Paweł Buszman

Polsko Amerykańskie Kliniki Serca, Catowice, Silesian Voivodeship, Poland

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Publications (48)143.91 Total impact

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    ABSTRACT: Background: Currently majority of coronary and peripheral interventions are performed with an overnight stay. This increases the cost and doesn't reduce logistic constraints on hospital resources. We hypothesized that by combining bivalirudin with vascular closure devices we can safely discharge patients on the same day after PCI and PTA without increasing their risk of bleeding. Aim: The aim of the study was to evaluate the safety and the feasibility of the same day discharge after PCI (percutaneous coronary intervention) and PTA (percutaneous transluminal angioplasty) using bivalirudin and vascular closure devices (VCD). Methods: This is a retrospective analysis of 833 consecutive patients who underwent percutaneous procedures in our center between January 2007 and February 2010. The population was divided into interventional and diagnostic arms. All interventions were done with use of bivalirudin for anticoagulation and vascular closure devices for achieving hemostasis. Hemostasis in diagnostic cohort was achieved with standard manual compression. The mean time of observation was 30days. The mean age of patients was 64.3 years. The primary end point was any bleeding event meeting GUSTO criteria. The secondary end points included local vascular complications, major adverse cardiac and cerebrovascular events, time to ambulation and discharge, as well as need for overnight hospitalization. Results: In 30-day observation the primary end point occurred in 4.0% patients in the interventional group and in 2.6% patients in the diagnostic group, p=0,31. The frequency of local vascular complications was higher in the interventional group although it was not statistically significant (3.1% vs. 2.9%) p=0,33. Patients from the interventional group were ambulated sooner compared to the diagnostic group (117.5min vs. 131 min), p=0,003. Time to discharge was 316.4±38.7 and 214.2±23.4 min. for interventional and diagnostic procedures respectively, p<0,001. Conclusions: PCI and PTA in selected group of patients, with use of bivalirudin and vascular closure devices do not appear to have increased risk of post procedural events when compared to diagnostic procedures, and can be done safely without the need for an overnight stay.
    No preview · Article · Dec 2015 · Kardiologia polska
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    ABSTRACT: There is limited comparative clinical data regarding the safety and efficacy profile of paclitaxel delivery via balloon versus stent-polymer matrix. In this study, we aimed to compare the clinical and angiographic results of two different methods of paclitaxel delivery among patients undergoing percutaneous coronary intervention (PCI) for single de novo coronary lesions. A total of 202 patients undergoing PCI due to symptomatic heart disease and at least one significant coronary artery lesion were prospectively enrolled in a multicenter non-inferiority trial. Eligible patients were randomized to a revascularization with either a paclitaxel eluting stent (PES = Coroflex Please, B.Braun) or a bare metal stent (BMS) followed by a paclitaxel coated balloon (PCB) dilation (BMS = Coroflex + PCB = Sequent Please, B.Braun). Clinical follow-up was obtained at 9 months in all patients, whereas angiographic in a subset of 94 (46.5%) patients. The baseline characteristics were well balanced between groups. At 9 months, the primary endpoint of in-stent late lumen loss in BMS + PCB was comparable and non-inferior to PES (0.21 ± 0.5 vs. 0.30 ± 0.7 mm, respectively. Pnon-inf < 0.05). At 9 months, the incidence of MACE (7.0 vs. 6.9%, HR = 1, 95%CI: 0.3-2.8; P = 0.99), comprising the occurrence of myocardial infarction (4.9 vs. 3.0%, HR = 1.62, 95%CI: 0.4-6.5; P = 0.32), target lesion revascularization (6.9 vs. 5.0%, HR = 1.42, 95%CI: 0.4-4.4; p = 0.54) and stent thrombosis (4.9 vs. 3.0%, HR = 2.01, 95%CI: 0.5-7.4; P = 0.74) was comparable between BMS + PCB and PES, respectively. In the BMS + PCB group, thrombosis tended to occur within 30 days (3.9 vs. 1.0%; P = 0.38). Paclitaxel delivery via drug coated balloon or polymer-stent matrix achieved comparable angiographic and clinical results among patients with de novo coronary lesions. BMS + PCB revascularization was associated with a higher rate of stent thrombosis when compared to newer generation drug eluting stents, therefore, should be recommended as a bail-out for PCB alone angioplasty. © 2015, Wiley Periodicals, Inc.
