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https://www.readbyqxmd.com/read/29356269/bioresorbable-vascular-scaffold-versus-everolimus-eluting-stents-or-drug-eluting-balloon-for-the-treatment-of-coronary-in-stent-restenosis-1-year-follow-up-of-a-propensity-score-matching-comparison-the-bioresolve-isr-study
#1
Elisabetta Moscarella, Akihito Tanaka, Alfonso Ielasi, Bernardo Cortese, Sebastian Coscarelli, Maria Carmen De Angelis, Davide Piraino, Azeem Latib, Giulietta Grigis, Renatomaria Bianchi, Dario Buccheri, Paolo Calabrò, Maurizio Tespili, Pedro Silva Orrego, Antonio Colombo, Attilio Varricchio
OBJECTIVES: to compare the 1-year outcome between bioresorbable vascular scaffold (BVS), everolimus-eluting stent (EES), and drug-eluting balloon (DEB) for in-stent restenosis (ISR) treatment. BACKGROUND: BVS has been proposed as alternative for ISR treatment. To date a direct comparison between BVS and DES or DEB for ISR treatment is lacking. METHODS: We retrospectively analyzed all ISR lesions treated with BVS, DEB, and EES from January 2012 to December 2014...
January 22, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29352151/effects-of-genetic-variants-on-platelet-reactivity-and-one-year-clinical-outcomes-after-percutaneous-coronary-intervention-a-prospective-multicentre-registry-study
#2
Hyung Joon Joo, Sung Gyun Ahn, Jae Hyoung Park, Ji Young Park, Soon Jun Hong, Seok-Yeon Kim, WoongGil Choi, HyeonCheol Gwon, Young-Hyo Lim, Weon Kim, Woong Chol Kang, Yun-Hyeong Cho, Yong Hoon Kim, JungHan Yoon, WonYong Shin, Myeong-Ki Hong, Scot Garg, Yangsoo Jang, Do-Sun Lim
Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29350374/extension-of-a-coronary-intramural-hematoma-after-blunt-chest-trauma
#3
Maeng Real Park, Mun Ki Min, Ji Ho Ryu, Dae Sub Lee, Kang Ho Lee
Coronary artery dissection and intramural hematoma after blunt chest trauma are rare, but life-threatening, complications. Coronary intramural hematoma extension is even rarer. A 31-year-old man was transferred to our hospital for worsening left chest pain during while he was admitted at a nearby hospital due to blunt chest trauma. Bedside echocardiography showed akinesis of the left ventricular apex and anterior wall as well as hypokinesis of the mid-to-basal anteroseptal wall and mid-to-basal lateral and posterior walls of the left ventricle...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349545/risk-of-discontinuation-of-clopidogrel-after-1-month-following-bare-metal-stents-a-propensity-score-adjusted-comparison-with-continued-administration-of-clopidogrel-after-drug-eluting-stents
#4
Christian M Valina, Sebastian Merz, Nikolaus Löffelhardt, Michael Amann, Miroslaw Ferenc, Christian Stratz, Franz-Josef Neumann, Willibald Hochholzer
In patients at high risk for bleeding undergoing percutaneous coronary intervention (PCI) the use of bare-metal-stent (BMS) is considered an option that allows discontinuation of clopidogrel after 4 weeks. We sought to investigate the risk of early discontinuation of clopidogrel in patients with BMS as compared with a 6-month course of clopidogrel after DES in patients with or without high on-treatment platelet reactivity (HTPR). In 765 consecutive patients undergoing PCI after loading with clopidogrel 600 mg, HTPR was tested by optical aggregometry and defined as residual platelet reactivity > 14%...
January 18, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29345592/prolonging-ticagrelor-beyond-a-year-of-acute-coronary-syndrome-worth-or-harmful
#5
Daniel Aradi, Dome Dezsi, Gabor Veress, Bela Merkely
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12-inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344756/the-current-state-of-left-main-percutaneous-coronary-intervention
#6
REVIEW
Harshith R Avula, Andrew N Rassi
PURPOSE OF REVIEW: While coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups...
January 17, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29344373/multianalysis-with-optical-coherence-tomography-and-vasomotion-in-everolimus-eluting-stents-and-everolimus-eluting-biovascular-scaffolds-the-moves-trial
#7
Diego A Arroyo, Sara Schukraft, Zacharenia Kallinikou, Jean-Christophe Stauffer, Gérard Baeriswyl, Jean-Jacques Goy, Mario Togni, Stéphane Cook, Serban Puricel
Aims: To compare endothelium-dependent vasomotor function and vascular healing 15 months after implantation of two new-generation drug-eluting stents and biovascular scaffolds (BVS). Methods and results: A total of 28 patients previously treated with a SYNERGY stent (bioabsorbable polymer everolimus-eluting stents (BP-EES)), a PROMUS stent (persistent polymer everolimus-eluting stents (PP-EES)) or an ABSORB (BVS) underwent control coronary angiography, 15 months after implantation, coupled with optical coherence tomography imaging and supine bicycle exercise...
