ABSTRACT
BACKGROUND: Bifurcation lesions account for 15-20% of interventions carried out in a catheterization laboratory. Several techniques have been described for treating bifurcation lesions of which culotte and T-stenting and protrusion(TAP) are commonly used. Both these techniques involve recrossing the struts of primary stent, failing which the flow in second branch which can be impaired and lead to catastrophic events. In this study, we describe a novel balloon embedded stenting technique which can be incorporated with traditional culotte or TAP technique and facilitates conversion to bail out crush in case of such an event. METHODS AND RESULTS: 28 patients who were treated with balloon embedded stenting for bifurcation lesions were included in the study. Angiographic and procedural success were achieved in all the patients. Primary stent could not be recrossed in 1 patient, who was successfully converted to bail out crush using the technique. There were no complications during the procedure. Mean fluoroscopy time and contrast volume was similar to that of conventional culotte and TAP. CONCLUSION: The present study suggests that incorporation of balloon embedded stenting into traditional culotte or TAP technique is achievable and can facilitate conversion to bail out crush when required.
Subject(s)
Coronary Artery Disease/surgery , Drug-Eluting Stents , Percutaneous Coronary Intervention/methods , Sirolimus/pharmacology , Surgery, Computer-Assisted/methods , Coronary Angiography , Coronary Artery Disease/diagnosis , Female , Fluoroscopy , Follow-Up Studies , Humans , Immunosuppressive Agents/pharmacology , Male , Middle Aged , Prospective Studies , Prosthesis Design , Time Factors , Treatment OutcomeABSTRACT
INTRODUCTION: Metabolic Syndrome (MS) consists of a cluster of metabolic abnormalities that confer exaggerated risk of cardiovascular disease. MS is a novel risk factor for Coronary Artery Disease (CAD) and is a rising disease entity in Asia. Incidence of ST Elevation Myocardial Infarction (STEMI) is high in patients with MS. There is limited data on prevalence of MS in patients with Acute Myocardial Infarction (AMI). AIM: To determine frequency of MS in patients admitted with STEMI. MATERIALS AND METHODS: Hundred Consecutive patients between 25 to 75 years who were admitted with STEMI at Govt medical college Thrissur were included in this prospective study. Subjects were assessed for five-component conditions of metabolic syndrome. Criteria to identify MS were based on a "Consensus statement for diagnosis of metabolic syndrome for Asian Indians". Presence of three or more of following suggest MS, Waist Circumference (WC)>90 cm in men and 80 cm in women, Blood pressure >130/85 mm Hg, Fasting Plasma Glucose (FPG) >100 mg%, serum triglycerides >150 mg/dl, High Density Lipoprotein (HDL)<40 mg/dl in male and<50 mg/dl in female. Statistical analysis was performed using Epi-Info software. Data expressed as numbers and percents were compared by Chi-square test. RESULTS: Study enrolled 100 patients (males 80, females 20) with a mean age of 58. Frequency of MS in patients with STEMI was 40% (36% of males and 55% of females). Prevalence of components in the MS group was WC >80/90 -31(71%), BP>130/85- 23(58%), FPG >100 - 37(93%), HDL <40 (male)/ 50 (female) - 18(45%), TG >150 -15(37.5%). CONCLUSION: The present study concluded that there is a remarkably high occurrence of metabolic syndrome and central obesity in patients with ST elevation Myocardial Infarction (MI) in our local population especially in females. Considering this fact the role of specific and targeted intervention for clinical detection and management of MS including lifestyle modifications needs to be addressed.