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Scaffold stent

Yohei Sotomi, Pannipa Suwannasom, Patrick W Serruys, Yoshinobu Onuma
The advent of intracoronary stents greatly increased the safety and applicability of percutaneous coronary interventions. One of the drawbacks of drug eluting stents (DES) is the increased risk of late and very late stent thrombosis (ST). The risk of ST after the DES implantation were anticipated to be solved with the advent of fully biodegradable scaffolds which offers the possibility of transient scaffolding of the vessel to prevent acute vessel closure and recoil while also transiently eluting an antiproliferative drug to counteract the constrictive remodeling and excessive neointimal hyperplasia...
October 25, 2016: EuroIntervention
Lorenzo Azzalini, Gennaro Giustino, Soledad Ojeda, Antonio Serra, Alessio La Manna, Hung Q Ly, Barbara Bellini, Susanna Benincasa, Jorge Chavarría, Livia L Gheorghe, Giovanni Longo, Eligio Miccichè, Guido D'Agosta, Fabien Picard, Manuel Pan, Corrado Tamburino, Azeem Latib, Mauro Carlino, Alaide Chieffo, Antonio Colombo
BACKGROUND: There is little evidence regarding the efficacy and safety of bioresorbable scaffolds (BRS) for the percutaneous treatment of chronic total occlusions. METHODS AND RESULTS: We performed a multicenter registry of consecutive chronic total occlusion patients treated with BRS (Absorb; Abbott Vascular) and second-generation drug-eluting stents (DES) at 5 institutions. Long-term target-vessel failure (a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target-lesion revascularization) was the primary end point...
October 2016: Circulation. Cardiovascular Interventions
Kateki Vinod, Steven J Gedde
PURPOSE OF REVIEW: This article reviews recent studies evaluating the efficacy and complication profiles of novel glaucoma procedures promoting aqueous outflow. RECENT FINDINGS: Literature from the 2015 to 2016 review period includes abundant data regarding new and emerging glaucoma procedures. Notable findings from recent randomized clinical trials include titratability of intraocular pressure with multiple trabecular microbypass stents (iStent; Glaukos, Laguna Hills, California, USA) and greater reduction in intraocular pressure and medication usage following intracanalicular scaffolding (Hydrus Microstent; Ivantis Inc...
October 19, 2016: Current Opinion in Ophthalmology
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
Douglas R Marques, Luís A L Dos Santos, Marie A O'Brien, Sarah H Cartmell, Julie E Gough
The polymeric blend of poly (lactic-co-glycolic acid) (PLGA) and polyisoprene (PI) has recently been explored for application as stents for tracheal stenosis and spring for the treatment of craniosynostosis. From the positive results presented in other biomedical applications comes the possibility of investigating the application of this material as scaffold for tissue engineering (TE), acquiring a deeper knowledge about the polymeric blend by exploring a new processing technique while attending to the most fundamental demands of TE scaffolds...
October 6, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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
Soumya Mukherjee, Arun Chandran, Anil Gopinathan, Mani Putharan, Tony Goddard, Paul R Eldridge, Tufail Patankar, Hans-Christean Nahser
OBJECTIVE The goal of this study was to assess the safety and feasibility of PulseRider, a novel endovascular stent, in the treatment of intracranial bifurcation aneurysms with wide necks. The authors present the initial results of the first 10 cases in which the PulseRider device was used. METHODS Patients whose aneurysms were intended to be treated with the PulseRider device at 2 institutions in the United Kingdom were identified prospectively. Patient demographics, procedural details, immediate neurological and clinical status, and immediate angiographic outcomes and 6-month clinical and imaging follow-up were recorded prospectively...
September 30, 2016: Journal of Neurosurgery
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
Marc Bosiers, Koen Deloose, Joren Callaert, Patrick Peeters, Michel Bosiers
Endovascular techniques have improved markedly over the past several decades. Plain old balloon angioplasty can only reach patencies around 40% after 1 year. Scaffolding stents have resulted in improved short-term results but encountered limitations for longer-term durability. With the introduction of drug-eluting technologies the process of intimal hyperplasia might be slowed, resulting in improved long-term patency results. At first, limus-eluting technologies were not able to transfer the enthusiasm from the coronaries to the infrainguinal vascular bed...
December 2016: Journal of Cardiovascular Surgery
Qian Wang, Gang Fang, Yinghong Zhao, Guohui Wang, Tao Cai
Poly-L-lactide Acid (PLLA), as a credible biodegradable polymer-based material, can provide a promising amount of degradation time for vessel remodeling. Served as a sort of reliable intravascular implants, PLLA stents are expected to provide sufficient scaffolding to the target arteries without generating too much recoil after deployment. Besides, the stress and strain distribution should be as homogeneous as possible, and the stent conformability in fitting to the nature curvature of the vessels needs to be guaranteed...
August 31, 2016: Journal of the Mechanical Behavior of Biomedical Materials
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
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