2018: Open Heart
https://www.readbyqxmd.com/read/29343616/rapamycin-activates-tgf-receptor-independently-of-its-ligand-implications-for-endothelial-dysfunction
#8
Ayumi A Miyakawa, Thais Girao-Silva, Jose E Krieger, Elazer R Edelman
Rapamycin, the macrolide immunosuppressant and active pharmaceutic in drug-eluting stents (DES), has a well-recognized anti-proliferative action that involves inhibition of the mTOR pathway after binding to the cytosolic protein FKBP12. TGF receptor-type I (TGFRI) spontaneous activation is inhibited by the association with FKBP12. We hypothesized that rapamycin, in addition to inhibition of mTOR signaling, activates TGFRI independent of TGFb. Human umbilical vein endothelial cells (HUVEC) were treated with rapamycin (10nmoL/L) and/or TGF-b RI kinase inhibitor (TGFRIi, 100nmoL/L) for 24 hours...
January 17, 2018: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#9
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29339714/stent-thrombosis-in-patients-with-drug-eluting-stents-and-bioresorbable-vascular-scaffolds-the-feared-complication
#10
Laura S Kerkmeijer, Erhan Tenekecioglu, Joanna J Wykrzykowska
The percutaneous coronary intervention has undergone rapid evolution over the last 40 years and has become one of the most widely performed medical procedures. The introduction of intracoronary stents improved the safety and efficacy of percutaneous coronary intervention. But with the advent of stenting, a new potentially fatal enemy emerged: stent thrombosis. Ever since, adjunct pharmacological therapy, stent technique and technology have been adjusted to reduce the risk of stent thrombosis. The aim of the present article is to provide an overview of past, present and future aspects of percutaneous intervention in relation to stent thrombosis...
January 15, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29338896/novel-bioabsorbable-polymer-and-polymer-free-metallic-drug-eluting-stents
#11
REVIEW
Jason Nogic, Liam M McCormick, Rohin Francis, Nitesh Nerlekar, Catherine Jaworski, Nick E J West, Adam J Brown
The introduction of drug-eluting stents (DES) significantly reduced angiographic restenosis and the clinical need for revascularization following percutaneous coronary intervention. However, concerns remain regarding the long-term safety and efficacy of DES. The use of durable polymers for drug elution that have limited biocompatibility is thought to contribute toward DES failure, by promoting an adverse local inflammatory response and vascular toxicity. Biodegradable polymer and polymer-free metallic stents represent two novel technological solutions to this challenging clinical problem...
January 12, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#12
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338303/evaluation-of-preprocedural-laboratory-parameters-as-predictors-of-drug-eluting-stent-restenosis-in-coronary-chronic-total-occlusion-lesions
#13
Chenguang Li, Yi Shen, Rende Xu, Yuxiang Dai, Shufu Chang, Hao Lu, Zhaohui Dong, Jianxin Deng, Juying Qian, Junbo Ge
This retrospective, single-center study assessed the prognostic value of several emerging inflammatory markers as predictors of in-stent restenosis (ISR) after drug-eluting stent implantation for coronary chronic total occlusion (CTO) lesions. Consecutive patients (n = 416) who underwent successful percutaneous coronary intervention (PCI) for documented CTO lesions and with follow-up angiography were enrolled. Preprocedural high-sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were analyzed...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29334682/body-mass-index-and-plasma-p-selectin-before-coronary-stenting-predict-high-residual-platelet-reactivity-at-6-months-on-dual-antiplatelet-therapy
#14
Elena Z Golukhova, Marina V Grigoryan, Mariya N Ryabinina, Naida I Bulaeva, Victor L Serebruany
BACKGROUND: High residual platelet reactivity (HRPR) during dual antiplatelet therapy (DAPT) may impact clinical outcomes following percutaneous coronary interventions (PCI). However, whether any biomarkers assessed before PCI at DAPT loading may predict delayed maintenance HRPR is not clear. OBJECTIVE: The aim of this study was to determine whether conventional clinical or laboratory indices at loading before stenting may predict HRPR at 6 months of maintenance DAPT...
