,Medicine - Published
- 2023
- Full Text
- View/download PDF
13. TCTAP A-028 Procedural and 1-year Outcomes Following Large Vessel Coronary Artery Perforation Treated by Covered Stents Implantation: Multicenter CRACK Registry
- Author
-
Wojciech Wańha, Rafał Januszek, Łukasz Kuźma, Tomasz Figatowski, Michalina Kołodziejczak, Magdalena Żak, Malwina Smolarek, Monika Monika Gruz-Kwapisz, Maciej Wybraniec, Mateusz Tajstra, Brunon Tomasiewicz, Andrzej Łoś, Dariusz Jagielak, Tomasz Roleder, Adrian Wlodarczak, Jakub Kulczycki, Damian Hudziak, Pawel Stachowiak, Krzysztof Reczuch, Miłosz Jaguszewski, Sławomir Dobrzycki, Grzegorz Smolka, Stanisław Bartuś, Andrzej Ochala, Mariusz Gąsior, and Wojciech Wojakowski
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2021
14. Assessment of effect of coronary angioplasty within main trunk of left main coronary artery using scoring balloon catheter in comparison with technique using non-compliant balloon catheter – preliminary results
- Author
-
Przemysław Żurek, Zbigniew Gąsior, Andrzej Kułach, and Andrzej Ochała
- Subjects
pci ,left main coronary artery disease ,plaque modification ,scoring balloon catheter ,non-compliant balloon ,Pharmacy and materia medica ,RS1-441 ,Dentistry ,RK1-715 - Abstract
Introduction The paper discusses the techniques of modifying the atherosclerotic plaque in the left main coronary artery along with the results of the author’s own procedures using a scoring catheter (AngioSculpt) and a non-compliant (NC) balloon catheter. Material and methods 23 patients who met the inclusion criteria in the absence of exclusion criteria were enrolled in the study. 13 patients underwent coronary angioplasty using a scoring balloon catheter, and 10 patients underwent coronary angioplasty (percutaneous coronary intervention – PCI) with a NC balloon catheter. Results The groups did not differ in terms of demographics and comorbidities. In the study group, a larger diameter of the LM trunk was obtained, as assessed by the IVUS technique. In the control group, the two-stent technique was used more often, however, due to the small number of participants, statistical significance was not achieved. In the control group, greater use of contrast was associated with more frequent use of the two-stent technique. Despite one MI related to procedure in the control group, the two-year mortality rate between groups was similar. Logistic regression did not reveal any of studied variable to be significantly related to 2-year mortality. Conclusions The preliminary results of our study suggest that there is no difference in early 30-day results and 2-year mortality in a randomized group of patients undergoing coronary angioplasty using a scoring balloon catheter and a non-compliant catheter. Selection of the optimal treatment strategy in LM stenosis is still a matter of research and the operator’s experience is of fundamental importance.
- Published
- 2022
- Full Text
- View/download PDF
15. Abstract 19218: Complete Intimal Healing of the Renal Arteries After Radio-frequency Renal Denervation in Long-term Follow-up by Optical Coherence Tomography
- Author
-
Tomasz Roleder, Mariusz Skowerski, Andrzej Wiecek, Marcin Adamczak, Beata Czerwienska, Wojciech Wanha, Tomasz Jadczyk, Lukasz Partyka, Grzegorz Smolka, Andrzej Ochala, Dariusz Dudek, Michal Tendera, Zbigniew Gasior, and Wojciech Wojakowski
- Subjects
Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Intoduction: Although radiofrequency renal denervation (RF-RND) may cause acute spasm, intimal injury and thrombus formation, there are no data on long-term renal artery (RA) healing. Hypothesis: Aim of this study was to assess the RA healing after RF-RND by optical coherence tomography (OCT) imaging and quantitative contrast angiography (QCA) at long-term follow-up. Methods: A single center registry enrolled 12 patients (22 RA) with refractory hypertension previously treated with RF-RND (Symplicity, Medtronic). Imaging studies (QCA and OCT) were done at (mean±SD) 18.41±5.83 months after RF-RND. Results: No adverse events or complications were noted during the follow-up. Ten patients (83%) achieved significant reductions of blood pressure by ≥10 mmHg on 4.50 ± 1.08 medications per patient. OCT analysis involved 518 mm of pullbacks and 518 cross-sections. There were 26 spots of focal intimal thickening found in 10 (83%) patients in 14 (64%) arteries and calcifications in 2 (9%) of treated RA. The mean area of focal intimal thickening was 0.054±0.033 mm2 and it was limited to the intimal layer. No vessel dissection, thrombus, intimal tear or acute vasospasms were observed during the OCT analysis. The QCA revealed that minimal lumen and proximal lumen diameter were smaller after the RND and this difference was persistent at follow-up, as compared to measurements obtained before RND [6.21±1.01 vs. 5.61 ± 0.60, p=0.005 and 5.53±0.99 vs. 5.15±0.67, p=0.034, respectively]. Conclusions: There is a favorable long-term vessel healing after RF-RND without significant RA stenosis. Only focal intimal thickening and a modest reduction of the minimal lumen diameter may be observed in long-term and their relation to the RND procedure needs further studies.
