17 results on '"Seixas AC"'
Search Results
2. Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries : A quantitative coronary angiography and three-dimensional intravascular ultrasound study
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Sousa, JE, Costa, M (Marco), Abizaid, A, Abizaid, AS, Feres, F, Pinto, IMF, Seixas, AC, Staico, R, Mattos, LA, Sousa, AGMR, Falotico, R, Jaeger, J, Popma, JJ, Serruys, PWJC (Patrick), Sousa, JE, Costa, M (Marco), Abizaid, A, Abizaid, AS, Feres, F, Pinto, IMF, Seixas, AC, Staico, R, Mattos, LA, Sousa, AGMR, Falotico, R, Jaeger, J, Popma, JJ, and Serruys, PWJC (Patrick)
- Published
- 2001
3. Impact of PCI Appropriateness in the Long-Term Outcomes of Consecutive Patients Treated With Second-Generation Drug-Eluting Stents.
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Seixas AC, Sousa A, de Ribamar Costa J Jr, Costa Moreira A, Costa R, Damiani L, Campos Neto C, Maldonado G, Cano M, and Sousa JE
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- Aged, Coronary Angiography, Coronary Artery Disease diagnosis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, Treatment Outcome, Coronary Artery Disease surgery, Drug-Eluting Stents, Percutaneous Coronary Intervention methods
- Abstract
Background: Appropriate use criteria (AUC) for coronary revascularization were developed to deliver high-quality care; however, the prognostic impact of these criteria remains unclear. We sought to assess the outcomes of patients treated with second-generation drug-eluting stent (DES) classified according to the updated American College of Cardiology Foundation/American Heart Association/Society for Cardiac Angiography and Intervention AUC for percutaneous coronary intervention (PCI)., Methods: Between January 2012 and December 2013, a total of 1108 consecutive patients treated only with second-generation DES were categorized according to the AUC in three groups, using the new proposed terminology: appropriate ("A"); uncertain ("U"); and inappropriate ("I"). Major adverse cardiac event (MACE, defined as cardiac death, non-fatal myocardial infarction, and ischemia-driven target-lesion revascularization) and stent thrombosis up to 3 years were compared., Results: PCI was categorized as A in 33.8%, U in 46.8%, and I in 19.4% of all cases. PCI-A patients had a higher prevalence of acute coronary syndromes, while PCI-I involved the treatment of more diabetics and patients with stable coronary disease. There were no differences in procedural complications among the three groups, with comparable rates of in-hospital MACE (9.3% for A vs 9.0% for U vs 7.0% for I; P=.70) and 2-year MACE (13.9% for A vs 9.0% for U vs 8.6% for I; P=.40). In the multivariable analysis, AUC classification was not associated with adverse outcomes., Conclusions: In this contemporary cohort of patients treated with second-generation DES implantation, AUC did not impact 3-year clinical follow-up.
