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New technology in coronary intervention

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https://www.readbyqxmd.com/read/28504955/three-dimensional-intravascular-reconstruction-techniques-based-on-intravascular-ultrasound-a-technical-review
#1
Chaoyang Shi, Xiongbiao Luo, Jin Guo, Zoran Najdovski, Toshio Fukuda, Hongliang Ren
Intravascular ultrasound (IVUS) imaging provides two-dimensional (2D) real-time luminal and transmural cross-sectional images of intravascular vessels with detailed pathological information. It has offered significant advantages in terms of diagnosis and guidance and has been increasingly introduced from coronary interventions into more generalized endovascular surgery. However, IVUS itself does not provide spatial pose information for its generated images, making it difficult to construct a 3D intravascular visualization...
May 12, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28454794/reduced-duration-of-dual-antiplatelet-therapy-using-an-improved-drug-eluting-stent-for-percutaneous-coronary-intervention-of-the-left-main-artery-in-a-real-world-all-comer-population-rationale-and-study-design-of-the-prospective-randomized-multicenter-ideal
#2
Miguel E Lemmert, Keith Oldroyd, Paul Barragan, Maciej Lesiak, Robert A Byrne, Evgeny Merkulov, Joost Daemen, Yoshinobu Onuma, Karen Witberg, Robert-Jan van Geuns
BACKGROUND: Continuous improvements in stent technology make percutaneous coronary intervention (PCI) a potential alternative to surgery in selected patients with unprotected left main coronary artery (uLMCA) disease. The optimal duration of dual antiplatelet therapy (DAPT) in these patients remains undetermined, and in addition, new stent designs using a bioabsorbable polymer might allow shorter duration of DAPT. STUDY DESIGN: IDEAL-LM is a prospective, randomized, multicenter study that will enroll 818 patients undergoing uLMCA PCI...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28414007/pok%C3%A3-mon-go-digital-health-interventions-to-reduce-cardiovascular-risk
#3
Chayakrit Krittanawong, Mehmet Aydar, Takeshi Kitai
Physical activity is associated with a lower risk of coronary heart disease/cardiovascular disease mortality, and current guidelines recommend physical activity for primary prevention in healthy individuals and secondary prevention in patients with coronary heart disease/cardiovascular disease. Over the last decade, playing classic video games has become one of the most popular leisure activities in the world, but is associated with a sedentary lifestyle. In the new era of rapidly evolving augmented reality technology, Pokémon Go, a well-known augmented reality game, may promote physical activity and prevent cardiovascular disease risks - that is, diabetes, obesity, and hypertension...
April 17, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28398396/-bioresorbable-vascular-scaffolds-clinical-experience-of-the-emilia-romagna-region-italy
#4
Alberto Menozzi, Gianluca Calogero Campo, Vincenzo Guiducci, Gianni Dall'Ara, Andrea Santarelli, Paolo Sbarzaglia, Marco Balducelli, Paolo Magnavacchi, Fabio Sgura, Luciano Losi, Luigi Vignali, Gianni Casella, Luigi Steffanon, Fabio Tarantino, Francesco Saia
BACKGROUND: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28388767/treatment-of-coronary-artery-disease-randomized-trials-on-myocardial-revascularization-and-complete-arterial-bypass-grafting
#5
Ardawan J Rastan
Friedrich Wilhelm Mohr from the very beginning of his career as a cardiac surgeon was involved in the refinements of coronary artery bypass grafting (CABG). At the Leipzig Heart Center, his spirit of early adapting to new technologies inspired the entire team and led to a matchless scientific atmosphere to find solutions to improve almost all fields of cardiac surgery, including CABG. In combination with a tremendous number of patients with indications for isolated coronary artery bypass Prof. Mohr as the surgical principle investigator and the Leipzig Heart Center were able to include patients in the Synergy between PCI [percutaneous coronary intervention] with Taxus and Cardiac Surgery (SYNTAX) trial, the first randomized trials comparing CABG and PCIs using the drug-eluting stents...