- Published
- 2015
16. Long-term outcomes following drug-eluting balloon or thin-strut drug-eluting stents for treatment of in-stent restenosis stratified by duration of dual antiplatelet therapy (DEB-Dragon Registry)
- Author
-
Rafał Januszek, Jacek Bil, Natasza Gilis-Malinowska, Bartłomiej Staszczak, Tomasz Figatowski, Marek Milewski, Maksymilian Mielczarek, Łukasz Dylewski, Maciej Wybraniec, Brunon Tomasiewicz, Piotr Kübler, Tomasz Walczak, Bruno Hrymniak, Piotr Desperak, Piotr Niezgoda, Rafał Wolny, Magdalena Chudzik, Grzegorz Smolka, Dariusz Ciećwierz, Krzysztof Reczuch, Marcin Gruchała, Jacek Kubica, Robert J. Gil, Elvin Kedhi, Fabrizio D’Ascenzo, Robert Balan, Artur Pawlik, Łukasz Kuźma, Sławomir Dobrzycki, Damian Hudziak, Stanisław Bartuś, Mariusz Gąsior, Andrzej Ochała, Adam Witkowski, Miłosz Jaguszewski, Wojciech Wojakowski, and Wojciech Wańha
- Subjects
drug-eluting balloon(s) ,drug-eluting stent(s) ,in-stent restenosis ,duration of dual antiplatelet therapy ,long-term outcomes. ,Medicine - Published
- 2022
- Full Text
- View/download PDF
17. FOXO1 and ANGPT2 relative gene expression in non-ST-segment elevation myocardial infarction among patients with or without type 2 diabetes
- Author
-
Tomasz Skowerski, Katarzyna Nabrdalik, Hanna Kwiendacz, Maciej Pajak, Andrzej Ochała, Katarzyna Mizia-Stec, Zbigniew Gąsior, and Janusz Gumprecht
- Subjects
angiopoietin-2 ,diabetes ,foxo-1 ,non-st elevation myocardial infarction. ,Medicine - Published
- 2021
- Full Text
- View/download PDF
18. Timing of events in STEMI patients treated with immediate PCI or standard medical therapy: Implications on optimisation of timing of treatment from the CARESS-in-AMI trial
- Author
-
Konstantinos, Dimopoulos, Dariusz, Dudek, Federico, Piscione, Waldemar, Mielecki, Stefano, Savonitto, Francesco, Borgia, Ernesto, Murena, Antonio, Manari, Achille, Gaspardone, Andrzej, Ochala, Krzysztof, Zmudka, Leonardo, Bolognese, Philippe Gabriel, Steg, Marcus, Flather, Carlo, Di Mario, J, Cabalion, Dimopoulos, Konstantino, Dudek, Dariusz, Piscione, Federico, Mielecki, Waldemar, Savonitto, Stefano, Borgia, Francesco, Murena, Ernesto, Manari, Antonio, Gaspardone, Achille, Ochala, Andrzej, Zmudka, Krzysztof, Bolognese, Leonardo, Steg, Philippe Gabriel, Flather, Marcu, Di Mario, Carlo, and Cardiology
- Subjects
Male ,medicine.medical_specialty ,thrombolysis ,Time Factors ,Time Factor ,medicine.medical_treatment ,Thrombolysi ,Myocardial Infarction ,acute myocardial infarction ,Acute myocardial infarction ,GpIIb/IIIa inhibitors ,law.invention ,Percutaneous coronary intervention ,Randomized controlled trial ,law ,Angioplasty ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Myocardial infarction ,cardiovascular diseases ,Angioplasty, Balloon, Coronary ,business.industry ,Standard treatment ,Medicine (all) ,percutaneous coronary intervention ,Thrombolysis ,GpIIb/IIIa inhibitor ,Middle Aged ,medicine.disease ,surgical procedures, operative ,Conventional PCI ,Cardiology ,Female ,business ,Cardiology and Cardiovascular Medicine ,TIMI ,Human - Abstract
Objectives: Early angioplasty after thrombolysis is now recommended for ST-elevation myocardial infarction, but the current guidelines propose a wide time-window ranging between 3 and 24 h after lytic administration. To identify the optimal timing for PCI after thrombolysis, we analyzed frequency and time course of the adverse events in patients randomized in the multicenter CARESS-in-AMI trial. Methods: 598 high-risk patients with STEMI recruited in the CARESS-in-AMI study, were divided into the Immediate PCI group (IMM, n=298), Rescue PCI group (RES, n=107) and Standard Treatment Arm without rescue PCI (STA, n=193). Results: RES patients had worse pre-procedural TIMI flow and post-procedural blush grade. At 30 days, there were 23 deaths: 11 (10.3%) in RES, 9 (3%) in IMM and 3 (1.6%) in STA (pb0.001). There were 22 episodes of refractory ischemia or re-infarction: 17 (8.8%) in the STA group, 4 (1.6%) in IMM and 1 (0.9%) in RES (pb0.001). In the RES group 10/11 (90.9%) deaths occurred before day 5. In the STA group, all deaths and the majority of ischemic events occurred after day 3. A reduction of risk of de Conclusions: The mortality benefit of immediate referral to PCI after pharmacological treatment for STEMI derives from a reduction in the time to reperfusion of patients with failed thrombolysis in need of rescue PCI. In patients with evidence of successful reperfusion, "elective" PCI within 3 days may be sufficient to reduce the recurrent ischemic events. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
- Published
- 2012
19. Long-Term Mortality After TAVI for Bicuspid vs. Tricuspid Aortic Stenosis: A Propensity-Matched Multicentre Cohort Study
- Author
-
Aleksandra Gasecka, Michał Walczewski, Adam Witkowski, Maciej Dabrowski, Zenon Huczek, Radosław Wilimski, Andrzej Ochała, Radosław Parma, Piotr Scisło, Bartosz Rymuza, Karol Zbroński, Piotr Szwed, Marek Grygier, Anna Olasińska-Wiśniewska, Dariusz Jagielak, Radosław Targoński, Grzegorz Opolski, and Janusz Kochman
- Subjects
aortic stenosis (AS) ,bicuspid aortic valve (BAV) ,transcatheter aortic valve implantation (TAVI) ,mortality ,outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