    No preview · Article · Aug 2015 · Journal of Interventional Cardiology
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    ABSTRACT: Fast releasing, rapamycin eluting stents although safe, showed inferior results with regard to inhibition of restenosis. Therefore, we report vascular effects of the novel, biodegradable polymer stent matrix with elevated sirolimus dose and fast release kinetics (ed-frSES, Alex, Balton) in the porcine coronary in stent restenosis model. A total of 19 stents were implanted with 120% overstretch in coronary arteries of 7 domestic pigs: 7 ed-frSES with 1,3 μg/mm² of sirolimus, 8 frSES with 1 μg/mm² of sirolimus and 8 bare metal stents. Following 28 days, coronary angiography was performed, animals sacrificed and stented segments harvested for histopathological evaluation. In angiography at 28 days, the late lumen loss was lowest in the elevated dose SES (ed-frSES: 0,20±0,2 vs. frSES 0,80±0,5 vs. BMS: 0,96±0,5±0,5 mm, p<0,01). This was confirmed in the morphometric evaluation in histopathology as represented by significant and dose dependent decrease in percent area stenosis (ed-frSES: 22,4±12,7% vs. frSES: 35±10,7% vs. BMS: 47,5±12,5%; p<0,01). There was no peri-strut inflammation in any of the groups. Endothelialisation score was numerically, however not meaningfully decreased in ed-frSES (ed-frSES: 2,93 vs. 3. vs. 3; p=0,05). Signs of fibrin were also noted in ed-frSES (ed-frSES: 0,4 vs. frSES: 0 vs. BMS: 0, p=0,05). Sirolimus dose dependent vascular response was reported. The elevated dose, fast releasing SES shows satisfactory vascular healing, similar to regular dose, fast release SES, with improved efficacy in restenosis inhibition.
    No preview · Article · May 2015 · Kardiologia polska
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    ABSTRACT: We aimed to comprehensively evaluate poly-lactide polymer degradation and sirolimus release kinetics from a drug-eluting stent matrix in the in vivo setting using a nuclear magnetic resonance (NMR) method. In 22 domestic swine, 18 biodegradable polymer-only coated stents (BPSs) and 36 biodegradable polymer-coated sirolimus-eluting stents (BP-SES) were implanted in coronary arteries with 115% overstretch. The animals were sacrificed at 1, 3, 7, 14, 28, and 56 days following baseline procedures. Vessel segments with BPS were harvested to evaluate polymer degradation with a NMR method, whereas BP-SES to analyze sirolimus tissue uptake and retention. Additionally, 8 BP-SES were implanted for histological analysis for 90 days of follow-up. The NMR showed a gradual absorption of the polymer over the 6 consecutive time points, from 5.48 µg of the polymer on the stent at 1-day follow-up, through 4.33 µg at 3 days, 3.16 µg at 7 days, 2.42 µg at 14 days, 1.92 µg at 28 days to 1.24 µg in the last day of the study. The curve of polymer degradation corresponds well with the pharmacokinetic profile of sirolimus eluted from its surface and measured at identical time points. In histopathology, at 90 days, complete healing and biocompatibility were reported. The utilization of NMR method for BP absorption kinetics evaluation is a useful tool, which may be widely adopted to test other biodegradable implants. Further, it may substantially improve their safety and efficacy by facilitating programmed polymer and drugs elution. © The Author(s) 2015.
    Full-text · Article · May 2015 · Journal of Cardiovascular Pharmacology and Therapeutics
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    ABSTRACT: Stent design may influence the outcomes, suggesting that adverse events rates vary according to free cell area and cell design. Open cell design technology of self expandable stents, dedicated for carotid revascularization has better deliverability nonetheless closed cell technology is expected to cause less thromboembolic events.
