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drug eluting stents

Şahin Avşar, Ahmet Öz, Aydan Köken Avşar, Adnan Kaya, Edibe Betül Börklü
Clomiphene citrate is a drug that stimulates ovulation and is commonly used in cases of female infertility. Generally, it is recognized as a safe agent for ovulation induction, but rarely, it is associated with life-threatening conditions. A 36-year-old woman who had been prescribed clomiphene citrate for infertility was admitted to the emergency department for chest pain lasting for 2 hours. She had no history of smoking, and she did not have any cardiac risk factor for myocardial infarction (MI). An electrocardiogram performed on admission revealed ST-elevation in the precordial leads...
July 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Leos Pleva, Pavel Kukla, Jana Zapletalova, Ota Hlinomaz
BACKGROUND: The efficacy of paclitaxel-eluting balloon catheters (PEB) and drug-eluting stents for treatment of bare-metal stent restenosis (BMS-ISR) have been demonstrated in several studies with follow-up times of 9 to 12 months; however, the long-term outcomes of ISR treatment are less defined. OBJECTIVES: We aimed to compare the long-term efficacy of PEB and everolimus-eluting stents (EES) for the treatment of BMS-ISR. METHODS: We analyzed 3-year clinical follow-up data from patients included in the TIS randomized clinical study...
July 18, 2018: Catheterization and Cardiovascular Interventions
Isabel Wustrow, Nikolaus Sarafoff, Bernhard Haller, Lisa Rössner, Dirk Sibbing, Stefanie Schüpke, Tareq Ibrahim, Aida Anetsberger, Heribert Schunkert, Karl-Ludwig Laugwitz, Adnan Kastrati, Isabell Bernlochner
OBJECTIVES: We aimed to assess the impact of omitting aspirin on clinical outcomes in a real-world collective of patients receiving oral anticoagulation (OAC) therapy who were treated with a current-generation drug-eluting stent (DES) or an everolimus-eluting bioresorbable vascular scaffold (BVS). BACKGROUND: Limited data are available regarding the clinical benefit of triple antithrombotic therapy (TAT) with aspirin compared with dual antithrombotic therapy (DAT) without aspirin in patients undergoing percutaneous coronary intervention (PCI) and requiring OAC...
July 18, 2018: Catheterization and Cardiovascular Interventions
J J Coughlan, Nial Blake, Napohn Chongprasertpon, Munir Ibrahim, Samer Arnous, Thomas John Kiernan
Purpose: In this study, we sought to prospectively analyse the management and long term outcomes associated with revascularisation of left main stem disease via percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in our centre. Methods: This prospective study enrolled all patients with unprotected left main stem disease undergoing revascularisation from January 2013 to June 2014. Baseline characteristics, hospital presentation and hospital stay length were collected...
2018: Open Heart
Yaping Zhao, Zhong Chen, Wayne W Zhang, Sheng Wang, Yaoguo Yang, Liao Yang
OBJECTIVE: This study aimed to compare, using optical coherence tomography (OCT), the outcomes of bioabsorbable drug-eluting stent with those of bare metal stent (BMS) following implantation in porcine iliac artery. METHODS: After the placement of BMS and bioabsorbable drug-eluting stents, we used OCT and digital subtraction angiography to investigate stent appositions, arterial neointima, evagination, and restenosis at 1 and 3 months. RESULTS: At 1 and 3 months after stent implantation, OCT study was performed to investigate 32 stents and 21 788 struts...
January 1, 2018: Vascular and Endovascular Surgery
Bartłomiej Orlik, Krzysztof Milewski, Kamil Derbisz, Michał Jelonek, Patrycja Chrząszcz, Sonia Beil, Adam Młodziankowski, Wojciech Picheta, Piotr P Buszman, Paweł E Buszman
Introduction: Most clinical trials related to bioresorbable vascular scaffold (BVS) technology are limited to a highly selected patient population. Aim: To evaluate early and long-term clinical outcomes of the Absorb everolimus-eluting BVS compared to the everolimus-eluting metallic XIENCE V stent in routine clinical practice. Material and methods: This is a multicenter, retrospective propensity score-matched comparative study, comprising 76 patients treated with a bare metal stents (BMS) and 501 with a XIENCE stent...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Woo Jin Jang, Sung Gyun Ahn, Young Bin Song, Seung-Hyuk Choi, Woo Jung Chun, Ju Hyeon Oh, Sung Woo Cho, Bum Sung Kim, Jung Han Yoon, Bon-Kwon Koo, Cheol Woong Yu, Yang Soo Jang, Seung-Jea Tahk, Hyo-Soo Kim, Hyeon-Cheol Gwon, Sung Yun Lee, Joo-Yong Hahn
BACKGROUND: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. METHODS AND RESULTS: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306)...
