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https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#1
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28514061/mapping-intermediate-degradation-products-of-poly-lactic-co-glycolic-acid-in-vitro
#2
Jian Li, Peter Nemes, Ji Guo
There is widespread interest in using absorbable polymers, such as poly(lactic-co-glycolic acid) (PLGA), as components in the design and manufacture of new-generation drug eluting stents (DES). PLGA undergoes hydrolysis to progressively degrade through intermediate chemical entities to simple organic acids that are ultimately absorbed by the human body. Understanding the composition and structure of these intermediate degradation products is critical not only to elucidate polymer degradation pathways accurately, but also to assess the safety and performance of absorbable cardiovascular implants...
May 17, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28494574/endoscopic-management-of-peri-pancreatic-fluid-collections
#3
REVIEW
Hon Chi Yip, Anthony Yuen Bun Teoh
In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery...
May 12, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28488403/drug-eluting-stents-for-very-long-lesions-go-long-but-know-the-risks
#4
EDITORIAL
Charles E Beale, J Dawn Abbott
Long coronary artery lesions are increasingly treated with new technologies including current generation drug eluting stents (DES) despite a lack of robust data on outcomes. In the current study, patients receiving Xience V DES for very long lesions (>35 mm) compared to lesions 25-35 mm had similar outcomes. Future research should address late outcomes, stent thrombosis rates, as well as investigation of lesions greater than 60 mm.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28487355/impact-of-fluoropolymer-based-paclitaxel-delivery-on-neointimal-proliferation-and-vascular-healing-a-comparative-peripheral-drug-eluting-stent-study-in-the-familial-hypercholesterolemic-swine-model-of-femoral-restenosis
#5
Pawel Gasior, Yanping Cheng, Andres F Valencia, Jenn McGregor, Gerard B Conditt, Grzegorz L Kaluza, Juan F Granada
BACKGROUND: A polymer-free peripheral paclitaxel-eluting stent (PES, Zilver PTX, Cook, IN) has shown to improve vessel patency after superficial femoral angioplasty. A new-generation fluoropolymer-based PES (FP-PES; Eluvia, Boston Scientific, MA) displaying more controlled and sustained paclitaxel delivery promise to improve the clinical outcomes of first-generation PES. We sought to compare the biological effect of paclitaxel delivered by 2 different stent-coating technologies (fluoropolymer-based versus polymer-free) on neointimal proliferation and healing response in the familial hypercholesterolemic swine model of femoral restenosis...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28479470/third-vs-second-generation-stent-graft-for-endovascular-aneurysm-repair-a-device-specific-analysis
#6
Marco Bergonti, Giovanni Teruzzi, Giulia Santagostino, Luca Grancini, Cristina Ferrari, Daniela Trabattoni, Alessandro Lualdi, Antonio Bartorelli
PURPOSE: to analyze outcomes of Endovascular Aneurysm Repair (EVAR) in patients treated with Excluder endograft (W.L. Gore and Associate, Flagstaff, AZ), comparing 2(nd) generation featuring SIM-PULL delivery system (ExSP), and 3(rd) generation, featuring C3 (ExC3), concerning intra-procedural data and long-term outcomes. METHODS: In our single-center, comparative study, we retrospectively analyzed all patients undergoing elective EVAR with Excluder from May 2008 to December 2015...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479444/intraoperative-type-iiib-endoleak-after-endograft-deployment-during-evar
#7
Konstantinos G Moulakakis, John Kakisis, George Geroulakos, Elias N Brountzos
Type IIIb endoleak usually occurs years after the initial endograft implantation and the cause is the chronic fatigue of the endograft. This rare case describes a type IIIb endoleak, appearing immediately after deployment of a new generation low profile stentgraft and highlights the diagnostic and treatment challenges associated with the type IIIb endoleak. A 74 years old man underwent elective EVAR for an infrarenal abdominal aortic aneurysm. A type IIIb endoleak near to the flow divider due to a fabric defect was diagnosed...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28446977/endoscopic-management-of-esophageal-leaks
#8
REVIEW
Gabie K B Ong, Richard K Freeman
Traditionally, gold standard treatment for an acute esophageal perforation has been operative repair. Over the past two decades, there has been a paradigm shift towards the use of esophageal stents. Recent advances in biomaterial allowed a new generation of stents to be manufactured that combined (I) a non-permeable covering; (II) radial force sufficient to occlude a transmural esophageal injury and (III) improved ease of removability. The amalgamation of these developments set the stage for utilizing esophageal stents as part of the management algorithm of an acute esophageal perforation...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445555/drug-eluting-balloon-versus-bare-mental-stent-and-drug-eluting-stent-for-de-novo-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-14-randomized-controlled-trials
