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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/28722266/second-generation-drug-eluting-stents-versus-bare-metal-stents-for-percutaneous-coronary-intervention-of-the-proximal-left-anterior-descending-artery-an-analysis-of-the-basket-prove-i-and-ii-trials
#1
Fernanda Marinho Mangione, Tor Biering-Sørensen, Kotaro Nochioka, Tannas Jatene, Odilson Marcos Silvestre, Kim Wadt Hansen, Rikke Sørensen, Jan Skov Jensen, Peter Godsk Jorgensen, Raban Jeger, Christoph Kaiser, Matthias Pfisterer, Søren Galatius
OBJECTIVES: To compare mid-term outcomes between patients undergoing proximal left anterior descending artery (LAD) percutaneous coronary intervention (PCI) with second generation drug-eluting stent (DES) or bare-metal stent (BMS). BACKGROUND: PCI with BMS and first-generation DES have shown to be safe options for the treatment of proximal LAD stenosis, however associated with considerable reintervention rates. Overall, second-generation DES has proven to be superior to BMS and first-generation DES, nevertheless, its effect for proximal LAD PCI has not previously been reported...
July 19, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28720725/optical-coherence-tomography-findings-in-patients-with-coronary-stent-thrombosis-a-report-of-the-prevention-of-late-stent-thrombosis-by-an-interdisciplinary-global-european-effort-prestige-consortium
#2
Tom Adriaenssens, Michael Joner, Thea Godschalk, Nikesh Malik, Fernando Alfonso, Erion Xhepa, Dries De Cock, Kenichi Komukai, Tomohisa Tada, Javier Cuesta, Vasile Sirbu, Laurent J Feldman, Franz-Josef Neumann, Alison H Goodall, Ton Heestermans, Ian Buysschaert, Ota Hlinomaz, Ann Belmans, Walter Desmet, Jurrien M Ten Berg, Anthony H Gershlick, Steffen Massberg, Adnan Kastrati, Giulio Guagliumi, Robert Byrne
Background -Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. Methods -Consecutive patients presenting with ST were prospectively enrolled in a registry using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28697937/complications-after-endovascular-treatment-of-hepatic-artery-stenosis-after-liver-transplantation
#3
Leighton E Goldsmith, Kristy Wiebke, John Seal, Clayton Brinster, Taylor A Smith, Hernan A Bazan, W Charles Sternbergh
BACKGROUND: Hepatic artery stenosis (HAS) after liver transplantation can progress to hepatic artery thrombosis (HAT) and a subsequent 30% to 50% risk of graft loss. Although endovascular treatment of severe HAS after liver transplantation has emerged as the dominant method of treatment, the potential risks of these interventions are poorly described. METHODS: A retrospective review of all endovascular interventions for HAS after liver transplantation between August 2009 and March 2016 was performed at a single institution, which has the largest volume of liver transplants in the United States...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28674616/biological-effect-of-microengineered-grooved-stents-on-strut-healing-a-randomised-oct-based-comparative-study-in-humans
#4
Boris Vesga, Hector Hernandez, Sergio Higuera, Pawel Gasior, Dario Echeveri, Juan A Delgado, Antonio Dager, Camilo Arana, Charles Simonton, Akiko Maehara, Julio Palmaz, Juan F Granada
OBJECTIVE: To evaluate the biological effect of microengineered stent grooves (MSG) on early strut healing in humans by performing optical coherence tomography (OCT) analysis 3 weeks following the implantation. BACKGROUND: In the experimental setting, MSG accelerate endothelial cell migration and reduce neointimal proliferation compared with bare metal stent (BMS). METHODS: A total of 37 patients undergoing percutaneous coronary intervention with de novo coronary lesions were randomly assigned to either MSG (n=19) or an identical BMS controls (n=18)...
2017: Open Heart
https://www.readbyqxmd.com/read/28671407/perioperative-cardiovascular-medication-management-in-noncardiac-surgery-common-questions
#5
Michael A Mikhail, Arya B Mohabbat, Amit K Ghosh
Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the risk of bleeding, unless the risk of a major adverse cardiac event exceeds the risk of bleeding. Antiplatelet therapy for secondary prevention should be continued perioperatively, except before procedures with very high bleeding risk, such as intracranial procedures...
