Read by QxMD icon Read

Bioresorbable stent

Takao Sato, John Jose, Mohamed El-Mawardy, Dmitriy S Sulimov, Ralph Tölg, Gert Richardt, Mohamed Abdel-Wahab
Heterogeneity of neointimal thickness is observed after drug-eluting stents implantation in bifurcation lesions (BL). We evaluated the vascular response of everolimus-eluting bioresorbable scaffold (BRS) struts deployed at BL using optical coherence tomography (OCT). 50 patients (64 scaffolds) underwent follow-up OCT after BRS implantation. Cross-sectional areas of each BL with a side branch more than 1.5 mm were analyzed using OCT every 200 µm. All images were divided into three regions according to shear stress: the 1/2 circumference of the vessel opposite to the ostium (OO), the vessel wall adjacent to the ostium (AO) and the side-branch ostium (SO)...
October 18, 2016: International Journal of Cardiovascular Imaging
Akihito Tanaka, Azeem Latib, Hiroyoshi Kawamoto, Richard J Jabbour, Katsumasa Sato, Tadashi Miyazaki, Toru Naganuma, Antonio Mangieri, Matteo Pagnesi, Claudio Montalto, Alaide Chieffo, Mauro Carlino, Matteo Montorfano, Antonio Colombo
AIMS: It has become clearly apparent that in comparison to metallic stents, bioresorbable vascular scaffold (BVS) require specific implantation techniques. The aim of this study was to investigate outcomes following BVS implantation using a dedicated strategy for optimal deployment. METHODS AND RESULTS: 400 consecutive lesions (264 patients) treated with Absorb BVS were analyzed. All procedures were performed based on the following principles: 1) aggressive lesion preparation; 2) high-pressure post-dilation; and 3) a low threshold for intravascular imaging...
October 18, 2016: EuroIntervention
Giuseppe Tarantini, Francesco Saia, Piera Capranzano, Bernardo Cortese, Marco Mojoli, Giacomo Boccuzzi, Andrea Cuculo, Salvatore Geraci, Alessio Mattesini, Jacopo Oreglia, Francesco Summaria, Luca Testa, Sergio Berti, Giovanni Esposito, Alessio La Manna, Ugo Limbruno, Alfredo Marchese, Ciro Mauro, Fabio Tarantino, Alessandro Salvi, Gennaro Santoro, Ferdinando Varbella, Roberto Violini, Giuseppe Musumeci
Drug-eluting stents (DES) are the current gold standard for percutaneous treatment of coronary artery disease. However, DES are associated with a non-negligible risk of long-term adverse events related to persistence of foreign material in the coronary artery wall. In addition, DES implantation causes permanent caging of the native vessel, thus impairing normal vasomotricity and the possibility of using non-invasive coronary imaging or preforming subsequent bypass surgery. On the contrary, coronary bioresorbable stents (BRS) may provide temporary mechanical support to coronary wall without compromising the subsequent recovery of normal vascular physiology, and have the potential to prevent late adverse events related to permanent elements...
October 2016: Giornale Italiano di Cardiologia
Yohei Sotomi, Yoshinobu Onuma, Pannipa Suwannasom, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Hans Jonker, Jouke Dijkstra, Nicolas Foin, Jaryl Ng Chen Koon, Carlos Collet, Robbert J de Winter, Joanna J Wykrzykowska, Gregg W Stone, Jeffrey J Popma, Ken Kozuma, Kengo Tanabe, Patrick W Serruys, Takeshi Kimura
AIMS: The current study aimed to assess the difference in lumen dimension measurements between optical coherence tomography (OCT) and quantitative coronary angiography (QCA) in the polymeric bioresorbable scaffold and metallic stent. METHODS AND RESULTS: In the randomised ABSORB Japan trial, 87 lesions in the Absorb arm and 44 lesions in the XIENCE arm were analysed. Post-procedural OCT-QCA lumen dimensions were assessed in matched proximal/distal non-stented/non-scaffolded reference (n=199), scaffolded (n=145) and stented (n=75) cross-sections at the two device edges using the Bland-Altman method...
October 10, 2016: EuroIntervention
Muhammad Muzaffar Mahmood, David Austin
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Jiang Ming Fam, Johannes N van Der Sijde, Antonios Karanasos, Cordula Felix, Roberto Diletti, Nicolas van Mieghem, Peter de Jaegere, Felix Zijlstra, Robert Jan van Geuns, Evelyn Regar
OBJECTIVES: The acute expansion of bioresorbable vascular scaffolds (BRS) and drug-eluting stents (DES) in lesions with different extent of calcification was compared by Optical Coherence Tomography (OCT). BACKGROUND: The acute mechanical performance of polymeric BRS in calcified lesions is poorly understood. METHODS: Acute device performance in lesions treated with either BRS(N = 50) or DES (N = 50) was compared using Optical Coherence Tomography (OCT)...
