Publications by authors named "Rafal Januszek"
Acute and short-term outcome of Intravascular Coronary Lithotripsy and Excimer Laser Coronary Atherectomy for Severe Stent Underexpansion: The Multicenter IVL-ELCA DRAGON Registry.
Kardiol Pol
March 2025
Background: Intravascular lithotripsy (IVL) and excimer laser-coronary atherectomy (ELCA) could be both used in the percutaneous treatment of coronary stent underexpansion.
Aims: To investigate the effectiveness and safety of IVL vs. ELCA for the treatment of stent underexpansion related to heavy calcifications.
Background: Little is known about the similarity of microcirculation assessment outcomes performed with regadenoson and adenosine. The aim of the current study was to compare coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) assessment using adenosine and regadenoson, and to evaluate predictors regarding the size of differences.
Methods: 44 patients were enrolled and diagnosed between 2021 and 2023.
Article Synopsis
- The study evaluates the performance of ultrathin drug-eluting stents (DES) versus thin-strut DES and drug-eluting balloons (DEB) in treating in-stent restenosis (ISR) in patients.
- Results show that ultrathin DES significantly lowers the risk of adverse events, including cardiac death and need for revascularization, when compared to both thin-strut DES and DEBs after three years of follow-up.
- Additionally, in patients with diffuse ISR, ultrathin DES outperformed thin-strut DES in reducing risks of target lesion revascularization (TLR) and target vessel revascularization (TVR).
Long-term outcomes of DCB and DES for the treatment of in-stent restenosis in relation to the vessel size.
Catheter Cardiovasc Interv
November 2024
Background: Percutaneous coronary intervention (PCI) with drug-coated balloons (DCB) or drug-eluting stents (DES) are well-established treatments for in-stent restenosis, however little is known about the impact of vessel size on the outcomes. The study aimed to evaluate the efficacy and safety profile of DCB versus DES in DES in-stent restenosis depending on the vessel size.
Methods: Consecutive patients with DES in-stent restenosis who underwent PCI between January 2010 and February 2018 entered the registry with a long-term follow-up.
Background: Rotational atherectomy (RA) is traditionally administered for patients with heavily calcified lesions and is thereby characterized by a high risk of the performed intervention. However, the prevalence characteristics of cardiac arrest are poorly studied in this group of patients. We aimed to evaluate the frequency and risk factors of cardiac arrest during percutaneous coronary interventions (PCI) performed with RA and preceding coronary angiography (CA).
View Article and Find Full Text PDF: The rate of in-stent restenosis (ISR) is decreasing; however, it is still a challenge for contemporary invasive cardiologists. Therapeutic methods, including drug-eluting balloons (DEBs), intravascular lithotripsy, excimer laser coronary atherectomy, and imaging-guided percutaneous coronary intervention (PCI) with drug-eluting stents (DES), have been implemented. Patients with diabetes mellitus (DM) are burdened with a higher risk of ISR than the general population.
View Article and Find Full Text PDFLong-Term Outcomes Following Sirolimus-Coated Balloon or Drug-Eluting Stents for Treatment of In-Stent Restenosis.
Circ Cardiovasc Interv
September 2024
Background: Evidence suggests that drug-coated balloons may benefit in-stent restenosis (ISR) treatment. However, the efficacy of new-generation sirolimus-coated balloon (SCB) compared with the latest generation drug-eluting stents (DESs) has not been studied in this setting.
Methods: All patients in the EASTBORNE (The All-Comers Sirolimus-Coated Balloon European Registry) and DEB-DRAGON (DEB vs Thin-DES in DES-ISR: Long Term Outcomes) registries undergoing percutaneous coronary intervention for DES-ISR were included in the study.
The Usefulness of Intravascular Ultrasound and Optical Coherence Tomography in Patients Treated with Rotational Atherectomy: An Analysis Based on a Large National Registry.
J Cardiovasc Dev Dis
June 2024
Article Synopsis
- Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) enhance outcomes in percutaneous coronary interventions (PCIs) for certain patients.
- A study analyzed data from 6,522 rotational atherectomy (RA-PCI) procedures performed between 2014 and 2021 to assess whether IVUS or OCT improves successful revascularization rates.
- Results indicated that using these imaging techniques led to a significantly higher likelihood of achieving optimal blood flow post-procedure (TIMI 3 flow), with IVUS and OCT increasing success rates by approximately 67% and 66%, respectively.
Article Synopsis
- The study investigates long-term outcomes of patients with in-stent restenosis (ISR) and chronic coronary syndrome (CCS) who underwent PCI using drug-eluting stents (DES) versus drug-coated balloons (DCB).
- Patients treated with DES had significantly lower rates of target lesion revascularization (TLR), target vessel revascularization (TVR), and device-oriented composite events (DOCE) compared to those treated with DCB.
- Overall, the findings suggest that using DES is more effective than DCB for this patient group in reducing revascularization needs over a long-term follow-up period.
Radial artery spasms - angiographic morphology, risk factors and management.
Postepy Kardiol Interwencyjnej
March 2024
Article Synopsis
- Radial artery access is often preferred in coronary interventions, but spasms can occur, causing pain and complications during the procedure.
- In a study of 103 patients, the incidence of radial artery spasm was found to be 24.3%, with factors like female sex and failed puncture attempts increasing the risk, while hydrophilic sheaths seemed to prevent spasms.
- Signs of arterial spasm were frequently observed in angiographies but did not always result in significant symptoms; tight narrowing at the sheath tip was a notable predictor of symptomatic spasm.
