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stent implantation

Yumika Tsuji, Masahiro Koide, Kanade Katsura, Hiroshi Fujita, Hatsue Ishibashi-Ueda, Fumiyuki Otsuka
A 53-year-old male presented with acute myocardial infarction and was subsequently implanted with a 4.0 × 28 mm everolimus-eluting platinum chromium stent in his proximal left anterior descending artery. Eight months after the implantation, he developed exertional angina and underwent coronary angiography, which revealed significant in-stent restenosis (ISR). Percutaneous coronary intervention was performed 1 month later, and the pre-procedural optical coherence tomography (OCT) revealed a diffusely bordered and rapidly attenuated signal-poor region with invisible stent struts at ISR site, potentially indicating a "lipid-laden" neointima...
July 15, 2018: International Heart Journal
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
Zenon Huczek, Kajetan Grodecki, Piotr Scisło, Krzysztof Wilczek, Dariusz Jagielak, Wojciech Fil, Piotr Kubler, Piotr Olszówka, Maciej Dąbrowski, Marek Frank, Marek Grygier, Michał Kidawa, Radosław Wilimski, Katarzyna Żelazowska, Adam Witkowski, Janusz Kochman, Marian Zembala, Grzegorz Opolski, Danny Dvir, Wojciech Wojakowski
OBJECTIVE: To compare the safety and efficacy of transcathether aortic valve-in-valve implantation (ViV-TAVI) in degenerated stentless bioprostheses with failed stented valves and degenerated native aortic valves. INTRODUCTION: Little is known about ViV-TAVI in degenerated stentless valves. METHODS: Out of 45 ViV-TAVI procedures reported in the POL-TAVI registry, 20 failed stentless valves were compared with 25 stented prostheses and propensity-matched with 45 native TAVI cases...
July 15, 2018: Journal of Interventional Cardiology
Tomotsugu Seki, Masato Takeuchi, Ryusuke Miki, Koji Kawakami
Follow-up tests after percutaneous coronary intervention (PCI) are considered inappropriate for asymptomatic patients. Despite this perception, many cardiologists conduct follow-up tests as routine practice. The objective of this study was to investigate the survival benefits of follow-up testing after PCI in a real-world setting in Japan. A nationwide Japanese administrative database was used to identify unselected patients who underwent PCI with stent implantation between January 2010 and December 2013. We used time-dependent Cox proportional hazards models to evaluate the association between follow-up testing and outcomes...
July 14, 2018: Heart and Vessels
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
Manabu Kashiwagi, Takashi Tanimoto, Hironori Kitabata
A 74-year old man presented recurrent angina pectoris due to in-stent restenosis (ISR) with severely calcified neointima. In-stent neoatherosclerosis (NA) is associated with late stent failure, and NA with calcified neointima occurs in some cases. Because the presence of neointimal calcification could lead to underexpansion of newly implanted stent for ISR, a scoring balloon was selected for predilatation to obtain maximum extrusion of the neointimal plaque and subsequently, an everolimus-eluting stent was implanted...
2018: Case Reports in Cardiology
Xueli Cai, Yixin Wei, Shaojun Ren, Zhiping Wu, Xiao Peng, Yuejin Huang, Liangtong Huang, Xiumei Liu, Zhihua Yang
Introduction: Vertebral artery stenosis is a major cause of posterior circulation ischemia in the elderly. There is not a clear consensus on the optimal therapeutic approach for symptomatic extracranial vertebral artery stenosis. Aim: To evaluate the feasibility and efficacy of balloon-expandable stent angioplasty in the treatment of vertebral artery stenosis in the V2 segment. Material and methods: Five patients with vertebral artery stenosis (V2 segment) and treatment of percutaneous transluminal stenting from July 2009 to June 2014 were retrospectively evaluated...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Masahiro Shimoda, Hirohiko Ando, Kazuhiro Naito, Akihiro Suzuki, Shinichiro Sakurai, Yusuke Nakano, Akiyoshi Kurita, Katsuhisa Waseda, Hiroaki Takashima, Kenta Murotani, Tadayuki Uetani, Tetsuya Amano
BACKGROUND: Despite the revolution of coronary stents, there remain concerns about the risk of stent thrombosis, especially in patients with ST-elevation myocardial infarction (STEMI). The present study compared early vascular healing as a contributing factor to reducing stent thrombosis between Xience everolimus-eluting stents (X-EES) and Synergy everolimus-eluting stents (S-EES) in patients with STEMI.Methods and Results:The present study included 47 patients with STEMI requiring primary percutaneous coronary intervention with X-EES (n=25) or S-EES (n=22)...
July 11, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Gianfranco Butera, Giuliano Giusti, Giuseppe Pomè
Disconnection of a pulmonary artery needs early surgical treatment in order to support the growth of the vessel. However, owing to the high rate of re-stenosis after traditional surgical reconstruction, we developed a hybrid approach involving the creation of pulmonary artery continuity by using autologous or heterologous tissue supported by stent implantation.
