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Bare Metal or Drug- Eluting Coronary Stents

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28523173/thrombotic-responses-to-coronary-stents-bioresorbable-scaffolds-and-the-kounis-hypersensitivity-associated-acute-thrombotic-syndrome
#13
REVIEW
Nicholas G Kounis, Ioanna Koniari, Anastasios Roumeliotis, Grigorios Tsigas, George Soufras, Nicholas Grapsas, Periklis Davlouros, George Hahalis
Percutaneous transluminal coronary angioplasty with coronary stent implantation is a life-saving medical procedure that has become, nowadays, the most frequent performed therapeutic procedure in medicine. Plain balloon angioplasty, bare metal stents, first and second generation drug-eluting stents, bioresorbable and bioabsorbable scaffolds have offered diachronically a great advance against coronary artery disease and have enriched our medical armamentarium. Stented areas constitute vulnerable sites for endothelial damage, endothelial dysfunction, flow turbulence, hemorheologic changes, platelet dysfunction, coagulation changes and fibrinolytic disturbances...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28498849/percutaneous-coronary-intervention-with-second-generation-drug-eluting-stent-versus-bare-metal-stent-systematic-review-and-cost-benefit-analysis
#14
Thomas G Poder, Jihane Erraji, Lucien P Coulibaly, Kouamé Koffi
BACKGROUND: Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries...
2017: PloS One
https://www.readbyqxmd.com/read/28492572/-the-spiral-of-evil-iatrogenic-coronary-and-aortic-dissection
#15
Paolo Canova, Giuseppe Musumeci, Roberta Rossini, Mauro Gori, Michele Senni, Orazio Valsecchi
Iatrogenic coronary and aortic dissection is one of the worst complication during a percutaneous coronary intervention. Nevertheless, it can be approached and effectively resolved by a percutaneous way, sealing the false lumen "entry door" with a covered stent, even if this device is more thrombogenic than other bare-metal or drug-eluting stents. We report the case of a 60-year-old man with acute ST-elevation myocardial infarction complicated by both iatrogenic dissection and multiple stent thrombosis.
April 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28480650/comparison-of-drug-eluting-balloon-followed-by-bare-metal-stent-with-drug-eluting-stent-for-treatment-of-de-novo-lesions-randomized-controlled-single-center-clinical-trial
#16
In Ho Chae, Chang Hwan Yoon, Jin Joo Park, Il Young Oh, Jung Won Suh, Young Seok Cho, Tae Jin Youn, Dong Ju Choi
The combined use of a drug-eluting balloon (DEB) and a bare metal stent (BMS) for the treatment of de novo non-small vessel coronary artery diseases (CAD) remains to be evaluated. We investigated the efficacy of a sequential treatment using a DEB together with a BMS implantation in comparison to a zotarolimus-eluting stent (ZES). This study was a prospective, randomized, open-label study. We designed it to demonstrate the non-inferiority of a sequential treatment using a DEB first followed by a BMS (DEB + BMS) compared with the use of a ZES...
June 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28473448/india-and-the-coronary-stent-market-getting-the-price-right
#17
Priya Wadhera, Thomas Alexander, Brahmajee K Nallamothu
On February 13, 2017, India's National Pharmaceutical and Pricing Authority (NPPA) made a landmark decision to fix price ceilings for coronary stents at 7260 rupees for bare metal stents and 29 600 rupees for drug-eluting stents (US equivalents of $108 and $444, respectively).(1,2) Stents had been placed on the National List of Essential Medications (NLEM) in July 2016 by the health ministry.(1) In India, stents turned out to be subject to substantial price markups on their journey from manufacturer to patient, at times exceeding 4 times their original imported value...
May 4, 2017: Circulation
https://www.readbyqxmd.com/read/28454795/rationale-and-design-of-the-japan-usa-harmonized-assessment-by-randomized-multicenter-study-of-orbusneich-s-combo-stent-japan-usa-harmonee-assessment-of-a-novel-des-platform-for-percutaneous-coronary-revascularization-in-patients-with-ischemic-coronary-disease
#18
David F Kong, Shigeru Saito, Shigeru Nakamura, Roxana Mehran, Stephen M Rowland, Allison Handler, Hussein R Al-Khalidi, Mitchell W Krucoff
Tissue trauma associated with stent implantation continues to generate early thrombosis rates of 0.9% to 1.3% for both bare-metal and drug-eluting stent platforms. The Combo sirolimus-eluting stent combines an abluminal, bioabsorbable polymer with a luminal CD34+ antibody designed to capture endothelial progenitor cells. This article describes the design and methods of the HARMONEE trial (NCT02073565), which represents the first randomized controlled trial of the Combo design against a best-in-class contemporary everolimus-eluting stent...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28445555/drug-eluting-balloon-versus-bare-mental-stent-and-drug-eluting-stent-for-de-novo-coronary-artery-disease-a-systematic-review-and-meta-analysis-of-14-randomized-controlled-trials
#19
Kongyong Cui, Shuzheng Lyu, Xiantao Song, Fei Yuan, Feng Xu, Min Zhang, Wei Wang, Dongfeng Zhang, Jing Dai
BACKGROUND: Drug-eluting balloon (DEB) has become an alternative option to drug-eluting stent (DES) for the treatment of in-stent restenosis (ISR). However, the effect of drug-eluting balloon with regular bare-mental stent (BMS) in de novo coronary artery disease (CAD) is unclear. This meta-analysis aimed to evaluate the efficacy of DEB with regular BMS compared to BMS or DES in de novo CAD. METHODS: Randomized controlled trials (RCTs) assessing the efficacy of DEB+BMS in comparison with BMS or DES were obtained by searching the PubMed, EMBASE, and Cochrane Library databases through January 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28427734/comparison-of-outcomes-and-prognosis-of-patients-with-versus-without-newly-diagnosed-diabetes-mellitus-after-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-the-horizons-ami-study
#20
Konstanze Ertelt, Sorin J Brener, Roxana Mehran, Ori Ben-Yehuda, Thomas McAndrew, Gregg W Stone
A history of diabetes mellitus (DM) is an independent predictor for adverse events in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Outcomes of patients with STEMI and newly diagnosed DM (NDM) are less well described. We used the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial database to identify the outcomes at 30 days and 3 years according to no, known, and NDM in patients with STEMI...
June 15, 2017: American Journal of Cardiology
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