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https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#1
REVIEW
Mikhail S Dzeshka, Richard A Brown, Davide Capodanno, Gregory Y H Lip
Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27872316/outcomes-of-acute-myocardial-infarction-patients-implanted-with-biodegradable-polymer-biolimus-eluting-stents-versus-new-generation-durable-polymer-drug-eluting-stents-a-retrospective-analysis
#2
Jeong Cheon Choe, Kwang Soo Cha, Hye Yoon Jang, Jong Hyun Choi, Bo Won Kim, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Youngkeun Ahn, Myung Ho Jeong
We compared outcomes between biodegradable polymer biolimus-eluting stent (BP-BES) and new-generation durable polymer drug-eluting stent (DP-DES) implantations in patients with acute myocardial infarction (MI). Among 13472 patients with acute MI in a nationwide registry, 557 (64.8%) were in the BP-BES and 303 (35.2%) in the new-generation DP-DES group following coronary reperfusion. The occurrence of major adverse cardiac events (MACE; death, MI, revascularization) and stent thrombosis was compared. Major adverse cardiac events occurred in 53 (6...
November 20, 2016: Angiology
https://www.readbyqxmd.com/read/27867580/understanding-and-managing-in-stent-restenosis-a-review-of-clinical-data-from-pathogenesis-to-treatment
#3
REVIEW
Dario Buccheri, Davide Piraino, Giuseppe Andolina, Bernardo Cortese
The lumen diameter reduction after percutaneous coronary intervention (PCI) is well known as "restenosis". This phenomenon is due to vessel remodeling/recoil in case of no-stent strategy or, in case of stent employ, "neointimal proliferation" that consists in an excessive tissue proliferation in the luminal surface of the stent otherwise by a further new-occurring atherosclerotic process called "neoatherosclerosis". The exact incidence of in-stent restenosis (ISR) is not easy to determine caused by different clinical, angiographic and operative factors...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27848221/mechanical-properties-of-high-entropy-alloy-al0-1cocrfeni-for-peripheral-vascular-stent-application
#4
Karthik Alagarsamy, Aleksandra Fortier, Mageshwari Komarasamy, Nilesh Kumar, Atif Mohammad, Subhash Banerjee, Hai-Chao Han, Rajiv S Mishra
High entropy alloys (HEAs) are new class of metallic materials with five or more principal alloying elements. Due to this distinct concept of alloying, the HEAs exhibit unique properties compared to conventional alloys. The outstanding properties of HEAs include increased strength, superior wear resistance, high temperature stability, increased fatigue properties, good corrosion, and oxidation resistance. Such characteristics of HEAs have generated significant interest among the scientific community. However, their applications are yet to be explored...
December 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27843185/drug-eluting-stents-to-evolve-or-dissolve
#5
REVIEW
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
https://www.readbyqxmd.com/read/27836296/long-term-comparative-effectiveness-of-paclitaxel-eluting-and-everolimus-eluting-stents-in-new-york
#6
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVE: First generation paclitaxel-eluting stents (PES) and second generation everolimus-eluting stents (EES) were approved for use in percutaneous coronary interventions (PCIs) in 2004 and 2008, respectively. However, relative long-term outcomes of PES vs EES in real practice remain unclear. We sought to determine the long-term comparative effectiveness of PES vs EES using New York State (NYS) cardiac registries and to assess long-term outcomes of PES vs ZES in six "off-label" and two "high-risk" patient subgroups...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27832467/second-generation-drug-eluting-stents-in-the-elderly-patients-with-acute-coronary-syndrome-the-in-hospital-and-12-month-follow-up-of-the-all-comer-registry
#7
Wojciech Wańha, Damian Kawecki, Tomasz Roleder, Beata Morawiec, Sylwia Gładysz, Adam Kowalówka, Tomasz Jadczyk, Barbara Adamus, Tomasz Pawłowski, Grzegorz Smolka, Maciej Kaźmierski, Andrzej Ochała, Ewa Nowalany-Kozielska, Wojciech Wojakowski
BACKGROUND: Katowice-Zabrze registry provides data that can be used to evaluate clinical outcomes of percutaneous coronary interventions in elderly patients (≥70 y/o) treated with either first- (DES-I) or second-generation (DES-II) drug-eluting stents (DES). METHODS: The registry consisted of data from 1916 patients treated with coronary interventions using either DES-I or DES-II stents. For our study, we defined patients ≥70 years of age as elderly. We evaluated any major adverse cardiac and cerebral events (MACCE) at 12-month follow-up...
