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New technology in coronary intervention

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https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#1
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160048/from-biodegradable-polymers-to-bioresorbable-vascular-scaffolds-available-evidence-in-the-current-era-of-new-generation-des
#2
Fabio Magliulo, Raffaele Piccolo, Anna Franzone, Giovanni Esposito, Gian B Danzi
New-generation drug-eluting stents (DES) encompass a large variety of coronary devices, featuring thin struts, biocompatible durable or biodegradable polymer coatings, and limus-eluting drugs. Due to improved early and long-term outcomes among patients undergoing percutaneous coronary intervention, new-generation metallic DES are recommended in almost all patient and lesion subsets. Available evidence from randomized trials indicate a similar safety and efficacy profile between biodegradable and durable polymers new-generation DES...
November 20, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29066425/mobile-technology-use-across-age-groups-in-patients-eligible-for-cardiac-rehabilitation-survey-study
#3
Robyn Gallagher, Kellie Roach, Leonie Sadler, Helen Glinatsis, Julie Belshaw, Ann Kirkness, Ling Zhang, Patrick Gallagher, Glenn Paull, Yan Gao, Stephanie Ruth Partridge, Helen Parker, Lis Neubeck
BACKGROUND: Emerging evidence indicates mobile technology-based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. However, little is known about cardiac patients' use of mobile technology, particularly for health reasons and whether the usage varies across patient demographics. OBJECTIVE: This study aimed to describe cardiac patients' use of mobile technology and to determine variations between age groups after adjusting for education, employment, and confidence with using mobile technology...
October 24, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29020417/the-reducer-device-in-patients-with-angina-pectoris-mechanisms-indications-and-perspectives
#4
Maayan Konigstein, Francesco Giannini, Shmuel Banai
Despite available pharmacological and interventional therapies, refractory angina is a common and disabling clinical condition, and a major public health problem, which affects patients' quality-of-life, and has a significant impact upon health care resources. Persistent angina is common not only in patients who are not good candidates for revascularization, but also in patients following successful revascularization. Clearly, there is a need for additional treatment options for refractory angina beyond currently available pharmacological and interventional therapies...
August 31, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28955184/neoatherosclerosis-and-late-thrombosis-after-percutaneous-coronary-intervention-translational-cardiology-and-comparative-medicine-from-bench-to-bedside%C3%A2-%C3%A2-%C3%A2
#5
REVIEW
Josip Anđelo Borovac, Domenico D'Amario, Giampaolo Niccoli
Neoatherosclerosis is a form of accelerated atherosclerosis that occurs within stented segments of the coronary vessel late or very late after drug-eluting stent (DES) implantation via percutaneous coronary intervention (PCI). This proliferation of neointima with a formation of new atheromatous plaque within stent struts lacking re-endothelialization can provoke thrombotic occlusion and lead to catastrophic acute coronary events. Knowing that coronary artery disease is the leading single cause of mortality worldwide and that there is a constant trend of increase in PCI procedures, it is reasonable to conclude that late thrombotic events and neoatherosclerosis post-PCI remain an important therapeutic challenge...
September 2017: Yale Journal of Biology and Medicine
https://www.readbyqxmd.com/read/28940020/improving-medication-adherence-in-coronary-heart-disease
#6
REVIEW
Leah L Zullig, Katherine Ramos, Hayden B Bosworth
PURPOSE OF REVIEW: The purpose of this review was to synthesize research findings from recently published randomized controlled trials (RCTs) targeting any phase of medication adherence, from initiation to discontinuation, among patients with coronary heart disease (CHD). RECENT FINDINGS: We identified successful strategies and promising practices for improving medication adherence among patients diagnosed with CHD. Consistent intervention strategies included the following: (1) facilitating patient-provider communication, (2) using mHealth technologies with emphasis on two-way communication, (3) providing patient education in tandem with lifestyle and behavioral counseling, and (4) providing psychosocial support...
September 22, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28923905/acute-coronary-syndromes-the-way-forward-from-mechanisms-to-precision-treatment
#7
REVIEW
Filippo Crea, Peter Libby
Well into the 21st century, we still triage acute myocardial infarction on the basis of the presence or absence of ST-segment elevation, a century-old technology. Meanwhile, we have learned a great deal about the pathophysiology and mechanisms of acute coronary syndromes (ACS) at the clinical, pathological, cellular, and molecular levels. Contemporary imaging studies have shed new light on the mechanisms of ACS. This review discusses these advances and their implications for clinical management of the ACS for the future...
