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Scaffold stent

Marina Dias-Neto, Manuela Matschuck, Yvonne Bausback, Ursula Banning-Eichenseher, Sabine Steiner, Daniela Branzan, Holger Staab, Ramon L Varcoe, Dierk Scheinert, Andrej Schmidt
PURPOSE: To report midterm results of the "pave-and-crack" technique to facilitate safe and effective scaffolding of heavily calcified femoropopliteal lesions in preparation for delivery of a Supera interwoven stent. METHODS: Data were collected retrospectively on 67 consecutive patients (mean age 71±8 years; 54 men) treated with this technique between November 2011 and February 2017 at a single center. A third (22/64, 34%) of the patients had critical limb ischemia (CLI)...
March 1, 2018: Journal of Endovascular Therapy
Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Ehsan Mostaed, Malgorzata Sikora-Jasinska, Jaroslaw W Drelich, Maurizio Vedani
The search for biodegradable metals with mechanical properties equal or higher to those of currently used permanent biomaterials, such as stainless steels, cobalt chromium and titanium alloys, desirable in vivo degradation rate and uniform corrosion is still an open challenge. Magnesium (Mg), iron (Fe) and zinc (Zn)-based alloys have been proposed as biodegradable metals for medical applications. Over the last two decades, extensive research has been done on Mg and Fe. Fe-based alloys show appropriate mechanical properties, but their degradation rate is an order of magnitude below the benchmark value...
March 9, 2018: Acta Biomaterialia
Giuseppe Tarantini, Giulia Masiero, Alberto Barioli, Valeria Paradies, Georgios Vlachojannis, Paola Tellaroli, Bernardo Cortese, Gaetano di Palma, Attilio Varricchio, Alfonso Ielasi, Bruno Loi, Giuseppe Steffenino, Daisuke Ueshima, Marco Mojoli, Pieter Smits
BACKGROUND: Patients with small vessel disease (SVD) are at higher risk of adverse events after PCI compared to non-SVD patients. In this subset, the use of bioresorbable vascular scaffolds (BVS) has raised particular concern. OBJECTIVE: We aimed to compare outcomes of Absorb BVS versus a 2nd-generation metallic everolimus-eluting stents (EES) in the SVD setting, by pooling patients from three large, prospective studies. METHODS: Patients with SVD (reference vessel diameter ≤2...
March 7, 2018: Catheterization and Cardiovascular Interventions
Yohei Sotomi, Yoshinobu Onuma, Shengnan Liu, Taku Asano, Jeroen Eggermont, Yuki Katagiri, Rafael Cavalcante, Robbert J de Winter, Joanna J Wykrzykowska, Salvatore Brugaletta, Lorenz Räber, Manel Sabaté, Stephan Windecker, Jouke Dijkstra, Patrick W Serruys
AIMS: We aimed to assess possible difference of the neointimal quality after everolimus-eluting bioresorbable scaffold (BVS) implantation in comparison with cobalt chromium everolimus-eluting scaffold (CoCr-EES) by optical frequency domain imaging (OFDI). METHODS AND RESULTS: This study is a post-hoc analysis of TROFI II trial assessing neointimal quality 6-month after the implantation of BVS(N=82) and CoCr-EES(N=87) in STEMI patients. Neointimal light property analysis by OFDI full-automatically computed light attenuation, backscatter and light intensity for superficial and deep neointima...
February 27, 2018: EuroIntervention
Pei-Jiang Wang, Nicola Ferralis, Claire Conway, Jeffrey C Grossman, Elazer R Edelman
Polymer-based bioresorbable scaffolds (BRS) seek to eliminate long-term complications of metal stents. However, current BRS designs bear substantially higher incidence of clinical failures, especially thrombosis, compared with metal stents. Research strategies inherited from metal stents fail to consider polymer microstructures and dynamics--issues critical to BRS. Using Raman spectroscopy, we demonstrate microstructural heterogeneities within polymeric scaffolds arising from integrated strain during fabrication and implantation...
February 26, 2018: Proceedings of the National Academy of Sciences of the United States of America
Anne Venkata Ganeshkumar, Rushikesh Sambhaji Patil, Irfan Khan Hamid
BACKGROUND AND OBJECTIVE: Studies conducted across the world have reported that the rates of major adverse cardiac events (MACE) following the use of bioresorbable vascular scaffolds (BVS) are comparable to that noted with traditional drug eluting stents (DES). However, there is limited data on the immediate and medium-term clinical outcomes following the use of the Absorb BVS (Abbott Vascular, Santa Clara, SA) in the Indian context. This study was conducted to determine real-world evidence on the immediate and medium-term clinical outcomes in all patients undergoing percutaneous coronary intervention (PCI) with the Absorb BVS...