October 7, 2016: Catheterization and Cardiovascular Interventions
Antonio Enrique Gómez Menchero, Santiago Jesús Camacho Freire, José Francisco Díaz Fernández, Jessica Roa Garrido, Javier León Jiménez, Rosa Cardenal Piris
A patient presented with an inferior non-ST segment elevation myocardial infarction and a tight lesion on the distal right coronary artery. After stent implantation, a large scaffold malapposition was observed by optical coherence tomography. This case emphasizes the importance of not expanding a bioresorbable vascular scaffold more than 0.5 mm over its nominal size.
October 2016: Journal of Invasive Cardiology
Ciro Indolfi, Salvatore De Rosa, Antonio Colombo
The introduction of percutaneous treatment of coronary artery stenosis with balloon angioplasty was the first revolution in interventional cardiology; the advent of metallic coronary stents (bare and drug-eluting) marked the second and third revolutions. However, the latest generation of drug-eluting stents is limited by several factors. Permanent vessel caging impairs arterial physiology, and the incidence of very late stent thrombosis - although lower with the second generation than with the first generation of drug-eluting stents - remains a major concern...
September 29, 2016: Nature Reviews. Cardiology
Artemis Ailianou, Karthik Ramachandran, Mary Beth Kossuth, James Paul Oberhauser, Julia A Kornfield
Poly(l-lactide) (PLLA) is the structural material of the first clinically approved bioresorbable vascular scaffold (BVS), a promising alternative to permanent metal stents for treatment of coronary heart disease. BVSs are transient implants that support the occluded artery for 6 mo and are completely resorbed in 2 y. Clinical trials of BVSs report restoration of arterial vasomotion and elimination of serious complications such as late stent thrombosis. It is remarkable that a scaffold made from PLLA, known as a brittle polymer, does not fracture when crimped onto a balloon catheter or during deployment in the artery...
September 26, 2016: Proceedings of the National Academy of Sciences of the United States of America
Roberto Adriano Latini, Dario Buccheri, Bernardo Cortese
This is the first documented case of a drug-coated balloon strategy for the treatment of bioresorbable in-scaffold restenosis caused by diffuse neointimal proliferation. This case can provide an alternative treatment option in this setting, avoiding potential problems related to further bulky metallic stents in a patient where a different strategy was initially planned. © 2016 Wiley Periodicals, Inc.
September 21, 2016: Catheterization and Cardiovascular Interventions
Nicolas Foin, Renick Lee, Christos Bourantas, Alessio Mattesini, Nicole Soh, Jie En Lim, Ryo Torii, Jaryl Ng, Leo Hwa Liang, Gianluca Caiazzo, Enrico Fabris, Dogu Kilic, Yoshinobu Onuma, Adrian F Low, Sukh Nijjer, Sayan Sen, Ricardo Petraco, Rasha Al Lamee, Justin E Davies, Carlo Di Mario, Philip Wong, Patrick W Serruys
AIMS: This study aimed to compare the acute expansion behaviour of a polymer-based bioresorbable scaffold and a second-generation metallic DES platform in a realistic coronary artery lesion model. Experimental mechanical data with conventional methods have so far shown little difference between metallic stents and currently available polymer-based bioresorbable scaffolds (BRS). Nevertheless, differences in acute results have been observed in clinical studies comparing BRS directly with metallic DES platforms...
September 18, 2016: EuroIntervention
Jean Fajadet, Michael Haude, Michael Joner, Jacques Koolen, Michael Lee, Ralph Tölg, Ron Waksman
Bioresorbable scaffolds represent an exciting milestone in the development of coronary stent technology with the potential to substantially improve the management of patients with coronary artery disease. In an attempt to provide first recommendations for the technology, experienced experts involved in the first-in-man studies met in Zurich on the 14 April 2016 in order to reach consensus on a responsible market introduction. This document will be updated regularly as new information from clinical trials becomes available and should be understood as a review of current data, opportunities, expectations, advice, and recommendations for future investigations...