ObjectivesPatients with bicuspid aortic valve (BAV) stenosis were excluded from the pivotal trials of transcatheter aortic valve implantation (TAVI). We compared the in-hospital and long-term outcomes between patients undergoing TAVI for bicuspid and tricuspid aortic valve (TAV) stenosis.MethodsWe performed a retrospective registry-based analysis on patients who underwent TAVI for BAV and TAV at five different centers between January 2009 and August 2017. The primary outcome was long-term all-cause mortality. Secondary outcomes were in-hospital mortality, procedural complications, and valve performance.ResultsOf 1,451 consecutive patients who underwent TAVI, two propensity-matched cohorts consisting of 130 patients with BAV and 390 patients with TAV were analyzed. All-cause mortality was comparable in both groups up to 10 years following TAVI (HR 1.09, 95% CI: 0.77–1.51). Device success and in-hospital mortality were comparable between the groups (96 vs. 95%, p = 0.554 and 2.3 vs. 2.1%, p = 0.863, respectively). Incidence of procedural complications was similar in both groups, with a trend toward a higher rate of stroke in patients with BAV (5 vs. 2%, p = 0.078). Incidence of moderate or severe paravalvular leak (PVL) at discharge was comparable in both groups (2 vs. 2%, p = 0.846). Among patients with BAV, all-cause mortality was similar in self-expanding and balloon-expandable prostheses (HR 1.02, 95% CI: 0.52–1.99) and lower in new-generation devices compared to old-generation valves (HR 0.27, 95% CI 0.12–0.62).ConclusionPatients who had undergone TAVI for BAV had comparable mortality to patients with TAV up to 10 years after the procedure. The device success, in-hospital mortality, procedural complications, and PVL rate were comparable between the groups. The high rate of neurological complications (5%) in patients with BAV warrants further investigation.
- Published
- 2022
- Full Text
- View/download PDF
20. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction
- Author
-
Gregg W, Stone, Alexandra J, Lansky, Stuart J, Pocock, Bernard J, Gersh, George, Dangas, S Chiu, Wong, Bernhard, Witzenbichler, Giulio, Guagliumi, Jan Z, Peruga, Bruce R, Brodie, Dariusz, Dudek, Martin, Möckel, Andrzej, Ochala, Alison, Kellock, Helen, Parise, Roxana, Mehran, and Cindy L, Grines
- Subjects
Adult ,Male ,Risk ,medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,Myocardial Infarction ,Kaplan-Meier Estimate ,Revascularization ,Coronary Angiography ,Coronary Restenosis ,Restenosis ,Fibrinolytic Agents ,Recurrence ,Internal medicine ,Angioplasty ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Stroke ,Aged ,Aged, 80 and over ,Sweden ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,equipment and supplies ,medicine.disease ,Combined Modality Therapy ,Surgery ,surgical procedures, operative ,Drug-eluting stent ,Conventional PCI ,Retreatment ,Cardiology ,Female ,Stents ,business ,Follow-Up Studies - Abstract
There is no consensus regarding the safety and efficacy of drug-eluting stents, as compared with bare-metal stents, in patients with ST-segment elevation myocardial infarction who are undergoing primary percutaneous coronary intervention (PCI).We randomly assigned, in a 3:1 ratio, 3006 patients presenting with ST-segment elevation myocardial infarction to receive paclitaxel-eluting stents (2257 patients) or otherwise identical bare-metal stents (749 patients). The two primary end points of the study were the 12-month rates of target-lesion revascularization for ischemia (analysis powered for superiority) and a composite safety outcome measure of death, reinfarction, stroke, or stent thrombosis (powered for noninferiority with a 3.0% margin). The major secondary end point was angiographic evidence of restenosis at 13 months.Patients who received paclitaxel-eluting stents, as compared with those who received bare-metal stents, had significantly lower 12-month rates of ischemia-driven target-lesion revascularization (4.5% vs. 7.5%; hazard ratio, 0.59; 95% confidence interval [CI], 0.43 to 0.83; P=0.002) and target-vessel revascularization (5.8% vs. 8.7%; hazard ratio, 0.65; 95% CI, 0.48 to 0.89; P=0.006), with noninferior rates of the composite safety end point (8.1% vs. 8.0%; hazard ratio, 1.02; 95% CI, 0.76 to 1.36; absolute difference, 0.1 percentage point; 95% CI, -2.1 to 2.4; P=0.01 for noninferiority; P=0.92 for superiority). Patients treated with paclitaxel-eluting stents and those treated with bare-metal stents had similar 12-month rates of death (3.5% and 3.5%, respectively; P=0.98) and stent thrombosis (3.2% and 3.4%, respectively; P=0.77). The 13-month rate of binary restenosis was significantly lower with paclitaxel-eluting stents than with bare-metal stents (10.0% vs. 22.9%; hazard ratio, 0.44; 95% CI, 0.33 to 0.57; P0.001).In patients with ST-segment elevation myocardial infarction who were undergoing primary PCI, implantation of paclitaxel-eluting stents, as compared with bare-metal stents, significantly reduced angiographic evidence of restenosis and recurrent ischemia necessitating repeat revascularization procedures. No safety concerns were apparent at 1 year. (ClinicalTrials.gov number, NCT00433966.)