Article Synopsis
- Low operator and institutional volume in percutaneous coronary interventions (PCI) can lead to worse outcomes for patients, prompting this study to assess the link between operator experience and procedural success in chronic total occlusion (CTO) cases.
- The study analyzed data from nearly 15,000 CTO-PCIs performed between 2014 and 2020, finding that higher annual caseloads per operator correlated with better procedural success rates and fewer complications.
- Results indicated that operators performing around 40 CTO cases annually had the best outcomes, suggesting that increasing experience could enhance the quality of treatments in PCI.
The assessment of coronary microcirculation may facilitate risk stratification and treatment adjustment. The aim of this study was to evaluate patients' clinical presentation and treatment following coronary microcirculation assessment, as well as factors associated with an abnormal coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) values. This retrospective analysis included 223 patients gathered from the national registry of invasive coronary microvascular testing collected between 2018 and 2023.
View Article and Find Full Text PDFBackground: Standard modifiable cardiovascular risk factors (SMuRFs) remain well-established elements of assessing cardiovascular risk scores. However, there is growing evidence that patients presented without known SMuRFs at admission demonstrate worse post-myocardial outcomes. The aim of the study was to assess the influence of the SMuRF status on short- and long-term mortality rates in patients with first-time ST-segment elevation myocardial infarction (STEMI).
View Article and Find Full Text PDFBackground: Transradial coronary angiography can be performed using a dual-catheter technique (DCT) or single-catheter technique (SCT). The current study aimed to compare DxTerity SCT Ultra and the Trapease curve SCT catheters with DCT catheters in procedures performed by young, less experienced, interventional cardiologists.
Methods: For this prospective, single-blinded, randomized study 107 were enrolled and assigned to 1 of 3 groups.
Article Synopsis
- Primary PCI is the preferred treatment for STEMI, and TIMI flow grade helps predict patient outcomes following the procedure.
- In a study involving 107 patients with anterior wall STEMI, 13% experienced suboptimal TIMI flow post-PCI, while 87% achieved optimal grade 3 flow.
- Factors linked to poorer TIMI flow outcomes included lower pre-PCI TIMI grades, higher troponin levels, and lower mean minimal systolic blood pressure before and after PCI.
Introduction: Conduction disorders following aortic valve replacement therapy (AVR), either surgical or percutaneous, are related to a higher risk of complete atrioventricular block and permanent pacemaker implantation (PPI).
Aim: The objective of this study was to assess risk factors regarding the incidence of new postoperative and persistent new left bundle branch block (LBBB) 1 year after the implantation of a sutureless/rapid-deployment (SURD) aortic valve prosthesis.
Material And Methods: The current study included 200 consecutive patients treated with isolated or concomitant AVR between May 2014 and May 2017 at the Department of Cardiac Surgery in Pasawa with SURD aortic valve EDWARDS INTUITY Elite implantation.
: Percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is a worldwide method of coronary revascularisation. The aim of this study was to assess the immediate and long-term effects of Nordic Walking (NW) training added to a standard cardiac rehabilitation programme on physical activity (PA) and capacity and life quality, as well as selected proatherogenic risk factors. : The studied group comprised 50 patients (considering exclusion criteria, 40 patients), aged 56-70, with CCS after elective PCI qualified them for a 6-weeks-long cardiac rehabilitation.
View Article and Find Full Text PDFArticle Synopsis
- The study compares single-operator (SO) and dual-operator (DO) approaches in treating chronic total occlusion (CTO) using percutaneous coronary intervention (PCI), noting that DO is suggested to handle the complexity of the procedure better.
- Data from the Polish Registry of Invasive Cardiology Procedures between 2014 and 2020 reveals that DO was used in only 13% of cases, showing lower rates of puncture-site bleeding but similar technical success rates between SO (72.4%) and DO (71.2%).
- The findings are preliminary due to the retrospective nature of the study, highlighting that DO was more common among patients with complex coronary diseases, but ultimately did not improve intervention success, only reducing
Objective: Kidney failure is highly prevalent in patients with non-ST-elevation myocardial infarction (NSTEMI). The aim of the study was to evaluate the prognostic significance of baseline renal function regarding in-hospital and 1-year mortality among patients with NSTEMI and treated with percutaneous coronary intervention (PCI).
Methods: Data were obtained from the Polish Registry of Acute Coronary Syndromes (PL-ACS) and included 47,052 NSTEMI patients treated with PCI between 2017 and 2021.
Article Synopsis
- * Analysis of data from a national registry showed a significant increase in the use of IVUS (from 0.8% to 1.54% for CAs and from 1.8% to 4.42% for PCIs) and modest growth in OCT usage during this period.
- * The research identified age as a key factor influencing the adoption of IVUS and OCT, and attributes the increase in use partially to changes in reimbursement policies, indicating the need for further improvements.
Article Synopsis
- - This study investigated sex differences in short- and long-term mortality outcomes for patients who underwent surgical aortic valve replacement (SAVR) between 2006 and 2020 at a hospital in Kraków.
- - Analysis involved 4,510 patients, finding no significant differences in in-hospital and long-term mortality between men and women, though women had a better 5-year survival rate (86.8%) compared to men (82.7%).
- - The results indicate that being female does not increase the risk of mortality post-SAVR, but more research is needed to fully understand the long-term advantages for women undergoing this surgery.
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of global mortality, while survivors are burdened with long-term neurological and cardiovascular complications. OHCA management at the hospital level remains challenging, due to heterogeneity of OHCA presentation, the critical status of OHCA patients reaching the return of spontaneous circulation (ROSC), and the demands of post ROSC treatment. The validity and optimal timing for coronary angiography is one important, yet not fully defined, component of OHCA management.
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