April 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28370939/stent-mediated-gene-and-drug-delivery-for-cardiovascular-disease-and-cancer-a-brief-insight
#6
REVIEW
Akshaya Krishnagopal, Aakash Reddy, Dwaipayan Sen
AIM: This article concisely recapitulates the different existing modes of stent mediated gene/drug delivery, their considerable advancements in clinical trials and a rationale of other merging new technologies such as nanotechnology and microRNA based therapeutics, furthermore addressing the breach in each of these perpetual stent platforms. DISCUSSION: Over the past decade stent mediated gene/drug delivery have materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to the routine conventional treatment modalities...
March 31, 2017: Journal of Gene Medicine
https://www.readbyqxmd.com/read/28228292/a-fresh-look-at-bioresorbable-scaffold-technology-intuition-pumps
#7
EDITORIAL
Sundeep Mishra
Bioresorbable scaffolds (BRS) are a new enticing treatment option in coronary interventions. Absorb BVS™ Is the most widely used and researched polymer based BRS, eluting everolimus. However currently it has several technical limitations; low radial support, larger strut size, poor visualization, poor deliverability and complex implantation technique. Magnesium based BRS are an alternate but they are also limited not only by lower radial support and poor visualization but also earlier bio-absorption. Material processing: blow-molding, annealing, polymer orientation, change in composition and use of higher molecular weight polymer, as well new polymers like tyrosine or salicyclate analogs and even hybrid (polymer and metallic) combined with intelligent cell design has led to evolution of BRS technology...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28220461/new-generation-coronary-stents-current-data-and-future-directions
#8
REVIEW
Ankur Kalra, Hasan Rehman, Sahil Khera, Braghadheeswar Thyagarajan, Deepak L Bhatt, Neal S Kleiman, Robert W Yeh
PURPOSE OF REVIEW: Drug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly evolving area of interventional cardiology...
March 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28183437/cardiac-3d-printing-and-its-future-directions
#9
REVIEW
Marija Vukicevic, Bobak Mosadegh, James K Min, Stephen H Little
Three-dimensional (3D) printing is at the crossroads of printer and materials engineering, noninvasive diagnostic imaging, computer-aided design, and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review, we discuss the methods and materials being used for 3D printing today...
February 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28164572/impact-of-the-cyp2c19-gene-polymorphism-on-clopidogrel-personalized-drug-regimen-and-the-clinical-outcomes
#10
Keguang Chen, Rui Zhang, Huanjun Liu, Xi Guo, Pingli Li, Xuehong Liu
BACKGROUND: Although the relationship between CYP2C19 genotype and clopidogrel metabolism has been studied clearly, we have not seen the report that clopidogrel was administered at a dose adjusted based on genotyping. The two main polymorphism loci of CYP2C19 gene were detected by the CYP2C19 genetic testing. ADP platelet aggregation technology was used to investigate the correlation between clinical effect and the clopidogrel dose, genetic metabolic type, physiological, pathological and other factors, to provide new ideas for clopidogrel therapy for percutaneous coronary intervention postoperation patients...
September 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28144714/-new-and-established-aspects-of-cardiological-diagnostics-using-tee-do-we-need-3d-technology-in-clinical-routine
#11
A Hagendorff, S Stoebe, D Jurisch, M Neef, M Metze, D Pfeiffer
In comparison to transthoracic echocardiography (TTE) transesophageal echocardiography (TEE) enables an acquisition of images with better spatial resolution due to the use of higher ultrasound frequencies. Thus, the morphology and function of cardiac structures can principally be analyzed better and more accurately with TEE than with TTE. In addition, using three-dimensional (3D) TEE data sets standardized sectional planes can be constructed by post-processing, which enables quantitative assessment of the target structures...
May 2017: Herz
https://www.readbyqxmd.com/read/28089778/image-noise-reduction-technology-reduces-radiation-in-a-radial-first-cardiac-catheterization-laboratory
#12
Ateka Gunja, Yagya Pandey, Hui Xie, Beata M Wolska, Adhir R Shroff, Amer K Ardati, Mladen I Vidovich
BACKGROUND: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. METHODS AND RESULTS: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N=200) and a new image noise reduction fluoroscopy system (N=200)...