- Published
- 2009
21. General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience
- Author
-
Ewa Kucewicz-Czech, Leszek Machej, Kazimierz Kiermasz, Andrzej Węglarzy, Maria Damps, Damian Hudziak, Radosław Gocol, Andrzej Ochała, and Radosław Parma
- Subjects
transcatheter aortic valve replacement ,anaesthesia ,conversion. ,Surgery ,RD1-811 ,Internal medicine ,RC31-1245 - Published
- 2021
- Full Text
- View/download PDF
22. Percutaneous Coronary Intervention vs. Coronary Artery Bypass Grafting for Treating In-Stent Restenosis in Unprotected-Left Main: LM-DRAGON-Registry
- Author
-
Wojciech Wańha, Jacek Bil, Michalina Kołodziejczak, Adam Kowalówka, Mariusz Kowalewski, Damian Hudziak, Radosław Gocoł, Rafał Januszek, Tomasz Figatowski, Marek Milewski, Brunon Tomasiewicz, Piotr Kübler, Bruno Hrymniak, Piotr Desperak, Łukasz Kuźma, Krzysztof Milewski, Bartłomiej Góra, Andrzej Łoś, Jan Kulczycki, Adrian Włodarczak, Wojciech Skorupski, Marek Grygier, Maciej Lesiak, Fabrizio D'Ascenzo, Marek Andres, Paweł Kleczynski, Radosław Litwinowicz, Andrea Borin, Grzegorz Smolka, Krzysztof Reczuch, Marcin Gruchała, Robert J. Gil, Miłosz Jaguszewski, Krzysztof Bartuś, Piotr Suwalski, Sławomir Dobrzycki, Dariusz Dudek, Stanisław Bartuś, Mariusz Ga̧sior, Andrzej Ochała, Alexandra J. Lansky, Marek Deja, Jacek Legutko, Elvin Kedhi, and Wojciech Wojakowski
- Subjects
left main ,in-stent restenosis (ISR) ,coronary artery bypass graft (CABG) ,stents (Coronary) ,percutaneous coronary intervention (complex PCI) ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundData regarding management of patients with unprotected left main coronary artery in-stent restenosis (LM-ISR) are scarce.ObjectivesThis study investigated the safety and effectiveness of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) for the treatment of unprotected LM-ISR.MethodsConsecutive patients who underwent PCI or CABG for unprotected LM-ISR were enrolled. The primary endpoint was a composite of major adverse cardiac and cerebrovascular events (MACCE), defined as cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), and stroke.ResultsA total of 305 patients were enrolled, of which 203(66.6%) underwent PCI and 102(33.4%) underwent CABG. At 30-day follow-up, a lower risk of cardiac death was observed in the PCI group, compared with the CABG-treated group (2.1% vs. 7.1%, HR 3.48, 95%CI 1.01–11.8, p = 0.04). At a median of 3.5 years [interquartile range (IQR) 1.3–5.5] follow-up, MACCE occurred in 27.7% vs. 29.6% (HR 0.82, 95%CI 0.52–1.32, p = 0.43) in PCI- and CABG-treated patients, respectively. There were no significant differences between PCI and CABG in cardiac death (9.9% vs. 18.4%; HR 1.56, 95%CI 0.81–3.00, p = 0.18), MI (7.9% vs. 5.1%, HR 0.44, 95%CI 0.15–1.27, p = 0.13), or stroke (2.1% vs. 4.1%, HR 1.79, 95%CI 0.45–7.16, p = 0.41). TVR was more frequently needed in the PCI group (15.2% vs. 6.1%, HR 0.35, 95%CI 0.15–0.85, p = 0.02).ConclusionsThis analysis of patients with LM-ISR revealed a lower incidence of cardiac death in PCI compared with CABG in short-term follow-up. During the long-term follow-up, no differences in MACCE were observed, but patients treated with CABG less often required TVR.Visual overviewA visual overview is available for this article.Registrationhttps://www.clinicaltrials.gov; Unique identifier: NCT04968977.