    No preview · Article · Nov 2014 · Kardiologia polska
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    ABSTRACT: Background: New paclitaxel coated balloons (PCB) developments have been proposed to maintain therapeutic levels of drug in the tissue while decreasing particle release. In this series of studies, we evaluated the pharmacokinetic profile and biological effects after paclitaxel delivery via novel microcrystalline PCB coating (mcPCB, Pax®, Balton) in porcine iliofemoral arteries. Methods: Ten domestic swine were enrolled yielding 24 iliofemoral segments for evaluation. In the pharmacokinetic study, nine mcPCBs were dilated for 60 sec and animals sacrificed after 1 hr, 3 and 7 days. Studied segments were harvested and tissue paclitaxel concentration was analyzed utilizing HPLC. In the biological response evaluation, self-expandable stents were implanted followed by post dilation with either mcPCB (n = 10) or POBA (n = 5). After 28 days, angiography was performed, animals were sacrificed and stented segments harvested for histopathological evaluation. Results: The 1-hr, 3 and 7 days vessel paclitaxel concentrations were 152.9 ± 154.5, 36.5 ± 49.5, and 0.9 ± 0.7 ng/mg respectively. In the biological response study, stents in the mcPCB group presented lower angiographic measures of neointimal hyperplasia as expressed by late loss when compared to POBA (-0.43 ± 0.9 vs. 0.23 ± 1.2; P = 0.24) at 28 days. In the histopathological evaluation, percent area of stenosis (%AS) was reduced by 42% in the mcPCB group (P < 0.05). The healing process in mcPCB group was comparable to POBA with regard to fibrin deposition (0.7 vs. 0.7; P = ns), neointimal maturity (1.97 vs. 1.93; P = ns), inflammation score (0.92 vs. 1; P = ns) and endothelialization score (1.77 vs. 1.73; P = ns). The mcPCB group did however display a greater tendency of medial cell loss and mineralization (60% vs. 0; P = 0.08). Conclusions: Delivery of paclitaxel via a novel mcPCB resulted in low long-term tissue retention of paclitaxel. However, this technological approach displayed reduced neointimal proliferation and favorable healing profile. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Feb 2014 · Catheterization and Cardiovascular Interventions
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    ABSTRACT: In United States alone there are more than 12 million people with peripheral artery disease (PAD). Long-term outcomes of plaque excision in high-risk population (patients with diabetes and patients with end stage renal disease on dialysis) are scarce. Since November 2003, we treated 225 consecutive patients (138 male, mean age: 66.3 ± 12.4, range: 29–93) with SilverHawkTM plaque excision for critical limb ischemia or disabling claudication. A total of 367 procedures were performed treating 832 lesions (157 restenotic, 675 de novo). One hundred fifty-five patients (68.9%) were diabetics, 74 (32.9%) were on dialysis. All patients were treated with statins, clopidogrel, aspirin, and aggressive glycemic control. The primary endpoint for our study was target lesion revascularization (TLR), and the secondary endpoint was an assessment of major adverse events (all cause death, amputation, TLR). The average time of observation was 2.2 ± 1.2 years. Procedural success rate was 99.4% with <30% residual stenosis achieved in 818 (98.9%) lesions. SilverHawk was used alone in 86.7%. No acute limb loss or major perforation occurred. Sixty (26.6%) patients had TLR. Long-term mortality was 16.4%. Seven (3.1%) patients had to undergo major amputations and 7 (3.1%) minor amputations. Seventy (31.1%) patients had a major adverse event. Atorvastatin 80 mg was found to be independent predictor of survival, and major amputation was found to be independent predictor of mortality. SilverHawk Plaque Excision combined with aggressive pharmacotherapy in this presented high-risk population is associated with promising long-term outcomes that compare favorably with accepted standards of care.
