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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/29455777/palliative-treatment-of-coronary-atherosclerotic-cancer-by-drug-eluting-or-bare-metal-stents-from-oculo-stenotic-reflex-period-to-age-of-precision-medicine
#1
Elif Hande Ozcan Cetin, Ozcan Ozeke, Erdogan Ilkay, Dursun Aras, Serkan Topaloglu, Zehra Golbasi, Sinan Aydogdu, Can Ozer
Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease such as atherosclerosis or cancer. Some authors speculated that atherosclerotic coronary artery disease (CAD) could be considered a "cancer of the coronary arterial wall". Although the percutaneous coronary intervention (PCI) has proven to be effective in decreasing mortality rates among patients with acute coronary syndromes, the previous meta-analyses of PCI versus optimal medical therapy for stable CAD have not been able to demonstrate a reduction in major adverse cardiac outcomes...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29448810/safety-and-effectiveness-of-zotarolimus-eluting-stents-for-percutaneous-coronary-intervention-a-systematic-review
#2
Jesse X Yang, Robert W Yeh
Drug-eluting stents revolutionized the treatment of coronary artery disease with vastly improved outcomes compared with bare metal stents. As stent technology has evolved, a wide variety of antiproliferative drugs have been developed to prevent stent restenosis and stent thrombosis. The Resolute stent system (Medtronic, CA, USA) elutes zotarolimus from a multipolymer blend to prevent early and late stent-related complications. The Resolute stents have evolved from the initial Resolute stent, to the Resolute Integrity™ and most recently, the Resolute Onyx™...
February 16, 2018: Future Cardiology
https://www.readbyqxmd.com/read/29408926/mid-to-long-term-mortality-following-surgical-versus-percutaneous-coronary-revascularization-stratified-according-to-stent-subtype-an-analysis-of-6-682-patients-with-multivessel-disease
#3
Shahzad G Raja, Charles Ilsley, Fabio De Robertis, Rebecca Lane, Tito Kabir, Toufan Bahrami, Andre Simon, Aron Popov, Miles C Dalby, Mark Mason, Richard Grocott-Mason, Robert D Smith, M Bilal Iqbal
BACKGROUND: Studies comparing coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) have largely been performed in the bare-metal stent (BMS) and first-generation drug eluting stent (F-DES) era. Second-generation DES (S-DES) have shown improved outcomes when compared to F-DES, but data comparing CABG with PCI using S-DES is limited. We compared mortality following CABG versus PCI for patients with multivessel disease and analyzed different stent types. METHODS: A total of 6,682 patients underwent multivessel revascularization at Harefield Hospital, UK...
2018: PloS One
https://www.readbyqxmd.com/read/29398633/incidence-predictors-and-long-term-clinical-outcome-of-angiographic-definite-stent-thrombosis-in-real-world-scenario-a-prospective-cohort-study
#4
Bhupinder Singh, Basvappa Ramesh, Ravindran Rajendran, Yadvinder Singh, Vivek Singla, Vikram B Kolhari, Abhishek Goyal, Bishav Mohan, Naved Aslam, Shibba Takkar Chhabra, Gurpreet Singh Wander, Manjunath Cholenhally Nanjappa
BACKGROUND: The occurrence of stent thrombosis (ST) in real world scenario is far different from that mentioned in the literature. Our study identifies the various parameters of ST. METHODS: This is a prospective observational-cohort study where-in consecutive patients who received successful percutaneous transluminal angioplasty (PTCA) over the study period of 1-year was included and were followed for 1-year from the primary procedure. RESULTS: The overall incidence of definite ST was 1...
January 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29396239/long-term-outcomes-of-new-generation-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-multivessel-and-or-left-main-coronary-artery-disease-a-bayesian-network-meta-analysis-of-randomized-controlled-trials
#5
George S Mina, Hussam Watti, Demiana Soliman, Anand Shewale, Jessica Atkins, Pratap Reddy, Paari Dominic
BACKGROUND: Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). METHODS: We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI...
January 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29381087/the-evolution-of-coronary-stents
#6
Peter McKavanagh, George Zawadowski, Naveed Ahmed, Michael Kutryk
Percutaneous coronary intervention (PCI) is 40 years old this year. From its humble beginnings of experimental work, PCI has transitioned over years with coronary artery stenting now a standard medical procedure performed throughout the world. Areas covered: The conversion from plain old balloon angioplasty (POBA) to the present era of drug eluting stents (DES) has been driven by many technological advances and large bodies of clinical trial evidence. The journey to present day practice has seen many setbacks, such as acute vessel closure with POBA; rates of instant restenosis with bare metal stents (BMS) and more recently, high rates of stent thrombosis with bioabsorbable platforms...