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- 2017
4. Stable expression of Mycobacterium bovis antigen 85B in auxotrophic M. bovis bacillus Calmette-Guérin.
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Rizzi C, Peiter AC, Oliveira TL, Seixas AC Neto, Leal KS, Hartwig DD, Seixas FK, Borsuk S, and Dellagostin OA
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- Animals, Antigens, Bacterial metabolism, BCG Vaccine genetics, Escherichia coli genetics, Female, Genetic Vectors genetics, Genetic Vectors immunology, Mice, Mice, Inbred BALB C, Mycobacterium bovis genetics, Plasmids genetics, Plasmids immunology, Antigens, Bacterial immunology, BCG Vaccine immunology, Mycobacterium bovis immunology
- Abstract
Background: Bovine tuberculosis (TB) is a zoonotic disease caused by Mycobacterium bovis, responsible for causing major losses in livestock. A cost effective alternative to control the disease could be herd vaccination. The bacillus Calmette-Guérin (BCG) vaccine has a limited efficacy against bovine TB, but can improved by over-expression of protective antigens. The M. bovis antigen 85B demonstrates ability to induce protective immune response against bovine TB in animal models. However, current systems for the construction of recombinant BCG expressing multiple copies of the gene result in strains of low genetic stability that rapidly lose the plasmid in vivo. Employing antibiotic resistance as selective markers, these systems also compromise vaccine safety. We previously reported the construction of a stable BCG expression system using auxotrophic complementation as a selectable marker., Objectives: The fundamental aim of this study was to construct strains of M. bovis BCG Pasteur and the auxotrophic M. bovis BCG ΔleuD expressing Ag85B and determine their stability in vivo., Methods: Employing the auxotrophic system, we constructed rBCG strains that expressed M. bovis Ag85B and compared their stability with a conventional BCG strain in mice. Stability was measured in terms of bacterial growth on the selective medium and retention of antigen expression., Findings: The auxotrophic complementation system was highly stable after 18 weeks, even during in vivo growth, as the selective pressure and expression of antigen were maintained comparing to the conventional vector., Main Conclusion: The Ag85B continuous expression within the host may generate a stronger and long-lasting immune response compared to conventional systems.
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- 2017
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5. 2-Aryl-3-(2-morpholinoethyl)thiazolidin-4-ones: Synthesis, anti-inflammatory in vivo, cytotoxicity in vitro and molecular docking studies.
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Pires Gouvea D, Vasconcellos FA, Dos Anjos Berwaldt G, Neto AC, Fischer G, Sakata RP, Almeida WP, and Cunico W
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- Animals, Anti-Inflammatory Agents, Non-Steroidal metabolism, Anti-Inflammatory Agents, Non-Steroidal toxicity, Chlorocebus aethiops, Cyclooxygenase 1 chemistry, Cyclooxygenase 1 metabolism, Cyclooxygenase 2 chemistry, Cyclooxygenase 2 metabolism, Mice, Protein Conformation, Thiazolidines metabolism, Thiazolidines toxicity, Vero Cells, Anti-Inflammatory Agents, Non-Steroidal chemical synthesis, Anti-Inflammatory Agents, Non-Steroidal pharmacology, Molecular Docking Simulation, Thiazolidines chemical synthesis, Thiazolidines pharmacology
- Abstract
Seven new 4-thiazolidinones bearing the morpholino moiety were easily synthesized by one-pot reactions of 4-(2-aminoethyl)morpholine (2-morpholinoethylamine), arenealdehydes and mercaptoacetic acid refluxing toluene for 19 h with moderate to good yields (45-97%). These novel compounds were fully identified and characterized by NMR spectroscopy and mass spectrometry. Thiazolidin-4-ones in vivo anti-inflammatory activities were determined using a croton oil-induced ear edema model of inflammation in BALB C mice. The best results were found for compounds 4c (49.20 mmol/kg), 4d (49.20 mmol/kg) and 4f (52.48 mmol/kg), which showed the ability to decrease the ear edema in mice by 50%, 48% and 54%, respectively, when compared to the standard drug indomethacin. In addition, the in vitro cytotoxicity activity of thiazolidin-4-ones against Vero cells was also performed and four compounds (4a, 4c, 4d and 4f) showed no toxic effect at 500 μg/mL. A docking simulation of compounds into the 1Q4G (COX-1) and 4PH9 (COX-2) enzymes binding site was conducted. This preliminary result will guide us in for further studies to improve the anti-inflammatory activity., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)
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- 2016
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6. Infection with Leptospira kirschneri Serovar Mozdok: First Report from the Southern Hemisphere.
