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Lorne Balfe (born 23 February 1976) is a Scottish composer and record producer of film, television, and video game scores.⭕️ A veteran of Hans Zimmer's Remote Control Productions, Balfe's scoring credits include the films 13 Hours: The Secret Soldiers of⭕️ Benghazi, Terminator Genisys, and Mission: Impossible – Fallout, as well as the video games Assassin's Creed: Revelations, Assassin's Creed III,⭕️ Crysis 2, Skylanders, and the Call of Duty franchise. He has also scored the television series The Bible, Marcella, The⭕️ Crown, and Genius, the latter for which he earned a nomination for a Primetime Emmy Award for Outstanding Original Main⭕️ Title Theme Music.
Discography [ edit ]
Television [ edit ]
Video games [ edit ]
The article is accompanied by the editorial on page 894
Coronary bifurcation lesions correspond to nearly 20–25% of all percutaneous coronary♣️ interventions (PCI) [1, 2]. Interventions in this subset of lesions pose a technical challenge with high early and late complication♣️ rates [3]. PCI of bifurcation lesions can be performed using a variety of techniques, depending on the plaque distribution across♣️ the main and daughter branches, and the bifurcation geometry [4]. The fractal geometry of coronary bifurcations defines a discrepancy in♣️ diameters between the proximal main vessel (MV) and the daughter branches — the distal MV (main branch, MB) and side♣️ branch (SB) [5]. Kissing balloon inflation (KBI) has been one of the first proposed stent-optimization techniques specific for bifurcation lesions♣️ and continues to play an essential role in bifurcation PCI by optimizing stent apposition and improving SB access. However, the♣️ application of KBI requires SB recrossing after main vessel stenting, which adds additional procedure and fluoroscopy time, as well as♣️ contrast. It also requires certain operator experience, especially in cases with SB occlusion after stenting. Additional disadvantages of KBI are♣️ the elliptical deformation of the proximal MV, which can further compromise long-term results [6]. Proximal optimization technique (POT) has been♣️ proposed as a stent-optimization technique able to adjust the tubular design of the coronary stent to the natural bifurcation anatomy♣️ [7]. It was expected that POT could correct stent apposition, respecting fractal vessel anatomy, without compromising and even improving SB♣️ patency. However, studies demonstrated that for the preservation of SB patency, without any functional vessel flow compromise, an additional SB♣️ balloon dilation is required [8]. The optimal result of POT is highly dependent on the precise balloon positioning, and inaccurate♣️ placing of the balloon may lead to uncomplete strut apposition to the SB lateral wall [9, 10]. Moreover, it is♣️ currently demonstrated that even an appropriately positioned POT balloon (according to the current criteria [4]) could cause further elliptical deformation♣️ at SB ostium thus additionally stenosing it [11]. Therefore, proposed herein is a new stent-optimization technique following bifurcation stenting consisting♣️ of a combination of POT and kissing-balloon inflation.
Dedicated bifurcation quantitative coronary angiography (QCA) analysis was performed according to the recommendation♣️ of the consensus on QCA methods for bifurcation lesions using General Electric QCA software and MicroDicom QCA software [13]. True♣️ bifurcation lesions were defined as visual percent diameter stenosis (%DS) > 50% at the SB. The minimal luminal diameter (MLD),♣️ reference vessel diameter (RVD), and %DS were measured for every segment of the bifurcation (i.e., proximal, and distal MV and♣️ SB) pre-and post-intervention. Lesion length was measured from the proximal main vessel to the distal main branch (i.e., we considered♣️ beginning and ending points where hypothetically the stent will be implanted). SB lesion length was measured from the ostium to♣️ the first normal-appearing part of the vessel. All analyzes were performed by two investigators (N.M. and P.P.) and in case♣️ of disagreement, a consensus was formed with additional analysis from the first author (D.V.).
Results
What would be the clinical consequences and♣️ if a better angiographic result translates into better clinical result is currently under investigation by the present group.
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