January 30, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29377941/sex-differences-in-the-outcomes-of-stent-implantation-in-mini-swine-model
#7
Mie Kunio, Gee Wong, Peter M Markham, Elazer R Edelman
Sex-related differences have been noted in cardiovascular anatomy, pathophysiology, and treatment responses, yet we continued to drive evaluation of vascular device development in animal models without consideration of animal sex. We aimed to understand sex-related differences in the vascular responses to stent implantation by analyzing the pooled data of endovascular interventions in 164 Yucatan mini-swine (87 female, 77 male). Bare metal stents (BMS) or drug-eluting stents (DES) were implanted in 212 coronary arteries (63 single BMS implantation, 68 single DES implantation, 33 overlapped BMS implantation, and 48 overlapped DES implantation)...
2018: PloS One
https://www.readbyqxmd.com/read/29369375/safety-and-efficacy-of-second-generation-drug-eluting-stents-compared-with-bare-metal-stents-an-updated-meta-analysis-and-regression-of-9-randomized-clinical-trials
#8
REVIEW
Ahmed N Mahmoud, Nikhil H Shah, Islam Y Elgendy, Nayan Agarwal, Akram Y Elgendy, Amgad Mentias, Amr F Barakat, Dhruv Mahtta, R David Anderson, Anthony A Bavry
The efficacy of second-generation drug-eluting stents (DES; eg, everolimus and zotarolimus) compared with bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention was challenged recently by new evidence from large clinical trials. Thus, we aimed to conduct an updated systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the efficacy and safety of second-generation DES compared with BMS. Electronic databases were systematically searched for all RCTs comparing second-generation DES with BMS and reporting clinical outcomes...
January 25, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29350374/extension-of-a-coronary-intramural-hematoma-after-blunt-chest-trauma
#9
Maeng Real Park, Mun Ki Min, Ji Ho Ryu, Dae Sub Lee, Kang Ho Lee
Coronary artery dissection and intramural hematoma after blunt chest trauma are rare, but life-threatening, complications. Coronary intramural hematoma extension is even rarer. A 31-year-old man was transferred to our hospital for worsening left chest pain during while he was admitted at a nearby hospital due to blunt chest trauma. Bedside echocardiography showed akinesis of the left ventricular apex and anterior wall as well as hypokinesis of the mid-to-basal anteroseptal wall and mid-to-basal lateral and posterior walls of the left ventricle...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349545/risk-of-discontinuation-of-clopidogrel-after-1-month-following-bare-metal-stents-a-propensity-score-adjusted-comparison-with-continued-administration-of-clopidogrel-after-drug-eluting-stents
#10
Christian M Valina, Sebastian Merz, Nikolaus Löffelhardt, Michael Amann, Miroslaw Ferenc, Christian Stratz, Franz-Josef Neumann, Willibald Hochholzer
In patients at high risk for bleeding undergoing percutaneous coronary intervention (PCI) the use of bare-metal-stent (BMS) is considered an option that allows discontinuation of clopidogrel after 4 weeks. We sought to investigate the risk of early discontinuation of clopidogrel in patients with BMS as compared with a 6-month course of clopidogrel after DES in patients with or without high on-treatment platelet reactivity (HTPR). In 765 consecutive patients undergoing PCI after loading with clopidogrel 600 mg, HTPR was tested by optical aggregometry and defined as residual platelet reactivity > 14%...
January 18, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#11
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#12
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29310720/direct-comparison-of-coronary-bare-metal-vs-drug-eluting-stents-same-platform-different-mechanics
#13
Wolfram Schmidt, Peter Lanzer, Peter Behrens, Christoph Brandt-Wunderlich, Alper Öner, Hüseyin Ince, Klaus-Peter Schmitz, Niels Grabow
BACKGROUND: Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance. The objective was to obtain mechanical parameters for direct comparison of BMS and DES. METHODS: In vitro bench tests evaluated crimped stent profiles, crossability in stenosis models, elastic recoil, bending stiffness (crimped and expanded), and scaffolding properties...