- Published
- 2022
- Full Text
- View/download PDF
23. The function of the left ventricle after complete multivessel one-stage percutaneous coronary intervention in patients with acute myocardial infarction
- Author
-
Andrzej, Ochala, Grzegorz A, Smolka, Wojciech, Wojakowski, Dariusz, Dudek, Artur, Dziewierz, Zbigniew, Krolikowski, Zbigniew, Gasior, and Michal, Tendera
- Subjects
Male ,Treatment Outcome ,Myocardial Infarction ,Humans ,Female ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Coronary Vessels ,Ventricular Function, Left ,Aged - Published
- 2004
24. Short-term healing response after implantation of the thin-strut, fast-releasing sirolimus-eluting biodegradable polymer-coated Alex Plus stent: optical coherence tomography study
- Author
-
Magdalena Dobrolińska, Paweł Gąsior, Tomasz Roleder, Magda Roleder-Dylewska, Grzegorz Smolka, Andrzej Ochała, Elvin Kedhi, and Wojciech Wojakowski
- Subjects
Medicine - Published
- 2020
- Full Text
- View/download PDF
25. Intracoronary Abciximab and Aspiration Thrombectomy in Patients With Large Anterior Myocardial Infarction
- Author
-
Gregg W, Stone, Akiko, Maehara, Bernhard, Witzenbichler, Jacek, Godlewski, Helen, Parise, Jan-Henk E, Dambrink, Andrzej, Ochala, Trevor W, Carlton, Ecaterina, Cristea, Steven D, Wolff, Sorin J, Brener, Saqib, Chowdhary, Magdi, El-Omar, Thomas, Neunteufl, D Christopher, Metzger, Theodore, Karwoski, Jose M, Dizon, Roxana, Mehran, C Michael, Gibson, and David, Brill
- Subjects
Male ,medicine.medical_specialty ,Abciximab ,medicine.medical_treatment ,Myocardial Infarction ,Infarction ,Immunoglobulin Fab Fragments ,Bolus (medicine) ,Interquartile range ,Internal medicine ,medicine ,Humans ,Bivalirudin ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Aged ,Thrombectomy ,business.industry ,Antibodies, Monoclonal ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,medicine.disease ,Coronary Vessels ,Magnetic Resonance Imaging ,Treatment Outcome ,Conventional PCI ,Cardiology ,Female ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Context Thrombus embolization during percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) is common and results in suboptimal myocardial perfusion and increased infarct size. Two strategies proposed to reduce distal embolization and improve outcomes after primary PCI are bolus intracoronary abciximab and manual aspiration thrombectomy. Objective To determine whether bolus intracoronary abciximab, manual aspiration thrombectomy, or both reduce infarct size in high-risk patients with STEMI. Design, Setting, and Patients Between November 28, 2009, and December 2, 2011, 452 patients presenting at 37 sites in 6 countries within 4 hours of STEMI due to proximal or mid left anterior descending artery occlusion undergoing primary PCI with bivalirudin anticoagulation were randomized in an open-label, 2 × 2 factorial design to bolus intracoronary abciximab delivered locally at the infarct lesion site vs no abciximab and to manual aspiration thrombectomy vs no thrombectomy. Interventions A 0.25-mg/kg bolus of abciximab was administered at the site of the infarct lesion via a local drug delivery catheter. Manual aspiration thrombectomy was performed with a 6 F aspiration catheter. Main Outcome Measures Primary end point: infarct size (percentage of total left ventricular mass) at 30 days assessed by cardiac magnetic resonance imaging (cMRI) in the abciximab vs no abciximab groups (pooled across the aspiration randomization); major secondary end point: 30-day infarct size in the aspiration vs no aspiration groups (pooled across the abciximab randomization). Results Evaluable cMRI results at 30 days were present in 181 and 172 patients randomized to intracoronary abciximab vs no abciximab, respectively, and in 174 and 179 patients randomized to manual aspiration vs no aspiration, respectively. Patients randomized to intracoronary abciximab compared with no abciximab had a significant reduction in 30-day infarct size (median, 15.1%; interquartile range [IQR], 6.8%-22.7%; n = 181, vs 17.9% [IQR, 10.3%-25.4%]; n = 172; P = .03). Patients randomized to intracoronary abciximab also had a significant reduction in absolute infarct mass (median, 18.7 g [IQR, 7.4-31.3 g]; n = 184, vs 24.0 g [IQR, 12.1-34.2 g]; n = 175; P = .03) but not abnormal wall motion score (median, 7.0 [IQR, 2.0-10.0]; n = 188, vs 8.0 [IQR, 3.0-10.0]; n = 184; P = .08). Patients randomized to aspiration thrombectomy vs no aspiration had no significant difference in infarct size at 30 days (median, 17.0% [IQR, 9.0%-22.8%]; n = 174, vs 17.3% [IQR, 7.1%-25.5%]; n = 179; P = .51), absolute infarct mass (median, 20.3 g [IQR, 9.7-31.7 g]; n = 178, vs 21.0 g [IQR, 9.1-34.1 g]; n = 181; P = .36), or abnormal wall motion score (median, 7.5 [IQR, 2.0-10.0]; n = 186, vs 7.5 [IQR, 2.0-10.0]; n = 186; P = .89). Conclusion In patients with large anterior STEMI presenting early after symptom onset and undergoing primary PCI with bivalirudin anticoagulation, infarct size at 30 days was significantly reduced by bolus intracoronary abciximab delivered to the infarct lesion site but not by manual aspiration thrombectomy. Trial Registration clinicaltrials.gov Identifier: NCT00976521JAMA. 2012;307(17):1817-1826
- Published
- 2012
26. Uncommon complication of common procedure. Embolization of multichambered radial artery pseudoaneurysm
- Author
-
Wojciech Stecko, Piotr Wańczura, Mateusz Wiśniowski, and Andrzej Ochała
- Subjects
Medicine - Published
- 2020
- Full Text
- View/download PDF
27. Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography
- Author
-
Grzegorz M. Kubiak, Magdalena Dobrolińska, Elżbieta Pociask, Wojciech Wańha, Paweł Gąsior, Grzegorz Smolka, Andrzej Ochała, Wojciech Wojakowski, and Tomasz Roleder
- Subjects
optical coherence tomography ,coronary artery disease ,saphenous vein graft coronary artery bypass grafting ,Medicine - Published
- 2018
- Full Text
- View/download PDF
28. Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry.
