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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/29210019/pathology-of-stent-implantation-in-internal-mammary-artery
#1
Hiroyoshi Mori, Ryan Braumann, Sho Torii, Hiroyuki Jinnouchi, Emanuel Harari, Robert Kutys, Maria Romero, Renu Virmani, Aloke Finn
The internal mammary artery (IMA) is the most durable conduit for bypassing the left anterior descending (LAD) coronary artery in patients undergoing coronary artery bypass graft surgery (CABG). However, little is known about how the IMA reacts histologically to stent implantation. From CVPath stent registry (1048 lesions, 614 cases), we obtained 4 stent lesions (2 bare metal stents, 2 drug-eluting stents) involving IMA grafts. The mean age of our patients was 63 years and the duration of stent implantation in the IMA ranged from 5 days to 5 years...
December 5, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29198986/australian-trends-in-procedural-characteristics-and-outcomes-in-patients-undergoing-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#2
Sinjini Biswas, Stephen J Duffy, Jeffrey Lefkovits, Nick Andrianopoulos, Angela Brennan, Antony Walton, William Chan, Samer Noaman, James A Shaw, Luke Dawson, Andrew Ajani, David J Clark, Melanie Freeman, Chin Hiew, Ernesto Oqueli, Christopher M Reid, Dion Stub
Over the last decade, systems of care for ST-elevation myocardial infarction (STEMI) have evolved to try to improve outcomes and timely access to percutaneous coronary intervention (PCI). There have also been advances in PCI techniques and adjunctive pharmacotherapies. In this study, we sought to determine temporal changes in practices and clinical outcomes of PCI in patients with STEMI. We prospectively collected data on 8,412 consecutive patients undergoing PCI for STEMI between 2005 and 2016 in the multicenter Melbourne Interventional Group registry...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29171207/formation-and-transformation-of-neointima-after-drug-eluting-stent-implantation-insights-from-optical-coherence-tomographic-studies
#3
REVIEW
Seung Yul Lee, Myeong Ki Hong, Yangsoo Jang
After coronary stent implantation, neointima formation resembles the wound healing process as it involves the sequential processes of inflammation, granulation, and remodeling. Because antiproliferative drugs and polymers of drug-eluting stents (DESs) delay vascular healing compared with bare metal stents, fibrin deposition can remain long after stent implantation, or inflammation can be excessive. Delayed vascular healing can be associated with adverse clinical outcomes including DES thrombosis or restenosis, and poor endothelization of DES neointima can accelerate neoatherosclerotic change inside the neointima, further contributing to luminal restenosis or neointimal instability...
November 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29169502/re-evaluating-the-safety-of-drug-eluting%C3%A2-stents-in-cancer-patients
#4
REVIEW
Sarju Ganatra, Ajay Sharma, Michael S Levy
Evidence increasingly shows that cancer and coronary artery disease are interlinked through common risk factors, co-occurrence in an aging population, and through the deleterious effects of cancer treatment on cardiovascular health. Many of the clinical risk factors for cancer, such as diabetes, smoking, and chronic inflammatory state, are also risk factors for coronary artery disease and for stent restenosis and thrombosis. The current generations of drug-eluting stents have been proven to reduce the risk of restenosis and stent thrombosis as compared with bare-metal stents...
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29160048/from-biodegradable-polymers-to-bioresorbable-vascular-scaffolds-available-evidence-in-the-current-era-of-new-generation-des
#5
Fabio Magliulo, Raffaele Piccolo, Anna Franzone, Giovanni Esposito, Gian B Danzi
New-generation drug-eluting stents (DES) encompass a large variety of coronary devices, featuring thin struts, biocompatible durable or biodegradable polymer coatings, and limus-eluting drugs. Due to improved early and long-term outcomes among patients undergoing percutaneous coronary intervention, new-generation metallic DES are recommended in almost all patient and lesion subsets. Available evidence from randomized trials indicate a similar safety and efficacy profile between biodegradable and durable polymers new-generation DES...