July 2018: Circulation. Cardiovascular Interventions
Sherri Rose, Sharon-Lise Normand
Postmarket comparative effectiveness and safety analyses of therapeutic treatments typically involve large observational cohorts. We propose double robust machine learning estimation techniques for implantable medical device evaluations where there are more than two unordered treatments and patients are clustered in hospitals. This flexible approach also accommodates high-dimensional covariates drawn from clinical databases. The Massachusetts Data Analysis Center percutaneous coronary intervention cohort is used to assess the composite outcome of 10 drug-eluting stents among adults implanted with at least one drug-eluting stent in Massachusetts...
July 13, 2018: Biometrics
Jarkko P Hytönen, Jouni Taavitsainen, Johannes T T Laitinen, Anna Partanen, Kari Alitalo, Olli Leppänen, Seppo Ylä-Herttuala
BACKGROUND: Antiproliferative drugs in drug eluting stents (DES) are associated with complications due to impaired re-endothelialization. Additionally, adventitial neovascularization has been suggested to contribute to in-stent restenosis (ISR). Since Vascular Endothelial Growth Factors (VEGFs) are the key mediators of angiogenesis, we investigated feasibility and efficacy of local gene therapy for ISR utilizing soluble decoy VEGF receptors to reduce biological activity of adventitial VEGFs...
July 9, 2018: Journal of Molecular and Cellular Cardiology
Thathya V Ariyaratne, Zanfina Ademi, Molla Huq, Franklin Rosenfeldt, Stephen J Duffy, Bonny Parkinson, Cheng-Hon Yap, Julian Smith, Baki Billah, Bryan P Yan, Angela L Brennan, Lavinia Tran, Christopher M Reid
BACKGROUND: There are limited economic evaluations comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for multi-vessel coronary artery disease (MVCAD) in contemporary, routine clinical practice. OBJECTIVE: The aim was to perform a cost-effectiveness analysis comparing CABG and PCI in patients with MVCAD, from the perspective of the Australian public hospital payer, using observational data sources. METHODS: Clinical data from the Melbourne Interventional Group (MIG) and the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) registries were analysed for 1022 CABG (treatment) and 978 PCI (comparator) procedures performed between June 2009 and December 2013...
July 12, 2018: Applied Health Economics and Health Policy
Cierra Bruck, Omar Jafar, Jayne Prats, Deepak Bhatt, Zubair Jafar
INTRODUCTION: Not infrequently, patients undergoing dual antiplatelet therapy for a recent cardiac stent develop a need for a non-cardiac surgery. Most of these surgeries can be delayed while the antiplatelet treatment is stopped and normal platelet function returns in order to avoid potential surgical complications and excessive bleeding. However, there are a number of patients who require urgent surgery where the procedure cannot be postponed. To date, no agents have been proven to bridge the patient off dual-antiplatelet therapy...
July 11, 2018: Cardiology and Therapy
Bobby Yanagawa, Kathryn Hong, Asim Cheema, Akshay Bagai, Subodh Verma
PURPOSE OF REVIEW: Hybrid coronary revascularization (HCR) combines minimally invasive surgical bypass with percutaneous coronary intervention (PCI) using drug-eluting stents, the goal being to leverage the strengths of each approach. Here we provide an update on HCR from the past 12 months. RECENT FINDINGS: HCR represents a minority of surgical revascularization cases from a small number of highly experienced surgical centers. Most single-center observational series show no differences in major cardiovascular outcomes comparing HCR and coronary artery bypass graft (CABG) or HCR and PCI...
July 9, 2018: Current Opinion in Cardiology
Julian Daniel Widder, Bernardo Cortese, Sebastien Levesque, Dominik Berliner, Simon Eccleshall, Kristof Graf, Luc Doutrelant, Javed Ahmed, Erwan Bressollette, Dennis Zavalloni, Davide Piraino, Ariel Roguin, Bruno Scheller, Pieter R Stella, Johann Bauersachs
AIMS: To investigate the use of drug-coated balloon (DCB) in daily clinical practice and provide further evidence for safety and efficacy of paclitaxel-coated balloon treatment using urea as inert excipient. METHODS AND RESULTS: Between December 2013 and December 2015, 757 patients treated for coronary lesions with the IN.PACT Falcon balloon were enrolled in this prospective real-world all comers registry. Primary outcome was clinically driven target lesion revascularization (TLR) rate at 12 months...