- Author
-
Wojciech Wańha, Rafał Januszek, Michalina Kołodziejczak, Łukasz Kuźma, Mateusz Tajstra, Tomasz Figatowski, Malwina Smolarek-Nicpoń, Monika Gruz-Kwapisz, Brunon Tomasiewicz, Jerzy Bartuś, Andrzej Łoś, Dariusz Jagielak, Tomasz Roleder, Adrian Włodarczak, Jan Kulczycki, Mariusz Kowalewski, Damian Hudziak, Paweł Stachowiak, Jarosław Gorący, Katarzyna Sierakowska, Krzysztof Reczuch, Miłosz Jaguszewski, Sławomir Dobrzycki, Grzegorz Smolka, Stanisław Bartuś, Andrzej Ochała, Mariusz Gąsior, and Wojciech Wojakowski
- Subjects
Medicine ,Science - Abstract
BackgroundData regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation.MethodsThis multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. The primary endpoint was the composite of major adverse cardiac events (MACEs), defined as cardiac death, target lesion revascularization (TLR), and myocardial infarction (MI).ResultsThe registry included 119 patients (mean age: 68.9 ± 9.7 years, 55.5% men). Acute coronary syndrome, including: unstable angina 21 (17.6%), NSTEMI 26 (21.8%), and STEMI 26 (21.8%), was the presenting diagnosis in 61.3%, and chronic coronary syndromes in 38.7% of patients. The most common lesion type, according to ACC/AHA classification, was type C lesion in 47 (39.5%) of cases. A total of 52 patients (43.7%) had type 3 Ellis classification, 28 patients (23.5%) had type 2 followed by 39 patients (32.8%) with type 1 perforation. Complex PCI was performed in 73 (61.3%) of patients. Periprocedural death occurred in eight patients (6.7%), of which two patients had emergency cardiac surgery. Those patients were excluded from the one-year analysis. Successful sealing of the perforation was achieved in 99 (83.2%) patients. During the follow-up, 26 (26.2%) patients experienced MACE [7 (7.1%) cardiac deaths, 13 (13.1%) TLR, 11 (11.0%) MIs]. Stent thrombosis (ST) occurred in 6 (6.1%) patients [4(4.0%) acute ST, 1(1.0%) subacute ST and 1(1.0%) late ST].ConclusionsThe use of covered stents is an effective treatment of CAP. The procedural and 1-year outcomes of CAP treated by CS implantation showed that such patients should remain under follow-up due to relatively high risk of MACE.
- Published
- 2021
- Full Text
- View/download PDF
29. Patient- and lesion-tailored algorithm of endovascular treatment for arterial occlusive disease of extracranial arteries supplying the brain: safety of the treatment at 30-day follow-up
- Author
-
Paweł Latacz, Marian Simka, Paweł Brzegowy, Piotr Janas, Marek Kazibudzki, Piotr Pieniążek, Andrzej Ochała, Tadeusz Popiela, and Tomasz Mrowiecki
- Subjects
carotid artery stenting ,proximal protection system ,distal protection system ,Medicine - Abstract
Introduction: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, stenting plays an important role as an alternative treatment modality, especially in high-risk patients. The actual safety profile associated with stenting procedures is probably better than that reported by randomized controlled trials. Aim : To assess the safety of stent implantations in extracranial arteries supplying the brain, and also to identify risk factors associated with this procedure. Material and methods: This was a post hoc analysis, with 30-day follow-up. We analyzed the results of treatment of 372 patients who underwent 408 procedures, 197 such procedures in asymptomatic, and 211 in symptomatic individuals. Stenting procedures were performed using a technique and armamentarium which were tailored to the type and anatomy of lesions. Results : There were 6 (1.5%) strokes, including 2 (0.5%) major strokes, 1 ipsi- and 1 contralateral, and 4 (1.0%) minor strokes. In asymptomatic patients there was 1 (0.3%) minor stroke. Transient ischemic attacks occurred in 5 (1.2%) patients. There were 2 (0.5%) non-STEMI myocardial infarctions and 2 (0.5%) non-stroke related fatalities. Risk factors of these adverse events were diabetes mellitus, lesions localized in a tortuous segment of the artery, embolic material in the filter and bilateral stenoses of carotid arteries. Additional risk factors in asymptomatic patients were renal impairment and advanced coronary artery disease; and in symptomatic patients, grade 3 arterial hypertension, dislipidemia, cigarette smoking and lesions requiring predilatation. Conclusions : Stenting procedures of extracranial arteries supplying the brain, which are tailored to the type and anatomy of lesions, seem to be relatively safe.