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da Cunha CE, Felix SR, Neto AC, Campello-Felix A, Kremer FS, Monte LG, Amaral MG, de Oliveira Nobre M, da Silva ÉF, Hartleben CP, McBride AJ, and Dellagostin OA
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- Animals, Brazil epidemiology, Cricetinae, Dog Diseases epidemiology, Dogs, Female, Humans, Leptospira genetics, Leptospirosis epidemiology, Leptospirosis veterinary, Mesocricetus, Middle Aged, Phylogeny, Dog Diseases microbiology, Leptospira classification, Leptospira isolation & purification, Leptospirosis microbiology
- Abstract
Leptospirosis is a global zoonosis caused by pathogenic Leptospira spp. In this study, we characterized two Leptospira kirschneri serogroup Pomona serovar Mozdok isolates, one obtained from a dog and the other from a patient with severe leptospirosis, 4 years later. Histopathological analysis showed that both isolates caused severe tissue damage when used to infect hamsters. While L. kirschneri serogroup Pomona serovar Mozdok is endemic in animals in Europe, there is only one report of human leptospirosis in the literature. Although strains belonging to L. kirschneri serogroup Pomona have been identified in cases of human leptospirosis in Europe, serovar Mozdok has not yet been implicated. The 4-year interval between isolations and the fact that this is the first report of serovar Mozdok as the causative agent of human leptospirosis in the southern hemisphere, demonstrates its epidemiological importance to public health. Moreover, the presence of serovar Mozdok in Brazil has the potential to affect vaccine and diagnostic test development., (© The American Society of Tropical Medicine and Hygiene.)
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- 2016
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7. Subunit approach to evaluation of the immune protective potential of leptospiral antigens.
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Félix SR, Hartwig DD, Argondizzo AP, Silva ÉF, Seixas FK, Neto AC, Medeiros MA, Lilenbaum W, and Dellagostin OA
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- Animals, Antigens, Bacterial genetics, Bacterial Vaccines administration & dosage, Bacterial Vaccines genetics, Cricetinae, Disease Models, Animal, Female, Leptospirosis immunology, Protein Subunits genetics, Protein Subunits immunology, Survival Analysis, Vaccines, Subunit administration & dosage, Vaccines, Subunit genetics, Vaccines, Subunit immunology, Vaccines, Synthetic administration & dosage, Vaccines, Synthetic genetics, Vaccines, Synthetic immunology, Antigens, Bacterial immunology, Bacterial Vaccines immunology, Leptospira interrogans immunology, Leptospira interrogans pathogenicity, Leptospirosis prevention & control
- Abstract
Leptospirosis is the most widespread zoonosis in the world. Current vaccines are based on whole-cell preparations that cause severe side effects and do not induce satisfactory immunity. In light of the leptospiral genome sequences recently made available, several studies aimed at identification of protective recombinant immunogens have been performed; however, few such immunogens have been identified. The aim of this study was to evaluate 27 recombinant antigens to determine their potential to induce an immune response protective against leptospirosis in the hamster model. Experiments were conducted with groups of female hamsters immunized with individual antigen preparations. Hamsters were then challenged with a lethal dose of Leptospira interrogans. Thirteen antigens induced protective immune responses; however, only recombinant proteins LIC10325 and LIC13059 induced significant protection against mortality. These results have important implications for the development of an efficacious recombinant subunit vaccine against leptospirosis.
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- 2011
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8. EXCELLA First-in-Man (FIM) study: safety and efficacy of novolimus-eluting stent in de novo coronary lesions.
