JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Aug 2013
Multicenter StudyEnhanced mortality risk prediction with a focus on high-risk percutaneous coronary intervention: results from 1,208,137 procedures in the NCDR (National Cardiovascular Data Registry).
This study sought to update and validate a contemporary model for inpatient mortality following percutaneous coronary intervention (PCI), including variables indicating high clinical risk. ⋯ Clinical acuity is a strong predictor of PCI procedural mortality. With inclusion of variables that further characterize clinical stability, the updated CathPCI Registry mortality models remain well-calibrated across the spectrum of PCI risk.
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JACC Cardiovasc Interv · Aug 2013
Randomized Controlled Trial Multicenter Study Comparative StudyImproved safety and reduction in stent thrombosis associated with biodegradable polymer-based biolimus-eluting stents versus durable polymer-based sirolimus-eluting stents in patients with coronary artery disease: final 5-year report of the LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) randomized, noninferiority trial.
This study sought to report the final 5 years follow-up of the landmark LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) trial. ⋯ The safety benefit of the biodegradable polymer BES, compared with the durable polymer SES, was related to a significant reduction in very late ST (>1 year) and associated composite clinical outcomes. (Limus Eluted From A Durable Versus ERodable Stent Coating [LEADERS] trial; NCT00389220).
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JACC Cardiovasc Interv · Aug 2013
Multicenter Study Comparative StudySurvival after endovascular therapy in patients with type B aortic dissection: a report from the International Registry of Acute Aortic Dissection (IRAD).
This study sought to evaluate long-term survival in type B aortic dissection patients treated with thoracic endovascular aortic repair (TEVAR) therapy. ⋯ Results from IRAD show that TEVAR is associated with lower mortality over a 5-year period than medical therapy for TBAAD. Further randomized trials with long-term follow-up are needed.
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JACC Cardiovasc Interv · Aug 2013
ReviewManagement of vascular access in transcatheter aortic valve replacement: part 2: Vascular complications.
The interventional cardiologist must be able to recognize and manage potential vascular complications. Iliofemoral complications are the most frequent vascular complications in transfemoral transcatheter aortic valve implantation. Small vessel dimensions, moderate or severe calcification, and center experience are the major predictors. ⋯ Treatment options for failed percutaneous closure include prolonged manual compression, balloon angioplasty, stent implantation, and surgery. Aortic complications are rare, but serious complications are associated with a high mortality rate, even if emergent surgery is performed. There are specific vascular complications associated with alternative access routes such as transapical and transaxillary and direct aortic access.