November 20, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29150493/very-late-pathological-responses-to-cobalt-chromium-everolimus-eluting-stainless-steel-sirolimus-eluting-and-cobalt-chromium-bare-metal-stents-in-humans
#6
Hiroyoshi Mori, Dheeraj R Atmakuri, Sho Torii, Ryan Braumann, Samantha Smith, Hiroyuki Jinnouchi, Anuj Gupta, Emanuel Harari, Melsi Shkullaku, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: The "very late" clinical outcomes for durable polymer drug-eluting stents and bare metal stents (BMSs) have been shown to be dissimilar in clinical studies. Conceptually, the long-term vascular compatibility of BMSs is still regarded to be superior to drug-eluting stents; however, no pathologic study to date has specifically addressed this issue. We evaluated the very late (≥1 year) pathologic responses to durable polymer drug-eluting stents (cobalt-chromium [CoCr] everolimus-eluting stents [EESs] and stainless steel sirolimus-eluting stents [SS-SESs]) versus BMSs (CoCr-BMSs)...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29132159/aspirin-in-patients-with-previous-percutaneous-coronary-intervention-undergoing-noncardiac-surgery
#7
Michelle M Graham, Daniel I Sessler, Joel L Parlow, Bruce M Biccard, Gordon Guyatt, Kate Leslie, Matthew T V Chan, Christian S Meyhoff, Denis Xavier, Alben Sigamani, Priya A Kumar, Marko Mrkobrada, Deborah J Cook, Vikas Tandon, Jesus Alvarez-Garcia, Juan Carlos Villar, Thomas W Painter, Giovanni Landoni, Edith Fleischmann, Andre Lamy, Richard Whitlock, Yannick Le Manach, Meylin Aphang-Lam, Juan P Cata, Peggy Gao, Nicolaas C S Terblanche, Pamidimukkala V Ramana, Kim A Jamieson, Amal Bessissow, Gabriela R Mendoza, Silvia Ramirez, Pierre A Diemunsch, Salim Yusuf, P J Devereaux
Background: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery. Objective: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI. Design: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#8
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#9
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29069364/pulmonary-vein-stenosis-or-occlusion-after-catheter-ablation-of-atrial-fibrillation-long-term-comparison-of-drug-eluting-versus-large-bare-metal-stents
#10
Thomas Fink, Michael Schlüter, Christian-Hendrik Heeger, Christine Lemes, Tina Lin, Tilman Maurer, Andreas Metzner, Shibu Mathew, Bruno Reissmann, Peter Wohlmuth, Andreas Rillig, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz
Aims: Pulmonary vein stenosis or occlusion (PVS/O) following catheter ablation of atrial fibrillation is a rare but potentially severe complication. Treatment options include angioplasty with or without stent implantation, but data on outcome and optimal treatment strategy are limited. We report long-term results after catheter-based treatment of patients with symptomatic PVS/O. Methods and results: Retrospective analysis was performed in patients undergoing pulmonary vein (PV) angiography for suspected PVS/O...
October 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29067073/impact-of-stent-length-and-diameter-on-short-term-clinical-outcomes-of-drug-eluting-stents-in-patients-with-stable-coronary-artery-disease
#11
Yasir Adnan, Lubna Noor, Muhammad Habeel Dar, Umair Ali, Muhammad Hafizullah
BACKGROUND & OBJECTIVE: The risk of restenosis and other adverse cardiovascular events with bare-metal stents have increased with smaller stent diameters and longer stent lengths. However, the exact impact of stent size on the short-term outcomes of drug-eluting stent (DES) implantations has not been much classified in Pakistani population. This study was designed to evaluate the impact of size (length and diameter) of Drug Eluting Stents on Clinical outcomes in patient with stable coronary artery disease at three months of implantation in Pakistani Population...
