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Coronary Angioplasty

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https://www.readbyqxmd.com/read/27928063/could-advanced-drug-delivery-systems-be-the-future-in-cardiovascular-revascularization-medicine
#1
Marco Zuin, Gianluca Rigatelli, Giuseppe Faggian, Roberto L'Erario, Mauro Chinaglia, Loris Roncon
Acute myocardial infarction, stroke and pulmonary embolism required a prompt revascularization to restore the normal blood flow as soon as possible. Fibrinolytic treatment has gradually become both dated and underused in the treatment of acute myocardial infarction, after the wide diffusion of cathlab and percutaneous transluminal coronary angioplasty. Conversely, the use of systemic thrombolysis remained a benchmark in the treatment of both ischemic stroke and massive pulmonary embolism. In daily clinical practice, the use of thrombolytic agents is often limited by absolute and/or relative contraindications and possible adverse events after the drug administration, as intracranial and/or extracranial bleeding events...
December 6, 2016: Vascular
https://www.readbyqxmd.com/read/27918857/new-approach-to-molsidomine-active-metabolites-coming-from-the-results-of-2-models-of-experimental-cardiology
#2
Michał Żorniak, Katarzyna A Mitręga, Maurycy Porc, Tadeusz F Krzemiński
Molsidomine is a well-known vasodilatating, antianginal drug. Despite earlier studies with its metabolites (3-morpholino-syndnonimine (SIN-1) and N-nitroso-N-morpholino-amino-acetonitrile (SIN-1A)), which indicated a potential favorable cardioprotective activity, a lot of controversy remains. The aim of our research was to compare molsidomine, SIN-1, SIN-1A, and lidocaine influence on arrhythmias and hemodynamic parameters in 2 experimental models in rats. In the Langendorff heart study, SIN-1A markedly elevated left ventricular systolic pressure, maximum rise and fall of the first pressure derivative, coronary flow, and myocardial oxygen consumption...
October 4, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27916742/angiographic-and-clinical-outcomes-of-patients-treated-with-drug-coated-balloon-angioplasty-for-in-stent-restenosis-after-coronary-bifurcation-stenting-with-a-two-stent-technique
#3
Yukinori Harada, Roisin Colleran, Susanne Pinieck, Daniele Giacoppo, Jonathan Michel, Sebastian Kufner, Salvatore Cassese, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Adnan Kastrati, Robert A Byrne
AIMS: We conducted this study to evaluate the efficacy of drug-coated balloon therapy for in-stent restenosis after coronary bifurcation stenting. METHODS AND RESULTS: Patients who underwent angioplasty with at least one paclitaxel-coated balloon for in-stent restenosis after bifurcation intervention using a two-stent approach were included. Two types of paclitaxel-coated balloon were used, with either iopromid (iopromide-PCB) or butyryltri-n-hexyl citrate excipient (BTHC-PCB)...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916655/allopurinol-as-a-therapeutic-option-in-cardiovascular-disease
#4
REVIEW
Osita N Okafor, K Farrington, Diana A Gorog
Epidemiological studies indicate that hyperuricaemia is an independent risk factor for cardiovascular disease. Alongside uric acid formation, increased xanthine oxidase activity also results in the formation of oxidative free radicals and superoxide particles. Oxidative stress significantly contributes to the development of cardiovascular disease, including endothelial cell dysfunction, atherosclerosis, vascular calcification and impaired myocardial energetics. Allopurinol, a competitive xanthine oxidase inhibitor, in addition to reducing serum uric acid levels, can act as a free radical scavenger...
December 1, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27916002/long-term-effect-of-stents-eluting-6-mercaptopurine-in-porcine-coronary-arteries
#5
Matthijs S Ruiter, Albert Doornbos, Vivian de Waard, Robbert J de Winter, Nico J M Attevelt, Rob Steendam, Carlie J M de Vries
BACKGROUND: Drug-eluting stents (DES) have dramatically reduced restenosis rates compared to bare metal stents and are widely used in coronary artery angioplasty. The anti-proliferative nature of the drugs reduces smooth muscle cell (SMC) proliferation effectively, but unfortunately also negatively affects endothelialization of stent struts, necessitating prolonged dual anti-platelet therapy. Cell-type specific therapy may prevent this complication, giving rise to safer stents that do not require additional medication...