July 10, 2018: EuroIntervention
Alexis A Krumme, Robert J Glynn, Sebastian Schneeweiss, Niteesh K Choudhry, Angela Y Tong, Joshua J Gagne
BACKGROUND: Continuation of antiplatelet therapy beyond 12 months after a drug-eluting stent procedure reduced the risk of a major adverse cardiovascular and cerebrovascular event (MACCE) in the DAPT trial (Dual Antiplatelet Therapy). Observational studies have evaluated outcomes related to different durations of therapy but are susceptible to bias. METHODS AND RESULTS: Using deidentified claims from commercially insured and Medicare populations in the United States, we compared how increasingly stringent definitions of exposure affect associations between antiplatelet continuation versus discontinuation and MACCE, myocardial infarction, and intracerebral hemorrhage or gastrointestinal bleeding in patients meeting DAPT trial inclusion criteria between 2004 and 2013...
July 2018: Circulation. Cardiovascular Quality and Outcomes
Kyohei Yamaji, Takeshi Kimura
No abstract text is available yet for this article.
June 29, 2018: European Heart Journal
Liang Chen, Tian Xu, Xian-Jun Xue, Jun-Jie Zhang, Fei Ye, Nai-Liang Tian, Shao-Liang Chen
Stenting coronary artery bifurcation lesion is associated with suboptimal clinical results. Clinical improvement by intravascular ultrasound (IVUS) guided bifurcation stenting is controversial because small-side-branch (SB), low-risk patients and false bifurcations were included in previous studies that had no exact IVUS criteria for optimal stent expansion. We sought determine whether IVUS guidance is superior to angiography guidance for patients with true and complex bifurcation lesions. Between July 2006 and July 2012, 1465 patients with unstable angina and Medina 1,1,1 or 0,1,1 coronary bifurcation lesions were prospectively studied...
July 6, 2018: International Journal of Cardiovascular Imaging
Vineet Meghrajani, Nitin Sabharwal, Vinod Namana, Moustafa Elsheshtawy, Bernard Topi
Thrombocytopenia is defined as a condition where the platelet count is below the lower limit of normal (<150 G/L), and it is categorized as mild (100-149 G/L), moderate (50-99 G/L), and severe (<50 G/L). We present here a 79-year-old man who developed severe thrombocytopenia with a platelet count of 6 G/L, less than 24 hours after intravenous tirofiban infusion that was given to the patient during a percutaneous transluminal coronary angioplasty procedure with placement of 3 drug-eluting stents...
2018: Case Reports in Hematology
Sungsoo Cho, Tae Soo Kang, Jung-Sun Kim, Sung-Jin Hong, Dong-Ho Shin, Chul-Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Myeong-Ki Hong, Yansoo Jang
OBJECTIVES: This study sought to investigate the long-term clinical effects of stent generation and stent strategy for left main coronary artery (LMCA) bifurcation lesion treatment. BACKGROUND: Limited data are available to assess long-term clinical outcomes after stenting, including use of current-generation drug-eluting stent (C-DES) for treatment of LMCA bifurcation lesions. METHODS: A total of 1,353 patients who were recorded in 2 multicenter real-world registries were treated by either early-generation drug-eluting stent (E-DES) (n = 889) or C-DES (n = 464)...
July 9, 2018: JACC. Cardiovascular Interventions
Ryota Kakizaki, Yoshiyasu Minami, Takehiro Hashikata, Teruyoshi Nemoto, Takuya Hashimoto, Kazuhiro Fujiyoshi, Kentaro Meguro, Takao Shimohama, Taiki Tojo, Junya Ako
BACKGROUND: The aim of this study was to investigate whether the underlying plaque type affects the neointimal coverage after drug-eluting stent implantation. METHODS: A total of 1793 struts in 22 zotarolimus-eluting stents were assessed using optical coherence tomography imaging within 3 months of implantation. Neointimal coverage was evaluated within 5 mm from each stent edge on cross-sectional optical coherence tomography images at every 1-mm interval. The percentage of struts covered by neointima was compared among the normal segment group, the fibrous plaque group, and the lipid plaque group on the basis of the underlying plaque type...
July 2, 2018: Coronary Artery Disease
Shota Okuno, Takayuki Ishihara, Osamu Iida, Mitsutoshi Asai, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Yasuhiro Matsuda, Mitsuyoshi Takahara, Masaaki Uematsu, Toshiaki Mano
BACKGROUND: Detection of yellow plaques (YP) by coronary angioscopy (CAS) 1 year after 1st-generation drug-eluting stent (DES) implantation has been related to future coronary events. However, the association between CAS findings and clinical outcomes following 2nd-generation DES implantation has not been investigated.Methods and Results:This study included a total of 248 2nd-generation DES in 179 patients, who were examined by CAS 9±2 months after implantation. Angioscopic evaluation included dominant neointimal coverage (NIC) grade, heterogeneity of NIC, presences of YP and intrastent thrombus...
July 3, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
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