November 10, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27830452/fabrication-of-self-expandable-niti-thin-film-devices-with-micro-electrode-array-for-bioelectric-sensing-stimulation-and-ablation
#8
Christoph Bechtold, Rodrigo Lima de Miranda, Christoph Chluba, Eckhard Quandt
Self-expandable medical devices provide mechanical functionality at a specific location of the human body and are viable for minimal invasive procedures. Besides radiopaque markers and drug-eluting coatings, next generation self-expandable devices can be equipped with additional functionality, such as conductive and flexible electrodes, which enables chronic recording of bioelectrical signals, stimulating or ablating tissue. This promises new therapeutic options in various medical fields, among them in particular neuromodulation (e...
December 2016: Biomedical Microdevices
https://www.readbyqxmd.com/read/27798056/computational-modelling-for-congenital-heart-disease-how-far-are-we-from-clinical-translation
#9
REVIEW
Giovanni Biglino, Claudio Capelli, Jan Bruse, Giorgia M Bosi, Andrew M Taylor, Silvia Schievano
Computational models of congenital heart disease (CHD) have become increasingly sophisticated over the last 20 years. They can provide an insight into complex flow phenomena, allow for testing devices into patient-specific anatomies (pre-CHD or post-CHD repair) and generate predictive data. This has been applied to different CHD scenarios, including patients with single ventricle, tetralogy of Fallot, aortic coarctation and transposition of the great arteries. Patient-specific simulations have been shown to be informative for preprocedural planning in complex cases, allowing for virtual stent deployment...
October 25, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27797464/bioresorbable-vascular-scaffolds-for-the-treatment-of-coronary-artery-disease-clinical-outcomes-from-randomized-controlled-trials
#10
David G Rizik, James B Hermiller, Dean J Kereiakes
The permanent metal prosthesis common to bare metal stents (BMS) as well as both first- and second-generation drug-eluting stents (DES) following treatment of coronary artery disease represents a long-lasting substrate for late adverse coronary events including restenosis, thrombosis, and neoatherosclerosis. Following resorbtion, bioresorbable scaffolds (BRS) may eliminate this nidus and improve late outcomes through restoration of the vessel to more normal vascular structure and function. BRS represents a single platform which incorporates the mechanical features of metallic stents to provide safe and effective revascularization, suppression of restenosis and prevention of constrictive remodeling with long-term restoration of the treated vessel to a more natural state...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27797462/paving-the-way-to-a-bioresorbable-technology-development-of-the-absorb-brs-program
#11
Laura E Leigh Perkins, Mary Beth Kossuth, Julia C Fox, Richard J Rapoza
Bioresorbable scaffolds (BRS) combine attributes of the preceding generations of percutaneous coronary intervention (PCI) devices with new technologies to result in a novel therapy promoted as being the fourth generation of PCI. By providing mechanical support and drug elution to suppress restenosis, BRS initially function similarly to drug eluting stents. Thereafter, through their degradation, BRS undergo a decline in radial strength, allowing a gradual transition of mechanical function from the scaffold back to the artery in order to provide long term effectiveness similar to balloon angioplasty...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27797459/the-unmet-needs-how-future-technologies-will-address-current-limitations-of-bioresorbable-scaffold-technology
#12
Alexandre Abizaid, J Ribamar Costa
First-generation bioresorbable scaffolds (BRS), represented by the three marked-approved devices (Absorb BVS 1.1, DESolve NX, and DREAMS) have demonstrated, in low to moderate angiographic scenarios, similar efficacy to current generation metallic drug-eluting stents. However, a trend toward more device thrombosis have been observed, especially when the scaffolds are used in off-label situations. Among the main shortcomings of this novel technology, we highlight: (1) Increased strut thickness (≥150 μm) and crossing profile; (2) low resistance to overexpansion; (3) lack of radiopacity, and; (4) special storage requirements...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27792992/a-review-of-the-coronary-applications-of-the-drug-coated-balloon
#13
REVIEW
Damon Jackson, David Tong, Jamie Layland
The drug coated balloon (DCB) platform offers several theoretical benefits over stent-based technologies. It allows the homogenous transfer of an anti-proliferative drug to reduce neo-intimal hyperplasia whilst potentially maintaining normal vessel anatomy and function. They also avoid the introduction of an additional stent layer in the context of in-stent restenosis. The data pertaining to the treatment of de-novo coronary disease still favors the new generation of drug eluting stents. DCB may, however, have a role in the context of challenging coronary anatomy and small vessel disease where results with stent insertion are poor...