May 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28659551/impact-of-stent-type-and-presence-of-vasospastic-angina-on-long-term-prognosis
#6
Reo Hata, Naoki Oka, Shunsuke Kubo, Akimune Kuwayama, Masanobu Ohya, Takenobu Shimada, Katsuya Miura, Hidewo Amano, Yusuke Hyodo, Suguru Otsuru, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Tsuyoshi Goto, Kazushige Kadota
BACKGROUND: Little is known about the impact of stent type on the prognosis of vasospastic angina (VSA) in patients who undergo stent implantation.Methods and Results:We evaluated consecutive patients undergoing coronary angiography with positive (n=650; VSA) and negative (n=2,872; non-VSA) ergonovine testing. Among them, 304 patients undergoing stent implantation for organic stenosis were classified for comparison into 3 respective VSA and non-VSA groups based on stent type (68 and 78 with bare-metal stent [BMS]; 21 and 49 with sirolimus-eluting stent [SES]; 26 and 62 with newer generation drug-eluting stent [N-DES])...
June 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28658826/analysis-of-12-months-clinical-outcomes-associated-with-implantation-of-ultrathin-60-%C3%AE-m-bare-metal-stent-in-an-unselected-real-world-population-with-coronary-artery-disease
#7
Adikesava Naidu Otikunta, Uday Kumar Hosad, Y V Subba Reddy, Srikanth Eruvaram, Ravi Srinivas, Rajeev Garg, Limmy Loret Lobo
INTRODUCTION: In the era of drug-eluting stents, Bare Metal Stent (BMS) has worked its way up to be recognized in several indications. Moreover, literature suggests that strut thickness has been directly related to the restenosis rate. AIM: We intended to evaluate the clinical performance of the ultrathin (60 μm) Flexinnium stent (Sahajanand Medical Technologies Pvt. Ltd. Surat, India) for treatment of a wide range of patients with coronary artery disease in routine clinical practice...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28647315/safety-and-efficacy-of-new-biodegradable-polymer-based-sirolimus-eluting-stents-in-a-preclinical-model
#8
Armando Pérez de Prado, Claudia Pérez Martínez, Carlos Cuellas Ramón, Marta Regueiro Purriños, María López Benito, José Manuel Gonzalo Orden, José Antonio Rodríguez Altónaga, Rodrigo Estévez Loureiro, Tomás Benito González, David Viñuela Baragaño, María Molina Crisol, Marc Amorós Aguilar, Isabel Pérez Serranos, Arnau Vidal Parreu, Ana Benavides Montegordo, Luis Duocastella Codina, Felipe Fernández Vázquez
INTRODUCTION AND OBJECTIVES: New drug-eluting stents (DES) designed to overcome the limitations of existing devices should initially be tested in preclinical studies. Our objective was to analyze the safety and efficacy of new biodegradable polymer-based DES compared with bare-metal stents (BMS) and commercially available DES in a model of normal porcine coronary arteries. METHODS: We randomly implanted 101 stents (BMS and biodegradable polymer-based sirolimus-eluting stents: 3 test stent iterations [BD1, BD2, and BD3], Orsiro, Biomime and Biomatrix) in the coronary arteries of 34 domestic pigs...
June 21, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28625402/comparison-between-catheter-based-delivery-of-paclitaxel-after-bare-metal-stenting-and-drug-eluting-stents-in-coronary-artery-disease-patients-at-high-risk-for-in-stent-restenosis
#9
Mostafa El-Mokadem, Mohamed El-Ramly, Amr Hassan, Hesham Boshra, Amir AbdelWahab
BACKGROUND: Drug eluting stents reduce the risk of in-stent restenosis but delay healing of the vascular wall. Recent data on late and very late stent thrombosis after drug-eluting stent (DES) implantation have raised concerns about the long-term safety. High lipophilicity of paclitaxel promotes rapid cellular uptake and prolongs its action. This makes paclitaxel a very promising candidate for local drug therapy intended to inhibit the proliferative and migratory processes involved in restenosis following PCI...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28600019/safety-and-efficacy-outcomes-of-second-generation-everolimus-eluting-stents-in-octogenarians-compared-to-non-octogenarians
#10
Hironori Kitabata, Takashi Kubo, Kazuya Mori, Yasunori Yamamoto, Manabu Kashiwagi, Yu Arita, Takashi Tanimoto, Takashi Akasaka
BACKGROUND: In patients ≥80 years of age, the use of second-generation cobalt-chromium everolimus-eluting stents (CoCr-EES) versus bare-metal stents has been shown to reduce myocardial infarction (MI) and target vessel revascularization (TVR) rates, without an increase in bleeding. However, safety and efficacy of CoCr-EES in octogenarians compared to younger populations are less certain. We aimed to compare the clinical outcomes between octogenarian and non-octogenarian patients undergoing percutaneous coronary intervention (PCI) with CoCr-EES...