July 12, 2018: Cardiology in the Young
Hassan Kamalzadeh, Shahrooz Yazdani, Mohammad Jalali
In patients with cardiac resynchronization therapy (CRT), loss of left ventricular (LV) stimulation occurs chiefly because of LV lead dislodgement. The occurrence rate of LV lead dislodgement in different reports is between 2% and 12% of patients. LV lead dislodgement precludes clinical improvement. We describe 2 patients with heart failure, fulfilling the criteria for CRT implantation. In both patients, right ventricular and right atrial leads were implanted via the left subclavian vein in the right ventricular apex and the right atrial appendage, respectively...
January 2018: Journal of Tehran Heart Center
Zhaohua Shen, Li Tian, Xiaoyan Wang
RATIONALE: Ultrasonography-guided gastrojejunostomy (EUS-GJ) might be a safe, innovative and minimally invasive interventional treatment for patients with gastric outlet obstruction (GOO) as an alternative to the surgical approach. To date, few cases have been reported in the literature. PATIENT CONCERNS: A case of pancreatic head carcinoma with obstructive jaundice occurred in a 78-year-old man with a prior history of pancreatic head cancer. Biliary stent placement was conducted 1 year earlier...
July 2018: Medicine (Baltimore)
Arash Salavitabar, Jonathan N Flyer, Alejandro J Torres, Marc E Richmond, Matthew A Crystal, Mariel E Turner, Paul Chai, Warren A Zuckerman
Transcatheter stent implantation for SVC obstruction following OHT has been well described, particularly in pediatric patients. This study describes a large single-center pediatric heart transplant experience that investigates the risk factors for SVC stenosis requiring stent implantation and its associated outcomes. All pediatric OHTs between January 1, 2000, and December 12, 2016, were examined for risk factors. Twelve of 349 (3.4%) OHTs required SVC stent implantation. Patients who required stents were younger (2...
July 11, 2018: Pediatric Transplantation
Leonardo Misuraca, Alberto Massoni, Paolo Calabria, Andrea Picchi, Giuseppe Galzerano, Riccardo Trovato, Ruggiero Landini, Ugo Limbruno
We report the case of a chronic total occlusion in the left circumflex coronary artery due to the struts of a stent previously placed on the left main artery. The procedure was complicated by detachment of the stent advanced into the culprit lesion within the struts of the previously implanted stent in the left main artery. The extraction of the lost stent was performed using the twisting wire technique, but this operation resulted in a further complication, i.e. avulsion of the previously implanted stent on the left main artery...
July 2018: Giornale Italiano di Cardiologia
J Ventriglia, A Petrillo, M Huerta Alváro, M M Laterza, B Savastano, V Gambardella, G Tirino, L Pompella, A Diana, F Iovino, T Troiani, E Martinelli, F Morgillo, M Orditura, A Cervantes, F Ciardiello, F De Vita
Background: High neutrophil to lymphocyte ratio (NLR) has shown to be a predictor of poor outcomes in various malignancies, including pancreatic cancer. Methods: We assessed 70 consecutive pts with histologically confirmed mPC who received chemotherapy with nab-paclitaxel/gemcitabine at two different European oncologic centers between January 2012 and November 2015. Variables assessed for prognostic correlations included age ≥ 66, sex, Karnofsky PS score, primary tumor site, baseline CA19...
2018: Gastroenterology Research and Practice
Evan Shlofmitz, Richard A Shlofmitz, Keyvan Karimi Galougahi, Hussein M Rahim, Renu Virmani, Jonathan M Hill, Mitsuaki Matsumura, Gary S Mintz, Akiko Maehara, Ulf Landmesser, Gregg W Stone, Ziad A Ali
Intravascular imaging plays a key role in optimizing outcomes for percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) utilizes a user-friendly interface and provides high-resolution images. OCT can be used as part of daily practice in all stages of a coronary intervention: baseline lesion assessment, stent selection, and stent optimization. Incorporating a standardized, algorithmic approach when using OCT allows for precision PCI.
July 2018: Interventional Cardiology Clinics
Tasneem Z Naqvi
Transesophageal echocardiography (TEE) plays a significant role during transcatheter aortic valve implantation (TAVR). 2DTEE allows assessment of anatomy of the aortic valve, aortic root, left ventricular (LV) outflow tract, severity of the aortic valve stenosis (AS), and the presence and severity of other valve stenosis and regurgitation. Left and right ventricular size and global function as well as cardiac hemodynamics pre and post TAVR and LV regional wall motion can be assessed. Three-dimensional (3D) imaging adds significantly via accurate measurement of aortic annulus that helps select the appropriate valve size...
July 2018: Echocardiography
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
Akihide Konishi, Masamichi Iwasaki, Toshiro Shinke, Hiromasa Otake, Tomofumi Takaya, Tsuyoshi Osue, Ryo Nishio, Hiroto Kinutani, Masaru Kuroda, Hachidai Takahashi, Daisuke Terashita, Junya Shite, Ken-Ichi Hirata
BACKGROUND: Although a prospective randomized control study revealed that 3-month dual anti-platelet therapy (DAPT) is safe and does not compromise the efficacy of everolimus-eluting stent (EES) in selected patients, detailed vessel healing at early phase after EES implantation has yet to be investigated in Japanese patients. METHODS AND RESULTS: A total of 27 lesions in 19 patients treated with EES were serially evaluated by using optical coherence tomography (OCT) at 3, 6, and 12 months after stent implantation...
July 3, 2018: Journal of Cardiology
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