Michael Maeng

Side branch fractional flow reserve measurements after main vessel stenting: a Nordic-Baltic Bifurcation Study III substudy.

AIMSnThe substudy was performed to evaluate the acute and eight-month follow-up effect of final kissing balloon dilatation (FKBD) on fractional flow reserve (FFR) in the side branch (SB) after main vessel (MV) stenting.nnnMETHODS AND RESULTSnWe included 75 patients in the Nordic-Baltic Bifurcation Study III FFR substudy: 42 in the FKBD group and 33 in the no-FKBD group. Complete angiographic and FFR eight-month follow-up was obtained in 25 (60%) patients in the FKBD group and 21 (63%) patients in the no-FKBD group. In the FKBD group the post-PCI mean SB FFR was significantly higher compared to the no-FKBD group (0.92 vs. 0.85, respectively; p=0.011). No significant difference in FFR value between treatments was detected at eight-month follow-up (0.91 vs. 0.87; p=0.19). There were no significant changes in mean SB FFR during the follow-up period (0.92 vs. 0.91; p=0.80) in the FKBD group and (0.87 vs. 0.87; p=0.91) in the no-FKBD group.nnnCONCLUSIONSnFKBD in simple stenting of bifurcation lesions improved acute functional outcome in SB compared to leaving the SB jailed. No significant difference was detected at follow-up. In both groups there was no significant functional late loss during follow-up. Thus, both strategies were equally effective in ensuring that side branch jailing would not cause ischaemia in the long term.

Randomised comparison of manual compression and FemoSeal™ vascular closure device for closure after femoral artery access coronary angiography: the CLOSure dEvices Used in everyday Practice (CLOSE-UP) study.

AIMSnTo compare in a randomised trial the safety and efficacy of the FemoSeal vascular closure device (VCD) versus manual compression (MC) after femoral access coronary angiography (CAG).nnnMETHODS AND RESULTSnIn 13 months, 1,014 patients were included and 1,001 patients entered analysis. Median [interquartile range] closure time was 8.0 [6-10] minutes after MC versus 1.0 [1-1] minute (p<0.0001) for the FemoSeal VCD. Bed rest for one hour after the closure procedure was recommended in both groups. The primary endpoint of incidence of large groin haematoma was 6.7% in the MC group vs. 2.2% (p=0.002) in the FemoSeal group. The combined endpoint of 14-day adverse vascular events occurred in 1.0% in the MC group vs. 0.6% in the FemoSeal VCD group (p=0.7). Manual compression (OR 3.3, 95% CI: 1.5-7.2, p=0.002), female gender (OR 2.1, 95% CI: 1.1-3.9, p=0.018), and multiple punctures (OR 10.5, 95% CI: 3.2-34.3, p=0.001) were identified as independent predictors of adverse events and large haematomas.nnnCONCLUSIONSnClosure of femoral access after coronary angiography by the FemoSeal vascular closure device was safe, faster, and associated with significantly fewer in-hospital large haematomas as compared to closure by manual compression.

EARLY HEALING AFTER TREATMENT OF CORONARY LESIONS BY EVEROLIMUS OR BIOLIMUS ELUTING BIORESORBABLE POLYMER STENTS: THE SORT-OUT VIII OPTICAL COHERENCE TOMOGRAPHY STUDY

Improved early healing after drug eluting stent (DES) implantation may reduce the risk of early stent thrombosis. We aimed to compare early healing patterns after implantation of a 74 µm thick, everolimus-eluting biodegradable polymer stent (Synergy, Boston Scientific, USA) or a 120 µm thick,

IMPACT OF LESION LENGTH ON OUTCOMES AFTER REVASCULARIZATION WITH EVEROLIMUS AND SIROLIMUS ELUTING STENTS. A SUBSTUDY OF THE SORT OUT IV TRIAL

Randomized trials comparing outcomes after implantation of first generation drug-eluting stents (DES) versus second generation DES in long lesions are limited. Stenting of long lesions might be associated with higher rates of adverse events. In this substudy of the SORT OUT IV trial, we assessed the