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instent restenosis

Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD). The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty with or without a drug coated balloon (DCB), atherectomy (rotational, directional, orbital or laser), and stenting. The development of next generation peripheral stents and drug-coated stents have led to the improved treatment of complex superficial femoral artery (SFA) lesions, and consequently increased their usage...
August 2017: Journal of Cardiovascular Surgery
Mohammad Alkhalil, Christopher P Conlon, Houman Ashrafian, Robin P Choudhury
A 54-year-old black African woman, 22 years human immunodeficiency virus (HIV)-positive, presented with an acute coronary syndrome. She was taking two nucleoside reverse transcriptase inhibitors and two protease inhibitors. Viral load and CD4 count were stable. Angiography revealed a right coronary artery lesion, which was treated with everolimus eluting stent. She also underwent balloon angioplasty to the first diagonal. She re-presented on three different occasions and technically successful coronary intervention was performed...
February 16, 2017: World Journal of Clinical Cases
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
Wei-Chieh Lee, Yen-Nan Fang, Chih-Yuan Fang, Chien-Jen Chen, Cheng-Hsu Yang, Hon-Kan Yip, Chi-Ling Hang, Chiung-Jen Wu, Hsiu-Yu Fang
BACKGROUND: Drug-eluting balloons (DEBs) have emerged as a potential alternative to current treatments of instent restenosis (ISR). The study aims to investigate the clinical outcomes of a DEB angioplasty to treat bare-metal stent (BMS) ISR and drug-eluting stent (DES) ISR at 1-year clinical follow-up period. METHODS: Between November 2011 and December 2014, 312 patients were diagnosed with coronary artery ISR at our hospital. A total of 426 coronary ISR lesions were treated with DEBs...
October 2016: Journal of Interventional Cardiology
Mei Mei Lin, Ji Hung Wang
We describe a patient who underwent coronary artery bypass grafting (CABG) surgery with the presentation of acute coronary syndrome (ACS). The diagnostic coronary angiogram showed acute thrombotic and occluded saphenous vein graft (SVG) and proximal right coronary artery (RCA) drug eluting stent (DES) instent restenosis (ISR) with chronic total occlusion (CTO). Our strategy was to recanalize the native left circumflex coronary artery (LCx) CTO instead of SVG or RCA instent CTO. After heparinization for 5 days, the LCx antegrade approach and the retrograde approach from left anterior descending coronary artery (LAD) septal branches were first attempted but failed, and the LCx CTO was successfully revascularized retrogradely via the acute thrombotic SVG without an embolic protection device (EPD)...
May 25, 2016: International Heart Journal
Leia Hee, Andrew Terluk, Liza Thomas, Andrew Hopkins, Craig P Juergens, Sidney Lo, John K French, Christian J Mussap
OBJECTIVES: The aims of this study were to evaluate clinical outcomes following PCI using SeQuent Please paclitaxel-coated balloons (PCB) of ISR and denovo lesions (DNL), in all-comer patients at Liverpool Hospital, Sydney, Australia. BACKGROUND: There have been promising results for PCI using drug-coated balloons; however, long-term data for clinical outcomes are lacking. METHODS: Baseline patient demographics, PCI procedural details, and clinical outcomes were collected...
February 15, 2017: Catheterization and Cardiovascular Interventions
Elena Z Golukhova, Marina V Grigorian, Mariya N Ryabinina, Naida I Bulaeva, Seth Fortmann, Victor L Serebruany
BACKGROUND: Despite recent advances in stent design and constantly improving protective pharmacological strategies, complications and adverse events following percutaneous coronary interventions (PCI) are still major factors influencing morbidity and mortality. Therefore, predicting secondary vascular occlusions represents an unmet medical need. OBJECTIVE: The aim of our study was to triage clinical and laboratory predictors of major adverse clinical events (MACE) following coronary stenting...