- Published
- 2017
- Full Text
- View/download PDF
30. The Polish Interventional Cardiology TAVI Survey (PICTS): adoption and practice of transcatheter aortic valve implantation in Poland
- Author
-
Radosław Parma, Maciej Dąbrowski, Andrzej Ochała, Adam Witkowski, Dariusz Dudek, Zbigniew Siudak, and Jacek Legutko
- Subjects
heart failure ,transcatheter aortic valve implantation ,transcatheter aortic valve replacement ,aortic valve stenosis ,Heart Team ,aortic valve regurgitation ,Medicine - Abstract
Introduction : Few studies have assessed the development of transcatheter aortic valve implantation (TAVI) in Poland since its introduction in 2008, and data on current TAVI activity or practice are missing. Aim : To assess the dynamics of TAVI adoption in Poland and to detect differences among Polish centres in TAVI practice and decision-making. Material and methods: The Polish Interventional Cardiology TAVI Survey (PICTS) was approved by the Polish Association of Cardiovascular Interventions and presented to all 21 national TAVI centres. Between 2008 and 2015 the cumulative number of TAVI performed in Poland was 2189. The annual number of TAVI rose from 8 in 2008 to 670 in 2015 (0.21 to 17.4 implants per million inhabitants, respectively). Results : The median TAVI experience per centre was 80 procedures (95% CI: 38.1–154.6). In 2015 the TAVI penetration rate reached 5.12% of the estimated eligible Polish population. Inoperable and high-risk patients are treated with TAVI in all centres, with 52% of Heart Teams also qualifying medium-risk patients. The rate of transfemoral implantations increased to 83.2% of all procedures in 2015, while transapical implantations decreased to 12%. The frequency of subclavian, direct aortic or transcarotid routes in 2015 was below 3% each. Conclusions : The PICTS survey observed a positive but slow rate of adoption of TAVI in Poland. When compared to Western European countries, our findings highlight a significant treatment gap in high or prohibitive surgical risk patients with severe aortic stenosis. Remarkable variations in TAVI practices among Polish TAVI centres warrant publication of joint national guidelines and recommendations.
- Published
- 2017
- Full Text
- View/download PDF
31. Circulatory support with Impella CP device during high-risk percutaneous coronary interventions: initial experience in Poland
- Author
-
Dariusz Dudek, Tomasz Rakowski, Adam Sukiennik, Michał Hawranek, Artur Dziewierz, Jacek Kubica, Piotr Suwalski, Robert Gil, Wojciech Wojakowski, Andrzej Ochała, Wiesław Mazurek, Krzysztof Żmudka, and Mariusz Gąsior
- Subjects
Medicine - Published
- 2016
- Full Text
- View/download PDF
32. Transcatheter paravalvular leak closure and hemolysis – a prospective registry
- Author
-
Grzegorz Smolka, Piotr Pysz, Andrzej Ochała, Michał Kozłowski, Wojciech Zasada, Zofia Parma, Michał Tendera, and Wojciech Wojakowski
- Subjects
paravalvular leak ,occluder ,percutaneous closure ,hemolysis ,Medicine - Abstract
Introduction : Paravalvular leak (PVL) related to a surgical prosthetic valve may be associated with clinically significant hemolysis. The influence of transcatheter PVL closure (TPVLC) on hemolysis remains uncertain. Material and methods : The prospective registry included patients undergoing TPVLC due to PVL-related heart failure and/or hemolysis. Procedural data, laboratory markers of hemolysis and heart failure status were recorded at baseline, discharge and at 1- and 6-month follow-up. Results : Of 116 patients from all those qualified for TPVLC, 79 fulfilled the inclusion/exclusion criteria. Hemolysis was significantly more frequent in patients with mitral location of PVL and with calcifications in its channel. After TPVLC prompt reduction of lactate dehydrogenase activity (617.0 (342.0–899.0) vs. 397 (310.0–480.5) IU/l, p < 0.05) and gradual resolution of anemia (hemoglobin (HGB) 11.7 (10.4–13.8) vs. 13.4 (12.9–13.8) g%, p 90% reduction of PVL cross-sectional area) resulted in a more prominent increase of red blood cell count and HGB than in patients with residual regurgitation. The TPVLC-related exacerbation of hemolysis was recorded in 14 patients. Its risk was aggravated by presence of significant hemolysis at baseline or residual flow either by a partially uncovered channel or across the occluder. Reduction of hemolysis after successful TPVLC was sustained in 6-month follow-up. Conclusions : Risk factors for PVL-related hemolysis were the presence of calcifications in the defect and mitral location of PVL. The TPVLC effectively reduced hemolysis if at least 90% reduction of PVL cross sectional area was achieved. The effect was sustained in 6-month follow-up. Incomplete closure of PVL may increase the magnitude of hemolysis after TPVLC, but it occurred rarely.