September 16, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27792651/comparison-of-vascular-responses-following-new-generation-biodegradable-and-durable-polymer-based-drug-eluting-stent-implantation-in-an-atherosclerotic-rabbit-iliac-artery-model
#14
Gaku Nakazawa, Sho Torii, Takeshi Ijichi, Hirofumi Nagamatsu, Yohei Ohno, Fumi Kurata, Ayako Yoshikawa, Masataka Nakano, Norihiko Shinozaki, Fuminobu Yoshimachi, Yuji Ikari
BACKGROUND: Incomplete endothelialization is the primary substrate of late stent thrombosis; however, recent reports have revealed that abnormal vascular responses are also responsible for the occurrence of late stent failure. The aim of the current study was to assess vascular response following deployment of biodegradable polymer-based Synergy (Boston Scientific) and Nobori (Terumo) drug-eluting stents and the durable polymer-based Resolute Integrity stent (Medtronic) in an atherosclerotic rabbit iliac artery model...
October 19, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27784884/second-vs-first-generation-drug-eluting-stents-in-complex-lesions-subsets-3-years-follow-up-of-eraci-iv-study
#15
Alfredo E Rodriguez, Omar Santaera, Miguel Larribau, Ricardo Sarmiento, Carlos Haiek, Juan F Del Pozo, Hernan Pavlovsky, Alfredo M Rodriguez-Granillo
BACKGROUND: Although percutaneous coronary intervention (PCI) with first-generation drug-eluting stents (DES-1) did not show a benefit in terms of death rate and myocardial infarction (MI) compared to bypass surgery (coronary artery bypass graft [CABG]), DES platforms have seen a remarkable improvement in the last few years, and a significant increase in their safety and efficacy was observed in randomized controlled trials and observational studies in comparison with DES-1 in patients with coronary artery disease (CAD)...
February 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27773393/are-all-stents-equal-need-for-scoring-system-to-evaluate-stents
#16
EDITORIAL
Sundeep Mishra
Currently drug eluting stents (DES) have reached a high degree of sophistication where there seems very little scope of improvement. Even so every year or so there is some advancement in technology and a new version is released, which is claimed to be a new generation (rather than pipeline innovation). It is really important to define what pipeline extension is and what is new innovation (generation)? This classification would not only be useful from regulatory perspective but also determining the true value of a product allowing for a correct pricing, which should ideally be able to mark-up for a real innovation...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27744039/effects-of-intravascular-ultrasound-guided%C3%A2-versus-angiography-guided-new-generation-drug-eluting-stent-implantation-meta-analysis-with-individual-patient-level-data%C3%A2-from%C3%A2-2-345%C3%A2-randomized-patients
#17
Dong-Ho Shin, Sung-Jin Hong, Gary S Mintz, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: The aim of this study was to evaluate the clinical usefulness of intravascular ultrasound (IVUS)-guided new-generation drug-eluting stent (DES) implantation using a meta-analysis of individual patient-level data from randomized trials. BACKGROUND: Published randomized trials that compare IVUS-guided versus angiography-guided new-generation DES implantation are scarce. METHODS: Searches of the MEDLINE, Embase, and Cochrane databases were performed to find randomized trials that compared IVUS-guided versus angiography-guided new-generation DES implantation...
October 6, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27725334/-metallic-ureteral-stents-present-and-future
#18
E Morcillo, I Fernández, M Pamplona, F M Sánchez-Margallo, F Soria
The management of ureteral obstruction of malignant origin or complicated benign obstruction continues to be a challenge for the urological community. In this sense, the use of metallic stents could be considered a useful alternative to the conventional drainage techniques, because it accomplishes the resolution of obstruction in a single procedure, without external diversions and without the adverse effects of current diversions. Another important advantage they offer is that they do not need replacement as frequently as double J catheters or nephrostomy tubes require...
October 2016: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/27718756/drug-eluting-balloons-in-coronary-interventions-the-quiet-revolution
#19
Fernando Alfonso, Marcos García-Guimarães, Gonzalo Navarrete, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Fernando Rivero, Bernardo Cortese
Drug-eluting balloons (DEB) may be considered as a "quiet revolution" in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES)...
October 8, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27715344/pharmacokinetics-and-pharmacodynamics-of-ticagrelor-in-the-treatment-of-cardiac-ischemia
#20
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
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