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Intravascular stent

Nimit C Shah, Peter D O'Kane, Jehangir N Din
Very late stent recoil is a rare albeit recognized phenomenon leading to subsequent in-stent restenosis. Angiography alone may not be adequate in making the diagnosis, and intravascular imaging with optical coherence tomography (OCT) is far superior in confirming the diagnosis and guiding subsequent management. We describe a case with interesting coronary angiogram and OCT images demonstrating very rare diagnosis of the late stent collapse. These images provide a valuable insight into a novel mechanism responsible for late target lesion failure...
September 2016: Indian Heart Journal
Arindam Pande, Soumya Patra, Manabhanjan Jena, Rabin Chakraborty
Thirty-nine year male had a history of road traffic accident with polytrauma. At emergency room he started having chest pain with ventricular tachycardia. He was subsequentially diagnosed with right coronary artery dissection secondary to blunt trauma which is an extremely rare cause of inferior wall myocardial infarction. After some dilemmas, he was ultimately treated with intravascular ultrasound guided coronary angioplasty with stenting and had an uneventful recovery.
September 2016: Indian Heart Journal
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
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
Hirohiko Ando, Akihiro Suzuki, Shinichiro Sakurai, Soichiro Kumagai, Akiyoshi Kurita, Katsuhisa Waseda, Hiroaki Takashima, Tetsuya Amano
Although late restenosis is one of the long-term complications of stent implantation, its pathogenesis has not been fully elucidated. For consecutive patients who developed in-stent restenosis (ISR) after stent implantation, integrated backscatter (IB) intravascular ultrasound was performed for ISR lesions. The tissue characteristics of neointima within the stented segment were compared between lesions with early restenosis and those with late restenosis. Of 73 ISR lesions arising after sirolimus-eluting stent (SES; n = 25) or bare-metal stent (BMS; n = 48) implantation, early and late restenosis were documented in 52 and 21 lesions, respectively...
October 11, 2016: Heart and Vessels
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
Shinsuke Mori, Keisuke Hirano, Yoshiaki Ito, Masahiro Yamawaki, Motoharu Araki, Norihiro Kobayashi, Hideyuki Takimura, Yasunari Sakamoto, Masakazu Tsutsumi, Takuro Takama, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai
AIM: To investigate the relationship between intravascular ultrasound (IVUS) findings and restenosis after stent implantation for long occlusive femoropopliteal (FP) lesions using the intraluminal approach. METHODS: This was a single-center retrospective study of 45 patients (49 lesions) with de novo long occlusive FP lesions treated with bare metal stents implanted using the intraluminal approach under IVUS guidance from April 2007 to December 2014. All patients were followed up at least 12 months...
October 1, 2016: Journal of Atherosclerosis and Thrombosis
Jae-Sik Jang, Ho-Cheol Shin, Jong Seok Bae, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Kyoung-Im Cho, Bo-Hyun Kim, Yong Hyun Park, Hyung-Gon Je, Dong-Soo Kim
BACKGROUND AND OBJECTIVES: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention frequently results in unnecessary stenting due to the low positive predictive value of IVUS-derived minimal lumen area (MLA) for identification of functionally significant coronary stenosis. We appraised the diagnostic accuracy of IVUS-derived MLA compared with the fractional flow reserve (FFR) to assess intermediate coronary stenosis. SUBJECTS AND METHODS: We searched MEDLINE and Cochrane databases for studies using IVUS and FFR methods to establish the best MLA cut-off values to predict significant non-left main coronary artery stenosis...
September 2016: Korean Circulation Journal
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
J Ribamar Costa, Daniel Chamié, Alexandre A C Abizaid, Expedito Ribeiro, George C Meireles, Maurício Prudente, Carlos A Campos, Juliana P Castro, Ricardo Costa, Pedro A Lemos
We sought to compare, by means of IVUS and OCT imaging, the performance of a novel sirolimus-eluting drug-eluting stent (DES) with biodegradable polymer (Inspiron™) to the Biomatrix™ DES. From the DESTINY trial, a total of 70 randomized patients (2:1) were enrolled in the IVUS substudy (Inspiron™, n = 46; Biomatrix™: n = 20) while 25 patients were evaluated with OCT (Inspiron™, n = 19; Biomatrix™: n = 06) at 9-month follow-up. The main endpoints were % of neointimal tissue obstruction (IVUS) and neointimal stut coverage (OCT) at 9 months...