January 16, 2018: Cardiology
https://www.readbyqxmd.com/read/29332914/long-term-clinical-outcomes-after-treatment-with-excimer-laser-coronary-atherectomy-for-in-stent-restenosis-of-drug-eluting-stent
#15
Eiji Ichimoto, Tadayuki Kadohira, Takashi Nakayama, Joseph De Gregorio
Excimer laser coronary atherectomy (ELCA) has been used for the treatment of complex percutaneous coronary intervention (PCI) such as in-stent restenosis (ISR). However, little information was provided about the clinical outcomes after treatment with ELCA for ISR of drug-eluting stents (DES). This study aimed to investigate the long-term clinical outcomes after PCI with ELCA for ISR of DES.A total of 81 consecutive patients with 87 lesions who underwent PCI for ISR of DES were included. Patients were classified into a PCI with ELCA group (23 patients with 24 lesions) and a PCI without ELCA group (58 patients with 63 lesions)...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29332315/comparison-of-treatment-strategies-for-femoro-popliteal-disease-a-network-meta-analysis
#16
Edward Koifman, Michael J Lipinski, Kyle Buchanan, Won Yu Kang, Ricardo O Escarcega, Ron Waksman, Nelson L Bernardo
OBJECTIVES: We sought to compare treatment strategies in a Bayesian network meta-analysis of randomized controlled trials. BACKGROUND: Peripheral artery disease (PAD) is a prevalent morbidity that is treated with various strategies. METHODS: We performed a MEDLINE search for randomized studies comparing at least 2 treatment strategies, including bypass surgery, percutaneous transluminal angioplasty (PTA) balloons, stents, covered stents, drug-eluting stents (DES), and drug-coated balloons (DCB), in patients with native femoro-popliteal disease...
January 14, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29327573/treating-complex-femoro-popliteal-lesions
#17
Rozemarijn J van der Vijver-Coppen, Yannick W 't Mannetje, Theo P Menting, Jan-Willem Lardenoije, Michel M Reijnen
Peripheral artery disease affects 202 million patients worldwide and may cause disabling intermittent claudication and critical limb ischemia. Next to life style changes, best medical treatment and supervised exercise therapy, it can be necessary to re-vascularise the limb. Treatment of femoro-popliteal lesions poses a challenge and a surgical bypass remains recommended in the guidelines for longer and more complex lesions. Bypass surgery is associated with substantial morbidity and even mortality. Endovascular alternatives are quickly evolving from plain balloon angioplasty to drug-eluting stents, drug-coated balloons, polytetrafluoroethylene covered stents and atherectomy...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29326821/age-sex-and-gene-expression-score-identifies-a-symptomatic-nondiabetic-male-patient-as-being-at-high-risk-of-obstructive-coronary-artery-disease
#18
Ronald J Polinsky
In October 2015, a 74-year-old Caucasian male patient (past medical history of hyperlipidemia, paroxysmal atrial fibrillation, hypertension, and hypothyroidism) presented to the cardiologist for follow-up outpatient evaluation of exertional chest pain. The patient had recently been seen at the Emergency Department for the same complaint. At that time, the patient's cardiac markers, EKG, and pharmacological nuclear stress testing were all reported as normal. At presentation to the cardiologist, the patient's physical examination findings were unremarkable...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29326773/clinical-outcomes-of-patients-undergoing-rotational-atherectomy-followed-by-drug-eluting-stent-implantation-a-single-center-real-world-experience
#19
Lucky R Cuenza, Ada Cherryl Jayme, James Ho Khe Sui
Background: Rotational atherectomy (RA) is used to improve procedural success of percutaneous catheter interventions (PCIs) of complex and heavily calcified coronary lesions. We report the clinical experience and outcomes in our institution with the use of RA, followed by drug-eluting stent implantation. Materials and Methods: Data of 81 patients treated with PCI and adjunctive RA were analyzed. Clinical follow-up for the occurrence of major adverse events (MAEs) was obtained in all patients and correlated with significant variables using multivariate Cox proportional hazards analysis...
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29322695/bioresorbable-scaffolds-in-coronary-intervention-unmet-needs-and-evolution
#20
REVIEW
Davide Capodanno
Bioresorbable scaffolds (BRS) represent a novel paradigm in the 40-year history of interventional cardiology. Restoration of cyclic pulsatility and physiologic vasomotion, adaptive vascular remodeling, plaque regression, and removal of the trigger for late adverse events are expected BRS benefits over current metallic drug-eluting stents. However, first-generation BRS devices have significant manufacturing limitations and rely on optimal implantation technique to avoid experiencing an excess of clinical events...
January 2018: Korean Circulation Journal
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