January 2018: Indian Heart Journal
Jonathan Brown, Caroline C O'Brien, Augusto C Lopes, Kumaran Kolandaivelu, Elazer R Edelman
Stent thrombosis is a major complication of coronary stent and scaffold intervention. While often unanticipated and lethal, its incidence is low making mechanistic examination difficult through clinical investigation alone. Thus, throughout the technological advancement of these devices, experimental models have been indispensable in furthering our understanding of device safety and efficacy. As we refine model systems to gain deeper insight into adverse events, it is equally important that we continue to refine our measurement methods...
February 9, 2018: Journal of Biomechanics
Daoyuan Si, Guohui Liu, Yaliang Tong, Yuquan He
RATIONALE: Inadequate stent expansion due to rigid calcified may result in restenosis lesions, but the available options are limited. PATIENT CONCERNS: We report a case via the trans-radial approach of the severely underexpanded freshly deployed stent due to heavily calcified plaques DIAGNOSES:: Coronary angiography revealed that there was no adequate expansion of the freshly deployed stent. INTERVENTIONS: Under the guide of intravascular ultrasound (IVUS), rotational atherectomy (RA) successfully ablated the stent layers and the protruding calcified plaque...
February 2018: Medicine (Baltimore)
Charles Nicolais, Vladimir Lakhter, Hafeez Ul Hassan Virk, Partha Sardar, Chirag Bavishi, Brian O'Murchu, Saurav Chatterjee
PURPOSE OF REVIEW: In-stent restenosis (ISR) is a complex disease process that became apparent shortly after the introduction of stents into clinical practice. This review seeks to define in-stent restenosis (ISR) as well as to summarize the major treatment options that have been developed and studied over the past two decades. RECENT FINDINGS: Recent developments in drug-coated balloons and bioresorbable vascular scaffolds have added new potential treatments for ISR...
February 12, 2018: Current Cardiology Reports
Luis Ortega-Paz, Salvatore Brugaletta, Manel Sabaté
Bioresorbable scaffolds (BRS) were introduced in clinical practice to overcome the long-term limitations of newer-generation drug-eluting stents. Despite some initial promising results of the Absorb BRS, safety concerns have led to the discontinuation of the commercialization of this device. Several retrospective studies have assessed the impact of the so-called Pre-dilation, Sizing and Post-dilation (PSP) technique concluding that an optimal PSP technique can improve clinical outcomes following BRS implantation...
February 6, 2018: Journal of Clinical Medicine
Yaling Han, Bo Xu, Guosheng Fu, Xiaozeng Wang, Kai Xu, Chongying Jin, Ling Tao, Lang Li, Yuqing Hou, Xi Su, Quan Fang, Lianglong Chen, Huiliang Liu, Bin Wang, Zuyi Yuan, Chuanyu Gao, Shenghua Zhou, Zhongwei Sun, Yanyan Zhao, Changdong Guan, Gregg W Stone
OBJECTIVES: The authors sought to evaluate the safety and effectiveness of the NeoVas bioresorbable scaffold (BRS) compared with metallic drug-eluting stents. BACKGROUND: BRS have the potential to improve very late outcomes compared with metallic drug-eluting stents, but some BRS have been associated with increased rates of device thrombosis before complete bioresorption. NeoVas is a new poly-l-lactic acid BRS that elutes sirolimus from a poly-D, l-lactide coating...
February 12, 2018: JACC. Cardiovascular Interventions
Frédéric Maes, Olivier Costerousse, Tomas Cieza, Mélaine Henry, Jean-Pierre Déry, Gérald Barbeau, Robert Delarochellière, Jean-Michel Paradis, Eric Larose, Can M Nguyen, Charles Pirlet, Rosaire Mongrain, Olivier F Bertrand
BACKGROUND: Whether polymeric bioresorbable vascular scaffolds (BVS) implantation with transradial approach is feasible and safe is unknown. We compared the feasibility and safety of the transradial approach for BVS delivery with metallic drug-eluting stents (DES). METHODS: We identified 118 consecutive patients who underwent BVS implantation and we compared 30-days and 1-year results with 118 matched patients with DES. Patients were matched for age, sex, risk factors and clinical indication...
January 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Qing Ling, Tao Wang, Xiao Yu, Shao-Gang Wang, Zhang-Qun Ye, Ji-Hong Liu, Sen-Wu Yang, Xiong-Bo Zhu, Jin Yu
We constructed a UC-VEGF-SMC three dimensional (3D) scaffold to explore its effect on blood vessel regeneration and bladder repair function in a rabbit model with bladder injury. Rabbit adipose tissue-derived stem cells (ADSCs) were cultured to construct pluripotent stem cell systems that can be induced to differentiate into urothelial cells (UCs) and smooth muscle cells (SMCs). Reverse transcriptase-polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, MTT assay and HE staining were used in our study...
