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https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#1
REVIEW
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Javier Mendoza, Florencia Sartori
PURPOSE OF REVIEW: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings. RECENT FINDINGS: Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28220461/new-generation-coronary-stents-current-data-and-future-directions
#2
REVIEW
Ankur Kalra, Hasan Rehman, Sahil Khera, Braghadheeswar Thyagarajan, Deepak L Bhatt, Neal S Kleiman, Robert W Yeh
PURPOSE OF REVIEW: Drug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly evolving area of interventional cardiology...
March 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28215414/meta-analysis-of-comparison-of-drug-eluting-stents-and-bare-metal-stents-in-patients-on-dialysis
#3
Shan Li, Dan Ye, Guoping Chen, Weiwei Xu
Coronary artery disease is common in patients with end-stage renal disease who are on hemodialysis. The efficacy and safety of evidence regarding the use of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with dialysis is unclear. We searched MEDLINE, EMBASE, Science Citation Index, CINAHL, and the Cochrane CENTRAL database of controlled clinical trials for controlled trials that compare DES and BMS in dialysis patients up to June 2016. We conducted a meta-analysis across 14 eligible studies (n = 62,250 patients)...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28213312/multiple-myocardial-abscesses-secondary-to-late-stent-infection
#4
Ayman Elbadawi, Marwan Saad, Islam Y Elgendy, Aneeqa Zafar, Ming-Yan Chow
A 53-year-old woman presented to our hospital with dizziness and low-grade fever. She underwent percutaneous coronary intervention to the obtuse marginal artery with a drug-eluting stent 20 months prior to this presentation. Physical examination was remarkable for bradycardia. Electrocardiogram showed a junctional rhythm with heart rate of 35 bpm. Blood and urine cultures were negative. Despite successful urgent pacemaker placement, she had cardiac arrest the following day with unsuccessful cardiopulmonary resuscitation attempt...
February 2, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28211603/impact-of-six-versus-12-months-of-dual-antiplatelet-therapy-in-patients-with-drug-eluting-stent-implantation-after-risk-stratification-with-the-residual-syntax-score-results-from-a-secondary-analysis-of-the-i-love-it-2-trial
#5
Miaohan Qiu, Yi Li, Jing Li, Kai Xu, Quanmin Jing, Shaohong Dong, Zhe Jin, Pitian Zhao, Bo Xu, Yaling Han
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation remains undetermined, especially for those at high risk of cardiac events postprocedure. OBJECTIVES: This study was aimed to investigate the impact of 6 versus 12 months of DAPT after DES implantation based on risk stratification with the residual SYNTAX score (rSS). METHODS: A total of 2737 patients in the I-LOVE-IT 2 trial were grouped according to rSS status (low rSS [rSS = 0, n = 1474] versus high rSS [rSS > 0, n = 1263]) and DAPT duration (6 months vs...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28208634/rna-eluting-surfaces-for-the-modulation-of-gene-expression-as-a-novel-stent-concept
#6
Olivia Koenig, Diane Zengerle, Nadja Perle, Susanne Hossfeld, Bernd Neumann, Andreas Behring, Meltem Avci-Adali, Tobias Walker, Christian Schlensak, Hans Peter Wendel, Andrea Nolte
Presently, a new era of drug-eluting stents is continuing to improve late adverse effects such as thrombosis after coronary stent implantation in atherosclerotic vessels. The application of gene expression-modulating stents releasing specific small interfering RNAs (siRNAs) or messenger RNAs (mRNAs) to the vascular wall might have the potential to improve the regeneration of the vessel wall and to inhibit adverse effects as a new promising therapeutic strategy. Different poly (lactic-co-glycolic acid) (PLGA) resomers for their ability as an siRNA delivery carrier against intercellular adhesion molecule (ICAM)-1 with a depot effect were tested...
February 10, 2017: Pharmaceuticals
https://www.readbyqxmd.com/read/28197826/safety-and-efficacy-of-a-novel-abluminal-groove-filled-biodegradable-polymer-sirolimus-eluting-stent
#7
Jinzhou Zhu, Huizhu Liu, Haipo Cui, Zhirong Tang, Chengli Song, Ruiyan Zhang
Late stent thrombosis (LST) following drug-eluting stent (DES) implantation in patients with coronary artery disease (CAD) is often associated with delayed vascular healing, resulting from vascular inflammation and hypersensitivity to durable polymers and drugs. Therefore, DES design, materials, and coatings have been technologically revolutionized. Herein, we designed a novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent (AGF-BP-SES), with a sirolimus content of only about one-third of traditional DES...