July 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29066343/intravascular-ultrasound-assessment-of-minimum-lumen-area-and-intimal-hyperplasia-in-in-stent-restenosis-after-drug-eluting-or-bare-metal-stent-implantation-the-nordic-intravascular-ultrasound-study-nivus
#12
Lisette Okkels Jensen, Saila Vikman, Lisbeth Antonsen, Petteri Kosonen, Matti Niemelä, Evald Høj Christiansen, Kari Kervinen, Andrejs Erglis, Jan Harnek, Indulis Kumsars, Leif Thuesen, Kari Niemelä
INTRODUCTION: Drug-eluting stents (DES) reduce the risk of restenosis after percutaneous coronary intervention. The aim of the study was to evaluate, by intravascular ultrasound (IVUS), the minimum lumen area site in the stented segment and the distribution of intimal hyperplasia in patients presenting with a DES or bare-metal stent (BMS) in-stent restenosis. METHODS: The "Nordic Intravascular Ultrasound Study (NIVUS)" study was conducted in Nordic and Baltic countries as a prospective multicenter registry...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29066340/drug-eluting-balloon-for-the-treatment-of-patients-with-coronary-artery-disease-current-perspectives
#13
REVIEW
Mattia Lunardi, Carlo Zivelonghi, Floris S van den Brink, Matteo Ghione, Giulia Vinco, Giovanni Benfari, Roberto Scarsini, Flavio Ribichini, Pierfrancesco Agostoni
Despite the improvement of outcomes after the introduction of bare metal and drug eluting stents for the treatment of CAD, certain type of patients have still an increased risk of stent failure. An alternative is represented by drug-eluting balloons (DEB). This innovation could give potential benefits in particular for the in-stent restenosis (ISR) and the de-novo lesions. In the first setting DEB have shown results superior to those with plain-balloon angioplasty and similar to those with first generation DES...
September 10, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29059255/prevalence-and-predictors-of-dual-antiplatelet-therapy-prolongation-beyond-one-year-in-patients-with-acute-coronary-syndrome
#14
Giuseppe Patti, Ilaria Cavallari, Emilia Antonucci, Paolo Calabrò, Plinio Cirillo, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo, Pasquale Pignatelli, Elisabetta Ricottini, Rossella Marcucci
There are limited real-world data on prevalence and predictors of dual antiplatelet therapy (DAPT) prolongation beyond one year after acute coronary syndrome (ACS). We have explored such issue in the START ANTIPLATELET Registry, which is a prospective, observational, multicenter, Italian registry performed in seven Italian cardiology institutions including patients admitted for ACS and followed up to one year. Out of a total population of 840 ACS patients, 596 patients had completed 12-month follow-up being on DAPT...
2017: PloS One
https://www.readbyqxmd.com/read/29045308/thirty-days-only-double-antiplatelet-therapy-after-drug-eluting-stenting-could-a-short-term-treatment-be-advantageous
#15
Gianni Casella, Elvira Resciniti, Pamela Gallo
: The duration of dual antiplatelet therapy (DAPT) after coronary stenting has been evaluated in randomized studies with apparently conflicting results. Prolonged DAPT reduces late stent thrombosis and myocardial infarction, but at the expenses of more hemorrhages. On the contrary, bleedings are associated with higher morbidity and mortality. Thus, in patients at high risk of bleeding, the less effective bare-metal stents could be preferred to drug-eluting stents (DES) due to the shortened DAPT needed. However, new DES technology carries a lower risk of stent thrombosis and casts doubts on the recommended prolonged DAPT regimen after DES...
October 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29030347/extracellular-matrix-proteomics-reveals-interplay-of-aggrecan-and-aggrecanases-in-vascular-remodeling-of-stented-coronary-arteries
#16
Gonca Suna, Wojciech Wojakowski, Marc Lynch, Javier Barallobre-Barreiro, Xiaoke Yin, Ursula Mayr, Ferheen Baig, Ruifang Lu, Marika Fava, Robert Hayward, Chris Molenaar, Stephen J White, Tomasz Roleder, Krzysztof Milewski, Pawel Gasior, Piotr P Buszman, Pawel E Buszman, Marjan Jahangiri, Cathy Shanahan, Jonathan M Hill, Manuel Mayr
Background -Extracellular matrix (ECM) remodeling contributes to in-stent restenosis and thrombosis. Despite its important clinical implications little is known about ECM changes post-stent implantation. Methods -Bare-metal (BMS) and drug-eluting stents (DES) were implanted in pig coronary arteries with an overstretch under optical coherence tomography guidance. Stented segments were harvested 1, 3, 7, 14 and 28 days post-stenting for proteomics analysis of the media and neointima. Results -A total of 151 ECM and ECM-associated proteins were identified by mass spectrometry...
