Kasparas Briedis

Twelve-month clinical outcomes of transradial coronary artery intervention: comparison of the right and left radial artery approach

Introduction. Trans-radial intervention has several advantages such as reduction of bleeding risk, improvement of patients’ convenience, and immediate ambulation as compared with the trans-femoral intervention. In the trans-radial intervention, there are some anatomical and technical differences between right and left radial approach. The aim of this study is to evaluate the impact of the choice of the right or left radial approach on 12-month clinical outcomes in patients undergoing the trans-radial intervention. Methods. A total of 506 consecutive patients who underwent trans-radial intervention were enrolled from Nov 2013 to Oct 2014 in the Lithuanian University of Health Sciences Trans-radial Intervention Registry. The patients were divided into two groups; a right radial approach group and a left radial approach group. To adjust potential confounders, propensity score-matched analysis was performed using the logistic regression model. Results. After propensity score matching, the baseline clinical and angiographic characteristics were balanced between the two groups. However, contrast volumes during the procedure were larger and fluoroscopic times were longer in the right radial approach group, whereas procedure times were longer in the left approach group. Procedural and in-hospital complications were similar between the two groups. The cumulative clinical outcomes up to 12 months, including mortality, recurrent myocardial infarction, repeat revascularisation, stent thrombosis, and MACE, were similar between the two groups. Conclusions. In this study, despite the procedural efficacy including procedural time and contrast volume were increased in the right artery approach, however, 12-month cumulative clinical outcomes were similar between the two groups.

Differences in mitral annulus remodelling in acute anterior ST elevation and acute inferior ST elevation myocardial infarction

Introduction. Myocardial infarction is known to account for left ventricular remodelling and mitral annular distortion. The aim of the study was to assess and compare morphometric changes of mitral annulus in patients presenting with acute anterior or inferior myocardial infarction. The objectives of our study were as follows: assessment of anteroposterior and septolateral annular dimensions of mitral annulus in patients with acute myocardial infarction; assessment of mitral annular area and annular contraction in patients with acute myocardial infarction; evaluation of parameters reflecting mitral apparatus (chordal length, chordal papillary muscle distance, etc.); and comparison of mitral annular geometry between patients with anterior and inferior myocardial infarction. Materials and methods. Echocardiographic data of 30 patients with an anterior ST elevation myocardial infarction and data of 30 patients with an inferior ST elevation myocardial infarction on an acute stage was collected, evaluated, and compared. Results and conclusions. The mitral annulus shows some significant changes in both post inferior myocardial infarction and post anterior myocardial infarction patients. The magnitude of movements of a post inferior myocardial infarction mitral annulus is greatly reduced when compared to mitral annulus in patients with anterior myocardial infarction. While echocardiographically measuring post-myocardial infarction mitral annulus, we decided that inferior myocardial infarction accounts for earlier mitral annular dilatation compared to patients with anterior myocardial infarction.

Evaluation of two years’ treatment results after implantation of Biolimus A9 stents in coronary arteries

Introduction. Stenting is a widespread procedure for patients suffering from coronary artery disease. The use of drug-covered stents has improved stenting safety and treatment efficiency. Using second-generation Biolimus drug-covered A9 stents is associated with reduced risk of stent thrombosis compared with first-generation ones. The aim of the study was to evaluate two years’ treatment results after implantation of Biolimus A9 stents in coronary arteries in patients who suffer from coronary artery disease. Methods. The study included 216 patients who suffered from coronary artery disease and were treated using Biolimus A9 drug-covered stents, in order to eliminate all greater-than-50% stenoses. Patients’ data were collected from hospital case histories and e-Biomatrix PMR questionnaire. Decisions regarding whether to use Biolimus A9 stents during percutaneous coronary intervention were made by the respective operators. The rate of complication after stenting was evaluated when stenosis was eliminated or reduced to 30% or TIMI 3 flow was determined. Results. Out of 216 patients included in the study, 151 were males (69.91%) and 30.09% (65) were females. Mean of age of patients was 60.2 ± 10.1 years; 19% of patients had diagnosed diabetes. The success rate of implanting Biolimus A9 stents was 100% with no complications during hospital stay.