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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/27916002/long-term-effect-of-stents-eluting-6-mercaptopurine-in-porcine-coronary-arteries
#1
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/27905013/impact-of-stent-type-and-prolonged-dual-antiplatelet-therapy-on-long-term-clinical-outcomes-in-hemodialysis-patients-with-coronary-artery-disease
#2
Masahiko Asami, Jiro Aoki, Tatsuyuki Sato, Shuzou Tanimoto, Mika Watanabe, Yu Horiuchi, Koichi Furui, Kentaro Yasuhara, Yu Sato, Takuya Hashimoto, Sen Yachi, Kazuhiro Hara, Kengo Tanabe
The aim of this study was to address 7-year clinical outcomes and impact of prolonged dual antiplatelet therapy (DAPT) after coronary stenting in hemodialysis patients. Our study included 123 consecutive hemodialysis patients who had undergone percutaneous coronary intervention with a drug-eluting stent (DES) or bare-metal stent (BMS) (DES: 64, BMS: 59) in our institution. We compared long-term clinical outcomes following DES with BMS implantation as well as clinical outcomes in patients on DAPT for ≥1 year (DAPT on group, 89) with those on DAPT for <1 year (DAPT off group, 34)...
November 30, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27867580/understanding-and-managing-in-stent-restenosis-a-review-of-clinical-data-from-pathogenesis-to-treatment
#3
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/27866748/promus-premier-versus-xience-v-and-taxus-liberte-in-contemporary-united-states-practice-rewards-premier-registry
#4
Michael A Gaglia, Randy Goodroe, Greg Mishkel, Wassim Gharib, Ali Tabrizchi, Tamim Nazif, John Wang, Thomas Scott, Mario Lopez, Daniel Steinberg, Jiaxiang Gai, Rebecca Torguson, Ron Waksman
BACKGROUND/PURPOSE: Drug-eluting stents (DES) reduce in-stent restenosis and repeat revascularization in comparison to bare metal stents. Individual DES vary, however, in regard to rates of restenosis and stent thrombosis; they also differ in regard to their platform and physical characteristics. The Promus Premier was designed to improve the performance of the Promus Element, with respect to conformability, trackability, and avoidance of longitudinal stent deformation; there is little published data, however, on clinical outcomes with Promus Premier...
September 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27862865/long-term-clinical-and-angiographic-outcomes-of-percutanenous-coronary-intervention-with-everolimus-eluting-stents-for-the-treatment-of-cardiac-allograft-vasculopathy
#5
Richard Cheng, Christopher Vanichsarn, Jignesh K Patel, Jesse Currier, David H Chang, Michelle M Kittleson, Raj Makkar, Jon A Kobashigawa, Babak Azarbal
BACKGROUND: Percutaneous coronary intervention (PCI) with bare-metal and first-generation drug-eluting stents (DES) for cardiac allograft vasculopathy (CAV) is associated with unexpectedly high restenosis rates and target lesion revascularization (TLR). Long-term outcomes of stenting for CAV using second-generation everolimus-eluting stents (EES) are not established. OBJECTIVE: To evaluate clinical and angiographic outcomes of CAV stenting with EES. METHODS: Patients who underwent PCI with EES for CAV were studied...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27861114/bioresorbable-stents-the-future-of-interventional-cardiology
#6
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/27860195/long-term-outcomes-in-patients-with-acute-coronary-syndromes-related-to-prolonging-dual-antiplatelet-therapy-more-than-12-months-after-coronary-stenting
#7
Neil J Wimmer, Alyssa B Dufour, Kelly Cho, David R Gagnon, Lien Quach, Samantha Ly, Jacquelyn-My Do, Simon Ostrowski, J Michael Gaziano, David P Faxon, Scott Kinlay
OBJECTIVES: To assess the impact of stent type on the risk of death or myocardial infarction (MI) related to dual antiplatelet therapy (DAPT) more than 12 months (prolonged DAPT) versus 12 or less months after PCI for an acute coronary syndrome (ACS). BACKGROUND: The recent DAPT study reported lower recurrent ischemic events from prolonged DAPT in patients treated with PCI for an ACS, but was underpowered to determine the impact of stent type. METHODS: We determined clinical outcomes after PCI for an ACS (median follow-up: DES = 26 months, BMS = 46 months) in 18,484 patients in the Veterans Affairs system treated with first generation drug-eluting stents (DES) or bare-metal stents (BMS)...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27846735/perioperative-management-of-dual-anti-platelet-therapy
#8
Tyler D Webster, Prashant Vaishnava, Kim A Eagle
Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. While there is uncertainty about the optimal duration of dual antiplatelet therapy following percutaneous coronary intervention, the new 2016 American College of Cardiology/American Heart Association Guidelines suggest that for patients with stable ischemic heart disease at least six months of such therapy following a drug eluting stent and one month following a bare metal stent should be implemented...
