Browsing by Author "Niyazova-Karben, ZA"

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Clinical, Angiographical, and Procedural Causes of Acute Vessel Closure During Transluminal Coronary Intervention
(Russian Heart Failure Soc, 2004) Batyraliev, TA; Pershukov, IV; Niyazova-Karben, ZA
Aim. To elucidate factors related to acute vessel closure (AVC) after transluminal coronary intervention. Methods. From population of 10439 patients subjected to transluminal coronary intervention 2 groups were formed: with (n=885) and without (n=885) acute vessel closure (AVC). Twenty five clinical, angiographical and procedural characteristics of patients of these 2 groups were included into mono and multifactorial logistic regression analysis. Result and conclusion. The following factors were univariate predictors of acute vessel closure: smoking [odds ratio (OR) 1.42], unstable angina (OR=2.130, acute myocardial infarction within previous 24 hours (OR 2.76), cardiogenic shock (OR 4.31), urgent procedure (OR 1.94), eccentric stenosis (OR 1.67), calcified lesion (OR 2.21), preexisting thrombosis (OR 3.79), lacerated complicated stenosis (OR 2.02), tortuous lesion (OR 1.35), low operator experience (OR 3.37), balloon angioplasty as sole procedure (OR 1.66), concomitant rheolytic thrombectomy (OR 1.95), urgent stenting (OR 1.45). Elective stenting significantly lowered risk of acute vessel thrombosis. Multifactorial step-tip analysis selected the following independent predictors of AVC: smoking, acute myocardial infarction within previous 24 hours, cardiogenic shock, preexisting thrombosis, lacerated complicated stenosis, and concomitant rheolytic thrombus extraction. Thus only elective stenting significantly reduced risk of AVC.
Current Role of Laser Angioplasty of Restenotic Coronary Stents
(Sage Publications inc, 2006) Batyraliev, TA; Pershukov, IV; Niyazova-Karben, ZA; Karaus, A; Calenici, O; Guler, N; Sidorenko, BA
Treatment of in-stent restenosis (ISR) with conventional percutaneous transluminal coronary angioplasty (PTCA) causes significant recurrent neointimal tissue growth in 30-85%. Therefore, laser ablation of intrastent neointimal hyperplasia before balloon dilation can be an attractive alternative. However, the long-term outcomes of such treatment have not been studied thoroughly enough. This prospective case-control study evaluated angiographic and clinical outcomes of PTCA alone and a combination of excimer laser coronary angioplasty (ELCA) and adjunct PTCA in 125 patients with ISR. ELCA was performed before balloon dilation in 67 patients, PTCA alone was performed in 58 patients. Basic demographic and clinical data were comparable in both groups. Lesions included in ELCA group were longer (17.1 +/- 9.9 vs 13.6 +/- 9.1 mm; p = 0.034), more complex (36.5% type C stenoses vs 14.3%; p = 0.006), and more frequently had reduced distal blood flow (TIMI < 3: 18.9% vs 4.8%; p=0.025) compared to lesions in the PTCA group. Immediate angiographic results of PTCA and ELCA + PTCA appeared to be comparable. PTCA alone was successful in 57 patients (98.3%), ELCA + PTCA, in 66 patients (98.5%). The rates of hospital complications were comparable (3.0% in ELCA group vs 8.6% in PTCA group). The 1-year follow-up showed that the rates of major adverse cardiac events (MACE) were comparable in the 2 groups (37.3% in ELCA group vs 46.6% in PTCA group). The rates of target vessel revascularization (TVR) within 1 year after the intervention were also similar in the 2 groups (32.8% vs 34.5%). The data mean that ELCA in patients with complex ISR is efficient and safe. Despite a higher complexity of lesions in the ELCA group, no increase in the rate of complications was registered.