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Costa JR Jr, Abizaid A, Feres F, Costa R, Seixas AC, Maia F, Abizaid A, Tanajura LF, Staico R, Siqueira D, Meredith L, Bhat V, Yan J, Ormiston J, Sousa AG, Fitzgerald P, and Sousa JE
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- Aged, Antibiotics, Antineoplastic adverse effects, Chromium Alloys, Coronary Angiography, Coronary Artery Disease diagnostic imaging, Feasibility Studies, Female, Follow-Up Studies, Humans, Macrolides adverse effects, Male, Middle Aged, Treatment Outcome, Ultrasonography, Interventional, Angioplasty, Balloon, Coronary, Antibiotics, Antineoplastic administration & dosage, Coronary Artery Disease therapy, Drug-Eluting Stents adverse effects, Macrolides administration & dosage, Sirolimus analogs & derivatives
- Abstract
Aims: First generation DES have markedly reduced restenosis. However, there is a major interest in developing new DES with greater flexibility, radiopacity and safety profile. The Elixir Medical drug eluting stent is a novel DES that combines a chromium-cobalt platform with novolimus (an antiproliferative sirolimus-analogue drug) and a polymer from the methacrylate family. As potential advantages, it provides a lower drug dose as compared to Cypher (85 microg of novolimus vs. 140 microg of sirolimus) and therefore has a lower polymer load. We sought to evaluate the safety and efficacy of this novel device in reducing neointimal hyperplasia as assessed by QCA and IVUS., Methods and Results: In April 2007 a consecutive cohort of patients with de novo lesions < or = 14 mm in length, located in native coronaries of diameter from 3.0 to 3.5 mm were consecutively enrolled in this First-in-Man study (FIM). By protocol, angiography and IVUS would be done at baseline and repeated at four and eight months. Dual anti-platelet therapy was maintained for a minimum of 12 months. The primary endpoint was QCA lumen loss at 4-month follow-up. Secondary endpoints included MACE, in-stent neointimal obstruction by IVUS and device success. A total of 15 patients were included with 67% female patients and diabetes was detected in 47% of the cohort. Angiographic and procedural success was achieved in all patients. At 4-month angiographic follow-up there was in-stent late lumen loss (0.15 +/- 0.29 mm) by QCA and % volume obstruction (2.6 +/- 2.6) by IVUS. The angiographic in-stent late lumen loss results at eight months were 0.31 +/- 0.25 mm and % volume obstruction by IVUS was 6.0 +/- 4.4%. Late incomplete stent apposition (ISA) were not observed among these patients and no MACE was evidenced through nine month clinical follow-up., Conclusions: In this FIM study, implantation of the novolimus-eluting stent was proven to be feasible, safe and elicited minimum neointimal proliferation. Additional large clinical trials should be considered to confirm these promising results.
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- 2008
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9. Anatomical and physiologic assessments in patients with small coronary artery disease: final results of the Physiologic and Anatomical Evaluation Prior to and After Stent Implantation in Small Coronary Vessels (PHANTOM) trial.
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Costa MA, Sabate M, Staico R, Alfonso F, Seixas AC, Albertal M, Crossman A, Angiolillo DJ, Zenni M, Sousa JE, Macaya C, and Bass TA
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- Coronary Artery Disease pathology, Coronary Artery Disease physiopathology, Female, Humans, Male, Middle Aged, Prospective Studies, Coronary Artery Disease surgery, Stents
- Abstract
Background: Patients with small coronary arteries are at high risk for complications after percutaneous coronary intervention (PCI). The objective of our study was to investigate the correlation between angiography, intravascular ultrasound (IVUS), and fractional flow reserve (FFR) in patients with moderate stenoses in small (<2.8 mm) coronary arteries., Methods and Results: Sixty consecutive patients, of 800 scheduled for PCI during the study period, were prospectively enrolled in the study. The FFR was measured after a 2-minute infusion of adenosine. For the preprocedural assessments, 60 patients underwent an FFR measurement, 56 underwent an IVUS, and 60 underwent an angiography; for the postprocedural assessments, 22 patients underwent an FFR measurement, 18 underwent an IVUS, and 22 underwent an angiography. The jeopardy score for the target vessel was calculated. Data were analyzed by an independent core laboratory. Patients with an FFR >0.75 were deferred from PCI. Patients were stratified in 2 groups according to their FFR values (< or =0.75 vs >0.75) and were followed for 1 year. Significant (FFR < or =0.75) coronary stenosis was observed in only 35% of the patients. The mean preprocedural FFR values were 0.79 +/- 0.13 for the overall population, 0.64 +/- 0.08 for the patients with an FFR < or =0.75, and 0.87 +/- 0.06 for the patients with an FFR >0.75. There was no correlation between angiography, IVUS, and FFR. The jeopardy score was inversely correlated with FFR (R = -0.32). Only a third of the patients with optimal stenting defined by IVUS achieved an FFR >0.90. After 1 year, 24% of the patients with an FFR < or =0.75 required a repeat PCI. There was no occurrence of myocardial infarction or death, and only 2.6% of the patients deferred from PCI required revascularization., Conclusion: Anatomical parameters are limited in determining the hemodynamic significance of small coronary disease. Most moderate stenoses in small coronaries could be safely deferred from PCI based on FFR.