#9
Kongyong Cui, Shuzheng Lyu, Xiantao Song, Fei Yuan, Feng Xu, Min Zhang, Wei Wang, Dongfeng Zhang, Jing Dai
BACKGROUND: Drug-eluting balloon (DEB) has become an alternative option to drug-eluting stent (DES) for the treatment of in-stent restenosis (ISR). However, the effect of drug-eluting balloon with regular bare-mental stent (BMS) in de novo coronary artery disease (CAD) is unclear. This meta-analysis aimed to evaluate the efficacy of DEB with regular BMS compared to BMS or DES in de novo CAD. METHODS: Randomized controlled trials (RCTs) assessing the efficacy of DEB+BMS in comparison with BMS or DES were obtained by searching the PubMed, EMBASE, and Cochrane Library databases through January 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28442660/anatomic-feasibility-of-next-generation-stent-grafts-for-the-management-of-type-a-aortic-dissection-in-japanese-patients
#10
Naoki Fujimura, Shinji Kawaguchi, Hideaki Obara, Akihiro Yoshitake, Masanori Inoue, Satoshi Otsubo, Yuko Kitagawa, Hideyuki Shimizu
BACKGROUND: The aims of the present study were to analyze the anatomical characteristics of type A aortic dissections (TAAD) in Japanese patients and evaluate the feasibility of 3 next-generation stent grafts dedicated to ascending/arch aortic lesions.Methods and Results:We analyzed 172 consecutive patients surgically treated for TAAD at 2 institutions between 2007 and 2015. Computed tomography (CT) images and operative records were used to identify the location of entry tear (ET)...
April 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28400917/coronary-stenting-a-matter-of-revascularization
#11
EDITORIAL
Aldo Bonaventura, Fabrizio Montecucco, Luca Liberale
In the last few decades, the recommended treatment for coronary artery disease has been dramatically improved by percutaneous coronary intervention (PCI) and the use of balloon catheters, bare metal stents (BMSs), and drug-eluting stents (DESs). Catheter balloons were burdened by acute vessel occlusion or target-lesion re-stenosis. BMSs greatly reduced those problems holding up the vessel structure, but showed high rates of in-stent re-stenosis, which is characterized by neo-intimal hyperplasia and vessel remodeling leading to a re-narrowing of the vessel diameter...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28400029/meta-analysis-of-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-unprotected-left-main-coronary%C3%A2-narrowing
#12
Partha Sardar, Jay Giri, Sammy Elmariah, Saurav Chatterjee, Dhaval Kolte, Amartya Kundu, Ramez Nairooz, Wilbert S Aronow, Theophilus Owan, Debabrata Mukherjee, Dmitriy N Feldman, J Dawn Abbott
Patients with unprotected left main coronary artery (ULMCA) disease are increasingly treated with percutaneous coronary intervention (PCI) using new-generation drug-eluting stents (DES); however, the benefits of DES compared with coronary artery bypass grafting (CABG) in ULMCA remain controversial. This meta-analysis evaluated the effects of PCI with DES compared with CABG for the treatment of ULMCA stenosis. Databases were searched through November 30, 2016. Randomized controlled trials (RCTs) comparing DES with PCI versus CABG for ULMCA stenosis were identified...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28398398/-new-technologies-and-applications-for-drug-coated-balloons
#13
Bernardo Cortese, Gaetano Di Palma, Roberto Nerla, Antonio Micari
Drug-eluting stents (DES) represent nowadays the gold standard treatment for coronary artery disease. Despite the safety and efficacy, and favorable long-term clinical outcomes of new generation DES, their use is still associated with a not negligible risk of long-term events, related to the presence of a definitive prosthesis in the vessel wall. In addition, DES implantation is not always desirable in particular anatomic settings (small vessels, bifurcations) or in patients with higher bleeding risk. In recent years, drug-coated balloons (DCB) have been developed to overcome some of these limitations, offering a combined mechanical (balloon dilation) and biological therapy (drug-release)...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28389121/long-term-comparative-effectiveness-of-endeavor-zotarolimus-eluting-and-everolimus-eluting-stents-in-new-york
#14
Feng Qian, Ye Zhong, Edward L Hannan
BACKGROUND: Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. We aimed to evaluate the long-term outcomes of E-ZES vs. EES using New York State (NYS) cardiac registries and to compare long-term effectiveness of E-ZES vs. EES in six "off-label" and two "high-risk" subgroups. METHODS: We created a longitudinal database by linking the NYS cardiac registries, the statewide hospital discharge data, the National Death Index, and the U...