September 19, 2017: Circulation
https://www.readbyqxmd.com/read/28915509/device-motion-indication-a-novel-image-based-tool-to-measure-relative-device-motion-during-coronary-intervention
#8
Rami Abu Fanne, Simcha Ron Meisel, Avraham Shotan, Aharon Frimerman
BACKGROUND: Movement of the stent delivery system in the coronary bed as a result of the cardiac cycle is a well-known clinical observation that usually is either underestimated or ignored. This effect may potentially jeopardize precise stent deployment. We used a novel technology to objectively measure the relative intracoronary device motion in the different coronary segments throughout the cardiac cycle. METHODS: A total of 193 patients undergoing coronary angiography were enrolled and their studies were analyzed for device movement using the SyncVision System (Philips Volcano)...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28894596/magmaris-a-new-generation-metallic-sirolimus-eluting-fully-bioresorbable-scaffold-present-status-and-future-perspectives
#9
REVIEW
Claudio Rapetto, Massimo Leoncini
Drug-eluting stents (DES) have reached a high safety and efficacy profile, becoming the best option for percutaneous coronary interventions (PCI) based revascularization. However, despite their optimal performance, a few concerns remain regarding their use, mainly due to permanent caging of the vessels and its consequences, first of all late stent thrombosis (ST). Bioresorbable scaffolds (BRS) aim to overcome these issues. The results achieved in randomized controlled trials (RCT) by the first generation of poly-L-lactic acid (PLLA) based scaffolds were promising at 1 year, but the first long term reports (albeit flawed by non-optimal implantation technique) have been disappointing, showing, for instance, an increased risk of ST and target vessel myocardial infarction (TV-MI)...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28889769/orsiro-cobalt-chromium-sirolimus-eluting-stent-present-and-future-perspectives
#10
Juan F Iglesias, Marco Roffi, Sophie Degrauwe, Gioel Gabrio Secco, Adel Aminian, Stephan Windecker, Thomas Pilgrim
New-generation drug-eluting stents (DES) represent the current standard of care in patients undergoing percutaneous coronary intervention (PCI). Biodegradable polymer DES (BP-DES) were recently developed to overcome current limitations of newer-generation durable polymer DES (DP-DES) attributed to sustained inflammatory responses induced by permanent polymers. The Orsiro DES (Biotronik AG, Bülach, Switzerland) is a novel thin-strut cobalt-chromium sirolimus-eluting stent with biodegradable polymer that features some of the latest developments in DES technology...
September 19, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28886892/the-atlantic-divide-in-coronary-heart-disease-epidemiology-and-patient-care-in-the-us-and-portugal
#11
Mariana F Lobo, Vanessa Azzone, Frederic S Resnic, Bruno Melica, Armando Teixeira-Pinto, Luís Filipe Azevedo, Alberto Freitas, Cláudia Nisa, Leonor Bacelar-Nicolau, Francisco Nuno Rocha-Gonçalves, José Pereira-Miguel, Altamiro Costa-Pereira, Sharon-Lise Normand
INTRODUCTION AND OBJECTIVES: We aimed to compare access to new health technologies to treat coronary heart disease (CHD) in the health systems of Portugal and the US, characterizing the needs of the populations and the resources available. METHODS: We reviewed data for 2000 and 2010 on epidemiologic profiles of CHD and on health care available to patients. Thirty health technologies (16 medical devices and 14 drugs) introduced during the period 1980-2015 were identified by interventional cardiologists...
September 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28851504/ultrathin-bioresorbable-polymer-sirolimus-eluting-stents-versus-thin-durable-polymer-everolimus-eluting-stents-in-patients-undergoing-coronary-revascularisation-bioflow-v-a-randomised-trial
#12
David E Kandzari, Laura Mauri, Jacques J Koolen, Joseph M Massaro, Gheorghe Doros, Hector M Garcia-Garcia, Johan Bennett, Ariel Roguin, Elie G Gharib, Donald E Cutlip, Ron Waksman
BACKGROUND: The development of coronary drug-eluting stents has included use of new metal alloys, changes in stent architecture, and use of bioresorbable polymers. Whether these advancements improve clinical safety and efficacy has not been shown in previous randomised trials. We aimed to examine the clinical outcomes of a bioresorbable polymer sirolimus-eluting stent compared with a durable polymer everolimus-eluting stent in a broad patient population undergoing percutaneous coronary intervention...