November 16, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27845875/comparison-of-drug-eluting-stents-with-bare-metal-stents-for-pci-of-saphenous-vein-graft-lesions-systematic-review-and-meta-analysis
#9
Wassim Mosleh, Sumeet Gandhi, Mohamed Elsiddig, Jon-David Schwalm, Michael E Farkouh
BACKGROUND: The superiority of drug-eluting stent (DES) implantation over bare-metal stent (BMS) implantation in saphenous vein graft (SVG) lesions is controversial, with significant heterogeneity demonstrated in the literature. METHODS: A study search was conducted from January 2003 to October 2015, and identified four randomized controlled trials (RCTs) and 35 observational studies comparing DES vs BMS in SVG interventions. Clinical endpoint data were abstracted and analyzed by combining the odds ratios (ORs) of individual studies into a pooled OR using a random-effects model...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27843185/drug-eluting-stents-to-evolve-or-dissolve
#10
REVIEW
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
https://www.readbyqxmd.com/read/27821401/comparison-of-drug-eluting-and-bare-metal-stents-in-patients-with-chronic-kidney-disease-an-updated-systematic-review-and-meta-analysis
#11
Renjie Lu, Fenglei Tang, Yan Zhang, Xishan Zhu, Shanmei Zhu, Ganlin Wang, Yinfeng Jiang, Zhengda Fan
BACKGROUND: Drug-eluting stents (DESs) and bare metal stents (BMSs) are both recommended to improve coronary revascularization and to treat coronary artery disease in patients with chronic kidney disease (CKD). However, the potential superiority of DESs over BMSs for reducing the incidence of long-term major adverse cardiovascular events and mortality in CKD patients has not been established, and the results remain controversial. We aimed to systematically assess and quantify the total weight of evidence regarding the use of DESs versus BMSs in CKD patients...