    No preview · Article · Sep 2013 · Catheterization and Cardiovascular Interventions
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    ABSTRACT: Background: The optimal revascularization strategy in patients with multivessel coronary artery disease (MVD) and unprotected left main coronary artery stenosis (ULMCA) presenting with non-ST acute coronary syndrome (NSTE-ACS) is unspecified. Therefore, we aimed to compare long-term outcomes after percutaneous (PCI) and surgical (CABG) intervention in this cohort Methods: In this multicenter prospective registry, 4856 patients with non-ST elevation myocardial infarction (NSTEMI), unstable angina and MVD with or without ULMCA stenosis were included. Following cardiac team consensus 3033 patients underwent PCI with stent implantation (including 10.3% drug eluting stents) whereas 1338 were assigned for CABG. The follow up on mortality was obtained at 3 years from all patients. Results: In the general population, patients assigned for PCI were younger (64.4±10 vs. 65.2±9 y.o., p=0.03), more frequently presented with NSTEMI (32.0 vs. 14.5% p=0.01), cardiogenic shock (1.5 vs. 0.7% p<0.01) history of prior PCI (13.1 vs. 5.5%; p<0.01) and CABG (10.6 vs. 4.6%, p<0.01). The Euroscore and TIMI risk score were slightly higher in PCI patients (5.36±2.3 vs. 5.16±2.0and 3.87±1.0 vs. 3.79±0.9 respectively,p<0.01). Patients consigned to CABG more often presented with triple and left main disease (82.2 vs. 33.8% and 13.7 vs. 2.4%; p<0.01). Otherwise, proximal LAD was more often revascularized with stenting (21.5 vs. 11.1%; p<0.01). After adjustment for differences in baseline risk factors (stand. diff. <5% in all variables, C-Statistic=0.82), 929 matched pairs were selected. Thirty day mortality was lower after PCI prior to matching (2.1 vs. 3.1%; p<0.01), whereas after balancing, the difference was not significant (2.5 vs. 2.8%; p=0.62). Three year survival was in favor of PCI when compared to surgery prior (87.5 vs. 82.8%, HR:1.44, 95% CI: 1.2-1.7, p<0.01) and after matching (86.4 vs. 82.3%, HR 1.33, 95% CI:1.05 - 1.7, p<0.01). Stenting was associated with significantly better outcome in the following subgroups: age>65, female gender, unstable angina, euroscore>5, TIMI risk score>4, DES and two vessel disease. Conclusions: Basing on this large, propensity matched registry data, in patients with NSTE - ACS and MVD with or without ULMCA stenosis, stenting was associated with lower risk of mortality at long term follow up. The subgroup analysis highlighted improved outcomes with PCI in high clinical risk cohorts.
    Preview · Article · Aug 2013 · European Heart Journal
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    ABSTRACT: Purpose: The aim of the study is to compare single dose of Paclitaxel delivered from Paclitaxel-coated Balloon Catheter - SeQuent Please (DEB) after implantation of the cobalt chromium bare metal stent- Coroflex Blue (BMS) versus the slow release of Paclitaxel from the drug eluting stent - Coroflex Please (DES). Method: We included 202 patients with stable or unstable angina and coronary artery stenosis > 50% in native vessels from 2.5 to 3.5 mm in diameter. All patients were randomized 1:1 to either DES or BMS+ DEB (DEB) group. In-hospital, 30 day and 6 month clinical data were collected after the randomization and index procedure. Primary endpoint was: target lesion failure (TLF) defined as cardiac death, myocardial infraction (MI), repeat percutaneous coronary intervention (PCI) or coronary artery by-pass (CABG) related to the target vessel. Angiographic endpoints were late loss and binary restenosis measured in 9 month angiograpy control in 50% of patients. In stent thrombosis (ST) (definite according to ARC definition) was recorded as additional safety endpoint. Results: Stent placement of DES or BMS postdilated with DEB was successful in 202 patients (100 DES vs. 102 DEB) There was no patient lost to follow up. Before discharge the primary endpoint was met in 5 patients. (two in DES vs three in DEB group; p= ns). ST occurred in 4 patients (one in DES vs three in DEB; p=ns). During 30 days follow up, primary endpoint occurred in 7 patients (2 in DES vs. 5 in DEB; p=ns). ST was noted in 6 patients (1 in DES vs 5 in DEB; p=ns). In the 6 months follow-up, the primary endpoint occurred in 11 patients (3 in DES vs. 8 in DEB; p=ns). There were more statisticaly non-significant ST in DEB group (1in DES vs. 6 in DEB; p=0.1). Concusions: SeQuent Please (DEB) after implantation the cobalt chromium bare metal stent- Coroflex Blue (BMS) is comparable with Coroflex Please (DES) treatment, nevertheless stent thrombosis was more frequent (not statistically significant) in Coroflex Blue (BMS) plus SeQuent Please (DEB) group.