October 6, 2016: International Journal of Cardiovascular Imaging
Hung-Hao Lee, Po-Chao Hsu, Wen-Hsien Lee, Chun-Yuan Chu, Ho-Ming Su, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Cheng-An Chiu
A 66-year-old male was treated percutaneously for a bifurcation lesion of the left anterior descending coronary artery by provisional stenting using the jailed wire technique. After successfully stenting the main branch, retraction of the looped main branch guidewire was impossible. After using an intravascular ultrasound we discovered the guidewire was entangled with a stent strut. Thereafter, the proximal stent elongated after retraction. With the support of an over-the-wire microcatheter, we finally pulled out the entrapped guidewire...
September 2016: Acta Cardiol Sin
Sebastian Kufner, Erion Xhepa, Christoph Lutter, Salvatore Cassese, Michael Joner
Despite the high anti-restenotic efficacy of contemporary percutaneous interventional techniques, a substantial number of patients who undergo percutaneous coronary intervention (PCI) still present with restenosis. Despite iterations of devices- from plain balloon angioplasty to bare metal stenting (BMS) to drug-eluting stent (DES) therapy - have granted a progressive decline in the rate of this complication, in-stent restenosis remains a critical issue encountered in clinical practice. Owing to the overall increase in the use of DES, the number of patients presenting with DES restenosis is not insignificant in absolute terms...
September 27, 2016: Minerva Cardioangiologica
Ahmad S Hussain, Namath S Hussain
Intravascular ultrasound (IVUS) can provide valuable information regarding endoluminal morphology. We present the first description of IVUS-guided intracranial and extracranial carotid artery stent placement for arterial dissection. A 41-year-old female with a sudden-onset headache and blurred vision underwent a computed tomography (CT) angiogram imaging that revealed bilateral carotid artery dissections (BCAD) and a left vertebral artery dissection (VAD). Endovascular treatment (EVT) of a long segment right carotid artery dissection (CAD) was performed employing two Carotid WALLSTENT™ Monorails™ (8 x 36 mm, 10 x 31 mm) (Boston Scientific, Marlborough, MA)...
2016: Curēus
Danyal A Siddiqui, Shiril Sivan, Jason D Weaver, Matthew Di Prima
Metallic medical devices such as intravascular stents can undergo fretting damage in vivo that might increase their susceptibility to pitting corrosion. As a result, the US Food and Drug Administration has recommended that such devices be evaluated for corrosion resistance after the devices have been fatigue tested in situations where significant micromotion can lead to fretting damage. Three common alloys that cardiovascular implants are made from [MP35N cobalt chromium (MP35N), electropolished nitinol (EP NiTi), and 316LVM stainless steel (316LVM)] were selected for this study...
September 23, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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
Donghoon Choi
UNLABELLED: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
Soon Jun Hong, Chul Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Seung-Ho Hur, Cheol Woong Yu, Seung-Jin Lee, Cheol Ung Choi, Je Sang Kim, Jung-Han Yoon, Young Joon Hong, Jae-Woong Choi, Seung-Hyuk Choi, Yangsoo Jang, Do-Sun Lim
AIMS: At present no proven standard treatment for drug-eluting stent (DES) restenosis is available, and the efficacy and safety of everolimus-eluting stent (EES) and zotarolimus-eluting stent (ZES) for DES restenosis are limited. The purpose of this prospective, randomized 9-month intracoronary ultrasound (IVUS) and 3-year clinical follow-up study was to compare the effects of EESs and ZESs on neointima volume and major adverse cardiovascular events (MACEs) such as death, myocardial infarction (MI), target lesion revascularization (TLR) and stent thrombosis in DES restenosis patients...
September 15, 2016: European Heart Journal
Masakazu Nagaoka, Naoko Tsumuraya, Masaki Nie, Yuji Ikari
The occurrence of allergy to iodinated contrast in certain patients may prevent the use of percutaneous coronary intervention (PCI) in such cases. We present a 53-year-old male with a history of allergic reaction to iodinated contrast who successfully underwent intravascular ultrasound (IVUS) guided PCI. Stent size was determined based on IVUS. After PCI, stent expansion and a lack of edge dissection or incomplete apposition were confirmed by IVUS. Thus, PCI without contrast injection under IVUS may be feasible in selected patients with allergy to iodinated contrast...
2016: Tokai Journal of Experimental and Clinical Medicine
I V Buzaev, V V Plechev, I E Nikolaeva, I G Zagitov, B A Oleĭnik
A series of studies demonstrated comparability of the incidence rate of major adverse cardiac events (MACE) in the middle-term postoperative period following implantation of last-generation drug-coated stents and biodegradable intravascular scaffolds. It was noted observed that these complications may be associated with malposition and inadequate inappropriate preparation of the lesion. We carried out a total of 16 percutaneous coronary interventions (PCI) with implantation of absorbable vascular scaffolds (Absorb, Abbott Vascular) under the guidance of optical coherent tomography...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Soo-Jin Kang, Gary S Mintz
No abstract text is available yet for this article.
August 2016: Journal of Thoracic Disease
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