October 21, 2017: Lancet
https://www.readbyqxmd.com/read/28844030/state-of-the-art-balloon-catheter-technologies-drug-coated-balloon
#13
Fernando Alfonso, Bruno Scheller
Four decades after its introduction into clinical practice, coronary balloon angioplasty is still used during most coronary interventions. Conventional balloon angioplasty is frequently used to predilate complex or severe lesions and remains of major value to optimise the results of stent implantation. Plain balloon angioplasty is still used alone in some anatomic scenarios where stent implantation is not desirable (very small vessels or diffuse lesions, large resistant thrombus burden, side branches of bifurcations)...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844027/state-of-the-art-role-of-intravascular-imaging-in-the-evolution-of-percutaneous-coronary-intervention-a-30-year-review
#14
Christos V Bourantas, Erhan Tenekecioglu, Maria Radu, Lorenz Räber, Patrick W Serruys
It has been 40 years since percutaneous coronary intervention (PCI) was introduced into the clinical setting. Over these years significant advances in device technology and the invention of new therapeutic strategies have broadened its applications in the clinical arena, rendering this treatment the first-line therapy for patients with obstructive coronary artery disease. The evolution of PCI would not have been possible without intravascular imaging which provided unique insights about coronary artery pathology, enabled evaluation of vessel wall response following PCI and allowed meticulous evaluation of the advantages and limitations of emerging devices...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844026/state-of-the-art-coronary-angiography
#15
Carlos Collet, Maik J Grundeken, Taku Asano, Yoshinobu Onuma, William Wijns, Patrick W Serruys
In the early days of coronary angiography, the precise quantification of luminal narrowing was challenging. The introduction of balloon angioplasty (percutaneous transluminal coronary angioplasty [PTCA]) by Andreas Grüntzig in 1977 was perhaps the greatest incentive to the development of quantitative coronary angiography (QCA). QCA has played a crucial role in evaluating interventional techniques and assessing the results of new technologies. With the advent of drug-eluting stents (DES), QCA metrics such as late lumen loss and diameter stenosis (restenosis) proved to be instrumental in assessing new technologies...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28838462/drug-eluting-balloons-a-new-tool-in-the-treatment-of-cardiac-allograft-vasculopathy-a-case-series
#16
B Skoric, J Bulum, M Cikes, H Jurin, D Lovric, J Ljubas-Macek, J Samardzic, M Pasalic, D Milicic
Percutaneous coronary intervention in patients with cardiac allograft vasculopathy is burdened with a lot of difficulties. Although they have allowed significant progress in comparison with plain balloon angioplasty and bare metal stents, drug-eluting stents have not fully overcome problems of diffuse lesions and small-vessel disease that are so common in transplant coronary artery disease. There is growing evidence that drug-eluting balloons might be a better choice for patients with small vessel atherosclerotic coronary disease and yet there is no experience with this technology in patients with cardiac allograft vasculopathy...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28819961/-bioresorbable-scaffolds-in-the-treatment-of-coronary-artery-disease-expert-consensus-statement-of-the-association-of-cardiovascular-interventions-of-the-polish-cardiac-society-acvi-pcs
#17
Krzysztof Reczuch, Krzysztof Milewski, Wojciech Wąsek, Łukasz Rzeszutko, Wojciech Wojakowski, Michał Hawranek, Adrian Włodarczak, Tomasz Pawłowski, Janusz Kochman, Sławomir Dobrzycki, Marek Grygier, Andrzej Ochała, Jarosław Wójcik, Maciej Lesiak, Dariusz Dudek, Jacek Legutko
Bioresorbable scaffold coated with antimitotic drug is the latest development in the coronary stents technology. The concept of temporary scaffolding and natural vessel healing after angioplasty is a very attractive alternative to conventional metal stents. The results of the first observational studies have confirmed their ultimate biodegradation. Newest results of randomised trials and registries in broader clinical and anatomical indications also revealed the limitations of the first generation of scaffolds...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28710605/current-clinical-applications-of-coronary-optical-coherence-tomography
#18
REVIEW
Teruyoshi Kume, Shiro Uemura
Optical coherence tomography (OCT) is an intra-coronary diagnostic technique that provides detailed imagings of blood vessels in the current cardiac catheterization laboratory. The higher resolution of OCT often provides superior delineation of each structure compared with intravascular ultrasound (IVUS), and it can reliably visualize the microstructure of normal and diseased arteries. The capabilities of OCT are well suited for the identification of calcified plaque and neointima formation after stent implantation...
July 14, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28667812/utility-of-3d-oct-imaging-with-angiographic-co-registration-in-acute-coronary-syndrome-with-normal-or-near-normal-coronary-arteries
#19
Santiago Jesús Camacho Freire, Javier León Jiménez, Antonio Enrique Gómez Menchero, Jessica Roa Garrido, Rosa Cardenal Piris, José Francisco Díaz Fernández
The OPTIS integrated system (St. Jude Medical) is a new technology allowing the online co-registration of optical coherence tomography (OCT) images with the angiogram in the catheterization laboratory. Additionally, 3D navigation can be performed. This integration of OCT information on an angiographic roadmap could find broad application in the characterization of substrates causing acute coronary syndromes with normal or near-normal coronary arteries. The utility of OCT with co-registration for the guidance of percutaneous coronary intervention could be considerable in the management of patients with acute coronary syndromes...
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28544782/rationale-and-design-of-amphilimus-sirolimus-eluting-stents-versus-zotarolimus-eluting-stents-in-all-comers-requiring-percutaneous-coronary-intervention-recre8-a-multicenter-randomized-clinical-trial
#20
Rik Rozemeijer, Mèra Stein, Peter Frambach, Michiel Voskuil, Adriaan O Kraaijeveld, Ramón Rodríguez-Olivares, Leo Timmers, Bruno Pereira, Saskia Z Rittersma, Pierfrancesco Agostoni, Pieter A Doevendans, Pieter R Stella
BACKGROUND: Amphilimus sirolimus-eluting stents (A-SES) represent a novel elution technology in the current era of drug-eluting stents with promising results in patients with diabetes mellitus. At present no large trial has been designed to evaluate clinical outcomes of A-SES as compared to new-generation drug-eluting stents in unselected patients. Accordingly, we designed this trial to evaluate clinical noninferiority of A-SES as compared with zotarolimus-eluting stents (ZES) in a real-world, all-comers setting...
May 22, 2017: Catheterization and Cardiovascular Interventions
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