November 7, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27817795/frequency-of-stroke-after-percutaneous-coronary-intervention-or-coronary-artery-bypass-grafting-from-an-eleven-year-statewide-analysis
#12
Abel E Moreyra, Gregory A Maniatis, Hui Gu, Joel N Swerdel, James S McKinney, Nora M Cosgrove, William J Kostis, John B Kostis
We compared stroke rates associated with coronary artery bypass grafting (CABG), both on-pump and off-pump, and percutaneous coronary intervention (PCI) with both drug-eluting stent (DES) and bare-metal stent (BMS) and the impact on 30-day and 1-year all-cause mortality. The Myocardial Infarction Data Acquisition System database was used to study patients who had on-pump CABG (n = 47,254), off-pump CABG (n = 19,118), and PCI with BMS (n = 46,641), and DES (n = 115,942) in New Jersey from 2002 to 2012. Multiple logistic and Cox proportional hazard models were used to compare the risk of stroke and mortality...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27806902/very-thin-strut-biodegradable-polymer-everolimus-eluting-and-sirolimus-eluting-stents-versus-durable-polymer-zotarolimus-eluting-stents-in-allcomers-with-coronary-artery-disease-bio-resort-a-three-arm-randomised-non-inferiority-trial
#13
Clemens von Birgelen, Marlies M Kok, Liefke C van der Heijden, Peter W Danse, Carl E Schotborgh, Martijn Scholte, R Melvyn Tjon Joe Gin, Samer Somi, K G van Houwelingen, M G Stoel, Frits H A F de Man, J Hans W Louwerenburg, Marc Hartmann, Paolo Zocca, Gerard C M Linssen, Job van der Palen, Carine J M Doggen, Marije M Löwik
BACKGROUND: In patients with coronary artery disease, treated with durable polymer-coated drug-eluting stents, the life-long presence of the polymer might delay arterial healing. Novel very thin strut biodegradable polymer stents, which leave only a bare metal stent after polymer resorption, might improve long-term outcome. We investigated in allcomers the safety and efficacy of three stents eluting either everolimus, sirolimus, or zotarolimus, often clinically used but never compared, of which the biodegradable polymer everolimus-eluting stent was never before assessed in allcomers...
November 26, 2016: Lancet
https://www.readbyqxmd.com/read/27797464/bioresorbable-vascular-scaffolds-for-the-treatment-of-coronary-artery-disease-clinical-outcomes-from-randomized-controlled-trials
#14
David G Rizik, James B Hermiller, Dean J Kereiakes
The permanent metal prosthesis common to bare metal stents (BMS) as well as both first- and second-generation drug-eluting stents (DES) following treatment of coronary artery disease represents a long-lasting substrate for late adverse coronary events including restenosis, thrombosis, and neoatherosclerosis. Following resorbtion, bioresorbable scaffolds (BRS) may eliminate this nidus and improve late outcomes through restoration of the vessel to more normal vascular structure and function. BRS represents a single platform which incorporates the mechanical features of metallic stents to provide safe and effective revascularization, suppression of restenosis and prevention of constrictive remodeling with long-term restoration of the treated vessel to a more natural state...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27789517/early-cessation-of-adenosine-diphosphate-receptor-inhibitors-among-acute-myocardial-infarction-patients-treated-with-percutaneous-coronary-intervention-insights-from-the-translate-acs-study-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal
#15
Emil L Fosbøl, Christine Ju, Kevin J Anstrom, Marjorie E Zettler, John C Messenger, Ron Waksman, Mark B Effron, Brian A Baker, David J Cohen, Eric D Peterson, Tracy Y Wang
BACKGROUND: Guidelines recommend the use of adenosine diphosphate receptor inhibitor (ADPri) therapy for 1 year postacute myocardial infarction; yet, early cessation of therapy occurs frequently in clinical practice. METHODS AND RESULTS: We examined 11 858 acute myocardial infarction patients treated with percutaneous coronary intervention discharged alive on ADPri therapy from 233 United States TRANSLATE-ACS study (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) participating hospitals to determine the prevalence of early ADPri cessation (within 1 year), patient-reported reasons for cessation, and associated risk of major adverse cardiovascular events at 1 year...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27788931/frequency-of-cardiac-death-and-stent-thrombosis-in-patients-with-chronic-obstructive-pulmonary-disease-undergoing-percutaneous-coronary-intervention-from-the-basket-prove-i-and-ii-trials
#16
Tannas Jatene, Tor Biering-Sørensen, Kotaro Nochioka, Fernanda Marinho Mangione, Kim Wadt Hansen, Rikke Sørensen, Jan Skov Jensen, Peter Godsk Jørgensen, Raban Jeger, Christoph Kaiser, Matthias Pfisterer, Søren Galatius
Chronic obstructive pulmonary disease (COPD) is associated with long-term all-cause death after percutaneous coronary intervention with bare-metal stents. Regarding other outcomes, previous studies have shown conflicting results and the impact of drug-eluting stent (DES) in this population is not well known. We analyzed 4,605 patients who underwent percutaneous coronary intervention with bare-metal stents (33.1%) or DES (66.9%) from the Basel Stent Kosten-Effektivitats Trial-Prospective Validation Examination trials I and II...