September 18, 2016: EuroIntervention
Daniel Chen, Nigel Jepson
Coronary angioplasty and coronary artery stents have revolutionised interventional cardiology. Contemporary coronary stent technology continues to seek to improve on the outcomes of the preceding generation of devices by refining their design, structure and component materials. These technologies include new generations of drug-eluting stents, non-polymeric stents, bioresorbable polymer-coated stents, and fully bioresorbable scaffolds. This review discusses the evolution of coronary stent technology, the efficacy and safety of currently available devices, and the rationale for new generation platforms as efforts continue to design the ideal coronary stent technology...
September 19, 2016: Medical Journal of Australia
Richard J Jabbour, Akihito Tanaka, Antonio Mangieri, Damiano Regazzoli, Marco Ancona, Matteo Pagnesi, Francesco Giannini, Azeem Latib, Antonio Colombo
We report the long-term outcome of a case of "full plastic jacket" treatment consisting of three bioresorbable scaffolds to manage a subtotally occluded left anterior descending artery with associated severe bare metal in-stent restenosis. Angiography 36months' post procedure revealed an excellent result with negative fractional flow reserve result. Bioresorbable scaffolds may be an attractive option for in-stent restenosis due to the avoidance of an additional metallic layer, and this case is unusual regarding the total scaffold length used and long term angiographic follow-up...
September 5, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Mohamed Farag, Nikolaos Spinthakis, Diana A Gorog, Abhiram Prasad, Keith Sullivan, Zaki Akhtar, Neville Kukreja, Manivannan Srinivasan
BACKGROUND: Differences in outcomes between bioresorbable vascular scaffold (BVS) systems and drug-eluting metal stents (DES) have not been fully evaluated. We aimed to compare clinical and angiographic outcomes in randomised studies of patients with coronary artery disease (CAD), with a secondary analysis performed among registry studies. METHODS: A meta-analysis comparing outcomes between BVS and DES in patients with CAD. Overall estimates of treatment effect were calculated with random-effects model and fixed-effects model...
2016: Open Heart
Poonam Velagapudi, J Dawn Abbott
Bioresorbable vascular scaffolds (BVS) are non-inferior to second generation drug eluting stents (DES) but thrombosis rates for BVS in small vesseles is a concern. The BVS-SAVE registry of small vesseles (<2.75 mm) supports safety and efficacy of BVS in this high risk lesion subset. Definitive recommendation for BVS in small vessels require further trials DES with evaluation of the lower threshold for minimal reference vesseles diameter.
September 2016: Catheterization and Cardiovascular Interventions
Jacek Bil, Robert J Gil
Bioresorbable vascular scaffolds (BVS) have emerged as an interesting alternative since the presence of the prosthesis in the coronary artery is transient. This technology enables to restore the normal vasomotor tone and allows positive remodeling, simultaneously reducing the trigger for persistent inflammation and facilitating further interventions by percutaneous or surgical means. Absorb BVS(®) is the first generation everolimus-eluting poly-L-lactide (PLLA) bioresorbable scaffold. In recent meta-analyses Absorb BVS(®) was definitely proved to be safe and effective device in the treatment of symptomatic coronary artery disease...
August 2016: Journal of Thoracic Disease
Ashleigh Dind, Usaid Allahwala, Kaleab N Asrress, Sanjit S Jolly, Ravinay Bhindi
Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y12 inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority...
August 22, 2016: Heart, Lung & Circulation
Arie Steinvil, Toby Rogers, Rebecca Torguson, Ron Waksman
OBJECTIVES: This study aims to describe the discussions and recommendations made during the U.S. Food and Drug Administration (FDA) Circulatory System Device Panel pre-market approval application for the Absorb Bioresorbable Vascular Scaffold (BVS) System. BACKGROUND: The Absorb BVS System is a first-of-its-kind fully bioresorbable percutaneous coronary intervention technology. The absorb BVS was studied in the ABSORB III (A Clinical Evaluation of Absorb BVS, the Everolimus Eluting Bioresorbable Vascular Scaffold in the Treatment of Subjects with de Novo Native Coronary Artery Lesions) trial, the pivotal U...
September 12, 2016: JACC. Cardiovascular Interventions
Ahmed Al-Mamary, Filippo Zilio, Massimo Napodano
Optimal management of multivessel coronary artery disease can be complex. We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction. Coronary angiography showed diffuse multiple sub-occlusive lesions of the proximal and distal left coronary vessels involving a long segment of the vessel. On intravascular ultrasonography (IVUS), the left main artery was moderately diseased with critically stenotic and calcified branch ostia...
August 2016: Sultan Qaboos University Medical Journal
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"