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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/28810900/polymer-free-dual-drug-eluting-stents-evaluated-in-a-porcine-model
#1
Bin Zhang, Bo Zheng, Xingang Wang, Qiuping Shi, Jia Jia, Yong Huo, Chunshui Pan, Jingyan Han, Ming Chen
BACKGROUND: Although drug-eluting stents have dramatically reduced the rates of restenosis and target lesion revascularization, they are associated with stent thrombosis (ST), a catastrophic event likely due to delayed endothelialization and chronic inflammation caused by the polymer and the metal scaffolds. To increase the safety and efficacy of stents, polymer-free dual drug-eluting stents (DDES) have been developed. METHODS: A total 160 stents (Bare-metal stents (BMS), polymer-free probucol stents (PrES), sirolimus-eluting stents (SES) and DDES) were randomly implanted in the coronary arteries of 80 pigs...
August 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28799125/non-polymer-drug-eluting-coronary-stents
#2
REVIEW
Nagavendra Kommineni, Raju Saka, Wahid Khan, Abraham J Domb
Cardiovascular complications are leading causes of most fatalities. Coronary artery disease and surgical failures contribute to the death of the majority of patients. Advanced research in the field of medical devices like stents has efficiently resolved these problems. Clinically, drug-eluting stents have proven their efficacy and safety compared to bare metal stents, which have problems of in-stent restenosis. However, drug-loaded stents coated with polymers have shown adverse effects related to the stability and deterioration of the polymer coating over time...
August 10, 2017: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/28780509/rehospitalizations-following-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-results-from-a-multi-center-randomized-trial
#3
Ernest Spitzer, Martina Frei, Serge Zaugg, Susanne Hadorn, Henning Kelbaek, Miodrag Ostojic, Andreas Baumbach, David Tüller, Marco Roffi, Thomas Engstrom, Giovanni Pedrazzini, Vladan Vukcevic, Michael Magro, Ran Kornowski, Thomas F Lüscher, Clemens von Birgelen, Dik Heg, Stephan Windecker, Lorenz Räber
BACKGROUND: Rehospitalizations (RHs) after ST-elevation myocardial infarction carry a high economic burden and may deteriorate quality of life. Characterizing patients at higher risk may allow the design of preventive measures. We studied the frequency, reasons, and predictors for unplanned cardiac and noncardiac RHs in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: In this post-hoc analysis of the COMFORTABLE AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction; NCT00962416) trial including 1137 patients, unplanned cardiac and noncardiac RHs occurred in 133 (11...
August 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28766865/trapping-as-retrieval-technique-to-resolve-a-ruptured-and-entrapped-coronary-balloon-catheter
#4
Javier León Jiménez, Jessica Roa Garrido, Santiago Jesús Camacho Freire, José Francisco Díaz Fernández
A 69 year old male, with a previous percutaneous revascularization of the mid-circumflex with a bare metal stent in 2007 was admitted to our centre for unstable angina. The angiography showed a severely calcified coronary tree with a functionally severe plaque on the proximal left anterior descending artery (LAD) and a critical focal lesion on the proximal right coronary artery. After a high pressure predilation on the proximal LAD, the balloon ruptured causing a retrograde LAD-left main (LM) dissection that was rapidly sealed with three overlapping zotarolimus-eluting stents from medial LAD to LM...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28763308/revascularization-strategies-and-in-hospital-management-in-acute-coronary-syndromes-complicated-by-hemophilia-a-or-hemophilia-b
#5
Matthew J Reilley, Anne Blair, William H Matthai, Rolando Vega, Meghan Buckley, Phyllis A Gimotty, Patrick F Fogarty
: Among adult patients with hemophilia A and hemophilia B the emergent management of acute coronary syndromes (ACSs) is challenging, and exposure to antithrombotic agents and/or revascularization procedures may confer an enhanced risk of bleeding. We sought to identify clinical characteristics and in-hospital outcomes among ACS patients with hemophilia A/hemophilia B, compared with matched noncoagulopathic ACS controls. Case discharges from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (1998-2011) had International Classification of Diseases, 9th Revision codes for hemophilia A/hemophilia B and ACS...
July 29, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28761388/coronary-stents-and-vascular-response-to-implantation-literature-review
#6
REVIEW
Marta Francesca Brancati, Francesco Burzotta, Carlo Trani, Ornella Leonzi, Claudio Cuccia, Filippo Crea
Drug-eluting stents (DESs) have minimized the limitations of bare-metal stents (BMSs) after percutaneous coronary interventions. Nevertheless, serious concerns remain about possible late complications of stenting, such as stent thrombosis (ST) and in-stent restenosis (ISR), although the introduction of second-generation DESs seems to have softened the phenomenon, compared to the first-generation ones. ST is a potentially catastrophic event, which has been markedly reduced by optimization of stent implantation, novel stent designs, and dual antiplatelet therapy...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28756388/drug-eluting-stents-in-clinical-routine-a-1-year-follow-up-analysis-based-on-german-health-insurance-administrative-data-from-2008-to-2014
#7
Elke Jeschke, Julia Searle, Christian Günster, Henning Thomas Baberg, Peter Dirschedl, Benny Levenson, Jürgen Malzahn, Thomas Mansky, Martin Möckel
OBJECTIVES: To describe the use of drug-eluting stents (DESs) in the largest population of statutory health insurance members in Germany, including newly developed bio-resorbable vascular scaffolds (BVSs), and to evaluate 1-year complication rates of DES as compared with bare metal stents (BMSs) in this cohort. DESIGN: Routine data analysis of statutory health insurance claims data from the years 2008 to 2014. SETTING: The German healthcare insurance Allgemeine Ortskrankenkasse covers approximately 30% of the German population and is the largest nationwide provider of statutory healthcare insurance in Germany...
July 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28750704/should-we-still-have-bare-metal-stents%C3%A2-available-in-our-catheterization%C3%A2-laboratory
#8
REVIEW
Antonio Colombo, Francesco Giannini, Carlo Briguori
The introduction of bare-metal stents (BMS) has represented a major advancement over plain old balloon angioplasty in the management of coronary artery disease. However, the high rates of target lesion revascularization associated with use of BMS have led to the development of drug-eluting stents, which require prolonged dual antiplatelet therapy due to the increased risk of late and very late stent thrombosis. The improvements in newer-generation drug-eluting stents have translated into better safety and efficacy compared with earlier generation and BMS, thus allowing shorter dual antiplatelet therapy duration...
August 1, 2017: Journal of the American College of Cardiology
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
September 2017: European Journal of Clinical Pharmacology
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