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- 2007
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10. Comparison between sirolimus-eluting stents and intracoronary catheter-based beta radiation for the treatment of in-stent restenosis.
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Feres F, Muñoz JS, Abizaid A, Albertal M, Mintz GS, Staico R, Centemero M, Mattos LA, Maldonado G, Tanajura LF, Chaves A, Pinto I, Abizaid AS, Seixas AC, Vaz VD, Sousa A, and Sousa JE
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- Catheterization, Peripheral, Coronary Angiography, Coronary Restenosis diagnostic imaging, Coronary Vessels diagnostic imaging, Coronary Vessels drug effects, Coronary Vessels radiation effects, Female, Follow-Up Studies, Graft Occlusion, Vascular diagnostic imaging, Humans, Immunosuppressive Agents therapeutic use, Male, Middle Aged, Prospective Studies, Reoperation, Secondary Prevention, Treatment Outcome, Ultrasonography, Interventional, Blood Vessel Prosthesis Implantation instrumentation, Brachytherapy methods, Coated Materials, Biocompatible, Coronary Restenosis therapy, Graft Occlusion, Vascular therapy, Sirolimus therapeutic use, Stents
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We report the outcomes of patients who had in-stent restenosis (IRS) that was treated with intravascular brachytherapy (IVBT) or sirolimus-eluting stent (SES) implantation. The benefit of IVBT for treating ISR is well documented. SES implantation decreases first-time ISR and, in preliminary reports, has been used to treat ISR. Fifty consecutive patients who had ISR were treated; the first 25 patients underwent SES implantation and the next 25 patients were treated with IVBT using a beta-Cath System (a 40-mm strontium-90/yttrium-90 source). Quantitative angiographic and intravascular ultrasound follow-up were performed at 5.2 +/- 1.1 and 12.1 +/- 1.2 months; clinical follow-up was performed at 15 months. SES deployment and IVBT were successful in all patients. At 12-month follow-up, 8 patients who underwent IVBT had angiographic recurrence (4 in the stent and 4 at the stent edge); only 1 patient who underwent SES implantation developed recurrent ISR. At 12 months, in-stent late luminal loss was similar between the SES and IVBT groups (0.35 +/- 0.45 vs 0.34 +/- 0.46 mm, p = 0.9); however, in-stent net luminal gain was higher in the SES group than in the IVBT group (1.32 +/- 0.13 vs 0.57 +/- 0.19 mm, p <0.0001), and in-lesion late luminal loss was higher in the IVBT group (0.48 +/- 0.32 vs 0.16 +/- 0.42 mm, p = 0.004). At 12 months, intravascular ultrasound stent volume obstruction was higher after IVBT versus than after SES implantation (38.7% vs 6.7%, p <0.0001). At 15-month clinical follow-up, 64% and 96% (p <0.01) of patients who underwent IVBT and SES implantation, respectively, were free of major adverse cardiac events. In conclusion SES implantation for the treatment of ISR was effective and superior to catheter-based IVBT in preventing recurrent neointimal proliferation and angiographic restenosis at 1-year follow-up.
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- 2005
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11. IMPACT Trial: angiographic and intravascular ultrasound observations of the first human experience with mycophenolic acid-eluting polymer stent system.
