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Bare Metal or Drug- Eluting Coronary Stents

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https://www.readbyqxmd.com/read/28529095/understanding-operator-stent-choice-in-the-catheterization-laboratory-using-a-pre-procedure-survey-opportunities-for-quality-improvement
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#10
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28411902/contemporary-drug-eluting-stent-platforms-design-safety-and-clinical-efficacy
#11
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...
May 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28404622/choice-of-stent-for-percutaneous-coronary-intervention-of-saphenous-vein-grafts
#12
Javaid Iqbal, Chun Shing Kwok, Evangelos Kontopantelis, Mark A de Belder, Peter F Ludman, Adrian Large, Rob Butler, Amr Gamal, Tim Kinnaird, Azfar Zaman, Mamas A Mamas
BACKGROUND: There are limited data on comparison of contemporary drug-eluting stent (DES) platforms, previous generation DES, and bare-metal stents (BMS) for percutaneous coronary intervention in saphenous vein grafts (SVG). We aimed to assess clinical outcomes following percutaneous coronary intervention to SVG in patients receiving bare-metal stents (BMS), first-generation DES, and newer generation DES in a large unselected national data set from the BCIS (British Cardiovascular Intervention Society)...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28402204/evaluation-of-the-mistent-sustained-sirolimus-eluting-biodegradable-polymer-coated-stent-for-the-treatment-of-coronary-artery-disease-does-uniform-sustained-abluminal-drug-release-result-in-earlier-strut-coverage-and-better-safety-profile
#13
Ruben Y G Tijssen, Robin P Kraak, Huangling Lu, Jeffrey G Mifek, Wenda C Carlyle, Dennis J Donohoe, Robbert J De Winter, Karel T Koch, Joanna J Wykrzykowska
Treatment of coronary artery disease has made strides over the last decades. Development of drug eluting stents (DES), coated with a polymer layer and an anti-proliferative drug to reduce neointimal hyperplasia, has reduced the incidence of in-stent-restenosis relative to treatment with bare metal stents. Patients treated with first generation DES more likely suffer from (very) late events which can be cause by the permanent presence of a polymer. Therefore second generation DES with more biocompatible coatings, and third generation DES, with very thin struts coated with biodegradable polymers, were developed...
April 24, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28400917/coronary-stenting-a-matter-of-revascularization
#14
EDITORIAL
Aldo Bonaventura, Fabrizio Montecucco, Luca Liberale
In the last few decades, the recommended treatment for coronary artery disease has been dramatically improved by percutaneous coronary intervention (PCI) and the use of balloon catheters, bare metal stents (BMSs), and drug-eluting stents (DESs). Catheter balloons were burdened by acute vessel occlusion or target-lesion re-stenosis. BMSs greatly reduced those problems holding up the vessel structure, but showed high rates of in-stent re-stenosis, which is characterized by neo-intimal hyperplasia and vessel remodeling leading to a re-narrowing of the vessel diameter...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28394644/bioss-lim-c-thin-strut-cobalt-chromium-version-of-the-dedicated-bifurcation-stent
#15
Robert J Gil, Jacek Bil, Mateusz Kaczynski, Krzysztof P Milewski
Coronary bifurcation lesions pose therapeutic challenges during percutaneous coronary interventions. Dedicated bifurcation stents are one of the treatment options available. Areas covered: This paper will analyze the results of the BiOSS (Bifurcation Optimization Stent System) Clinical Program with a special focus on the cobalt-chromium BiOSS LIM C stent which has recently been introduced into the market (CE 2016). The stent is characterized by a strut thickness of 70 µm and sirolimus concentration of 1.4 µg/mm(2)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28382368/on-clopidogrel-platelet-reactivity-as-predictor-for-long-term-clinical-outcome-in-patients-after-planned-discontinuation-of-clopidogrel
#16
Timo Bömicke, Christian M Valina, Christian Stratz, Michael Amann, Franz-Josef Neumann, Willibald Hochholzer
It is unknown whether the known association of high on-treatment platelet reactivity (HTPR) with worse clinical outcome in patients on clopidogrel following coronary stent implantation persists after planned discontinuation of clopidogrel. This study investigated the association of HTPR with major ischaemic events after planned discontinuation of clopidogrel. Consecutive patients undergoing elective coronary stent implantation after loading with clopidogrel 600 mg were followed for up to seven years (n=765)...