June 1, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28595326/multiarterial-grafts-improve-the-rate-of-early-major-adverse-cardiac-and-cerebrovascular-events-in-patients-undergoing-coronary-revascularization-analysis-of-12%C3%A2-615-patients-with-multivessel-disease%C3%A2
#11
Chaim Locker, Hartzell V Schaff, Richard C Daly, Malcolm R Bell, Robert L Frye, John M Stulak, Sameh M Said, Joseph A Dearani, Lyle D Joyce, Kevin L Greason, Alberto Pochettino, Zhuo Li, Ryan J Lennon, Amir Lerman
OBJECTIVES: Our goal was to compare the rates of in-hospital and 30-day major adverse cardiac and cerebrovascular events (MACCE) including death, stroke, myocardial infarction and repeat revascularization in patients with multivessel disease undergoing multiarterial (MultArt) coronary artery bypass grafting (CABG) with the left internal mammary artery/saphenous vein (LIMA/SV) CABG or percutaneous coronary intervention (PCI). METHODS: From 1 January 1993 to 31 December 2009, 12 615 consecutive patients underwent isolated primary CABG ( n  = 6667) with LIMA/SV ( n  = 5712) or MultArt ( n  = 955) or were treated by PCI ( n  = 5948) with balloon angioplasty ( n  = 1020), bare metal stent ( n  = 3242), and drug-eluting stent ( n  = 1686)...
June 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28589365/variability-of-platelet-response-to-clopidogrel-is-not-related-to-adverse-cardiovascular-events-in-patients-with-stable-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#12
Szymon Olędzki, Zdzisława Kornacewicz-Jach, Krzysztof Safranow, Radosław Kiedrowicz, Barbara Gawrońska-Szklarz, Maria Jastrzębska, Jarosław Gorący
BACKGROUND: Antiplatelet response to clopidogrel and its influence upon the risk of cardiovascular adverse events among patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI) has not been investigated fully. METHODS: Two hundred eleven patients treated with aspirin and clopidogrel were included in the study. Immediately before PCI, residual platelet reactivity testing with impedance aggregometry assay and a single-nucleotide polymorphism genotyping analysis targeting variants of CYP2C19, ABCB1, and PON1 genes was performed...
June 6, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28582032/design-principles-of-bioresorbable-polymeric-scaffolds
#13
REVIEW
Mary Beth Kossuth, Laura E L Perkins, Richard J Rapoza
The concept for a bioresorbable vascular scaffold combines the best features of the first 3 generations of percutaneous coronary intervention (namely), balloon angioplasty, bare metallic stents, and drug-eluting stents, into a single device. The principles of operation of a BRS follow 3 phases of functionality that reflect the different physiologic requirements over time; revascularization, restoration, and resorption. Most BRS designs make use of the continuum of hydrolytic degradation in aliphatic polyesters, such as poly(l-lactide), in which molecular weight, strength, and mass decrease progressively in 3 distinct stages, consistent with the in vivo requirements of each performance phase...
July 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28582031/contemporary-drug-eluting-stent-platforms-design-safety-and-clinical-efficacy
#14
REVIEW
Ramon A Partida, Robert W Yeh
First-generation drug-eluting stents significantly improved treatment of coronary disease, decreasing rates of revascularization. This was offset by high rates of late adverse events, driven primarily by stent thrombosis. Research and design improvements of individual DES platform components led to next-generation devices with superior clinical safety and efficacy profiles compared with bare-metal stents and first-generation drug-eluting stents. These design improvements and features are explored, and their resulting clinical safety and efficacy reviewed, focusing on platforms approved by the Food and Drug Administration currently widely used in the United States...
July 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28579092/coronary-artery-aneurysm-formation-following-implantation-of-a-bioresorbable-vascular-scaffold-for-in-stent-restenosis
#15
Marcos García-Guimaraes, Javier Cuesta, Teresa Alvarado, Fernando Rivero, Teresa Bastante, Amparo Benedicto, Fernando Alfonso
Coronary artery aneurysm (CAA) formation is a rare complication of coronary intervention that may develop after implantation of bare-metal or drug-eluting stents. The etiology of this entity appears to be multifactorial and its prognosis is poorly understood, but it has been associated with an increased risk of stent thrombosis. To date few cases of CAAs related to bioresorbable vascular scaffold (BVS) implantation have been reported, and the development of CAA after BVS implantation for the treatment of in-stent restenosis (ISR) has not been previously described...