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Abizaid A, Albertal M, Ormiston J, Londero H, Ruygrok P, Seixas AC, Feres F, Mattos LA, Staico R, Silva RL, Webster M, Stewart J, Paoletti F, Kataoka T, Fitzgerald P, Sousa A, and Sousa JE
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- Antibiotics, Antineoplastic pharmacology, Coronary Restenosis diagnostic imaging, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Polymers, Prosthesis Design, Treatment Outcome, Blood Vessel Prosthesis Implantation instrumentation, Coated Materials, Biocompatible, Coronary Angiography, Coronary Restenosis surgery, Mycophenolic Acid pharmacology, Stents, Ultrasonography, Interventional
- Abstract
The purpose of the study was to examine the safety and efficacy of two different formulations of mycophenolic acid (MPA)-eluting Duraflex stents on coronary de novo lesions. Recent data indicate that local delivery of MPA in the porcine overstretch coronary model significantly reduces neointimal hyperplasia (NIH). Patients were divided into three consecutive groups. The first (n=50) and second (n=55) groups received moderate- and slow-release MPA-eluting Duraflex stent, respectively. The last group (n=50) received the bare metal Duraflex stent. Clinical, angiographic, and intravascular ultrasound analysis were performed at 6-month follow-up. All stents were successfully deployed and patients were discharged home without clinical events. Compared to controls, 6-month in-lesion and in-stent minimum luminal diameter as well as late lumen loss were not significantly different in the moderate- and slow-release treatment groups. At follow-up, percentage obstruction and NIH volume were also similar between the three groups. At 30 days and 6 and 12 months, there were no differences noted between the three groups with respect to major adverse cardiac events as well as the individual rates of mortality, myocardial infarction, or repeat revascularization. There were no cases of subacute or late thrombosis. In this feasibility trial, the MPA-eluting Duraflex stents in either slow- or moderate-release formulations were well tolerated, but showed no benefit for treatment of coronary lesions when compared to controls. Further testing with different drug dosing or delivery rate might improve these results., (Copyright (c) 2005 Wiley-Liss, Inc.)
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- 2005
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12. Four-year angiographic and intravascular ultrasound follow-up of patients treated with sirolimus-eluting stents.
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Sousa JE, Costa MA, Abizaid A, Feres F, Seixas AC, Tanajura LF, Mattos LA, Falotico R, Jaeger J, Popma JJ, Serruys PW, and Sousa AG
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- Cardiovascular Diseases, Coronary Angiography, Disease-Free Survival, Follow-Up Studies, Graft Occlusion, Vascular, Humans, Incidence, Kinetics, Stents standards, Treatment Outcome, Ultrasonography, Interventional, Sirolimus administration & dosage, Stents adverse effects
- Abstract
Background: Despite the proven superiority of sirolimus-eluting stents (SESs) compared with bare stents in the first year after implantation, long-term outcomes of patients treated with these novel devices remain unknown. Our goal was to evaluate the clinical, angiographic, and intravascular ultrasound (IVUS) outcomes of patients treated with SESs 4 years after implantation., Methods and Results: The study included 30 patients treated with sirolimus-eluting Bx Velocity stenting (slow release [SR; n=15] and fast release [FR; n=15]). Twenty-six patients underwent 4-year angiographic and IVUS follow-up and had matched assessments at all time points (index and 4-, 12-, 24-, and 48-month follow-up). One death occurred during the study period in a patient with a patent SES. There were no target-vessel revascularizations or thromboses between 2- and 4-year follow-up examinations. There was no stent thrombosis, target-lesion revascularization, death, or myocardial infarction in the SR group up to 4 years. Cumulative event-free survival rate was 87% for the total population (80% in the FR group and 93% in the SR group). In-stent late loss was slightly greater in the FR group (0.41+/-0.49 mm) than the SR group (0.09+/-0.23) after 4 years. One patient in the FR group had a 52% in-stent restenosis lesion. Percent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 4 years (FR=9.1% and SR=5.7%)., Conclusions: This study confirms the longevity of the optimal outcomes observed in patients treated with sirolimus-eluting Bx Velocity stents 4 years after implantation. In-stent lumen dimensions remained essentially unchanged at 4-year follow-up, particularly in the population treated with the currently available SES (SR formulation).