    Preview · Article · Aug 2013 · European Heart Journal
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    ABSTRACT: Severe heart failure can be a rare symptom of hypocalcemia. We report a case of a 58 year-old male admitted with a diagnosisof acute coronary syndrome. The ECG showed prolonged QTc interval with severly impared left ventricular ejection fractionrecognised in echocardiography. During the hospitalisation hypocalcemia due to primary hypoparathyreoidism was revealedto be the cause of those symptoms.
    No preview · Article · Jun 2013 · Kardiologia polska
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    ABSTRACT: Simultaneous thrombosis of multiple epicardial coronary arteries is an uncommon clinical finding in ST-segment elevation myocardial infarction (STEMI). We describe a 44 year-old male present with STEMI who was found to have simultaneously occluded two epicardial arteries. There is many clinical states that can lead to multiple thrombosis i.e. essential trombocytosis, hiperhomocysteinaemia, depletion of antitrombin III, cocaine abuse etc. In this particular case L-arginin supplementation and association with thrombosis or atherosclerosis progression is discussed.
    No preview · Article · Apr 2013 · Kardiologia polska
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    ABSTRACT: Backgroud: Cardiogenic shock (CS) affects the prognosis in patients with myocardial infarction (MI). An additional factor affecting the prognosis is diabetes mellitus (DM). Aim: To evaluate the impact of DM on in-hospital and long-term mortality in patients with MI complicated by CS, who were included in the Polish Registry of Acute Coronary Syndromes (PL-ACS). We also sought to demonstrate a relationship between treatment method and mortality in this group. Methods: 71,290 consecutive patients with non-ST elevation MI (NSTEMI; 33,392) and ST elevation MI (STEMI; 37,898) were included in the PL-ACS register. CS was diagnosed on admission in 4,144 patients. This group included 1,159 patients with DM. Results: The patients with DM were older, more frequently female and more frequently presented with hypertension, hypercholesterolaemia, obesity, suffered from multivessel coronary disease significantly more frequently (76.4% vs. 64.6%; p = 0.00003) and had lower coronary angioplasty efficacy (TIMI 3 flow) (67% vs. 75.8%; p = 0.001) compared to patients without DM. The mortality rate comparisons for patients with DM vs. those without DM, respectively, were as follows: inhospital mortality, 61.4% vs. 55.9%; p = 0.001 (revascularisation treatment: 45.7% vs. 39.5%; p = 0.03, conservative treatment: 69.3% vs. 64.6%; p = 0.02) and 3-year mortality 78.6% vs. 70.7%; p 〈 0.0001 (revascularisation treatment: 64.7% vs. 55.0%; p = 0.001, conservative treatment: 85.5% vs. 79.2%; p = 0.0001). In the multivariate analysis, DM was, with borderline statistical significance, an independent predictor of higher in-hospital mortality (OR = 1.16; 95% CI 1.00-1.35; p = 0.054] and 3-year mortality (HR = 1.11; 95% CI 1.02-1.20; p = 0.01). Interestingly, after excluding patients who died in the hospital, DM was still associated with significantly higher 3-year mortality (50.1% vs. 40.0%; p 〈 0.0001). Multivariate analysis revealed that DM was still an independent risk factor for higher 3-year mortality (HR = 1.21; 95% CI 1.04-1.41; p = 0.02). Conclusions: Diabetes is associated with higher in-hospital and long-term mortality in patients with MI complicated by CS. Revascularisation treatment, compared to conservative treatment, reduces mortality in this group of patients.
