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instent thrombosis

Nicole Gilgen, Ahmed Farah, Bruno Scheller, Marc-Alexander Ohlow, Norman Mangner, Daniel Weilenmann, Jochen Wöhrle, Peiman Jamshidi, Gregor Leibundgut, Sven Möbius-Winkler, Robert Zweiker, Florian Krackhardt, Christian Butter, Leonhard Bruch, Christoph Kaiser, Andreas Hoffmann, Peter Rickenbacher, Christian Mueller, Frank-Peter Stephan, Michael Coslovsky, Raban Jeger
The treatment of coronary small vessel disease (SVD) remains an unresolved issue. Drug-eluting stents (DES) have limited efficacy due to increased rates of instent-restenosis, mainly caused by late lumen loss. Drug-coated balloons (DCB) are a promising technique because native vessels remain structurally unchanged. Basel Stent Kosten-Effektivitäts Trial: Drug-Coated Balloons vs. Drug-Eluting Stents in Small Vessel Interventions (BASKET-SMALL 2) is a multicenter, randomized, controlled, noninferiority trial of DCB vs DES in native SVD for clinical endpoints...
March 11, 2018: Clinical Cardiology
Maheswara S Golla, Subasit Acharji, Timir K Paul, Praveena Madapathi, Lawrence A Garcia
BACKGROUND: FDA approved the Gore Viabahn (WL Gore, Flagstaff, AZ, USA) stent for both femoro-popliteal arterial denovo and instent restenosis (ISRS) lesions. To date there is little data on Viabahn stent graft outcomes in ISRS arterial disease. METHODS: Between 2007 and 2014 we identified 734 patients who underwent 1573 endovascular interventions in our institution for infra-inguinal revascularization. Among these, 48 patients had 143 Viabahn stents placed. Of these, 26 patients had 94 stents placed for ISRS and 22 patients had 49 stents placed for denovo lesions...
December 7, 2017: Catheterization and Cardiovascular Interventions
Julia Heid, Andreas Greinacher, Hugo A Katus, Oliver J Müller
A 59-year-old male patient suffered three life-threatening instent thromboses after an initial resuscitation due to an ST-segment elevation myocardial infarction of the anterior cardiac wall. With a high-risk profile for heparin-induced thrombocytopenia (HIT), he was placed on argatroban after the second reinfarction. Under this apparently appropriate treatment, a third reinfarction occurred, and the patient had to undergo high-risk cardiac bypass surgery. Later on, a deep vein thrombosis and an intracardiac thrombus formed...
October 23, 2017: BMJ Case Reports
Ahmad Samir, Ahmed ElGuindy
Optical coherence tomography (OCT) has emerged as a powerful intravascular imaging modality in recent years. The introduction of frequency-domain OCT has simplified the procedure and enabled its safe utilisation in different clinical settings including acute coronary syndromes, where it can determine the mechanism of plaque disruption, thrombus burden, and guide percutaneous coronary intervention. In patients presenting with stent failure (stent thrombosis and instent restenosis), OCT can also be very useful in determining the underlying mechanism and guiding therapy thereafter...
December 30, 2016: Global Cardiology Science & Practice
Prashant Bharadwaj, D S Chadha
Currently, percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is the most commonly employed modality in the treatment of patients with coronary artery disease. PCI has come of age over the last four decades with enormous forays in the technology and drugs which have greatly enhanced its capability. Angioplasty and bare metal stents were plagued by high failure rates on account of restenosis leading to repeat revascularization procedures. Insights into pathophysiology of instent restenosis (ISR) and neointimal hyperplasia triggered the development of DES...
October 2016: Medical Journal, Armed Forces India
Usman Baber, George Dangas, Jaya Chandrasekhar, Samantha Sartori, Philippe Gabriel Steg, David J Cohen, Gennaro Giustino, Cono Ariti, Bernhard Witzenbichler, Timothy D Henry, Annapoorna S Kini, Mitchell W Krucoff, C Michael Gibson, Alaide Chieffo, David J Moliterno, Giora Weisz, Antonio Colombo, Stuart Pocock, Roxana Mehran
OBJECTIVES: The aim of this study was to examine the independent associations between actionable bleeding (AB) and coronary thrombotic events (CTE) on mortality risk after percutaneous coronary intervention (PCI). BACKGROUND: The independent impact of AB and CTE on mortality risk after PCI remains poorly characterized. METHODS: A post hoc analysis was conducted of the PARIS (Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients) registry, a real-world cohort of 5,018 patients undergoing PCI with stent implantation...