March 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28197713/early-vascular-responses-after-everolimus-eluting-stent-implantation-assessed-by-serial-observations-of-intracoronary-optical-coherence-tomography
#8
Hideki Yano, Shigeo Horinaka, Mayuko Ishikawa, Toshihiko Ishimitsu
A recent OCT study revealed that the lack of stent strut endothelial coverage is associated with late stent thrombosis after drug-eluting stent implantation. However, the sequential changes of stent strut endothelial coverage in the extremely early period have never been reported. Serial OCTs were performed in 35 patients with 35 EES (everolimus-eluting stent)-treated de novo lesions at 0, 2, 4, and 12 weeks after EES implantation. Serial changes in quantitative parameters of the neointima (neointimal thickness, stent strut coverage, and apposition of each strut) were analyzed...
February 14, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28197276/percutaneous-coronary-intervention-safety-of-methotrexate-and-its-possible-benefits-on-restenosis-after-bare-metal-stent-deployment
#9
Viviane Gouveia, Dinaldo C Oliveira, Emmanuele Tenorio, Norma Brito, Emanuel Sarinho
BACKGROUND: Percutaneous coronary intervention (PCI) revolutionized treatment of coronary artery disease. Drug-eluting stents are effective and safe but their cost is high, especially for some countries. The primary objective was to evaluate the safety of methotrexate (MTX) in patients who underwent PCI and the secondary goal was to evaluate the possibility that MTX has an impact on restenosis. METHODS: This was a transversal, prospective and descriptive study that recruited 16 patients in whom PCI was planned...
June 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196432/association-of-seven-renin-angiotensin-system-gene-polymorphisms-with-restenosis-in-patients-following-coronary-stenting
#10
Min Zhu, Minjun Yang, Jiangbo Lin, Huanhuan Zhu, Yifei Lu, Bing Wang, Yinshen Xue, Congfeng Fang, Lijiang Tang, Baohui Xu, Jianjun Jiang, Xiaofeng Chen
BACKGROUND AND OBJECTIVE: Percutaneous coronary intervention, despite being effective for coronary revascularization, causes in-stent restenosis due to neointimal hyperplasia in a large number of patients. The renin-angiotensin system is involved in neointimal hyperplasia. This study sought to evaluate seven gene polymorphisms of key renin-angiotensin system components, including angiotensinogen, angiotensin-converting enzyme and angiotensin II type 1a receptors, and their associations with in-stent restenosis in patients with coronary artery disease following coronary stenting...
January 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/28194700/perioperative-management-for-iatrogenic-aortocoronary-dissection-during-percutaneous-coronary-intervention
#11
Takashi Shuto, Hirofumi Anai, Jun Hirota, Tomoyuki Wada, Satoshi Takebayashi, Shinji Miyamoto
Aortocoronary dissection is a rare but serious complication. We report the case of a 72-year-old female with angina. Percutaneous coronary intervention was performed for right coronary artery disease. Manipulation of the guiding catheter led to aortocoronary dissection. A drug-eluting stent was immediately implanted in the right coronary ostium to seal the entry of the dissection. Computed tomography (CT) showed ascending aortic dissection. The patient was observed without surgery. CT performed the following day and showed the contrast in the false lumen which had disappeared...
February 13, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28193677/sex-differences-in-the-clinical-impact-of-high-platelet-reactivity-after-percutaneous-coronary-intervention-with-drug-eluting-stents-results-from-the-adapt-des-study-assessment-of-dual-antiplatelet-therapy-with-drug-eluting-stents
#12
Jennifer Yu, Roxana Mehran, Usman Baber, Sze-Yuan Ooi, Bernhard Witzenbichler, Giora Weisz, Michael J Rinaldi, Franz-Josef Neumann, D Christopher Metzger, Timothy D Henry, David A Cox, Peter L Duffy, Ernest L Mazzaferri, Bruce R Brodie, Thomas D Stuckey, Akiko Maehara, Ke Xu, Ori Ben-Yehuda, Ajay J Kirtane, Gregg W Stone
BACKGROUND: Sex differences in the outcomes after percutaneous coronary intervention with drug-eluting stents and in the response to clopidogrel therapy have been reported; however, the differential risk of high platelet reactivity (HPR) on clopidogrel in women versus men is unknown. METHODS AND RESULTS: We compared 8448 patients enrolled in the ADAPT-DES study (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) according to sex and the presence/absence of HPR on clopidogrel (defined as P2Y12 reactivity units >208)...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28190783/a-retrospective-analysis-of-catheter-based-sources-in-intravascular-brachytherapy
#13
J DeCunha, C Janicki, S A Enger
PURPOSE: Coronary artery disease involves the deposition of plaque along the walls of a coronary artery leading to narrowed or blocked vessels (stenosis) and is one of the main causes of death in developed countries. Percutaneous transluminal coronary angioplasty (PTCA) is used to reverse stenosis. Restenosis (renarrowing) of the treated vessel is a major complication of PTCA. A metal mesh tube (stent) can be placed inside the vessel to prevent restenosis. Tissue stress incurred during PTCA and stenting can provoke neointimal cell proliferation leading to in-stent restenosis (ISR)...
