CBS 2019
CBSMD教育中心
中 文

Bifurcation Stenting

Abstract

Recommended Article

Treating Bifurcation Lesions: The Result Overcomes the Technique 3-Year Outcomes After 2-Stent With Provisional Stenting for Complex Bifurcation Lesions Defined by DEFINITION Criteria The European bifurcation club Left Main Coronary Stent study: a randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN) Impact of stent deformity induced by the kissing balloon technique for bifurcating lesions on in-stent restenosis after coronary intervention A Randomized Trial Evaluating Online 3-Dimensional Optical Frequency Domain Imaging-Guided Percutaneous Coronary Intervention in Bifurcation Lesions Systematic Review and Network Meta‐Analysis Comparing Bifurcation Techniques for Percutaneous Coronary Intervention Validation of bifurcation DEFINITION criteria and comparison of stenting strategies in true left main bifurcation lesions Selection of stenting approach for coronary bifurcation lesions

Original ResearchSep 17, 2022. Epublished DOI: 10.1016/j.jcin.2022.09.013

JOURNAL:J Am Coll Cardiol Intv. Article Link

Pulmonary Artery Denervation for Pulmonary Arterial Hypertension: A Sham-Controlled Randomized Trial

H Zhang , YY Wei , SL Chen et al. Keywords: PADN; WHO Group I PAH; 6MWD

ABSTRACT


BACKGROUND - WHO Group I pulmonary arterial hypertension (PAH) is a progressive, debilitating disease. Previous observational studies have demonstrated that pulmonary artery denervation (PADN) reduces pulmonary arterial pressures in PAH. However, the safety and effectiveness of PADN have not been established in a randomized trial.


OBJECTIVES - We aimed to determine the treatment effects of PADN in Group I PAH patients.


METHODS - WHO Group I PAH patients not taking PAH-specific drugs for at least 30 days were enrolled in a multicenter, sham-controlled single-blind, randomized trial. Patients were assigned to receive PADN plus a phosphodiesterase-5 inhibitor (PDE-5i) or a sham procedure plus a PDE-5i. The primary endpoint was the between-group difference in the change in 6-minute walk distance (6MWD) from baseline to 6 months.


RESULTS - Among 128 randomized patients, those treated with PADN compared with sham had a greater improvement in 6MWD from baseline to 6 months (mean adjusted between-group difference 33.8 m, 95% CI, 16.7 to 50.9, p<0.001). From baseline to 6 months PVR was reduced by -3.0 ± 0.3 Wood units after PADN and -1.9 ± 0.3 Wood units after sham (adjusted difference -1.4, 95% CI -2.6 to -0.2). PADN also improved right ventricular function, reduced tricuspid regurgitation and decreased NT-proBNP. Clinical worsening was less (1.6% vs. 313.8%; OR 0.11 , 95% CI 0.01 to 0.87) and a satisfactory clinical response was greater (57.1% vs. 32.3%; OR 2.79 , 95% CI 1.37 to 5.82) with PADN treatment during 6-month follow-up.


CONCLUSIONS - In patients with WHO Group I PAH, PADN improved exercise capacity, hemodynamics and clinical outcomes during 6-month follow-up. ( ClinicalTrials.gov number: NCT03282266).