July 11, 2016: JACC. Cardiovascular Interventions
O M Anil
A prospective study was carried out to evaluate safety, in-hospital clinical end points and early outcome in a consecutive series of 212 patients with coronary artery disease (CAD) who underwent coronary angioplasty in Manmohan Cardiothoracic Vascular and Transplant Centre from October 2012 to April 2014 over a period of 18 months. All patients who underwent angioplasty during the specified period were included in the study. Majority of the patients were male (84.4%). Hypertension was found in 31%, diabetes in 29%, dyslipidemia in 23% and smoking in 19%...
December 2014: Nepal Medical College Journal: NMCJ
Sabareesh K Natarajan, Ashish Sonig, J Mocco, Travis M Dumont, Harjot Thind, Mary L Hartney, Kenneth V Snyder, L Nelson Hopkins, Adnan H Siddiqui, Elad I Levy
BACKGROUND: The preliminary results of a prospective consecutive series of 20 patients who underwent Enterprise-assisted recanalization for acute ischemic stroke were recently reported. Recanalization to thrombolysis in myocardial infarction (TIMI) grade 2 (n = 6) or 3 (n = 12) flow was achieved in 18 patients (90% revascularization rate). Good outcome (modified Rankin Scale [mRS] score of ≤2) was obtained in 10 patients (50%) at 30 days. Here, we report the 2-year clinical follow-up data for patients enrolled in that prospective study...
July 2015: Journal of Vascular and Interventional Neurology
Elena Z Golukhova, Marina V Grigorian, Mariya N Ryabinina, Naida I Bulaeva, Seth Fortmann, Victor L Serebruany
BACKGROUND: Despite recent advances in stent design and constantly improving protective pharmacological strategies, complications and adverse events following percutaneous coronary interventions (PCI) are still major factors influencing morbidity and mortality. Therefore, predicting secondary vascular occlusions represents an unmet medical need. OBJECTIVE: The aim of our study was to triage clinical and laboratory predictors of major adverse clinical events (MACE) following coronary stenting...
2015: Cardiology
Şeref Ulucan, Ahmet Keser, Zeynettin Kaya, Hüseyin Katlandur, Hüseyin Özdil, Mustafa Bilgi, İsmail Ateş, Mehmet Sıddık Ülgen
BACKGROUND: The aim of the present study was to perform a preliminary evaluation of the potential association between platelet distribution width (PDW) and frequency of major adverse cardiovascular events (MACEs) development in an observational study of acute coronary syndrome (ACS) patients. METHODS: A total of 679 consecutive patients with ACS (498 (73.3%) males; mean age was 63.31±11.2 years; study population composed of 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) subjected to primary percutaneous coronary intervention with transradial approach (TRA) were retrospectively enrolled to the study...
January 2016: Heart, Lung & Circulation
Shmuel Chen, Chaim Lotan, Ronen Jaffe, Ronen Rubinshtein, Eyal Ben-Assa, Ariel Roguin, Boris Varshitzsky, Haim D Danenberg
OBJECTIVES: To evaluate initial and long term results of coronary perforation treatment with pericardial covered stent. BACKGROUND: Iatrogenic coronary perforation is a rare life threatening complication of percutaneous coronary interventions (PCI) occurring in 0.1-0.8% of cases. Covered stents are the mainstay of therapy for coronary perforation. However, polytetrafluoroethylene covered stents are bulky with limited flexibility and thus may not be easy to deliver in difficult anatomy...
September 2015: Catheterization and Cardiovascular Interventions
Behshad Naghshtabrizi, Azadeh M Monfared, Farzad Emami, Jalal Poorolajal
BACKGROUND: The aim of this study was to compare 3 year incidence of major adverse cardiac events (MACE) between bare metal stents (BMS) and drug-eluting stents (DES) in large coronary arteries with tubular and diffuse lesions. METHODS: Seven hundred forty-five consecutive patients (894 lesions) who underwent percutaneous coronary intervention (PCI) on large coronary arteries (3.0, 3.5 and 4 mm) with tubular (10-20 mm length) or diffuse (>20 mm) lesions using BMS or DES at Ekbatan University Hospital, Hamadan, Iran between October 2009 and September 2012 were included...
October 2016: Minerva Cardioangiologica
J Alibegovic Zaza, S Zaza
The new generation drug eluting stents have improved the results of coronary angioplasty by reducing the rate of instent restenosis and stent thrombosis compared to earlier devices, due to the thinner stent struts and improved or bioresorbable polymers. But permanent metallic stent struts may have some long term harmful effects such as inducing late thrombosis, neoatherosclerosis, restenosis and also impairing vasomotion and endothelial function. This was the rationale for introducing bioresorbable stents which offer radial support to the artery during the period needed (scaffolding) and then disappear, (liberating the vessels and restoring its physiological vasomotion...