March 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28385356/the-promus-premier-everolimus-eluting-platinum-chromium-stent-with-durable-polymer-evaluated-in-a-real-world-all-comer-population-in-rotterdam-cardiology-hospital-the-p-search-registry
#15
Miguel E Lemmert, Nicolas M van Mieghem, Robert-Jan van Geuns, Roberto Diletti, Rutger J van Bommel, Ron T van Domburg, Peter P de Jaegere, Evelyn Regar, Felix Zijlstra, Eric Boersma, Joost Daemen
BACKGROUND: A new-generation everolimus eluting platinum-chromium stent (EePCS), offering improved radial strength, radiopacity and conformability compared to everolimus-eluting cobalt-chromium stents (EeCCS), was evaluated with regard to safety and efficacy in an all-comer cohort. METHODS: A total of 1000 consecutive all-comer patients (including acute coronary syndrome, multivessel disease, calcified lesions) treated with an EePCS (Promus Premier™, Boston Scientific, Natick, Massachusetts) from May 2013 to October 2014 were compared to 1000 consecutive patients treated with an EeCCS (Xience Prime™, Abbott Vascular, Santa Clara, California) from April 2012 to May 2013...
March 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28371505/compositions-including-synthetic-and-natural-blends-for-integration-and-structural-integrity-engineered-for-different-vascular-graft-applications
#16
REVIEW
Mozhgan Shojaee, Chris A Bashur
Tissue engineering approaches for small-diameter arteries require a scaffold that simultaneously maintains patency by preventing thrombosis and intimal hyperplasia, maintains its structural integrity after grafting, and allows integration. While synthetic and extracellular matrix-derived materials can provide some of these properties individually, developing a scaffold that provides the balanced properties needed for vascular graft survival in the clinic has been particularly challenging. After 30 years of research, there are now several scaffolds currently in clinical trials...
March 29, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28370939/stent-mediated-gene-and-drug-delivery-for-cardiovascular-disease-and-cancer-a-brief-insight
#17
REVIEW
Akshaya Krishnagopal, Aakash Reddy, Dwaipayan Sen
AIM: This article concisely recapitulates the different existing modes of stent mediated gene/drug delivery, their considerable advancements in clinical trials and a rationale of other merging new technologies such as nanotechnology and microRNA based therapeutics, furthermore addressing the breach in each of these perpetual stent platforms. DISCUSSION: Over the past decade stent mediated gene/drug delivery have materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to the routine conventional treatment modalities...
March 31, 2017: Journal of Gene Medicine
https://www.readbyqxmd.com/read/28359716/pretreatment-with-and-ongoing-use-of-omega-3-fatty-acid-ethyl-esters-reduce-the-slow-flow-phenomenon-and-prevent-in-stent-restenosis-in-patients-undergoing-carotid-artery-stenting
#18
Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Syuichi Yamada, Yasushi Motoyama, Kimihiko Kichikawa, Hiroyuki Nakase
OBJECTIVE: Carotid artery stenting (CAS) is a less invasive alternative to carotid endarterectomy, but it is essential to prevent thromboembolic complications during CAS and to suppress in-stent restenosis (ISR) after CAS because of the relatively high risk of periprocedural and follow-up stroke events. Clinical trials have demonstrated the strong relationship of carotid plaque vulnerability with the subsequent risk of ipsilateral ischemic stroke and thromboembolic complications during CAS...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28341491/one-year-follow-up-optical-coherence-tomography-after-endovascular-treatment-with-a-new-generation-zotarolimus-eluting-stent-for-chronic-mesenteric-ischemia
#19
Toru Naganuma, Yusuke Fujino, Satoru Mitomo, Sandeep Basavarajaiah, Sunao Nakamura
No abstract text is available yet for this article.
March 21, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28335102/efficacy-of-a-multiplex-paclitaxel-emission-stent-using-a-pluronic-%C3%A2-mixture-membrane-versus-a-covered-metal-stent-in-malignant-biliary-obstruction-a-prospective-randomized-comparative-study
#20
Sung Ill Jang, Se Joon Lee, Seok Jeong, Don Haeng Lee, Myung-Hwan Kim, Hong Jin Yoon, Dong Ki Lee
Background/Aims: A drug-eluting stent for unresectable malignant biliary obstruction was developed to increase stent patency by preventing tumor ingrowth. The safety and efficacy of a new generation of metallic stents covered with a paclitaxel-incorporated membrane using a Pluronic(®) mixture (MSCPM-II) were compared prospectively with those of covered metal stents (CMSs) in patients with malignant biliary obstructions. Methods: This study was initially designed as a prospective randomized trial but was closed early because of a high incidence of early occlusion...
March 24, 2017: Gut and Liver
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