2015: Cardiology
Thomas Zeller, Aljoscha Rastan, Roland Macharzina, Ulrich Beschorner, Elias Noory
Introducing anti-restenotic drug-based treatment modalities in femoropopliteal interventions is the potential revolutionizing reperfusion treatment of peripheral artery disease. Durability of recanalization procedures using drug-coated balloons (DCB) and drug-eluting stents (DES) yields in excellent mid-term and long-term technical and clinical outcomes and may be cost saving on the long term as compared to traditional treatment modalities such as plain old balloon angioplasty (POBA) and bare metal nitinol stent implantation...
September 2015: Current Cardiology Reports
Paolo Angelini, Carlo Uribe, Jorge Monge, Jonathan M Tobis, MacArthur A Elayda, James T Willerson
OBJECTIVES: We attempted to characterize the anatomy, function, clinical consequences, and treatment of right-sided anomalous coronary artery origin from the opposite side (R-ACAOS). BACKGROUND: Anomalous aortic origin of a coronary artery is a source of great uncertainty in cardiology. A recent study by our group found that ACAOS had a high prevalence (0.48%) in a general population of adolescents. METHODS: Sixty-seven consecutive patients were diagnosed with R-ACAOS according to a new definition: ectopic right coronary artery (RCA) with an intramural proximal course...
August 2015: Catheterization and Cardiovascular Interventions
Şeref Ulucan, Ahmet Keser, Zeynettin Kaya, Hüseyin Katlandur, Hüseyin Özdil, Mustafa Bilgi, İsmail Ateş, Mehmet Sıddık Ülgen
BACKGROUND: The aim of the present study was to perform a preliminary evaluation of the potential association between platelet distribution width (PDW) and frequency of major adverse cardiovascular events (MACEs) development in an observational study of acute coronary syndrome (ACS) patients. METHODS: A total of 679 consecutive patients with ACS (498 (73.3%) males; mean age was 63.31±11.2 years; study population composed of 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) subjected to primary percutaneous coronary intervention with transradial approach (TRA) were retrospectively enrolled to the study...
January 2016: Heart, Lung & Circulation
Shmuel Chen, Chaim Lotan, Ronen Jaffe, Ronen Rubinshtein, Eyal Ben-Assa, Ariel Roguin, Boris Varshitzsky, Haim D Danenberg
OBJECTIVES: To evaluate initial and long term results of coronary perforation treatment with pericardial covered stent. BACKGROUND: Iatrogenic coronary perforation is a rare life threatening complication of percutaneous coronary interventions (PCI) occurring in 0.1-0.8% of cases. Covered stents are the mainstay of therapy for coronary perforation. However, polytetrafluoroethylene covered stents are bulky with limited flexibility and thus may not be easy to deliver in difficult anatomy...
September 2015: Catheterization and Cardiovascular Interventions
Zi-Liang Wang, Bu-Lang Gao, Tian-Xiao Li, Dong-Yang Cai, Liang-Fu Zhu, Wei-Xing Bai, Jiang-Yu Xue, Zhao-Shuo Li
PURPOSE: To investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70-99%) concurrent with contralateral vertebral artery atherosclerotic diseases. MATERIALS AND METHODS: Eighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent...
September 2015: European Journal of Radiology
J Alibegovic Zaza, S Zaza
The new generation drug eluting stents have improved the results of coronary angioplasty by reducing the rate of instent restenosis and stent thrombosis compared to earlier devices, due to the thinner stent struts and improved or bioresorbable polymers. But permanent metallic stent struts may have some long term harmful effects such as inducing late thrombosis, neoatherosclerosis, restenosis and also impairing vasomotion and endothelial function. This was the rationale for introducing bioresorbable stents which offer radial support to the artery during the period needed (scaffolding) and then disappear, (liberating the vessels and restoring its physiological vasomotion...
March 4, 2015: Revue Médicale Suisse
M El-Mourad, P Merveille, N Preumont
Since Gruentizg's first percutaneous transluminal ballon angioplasty in 1977 in Zurich, percuta. neous coronary intervention evolved significantly in order to overcome the numerous associated complications of each technique. Bare-metal stents (BMS) made their initial appearance followed by three generations of drug-eluting stents (DES). The use of bioabsorbable vascular scaffold stents (BVS) has become more frequent creating a temporary scaffold allowing healing of the endothelium within 2 years. In this article, we discuss the nomenclature of the main intravascular complications linked to percuta...