September 29, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27751325/successful-management-of-a-giant-unruptured-mycotic-coronary-artery-aneurysm-after-coronary-angioplasty
#17
Pankaj Aggarwal, Pravin Saxena, Anil Bhan
Coronary artery stent infection has been reported with both bare metal stent and drug eluting stent and can present as mycotic coronary artery aneurysm, pseudoaneurysm, myocardial abscess, pericarditis or exudative effusion. Infection at the site of coronary stent implantation is rare and is believed to result typically from either direct stent contamination at the time of delivery or transient bacteraemia from access site. Introduction of drug-eluting stent (DES) has led to a marked reduction in the problem of in-stent restenosis across all patient subsets and lesions complexities...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27737596/clinical-humanistic-and-economic-outcomes-between-drug-eluting-stent-des-and-bare-metal-stent-bms-18-month-follow-up-study
#18
Vivian W Y Lee, Franco W Cheng, Adrian Y Choi, Sam T Fong, Cheuk Man Yu, Bryan P Yan
BACKGROUND: Percutaneous coronary intervention (PCI) is one of the most performed interventions for ischemic heart diseases. In Hong Kong, the total number of patient discharges and deaths for ischemic heart diseases in 2009 was 33,363, including 4,360 deaths. There are over 5,000 cases of PCI yearly. This study aimed to compare clinical, economic and humanistic outcomes among patients receiving drug-eluting stent (DES) or bare metal stent (BMS) in Hong Kong. METHODS: Patients who received stent implantation between 15(th) September, 2009 and 11(th) October, 2010 in Prince of Wales Hospital, Hong Kong, were recruited and followed for 18 months...
October 14, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27713606/frequency-of-vascular-inflammation-and-impact-on-neointimal-proliferation-of-drug-eluting-stents-in-porcine-coronary-arteries
#19
Jong Shiuan Yeh, Seung Jin Oh, Chun Mei Hsueh
BACKGROUND: We aimed to describe the frequency of vascular inflammatory reactions with second generation drug eluting stents (DES) compared to first generation DES, and analyze the impact on inflammation and neointimal proliferation in a porcine coronary model. METHODS: A total of 26 stents (7 multi-link VISION, 6 CYPHER, 6 TAXUS and 7 XIENCE V) were deployed in the coronary arteries of 10 domestic swine for 28 days, after which each stent was harvested and processed (divided into 8 or 9 segments) for histomorphometric analysis...
September 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27702766/five-year-optical-coherence-tomography-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-bare-metal-versus-everolimus-eluting-stents
#20
Josep Gomez-Lara, Salvatore Brugaletta, Francisco Jacobi, Luis Ortega-Paz, Marcos Ñato, Gerard Roura, Rafael Romaguera, Jose-Luis Ferreiro, Luis Teruel, Montserrat Gracida, Victoria Martin-Yuste, Xavier Freixa, Monica Masotti, Joan-Antoni Gomez-Hospital, Manel Sabate, Angel Cequier
BACKGROUND: The main causes of late (>1 month) stent thrombosis (ST) are stent uncoverage, malapposition, and neoatherosclerosis. First-generation drug-eluting stents were associated with higher rate of late ST compared with bare-metal stents (BMS), especially in patients with ST-segment-elevation myocardial infarction. Second-generation everolimus-eluting stents (EES) have shown similar rate of late ST than BMS. The aims of the study are to compare the ratio of uncovered to total struts per cross-section ≥30% and other optical coherence tomographic findings associated with ST between EES and BMS in patients with ST-segment-elevation myocardial infarction at 5 years...
October 2016: Circulation. Cardiovascular Interventions
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