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AS-42: Short- and Long-Term Clinical Outcomes after Carotid Artery Stenting Followed by Staged Coronary Artery Bypass Graft Surgery
Thursday, April 29, 2010
O R A L
Peripheral Intervention
A B S T R A C T S
Thursday, April 29, 2010 4:00 PM ⬃ 5:00 PM
Endovascular Intervention I Ida I
(Abstract nos. AS-42, AS-45, AS-46, AS-48, AS-49) Endovascular Intervention II Ida I Thursday, April 29, 2010 5:00 PM⬃ 6:00 PM (Abstract nos. AS-43, AS-44, AS-47, AS-50, AS-51)
AS-42
Thrombosed Native Hemodialysis Arteriovenous Fistulas. Chih-Cheng Wu, Chih-Chung Yang, Shih-Yun Pu, Kuei-Chin Tsai, Szu-Chi Wen. Hsinchu General Hospital, Hsinchu, Taiwan. Background: Percutaneous thrombectomy has become an accepted treatment for thrombosed hemodialysis native arteriovenous (AV) fistulas. Devices with different mechanisms have been developed for thrombus removal. The aim of our study was to compare the efficacy, safety, and patency between thrombectomy devices of different mechanisms for the treatment of thrombosed native AV fistulas. Methods: We retrospectively reviewed all the thrombectomy procedures for native AV fistulas from September 1999 through December 2008. Mechanical thrombectomy with either with the Arrow-Trerotola percutaneous thrombectomy device (PTD) or AngioJet rheolytic catheter (AngioJet) were accrued from an existing database. AngioJet was used in our institution until December 2005, and PTD was used after January 2004. Procedures performed during the period when both devices were available (January 2004 to December 2005) were excluded from this analysis. Medical record including dialysis records and fistulogram, and radiology reports were reviewed. Clinical success was defined as resumption of at least 1 hemodialysis session. Evaluation included the clinical success, complication, procedure time, and primary and secondary patency rates. Results: Included were 184 thrombectomy procedures for native AV fistulas (96 procedures with AngioJet; 88 procedures with PTD). The clinical success rates were 76% for the AngioJet group and 86% for the PTD group (p ⫽ 0.09). There was a higher complication rate in the AngioJet group (27% vs 10%, p ⫽ 0.04). The procedure time of the PTD group was significantly less than that of the AngioJet group (54 minutes vs 88 minutes, p ⬍0.001). The primary patency rates for the AngioJet group were 68%, 59%, and 42% at 1 month, 3 months, and 6 months, respectively. The primary patency rates for the PTD group were 66%, 45%, and 30% respectively. There was no significant difference in the 6-month primary patency between AngioJet and PTD groups (42% vs 30%, p ⫽ 0.11; Figure 1).
Short- and Long-Term Clinical Outcomes after Carotid Artery Stenting Followed by Staged Coronary Artery Bypass Graft Surgery. Won-Jang Kim, Seung-Whan Lee, Sung-Cheol Yun, Jong-Young Lee, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park. Asan Medical Center, Seoul, Republic of Korea. Background: Our objective was to assess clinical outcomes of patients undergoing staged carotid artery stenting (CAS) followed by elective coronary artery bypass graft (CABG) surgery. Methods: Current guidelines suggesting that carotid endarterectomy (CEA) be performed before or concomitant with CABG in patients with significant carotid artery stenosis remain controversial. CAS has recently been suggested as preferable to CEA in high-risk patients. Results: Between April 2001 and November 2007, 42 patients (44 lesions) with coexisting carotid and coronary atherosclerotic disease underwent CAS followed by CABG. We analyzed clinical carotid stenting outcomes during in-hospital stays, between discharge and CABG, 30 days after CABG, and 30 days later. Stroke and all-cause mortality rates were assessed at different times. Conclusion: Mean patient age was 67 years, and 84% of patients were men. Of all patients, 36% had bilateral carotid stenosis (350% stenosis), and all lesions were severely stenotic (41 lesions with 70%– 90% stenosis and 3 with ⬎90% stenosis). Asymptomatic carotid artery stenosis was present in 79% of lesions. The median time from CAS to CABG was 34 days (interquartile range [IQR], 26.3– 44.8 days).
AS-43 Comparison of Arrow-Trerotola Percutaneous Thrombectomy Device versus AngioJet Rheolytic Catheter in the Treatment of
20B
Conclusion: Mechanical thrombectomy with PTD had higher clinical success and was more time-efficient than the AngioJet. In addition, there was no significant difference in the 6-month primary patency between these 2 devices.
AS-44 Factors of Success and Patency after Subintimal Angioplasty in Patients with TransAtlantic Inter-Society Consensus C and D Severe Lower Extremity Occlusive Disease. Seung-Ju Kim1, Weon Kim2, Jong-Bum Kim1, Won-Yu Kang1, Sun-Ho Hwang1, Wan Kim1, Sang-Jin Ha2. 1Gwangju Veterans Hospital, Gwangju, Republic of Korea; 2Kyung Hee University Medical Center, Seoul, Republic of Korea.