    No preview · Article · Dec 2012 · Kardiologia polska
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    Full-text · Article · Oct 2012 · Journal of the American College of Cardiology
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    Full-text · Article · Oct 2012 · Journal of the American College of Cardiology
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    Full-text · Article · Oct 2012 · Journal of the American College of Cardiology
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    ABSTRACT: Although durable polymer coated drug-eluting stents (DES) are standard care in percutaneous coronary interventions, new stent platforms employing biodegradable polymer based drug delivery are increasingly being used in clinical practice. To evaluate the short- (28 days) and medium-term (90 days) vascular effects of the new biodegradable polymer coated sirolimus-eluting stent - the PROLIM stent. The objectives of the study were evaluated using standard angiographic and histological methods. In addition, the mechanical integrity of tested stents was assessed using Faxitron imaging. A total of 12 PROLIM stents, 11 biodegradable polymer only coated stents (BPCS), and 12 bare metal stents (BMS) were implanted in the coronary arteries of 16 female non-atheroslerotic domestic swine using an overstretch of 1.1:1.0. At 28 days, neointimal proliferation was significantly lower in the PROLIM and BMS stents compared to the BPCS stents (p ≤ 0.05). Interestingly, despite thin neointima found at this time in the PROLIM group, there was a further significant decrease in neointimal formation between 28 and 90 days (p = 0.04). Although a statistically bigger neointima was found in BPCS stents at 28 days compared to the PROLIM and BMS stents, there was a 50% decrease in the neointimal area at 90 days follow-up (p = 0.02) which reached the level seen in other groups. The endothelialisation was completed in all tested stents after 28 days. There was a significant increase of fibrin depositions in the PROLIM treated arteries at 28 days which were resorbed nearly completely at 90 days follow-up. At 28 days, the inflammatory response was found to be numerically higher in the BPCS stents (p = NS) compared to other tested groups. On the contrary, at 90 days follow-up when the degradation process of the polymer had been completed, the inflammatory reaction decreased substantially to the level seen in the PROLIM and BMS stents. Faxitron analysis of the stented arteries revealed no major abnormalities except for isolated strut fractures observed in the mid portions of two BMS stents and one BPCS stent. The PROLIM - a biodegradable polymer coated sirolimus-eluting stent - demonstrates very good short-term and medium-term angiographic and histological results. The lack of 'catch-up phenomenon', fast endothelialisation process, and minimal inflammatory reaction may contribute to favourable clinical outcomes using PROLIM stents.
    No preview · Article · Jul 2012 · Kardiologia polska
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    ABSTRACT: Objective We performed a meta-analysis of randomized controlled trials to compare coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for the treatment of de novo unprotected left main disease. Background Although CABG is accepted to be standard of care for revascularization of unprotected left main stenosis, PCI is increasingly being used as an alternative primary approach. Methods We searched for randomized, controlled trials comparing CABG and PCI for the treatment of unprotected left main disease. Major adverse cardiac and cerebrovascular events (all-cause death, myocardial infarction, stroke, and repeat revascularization) were analyzed. Results The search strategy identified 4 randomized controlled trials enrolling a total of 1,611 patients. Follow-up ranged between 1 and 2 years. There were no significant differences in the risk of death or myocardial infarction between the two treatment modalities. While the risk of stroke was significantly lower in patients undergoing PCI (risk ratio (RR) 0.26, 95% confidence interval (CI) 0.10–0.69, p = 0.007), the risk of repeat revascularization was higher among patients undergoing PCI (RR 1.94, 95% CI 1.43–2.61, p < 0.001). No relevant statistical heterogeneity across studies could be found. Conclusion In this largest series of randomized patients with unprotected left main stenosis to date, the risk of death and myocardial infarction was comparable between CABG and PCI. However, patients undergoing CABG had a higher risk of stroke, whereas patients undergoing PCI were at a higher risk for repeat revascularization.
    No preview · Article · Feb 2012 · Herz
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    ABSTRACT: We present the case of a 55 year-old male admitted to Malopolskie Centrum Sercowo-Naczyniowe PAKS in Chrzanów with diagnosis of anterior wall myocardial infarction (STEMI). We decided to treat the patient invasively because of presence of chest pain, persistent ST elevation and signs of haemodinamical instability. As it revealed later patient needed combination of PCI of left main/left anterior descending artery with PTA of iliac artery.