Effectiveness of Excimer Laser Coronary Angioplasty in Treatment of Patients With In-Stent Restenosis
(Izdatelstvo Meditsina, 2003) Pershukov, IV; Niyazova-Karben, ZA; Batyraliev, TA; Eryonucu, B; Guler, N; Temamogullari, A; Sidorenko, BA
In-stent restenosis (ISR), when treated with balloon angioplasty (PTCA) alone, has an angiographic recurrence rate of 30-85%. Ablating the hypertrophic neointimal tissue prior to PTCA is an attractive alternative, however late outcomes of such treatment have not been fully determined. This multicenter case control study assessed angiographic and clinical outcomes of 137 consecutive procedures in 125 patients treated for ISR with either PTCA alone (n=58) or excimer laser assisted coronary angioplasty (ELCA, n=67). Demographics were similar. Lesions selected for ELCA compared with those selected for \PTCA were longer (17.1+/-9.9 mm vs. 13.6+/-9.1 mm; p=0,034), more complex (ACC/AHA type C: 36,5% vs. 14,3%; p=0,006), and with reduced antegrade flow (TIMI flow <3: 18,9% vs. 4,8%; p=0,025). IELCA- and PTCA treated patients had similar rates of procedural success (98,5 and 98,3%, respectively, p=1,0), major clinical complications (3,0% and 8,6%; respectively, NS), major cardiac events at 1 year (37,3 and 46,6%. respectively, ISIS), and target lesion revascularization (32,8 and. 34,5%; respectively, NS). These data suggest that ELCA in patients with complex in-stent restenosis is as safe and effective as PTCA. Despite higher lesion complexity in ELCA-treated patients, no increase in event rates was observed.
Excimer Laser Coronary Angioplasty in Treatment of Patients With In-Stent Restenosis
(Excerpta Medica inc, 2003) Pershukov, IV; Niyazova-Karben, ZA; Batyraliev, TA; Eryonucu, B; Guler, N; Temamogullari, A; Sidorenko, BA
Prognosis of Unstable Angina Resulting From Restenosis After Percutaneous Angioplasty of Saphenous Vein Grafts
(Russian Heart Failure Soc, 2004) Peresypko, MK; Niyazova-Karben, ZA; Petrakova, LN; Batyraliev, TA; Pershukov, IV; Guler, N; Sidorenko, BA
Aim. To assess frequency of unstable angina due to restenosis after percutaneous angioplasty of venous grafts and to elucidate risk factors of its development. Material and methods. Percutaneous interventions were successfully performed in 100 out of 106 patients with venous graft stenoses. These patients were followed up for 17+/-11 (maximum 36) months. Results. Unstable angina due to venous graft restenosis developed in 24% of patients. Patients with unstable angina compared with those without were characterized by higher frequency of hyperlipidemia (83 vs. 51%, respectively, p=0.032), lower rate of stenting (46 and 72%, respectively, p=0.032), greater residual stenosis (15+/-13 and 9+/-8%, respectively, p=0.008). At multifactorial regression analysis the following factors were significant predictors of unstable angina: hyperlipidemia (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.64-8.39), and residual stenosis after intervention (OR 1.04, 95% CI 1.01-1.07, p=0.04). In a subgroup of patients with hyperlipidemia there was a tendency to greater rate of unstable angina among patients not taking statins compared with users of statin (50 and 29%, respectively, p=0.083). Conclusion. Unstable angina developed in 1/4 of patients after balloon dilatation of venous grafts and hyperlipidemia was its most powerful predictor.
Rheolytic Thrombectomy With Angiojet Catheter During Transluminal Coronary Revascularization in Patients With Acute Myocardial Infarction
(Russian Heart Failure Soc, 2003) Batyrailiev, TA; Pershukov, IV; Niyazova-Karben, ZA
Background Although balloon angioplasty and stenting are effective in the treatment of acute myocardial infarction (M1), reduced coronary flow and distal embolization frequently complicate interventions when thrombus is present. Adjunctive treatment with mechanical thrombectomy devices was suggested to reduce these complications. Methods We evaluated immediate angiographic, in-hospital and 30-day follow-up clinical outcomes of 185 patients with acute MI and angiographically evident thrombus who were treated with Angiolet rheolytic thrombectomy followed by immediate definitive treatment. Results. Procedural success (residual diameter stenosis <50% and Thrombolysis in Myocardial Infarction [TIMI flow >2 after final treatment) was 97%. Rheolytic thrombectomy success was achieved in 7% of patients. Subsequent definitive treatment included stenting in 67% and balloon angioplasty alone in 26% of patients. Final TIMI 3 flow was achieved in 89%. Angiolet treatment resulted in mean thrombus area reduction from 69,6 mm(2) at baseline to 17,3 mm(2) post-thrombectomy (p<0,001). Procedural complications included distal embolization (7,6%) and perforation (1,1%). Clinical success (procedure success without major in-hospital cardiac events) rate was 88%, in-hospital mortality - 7,0%. There were no further major adverse events during 30-day follow-up. Conclusion. Rheolytic thrombectomy can be performed safely and effectively in patients with acute MI, allowing for immediate definitive treatment of thrombus-containing lesions.