October 13, 2017: Circulation
https://www.readbyqxmd.com/read/29027735/temporal-trends-in-percutaneous-coronary-interventions-thru-the-drug-eluting-stent-era-insights-from-18-641-procedures-performed-over-12-year-period
#17
Uri Landes, Tamir Bental, Amos Levi, Abid Assali, Hana Vaknin-Assa, Eli I Lev, Eldad Rechavia, Gabriel Greenberg, Katia Orvin, Ran Kornowski
BACKGROUND: The last decade, regarded as the DES era in PCI, has witnessed significant advances in the management of coronary disease. We aimed to assess temporal trends in the practice and outcome of percutaneous coronary intervention (PCI) during the drug eluting stent (DES) era. METHODS: We analyzed 18,641 consecutive PCI's performed between January 2004 and December 2016, distinguished by procedural date (Q1 : 2004-2006, n = 4,865; Q2 : 2007-2009, n = 4,977; Q3 : 2010-2012, n = 4,230; Q4 : 2013-2016, n = 4,569)...
October 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29021434/effectiveness-of-bare-metal-stent-implantation-for-the-treatment-of-coronary-artery-aneurysm-a-multimodality-imaging-evaluation
#18
Yasuaki Hada, Hiroyuki Fujii, Masato Shimizu, Noriyoshi Yamawake, Mitsuhiro Nishizaki
Coronary artery aneurysm (CAA) after sirolimus-eluting stent (SES) implantation is one of the most troublesome problems associated with first-generation drug-eluting stents. However, the natural course and standard therapy of CAA has been unknown. A 49-year-old man underwent SES implantation for the left anterior descending artery. Follow-up coronary angiography (CAG) revealed CAA in the SES. We performed bare metal stent (BMS) implantation for treatment of CAA. Ten months after the BMS implantation, the size of the CAA had diminished, and a very thin layer of endothelium on the BMS was observed by optical coherence tomography...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28992207/propensity-score-based-methods-in-comparative-effectiveness-research-on-coronary-artery-disease
#19
Alexandra G Ellis, Thomas A Trikalinos, Benjamin S Wessler, John B Wong, Issa J Dahabreh
This review examines the conduct and reporting of observational studies using propensity score-based methods to compare coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or medical therapy for patients with coronary artery disease. A systematic selection process identified 48 studies: 20 CABG vs. PCI; 21 bare-metal stents vs. drug-eluting stents; 5 CABG vs. medical therapy; 1 PCI vs. medical therapy; and 1 drug-eluting stents vs. balloon angioplasty. Of 32 studies reporting information on variable selection, 7 relied exclusively on statistical criteria for the association of covariates with treatment and 5 used such criteria to determine whether product or non-linear terms should be included in the propensity score model...
July 13, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28941481/does-the-new-generation-of-drug-eluting-stents-render-bare-metal-stents-obsolete
#20
REVIEW
Kyle Buchanan, Arie Steinvil, Ron Waksman
The development of bare metal coronary stents revolutionized the treatment of coronary artery disease by reducing rates of acute vessel closure and restenosis associated with balloon angioplasty. However, bare metal stents (BMS) resulted in high rates of restenosis and led to the development of drug-eluting stents (DES). Those first-generation DES were followed by successive generations of DES that included improvements, such as biodegradable and more biocompatible polymers. Despite the superiority of the current DES compared to BMS, a subset of patients still receives BMS...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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