    No preview · Article · Jan 2012 · Kardiologia polska
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    ABSTRACT: Background: The Taxcor PL registry was a multicentre, phase IV open clinical trial, in which there participated 10 academic centres in Poland. Its aim was to assess the safety and effectiveness of the stent Genius TAXCOR I (Eurocor GmbH, Germany) at a dose of 1 μg/mm2 of paclitaxel, implanted during PCI with elective or urgent indications. Material and methods: Patients who entered the study were a group of patients qualified for PCI, based on clinical symptoms and provocative tests, in whom coronary angiography confirmed the presence of significant stenosis (length up to 25 mm) in the coronary arteries. Implantation procedure, peri- and postoperative procedure were in accordance with guidelines and local practice. The study protocol did not interfere with standard treatment for patients with a diagnosis of ischaemic heart disease. The total number of patients studied in the Taxcor PL registry is 100 people recruited in 10 centres in Poland. Results: Data were collected during the study on 100 PCIs (110 treated lesions). Average duration of PCI was 43 min (SD 24). Mean diameter of the implanted stent was 3.17 mm (SD 0.36) and the average length of 20.5 mm (SD 5.82). The mean time of hospitalization of patients enrolled in the study was 2.5 days (SD 3.4). During hospitalization, 2 patients experienced myocardial infarction which was the result of side branch closure during PCI. Three patients had a haematoma at the puncture site, which did not require surgical intervention and transfusion of blood products. During percutaneous coronary intervention also three cases of distal dissection were reported (type B, C and D). There were no other adverse events. In one-month follow-up one of the patients had a planned PCI procedure performed in another vessel than previously treated, which was the next stage of coronary revascularization. Similarly, in the 3-month follow-up one of the patients needed to undergo a PCI procedure on a vessel untreated with Taxcor. In the 6-month follow-up (3-6 months) one patient died - he was hospitalized with a diagnosis of malignant tumour and the gastrointestinal tract and operated on at the surgical ward (hemicolectomy); after 2 months of hospitalization, he died due to multiorgan failure. Five patients had a second percutaneous coronary intervention in other vessels than at the time of study enrolment. At 12-month follow-up (6-12 months) two patients had a second PCI procedure performed, including one in a vessel treated at the time of enrolment. Ineffectiveness of supply target vessel (called target vessel failure, TVF) occurred in three patients (death from coronary causes - 0, MI - 2, target vessel revascularization (TVR - PCI or CABG) during the 12-month observation period - 1. Conclusions: Taxcor PL registry results showed that the stent Genius Taxcor I is safe to use and provides satisfactory results in short- and long-term observation, in comparison with other commercially available coronary stent systems.
    Full-text · Article · Oct 2011 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology
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    ABSTRACT: The subintimal angioplasty is one of the most frequent techniques used for total chronic occlusion (CTO) treatment. Nevertheless, this approach is limited by the lack of controlled re-entry into the true lumen of the target vessel. We present a case of a 85-yearold man with symptomatic CTO of the left superficial femoral artery (SFA). After initially unsuccessful subintimal recanalization with Confianza wire, Pioneer Plus Catheter with Intravascular Ultrasound Volcano system guidance were used for a true lumen re-entry. Finally lesion was treated with angioplasty and stents. Procedure was successful without complications, no residual stenosis was noted. The patient was discharged home four hours after procedure. The one day and three weeks follow up showed no vascular complications and the patient had no residual symptoms. The ankle-brachial index of the left extremity has improved from baseline 0.22 to 0.98.
    Full-text · Article · Jul 2011 · Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology

Publication Stats

537 Citations
143.91 Total Impact Points

Institutions

  • 2008-2015
    • Polsko Amerykańskie Kliniki Serca
      Catowice, Silesian Voivodeship, Poland
  • 2007-2015
    • Medical University of Silesia in Katowice
      • • Department of Histopathology
      • • Third Division of Cardiology
      Catowice, Silesian Voivodeship, Poland
  • 2012
    • Śląskie Centrum Chorób Serca
      • Department of Cardiac Surgery and Transplantology
      Hindenburg, Silesian Voivodeship, Poland
  • 2007-2009
    • Pomorski Uniwersytet Medyczny
      Stettin, West Pomeranian Voivodeship, Poland