January 8, 2018: European Journal of Medical Research
https://www.readbyqxmd.com/read/29285790/drug-eluting-stents-are-superior-to-bare-metal-stents-to-reduce-clinical-outcome-and-stent-related-complications-in-ckd-patients-a-systematic-review-meta-analysis-and-network-meta-analysis
#14
REVIEW
Gabriele Crimi, Valeria Gritti, Vincenzo Alessandro Galiffa, Valeria Scotti, Sergio Leonardi, Maurizio Ferrario, Marco Ferlini, Gaetano Maria De Ferrari, Luigi Oltrona Visconti, Catherine Klersy
AIMS: To compare clinical outcome in Chronic kidney disease (CKD) patients receiving coronary stents according to stent type BMS versus DES and 1st generation versus 2nd generation DES. METHODS AND RESULTS: PubMed, Cinhal, Cochrane, Embase, and Web of Science were searched for studies including CKD patients. CKD was defined as eGFR < 60 mL/min. We selected n = 35 articles leading to 376 169 patients, of which 76 557 CKD patients receiving BMS n = 35,807, 1st generation DES n = 37,650, or 2nd generation DES n = 3100...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29278215/percutaneous-coronary-intervention-in-the-elderly-are-drug-coated-balloons-the-future
#15
Ioannis Merinopoulos, Tharusha Gunawardena, Upul Wickramarachchi, Alisdair Ryding, Simon Eccleshall, Vassilios S Vassiliou
Balloon angioplasty revolutionised percutaneous treatment for coronary artery disease four decades ago, but vessel-threatening dissections, elastic recoil and restenosis were major drawbacks to an otherwise successful long-lasting intervention. Subsequent advances with bare metal stents and then drug eluting stents followed, aiming to mitigate the risks of acute vessel closure and restenosis. However, stent implantation often necessitates dual antiplatelet therapy for a prolonged period of time, which in itself can lead to adverse outcomes, especially in the frail elderly population at higher risk of bleeding...
December 26, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29260713/correlates-of-non-target-vessel-related-adverse-events-in-patients-with-st-segment-elevation-myocardial-infarction-insights-from-5-year-follow-up-of-the-examination-trial
#16
Giosafat Spitaleri, Elisabetta Moscarella, Salvatore Brugaletta, Alberto Pernigotti, Luis Ortega-Paz, Josep Gomez-Lara, Angel Cequier, Andrés Íñiguez-Romo, Antonio Serra, Pilar Jiménez-Quevedo, Vicente Mainar, Gianluca Campo, Maurizio Tespili, Peter den Heijer, Armando Bethencourt, Nicolás Vazquez, Marco Valgimigli, Patrick W Serruys, Manel Sabaté
AIMS: to determine the 5-year correlates of non-TV related adverse events (AE) in STEMI patients included in the EXAMINATION trial. METHODS AND RESULTS: the EXAMINATION trial randomized 1498 STEMI patients to bare-metal or everolimus-eluting stent. In this sub-study, patients were analyzed according to non-TV related AE, defined as the composite of either non-TV revascularization (non-TVR) or non-TV related myocardial infarction (MI). At 5-year follow-up, 125 patients (8...
December 19, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29247157/a-case-of-subacute-bioresorbable-vascular-scaffold-thrombosis-what-was-wrong
#17
Seraj A Abualnaja, Hanan M Alrammah, Bayan A Alsaif, Malak O Almulla, Bayan A Alzahrani
BACKGROUND The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents. CASE REPORT A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done...
December 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29234061/evaluation-of-promoting-effect-of-a-novel-cu-bearing-metal-stent-on-endothelialization-process-from-in-vitro-and-in-vivo-studies
#18
Shujing Jin, Xun Qi, Bin Zhang, Ziqing Sun, Bingchun Zhang, Hui Yang, Tongmin Wang, Bo Zheng, Xingang Wang, Qiuping Shi, Ming Chen, Ling Ren, Ke Yang, Hongshan Zhong
Drug eluting stents (DES) have been extensively applied nowadays and reduce the incidence of in-stent restenosis (ISR) greatly as compared with bare metal stents (BMS). However, the development of DES is hindered by the risk of late stent thrombosis (LST) due to delayed re-endothelialization, while endothelialization is an important process related to ISR and LST after implantation. 316L is a traditional stent material without bioactivity and have a high risk of ISR. Cu is recognized for angiogenesis stimulation in these years...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29210019/pathology-of-stent-implantation-in-internal-mammary-artery
#19
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
#20
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
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