May 31, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28571187/study-of-short-and-intermediate-term-clinical-outcomes-of-patients-with-protected-and-unprotected-lmca-stenting
#16
Pooja M Vyas, Jayesh S Prajapati, Sibasis S Sahoo, Iva Vipul Patel, Jagjeet K Deshmukh, Chirag Patel, Roopesh Singhal
INTRODUCTION: Significant unprotected Left Main Coronary Artery (LMCA) disease is detected in 5%-7% of cases undergoing Coronary Angiography (CAG). Present guidelines have revealed the significance of anatomical location in left main artery stenosis and syntax scores for determination of Major Adverse Cardiac Events (MACE). Debate still persists over the best treatment regarding outcomes of Coronary Artery Bypass Grafting (CABG) and LMCA stenting for patients with LMCA disease. AIM: Aim of the study was to evaluate short and intermediate term clinical outcomes of Percutaneous Coronary Intervention (PCI) in LMCA disease in respect to mortality, Cerebrovascular Accidents (CVA), reinfarction, stent restenosis and need for repeat target lesion revascularization...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567083/the-current-status-of-percutaneous-coronary-intervention-in-korea-based-on-year-2014-cohort-of-korean-percutaneous-coronary-intervention-k-pci-registry
#17
Jae-Sik Jang, Kyoo-Rok Han, Keon-Woong Moon, Dong Woon Jeon, Dong-Ho Shin, Jung-Sun Kim, Duk-Woo Park, Hyun-Jae Kang, Juhan Kim, Jang-Whan Bae, Seung-Ho Hur, Byung Ok Kim, Donghoon Choi, Hyeon-Cheol Gwon, Hyo-Soo Kim
BACKGROUND AND OBJECTIVES: Although several multicenter registries have evaluated percutaneous coronary intervention (PCI) procedures in Korea, those databases have been limited by non-standardized data collection and lack of uniform reporting methods. We aimed to collect and report data from a standardized database to analyze PCI procedures throughout the country. MATERIALS AND METHODS: Both clinical and procedural data, as well as clinical outcomes data during hospital stay, were collected based on case report forms that used a standard set of 54 data elements...
May 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28562383/treatment-options-for-stent-restenosis-insights-from-intracoronary-imaging-clinical-trials-and-registries
#18
Fernando Rivero, Javier Cuesta, Teresa Bastante, Marcos García-Guimaraes, Fernando Alfonso
Although drug-eluting stents (DES) have markedly reduced the incidence of stent restenosis (SR), the increased number and complexity of percutaneous coronary interventions performed worldwide explain the sustained prevalence of SR. Intracoronary imaging techniques remain essential tools to unravel the underlying mechanical causes potentially leading to SR. Current clinical trial data suggest that DES are the most effective therapy for the management of both bare-metal stents SR and DES-SR. In this setting, however, drug-eluting balloons represent a valid therapeutic alternative with the attractive advantage of not requiring the implantation of an additional metallic layer...
May 30, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28557275/four-year-comparative-effectiveness-of-bare-metal-and-everolimus-eluting-stents-in-new-york
#19
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVES: To study four-year outcomes for patients receiving either bare-metal stents (BMS) or everolimus-eluting stents (EES) and to evaluate the comparative effectiveness of BMS versus EES in six "off-label" and two "high-risk" patient subgroups. BACKGROUND: BMS and EES (a second generation of drug-eluting stent) are used in contemporary practice to treat coronary artery disease. However, little is known about long-term comparative effectiveness between BMS and EES...
May 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28529095/understanding-operator-stent-choice-in-the-catheterization-laboratory-using-a-pre-procedure-survey-opportunities-for-quality-improvement
#20
Matthew J Chung, Jonathan D Hansen, Ryan D Schulteis, Joel C Boggan, W Schuyler Jones, Thomas J Povsic, Susan Roberts, Mitchell W Krucoff, Sunil V Rao
OBJECTIVES: We sought to characterize how the perceived risk of early dual antiplatelet therapy (DAPT) discontinuation is incorporated into operator decision-making regarding stent choice, using a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation. BACKGROUND: Understanding which factors influence operator decision-making regarding stent choice during percutaneous coronary intervention (PCI) could help identify areas for quality improvement...
May 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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