February 10, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28185168/polymer-free-drug-coated-coronary-stents-in-patients-with-stable-coronary-artery-disease-at-high-bleeding-risk
#14
REVIEW
Hemang B Panchal, Ramesh Daggubati, David Zhao, Sunil V Rao, Timir Paul
PURPOSE OF REVIEW: Patients with stable coronary artery disease (CAD) and a high risk of bleeding are not ideal candidates for a polymer-based drug-eluting stent (DES) because it requires 6-12 months of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). The purpose of this review is to assess the angiographic and clinical outcomes of polymer-free drug-coated stents (PF-DCS) in stable CAD patients with a high bleeding risk. RECENT FINDINGS: Several randomized controlled trials (RCTs) have compared angiographic and clinical outcomes of PF-DCS with bare-metal stents (BMS), permanent polymer (PP)-DES, or biodegradable polymer (BP)-DES...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28184335/drug-and-gene-eluting-stents-for-preventing-coronary-restenosis
#15
REVIEW
Kamali Manickavasagam Lekshmi, Hui-Lian Che, Chong-Su Cho, In-Kyu Park
Coronary artery disease (CAD) has been reported to be a major cause of death worldwide. Current treatment methods include atherectomy, coronary angioplasty (as a percutaneous coronary intervention), and coronary artery bypass. Among them, the insertion of stents into the coronary artery is one of the commonly used methods for CAD, although the formation of in-stent restenosis (ISR) is a major drawback, demanding improvement in stent technology. Stents can be improved using the delivery of DNA, siRNA, and miRNA rather than anti-inflammatory/anti-thrombotic drugs...
January 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#16
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183506/more-time-to-sort-out-clinical-outcomes-after-first-generation-drug-eluting-stents-related-versus-unrelated-events
#17
EDITORIAL
David J Moliterno, Khaled M Ziada
No abstract text is available yet for this article.
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28183505/10-year-clinical-outcome-after-randomization-to-treatment-by-sirolimus-%C3%A2-or-paclitaxel-eluting-coronary%C3%A2-stents
#18
Anders M Galløe, Henning Kelbæk, Leif Thuesen, Henrik S Hansen, Jan Ravkilde, Peter R Hansen, Evald H Christiansen, Ulrik Abildgaard, Ghita Stephansen, Jens F Lassen, Thomas Engstrøm, Jan Skov Jensen, Jørgen L Jeppesen, Niels Bligaard
BACKGROUND: First-generation drug-eluting coronary stents (DES) were introduced in 2003 to 2004, and their use resulted in a considerable reduction in the development of in-stent restenosis at the cost of an increased risk of late stent thromboses. OBJECTIVES: This study followed clinical outcomes of patients included in a large randomized trial for 10 years to enable detection of late changes in annual event rates that could necessitate medical attention. METHODS: A total of 2,098 unselected all-comer patients (50% with acute coronary syndrome) were randomly assigned to have a first-generation DES implanted...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28183306/third-generation-drug-eluting-stent-des-with-biodegradable-polymer-in-diabetic-patients-5%C3%A2-years-follow-up
#19
Marcus Wiemer, Sinisa Stoikovic, Alexander Samol, Zisis Dimitriadis, Juan M Ruiz-Nodar, Ralf Birkemeyer, Jacques Monsegu, Gérard Finet, David Hildick-Smith, Damras Tresukosol, Enrique Garcia Novo, Jacques J Koolen, Emanuele Barbato, Gian Battista Danzi
OBJECTIVE: To report the long-term safety and efficacy data of a third generation drug eluting stent (DES) with biodegradable polymer in the complex patient population of diabetes mellitus after a follow-up period of 5 years. BACKGROUND: After percutaneous coronary intervention patients with diabetes mellitus are under higher risk of death, restenosis and stent thrombosis (ST) compared to non-diabetic patients. METHODS: In 126 centers worldwide 3067 patients were enrolled in the NOBORI 2 registry, 888 patients suffered from diabetes mellitus (DM), 213 of them (14%) being insulin dependent (IDDM)...
February 10, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28182024/impact-of-hospital-and-sociodemographic-factors-on-utilization-of-drug-eluting-stents-in-2011-2012-medicare-cohort
#20
Tushar A Tuliani, Maithili Shenoy, Milind Parikh, Mauricio G Cohen, Cindy Grines, Kenneth Jutzy, Anthony Hilliard
OBJECTIVE: Insurance status is a predictor of drug-eluting stent (DES) usage. Our study sought to determine the effect of hospital and sociodemographic characteristics on utilization of DES in nationwide inpatient discharges with uniform insurance (Medicare). METHODS: We linked data from the 2011 to 2012 Medicare discharges, 2011 Medicare hospital referral region (HRR) report (racial composition of each HRR), American Hospital Association (number of beds, rural/urban location, public/private status, and academic affiliation of hospitals), and American Community Survey 2011 (median income using zip code)...
January 2017: Avicenna Journal of Medicine
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