April 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28342839/a-case-of-severely-calcified-neoatherosclerosis-after-paclitaxel-eluting-stent-implantation
#17
Kei Yamamoto, Kenichi Sakakura, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
A 79-year-old male who had a history of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) received coronary angiography (CAG), because of angina pectoris. CAG showed in-stent restenosis of the paclitaxel-eluting stent (PES). Since the devices could not pass the lesion, we performed rotational atherectomy. Although we could not identify the calcified lesion by the optical frequency domain imaging (OFDI) findings because of strong attenuation, the intravascular ultrasound (IVUS) image showed the superficial calcification...
March 15, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28328833/drug-coated-balloon-in-combination-with-bare-metal-stent-strategy-for-de-novo-coronary-artery-disease-a-prisma-compliant-meta-analysis-of-randomized-clinical-trials
#18
REVIEW
Wenjie Lu, Yongjian Zhu, Zhanying Han, Xi Wang, Xule Wang, Chunguang Qiu
BACKGROUND: Studies examining the efficiency of drug-coated balloon (DCB) + bare metal stent (BMS) compared with stents alone for de novo lesions have reported inconsistent results. The present comprehensive meta-analysis of randomized controlled trials (RCTs) assessed and compared the clinical efficacy and safety of DCB + BMS with those of stents alone for de novo coronary artery disease. METHODS: We formally searched electronic databases before September 2016 to identify potential studies...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28322012/3d-printed-multidrug-eluting-stent-from-graphene-nanoplatelet-doped-biodegradable-polymer-composite
#19
Santosh K Misra, Fatemeh Ostadhossein, Ramya Babu, Joseph Kus, Divya Tankasala, Andre Sutrisno, Kathleen A Walsh, Corinne R Bromfield, Dipanjan Pan
Patients with percutaneous coronary intervention generally receive either bare metal stents or drug-eluting stents to restore the normal blood flow. However, due to the lack of stent production with an individual patient in mind, the same level of effectiveness may not be possible in treating two different clinical scenarios. This study introduces for the first time the feasibility of a patient-specific stenting process constructed from direct 3D segmentation of medical images using direct 3D printing of biodegradable polymer-graphene composite with dual drug incorporation...
March 21, 2017: Advanced Healthcare Materials
https://www.readbyqxmd.com/read/28318654/safety-and-efficacy-of-drug-eluting-stents-in-patients-with-spontaneous-coronary-artery-dissection
#20
Federico Conrotto, Fabrizio D'Ascenzo, Enrico Cerrato, Antonio Fernández-Ortiz, Nieves Gonzalo, Fernando Macaya, Corrado Tamburino, Marco Barbanti, Martijn van Lavieren, Jan J Piek, Robert J Applegate, Azeem Latib, Maria Teresa Spinnler, Raffaella Marzullo, Mario Iannaccone, Marco Pavani, Gabriele Crimi, Rossella Fattori, Alessandra Chinaglia, Patrizia Presbitero, Ferdinando Varbella, Fiorenzo Gaita, Javier Escaned
AIMS: Given the different pathogenesis, use of drug eluting stent (DES) in patients with Spontaneous Coronary Artery Dissection SCAD may delay the healing of the dissected vessel. Aim of our study was to compare the safety and the efficacy of DES vs. bare metal stent (BMS) in a cohort of patients who underwent stenting for SCAD. METHODS AND RESULTS: Consecutive patients with SCAD between January 1995 and August 2014 were retrospectively identified in 12 centers and included...
March 9, 2017: International Journal of Cardiology
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