December 5, 2016: Journal of Negative Results in Biomedicine
https://www.readbyqxmd.com/read/27914488/safety-of-6-month-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-rationale-and-design-of-the-smart-angioplasty-research-team-safety-of-6-month-duration-of-dual-antiplatelet-therapy-after
#6
Joo Myung Lee, Deok-Kyu Cho, Joo-Yong Hahn, Young Bin Song, Taek Kyu Park, Ju-Hyeon Oh, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) is a fundamental treatment that optimizes clinical outcomes after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). Although current international guidelines recommend DAPT for at least 12 months after implantation of a drug-eluting stent in patients with ACS, these recommendations are not based on randomized controlled trials dedicated to ACS population. STUDY DESIGN: The SMART-DATE trial is a prospective, multicenter, randomized, and open-label study to demonstrate the noninferiority of 6-month DAPT compared with 12 months or longer DAPT in patients with ACS undergoing percutaneous coronary intervention...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913753/neutrophil-derived-microparticles-are-released-into-the-coronary-circulation-following-percutaneous-coronary-intervention-in-acute-coronary-syndromes
#7
Gonzalo J Martinez, Jennifer Y Barraclough, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David S Celermajer, Sanjay Patel
AIMS: To evaluate (i) local coronary and systemic levels of microparticles (MP) in Acute Coronary Syndrome (ACS) and Stable Angina Pectoris (SAP) patients and (ii) their release after plaque disruption with percutaneous coronary intervention (PCI). BACKGROUND: Microparticles are small vesicles originating from plasma membranes of cells after activation or apoptosis and are implicated in the pathogenesis of atherosclerosis. Neutrophils play a role in plaque destabilisation and shed neutrophil-derived microparticles have the potential to drive significant pro-inflammatory and thrombotic downstream effects...
December 2, 2016: Bioscience Reports
https://www.readbyqxmd.com/read/27898505/clinical-role-of-post-angioplasty-hyperemic-microvascular-resistances-in-chronic-ischemic-left-ventricular-dysfunction
#8
Riccardo Gorla, Edoardo Verna, Simone Scotti, Sergio Ghiringhelli, Laura Zoli, Stefano Provasoli, Silvana Garancini, Roberto De Ponti, Jorge A Salerno-Uriarte
AIMS: To investigate the impact of hyperemic microvascular resistances (HMRs) on myocardial perfusion and contractility after percutaneous coronary intervention (PCI) in chronic ischemic left ventricular dysfunction (CILVD). METHODS: The current retrospective study included 48 patients with CILVD of the left anterior descending territory undergoing HMRs assessment before and after PCI with a dual-sensor intracoronary pressure-flow wire. The severity of resting myocardial underperfusion and contractile dysfunction of the left anterior descending territory was scored as summed rest score (SRS-T) by single photon emission tomography, wall motion score index (WMSI-T) and left ventricular ejection fraction (LVEF) by transthoracic echocardiography before PCI and after 3 months...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27894569/five-year-outcomes-after-paclitaxel-coated-balloon-angioplasty-for-drug-eluting-stent-restenosis
#9
Katsuya Miura, Kazushige Kadota, Seiji Habara, Takenobu Shimada, Masanobu Ohya, Hidewo Amano, Shunsuke Kubo, Yusuke Hyodo, Suguru Otsuru, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto
The long-term outcomes of patients who underwent paclitaxel-coated balloon (PCB) angioplasty for drug-eluting stent restenosis (DES-ISR) remain unclear. We investigated the 5-year safety and efficacy outcomes of PCB angioplasty for DES-ISR. The study included 185 patients with 216 DES-ISR lesions who underwent PCB angioplasty from September 2008 to December 2010. Two serial angiographic follow-ups were routinely scheduled at 6 and 18 months after the index procedure. Five-year clinical outcomes were investigated...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27888672/incidence-of-coronary-intervention-in-cardiac-arrest-survivors-with-non-shockable-initial-rhythms-and-no-evidence-of-st-elevation-mi-stemi
#10
Matthew Wilson, Anne V Grossestreuer, David F Gaieski, Benjamin S Abella, William Frohna, Munish Goyal
OBJECTIVE: With the demonstrated benefit of an early-invasive strategy for STEMI and VF/VT arrest patients, there is interest in assessing the potential benefit of early angiography for non-shockable (PEA/Asystole) arrest patients. We hypothesized that in cardiac arrest patients who obtain return of spontaneous circulation (ROSC) after a non-shockable initial rhythm and do not have STEMI the incidence of coronary intervention would be clinically insignificant (<5%). METHODS: Retrospective multicenter US clinical registry study of post-cardiac arrest patients at 18 hospitals between 1/00 and 5/14...
November 23, 2016: Resuscitation
https://www.readbyqxmd.com/read/27887648/the-potential-hazard-of-drug-eluting-stent-induced-coronary-vasospasm-causing-subacute-stent-thrombosis-a-case-report
#11
Hiroki Shibutani, Yuzo Akita, Yumie Matsui, Masahiro Yoshinaga, Masahiro Karakawa
BACKGROUND: Drug-eluting stent (DES) -induced coronary vasospasm is a well known phenomenon after stent implantation; however, the extent of this risk is still unknown. We report a case in which DES-induced severe coronary vasospasm was clinically suspected as a cause of subacute stent thrombosis (ST). CASE PRESENTATION: A 67-year-old man came to our hospital due to chest pain with mild exercise. He was diagnosed with effort angina by coronary angiography and underwent DES implantation in the mid-left ascending artery (LAD) after the administration of dual anti-platelet therapy...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27886817/antithrombotic-therapy-to-reduce-ischemic-events-in-acute-coronary-syndromes-patients-undergoing-percutaneous-coronary-intervention
#12
REVIEW
Freek W A Verheugt
Antithrombotic therapy is essential in the prevention of periprocedural death and myocardial infarction during and after percutaneous coronary intervention. In the pathogenesis of acute coronary syndromes (ACS), both platelets and the coagulation cascade play an important role. Therefore, periprocedural antithrombotic therapy is even more important in ACS than in elective PCI. The most used agents are aspirin, platelet P2Y12 blockers, platelet glycoprotein IIb/IIIa blockers, and parenteral anticoagulants. The P2Y12 blockers must be continued at least 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27876466/primary-angioplasty-in-a-single-coronary-artery
#13
Blanca Trejo, Pilar García, Eva Rumiz
No abstract text is available yet for this article.