March 4, 2015: Revue Médicale Suisse
M El-Mourad, P Merveille, N Preumont
Since Gruentizg's first percutaneous transluminal ballon angioplasty in 1977 in Zurich, percuta. neous coronary intervention evolved significantly in order to overcome the numerous associated complications of each technique. Bare-metal stents (BMS) made their initial appearance followed by three generations of drug-eluting stents (DES). The use of bioabsorbable vascular scaffold stents (BVS) has become more frequent creating a temporary scaffold allowing healing of the endothelium within 2 years. In this article, we discuss the nomenclature of the main intravascular complications linked to percuta...
September 2014: Revue Médicale de Bruxelles
Alpa Bharati, Suleman Merchant, Tilak Suvarna, Neha Parashar
Coronary stent fracture is a known complication of coronary arterial stent placements. Multiple long-term risks are also associated with drug eluting stents. 64-slice multidetector CT (MDCT) coronary angiography has been shown to detect poststent complications such as instent stenosis, thrombosis, stent migration and stent fractures. We report a case of stent fracture in a patient who underwent RCA stenting with associated RCA perforation and almost complete thrombosis of the RCA and peristent fibrinoid collection...
2012: Case Reports in Cardiology
Vijayakumar Subban, Brendan Bell, Owen Christopher Raffel, Andrew Small, Michael Savage, Alexander Incani, Darren L Walters
Very late stent thrombosis is an uncommon event following implantation with bare metal stents (BMS) in coronary arteries. Long term follow up studies have shown that a small number of BMS develop very late thrombosis following years of stability. Atherosclerotic transformation of neointimal tissue is increasingly being recognised as the cause of these adverse events. A 49 year-old male presented with acute inferior wall myocardial infarction resulting from thrombosis of the BMS implanted in his right coronary artery five years earlier...
February 2014: Heart, Lung & Circulation
Flora Koegler, Edoardo De Benedetti
Coronary angioplasty has undergone several technological revolutions: starting with balloon angioplasty, then with bare metal stent and finally with drug eluting stent (DES), this technique is now mature. However, once we thought the problem of instent restenosis solved with DES, new concerns arise with late and very late stent thrombosis. Should we therefore proscribe DES? How long should be the duration of dual antiplatelet therapy? And how should we manage the patients who need a surgery and are at high risk of bleeding? Are bioresorbable stents the final solution with their initial mechanical properties, then with their drug eluting effect against intra-stent restenosis, and finally with their complete resorption which leaves the artery free of any foreign material?...
April 10, 2013: Revue Médicale Suisse
Jan P Goltz, Bernhard Petritsch, Leo Spor, Dietbert Hahn, Ralph Kickuth
Acute thromboembolic occlusion of the superior mesenteric artery is a rare and often fatal condition in which surgery represents the golden standard in therapy. We present a case in which a patient was treated with covered stent implantation for acute bleeding from the superior mesenteric artery following pancreatic resection, radiation, and embolization of a hepatic artery pseudoaneurysm. Some weeks later clinical signs were suggestive of acute thromboembolic occlusion of the superior mesenteric artery and digital subtraction angiography showed occlusion of the previously implanted covered stents...
September 2012: VASA. Zeitschrift Für Gefässkrankheiten
Rishi Sethi, Chi-Hang Lee
The endothelial progenitor cell (EPC) capture stent is an innovative device that makes use of the ability of bone marrow-derived EPCs to migrate to injured arterial segments to facilitate healing. The EPC antibody surface, consisting of a covalently coupled polysaccharide intermediate coating with anti-human CD34 antibodies, is attached to a stainless steel stent. Upon stent placement, the anti-human CD34 antibodies will attract circulating EPCs, which are expected to develop into mature functional endothelium...
October 2012: Journal of Interventional Cardiology
K Xiromeritis, I Dalainas, M Stamatakos, V Katsikas, V Martinakis, K Stamatelopoulos, V Psarros
BACKGROUND: Carotid artery stenting (CAS) is a reasonable alternative to carotid endarterectomy (CEA), especially in patients at high risk for surgery. Carotid artery thrombosis of the treated segment is a rare, early but potentially devastating complication of this endovascular procedure. The aim of this article is to identify and critically review cases of acute stent thrombosis reported in the literature. MATERIALS AND METHODS: Previous trials that compared CEA with CAS were rather heterogeneous and not large enough to allow reliable conclusions...
March 2012: European Review for Medical and Pharmacological Sciences
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