April 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28064551/fd-oct-and-ivus-intravascular-imaging-modalities-in-peripheral-vasculature
#13
REVIEW
S Spiliopoulos, P Kitrou, K Katsanos, D Karnabatidis
Intra-Vascular Ultra-Sound (IVUS) and Frequency Domain-Optical Coherence Tomography (FD-OCT), in vivo, intra-vascular, imaging modalities, widely used in the field of coronary disease, have been recently implemented in peripheral endovascular procedures, for procedural assessment, plaque characterization and determination of predictors of treatment outcomes. Their unique characteristics have also been used in order to provide additional features and improve the performance of re-entry devices and atherotomes...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27957249/physiology-of-in-situ-arterial-revascularization-in-coronary-artery-bypass-grafting-preoperative-intraoperative-and-postoperative-factors-and-influences
#14
REVIEW
T Bruce Ferguson
Surgical revascularization with coronary artery bypass grafting (CABG) has become established as the most effective interventional therapy for patients with moderately severe and severe stable ischemic heart disease (SIHD). This recommendation is based on traditional 5-year outcomes of mortality and avoidance of myocardial infarction leading to reintervention and/or cardiac death. However, these results are confounded in that they challenge the traditional CABG surgical tenets of completeness of anatomic revascularization, the impact of arterial revascularization on late survival, and the lesser impact of secondary prevention following CABG on late outcomes...
November 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27861114/bioresorbable-stents-the-future-of-interventional-cardiology
#15
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/27843185/drug-eluting-stents-to-evolve-or-dissolve
#16
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/27797462/paving-the-way-to-a-bioresorbable-technology-development-of-the-absorb-brs-program
#17
REVIEW
Laura E Leigh Perkins, Mary Beth Kossuth, Julia C Fox, Richard J Rapoza
Bioresorbable scaffolds (BRS) combine attributes of the preceding generations of percutaneous coronary intervention (PCI) devices with new technologies to result in a novel therapy promoted as being the fourth generation of PCI. By providing mechanical support and drug elution to suppress restenosis, BRS initially function similarly to drug eluting stents. Thereafter, through their degradation, BRS undergo a decline in radial strength, allowing a gradual transition of mechanical function from the scaffold back to the artery in order to provide long term effectiveness similar to balloon angioplasty...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27714584/contemporary-management-of-st-segment-elevation-myocardial-infarction
#18
REVIEW
Ajay Yadlapati, Mark Gajjar, Daniel R Schimmel, Mark J Ricciardi, James D Flaherty
ST-elevation myocardial infarction (STEMI), which constitutes nearly 25-40 % of current acute myocardial infarction (AMI) cases, is a medical emergency that requires prompt recognition and treatment. Since the 2013 STEMI practice guidelines, a wealth of additional data that may further advance optimal STEMI practices has emerged. These data highlight the importance of improving patient treatment and transport algorithms for STEMI from non-primary percutaneous coronary intervention (PCI) centers. In addition, a focus on the reduction of total pain-to-balloon (P2B) times rather than simply door-to-balloon (D2B) times may further improve outcomes after primary PCI for STEMI...
December 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27619478/bioresorbable-vascular-scaffolds-what-does-the-future-bring
#19
COMMENT
Jacek Bil, Robert J Gil
Bioresorbable vascular scaffolds (BVS) have emerged as an interesting alternative since the presence of the prosthesis in the coronary artery is transient. This technology enables to restore the normal vasomotor tone and allows positive remodeling, simultaneously reducing the trigger for persistent inflammation and facilitating further interventions by percutaneous or surgical means. Absorb BVS(®) is the first generation everolimus-eluting poly-L-lactide (PLLA) bioresorbable scaffold. In recent meta-analyses Absorb BVS(®) was definitely proved to be safe and effective device in the treatment of symptomatic coronary artery disease...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27595692/rationale-and-design-of-a-randomized-trial-of-automated-hovering-for-post-myocardial-infarction-patients-the-heartstrong-program
#20
Andrea B Troxel, David A Asch, Shivan J Mehta, Laurie Norton, Devon Taylor, Tirza A Calderon, Raymond Lim, Jingsan Zhu, Daniel M Kolansky, Brian M Drachman, Kevin G Volpp
BACKGROUND: Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. METHODS: HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures...
September 2016: American Heart Journal
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