September 2014: Revue Médicale de Bruxelles
Irmak Durur-Subasi, Mecit Kantarci, Afak Durur-Karakaya, Adnan Okur
OBJECTIVE: In this study, we evaluated the utility of 16-slice MDCT (multidetector computed tomography) to assess stent patency after coronary artery stenting. MATERIALS AND METHODS: Retrospective ECG-gated CT-angiography using 16-slice MDCT was performed in 52 consecutive patients with coronary artery stents. Qualitative assessment of 61 coronary stent lumens by MDCT is reported, and the reasons preventing assessment were investigated. RESULTS: All non-assessable stents were non-assessable due to partial volume effects and metal artifacts...
April 2009: Eurasian Journal of Medicine
S Rekik, C Wehrlin, L Jacq, A Bellemain, F Bernasconi
Percutaneous coronary interventions of saphenous vein grafts are associated with an increased risk of periprocedural complications; among these, the rupture of the vein graft is probably the less common and the most dangerous; it is even more exceptional when it occurs on a stented portion of the graft. We report the case of a 75-year-old man who presented during a balloon angioplasty of intent restenosis of a saphenous vein graft a spectacular graft rupture at the level of the previously stented site and who was ultimately successfully treated with a covered stent...
November 2014: Annales de Cardiologie et D'angéiologie
Jin-tao Han, Xuan Li, Mun Zheng, Jun Fu, Chang-ming Wang, Guo-xiang Dong, Qing-yuan He
OBJECTIVE: To assess the safety and effectiveness of middle cerebral artery angioplasty in treatment of subcortical watershed infarcts (S-CWI) with moderate or severe disabilities. METHODS: From June 2011 to May 2012, 5 S-CWI patients (six lesions) with moderate or severe disabilities combining severe stenosis in Ipsilateral middle cerebral artery received middle cerebral artery angioplasty in Interventional Radiology and Vascular Surgery Department, Peking University Third Hospital...
August 18, 2014: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Ismail Dogu Kilic, Nikolaos Konstantinidis, Michele Pighi, Alessio Mattesini, Carlo Di Mario
The optimal management of instent restenosis has yet to be fully clarified. Drug eluting balloons are a popular strategy, but a new stent is preferred when dilatation gives a suboptimal result because of insufficient extrusion of neointimal tissue. There is concern for adding multiple permanent metallic layers to the vessel wall, especially in small vessels. The use of bioabsorbable vascular scaffolds appears an appealing alternative strategy, since it scaffolds the neointimal tissue without further adding metal struts to the vessel wall...
March 2015: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Klára Törő, Balázs Matlakovics, Ibolyka Dudás, Kinga Karlinger, Mátyás Kiss, Agnes Molnár, Agnes Nemeskéri
A careful post-mortem investigation is needed to determine the cause of death of patients bearing coronary stents and to describe complications of stent implantation. The main purpose of this study was to combine post mortem methods of CT angiography and corrosion cast preparation for the visualization of coronary stenoses, coronary stents, instent restenosis, and stent occlusion. Injection-corrosion method was combined with post-mortem MSCT angiography to characterize the pathomorphological changes after stent implantation in 6 male cadaver hearts...
September 2014: Legal Medicine
Grant C Sorkin, Travis M Dumont, Jorge L Eller, Maxim Mokin, L Nelson Hopkins, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Treatment of instent restenosis after carotid artery stenting because of circumferential or calcified lesions can be difficult and refractory to conventional balloon angioplasty. We describe the off-label use of a cardiac scoring balloon that was used for lesions refractory to angioplasty with other balloons. CASE DESCRIPTIONS: Two patients with a history of carotid artery stenting 6 and 8 years ago, presented with symptomatic carotid instent restenosis caused by circumferential and calcified lesions, respectively...
May 2014: Journal of Vascular and Interventional Neurology
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