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- 2005
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13. [The use of intravascular ultrasound in deciding on the treatment of moderate coronary lesions].
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Abizaid AC, Piegas LS, Abizaid AA, Tanajura LF, Chaves AJ, Centemero MP, Seixas AC, Mattos LA, Pinto I, Sousa AG, and Sousa JE
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- Coronary Angiography, Coronary Disease surgery, Female, Follow-Up Studies, Humans, Male, Prognosis, Prospective Studies, Severity of Illness Index, Coronary Disease diagnostic imaging, Decision Making, Stents, Ultrasonography, Interventional methods
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- 2004
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14. Images in cardiovascular medicine. Vascular healing 4 years after the implantation of sirolimus-eluting stent in humans: a histopathological examination.
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Sousa JE, Costa MA, Farb A, Abizaid A, Sousa A, Seixas AC, da Silva LM, Feres F, Pinto I, Mattos LA, and Virmani R
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- Coronary Stenosis therapy, Drug Delivery Systems, Humans, Male, Middle Aged, Radiography, Sirolimus therapeutic use, Wound Healing, Coronary Stenosis diagnostic imaging, Coronary Stenosis pathology, Sirolimus administration & dosage, Stents
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- 2004
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15. Influence of balloon pressure inflation in patients undergoing primary coronary stent implantation during acute myocardial infarction. A quantitative coronary angiography analysis.
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Mattos LA, Sousa AG, Chaves A, Feres F, Pinto I, Tanajura L, Centemero M, Abizaid A, Seixas AC, Abizaid A, Maldonado G, Staico R, and Sousa JE
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- Adolescent, Adult, Aged, Aged, 80 and over, Clinical Protocols, Female, Humans, Male, Middle Aged, Pressure, Prospective Studies, Treatment Outcome, Angioplasty, Balloon, Coronary, Coronary Angiography, Coronary Restenosis prevention & control, Myocardial Infarction therapy, Stents
- Abstract
Objective: To verify the influence of moderate- or high-pressure balloon inflation during primary coronary stent implantation for acute myocardial infarction., Methods: After successful coronary stent implantation, 82 patients were divided into 2 groups according to the last balloon inflation pressure: group 1 (> or = 12 to < 16 atm) and group 2 (> or = 16 to 20 atm), each with 41 cases. All patients underwent late coronary angiography., Results: In group 1, the mean stent deployment pressure was 13.58 +/- 0.92 atm, and in the group 2 it was 18.15 +/- 1.66 atm. Stents implanted with moderate pressures (> or = 12 to < 16 atm) had a significantly smaller post-procedural minimal lumen diameter, compared to with those with higher pressure, with lesser acute gain (2.7 +/- 0.4 mm vs 2.9 +/- 0.4 mm; p = 0.004), but the late lumen loss (0.9 +/- 0.8 mm vs 0.9 +/- 0.6 mm) and the restenosis (22% vs. 17.1%) and target-vessel revascularization rates (9.8% vs 7.3%) were similar between the groups., Conclusion: During AMI stenting, the use of high pressures (> or = 16 atm) did not cause a measurable improvement in late outcome, either in the late loss, its index, and the net gain, or in clinical and angiographic restenosis rates.
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- 2003
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16. Two-year angiographic and intravascular ultrasound follow-up after implantation of sirolimus-eluting stents in human coronary arteries.