- Published
- 2016
- Full Text
- View/download PDF
33. Transcatheter closure of paravalvular leaks using a paravalvular leak device – a prospective Polish registry
- Author
-
Grzegorz Smolka, Piotr Pysz, Michał Kozłowski, Marek Jasiński, Radosław Gocoł, Tomasz Roleder, Agnieszka Kargul, Andrzej Ochała, and Wojciech Wojakowski
- Subjects
percutaneous closure ,paravalvular leak ,occluder ,prosthetic heart valve ,Medicine - Abstract
Introduction : Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD – Occlutech). Aim : We present initial short-term results of a prospective registry intended to assess the safety and efficacy of TPVLC with PLD. Material and methods : We screened patients with paravalvular leak (PVL) after surgical valve replacement (SVR). Heart failure symptoms and/or hemolytic anemia were indications for TPVLC. Patients were selected according to PVL anatomy by RT 3D TEE. Only those considered appropriate for closure with a single PLD were enrolled. The procedures were performed via transvascular or transapical access using type W (waist) PLDs only. Results : Thirty patients with 34 PVLs (18 aortic, 16 mitral) were included. We implanted 35 PLDs with a total device success rate of 94.3% (100% for aortic, 88.2% for mitral). The procedural success rate, encompassing device success without in-hospital complications, was 94.1% (100% for aortic, 93.8% for mitral). During the follow-up period we recorded an increase of hemoglobin concentration (3.9 to 4.1 g/dl), red blood count (11.6 to 12.2 M/mm3) and functional improvement by NYHA class. Conclusions : Paravalvular leak device type W is a promising TPVLC device, but meticulous preselection of patients based on imaging of PVL anatomy is a prerequisite. A PLD should only be chosen for channels shorter than 5 mm. Size of the device should match the PVL cross-sectional area without any oversizing. Such an approach facilitates high device and procedural success rates.
- Published
- 2016
- Full Text
- View/download PDF
34. Twelve months clinical outcome after bioresorbable vascular scaffold implantation in patients with stable angina and acute coronary syndrome. Data from the Polish National Registry
- Author
-
Łukasz Rzeszutko, Zbigniew Siudak, Tomasz Tokarek, Krzysztof Plens, Adrian Włodarczak, Andrzej Lekston, Andrzej Ochała, Robert J. Gil, Wojciech Balak, and Dariusz Dudek
- Subjects
stent ,calcified ,bifurcation ,tortuosity ,complex lesion ,Medicine - Abstract
Introduction : There are limited data describing bioresorbable vascular scaffold (BVS) implantation in complex lesions. Only short-term clinical outcomes are available for patients with acute coronary syndrome (ACS). Aim: To evaluate 12-month clinical outcome, safety and effectiveness of BVS implantation in complex lesions and in stable angina (SA) or ACS. Material and methods: Five hundred ninety-one patients with SA/ACS were enrolled between October 2012 and November 2013 in 30 invasive cardiology centres in Poland. At least one BVS implantation during percutaneous coronary intervention (PCI) was the only inclusion criteria. The clinical endpoint was the occurrence of a major adverse cardiovascular event (MACE) (all-cause death, myocardial infarction (MI), clinically driven target lesion revascularisation (TLR) with urgent PCI or target vessel revascularisation (TVR) with urgent coronary artery bypass grafting (CABG)) and device-oriented composite endpoint (DOCE) (cardiac death, urgent target vessel revascularisation with PCI/CABG, target vessel MI) during 12-month follow-up. Results: After 12 months TLR with urgent PCI was significantly more often reported in patients with diagnosed UA (4.59%; p < 0.02) in comparison with other PCI indications. No significant differences were found in terms of composite MACE endpoint, cumulative MACE (p = 0.09), stent thrombosis (p = 0.2) or restenosis (p = 0.2). There were no significant differences in cumulative MACE and composite MACE endpoint between patients with no/mild versus moderate/severe tortuosity and no/mild versus moderate/severe calcification of the target vessel. No significant difference was found between groups of patients with or without bifurcation of the target vessel. Device-oriented composite endpoint was significantly more often reported in the ACS group (3.2% vs. 0.47%; p < 0.03), most frequently in patients with diagnosed UA (5.5%). Conclusions : Bioresorbable vascular scaffold can be successfully and safely used for ACS treatment and in lesions of higher complexity.
- Published
- 2016
- Full Text
- View/download PDF
35. First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry)
- Author
-
Damian Kawecki, Beata Morawiec, Janusz Dola, Wojciech Waha, Grzegorz Smolka, Aleksandra Pluta, Kamil Marcinkiewicz, Andrzej Ochała, Ewa Nowalany-Kozielska, and Wojciech Wojakowski
- Subjects
Síndrome Coronariana Aguda ,Stents Farmacológicos ,Trombose ,Intervenção Coronária Percutânea ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background: There are sparse data on the performance of different types of drug-eluting stents (DES) in acute and real-life setting. Objective: The aim of the study was to compare the safety and efficacy of first- versus second-generation DES in patients with acute coronary syndromes (ACS). Methods: This all-comer registry enrolled consecutive patients diagnosed with ACS and treated with percutaneous coronary intervention with the implantation of first- or second-generation DES in one-year follow-up. The primary efficacy endpoint was defined as major adverse cardiac and cerebrovascular event (MACCE), a composite of all-cause death, nonfatal myocardial infarction, target-vessel revascularization and stroke. The primary safety outcome was definite stent thrombosis (ST) at one year. Results: From the total of 1916 patients enrolled into the registry, 1328 patients were diagnosed with ACS. Of them, 426 were treated with first- and 902 with second-generation DES. There was no significant difference in the incidence of MACCE between two types of DES at one year. The rate of acute and subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p < 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression, first-generation DES was an independent predictor for cumulative ST (HR 3.29 [1.30-8.31], p = 0.01). Conclusions: In an all-comer registry of ACS, the one-year rate of MACCE was comparable in groups treated with first- and second-generation DES. The use of first-generation DES was associated with higher rates of acute and subacute ST and was an independent predictor of cumulative ST.
- Published
- 2016
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.