The American Journal of Cardiology姞 APRIL 28 –29 2010 ANGIOPLASTY SUMMIT ABSTRACTS/Oral
O R A L
Peripheral Intervention
A B S T R A C T S
Thursday, April 29, 2010 4:00 PM ⬃ 5:00 PM
Endovascular Intervention I Ida I
(Abstract nos. AS-42, AS-45, AS-46, AS-48, AS-49) Endovascular Intervention II Ida I Thursday, April 29, 2010 5:00 PM⬃ 6:00 PM (Abstract nos. AS-43, AS-44, AS-47, AS-50, AS-51)
AS-42
Thrombosed Native Hemodialysis Arteriovenous Fistulas. Chih-Cheng Wu, Chih-Chung Yang, Shih-Yun Pu, Kuei-Chin Tsai, Szu-Chi Wen. Hsinchu General Hospital, Hsinchu, Taiwan. Background: Percutaneous thrombectomy has become an accepted treatment for thrombosed hemodialysis native arteriovenous (AV) fistulas. Devices with different mechanisms have been developed for thrombus removal. The aim of our study was to compare the efficacy, safety, and patency between thrombectomy devices of different mechanisms for the treatment of thrombosed native AV fistulas. Methods: We retrospectively reviewed all the thrombectomy procedures for native AV fistulas from September 1999 through December 2008. Mechanical thrombectomy with either with the Arrow-Trerotola percutaneous thrombectomy device (PTD) or AngioJet rheolytic catheter (AngioJet) were accrued from an existing database. AngioJet was used in our institution until December 2005, and PTD was used after January 2004. Procedures performed during the period when both devices were available (January 2004 to December 2005) were excluded from this analysis. Medical record including dialysis records and fistulogram, and radiology reports were reviewed. Clinical success was defined as resumption of at least 1 hemodialysis session. Evaluation included the clinical success, complication, procedure time, and primary and secondary patency rates. Results: Included were 184 thrombectomy procedures for native AV fistulas (96 procedures with AngioJet; 88 procedures with PTD). The clinical success rates were 76% for the AngioJet group and 86% for the PTD group (p ⫽ 0.09). There was a higher complication rate in the AngioJet group (27% vs 10%, p ⫽ 0.04). The procedure time of the PTD group was significantly less than that of the AngioJet group (54 minutes vs 88 minutes, p ⬍0.001). The primary patency rates for the AngioJet group were 68%, 59%, and 42% at 1 month, 3 months, and 6 months, respectively. The primary patency rates for the PTD group were 66%, 45%, and 30% respectively. There was no significant difference in the 6-month primary patency between AngioJet and PTD groups (42% vs 30%, p ⫽ 0.11; Figure 1).
Short- and Long-Term Clinical Outcomes after Carotid Artery Stenting Followed by Staged Coronary Artery Bypass Graft Surgery. Won-Jang Kim, Seung-Whan Lee, Sung-Cheol Yun, Jong-Young Lee, Duk-Woo Park, Soo-Jin Kang, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park. Asan Medical Center, Seoul, Republic of Korea. Background: Our objective was to assess clinical outcomes of patients undergoing staged carotid artery stenting (CAS) followed by elective coronary artery bypass graft (CABG) surgery. Methods: Current guidelines suggesting that carotid endarterectomy (CEA) be performed before or concomitant with CABG in patients with significant carotid artery stenosis remain controversial. CAS has recently been suggested as preferable to CEA in high-risk patients. Results: Between April 2001 and November 2007, 42 patients (44 lesions) with coexisting carotid and coronary atherosclerotic disease underwent CAS followed by CABG. We analyzed clinical carotid stenting outcomes during in-hospital stays, between discharge and CABG, 30 days after CABG, and 30 days later. Stroke and all-cause mortality rates were assessed at different times. Conclusion: Mean patient age was 67 years, and 84% of patients were men. Of all patients, 36% had bilateral carotid stenosis (350% stenosis), and all lesions were severely stenotic (41 lesions with 70%– 90% stenosis and 3 with ⬎90% stenosis). Asymptomatic carotid artery stenosis was present in 79% of lesions. The median time from CAS to CABG was 34 days (interquartile range [IQR], 26.3– 44.8 days).
AS-43 Comparison of Arrow-Trerotola Percutaneous Thrombectomy Device versus AngioJet Rheolytic Catheter in the Treatment of
20B
Conclusion: Mechanical thrombectomy with PTD had higher clinical success and was more time-efficient than the AngioJet. In addition, there was no significant difference in the 6-month primary patency between these 2 devices.
AS-44 Factors of Success and Patency after Subintimal Angioplasty in Patients with TransAtlantic Inter-Society Consensus C and D Severe Lower Extremity Occlusive Disease. Seung-Ju Kim1, Weon Kim2, Jong-Bum Kim1, Won-Yu Kang1, Sun-Ho Hwang1, Wan Kim1, Sang-Jin Ha2. 1Gwangju Veterans Hospital, Gwangju, Republic of Korea; 2Kyung Hee University Medical Center, Seoul, Republic of Korea.
The American Journal of Cardiology姞 APRIL 28 –29 2010 ANGIOPLASTY SUMMIT ABSTRACTS/Oral