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Sousa JE, Costa MA, Sousa AG, Abizaid AC, Seixas AC, Abizaid AS, Feres F, Mattos LA, Falotico R, Jaeger J, Popma JJ, and Serruys PW
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- Combined Modality Therapy, Coronary Angiography, Coronary Restenosis prevention & control, Coronary Vessels diagnostic imaging, Coronary Vessels surgery, Delayed-Action Preparations, Follow-Up Studies, Humans, Sirolimus therapeutic use, Treatment Outcome, Ultrasonography, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease drug therapy, Coronary Artery Disease surgery, Sirolimus administration & dosage, Stents adverse effects
- Abstract
Background: The safety and efficacy of sirolimus-eluting stenting have been demonstrated, but the outcome of patients treated with this novel technology beyond the first year remains unknown. We sought to evaluate the angiographic, intravascular ultrasound (IVUS), and clinical outcomes of patients treated with sirolimus-eluting stents 2 years after implantation., Methods and Results: This study included 30 patients treated with sirolimus-eluting Bx Velocity stenting (slow release [SR], n=15, and fast release [FR], n=15) in São Paulo, Brazil. Twenty-eight patients underwent 2-year angiographic and IVUS follow-up. No deaths occurred during the study period. In-stent late loss was slightly greater in the FR group (0.28+/-0.4 mm) than in the SR group (-0.09+/-0.23 mm, P=0.007). No patient had in-stent restenosis. At 2-year follow-up, only 1 patient (FR group) had a 52% diameter stenosis within the lesion segment, which required repeat revascularization. The target-vessel revascularization rate for the entire cohort was 10% (3/30) at 2 years. All other patients had < or =35% diameter stenosis. Angiographic lumen loss at the stent edges was also minimal (in-lesion late loss was 0.33+/-0.42 mm [FR] and 0.13+/-0.29 mm [SR]). In-stent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 2 years (FR= 9.90+/-9 mm3 and SR=10.35+/-9.3 mm3)., Conclusions: This study demonstrates the safety and efficacy of sirolimus-eluting Bx Velocity stents 2 years after implantation in humans. In-stent lumen dimensions remained essentially unchanged at 2-year follow-up in the 2 groups, although angiographic lumen loss was slightly higher in the FR group. Restenosis "catch-up" was not found in our patient population.
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- 2003
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17. Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries: a quantitative coronary angiography and three-dimensional intravascular ultrasound study.
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Sousa JE, Costa MA, Abizaid A, Abizaid AS, Feres F, Pinto IM, Seixas AC, Staico R, Mattos LA, Sousa AG, Falotico R, Jaeger J, Popma JJ, and Serruys PW
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- Aged, Arteries, Coronary Angiography, Coronary Vessels diagnostic imaging, Delayed-Action Preparations, Feasibility Studies, Female, Humans, Male, Middle Aged, Pilot Projects, Treatment Outcome, Tunica Intima diagnostic imaging, Ultrasonography, Interventional, Coated Materials, Biocompatible, Coronary Restenosis prevention & control, Coronary Vessels surgery, Immunosuppressive Agents, Sirolimus, Stents, Tunica Intima surgery
- Abstract
Background: Restenosis remains an important limitation of interventional cardiology. Therefore, we aimed to determine the safety and efficacy of sirolimus (a cell-cycle inhibitor)-coated BX Velocity stents., Methods and Results: Thirty patients with angina pectoris were electively treated with 2 different formulations of sirolimus-coated stents (slow release [SR], n=15, and fast release [FR], n=15). All stents were successfully delivered, and patients were discharged without clinical complications. Independent core laboratories analyzed angiographic and 3D volumetric intravascular ultrasound data (immediately after procedure and at 4-month follow-up). Eight-month clinical follow-up was obtained for all patients. There was minimal neointimal hyperplasia in both groups (11.0+/-3.0% in the SR group and 10.4+/-3.0% in the FR group, P:=NS) by ultrasound and quantitative coronary angiography (in-stent late loss, 0.09+/-0.3 mm [SR] and -0.02+/-0.3 mm [FR]; in-lesion late loss, 0.16+/-0.3 mm [SR] and -0.1+/-0.3 mm [FR]). No in-stent or edge restenosis (diameter stenosis >or=50%) was observed. No major clinical events (stent thrombosis, repeat revascularization, myocardial infarction, or death) had occurred by 8 months., Conclusions: The implantation of sirolimus-coated BX Velocity stents is feasible and safe and elicits minimal neointimal proliferation. Additional placebo-controlled trials are required to confirm these promising results.
- Published
- 2001
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