November 19, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/27869561/successful-drug-coated-balloon-angioplasty-and-single-anti-platelet-therapy-to-treat-an-ischaemic-stroke-patient-with-haemorrhage-and-acute-coronary-syndrome
#14
Hee Hwa Ho, Kwang How Mok
A 55-year-old male presented with two challenging problems, i.e. acute coronary syndrome (ACS) and a major bleeding episode. He first presented with ischaemic stroke and was treated with thrombolysis. However this was complicated by haemorrhagic transformation. He subsequently developed ACS with urgent coronary angiography demonstrating a critical stenosis in the proximal left anterior descending artery. Percutaneous coronary intervention (PCI) was deemed necessary but we were mindful of causing bleeding complications from the use of anti-thrombotic therapy...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27867580/understanding-and-managing-in-stent-restenosis-a-review-of-clinical-data-from-pathogenesis-to-treatment
#15
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/27866469/the-effects-of-percutaneous-transluminal-coronary-intervention-on-biomarkers-of-oxidative-stress-in-the-erythrocytes-of-elderly-male-patients
#16
Karolina Szewczyk-Golec, Paweł Grzelakowski, Tomasz Ługowski, Józef Kędziora
OBJECTIVES: Oxidative stress plays a key role in the pathogenesis of coronary artery disease. The aim of this study was to compare the effects of percutaneous transluminal coronary angioplasty (PTCA) and elective coronary angiography (EC) on erythrocytic antioxidant defense in elderly male patients. METHODS: Twenty-three stable angina pectoris (SAP) patients undergoing PTCA and 18 patients with ischemic symptoms scheduled to undergo diagnostic EC were included in the study...
November 20, 2016: Redox Report: Communications in Free Radical Research
https://www.readbyqxmd.com/read/27862848/safety-and-efficacy-of-rotational-atherectomy-for-the-treatment-of-undilatable-underexpanded-stents-implanted-in-calcific-lesions
#17
Luca A Ferri, Richard J Jabbour, Francesco Giannini, Susanna Benincasa, Marco Ancona, Damiano Regazzoli, Antonio Mangieri, Matteo Montorfano, Antonio Colombo, Azeem Latib
OBJECTIVES: Coronary stent underexpansion is a known risk factor for in-stent restenosis and stent thrombosis. There are limited options once noncompliant balloons have failed to achieve optimal stent expansion. Excimer Laser Coronary Angioplasty with contrast medium injection is one possibility, but not readily available. Rotational atherectomy is an alternative, and has been described in case reports, but concerns exist regarding safety. METHODS: All consecutive patients undergoing rotational atherectomy for symptomatic in-stent restenosis due to stent underexpansion resistant to noncompliant balloon postdilatation between January 2005 and December 2015 were analysed...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27861114/bioresorbable-stents-the-future-of-interventional-cardiology
#18
REVIEW
Stephen G Ellis, Haris Riaz
The introduction of stents has drastically reduced target-lesion restenosis rates associated with percutaneous coronary angioplasty. Bare-metal stents were the first introduced, followed by drug-eluting stents, both of which had significant impacts on the complication rates. Stents, however, have resulted in the emergence of stent thrombosis and stent restenosis, which can cause life-threatening cardiac complications. Three new technological approaches are being investigated to overcome these complications: stents coated with bioresorbable polymers, stents without polymers, and completely bioresorbable stents...
November 2016: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/27852881/treatment-of-angio-seal-related-femoral-artery-occlusion-using-directional-atherectomy-primary-results-and-midterm-follow-up
#19
Anvar Babaev, Rohit Gokhale, Susanna Zavlunova, Michael Attubato
OBJECTIVE: We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment. BACKGROUND: Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions...
November 16, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27849190/prediction-of-fractional-flow-reserve-with-angiographic-dilemma-score
#20
Osman Beton, Hakkı Kaya, Okan Onur Turgut, Mehmet Birhan Yılmaz
OBJECTIVE: Angiographic assessment of stenosis has limited predictive value for functionally significant lesions compared with fractional flow reserve (FFR). The recently developed angiographic DILEMMA score, which consists of minimal lumen diameter (MLD), lesion length (LL) and Bypass Angioplasty Revascularization Investigation (BARI) Myocardial Jeopardy Index (MJI) was found to have diagnostic value in predicting FFR ≤0.80. The present study was an investigation of prediction of FFR ≤0...
November 10, 2016: Anatolian Journal of Cardiology
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