March 2017: Journal of Biomedical Nanotechnology
Mostafa Elwany, Gaetano Di Palma, Bernardo Cortese
Coronary lesions at bifurcation sites are frequent and still remain a challenging subset for the interventional cardiologist. Although in the last years the provisional stenting technique has shown more consistent results, coronary bifurcation interventions still share a worse procedural success rate and increased rates of mid- and long-term cardiac events. Most of the dedicated devices proposed in the last few years have failed to show improved results when compared with standard devices. The broader use of imaging techniques, such as intravascular ultrasound and optical coherence tomography, lead to a better understanding of the real anatomy of bifurcations and has shown to be a great tool for percutaneous coronary intervention optimization...
January 26, 2018: Future Cardiology
Constantin von Zur Mühlen, Simon Reiss, Axel J Krafft, Lisa Besch, Marius Menza, Manfred Zehender, Timo Heidt, Alexander Maier, Thomas Pfannebecker, Andreas Zirlik, Jochen Reinöhl, Peter Stachon, Ingo Hilgendorf, Dennis Wolf, Philipp Diehl, Tobias Wengenmayer, Ingo Ahrens, Christoph Bode, Michael Bock
BACKGROUND: Evaluation of recurrent angina after percutaneous coronary interventions is challenging. Since bioresorbable vascular scaffolds (BVS) cause no artefacts in magnetic resonance imaging (MRI) due to their polylactate-based backbone, evaluation of vascular patency by MRI might allow for non-invasive assessment and triage of patients with suspected BVS failure. METHODS: Patients with polylactate-based ABSORB-BVS in proximal coronary segments were examined with 3 Tesla MRI directly (baseline) and one year after implantation...
2018: PloS One
Elisabetta Moscarella, Akihito Tanaka, Alfonso Ielasi, Bernardo Cortese, Sebastian Coscarelli, Maria Carmen De Angelis, Davide Piraino, Azeem Latib, Giulietta Grigis, Renatomaria Bianchi, Dario Buccheri, Paolo Calabrò, Maurizio Tespili, Pedro Silva Orrego, Antonio Colombo, Attilio Varricchio
OBJECTIVES: to compare the 1-year outcome between bioresorbable vascular scaffold (BVS), everolimus-eluting stent (EES), and drug-eluting balloon (DEB) for in-stent restenosis (ISR) treatment. BACKGROUND: BVS has been proposed as alternative for ISR treatment. To date a direct comparison between BVS and DES or DEB for ISR treatment is lacking. METHODS: We retrospectively analyzed all ISR lesions treated with BVS, DEB, and EES from January 2012 to December 2014...
January 22, 2018: Catheterization and Cardiovascular Interventions
Daisuke Taniguchi, Keitaro Matsumoto, Tomoshi Tsuchiya, Ryusuke Machino, Yosuke Takeoka, Abdelmotagaly Elgalad, Kiyofumi Gunge, Katsunori Takagi, Yasuaki Taura, Go Hatachi, Naoto Matsuo, Naoya Yamasaki, Koichi Nakayama, Takeshi Nagayasu
OBJECTIVES: Currently, most of the artificial airway organs still require scaffolds; however, such scaffolds exhibit several limitations. Alternatively, the use of an autologous artificial trachea without foreign materials and immunosuppressants may solve these issues and constitute a preferred tool. The rationale of this study was to develop a new scaffold-free approach for an artificial trachea using bio-3D printing technology. Here, we assessed the circumferential tracheal replacement using scaffold-free trachea-like grafts generated from isolated cells in an inbred animal model...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
Diego A Arroyo, Sara Schukraft, Zacharenia Kallinikou, Jean-Christophe Stauffer, Gérard Baeriswyl, Jean-Jacques Goy, Mario Togni, Stéphane Cook, Serban Puricel
Aims: To compare endothelium-dependent vasomotor function and vascular healing 15 months after implantation of two new-generation drug-eluting stents and biovascular scaffolds (BVS). Methods and results: A total of 28 patients previously treated with a SYNERGY stent (bioabsorbable polymer everolimus-eluting stents (BP-EES)), a PROMUS stent (persistent polymer everolimus-eluting stents (PP-EES)) or an ABSORB (BVS) underwent control coronary angiography, 15 months after implantation, coupled with optical coherence tomography imaging and supine bicycle exercise...
2018: Open Heart
Laura S Kerkmeijer, Erhan Tenekecioglu, Joanna J Wykrzykowska
The percutaneous coronary intervention has undergone rapid evolution over the last 40 years and has become one of the most widely performed medical procedures. The introduction of intracoronary stents improved the safety and efficacy of percutaneous coronary intervention. But with the advent of stenting, a new potentially fatal enemy emerged: stent thrombosis. Ever since, adjunct pharmacological therapy, stent technique and technology have been adjusted to reduce the risk of stent thrombosis. The aim of the present article is to provide an overview of past, present and future aspects of percutaneous intervention in relation to stent thrombosis...
January 15, 2018: Polish Archives of Internal Medicine
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